Pregnancy is a beautiful journey for a Women, however, it can also be a stressful or even a life threating experience.  A mother’s anticipation for her new baby carries her through the fear of numerous possible complications that can affect herself or her baby. When a life threatening complication such as preeclampsia develop, many become extremely anxious and worried, fearing for the future of their unborn child and themselves. It is a nurse’s role during the pregnancy is to educate as well as support the soon to be mother on what preeclampsia is, the complications it can lead to, the early warning signs and how to identify these signs when they are no longer under the direct care of a health care professional.

Hypertensive disorders of pregnancy are one of the most common medical disorders that increase maternal and perinatal morbidity and mortality. Preeclampsia alone is responsible for 75,000 deaths per year worldwide (Davidson, London, & Ladewig, 2020). Preeclampsia is one of the many possible complications that can happen to an expecting mother. Exclusive to pregnancy preeclampsia affects about five to ten percent of all pregnancies in the united states… Preeclampsia is characterized by new-onset hypertension, and proteinuria, usually after 20 weeks’ gestation (Davidson, London, & Ladewig, 2020). Witcher states “Preeclampsia is typically diagnosed by new-onset hypertension (systolic blood pressure of ≥ 140 mm Hg or diastolic blood pressure of ≥ 110 mm Hg) with proteinuria (≥ 300 mg protein in 24-hour urine specimen or protein-to-creatinine ratio of ≥ 0.3 mg/dL).” (Witcher, P.M. 2018). In addition, clinical manifestations such as visual disturbances, thrombocytopenia, hyper-reflexive changes, severe headaches, impaired kidney function/liver function and epigastric pain can occur

Pregnant females spend most of their pregnancy out of the hospital setting unless absolutely necessary, that being said, the patient is not being monitored frequently under a professional health care provider. In hopes of preventing the possible major complications caused by preeclampsia, extensive teaching, maternal and fetal monitoring is required. It is extremely important for the nurse to educate and instruct their patient about prenatal check ups, what preeclampsia is, the clinical manifestations, and complication along with the danger signs of these complications. Educating the can aid in early diagnosis of preeclampsia, which can help prevent preeclampsia from becoming more severe then it already is and intervene in a timely manner. The role of the nurse in caring for patients with preeclampsia is to maintain the safety and wellbeing of both mother and child. Many of these deaths that resulted from preeclampsia could have been prevented through timely and appropriate interventions, including surveillance for clinical manifestations that indicate progression in severity and appropriate timing of delivery” (Witcher, P.M. 2018).

“Given the maternal and fetal consequences of chronic hypertension, it is recommended that a hypertensive patient be followed closely as an outpatient; in fact, it is advisable that she check her BP at least twice daily. Beginning at 24 weeks of gestation, serial ultrasonography should be performed every 4 to 6 weeks to evaluate interval fetal growth. Twice-weekly antepartum testing should begin at 32 to 34 weeks of gestation.” (Incerpi, M. H. (2018).  Elevated blood pressure is an indicator of preeclampsia. It is a vital intervention to educate the mom on how to preform blood pressure monitoring at home and ensure that the patient has an adequate understanding of that teaching. If the mom performs her blood pressure at least twice a day this can help identify preeclampsia early. A recent study that provided 161 women with sufficient teaching on how to use an automated electronic sphygmomanometer, found that of those women in the group who developed preeclampsia, 39% recorded high blood pressure reading before their health care provided did in the clinical setting (Tucker, et al., 2017). This demonstrates the importance of patient teaching by the nurse, not only can it be effective but can also yield pertinent information that can lead to early detection of a possibly deadly pregnancy complication.

It is also vital for the nurse to educate the patient on the complications of preeclampsia because the patient can then identify these complications before they progress. The maternal complications include eclampsia, intracranial hemorrhage, hemorrhagic complications such as DIC, acute kidney injury, and cardiac compromise (Witcher, P.M. 2018). Preeclampsia can cause fetal complications such as placental abruption, fetal growth restriction, and fetal death (Incerpi, M. H. (2018).  If these complications are identified and acknowledged by the patient, it can be managed earlier then later which can be vital to the mother and fetus. It will allow us, the health care team to tailor our management and individualize accordingly.

As mentioned, a nurse’s obligation for their patient is to promote both the wellbeing of the mother and child. In order to do this the nurse must educate the patient that preeclampsia is an extremely serious complication that can occur during pregnancy. After properly educating their patient will be able to identify risk factors, early indicators of preeclampsia and the early indicators of the complications that result from preeclampsia; by doing so the patient can contact their health care provider within a quicker manner which can be vital to theirs and the fetus health and wellbeing. Mothers who are uninformed may not be as aware of the early signs of preeclampsia or complications of preeclampsia which prevents them from receiving early intervention treatment.

References:

• Davidson, M. R., London, M. L., & Ladewig, P. A. (2020).
  
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Occupational Therapy In Mental Health Health And Social Care Essay

Occupations are collections of activities and tasks of routines which are valued by individuals and cultures. Occupations include everything such as self-care, relishing life, and contributing to the social and economic aspects of societies (CAOT, 2002). It engages people in mutual work and it also promotes personal growth and development which offers possibilities to maintain healthy environment where people can interact with each other. (Creek & Laugher, 2008).Occupational therapy is rehabilitation profession which involves the individuals with disabilities to attain maximum potential in performing function of daily living, employment, through the use of purposeful activities. (Stein & Cutler, 2002).

According to (Awan, 2009) “Pakistan has poor condition in terms of occupation its safety and health legislature”. People are more susceptible because they work informally, with no access to basic occupational health .Which creates barrier for a person to involve in any activities and participates in society which ultimately leads to loss of roles and responsibilities. Therefore occupational therapy is essential to accomplish basic tasks of daily living in order to enhance quality of life. More over Occupational therapy minimizes dependence on expensive health care and it also promotes societal acceptance of individuals. This reason led me to think about the occupational therapy in mental health context for Pakistani people. Where people are renowned for their occupation, because society value those who earns and make diverse contribution in society. Any mental disorder creates barrier for a person in occupation and compromises their quality of life. Therefore occupational therapy is essential for a people because it engages people in various tasks of daily living and enhances self-worth of individuals so that they can live peacefully in societies.

It was our first Mental Health clinical rotation at Karwane-e-hayat. The things which had convinced me in this rehabilitation center is occupational therapy. I noticed that my client was greatly involved with occupational Therapists. Every day new innovative activities were planned which influence the health and wellbeing of patient effectively, as patient involved in these activities very well. Furthermore when my client receives occupational therapy interventions he improves significantly more in terms of interpersonal relationships, which is the sign of disease improvement.

The effectiveness of occupation therapy has convinced us a lot. Therefore we decided to plan more activities for the patient so that they can participate easily and interact more with other patients. To achieve this purpose we began with the assessment of patient’s interest and abilities. By identifying this we can plan activities according to their interest and implement them at clinical setting. Finally we evaluated our effectiveness of intervention which was positive and patients were happy and they request our group to plan more activities for them next time.

To improve health and wellbeing of patient occupational therapist believed that person needs to participate in the activity of daily living. To describe this relationship of health and wellbeing a person environment occupational model has been proposed. This model deals with the interdependent relationship between three factors which are person, aspects of occupation and environment and their effects on performance of a person and health. The personal factors which have an effect on occupational performance are sex, age, gender, self-efficacy (feeling of I can do it).Environmental factor includes social, physical, cultural, institutional characteristics these factor interact with the personal factor which then have either positive or negative impact on person’s occupational performance. The third factor which has an influence on occupational

Performance, health and well-being is occupation, which includes tasks and activities that person performs on daily basis. These factors are constantly interacting with each other and they influence health and well-being of person’s health (Law, Steinwender, Leclair, 1998).

Relating this scenario, to our clinical setting, the self-efficacy of a patient motivated him a lot, and to increase the self-efficacy, environmental factor which includes social support system example friends and families considered being a strongest support system. The Patient who involve in the activity they insist their friends to be a part of the activity. Besides patient’s family support them very well to enhance their wellbeing, it was seen in clinical area that after taking discharge family members bring the patient in occupation therapy room to participate in the activity for 2-3 hours. The third component is occupation that includes tasks which sometimes produce negative symptoms on wellbeing for example work load, expectation of a job. During Mental status examination a client verbalized that he got ill because of major loss in business. Due to which client suffered from major depression and he got admitted in this rehabilitation center. Thus 3 factors are very important for the person to participate in the activity and improve their health prognosis.

Occupational therapy has a positive impact in mental health settings. It treats individuals who are mentally ill, impaired cognition or emotionally disturbed. To treat these problems, therapists provide physical training and exercise training. It also provides independent living skills such as self-care for mentally ill and person who have cognitive impairment. Moreover it provides education for stress management to a client with disorder. It also promotes sense of independency, enhances self-esteem and self- worth.

Occupational therapist collaborate with other health care professional to provide intervention for a group by leading activity in a group to prevent depression, increase socialization, It provide parenting skills to those parent who are disable or who have children with disabilities, They also educate regarding normal growth and improvement and how to deal with a patient with problematic behaviors. Therapist also arranges programs, to resolve conflict and for anger management to enhance motivation in a community so that people can develop interest for their work roles (AJOT, 2001).

Occupational therapists are devoted to plan different activities for the patient to increase their well-being, but as a nurse we are also in a business to promote patient’s health, alleviate suffering and prevent them from disabilities. For this purpose we also planned activities for the patient in the rehabilitation center, which was exercising, sandwich making, cap making, collage work, word game and many more. Patient responded very well towards our planned activities they were greatly involved with other patient which increase their socialization, enhance their self-esteem, reduce their depression and decreases their feeling of loneliness which was verbalized by the patient.

Moreover as a individuals it is our first and foremost responsibility to encourage people to adapt occupational therapy as an intervention because occupational therapy prevent the relapses. First of all people should know the positive outcome of occupational therapy which can be done through education and awareness, awareness through television and radio about disease related to mental health so that people should came to know about proper intervention related to disease process, Modifying exercise facilities to make them accessible to people so that they can easily practice, provide education skill development training in the context of everyday occupation, and also self-management training to manage health. However training of staff is very necessary to promote occupational therapy in mental health, government and private sector should established a programmed to trained therapist (AJOT, n.d).

By concluding this, Occupational therapy plays essential role to promote wellbeing and to reduce the suffering, positive aspect of mental health can be promoted through occupational therapy, which enhance societal acceptance of patients and reduce the health expense by promoting wellbeing through activities and counseling. It is the responsibility of a nurse to promote OT in collaboration with other health care professionals to reduce the disabilities in the societies. Furthermore certain law and legislature should be imposed by government in the country to promote OT in the hospital which lacks this facility. All in all occupational therapy has a positive impact on patient’s wellbeing however if this intervention being neglected by the therapist or a nurse so it can produce negative impact on patient’s mental health.

Awan, T. (2009, September 11). OCCUPATIONAL HEALTH AND SAFETY IN PAKISTAN | Asia Monitor Resource Centre. Home | Asia Monitor Resource Centre. Retrieved from http://www.amrc.org.hk/alu_article/occupational_health_and_safety/occupational_health_and_safety_in_pakistan.

CAOT – Canadian Association of Occupational Therapists -Position Statement- Universal design. (2002). CAOT-ACE. Retrieved from http://www.caot.ca/default.asp

Creek, J., & Lougher, L. (2008). In Occupational therapy and mental health. London: Churchill Livingstone.

Law, M., Cooper, B,. Strong, S., Stewart, D., Rigby, P. & Letts, L. 1996. The Person-Environment-Occupation Model: A transactive approach to occupational performance. Canadian Journal of Occupational Therapy. 63(1):9-23

Law, M., Steinwender, S., & Leclair , L. (1998). Occupation, health and well-being. Canadian journal of occupational therapy, 65(2),Pp, 81-91.

Occupational Therapy in the Promotion of Health and the Prevention of Disease and Disability Statement. (2001). The American Journal of Occupational Therapy, 55, PP, 656-660.

Stein, F., & Cutler, S. K. (2002). Psychosocial Occupational Therapy: A holistic approach (2nd ed.). Albany,New York, USA: Delmar.