Chapman, D. J., Damio, G., Young, S., & Pérez-Escamilla, R. (2004). Effectiveness of breastfeeding peer counseling in a low-income, predominantly Latina population: A randomized controlled trial. Archives of Pediatrics & Adolescent Medicine, 158(9), 897-902.
PICOT Question
Among young, low-income, predominantly Latina pregnant women who consider breastfeeding, will routine breastfeeding education plus peer counseling, compared to routine breastfeeding education only, improve the breastfeeding initiation rate and the breastfeeding rate at one and three months postpartum, if the intervention is conducted during pregnancy (daily visits) and after it (one, three, and six months postpartum)?
Purpose of the Study
The purpose of the study was to evaluate the effectiveness of the breastfeeding peer counseling program that is currently used in the United States for improving breastfeeding rates among low-income young women from a predominantly Latina population.
Research Questions
Will an existing breastfeeding peer counseling program (in addition to the currently implemented routine prenatal education on breastfeeding) raise the breastfeeding initiation rate? Will it raise the breastfeeding rates during the first three months postpartum?
Hypotheses
The authors’ major hypothesis was that a breastfeeding peer counseling program, which consists of both home- and hospital-based services, would improve the breastfeeding rates among targets of the research. It was also expected that, due to the support from women who had successful breastfeeding experience, the breastfeeding rates in the intervention group would be remarkably higher than in the control group.
Aims of the Study
The study was aimed at providing the intervention to women randomly selected from the sample (the rest of the sample was assigned to be the control group) and measuring the results both during pregnancy and postpartum.
Study Design
The study is a randomized controlled trial in which the participants were recruited by research assistants who would not be the participants’ peer counselors. The design was approved by both the researchers’ institution and the health care facility.
Sample
In the study, 165 women participated; 90 in the intervention group, and 75 in the control group. Inclusion criteria included being pregnant (less than or equal to 26 weeks’ gestation), having low income, considering breastfeeding, and having access to a telephone for contacts as needed.
Variables
The independent variable was the breastfeeding peer counseling program, i.e. the intervention provided as part of the study. The dependent variables were various breastfeeding rates, including breastfeeding initiation (breastfeeding status at birth) and successful breastfeeding within the first three months postpartum.
Statistical Analysis
Various participant characteristics were considered in the analysis of data apart from income, including, origin, education, marital status, previous breastfeeding experiences, and others. The use of statistical tools allowed considering and ruling out the null hypothesis, i.e. the assumption that there were no correlations between independent and dependent variables.
Validity of Results
The validity of results can be evaluated from two perspectives: study design and data analysis. The design, including sampling, random distribution into groups, and performing baseline measurements, made the study generalizable and replicable. Data analysis with the use of appropriate statistical tools allowed regarding the quantitative results as reliable.
Results of the study
In the intervention group, only nine percent did not initiate breastfeeding, while in the control group, this rate was 23 percent. Also, the members of the control group were more likely to stop breastfeeding both within the first-month postpartum (49 percent) and during the next two months (71 percent).
Implications
These results can help me in caring for patients and families because the study confirms that the use of the breastfeeding peer counseling program is effective in terms of improving breastfeeding rates. Studying this program and applying it to my practice and the provision of prenatal education will help me improve patient outcomes in terms of encouraging young women to breastfeed.
Reference
Chapman, D. J., Damio, G., Young, S., & Pérez-Escamilla, R. (2004). Effectiveness of breastfeeding peer counseling in a low-income, predominantly Latina population: A randomized controlled trial. Archives of Pediatrics & Adolescent Medicine, 158(9), 897-902.
Due to the presence of multiple health issues in most aging patients, the introduction of multidisciplinary teams into addressing the health concerns experienced by the specified demographic is an absolute necessity. However, the described solution to the health problems of aging patients may entail difficulties in coordinating the work of the health experts involved in a team (Hash, Jurkowski, & Krout, 2015). Therefore, the creation of an interdisciplinary team that will utilize a patient-centered approach and be involved in the nurse-patient dialogue, thus boosting patient education, is needed.
The use of an interdisciplinary approach is critical in handling health issues faced by the aging population. Unlike the multidisciplinary framework, it allows for a patient-centered treatment process, which leads to higher levels of patient engagement and education, yet it also reduces the number of expenses that the transdisciplinary framework implies (Hash et al., 2015). Thus, when approaching the current management of the aging population’s needs from a realistic perspective, one will have to opt for the interdisciplinary strategy as the best model for care coordination in the rural context given infrastructure- and resource-related constraints (“Rural care coordination toolkit,” n.d.). Collaboration can be encouraged by introducing innovative conflict management techniques and revisiting the present hospital hierarchy to increase the role of nurses’ opinions.
Moreover, the selected approach toward cooperation across different healthcare disciplines will prompt knowledge sharing between and education of healthcare experts themselves. The described method of collaboration will prompt the reciprocal dialogue that will lead to discussing diagnoses and treatment solutions, inviting healthcare professionals to expand the range of their competencies. Ideally, the specified scenario may also lead to launching geriatric education programs for healthcare experts and patients (“Aging in rural places – Part 12, interdisciplinary teams and geriatric education centers,” 2014). Consequently, the quality and efficacy of care for aging people will rise.
Providing high-quality care in rural populations poses challenges to the healthcare professionals for the lack of mobility in the area. However, Pender’s health promotion model allows practitioners to increase the level of care through a multitude of approaches, including but not limited, to medical, societal, behavioral, educational, and client-centered. This assignment briefly assesses the ways nurses can evaluate the role of the patient-centered care approach in the rural population while utilizing the health promotion model.
Patient-centered care in rural population
In a patient-centered approach, the focus of healthcare shifts from generalized clinical guidelines to individual care based on specific customer’s needs and wants. According to Charlesworth and McManus (2017), delivering patient-centered care in rural populations may be difficult for the overall low level of individuals’ awareness about their health. Therefore, nurses should engage in educational training and detailed conversations with patients on genetic predisposition to certain diseases to increase people’s knowledge. The efficiency of such activities may be evaluated with the reoccurring admissions rate to the hospital, instances of late-stage diagnosis, and incidents of preventable hereditary diseases, such as Diabetes-II.
The critical role of the health promotion model (HPM) in this case lies in the motivation of rural residents to treat their health more seriously. As supported by Khoshnood, Rayyani, and Tirgari (2018), in HPM, nurses act as agents of change who strive to prevent diseases by enforcing rules, improving the environment, engaging in counseling, and supporting patients in their routine.
Conclusion
To master such qualifications, a prepared healthcare professional should be able to provide powerful health promotion messages, using advanced technologies, and develop practical programs, aimed at impacting patients’ attitudes toward their health. In terms of the rural population, one of the key evaluative factors would be comparing statistics rates showing quality rates of healthcare in the city and in the countryside.
References
Charlesworth J. M., & McManus E. (2017). Delivering patient-centered care in rural family practice: Using the patient’s concept of health to guide treatment. BMJ. Web.
Khoshnood, Z., Rayyani, M., & Tirgari, B. (2018). Theory analysis for Pender’s health promotion model (HPM) by Barnum’s criteria: A critical perspective. International Journal of Adolescent Medical Health. Web.
With the introduction of new technologies that expand the range of options for different groups of people, the aging population has become much more numerous and gained more agency in the global society. The propensity toward aging as a common trend in developed countries has been noticed by several global entities, such as the World Health Organization (WHO). Moreover, the percentage of people over 65 has increased significantly. For example, the World Bank Data points to the fact that the number of aging people has risen to 617,000,000 (World Bank Data). The report by Population Reference Bureau mentions that there are currently more of 65-year-old people in the world than there are 25-year-olds (Population Reference Bureau). The described trend toward population aging can be seen from several perspectives, the positive one implying that people nowadays tend to live more, whereas the negative one suggests that the rates of birth are dropping (Arensberg, p. 4). Either way, the current trend toward aging of the world population is rather noticeable and has a distinctively vast impact on numerous domains.
Main Text of the Study
The area of healthcare is the domain that has been affected by the rise in the number of aging people to the greatest extent. With the need for geriatric services rising consistently, the demand for people specializing in the described area affects the trends in healthcare education, job openings, and overall job market demand (Giacalone et al., 2016). Therefore, the healthcare domain is affected significantly by the tendency in question.
The process of aging on the global scale has also had its effect on the business realm. With more people aged 65 and older remaining employed, job opportunities for people of other ages have shrunken in the cities where employment rates are a socioeconomic issue (Arensberg, 2018). However, the rise in the number of people aged 65 and older among employees in a business setting has also led to the creation of opportunities for expansion for numerous companies. Reports show that the experience that people develop by the age of 65 is essential for business decision-making (Arensberg, 2018). Being able to predict the outcomes of specific solutions more effectively than their younger counterparts are, aging people can advance significantly in business.
The social domain is also worth mentioning as the one affected by the aging population. After gaining key skills in using social networks, aging people tend to spend a significant amount of time online conversing with their peers (Tang, Yusuf, Botzheim, Kubota, & Chan, 2015). Thus, the communication trends, media, and even digital marketing is shaped by aging people based on their search queries. As a result, the global network is altered as the aging population participates in online communication.
However, it is worth keeping in mind that aging people have unique needs and that tools for meeting these needs have to be introduced into the described settings to facilitate an increase in the target demographics’ quality of life. In healthcare, the support of home health workers can be seen as an urgent task that has to be addressed at the global level. Due to the limitations in mobility and the related health concerns, aging people may have severe difficulties accessing the required health management services (Tang et al., 2015). For this reason, creating job openings for home health workers and enhancing the levels of education among them so that they could offer assistance to aging community members should be recognized as an immediate necessity.
Conclusion
Similarly, in the business domain, consultations and competency improvement courses will have to be provided to aging people. By offering the target demographic immersive courses for building knowledge of data management and similar skills, one will invest in effective talent management. Finally, the social domain needs to be addressed by building community awareness about the need for communication that aging people have. As a result, the specified group will remain in contact with their friends, families, and the community as a whole, retaining their interest in life and enjoyment thereof.
Works Cited
Arensberg, Mary Beth. “Population Aging: Opportunity for Business Expansion, an Invitational Paper Presented at the Asia-Pacific Economic Cooperation (APEC) International Workshop on Adaptation to Population Aging Issues, 2017, Ha Noi, Viet Nam.” Journal of Health, Population and Nutrition, vol. 37, no. 1, pp. 1-8. doi:10.1186/s41043-018-0138-0.
Giacalone, D., Wendin, K., Kremer, S., Frøst, M. B., Bredie, W. L., Olsson, V., Risvik, E. (2016). Health and quality of life in an aging population–Food and beyond. Food Quality and Preference, 47, 166-170. doi:10.1016/j.foodqual.2014.12.002
Tang, D., Yusuf, B., Botzheim, J., Kubota, N., & Chan, C. S. (2015). A novel multimodal communication framework using robot partner for aging population. Expert Systems with Applications, 42(9), 4540-4555. doi:10.1016/j.eswa.2015.01.016
Geriatrics is a private branch of gerontology that deals with the study, prevention, and treatment of diseases of old age. Some diseases are often observed precisely in the elderly. For example, Alzheimer’s disease is usually found in older people. The phenomenon of aging refers to all morphological, biochemical, functional, and mental changes that occur during the life of an organism. These are gradually developing and irreversible changes in the structures and functions of a living being. However, a certain degree of disparity in the healthcare industry can be observed, where the geriatric population has unequal access to essential services.
Historically, the Older Americans Act (OAA) was designed to fund critical aspects of geriatric care. However, it was expired, and currently, it is signed by the president, but the bill was not enacted (“Older Americans Act,” 2020). The primary purpose and the potential outcome of the OAA are to fund several services, such as transportation, caregiver support, health promotion, senior centers, job training, and meals. Therefore, the current policy goal is to enact the Older Americans Act to allow senior citizens to have relatively equal access to healthcare as other demographic groups. In psychiatry, ophthalmology, otorhinolaryngology, dentistry, surgery, urology, and other areas of medicine, there are scientific and practical problems that are associated with geriatrics.
There are specialized geriatric and gerontology centers that provide versatile medical care to patients of older age groups. The geriatric center and nursing home should not be confused. While the nursing home is a social institution and may not provide medical services, the geriatric center is a medical institution. To obtain the status of a geriatric center, an institution must have a license to provide medical services, including in the field of geriatrics.
The majority of patients visiting polyclinics are elderly and senile. The satisfaction of the medical needs of this age group is determined by the socio-economic level of society and by the state of gerontology and geriatrics. The modern elderly patient is a unique clinical phenomenon in terms of the presence and combination of a variety of pathologies, which are extremely important in terms of prognostic value and impact on the patient’s quality of life.
Geriatrics differs from standard medicine for adults by focusing on the unique needs of an older adult. The old body is physiologically different from the young adult body, also in old age, a decline in the activity of various organ systems is manifested. Lifestyle and previous health problems lead to different groups of diseases and symptoms in different people. The onset of symptoms depends on the remaining healthy reserves in the organs (Burton, Lee, & Potter, 2016). Geriatrics distinguishes between diseases and the consequences of normal aging and seeks to treat diseases and achieve healthy aging. Geriatrics is focused on achieving the patient’s highest priorities in the context of multiple chronic conditions and on maintaining function.
It is important to note that there are several determining factors for the disparity in healthcare for the geriatric population. Psycho-social aspects of the issue can be associated with the fact that many neurodegenerative disorders and mental health problems are more likely to develop among senior citizens (Burton et al., 2016). Economic factors also play a major role in contributing to the given disparity. It is stated that many citizens, including senior ones, are uninsured, and these unmet healthcare needs result in healthcare access disparity (Yamada et al., 2015). Therefore, economic misbalance leads to the fact that many older adults tend to be uninsured or underinsured due to their financial status, which manifests itself in gradual disparity growth in healthcare.
In addition, ethnic factors need to be included, because minority groups can have a larger income gap. This can result in many minority senior citizens will have a significant portion of their healthcare needs unmet. The language barrier can be a critical component of such disparity because proper communication ensures that all treatment and care are handled correctly (Burton et al., 2016). It can be manifested in a geriatric patient being underdiagnosed, which results in the treatment being ineffective.
The primary utilization for the given topic is that legislative inactivity can directly affect a senior citizen’s quality of life and well-being. Many older adults need governmental assistance and support regarding the necessary geriatric services. Protecting the health of citizens is an essential condition for the life of society, and the state is responsible for the level of medical care that would guarantee the preservation and maintenance of health, prevent disability, and premature death. Currently, the main problems in the healthcare sector are the quality of medical care and its free delivery. Of particular relevance to these problems is the onset of retirement age, when a person’s income, as a rule, decreases, and their health deteriorates.
In conclusion, it is highly important to understand that the disparity observed in healthcare regarding the geriatric population is fueled by healthcare access inequality and unmet medical needs. Senior citizens are at most risk for chronic and neurodegenerative disorders, where the latter be manifested in psych-social barriers. In addition, the fact that Older Americans Act is not enacted results in many older adults being underinsured or uninsured. There can also be ethnic reasons for healthcare disparity among the geriatric population due to certain language barriers.
References
Burton, J. R., Lee, A. G., & Potter, J. F. (2016). Geriatrics for specialists. Berlin, Germany: Springer.
Yamada, T., Chen, C. C., Murata, C., Hirai, H., Ojima, T., Kondo, K., & Harris, J. R., (3rd ed.) (2015). Access disparity and health inequality of the elderly: Unmet needs and delayed healthcare. International Journal of Environmental Research and Public Health, 12(2), 1745-1772. Web.
Today, the most important health issue of the population is that healthcare is focused on treating people’s sicknesses instead of preventing them and vaccine-preventable diseases outbreaks. It affects people in a significant way, making them more vulnerable to these issues. Among factors that impact and even aggravate health issues is the ecological and economic situation, and people who refuse to vaccinate (Walsham, 2019).
Bad ecology affects not only people in risk groups with existing health problems but also harms healthy population. It weakens their immune system and makes them susceptible to different diseases. Health professionals’ role in identifying such issues is quite important since they are the first ones to notice the problem (Walsham, 2019). When the unknown problem first appears, it is their responsibility to make it known to the public, and learn about its possible consequences. If a health issue is neglected, it can have an unpredictable outcome.
The best practice for infectious disease prevention so far is vaccination. Some infectious sicknesses have been almost eliminated by vaccinating the population (Walsham, 2019). When the outbreak happens, the best way to manage it is to contain it, so it does not spread further. When addressing the public about health-related information, authorities must consider cultural and environmental factors to achieve a better understanding of the issue among people (Walsham, 2019).
Therefore, the best strategy would be the combination of information and behavioral approaches, where the public is provided with information and tools to make healthy choices. CDC presents School Health Policy that promotes health issues to the young generation (“School Health Policies and Practices Study,” 2019). Educating the population on health-related issues is also essential to avoid legal, ethical, and financial problems.
The concepts of critical thinking, such as identifying, analyzing, and finding a solution for problems are crucial to health-related issues and presenting them to the public (Paul & Elder, 2008). When identifying the problem, it is essential to ask the right question and correctly evaluate the reasons for supporting a specific answer. The method of critical thinking is an important skill to use in public health, it can help to identify the health issue, choose the right strategy to address the public, and educate the population about a way to prevent and to manage it. It can help to connect a pass experience with newly received knowledge in current or future career.
References
Paul, R., & Elder, L. (2008). The miniature guide to critical thinking concepts and tools. Foundation for Critical Thinking Press.
Walsham, G. (2019). Health information systems in developing countries: Some reflections on information for action. Information Technology for Development, 26(1), 194–200. Web.
The vulnerable population is becoming a more and more serious challenge for the healthcare and medical spheres. The world faces the problem of human aging, and it causes an increase in the risk of mental diseases. Despite technological advances, there is still no treatment for personality disorders. One of the most widespread illnesses of the elderly is dementia. It is described by a continuous decline in cognitive activity with the loss to some extent of previously acquired knowledge and practical skills and difficulty or inability to learn new ones. The purpose of this paper is to describe the ways of supporting older people with dementia with the use of several strategies. It is possible to aid the elderly by providing direct care, reducing the level of their stress, organizing their schedule, and establishing national governmental programs.
For a person with a mental disease, it is hard to perceive reality in the appropriate way. There are many issues that are stressful for people with dementia but ordinary for others. This is the reason why understanding the way of thinking of an older person is so crucial. First of all, they face the problem of getting access to medical aid. Not all of them live in specialized organizations or are being looked after by a caregiver or a nurse. A new way of contacting the hospital should be provided. It should be taken into consideration that for people with dementia, it is difficult to leave the house, not to mention medical facilities.
What is more, medicine and drugs for dementia are expensive. Older adults with the mental disease are disabled, and the pension is not enough to cover all the expenses concerning the illness. There is no special governmental program to support them financially and psychologically. It is also important to mention that to make the disease progress slower, it is necessary to attend special classes and to work with the psychiatrist. The hypothetical counseling program might be focused on opening several centers with free activities for people with personality disorders.
Mental disorders are among those diseases that hardly can be treated. One of the most common situations that are likely to develop problems for older people with dementia is asking for help. Depending on the level of progress of the illness, the human does not remember the number, cannot find the telephone, or forget the process of the conversation. However, there is a solution to this problem – all people who have such a diagnosis should be provided with the tracker on their hands. It looks like a bracelet or a wristwatch; and works in a very efficient way. Once a person with dementia needs some aid, he or she should only press the button on this gadget. In accordance with the circumstances, it might give a signal to the family members or the healthcare workers. The lack of physical activity is another urgent issue that has to be solved. There is the special equipment for passive exercises that have a positive impact on the propulsion system of a person (Heesterbeek et al., 2019). They should be available in medical centers and hospitals for free.
The situation that cannot be solved in the present moment is the lack of professional communication between a person with a mental disease and a psychologist. As a way to overcome this difficulty, it may be proposed to create a series of exercises for older adults so that they could maintain their skills of communication. Moreover, there might be organized a voluntary center: students, pupils, or even adults after a short educational session might visit people with dementia in their spare time to have a little conversation or to help with some household responsibilities.
First of all, a particular governmental program is needed, for example, a department of client service has to be developed. It would be helpful both as a counseling community and as a supervising authority. The collaboration with the art therapy centers would be very efficient for the elderly, especially if there would be a possibility to do it online without the stress of leaving the house (Cornejo et al., 2016). What is more, the government should provide robotic gadgets to make the life of people with dementia more comfortable (Ienca et al., 2016). This technological device would play the role of the assistant for older people.
At the present moment, I am already carrying, and I can control myself in stressful situations. I am empathic, but at the same time, I am able to be objective when it is needed; I am always ready to give a helping hand. From my point of view, I am facing a lack of managing skills like responsibility, patience, and the ability to evaluate risks.
I plan to improve my managing skills by ameliorating my theoretical knowledge of the issue. I would try to train to take care of my parents or other relatives as it is supposed to be done in the specialized center. I would pay more attention to my own well-being as “the first step in developing self-responsibility relates to care of the self” (Morrison-Valfre, 2016, p. 82). I would read more about the types of mental diseases and the ways of its treatment.
References
Cornejo, R., Brewer, R., Edasis, C., & Piper, A. M. (2016). Vulnerability, sharing, and privacy: Analyzing art therapy for older adults with dementia. Proceedings of the 19th ACM Conference on Computer-Supported Cooperative Work & Social Computing, 16(1), 1572-1583. Web.
Heesterbeek, M., van Der Zee, E. A., & van Heuvelen, M. J. G. (2019). Feasibility of three novel forms of passive exercise in a multisensory environment in vulnerable institutionalized older adults with dementia. Journal of Alzheimer’s Disease, 70(1), 681-690. Web.
Ienca, M., Jotterand, F., Vică, C., & Elger, B. (2016). Social and assistive robotics in dementia care: Ethical recommendations for research and practice. International Journal of Social Robotics, 8(4), 565-573. Web.
Morrison-Valfre, M. (2016). Foundations of mental health care – E-Book. Elsevier Health Sciences.
The primary research question is, “What are the long-term intervention effects of a wb-MRI-scan in a general population study on quality of life and depressive symptoms?” which appropriately expresses the variables’ relationship. The research question is specific to one relationship of the independent, the MRI screening, and the dependent, the participants, variables. It relies on theoretical and practical frameworks of the previously conducted studies. The study’s goal was substantiated by the absence of relevant research on the MRI’s long-term effects on quality of life. The research can be potentially used by medical personnel in order to understand how MRI scanning affects their patients’ quality of life.
Review of the Literature
The authors’ search strategy includes a sufficient number of databases and resources that identify the research and theoretical framework they use. The study follows a theoretical framework, which allows the authors to detect the existing gap in knowledge about the long-term psychosocial effects of MRI. There is both a summary of strengths/weaknesses that help formulate the research question and a logical literature review present.
Internal and External Validity
The authors designed an appropriate way to ensure internal validity, introducing a control group that did not participate in the scanning. The external validity threats were decreased by inviting adult participants of different ages and sex, which eliminated sampling bias, yet the participation in a survey bias was not addressed by the authors. Internal and external validity threats mostly do not affect the quality of evidence, since a large number of people was studied. The intervention fidelity was maintained since researchers completed the study according to the plan.
Research Design
The study relies upon the longitudinal cohort design, its use is appropriately justified by the nature of the research and main questions of the study. The research design increased bias by introducing pre-examination questionnaires and decreased it by carrying out the experiment on a large group of people.
Sampling
The research used a stratified sampling strategy by selecting 4,420 people based on age, sex, and city/county of residence, this strategy is appropriate for the design. The sample reflects the population identified in the research question, and the size of the sample is appropriate because of a large number of subjects, a power analysis was not used, and the findings can be generalized to the adult general public.
Legal-Ethical Issues
The study was conducted in Germany, thus, the rights of the participants were protected Patients’ rights Act (Directorate-General for Health and Food Safety, 2016). It is stated in the article that the institutional review board gave its approval, and the examination was preceded by a consent process that included educational materials, a video, and radiologists’ explanation (Schmidt et al., 2016).
Data Collection Methods and Procedures
The authors use MRI scanning as a research method to find its long-term effects on the population, there is no data given about this instrument’s accuracy. Scans were observed by the radiologists with 1–5 years of experience supervised by a professional with 15 years of experience. They had no access to the participants’ clinical information, which minimized bias, interrater reliability was not calculated, and there is no reason to believe observers could influence the subjects’ behavior. There were no interviewers, instead, questionnaires were used, which eliminated any bias. There were two primary instruments, MRI and questionnaires, their operation definitions are consistent with the conceptual ones, and their format is appropriate. Using questionnaires, a self-report instrument could entail receiving false information from the participants (Leggett et al., 2016). Records and data sets used in the study are appropriate, yet the questionnaires may have affected their bias, overall, intervention fidelity was properly maintained.
Reliability and Validity
There was no method used to test the reliability and validity of the instruments, yet their strengths and weaknesses are present in the article. It lists the disclosure of incidental findings as a potential threat to the study’s validity, extending intervention to 2-3 years can eradicate it, the study’s prolonged period constitutes its strength.
Data Analysis
There are descriptive statistics used in the paper relevant to the variable’s level of measurement, while inferential statistics are appropriate, too. The tables used to meet the standards of supplementing and economizing the text, having precise titles, and do not repeat the text., while the testing supports the research question.
Conclusions, Implications, and Recommendations
The research question results are presented objectively in a concise and sequential manner, the authors provide a theoretical framework’s discussion. The investigator identifies the study’s weaknesses, limitations, and strengths, implying that a similar study can be conducted in the future in specific groups. The authors discuss the study’s relevance to clinical practice, making a generalization that MRI screening has differential short- and long-term psychosocial implications, which is in the study’s scope.
Applicability to Nursing
Doctors, with the study’s findings, can discard the use of MRI screening to improve patients’ quality of life, thus patients may benefit from not having to experience an ineffective procedure. There is no risk for patients, and the study’s benefits are minor, yet its strengths outweigh its weaknesses since the evidence suggests that MRI screening does not affect the quality of life. The findings are feasibly applicable, generalizable, and can be applied in another clinical setting.
References
Directorate-General for Health and Food Safety. (2016). Patients’ rights in the European Union mapping exercise. Publications Office of the European Union. Web.
The Western United States comprises 13 states that lie on the western part of the United States of America. They include Utah, Arizona, Oregon, New Mexico, Nevada, Colorado, Alaska, Washington, California, Hawaii, Wyoming, Idaho, and Montana. This region is commonly referred to as The West or the American west. Since the US expanded towards The West soon after it was founded, the meaning of the name “The West” has undergone an evolution since then. The region is not merely a geographical designation rather it has a special connotation in terms of anthropology. Whereas there is some internal diversity, the area is generally considered to have a by and large common culture shared history and one perception of the world, and intimately related English dialects. There are however some idiosyncratic differences interspersed in the geographical area.
Demographics
The US Census Bureau describes The Western US as the area covered by the 13 states covered. It further gives the estimated population of the region to be about 34 million. The proportion of the older people in the western US varies greatly in every state where some states experience greater growth while others experience lesser increases. These are the statistics of 2009. Older population refers to people aged 65 years plus
California was one of the 11 that had over 56.5% people aged 65 and above with 4.1 million people.
Two States Montana and Hawaii had over 14% or more people aged 65 and above. Montana had 14.6% and Hawaii had 14.5% of the total population is the older generation.
In Nevada, Arizona, Utah, Alaska, Idaho, and Colorado state, the older population increased by 25%. In New Mexico, there was a high level of poverty among the older population.
Utah had an estimated increase of 251,159 in population. The other states had the following statistics, Arizona 866,734, Oregon 516,862, New Mexico 261,342, Nevada 306,843, Colorado 533,580, Alaska 52,849, Washington 806,202, California 4,148,055, Hawaii 188,180, Wyoming 66,867, Idaho 187,418 and Montana 141,903.
The Impact of Population Change on Health
The geographic distribution of the elderly population and the recent changes observed have a critical impact on government policies, especially healthcare. The implication includes both directly and indirectly, besides it also affects the state and local policy, and these, in turn, influence the federal policy decisions (Nelson, 2002, p. 2662). The federal government usually depends on the population statistics collected by the US Census Bureau so that it can be able to disburse about $200 billion cash to the three levels of government. The older generation is a very important group of the general population that the government has to take care of especially when addressing healthcare Nelson, 2002, p. 2662).
The reason why older people are a group to watch when addressing healthcare policies is that they are the most vulnerable people. This is because their bodies have deteriorated functionality including reduced mobility, limited access to important resources, and changed physiology and all these limit their adaptability (Nelson, 2002, p. 2662). This makes them more vulnerable to changing health. The vulnerability of the older population due to adaptability challenges can have a grave impact on health and societal strategies to help cope with the implications. The older population in the western US is disproportionately compromised because the climate has a great impact on the health of older people, yet these older people’s adaptability is compromised (Nelson, 2002, p. 2662). The climatic conditions like temperatures extremes in Utah and California often cause health problems. The West has witnessed worse conditions like vector-borne diseases and other challenges. The older generation in this region is threatened by cooling and heating, stress on water and food, poor mobilization, and decreased immunity. As a result, many health programs are targeting older people (Nelson, 2002, p. 2662). Medicaid and Medicare are the main health agencies offering healthcare to these populations.
The aging population of The West is a great influence on healthcare research as well. There has been increased research in individual states and on a regional basis aimed at helping in the development of health policies. The cost of healthcare continues to grow and the aging population also increases steadily and it’s estimated that with fundamental changes, the west will spend about 27% of their income on the provision of healthcare. Out of that, about one-third will be for taking care of the older population (ages 65 and above). In the next two decades, about 50% of the entire healthcare encounters are likely to be involving the aging population.
The Healthcare Needs of The West
Addressing the health needs of the aging population of the west is not very different from the needs of the general population though some medical conditions are more common among the elderly. The needs of the older population include safe and decent housing, access to basic goods and services, quality healthcare, and transport. The healthcare services needed by this population include preventive services for common diseases and affordable care for the elderly who may not be having the regular income (Strine, et al, 2008b, p. 151). The majority of older people live in populated states like California which is in the West. The other western states are averagely populated but still host a considerable number of the older population.
The older generation also needs social and civic engagement so that they can be able to remain connected to the community and not feel isolated. Older people can get lonely and end up getting stressed especially after retirement when they stay at home and are not involved in the activities of the community (Strine, et al, 2008b, p. 151). The older population also requires support for them to be independent like doing their domestic chores and reminders to take their medication and so on. When they are not able to use these they require support like homecare and transport.
The aging population of the west also needs special care for the increasing rates of chronic and degenerative diseases which are very costly to manage (Strine et al, 2008a, p. 42). The CDC estimated that about 80% of the older population in the west suffered at least one chronic medical condition while 50% suffered at least two conditions. With the population growing faster in California, Utah, Nevada, and Alaska, the cost of health care in the west is likely to skyrocket. With the increasing number of elderly people, Expenses like home healthcare and/or paying for nursing home services are the greatest threat to the public resources of this region (Strine, et al, 2008b, p. 155). The federal government will be forced to increase disbursement to each state for Medicaid and Medicare.
Another problem is mental health which has often been overlooked in many states in the region but it is a very crucial issue (Stephen, 2003, p. 489). Community service to the elderly is being overwhelmed because mental problems are on the increase. Mental health is very important to the overall health and social involvement and therefore reducing vulnerability to problems (Parks & Roberts, 2006, p. 339). Issues like loneliness, social isolation, depression, and dealing with losses can critically affect general healthiness. However, there are a number of random cases where community service for the elderly is has been improved considerably like in California, Idaho, Washington, Nevada, and Utah. The rest of the western states are also setting policies in place to improve their health services.
Key Healthcare Challenges
The nursing home model of caring for the elderly offer two main benefits. First, it offers nursing and therapeutic care for people recovering from medical conditions or injuries. The objective is to ensure that the older patients are well attended to and returned to the community in good health (Stephen, 2003, p. 489). A second objective is to care for patients suffering serious chronic health problems or cognitive impairment and they may not be expected to get better but need rehabilitation and management of symptoms just to cope with the situations (Strine et al, 2008a, p. 42). The number of older people living in nursing homes has reduced in California, Washington, Arizona, and Idaho. People have had a negative attitude about these nursing homes implying that the patient who visit these places never get to recover hence discriminating people by age.
Another challenge has been the availability of visiting doctors. Over the past decade, doctors have been coming back to medical practice and engaging in the house to house calls. This is because the Medicare policies changed and a doctor can be reimbursed when they visit homebound patients. Some families cannot afford to pay for nursing home expenses and hence they just take care of their aging relatives from home. However, these older persons still need professional services (Parks & Roberts, 2006, p. 339). This means that a medical practitioner has to visit them to give these services. The patient could be disabled or the means to transport them to health facilities are lacking especially when it involves a lot of requirements. Sometimes it’s difficult to provide safety for the patient, therefore, jeopardizing them at home (Strine et al, 2008a, p. 44). Experienced geriatric doctors can make visits to attend to these patients and will be reimbursed by the insurance accordingly.
The number of visiting doctors in Colorado, Oregon, and Nevada has improved considerably hence geriatric services are not a big problem. Besides, the county’s involvement in the care of the older population as well as the support from the government has seen the healthcare of this region improve. There is a lot of volunteer services on the part of the community had these services bolster care for the elderly.
The nursing home in California, like the Meyers Memorial Home in Fall River Mills, has been working with the community and the government to acquire more funds to improve its services. The nursing home facilities in California received extra funding last year to increase the number of caregivers to boost their services and wages. In Nevada, the Highland Manor Of Fallon in Churchill County has improved its staff and the number of volunteers who work under the direction of professional medical practitioners. They offer long-term inpatient care to older people and the disabled (Stephen, 2003, p. 489).
Wellness Program
Old people are disproportionately vulnerable to chronic disease and other injuries like arthritis, heart diseases, or falls causing disability. In the western US, the chronic wellness program is the collaboration between states, the national council on aging, and human and health service agencies (Kane & Kane, 2001, p. 142). These bodies have set up a community-based model of preventing and providing care. These wellness programs have improved self-efficacy, reduced utilization of health services, and allowed players or participants to adopt healthy lifestyles and self-management behavior. The program uses evidence-based services that have been proven to work better. The benefits drawn from the use of evidence-based practice are lower medical expenses, decreased number of medical and injury cases (Kane & Kane, 2001, p. 142), enhanced productivity and efficiency, boosted morale and retention of workers, and finally less absenteeism and stress level among workers.
Reference List
Kane, R.L & Kane, R.A., (2001). What Older People Want From Long-Term Care, And How They Can Get It. Health Aff, 20(6), 114-127.
Nelson, D. E. (2002). State Trends in Health Risk Factors and Receipt of Clinical Preventive Services Among US Adults During the 1990s. JAMA, 287 (20): 2659-2667.
Parks, B.C., & Roberts, J.T. (2006). Globalization, Vulnerability To Climate Change, And Perceived Injustice. Society And Natural Resources, 19 (4), 337-355.
Stephen, B. (2003). Improving the United States’ System of Care for Older Adults With Mental Illness: Findings and Recommendations for The President’s New Freedom Commission on Mental Health. American Journal of Geriatric Psychiatry, 11(5), 486-497.
Strine, T.W. et al. (2008). The Associations Between Life Satisfaction and Health-related Quality of Life, Chronic Illness, and Health Behaviors among U.S. Community-Dwelling Adults. Journal Of Community Health, 33(1), 40-50.
Strine, T.W., Chapman, D.P., Balluz, L., & Mokdad, A.H. (2008). Health-Related Quality Of Life And Health Behaviors By Social And Emotional Support: Their Relevance To Psychiatry And Medicine. Social Psychiatry And Psychiatric Epidemiology, 43(2), 151-159.
According to (Fitzpatrick, 2006) a vulnerable population is a statement that is used to define the ability of a certain group of people to be at risk of something. This term can be used in both positive and negative situations. Although there are many different situations that a person is vulnerable to, our focus in this context shall be health. There are different environments that make a person be vulnerable to attacks that may risk the well-being of their health. Since different environments have unique risks that can endanger their health, appropriate measures need to be taken according to the risks. For any organization to achieve commendable results in protecting the concerned people, they need to cooperate with them so as to determine the real issues.
Vulnerable Population
The vulnerable group that is chosen for study is the children in the inner city that go to a certain daycare center. The daycare center is located in their home area and the food is provided to them by their parents. The children’s vulnerability comes because the resources and services they need are not available. Since they are children, they are unable to advocate for themselves. They are also at risk because nobody seems to be aware of the situations that they are going through.
The daycare center is committed to providing an interactive education program that is of high quality and good standards. The centers in collaboration with the parents strive for excellence and provide challenging experiences to meet the high standards of performance of the school. The objectives of my study were to find out the benefits of social interaction among these children, the different ways that can encourage the children to participate in social activities at the daycare center, and the importance of balancing the time of sleep and play among the children (Fitzpatrick, 2006).
Education facilities are inadequate for these children as the teaching process is done in the hospital. To be able to feel the situation of these children, one needs to intensively interact with them in their programs which include feeding them during their mealtimes, helping them in their bathroom, and teaching them. Participating in these programs enables one to be part of their conditions which will ultimately help them to find the possible solution.
Factors Affecting Health Conditions in Children
The organizations that are mostly involved in such programs include; the government, nongovernmental organizations, health institutions, and individual organizations. The question of protecting such children against environmental hazards is a personal responsibility that has to be motivated by the desire of the concerned to see them healthy. The children live in environments that do not have good facilities for their health. Unless the local authorities move in to protect them from these hazards, they will continue to suffer ill health. There is however a tendency for them to be ignored due to the fact that the authorities concerned cannot feel their agony and help them. They simply cannot understand the pain because they have not been exposed to such situations. The situation mostly comes to their attention when they discover the adverse effects it has caused to the community (Frances, 2004).
It is however not advisable for the authorities to wait until when the situation is out of hand for them to behave responsibly. When measures are taken to prevent and control the occurrence of these issues, it will save us a lot in terms of expenses and lowering the mortality rate of the children. Some of the efforts that can be employed by the local government are to upgrade the living conditions of the children by ensuring that clean water is available to them, the sewerage system should be well maintained, good housing facilities, and equipped health facilities. The communities also need to be educated on the hygiene measures that they need to employ in order to protect innocent lives from controllable diseases.
Children may be vulnerable to health conditions in relation to their living conditions. If they live in congested areas, they are usually vulnerable to communicable diseases like flu and tuberculosis. It is not always easy to contain such sicknesses in case of an outbreak. The diseases spread so fast that, if controllable measures are not taken in time, the disease will spread rapidly and claim lives. Children in such environments are also vulnerable to certain outbreaks such as cholera and typhoid due to limited sanitation and contaminated water. To protect them from such possible attacks, adequate sanitary facilities should be provided and cleaned on a regular basis. Water tanks should also be sterilized and the water treated to ensure that they are safe for use. In case of a breakout of any communicable disease, the patients should be separated from the rest and given immediate treatment to avoid any other infection (Frances, 2004).
Environmental hazards like improper disposal of waste materials can be a serious risk to children who like playing and touching things. Some of these materials may include plastic bags, old utensils, used batteries, and scrap metals. Children who are mostly not aware of the dangers of using these materials may mistake them to be toys and use them. They are therefore exposed to risks such as suffocation, injuries, and poison. Proper disposal bins that are far from reach by the children need to be placed in the correct places to avoid any misfortune.
Drug and chemical use is another common behavior that makes children vulnerable to some complications. Some of the drugs that are commonly abused include; alcohol and tobacco. With the continuous use of these substances the individuals using them may expose the children around them to risks such as breathing complications. When such substances are used by expectant mothers, the effects may be transferred to the unborn baby who might cause miscarriage and future complications to the baby. Due to the addictive nature of these substances, some children may be influenced into using them which will put them at serious risks. Such children may end up growing in rehabilitation centers where they are canceled and helped to stop their use. (Navarro, 2000).
The eating habits of children may expose them to some health problems like obesity and malnutrition. Parents and guardians are at times unable to control such behaviors in children which expose them to such risks. They may also contribute to the cravings of the children by persistently providing for them foods that may risk their well-being. Sugary confectionaries like sweets and biscuits have been the largest contributors to teeth problems among children. Junk foods have been a major problem among the American population where the consumption of foods such as pizzas, burgers, and hot dogs are the major causes of weight-related complications. The consumption of these foods has negative effects on children who are developing complications such as heart diseases, high blood pressure, and diabetes. It is also a major hindrance to the development of the children making them remain inactive (Navarro, 2000).
Health Vision 2010
In its effort to minimize the rate of vulnerable populations to risk factors that may expose the children to diseases, the government of the united states has put in place some procedures that will enable it to reach its target by the year 2010. Among the stipulated plans of this vision is to ensure that the health services are available to everybody no matter their status and location. The government has also set plans to do more research on major sicknesses that are a threat to the people and provide solutions to ensure that the cases are put under check. It also intends to improve medical facilities by installing modern equipment that will enhance faster diagnosis of the diseases in their earlier stages to protect the masses from diverse effects.
Health-Related Goals
According to (Tierney, 2004), to permanently eradicate these problems, long-term plans need to be made that should be aimed at improving the living condition of people. This may involve a lot of finances yet the results will save a lot. Most people may not be aware of the consequences that may accrue to them by living in certain conditions. For example; it may not be practical to advise a person to stay at a better place to protect them from sicknesses when they opted to stay where they are due to the high living costs in other areas. Instead, it is practical to build them better houses and advice them on how they can take care of themselves in those houses to protect themselves and their children. It is also possible to provide clean water to society and ensure that they do not suffer from water-borne diseases without having to advise them on its importance. Some preventive measures may be theoretical yet others are practical.
Some of the theoretical, measures that are taken to protect the vulnerable population from preventable health hazards include counseling. The organizations that are mostly involved in this activity are the health practitioners who mostly visit the areas that are vulnerable and educate them on their role towards a healthy society. They use the local authorities who assist them by informing them of their visit and in bringing them together. Through their various initiatives, they provide practical hygiene procedures that they should apply in their daily lives for constant safety (Jonsen, 2006).
One of the many challenges that face these initiatives is the inability of the concerned groups to apply the advice given to them. They at times never realize the importance of what they are being told and resort back to their old lifestyles. Another factor that renders these methods unpractical is that the people find them too sophisticated that they cannot stick to them on daily basis. It has thus been the responsibility of the concerned groups to follow up on them until they get used to the routine. They also offer them some guidance on what to do in case they are faced with a certain condition. It has sometimes occurred that most children lose their life simply because they could not be administered the first aid that would have saved their lives. Health facilities may be far away from them and if they are near, the people may not access them due to the high costs that are involved. It is therefore important that they are given tips on what to do in case of burns, fainting, snake bites, and other common ailments (Tierney, 2004).
There are also some uncontrollable conditions that may arise and people should be aware of them. In such situations, the populations are taught methods through which they can prepare themselves to avoid being caught offside. In cases that involve emergency measures to be taken like fires, the parents and guardians may concentrate on rescuing other important things and forget about the children. Children are generally tender and they, therefore, need to be treated with a lot of care. During their earlier stages, they are supposed to be immunized against some illnesses that may cause them a lot of complications when they grow up. Parents are usually advised to take their children for immunization programs so as to get their children out of danger. The vaccines that are administered to them include; whooping cough, tuberculosis, polio and measles.
(Danis, 2002) found that, the psychological well being of children is necessary for their healthy growth. Some of the children are unable to concentrate in activities like studying and playing well like the others due to the trauma that they encounter in their lives. When they are at home with their parents and care takers they may be exposed to some conditions like violence, abuse and the like. Such conditions affect the young children as they try to figure out the events surrounding the ordeal. Although such cases are easy to identify in children through their behavior in the day care centers, helping them out of the problem may not be easy. It thus requires a person who is skilled and experienced to sit with the children and find out exactly what is making them behave in a certain manner. Some of the problems may not be easy to be explained by the children whose mind may be too young to comprehend.
The Personal Goes Political
This is an initiative that is aimed at utilizing the personal for the benefit of all. It is about realizing your personal abilities and strengths for the common good of the masses. Such programs involve soul searching with the intention of exposing the inner person. It has been discovered that some psychological and environmental issues that affect most people is because they have never taken a critical study of their own self to find out the origin of their circumstance. It has been identified that most of the solutions to our problems are not physical but psychological (Gibbs, 2005).
Some of the initiatives that are involved in such programs include making people aware of their bodies and the diseases that they are most vulnerable to. The measures that they can employ in their day to day life to minimize any future risks. People are also encouraged to take good care of their environment and utilize the available resources to remain healthy. They are also discouraged from some habits like smoking and drinking that could expose them to certain risks such as cancer (Danis, 2002).
The Role of Nurses in Education and Advocacy
(Moss, 2000) argues that, nurses who are specialized in the needs of the children can be of great help in advocating for the needs of the children. They have good knowledge of the children’s psychology and health. When the local governments and the non governmental organization are being used to educate the masses on the measures that need to be taken to protect the children against vulnerability, they should be included to provide the necessary advice that can be employed to safeguard the children. These nurses are usually equipped with the tactics that can be employed in counseling a child and offering the necessary help.
Cases that deal with abuse of the children have to take the effort of the guardians and the nurses. With the children’s inability to express themselves, the nurses will have to identify the kind of abuse that the child is going through and the person or persons that are involved in the abuse. Once these factors are involved, the appropriate methods need to be employed to ensure that the problem is not only permanently solved but also that the relationship between the children and their guardians is maintained (Lainie, 2006).
More nurses need to be trained and equipped to deal with such issues that affect the children. They also need to be deployed to the institutions that deal with children so that they can offer specialized care. Different children have unique needs that need to be taken care of on a personal basis. They also need to be monitored closely to identify any issue that may arise. Children are at times left in the hand of the care takers that may not understand the needs of the children. The methods that they use may also be abusive on the children who seem not to corporate with them or the other children. In fact some of the measures that should be taken to completely solve the situation are to let only the qualified staff be with the children to serve as day care guardians.
According to (Conwell, 2004) Nurses also have a role of educating the public on the measures that they can take to ensure that the children are safe from diseases. Through the social groups, they need to frequently visit homes and provided the necessary advice to families. In these efforts they should mostly target the mothers who have the biggest responsibility in taking care of the children. They should advice them on hygiene matters and the general care that they should observe to protect their children.
Conclusion
The health of the children should not just be the concern of the few individuals that are directly involved. As the entire society, we are responsible for the wellbeing of the children. Some of the roles that we can play to are to ensure a good environment for our children by providing them with an environment that should be free from such hazards as scattered scrap and plastic bags. Litter bins should be placed in the correct places and the rubbish well disposed. To the children around us, we need to give them the attention that they need especially psychologically. Their growth should not in any way be interfered with by negligence on our part. We need to give them the assurance and the comfort that they deserve and at the same time not compromising especially on the eating habits that may endanger their health (Lainie, 2006).
References
Conwell, F. (2004): If suicide is a public health problem, what are we doing to prevent it? American Journal of Public Health: Am Public Health Assoc, 34(2), pp. 17-19
Danis M. (2002): Ethical dimensions of health policy, US: Oxford University Press US pp. 12-15
Fitzpatrick J. (2006) Encyclopedia of nursing research: Published by Springer Pub pp. 31-39
Frances A. (2004): Community/public health nursing practice: health for families and populations: Elsevier Health Sciences pp. 42-46
Gibbs, J. (2005): Mental health and well-being of Black women: Toward strategies of empowerment: Journal of Community Psychology: Springer, 24(3), pp. 21-23
Jonsen A. and Siegler M. (2006): Clinical Ethics: A Practical Approach to Ethical pp. 19-23
Lainie R. (2006): Children in Medical Research; Access versus Protection: Oxford University Press pp. 37-44
Moss, N. (2000): Social Science & Medicine: Journal Socioeconomic disparities in health in the US: an agenda for action: Elsevier, 17(1), pp. 27-29
Navarro, V. (2000): Development and quality of life: A critique of Amartya Sen’s development as freedom: International Journal of Health Services: Baywood, 45(4), pp. 10-12
Tierney, W. (2004): Stepping up to the plate: Journal of General Internal Medicine: Springer, 6(2), pp. 33-37