Introduction
COVID-19 and vaccination against it often cause complications in the body’s cardiovascular system. For example, pericarditis can be caused by a viral infection. According to Betty Neuman’s systems model, a patient’s recovery can be improved if the issue is addressed in a comprehensive manner, considering both intra-, inter-, and extra-personal factors. Therefore, this paper will analyze physiological, psychological, sociocultural, developmental, and spiritual stressors for the patient with pericarditis after revaccination against COVID-19. Furthermore, nursing prevention and intervention levels will be determined to assess the opportunities for applying the model to the patient.
Case Background
The patient is a 57-year-old woman who presented to the emergency department with difficulty breathing, chest pain, fever, and vomiting. Three days before, she had been revaccinated against COVID-19. The client felt unwell a few hours after the vaccination but considered this a temporary effect. The next day, the patient developed a dry cough, shortness of breath, and a fever.
In the emergency department, using a polymerase chain reaction test, she was diagnosed with COVID-19 infection. The patient received treatment for coronavirus in the hospital, but complaints of chest pain continued. As a result of the additional examination, the patient was diagnosed with acute pericarditis caused by revaccination.
In the patient’s medical records, there were no complaints about the functioning of the cardiovascular system. The patient has smoked for 25 years but does not consume alcohol or other substances. She has no allergic reactions to medicines or food.
The patient wants to finish treatment and leave the hospital because she has three minor children at home who need care. The patient’s family is deeply concerned about the woman’s condition, but they are also willing to support her and provide funding for the treatment. The patient was prescribed aspirin, colchicine, and antibiotics. However, doctors are in no hurry to discharge the patient, fearing a relapse.
Application of the Model
Theory’s Concepts and Components of the Client System
Betty Neuman’s system model treats each patient as a separate system. This system constantly “integrates physiological, psychosocial culture, growth, and spiritual variables, constantly interacting with the internal and external environment” (Wang et al., 2019, p. 116). The main task of nurses in this model is to identify problems and stressors for the patient and reduce their impact on the treatment process. The client system includes physiological, psychological, sociocultural, developmental, and spiritual variables (McDowell et al., 2022). At the physiological level, the patient has chest pain caused by pericarditis and difficulty breathing, fever, sleep disturbances, and loss of appetite due to COVID-19.
A positive attitude toward the treatment process characterizes the psychological variables of the patient. However, sometimes a woman’s psychological state worsens due to anxiety associated with limited knowledge about her disease and the duration of treatment. The patient’s family provides excellent social and financial support in the treatment, so no stressors have been identified at the sociocultural level. However, communication and interaction with others are essential to a woman’s life. Nevertheless, the possibility of interaction with the external environment for the patient is limited due to COVID-19 and pericarditis caused by a viral infection.
The patient’s age and the increased risk of cardiovascular disease complicate developmental variables. At the same time, the patient can function as an independent person and express her needs and concerns. Moreover, according to Neuman’s systems model, spiritual variables influence the patient’s condition. However, in this case, these variables are not a problem for the patient since she does not follow any religion. The primary source of strength for the patient is her family and children.
Stressors
The main stressors for the patient appear on the physiological, psychological, and sociocultural levels. First, the patient is unaware of the causes and nature of her diagnosis. Since she had not previously been diagnosed with diseases of the cardiovascular system, this area was not of interest to her. Second, the psychological stressor is characterized by anxiety about children and a lack of understanding by the patient about how long the treatment will take.
Psychological stressors are exacerbated by the patient’s physiological symptoms, such as fever, sleep disturbances, and loss of appetite. In addition, sociocultural variables significantly impact the patient’s condition. Family and friends are the woman’s primary sources of strength, so constant communication with them is crucial for the patient. However, the patient’s ability to maintain constant direct communication with others is limited due to their risk of contracting COVID-19.
Nursing Goals
Physiological: relieve symptoms, avoid complications, improve nutrition, and improve sleep quality. Instruct the patient on adhering to the doctor’s recommendations and a healthy lifestyle to prevent pericarditis recurrence. In addition, it is necessary to reduce the patient’s anxiety level to improve her psychological state. Therefore, the nurse’s task is to provide the patient with the necessary support and prevent feelings of loneliness (Joshi et al., 2020). Moreover, providing the patient with constant communication with her family and the outside world is necessary.
Nursing Interventions
Nursing interventions for the patient must be on all levels of prevention. According to Neuman’s system model, nurses should perform an educational function for patients (Diniz et al., 2019). Therefore, primary prevention includes communicating information to the patient about the causes of pericarditis, the characteristics of this disease, and the possibilities and duration of treatment.
Secondary prevention is about providing the patient with proper care throughout treatment. It includes interventions to improve sleep and nutrition and alleviate painful symptoms (Joshi et al., 2020). In addition, ventilator control is essential for the patient to maintain optimal oxygenation and body temperature control with medication and tepid sponging.
Furthermore, secondary prevention involves teaching the patient coping techniques to reduce anxiety levels. The patient should be regularly informed about the progress of treatment to reduce the nervousness and anxiety associated with an extended stay away from home (Diniz et al., 2019). In addition, nurses should encourage the patient to share her feelings and concerns. Moreover, it is necessary to ensure regular communication between the woman and her children and friends through video calls.
Tertiary prevention includes regular monitoring of the patient’s condition and informing her of possible risks. In addition, it is necessary to educate the patient about ways to prevent relapse, including diet control, exercise therapy, setting a sleep schedule, and avoiding smoking (Wang et al., 2019). Therefore, conducting additional educational activities for the patient’s family is possible. These activities will help them learn about the potential risks to the woman’s health and lead to positive behavioral changes for the whole family.
Conclusion
Hence, Betty Neuman’s systems model makes it possible to take a comprehensive approach to treating the patient. Taking into account physiological, psychological, sociocultural, developmental, and spiritual stressors and appropriate treatment planning helps to accelerate the patient’s recovery and reduce the risk of recurrent illnesses. However, the possibility of interaction with the patient is limited due to COVID-19, which means that the influence of psychological and sociocultural factors cannot be completely leveled. In addition, the risks of recurrent pericarditis depend on the patient, following physician recommendations, and behavioral changes after leaving the hospital.
References
Diniz, J. D. S. P., Batista, K. D. M., Luciano, L. D. S., Fioresi, M., Amorim, M. H. C., & Bringuente, M. E. D. O. (2019). Nursing intervention based on Neuman’s theory and mediated by an educational game. Acta Paulista de Enfermagem, 32, 600-607.
Joshi, P. K., & Ajesh, K. T. (2020). Application of Betty Neuman Systems Model in Nursing Care of Patients with COVID-19. Ann Nurs Pract, 7(2), 1116.
McDowell, B. M., Beckman, S., & Fawcett, J. (2022). Created Environment: Evolution of a Neuman Systems Model Concept. Nursing Science Quarterly, 36(1), 89-91.
Wang, H. P., Huang, Y. Q., & Jin, C. D. (2019). Betty Newman’s systematic model and its application in clinical nursing. TMR Integrative Nursing, 3(4), 113-117.