Precious (2009): Patient Assessment and Treatment

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Introduction

It could be stated with certainty that the 2009 Lee Daniel’s movie Precious, which is based on the novel “Push” by Sapphire, is the work of art that elicits numerous problems that are highly relevant for the contemporary society. In particular, the movie depicts the life of the African American urban community, focusing on various health-related and social issue, such as single-parent households, physical, emotional, and sexual abuse, teenage pregnancy, HIV/AIDS, and interaction with society (Sweeney, 2010).

The majority of the mentioned topics has a direct relation to the question of care and self-care, making the movie a substantial source of information for healthcare professionals. Therefore, it is decided to conduct an assessment of the movie’s central character, Precious, in order to overview various factors influencing her health so that a comprehensive treatment plan could be successfully developed. The paper is supported by the vast academic literature research in spheres related to issues depicted in the movie.

Conducting the Assessment of the Patient

Description of the Patient

First of all, it is essential to provide an overall description of the patient. Also, to put further reasoning in the proper context, it is critical to notice that the whole assessment and discussion of the treatment plan are based entirely on what is presented in the movie, and thus they might lack some features of a formal assessment. As it is presented in the movie, Precious Jones is a 16-year old African American female, who lives in a sing-parent household with her mother, Mary (Watkins-Hayes, Patterson, & Armour, 2011). The movie is set in Harlem, 1987; and the characters live in a tiny, dirty apartment in Section 8 project housing.

Precious is the subject to constant physical, emotional, and verbal abuse from her mother, also she was sexually abused by her father at the time when he was with the family (Watkins-Hayes et al., 2011). Also, she became HIV-positive because her father had AIDS (Watkins-Hayes et al., 2011). As the result, Precious is pregnant for the second time, and the principal of her school expels her, suggesting to enroll to an alternative education program (Watkins-Hayes et al., 2011).

It is evident that the situation depicted in the movie represents a situation which is to be thoroughly investigated from the perspective of a healthcare professional (Jarman, 2012). The overall thesis is that abuse in its various forms resulted in unwanted pregnancy, low literacy, and HIV-positive diagnosis, contribute to the adverse mental and physical condition of Precious (Jarman, 2012).

Case Formulation

On the basis of the overall information, it is possible to formulate the case. Generally, the problem is that Precious is put in the unfavorable situation in which she as an adolescent does not have enough power to confront the pressure from her familial members and the large-scale social conditions of her life. Thus, there are three evident issues that should be addressed.

Firstly, the various kinds of abuse that are experienced by Precious are caused by her family. Secondly, she is HIV-positive, which is a highly difficult disease to handle, both physically and emotionally, at her age. Thirdly, she is pregnant, and adolescent pregnancies are usually a very difficult case, both for mother and child. Accordingly, these three primary problems serve as the foundation for the development of change effort’s goals. These goals could be synthesized into one concise statement: it is essential to provide Precious with sufficient instruments for her to handle her unfavorable social conditions and support her struggle with AIDS and pregnancy. This statement will later serve as the basis for the development of the treatment plan.

Referral and Background Information

As the assessment is based on the movie, it is hardly possible to provide referral and background information in a complete and formal manner due to the lack of precise information. Precious Jones is 16-year old, and she lives with her mother Mary, as her father Carl left the family. Precious has a daughter, who was conceived in a sexual intercourse between Precious and Carl. The family lives in Harlem, in a small apartment from the project housing. In general, it is the maximum amount of referral and background information that could be retrieved from the film.

Individual and Family History

For the aspect of individual and family history, the problem is relatively the same as it is in the previous subsection. The movie does not provide concise information about the Precious’ individual and family health history. The most evident fact, which is revealed toward the end of the film, is that Carl is HIV-positive, and thus Precious also has AIDS. Further, it is apparent that Precious suffers from obesity, which might have been caused by the genetic legacy of her mother. Also, Precious’ daughter has Down syndrome, which is most likely caused by the fact that she was conceived be blood relatives as Carl sexually abused Precious, his daughter. Also, it is mentioned in the movie that when Precious went in labor, giving birth to her second child, it was the first time when she had been to the hospital.

Discussion of Data Collection Sources of Information for Analyses

Once again, the discussion of data collection sources of information for analyses is the subject to the same problem as it is in the previous two subsections. Due to the fact that the available information is limited to what is presented in the movie, the author has to rely solely on this information. Since the authors of the film were not concerned with creating a full set all data that is formally needed for thorough clinical assessment, it is apparent that the process of data collection is significantly restricted to what is shown in the movie.

Discussion of Cultural and Societal Factors

It is possible to state with certainty that cultural and societal factors play an immensely important role in the case of Precious Jones. The problems that she experiences are largely determined by her cultural and social background (Sutton, Lasswell, Lanier, & Miller, 2014). First of all, she comes from a low-income family that lives on the edge of poverty, and it is largely recognized that exposure to such social circumstances raises the probability of different kinds of abuse, low literacy, insufficient access to medical treatment and care, unwanted adolescent pregnancies, and increased HIV risk (Assini-Meytin & Green, 2015; Kinser & Masho, 2015).

For example, it is apparent that Precious can hardly escape the abuse within the family as she lives with her mother and could not provide for herself due to her age and lack of education (Watkins-Hayes et al., 2011). Moreover, Precious’ low literacy in the questions of sex and pregnancy, as well as the inability to escape the abuse from her father, contribute to her poor understanding of the effects of adolescent pregnancy (Coyle et al., 2016). Therefore, it could be observed that social and cultural factors have an immense impact on the development of negative effects on Precious’ health.

Discussion of Multidimensional Assessment

Regarding the discussion of the multidimensional assessment, it is worth mentioning that it is difficult to perform it due to the lack of information provided in the movie. As it was already mentioned, the authors of the film did not intend to develop a comprehensive and full set of medical information that is usually obtained from family and individual health records and personal interviews. Thus, based on the information that could be retrieved from the film, one can observe that the primary influencing factors within the multidimensional framework are social and cultural factors, as it was exemplified in the previous subsection. Other factors that should be mention are Precious’ obesity and HIV-positive status.

These factors contribute to the overall adverse physical and mental state of the young African American. For example, Chaney (2018) expresses the following point of view in her article. The author states that the negative stereotypes about young African American mothers largely drives people from outside the African American community to disregard these females’ intention and actual ability to successfully participate in the contemporary society (Chaney, 2018). From this perspective, it is evident that young African American mothers should be assessed with the understanding of numerous specific dimensions of their health, but without prejudice.

The Development of the Treatment Plan

Discussion of Intervention Strategy and Treatment Goals

In general, the treatment goals for Precious were shortly formulated in the previous section. These goals could be states as follows: (1) to provide Precious with sufficient instruments for reducing the negative effects of physical and mental abuse on her health, (2) to ensure that both the mother and her children are provided with care and access to proper treatment, and (3) to ensure that Precious is treated efficiently from AIDS.

These goals cover a considerably large area of concern that covers several dimensions of life. However, as the instrument of reducing stress among African American adolescent mothers, Kinser and Masho (2015) propose yoga sessions. Additionally, Coyle et al. (2016) propose the promotion of Safer Choices intervention, which is intended to increase the awareness about sexually transmitted diseases among adolescents. Also, the antiretroviral therapy is recommended for Precious.

Discussion of the Application of a Theory and its Rationale

Based on the conducted assessment as well as on the development of the treatment plan, the most suitable nursing theory would be Dorothea Orem’s self-care deficit nursing theory. The theory is based on the following assumption: it is a “theory created for a practical science such as nursing encompasses not only the What and Why, but also the Who and How” (Hartweg, 2015, p. 107). Viewed in the holistic context, nurses and patients should have active, dynamic, and meaningful relationships, in which the needs and the overall importance of the patient is the highest priority (Morton & Fontaine, 2017).

The historical context, within which the theory was created, is important for the understanding of the theory. Primarily, in the process of her practice in the Indiana State Board of Health between 1949 and 1957, Orem noticed that nurses are able to “do nursing,” but they cannot “describe nursing” (Hartweg, 2015). Thus, it was her initial motivation to combine a solid theoretical approach with her practical experience. Orem’s personal values, her formal education as well as familiarity with works of such philosophers as Aristotle, Aquinas, Harre, and many others, contributed significantly to the development of her theory (Hartweg, 2015).

The main concepts of the theory include six elements. Four of them are related to patients (self-care/dependent care, self-care agency/dependent-care agency, therapeutic self-care demand/dependent-care demand, and self-care deficit/dependent-care deficit), and other two are related to nursing professionals (nursing agency and nursing system) (Hartweg, 2015). In general, the connections between the theory’s concepts are presented by the interaction between “the self-care agent (person receiving care)/dependent-care agent (family member/friend providing care)” and “the nurse (nurse agent)” (Hartweg, 2015, p. 109).

Therefore, one can state with certainty that the theory under consideration is highly applicable to the case of Precious. The fact that the girl, as of the end of the movie, is left to care for herself and her children almost on her own, it is essential that she has self-care skills and competencies developed.

Conclusion

In conclusion, one should state with certainty that the Precious movie is an example of a work of art that raises highly important social and health-related problem in the context of the African American community. Despite the fact that it is not possible to retrieve information about the patient’s health and various multidimensional factors, it is still appropriate to use the character of Precious for the investigation of such problems as physical and emotional abuse, the effects of the single-parent household, low literacy, and adolescent pregnancies. In general, this paper represents a successful attempt at conducting the assessment of the patient and developing a treatment plan for her.

References

Assini-Meytin, L. C., & Green, K. M. (2015). Long-term consequences of adolescent parenthood among African-American urban youth: A propensity score matching approach. Journal of Adolescent Health, 56(5), 529-535. Web.

Chaney, C. (2018). The movie “Precious”: A misrepresentation of most young Black urban mothers. Journal of Pan African Studies, 11(6), 142-168.

Coyle, K., Basen-Engquist, K., Kirby, D., Parcel, G., Banspach, S., Collins, J.,… Harrist, R. (2016). Safer choices: Reducing teen pregnancy, HIV, and STDs. Public Health Reports, 116, 82-93. Web.

Jarman, M. (2012). Cultural consumption and rejection of Precious Jones: Pushing disability into the discussion of Sapphire’s Push and Lee Daniels’ Precious. Feminist Formations, 24(2) 163-185.

Hartweg, D. L. (2015). Dorothea Orem’s self-care deficit nursing theory. In M. C. Smith & M. E. Parker (Eds.), Nursing theories and nursing practice (4th ed.) (pp. 76-81). F. A. Davis Company.

Kinser, P., & Masho, S. (2015). “I just start crying for no reason”: The experience of stress and depression in pregnant, urban, African-American adolescents and their perception of yoga as a management strategy. Women’s Health Issues, 25(2), 142-148. Web.

Morton, P. G., & Fontaine, D. K. (2017). Critical care nursing: A holistic approach. New York, NY: Lippincott Williams & Wilkins.

Sutton, M. Y., Lasswell, S. M., Lanier, Y., & Miller, K. S. (2014). Impact of parent-child communication interventions on sex behaviors and cognitive outcomes for black/African-American and Hispanic/Latino youth: A systematic review, 1988–2012. Journal of Adolescent Health, 54(4), 369-384. Web.

Sweeney, M. (2010). A precious and painful life. The Lancet, 375(9710), 189-190. Web.

Watkins-Hayes, C., Patterson, C. J., & Armour, A. R. (2011). Precious: Black women, neighborhood HIV/AIDS risk, and institutional buffers. Du Bois Review: Social Science Research on Race, 8(1), 229-240. Web.

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