SUMMARIZED PATIENT REPORT

MBChB II - 2023
COMMUNITY BASED EDUCATION AND SERVICE (COBES II)
CODE: COB26M0

MEMBERS:
• TSHIRELETSO MANOTO
(222026421)
• ZINTLE NGOLLO
(217080707
Table of Contents
DEMOGRAPHIC PROFILE: ....................................................................................................................3

EPIDEMIOLOGICAL DATA: ...................................................................................................................5

RISK FACTORS .......................................................................................................................................6

PSYCHOSOCIAL ISSUES/FACTORS .....................................................................................................7

INTERVENTION STRATEGIES/HEALTH PROMOTION STRATEGIES ..............................................7

DERIVED LEARNING ISSUES ...............................................................................................................9

BIO-MEDICAL SCIENCES ..................................................................................................................9

CLINICAL SCIENCE ............................................................................................................................9

POPULATION MEDICINE ..................................................................................................................9

DEMOGRAPHIC PROFILE:

The above histogram depicts the 10 summarized patients by age group, ranging
from 0-60 years old. It is in a descending order with the most patients ranging from
ages 31- 40years old and the age 0-30 years old ranges showed the least number of
patients who were interviewed.

10 PATIENTS BY GENDER AT
SETTLERS DISTRICT HOSPITAL 2023

40% MALE
FEMALE
60%
The above pie chart represents the percentage of patients interviewed with respect
to gender. Out of 10 patients interviewed 40% were females and 60% were males.

INTERVIEWED PATIENT OCCUPATION AT

SETTLERS DISTRICT HOSPITAL 2023
6

5
5
4

3
3
2

1
1 1
0
Employed Unemployed Retired Student

The above bar graph shows the occupation status of the 10 patients interviewed.
Out of the 10 patients 5 were unemployed, 3 were employed, 1 is retired and 1 is a
student.

ETHNICITY

20%
Blacks
10% Whites
Mixed Race
70%

The above pie chart displays the ethnicity in percentages of the 10 patients
interviewed. Out of 10 patients 70% were blacks, 20% were mixed race and 10%
were whites.
EPIDEMIOLOGICAL DATA:

This report is based on data collected from the 14th June 2023 to the 30th June 2023
at the Settlers District Hospital, Grahamstown. The most common infectious illnesses
that we have encountered in our study were respiratory related diseases, followed
by chronic illnesses such as hypertension, diabetes, and heart diseases.
Respiratory tract infection is a frequent burden to the hospital even though they
have cost effective methods for prevention. RTI often have strong seasonal patterns
associated with cold weather, which confirms the high number of diseases we
recorded attributed to the winter season. Several additional factors including
environmental conditions, relative humidity, temperature, and person-to-person
contact.
Tuberculosis is also amongst the most frequent cause of admission (and people with
history), as it is a communicable disease and it is easily passed from one person to
another, making it a principal disease of poverty. The rate of TB varies with age, as
it is mainly a disease of elderly people and the immunocompromised. One of the
challenges with TB patients is defaulting on treatment, placing at an increasing risk
of resistant tuberculosis.
Blood pressure rises with aging thus increasing the risk of hypertension. Up until the
age of 45 years, a higher percentage of men than women have hypertension,
however between ages 45-64 years the percentages are nearly equal. Above ages
64 years a higher percentage of women have hypertension than men. A high
prevalence of hypertension puts a tremendous strain to the public health care. As it
is a primary contributor to coronary diseases, strokes, heart failures and chronic
kidney diseases.
Lifestyle factors make a patient more susceptible to chronic diseases. For example,
lack of physical exercises, poor diet, alcohol intake and smoking may cause the
dysfunction of body systems mainly the cardiovascular system and the respiratory
system.
RISK FACTORS

Smoking (and exposure to second-hand) is one of the most common forms of

recreational drug use and a leading cause of preventable deaths. Smoking results in
an increased risk of coronary heart disease, lung diseases and chronic obstructive
pulmonary disease. These tend to alter the mucosal layer or mucosal resistance to
infectious microorganisms.
Alcoholism can affect a whole range of the body parts, the brain, heart, liver,
pancreas, and the immune system. Alcohol use results in mental or physical health
problems. Increases the risk of heart disease, high blood pressure, atrial fibrillation,
and stroke. Long-term alcohol abuse induces several physical complications including
cirrhosis of liver, pancreatitis, epilepsy, polyneuropathy, malabsorption, alcoholic
dementia, sexual dysfunction and can even be fatal.
Drinking during pregnancy can result in fetal alcohol spectrum disorders. Women are
more sensitive than men to the harmful effects of alcohol, this is primarily due to
their smaller body weight, lower capacity to metabolize alcohol, and higher
proportion of body fat.
Illicit drugs are a risk factor for many diseases, they can cause a lot of preventable
death and disabilities. It is also associated with risks to the users' family and friends
and the community at large.
Immunocompromised or a weakened immune system is more susceptible or
prone to RTI, opportunistic bacteria and viruses, e.g., increases the risk of
a TB infection becoming active TB disease. Autoimmune disorders, such as
rheumatoid arthritis, psoriasis, and Crohn’s disease, cause the body’s immune
system to attack itself. Treatments for these disorders often involve medication that
suppresses the immune system. But that means your immune system may not be
able to fight off infectious microorganisms after exposure.
In addition, airborne diseases are easily transmittable in overcrowded areas, with
close contact to a person with an infectious disease. Waterborne diseases or
infection are predictably highest in communities in which water is of scarcity or not
potable, and where personal and community hygiene standards are low.
People living in poverty often lack access to quality healthcare. They are often
medically underprivileged and resource poor communities. This increases their risk of
poor health care and contribute to the lack of awareness of certain diseases.
PSYCHOSOCIAL ISSUES/FACTORS

These issues describe the patient in relation to their social environment and how
they affect the physical and mental health of a patient.
Most of the patients that are diagnosed with chronic diseases suffer from stress and
depression. Patients often get to overthink their state of health, and this makes
them suffer from stress and now it makes them unable to live normally like before.
For example, when patients are diagnosed with hypertension, they get to perceive
themselves as already dead and stress may affect them in a way that they may stop
taking treatment since they believe they have no hope. In other cases, patients may
have no emotional support from family and friends, they may experience isolation.
Patients with chronic illnesses are most likely to be vulnerable and dependent.
Patients become vulnerable in a way that they become prone to any harm in society,
they can easily be victims of illegal doings, since they are unable to protect
themselves. Consequently, patients may depend on other people to help them in
their day-to-day activities since they are unable to help themselves. Not all patients
have social support, and this makes them more vulnerable and dependent. Patients
may also be likely to lose their jobs due to being diagnosed with chronic diseases, so
this makes a patient unable to take care of himself and his family.
Discrimination and misconceptions may be another major psychosocial factor that
affects the well-being of a patient. Many patients may be discriminated against in
their state of health, for example patients with RVD may find it hard to be accepted
in the community and this may cause them to have suicidal thoughts. People in
society may have different views about certain diseases and this cause
misconception about those diseases, and this affects patients in a way that now
patients end up not being socially accepted.

INTERVENTION STRATEGIES/HEALTH PROMOTION STRATEGIES

Lifestyle changes including weight loss, physical exercise, diets low in salt, total fat,
and cholesterol (healthy diet)
Educational campaigns to teach people about common chronic illnesses. This can be
done in the form of adverts or outreach projects to be able to reach large
populations.
Easy access to primary health care, this will allow people to have vaccines and
immunizations. This prevents the spread of any underlying disease.
Administer wellness through WELLNESS APPS, this will help to promote short-term
goals that contribute to creating a long-term health benefit. This allows easy
modification of patients' wellness
Educate patients on the importance of washing hands and keep good hygiene levels.

ETHICAL ISSUES
Autonomy vs. beneficence. Doctors are required to administer prescribed medicine,
but patients, at the same time, can refuse them. Patient autonomy can go against
medical directives, despite clearly defined needs. Patients have a right to refuse all
medical care.
Honesty vs. withholding information. Family members may want to withhold medical
information from sick patients to protect their emotions. However, patients have the
right to know about their medical conditions. Deciding how to share this information,
especially if it goes against the family’s beliefs, can be a touchy situation.
Healthcare needs vs. resource allocation. The rising cost of healthcare is increasingly
putting nurse managers at odds with budgeting constraints and patient needs. Many
medical facilities have scarce resources, which puts patients at risk for not getting
the care they need. These resources range from medical equipment to healthcare
staff. I would suggest that nurse leaders must include staff in the budgeting process
so that they can better understand the needs and demands.
Science vs. spirituality. Healthcare, which is science-based, and results driven, can
impede religious or personal beliefs. Some religions restrict medical interventions
and lifesaving techniques. Nurses focus on providing medical care to reduce
suffering and to allow patients to concentrate on self-care. For patients or their
families with strong religious or spiritual convictions, the focus may be on adhering
to a strict set of guidelines. The doctor should respect “unique differences of the
patient, “lifestyle, value system, and religious beliefs.” However, respect for the
belief “does not imply that the doctor condones those beliefs or practices on a
personal level.”
DERIVED LEARNING ISSUES

BIO-MEDICAL SCIENCES
-External and internal features of heart
-Blood supply to the heart, histological features of heart
-Physiology of heart sounds and lung sounds
-Respiratory system

CLINICAL SCIENCE
-Coronary heart disease

-Congestive cardiac failure

-Respiratory Tract Infection
-Pneumothorax
-COPD
-Diabetes, Epilepsy, Tuberculosis, and hypertension

POPULATION MEDICINE
-Risk factors of RTI, CCF and COPD

-Patient’s autonomy
-The impacts of living with chronic illness
-How unemployment affects health
-Impact of stress on health
-Role of poverty and lack of education on health