process paper help!please!

  1. Hey everyone, I am writing a process paper over CHF and am confused about the sociological, spiritual, and psychological categories. I don't know what diagnosis fall under ehat, especially sociological. Any ideas? Thanks
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    About tsu_girl82

    Joined: Mar '04; Posts: 63


  3. by   meownsmile
    Sociologic issues of CHF? Might think about having to use portable oxygen and how limiting it is. Low salt diets and restrictions in diet/fluids. Limitations of edematous lower extremities and ambulation even short distances.
  4. by   rebel_red
    Psychosocial or psychological can be expressed as ego integrity issues.. e.g., Your patient may report anxiety, apprehension, or fear, evidence stress related to illness/financial concerns (loss of job, loss of role in society/family, cost of medical care). May exhibit various behavioral manifestations e.g. anxiety, anger, fear, irritability.

    As meownsmile stated lugging around the portable 02 can cause a myriad of issues. My mom has COPD and you should just see people stare! Some are extremely cruel as well, so enter self image issues, self esteem, body changes etc. Not to mention activity tolerance r/t imbalanced 02 supply/demand and generalized weakness how does this affect a person's social schedule? Even with the 02 people generally fatigue easier.

    Spiritually, is a tougher nut to crack. What is their religious/spiritual orientation? Current involvement in church/belief system practice? Will their spiritually carry them through this time? Or will they begin to question their version of the divine? Is now when they face thier own mortality?

    As to diagnosis:

    Sociological: Role Performance, ineffective r/t presence of chronic illness AEB (pick your pt's defining symptoms)

    Social: Activity tolerance r/t generalized weakness AEB

    Spiritually: Spiritual distress r/t loss of ______ AEB

    If you have a Taber's check the nsg dx section they have good ones. The careplan book we use is NANDA accepted diagnosis and includes NIC/NOC. Though I have noticed that is seems all schools teach care plans differently. Either way a good care plan book is a must.

    And I am sure there are people far more skilled than myself at this so jump on in!!

    Be well.
  5. by   tsu_girl82
    Thanks for your help, you're a lifesaver. We haven't focused on anything but biological problems, so this really threw me!
  6. by   mother/babyRN
    Spirituality can also emcompass a patient's ability to get to church if that is an issue either for that particular person, his or her family, or the expectations of their religion. Even understanding that physically a person may not be able to attend an actual service, has often impacted negatively on patients I have had.
    Sometimes the misconception either by the patient or others he or she are involved with, centers on no longer feeling strong, or vibrant. For an independent person, male or female, CHF or any debilitating malady, whether permanent or temporary, can wreak havoc on them. Also, the very fact that the word failure is included in the disease process identifier, has bothered some patients I have had.
    Being dependent upon oxygen or med therapy can exacerbate a persons feelings of no longer feeling independent, and worsen the burden of a person who lives for dependence, or it accustomed to it, on the person charged with caring for him or her.
    In cultures where independence or matriarchial or patriarchial societies, these feeling are even more outlined.