Therapeutic Interventions in Relation to End Stage Renal Disease

Question: Evaluate and Identify Potential Psychosocial Issues, which will further allow you to Develop Therapeutic Interventions in relation to End Stage Renal Disease. Answer: Issue: End stage renal disease Intervention: Mindfulness for stress reduction Signs and symptoms Client has been suffering from end stage renal disease (ESRD) in which the needs of daily life are compromised due to loss of normal functioning of the kidneys at the final stage of chronic kidney disease. Client presented symptoms of decreased urination, malaise, fatigue and headaches along with unexplained weight loss, confusion and difficulty in concentrating. Numbness in hands and feet, excessive thirst in addition to sleep problems and swelling of the hand and foot regions are also observed. Associated conditions Client presented chronic conditions of diabetes and hypertension. Course and Prognosis Glomerular filtration rate has declined drastically necessitating the need to undergo kidney transplantation instead of the dialysis that had been followed for so long. Dialysis is no longer found to be effective considering the progression of the ESRD. As adjunct therapy drugs and certain modifications in lifestyle is suggested to account for holistic outcomes (Go et al., 2004). Potential psychosocial issues Client reported of feeling depressed and feels a diminished quality of life (QOL). Non-adherence to restriction related to fluid intakes, limitations to personal freedom and control in conjunction with impaired self and body image all contributed to the culmination of depression and anxiety in the patient. Coping and adjustment responses also suffer significant impairment thereby affecting the activities of daily living as well as the quality of life. Impact of psychosocial issues on occupational roles, habits, routines and occupational performance All the factors related to occupational roles, habits, routines and occupational performance are influenced by the psychosocial issues of the client. The psychosocial problems might adversely affect the disease progression of the ESRD client demonstrated through decreased personal and social interaction. Health and wellbeing is likely to be threatened due to the ensuing psychosocial issues (Ramsey, 2004). Refraining from performing activities of daily living with a sense of isolation is likely to result under such condition with feelings of depression, anxiety and pessimistic outlook towards life. Matters consistent with the interpersonal, personal as well as social performance declined vigorously. Activities of daily living are hampered and regular routines consisting of normal and healthy lifestyle undergoes drastic alterations (Cakmak et al., 2016) week Intervention Program Plan The Mindfulness Based Stress Reduction (MBSR) has been found to harbor positive benefits by means of a proven individual self care technique to reduce the level of stress and associated depression as a suitable alternative or adjunct therapy alongside conventional treatment modality. Emphasis is laid on living in the present moment, on purpose and in a non-judgmental manner. Lowered incidences along with decreased severity of post traumatic stress disorder (PTSD) have also been reported following participation in MBSR (Nykl?ek Irrmischer, 2017; Hlsheger et al., 2013). The intervention in the given case will aim to mitigate the level of stress and curb the depressive symptoms in the client through effective strategies implementation by means of conducting MBSR program. The client is likely to feel better from participating in such programs thereby leading to improvement in QOL and ADL. Methods to evaluate progress and outcomes Patient Health Questionnaire (PHQ-9) will be used to identify depression in the client and screening the behavioral health symptoms (Manea, Gilbody McMillan, 2015). Further the Holmes and Rahe Stress Scale will be implemented for the purpose of gauging the impact of long terms tress on the client (Gross, 2016). Inclusion/exclusion criteria The client will be recruited in the 4 week program without any interruptions and measures will be taken to ensure that the client performs in compliance with the suggested protocols and guidelines as put forward by the occupational therapist. Simple activities that do not physically or mentally strain the client and give him enough opportunity to engage in activities that suits his choice. Program/weekly outlines Client will be asked to report to the clinical setting facility having a quiet room environment to take part in the MBSR for 3 hrs everyday on a regular basis for 4 consecutive weeks without any disruptions or missing. Session outlines Each session for everyday will be fragmented into three halves whereby 1 hr will be allotted for doing each of the projected tasks. Tips for mindfulness include: Practice slow breathing and meditation for an hour to rejuvenate the mind and body and concentrate as completely as possible without feeling distracted. Lunch must be taken as slowly as practicable by means of savoring every bite of the food consumed so as to enjoy the flavor and experience satiety. Take a leisurely 10 min slow walk to relax the soul and body through synchronizing the breathing patterns including inspiration and expiration (Noonan, 2014). Potential problems In any of the MBSR program if the client expresses dissatisfaction or discomfort while participating, the intervention should be immediately stopped and clinical advice and referral must be promptly made to attending physician and other healthcare professionals without any delay. Precautions/Safety issues The intervention must be conducted under the expert guidance of competent occupational therapist. Contraindications The intervention must be halt whenever any symptom of discomfort or unwillingness is indicated. Variations Based on the feedback received from the client, the intervention modalities may be altered slightly depending upon the circumstances and the changes made must be documented properly for future reference. References Cakmak, S., Hzn, S. . T., ZTRK, S., Tamam, L., Ufuk, B. A. L. (2016). The Effects of Occupational Therapy and Psychosocial Interventions on Interpersonal Functioning and Personal and Social Performance Levels of Corresponding Patients. Noropsikiyatri Arsivi-Archives Of Neuropsychiatry, 53(3), 234-240. Go, A. S., Chertow, G. M., Fan, D., McCulloch, C. E., Hsu, C. Y. (2004). Chronic kidney disease and the risks of death, cardiovascular events, and hospitalization. New England Journal of Medicine, 351(13), 1296-1305. Gross, C. (2016). The Standard Stress Scale (SSS): Measuring Stress in the Life Course. In Methodological Issues of Longitudinal Surveys (pp. 233-249). Springer Fachmedien Wiesbaden. Hlsheger, U. R., Alberts, H. J., Feinholdt, A., Lang, J. W. (2013). Benefits of mindfulness at work: The role of mindfulness in emotion regulation, emotional exhaustion, and job satisfaction. Journal of Applied Psychology, 98(2), 310. Manea, L., Gilbody, S., McMillan, D. (2015). A diagnostic meta-analysis of the Patient Health Questionnaire-9 (PHQ-9) algorithm scoring method as a screen for depression. General hospital psychiatry, 37(1), 67-75. Noonan, S. (2014). Mindfulness-based stress reduction. The Canadian Veterinary Journal, 55(2), 134. Nykl?ek, I., Irrmischer, M. (2017). For Whom Does Mindfulness-Based Stress Reduction Work? Moderating Effects of Personality. Mindfulness, 1-11. Ramsey, R. (2004). Psychosocial aspects of occupational therapy. American Journal of Occupational Therapy, 58(6), 669.