Case Vignette
Peter, a 52-year-old self-employed builder with a history of diabetes presents at the Accident and Emergency Department
complaining of insomnia and fatigue over the past 4 months. He says that his blood sugars are ‘all over the place’. When further
enquiries are made, Peter states that he generally does not worry too much about his diabetic control. He says his wife ‘keeps an eye on
him’ and that she has insisted he see a doctor.
Peter also has hypertension and has been receiving antihypertensive medication for the
last five years. He also takes medication to lower his cholesterol. Peter says he smokes about twenty cigarettes a day and drinks alcohol
frequently. When asked about his lifestyle choices Peter states that his father drank and smoked all his adult life and lived to a ‘grand
age’.
Peter appears to be overweight and he has a body mass index of31. On his last medical review his HbA1c level had increased from
8% to 9.2% and his cholesterol level was 5.8mmolll. His current blood pressure is 145/85 mmlHg.
Peter reveals that he feels increasingly
stressed by the downturn in the construction industry which has caused him some economic hardship. He talks vaguely about family issues.
describes his relationship with his unemployed ‘no hoper’ son as strained and this in turn has caused tension with his wife.
Peter
displays little spontaneous emotion, avoids eye contact and speaks quietly. He says he is ‘fed up’ and needs to ‘pull himself
together’ but says his current circumstances are making this difficult.
Task:
Complete four short essay questions using the case vignette
below. A maximum of 400 words per question is required. A minimum of two reference per question is required. The reference list is to be
included at the end of each short essay. Revise CDU-Harvard Referencing. Go to http:lllibguides.cdu.edu.aulcdureferencing for help with
referencing.
1. Choose one defence mechanism and explain how this helps you to better understand Peter’s presenting problems.
2. Discuss
how ‘Stress Theory’ might be applied to the Peter’s current situation.
3. How would you respond to Peter’s statement about being
‘fed up’ and needing to ‘pull himselftogether’? Your answer must include specific therapeutic communication techniques.
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