The patient selected is part of the Nursing 203 – Foundations of nursing II, he is currently experiencing Intimacy versus Isolation stage of development but falls under the isolation category because he just experienced a painful breakup with his former girlfriend. This development stage is crucial in nursing care because it enables the nurse to create the best communication strategy to reassure and periodically guide the patient about their health (Amin, Amir, Rahman & Lubis, 2017). The identified client will be used to form an assessment of variables in line with the inherent theme of holistic variables.
Upon observation, the patient appears to be a male just entering the threshold of adulthood. He possesses secondary characteristics such as beard, broad shoulders and a broken voice. The family nursing assessment of the patient indicates that he is the firstborn child in his family and is followed by two sisters, his parents have the most influence in his life. The patient is twenty years old and is accompanied by two sisters who are three and two years younger respectively. His parents are teachers, and his siblings including him are students. All his family members are in good state of health apart from his grandmother who has diabetes. Understanding the family of the patient is key as it plays a significant role in health care management and enables the nurse to formulate an effective treatment plan (Amin et al., 2017). The educational background, age, and career are important as they act as a guide for the nurses teaching method that is accessible, useful and understandable for the patient.
Erikson's psychosocial theory of development is an eight stage theory of psychological development and identity. It takes into account the impact of external factors such as society and parents and their influence on personality development from childhood to adulthood. The psychology behind the young adult between ages eighteen to thirty-five who is in the intimacy versus isolation stage of development, Erik states that majority of the youths in this category seek love and companionship, those who succeed begin to settle down and start families while those who fail to apply for isolation. At this stage, the youth are moving away from their parents looking to settle down on their own and establish some stability.
The patient is an African American and follows the Islamic faith. He is close to his family and has not moved out of home yet but plans to do it once he finishes studying. He does not understand English very well but is fluent in Arabic. His family relocated from Africa and came to the states recently, so he is still learning to adapt the new environment, they believe that males are the heads of households and when speaking with women they avoid eye contact. The patient prays five times in a day irrespective of where, adheres to a strict religious dressing code which includes a turban on his head, and they believe that women should cover their bodies completely apart from their palms and face. Islam does not allow him to eat animal flesh that died from a natural cause or pork because it is considered unclean, so most of the food he eats is prepared by his mother who is a strict follower of the religion. Illness and suffering and dying from his perspective are part of life and are mainly a test from God, and disease is a trial from God by which an individual's sins are removed.
The sociocultural variables are paramount in nursing care as they assist the nurse in understanding the ramifications of the patient's beliefs and faith to deliver high-quality health care to patients from different cultures (Scott & Saginak, 2016). Adherence to the rules provides information that explains the implications of spiritual and cultural values, for the nurse to have a successful interaction with the patient he or she must respect his religion. In a case where the nurse is female, she must cover herself like the Muslim women do. The nurse will also have to acquire an Arabic interpreter or Muslim nurse to interpret the English conversation that would take place between the two or outline any conflicts between the treatment offered and religion.
Islam has five pillars that all Muslims follow strictly the first is the confession of faith, it is done five times in a day, at dawn, mid-day, afternoon, sunset and evening. The Muslim prayer is a combination of verbal sayings, physical actions and deep feelings of the heart; they should be in a state of humility. Once prayer begins a series of Qur'an recitations as well as glorifying and thanking God, this gives Muslims an opportunity to request something from God as well as thank Him for blessings. 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 very year because it is based on the lunar cycle and can either be 29 or 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 they travel to Saudi Arabia to perform the specified rites of pilgrimage, where they spend their days in complete devotion and awe to God as they repent their sins.
The perception of illness and death vary from one patient to another and are majority shaped by beliefs and spirituality. The goal of every nurse is to design an efficient treatment plan that is acceptable to patients, neglecting information about a patient's spirituality and religious practices can result in a disaster such that the nurse may end up proposing activities that a patient cannot consent to do because of their spirituality and religion (Nader, 2016). Spirituality explains the fundamental issues about the patient's very existence, medicine in its nature heals the body only and for the patient to experience complete healing the spirit and the mind must be involved.
When he entered the office, he was wearing a clean, white, well ironed outfit and a religious turban. He was well dressed for the summer season since it was scorching. Before he entered the office, he was quietly and patiently waiting at the lobby sitting while his hands were crossed. He appeared to be anxious as if he was in a hurry to get somewhere. The nurse established a good rapport with the patient by introducing herself first then requesting the client to present his problems. She spoke directly to the patient and was able to maintain a little eye contact with the patient. The conversation began with an open-ended question that provided the patient with a platform to share their unlimited thoughts. The patient responded with one-word answers throughout the one on one discussion and was very anxious to finish and leave. The nurse proceeded by asking more specific closed-ended questions to get accurate information that would help her treat the patient efficiently.
According to Nader (2016), patients' psychological variables contribute in judging his emotional functioning and cognitive ability before proceeding for further examination. It assures the nurse that the patient is aware of who they are, where the time and their health situation. The nurse can assess if the patient is experiencing any stressful situation, anxiety, worry hence is careful while communication to prevent saying anything that may annoy or upset the patient. Discussing family mental illness history is of even more significance in making the correct diagnosis about a patient's mental state. The nurse should not only rely on the psychological variables in that they may not be accurate tools because some patients might pretend to be okay when they are not.