Patient Interview Paper

From a psoriatic convalescent to all patients: A brief view of healthcare system and nursing role

On 27th September 2016, our group (group 56) paid a visit to the Hong Kong Psoriatic Arthritis Association and interviewed a middle-aged female convalescent who had suffered from psoriatic arthritis for a few decades. Psoriatic arthritis (PsA) is an immunologically triggered, chronic inflammatory arthropathy, which post long-lasting health effect without known caused and complete treatments [1]. The interviewed patient had shared her experience with PsA such as the discrimination of her friends when noticing she had skin flaking problem. Through the interview, I was inspired to have different views towards my future career, the Hong Kong healthcare

When she enquired the orthopaedist afterwards, the orthopaedist refused, because she did not have the prescription letter from the dermatology department. The convalescent did not expect that the dermatology unit did not intimate the orthopaedic department about the prescription and was quite frustrated. This is the communication problem within the public hospital department. Ineffective communication is now the main contributor to patient harm in hospitals [7]. Multiple clinician involvement in a patient’s continuity of care may cause such problem due to the conscientious among involved professionals seldom exist and documentations, which is a worldwide healthcare problem [8]. In a hospital study in 2011, physicians involved reflected that the method of communication has an utmost importance of transferring patient information among healthcare professionals and there are about 26% participated clinicians notice problems associated with interdisciplinary connections [9]. In order to improve the form of interdisciplinary communication, government could develop a territory-wide Electronic Health Record (eHR) system, allowing the healthcare professionals acquire a brief patients’ medical record and as a bridge for inter-department

At the later part of the interview, we had an opportunity to have a look on the patient’s limbs that have psoriasis and about their experience during their recovery period. I was very shocked about the seriousness about the psoriasis of her legs and when compared to another patient that received constant biologic treatments that was accompanied with her. A great difference in appearance and, according to the interviewee’s companion, the feeling of pain and itchiness was greatly reduced. However, these kind of tailor-made treatments were expensive and it cost ten thousand dollars per injection. In 2013, The government listed biomedical treatment injections for PsA into the drug formulary, which drugs in the formulary required by the patients could receive government subsidise, and convalescents who receive PsA medication afterwards merely need to pay 10 dollars per injection [12][13]. Despite the PsA treatment could be subsidised, there are still a considerable number of medicine of chronic disease are not listed and could not help patients with financial problems. For instance, in 2014, Crizotinib was discovered in Hong Kong as an effective targeted therapy for ALK induced lung cancer, which cost HK$55,000 to HK$60,000 a month [14]. However, patients still need to purchase these drugs, which are not possible for an average commonwealth to afford, in a self-financed way until