Individual's Health: Interpersonal, Intrapersonal and Community Factors

This study will be looking at factors that influence an individual's health such as interpersonal, intrapersonal and community factors. The positive and negative effects of these factors will be outlined throughout the study. Also, attitudes and views towards an individual's view of health will be discussed. Due to legislation surrounding confidentiality according to the NMC (2018), the patient referred to throughout this study will be known as Mrs A. Mrs A is an elderly lady living in the Barnsley area. Mrs A was a current smoker until her latest hospital admission.

She had smoked around fifteen cigarettes a day for over sixty years. Her past medical history includes Cerebrovascular Accident (CVA), hypertension and chronic obstructive pulmonary disease (COPD). She has also recently had two burst aneurysms than have led to a Subarachnoid Hemorrhage (SAH).

My reasoning for choosing Mrs A to be the subject of this study is due to the belief I have that her lifestyles factors may have had a large impact upon her health over time.

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I am also interested in finding more out about the link of her lifestyle factors on her health. Also, Mrs A manages to cope well in life regardless of her medical history and deteriorating health. She is quite active with social activities and daily activities independently or with minimal assistance from her husband. Mrs A struggles due to her COPD with walking great distances and stairs due to breathlessness. This can sometimes affect her independence with her mobility due to having to loan a wheelchair.

Also regardless of the previous health complications and conditions she has been diagnosed with and received, she still continues to smoke. Mrs A has suffered a stroke, has been diagnosed with COPD, hypertension and has had a hemorrhage on her brain yet still continue with her lifestyle choices which intrigues me as to why.

World Health Organization, (2018), define health as "a state of complete physical, mental and social well-being" and not just being without ill health or disease. World Health Organization also state through their principles that there are other factors affecting health. These include examples such as compliance by individuals with their health and uneven distribution of resources in different demographic areas. Mrs A defined 'health' for herself as 'being able to be at home with her husband and being able to care for herself'. She is aware that she is not in full good health, however she believes she copes and manages well for a lady of her age.

Mrs A health conditions such as hypertension, COPD and her injuries obtained can all be related to choices in which she has made throughout her life. Fabbri, L.M., (2016), states COPD, strokes, diabetes, hypertension and coronary heart disease are just some of the diseases that can be caused from smoking. The lungs are believed to be the most obvious organ affected from smoking, even though it has a large overall impact on an individual's health. NICE, (2018), state that two thirds of people suffering with COPD in the United Kingdom are not diagnosed.

Mrs A has had COPD for a number of years which is believed to be attributable to smoking. Pu, C. et al., (2017), define COPD as a respiratory disease with recurrent symptoms, acute worsening of symptoms and deterioration of the lungs. COPD is in the top five most common causes of death in the world. Berry, C.E.E. & Wise, R.A.A., (2010), suggested COPD will be developed in fifty percent of the population who smoke. A crucial implement in treating an individual with COPD is smoking cessation. Mrs A is currently prescribed nicotine inhalers in order to assist in this lady withdrawing from smoking after accepting nicotine replacement therapy. The effects seen are positive from this intervention as she no longer craves a cigarette or asks to go outside for a cigarette. Mrs A also stated that she can notice a difference when walking around as she doesn't feel as breathless as she previously had before stopping smoking.

Mrs A had suffered a subarachniod hemorrhage after having two burst aneurysms. Centers for Disease Control and Prevention (CDC), (2018), state that a Subarachnoid hemorrhage is a form of stroke that is not seen often. This type of stroke consists of a bleed on the brain, which is situated within the brain and the narrow tissue layer surrounding it. Swann, J., (2013), state a person who smokes is fifty percent more like to suffer a stroke than a non smoker. This suggests that Mrs A's smoking habits could have had an impact on the injury in which she had obtained. This also lead to her having a CVA post op. The impact this has taken on Mrs A's health is substantial as it has affected her memory and caused problems when socialising: such as struggling to find words and initiate conversations.

Firstly, we will cover the intrapersonal factors surrounding lifestyle choices that Mrs A has chosen throughout her life that have impacted her health. Cambridge University Press (2018), define intrapersonal factors as factors associated with what is inside an individual's mind. This includes factors such as beliefs, attitudes and personality. As mentioned previously Mrs A smoked around fifteen cigarettes a day for over sixty years before her most current admission to hospital. Mrs A said she is now aware of the dangers associated with smoking, however when she had first started smoking the education on cigarettes was not known: she had little knowledge on the information surrounding smoking.

Katainen, A., (2006), states the issues that can arise from smoking aren't regarded as a risk taking opportunity. However, the problems that can be cause are associated with being inevitable due to the person's addiction. Even though people who smoke are education on the health risks associated with smoking, they continue to smoke still with the knowledge. Also, individuals believe smoking is a decision that is made on a personal level and that they have the right to make choices surrounding their health regardless of the issues associated with the choice they made, (Heikkinen, Patja & Jallinoja, 2010). Mrs A believes that smoking was a choice that she had made and must be willing to deal with the consequences regarding her health that surrounded the issue.

Mrs A stated that she enjoys smoking and find pleasure in it even after being educated and understanding the negative effects on smoking. Dependance on cigarettes tends to be seen more in women that smoke; and women are more likely to find smoking highly pleasurable (West et al, 1999 cited in British Journal of Nursing, 2008). As research shows nicotine is a very addictive substance. Royal College of Physicians (2016), state that smoking cause addiction and can be very dangerous. Nieva et al., (2011), states that personality amongst other influences have been linked to an individual beginning to smoke, continuing to smoke and stopping smoking. Kim, Sung Reul et al., (2019), states that Type D personality showed significant correlation with an individual's addiction to nicotine. It also has been linked to a lower probability of a person being able to quit smoking even after receiving professional help to quit. The definition of Type D personality is the avoidance of social interactions and high levels of negative emotions (De Fruyt and Denollet, 2002 as cited by Dehghani, F., (2018). Although, Mrs A does not show these qualities of Type D personality all the time, she projects that she tends to smoke more when she is placed in socially awkward situations as an escape. She also states that she smokes more when low in mood.

This essay will now continue to look at interpersonal factors. Cambridge University Press (2018), define interpersonal factors as issues relating to social bonds between individuals. These include factors such as family support network, community, social and the workplace. Statistics and figures regarding people's health in certain demographic areas suggest that where an individual lives can affect their health and their lifestyle choices. Several observations have been carried out and shown potential impacts that interpersonal factors may have on an individual's avoidance in certain tasks, (Finkel et al., 2006, Richeson and Trawalter, 2005 as cited by vanDellen, M. R. and Hoyle, R. H., 2010). The statistics provided suggest that the area in which Mrs A lives in, provides worse statistics that the national average for factors surrounding her health. NICE (2018), state differences within people's demographic areas are linked with the total number of cases of COPD, varying with more and less deprived areas.

Barnsley Metropolitan Borough Council, (2016), state that over twenty three percent of women in the patients demographic area smoke. These figures suggest that the demographic area is within the top ten highest smoking rates for women within Barnsley. Overall, the percentage of smoking prevalence in Barnsley is over twenty one percent and between the ages of seventy to seventy four is around sixteen percent. Barnsley Metropolitan Borough Council, (2016), findings suggest that hospital admission attributed from smoking are excessively greater in Barnsley than the national average for England. Individuals being clerked into hospital for COPD in emergency situations is also almost double the national average for England. Barnsley is a working class community, it is suggested that smoking is now being branded as a habit taken up by working class citizens (Graham, H., 1994).

Yorkshire is known for its historical influences which include coal mining mainly associated with males and the textile mills associated with women. These were jobs that were carried out by a large number of the population in Mrs A's demographic area, (South Yorkshire Historic Environment Characterisation Project, n.d). There were also mills and pits situated within this area which could of affected the health of Mrs A. Hendrick, D (1996), states that exposure to certain substances and environments within a workplace, including cotton mills and the mines can have an affect on the health of individuals surrounding breathing related issues. Mrs A's previous employment included working in the textile mills, before the closure of the textile mills in the late seventies. Perfitt, B.J., (2014), states that the textile mills began to fail in the late twentieth century. It is suggested that as early as 1835 over fifty percent of textile mills were based in Yorkshire. Also, the three main jobs available to women involved spinning, weaving and mending. Each of these jobs proved to have extremely tough working conditions relating to an individual's health associated with them.