Published Sep 19 – 20, 2025 | Version v1
Conference paper Open

Hope in the shadows: restoring well-being in a bedbound patient through community nursing in an underserved setting

  • 1. Primary Medical Care Unit, Sedawatte
  • 2. Office of the Regional Director of Health Services, Colombo
  • 3. Office of the Provincial Director of Health Services, Western Province

Description

This abstract was presented at the Fourth Annual Academic Sessions of the College of Palliative Medicine of Sri Lanka 2025.

The abstract was published in the official conference abstract book. Only the relevant pages (cover page and author’s abstract) are included here.

This work contributes to public health evidence dissemination.

Abstract

Introduction: Delivering healthcare to marginalised communities poses significant challenges and is often suboptimal. Among the many unmet needs, psychosocial well-being is frequently overlooked, despite being integral to holistic health — particularly in underserved populations.

Case presentation: Mr. AB, a 41-year-old unmarried man, has been bedbound since 2022 following a train accident that resulted in paraplegia and significant upper body weakness. He resides in an urban informal settlement and is cared for by his sister, his primary caregiver. He is a known hypertensive patient registered for follow-up at the nearest Primary Medical Care Unit. His repeated absence from clinic visits, despite his sister routinely collecting medications, was noted by the attending medical officer. Further inquiry revealed the circumstances of his disability and current living conditions. With the leadership of the institutional head, a home-based care plan was initiated to be delivered via the Public Health Nursing Officer (PHNO), supported by a healthcare assistant familiar with the locality.

The care plan included bi-monthly visits for blood pressure monitoring, physiotherapy, and blood sampling for investigations. Initially, the patient showed features of depression, confined to bed with limited interaction. However, through regular visits, trust and therapeutic rapport was developed. Over time, he regained upper body strength and can now sit upright. His mood has also improved; he is more engaged with care and expresses renewed optimism about life.

Conclusion: This case highlights how simple yet impactful measures by a primary healthcare team can significantly uplift the quality of life of a bedbound patient. It underscores the importance of addressing psychosocial well-being, which not only enhances a patient’s acceptance of care but also helps build trust in the healthcare system among underserved communities.

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