Reference no: EM133846047

Question

Matt Redman is a 20-year-old trade school student who is studying commercial heating and ventilation systems. He was diagnosed with Stage I testicular cancer two years ago. Matt clearly recalls the day he was diagnosed stating, "My family doctor never looked so pale. He asked me to sit down to hear my test results. His words of 'Matt, you have testicular cancer' still resound in my head."

Matt thought there couldn't possibly be any truth to the diagnosis since he was only 18 years old. As the doctor began to list the steps Matt would need to take for surgery and chemotherapy, Matt felt as if he were "in another world and at the mercy of the cancer and treatment regimen." He was fearful and questioned the doctor, "Am I going to die?"

In the few days following Matt's diagnosis, he decided to learn everything that he could about testicular cancer, research treatments on the Internet, find a support group, and involve and remain close to his family and friends throughout his treatment. He reminded himself of the positive things in his life: his girlfriend, Amanda, his studies, and his many hobbies. Matt became determined to have power and control over his life.

Matt now talks with other young men about their diagnosis of testicular cancer and his own experiences. He admits that from the time of his diagnosis, throughout his treatment, and even now, he sometimes feels like he is on an emotional roller coaster. Matt credits a source of his empowerment as access to information, resources, and support. He feels that he lives a full life, but does admit to worrying about the possibility of future illness.

1. How do you think that Matt would define power/powerlessness? Over the course of his illness, do you think that Matt has experienced powerlessness? If so, when was his first experience? What other times of powerlessness do you think that he has experienced?

2. What types of threats to well-being and multidimensional changes and challenges do you think that Matt and his family experienced at diagnosis? Over the last 2-years? Now?

3. The phenomenon of powerlessness is dynamic and complex in chronic illness. Feelings of powerlessness can recede and advance throughout the course of the chronic illness as individuals negotiate between control and loss and the changing landscape of their daily realities. Powerlessness can extend beyond medical and treatment issues to feelings of insecurity and threats to social and personal identity. What do you think that Matt has experienced over the course of his illness? His family? His friends?

4. Chronic illness is described as a complex dialectic between the individual and his other world. Clients shift between the perspectives of wellness in the foreground and illness in the background. Using the Shifting Perspectives Model of chronic illness, how would you describe Matt's experience? How can you apply the principles of the Self-Determination Theory to Matt's situation?

5. What problems and issues associated with powerlessness do you think that Matt and his family experienced? Do you think that he/they were ever consumed by Matt's chronic illness and its treatment regimens? What strategies do you think that Matt/his family used to diminish feelings of powerlessness?

6. The nurse-client relationship emphasizes the primacy of the client's own ideas, emotions, and beliefs about the chronic illness. Within this relationship, the nurse must provide information and opportunities for choice and negotiation regarding treatment-related issues. What considerations and steps might you take to promote Matt's empowerment? His family's empowerment?

7. Outcomes associated with powerlessness in clients with chronic conditions can be measured from three perspectives: self, relationships with others, and client behaviors. What specific outcomes do you think that Matt would want? His family? His friends? His healthcare providers?