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NRSG 366 Partnerships in Chronicity For Prioritization Assignment

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Describe the Partnerships in Chronicity For Prioritization.



Prioritization is a very important concept that should be put into practice whenever delivering healthcare services to the patients. It is necessary because of the scarcity of resources and unlimited patent needs that should be met while attending to them. Prioritization should be a key principle to be adhered to when serving Michael. From his medical records, Michael has a multimorbid condition. He suffers from chronic illness including Type 2 Diabetes, morbid obesity, obesity ventilation syndrome, and sleep apnoea. The healthcare provider should keenly analyze the patient, consider all the factors and make a proper choice on the needs to prioritize. This will help in providing quality healthcare that will be satisfactory and safe for the life of the patient.

Priority Areas

Michael has a chronic condition. He has many clinical needs: depression, hypertension, Type 2 Diabetes, morbid obesity, obesity ventilation syndrome, and sleep apnoea each of which needs to be addressed. However, while attending to him, the healthcare provider should scan the condition of the patients and prioritize the needs and appropriately address them (Fairman, Rowe, Hassmiller & Shalala, 2011). Having said this, it is important to point out that the most priority areas for Michael are depression, and obesity. These are the needs that should be treated as priority areas because they deserve to be addressed before any other.


Michael has been suffering from obesity. Obesity, also called overweight, is a condition that simply refers to an increase in the body weight. From his medical history, Michael has been suffering from the condition. According to the information from his health records, it was observed during the latest observation that Michael has a body weight of 165 Kg and a Body Mass Index (BMI) of 57.09 m2. This is a clear proof that the patient is obese. Obesity is a lifestyle disease that is caused by poor diet and lack of physical exercises.  The patient must have contracted the disease because of his vulnerability. His lifestyle put him in a risky position because he has not been engaging in physical activities (Bray & Popkin, 2014). Obesity has become an issue of concern to the life of the patient.  

The rationale for prioritizing obesity is because it has become a major challenge to the patient. The nurse should do his best to control the patient’s weight because it has negatively impacted on her life. First and foremost, the patient’s obese condition made her to lose his job as a forklift driver. This implies that obesity has become an economic burden to him (Minihane, et al., 2015). As an adult, Michael does not have to rely on financial benefits. He is in his prime age in which he should be a productive member of the society. However, he has lost his job and become unable to clinch another employment opportunity thanks to his overweight (Schlicht, Morgan, Fuller, Coates & Dunbar, 2013).  Meaning, if the problem of obesity is addressed, the patient can be able to resolve the problem with his former employer and be able to get another opportunities.

The other reason why obesity should be considered as a priority area for the patient is because it has negatively impacted on his psychological health. The records show that the patient has become depressed because of his obese condition. Apart from the fact that he cannot find job opportunities, obesity has made Michael to perceive himself as a misfit (DiCenso; Cullum & Ciliska, 2011). He has decided to be antisocial because he is ashamed of his weight. Therefore, he cannot freely interact with other people thinking that they are jeering at him. At the same time, the patient cannot engage in his daily activities because his obese condition does not allow him to do so (Beverly, 2014). This kind of suspicion has made Michael to be an emotionally-disturbed person who does not find comfort in life at all.

Upon the identification and justification of obesity as a priority area, the nurse should be ready to take the necessary measures to address it. The treatment of obesity can help the patient a great deal. First, it will enable him to lose weight and regain his normal shape. Secondly, it will improve the quality of his life and enable him to get job opportunities that he lost because of his body weight. Lastly, the treatment of obesity will relieve the patient of the psychological distresses he has been undergoing. Hence, to achieve all these, it is recommended that the healthcare provider should administer appropriate medications, and therapies (Brunero & Stein-Parbury 2007). For example, if a counseling therapy is provided, the patient will be provided with adequate information on how to adopt behavior changes such as healthy eating habits and active engagement in physical exercises. 


The other priority area to consider when attending to Michael is depression. A thorough assessment of the records reveals that the patient was diagnosed with depression three months ago. Meaning, depression is a very serious condition that should be addressed. The social history of the patient shows that life has been unbearable for him. His stressful conditions are worsening because of the myriad of challenges he faces in his day-to-day life. The first cause of his depressive condition is that he lost his job. The second cause is that he has failed to get another job opportunity. Lastly, he has an obese condition that has made him to be isolated person who does not freely interact with the rest of the people (Bogner, et al., 2016). He lives in despair because despite his prime age, he is unemployed and has lost his financial autonomy.

The nurse should therefore consider depression as a priority area that should be addressed before any other condition. The rationale for this choice is that depression has negatively impacted on the patient’s health. It has acted as a precursor for High Blood Pressure. When the patient was assessed, he was found to be having a blood pressure of 180/92 which is a clear proof that the patient is suffering from a Stage 3 Hypertension.  Hypertension is a silent killer disease that should not be left untreated if detected. Hypertension is caused by depression which has been found out to be one of its major risk factors (Leontjevas, Gerritsen, Smalbrugge, Teerenstra, Vernooij-Dassen & Koopmans, 2013). Therefore, by addressing the problem of depression, the healthcare provider will be doing a commendable job because he will be seeking for a long-term solution to the problem of hypertension.

The other reason why depression should be considered as a priority area when attending to Michael, is that it can be linked to weight-gain which has of course resulted into depression (Chu, Yang, Lin, Ou, Lee, O'Brien & Chou, 2013). It is no doubt that the most serious problem affecting the patient is depression.  Since he gained weight, the patient has not been in a good state of health. He is stressed because he has lost a job and cannot find any either. His stress arises because he is stigmatized by the employers (Barlow, 2012). The patient has also developed a self-stigma. Meaning, he has worsened his condition by looking down upon himself. He cannot feel free to walk around because he is suspicious that other people will mock him.  Once depression is managed the patient will be able to overcome all these challenges.

Finally, depression should be prioritized because the patient is already undergoing a treatment for diabetes. So, the other serious condition that should be treated after obesity is depression. it has been linked to other conditions such as sleep apnoea. If treated, depression will provide a long-term solution to the other challenges faced by the patient. It is an important thing to do because it can help in improving the overall conditions of the patient. Michael does not need to continue wallowing in suffering. His conditions should be properly managed because it is necessary to do so. Depression should therefore be considered as a priority area by the nurse (Chu, Yang, Lin, Ou, Lee, O'Brien & Chou, 2013). It is a major threat in the life of the patient. Failure to treat it as a priority will further expose the patient to dangers.

Therefore, to achieve this strategy, the healthcare provider should use appropriate strategies. The first strategy to use while managing depression is to provide counseling therapy to the patient. Here, the patient should be thoroughly sensitized on how to change his lifestyle and start engaging in healthy activities such as physical exercises (Nanditha, et al., 2016). At the same time, the patient should be educated on diet issues. Adoption of a healthy diet can help in improving the patient’s condition as nutrition is a necessary requirement for mental as well as physical health.


Michael has a complex condition that cannot be simultaneously addressed in entirety. Therefore, it is necessary to prioritize his needs and address them in order of importance. Having analyzed his condition, it was concluded that the only areas to be prioritized are depression and obesity. These are the conditions that have caused lots of challenges to the patient. It is these conditions that have worsened the patient’s condition and made him whom he is. The healthcare provider can address these challenges by providing counseling therapies on behavior change as well as the prescription of medications to the patient.


Barlow, D., (2012). The Oxford Handbook of Clinical Psychology. New York: Oxford  University Press.

Beverly, E. A. (2014). Stressing the Importance of Diabetes Distress: a Comment on Baek et al.

Annals of Behavioral Medicine, 48(2), 137-139.

Bogner, H.R., et al., (2016). Does a Depression Management Program Decrease Mortality in

Older Adults with Specific Medical Conditions in Primary Care? An Exploratory

Analysis. Journal of the American Geriatrics Society, 64(1), pp.126-131.

Brunero, S, & Stein-Parbury, J. (2007). The effectiveness of clinical supervision in nursing: an

evidenced based literature review, Australian Journal of Advanced Nursing, vol. 25, no.3, pp. 85–94.

Bray, G. A., & Popkin, B. M. (2014). Dietary sugar and body weight: Have we reached a crisis in the epidemic of obesity and diabetes? Diabetes care, 37(4), 950-956.

Chu, H., Yang, C.Y., Lin, Y., Ou, K.L., Lee, T.Y., O'Brien, A.P. & Chou, K.R. (2013). The impact of group music therapy on depression and cognition in elderly persons with dementia: a randomized controlled study. Biological research for Nursing, p.1099800413485410.

DiCenso, A.; Cullum, N. & Ciliska, D. (2011). Implementing evidence-based nursing: some misconceptions. Evidence Based Nursing 1 (2): 38–40. doi:10.1136/ebn.1.2.38.

Minihane, A.M., et al. (2015). Low-grade inflammation, diet composition and health: current research evidence and its translation. British Journal of Nutrition, 114(07), pp.999-1012.

Nanditha, A., et al., (2016). Impact of lifestyle intervention in primary prevention of Type 2 diabetes did not differ by baseline age and BMI among Asian?Indian people with impaired glucose tolerance. Diabetic Medicine.

Fairman, J. A., Rowe, J. W., Hassmiller, S., & Shalala, D. E. (2011). Broadening the scope of nursing practice. New England Journal of Medicine, 364(3), 193-196. DOI: 0.3912/OJIN.Vol19No02Man02

Leontjevas, R., Gerritsen, D.L., Smalbrugge, M., Teerenstra, S., Vernooij-Dassen, M.J. & Koopmans, R.T. (2013). A structural multidisciplinary approach to depression management in nursing-home residents: a multicentre, stepped-wedge cluster-randomised trial. The Lancet, 381(9885), pp.2255-2264.

Schlicht, K., Morgan, M. A. J., Fuller, J., Coates, M. J., & Dunbar, J. A., (2013). Safety and acceptability of practice-nurse-managed care of depression in patients with diabetes or heart disease in the Australian TrueBlue study. BMJ open, 3(4), e002195.

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