Model of Psychodynamic Psychotherapy - Free Samples to Students

Question: Discuss about the Model of Psychodynamic Psychotherapy. Answer: Introduction Acute Rheumatic Fever (ARF) describes a sequela of streptococcal infection-characteristically after two to three weeks following group A streptococcal pharyngitis which takes place most frequently among children and has cardiac, rheumatologic, and neurologic manifestations. The ARF incident has dropped in advanced economies, and several physicians have little or no practical experience with diagnosis alongside management of ARF. This paper seeks to demonstrate the pathophysiology alongside main clinical presentations of ARF by taking into account a particular case of Sue (case study 3), 14-year-old native girl, who was diagnosed with ARF. Later, the paper would further focus on the nurse role in the provision of suitable care to adolescents and members of their families taking into account the current nursing practices. ARF is manifested by nonsuppurative inflammatory lessons of heart, joints, central nervous system and subcutaneous tissue. The literature has demonstrated that, at least in advanced economies, rheumatic fever proceeds pharyngeal infection with rheumatogenic group A streptococci (Webb, Grant Harnden, 2015). The rheumatic fever development risk following a streptococci pharyngitis episode is estimated at 0.3 to 3 percent. Some studies have also associated rheumatic fevers amongst the aboriginal population of Australia to streptococcal skin infections (Burke Chang, 2014). The tissue injury occurring in rheumatic fever is accounted for by the molecular mimicry. Both cellular and humoral host defense of a genetically vulnerable host remain engaged. The immune responses of the patient, in this process for both T- and B-cell mediated cannot distinguish between such microbes that invade and some host tissues. T helper1 alongside cytokine Th17 seem to be central mediators of rheumatic heart disease. The resulting inflammation might persist past acute infection and generates the rheumatic fever or protean manifestation (Gewitz et al., 2015). The initial step is a pharyngeal infection by Streptococcus pyogenes, proceeded by antigens presentation to the immune B and T cell. The production of particular chronic and acute stage antibodies (IgM and IgG) results from the CD4+ cells activation by lymphocytes. Such antibodies alongside activated T cells react with structurally identical peptides or proteins in tissues of the heart that is known as the cross-section. Consequently, the heart will be inflamed. The joints will then develop swelling alongside pain because of accumulation of immune complexes that antigen-antibody merger have formed. The skin and chorea rashes or the nodules are the additional manifestations of such immune activation, in basal ganglia alongside skin in that order. The M protein and N-acetyl-beta-D-glucosamine antigens will mimic one another alongside the myosin in cardiac muscle. Such molecules have an identical antigenic structure with myosin which is the human muscle protein. Antibodies are formed hence reacting with human heart valve tissue. The CD4+ cells will stick to as well as burrow into endothelium of the valve due to VCAM-1 molecules overexpression thereby activating the cellular immune response within the valve. The inflammation of the valve tissue thus follows with new blood vessels growth. The T cells availability thus ensues due to the surged supply of blood resulting from such vessels. Several antigenic attraction spots will occur on the valve, on such proteins as tropomyosin and vimentin thereby making T-cell attack stretch to further areas. The Aschoff bodies or granulomas the form underneath endocardial heart layer. Calcification further takes place a share of such information and is connected the osteopontin levels. Additional inflammation markers like CRP alongside oxidation protein products that are raised in a patient with RHDs blood. Nurses play an important role in symptom management to alleviate the complication of the illness. To accomplish this, nurses must comprehend the illness pathophysiology as well as have patients development stage, age as well as other associated variables of the patients which would assist them in offering patient-focused or individualized care (Dunkel Harbke, 2017). The physical maturity alongside the overall development of children is distinguished from those of adolescents which influence the process of healing, metabolism of medication as well as pathophysiologic processes. As indicated in the case study 3, Sue is a 14-year old girl and hence, falls in the adolescent bracket, in which the social, physical, cognitive as well as personality development range from childhood (He et al., 2016). Some developmental indications entail surge in height and weight and so on. Girls attend their puberty between thirteen and sixteen of age as well as the level alongside the activity of the pituitary-released hormones surge (Maier Kommer, 2016). However, such alterations, as well as hormonal changes in the adolescents, influence their behavior and accomplishment, whereas they are increasingly busy developing their corresponding personal identity. This calls for tremendous psychological, as well as social support and nurses, play an imperative role in this respect by making sure that the privacy of the patients are guaranteed as they provide healthcare and respect their ethical identities. Growth and Development Theories The theories of development and growth might be useful for this given case study. The theory advanced by Erickson relating to the psychosocial development alongside Piaget's theory remains relevant. As indicated in the Piagets theory, the adolescents thought process in the course of the formal operational stage might be regarded systematic progressively, mature, abstract, logical as well as reflective (Bjorklund Causey, 2017). This demonstrates that adolescents might take own life decisions, and hence they require involvement in their care plan. Therefore, the adolescent is regarded as an essential age bracket whereby they become mature both cognitively and physically. According to Erickson theory of psychological development, the adolescents give primary attention to their formation of identity, self-identity search and hence leading to the independence sense from their corresponding parents, and occasionally surges dependence on their peers (Malone et al., 2016). This might hardly be life-threatening when adolescents are swayed away by their relevant peers. A typical example in this setting might be peer pressure to consume alcohol, smoking, and substance abuse which affect the adolescents health to a higher degree. It is a fact that nearly seventy percent of young adolescents affected with this illness are further massive smokers. Therefore, it might be stated that Sue needs to be educated by the care practitioner or professional that might teach her how the illness is affecting her health as well as urging her to stop the predisposition factors (Darling-Fisher Leidy, 2015). It has been mentioned in the previous studies that educating the adolescent patient on a given disease promote their better understanding that continued assistance improve their QoL. Family-Centered Care Family-centered care is further imperative when caring for adolescent patients. This both family members and parents are primary and immediate contact points for adolescents that them to pose better understanding and knowledge regarding their children and adolescent. This kind of approach stays effective because it encompasses building a partnership among the family members, care professionals as well as children (Greene, 2017). Openness communication with parents regarding the care concerns of their children outlines the importance of rapport and trust building. The family-centered cares fundamental factors regard family as both culturally responsive as well as stable assistance and support (Hill, Knafl Santacroce, 2017). Based on Sues case, it might be highlighted that she and her family need to get proper care and must be accorded the best opportunity to access essential healthcare resources. This is because of an insufficient report on values, lifestyle and customs of the Aboriginal and Torres Strait Islander alongside their impact on healthcare practices Davidson, 2017 (). It has been highlighted that health care providers that look after the natives in Australia must remain culturally sensitive, empathic, recognize native family structure, land, community, family and health history. Thus, family-centered care remains a central portion of multidisciplinary team whereby health associated and additional concerns which affect QoL are solved successfully (Festini, 2014). Hospitalization negatively and positively influences the family and children. Hospitalization promotes patient care and makes patients understand why it is imperative to seek medical advice. On the flip side, hospitalization/admission might surge stress on the patient, insufficient support of which might affect the QoL of adolescents and their corresponding members of the family. Occasionally, it is observed that members of the family become anxious because of the context which results in hospitalization (Franck et al., 2015). Thus, getting engaged in adolescent care alongside being increasingly informed allow parents to lower their stress levels. Conversely, the absence of stress among parents might affect the health of their children. The role of family members could be changed when parents are distributing their respective work responsibilities as well as equally taking care of their other kids, negligence of which might affect the remaining siblings health (Knight, 2017). Thus, it is significant that healthcare providers encourage and support the access of parents to healthcare resources to meet similar demands and needs. Adolescents together with their parents might be ushered in members of the same age and suffering from single health concerns, whereby they can share and discuss their concerns and experience (Demetriou, Shayer Efklides, 2016). It might also assist them to comprehend progression of illness, efficient coping strategies alongside healthy-lifestyle selections/choices. This gives better health outcomes. The adolescents and members of the family will be referred to other suitable health professionals that guarantee better healthcare provision. For example, a healthy diet could be prepared by nutritionist create proper diet chart for the illness affected adolescents thereby boosting their immunity power as well as save them from the sudden loss of weight through cell rejuvenation (Rmond et al., 2015). The considerate aerobic exercises might assist Sue to remain active as well direct their energies towards daily living tasks rather than getting deprived daily, as a result of a long-run disease. Whereas people live with such enduring illness, it is the responsibility of healthcare providers to teach them practical coping mechanisms so that they can survive for the balance of their corresponding lives while still uncompromising QoL. Conclusion It can be mentioned that ARF is a chronic disease which affects both wellbeing and health of the infected person. The healthcare providers must remain supportive and assist such patients to easily access sufficient care linked to resources so that they can meet their healthcare needs effectively. The healthcare providers must give culturally competent care as well as maintain quality healthcare system. They must make adolescent together with their respective members of family fathom the significance of family-focused care which might assist them to maintain wellbeing and health through their separate lives. References Bjorklund, D. F., Causey, K. B. (2017).Children's thinking: Cognitive development and individual differences. 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