Chapter 1

In the present day, the number of individuals being diagnosed with chronic illness continue to increase due to the changes in lifestyle that increase the risk of illness among individuals in the society (Megari, 2013). In the interview, I had an opportunity to discuss the coping strategies that individuals undertake upon diagnosis of a chronic illness through highlighting the social, psychological and emotional consequences on the individual. The participant of the interview, Mr. X that has been recently diagnosed of having diabetes at the hospital by the general physician. The participant was very cooperative during the interview and also was willing to share his experiences in coping with the new diagnosis that has resulted in a total change of this lifestyle through the assistance of the multidisciplinary team at the hospital as well as his family. Prior to conducting the interview, I had sought out the consent of the participant as well as providing the topic of discussion and the reflective question that I was going to ask him during the interview. Based on the preparation of the interview, the participant shared his experiences before and after the diagnosis was established while at the same time highlighting some of the challenges that he experienced in terms of his lifestyle so that he could effectively cope with the new diagnosis. The purpose of the interview was to draw upon the experiences of the participant regarding coping with a new diagnosis in order to understand the various challenges as well as triumph attained so that I can get insight into supporting patients with new diagnosis during my practice. 

During the interview and also while listening to the audio record of the interview, listening the participant share their life experiences in regard to coping with a new diagnosis of diabetes is a little nostalgic. This is because through listening to the person, one gets the insight regarding the personal and individualized experience of chronic illness that provides a totally new dimension in regards to the management of patient at the healthcare facility. This is evident because as a nurse working in at a health facility that serves chronically ill patients; often the relationship is defined by the role of a nurse toward the patient therefore resulting into a nurse-patient relationship that is usually professional. Through the interview rather, the participant shares his experiences regarding coping with the new diagnosis on a personal basis therefore making the interview mood filled with empathy due to the emotional and psychological impact of the response provided. Also, through maintaining eye contact with the participant without staring during the interview, it was very emotional listening to the participant share his experiences prior to the illness as well as after the illness. This is because, prior to commencing the interview, I had a moment with the participant where we shared a lot of experiences regarding everyday life such as hobbies, functioning within a family and also the significance of good health. Therefore during the interview, the description of the events that unfolded prior to the diagnosis as well as after the diagnosis created a sober mood in the room because of the vivid and clears description of the changes and challenges that were experienced. On the other hand, apart from the emotional consequences of the interview, listening intently to the participant also triggered me to conduct an active reflection of my practice values and attitude towards new diagnosis among the patients that visit the facility. This is because the description of the experiences and life changes that have occurred due to the development of diabetes has changes the lifestyle and habits of the participant so much that nursing care should be extended to the home and family of the participant. In undertaking an active reflection of my nursing practice in the society, I realized that nurses should be actively involved in assisting patients with new diagnosis of chronic illness to adopt effective coping mechanisms that will promote their quality of life. For nurses and other multidisciplinary members such as nutritionists and physicians, the provision of support through training resources or counseling and education provides knowledge and empowers the patient to benefits from the care provided.

Chapter 2

The response of the participant during the interview can be considered to be a representative of the experiences of new diagnosis of chronic illness. One of the significant responses of the participant during the interview is the adverse emotional and psychological significance of the new diagnosis that was characterized by denial, depression and anxiety. Mr. X responded that upon the establishment of the diagnosis, he had anxiety and depression due to the severity of his condition and he went into a state of denial because he viewed himself as relatively healthy. The adverse psychological and emotional reaction to the new diagnosis by the participant is an important indication of the challenges individuals experience upon disclosure of a diagnosis of a chronic illness. In undertaking a further analysis of the interview, some of the responses that are considered to be a representative of the experiences of the patient’s coping with the new diagnosis of diabetes include the health seeking behavior of the participant. The interview addressed the health seeking behaviors of the respondent through questions seeking to establish the frequency of health checkups or the lessons that the participant learn through the experience. In responding to his health seeking behavior prior to the new diagnosis, the participant hardly went for health checkup unless he was ill or it was mandatory to go for health checkups due to the requirement of his job. Therefore from the response of the participant it was evident that health seeking behavior among individuals is important in promoting timely interventions in the management of health problems. Furthermore, apart from the health seeking behavior of the patient, another response that is considered to be a representative of the experiences of the patient’s coping with the new diagnosis of diabetes include the history of the presenting illness that is, prior to the establishment of the diagnosis. According to the participant, some of the presenting symptoms of diabetes included increased frequency of urination especially during the night, increased hunger and thirst that he acknowledge to be highly unusual to him. Despite experiencing such symptoms early in the course of the illness, the participant did not seek healthcare services until he noticed a significant change in his weight which was evidenced by the reduced waist circumference as the participant stated, “my trousers no longer fits me around the waist.” Also, one of the significant representatives of the responses regarding the experiences of the participant regarding the new diagnosis is also significant in understanding the impact of the new diagnosis on the health and wellbeing of the patient. The participant responded that through the support of the healthcare practitioners, he understands the various methods of coping with the chronic illness and he identified a change in lifestyle through exercising regularly, replacing fast sugars and fats with a diet that is rich is protein and complex starch and cutting down on alcohol and smoking. The response from the participant regarding the lifestyle changes that have occurred as a means of coping with diabetes indicates the importance of providing information and support to the patient regarding the management of chronic illness such as diabetes. In addition, the coping mechanism that the participant has adopted in order to promote his health and well-being in the society amidst the challenges presented by the illness are also some of the representative samples that are important in understanding the experiences of the patient. In line with the interview, a good representative sample that indicates the experience of the patient regarding the new diagnosis include challenges such as managing the poly-pharmaceutical regimen of anti-diabetic medication to regulate blood sugars. Therefore based on the experiences of the participant, I have managed to get insight into the management of patient with a new diagnosis of a chronic illness in the community.

The new insights that I have gained regarding coping with a new diagnosis of chronic illness is that for the patients, a new diagnosis comes with adverse social, emotional and psychological impact on an individual. According to Livneh (2015), new diagnosis of chronic illness such as diabetes or cancer predisposes an individual to adverse psychosocial situation due to the impact of illness on the quality of life. Therefore, due to the significance of new diagnosis on the quality of life and wellbeing of an individuals and the family, nurses should assist the patients towards coping in the community. The new insights into the management of patients experiencing adverse psychosocial conditions due to new diagnosis involves the promotion of an individual’s copping mechanism through providing social support through establishing and maintaining an effective working relationship with the patients. In the management of the patient, establishing an effective working relationship is important because it provides an opportunity for building trust that enables an individual to open up or seeking support within the care environment (Livneh, 2015). Also in regard to the psychosocial conditions caused by new diagnosis, the interview has enabled me to have a new insight towards providing a conducive environment that will enable individuals that are diagnosed with new illness to express themselves. This insight is important in promoting effective coping amongst individuals because through the expression of oneself, an individual communicates his/her own fears, concerns as well as expectations regarding the outcome of the illness (Engevold & Heggdal, 2016). In the nursing management of patients, effective coping can be promoted through understanding the fears and concerns of the patient so that the nurse can work alongside the patient to set realistic goals towards coping that are based on the knowledge and health condition of the patient.

Furthermore, other new insights developed through the interview include the significance of including the patient in the management of their own care so that the patient can be in control through contributing in setting goals and planning interventions alongside other members of the multidisciplinary team such as the nutritionists and the physicians (Gafvels, Hagerstrom, Rane, Wajngot & Wandell, 2016). This is important because to promote the quality of life and wellbeing of the patient so that the patient can effectively cope with the new diagnosis, a feeling of control on the part of the patient is important in building upon the self-esteem of the patient. Therefore, including the patient in the management of his/her own care is an important step towards promoting effective coping mechanisms in the management of chronic illness. Also in the management of patient, the community nurse alongside others involved in the care of the patient should be involved in the provision of information to the patient so as to empower the patient towards developing knowledge and skills that are essential in making decisions regarding their own care (Engevold & Heggdal, 2016). The provision of information regarding the course of the illness as well as the effective interventions towards the management of the chronic illness promotes coping because the patient can effectively contribute in setting realistic goals. The insights developed towards promoting coping among patients with new diagnosis of chronic illnesses such as diabetes or even cancer builds upon the development of new nursing approaches in the community. 

Chapter 3

In nursing practice, interviews is one of the most common and important methods that nurses use to collect valuable data regarding patients. Nursing interviews are an important part of nursing research because it provides new evidence regarding the various aspects of providing care to patients. Through the interview process, I have learnt that the development of a new diagnosis of chronic illness sets an individual into adverse emotional, social and psychological situation due to the impact of illness on the holistic aspects of an individual. This is because throughout the interview process, adverse emotional reaction to the various aspects of the new diagnosis such as experiences of the participant prior and after the diagnosis resulting in adverse emotional reactions on the part or the respondent. Due to the significance of emotions in the interview process, I have learnt that emotional intelligence is important in conducting nursing interviews because the response touches on sensitive matters regarding the respondent. Furthermore, during the process of conducting the interview, the questions to be put across to the respondent should be designed in such a way that the questions are culturally sensitive to the participants. This is an important consideration in the process of the interview because cultural sensitivity is important because it allows the interviewer to effectively participate in the interview process as well as respond effectively to the question. Also, other important aspects learnt through the interview process is based on the significance of providing support to individuals in the community in regard to the management of chronic illnesses such as diabetes. This is because due to the psychosocial and functional impact of new diagnosis, individuals require social, emotional and psychological support from the family and other support system available within their environment. The interview process was also important in highlighting the factors that are associated with the ability of an individual to effective cope with the chronic illness after the diagnosis is established. The interview process highlights the importance of providing a person-centered approach whereby the various factors that are associated with the quality of life and wellbeing of the patient are considered as priorities that should be addressed first. For example, the interview addressed factors such as the involvement of the patient in the management of care, providing information to the patient regarding the illness and developing effective supporting system for the patient. Therefore based on all these, the interview process is an important part of nursing research that identified new information that contributes to the development of new strategies in nursing practice that will be effective in filling the existing gaps in knowledge within the nursing profession. 

In conclusion, the interview process was undertaken to establish the coping strategies of individuals that are newly diagnosed with a chronic illness such as diabetes in the community due to the changes in lifestyle that increase the risk of illness among individuals in the society. In discuss the coping strategies that individuals undertake upon diagnosis of a chronic illness through highlighted the social, psychological and emotional consequences on new diagnosis through the experiences of the participant. The interview process provided valuable information that was effective in developing new insights regarding the management of patients with new diagnosis. Among the new insights developed include the need for addressing the adverse social, emotional and psychological issues associated with new diagnosis, providing information to the patient to develop the knowledge and skills that are essential in making decisions regarding care and supporting the patient.