Posted: November 13th, 2022

Phillip is a 57-year old Aboriginal man

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INDH1006, SEMESTER 2 2021
Assessment 3 – Case Study
Students must use this case study to qualify for your report to be marked.
Phillip is a 57-year-old Aboriginal man in a Perth hospital cardiology ward waiting for heart
surgery. Phillip has been in the ward for over 3 weeks and wants to go home. He is currently
residing in Perth but comes from the Kimberley and is not comfortable being so far away from his
homeland, nor is he accustomed to the cold winter weather in Perth. Phillip was born with a cleft
lip and because of it, he has experienced bullying throughout his life. Because he ‘speaks funny’,
people think him to be simple and unintelligent, which is not the case.
Phillip has lost one leg from the knee down, which was likely linked to smoking cigarettes.
He has tried to quit in the past, but it is difficult, however he is extra motivated now that he needs
heart surgery. Although Phillip has many siblings, he only has one sister currently residing in
Perth, with the second closest sibling living in Northam. For the first two weeks, the sister that
resides in Perth would visit Phillip two or three times a week and bring him home cooked meals,
as he found it difficult to stomach the hospital food. Since then, she has had to take a full month’s
leave back to the Kimberley. While in hospital, Phillip is feeling isolated and bullied by the nurses
in the ward and has complained to his sister that they are not treating him right. He is on a waiting
list for the surgery but there is no official date for when it will happen, and because of the trauma
experienced at the hospital, compounded by the feeling of intense isolation, he asks to go home.
They say his condition is too serious to leave but Phillip insists. He wants to travel to Port Hedland
to familiar surrounds, where another sister lives and to the warmer weather. He discharges
himself and agrees that he will check into the hospital in Port Hedland when he arrives. He takes a
20-hour bus trip to Port Hedland because he cannot afford a plane ticket.
On arriving in Port Hedland, he goes to his sister’s place; she takes him to the hospital but
has to take care of some other business while in town, so does not stay with Phillip. The hospital
examines Phillip and informs him that his condition is too serious, and they do not have the
facilities to provide him with the care that he needs. They offer to have the Royal Flying Doctors
Service take him back to Perth, to which he responds, “I just got here on a bus to get away
from the cold in Perth”. They tell him that if he does not return to Perth then he should go home to
be with his family. Phillip is disappointed that his only option is to return to Perth, and the situation
that he had just left. However, he is feeling better to be back in the warmer weather and in familiar
surroundings, so he does not tell his sister what the hospital said; Phillip thinks, “I will deal with
this after I’ve had a break, in a week’s time or so”. Within two days, Phillip is found in his bed
deceased.
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INDH1006, SEMESTER 2 2021
Assessment 3 – Case Report (50%)
Due Date: Monday 25th October 2020 @ 13.00hrs via Turnitin submission point in
Blackboard
Word Limit: Minimum 1100 words – Maximum 1250 words. Including in-text
citations, from introduction to end of conclusion, excluding
referencelist.
Words above 1250 will incur a 6 marks penalty.
Formatting: Arial 11 point, Double spacing, Page
margin 2.5, Page number in the RHS.
Footer: full name on LHS, student ID in middle, case name on RHS.
As in example.
APA 7th Edition referencing (see below)
Writing style: It is important to use a formal, objective, third person writing style (do not
use – ‘I’, ‘we’ etc.). Avoid over-generalisation and sweeping statement;
instead use academic language: use “appears”, “seems to”, “more likely”,
“less likely”, “greater chance”, “lesser chance”; as opposed – “the outcome
will be” – as you can never predict with 100% accuracy what WILL happen.
Referencing: You must follow the APA 7th guide for in-text citations and all
referencing:http://libguides.library.curtin.edu.au/referencing/apa
This is your major piece of writing assessment for the unit.
For the following case, you are required to develop a case study report that consists of a
Critical analysis, and discussion section using credible research of sources.
Requirements
Within 1250 words only – The word count is from the beginning of the introduction section
to the end of the conclusion section and includes headings, sub-headings, in-text citations,
quotes, and tables. The marker will stop reading the report at 1400 words, but 6
markspenalty will be incurred for words over 1250.
Use Credible Sources
As a minimum, you are required to find useful information from:
– Two (2) books or government reports &
– Three (3) peer reviewed journal articles published within the last 10 years.
You may NOT use general websites, webpages, or fact sheets, doing so will cause you to
lose significant marks.
Content should be an evidence-based analysis of the case, directed by the knowledge
learnt in this unit. Paraphrase information acquired from reference sources. Maximum
of One quote allowed in the whole document.
See next page for what is needed for each section of the report.
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INDH1006, SEMESTER 2 2021
Formatting:
You are required to lay out the document similarly to that of the example provided on
blackboard. The page number can start from the beginning of the cover page.
The case report MUST be organised under the following headings:
You will find a number of concerns and ways of supporting the client.You are
required to concentrate on TWO of these in-depth (as they relate to SDH, see below
in the discussion section).
Introduction
In the introduction, you are required to briefly introduce the importance
of the chosen TWO concerns.
i.e., Ensure you include the topic highlights & a fact presented as a quote
(see example case study).
Case
Description
Using a paragraph format, provide a summary of the case and of ALL
the factors or concerns within the case study that led to Phillip’s death.
Also, include what you will aim to suggest interventions/solutions for,
relating to what you have identified in the case study.
Discussion Using the knowledge learnt from this unit, with credible literature to
backup your analysis:
(i) Discuss TWO of the social determinants that relate to the case in
more depth and the consequences of the determinants; that led to
Phillip’s death.
ONE MUST be specific to Aboriginal and Torres Strait Islander peoples (Land, History,
Racism). The second can be from the WHO 10 SDH showed in class. OR they can both be
specific to Aboriginal and Torres Strait Islander peoples (Land, History, Racism).
(ii) Suggest interventions/solutions related to the chosen TWO
concerns that could have been implemented by relevant health
professionals – that could have Helped, to prevent/avert his death.
Conclusion Conclude by briefly summarising the social determinants outlined in your
report and state the action plan/suggestions that you have put forward,
that could have led to a better outcome for Phillip.
References Include in-text citations within the body of text and a reference list on a
separate page at the end of the report.
Please review the marking rubric in depth and below for some additional guidance.
A case report is a tool that is used in the ‘field’; therefore, it needs to be useful, accurate, andprovide
enough information for another health professional to use the information and recommendations to
Help and support the client. The client will be able to request the report to read, so this should also be
a consideration when writing your report, this does not mean you need to use lay English, you still need
to follow academic standards and science/evidenceguidelines. The report should address solutions that
the client can use now, and the Social Determinants of Health (SDH) that will be the focus of your
report need to be relevant to the client now. Past information about the client/patient is provided to offer
a holistic perceptive of the client, but also might relate to something that is impacting the client now or
not. Your analysis will need to explain what is relevant, why, and how solutions can be directed to
support the client’s health in the present day. Solutions should not be ‘awareness training’ or ‘changes
of policies’, as these are future solutions that the client will not be able to benefit from now.
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INDH1006, SEMESTER 2 2021
Curtin University is a trademark of Curtin University of Technology
CRICOS Provider Code 00301J
10 WHO identified social determinants
1. The social gradient (i.e. class/SES)
2. Stress
3. Early life
4. Social exclusion
5. Work
__________________________________________________________
 The 10 WHO social determinants are intended to explain global health injustice for all
humans on the planet.
1) Land 2) History 3) Racism
 There are 3 particular social determinants also identified by Australian Aboriginal &
Torres Strait Islander peoples that reflect the history of colonisation & past government
polices/practice – these will be reviewed in more detail in future workshops.
6. Unemployment
7. Social support
8. Addiction
9. Food
10. Transport
The Solid Facts (Wilkinson & Marmot, 2003)
Assessment 3 – Case Study
Introduction
Phillip is a 57-year old Aboriginal man in a Perth hospital cardiology ward waiting for heart surgery. Phillip has been in the hospital for three weeks and wants to go home. The reasons for going home include the harassment from the nurses, the unfamiliar environment, and the cold weather. He was born with a cleft lip which makes people thinking he is less intelligent due to how he speaks. He lost his leg down due to complications related to smoking. His sister cannot sufficient time with him or visit him several times. He insists on going to Port Hedland where the environment is warmer.
The two chosen issues include racism and social support networks. Phillip is affected by racism since he cannot secure an opportunity for surgery despite his worsening health condition. Inequality in the healthcare environment is a result of the negative perception against minority groups. Phillip does not enjoy sufficient social support from the nurses and family members. The social determinants of health affect his decisions to travel away and not go back to Perth and contribute to his demise.
According to World Health Organization, social determinants of health are more important than healthcare since it affects health outcomes by 30-55 percent. Social determinants of health are critical in improving care delivery and eliminating longstanding inequities in the delivery of care (Alderwick & Gottlieb, 2019).
Phillip’s Case Study Description
The concerns in the case study revolve around racism and lack of social support networks. Racism leads to trauma and bullying at the healthcare facility. He seeks to go home or transfer to another hospital near his sister where he can be assured of quality and timely care. Lack of social support compounds the failure to go back to Perth to continue with treatment as he awaits surgery. Living away from Perth means he has no access to quality care. Lack of social support makes him miserable and contributes to his decision to leave Perth. He has no social support due to the bullying and his sister cannot visit daily to give him company and bring home-cooked food. The suggested intervention is to enhance access to healthcare services to people from all ethnic groups and eliminate racism. Inequality in healthcare delivery is a challenge for the minority groups.
Social Determinants of Health
The social determinants of health in the case study involve racism and lack of social support. One of the indicators of racism is that the patient is in hospital waiting for surgery for three weeks. Cardiovascular conditions require urgent attention to avoid complications. One of the reasons is that the patient is from a minority group yet healthcare workers do not take the issue of Aboriginal patients seriously. Social determinants of health such as racism, according to the World Health Organization, contribute to 30-55 percent of the health outcomes (Donkin et al., 2018).
Aboriginal and Torres Strait Islander people have a high risk of facing racism in the healthcare environment (Donkin et al., 2018). Other ethnic groups such as Whites who can visit healthcare facilities that address their issues promptly. Aboriginal and Torres Strait Islander people are at risk of negative health outcomes due to the discrimination.
Social support makes Philip feel rejected and unwanted. Rejection can lead to stress and depression which can further complicate the health condition of the patient (Donkin et al., 2018). Aboriginal and Torres Strait Islander people experience discrimination and racism in the healthcare sector. The minority group have poor access to healthcare services leading to inequality in delivery of care. Lack of equality denies the Aboriginal and Torres Strait Islander people an opportunity to access quality and safe care.
Discussion
The social determinants of health include racism and social support. Racism involves discrimination that undermines the ability to access resources, employment opportunities, food, and housing. Racism can undermine access to quality care (Donkin et al., 2018). For instance, the sister would have transferred the patient to a better hospital where they would prioritize the health issue. Putting the patient in waiting is simply exposing him to the risk of complications or death. Minority groups are at risk of racism leading to poor access to education and opportunities (Islam, 2019). Racism and discrimination affects access to quality of healthcare services. Racism and inequality is one of the most important determinants of health since it affects priority to safe and timely care (Islam, 2019). For instance, systemic racism affects the perception of the healthcare workers towards the minority groups such as Aboriginal and Torres Strait Islander people.
Social support is detrimental to quality care in the case study. Patients need to have the positive belief they are loved and cared for by family members and healthcare providers. Trauma and stress trigger negative outcomes that undermine health outcomes (Cantor & Thorpe, 2018). Phillip lacks the essential support from the family members who do not visit him often. Lack of sufficient support escalates to wrong decisions such as checking out of the hospital without full authorization. He decides to go to another hospital despite his heart condition (Cantor & Thorpe, 2018). He lacks social support from the nurses since he states the healthcare workers bully him. The patient is at risk of anxiety, depression, and stress due to poor social support and rapport with the healthcare workers. Providing healthcare services in a friendly environment is critical in boosting quality outcomes (Cantor & Thorpe, 2018). Patients need to feel they are loved and valued by family members and healthcare providers.
Conclusion
The social determinants of health in the case study involve racism and lack of social support. Alternative actions are essential such as eliminating inequality and promoting discrimination-free healthcare environments. According to World Health Organization, social determinants of health are more important than healthcare since it affects health outcomes by 30-55 percent (Alderwick & Gottlieb, 2019).
Recommendations
The recommended strategy is to eliminate inequalities in the healthcare sector. It is important to educate the nurses to avoid racism that leads to inequality in delivery of care. Cultural competence in the healthcare sector can eliminate inequalities such as discrimination (Cantey et al., 2017). The second recommendation is to implement policies that will reduce the cost of care for patients with critical conditions. Addressing the discrimination issue will reduce the inequalities existing in the healthcare sector (Cantey et al., 2017). Healthcare workers should learn the need to carry out comprehensive assessments to help patients suffering from different needs.
Implementation
Implementation of the recommendation will involve various stakeholders such as nurse managers, nurses, and physicians. The healthcare workers should learn the role of cultural competence in patient outcomes. Healthcare facilities should provide equal opportunities for patients from different ethnic groups. Hospitals should provide platforms for patients to convey their concerns about poor delivery of care and discrimination. Implementation of the recommendations will transform the healthcare sector and eliminate the risk of poor health outcomes.

References
Alderwick, H., & Gottlieb, L. M. (2019). Meanings and misunderstandings: a social determinants of health lexicon for health care systems. The Milbank Quarterly, 97(2), 407.
Cantey, D. S., Randolph, S. D., Molloy, M. A., Carter, B., & Cary, M. P. (2017). Student-developed simulations: enhancing cultural awareness and understanding social determinants of health. Journal of Nursing Education, 56(4), 243-246.
Cantor, M. N., & Thorpe, L. (2018). Integrating data on social determinants of health into electronic health records. Health Affairs, 37(4), 585-590.
Donkin, A., Goldblatt, P., Allen, J., Nathanson, V., & Marmot, M. (2018). Global action on the social determinants of health. BMJ Global Health, 3(Suppl 1), e000603.
Islam, M. M. (2019). Social determinants of health and related inequalities: confusion and implications. Frontiers in Public Health, 7, 11.

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