Dental caries is one of the most prevalent diseases in the United States, as 94% of adults have it (Centers for Disease Control and Prevention: Dental caries, 2015). Thus its inclusion in Health People 2020 underlines its significance and necessity to study (Centers for Disease Control and Prevention: Healthy People 2020, 2016). Thus, individuals with low socioeconomic status were selected as a target group due to the increased vulnerability of their teeth. The background information will be studied with the help of the literature review, and the analysis of health records and semi-structured interviews with the patients will support the evidenced-based research. Acquiring information by using these methods will help determine a rationale for the development of the disease and provide appropriate methods for intervention.
Annotated Bibliography
Costa, S., Vasconcelos, M., & Abreu, M. (2013). High dental caries among adults aged 35-44 years: Case-control study of distal and proximal factors. International Journal of Environmental Research and Public Health, 10(6), 2401-2411.
The initial goal of the study is to find a connection between the caries severity and low income, frequency of visits to the dentist, and using the community benefits among the Brazilian adults (Costa, Vasconcelos, & Abreu, 2013). Thus, speaking of the correlation of the socioeconomic status and caries intensity, adults with a low income had a 2.2 higher chance of caries than individuals with a greater income (Costa et al., 2016). It was revealed with the help of using two focus groups with high caries and lower severity. In this case, the primary finding of this article is the fact that high caries severity vehemently pertains to the low-income level and decreased social cohesion. Keywords used: caries and low income. Database: PubMed.
Costa, S., Martins, C., Bonfim, M., Zina, L., Paiva, S., Pordeus, I., & Abreu, M. (2012). A systematic review of socioeconomic indicators and dental caries in adults. International Journal of Environmental Research and Public Health, 9(10), 3540-3574.
The authors of the article propose that a high level of caries and socioeconomic factors such as level of income, educational background, and socioeconomic status are interdependent (Costa et al., 2012). In this case, the hypothesis such as less schooling and more caries (p>0.5) and low level of occupation and more decayed teeth (p>0.5) received support with the assistance of the multivariate and bivariate analyses (Costa et al., 2012). It remains apparent that the findings depicted the initially proposed relationship with the help of the literature review. Nonetheless, it is questionable whether the level of income has an as high influence on the caries prevalence as for other variables. Keywords used: dental caries and socioeconomic factors. Database: PubMed.
Dye, B., Li, X., Thornton-Evans, G. (2012). Oral health disparities as determined by Selected Healthy People 2020 oral health objectives for the United States, 2009-2010. National Center for Health Statistics, 104, 1-8. Web.
The primary goal of the article is to provide a synthesis of statistical information to understand the rationale for the objectives reflected in Healthy People 2020. In this case, the authors of the publication refer to teeth retention as one of the factors, which require intervention (Dye, Li, Thornton-Evans, 2012). With the assistance of the assessment of statistical findings, the researchers depict a connection between teeth retention and poverty level. In this case, the article portrays that the adults living at the poverty level lost 38% of their permanent teeth, and the adults with a higher level of income have 45% of them (Dye et al., 2012). In turn, the complete retention of teeth was lower among the adults below the Federal poverty level (15%) than among adults with better socioeconomic status (32%) (Dye et al., 2012). It could be said that the findings provide a clear rationale for the need to include dental caries in Health People 2020. Keywords: dental caries, low income, statistics. Web.
Conclusion
In the end, it could be concluded that the publications offer a clear understanding that dental caries are an issue among adults in the modern world. In this case, the selected articles provide a clear image of the interdependence of socioeconomic status and dental caries. It was revealed that the level of income contributes to the increased severity of the disease. At the same time, the aspects such as educational background, occupation, and socioeconomic status cannot be underestimated, as they also affect the situation with caries prevalence among adults. Based on the factors provided above, it could be stated that the articles support the topic of research with profound background information and highlight that the continuation of the study is necessary.
Centers for Disease Control and Prevention: Healthy People 2020: Oral health objectives. (2016). Web.
Costa, S., Martins, C., Bonfim, M., Zina, L., Paiva, S., Pordeus, I., & Abreu, M. (2012). A systematic review of socioeconomic indicators and dental caries in adults. International Journal of Environmental Research and Public Health, 9(10), 3540-3574.
Costa, S., Vasconcelos, M., & Abreu, M. (2013). High dental caries among adults aged 35-44 years: Case control study of distal and proximal factors. International Journal of Environmental Research and Public Health, 10(6), 2401-2411.
According to statistics on employment by the economic sector in Ireland provided by the Central Statistics Office (2018), the biggest percentage of Irish citizens (26.7 percent) are employed in the sector of human health and social work activities. Besides, the ongoing COVID-19 pandemic shows how important this sphere is. The current paper describes my work as a day shift care support assistant at the Bantry General Hospital.
The hospital has a broad area of specialization. For example, it has a surgical division, dietician, and diabetes clinics as well as provides palliative care. However, the planning processes at all of the divisions of the hospital and clinics are the same. The first step of a planning process is the assessment of a patient. Apart from analyzing the clients symptoms and the state of health, it is essential to gather information on his or her medical history, habits, hobbies, and social background. A specialist should know whether a patient lives alone or have friends or relative who could help during the rehabilitation period.
The second step of the planning process is discussing the expected outcome and peculiarities of the treatment with a patient.
Then, logically, the phase of implementation follows. The final step of the care planning is the control over a patients progress and regular observation of his or her health conditions. Doenges, Moorhouse, and Murr (2019) emphasize the importance of critical thinking in planning the care process. At the workplace, employees are obliged to follow this principle strictly. In other words, care assistants create individual care plans for every client and do not use universal patterns in every single case.
It is important to notice that in the provision of care support, the entire team of specialists is involved. Already at the stage of planning, a patient is observed not only by one nurse but several professionals depending on the symptoms and diagnoses. Besides, the implementation of care support is conducted not only by one assistant. A narrow specialist prescribes medicines and medical procedures and controls the progress of a client. It is impossible to imagine that the entire team is not engaged in the process. Hervey and Ramsay (2004) emphasize that carers could become vital partners in helping a patient, and that is why the hospital engages them as well. What is more, managerial personnel are an indispensable component of the general hospitals performance and the quality of the care provided to the clients. That is because communication between administration and the staff members is a tool to fix the existing problem, create a more convenient schedule and allocation of responsibilities, mitigate and resolve conflicts in the team.
Undoubtedly, the most significant resource used is personnel because the provision of decent help is unthinkable without qualified and experienced specialists. In addition to that, another significant resource used is medical equipment, including such consumables as bandages, syringes, and tongue depressors and specialized hardware such as sterilizers, sphygmomanometers, thermometers, weights, oxygen masks, defibrillators, dialyzers, blood infusion sets, etc. Additionally, the hospital also possesses all the necessary equipment for surgeries, x-ray, MRI, electrocardiography, and blood, and other body liquid tests. The equipment is purchased for the subsidies from the government, private donations, and revenue of the hospital.
The activity of a care support assistant includes the provision of moral and physical support to the patients of the hospital. In some cases, as a worker, I visited some patients at home to check if their recovery goes as planned. Herber and Johnston (2013) write that care support workers frequently face the problem of psychological attachment to their clients. In the beginning, the provision of palliative care was a challenge precisely due to the issues with attachment. However, training that was conducted during the period of employment at the hospital taught me how to accept the deaths of other people and move on.
Unsurprisingly, clients are immensely involved in the caring process because they are the targets of care support workers activities. Still, it is essential to notice that clients are always encouraged to express their opinion and emotions in the process of care. For example, I have always tried to establish trusting relations with the clients because this could help to improve the quality of the care. Besides, genuine attention is of particular value for older adults. Frequently, these people have no relatives who are willing to take care of them and, therefore, in this case, the main task of a care support assistant is to involve the client in the process of care by establishing relations based on trust.
Emotional stability is a vital component of successful recovery. This way, the goal of activities conducted by care support workers is to help people staying at hospitals. As a result of such help, the client feels that they are not alone and that there are people whom they could rely on. From this, it could be inferred that the significant impact of the activity on the client is the creation of emotional stability and a supportive atmosphere.
The achievement of such effects is possible only through constant communication with a client. As it has been mentioned above, a care support worker should know everything about the fears, interests, and wants of a client. Furthermore, in the process of working with a client, a worker should communicate with him to know if there is something that makes him worried or something that should be fixed in the caring process. At this point, it is interesting to notice that older patients began to regard me as a close person or even a relative. Indeed, they felt so lonely that the attention of the care support assistant was a blessing for them. That is because they realized that they are not obliged to fight with a disease one-on-one. In addition to the communication with a client, I, as a care support assistant, had a dialogue with the medical personnel who provides nursing care to a client. Through communication with these people, I made adjustments to the developed plan of care support.
To conclude, it seems fair to say that my performance as a care support assistant lacks practical experience. Nonetheless, no critical mistakes have been made. Instead, I have understood what it means to provide individual help to people who are fighting with a mental or physical disease and have no one to rely on except themselves. The work that has been conducted was immensely hard in a psychological sense because it obliges to deal with peoples suffering on a daily basis. This experience taught me that a care support worker should not overreact and take personally everything that happens to clients.
Reference List
Central Statistics Office (2018). Women and Men in Ireland 2019. Web.
Doenges, M. E., Moorhouse, M. F., & Murr, A. C. (2019). Nursing care plans: Guidelines for individualizing client care across the life span. FA Davis.
Herber, O. R., & Johnston, B. M. (2013). The role of healthcare support workers in providing palliative and endoflife care in the community: a systematic literature review. Health & social care in the community, 21(3), 225-235.
Hervey, N., & Ramsay, R. (2004). Carers as partners in care. Advances in Psychiatric Treatment, 10(2), 81-84.
Auscultation is the selected diagnostic tool; it is a diagnostic tool that uses sound to examine the body. It is used to listen to heart, breathing, and bowel sounds. Auscultation is typically used in young children and infants who are unable to speak or communicate effectively (Drake et al., 2020). It can help identify problems such as respiratory infections, heart conditions, and intestinal blockages. Heart sounds are evaluated to assess the condition of the heart, and breath sounds are evaluated to assess the condition of the lungs (Gardezi et al., 2018). The use of a stethoscope allows a doctor or nurse to listen to these sounds more clearly and determine if there is a problem. Auscultation has been used and tested in children and in adults to examine heart conditions.
There are a few ways to know if the test is reliable and valid. The first way is to ensure the person being tested is sick. The second is to make sure that the doctor is listening in the right place; it must not be placed on an irrelevant part of the body (Voin et al., 2017). The best method to make sure that the person being tested is sick is to use a control group. For example, if one wants to test whether or not a cold medication works, they would give half of the people in the study the cold medication and half of the people in the study would not get any medication. Then, one would compare how many people in each group got better.
Auscultation reliability and validity values refer to a measure of how well a test measures what it is developed to measure. It means that there are ways to quantify the accuracy and precision of a test (Voin et al., 2017). The tests reliability is determined by how well it produces consistent results when administered multiple times to the same group of people. The validity of a test is measured by how well it actually evaluates what it is supposed to measure (Gardezi et al., 2018). Both reliability and validity can be measured in different ways, but two common methods are called Cronbachs Alpha and Pearsons Correlation Coefficient. Cronbachs Alpha measures the internal consistency of a test, while Pearsons Correlation Coefficient evaluates the degree of correlation between two tests.
The auscultation predictive values are the likelihood of a positive result when a test is conducted. In other words, they are chances that a condition is present when a patient has certain symptoms (Voin et al., 2017). For example, if a doctor listens to the patients lungs and hears wheezing, he might say that the wheezing is indicative of asthma. This would be an example of using the auscultation predictive values to make a diagnosis.
Auscultation is a highly sensitive way to measure heart and breathing sounds. By listening to the sounds the heart and lungs make, a doctor can often identify problems with these organs. Auscultation can also help doctors determine how well an organ is functioning (Drake et al., 2020). The integration of Auscultation into advanced practice will be considered based on its benefits concerning human heart health. It helps in detecting murmurs, abnormal heart sounds, and abnormal rhythms, which can be a sign of a serious problem with the heart.
References
Drake, R. L., Vogl, A. W., Mitchell, A. W., Tibbitts, R., & Richardson, P. (2020). Grays Atlas of anatomy (3rd ed). Elsevier Health Sciences.
Voin, V., Oskouian, R. J., Loukas, M., & Tubbs, R. S. (2017). Auscultation of the heart: The Basics with Anatomical Correlation. Clinical Anatomy, 30(1), 5860. Web.
Accidents affect many older adults livelihood and independence since they may cause mortality, increased morbidity, reduced functioning, development of chronic diseases, and lack of autonomy, leading to premature nursing. Fatalities arising from the fall or injuries related to falling are the second cause of deaths that are not intentional, standing at 684,000 fatalities. A substantial amount of money has been spent on fall-related injuries in the USA (Falls, 2022). Research conducted by CDC indicates that each year at least 300,000 old age people are hospitalized for hip fractures. Women fall more than men; therefore, they account for three-quarters of (All hip structures, 2020).
The cost incurred by the elderly is a lot on their hospitalization due to fall-related problems. Family and friends have a hard time looking out for the elderly who have suffered fall-related injuries, thus taking them to nursing homes. Measures should be put in place to mitigate this problem, thus reducing fatalities or injuries sustained from falls.
Background information
All injuries are the leading cause of unintentional mortalities in persons over 65 years; these account for 41 fatalities per 100000 deaths annually (Majdan & Mauritz, 2015). The number one cause of injuries and deaths in the United States (US) among the elderly is falling. This, in turn, results in hip fractures and other serious injuries, leading to hospitalization and loss of independence, thus admission to nursing homes. These falls may lead to increased aging, erectile dysfunction, or other chronic problems (Coggins, 2018). The falls can cause fear among the elderly, thus preventing them from carrying on their daily errands, that is, taking part in social activities, walking, and shopping. Many risk factors arise from these physical factors, behavioral/ lifestyle, and environmental factors.
Physical
While aging, many people tend to develop an illness or physical condition that leads to balance and gait problems. These conditions include Parkinsons disease, thyroid problems, stroke, old age, muscle weakness, urinary inconsistency, anemia, vertigo, arthritis, brain disorders, and dehydration. Lack of body fluids in the elderly may lead to hypotension, leading to a fall. As one becomes old, the eyesight, hearing, and reflexes are affected compared to when they were younger ( Prevent Falls and Fractures, 2022). The muscles tend to grow weaker as we age. This has a significant effect on our balance and strength. Risk factors for having weak muscles can be related to lack of exercise, arthritis, and polymyalgia rheumatic. Hearing or inner ear problems such as labyrinthitis may cause dizziness, a risk factor for an older adult for a fall. Urinary inconsistency makes a more senior person take so many trips to the washroom; while they hasten to go to the bathroom, it increases their susceptibility to a fall.
The occurrence of falls amongst neurological patients is not well known though it causes disturbances in gait and balance. Brain disorders include dementia, Alzheimers disease, delirium, depression, or psychotic behavior. These diseases majorly affect normal brain activities; hence, one cannot offer appropriate motor skills, making them more prone to a fall. This may be due to dizziness and drowsiness.
Behavioral/ Lifestyle
Lifestyle factors include actions, emotions, and choices an older person makes (What Contributes to Falls, 2022). They include medicine, inappropriate footwear, lack of physical activity, and poor nutrition. Some medications might bring about dizziness, drowsiness, or reduce alertness due to their ability to suppress the nervous system, thus making one more susceptible to a fall. They include psychotropic drugs, anti-psychotics, antidepressants, anticholinergic, cardiovascular, diuretics, antihypertensive, painkillers, anticonvulsants (Coggins, 2018). Some symptoms that cause falls include postural disturbances and altered gait and balance; opiates and antipsychotics cause these effects. Antihypertensives, antidepressants, and cardiac drugs bring about confusion, induced orthostasis, and poor health status. At the same time, the diuretics cause ambulation and reduced orthostasis (Center for Disease Control, 2018).
Environmental
These are risk factors that are hazardous conditions on someones property that might trigger a fall. They include weather, lighting conditions, designs standards, physical obstacles, spatial distractions, and pedestrian traffic.
Discussion
Exhaustive studies conducted clinically show that older adults with underlying problems have more susceptibility to falls than healthy ones (Huang et al., 2012). Even healthy people experience fall-related injuries and deaths, ranging from lifestyle to environmental factors. The design standards cause most falls that are environmental related, that is, loose tiles fittings which may cause falls. The female seniors of 75 years and above with body mass, cognitive impairment, and history of stroke are determinants for most falls. Muscles grow weaker; hence older adults who work out regularly are less susceptible to fall than those who never exercise apart from other underlying factors.
Conclusion
Gender plays a massive role in the fall-related injury. Older adults with underlying health conditions are more susceptible to fall-related injuries. Therefore, health problems should be taken seriously and treated on time as others might develop into chronic issues. Older people should embrace exercising to keep their muscles fit and feed on a proper diet. Education related to falls should be done, thus creating awareness among the elderly about proper medicinal use as some drugs are abused, for example, Opiates.
Recommendations
Research should be conducted to determine if nurse staff to old patient ratio contributes to fall-related injuries.
Evaluation if dietary factor vitamin D plays a role in the healing of the injuries that are fall-relate.
References
Centers for Disease Control and Prevention. (2020). Keep on your feet-preventing older Adult Falls. Centers for Disease Control and Prevention.
Centers for Disease Control and Prevention. (2018). STEADI materials for health care providers.
Coggins, M. D. (2018). Medication monitor: Medications that increase fall risk. Todays Geriatric Medicine, 11(4), 30.
Huang, A., Mallet, L., Rochefort, C., Eguale, T., Buckeridge, D., & Tamblyn, R. (2012). Medication-Related Falls in the Elderly. Drugs & Aging, 29(5), 359-376. Web.
This kind of medical service allows a provider to consult patients online. Clients can get immediate access to professional treatment, recommendations, education, and other services. Thus, organizations can care for a vast number of clients, reduce costs, and enhance outcomes by raising healthcare access.
Health Care Workforce Shortage
An issue that continues to negatively affect the healthcare system is the shortage of medical workers. Many organizations do not have enough professionals to treat the required number of patients or offer some services. Therefore, patient outcomes and quality of care decline, and workforce burnout increases.
Labor Disputes/Negotiations
Current issues in healthcare that organizations fail to address cause protests among medical workers. For example, problems with paychecks, employee retention, patient safety, unethical working conditions, and staffing make medical workers dispute and negotiate with employees or the government. As a result, patients cannot receive proper care in some facilities.
New Regulations Such as HIPAA
There are numerous issues and concerns in healthcare that make it challenging to provide high-quality services. Therefore, new regulations and guidelines address these problems, and while it may be difficult for medical workers to follow them at first, eventually, these interventions improve access to healthcare.
Medicare Pharmaceutical Coverage
It is hard to disagree that not all patients can afford the required medications. Therefore, the need for Medicare pharmaceutical coverage cannot be overestimated. This coverage helps people pay for the drugs prescribed to them and make sure that their treatment is effective and complete. Patients are protected against higher costs, which generally means that patient outcomes enhance significantly.
Physician-Patient Visits Via Email
Similar to telemedicine, e-visits can reduce healthcare workload because fewer patients will need in-person visits. As a result, people can email a physician and receive a detailed response with recommendations or advice to visit personally. Nevertheless, such a practice can also reduce outcomes and make medical workers dissatisfied because it is uncertain whether they should be paid for their responses.
Increased Emergency Room Utilization
Preventive and primary care efforts sometimes fail, which leads to an increased number of patients being sick enough and needing to access the emergency department. As a consequence, spending per person on the utilization of ER grows drastically, and emergency department workers burnout increases. What is more, some patients come to the ER without a proper reason, making other persons with actual emergency situations wait longer.
Increasing Health Premiums
Health premiums are the amount of money that people have to pay for their coverage, regardless of how often they access medical services. Generally, the effects of an increase in these premiums are negative patients can encounter workplace issues or face other problems that will reduce their level of life.
Selected and Alternative Topic
The topic selected for the project is telemedicine since it probably has the most significant effect on the quality of services provided. In the age of active technological development, healthcare facilities need to take advantage of this opportunity and offer online consultations because the latter has great potential and can provide numerous benefits. For example, in the time of the COVID-19 pandemic, it is not recommended for people to visit hospitals if their situation is not an emergency. Therefore, they can use email, video, or online portals to receive advice from their healthcare providers, describe symptoms or change treatment, discuss side effects of medications, make sure care tips are being followed correctly, and access many other services. The main beneficial effects are the lower workload and reduced burnout of medical workers because they do not have to communicate with patients in person. What is more, access to high-quality healthcare improves as distant, low-income, rural, or limited mobility patients, as well as individuals without insurance, are not left without consultations or help.
Shortage of medical workers is an alternative topic because this problem impacts healthcare in a very negative way. Rapid increases in chronic health concerns and the aging workforce contribute to the identified issue, and there are not many solutions to it. Many facilities lack nurses or physicians, which means that they can accept fewer patients and are unable to provide access to some examinations. Consequently, the quality of services declines, employee burnout rises, and patient safety is under question.
American Telemedicine Association [ATA]. (2022). About us.
Bakhtiar, M., Elbuluk, N., & Lipoff, J. B. (2020). The digital divide: How COVID-19s telemedicine expansion could exacerbate disparities. Journal of the American Academy of Dermatology, 83(5), e345-e346.
Chiron Health. (n.d.). Telemedicine related associations and agencies: Telemedicine Resources. Web.
Kane-Gill, S. L., & Rincon, F. (2019). Expansion of telemedicine services: Telepharmacy, telestroke, teledialysis, teleemergency medicine. Critical Care Clinics, 35(3), 519-533.
Walker, C., Echternacht, H., & Brophy, P. D. (2019). Model for medical student introductory telemedicine education. Telemedicine and e-Health, 25(8), 717-723.
The era of technological advancement resulted in the efficient processing of information in healthcare facilities. However, such systems represent the main target for hackers because they contain a huge amount of sensitive data. Therefore, specific nursing policies should be implemented to minimize the vulnerability of electronic systems.
Discussion
Usually, the problem of protecting electronic health record systems needs a multidisciplinary approach. First, there is a need to adjust compliance regulations, healthcare laws, and security guidance frameworks in terms of their integrity with real-life circumstances of work in hospitals (Abraham et al., 2019). This requirement is pre-conditioned by the pressure on healthcare workers that are difficult to remember all the rules. Argaw et al. (2020) also suggest a range of internal policies and vulnerability management and incident response plan are the most suitable for the context of a separate healthcare facility. The first option allows for assessing risks, developing mitigating steps, and performing re-evaluation (Agraw et al., 2020). In addition, it is necessary to implement the hands-on assessment of cybersecurity skills in healthcare workers (Carlton et al., 2019). It can help to identify the gaps in cybersecurity-related knowledge and develop further programs for non-IT experts (Carlton et al., 2019). Such measures will not only protect the sensitive information of patients and healthcare facilities but also strengthen the relevant skills of healthcare providers to respond to cyber threats.
Conclusion
In conclusion, the reliance on technologies in health care implies particular risks to cybersecurity. Since patient information and hospital financial data are under threat of cyberattacks, it is crucial to implement appropriate policies. Thus, adjustment of healthcare laws and compliance regulations, vulnerability management, incident response plan, and assessment of cybersecurity skills in medical professionals can make the electronic environment safer.
References
Abraham, C., Chatterjee, D., & Sims, R. R. (2019). Muddling through cybersecurity: Insights from the U.S. healthcare industry. Business Horizons.
Argaw, S. T, Troncoso-Pastoriza, J. R., Lacey, D., Florin, M.-V., Calcavecchia, F., Anderson, D., Burleson, W. , Vogel, J.-M., OLeary C., Eshaya-Chauvin, B., & Flahault, A. (2020). Cybersecurity of Hospitals: discussing the challenges and working towards mitigating the risks. BMC Medical Informatics and Decision Making, 20(146).
Carlton, M., Levy, Y. and Ramim, M. (2019). Mitigating cyber attacks through the measurement of non-IT professionals cybersecurity skills, Information and Computer Security, 27(1), pp. 101-121.
The assessment tool is intended to review the nursing requirements of an older person requiring long-term care. The tool is intended to summarize a methodical formulation to evaluation at the same time implementing specialized decision-making that takes place in the associations among a nurse and another individual. For this cause, the tool receives the assessment through an arranged approach, moving from a broad narrative-based measurement of domains of care need to a concentrated evaluation of features of possibility and complication.
Dysfunctional Attitude Scale
Form A of the Dysfunctional Attitude Scale (DASA; Weissman, 1979; Weissman & Beck, 1978) is a 40-item self-report feedback form intended to gauge the suppositions and attitudes connected with the cognitive content of depression (Beck, 1976). According to Becks hypothesis, these statements and beliefs reproduce fairly steady and lasting cognitive outlines that influence the association of previous experience, understanding of present experiences, and expectations about potential experiences. Dysfunctional models are assumed to take action as cognitive vulnerabilities that act together with pertinent ecological significance to set off and uphold clinical symptoms of the disease, especially depression.
The DAS-A is one of the most widely used measures of dysfunctional attitudes and has been frequently engaged to test Becks cognitive vulnerability stress model of depression (e.g., Hankin, 2005). It has also been used as a gauge of results for the management of depression (e.g., Blatt, 1995). Even though a large amount of this investigation employs the total score acquired from the DAS-A, more current studies (e.g., Blatt et al., 1995) has started on using subscales meant at tapping into further precise extents of cognitive susceptibility, particularly an accomplishment measurement (also pertained to as Performance Evaluation, Perfectionism, etc.) and an interpersonal dimension (Need for Approval, Dependency, etc.).
Since the DAS-A total score and subscale scores are so extensively used, it is significant to appreciate the feature organization of the DAS-A. Studies using a total score create the unspecified supposition that the gauge exhibit a common factor that accounts for the greater part of the whole discrepancy of the scale scores, therefore representing that the entire score is a measure of a particular construct (Revelle, 1979).
It is above all important to understand the DASA factor associations in an adolescent population where depression is frequent. Results from a 10-year longitudinal study demonstrate depression occurrence rates increasing from 3% at age 15 to 17% at age 18 (Hankin et al., 1998), and one more study illustrates an apparent and sharp point of variation in depression vulnerability rate curves between ages 15 and 19 (Burke, 1990). Particular in the increase in rates of clinical depression throughout this life stage, adolescent samples are perfect for studying the functions of detailed cognitive susceptibilities and environmental significance in the beginning and protection of depressive symptomatology.
Mini-Mental state exam
The Mini-Mental State Examination (MMSE) is a generally used assessment tool for determining disease intensity and dementia development in Alzheimers disease (AD) (Folstein, 1975). MMSE consists of stuff that assesses orientation, attention, working memory, executive function, language, and immediate and delayed verbal recall (Strauss, 2006). Every item is practically relying on understanding oral directions and reacting orally, by talking or writing. Studies have exposed that over time, patients with AD demonstrate a steady decrease in their MMSE scores (Apostolova, 2006). Though, there has been a modest investigation on the usefulness of this assessment to follow the development in non-AD dementias.
Numerous studies have used the MMSE to gauge the rate of cognitive diminution in patients with FTLD. One study establish that patients with bvFTD showed a standard yearly decline of 6.7 points on the MMSE, considerably better than the 2.3-point yearly decline displayed by patients with AD (Rascovsky et al, 2005). In contrast, additional studies have accounted that patients with bvFTD demonstrated fewer declines on the MMSE than patients with AD (Pasquier, 2004).In recent times, the amount of cognitive decrease calculated by the MMSE has been evaluated in the language and behavioral deviations of FTLD and AD patients (Chow, 2006).
Given some of the boundaries of the MMSE for determining the cognitive decrease in non-AD dementias, measurements of ADL may be more dependable in following disease intensity and development in these non-amnestic conditions (Kertesz, 2003). Even though several research have evaluated the rate of decline on the
MMSE among AD and the deviations of FTLD (Rascovsky et al, 2005), no studies have contrasted rates of decline in bvFTD and PPA as calculated by the MMSE against a gauge of ADL (Chow, 2006). Osher et al (2008) support and suggest that both the MMSE and ADLQ may be sufficiently measured to follow severity and disease development in bvFTD. Osher et al (2008), suggest that the MMSE is successful in identifying and staging the indications that go with frontal lobe worsening, which comprise behavioral disinhibition as well as, awareness, working memory, and decision-making functions insufficiency.
Adult Life Stress Measurement
Stress is involving several factors and multifaceted perception, which involves a course caused by several factors (i.e. hereditary and environmental and their connections), and personality dissimilarities (i.e. prior vulnerabilities, capability to manage) and this process is the basis for change in hypothetical stability within physiological systems, which is normally seen as a contributor to disease (Le Moal, 2007).
To recognize this stress model and to build up well-organized involvement programs, significant and practical measurement methods are vital (Wietzman , 2004). There are numerous diverse measurement techniques, of which biochemical and physiological measures are often long and not easy to deal with and understand (Noble, 2002). Questionnaires may be the most complete method to assess stress frequently, and particularly in great samples. There are several questionnaires, measuring dissimilar features of stress (Cohen, 1997). Some of these questionnaires are inadequate by their duration and too much respondent load. Shorter instruments are particularly advantageous in clinical settings as well as in longitudinal studies, but these are less in amount (Coste, 1997).
To find out the value of a questionnaire, numerous diverse measurement properties such as internal consistency and construct validity are to be measured (Terwee, 2007). The time, effort, and additional burdens to be found on those to whom the tool is managed, or on those who administer the instrument, are also imperative (SACMOTA, 2002).
The Arnetz and Hasson Stress Questionnaire were developed as an open web-based instrument for normal individual evaluation (www.pql.se). The most pertinent areas were established to be present health status, capability to sleep, skill to concentrate, worldwide stress height, power, life has power over, and social existence.
The questionnaire includes Seven Visual Analogue Scales (VAS), one for every part. VAS is an easy technique for gauging personal experience and is particularly appropriate for measuring complex constructs known to change, such as stress (Hasson , 2005). Characteristically, respondents are required to put a mark on a 100-millimeter line attached at each end by differing statements relating to the least and maximum boundaries of the measurement being calculated. Because the Arnetz and Hasson Stress Questionnaire is composed of seven scales, the least score for the complete questionnaire is zero points, whereas the maximum score is 700 points.
Conclusion
Wholistic care is generally documented as a foundation of nursing practice. The standard of nursing holds completeness (Newman, 1997). It would be supportive to offer nurses and nursing undergraduates customary, as well as unconventional, practices and tools that possibly will improve their understanding of the professions holistic example.
References
Weissman, A. N. (1979). The Dysfunctional Attitude Scale: A validation study. Dissertation Abstracts International, 40, 1389B-1390B.
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End-Stage Renal Failure (ESRF) is a decrease in the excretory filtration systems of the kidneys, which arose due to the death of nephrons and was provoked by a chronic organ disease. The extinction of renal function causes a violation of normal life, to which various body systems respond with complications. The incidence of ESRF has recently reached more than 1 in 7 adults in the US, with 144 cases per million reported globally (Cobo et al., 2018). In the last decade, the prevalence of ESRF has been steadily increasing in parallel with the rapid growth of the population, including about 759 people per one million (Benjamin & Lappin, 2021). In 2017, the ESRF-caused mortality rate was 28% worldwide, with frequent comorbidities of ESRF being hypertension, diabetes mellitus, cardiovascular diseases, and malignancy (Cobo et al., 2018). Given this evidence, ESRF is a highly dangerous disorder with numerous adverse effects on the populations health.
The body cavity associated with the disease is the abdominal cavity, where the kidneys, the main affected organs, are located. Kidneys are gradually losing their functions, failing to filter blood; there may also be a deterioration in blood clotting, the level of prothrombin decreases, and thrombocytopenia occurs (Cobo et al., 2018). The affected body system is the urinary system, which cannot efficiently eliminate waste from the blood; however, changes in the central nervous system may also occur, such as sleep disorders, problems with concentration, and inhibited reactions.
Prefixes that could be used for describing the disease are nephro-, hemato-, patho-, and reno-. While nephro- and reno- mean kidney, which can be used to describe the organs failure, hemato- is defined as blood and can be utilized to specify the issues with blood filtration. Patho-, which means disease, can be used to explain the pathologic nature of ESRF. Thrombo- could also be used, as blood clotting may occur together with ESFR.
A useful suffix for ESFR could be -al, defined as about ; for example, renal is about the kidney . Another similar suffix is -ic, which has the same meaning. Suffixes -in and -ism can be utilized to discuss the condition of ESRF, with -ism also referring to the process. Finally, -osis explains the abnormal condition of the kidneys and body systems.
Combining forms that could be used to describe ESFR can be renal, nephric, and nephritic, which means relating to the kidney . Nephrosis could be used to describe the degenerative nature of the kidney tubules. Nephrogenic and renogenic are also utilized to describe the excretory body system, as these words are defined as originating in or derived from the kidney . Renopathy and nephropathy may be used to discuss a kidney disorder. Nephroma is another word specific for the kidney system, as it relates to the tumor of the renal cortex; a nephrocyte is a cell involved in the excretory process.
As chronic renal failure causes a decrease in hemoglobin levels, hematopoiesis is a term related to this disorder. Although this process is defined as the creation of blood cells, during ESRF, it becomes suppressed. Hypertension, myocarditis, and pericarditis are also related to the disorder (Cobo et al., 2018). Hypertension is defined as elevated blood pressure. Myocarditis is an inflammation of the heart muscles. Pericarditis is the swelling of the hearts pericardium. Congestive heart failure, where the heart cannot efficiently pump blood, can occur. Convulsions or random muscle contractions can also be observed in most ESRF patients (Cobo et al., 2018). Skin irritability is a frequent symptom during ESRF. Anemia, or lack of hemoglobin, is also closely related to ESRF. Diarrhea is another condition that can emerge, with the patients bowel movements becoming watery.
It is extremely difficult to keep my productivity up; I feel fatigued most of the time. I often have a dry mouth, and I recently lost a lot of body weight. I noticed that my skin is less normal, it has less color and is easily irritated.
References
Cobo, G., Lindholm, B., & Stenvinkel, P. (2018). Chronic inflammation in end-stage renal disease and dialysis. Nephrology Dialysis Transplantation, 33(3), 35-40.
Benjamin, O., & Lappin, S. L. (2021). End-stage renal disease. StatPearls.
The change to quality and well-being in the new alumni enrolled attendants training stays tricky, straightforwardly affecting patient results. Viable tutoring during progress serves to improve experiential picking up, permitting the turn of events and foundation of protected, quality nursing practice. Complete comprehension of the change cycle, including the hindrances and compelling empowering agents to progress, is the way to successful coaching. A hypothetical structure directed by Duchschers stages of Transition and Transition Shock Model and Benners from beginner to the master model can work with such agreement. Healthcare philosophers have a significant influence in forming attendant schooling and rehearse and have given medical caretaker teachers and pioneers a comprehension to shape ability obtaining and the progress interaction for new alumni enrolled attendants.
Nursing Models and Theories
The Middle Range hypothesis has been viewed as helpful in both exploration and practice. The hypothesis can serve a heuristic capacity to animate and give the reasoning to studies, just as assist with directing the determination of exploration questions and factors. Middle Range theories additionally can help practice by working with comprehension of customers conduct, proposing intercessions, and giving potential clarifications to the level of adequacy of the mediations (Drevenhorn, 2018). Nursing has a requirement for a nursing hypothesis that will set out the sorts of nursing practice and the specific arrangement of moral beliefs that nursing practice tries to achieve. Middle Range speculations have been censured as being mentally unambitious. Some scholars contend that their extension and proposed strategies for requests are excessively restricted (Drevenhorn, 2018). A few medical services savants countered that the Middle Range hypothesis was simply resolving the inquiries that the discipline of humanism was asking (Drevenhorn, 2018). It is also questionable whether Middle Range speculations can go through the very deliberate observational testing that more and less conceptual hypotheses would be able. A few theoretical models and excellent hypotheses have filled in as the establishment for the advancement of Middle Range speculations.
New alumni enlisted attendants are significant companions of the local nursing area, bringing current proof-based theory and a new power to the working environment. Change to rehearse, however, is a fierce time for new alumni enlisted medical attendants as they are weak newbies who require comprehension and backing from their more experienced partners. The Middle Range concept is helpful for clinical intercession research with trial plans called randomized controlled preliminaries (Drevenhorn, 2018). It is valuable in ready grown-up populaces in which intense agony is not completely constrained by medicine alone, and secondary effects might forestall expanding pain-relieving prescriptions. The hypothesis has been taken on by post surgical nursing units as the reason for their postoperative aggravation of the board program. It has been utilized ordinarily to show graduate nursing understudies the value and structure of an engaged, substantial nursing hypothesis. It can likewise be utilized to show the intense torment of the executives to college understudies, utilizing the three standards with current practice rules that add the subtleties.
It would be great if a whole postoperative nursing unit could carry out the total hypothesis in focusing on their patients. They could initially appoint readings from this section and afterward hold instructive meetings for the nursing staff on tormenting the board, the hypothesis, and the benefits of utilizing proof-based speculations and mediations (Im, 2018). In these meetings, medical caretakers could examine the ideas of the hypothesis and realize what could be presented as far as analgesics and reach orders, nonpharmacological adjuvants, patient instructing, and objective setting. They could talk about the everyday help objectives and solace work objectives that they think would be practical on their unit as patients recuperate (Im, 2018). They could examine the significance of mindful consideration.
Many attendants have taken on the thoughts with respect to the requirement for Middle Range Theories rather than an expansive applied model to direct practice. Again and again, these hypotheses neglect to address the nursing philosophical and hypothetical underpinnings of the Middle Range Theory, subsequently restricting their handiness in building and propelling nursing science (Drevenhorn, 2018). Further, without connecting the hypothesis to wide philosophical suspicions about nursing, well-being, people, and the climate, the model gives just a restricted manual for nursing practice. Along these lines, a conversation follows about the improvement procedures and philosophical suspicions of the Middle Range Theories of taking care of oneself (Im, 2018). Pain or torment is a widespread human encounter that has been known since the main human experienced ailment, injury, or work (Im, 2018). Even though aggravation has been read up clearly for over a century, it has, as of late, been examined from a prescriptive nursing point of view. The Middle Range prescriptive torment the board hypothesis of harmony among pain-relieving and aftereffects mirrors the nursing mission to intercede successfully and comprehensively to soothe torment, enduring, and forestall their negative impacts (Im, 2018). There is expanding exact help and attendant analysts can proceed to test and offer help and inventive expansions of the hypothesis. Rehearsing attendants are utilizing proof-based standards to successfully alleviate intense agony in their patients.
Palliative consideration nursing requires a different scope of information, mentalities and abilities to give nursing care to individuals toward the finish of life. It includes supporting patients physical and feelings and offers support for family, friends, and family (Khalil et al., 2019). The improvement of the public approach to advocate for the arrangement of palliative consideration is important for the fundamental well-being administration framework by the public authority. Torment control requires preparing and consciousness of well-being experts and backing to change guidelines to make compelling help with discomfort accessible. lastly, preparing for well-being laborers and state-funded schooling. Preparing techniques for medical caretakers have changed throughout the years because of educational plan changes and varieties in medical services conveyance (Khalil et al., 2019). Seen self-capability has been utilized in the palliative consideration setting and alludes to medical attendants appraisal of their degree of ability to give quality consideration to patients and family
Benner reaffirmed the significance of really focusing on the calling through philosophical discussions, hypothesis advancement, and examination. She has driven the calling in reminding medical attendants that really focusing is fundamental on the conveyance of sound nursing care. Dreyfus and Dreyfust offered the five phases of capability in the fledgling to master model: beginner progressed novice, skillful, capable, and master. (Khalil et al., 2019). As per this model, a singular maneuver through these phases of ability improvement as they amass arranged useful experience, moving from scientific to instinctive thinking and from deciphering circumstances from its seven sections to the circumstance overall. Benners hypothesis combination was led by means of perception and meeting accounts which empowered her to depict the presentation qualities of medical attendants at each degree of improvement eight similar as the Dreyfus siblings concentrated on the exhibition of chess players, flying corps pilots, and armed force tank drivers and leaders.
The four metaparadigms of nursing incorporate individual, climate, well-being, and nursing. The metaparadigm of individuals spotlights on the patient who is the beneficiary of care. This might incorporate things like an individuals otherworldliness, culture, loved ones or even financial status. The metaparadigm climate incorporates both interior and outside factors related to the patient. This might incorporate the cooperation patients have with guests just as their environmental factors. The metaparadigm of well-being alludes to the quality and health of the patient. It additionally incorporates the entrance the patient needs to medical care. The last metaparadigm is the nursing part. This alludes to the medical attendant and how the individual will apply their insight and abilities when really focusing on patients. It likewise alludes to the qualities of the medical caretaker who is giving the consideration. It is fundamental for medical caretakers to apply these four meta paradigms to the nursing system when mindful for patients to address patient considerations overall. Following Benners view of the four metaparadigms, a person is somebody living on the planet who is a self-deciphering being. Additionally, a nurse is the one with a mindful relationship who concentrates on illness, wellbeing, and illness. This hypothesis might decipher Health as the experience of completeness and well-being. Finally, the environment should be visible as a friendly climate with social definition and weightiness.
Benners hypothesis has sound hypothetical underpinnings and has qualities that have considered it valuable in the area of nursing. This hypothesis depends on arranged execution and stresses clinical nursing. Above all, it centers around learning in setting to genuinely comprehend the conditions encompassing each opportunity for growth. In any case, despite this current hypothesis numerous assets, there are intrinsic hypothetical impediments. One impediment to the model is the trouble in applying the five degrees of ability procurement or aptitude (Khalil et al., 2019). The Model of Skill Acquisition gives an illustration of a restorative radiographer who performs at a specialist level when talking about the results of a specific radiological treatment, however, at a capable level in a new radiotherapy strategy (Khalil et al., 2019). Much would be no different for an oncology nurturer who performs at the master level in the organization of chemotherapeutic specialists, however just as a high-level amateur in performing peritoneal dialysis (Murray et al., 2019). A fledgling who is new to an errand might be provoked to utilize instinct to sort out their reasoning since they have not yet gained any insightful standards about the circumstance. Also, this model neglects to clarify how an individual turns into a specialist. Constraints distinguished in the Dreyfus and Dreyfus model of expertise stretching out to Benners model.
Benner argues that the master attendant can naturally react to clinical issues and read the patient without cognizant pondering. This hypothesis states that the masters activities depend on notable data gathering and that they depend less on the association, need setting, and assignment culmination (Murray et al., 2019). As per Benner, at least five years of full-time association in nursing practice is important for one to accomplish master status however even after numerous long periods of involvement with a clinical setting, many attendants dont foster master practice (Murray et al., 2019). The conscious practice system sets that notwithstanding experience, the fundamental and recognizing element to accomplish master execution levels is broad long periods of intentional practice. Purposeful practice is characterized as exercises that are explicitly intended to further develop execution, incorporate input that thinks about real execution to wanted execution, and gives an open the door to reiteration until the objective is accomplished.
The fundamental presumption of the structure states that a singulars presentation level is straightforwardly connected with how much intentional practice one takes part in throughout some stretch of time. Its establishment is started on master execution being accomplished by a persons supported work to improve, not as the aftereffect of intrinsic capacities or ability. The intentional practice structure stops recognizing specialists considering social rules or broadened insight. This spotlights on the sort, not length of involvement one has that can work with enhancements, specifically parts of execution. The experience itself makes execution less effortful and less requesting; nonetheless, to improve, it is important to search out training exercises that permit one to about fifteen works on further developing execution. It is this model that filled in as the hypothetical reason for this paper.
Benner featured the distinctions between reasonable information and hypothetical information, stating that information is installed in aptitude and skill created with experience and openness to clinical circumstances. Restricted involvement with circumstances of clinical weakening is a reason for tension and stress. Adding to that correspondence nerves between enlisted attendants, senior attendants, clinical staff, and associated wellbeing, and in that lies the potential for diminished nature of patient results. Benners stages of expertise obtained in the nursing setting shows ability procurement is experiential. Duchscher recognizes this and gives a model of change that helps capable and master medical attendants comprehend and work with recent progress during their underlying long periods of training (Murray et al., 2019). This gave a premise to the scientist to investigate nurses information on, and mentality to, patient wellbeing during progress to rehearse. Considering that Duchscher put her model in the course of events showing the improvement of the nurse genuinely and expertly, the scientist had the option to utilize those equivalent time focuses on reviewing RNs to learn information levels and mentalities and contrast them and the registered nurses qualities Duchscher hypothesized at the simultaneous times.
Fostering a culture of conscious practice would urge and permit medical caretakers to distinguish mastering needs and areas of ability improvement. Consolidated, this would work with and urge medical attendants to search out purposeful practice encounters to accomplish and support master practice levels and give top-quality consideration. Indeed, without purposeful practice, an expert medical caretaker can become mechanized in his/her abilities, hindering their capacity to deliver unrivaled execution (Murray et al., 2019). Concentrating on intentional practice in nursing will upgrade hypothetical information in the space of expertise improvement (Murray et al., 2019). With the estimated retirement wave, there might be an overall decrease in this significant asset, making this an important commitment to the discipline to move this obligation to the impending, unpracticed labor force.
The beginner-to-master model has been utilized in medical care frameworks to foster tutor programs, and administration programs, increment nurture maintenance, and give helping associates to staff attendants. When creating administration programs, using mentorship alongside self-evaluation guides might proceed with development for current and future heads of the medical services industry (Murray et al., 2019). Powerful initiative arrangement and responsibility can prompt upgraded staff maintenance just as diminished turnover costs and worked on quality results. Giving proficient advancement in view of the fledgling to master model for nurturing pioneers permits medical services frameworks to assemble certain, fit pioneers who increment staff maintenance and add to quality, safe patient consideration.
Conclusion
In conclusion, consistently, new medical caretakers move on from a nursing project and start work in the clinical setting. As new attendants acquire understanding and information all through their vocations, they become prepared medical caretakers and coaches for the future. Patricia Benners amateur to master model has been utilized to expand the maintenance of medical attendants just as to assist with building experience with new attendant directors and heads. The model basically examines how a singular starts in the amateur stage and, as new abilities and information are acquired, advances through various stages to end in the master domain. The model considers ability to secure and information to be acquired as advances through each stage. It likewise talks about significant showing systems for each phase of the model.
All of the ANA Code of Ethics provisions seem exemplary and essential, but the third one is nearest to my values. It emphasizes the critical role of the nurse in promoting and protecting the rights and health of the patient (Gurney et al., 2017). The patient entrusts his life to the other person, and therefore nurse must be responsible for his comfort and provide the necessary care, regardless of his nationality, faith, age, or belief. The fundamental responsibility of the nurse includes four components: to promote health, to prevent disease, to restore soundness, and to alleviate suffering. She must maintain the highest level of care possible in a particular situation and ensure that no one is harmed.
I am guided by the duty to provide care at the most professional level and never, under any pretext, participate in actions against peoples physical and mental health. Furthermore, I follow the purpose of continuous professional and cultural competence improvement. Every nurse must be qualified for the moral and legal rights of the patient (Gurney et al., 2017). Therefore, learning to comprehend the most reasonable and practical treatment practices and legal principles is crucial.
My mission statement is not to leave a person in trouble under any circumstances and respect each patients particular values and choices. It is vital to consider their wishes and carry out those measures that will be most comfortable and effective simultaneously. The joint efforts of the patient and the doctor will contribute to quality treatment and a quick recovery. Furthermore, regardless of where the nurse is, she is obligated to help the person in need, irrespective of the nature of the injury or other external occurrences.
Peace and equality are my most significant hopes for the community, country, and world. If everyone begins to respect the other now, it will cause better living conditions, leading to the absence of conflicts in the long term. I have several fears regarding the healthcare system and taxes. The high cost of services and insurance is the reason for the hardship of accessing care. In the future, the number of people who cannot get treatment may increase, which is a severe cause for concern. All people should be equal, and then the world and care system will change for the better.
Reference
Gurney, D., Gillespie, G. L., McMahon, M. P., & Kolbuk, M. E. (2017). Nursing code of ethics: provisions and interpretative statements for emergency nurses. Journal of Emergency Nursing, 43(6), 497-503.