You’re caring for a 28 y.o. woman with hepatitis B. She’s concerned about the duration of her recovery. Which response isn’t appropriate?
A. Encourage her to not worry about the future.
B. Encourage her to express her feelings about the illness.
C. Discuss the effects of hepatitis B on future health problems.
D. Provide avenues for financial counseling if she expresses the need.
Correct Answer: A. Encourage her to not worry about the future.
Telling her not to worry minimizes her feelings. Contract with the patient regarding time for listening. Encourage discussion of feelings/concerns. Establishing time enhances trusting relationships. Providing an opportunity to express feelings allows the patient to feel more in control of the situation. Verbalization can decrease anxiety and depression and facilitate positive coping behaviors.
Option B: The patient may need to express feelings about being ill, length and cost of illness, possibility of infecting others, and (in severe illness) fear of death. She may have concerns regarding the stigma of the disease. The recovery period may be prolonged (up to 6 mo), potentiating family and/or situational stress and necessitating the need for planning, support, and follow-up.
Option C: Avoid making moral judgments regarding lifestyle. The patient may already feel upset and angry and condemn self; judgments from others will further damage self-esteem. This can also start distrust issues with care workers.
Option D: Assess the effect of illness on economic factors of the patient and SO. Financial problems may exist because of loss of the patient’s role functioning in the family and prolonged recovery. Make appropriate referrals for help as needed: case manager, discharge planner, social services, and/or other community agencies.
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