CNA153 | Research / Evidence-based Practice Paper
Introduction
The given case study presents several different clinical issues. The most significant issue is being faced by Violet who is suffering from numerous medical ailments which has made her dependent on others. Since she is living with her daughter Gemma who is the sole bread-earner of her family that comprises of her husband, two children and now her sick mother too, it has put Gemma under undue pressure. The children have also become quite cranky as they have been made to leave their room which is now occupied by their grandmother. Gemma’s husband, Matthew, is suffering from an addiction to alcohol. This can be attributed to his unemployment.
Even though each one of these clinical issues is worthy of investigation, I will limit my inquiry to the clinical issues being faced by Violet and Gemma’s husband Matthew.
Quantitative Questions
Quantitative questions are most appropriate for clinical issues when the issue at hand concerns a particular segment of the population, focuses on a specific issue, relies on a comparison, is based on an outcome of an intervention, or has a time frame given to achieve the desired outcome. Such questions are usually very specific and well-defined.
The quantitative question that will be my focus regarding Violet’s clinical issue is “Does the use of therapeutic intervention or counseling improves the psychological condition of old age people who have restricted mobility within 8 weeks?”
In this question, population consists of old age people with mobility issues; intervention is psychological therapy; comparison is being done with nothing; and the desired outcome is better psychological condition.
Literature Review
The existing body of research on the psychological well-being of old age people who have restrictive mobility due to their health condition is rather limited. Even though numerous studies have been conducted on similar topics, the available data is still not thorough enough to reach a conclusive argument.
One important research that covers this aspect is Czaja and J. (2016). The research mainly talks about how technological innovations can be used to improve the lifestyle of old age people. Over the years, technology has drastically advanced. It has advanced to such an extent that the areas which were previously considered far beyond the reach of the influence of technology are now very much influenced by it. Technology can be used by older adults who are suffering from chronic health conditions to find online support groups. These support groups help in uniting people from across the globe who are suffering from a similar ailment. Hence, such groups provide emotional support and help in improving the psychological well-being of old age people.
Similarly, another important research also focuses on incorporating the use of mobile phones for giving psychosocial therapy to vulnerable people (Vazquez et al., 2016). Vulnerable people are usually not easily approachable. They find it hard to come to another location for therapy regularly. This can be due to social, cultural, economic or personal barriers that these people face. Therefore, it is in their best interest to get therapy remotely on their mobile phones. Since Violet can also be considered vulnerable as she is suffering from multiple chronic diseases and mobility issues, she can be given psychosocial therapy through a mobile phone.
Likewise, a group of researchers claimed that ‘Aging is often characterized by declines in physical and mental health and increased risk for depression and social isolation. A protective factor that has been found to effectively moderate these phenomena is psychological well-being’ (Friedman et al., 2015, p.1). This research claims that programs that foster positive emotions such as gratitude, forgiveness, humility and pride in the participants can improve their psychological well-being significantly. The researchers designed a program named ‘Lighten Up!’ which was ‘an 8-week program consisting of 90 min group session designed to teach participants to identify and savor positive experiences across multiple domains of eudaimonic well-being’ (Friedman et al., 2015). At the end of this program, the participants reported high level of psychological well-being on various psychometric tests and scales. Hence, Violet may benefit from participating in such a light-hearted program that will help her in recounting the positive experiences of her life and letting go off the negative aspects.
Proposed Solution
In light of the research findings discussed above, it can be concluded that therapeutic interventions and counseling do significantly improve the psychological well-being of old age people. Since my patient, Violet, is going through a psychologically challenging time because of her physical ailments, she can benefit from remote therapy sessions of mobile phone and by participating in programs that help in fostering positive emotions in the participants. She should also join online support groups so that she can connect to like-minded people of her age and does not feel isolated.
Qualitative Questions
In comparison to quantitative questions, qualitative questions are broader and more general. Components of a qualitative question include a specific group of people, a certain type of exposure, and the desired outcome; or a specific group in the population, interest of the researcher, and the context of the particular case at hand.
The qualitative question that will be my focus regarding Matthew’s clinical issue is “How can an unemployed young adult man overcome his addiction?”
In this question, the specific group of interest within the larger population is that of young adult men, interest lies in the problem of drug addiction and the context is that he is unemployed and is living in a stressful home environment.
Literature Review
The existing body of research on alcohol addiction is quite promising. Even though only a handful of studies have been done on the issue of alcohol addiction among unemployed men, a lot of lessons can be borrowed from researches that have been broadly done on the issue of alcohol addiction.
One of the key studies done on this issue was by Alexander Bruce (2001). He basically conducted an experiment on rats called “The Rat Park Experiment”. In this experiment, he created a park for rats which had several rats, cheese, a bowl of plain water and a bowl of drugged water. He noticed that none of the rats drank drugged water. They only drank plain water. Based on the findings of this experiment, Alexander concluded that addiction is not the opposite of sobriety, but rather it is the opposite of connection. If you want to take people away from the menace of addiction, help them in establishing new connections. People who are suffering from drug addiction usually feel isolated. When such people are given a chance to socialize and become part of a group, they are very likely to move away from addiction. These findings can very well be applied to the clinical issue of Matthew. He is unemployed and staying at home which means he does not have many social connections. That can very likely be a cause of his addiction. Going out and establishing new as well as meaningful connections might help Matthew in getting over with his addiction of alcohol.
Another such research was done by Best et al. (2015). This research focused on the social identity model of recovery (SIMOR). People who become addicted to drugs make this aspect of their life part of their social identity. Either they are influenced by their friends to start consuming drugs or they become friends with people who are addicted to drugs once they start consuming drugs. Either way, they incorporate drug addiction in their social identity. Therefore, “By applying a social identity approach, recovery can be conceptualized as involving the emergence of a new sense of self, encompassing a history of substance abuse, yet embedded within new, health-promoting social groups” (Best et al., 2015, p.10). If a person wants to give up drug addiction, it is absolutely necessary that the person starts off by hanging out and establishing connection with people who are on a similar path. This helps in recovering from addiction and preventing relapse. That is why Matthew also needs to join either a social support group or a rehabilitation centre where he can socialize with people who are on this difficuly yet not impossible journey of giving up drug addiction.
Likewise, another research study (Silverman, Roll & Higgins, 2008) established that operant conditioning is one of the most effective approaches to treat drug addiction. Applied Behavioral Analysis, in particular, can be used to treat the problem of addiction. However, whether this strategy will be useful for Matthew or not is debatable. This is because operant conditioning requires some sort of intervention either by a therapist or by family members. Since Matthew does not currently have access to a therapist neither are his family members supportive enough, it might be hard for Matthew to undergo operant conditioning to treat his problem of alcohol addiction.
