PREVALENCE OF CARDIO-VASCULAR ILLNESS IN MENTAL HEALTH PATIENTS SUFFERING FROM SCHIZOPHRENIA
PREVALENCE OF CARDIO-VASCULAR ILLNESS IN MENTAL HEALTH PATIENTS SUFFERING FROM SCHIZOPHRENIA
Introduction
Mental health care globally is one area receiving less focus, and despite this, it is a fact that mental health issues continue to soar and more people are affected. Of all the mental health cases, schizophrenia is the least common but chronic and severe. The symptoms of schizophrenia are very disabling, and interest in the research developed because of getting into contact with a patient suffering from cardiovascular disease who was schizophrenic (Fan et al., 2013). There are always strategies that can be developed and initiated to ensure that mental health patients get to live healthy lives similarly to their counterparts, but dedication and undivided support are vital. These people are human beings like the rest, citizens contributing to society and economy at large; hence have to enjoy the right to healthy lives (Bresee et al., 2010).
Experience from the contact with the schizophrenic patient drove my interest into researching about the topic, the current trends in the public health sector specifically dealing with intellectually disabled persons and lastly what interventions the government, health sector and other stakeholders in the industry have in place to improve the quality of lives of these persons. Despite the data, depicting some conflicting inferences, it can be concluded that recommendable steps have been made in the sector depicting the concern and effort various stakeholders are putting in place to ensure that intellectually disabled persons get to live a healthy life in the country.
Overview
Over the years, mental health issues have been swept under the carpet despite them being prevalent in society. Equality act of 2010 can be considered as the turning point in the management of mental health cases in the United Kingdom, under which schizophrenia is included. Before the bill being signed, most mental health victims may have been exposed to lower quality health care as compared to their counterparts but thanks to the law, changes in their health status are being recognized.
Schizophrenic patients record higher mortality rates as a result of cardiovascular diseases as depicted by research studies carried over the globe and not only in the United Kingdom. With such indexes, there is a need for health practitioners, families and the authority at large to invest more in caring and supporting these victims to ensure that deaths because of cardiovascular diseases are limited and schizophrenic patients get to live healthy lives exposed to little or no risk factors that may lead to cardiovascular diseases.
Various professionals have been significant in the management of schizophrenia and ensuring that schizophrenic patients do not suffer from cardiovascular diseases that may be brought about by their behaviors and lifestyles. The intervention strategies include developing proper diet plans that ensure these victims eat balanced diets and not only foods rich in fats, a precursor to cardiovascular disease development. Developing practice plans that ensure these patients exercise physically hence breaking the monotony of their sedentary lives and prescribing best medication for their conditions.
Definitions, statistics, and impacts
Meehl (2017) defines schizophrenia as a severe and long-term mental health condition that causes a range of different psychological symptoms. In most cases, schizophrenia is a particular type of psychosis whereby the victims are not able to distinguish the reality from their ideas and thoughts.
Data has it that one in every six people in the United Kingdom suffers from mental health at one stage in their lives and one in every 100 will experience a schizophrenic episode. An astonishing fact about schizophrenia is that it affects individuals from all lifestyles or social backgrounds, regardless of gender or social class. National Health Service (NHS) treats around 220,000 cases of schizophrenia annually, and these patients have an incidence of between 5- 10 percent of dying within 10 years after diagnosis (NHS, n.d.). Compared to the other population, this mortality incidence percentage is high. Regarding cost, schizophrenia is an economic burden in the United Kingdom (UK) as mental health cases cost the economy close to £77 Billion annually, and this calculated in percentage is close to 4 percent of the national Gross Domestic Product (GDP) (NHS, n.d.).
Cardiovascular diseases (CVD) on the other end are a class of ailments related to the heart and blood vessels. Examples of CDV’s include coronary artery diseases, stroke, heart failure, Venus thrombosis and congenital heart disease (World Health Organization, 2017). Despite 90 percent of CDV disease being preventable, statistics have it that it is the leading cause of mortality globally accounting for tens of millions of deaths annually.
Mortality among schizophrenic victims because of cardio-vascular illnesses has significantly elevated over the years, and despite the research and studies were done in this area, no single cause can be attributed to being a cause of the occurrence (NHS, n.d.). Deductions from this may be that the area has not been adequately addressed or no strict studies have been undertaken in the area. An example is the sedentary life of schizophrenic people hence increased incidences of diseases related to CDV (Taylor & Perera, 2015).
Role of a nurse practitioner in assisting Schizophrenic patients with cardiovascular disease
People with schizophrenia are the most affected by cardiovascular diseases, given the likelihood of the unhealthy life that they live. The basis of this statement is from statistics that show that schizophrenic patients record higher mortality rates from CDV compared to their counterparts, hence the need to develop appropriate public health interventions explicitly targeting this group of people with the aim of reversing the trend (Laursen et al., 2012).
Schizophrenic people just like other people with mental issues need adequate access to healthcare, and nurses as the primary health practitioners in the UK more likely to come into contact with them have to understand the needs of this select group of people. The equality act of 2010 makes this a mandatory requirement for people with mental disability, an area under which schizophrenia perfectly suits.
Research by Laursen et al., (2012) showed that the lifestyle of schizophrenic people is a leading factor towards their increased incidences of CVD’s but there also exists other factors contributing to that but with a much lower significance as compared to lifestyle. Given this, the central role of a nurse, at this phase is to enable schizophrenic victims with CVD’s live quality life.
There are strategies and programs in place to ensure that health practitioners play a vital role in providing medical support to schizophrenic patients with CDV. Contrary, studies have shown that inadequacy in relevant skills and knowledge as a result of inadequate training and reluctance to accept more responsibilities are leading factors towards limiting nurses offering services to these patients (Ringen et al., 2014).
Schizophrenic patients require assistance in managing their health despite their being variance in dependency on families or other practitioners to assist. The result is that nurses have to lias with family members or other people close to the patient to ensure that communication regarding the health needs of the patient, decision making and other health-related activities is enhanced for the health benefit of the schizophrenic patient (Bradshaw & Pedley, 2012). Given the sedentary life of most schizophrenic patients, developing issues like high blood pressure and being overweight is common and these are the leading risk factors for CVD. Nurses have a role to play, like ensuring that regular health check-ups are carried out on these people and the right medication or public health intervention auctioned.
Nurses also have the responsibility of enhancing self-management knowledge through public health education. The primary aim of this is to develop constructive and sustainable strategies aimed at mitigating the risk factors for CDV amongst schizophrenic patients (Videbeck & Videbeck, 2013). This may not be necessarily on the patients, but adults or family members of the patients may be advised and educated on the need to change their lifestyle or behavior patterns to limit the risks factors for developing CDV amongst schizophrenic persons. Nurses are professionally required to play this role effectively. Communication skills and knowledge of the particular nurse about the care and health needs of the schizophrenic patient with CDV is crucial in undertaking such a responsibility.
Prescription of medication in case a prior one is considered ineffective may be required and as a nurse frequently assessing the health condition of the patient, protocol to initiate such changes have to be observed. Prescriptions that trigger unlikely responses from the patient have to be substituted and given the fact that stress may be a risk factor to behavioral changes that may risk the development of CDV among schizophrenic patients; interaction with the patient in a manner that develops trust is a role to be played by the nurse. Development of such a relationship between the patient and the nurse not only enables the nurse to attain vital information from the patient but also enables the family and health practitioner to develop strategies and make decisions applicable and effective to the health of the patient (Videbeck & Videbeck, 2013).
Involvement of the patient, family and health practitioner (nurse)
Caring for schizophrenic victims with CVD is a responsibility to be performed by the family, health practitioner and the individual patient. Despite most people considering mental health cases victims like those who have schizophrenia as being incapable of making an informed decision, it is vital to involve them in the decision-making process since it is their health at stake and they have the right to make decisions also. Exceptional cases like where the victim is a minor or have been proved medically to be incapable of making such decisions are common, and it is only in such scenarios where the patient may be excluded from the decision-making process (Kakuma et al., 2011).
In most cases, schizophrenic patients live with their families, friends or extended families and it is always essential to ensure that all the people in close and frequent contact with the patient get to understand the condition their mate is suffering from to reduce conflicting instances. These family members and close acquaintances, commonly referred to as informal carers have to be actively involved in decision-making. Nurses have to ensure that the family members are presented with national policies and strategies that make it easier for them to assess the health needs of schizophrenic patients hence making it easier for the health practitioners to make informed decisions regarding the health status of the patient (Kakuma et al., 2011).
The support given to the schizophrenic patient has to be developed in a manner that makes it easier for both the nurse and family deliver health care that is manageable. Contact between the family and health practitioner is essential in ensuring that a strategy to offer the schizophrenic patient health care without any hardship or inequality on both ends hence regardless of the service provided by the family or nurse, the patient is satisfied (Richards et al., 2010). The family also plays a vital role in conjunction with the nurse and the patient may develop routines aimed at improving the health of the CDV schizophrenic patient. Like having routine chores that may enable the schizophrenic patient exercise. Diet management is also vital, and the parties involved may work together to develop a dietary routine that is healthy for the patient. Example, more vegetables may be included in the diet of the patient and foods with high levels of fats minimized, and this acts as a strategy to reinstate the health of the schizophrenic patient.
Characteristic health problems is also an area, which requires assistance and support from the parties involved; family and health practitioners. In some instances, schizophrenic patients with CVD may find it hard to express their emotions or communicate effectively. With the aid of the family, the connection that has been initially developed between the patients and their kinship they can be able to express their emotions or feelings. This may be vital in enabling health practitioners to make decisions regarding the health condition of the patient and develop supportive interventions (Kates et al., 2011).
Patients with schizophrenia and suffering from CDV’s are in most cases admitted to hospitals because of acute emergency conditions that can be easily avoided. Involvement of the patient’s family in the treatment process may play a significant role in minimizing the occurrence and likelihood of such emergency hospitalization cases depicting an improvement in the quality of life of the patient and limiting the economic burden because of frequent hospitalization of schizophrenic patients suffering from CDV’s. Engagement of the family and the nurse effectively ensures that knowledge and information for effective home-based care for the schizophrenic patient is initiated. The information provided by the nurse to the family and the victim is aimed at ensuring that the decisions made are sustainable and aim to improve the health status of the patient. Poor coordination and involvement of the parties in the treatment process increase the risks of failure, and the results may be deteriorated the health status of the patient or even mortality (Kates et al., 2011). To avoid such, it is always important to ensure that all the parties involved actively take part in the decision-making and initiation of health programs and strategies for the patient.
Roles played by different professionals in caring for schizophrenic victims suffering from CDV’s
Caring for schizophrenic patients with CDV involves various professionals. Nursing as a healthcare profession is considered the most involved in caring for these people but in reality, multiple professionals are involved but nurses play a major role, and that goes undisputed. The support provided by nurses is crucial as they provide physical care, public health advice and even support (Azad et al., 2016). The family and schizophrenic patient with CDV can share emotions and feelings with the nurse with the aim of relieving stress
Schizophrenic victims have a speech disorder. The order in which they organize their speech may be hard for others to understand. Speech pathologists role, in this case, is to work with these patients to help them manage their communication. These pathologists educate both the family and schizophrenic patient, and this is vital to enable the patient to communicate about their feelings and conditions about CDV’s. Communication is essential in ensuring that the right medication and decisions are made and limits the probability of misdiagnosis (Lee et al., 2017).
Apart from exercise, diet is important in enabling CDV patients to manage their conditions and live a healthy life. Dieticians help schizophrenic patients suffering from CDV’s and their families develop a healthy eating plan that is focused on the health needs of the victim. The objective is to enable the schizophrenic patient to eat healthy to reinstate their health condition or avoid risks factors that may lead to CDV. Emotional, practical and social support are required for schizophrenic patients with CDV and their families. These forms of support aid in relieving pain and gaining a better understanding of the system and social workers provide this support effectively (Lee et al., 2017). The families of schizophrenic CDV patients and the patients may take the initiative of enrolling themselves in societal groups that may offer these types of support or nurses, and other practitioners may pinpoint an organization where this support may be sort from. The main role of social workers, in this case, is to enable families, schizophrenic patients suffering from CDV adjust to changes, and experiences brought about because of the rehabilitation process (Azad et al., 2016). Pharmacists are also an essential professional in caring for schizophrenic patients with CDV. The medication provided to these patients may have effects and pharmacists may provide the information regarding these effects.
In some cases, the drugs provided may be ineffective, it is the role of the pharmacists to review the medication and advice health professionals on what changes can be made if necessary. Volunteers also work in close association with the health practitioners and aid in providing practical and emotional help. These include tasks such as getting schizophrenic patients to appointments. Specifically, volunteers do not replace paid health practitioners — psychologist’s aid in managing social factors, behaviors, and emotions related to schizophrenia and CDV. Psychologists may develop non-drug approaches that aid in the management of pain and health.
Pastoral care workers and chaplains are also essential healthcare professionals in managing schizophrenic patients suffering from CDV. Regardless of religion, pastoral care workers and chaplains provide emotional and spiritual support in rehabilitation.
The proposed plan of care and support
There is a need to develop a plan that is both manageable financially and sustainable in caring for schizophrenic patients with CVD. Lifestyle concerns are an important factor in the management of CDV. Practices such as smoking which is widely associated with CVD mortality is high among Schizophrenic patients as compared to the other population with indexes standing at about three times higher. Programs to ensure that these categories of people are educated against such practices are important as a health intervention to enable schizophrenic patients to limit risks for developing CDV (American Diabetes Association, 2015).
Schizophrenia is associated with a sedentary behavior that is associated with an increased risk of being overweight, a prerequisite risk for developing CDV. A plan to ensure that schizophrenic individuals engage in physical activities is essential and to improve their fitness hence reducing risks of developing Cardiovascular related illnesses (Bresee et al., 2010). The activities selected for a schizophrenic patient have to consider their functioning levels, and the nature of the psychiatric setting the victim is exposed to. Diet is also an important consideration when developing a care plan for schizophrenic patients. To avoid include foods rich in calories, carbohydrates, and fats as they increase the risk of CVD. People with schizophrenia have unhealthy diets if let to make diet decisions on their own, so it is important to develop a plan with balanced nutrition. Eating habits also have to be observed to ensure that these patients are served the right amounts of foods so that instances of overeating or undereating that may lead to eating disorders are minimized (De Hert et al., 2011).
Medication with Antipsychotic is a central and significant element in the treatment of schizophrenia. Some of this medication are obesogenic hence the need to ensure that these patients adopt an active lifestyle to reduce instances of developing CDV risks (Bresee et al., 2010). Adherence to medication is also a problem given the personal suffering associated with them, hence the need to include a plan that makes drug adherence a priority among these patients, and effectively may be making a family member monitor these patients to ensure that they do take their medication as prescribed.
Conclusion
Schizophrenia may be a rare condition but based on the facts, the economic burden is high, and interventions have to be made to ensure that the condition is managed and people suffering from it live a quality life, similarly to the other citizens in the country. Mortality and morbidity cases related to cardiovascular diseases are high among schizophrenic patients, hence the need for families and health professionals to intervene. Their sedentary lives and behaviors are considered as the main factors in them developing cardiovascular-related illnesses, whereby these diseases can be easily managed if proper care is initiated in time.
Various professionals are involved in the management of the health of schizophrenic patients, from families, social workers, nurses and even psychologists. Of importance is to ensure that proper communication is maintained for medication and all vital information assessed before decisions regarding the health of the victim are made. Schizophrenic patients also have the right to be involved in decision-making and made aware of the practices they are made to go through as a way of limiting aggressive behaviors that may be depicted at times.
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