Describe how your choice of a career as a mental health clinician or marriage and family therapist has been influenced by your family.

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Describe how your choice of a career as a mental health clinician or marriage and family therapist has been influenced by your family.

Career Genogram

After reviewing the multimedia piece on developing a career genogram earlier in this unit, complete the following:

  • Reflect on how choosing a career plays an important role in one’s family history.
  • Describe how your choice of a career as a mental health clinician or marriage and family therapist has been influenced by your family.

May law enforcement officers take an item off the shelf in an antique store and examine it to determine whether it is stolen?

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May law enforcement officers take an item off the shelf in an antique store and examine it to determine whether it is stolen?
Chapter 10

May law enforcement officers take an item off the shelf in an antique store and examine it to determine whether it is stolen? May officers do the same thing in a private home into which they have been invited by a person who does not know they are law enforcement officers?
Does the plain view doctrine authorize a warrantless entry into a dwelling to seize contraband visible from outside the dwelling? Why or why not? What if an officer observes contraband from the hallway of a motel through the open door to one of the rooms? What if an officer observes contraband lying on the desk in someone’s office?
Chapter 11

Are there any situations in which a warrant is required to search a motor vehicle? In reality, isn’t the warrant requirement the exception rather than the rule in automobile cases? Fully explain your answer.
If officers have probable cause to search a vehicle stopped on the highway but no probable cause to arrest the passengers of the vehicle, can they search the passengers also? Does the answer depend on the nature of the evidence for which the officers are looking?
Chapter 12

Does the value of an object have any bearing on the question of whether a person abandoned it? Can a person who runs away from his or her automobile to avoid apprehension by the police be said to give up all reasonable expectations of privacy in the vehicle? What if the person locks the vehicle before fleeing? In a related vein, does the size or other physical characteristics of an object have any bearing on the question of whether a person abandoned it?
If a person undergoes emergency surgery after being shot by police while driving a stolen automobile, which of the following, if any, has the person abandoned?
Clothing worn at the time of the shooting
Wallets and other items in the pockets of the clothing
Bullets surgically removed
The automobile

Factors Influencing Mental Illness Rates in Pakistan

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Introduction

At the 13

th

year of her life, she was worried due to the recently started bleeding from her vaginal area without any manifested injury. She ran to her mother and asked that what is happening to her. Her mother scolded and asked her to put some piece of cloth over there so that the bleeding nobody could notice the bleeding as it would be a source of embarrassment for the family and for the girl herself. Her mother then sent her to a special house which was full of menstruating girls and pregnant women. This is the story of 13 years old Huran Bibi from Kalash valley of Chitral, who was one of the members of Bashalani

(the house built specially for the menstruating and pregnant women.)

The cultural view of Kalash people is based on the concept of purity and menstruating and pregnant women are considered impure as per their cultural beliefs. Being a girl from a primitive culture I always thought to explore the different strong and weak parts of our culture which may impact the mental health of people in a healthy or unhealthy way respectively. The reason for choosing this topic is the trial to understand the impacts of our culture on our mental health.

Numerous studies have been conducted on relationship between Culture and mental health. Mostly, the concept of being well or sick is well-defined according to the cultural background, cultural beliefs and cultural practices used by a specific group. defined culture in relations of objective components (

houses and tools

) and subjective components such as societal norms, roles, dogmas, and principles, further argued that culture is a dynamic practice designed by an individual’s commitment within their social set-up. Pumariega, explained culture as a way of life which includes traditions and customs. These customs transmitted through learning and play a vital role in molding the beliefs and behaviors of the people exposed to them. Generally, people in social groupings who share same religion, children and adolescents who play together and adults who work in same professions have their own cultural beliefs and practices.Culture is largely defined as a collective tradition or fixed dogmas, standards, and ethics. Culture frequently changes and is influenced both by the views of people and the burdens of their surroundings. People are bound to their customs and traditions because they think that their ancestors have transferred these practices to them so these practices are to be preserved for their future generations.


Body

Different cultures have different practices and beliefs regarding mental illnesses. In some cultures mental illness is thought to be the result of bad deeds and going against almighty Allah. In addition to that, a concept of bad evil entrance into the body is also found in few cultures. For the treatment of those mentally ill patients people incorporate religious/spiritual treatment. Sometimes religious treatment enhances coping mechanism of mentally ill patients but sometimes its themes may incorporate into religious delusions.


Prevalence of Mental Illness in Pakistan

explained the prevalence of anxiety and depressive disorders in Pakistan was 34% out of which 29-66%women were affected and 10-33% men were affected. Furthermore, the study also highlights the prevalence of pediatric mental disorders which was found to be15.8% in Pakistan. studied the prevalence of anxiety, depression and their associated factors on medical students in different institutions of Karachi .Approximately 70% of students were suffered by anxiety and depression. Among 70% about 59% of the students were female and 43% students were Urdu speaking.


Causes and outcomes

Cultural beliefs and traditional practices are the root cause of mental illnesses and mental disorders. Referring to the scenario, the cultural practices and beliefs of purity made the little girl isolated from the society. Living away from family once in a month makes the girl feel guilty and being an alien to her. Not having a bath till the menstruation period ends make the young girl to think of being untouchable and lowers self-esteem. Such kinds of practices can lead to social isolation or depression with many other mental health problems. Similarly many other traditional practices are found in our culture which influence our mental health such as gender based violence, divorce, forced and early marriages, domestic violence, son preferences, concept of being virgin, duty to be obedient, polygamy and honor killing. Furthermore acculturation is also known cause of mental illnesses in immigrants and ethnic minorities.


Gender based violence/ domestic violence.

, a total of 8,548 cases of gender based violence were reported.In addition to that, the duty of obedience is considered as the main cause of spouse abuse. A lifetime incidence rates of wife abuse in global range is from 16% to 50% .Disobedience and clashes with the in-laws are specifically the major causes which explain wife abuse. Women are thus advised to forgive or say sorry in order to safeguard their kids and their home. Abused women are more prone to mental disorders namely self-inflicted injuries, sleep or appetite disorders, and suicidal attempts. Depression is the most common mental disorder in abused women.


Divorce

. It is a process of breaking marital relationships due to many reasons including cultural incompatibility of women and her husband family. It is the most stressful condition for husband as well as for wife. When a women is given divorced then it is thought to be a very shameful act for women because the low status of women in Pakistani culture. On the basis of this, society labeled women with bad deeds and bad character. This stigma leads to discrimination and women end up with severe mental illnesses like schizophrenia, depression, fear even commit suicide.


Polygamy.

Polygamy is officially permitted in the Islamic tradition which is definitely a stress for women. polygamy appears to increase exposure to psychiatric disorders in the wife; of those in monogamous marriages, 17.8% were cases, in contrast to 39.1% of women in polygamous marriages. declared Polygamy as a high tensioned condition triggering a neurotic anxiety, and in severe cases somewhat serious mental disease.


Honor killing

explained that in some Islamic societies, the only way to cleanse the family honor is to kill the “offending” woman or girl. Depression and a number of anxiety disorders, somatoform and eating disorders, or suicide attempts are the most common psychiatric situation in Islamic women.


The duty to be a virgin.

According to the loss of virginity is thought to be equated with young women worth. So losing virginity is the major reason of suicidal behavior in teenagers. They are also in threat of being killed by a father, brother, uncle or cousin in order to restore the family’s honor and place in the community. As a result to the duty of virginity, illegal pregnancies are severely fated and are related with several social problems (

running away from the family/home, aggression towards these girls by their own parents, or even homicide

) with a high occurrence of depressive and anxiety reactions with suicidal behavior.


Imposed marriage/early marriage.

Traditionally, it is expected from a daughter to shy away from expressing her wishes and her parents are responsible to decide for her. An arranged marriage is the decision of parents to select a life partner for their daughter, often with either a cousin or someone completely unknown before the marriage. This can lead to depression, anxiety, fear and isolation.


Acculturation.

Unfavorable and shocking life experiences can change the brain chemistry of the people e.g., migration from one country to another for many reasons such as natural disaster, education or job opportunities. This can give the concept of acculturation in which culture-of-origin and host cultural characteristics can disagree autonomously. Furthermore, acculturation is a dual process of cultural and psychological change that takes place as a result of contact between two or more cultural groups and their individual members. Acculturation may assists daily social interaction and encourages management opportunities. Conversely, it may escalate tension or clash between two opposing cultures or can be related with a decrease in family support.


Conclusion

In conclusion, some cultural beliefs and practices are leading to mental illnesses such as, the concept of keeping a menstruating girl in a separate house without taking bath till menstruating period ends. Likewise, gender based violence including domestic violence, rape cases, abusing women at home as well as on work place can be the leading cause of mental illness in women. In some cultures it is the responsibility of parents to take decisions of selecting life partners for their daughters which mostly results in cultural incompatibility and domestic violence. Furthermore, marrying more than one woman or separation from an intimate relationship can increase the risk for mental health disorders. Honor killing and being not virgin are interrelated to each other in which the only solution to cleans the family honor is to kill the offending girl which includes virginity also.

Study On Palliative Care And Quality Of Life Nursing Essay

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Quality of life (QoL) is a frequently used term within society, yet there remains a lack of consensus as to its definition, with one review identifying three categories of QoL within the literature (Farquhar, 1995): global definitions (i.e. QoL is referred to in general terms, e.g. life satisfaction); component definitions (i.e. QoL is divided into dimensions, e.g. health, psychological well-being, social well-being); and focused definitions (i.e. where the emphasis is on one or two of the possible component definitions).

Despite the inconsistency in how QoL is defined, it has been agreed that it is a multidimensional concept comprising the following dimensions: physical function; symptoms; global judgments of health (i.e. perceived health status); psychological well-being; social well-being; cognitive functioning; role activities (e.g. employment, household management); personal constructs (e.g. life satisfaction, spirituality); and, satisfaction with care (Fitzpatrick, Davey, Buxton, & Jones, 1998). This multidimensionality is most clearly reflected in the definition proposed by the World Health Organisation (WHO, 1995): “the perception by individuals of their position in life, in the context of the culture and value systems in which they live and in relation to their goals, expectations, standards and concerns.” WHO also clarify that “It is a broad ranging concept affected in a complex way by the person’s physical health, psychological state, level of independence, social relationships and their relationships to salient features of the environment.”(p. 1405)

In distinguishing between active life-expectancy versus actual life-expectancy, Katz et al. (1993) introduced the concept of QoL in palliative care. The difference between active and actual life-expectancy is reflected in the following quote, “And in the end, it’s not the years in your life that count. It’s the life in your years” (Abraham Lincoln). In other words, length of life does not equate with quality of life. This is the approach taken within palliative care, also referred to as end of life care, where the focus shifts from treating pathology to tending to the individual (George & Jenning, 1993). Traditionally, the key aim of medicine and healthcare has been to increase actual life expectancy (number of years alive). However, now that people are living for longer as a result of improved treatment, the focus has moved to what Katz refers to as ‘active’ life expectancy – i.e. not just enhancing years of life, but the quality of that life. The notion is that quality of life is subjective. For example, some patients choose treatments that reduce their life expectancy in order to avoid treatment side-effects that would compromise the quality of the years that they do have left – they actively choose quality over and above length. Some people who believe in ‘the right to die’ advocate that keeping someone alive might be lengthening the number of years they are alive, but that life isn’t a ‘life’ in the sense of having any quality to it. In palliative care, the focus is on maintaining quality of life during the dying process by reducing pain, keeping the patient comfortable, ensuring their needs are met, etc. Keeping a person alive is not the priority – making their final years as comfortable as possible is.

Palliative care emphasises that even when someone cannot be cured, their life is still the main focus of healthcare professionals, as is their quality of life. Thus, palliative care is directed towards the priorities of an individual and what might make the time an individual has left as comfortable and fulfilling as possible. One key aspect of this is providing a dignified and pain-free death. Paradoxically, this has been found to increase life-expectancy as well as quality of life in people reaching the end of life (Temel et al., 2010).

Controversially, palliative care has been associated not with enhancing QoL by providing individualised care early on within the disease trajectory, but more so as ‘giving up’ and admitting defeat. During debates over US health reforms, palliative care was described by some as ‘euthanasia,’ the practice of intentionally ending a life to ease pain and suffering (Mongan, Ferris & Lee, 2008).

For those providing palliative care, however, the service is about life rather than death, about maintaining a patients’ QoL (as perceived by them) by bringing together experts and specialists who can assist with symptom control (Agar et al, 2008). Rather than palliative care being an alternative to life-prolonging or curative care, providers view it as an adjunct to disease-focused treatment, which should be integrated into standard treatment pathways. Traditionally, palliative care has been provided at the last minute, as a last resort and a sign that the patient needs to prepare for death. This is despite evidence suggesting that to have a meaningful impact on QoL, palliative care needs to be provided earlier on in the disease trajectory (Temel et al., 2010). Fortunately, practice is changing and palliative care is provided sooner rather than later, so that patients can prepare not for death but to fulfil the time they have left.

This new, individualised, quality of life approach to palliative care introduces new ways of working for health professionals and those close to the patient. Rather than working with the concepts of pain, suffering and death, these concepts are being replaced with achievements, rewards, improvement, and quality (Claffey, 2005). There is a whole new narrative being utilised within palliative care. Palliative care used to have negative connotations attached to it (i.e. death, suffering, pain, deterioration, loss, ending). In the present day, palliative care has a less fatalistic association attached to it, with the recognition that it isn’t merely about preparing for death but also about enhancing the remaining weeks, months, or years of life. Of course, it remains a daunting term to people, but at the same time it offers comfort and support. Indeed, rehabilitation, a term traditionally associated with cure and recovery, is a key component to palliative care, helping patients to gain opportunity, control, independence and dignity (National Council for Hospices and Socialist Palliative Care, 2000). There is now a dual approach to working with people whose illness cannot be cured. On the one hand, the focus is on maintaining QoL and on the other it is preparing for death. Therefore, maintaining QoL through palliative care requires a holistic approach based on the QoL components offered by Fitzpatrick et al. (1998).

It could be argued that if palliative care is about maintaining QoL, then allowing a prolonged death is not consistent with the palliative care ethos. However, the duty of health professionals is to provide the patient with care and ease their suffering without prolonging or hastening their death. Again, the focus is on life, not death, with any medical intervention being designed to ease suffering and enhance independence and dignity (Jeffrey, 1995). This is related to active versus actual years. Some people advocate euthanasia, arguing that keeping someone alive is inhumane if they no longer have any quality to their lives. Palliative care could be viewed as keeping someone alive despite loss in quality of life (it has been found that people do live longer if they receive palliative care). However, a challenge to the notion of palliative care being inhuman would be that it does not prolong death – it enhances life by reducing pain, keeping the patient as comfortable as possible, and ensuring their needs are met.

Palliative care is, in the main, available for cancer patients who can benefit from medical support to control physical symptoms of pain and dyspnoea, as well from emotional and spiritual support to assist with fears or feelings of grief or anger (Morrison & Meier, 2004). Such care is reported to be low for other conditions, such as chronic pulmonary disease, raising the question of where QoL is incorporated into their care (Yohannes, 2007).

The effectiveness of healthcare has traditionally been measured via increased life-expectancy, yet palliative care demonstrates that the recent move towards considering QoL outcomes as a measure of healthcare efficacy is apt. With a greater focus on quality rather than quantity of life, patient-reported outcomes are becoming important indicators of healthcare effectiveness (Clavarino, 1999). This also takes into account the subjective nature of QoL and healthcare needs, with different people placing different levels of importance on various aspects of health and well-being. It could be argued that the lack of consensus on a definition for QoL is due to the very subjective nature of the concept. Measuring QoL or healthcare effectiveness purely by disease outcomes takes a ‘one size fits all approach,’ which is no longer sufficient in efforts to provide individualised patient care at a time when personal needs are at their greatest – during the end of life.

Evaluation of the Integrated Physician Model

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Physician-hospital alignment is important to improving the U.S. healthcare system. In this essay, we will go over the concept of the integrated physician model, clinical integration, the workings and controversies of accountable care organizations (ACOs), and the pros and cons for physicians that work under hospital-owned group practices.


Part 1

The integrated physician model is best described as a group of physicians and hospitals coming together to form a partnership to help aid in the improvement of quality patient care, (Harrison, 2016). The concept of the integrated physician model is to have physicians and other administrative roles cooperate on multiple different ventures in order to accomplish a goal. A goal may be difficult to accomplish by one hospital or organization, but if a group is able to get together and effectively communicate and work towards the goal it may result in a more positive outcome. An example of an integrated physician model would be a primary care clinic, oncology clinic, independent medical group, and private oncologist practice working together to improve cancer related treatment protocols.

Having physicians be a part of the planning process is important because they get to see firsthand how procedures and daily operations are performed. When physicians from different organizations communicate it’s easier to achieve a more cohesive treatment plan for a patient because the medical history can be more readily accessible. The integrated physician model is designed to allow various physicians to accomplish and meet goals for the patients and their practice.


Part 2

There are multiple definitions for clinical integration. The American Medical Association (AMA) describes at is a way to coordinate patient care across multiple different outlets to achieve safe, timely, and efficient patient-focused results. The Affordable Care Act (ACA) describes clinical integration as coordination of care across settings to increase positive outcomes in areas such as expanding coverage, boosting quality care, promotion of innovation, and cost control, (Athena Health, n. d.). Both definitions encompass improvement of the coordination of care for patients through provider communication.

Clinical integration is very important into day’s healthcare system due to the variety of specialties that exist today. It’s especially important for patients with chronic conditions who receive care at multiple different facilities. Clinical integration is a continuous process of alignment across the care continuum that supports the triple aim of health care: improving quality of care, reducing or controlling the cost of care, and improving access to care and the overall patient experience, (Athena Health, n. d.). Clinical integration has an overall goal of improving the consistency of quality care for patients.


Part 3

Affordable Care Organizations (ACOs) are groups of doctors and hospitals who come together voluntarily to give coordinated high-quality care to their Medicare Patients. They share both a financial and medical responsibility to keep their patients healthy, (ACOs, 2016). They can be financially compensated for accomplishing this goal. The groups receive the compensation by effectively coordinating the care of Medicare patients. This provides incentives to doctors to reduce costs of medical services and weed out duplicate processes.

There are controversies surrounding ACOs. ACO’s allow multiple providers to look into a patient chart. This adds an increased risk for HIPAA and PII breaches. Capitation is a possibility within ACOs. Patient’s that require chronic care may be high cost. Under an ACO these patients may be placed under a ceiling for payments that can be provided, leading to lesser care due to potential financial ruin, (ACOs, 2016). Total implementation may be very cost heavy depending on whether or not the organization already has an electronic medical record (EMR) in place. Setting one up may play a heavy financial burden on the organization.


Part 4

Hospital acquisition of medical group practices began in the 1990s as healthcare organizations crated integrated delivery systems, (Harrison, 2016). Hospital-owned group practices refers to the acquisition of medical practices by a hospital. This is becoming more frequent in the U.S. due to the advantages that come along with being associate with a network of hospitals. In 2015, 63 percent of physicians said they were employed by hospital-owned medical groups and less than 32 percent were in private practice, (Harrison, 2016).

A major advantage for physicians within a hospital-owned group practice is that they do not have to pay out of pocket for any special equipment that needs to be replaced because the hospital is generally responsible for it. When a physician is employed through a hospital their compensation includes their salary, bonuses, and contributions for profit-sharing. Physicians have more access to specialty care for their patients allowing for more optimized patient care experiences.

One disadvantage may be that a physician under a hospital-owned group practice is required to abide by rules of the facility that employees them. This means that they are unable to make certain decisions on their own due to possibility breaking hospital policy. In a private practice, physicians are, for the most part, able to make their own decisions without having to worry about interference from a high entity. Another disadvantage is that although having multiple providers can be a benefit, it can also cause issues. Too many providers dealing with one patient can cause conflict. One physician in the chain of care may disagree with another and may attempt to treat the patient their own way.

As the health care industry evolves, it seems integration is becoming more prevalent. Integration will continue to be improved upon as time goes on. As Healthcare administrators it will be important for us to maintain a knowledge of all aspects of this venture. Understanding topics such as the integrated physician model, and clinic integration will be key in the success of our careers.

References

  • AHA. (2012). A Guide to Physician Integration Models for Sustainable Success. Retrieved from URL: https://www.aha.org/system/files/hpoe/Reports-HPOE/guide_to_physician_integration_models_for_sustainable_success.pdf
  • Harrison, J. P. (2016). Essentials of Strategic Planning in Healthcare. [Purdue University Global              Bookshelf]. Retrieved from https://purdueuniversityglobal.vitalsource.com/#/books/9781567937916/
  • Athena Health (n.d.). What is Clinical Integration? Retrieved from URL: https://www.athenahealth.com/knowledge-hub/clinical-integration/what-is-clinicalintegration
  • (2016, June 7). ACOs – Pros, Cons & Challenges of Accountable Care. Retrieved from https://eligible.com/community/pros-cons-accountable-care-acos/

Health Strategy For Diabetes Case Study

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Description of the case

Berks Community Health Center serves communities of Berks County, Pennsylvania, which include urban, suburban, and rural areas with distinct populations and different needs. However, the population of the City of Reading is a group of particular concern. The racial and ethnic structure of the City population changed over the past two decades. The proportion of White residents decreased from 47.0% to 28.7%, and the share of Latino residents increased from 38.0% to 58.2% (Public Health Management Corporation, 2013). Today, Latino is the largest cultural group with specific healthcare needs in the area. According to the survey of the Public Health Management Corporation (2013), the members of the Hispanic community in the City of Reading, PA, identify diabetes as one of the most pressing health issues.

Type 2 diabetes disproportionately affects Hispanic adults. They show a higher death rate from diabetes (51% higher) and higher prevalence of diabetes (133%) and obesity (23%) compared with Non-Hispanic Whites (Dominguez et al., 2015). Hispanics have demonstrated poorer glycemic control, higher rates of diabetes-related complications, and lower rates of self-management compared to Non-Hispanic Whites with type 2 diabetes (Hatcher & Whittemore, 2007). Considering Hispanic disparities in diabetic health outcomes, there is an urgent need for preventive measures to decrease the burden of diabetes in the local Hispanic community.

Several evidence-based and culturally tailored diabetes education interventions have been developed for Hispanic population. Examples include the Starr County Border Health Initiative, La Diabetes y la Unión Familiar, Project Dulce, and ¡Si! (Culica, Walton, Harker, & Prezio, 2008; Prezio et al., 2013). However, none of them are implemented in the City of Reading. The YMCA of Philadelphia Freedom Valley offers the CDC-recognized diabetes prevention program in Boyertown, the only place in Berks County (CDC, 2019). The program is unavailable to the majority of Hispanics due to costs and transportation barriers. To address these issues, Berks Community Health Center decided to form an alliance with other community organizations and develop a free-of-charge digital health program to prevent diabetes and its complications among low-income Hispanic patients.


Description of the facts of the case


Background and goals/objectives/mission of the new idea

To achieve optimal control of diabetes, patients should be proactively engaged in self-management practices that involve behavioral changes and execution of complex medical treatment regimens (Fontil et al, 2016). Practice-based interventions that provide support for self-management have become a foundation of various diabetes prevention programs. Overall structure of the diabetes prevention program includes a trained lifestyle coach that facilitates a small group of participants in learning about healthier eating, physical activity, and other behavior changes. Advancements in information technology (IT) have expanded the ability to engage patients in the healthcare process, motivate health behavior change, and offer the potential to disseminate lifestyle self-management programs like DPP on a large scale.

The overall goal of the digital health program is to reduce health disparities for local Hispanic population. It will be designed specifically for Hispanic population addressing issues, such as language barrier, low literacy, low acculturation level, limited preventive attitudes, poor knowledge about diabetes and health care system in the US, and low socio-economic status of many Latinos. It will be culturally appropriate in terms of diet, beliefs, barriers to exercise, limited access to health care, and personal preferences. Two primary objectives for the development team is (1) to adapt the literacy level and cultural relevance of the standard DPP content for the low-income, underserved Spanish-speaking population and (2) to develop a user-centered design.


Facts of the case

In its digital version, DPP includes online group support, personalized health coaching, and a weekly curriculum. The cornerstone of this program is a health coach figure who shares the same ethnicity, language, and geographic community with target population. Patients are more likely to trust a peer from a similar background who understands their culture. Therefore, health coaches will serve as a bridge between patients and providers. They will improve diabetes-specific behaviors by delivering educational sessions, helping patients navigate health care system, and providing referrals to health care providers if needed.  The online platform would allow participants to asynchronously complete weekly lessons, send messages and call a health coach for individual counseling, and monitor weight loss progress and engagement in physical activity.

Currently, the Pennsylvania state legislation relating to diabetes does not mandate coverage for diabetes prevention programs, and Medicare and Medicaid programs do not provide reimbursement for such interventions, nor do they cover HbA1c testing for the diagnosis of prediabetes (Vojta, Koehler, Longjohn, Lever, & Caputo, 2013). Non-profit organizations and philanthropic groups will provide funding for this program. However, financial sustainability and potential issues related to integration of the program into the existing health care services are not a focus of this paper.


Analysis of the problem including key stakeholders and their perspectives

The list of key stakeholders includes two distinctive groups: those who would benefit from outcomes of the program and those who will be involved in development and implementation of the program. The community stakeholders who would benefit from outcomes of the program include Latino community of the City of Reading,

Centro Hispano

(the Latino community organization of the City of Reading), and local health care systems and community clinics, such as Berks Community Health Center and Penn State Health St. Joseph. Stakeholders who will be involved in development and implementation of the program include research and clinical groups including endocrinologists, certified diabetic educators, and public health nurses, software developers, health coaches, and volunteers from Latino community. Non-profit organizations and philanthropic groups, such as Berks County Community Foundation, the United Way of Berks County, and local churches, will provide funding (Holleran Community Engagement Research & Consulting, 2016).

The central problems derived from the stakeholders’ analysis include awareness and acceptability of the program by the Hispanic Community and adequacy and availability of culturally sensitive health care providers. Many may not understand concepts of Western medicine and have limited preventive attitudes. Many types of preventive care are not commonly available in the Latin culture, and many Hispanics do not realize the benefits of preventive services and do not seek health care unless they feel ill. They share a cultural belief that their lives and destiny, including illness, are not under their control, so seeking early preventive care is pointless (Abraido-Lanzo et al., 2007).

Another area of concern is cultural competence of health care providers. Cultural competency goes much deeper than a language barrier and the routine use of translation services would not eliminate all possible mistakes and misunderstanding. In addition, the majority of programs on cultural competence focus on superficial cultural characteristics such as rituals and beliefs.   This approach would do more harm than good because it leads to stereotyping, development of a very simplistic schema of a person as a member of a certain cultural group (Garneau & Pepin, 2015). The most immigrants are acutely aware of possible differences and do not expect that a health care provider would know everything about their culture. What they need is reliable means to communicate their needs.


Decision-making and implementation issues

The primary decision the team needs to make is how to incorporate the perspectives and experiences of Hispanic clients in developing and finalizing a culturally appropriate content and user-friendly digital platform with the ultimate goal of improving usability, acceptability, and value to end-users. The team considers two alternatives. First alternative is to develop a digital product based on Community Diabetes Education (CoDE) program. This program was developed in response to the local diabetic epidemic in Dallas, Texas, an area similar to the City of Reading in terms of high diabetes prevalence, a high percentage of Latino populations and residents without health insurance (Culica, Walton, Harker, & Prezio, 2008; Prezio et al., 2013). It was designed specifically for Hispanic population and involved bilingual and bicultural community health workers who served as a primary diabetes educator and as the “bridge” between patients and health care providers.

There are two disadvantages of this option. First, the content of the CoDE program was designed specifically for Hispanics of Mexican American origin, while the Latino majority in the City of Reading is Puerto-Ricans. Differences between these two cultural groups in terms of diet, beliefs, and attitudes are considerable. This raises concerns about appropriateness of the content of the CoDE program to the local context. In addition, this option does not offer ready-to-use technological solutions.

Second alternative is the Omada Health Program, an Internet- and mobile-phone-based educational solution program. It provides a ready-to-use technological solution that can be customized according to the needs of specific users (Fontil et al, 2016). This option is preferred because it addresses disadvantages of the CoDe program. To transform the standard content of the Omada Health Program into culturally appropriate material, the team plans to iterate a prototype through a series of Plan-Do-Study-Act (PDSA) cycles. In Plane phase, the team will conduct interviews with focus groups to understand the needs and perspectives of Hispanic clients. Then, based on this feedback, the team will translate and adapt the online curriculum. In the Study and Act phases, the team will test the modified program and develop recommendations for the next iteration.


Barriers and facilitators to implementation

The access to primary/preventive health care services is the big issue for the community. The significant barriers are a shortage of providers accepting Medicaid/Medical Assistance and financial issues. Only two not‐for‐profit community clinics, the Berks Community Health Center and Penn State St. Joseph Downtown Campus, provide many low-cost or free health care services (Public Health Management Corporation, 2013). However, these clinics have long waiting times due to insufficient capacity to satisfy the community needs and have a significant shortage of bilingual health care providers who potentially could participate in development and implementation of the program (Public Health Management Corporation, 2013). Literature sources cited the lack of trust in providers as a common barrier for DPP implementation (Culica et al, 2008).  The area of particular concern is limited computer literacy of older Hispanic adults (Fontil et al, 2016). Many Hispanics may be illiterate and cannot read written information even in Spanish (Delmarva Foundation for Medical Care, 2014).

However, the local Latino community identified diabetes as one of the most pressing health needs (Public Health Management Corporation, 2013). Community leaders confirmed their readiness to provide funding and all necessary assistance, and many bilingual and bicultural members of

Centro Hispano

are willing to volunteer and help with content adaption and development. These factors can facilitate the implementation of the project.


Evaluation of the outcomes or future planning involved

The team will evaluate an enrollment rate and attrition rate because the goal of the program is to achieve better glycemic control in all out target population. The team will develop recommendations regarding a target enrollment rate based on data that will be collected during prototype testing.  The enrollment rate will be calculated as a proportion of all eligible patients who will complete a sign-up process.  Based on literature reviews, the expected target attrition rate is 14-22% (Culica et al, 2008; Prezio et al., 2013). The same studies found that patients who attended more education sessions achieved better glycemic control, and participation in the program was associated with frequency of patient contacts with a health coach. Thus, the team will evaluate the effectiveness of the program by monitoring the improvements in glycosylated hemoglobin level. According to Prezio et al. (2013), 1.14-1.6% decrease over 1 year is an achievable level. In addition, the team will monitor a frequency of signing in, a proportion of individuals who contact a health coach, a proportion of participants who contact a health coach by phone, and the proportion of individuals who prefer text messages or email.

References

  • Centers for Disease Control and Prevention. (2019). National Diabetes Prevention Program. Retrieved February 21, 2019, from http://www.cdc.gov/diabetes/prevention/index.html
  • Culica, D., Walton, J. W., Harker, K., & Prezio, E. A. (2008). Effectiveness of a community health worker as sole diabetes educator: Comparison of CoDE with similar culturally appropriate interventions.



    Journal of Health Care for the Poor and Underserved

    ,

    19

    (4), 1076-95. http://dx.doi.org/10.1353/hpu.0.0076
  • Delmarva Foundation for Medical Care. (2014).

    Hispanic diabetes disparities learning network in community health centers

    (08-0044-EF). Retrieved from Agency for Healthcare Research and Quality website: http://www.ahrq.gov/research/findings/final-reports/diabetesnetwork/index.html
  • Dominguez, K., Penman-Aguilar, A., Chang, M. H., Moonesingle, R., Castellanos, T., Rodriguez-Lainz, A., & Schieber, R. (2015). Vital signs: Leading causes of death, prevalence of diseases and risk factors, and use of health services among Hispanics in the United States — 2009–2013.

    Morbidity and Mortality Weekly Report (MMWR)

    ,

    64

    (17), 469-478. Retrieved from http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6417a5.htm
  • Fontil, V., McDermott, K., Tieu, L., Rios, C., Gibson, E., Castro, S.,…R. Lyles, C. (2016). Adaptation and feasibility study of a digital health program to prevent diabetes among low-income patients: Results from a partnership between a digital health company and an academic research team.

    Journal of Diabetes Research, 2016

    (8), 1-10. doi:10.1155/2016/8472391.
  • Hatcher, E., & Whittemore, R. (2007). Hispanic adults’ beliefs about type 2 diabetes: Clinical implications.

    Journal of the American Academy of Nurse Practitioners, 19

    (10), 536-45. doi: 10.1111/j.1745-7599.2007.00255.x
  • Holleran Community Engagement Research & Consulting. (Ed.). (2016).

    Berks County health collaborative community health needs assessment.

    Retrieved from https://www.thefutureofhealthcare.org/assets/community-health-needs-assesment.pdf
  • Prezio, E. A., Cheng, D., Balasubramanian, B. A., Shuval, K., Kendzor, D. E., & Culica, D. (2013). Community Diabetes Education (CoDE) for uninsured Mexican Americans: A randomized controlled trial of a culturally tailored diabetes education and management program led by a community health worker.

    Diabetes Research and Clinical Practic

    ,

    100

    (1), 19-28. http://dx.doi.org/10.1016/j.diabres.2013.01.027
  • Public Health Management Corporation. (2013).

    Berks County, Pennsylvania. Community health needs assessment.

    Retrieved from https://www.readinghealth.org/~/media/Files/About/Community%20Health%20and%20Wellness%20County%20Health%20Needs%20Assessment.pdf
  • Vojta, D., Koehler, T. B., Longjohn, M., Lever, J. A., & Caputo, N. F. (2013). A coordinated national model for diabetes prevention: Linking health systems to an evidence-based community program.

    American Journal of Preventive Medicine

    ,

    44

    (4), S301-S306. doi:10.1016/j.amepre.2012.12.018

ADM 634 ASSIGNMENT BUNDLE WEEK 5 TO 8

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Description

ADM 634 Assignment Bundle Week 5 to 8

Below shown is the description of “ADM 634 Assignment Bundle Week 5 to 8“.

Week 5 Assignment Federalism

The Founding Fathers were seeking to create a system of government with more liberty than almost any other form of government known at the time. In 500-750 words, do the following:

  1. Describe the aspects of a federalist system that appealed to the founding fathers to assist them in creating a just form of government (Note: Madison’s “double protection” argument in Federalist 51).
  2. Explain if federalism in fact lends itself to creating and protecting such liberty. Use research to support your claim.

Use three to five scholarly resources to support your explanations.

Week 6 Assignment Economic Policy Powerpoint

Choose an economic period in the United States within the past 100 years (this could be any period of time that you choose). Create a PowerPoint presentation (10-12 slides, not including title and reference slide) that addresses the following:

  1. Catalogue what was happening in the economy during your chosen period.
  2. Explain what actions the government took in reaction to the state of the economy during this period.
  3. Explain if budget deficits and divisiveness in government increased or decreased during this period?
  4. Describe what, if any, fiscal policies came out of this period. Why was there an enaction of those fiscal policies?

Use pictures, graphics, graphs, quotes, etc. to represent your findings. As well as three to five scholarly sources.
Include speaker notes below each content-related slide that represent what would be said if giving the presentation in person. Expand upon the information included in the slide and do not simply restate it. Please ensure the speaker notes include 50-75 words per slide.

Week 7 Assignment Benchmark Public Policy Paper

Using the public policy that you chose in Topic 1 and outlined in Topic 4, create a paper to discuss the following criteria applying the six stages of public policy making. In 1,750-2,000 words, do the following:

  1. Describe the public policy and the agenda setting. Also, describe the reason for the creation of this foreign. Finally, explain the reason and methodology for the adoption of those policies.
  2. Explain the methodology of the implementation of policy. Also identify the target group the policy was intended for. 
  3. Describe different contexts that drive the public policy and if government has been involved in any way.
  4. Evaluate the impact of the policy and suggest changes or make recommendations for improving the policy.
  5. Correctly identify and discuss any public relations techniques that were used to promote this public policy.
  6. Describe the forces and dynamics at play in the policy formulation, adoption, and implementation process. Which forces and dynamics were most significant in the formation of the policy?

Use five to eight scholarly resources to support your explanations.

Week 8 Assignment The U.S. Politics of Global Conflicts

Choose a current conflict in the world where the United States is involved because of its foreign policy. In 1,000-1,250 words, describe the following:

  1. Explain the role of the legislative branch while involved in this conflict. Should the legislative branch be more or less involved than it has been?
  2. Explain the role of the executive branch while involved in this conflict. Should the executive branch be more or less involved than it has been?
  3. Describe how involved the United Nations and other international organizations have been in the conflict. Have these organizations influenced the United States foreign or defense policy in relation to this conflict? How important is it that the United Nations and other international organizations are involved in situations similar to this?

Use three to five scholarly resources to support your explanations.

 

Case Study Of A Man With Severe Depression

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Peter a 40 year old man, had become depressed following some money pressures which had put his livelihood and home under threat.

He had been to see his GP who had asked Peter to complete the self reporting Patient Health Questionnaire (PHQ9) to aid diagnosis and determine the level of depression. Peter scored 16 on this tool, which is indicative of a moderately severe depressive episode.

The GP suggested Peter should have a couple of weeks off work, make an appointment to see me for some psychological support and also prescribed the antidepressant drug Fluoxetine.

Peter did not attend the appointment given to him to attend my clinic, did not take anytime off work and did not use the prescription for medication. Peter later explained he had been rather shocked by his GP’s diagnosis as he felt that depression was a sign of weakness and had not considered himself to be a weak man. Therefore he decided he would try to sort himself out without any other intervention.

Unfortunately Peter was unable to deal with things himself and his depression worsened. When he attended the GP practice some 2 months later at the insistence of his wife, he was severely depressed and had a PHQ9 score of 25.

The GP immediately booked him into a space in my clinic and again urged Peter to start taking the Fluoxetine.

I saw Peter the following day and again assessed him to have a severe depression. I offered to commence a cognitive behavioural therapy approach to manage the depression and again suggested the antidepressant may be helpful to lift his mood. I explored his uncertainty around taking the medication and explained the potential side effects which may occur. Peter took the medication and after a week found that his symptoms were starting to lift. He experienced some gastro intestinal side effects, in particular, nausea which lasted for about 6 weeks but was manageable. I saw Peter on 4 further occasions when we worked on some behavioural activation work, which is known to be effective for depression, (NICE, 2009) and his mood began to lift further. His PHQ9 score dropped from 25 to 9, which is indicative of mild depression.

At the 6tth session, some 12 weeks later, Peter informed me he had stopped taking the Fluoxetine as it was causing some sexual dysfunction which was affecting his ability to achieve orgasm. Peter found this very difficult to talk about but explained that he and his wife fond this very frustrating and so therefore had decided to stop the medication.

I tried to explore this with Peter and advised that another antidepressant could be prescribed which may not have this particular side effect. I also explained that his choice to stop the antidepressant may also increase his chances of relapse. Peter was reluctant to explore these issues further and although he made another appointment to see me, he did not attend that appointment and failed to respond to any further communication.

REFLECTION

On reflection, it would appear that Peter had several issues relating to his diagnosis of depression. Peter clearly had negative views about depression and what it meant for him as a person, unfortunately this is the case for many people as there is a great deal of stigma associated with depression.

He did not have enough information about taking the medication from his GP and although I felt I had covered the side effect profile in detail, it was clear that Peter had difficulty talking about sexual dysfunction side effects with me. He found this area particularly embarrassing to disclose.

I also feel that I did not wholly follow the 7 principles of prescribing thoroughly enough as I did not make Peter aware of the need to continue taking the medication for at least 6 months following remission in order to prevent relapse. I did not discuss this initially with Peter as I was conscious this could be information overload for him at the beginning of treatment when our main concerns were symptom reduction. I was planning to discuss this aspect as part of my discharge planning session but Peter opted out of treatment prior to this happening. With hindsight it may have been beneficial to introduce this concept earlier.

These 3 points affected Peter’s ability to adhere to his medication regime and so therefore I will explore the issue of adherence within the assignment attached to this case study.

ASSIGNMENT

This assignment will consider the issue of medication concordance relating to depression and the use of antidepressant medication as this was clearly an issue which became apparent within the case study. The assignment will explore what is meant by concordance in relation to the case study, factors affecting it and strategies which may be used to encourage concordance for the treatment of depression.

Depression is recognised as one of the major causes of ill health worldwide and in Britain it is the most common reason listed on incapacity benefit claims (World Health Organization (WHO) 2001). Despite this statistic, depression along with other mental health problems continues to have a great deal of stigma attached to it. Gray et al, (2008) supports this view and argues depression has been stigmatised due to widespread ignorance about the causes of the illness which has led it to be often perceived as a sign of personal weakness. Consequently, people experiencing depression often fail to seek help as they feel ashamed or embarrassed to disclose their symptoms or do not realize there are treatments available which may help.

The National Institute for Clinical Excellence, (NICE, 2004) recommended approaches to raise the profile of mental health by recommending ways of improving the recognition and treatment of common mental health problems, such as depression by the use of self help, Cognitive behavioural therapy and antidepressant medication.

The role of the mental health nurse prescriber also has the potential to improve the treatment of moderate to severe depression in primary care by combining the use of psychological treatments with medication management, (Badger, 2006). The level of depression can be determined by use of the Patient Health Questionnaire, (PHQ9) which states that a score above ten signifies a probable moderate to severe depressive episode, if the reporter has had these symptoms for longer than a two week period, (Anderson et al, 2008).

Several research articles have highlighted that only a proportion of antidepressants are taken as prescribed and discontinuation after one month is common. The figures for this vary between 30 to 68% depending on the article. Fox, (1999), Warrington et al, (2000) and Olfson et al, (2006) confirmed that 42% of people prescribed antidepressants stop taking them at one month.

Prior to 2005, the words compliance and adherence had been used to describe patients taking medication in accordance with instructions but since the NICE guidance …….. the term concordance has been used as this implies a negotiated agreement between the prescriber and the patient about the taking of medication. Despite this guidance, Hunot et al, (2007) argues concordance may not be any more than compliance, unless the patient believes they have an equal partnership with the prescriber.

.

Between a third and a half of medicines1 that are prescribed for long-term conditions are not used as

recommended. This represents a health loss for patients and an economic loss for society.

Non-adherence should not be considered the patient’s problem. Rather, it usually results from a failure

to fully agree the prescription with the patient in the first place and to support the patient once the

medicine has been dispensed.

Non-adherence falls into two overlapping categories: intentional (the patient decides not to follow the

treatment recommendations) and unintentional (the patient wants to follow the treatment

recommendations but has practical problems).

To understand non-adherence we need to consider perceptual factors (beliefs and preferences) that

influence motivation to start and continue treatment as well as practical factors.

This requires:

_ an open, no-blame approach that encourages patients to discuss any doubts or concerns about

treatment

_ a patient-centred approach that encourages informed adherence

_ identification of perceptual and practical barriers to adherence at the time of prescribing and

during regular review.

A discussion of the possible application of the borrowed theory (expectancy-value theory and social cognitive theory) to improve health promotion patient education in primary care clinic.

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A discussion of the possible application of the borrowed theory (expectancy-value theory and social cognitive theory) to improve health promotion patient education in primary care clinic.

A discussion of the possible application of the borrowed theory (expectancy-value theory and social cognitive theory) to improve health promotion patient education in primary care clinic. A discussion of the possible application of the borrowed theory to improve health promotion patient education in primary care clinic.

2. How to integrate Nola Pender’s Health Promotion Model with expectancy-value theory and social cognitive theory as a solution. 1000 Words

Principles in Radiography: Case Study

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The case study entails a female service user aged 25. Coming from the A&E department of which was raised for an Abdomen X-ray for an alleged bowel perforation. Received in the x-ray department on a trolley with only known relative, her brother. Signs of anxiety and pain, the service user is “laconic” and the brother translates for her. Vomited in the department room. My aim is to address the psychological needs of the service user, such as factors influencing her state of mind, experience and interaction of different health professional.

Below are the factors that affect the service users’ experience:


Consent:

Consent is a vital aspect in contributing care and treatment. In rare instances, performing stringently in accord with permission will mean that several of the other policies being ignored and not met (Cqc.org.uk, 2019).  Take into consideration as well as the “Mental Health Act 1983 and Mental Capacity Act 2005”. The management of patients must only be provided with the consent of the pertinent person.

If the service user is aged 16 and/or over and is incapable to provide consent for the reason that they lack capacity to do so, the disclosed individual essentially act in agreement with the 2005 Act. But if Part 4 or 4A of the 1983 Act applies to a service user, the registered person must act in accordance with the provisions of that Act. As such, it would not affect the regulation to enact upon: Section 5 of the 2005 Act, and as given by section 6 of that Act (performs in correlation with care and treatment).


Communication:

It is a blasé process, based on person centred care requires general practitioner and inter healthcare providers have the communication skills to cater to each individual needs and wishes (Qualitysafety.bmj.com, 2019). Skills that are gained and honed through experience, throughout ones professional career. Saying this we needed the patients consent. Consent is defined as to give affirmation, permission that is offered willingly or given away (e.g. marriage) (Vocabulary.com, 2019). For starters it is important to let patients know our name, one popular campaign is the “hello my name is” which was envisioned by Dr Kate Granger, a medical doctor who had the experience of being a patient. It focuses on staff professionally introducing themselves to patients, it advocates the sense of confidence by the practitioner by providing due care and puts the patients at relaxed state (Health, 2019). Following the department protocols, a three-point check is done (name, date of birth and address) and additional verification done especially of the person is not able to verbalize. With this case, the brother is the main interpreter which bridge between the patient and the health professionals. Usually this method is not the normal procedure and exceptions to the rules cannot be ruled out, interpreters are perceived as utilitarian view to reinforce the health care settings. But in this situation creates an interpersonal and ethical dilemma that could compromise duty of care (Hsieh and Kramer, 2019).  In connection an Emergency multilingual phrasebook was issued to every UK hospital, led by the British Red Cross and the Department of Health in 2004 (Webarchive.nationalarchives.gov.uk, 2019). Its intention to provide translation to commons terms and provide simplified phrased questions to patients. Although other issues can affect communication, such as the state of the service user (pain, anxious, nervous, scared).


Dignity/ Beliefs:

It adds up to the patients’ experience. Imagine yourself to reveal your intimate part to a complete stranger. Clothes asked to be taken away and to put on a gown which, if they’re lucky, actually fit, have fastener to close it. Privacy, Religious Beliefs, Social and Ethical Beliefs falls under dignity. Getting permission before accessing people’s possessions and documents (Legislation.gov.uk, 2019). But some rights, like the right to liberty and the right to private and family life, are limited, it means some restrictions are covered in certain circumstances (Citizensadvice.org.uk, 2019). Or by providing a private place (or just closing the door) for examination is one gesture for privacy. Choosing an interpreter with the consent of the patient is a good practice especially in this case study, which her brother in this case the best to interpret but taking in consideration when people have peculiar and voluptuous relationships, plus careful assessment of risk (Scie.org.uk, 2019). With the communication proper established, we have to take into account the ethical beliefs, religious beliefs. During the admission process typically, the patient is asked if they have any religious and cultural inclinations. But on the flip side we should not make rules based on the patient’s responses about religious preferences. Most often patients adhere to their religion’s beliefs, and minority of others have reformed their beliefs from those of their religion It is a good practice to ask patients about their religious preferences in a private area where family members aren’t present, if feasible. This will minimize the patient feeling influenced by opposing views of relatives (Nursingcenter.com, 2019).


Cultural, social & ethical issues:

‘Culture’ – termed as to be ambiguously hypothesized and mistakenly used in medical training and practice (Vocabulary.com, 2019). Cultural notions are frequently explained and taught as being inter-linked with race or as a catch-all, monumental expression to explain individuals who appear substantially similar and are assumed to have the same beliefs, values, and behaviours. We tend to stereotype people in a wrong manner (Rejina Kamrul, 2019). As a professional “carer” of people with different ailment within the department or hospital setting, you may sometimes encounter situations in which it is hard to decide what would be the right thing to do. It is for the most part arduous to make such judgements when each probable alternative seems to be moral for some people but not for others. This comes down to every individuals morals, In addition, medical professional carers embrace very different ideas about what is (ethically) right or wrong (sometimes may even assert that they know better) and on what basis a undeniable approach would and/or would not be ethically correct. Such disputes are further convoluted when acting ethically in the context of interprofessional care is incompatible with respecting recognized professional and institutional practices or formal guidelines for care (Alzheimer-europe.org, 2019).


Inter-professional Collaboration:

Interprofessional Collaboration can be defined as collaborations among two or more associates of different professional disciplines (e.g. midwife, radiographer, nurse etc.) (Journals.sagepub.com, 2019). Moreover, diverse branches in health care can have different “philosophies” and distinctive “problem-solving styles”. Aimed at the benefits of service users and health care professionals, they have to cooperate on the team-based structure. Each health care team adhere to certain rules of operation, certain ways of proceedings to accomplish its task. These could be seen from traditional or informal group standards of behaviour to formal written procedural manuals (Reel and Hutchings, 2007). The main objective is to convey a clearer meaning of health care professional’s skill, knowledge based-skill and know-how to improve the quality of care and as well as the quantifiable outcomes related to service users’ well-being, complications and issues. The foremost issue of interprofessional collaboration is whether interprofessional care is benefiting the service users, their families, health care professionals and the health system. “Interprofessional collaboration comes into practice to ensure that health care professionals can complete a care task or combination of tasks that they could not achieve effectively on their own” (Reeves et al, 2010). As medical professionals dedicate their time and efforts to provide the best possible care to patients and families to improve the quality of life, to alleviate health issues and improve the health conditions. Both from the viewpoint of their interest as health service providers and through the standpoint of hospitals as place of acquiring experience, learning, effective teamwork and first-rate health service delivery are needed. This shows that service users are profiting from contemporary modes of working by the interprofessional team through collaboration.


Conclusion:

In this case study, the lady patient, who communicates little English and a suspected perforation of the abdomen should be treated immediately. We need to address the special circumstances that she needs. Special measurements for communication with possible use of an interpreter, assessment of her pain control, her consent if she would like to be treated by a female practitioner, taking into account her religious as well as her cultural background. We describe what we consider to be principles of ‘patient-centred cultural competence’ duly to the busy inter-professional people in the care of vulnerable patients, regardless of their race, nationality, religion, socio-economic status, education, or other background. Especially in the x-ray department, were interaction with patient and practitioner are limited, so called fast paced. Changing a hospital culture is not easy, but evidence is accumulating that this process needs to be started. Policy makers need to understand the complex factors that influence this situation and to address those that hinder interprofessional–patient communication process, using the “hello my name is” campaign. The role of a medical practitioner, its duty is to treat our “patients as we would want others to treat us” during periods of susceptibility and distress. We need not memorize social customs, prevailing beliefs, or rules of engagement in order to take excellent care of people from all religions, ethnic groups, countries, and races. The main goal is to achieve patient-centred care built on respect, sensitivity, equanimity, conglomerate, honesty, wisdom, curiosity, and tolerance. In the end of the day, service users really care about is being tended about. In this case is the 24-year old female welfare.


Reference:

  • Alzheimer-europe.org. (2019). Alzheimer Europe – Ethics – Ethical issues in practice – 2015: Ethical dilemmas faced by professionals providing dementia care in care homes and hospitals – Introduction. (Online) Available at: https://www.alzheimer-europe.org/Ethics/Ethical-issues-in-practice/2015-Ethical-dilemmas-faced-by-professionals-providing-dementia-care-in-care-homes-and-hospitals/Introduction (Accessed 1 Feb. 2019).
  • Citizensadvice.org.uk. (2019). Human rights. (Online) Available at: https://www.citizensadvice.org.uk/law-and-courts/civil-rights/human-rights/ (Accessed 1 Feb. 2019).
  • Cqc.org.uk. (2019). Regulation 11: Need for consent | Care Quality Commission. (Online) Available at: https://www.cqc.org.uk/guidance-providers/regulations-enforcement/regulation-11-need-consent#full-regulation (Accessed 1 Feb. 2019).
  • Health. (2019). Hello my name is… | Department of Health. (Online) Available at: https://www.health-ni.gov.uk/articles/hello-my-name (Accessed 1 Feb. 2019).
  • Hsieh, E. and Kramer, E. (2019). Medical interpreters as tools: Dangers and challenges in the utilitarian approach to interpreters’ roles and functions.
  • Journals.sagepub.com. (2019). SAGE Journals: Your gateway to world-class journal research. (Online) Available at: https://journals.sagepub.com/doi/pdf/10.1177/175045891302300503 (Accessed 1 Feb. 2019).
  • Legislation.gov.uk. (2019). Human Rights Act 1998. (Online) Available at: http://www.legislation.gov.uk/ukpga/1998/42/contents (Accessed 1 Feb. 2019).
  • Ncbi.nlm.nih.gov. (2019). Home – PMC – NCBI. (Online) Available at: https://www.ncbi.nlm.nih.gov/pmc/articles (Accessed 1 Feb. 2019).
  • Nursingcenter.com. (2019). CEArticle. (Online) Available at: https://www.nursingcenter.com/cearticle?an=00152258-201411000-00008&Journal_ID=417221&Issue_ID=2603606 (Accessed 1 Feb. 2019).
  • Personcentredcare.health.org.uk. (2019). What is person-centred care | Person-Centred Care Resource Centre. (Online) Available at: https://personcentredcare.health.org.uk/overview-of-person-centred-care/what-person-centred-care (Accessed 1 Feb. 2019).
  • Qualitysafety.bmj.com. (2019). (Online) Available at: https://qualitysafety.bmj.com/content/qhc/early/2011/08/19/bmjqs-2011-000323.full.pdf (Accessed 1 Feb. 2019).
  • Reel, K. and Hutchings, S. (2007). Being part of a team: Interprofessional care. In G. Hawley (ed.), Global Journal of Medical Research Interprofessional Team Collaboration in Health Care Ethics in clinical practices: an interprofessional approach. Essex: Pearson Education.
  • Rejina Kamrul, V. (2019). Beauty of patient-centred care within a cultural context. (Online) PubMed Central (PMC). Available at: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4046555/ (Accessed 1 Feb. 2019).
  • Scie.org.uk. (2019). Dignity in care – The Dignity Factors: Privacy. (Online) Available at: https://www.scie.org.uk/publications/guides/guide15/factors/privacy/ (Accessed 1 Feb. 2019).
  • Webarchive.nationalarchives.gov.uk. (2019). Emergency multilingual phrasebook: Department of Health – Publications. (Online) Available at: https://webarchive.nationalarchives.gov.uk/20130105192116/http://www.dh.gov.uk/en/Publicationsandstatistics/Publications/PublicationsPolicyAndGuidance/DH_4073230 (Accessed 1 Feb. 2019).
  • Vocabulary.com. (2019). Consent – Dictionary Definition. (Online) Available at: https://www.vocabulary.com/dictionary/consent (Accessed 1 Feb. 2019).