Bridge's Transition Model Of Asthma
Table of Contents Introduction 3
Summary of Articles 3
Analysis of Articles 4 Similarities 4 Differences 5
Application to Nursing Practice 6 Foster Positive Relationship with Health Care Professionals 6 Encourage Positive Familial Relationships 7 Developing and Maintaining Positive Emotional Status 8 Address Fear and Uncertainty 8
Summary 9
References 10
Appendix 11
According to Cicutto (2014), asthma is a chronic inflammatory disorder of the airways that is characterized by wheezing, breathlessness, chest tightness, and coughing. It is a form of airway hyperresponsiveness that results in airway edema and excessive mucus production (Cicutto). In this paper, asthma is discussed in relation to the adolescent population. …show more content…
Adolescence refers to thirteen to nineteen years old, who experience a period of rapid physical, psychological, emotional, and social development (Taylor, Gibson, and Franck, 2008).
Although being diagnosed with a chronic illness is devastating, the sense of uncertainty can serve as a motivation to consider possibilities, alternatives, and effective coping strategies to adapt to a new normal (Chronicity Class Notes, 2014). This is the process of normalization, which acts a means for adolescents to resolve their sense of uncertainty (Chronicity Class Notes). Being diagnosed with asthma can impact, positively or negatively, the adolescents’ development. The purpose of this paper is to gain an understanding of adolescents’ experiences with asthma. Therefore, as student nurses, we recognize and implement appropriate nursing interventions that are relevant to adolescents in order to help them adapt to asthma and achieve normalization.
Summary of Articles
In Taylor’s, Gibson’s, and Franck’s (2008), “The experience of living with a chronic illness during adolescence: A critical review of the literature”, Taylor et al. highlight the limited knowledge available regarding chronic illness implications for the adolescent population, despite the vast developmental changes during this period of life. The main arguments identified in the article are that adolescents with chronic illness have seven challenges that they have to adapt to in order achieve normalization: developing friendships, maintaining family relationship, being normal and getting on with life, maintaining a positive attitude towards treatment, dealing with experiences in school, developing relationship with health care professionals, and reflecting about future. On a final note, the authors emphasize that even though emotional similarities exists between adolescents, their level of experience vary greatly, and failure to acknowledge this could result in poor asthma management.
In Rhee’s, Wenzel’s, and Steeves’s (2007), “Adolescents’ Psychosocial Experiences Living with asthma: A Focus Group Study”, Rhee et al. discuss the psychosocial implication of asthma on adolescents. “Adolescents’ tendency to compare their limited situation to their nonlimited peers augment their sense of loss” (Rhee et al., p.100). By exploring the psychosocial component of normalization, the authors identify three common experiences with asthma: doing less with more effort, missing out on important experiences, and benefiting from certain situations. Also, Rhee et al. highlight that adolescents perceive others’ attitude and behaviour towards them as being disappointed, misunderstood, and overprotected. As a result, some of the adolescents’ coping mechanisms are to toughen up by downplaying symptoms, guarding themselves to be prepared for the worst, and modifying their lifestyle to accommodate symptoms of asthma. Finally, the authors emphasize the importance of identifying predominant styles of coping of adolescents to provide appropriate support and strategies for asthma management.
Analysis of Articles
Similarities:
There are distinct similarities in themes and ideas between both articles. For instance, both articles address the adolescents’ determination to attain normalcy. Rhee et al. (2007) discuss adolescents’ natural inclination “to compare their limited situations with those of their nonlimited peers,” (p.100). Similarly, Taylor et al. (2008) emphasize the adolescents’ motivation to confront their limitations imposed by illness. As a result of asthma, adolescents initially tend to have emotional difficulties (e.g., anger, embarrassment, and frustration) because of the visible physical limitations. Subsequently, adolescents adjust, and adapt to restrictions of asthma. Some of the positive adaptations are: demonstrating assertiveness, and incorporating the limitations into daily living to ensure self-management of asthma. Maladaptive behaviours include adolescents disregarding symptoms, and rejecting therapy. This idea is relevant to adolescents because they adapt to asthma to redefine a new normal with a positive self-concept (Santrock, Machenzie-Rivers, Malcomson, and Leung, 2012). Therefore, failure to acknowledge this, may result in maladaptation.
Similarly, both articles highlight adolescents’ constant challenge in maintaining relationship with family, friends, and community. It is evident that parents, siblings, friends, and community services are best allies in helping young people cope with asthma. However, they are a potential source of tension and resentment because of the illness-oriented life, lifestyle changes, and excessive attention (Taylor et al., 2008). Furthermore, adolescents had difficulty making or maintaining friends because of the visible differences. Rhee et al. (2007) reveal that adolescents feel lonely, disappointed, misunderstood, and annoyed because of others’ actions and reactions towards them. This idea is relevant to the adolescent population, because they seek independence and ability to making decisions, and denying them their ability to do so will result in maladaptation like lack of treatment compliance, and lying about medication administration (Taylor et al.).
Differences:
Although both articles discuss the implications of chronic illness in adolescent population, the focus of some themes identified are distinct. For instance, Taylor et al. (2008) classify adolescents into three subgroups: early adolescent, middle adolescent, and late adolescent. Taylor et al. illustrate the vast changes in development between adolescents of different subgroups. For example, early adolescents do not dwell on the illness, middle adolescents were “asserting normality by confronting limitations” of the illness, and late adolescent have developed flexible adherence to therapy (Taylor et al., p.3088). By establishing the vast developmental changes, Taylor et al. emphasizes the importance of developmentally appropriate care for adolescents with asthma in order to increase normalization. In contrast, Rhee et al. (2007) classify adolescents into two subgroups: young adolescent, and old adolescent. Rhee et al. classify adolescents into subgroups to emphasize the emotional changes throughout adolescence. For examples, the physical limitation resulted in young adolescents feeling extremely scared and lonely, while old adolescents feeling annoyed and angered due to missed opportunities (Rhee et al.). Therefore, Rhee et al. highlight the need for focusing on emotional aspects of dealing with asthma in order to decreased emotional difficulty that can hinder asthma management and normalization.
One of the main concepts discussed in both articles is fear during the adolescents’ process of adaptation. Taylor et al. (2008) discuss adolescents’ fear about the future in relation to employment, family, and moving away from parents. As a result, there is an emphasis on nursing interventions focusing on wellness rather than the illness. Also, Taylor et al. highlight that having positive relationships with health care professionals (HCP) results in decreased fear and better adaptation. By doing this, adolescents receive adequate support and strategies in order to help maintain a balance between their developmental need for normalcy (e.g., independence) and daily demands of asthma. On the contrary, Rhee et al. (2007) highlight adolescents’ fear regarding asthma symptoms and exacerbations. For example, an adolescent is afraid of falling asleep after having asthma exacerbation during his sleep. As a result, there is an emphasis on identifying the adolescents’ specific coping strategies to greater facilitate adaptation to asthma management.
Application to Nursing Practice
Foster Positive Relationship with Health Care Professionals:
Acceptance of the medical diagnosis is crucial prior to an adolescent attempting to normalize (Taylor et al., 2008). Although adolescents receive support from various individuals during this health illness transition, the most important individual support is provided by nurses (Taylor et al.). Therefore, Taylor et al emphasize that positive interactions and relationship with HCP is important in helping adolescents accept the diagnosis and adapt to asthma.
In order to foster a positive relationship with a HCP, one of the first interventions to implement is to involve adolescents in the decision making process (Taylor et al., 2008). Taylor et al. highlight disrespect towards adolescents acts as a “precursor to them wanting to stop treatment” (p.3089). By doing the opposite, adolescents view that they are in control of their life, which influences a positive self-concept (Miller, 2000). Likewise, engaging adolescents in discussion ensures that adolescents feels respected by HCP (Taylor et al.). Conveying respect to the adolescents decreases their sense of unease and limits their perception of being judged or devalued. Furthermore, HCP should ensure atraumatic care during hospitalization (Kyle, 2008). Atraumatic care is care that decreases distress experienced by patient and their family (Kyle). By providing flexible treatment plans, nurses are being most supportive for the adolescent’s recovery and adaptation. Therefore, by implementing these interventions, HCP promote positive relationships with patients and family.
Importance of Positive Familial Relationships:
Families are a great source of social support, and an important component of the recovery process helping adolescents transition through chronic illness (Hospitalization Class Notes, 2014). During hospitalization, the relationship between family members can strengthen or weaken. As HCP, it is essential to try to strengthen familial relationship to positively enhance normalization.
To provide a facilitating environment, Rhee et al. (2007) suggest providing information regarding asthma to the family. By doing this, the family will be informed and can be more supportive to what adolescents are experiencing. Also, family members will not disregard, or overreact to asthma symptoms adolescents experience (Rhee et al.). This reduces emotional difficulties (e.g. sadness, annoyance) experienced by adolescents. Likewise, provide family with strategies to modify lifestyle to accommodate the needs of adolescents with asthma (Hospitalization Class Notes, 2014). By modifying lifestyle, family is supporting and motivating adolescents to adapt to a new normal. Moreover, Taylor et al. (2008) encourage any HCP to address the entire family. This ensures that family members are aware of the situation, which is important to strengthen family functioning and support during hospitalization and recovery in community (Arnold & Boggs, 2011). Therefore, by practicing these interventions, HCP promote positive familial relationships.
Developing and Maintaining Positive Emotional Wellbeing:
Being with friends and gaining acceptance is an important aspect of an adolescents’ life. During hospitalizations, adolescents have separation anxiety from friends due to social isolation (Hospitalization Class Notes, 2014). This results in anxiety, depression, and loneliness “triggered by deprived opportunities” (e.g., loss of normal activities) (Rhee et al., 2007, p.103). Therefore, as HCP, it is essential to provide an environment where adolescents with asthma can still maintain relationships, and positive emotional wellbeing.
To foster an accommodating environment, Taylor et al. (2008) encourage friends to visit during hospitalization. By doing so, adolescents have decreased social isolation. Also, they may receive emotional support from friends increasing the sense of normalcy during hospitalization. Similarly, it is important to encourage an adolescents’ physical potential to develop a positive self-identity, body image, and self-concept. Providing examples of prestigious individuals with asthma and their accomplishments in life can act as a source of strength by instilling hope and motivation in adolescents (Miller, 2000). Furthermore, Taylor et al. propose to provide community services support resources. This provides the adolescents with asthma the opportunity to meet other adolescents going through similar experiences like themselves. Since adolescents share same life experiences, they do not have to hide visible differences (Taylor et al.). Thus, these interventions can be implemented to ensure adolescents develop and maintain positive emotional wellbeing.
Acknowledge and Alleviate Fear and Uncertainty:
The diagnosis of a chronic illness like asthma may causes a series of changes in adolescents’ life.
According to the Bridge’s transition model, the individual will experience loss, fear, and uncertainty during the Ending phase (Bridges, 1980). As discussed by both articles, the fear and uncertainty experienced during early stages of adaptation can be related to asthma exacerbations, or future in terms of job, family, and children. As nurses, it is imperative to identify the source of fear in order to reduce stress level. By alleviating stress, nurses can facilitate adaptations to asthma.
To alleviate fear and uncertainty, HCP can reassure adolescents and family by providing appropriate information. Arnold and Boggs state that fear of unknown is eliminated by helping clients and family anticipate what will happen as a chronic illness progresses and how the day-to-day needs will change (2011). As HCP, providing suggestions to change, and supporting family through change is crucial for positive normalization (Arnold and Boggs). Similarly, Rhee et al. (2007) suggest identifying individualized coping strategies that have worked for adolescents. By strengthening and redirecting existing coping strategies, there are increased chances of coping with fear and uncertainty. Furthermore, Cicutto (2014) suggest answering questions and concerns expressed by patient and family. By providing factual information about patient’s condition helps …show more content…
the family have a sense of control and know what to expect, thus power resource relieves fear (Miller, 2000). Hence, to alleviate fear experienced by adolescents and family, these interventions can be applied to practice.
Conclusion
Based on both articles, it is evident that adolescents diagnosed with asthma strive to attain normalcy through adaptation. They have difficulty maintaining relationships, for they may be a source of stress, tension, and resentment. Taylor et al. (2008) argue developmentally appropriate care focusing of wellness rather than illness. To the contrary, Rhee et al. (2007) argue using individualized coping skills that foster emotional wellbeing of adolescent with asthma. Consequently, four key concepts that can be practiced in hospital context are alleviate fear, foster positive relationship with HCP, and family, and maintain positive emotional wellbeing. By applying suggested interventions, adolescents can achieve normalization within the constraints of asthma.
References
Arnold, E. C., & Boggs, K. U. (2011). Interpersonal Relationships: Professional communication skills for nurses (6th ed.). Missouri: Elsevier Saunders.
Bridges, W. (1980). Transitions: Making sense of life’s changes (pp. 8-25). Don Mills, Ontario. Addison-Wesley.
Cicutto, L. (2014). Nursing Management: Obstructive Pulmonary Diseases. In Barry, M. A., Goldsworthy, S., & Goodridge, D. (Eds.), Medical-Surgical Nursing in Canada: Assessments and management of clinical problems (3rd Canadian ed., pp. 709-762). Toronto, ON: Elsevier.
Kyle, T.
(2008). Working with Children and Families. In DiPalma, D., & Sweeney, E. (Eds.), Essentials of pediatric nursing (4th ed., pp. 47-68). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Miller, J. F. (2000). Coping with chronic illness: Overcoming powerlessness (3rd ed., pp. 3-16). Philadelphia: F. A. Davis Co.
Rhee, H., Wenzel, J., & Steeves, R. H. (2007). Adolescents’ psychosocial experiences living with asthma: A focus group study. Journal of Pediatric Health Care, 21(2), 99-107. doi: http://dx.doi.org/10.1016/j.pedhc.2006.04.005
Santrock, J. W., Machenzie-Rivers, A., Malcomson, T., & Leung, K. H. (2012). Life-span Development (4th Canadian ed.). Boston, Mass.: McGraw-Hill.
Taylor, R. M., Gibson, F., & Franck, L. S. (2008). The experience of living with a chronic illness during adolescence: a critical review of the literature. Journal of Clinical Nursing, 17(23), 3083-3091.
Torres, G. (2014). Chronicity. Nursing 201 lecture notes in the UFV Nursing program, Chilliwack, B.C.
Torres, G. (2014). Hospitalization. Nursing 201 lecture notes in the UFV Nursing program, Chilliwack,
B.C.
Appendix
Summary of Articles 3
Analysis of Articles 4 Similarities 4 Differences 5
Application to Nursing Practice 6 Foster Positive Relationship with Health Care Professionals 6 Encourage Positive Familial Relationships 7 Developing and Maintaining Positive Emotional Status 8 Address Fear and Uncertainty 8
Summary 9
References 10
Appendix 11
According to Cicutto (2014), asthma is a chronic inflammatory disorder of the airways that is characterized by wheezing, breathlessness, chest tightness, and coughing. It is a form of airway hyperresponsiveness that results in airway edema and excessive mucus production (Cicutto). In this paper, asthma is discussed in relation to the adolescent population. …show more content…
Adolescence refers to thirteen to nineteen years old, who experience a period of rapid physical, psychological, emotional, and social development (Taylor, Gibson, and Franck, 2008).
Although being diagnosed with a chronic illness is devastating, the sense of uncertainty can serve as a motivation to consider possibilities, alternatives, and effective coping strategies to adapt to a new normal (Chronicity Class Notes, 2014). This is the process of normalization, which acts a means for adolescents to resolve their sense of uncertainty (Chronicity Class Notes). Being diagnosed with asthma can impact, positively or negatively, the adolescents’ development. The purpose of this paper is to gain an understanding of adolescents’ experiences with asthma. Therefore, as student nurses, we recognize and implement appropriate nursing interventions that are relevant to adolescents in order to help them adapt to asthma and achieve normalization.
Summary of Articles
In Taylor’s, Gibson’s, and Franck’s (2008), “The experience of living with a chronic illness during adolescence: A critical review of the literature”, Taylor et al. highlight the limited knowledge available regarding chronic illness implications for the adolescent population, despite the vast developmental changes during this period of life. The main arguments identified in the article are that adolescents with chronic illness have seven challenges that they have to adapt to in order achieve normalization: developing friendships, maintaining family relationship, being normal and getting on with life, maintaining a positive attitude towards treatment, dealing with experiences in school, developing relationship with health care professionals, and reflecting about future. On a final note, the authors emphasize that even though emotional similarities exists between adolescents, their level of experience vary greatly, and failure to acknowledge this could result in poor asthma management.
In Rhee’s, Wenzel’s, and Steeves’s (2007), “Adolescents’ Psychosocial Experiences Living with asthma: A Focus Group Study”, Rhee et al. discuss the psychosocial implication of asthma on adolescents. “Adolescents’ tendency to compare their limited situation to their nonlimited peers augment their sense of loss” (Rhee et al., p.100). By exploring the psychosocial component of normalization, the authors identify three common experiences with asthma: doing less with more effort, missing out on important experiences, and benefiting from certain situations. Also, Rhee et al. highlight that adolescents perceive others’ attitude and behaviour towards them as being disappointed, misunderstood, and overprotected. As a result, some of the adolescents’ coping mechanisms are to toughen up by downplaying symptoms, guarding themselves to be prepared for the worst, and modifying their lifestyle to accommodate symptoms of asthma. Finally, the authors emphasize the importance of identifying predominant styles of coping of adolescents to provide appropriate support and strategies for asthma management.
Analysis of Articles
Similarities:
There are distinct similarities in themes and ideas between both articles. For instance, both articles address the adolescents’ determination to attain normalcy. Rhee et al. (2007) discuss adolescents’ natural inclination “to compare their limited situations with those of their nonlimited peers,” (p.100). Similarly, Taylor et al. (2008) emphasize the adolescents’ motivation to confront their limitations imposed by illness. As a result of asthma, adolescents initially tend to have emotional difficulties (e.g., anger, embarrassment, and frustration) because of the visible physical limitations. Subsequently, adolescents adjust, and adapt to restrictions of asthma. Some of the positive adaptations are: demonstrating assertiveness, and incorporating the limitations into daily living to ensure self-management of asthma. Maladaptive behaviours include adolescents disregarding symptoms, and rejecting therapy. This idea is relevant to adolescents because they adapt to asthma to redefine a new normal with a positive self-concept (Santrock, Machenzie-Rivers, Malcomson, and Leung, 2012). Therefore, failure to acknowledge this, may result in maladaptation.
Similarly, both articles highlight adolescents’ constant challenge in maintaining relationship with family, friends, and community. It is evident that parents, siblings, friends, and community services are best allies in helping young people cope with asthma. However, they are a potential source of tension and resentment because of the illness-oriented life, lifestyle changes, and excessive attention (Taylor et al., 2008). Furthermore, adolescents had difficulty making or maintaining friends because of the visible differences. Rhee et al. (2007) reveal that adolescents feel lonely, disappointed, misunderstood, and annoyed because of others’ actions and reactions towards them. This idea is relevant to the adolescent population, because they seek independence and ability to making decisions, and denying them their ability to do so will result in maladaptation like lack of treatment compliance, and lying about medication administration (Taylor et al.).
Differences:
Although both articles discuss the implications of chronic illness in adolescent population, the focus of some themes identified are distinct. For instance, Taylor et al. (2008) classify adolescents into three subgroups: early adolescent, middle adolescent, and late adolescent. Taylor et al. illustrate the vast changes in development between adolescents of different subgroups. For example, early adolescents do not dwell on the illness, middle adolescents were “asserting normality by confronting limitations” of the illness, and late adolescent have developed flexible adherence to therapy (Taylor et al., p.3088). By establishing the vast developmental changes, Taylor et al. emphasizes the importance of developmentally appropriate care for adolescents with asthma in order to increase normalization. In contrast, Rhee et al. (2007) classify adolescents into two subgroups: young adolescent, and old adolescent. Rhee et al. classify adolescents into subgroups to emphasize the emotional changes throughout adolescence. For examples, the physical limitation resulted in young adolescents feeling extremely scared and lonely, while old adolescents feeling annoyed and angered due to missed opportunities (Rhee et al.). Therefore, Rhee et al. highlight the need for focusing on emotional aspects of dealing with asthma in order to decreased emotional difficulty that can hinder asthma management and normalization.
One of the main concepts discussed in both articles is fear during the adolescents’ process of adaptation. Taylor et al. (2008) discuss adolescents’ fear about the future in relation to employment, family, and moving away from parents. As a result, there is an emphasis on nursing interventions focusing on wellness rather than the illness. Also, Taylor et al. highlight that having positive relationships with health care professionals (HCP) results in decreased fear and better adaptation. By doing this, adolescents receive adequate support and strategies in order to help maintain a balance between their developmental need for normalcy (e.g., independence) and daily demands of asthma. On the contrary, Rhee et al. (2007) highlight adolescents’ fear regarding asthma symptoms and exacerbations. For example, an adolescent is afraid of falling asleep after having asthma exacerbation during his sleep. As a result, there is an emphasis on identifying the adolescents’ specific coping strategies to greater facilitate adaptation to asthma management.
Application to Nursing Practice
Foster Positive Relationship with Health Care Professionals:
Acceptance of the medical diagnosis is crucial prior to an adolescent attempting to normalize (Taylor et al., 2008). Although adolescents receive support from various individuals during this health illness transition, the most important individual support is provided by nurses (Taylor et al.). Therefore, Taylor et al emphasize that positive interactions and relationship with HCP is important in helping adolescents accept the diagnosis and adapt to asthma.
In order to foster a positive relationship with a HCP, one of the first interventions to implement is to involve adolescents in the decision making process (Taylor et al., 2008). Taylor et al. highlight disrespect towards adolescents acts as a “precursor to them wanting to stop treatment” (p.3089). By doing the opposite, adolescents view that they are in control of their life, which influences a positive self-concept (Miller, 2000). Likewise, engaging adolescents in discussion ensures that adolescents feels respected by HCP (Taylor et al.). Conveying respect to the adolescents decreases their sense of unease and limits their perception of being judged or devalued. Furthermore, HCP should ensure atraumatic care during hospitalization (Kyle, 2008). Atraumatic care is care that decreases distress experienced by patient and their family (Kyle). By providing flexible treatment plans, nurses are being most supportive for the adolescent’s recovery and adaptation. Therefore, by implementing these interventions, HCP promote positive relationships with patients and family.
Importance of Positive Familial Relationships:
Families are a great source of social support, and an important component of the recovery process helping adolescents transition through chronic illness (Hospitalization Class Notes, 2014). During hospitalization, the relationship between family members can strengthen or weaken. As HCP, it is essential to try to strengthen familial relationship to positively enhance normalization.
To provide a facilitating environment, Rhee et al. (2007) suggest providing information regarding asthma to the family. By doing this, the family will be informed and can be more supportive to what adolescents are experiencing. Also, family members will not disregard, or overreact to asthma symptoms adolescents experience (Rhee et al.). This reduces emotional difficulties (e.g. sadness, annoyance) experienced by adolescents. Likewise, provide family with strategies to modify lifestyle to accommodate the needs of adolescents with asthma (Hospitalization Class Notes, 2014). By modifying lifestyle, family is supporting and motivating adolescents to adapt to a new normal. Moreover, Taylor et al. (2008) encourage any HCP to address the entire family. This ensures that family members are aware of the situation, which is important to strengthen family functioning and support during hospitalization and recovery in community (Arnold & Boggs, 2011). Therefore, by practicing these interventions, HCP promote positive familial relationships.
Developing and Maintaining Positive Emotional Wellbeing:
Being with friends and gaining acceptance is an important aspect of an adolescents’ life. During hospitalizations, adolescents have separation anxiety from friends due to social isolation (Hospitalization Class Notes, 2014). This results in anxiety, depression, and loneliness “triggered by deprived opportunities” (e.g., loss of normal activities) (Rhee et al., 2007, p.103). Therefore, as HCP, it is essential to provide an environment where adolescents with asthma can still maintain relationships, and positive emotional wellbeing.
To foster an accommodating environment, Taylor et al. (2008) encourage friends to visit during hospitalization. By doing so, adolescents have decreased social isolation. Also, they may receive emotional support from friends increasing the sense of normalcy during hospitalization. Similarly, it is important to encourage an adolescents’ physical potential to develop a positive self-identity, body image, and self-concept. Providing examples of prestigious individuals with asthma and their accomplishments in life can act as a source of strength by instilling hope and motivation in adolescents (Miller, 2000). Furthermore, Taylor et al. propose to provide community services support resources. This provides the adolescents with asthma the opportunity to meet other adolescents going through similar experiences like themselves. Since adolescents share same life experiences, they do not have to hide visible differences (Taylor et al.). Thus, these interventions can be implemented to ensure adolescents develop and maintain positive emotional wellbeing.
Acknowledge and Alleviate Fear and Uncertainty:
The diagnosis of a chronic illness like asthma may causes a series of changes in adolescents’ life.
According to the Bridge’s transition model, the individual will experience loss, fear, and uncertainty during the Ending phase (Bridges, 1980). As discussed by both articles, the fear and uncertainty experienced during early stages of adaptation can be related to asthma exacerbations, or future in terms of job, family, and children. As nurses, it is imperative to identify the source of fear in order to reduce stress level. By alleviating stress, nurses can facilitate adaptations to asthma.
To alleviate fear and uncertainty, HCP can reassure adolescents and family by providing appropriate information. Arnold and Boggs state that fear of unknown is eliminated by helping clients and family anticipate what will happen as a chronic illness progresses and how the day-to-day needs will change (2011). As HCP, providing suggestions to change, and supporting family through change is crucial for positive normalization (Arnold and Boggs). Similarly, Rhee et al. (2007) suggest identifying individualized coping strategies that have worked for adolescents. By strengthening and redirecting existing coping strategies, there are increased chances of coping with fear and uncertainty. Furthermore, Cicutto (2014) suggest answering questions and concerns expressed by patient and family. By providing factual information about patient’s condition helps …show more content…
the family have a sense of control and know what to expect, thus power resource relieves fear (Miller, 2000). Hence, to alleviate fear experienced by adolescents and family, these interventions can be applied to practice.
Conclusion
Based on both articles, it is evident that adolescents diagnosed with asthma strive to attain normalcy through adaptation. They have difficulty maintaining relationships, for they may be a source of stress, tension, and resentment. Taylor et al. (2008) argue developmentally appropriate care focusing of wellness rather than illness. To the contrary, Rhee et al. (2007) argue using individualized coping skills that foster emotional wellbeing of adolescent with asthma. Consequently, four key concepts that can be practiced in hospital context are alleviate fear, foster positive relationship with HCP, and family, and maintain positive emotional wellbeing. By applying suggested interventions, adolescents can achieve normalization within the constraints of asthma.
References
Arnold, E. C., & Boggs, K. U. (2011). Interpersonal Relationships: Professional communication skills for nurses (6th ed.). Missouri: Elsevier Saunders.
Bridges, W. (1980). Transitions: Making sense of life’s changes (pp. 8-25). Don Mills, Ontario. Addison-Wesley.
Cicutto, L. (2014). Nursing Management: Obstructive Pulmonary Diseases. In Barry, M. A., Goldsworthy, S., & Goodridge, D. (Eds.), Medical-Surgical Nursing in Canada: Assessments and management of clinical problems (3rd Canadian ed., pp. 709-762). Toronto, ON: Elsevier.
Kyle, T.
(2008). Working with Children and Families. In DiPalma, D., & Sweeney, E. (Eds.), Essentials of pediatric nursing (4th ed., pp. 47-68). Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Miller, J. F. (2000). Coping with chronic illness: Overcoming powerlessness (3rd ed., pp. 3-16). Philadelphia: F. A. Davis Co.
Rhee, H., Wenzel, J., & Steeves, R. H. (2007). Adolescents’ psychosocial experiences living with asthma: A focus group study. Journal of Pediatric Health Care, 21(2), 99-107. doi: http://dx.doi.org/10.1016/j.pedhc.2006.04.005
Santrock, J. W., Machenzie-Rivers, A., Malcomson, T., & Leung, K. H. (2012). Life-span Development (4th Canadian ed.). Boston, Mass.: McGraw-Hill.
Taylor, R. M., Gibson, F., & Franck, L. S. (2008). The experience of living with a chronic illness during adolescence: a critical review of the literature. Journal of Clinical Nursing, 17(23), 3083-3091.
Torres, G. (2014). Chronicity. Nursing 201 lecture notes in the UFV Nursing program, Chilliwack, B.C.
Torres, G. (2014). Hospitalization. Nursing 201 lecture notes in the UFV Nursing program, Chilliwack,
B.C.
Appendix