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Holistic variables

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    The intimacy vs. isolation concept highlights different developmental challenges. It is during intimacy vs. isolation that decision making becomes considered as mature and people in this stage are often at crossroads about who to marry. Imperatively not every young adult has similar success stories with some their social lives as will be highlighted by the case of Wellington Mustafa who is currently experiencing a lot of health challenges which makes him detached and withdrawn, hence desires remain isolated more often with a bare minimal contact with other people. Wellington Mustafa just turned 22 years but favors a more reclusive lifestyle after suffering a post-traumatic stress disorder given his history with drug and substance abuse and unsuccessful attempts towards rehabilitation. Mustafa is a sophomore student at the State University and comes from a family with a well-documented history of mental disorders. Apparently, it is imperative to take cognizance of the fact that due care needs to be considered when evaluating the communication strategies to be used by the nursing officer or any other practitioner attending to Mustafa to help in reassuring him about his apparently failing health. The subsequent portions of the paper will highlight various variables that play a significant role towards informing the best nursing practices to be employed to assist the patient to pursue a determined path towards self-recovery. Similarly, the patient will also be able to be valuated based on the assessment of the variables in tandem with the related holistic variables that contribute to the client’s wellbeing.

             When Mustafa was subjected to the medical examination before the onset of his treatment, it emerged that he had battled depression for an extended period for almost two years before seeking treatment. Mustafa according to medical documentation was entered as a young adult who had just turned 23 years. Mustafa exhibits signs of secondary growth exemplified by his growing beard, muscular biceps, broad shoulders and a deep baritone voice. Mustafa is the second born in a family of 3 and family nursing assessment revealed that his father had attempted suicide twice after divorcing from Mustafa’s mother. The family also has a history with schizophrenia dating back to Mustafa’s great grandfather and currently, the father is under medication for schizophrenia. Socially, he has lived a depressed life given his family circumstances emanating from his family history with depression. Invariably, Mustafa’s mental problems have led to him not focusing fully on his academics and this has affected his grades. The toll of mental instability has seen him also take a semester off from studies.

             Based on the development variables, Potter et al. (2017) affirm that understanding the background of the family plays a significant role in the subsequent, management of health issues arising from the predisposing factors such as medical history of the patient and how such factors enable the nursing officers to come up with an effective treatment plan. Similarly, Potter et al. (2017) suggest that the educational background, age, and even career plays an important role in guiding practicing nurses on formulating better methods to obtain relevant information for informed decision making, crucial in understanding the patient. Erickson’s psychosocial theory of development provides an insightful understanding of the development variables. According to Jarvis (2016), there is an eight stage theory of psychosocial development and identity that inform the processes of care for a patient. Jarvis (2016) takes account the influence of several external factors such as the society and the immediate social circle that influence the development of personality from childhood to adulthood. Erickson’s psychosocial theory of development suggests that the psychological characteristics of young adults between eighteen to thirty-five are often in the intimacy versus isolation stage of development. The theory states that majority of the youths in within the category of isolation versus intimacy intuitively seek love and companionship while those who succeed consider settling down and start families while those who fail to succeed end up pursuing isolation (Jarvis, 2016).

Sociocultural Variables

            Wellington Mustafa is an Iraqi-American citizen and ascribes to the Islamic faith. He was born in Iraq but immigrated to America with his family when he was a toddler. The family settled in Nevada and has stayed there since. His father used to work for a mining company before he started having mental problems. Mustafa moved away from home to cohabit with a female friend but broke up soon afterward which led to him relocating to his home but plans to move out after completion of college studies. Having grown in the US, he speaks English fluently like a native but often tries to attempt speaking Arabic to keep his roots intact.  The family has fully adapted to the social life in America, but Mustafa’s Islamic background has made them easy targets for victimization. Most often, they are viewed with suspicion and in extreme circumstance, are denied services due to their religion. The effect of their victimization has contributed to a massive psychological toll on the family with Mustafa having endured bullying in high school. The patient strongly believes in his religion and comes across as a pious individual with adherence to very strict Islamic beliefs and must pray 5 times a day. Mustafa does believe that Women must cover their bodies with veils to protect and preserve their dignity. Also, he does not take some type of foods. Beef and pork is prohibited by his culture and doing so could have extreme consequences. Pork is considered unclean, and any food that is taken must follow strict religious rules. In the same regard, Mustafa often visits his mother who prepares much of his meals. Mustafa believes that illness that has befallen his family and himself are the making of nature and a test from God and withstanding this tests leads to the pardoning of sins by God. From the prevailing socio-cultural perspectives surrounding Mustafa, Potter et al. (2017) confirm that the sociocultural variables play a primary role within nursing care as they assist the nurse in providing healthcare services based on the patient’s beliefs and faith in developing a comprehensive treatment and care plan for better health outcomes. Culture informs so many things from health seeking behaviors to the utilization of the healthcare services. The socio-cultural perspective empowers nurses to provide unprejudiced quality care accommodating to the diversity. For instance, to help Mustafa the nurse must create an amiable environment by adhering to customer expectations to facilitate an interactive and productive interaction.

Spiritual Variables

              Mustafa professes the Islam religion which focuses on the fundamental pillars of faith anchored in prayers. For instance, Mustafa prays five times a day that is at dawn, mid-day, afternoon, sunset and evening. The prayer sessions include a combination of verbal sayings, physical actions, and the outpouring of deep feelings of the heart which requires Mustafa to wholly submit to a state of humility. Once prayers begin a series of Qur'an recitations then follows. The second is fasting which is defined as refraining from all drink, food, and intercourse from dawn to sunset which is done during the holy month of Ramadan every year. The holy month changes every year because it is based on the lunar cycle and can last thirty days. Fasting is believed to cleanse the soul from all worldly desires and commit to the obedience of God. Thirdly before performing prayer and other rituals they are expected to carry out a form of purification that involves washing of the hands, arms, feet and face with water, this also helps them maintain a level of hygiene between dawns tonight. Fourthly, they are required to give a certain percentage of their wealth, and this is part of the Muslim charity. Lastly, they are expected to carry out the pilgrimage which is a spiritual and physical journey and therefore often travel to Saudi Arabia to perform the specified rites of pilgrimage, where they spend their days in complete devotion and repent their sins.

            Jarvis, therefore, concurs that the perfection attributed to illness and ultimately death often vary from one patient to another and are the majority of these perceptions shaped by beliefs and spirituality (2017). Alternatively, Jarvis affirms that nurses are mandated to come up with effective and workable solutions that are feasible and acceptable to their respective patients for informed care provision to negate the possibility of negligence and withholding of information from patient. Jarvis sees the nurses as playing a critical role in influencing these spiritual perceptions towards illnesses. Invariably, a successful interaction often relies on the consent for to participate in healthcare procedure. Similarly, the consent can be withheld when the nurses fail to accept and accommodate cultural diversity within the process of care provision.

Psychological Variables

            Once Mustafa visited the nurse, it emerged that the nurse had adequate training on how to interact with people from different backgrounds. The nurse established a great rapport with the patient and the conversation struck a positive cord because she was friendly and more sociable. She asked Mustafa to present his problems in an assuring manner. The nurse spoke directly to the patient and was able to maintain eye contact with the Mustafa. The conversation began with an open-ended question that provided the patient with a platform to share their unlimited thoughts.  Mustafa initially felt uncomfortable but became more cooperative as the conversation progressed. The patient responded with one-word answers initially because of discomfort but after the nurse assured her of confidentiality and privacy of information shared, Mustafa opened up more. On a similar note, Jarvis opines that patient psychological variables are the chief contributors to their emotional function and cognitive abilities hence have the huge impact on the processes and outcomes of care provision (Jarvis, 2017). Effective interaction is key to successful assessment as it ensures that the nurse can assess if the patient is experiencing any stressful situation, anxiety, worry hence provide the right approach to mitigate on negative elements of individual psychological experiences. Discussing family mental illness history is of even more significance in making the correct diagnosis about a patient's mental state.

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