A lot of Americans claim that the issues concerning obesity are already ubiquitous. There are far too many facets to be considered. For instance, the rise of the cost of healthcare services as well as insurance has brought to the fore the issue concerning wellness programs in workplace. Some people state that weight should be controlled (and can be controlled) and overweight people should be responsible and stick to certain wellness programs (Jameson, 2010).
Others argue that it can be difficult or even impossible to control weight as there is certain predisposition and people cannot be punished for something they are not responsible for (Tsai & Bessesen, 2012). However, these arguments are a bit far-fetched as researchers claim that weight can be controlled. Of course, it may require extra effort, but the contemporary labor market is highly competitive and all people try to be effective.
In the first place, it is necessary to note that lots of people are tired of the very discussion of the problem. Thus, Jameson (2010) states that a lot of people are frustrated as they think that sometimes they feel guilty for being fit. They stress that they watch what they eat and they try to be fit, which is possible if one stops eating and starts paying more attention to physical activity (Jameson, 2010).
At the same time, some people refer to certain research that shows that there is genetic predisposition and some people simply cannot do anything about their weight (Tsai & Bessesen, 2012). Though, it is necessary to add that the vast majority of researchers claim that obesity and overweight should be treated as any other disorder as these problems are often associated with other serious diseases.
Admittedly, apart from a purely medical facet, there is a constitutional side, so-to-speak. Admittedly, each person has the right to make own choices. If an individual chooses to live a healthy life, it is really good and praiseworthy. However, a person can choose any path and if an individual has nothing against being overweight, it is his/her choice. Unwillingness or inability to live a healthy lifestyle is not a crime, but it is a life choice which people have the right to make.
Nonetheless, the state cannot let people make wrong choices. Of course, it is inappropriate to make people change their lifestyle. No democratic country can do this. However, it is one of the responsibilities of the state to encourage its citizens to be healthy. Therefore, lots of wellness programs should be launched and promoted. One of the ways to encourage people to live a healthy life is to introduce wellness programs in workplace.
This brings the third facet of the issue to the fore. Employers should introduce wellness programs to encourage people to be healthy. Employers offer a variety of perks to win the best employees and to enhance their performance. Medical insurance is one of these perks.
It is necessary to note that medical insurance costs rise, which is a meaningful obstacle for companies struggling with financial constraints. More so, overweight people tend to have health problems, which negatively affects their performance and they can often be on a sick leave. All this can have a negative impact on the overall performance of the company.
Besides, this also makes healthier people less committed to work hard. People who do not have weight issues and overweight people often have equal opportunities and perks, while the latter can be regarded as less effective for a company (regarding insurance costs). It seems fair that each employee should be rewarded in terms of his/her contribution to the companys development. As far as I am concerned, overweight people should make the effort to be more cost-effective, so-to-speak.
Admittedly, it is impossible to discriminate people for the way they look. Nonetheless, companies also need high-profile employees who bring profit. Companies cannot reject candidates who are overweight. However, they should have wellness programs that are thoughtful and effective. This can be regarded as one of the perks as employers can remain fit and healthy. Participating in the wellness program can imply a better insurance package for employees.
At the same time, if an employee does not comply with the rules and ignores the wellness programs it is necessary to penalize him/her. One of the ways to penalize such employees is to provide a reduced insurance package. Basically, penalties will compensate insurance costs. As for the ethical facet, each employee should try to be more competitive. Being healthy and professional can be regarded as being more competitive nowadays.
To sum up, it is necessary to note that overweight people as well as fit people should try to remain competitive. Remaining healthy and participating in a wellness program is a good way to show commitment and readiness to make the extra effort for the company. Therefore, I believe overweight people can be penalized for their unwillingness to participate in wellness programs which are properly developed. This is not a way to discriminate these people; this is the way to encourage them to be healthier.
The human body organs have several neuroendocrine cells. These cells are mostly found in the lungs and digestive system. Neuroendocrine cells produce hormones in the endocrine glands thyroid and adrenal glands (What is NET Cancer?, n.d.). At times, these organs can develop tumors from the neuroendocrine cells, and then multiply as it spread to other body parts.
Notably, tumor development occurs when special cells undergo various changes making them to disintegrate uncontrollably and form abnormal tissues (Neuroendocrine Tumors Diagnosis and Treatment at Mayo Clinic, n.d.). Some of neuroendocrine tumors (NETs) are carcinoid tumor, insulinoma, pancreatic endocrine tumor, and medullary thyroid carcinoma. The symptoms that come with NET largely rely on an individuals biological set up and the place where the disease has infested.
For instance, overall tiredness and digestive problems are experienced at the early stages of infection. For bronchial carcinoid, there is constant cough, wheezing, and bloody sputum. Intestinal carcinoid shows obstruction in the bowel, pain in the abdomen, and diarrhea. On the other front, insulinoma shows symptoms of low sugar level through sweating and nausea.
This type of cancer causes extreme negative conditions on a humans life. Specifically, NET can result to diabetes, which come due to insulins failure to absorb sugar into the blood stream (Neuroendocrine Tumor, 2012). This effect can be realized if NETs have shown features such as insulinoma and glucagonoma. In addition, massive weight loss, disturbance in balance of water in the body, and development of peptic ulcer disease are the consequences of NETs.
The disease can also cause pancreatic related diseases. When the disease attacks the pancreas, the normal function of this organ is disrupted. In the end, NETs can cause death. Excess acid in the stomach can also erode the parts of an individuals stomach. An infection on the intestines can cause abdominal pain and complications in the ileum thus preventing sufficient food absorption.
This disease has some factors that facilitate or accelerate the entire tumors growth process in a human being. The first risk factor is age; older people tend to develop pheochromocytoma, which is another form of cancer (Cancer (General) National Institutes of Health (NIH), n.d.). Secondly, family history is another risk factor. This factor is linked to hereditary affairs. For instance, tumors grow extremely fast under the influence of multiple endocrine neoplasia type 1 (MEN1).
On the other hand, multiple endocrine neoplasia type 2 (MEN2) links with the medullary thyroid cancer and pheochromocytoma. In addition, ethnicity has a role in the spread of NET; for example, Merkel cell cancer mostly affects whites than the blacks. Since NET affects even the skin, sun exposure is, therefore, a great risk factor. The sun makes the skin to easily be peeled off. Immune system suppression also acts as a facilitator in the spread of NET.
Surely, a person who is having human immunodeficiency virus (IV) has high chances of developing neuroendocrine tumors (Kulke et al., 2011). These cases of tumor growth can be minimized. For pancreatic tumors, there is no preventive measure that is currently in place. However, for glucagonoma, a person should avoid direct sunlight that could make the skin to peel off easily.
People who suffer from NET can consume many greens in their diet. Fruits and vegetables help to eliminate toxins from organic foods that were consumed, as they have photochemical thus mitigating undesired growths (Summers, 2012). Foods full of protein, if consumed beyond the required limit, facilitate tumor growth.
Therefore, safe-eating habits as a form of life style can assist in reducing cases of NETs. Remarkably, watermelons, onions, and tomatoes have lycopene chemical that can prevent oxidative damaging; therefore, a good diet tries to reduce cancerous growths (Summers, 2012). From the steps outlined, a patient can employ such techniques not only to reduce the disease progress but also to improve his/her quality of life. In general, each person should know the nutrient content of foods he/she consumes.
In detecting some type of cancers, most health providers misdiagnose these diseases. This is due to the similarity that some of the NETs cancers have in their symptoms. For example, signs noticed in Irritable Bowel Syndrome (IBS) are similar to those of carcinoid tumors. At Mayo Clinic, chemotherapy, radiotherapy, and surgery are extensively used in the treatment process.
Although there are promising steps towards NETs treatment, wrong diagnosis is still arising. Under chemotherapy, only pancreatic tumors act in response to this therapeutic tool, while carcinoid tumors do not respond (Neuroendocrine Tumour, n.d.). Then, there is the radio ablation, which uses hot electrodes to destroy abnormal growths.
From the given perspective, NET treatment lies on a nutritional balance. This approach is easy to practice and reduces chances of wrong diagnosis. A current research is trying to distinguish clearly between two different types of NET (Kulke et al., 2011). The research is aiming at coming up with a specific drug for a specific type of NET.
This scenario will limit cases of misdiagnosis and even ensure that one drug treats only a specified disease. Further research should assist in distinguishing between two different unusual growths at their earliest stage possible.
References
Cancer (General) National Institutes of Health (NIH). Health Information National Institutes of Health (NIH). Web.
Kulke, M. H, Siu. L. L, Tepper. J. E, Fisher. G, and Jaffe. D. (2011). Future Directions in the Treatment of Neuroendocrine Tumors: Consensus Report of the National Cancer Institute Neuroendocrine Tumor Clinical Trials Planning Meeting. Journal of clinical oncology, 29(7), 934 943. Web.
Neuroendocrine Tumor. (2012). Cancer.Net | Oncologist-approved cancer information from the American Society of Clinical Oncology. Web.
Essential II: Basic Organizational and Systems Leadership for Quality Care and Patient Safety discusses the role of leadership skills in improving the quality of the provided care and focuses on the issue of patient safety which can be addressed with references to the nursing practice. According to Essential II, leadership skills are necessary to accentuate ethical and critical decision making, initiating and maintaining effective working relationships, using mutually respectful communication and collaboration within interprofessional teams, care coordination, delegation, and developing conflict resolution strategies (American Association of Colleges of Nursing, 2008, p. 13). Thus, the nurses leadership skills are significant to improve the healthcare environment about quality and safety questions.
Exemplar
The principles of Essential II can be discussed with references to the case of proposing initiatives for improving patient safety within the healthcare organization. Referring to the case, I have learned that the discussion of patient safety initiatives is based on provided reports and conducted analyses. This process is associated with the leaders decision-making activities, thus, this case was selected for the discussion. Patient safety initiatives are discussed and implemented to contribute to patient safety while decreasing the number of medical errors (Jones, 2009; Sullivan, 2012). The case is based on using specific Six Sigma and Plan-Do-Study-Act methods to analyze the effectiveness of the proposed initiatives to reduce the number of medical errors while providing care and treatment.
Reflection
I can state that the discussed case of analyzing the proposed patient safety initiatives is closely associated with the ideas related to Essential II because the nurse implements safety principles and works with others on the interprofessional healthcare team to create a safe, caring environment for care delivery (American Association of Colleges of Nursing, 2008, p. 13). Thus, the proposition, analysis, and discussion of patient safety initiatives are the components of the nurses activities (Amer, 2013; American Psychological Association, 2010). The reason for the statement is in the fact that the focus on such activities develops the nurses leadership qualities along with improving their professional level. Following the cases aspects and the idea that nurses should act as the leaders in the healthcare organizations, I can state that the development and analysis of different initiatives and projects such as the patient safety initiatives are important to promote the quality of the care (Bell, 2001; Meister et al., 2002; Oermann, 2002).
E-Folio: Essential III and the Case
Essential III: Scholarship for Evidence-Based Practice states with references to the nursing practice that scholarship for the baccalaureate graduate involves identification of practice issues~ appraisal and integration of evidence~ and evaluation of outcomes (American Association of Colleges of Nursing, 2008, p. 15). A nurse needs to find the credible information which is necessary for the work, to evaluate the evidence appropriately, and to integrate the data into practice because the nursing practice should be evidence-based, and it should be supported with the significant scholarship background (Bell, 2001; Meister et al., 2002; Oermann, 2002).
Exemplar
I have selected to analyze the project in which I had ranked the evidence according to the GRADE system. I am inclined to state that this case is an effective example to demonstrate the importance of Essential III. Thus, it was necessary for the project to choose the grading system, to provide the practice recommendation, to evaluate the strength of the recommendation and the quality of the evidence. From this point, the development of the project can be discussed as an example of the necessity to learn how to evaluate the evidence to continue the research and make the effective conclusions appropriate for the nursing practice (Schmidt & Brown, 2012). The overall number of recommendations provided was three recommendations. Thus, I received the opportunity to evaluate the evidence about three different recommendations to improve my skills in conducting the research and evaluating the information. The ability to rank or classify the evidence according to definite criteria is important to promote the evidence-based practice with references to the scholarship skills (Majid, 2011, p. 229).
Reflection
I have analyzed the role of the completed project for my learning and career with references to the principles stated in Essential III. Thus, it is mentioned in the essential that nurses should integrate reliable evidence from multiple ways of knowing to inform practice and make clinical judgments (American Association of Colleges of Nursing, 2008, p. 16). Working on the project, I could improve my skills in conducting the necessary research, evaluating the resources, choosing the most appropriate material, and providing effective conclusions. From this point, the project was effective enough to improve skills and abilities in activities that are closely connected with the evidence-based practice (American Psychological Association, 2010). Today, I understand the principles of the evidence-based practice clearly and can use them with references to the scholarship and work with the information, data, and evidence.
References
Amer, K. S. (2013). Quality and safety for transformational nursing: Core competencies. Upper Saddle River, NJ: Pearson.
American Association of Colleges of Nursing. (2008). The essentials of baccalaureate education for professional nursing practice. Web.
American Psychological Association. (2010). Publication manual of the American Psychological Association. Washington DC: American Psychological Association.
Bell, S. (2001). Professional nurses portfolio. Nursing Administration Quarterly, 25(2), 69-73.
Jones, S. (2009). Reducing medication administration errors in nursing practice. Nursing Standard, 23(50), 40-46.
Majid, S. (2011). Adopting evidence-based practice in clinical decision making: Nurses perceptions, knowledge, and barriers. JMLA, 99(3), 229236.
Meister, L., Heath, J., Andrews, J., & Tingen, M. (2002). Professional nursing portfolios: A global perspective. MEDSURG Nursing, 11(4), 177-182.
Oermann, M. (2002). Developing a professional portfolio in nursing. Orthopaedic Nursing, 21(2), 73-78.
Schmidt, N. A. & Brown, J. M. (2012). Evidence-based practice for nurses: Appraisal and application of Research. Boston: Jones and Bartlett Publishers.
Sullivan, E. J. (2012). Effective leadership and management in nursing. Upper Saddle River, NJ: Pearson.
Usual source of medical care: pediatricians office, attending practice for the first time
Patient provided information on his own, aware and oriented, reliable as a historian.
Chief Complaint
I have a sore throat for three days now, the ache is stronger closer to the evening, and it hurts when I swallow.
History of Present Illness
17-year-old Caucasian male with no major health concerns and/or history of family illness.
No reported hospitalizations, surgeries, or major illnesses/health conditions for one year prior to the admission.
Illness: A sore throat. Onset three days before the admission. Frequency constant. Location: throat, pulsating headache in the whole head, swollen glands. Characteristics persistent, dull, strengthened closer to the end of the day. Aggravating factors pain is stronger during swallowing. Relieving factors medications (ibuprofen). Timing three days with no sign of relief. Progression since the onset addition of abdominal pain and pounding headache. Patients perception pain reported as severe (8/10), disruption of daily routines (has difficulty eating and drinking), increased tiredness, disruption of academic activity (missed three days of school). Precipitating factors not identified.
Review of Systems
Head: Reported pounding headache across the whole head.
Ears, nose, throat, and mouth: Swollen glands. No nasal congestion. No sinus pressure. No ringing in ears. No ear pain. No jaw pain. No tooth pain.
Eyes: No reported vision problems.
Chest and lungs: No cough, no shortness of breath, no pain in the chest.
Gastrointestinal and endocrine system: dull pain throughout the course of illness. Pain in the tip of the abdomen. No reported change in bowel movement, one BM per day. Normal bowel movement this morning (LBM).
Musculoskeletal system: body ache throughout the course of illness (relieved by Motrin).
Past medical history no reported major illnesses.
Past hospital, surgical, and injury history N/A
Allergies N/A
Medications: Ibuprofen, Motrin, cough drops (unidentified, stopped using due to ineffectiveness). No flu immunizations.
Pertinent social history and habits lives with parents (both employed) and two sisters. Feels safe at home. Good academic performance. No mood disorders, no suicidal thoughts. Has a girlfriend. Not sexually active.
Family History no illness observed in the family. No record of similar symptoms in the past.
Objective Data
Physical Exam
Vital signs: blood pressure 125/85. Heart rate 65 bpm, regular. Respiratory rate 15 per minute. Temperature 102 F. Patient not in distress, is not under the influence of drugs or alcohol, articulates clearly. Alert, aware and oriented. Poor state of well-being due to severe pain and disrupted routines and habits.
Pertinent positive findings persistent pounding headache, abdominal pain, soreness in the back of the throat, high temperature, tiredness, painful sensation during swallowing, swollen glands. Overall pain in the musculoskeletal system.
Pertinent negative findings no cough, no nasal congestion, no ear pain, no ringing in the ears, no sinus pressure. Abdominal pain not accompanied by disrupted bowel movement cycle. No previous personal or family history of similar illnesses in the past year.
Assessment
Primary diagnosis of illness: Flu (ICD-10-CM Diagnosis Code J11.1). The common symptoms of the illness include high body temperature (over 100 F), headaches, body ache, sore throat, weakness and tiredness, and, on some occasions, abdominal pain (Healthline, n.d.a). The symptoms can become stronger closer to the end of the day. Some types of influenza are not associated with lower respiratory symptoms such as cough (Healthline, n.d.a). The absence of flu immunizations increases the likelihood of developing the disease.
Differential Diagnoses
Strep throat (ICD-10-CM Diagnosis Code J02.0). A bacterial infection of the higher respiratory systems that results in the inflammation and discomfort in the throat. Many of the positive findings are consistent with the condition, including a sore throat, pain during swallowing, fever, high temperature (above 100 F), and pounding headache (Healthline, n.d.b). However, neither abdominal pain nor body pain is characteristic of the condition. In addition, strep throat is unlikely to develop without cough.
Tonsillitis (ICD-10-CM Diagnosis Code J03.90). The condition resulting from the inflammation of the tonsils caused by overexposure to the viruses or bacteria. Commonly occurs as a result of a bacterial infection but can be caused by a viral disease such as influenza. Pertinent positive findings consistent with the diagnosis include swollen glands, headache, throat pain during swallowing, fever, and abdominal pain (WebMD, n.d.). However, the pertinent negative findings of ear pain and the characteristic white coating of the tonsils must be taken into account.
Toxic Shock Syndrome (ICD-10-CM Diagnosis Code A48.3). A severe health condition caused by the bacterial toxins in the bloodstream. The condition is associated with symptoms such as fever, headache, abdominal pain, tiredness, redness and pain in the throat, and muscle aches (Mayo Clinic, n.d.). However, it is inconsistent with several negative findings, namely the absence of vomiting, nausea, disruption of bowel movement, diarrhea, confusion, and redness of the eyes. In addition, the condition is relatively rare and is uncommon in association with flu.
Health Promotion Diagnosis
The lack of awareness of the importance of seasonal vaccinations in the patients family. The fact that Johns mother is against the flu shots puts all her children under the increased risk of developing a viral condition. The risk is further aggravated by the fact that flu is highly contagious and can spread across the entire family once developed by one of its members, thus complicating the treatment process.
Plan
The plan for management of the primary diagnosis includes the treatment of fever, ache, and soreness, as well as rest and appropriate changes in food and liquid intake. The patient is recommended to proceed with soft foods as a primary dietary choice as long as the unpleasant sensation during swallowing persists. He is also advised to increase the daily intake of fluids in order to maintain the necessary level of hydration of the lower respiratory system and prevent the formation of mucus later in the course of illness.
The fever can be treated with ibuprofen in order to prevent musculoskeletal pain. The patient is advised to avoid contacts with peers to contain the disease and get as much rest as possible. It is also recommended to increase the humidity of the environment (e.g. by using a humidifier) in order to prevent the development of cough and mucus formation. Finally, the patient as well as his family should be educated on the common symptoms of flu that might develop in the future (e.g. nasal congestion and cough) and provided with the information on the feasible ways of preventing and addressing them (e.g. administration of saline nasal drops).
Finally, it is important to educate Johns parents on the safety and effectiveness of the flu shots, outline the main risks associated with the viral infections, explain the principle of seasonal vaccination effects, and focus on the common misconceptions accompanying the decision to limit the vaccination practices.
Signature (first name initial, last name, RN, UIC, specialty)
The patients presenting problem is of moderate severity. The inquiry of patient history, as well as the physical exam, was expanded but not detailed. The decision-making is relatively straightforward. The patient is new to the practice. Therefore, the CPT billing level code is 99202.
The social comprehension of health care service provision has changed a lot over the last couple of years. The most notable changes regarding health and illness are the classification of human conditions and experiences from being normal to medical conditions (Micah and Rich 45). Studies have established that no matter the peoples position regarding health care services they will always diffuse through various elements of human life. Medicalization is a contemporary medical subject that has completely changed peoples perceptions about life, medicine, as well as human conditions and experiences they considered ordinary (Best 123). The concept has had a huge impact in the medical realm, as studies show that medical practitioners consider it as an effective tool for increasing the rate of diagnosing various health conditions affecting people.
Studies indicate physicians do not have much influence on the development of medicalization compared to patients, pharmaceutical industries, and policy cover providers (Best 126). In addition, the studies show that medicalization has a bright future. Research on improving its effectiveness is underway, meaning that there is room for innovation (Micah and Rich 51). This research paper will examine the concept of medicalization in terms of its meaning, growth, development, and benefits. The research will also provide examples of human conditions and experiences subject to medicalization.
What is Medicalization?
Medicalization refers to a cognitive process through which behavioural, poignant, or physiological human conditions get pathological classification for medical treatment (Conrad and Schneider 16). The concept of medicalization developed out of research on the causes, nature, and effects of diseases. Human conditions or experiences subject to medicalization undergo medical studies to establish their practicability to identification, deterrence and management. In addition, the process looks up for human conditions that result from body malfunctions. Some of the human conditions subjected to medicalization include sexual abuse, alcoholism, pregnancy, childbirth, obesity, and erectile dysfunction among others (Conrad and Schneider 22). Studies have shown that physicians often look up, and handle these problems.
The main driving force behind the development of this concept is the ability to change peoples attitudes. A positive attitude towards biomedicine allows people to develop deeper knowledge about various human conditions and the best ways of managing them. Medicalization classifies human conditions or experiences as either a sickness or a disorder (Conrad and Schneider 31).
As a psychological concept, medicalization identifies the impact that physicians, patients, and health care providers can have in managing the human conditions. It is important to manage the conditions as either illnesses or disorders because they do not compromise the identity of a society in terms of their attitude towards them, financial obligations, and improved provision of health care services (Conrad 100). In addition, the psychological application of this concept focuses on the impacts felt by people who suffer from the conditions or undergo through the classified experiences. The role of medicalization in the management of human conditions is moving them from social models to medical models.
History and development of medicalization
The concept of medicalization first came into the limelight during the 1970s. It was introduced through sociological and medical literature that focused on promoting the need for increased coverage of medical services. Two sociologists, Ivan Illich and Michel Foucault, developed the concept of medicalization (Best 128). Ivan argued against the overreliance of people on physicians to solve their problems because medical intervention was leading to more illnesses. Ivan further stressed his concern by saying that the society was suffering the greatest loss because people did not have options of dealing with their problems other than medicine (Micah and Rich 58).
Ivan and his friend felt the need to develop a strategy that will make physicians have the ability to deal with numerous human conditions and experiences that were affecting people. The best solution to this predicament was to reduce the power of the people to deal with their conditions and transfer the abilities to medical practitioners. This is how human conditions and experiences underwent pathological classification. Henceforth, these conditions became the concern of physicians (Conrad and Schneider 43). The term medicalization was developed out of this idea. It was used to refer to a process of transforming ordinary human conditions into treatable conditions.
Psychological experts believed that physicians were applying the concept of medicalization even before it was developed. According to the nature of work done by medical authorities, their concern for human conditions and experiences has always been part of their work through social control (Conrad 109). Technological advances and change of perceptions in the society are some of the factors that helped in the development of medicalization. However, studies show that people were reluctant to embrace change because of their perceptions regarding the conditions and experiences subjected to medicalization (Micah and Rich 62).
Most people were unwilling to accept a different life, owing to the fact that things they considered normal were now changing into medical conditions. People went through a phase of denial. Most of them could no longer understand and deal with natural processes anymore as they used to do in the past. Psychological experts argue that human beings are afraid of change for the fear of losing their identity and ability to continue meeting their daily needs (Best 141). Medicalization introduced numerous changes to the lives of people, which they initially struggled to deal with.
Criticisms of medicalization
Over the last couple of years, medicalization has made numerous strides. However, it has not been a smooth ride as the concept has been subject to numerous criticisms. Most critics have expressed their concerns over the effect that medicalization has on peoples lives and the legal power of medical practice. Most people felt that medicalization demonstrated the advancement of a capitalist society that focused on oppressing people (Conrad and Schneider 62).
Some critics also argued that medicalization was overlooking the real causes of the human conditions and experiences that were classified for medical treatment. They believed that some of the classified conditions and experiences were caused by social and economic factors. Medical practitioners were using medical terms to create a mystery out of the concept and to generate a good reason for the need to give those human conditions and experiences pathological classifications. Other critics argued that medicalization was having a negative effect on peoples lives instead of improving the quality of life (Conrad and Schneider 74). They argued that medicalization bleached the ethical code of conduct for medical professionals because it had an orientation towards making profits rather than giving people a chance for a better life.
The critics referred to studies, which established that diagnosis of new health conditions by medical practitioners plays a crucial role in the growth of the pharmaceutical industry. Diagnosis creates an opportunity for health care institutions and physicians selling drugs a chance to increase their profitability (Conrad 117). Pathological classification of certain human conditions and experiences created an opportunity for the health care industry, while people had with limited choices regarding the effective ways of handling natural processes. In addition, the critics felt that medicalization was having a psychological effect on people because of the stigma associated with medical conditions. People were feeling less assured about life because they did not feel normal anymore. Certain natural human experiences such as feeling shy did not qualify for pathological classification (Conrad 121).
The critics believed that pathological classification was necessary only to human conditions and experiences associated with body malfunctions. Critics also think that medicalization has taken away the role of nature in helping people to differentiate between medical and natural conditions. This role remains a preserve for health care institutions and physicians who have the power to decide whether a human condition or experience qualifies for medical treatment or not (Best 160).
Driving forces behind the development of medicalization
Four forces relating to the field of medicine have catalysed the development of medicalization. The four forces are health care professionals, patients, health care institutions, and the society. These forces have had different influences on the development of this concept. In the beginning, physicians had the most influence regarding the acceptance of medicalization (Micah and Rich 80). They were responsible for conducting diagnosis on various human conditions and experiences.
They applied their pathological knowledge and expertise to establish the causes, nature, and effects of the conditions on human health. Then, they would classify the conditions depending on the results of the diagnosis. When people begun to understand and embrace the concept of medicalization, changes were already happening in the medical industry. Corporations in the medical industry such as pharmaceutical companies were slowly finding their position in the development of this phenomenon (Conrad and Schneider 77).
Classification of numerous human conditions as medically treatable, increased demand for medical and pharmaceutical companies had a bigger role to play. Their influence in the development of medicalization was growing fast because physicians had to rely on the availability of medicine to classify a condition as treatable by use of medical means. Another driving force behind the development of this concept has been the patients (Best 203).
People suffering from the classified human conditions and experiences have helped in influencing the acceptance of medicalization and the drugs used to manage their situations. Initially, patients were victims of a change process that did not consider their social needs and the psychological impacts that they were suffering. They had a passive role in the development of the phenomenon, as their work was only to allow physicians to conduct diagnosis on them and prescribe medicine (Micah and Rich 84). However, their influence in the contemporary world has tremendously changed.
Patients had a more active role in the medicalization process, because they have more knowledge about the process. Pharmaceutical companies and health care facilities are using patients to advocate for increased pathological classification of various human conditions. As consumers, patients were also playing a crucial role in encouraging people to accept medication offered by physicians for managing their conditions (Conrad and Schneider 109). Patients were also actively involved as change agents who help to convince the society to change their perceptions about the medicalization and its possible impacts. Society is another force that has highly influenced the development of medicalization. The societal perceptions about disease and medicine played a major role in the prolonged classification of certain human conditions and experiences as being natural (Conrad 129).
This created a need for better strategies for managing the conditions, as people were continuing to suffer under the pretence of adhering to social intervention. However, after some time, people accepted that they needed help, although they feared for the effects of the association with medical conditions. The perceptions that people had regarding medical conditions, made it very hard for patients dealing with the stigma (Conrad and Schneider 116). The society did not perceive medical conditions in good light, thus the reason why most critics of medicalization considered it an imperialistic approach that would make people suffer.
Benefits of medicalization
According to critics, medicalization has increased peoples dependency on medicine and doctors to solve their problems. Psychologists argue that people can be harmed when they depend too much on something or somebody (Best 219). The reason for this is that over dependence leads to people lacking determination and loss of self-esteem. However, this is hard to avoid because people work towards leading healthy and happy lives for a long time.
Medicalization offers protection against factors and elements within the environment that can cause harm to human beings. Studies have shown that medicalization has helped to improve the quality of life for millions of people because of its numerous health benefits (Micah and Rich 91). Pathological classification of certain human conditions as diseases helps to provide the right treatment. Although people considered some of the classified human conditions as natural, studies have established that medicalization has helped to relieve many people of pain and agony they could have lived with for a long time.
Medicalization helped to change peoples perceptions about medicine. People had a negative perception about medicine because they felt it was moving them away from their identity and setting them up for the suffering due to stigma. Medicalization changed people from feeling normal to feel healthier. It has also given people more freedom to enjoy life to the fullest because they do not have worries about their health (Conrad and Schneider 130).
For example, people considered certain human conditions such as depression and bad behaviour as natural and untreatable. However, advances in medical research helped to identify medical approaches of establishing their patterns and providing effective medical treatment. For a long time, people thought that conditions such as bad behaviour among children were a natural and irreversible condition. However, medicalization has helped to develop treatment options that can help a child to change certain traits and improve their behaviour (Micah and Rich 109).
Medicalization of alcoholism
Studies have shown that since the inception of medicalization, people in professions out the field of medicine embraced the phenomenon more that their counterparts in medical practice. Patients and activist groups were very aggressive in promoting the concept, as they sought to cover as many areas of medicalization as possible (Best 300). One of the medicalization areas that received enormous backing from the support groups was alcoholism. In the context of medicalization, alcoholism refers to the prolonged and excessive intake of alcoholic drinks leading to a breakdown in health. In addition, alcoholism also leads to addiction to the extent that abrupt deprivation leads to severe withdrawal symptoms. Alcoholism is a popular area of medicalization because of the fact that it attracts people with shared interests.
The same case applies to the impact that the society had on the development of this concept, because people were working towards achieving a common goal. Medicalization of alcoholism resulted in the formation of the infamous group, Alcoholics Anonymous (AA) (Best 320). AA was formed to provide alcoholics with a platform for expressing themselves and managing their situation in the midst of people with similar challenges.
Alcoholism is classified as a disorder because the physical condition of alcoholics results in the disturbance of the normal functioning of the body. AA and other similar groups have continued to exist without the provision of medical treatment to members because alcoholism as a disorder has not received the right acknowledgement from physicians and pharmaceutical companies (Conrad 138). During the medicalization of alcoholism, it was hard for physicians to convince policy cover providers and pharmaceutical companies to back it up because it disorder classification did not prove any connection to an individuals genes. Instead, alcoholism classified as a disorder developing from bad life choices and social influence. Psychotherapists argue that any research that can prove the existence of a relationship between alcoholism and human genes can have a tremendous impact of its medicalization (Conrad and Schneider 161).
It is important to note that medicalization of alcoholism does not mean that the disorder is treated by the use of medicine. The treatment approach applies a therapeutic strategy that allows the patients to express themselves, accept their situation, and learn tips on dealing with their problem (Conrad 140).
Up to now, alcoholism does not apply as a medical disorder because of the lack of evidence to link it with an individuals genetic composition. Alcoholism was subject to medicalization because the condition was having serious effects on the health of the addicts (Conrad and Schneider 169). Some of the individuals were even more vulnerable to attack by certain diseases compared to those who took alcoholic drinks on a regulated scale. Studies indicate that most alcoholics are less productive and a huge burden to their family members who have to work to feed them. In addition, the studies indicate that most alcoholics rely on others to sustain their addiction, as they do not have sources of income and cannot do anything without taking alcohol (Conrad and Schneider 180). Therefore, medicalization of alcoholism happened in order to improve the health and productivity of people crippled by the disorder.
Conclusion
Medicalization is a contemporary medical subject that has completely changed peoples perceptions about life, medicine, as well as various human conditions and experiences they considered ordinary. Medicalization refers to a cognitive process through which demeanour, poignant, or physiological human conditions get pathological classification for medical treatment. Examples of human conditions subject to medicalization include sexual abuse, alcoholism, pregnancy, childbirth, obesity, and erectile dysfunction among others. Medicalization has moved human conditions and experiences from social models for medical models. Psychological experts argue that human beings are afraid of change. Medicalization introduced numerous changes to the lives of people, which they initially struggled dealing with. Critics argue that medicalization has increased peoples dependency on medicine and doctors to solve their problems.
Works Cited
Best, Joel. Images of Issues: Typifying Contemporary Social Problems. New Jersey: Transaction Publishers, 2005. Print.
Conrad, Peter. The Medicalization of Society: On the Transformation of Human Conditions into Treatable Disorders. New York: JHU Press, 2007. Print.
Conrad, Peter, and Joseph, Schneider. Deviance and Medicalization: From Badness to Sickness. California: Temple University Press, 2010. Print.
Micah, Andy, and Emma, Rich. The Medicalization of Cyber Space. New York: Routledge, 2008. Print.
Lessons Learned: St. Leos Values and Stages of Anger in Autistic Patients
The environment of the St. Leo offers a plethora of opportunities for education and training of the skills for helping children, teenagers, and adults with autism (St. Leo University, 2017). The experience that I gained there played a pivotal role in my professional growth. By working with adults with autism and autism spectrum disorders as a volunteer, I learned a variety of important techniques and acquired the information that will help me create efficient treatment strategies in the future based on my knowledge of the stages of anger.
The core values of St. Leo must be listed among the key factors that contributed to my education and professional growth. The emphasis on professional integrity and ethics, as well as the need to focus on a patient-centered and evidence-based approach, served as the platform for the rapid development of necessary knowledge and skills. For example, the need to be respectful toward any individual, appreciate their ideas, and recognize the rights and freedoms to which they are entitled should be mentioned among the core values that St. Leo views as necessary (St. Leo University, n.d.).
The issue of anger management takes a special place in the contemporary healthcare system and especially in the approach toward managing the needs of people with autism. While it is essential to convey to target demographics that giving vent to their feelings is important, it is also imperative to provide them with healthy techniques for handling their anger and the relevant emotions. Working at the St. Leo, I realized that five primary anger stages could be isolated in autism patients. The first stage can be defined as being calm, i.e., the lowest level of anger. The said stage is a desirable condition that social workers in similar facilities must strive to maintain in patients.
The second stage can be described as mild anger, i.e., slight irritation at specific irritants. It is easiest to manage anger issues of autistic people at the identified stage, which means that tools for monitoring changes in autistic patients moods and behaviors must be introduced to provide them with proper care. The specified stage is often conflated with the third stage, which can be described as a higher level of annoyance that approaches frustration. Strong irritation and the feeling of being overwhelmed can be regarded as the third and fourth stages, whereas anger itself is the fifth and final stage.
The specified information is crucial for tending to the needs of autistic patients. By creating the environment in which autistic patients will feel relaxed and will not have to deal with the irritants that typically provoke an anger-related incident in autistic patients, one will be able to align with the values and ethics of the St. Leo University. By learning more about the stages of anger and management techniques that can be deployed to handle each of them, as well as participating actively in volunteer work, I experienced impressive professional growth. Based on the information about the stages of anger that I have learned, I will be able to design new and improved approaches toward providing required care and support for people with autism and autism spectrum disorders. Therefore, working at the St. Leo was a valuable experience that shaped me as a healthcare professional and helped me gain a deeper insight into the needs of patients with autism.
References
St. Leo University. (2017). Leadership development. Web.
Extant literature shows that Klinefelter syndrome (KS) is a chromosomal condition that affects the male physical, psychosocial and cognitive capacities due to the presence of one or more supernumerary X chromosomes among the affected individuals.
With an occurrence rate of 1:500 to 1:1000 live male births, affected persons exhibit a multiplicity of signs and symptoms such as hypogonadism, fertility problems due to low testosterone, decreased body and pubic hair, tall stature, gynecomastia, language-based learning incapability, and disorders of the executive function (Turriff et al., 2011; Verri et al., 2010).
KS remains a common yet underdiagnosed genetic condition due to its high variability among individuals, overlapping of symptoms with those of other medical conditions, and complexities in clinical manifestation (Genetic Home Reference, 2013; Herlihy et al., 2011). The present paper aims to illuminate the cognitive and psychosocial aspects of a male with KS in the post-puberty stage.
Although cognitive characteristics vary among affected individuals, available literature demonstrates that a considerable number of young adults with KS exhibit learning disabilities and delayed speech and language development (Genetic Home Reference, 2013) caused by chromosomal abnormalities (van Rijn et al., 2012).
A study by Verri et al (2010) shows that 70-80% of XXY males demonstrate language disabilities that are exhibited in terms of delay in onset of first words, acquisition of the main phases of language development and challenges in the articulation of sounds or syllables in lexical retrieval and processing of phonemes, resulting in limitations in reading, expression, writing and reasoning abilities in arithmetic (Verri et al., 2010).
Verri et al (2010) acknowledge that individuals with KS have limitations in material processing speed and memory of auditory verbal material, which are associated with problems in decoding words (p. 426).
Cognitively, therefore, these challenges result in a lower speed, accuracy and verbal comprehension, particularly when the reading of material is done aloud. Adults may not exhibit these symptoms probably due to experience gained over a long time, but they too exhibit distinctive characteristics of cognitive deficiencies (Turriff et al., 2011).
Substantial reduction in verbal scale and IQ performance has been noted in young adults diagnosed with atypical aneuploidy (e.g., XXXY 48 and 49 XXXXY) compared with those exhibiting the XXY variant (Verri et al., 2010), demonstrating that cognitive limitations are correlated with an increasing number of supernumerary X chromosomes (van Rijn et al., 2012).
It has also been reported in the literature that young adults with KS are hyperactive, demonstrate difficulties in concentration and short-term memory, and also project a docile temperament and lower activity levels compared with unaffected peers within the general population (Herlihy et al., 2011; Verri et al., 2010).
Indeed, as reported by Verri et al (2010), in a population of KS aged 16 and 61, younger subjects have lower performance in tasks that require executive functions, problem-solving skills and speed in processing the information, whereas adults show adequate performance (p. 427).
This finding is critical in demonstrating that the cognitive performance of young adults diagnosed with KS may actually improve as they progress through the lifespan due to experience. However, these individuals need to be exposed to speech, educational and cognitive interventions earlier in life to improve later outcomes (Herlihy et al., 2011).
In psychosocial aspects, extant literature demonstrates that lack of incomplete puberty, breast enlargement (gynecomastia), unusually small penis (micropenis), speech and languages deficiencies and other physical, developmental and cognitive challenges posed by KS may lead to poor socialization and lack of integration of the affected young adults within the peer group (Genetics Home Reference, 2013; Turriff et al., 2011).
These challenges, according to Verri et al (2010), act as a source of anxiety and mood disorders, shyness, immaturity and incapacity to establish intimate relationships with significant others.
Indeed, according to Verri et al (2010), most young adults exhibiting KS symptoms seem to be more sensitive, anxious and insecure, and show a higher incidence of anxious-depressive disorders than the general population and an increased propensity to use drugs (p. 428).
The literature is also unanimous on other psychosocial characteristics exhibited by young adults with KS, including atypical calmness, sensitivity to the immediate environment, lack of assertiveness, depression, closure, low self-esteem, passiveness and problems in socialization (Herlihy et al., 2011; Verri et al., 2010).
In most occasions, these aspects combine with unattended learning difficulties and limitations in normal developmental processes to result in secondary adaptation and behavioral challenges for the affected individuals. This scenario compromises the individuals quality of life outcomes, including subjective well-being, interpersonal relationships, self-esteem, body image, mental health and general health, leading to high school dropout rates, antisocial behavior, sickness and deviance (Herlihy et al., 2011).
There are a number of opposing views concerning the presence and occurrence of KS. To date, some people think that KS results from the presence of one extra copy of the X chromosome in each cell; however, available literature has proved that some individuals with characteristics of KS may indeed have more than one extra X chromosome in each cell (e.g., 48, XXXY or 49, XXXXY), resulting in more severe signs and symptoms than classic KS (Verri et al., 2010).
Other people have argued that KS and its variants are inherited; however, research has proved that the chromosomal shifts normally occur during the development of reproductive cells in a parent and the extra X chromosome is essentially caused by an error in cell division (Genetics Home Reference, 2013).
Lastly, although some studies have found KS subjects to have a general cognitive capacity around the normal range, the correct position is that the cognitive ability demonstrated by KS subjects is approximately 10 points lower compared to normal individuals within the general population (Verri et al., 2010).
References
Genetics Home Reference. (2013). Klinefelter syndrome. Web.
Herlihy, A.S., McLachlan, R.I., Gillam, L., Cock, M.L., Collins, V., & Halliday, J.L. (2011). The psychosocial impact of Klinefelter syndrome and factors influencing quality of life. Genetics in Medicine, 13(7), 632-642.
Turriff, A., Levy, H.P., & Biesecker, B. (2011). Prevalence and psychosocial correlates of depressive symptoms among adolescents and adults with Klinefelter syndrome. Genetics in Medicine, 13(11), 966-972.
Van Rijn, S., Bierman, M., Bruining, H., & Swaab, H. (2012). Vulnerability for autism traits in boys and men with an extra X chromosome (47, XXY): The mediating role of cognitive flexibility. Journal of Psychiatric Research, 46, 1300-1306.
Verri, A., Cremante, A., Clerici, F., Destefani, V., & Radicioni, A. (2010). Klinefelters syndrome and psychoneurologic function. Molecular Human Reproduction, 16(6), 425-433.
The secrecy of the individual information about the patients is the primary issue in the ethics of medicine since every person has a legal right for the protection of personal health data (De Bord par. 2). Nevertheless, in the exceptional cases, the regulation may be breached. Specifically, there are three categories of the conditions, under which the rules of confidentiality may be breached. Thus, the disclosure of the personal medical data may be sustained out of the patients consent, for the sake of the community interests, and, according to law requirements. Primarily, the individuals have a right for breaching their personal medical confidentiality either in the explicit form or in the implied model. The explicit consent for medical information disclosure can not be called a breach but rather a willful revelation of ones health data. Concerning the implied consent, it refers to the patients, who are disabled to show the signs of breach acceptance but their health situation requires it. In the latter case, the breach is attained through the assistance of Mental Capacity representatives (Blightman 12). The disclosure of medical information, which is sustained, according to the legal orders, often stems from the necessity to use the private data in certain law cases. Therefore, such data revelation, which is supported with the help of the corresponding legal documentation, can not be considered a breach as well. Finally, the interests of the society may require health information disclosure in such cases as contamination threats.
Every individual has certain medical history and specific medical concerns. Therefore, health records were devised with an aim of allowing the patients keeping their clinical data in one common place (What Is a Personal Health Record? par. 5). The records help people to manage their health requirements as well as assess the physicians in the determination of specific diagnosis, which often stem from the previous clinical concerns of a patient. Both a user of medical services and a clinical worker have to be well aware of the information, which is, traditionally, provided in health records. Thus, primarily, a compilation of information about the patient must contain the contact data about his/her doctor so that the respective person could be easily addressed. Secondly, health record, usually, provides some information about the allergies of the patient and the medication, which is or was taken by a record holder. Thirdly, medical scripts include some chronic diseases of a patient (if any) as well the dates and descriptions of the surgeries (if any). Finally, a critical component of a health record is the history of patients immunization and family history. The optional constituents of clinical script embrace dietary preferences, the data about blood pressure and cholesterol level (Personal Health Record: A Tool for Managing Your Health par. 5).
The disclosure of personal health data after the patients death relies on multiple factors. In general, the primary indicator of the confidentiality breakage stems from the desire of a deceased person. Thus, if a patient has mentioned that the disclosure of his clinical history is forbidden after his death, it is essential to follow the desire of a deceased (Confidentiality Guidance: Disclosure after a Patients Death par. 7). However, if the suggestion was not made, the medical worker may decide whether to reveal the private data or not by taking into account the interests of the patients family. In exceptional cases, for instance, in law cases, with the purpose of health surveillance or the community interests, the medical worker is entitled to break patient confidentiality to any desirable extent (Confidentiality of Medical Information Postmortem par. 8).
Works Cited
Blightman, Kevin. Patient Confidentiality: When Can a Breach Be Justified? Medicine & Health 22.3 (2013): 11-23. Print.
Confidentiality Guidance: Disclosure after a Patients Death 2013. Web.
Confidentiality of Medical Information Postmortem 2014. Web.
It is wrong to neglect the fact that many different organizations around the whole world want to earn easy money. People want to perform their work and get benefits in a short period of time. In such a country as the United States, much attention is paid to control such situations. However, there are cases when it is not expected from a company to break the law or the norms when it is involved in such fields as medicine, healthcare, and pharmacology. Employees have to comprehend that millions of lives may depend on the quality of the work they perform. It is impossible and unethical to steal or cheat on peoples lives just to earn some money. Still, the outbreak of meningitis in 2012 proves that, unfortunately, there are companies that can take such dangerous steps.
The activities of the New England Compounding Center (NECC) led to the outbreak of 753 cases of meningitis with 64 of them being fatal. People from more than 20 states underwent significant threats because of fungal meningitis.1The case ended with a serious trial of the owner and the main pharmacist of the company, Barry J. Cadden, and the up-to-life in a prison sentence. The investigation of a chronicle of the events that led to such an outcome should help to clarify the main reasons and comprehend the peculiarities of the case to avoid similar situations in the future.
September 18, 2012 The Tennessee Department of Health received the report where a 56-year-old patient with no evident risk factors was diagnosed with meningitis.2The only precedent that could be was his 46-day-earlier address to the center with lower back pain and the received epidural glucocorticoid injection.
September 25, 2012 seven more patients with meningitis from the same ambulatory surgical center were reported after the same type of injection. The investigation by the Centers for Disease Control and Prevention (CDC) showed that all vials of methylprednisolone acetate that were used for injections came from the same compounding pharmacy, the NECC. The company was informed about the investigation.
September 27, 2012 a North Caroline patient was diagnosed with subacute meningitis after the same injection.2In several days, all patients, who could have a connection with similar injections, were informed.
October 4, 2012 the microscopic evaluation of all NECC vials with methylprednisolone acetate occurred.
October 18, 2012 the representatives of the CDC and the FDA proved the presence of Exserohilum rostratum, the fungi Rhodotorula laryngitis, Rhizopus stolonifer, Cladosporium cladosporioides, and other types of fungi in all vials. 3
October 19, 2012 all state health departments admitted that they contacted all patients at risk of having meningitis because of the injections.
July 1, 2013 749 cases of meningitis with different complications, including the deaths of 8% of the patients in 20 states were reported.
As soon as the fault of the company was proved, Barry J. Cadden was accused of numerous deaths. The trial related to the outbreak of meningitis took place at the federal level. 4Cadden, as well as his wife, who performed the functions of another pharmacist, took responsibility for the deaths of people from different states.
Commentary and Creativity
In fact, the development of the events could be predicted and understood. The cases of meningitis are not frequent. Each time they occur, much attention is paid to clarify the reasons and identify the actual source of infection. The chronicles of the events in 2012 show that meningitis was not expected. It came from the company no one could even believe. However, at the same time, it is necessary to admit that some representatives of the surgical center where the first case of meningitis was observed in 2012 confessed that they decided to cooperate with the NECC because of low prices on the products and the possibility to buy everything in a short period.
In the field of pharmacy, the conditions under which the NECC employees worked were appropriate. During the trial, Giamei was the first person to testify in a trial4. He underlined that he could hardly believe that the company could be responsible for so many deaths because each product was properly tested. The compounding center followed all federal guidelines.
From pharmacy education, all pharmacists of the company were properly trained and tested before being employed. At the same time, the same witness, Giamei, discussed the peculiar feature of the organization and said that he had never seen the pharmacy laboratory but had to focus on promotions and sales. As well as Giamei, many other workers did not see the problem until the outbreak of 2012. Such a statement seems to be strange and unbelievable indeed.
Pharmacology and microbiology are the fields where numerous tests and analyses should occur regularly. It is not enough to train people or make all employees follow the norms. It is also necessary to take responsibility for each decision and think about the professional improvements but not about financial benefits.
Such organizations as the FDA and the CDC took all necessary steps and precautionary methods to protect people and underline the importance of public health. It is hard for people to deal with such health challenges alone. Therefore, the representatives of the FDA and the CDC demonstrated how it was necessary to organize the case, find the solution, and meet peoples needs.
Future
Many people want to know if it is possible to prevent such cases of meningitis or similar public health problems in the future. The answer is certainly yes. Still, people have to be ready to work hard and take responsibility. In its turn, the government has already demonstrated the intention to improve the situation and develop the regulations under which compounding pharmacies should work. President Obama signed the law within the frames of which it was possible to increase federal oversight and control medical and microbiological organizations1.
There are also many other steps that not only the government, but ordinary people should take. First of all, people should stop thinking that good medicine and pharmacology can be cheap. If there is one or several companies offer cheap production without any reasons in comparison to millions of other organizations with the already established prices, some threats can occur. Todays greed and the intention to save as much money as possible make many people take reckless steps and forget about such factors as safety, quality, and trust. Many companies are ready to provide their customers with guarantees. When something goes wrong, financial compensation turns out to be the best solution. Human life should be priceless. People may save on food, clothes, entertainment, and even education. However, when health is under consideration, no discussions should occur.
The outbreak of meningitis in 2012 occurred due to the mistakes made by the representatives of the compounding pharmacy. People were accused and sentenced. Still, 64 deaths occurred. It is high time for people to start thinking about the outcomes of their pettiness in such fields as pharmacology and medicine.
References
Enwemeka, Zeninjor. 7 things to know about the trial over deadly meningitis outbreak. Wbur News. 2017. Web.
Smith, RM, Schaefer, MK, Kainer, MA, et al. Fungal infections associated with contaminated methylprednisolone injections. N Engl J Med. 2013; 369(17): 1598-1609. Web.
Sulaiman, IM, Jacobs, E, Simpson, S, Kerdahi, K. Genetic characterization of fungi isolated from the environmental swabs collected from a compounding center known to cause multistate meningitis outbreak in United States using ITS sequencing. Pathogens. 2014; 3(3): 732-742. Web.
This study recognized that the education of patients in various rural areas varies widely and it was due to several reasons affecting the nurses who were to impart this information. There are factors that impacted the education of patients in those numerous rural areas. It is important to study this so as to prevent and to stop the current discrepancies in rural areas.
The main purpose of the study was to explore the matter that there are variations of patient knowledge in terms of their healthcare in different rural areas. It establishes what might be the possible causes of these differences based on nurses and which factors arise in the patient education concerning nurses academic preparation, years of experience and job roles of the nurses influenced their attitudes and comfort on the matter.
Do registered nurses attitudes and degrees of comfort affect the patient education in a rural area? This study tries to tackle this research question and uses hypotheses to lead it: Is there a variance in patient education in various rural areas? Are nurses involved in imparting patient education? Does the academic preparation, years of experience and job roles of the nurses all affect education of the patients?
Dependent variables are those that rely on another factor. They cannot exist on their own and come up only after the establishment of the independent variable. An independent variable is one that does not need the existence of another factor for it to occur. Nurses attitudes and degree of comfort are the dependent variables while years of experience, academic preparation and job roles, are the independent ones.
The theoretical framework is expressed through various statements in the body of the study and is based more on a scientific theory. The scientific theory is whereby a certain aspect is based on knowledge that was gathered from information collected. The study illustrates clearly that the concepts of interest are years of experience, job roles and academic education progression of the nurses.
It also demonstrates how the concepts of interest come together to define the kind of relationship between them. The framework is related to the body of nursing because it describes in detail how the various factors that affect nurses, end up affecting patient education, a part of nursing.
The articles described in the study are very much relevant to previous theories and studies. The independent variables are illustrated through various theories and studies like Kinnairds Model of Dynamics of Nurse Participation in Patient Education, the 5 levels of proficiency in the acquisition and the development of the necessary skills to become an expert by Benner, and so much more (Kinnaird, 1987).
The literature review relies more on sources that were established ten years ago and older, with the earliest being 1987 and the latest being 2004. It proves that the research question is valid and that the dependent variables and independent ones are very much correct, through various quoted studies and theories.
The only thing not described here, is how to go about solving this problem and prevent the same so it can never happen again. Therefore, since the research has proven to be valid and of correct information, the gap that needs to be filled is the way forward on how to ensure there is proper patient education in rural areas.
Surveys were majorly used to gather the necessary information in this study. Computerized databases were used to establish the basic information of various nurses for example, their academic background level. Surveys were used to collect a wider range of data in the field.
They are generally used to enable one to sample various individual responses in a target population and are done through different means like questionnaires. It supports improved accuracy and number of responses (Andres, 2012). This was a great method to use because it enabled the gathering of information from a wide number thus widening its scope.
There are two types of criteria involved in sample and setting: The inclusion and exclusion criteria. The inclusion criteria is whereby one establishes a conditions to enable a patient be incorporated in a study while exclusion criteria are those conditions designed to keep particular patients out of the study (Seright, 2010). Specification must be precise enough to enable a professional in the field to carry out the same study and understand these conditions (Rankin & Stallings, 2001).
The method used to identify the sample was the use of these criteria which were: hospitals that the Joint Commission on the Accreditation of Healthcare Organization has accredited, places with acute care and not non-profit hospitals in rural areas and hospitals with more than 200 beds. The questionnaire was sent to 412 nurses but only 273 were filled and sent back. As a result the sample size consisted of 273 (66.3%) nurses. Power analysis was not necessary for there were no statistically insignificant results found.
The demographics used in this study were gender, age, education level, work shifts, year graduated from initial nursing program, years worked in direct patient care, licensure and job role. The attrition impacts the features of the particular sample being examined, whereas mortality selection affects both the classification of the population and directly affects the sample under study (Stickley et al., 2009).
This was revealed in the results after collection of the samples, whereby most of the respondents were female staff nurses with most of them in the 40-49, having an associates degree while the highest education level was the masters degree. Most of them were experienced and with the 7pm-7am work shifts being the most common and held a registered nurses license.
The study secured permission from nurse executives who worked at 5 hospitals that passed the inclusion standards and it qualified for an advanced institutional review board authorization which was founded on hospital policy. The setting was 5 rural hospitals which is located on the Eastern Shore of Maryland. This was appropriate for the study for there was collection of important information.
Extraneous variables are those that are not necessarily independent but also affect the conduct of the subject being studied. These may include lack of educational planning and training; impact of peers, physicians, and management; or lack of time because of the complex schedules in the nursing field (Jones, 2010). The use of a database with all collected sample information and the inclusion and exclusion criteria enabled the study to be streamlined hence it focused on only the variables being looked into.
The key instrument and measurement strategy used was the questionnaire. It was designed particularly to measure demographics, patient education attitudes of the nurses, level of education attained and comfort in teaching self-care. The level of measurement was that of ratio or interval because of the information collected, there were various gaps between a number of scores or measurements.
Reliability is whereby consistent results are released while validity is how well measurements are done by an assessment tool. The questionnaires prove to be reliable for they give a relatively constant data but not necessarily valid depending on those answering them such that, wrong or incomplete information may be given.
Data was collected through the survey method whereby 412 nurses were mailed the questionnaires and upon completion sent them back. This was appropriate for it saved on time and resources while capturing a large audience. The questionnaires did not need indication of name or any other delicate personal details and thus protected the rights of the participants for non-disclosure naturally existed.
Statistical analysis procedures used were frequency, which estimated the particular number of responses on the questionnaires that fell in particular categories (also calculated in percentages) and one-way analysis of variance (ANOVA) with Bonferroni post hoc comparisons of the three independent variables.
As a result of this study, we know that nurses understand that need for patient education and their responsibility. They recognize the learning needs of a patient and can assess their willingness to learn. Though they comprehend the importance, establishment of goals with patients and their families are rarely or never done.
The same applies to the education process coordination and collaboration. The study also demonstrates that the more experience a nurse has, the more comfortable they feel imparting health care knowledge to patients. Nurses more advanced in their education also strongly support patient education. On the other hand the type of licensure did not prove to affect dependent variables. Role ambiguity proved to be a major problem in nursing.
The strengths of the scientific merit of this study is that the information collected was precise and categorized data accordingly therefore enabling focus on important data. Meanwhile the use of only 5 hospitals for sampling and use of anonymous surveys may not have been entirely valid for there is no way to determine if the information was true.
The implications of the study were: nurses play a major role in patient education, and must find a way to impart information in a more efficient and cost effective manner. Investigation of how their education background prepares them for the educator role and the hiring and retaining of experienced nurses (more than 10 years) is also important.
The data was relevant in distinguishing the information needed for the study, demonstrating that the role of nurses in educating, and in establishing job roles and academic preparation are relevant factors in attitudes and comfort of nurses towards teaching.
Results can be applied in identifying the most suitable nurses to employ and establishment of nurses as educators. Areas for further study suggested were other health care areas, consequence of the program for nurses and effects for nursing in clinical situations. The study thus proved to be significant for repetition in the future.
This study has enabled me to realize that as a nurse I am required to not only treat patients but also teach them. To be the best, I must advance my knowledge and gain as much experience in the field. I shall make sure I impart as much relevant information to the patient to enable them take care of their health.
References
Andres, L. (2012).Designing and Doing Survey Research. London: Sage.
Jones, A.R. (2010). Patient Education in Rural Community Hospitals: Registered Nurses Attitudes and Degrees of Comfort. The Journal of Continuing Education in Nursing, 41(1), 41-48.
Kinnaird, L. S. (1987). Nurse participation in patient education in a community hospital. Dissertation Abstracts International, 48, 3532 (UMI No. 8802819).
Rankin, S. H., & Stallings, K. D. (2001). Patient education: Principles and practice. Philadelphia: Lippincott.
Seright, T.J. (2010). Clinical Decision Making of Rural Novice Nurses. ProQuest LLC, p. 225.
Stickley, T., Roberts, S., Rush, B., Shaw, R., Smith, A., Collier, R.,&Felton, A. (2009). Participation In Nurse Education: the Pine project. The Journal of Mental Health Training, Education, and Practice, 4(1), 11.