Strengths And Weakness Of Managing Stressors Health And Social Care Essay

Case study

Introduction

Ahmed and Katya are remarried couple who recently migrated to Australia with their eight kids. This case study will discuss the challenges that this new migrant family has to face, in order to view the family members’ physical and psychological health status which could be impacted by those challenges. This paper will also address how to manage their health care and provide information and support to improve their wellbeing.

Challenges

A review of the health status of migrants in Australia (Anikeeva et al 2010) shows that new migrants have lower mortality and hospitalization rates than the average Australian born population. However, their health status will deteriorate with increased length of stay. Owing to new migrants are away from their original country, which prevents them from maintaining cultural traditions, as an example is that Katya cannot go to the mosque daily. Ahmed and Katya live in a semi-rural environment which makes it harder to fully maintain cultural traditions. This may decline their health status (Anikeeva et al 2010).

Additionally, this review also points out new migrants tend to have mental health problems because of conflicting of different cultures, language barriers, finding employment and feelings of loneliness. Ahmed and Katya are away from the rest of their family, Katya has limited English and Ahmed feels pressure from setting up his own business. These factors may cause mental stress (Anikeeva et al 2010).

New migrants who live in cities have better health outcomes than those who live in rural areas, due to the fact that cities can create a supportive environment (Anikeeva et al 2010). As Ahmed and Katya live in a semi-rural community, this limits social and financial supports. In addition the hospital may be unable to provide enough information and resources about treatments for Katya’s cervical cancer.

Some communicable diseases may kill a child once infected, but safe and effective vaccines can protect children and save their lives (Centers for Disease Control and Prevention 2013). In this case, none of the children have been immunized which put them in a high risk of getting infected.

Strengths and Weakness of Managing Stressors

According to a Harvard Medical School’s (2010) study, religion and spirituality have positive effects on lowing blood pressure, decreasing anxiety and hostility. Prayers comfort people. Attending to active religious services can improve people’s happiness and satisfaction of life, in a way to maintain their quality of life (Harvard Medical School 2010). In this case, Katya is a very religious woman who usually attends the mosque daily which is very helpful for this family to manage their stressors. An expanding social circle is beneficial to reduce stress. As an example, Samira has adjusted well to the new environment and started to make friends in her secondary school. Her friends may provide emotional support while she faces stress (Harvard Medical School 2010).

Social support, effective communication, cognitive restructuring and relaxation exercises are the most important factors that contribute to manage stressors (Harvard Medical School 2010). However, in this case, Ahmed and Katya have immigrated to Australia without the rest of family, which prevents them from gaining family support. As they have chosen to live in a semi-rural community, which limits supports and resources, such as limiting financial assistance for Ahmed to set up his own business , this could result in greater stress. Due to language barriers Katya cannot effectively communicate with other people. This leads to a limited social circle, which will not help with her stressors. Cognitive restructuring is a theory used to prioritize negative thoughts in order to assist people to manage them effectively, and helps minimize stress (Harvard Medical School 2010). In this case, Zak doesn't want to disappoint his family, so is choosing to hide his real interest, being a chef. Katya is worry about how her condition will impact on her family. The family is worried about how to cope while Katya is in hospital in the next town. No one helps this family reframe these negative thoughts in order, which leads poor management of stress. Katya has to stay at home caring for her husband and children, and she is no longer able to go to the mosque every day because she doesn't drive. This prevents her from exercising, which can be considered to increase stress level.

Blended Family

Forming a healthy blended family is not an instant task, but it needs all family members to participate in building a good relationship. Blended families tend to have more trust issues because the stepchildren and stepparents need more time to gain trust between each other as compared to nuclear families (Kemp, Segal, Robinson 2013). Children need extra time to adjust to a new environment, they have to learn and practice the skills of understanding and expressing feelings to stepparents and stepsibling (Kemp, Segal, Robinson 2013). The outcomes of relationships in blended families are different depending on the children’s age. The teenagers have more difficulties in dealing with the transition between nuclear family and blended family, which may lead to risk taking behaviour. The stepparents cannot force the close relationship. Therefore it is stepparents are better they act like a friend to make the teens to feel more sense of stability (Kemp, Segal, Robinson 2013).

Issues Impacting on Health Access

People who live in rural areas have limited support in their environment (Anikeeva et al 2010). Ahmed and Katya cannot get enough social supports. Such as they don’t have financial recourses may leads they cannot pay for Medibank, they also may not be aware of available services they can access, this impacts their ability to access to health care.

Limited English is one of the barriers causing social isolation. Gwatirisa (2011) cites statistics in 2006 shows that 1 in 7 immigrant women who come from non English speaking countries state they had no social support when they need help, because those women tend not to attend to any social activities due to limit English speaking. Thus, Katya cannot have effective conversation with other people, which may lead prevent her accessing to health care.

Islamic women’s clothes have to be loose and can cover their arms and legs, and hijab is a typical dress that Islamic women have to wear (Mohammadi Evans & Jones 2007). In the Muslim culture, people believe women should wear hijab as they are not allowed to show their body parts in public or to have body contact with other males as this is the way to conduct decorum and propriety. However, in non Islamic cultural, it is common that male heath providers look after opposite gender in clinical environment, which may cause Islamic women like Katya to avoid access to health care to minimize the conflict between her and health providers (Mohammadi Evans & Jones 2007).

The Islamic culture believes Halal will guide people to have a pure and healthy life, which cause people have traditional perception of health (Mohammadi Evans & Jones 2007). For example, Ramadan is an Islamic month that all adult Muslims should be fasting, and it is considered that the spirit of Halal elevates people’s souls and purifies their body. However, non Islamic health care services believe it is very important for hospitalized people to have full nutrition to maintain wellbeing while they are sick. Thus, it is difficult for Muslims to be hospitalized during Ramadan (Mohammadi Evans & Jones 2007).

Education Program

Quitnow website is founded by the Australian government which provides a variety of campaigns and supports to help people quit smoking. ‘Pregnancy and quitting’ is a campaign released in 2012. This program is focused on how smoking affects women in pregnancy and babies. The chemicals released from tobacco affect women’s reproductive system, which may cause poor response to fertilization that increases the risks of miscarriage or ectopic pregnancy and delivering a premature baby. It is also highly associated with developing cervical and vulval cancer (Australian Government 2012). This program is relevant to the situation as Ahmed is a heavy smoker. Second-hand smoking has the same effects on women. Nicotine and carbon monoxide will reduce the quality of sperms, which also leads the parents may have unhealthy baby (Australian Government 2012). Children expose to second-hand smoke have higher risks of asthma, respiratory diseases, hearing impairment, and sudden infant death syndrome in young children and infant (Australian Government 2012). The government could put pregnant women in banning smoking advertisements to remind men. The government could also provide posters or brochures in the maternal clinics, pubs or footy stadiums.

Allied Health Care Providers

Social workers are one of the professionals that utilize theories of human development and behaviour and social system to analyse the interaction between well being and social environment. They provide counselling to help people solve personal and social problems (International Federation of Social Workers 2012). In this case, no social support and financial resources are the triggers which cause stressors. The role of social workers is to provide available information and services that can assist Ahmed and Katya. They work with the communities to provide education programs for individuals to learn social skills, which can be helpful for new immigrants (Myfuture 2012a).

Counsellors work in many fields in order to assist people to identify their own mental problems such as distress or depression. They merely help people set up goals for recovery and encourage people to attend available therapies to solve their emotional issues (Myfuture 2012b). In this case, the counsellor can encourage the whole family to be involved, share their feelings, and assist the family to find solutions.

Psychologists are the professionals that use tests and assessments to study human behaviour, and diagnose people’s mental disorders. They can provide therapies to promote clients’ mental status (Myfuture 2012c). Thus, they may helpful to reduce the family’s stressors.

Professional & Practical Issues

According to Blackford & Street (2002), a recent Australian research shows the outcomes of nursing to meet the health care needs for non English speaking background migrant women in hospitals are not as effective as in community settings. Those women state they have difficulty to have their needs met because they feel discriminated. Nurses may try to avoid or reduce conversations to the patients or don't want to waste time using health interpreters. Additionally, those women cannot get enough information about available services and they fear to ask questions which they think it makes them look stupid (Blackford & Street 2002).

When caring for Katya in hospital, nurses should be aware of the cultural sensitivity issues. Female nurses should look after Katya, and provide equal nursing practices, introduce available services, increase interaction with her, creating empathy and ask for health interpreters when possible. However, nurses should also be aware that once relating to women’s health, immigrant women would rather have female interpreters instead of family members, children, or male interpreters (Blackford & Street 2002).

Feminist values of equality are part of western culture. When it comes to nursing practices on diverse cultural populations, nurses should examine the roles of men and women in different cultures (Blackford & Street 2002). In this case, Katya is heavily relying on her husband, thus, nurses should involve Ahmed in caring for his wife. Care plans or medical decisions should involve Ahmed and Katya together.

Expectations in Development of Infant

In this case, Layla is a 7 month old baby that is experiencing the fastest physical growth period of her life. The changes are not only represented in the increasing baby’s size and weight, but also showing in the baby’s abilities to coordinate their motor skills (Ruffin 2009). When it comes to motor development, it includes gross motor and fine motor development. Gross motor development means the improvements of the ability in controlling large muscles. As a 7 month old baby, Layla is able to crawl on the floor, roll her body and sit upright with help (Ruffin 2009). Fine motor development refers to coordination of the small muscles. Layla is able to pick up or hold objects. However, it is still too early for her age for her brain to develop skills, such as drawing or writing (Ruffin 2009).

Erikson’s psychosocial development theory says the child will build up a basic sense of trust to the environment from birth to 1 year old. Thus, Layla will feel secure with familiar people, like her parents around her (McLeod 2008a).

Freud’s psychosexual development theory defines the behaviour of a newborn to 1 year old baby as oral stage. Thus, Layla will present oral behaviours such as sucking or biting (McLeod 2008b).

According to Piaget’s theory, cognitive development is based on how well the babies interact with the world through the senses such as see and hear. Layla will show interest in bright colors, respond to her parents’ voice, as well as cry or smile to present her feelings (Ruffin 2009).

Immunization

Although immunization is not compulsory, ACT Health (2013) strongly recommends that parents get their children immunized to reduce the risks of infection. All families with children can get free services from their local General Practices and the Health Directorate's Immunization Clinics for all childhood vaccinations (ACT Government Health 2013). Those services also provide information about the schedule of vaccinations to help families update their immunization status.

Nurses can inform Katya that she can access free services from her local GP and council to keep her children fully immunized. The Australian Childhood Immunisation Register records each child’s immunization history, so Katya can get her children’s statement of immunization at any time by accessing the service. Even for the old children, like Zak and Samira, they can still get immunized from the school health immunization team (ACT Government Health 2013).

In order to ensure this family understands the immunization based education, the nurses can provide brochures in their own language or use interpreters. Contact with a local group to share their experience about childhood immunization.

Conclusion

This case study discussed the challenges that a migrated and blended family has to face, identified what were the strategies they could use for managing these challenges and how well the family did. This paper talked about the barriers that inhibit this family access to health care. And it addressed how nurses provide information and utilise available services for this family to improve their health status.