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* = Presenting author

N024 Nursing management at Crohn’s disease: functional health pattern model

B. N. Ozgursoy Uran*1, Y. Yildirim2, Y. Tokem1, E. Saritas Yuksel3, G. Arslan3

1Izmir Katip Celebi University, Health Science Faculty, Nursing Dep., Izmir, Turkey, 2Ege University, Nursing Faculty, Izmir, Turkey, 3Izmir Katip Celebi University Ataturk Education and Research Hospital, Izmir, Turkey

Background

With regular feeding, regular drug use, and regular checks, the extension of the remission process should be ensured by the planning and application of nursing management according to the patient’s needs in the management of chronic diseases. The aim of this case study is to obtain the patient’s evaluation according to the Model of Functional Health Patterns to empower and enable the patient to live with IBD.

Methods

A 51-year-old patients (SC) was diagnosed with Crohn’s disease (CD) 8 years ago. Over the last week, he was admitted to the gastroenterology clinic after complaining of oral intake disorder, going to the toilet 8–10 times a day, and fatigue. Because of his recent complaints, he expressed himself as being ‘very bad’. He had loss of appetite, nausea, and diminished taste perception. Although oral intake was open, his nutritional needs were met through an hour with 60 mL of intravenous TPN. In the last 2 months he had lost in weight (about 8 kg), and his body mass index was weak with 17.52. His fatigue score (VAS) (0–10) was 8 points; pain score 7 points. Table 1 includes the patient’s history of CD. The nurse has major responsibilities in the management of the patient with CD. The role of the nurse varies according to the patient’s needs. Disease management of the IBD nurse towards patient care provides a cost advantage by reducing waiting times at the hospital, preventing unnecessary hospitalisation, and improving the delivery of innovative services. The IBD nurse focuses on patient needs, choices, and ability to cope at IBD education. In the studied patient, there were some problem such as fatigue, pain, and discharge problems in this case study. As the planned training and the level of information about the disease has increased, and the patient has resumed regular feeding, quit smoking, and use of drugs and regular medical checks was proposed and supported, the patient has begun to participate in self-care recognize his problem.

Results

The health / disease story according to the functional health patterns model is shown Tables 1 and 2.

Table 1 Health / disease story according to the functional health patterns model

Functional health patternsStory / condition
Perception of 
health / health 
managementBecause of his recent complaints, he expressed himself as being ‘very bad’; because the case being improved in about 3 days; he mentioned that he ‘did not know how many more days’, ‘worried that this situation’ and that he was ‘not as healthy as one used to be’; he used to smoke
Nutrition and 
metabolismAlthough oral intake is open, his nutritional needs are met through an hour with 60 mL of intravenous TPN; in the last 2 months he lost in weight (about 8 kg), and his body mass index is weak (17.52); his observed fluid intake was insufficient
ExcretionHe had CD for about 8 years, so his defecation 
habits vary; when he eats, foods trigger the CD and lead to up to 15–20 times daily defecation; if he watches his diet, he goes 5 times a day for defecation, and he stated that he never had any trouble
Activity-
exerciseHis vital signs are normal (fever 36–37 °C; breath 18–25/min; pulse 70–92/dk; blood pressure 100–
130/50–70 mmHg). He depends on going to toilet, climbing stairs, and walking, but semi-depends on eating and drinking, dressing, and undressing and moves in
Sleep-restHe explained that he was sleeping only 4 hour at night and woke up tired; his pain has increased at night because of the frequency of defecation
Cognition and perceptionThe patient has no problems with hearing or perception; person, place, and time orientation is available; there is no problem with the instant, short-, and long-term memory
Self-perception and self-respectHe looks worried and thinks to continue 
considering the complaints after being discharged from hospital; therefore, it was determined that he needs information about nutrition, drugs use,and exercise related the CD
Roles and 
relationshipsThe patient lives at home with his wife and 2 children; because of CD, he was forced to retire at an early stage, so he lives with financially 
difficulties and he works in temporary jobs when he feels better; his wife and children support him
Sexuality 
and fertilityThe patient stated to avoid sexual intercourse because of pain and frequent defecation
Coping 
and stressWhile he was living with anxiety and stress disorders because of the illness, he felt worse for himself because he was using a diaper for defecation and miction; no method adopted to deal with his illness
Values 
and beliefsPatient stated that he cannot interview with 
relatives and friends, cannot adequately deal with his kids, wants to return to healthy days; but also stated that there is no hope in this regard

Conclusion

The nursing process about CD was explained according to the functional health patterns model, and the patient gained the ability to manage his CD more effectively.