Jozien Bensing: Article Analysis

Hypertension is a very common problem, affecting 1 billion people worldwide, with 50 million cases in the United States, and one third of cases going undiagnosed. 1% of the cases will experience a hypertensive emergency in their life. (1,2)

The convenience sampling that was used in recruiting all male patients who were on blood pressure medications is a glaring bias in this study. There was no information provided addressing why the patients were presenting to the clinic. There are many interventions that can raise blood pressure. For example, the study conducted by Marshall, Anantharachagan, Choudhary, Chue and Kaurhis, (2002) investigated the effect of situational anxiety on blood pressure experienced in anticipation of a blood test. Marshall, et. al., (2002) found that anticipation of a blood test can raise blood pressure. Foster-Fitzpatrick, et. al., 1999 did not address the purpose of the patient’s visit to the clinic.

Ross, S., Walker, A., & MacLeod, M. J. (2004). Patient compliance in hypertension: Role of illness perceptions and treatment beliefs. Journal of Human Hypertension, 18(9), 607-613. Retrieved from http://dx.doi.org/10.1038/sj.jhh.1001721

In a study published in the Archives of Internal Medicine, it was found that the better a physician communicates with their patient, the more likely that patient is to follow medical protocol (Tarn, 2006). In fact, there was a direct connection to proper use of medications and comprehension of factors such as side effects. This is especially important for physicians to keep in mind when dealing with patients who speak a different language.

Hypertension related research could be assessed using meta-analyses and randomized control trials. A combination of both will be used for this narrative review, since all three have been useful in determining JNC guidelines. Much of the research conducted has been on different interventions that include lifestyle and pharmacological treatment that have been used to reduce blood pressure and control hypertension. JNC 6 focused its efforts on improving dietary habits to avoid developing hypertension or manage it once diagnosed. JNC 7 appears to be an intermediate of the other two guidelines. It contains information on the lifestyle modifications as well as pharmacological treatment. JNC 8 is formatted quite differently that the other two and appears to be geared towards proper and prompt diagnoses of the disease, as well as forms of treatment.

First, when physicians place their self-interests ahead of their patients, they are creating an environment in which patient’s concerns are inferior to their own. This can severely damage the physician-patient relationship. In a study researchers found that hypertension patients became “non-compliant” when they believed their physician was unconcerned (Jin & Sklar, 2014). Additionally, many studies have addressed the need

Chemical weathering occurs when rocks or other natural structures get broken down as a result of chemical reactions. This usually takes places in places with a lot of water, as water helps initiate chemical reactions, you can see the structure has been broken down in the image to the right. Chemical weathering usually happens more in times when there is a lot of rain, such as springtime. Again, this is because water causes some chemical reactions to occur.

This assignment will critique the enhanced communication skills between a registered nurse and service user. For the purpose of this assignment the service user will be referred to as Iris. Confidentiality will be maintained throughout, as stated by the nursing and midwifery council (Nursing and Midwifery Council [NMC], 2015). The physiological assessment being observed was blood pressure and will critique the communication skills, active listening, non-verbal, verbal communication and dignity. Verbal, non-verbal, visual and written communication are the four main types of communication (Boyd & Dare, 2014). During this observation Iris was having her blood pressure taken prior to commencing haemodialysis. Rapid removal of fluid increases the chance of hypotension during and towards the end of dialysis (Cormier, Magat, Hager & Lee, 2012). This is why it is important to monitor Blood pressure before, during and after haemodialysis. I observed Iris’s Blood Pressure being monitored prior to commencing haemodialysis.

Modern medical advancements have significantly decreased the prevalence and severity of infectious disease as well as the treatment of acute, traumatic conditions. Pharmacological research has also gained insight into the management of chronic disease. Still, there is an epidemic of chronic, treatable diseases like stroke, heart disease, and kidney disease. Hypertension proves to be the underlying factor associated with these diseases. Hypertension is often referred to as the silent killer because of its indication in deadly disease, and the importance of monitoring ones blood pressure is vital. Lifestyle, diet, and genetic predisposition are all factors of high blood pressure. Chronic high blood pressure above safe levels, known as hypertension, puts elevated physical stress on the renal and cardiovascular systems. By controlling this factor in patients, healthcare providers can decrease cardiovascular events, improve health outcomes, and decrease overall mortality. Patient education is often overlooked in its role in the control and prevention of high blood pressure. This paper analyzes the causes and physiology behind high blood pressure as they relate to the current nursing interventions. The role of nurses is discussed in relation to patient education regarding high blood pressure, and educational approaches are analyzed.

There are a number of key elements that help to provide a framework that enhances truthful communication. Firstly, there is the need to develop open and honest communication from the very beginning of the patient-health professional relationship. Secondly, the health professional needs to use patient penchant as a “weigh” by asking them what they wish to know, how much they wish to know, and determining what they already know. In other words, it is a responsibility of the health professional to get a ‘feel’ for the situation, including the patients’ perception of the situation (Ashcroft, Dawson & Drape 2007).

In spite of the medications he has been prescribed requiring him to monitor his blood pressure, Mark’s nurse has never provided him with a teaching as to the importance of measuring and tracking his blood pressure while taking these medications (American Heart Association, 2016). Without this teaching, or any medication-based teaching for that matter, patients like Mark are left in the dark in regards to their knowledge and understanding of their own medications (Macdonald et al., 2014). In order to avoid being left in the dark, best practice suggests that Mark’s nurse should have provided a health teaching that addressed various aspects, including the reason he has been prescribed each of his medications, why they may look different from those that he takes at home, as well as the physical assessments that he should conduct while taking the medications, if any (Macdonald et al., 2014). In the future, Mark’s nurse should make patient teaching a high priority and spend a few minutes talking to him about each of his medications. She must also address any concerns he may have regarding any of his medications and their side effects (Macdonald et al., 2014). By doing this, she will ensure that Mark understands what medication he is taking and why, thus fostering patient-centred care and allowing Mark to feel that he is an active participant in caring for his health (CNO, 2015; Macdonald et al.,

In recent times, in the field of health communication, a shift in beliefs has become apparent. Many feel that the physician-centered approach is no longer the best way to manage the interaction between patients and doctors. A new collaborative approach has been adopted by many. This collaborative approach is more of a partnership between the patient and doctor. More communicating by the patient, and more listening by the doctor. When the doctor and patient speak to one another, they speak to each other as peers sharing ideas,

Studies evaluating hypertensive patients’ perceptions of causes prompting their self-management have demonstrated that obstacles are multifactorial. Studies have shown that family members often play a vital role in patients’ hypertension self-management, including providing support with food choice and preparation, helping patients to follow the behavioral recommendations (for example, smoking cessation), and supporting patients with medication and medical appointment adherence. Family members may also play a central role in easing patient–provider thoughts about hypertension care (Wassertheil et al,

Quite often, I get compliments on my eyes for their bright blue color. Not only am I given positive comments, but questions as well. For example, “What’s wrong with your eyes?” or “Why do your eyes move like that?” Trying to not bore people with a long medical definition of the exact issue, I simply reply with “I have Nystagmus.” Typically, I’ll receive dumbfounded expressions. Because of this, I try to give people a straightforward explanation. Nystagmus is a condition in the eye that causes uncontrollable movement, typically involving poor vision. Basically the muscles in my eyes are feeble. I have learned to adapt to my surroundings while living with my condition. Consequently every day is a challenge in some way or other.

The relationship between a patient and his/her doctor is a prominent concern in the health industry. (Berry 2007) In the review titled, ‘Effective Physician-Patient Communication and Health Outcomes: A Review’, Moira Stewart states that physicians interrupt patients an average of 18 seconds into the patient’s description of presenting their health problem, and that there exists a major lack of patient involvement during discussion. Effectively communicating one’s well being is an extremely important aspect of health. In