Describe your thoughts about attending a support group.

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Describe your thoughts about attending a support group.

1. Describe your thoughts about attending a support group.
2. Describe your expectation(s) prior to the start of the support group.
3. Discuss a significant event that occurred during this clinical experience. Explain why the event was significant to you.
4. Discuss one specific thing you learned today? Discuss how you can apply this learning in your practice as a nurse.
5. Identify some differences in what you learned today from what you previously believed about the topic of the support group. Discuss the effect those differences will have on your practice as a nurse.
6. Describe your thoughts at the completion of the meetings.
7. Be prepared to share your experience with the class.

Behaviour change model of health education

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This essay will discuss the, “Behaviour Change Model of Health education” or “The Trans-theoretical Model”, (TTM), in relation to smoking cessation. The essay will begin by giving the reader a personal interpretation of what is meant by Theories and Models, followed by Prochaska and Di Clements, Trans-theoretical Model, (TTM), it will discuss some of the key elements of the model and explore how it is used in practice. Drawing on evidence from the current relevant literature the effectiveness of the model, its strengths and weaknesses will be discussed and a conclusion together with any recommendations for its future use will be provided.

Theories, or models according to Redding et al, if used in a metaphor would be explained as road maps, The author of this assignment can understand this metaphor, but in her minds eye her interpretation of it is more of a underground map around London, all the different colours of train lines are there, they are all leading or ending in the same place, most of them stop at the same stations, but take different routes to get there. The same can be said for theories and models, we take a train on a certain route or direction to get us to our destination, some trains get us there easier than others, we may have to disembark and travel on another line because the one we are on does not get us directly to where we want to be, and other trains may give some passengers an express route and they will finish their journey quicker than others.

Redding et al states that, “Theoretical models are fundamentally guides, which guide both our current and future understanding of Health behaviour, which also provides a direction for research and intervention development”, and also “that there are no final or true maps only maps and theory that best match are needs now in the present”.

The author feels that these two quotes, and the metaphor, have helped her understand key concepts and comparisons between Theory and Models, she understands that they are guides that have been tested, challenged and researched by many others in the health promotion field.

Theoretical models of behaviour change are not new, Beckers Health Belief Model 1974, also Fishiens and Ajzens Theory of Reasoned Action 1975, are but a few that were applied over the years to a wide range of disciplines. The theory the author will be looking at for this assignment is; The Stages of Change (SOC) model or, The Transtheoretical Model, (TTM).

A definition of The Transtheoretical Model is “an eclectic theory that combines constructs from different theories into a comprehensive theory of behaviour change”.(Procheska Velicer 1997 as cited inSchumann 2005p12)

According to Redding et al as cited in the International Electronic Journal of Health Education 2003 (special issue 180-193. Dr Procheskas is one of the most influential authors of psychology in the USA, he has published over 100 papers and 3 books on the subject of, The Transtheoretical Model of behaviour change for health promotion, he was also one of the originators of the TTM model, along with Dr Carlo DiClement .

These two American psychologists have made significant contributions to the understanding of behaviour change, but more so their attention to behavioural changes within groups, organisations and whole communities.

. Di Clement and Procheska built on the work of others namely Horn & Waingrow (1996), Cashdan (1973) and Egan (1975) psychologists who’s work identified the four stages of change model in the previous years, what made the difference to Procheska and Di Clement, was the identification and realisation, during their research of the clusters of people who scored highly in both the contemplation and action stage. This lead the way for the psychologists to reveal a fifth stage and according to both men, the very significant stage of, “preparation”. Lawrence (2001) (as cited in Perkins Simnet & Wright 2001 evedence health promotion

These two very influential psychologists carried out further research , and in 1983, suggested, after mounting evidence, that behaviour change occurred in stages and steps, and that any movement throughout these stages where not linear but repeated, involving patterns of adoption, maintenance, relapse, and readopting over time . These patterns were discovered as the two psychologists were carrying out research with smokers attempting to quit on their own and smokers in professional treatment programs, . (Prochaska et al 1993)

The finding led to Procheska, DiClement and their colleagues to identify the dynamics and structure of staged behaviour change, and go on to explain the patterns of behaviour by developing a Transtheoretical Model of Behavioural Change, which proposed that there were five stages in which people move through a cyclical or a spiral pattern; precontemplation, contemplation, preparation, action and maintenance.

The first of the stages is pre-contemplation, this is a stage where the individual has no intention of behaviour change, they don’t see a problem as far as they are concerned there is no risk to them, not until they become aware of a problem in the future would they think of progressing to the next stage.

The second stage is contemplation, at this point the individual is aware of the problem maybe something has changed in their life and they start looking for information to deal with their addiction but have not yet made any steps to do anything about it.

The third stage preparation, this is when the individual is preparing to change, they may see the benefit of giving up their addiction and need support to help them.

The fourth stage, action, this is where the individual has to make a positive decision to quit, he works towards goals that are realistic and achievable, the need for support is very strong at this stage.

The fifth stage, is maintenance, this is the stage of new behaviour for example the individual has quit smoking and moved on to a healthier lifestyle. This is a very difficult time for a lot of people and many fall at this point and revert back to earlier behaviour. Naidoo&Wills foundations for health promotion 3rd edition

Acording to Procheska and Di Cement

Outline the key consumer psychology and buying behaviour theory/ies/concept/s being addressed.

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Outline the key consumer psychology and buying behaviour theory/ies/concept/s being addressed.

 

Outline the key consumer psychology and buying behaviour theory/ies/concept/s being addressed. • Draw conclusions from the academic journal article/s and relate them to the main theory

Analyze how this snapshot, this one piece, will fit with those around it.

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Analyze how this snapshot, this one piece, will fit with those around it.

When developing a curriculum or program, it is important to remember that the content created is just one piece of the institution or agency. Much like placing a snapshot into a collage, nurse educators must be mindful of the larger picture. They should analyze how this snapshot, this one piece, will fit with those around it. However, it is not uncommon for nurse educators to become so involved with the contents of their curriculum that they inadvertently develop content in isolation. They identify skills, procedures, and processes that are important but can forget to translate these ideas across the span of their curriculum. This can present problems for learners, especially in academic settings where the skills presented in one course generally build on those learned in previous courses.
One way nurse educators can place importance on the larger picture is to align the components of their curriculum with the components of the institution or agency. In fact, using the setting’s mission, vision, and philosophy to create the mission, vision, and philosophy of the curriculum is an effective way to build congruence. There are many strategies nurse educators can use when seeking alignment and congruence. In this Discussion, you explore these strategies and consider how you might align your team’s curriculum to that of your selected setting.

To prepare:
• Review Chapter 9, “Components of the Curriculum,” in the Keating text to reexamine the meanings behind a setting’s mission, vision, and philosophy.
• Review this week’s media, Curriculum Components. Consider why nurse educators should be cognizant of their setting’s mission, vision, and philosophy when developing the mission, vision, and philosophy for their curriculum or program.
• Examine the chapter titles and overviews of Chapters 10-15 in the Keating text. Then, select and review the chapters that correspond with the focus of your Course Project.
• Use this week’s Learning Resources and your own independent research to identify strategies nurse educators can implement to achieve alignment and congruence of curriculum components. Consider how these strategies could help to align the components of your curriculum or program to the components of your team’s selected setting.

Theory of Culture Care: Diversity and Universality

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Introduction

The ever increasing multicultural world we live in today makes us see cultural competency as a really fundamental element in health care. A main feature of culture is its power to bring people together. Studying the concept of culture can lead to exceptional health care since it will establish a close bond between the patient and the health care professional.

The cultural beliefs that a community may have will shape their own behaviors all along and, therefore, it will make it possible for medical treatment to be effected when culture becomes an obstacle. Being knowledgeable and sensitive to the social, structural, physiological, and cultural factors that affect health could make a difference in diagnosis, preventive care, or the overall health outcome. Nurses play an important role in patient care, and disease prevention.

Madeleine Leininger a pioneer in transcultural nursing has played an important role in educating nursing for the past 35 years. Her theory focus on changing patterns on the health care practices that will bring the efforts on strong nurse-patient relationship. To achieve harmony in health care, Leninger’s model depicts health is both universal and diverse; therefore nurses must be knowledgeable about the specific culture in which nursing is practiced. Health is cataloged as ‘Universal’ across cultures but it is distinct from each culture on the beliefs, values, and practices. Thus, the concept of health is the same for every culture but it is diverse on the manners that specific cultural approaches to care.

Theory Study of Madeleine M. Leininger

Leninger focused patient care from a cultural perspective. She describes nursing as a humanistic and scientific discipline as whole that focuses on human care and culturally meaningful ways to help patients achieve health. Nursing observation and decision are guided in her theory by Culturally congruent decisions that “are tailor-made to fit with the individual, group or institutional cultural values, beliefs and life ways in order to provide or support meaningful, beneficial and satisfying health care or well being services” (George, 2002).

Nursing is an expression of compassion reflected in the care and respect of individuals in society. Madeleine M. Leininger developed her theory from her strong discipline and concern with understanding people and their cultural backgrounds to excel on patient care. Madeleine M. Leininger was born in Nebraska in 1925. Nurse pioneer graduated from Saint Anthony’s School of Nursing in 1948. She continued her education in Mount Saint Scholastica College, where she obtained her bachelor’s degree. Afterwards, in 1954 she acquired a master degree in science from The Catholic University of America and in 1965 a PhD in cultural and social anthropology from the University of Washington DC (George, 2002).

In 1950, Leninger during time she worked as clinical nurse in a child guidance home with disturbed children experienced what she describes as a cultural shock. She noticed the recurrent behavioral differences among children, what made her realized these differences had a cultural base. After, continuous observation she concluded that these missing links have a factor base in cultural knowledge and understanding. In the 1960’s with her observation and educational background; she developed the terms trans-cultural nursing, ethno-nursing and cross-cultural nursing (George, 2002).

Leninger keep building her theory of transcultural nursing on the foundation of her observation and how people from each culture can perceive their nursing care and experiences differently according to their health beliefs and practices. Based on Leninger’s theory of transcultural nursing, the care nurses provide on their patients is derived and shaped from the cultural context in which it is to be provided.

Leininger defined in 1978 transcultural as:

“a substantive care of study and practice focused on comparative cultural care (caring) values, beliefs, and practices of individuals or groups of similar or different culture with the goals of providing culture-specific and universal nursing care practices in promotion health or wellbeing or to help people to face unfavorable human conditions, illness or death in culturally meaningful ways ” (George, 2002).

Leininger defined in 1979 ethonursing as: “the study of nursing care beliefs, values and practices as cognitively perceived and known by a designated culture through theirs direct experience beliefs, and values system” (George, 2002).

The theory of Culture Care emphasizes that cultural awareness it is fundamental to develop an excellent discipline in the profession of nurses. Culture is an important aspect to understand society. Leininger studied how individuals of each culture interpret nursing care practices in different ways. Her studies help her construct the concept of trans-cultural theory. In 1991, she stated, “human care is central to nursing as a discipline and as a profession.” With this statement, nursing care was a profound fact that knowledge and care are an important aspect in nursing care practices. She also developed another important cultural concept in her theory that relies on the fact that every culture has both health care practices; she defines one of the practices as the specific culture of the individual and the other as prevailing patterns which are common across cultures. From these concepts are born the terms of Universality and Diversity (George, 2002).

World War II brought a complete change into the nursing field. During war time 1939-1945, there was a reemergence of new nurses as the government developed programs to entice women into the nursing profession. The US Cadet Nurses Corps from 1943 to 1948 aim in the recruitment of nurses. Many women were offered books, tuition, housing, and stipends if they decided to embark in a nursing career and assist during war. From this point on, we can appreciate how in the nursing discipline became important cultural knowledge. More than 59,000 American Nurses served during war. Nurses worked close to the front lines and served under fire in field hospitals and during evacuations. They also served on hospital trains, ships, and as flight nurses on medical transport (Bellafaire, 1998).

Army nurses experience on the field gave them self-confidence and the desires to grow professionally. When they returned to the United States, many opportunities to pursue career and further education were given to nurses. War World II forever changed the nursing profession, as society was ready to accept nurses as professionals in the medical field and as members of the health care system (Bellafaire, 1998).

During war, nursing was acknowledge as profession and as result nursing studies began to grow. Also, educational programs were not as limit as before. Before war nursing programs were not available in every university, the first nursing masters programs was offered by Yale University in 1923 and the first doctoral program was offered by the University of Columbia in 1929. After war ended, a research trend in nursing began to sprout. In 1950’s the American Association (ANA) begun a 5-year study on nursing functions and activities. The study developed functions, standards and set the qualifications for professional nurses in 1959 (Burns & Grove, 2005).

After the war ended, the baby boomers era stated during 1946 to 1964 more than 75 million babies were born. Health care was needed for the emergent population. The demand for nurses increased and many women nurses decided to get married and stay home with their family leading to a shortage of nurses. Also, during the 1960’s government created Medicare and Medicaid increasing the possibilities of people receiving health care leading to the overall demand of nurses in the United States (Bellafaire, 1998).

The high demand for nurses created the need of developing studies that determined the most effective educational preparation for registered nurses. These studies were conducted during the 1950s and the 1960s by Mildred Montag, a nurse educator who developed and evaluated a 2-year associate degree. In 1953, an Institute for Research and Service in nursing was created at Columbia University; the program was aimed to provide research and learning experiences in doctoral students. Later in 1957, The Walter Reed Army Institute of Research established a department of nursing research. This was the first nursing entity that carried out clinical research (Burns & Grove, 2005).

Between 1950’s and 1960’s we can find numerous clinical studies that focused on the quality of care and how nurses can developed a criteria to measure nurse-patient intervention success. During this time nurses were acknowledge as part of the health care system and the increasing demand of nurses created advance study programs for professionals leading to more clinical research and encouraging nurses to find ways to improve patient care (Burns & Grove, 2005).

Leninger’s theory of Cultural Care, Diversity and Universality, can be apply to everyone as a group or individual since we all form part of a cultural group. The theory can help recognized when a nurse can experience a cultural shock and how can correctly approached cultural differences to deliver the best care. This theory requires critical thinking from the nurse as involves collecting and using data to support overall decisions on patient care (George, 2002).

This theory is universal and can be found in any place where nursing care is delivered. Leninger’s theory has been study by many other researchers who have used the theory as a guide and today is the frame of many nursing organizations. Not only on research and organizations Cultural Care theory has been spread, the education of nurses around the world has also been impacted with Leninger’s framework (George, 2002).

Dr. Leninger is considered an international scholar and worldwide founder and pioneering of the field of transcultural nursing. Leninger has spread her word in over 220 articles and 28 books around the world. Among her most important works we can include; the significance of culture in nursing (1967), Nursing and anthropology: two worlds to blend (1970), and Transcultural nursing concepts, theories, research and practice (1978) (Akram, 2001).

Research on cultural diverse care has been detail in studies from many other researchers including; American Gypsies (Bodnar & Leininger, 1992, 1995); Anglo and African American elders in long-term care (McFarland, 1997); Culture and Pain (Villarruel, 1995); the Gadsup of New Guinea (Leninger, 1991, 1995); Muscogee Creek Indians (Wing & Thompson, 1996); Old Order Amish (Wenger, 1991, 1995); etc (George, 2002).

Some organizations found today that share Leninger’s values and beliefs are; Cultural Diversity a non-profit organization dedicated to increase cultural awareness among nurses and propose solutions when problems of bias conflict arise. The organization is run by Victor Fernandez RN BSN and Kathy Fernandez RN BSN. The organization is aim to promote workshops, guest speaker appearances focused to teach student nurses increase awareness of cultural diversity they also offer a web-based center that promotes interactive teaching and learning content about transcultural nursing (Fernandez, V. & Fernandez, K. 2008).

Another non-profit organization is Transcultural nursing society, their mission is to “enhance the quality of culturally congruent, competent, and equitable care that results in improved health and well being for people worldwide” (Leininger, 2010). This organization based their beliefs on Leninger’s work and theory.

Madeleine Leininger has provided transcultural knowledge across the world. Her theory has been used widely spread across nursing and other fields. As cities get multi-culturally populated, nurses need to identify and understand patient’s health status and illness to better assist and educate patient on their illness and condition. The future of transcultural care will continue growing in the research field to advance, reform, adapt, and serve population with diverse cultures. As Dr. Leininger stated nurses have to be educated and be ready for the future because culturally congruent care it is an fundamental in the nursing practice for the future of many cosmopolitan cities (Leininger, Madeleine and McFarland, 2002).

Leininger’s Sunrise Model established the interrelationship between Universality and Culture Care Diversity. The Sunrise Model centers its attention to individuals or groups with different socio-cultural backgrounds. The theory of culture care diversity and universality rises from a transcultural point of view in human care. “It provides a holistic rather than a fragment view of people.” (George, 2002) This Model extends to everyone that belongs to a culture and/or subculture. In addition, the model is relevant to any cultural situation. As a nurse, is important to recognize patient’s cultural identifier. In additions, is vital to assess patient care perception to provide a standing medical management and maximizes the outcome nurse-patient relation. Leininger has educated us for the past 35-years in transcultural nursing. The vast majority of nursing schools around the world and medical institutions have educated their students in patient perceptions and cultural identifiers like knowledge, behaviors, actions, and values, which play an important role in providing a safe therapeutic care (Akram, 2001).

Nurses that are specialized in different nursing fields report consistent use of Leininger’s theory; since, the well being of individuals and/or groups of diverse cultures are affected in a positive manner. In addition, nurses consider Leininger’s theory as an important tool to view human holistic care in a way that promotes well being. This holistic view utilizes specific assessment tools for an extensive selection of research problems used by many researchers. Some of the nursing researchers that have utilized Leininger framework include; Orque, Boyle & Andrews, Dobson, Ginger & Davidhizar. They have explored and investigate culture and its relationship to care (Leininger, 2010).

Leininger defined Nursing as:

“a learned humanistic and scientific profession and discipline focused on human care phenomena and caring actives in order to assist, support, facilitate, or enable individuals or groups to maintain or regain their health or well-being in culturally meaningful and beneficial way, or to help individuals face handicaps or death” (George, 2002).

Leininger defined the profession of nursing as “a societal mandate to server people.” (George, 2002) Also, defined nursing as a discipline, “nursing discipline is expected to discover, develop, and use knowledge distinctive to nursing’s focus on human care and caring” (George, 2002). She stated that nurses need more transcultural education and awareness to reduced cultural stress and possible disagreement between nurse and patient. Three nursing actions have been recommended from Leininger. “These are culture care preservation/maintenance, culture care accommodation/negotiation, and culture care re-patterning /restructuring” (George, 2002).

The theory of Cultural Care offers a framework for the future study of new changes in culture. The development of this theory over the years has allowed testing the theory in a large number of cultures and researches; as well as potential future cultures can be analyzed under this model. Another strong point is the structure of this theory involves all parts in nursing care, such as the recipients and all health care providers. In the other hand, some limitations to this theory is Leninger’s theory requires nurses academically prepared to provide transcultural nursing care; however there are very few funds for research in this field, and support the further study of these practices. In addition, the sunrise model due to its complexity can be viewed as both; a strength or limitation. Its complexity can depict the importance of cultural behaviors in nursing practices; however, the model’s complexity can also lead to misinterpretation.

Case study

LP is a 45 years old Cuban American Male, aerospace engineer at Miami International Airport with no previous medical history. LP was found to be Diabetic type II after a routine medical checkup with his primary physician. The medical assessment indicates that the patient was for the past couple of weeks suffering of increased thirst and frequent urination. Diagnostic demonstrated a sugar fasting of 182 and A1C of 7.2. Dr LD Primary Physician ordered oral hypoglycemic medication metformin, diet, and exercise. However, he was encouraged by the MD to see his nurse educator before going home.

Nurse educator RD White American descendent reviewed the patient’s cultural background to develop a proper approach to teach the patient about his diabetes care. RD gave details to the patient about how to customize an 1800-calorie diet plan based on the most common meals for Cubans, exercise, as well as information of metformin.

RD in a compassioned and interested way explained how some typical foods can still be eaten on a daily bases but controlling the amounts and choice. For instance, for breakfast it is fine to have a hot cup of ‘café con leche’ (coffee and milk) with low fat milk and non-sugar sweeteners, also he could add a small serving of fruit of the size of a fist. For lunch, a small portion of black beans or any other legumes combined with a small portion of a stake or poultry, and for dinner Atlantic salmon fillet or tilapia, broiled with rice keeping a daily regimen of 1800 calories per day.

LP agreed to avoid foods with high concentration of sugars, carbohydrates and to keep food intake controlled to 1800 calories per day. LP verbalized understanding the educational care that was given to him and he stated, “I will be away from the beloved Cuban pastry, many sugary deserts, and sweet drinks and will measure the amount of carbohydrates, starch, fruit, and milk”. In addition, he was also made aware of hypoglycemic and hyperglycemic symptoms. Without losing eye contact from the nurse, he showed with a lot of emphasis of exercise and medication routine and gave multiple examples of hypoglycemic and hyperglycemic symptoms.

After three months of strict exercising, proper diet and insulin administration LP goes back to see his PCP for a follow up. A1C blood work shows a remarkable well controlled blood sugar levels. Patient verbalized to the PCP happily, “This is the product of having such of caring nurse that educate me well, every gesture, word, and care practice nurse passed onto me became a success to control my diabetes”

The case above reflects a nursing situation developed under the Leininger’s culture care theory. The nurse was taking into consideration Leininger ultimate goal of offering harmonious nursing care practice to patients of different cultures. RD nurse educator and professional practitioner were able to make clear and foresee patient well being through proper care meanings, patterns, and processes.

Society has been growing non-stop for the past decades and immigration from different countries has played an important role in the multicultural environment we live in today. Leininger has emphasized how important is to be cultural competent and nurses have to be prepare in transcultural nursing. She stated, “All nurses need to be prepared in transcultural nursing to serve culturally vulnerable populations and to develop professional competencies in transcultural nursing by the year 2015.” (Leininger, Madeleine and McFarland, 2002)

As clinicians, we have seen and been educated under her theory. In addition, we have been exposed to her cultural awareness into our everyday practice. For instance, we take into consideration many cultural aspects that take the human expression to a next level of humanity. As practitioners, we do not see patients as clients, we see human beings that need our support and our goodwill. Her holistic view of care and understanding of individual sickness, health, welfare, and death is an exciting way to value any multicultural society. Furthermore, Leininger’s job of putting together human beings and care into a well-organized theory embraces an important step into patient care.

What are the needs of the community? How can a pharmacist meet those needs?

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What are the needs of the community? How can a pharmacist meet those needs?

 

My role as a 21st Century Pharmacist

Please reflect on the various roles a community pharmacists can hold in the healthcare system and consider the needs of the community and the healthcare system in the 21st Century.

What are the needs of the community? How can a pharmacist meet those needs?

What are the challenges in meeting the needs of the patient? How can you overcome those challenges?

How can a pharmacist serve as a patient advocate?

What are the needs of the healthcare system? How can a pharmacist meet those needs?

What are the challenges in the healthcare system? How can a pharmacist be a part of the solution and not the problem?

Please include links to the sources.

Draw a picture of the Innovation Adoption curve

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Draw a picture of the Innovation Adoption curve

 

How can Epidemiology affect clinical medicine? 2. Draw a picture of the Innovation Adoption curve (or cut and paste a picture of the innovation adoption curve). Write a paragraph explaining adoption dates and process of any health innovation of your choosing (ie. Mammograms, HPV vaccine). Make sure to include the population described. 3. The charts below depict Tractor Accidents in Georgia between 1971 and 1981 by Time of Year and Time of Day. What inferences can be drawn from this data? ORDER THIS ESSAY HERE NOW AND GET A DISCOUNT !!!How can Epidemiology affect clinical medicine? 2. Draw a picture of the Innovation Adoption curve (or cut and paste a picture of the innovation adoption curve). Write a paragraph explaining adoption dates and process of any health innovation of your choosing (ie. Mammograms, HPV vaccine). Make sure to include the population described. 3. The charts below depict Tractor Accidents in Georgia between 1971 and 1981 by Time of Year and Time of Day. What inferences can be drawn from this data? ORDER THIS ESSAY HERE NOW AND GET A DISCOUN

Childhood Obesity as a Global Epidemic

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Childhood obesity has reached epidemic proportions worldwide and its prevalence is increasing e.g. In america, direct measures of body mass and height obtained through the national health and nutrition examination survey (nhanes) indicate that approximately 15% of 6 – 19 year olds were classified as overweight in 1999 – 2000. This value was up approximately 5% from 1988 to 1994 (ogden cl,p1728)

All of the literature refers to similar statistics regarding childhood obesity.

The list below gives some examples of the data available from the different sources.

  • obesity has more than doubled between 1990 and 2000 in britain.
  • one in 10 six year olds (8.5%) are obese.
  • one in six (15%) 15 year olds is obese.
  • if the current trends continue, one fifth of boys and one third of girls will be obese by 2020.

Obesity is measured using the body mass index (bmi) for an individual. This is measured through a calculation relating height to weight and age, and there are agreed figures for obesity.

2 INTRODUCTION

Obesity is measured using the body mass index (BMI), for an individual. This is measured through a calculation relating height to weight and age, and there are agreed figures for obesity.

Childhood obesity is becoming a worldwide problem. All the articles that were reviewed highlight the rising levels but also look into health and school policies to tackle the problem.

All the articles also support family focused approach for influencing dietary habits of the children, as well as support and involvement of the communities.

Diseases which were only diagnosed in adults are now also diagnosed in the children, e.g. Heart diseases, diabetes, some cancers, hypertension and dyslipidemia. (vitale, e: 2010)

Children are not fully responsible for their own health choices and rely on adults to protect and nurture them. (vitale, e : 2010).

In South Africa overweight and obesity are not restricted to only one population group or socio-economic group. The South African youth risk behaviour study (www.mrc.ac.za/healthpromotion.htm) showed that overweight and obesity are very common in all age groups.

3 ARTICLES REVIEWED

Vitale, E. (2010). A School Nursing approach to childhood obesity: an early chronic inflammatory disease. Immunopharmacology and Immunotoxicology, 32(1), 5-16

Berg, Frances M. (2004). Underage & Overweight: America’s Childhood Obesity Crisis – What Every Family Needs to Know. Preventing Chronic Disease Public Health Research, Practice, and Policy, New York:Hartherleigh Press 464 p

Kristen, R. Howard. (2007). Childhood Overweight: Parental Perceptions and Readiness for Change. The Journal of School Nursing, 23(2), 73-79

Armstrong, M E G, Lambert, M I, Sharwood, K A, Lambert, E V, (2006). Obesity and overweight in South African primary school children – the Health of the Nation Study. 11(2), 52-64

Steyn, N P. (2005). Managing childhood obesity: a Comprehensive Approach. CME 23(11), 540-543

Goedecke, Julia H, Jennings, Courtney L, Lambert, Estelle V. (1995-2005) Obesity in South Africa. Chronic Disease of Lifestyle 65-78

Ben-Sefer E, Ben-Natan M, Ehrenfeld M, (2009). Childhood obesity: current literature, policy and implications for practice. International Nursing Review 56, 166-173

Saunders Karen L, (2007). Preventing obesity in pre-school children: a literature review. Journal of Public Health 29(4), 368-375

Van Staveren, T and Dale, D (2004). Childhood Obesity: Problems and Solutions. JOPERD 75(7), 44-49

4 RESEARCH TITLE

A good title should give insight into what (what was done), whom (it was done to) and how (it was done)

Vitale, E. (2010). A School Nursing approach to childhood obesity: an early chronic inflammatory disease. Immunopharmacology and Immunotoxicology, 32(1), 5-16

What (was done)

A School Nursing Approach

Whom (it was done to)

Children with Obesity

How (it was done)

As a Nursing Approach – can be observation or questionnaires

The titles of the articles reviewed communicate an intent and findings of the research that was done for the articles.

All the articles reviewed titles were specific enough to describe the contents of the research that was done, but not so technical that only specialists will understand it.

The titles also describe the subject matter of the article e.g. a school nursing approach to childhood obesity: a chronic inflammatory disease.

All the above mentioned literature research title’s were very concise and descriptive.

The title’s also prick me as reader and motivated me to read the whole article.

PURPOSE

To discuss the current literature in relation to childhood obesity and to provide health practitioners, especially nurses, with the fundamental knowledge that is imperative in the recognition of children who are at risk and thereby tailor appropriate interventions.

KEYWORDS

The following words was used as keywords throughout the articles that was reviewed:

childhood obesity, obesity, overweight, nursing, nursing program, chronic disease

The terms “obese,” “overweight,” and “at risk for overweight” have not been used

consistently in the research literature regarding children and adolescents. Children and

adolescents identified as overweight have a body mass index (BMI) at or above the 95th

percentile of the sex-specific BMI-for-age growth charts

DEFINITIONS

Childhood Obesity

Is defined as having a Body Mass Index (BMI) greater as the 95th percentile.

BMI = weight in kilograms ÷ height in meters2

The BMI of an individual is correlated to the total body fat and percentage body fat.

Overweight in childhood

According to the National Center for Health Statistics (NCHS), overweight in childhood is defined as having a body mass index (BMI) at or above the 95th percentile, based on the current growth chart designated for each gender.

Overweight

Overweight is generally defined as an excess of body mass (in practice this is mostly body fat), whereas obesity is defined as an abnormal excess of body fat. For this reason, the Centers for Disease Control and Prevention (CDC) uses the terminology “extreme overweight” instead of “obesity” when estimates are based on relative weight indices (like the Body Mass Index, see below) rather than on direct measurement of body fat.

Obesity

Obesity is when there is too much body fat other than the fat tissue in our bodies. It is also defined as an excessively high amount of body fat or adipose tissue in relation to lean body mass.

RESEARCH PROBLEM

Childhood obesity is a worldwide spread chronic disease. There are many factors contributing to this chronic disease e.g. genetics, environment,metabolism, lifestyle and behavioural components.

Overweight or obesity during childhood in most of the industrialized world, a childhood obesity epidemic is evident, with the numbers rising each year.

Obesity impacts many lives: male and female of all ages, races, economic background, and education status

Why is obesity a chronic disease?

Obesity is associated with high blood cholesterol, complications of pregnancy, menstrual irregularities, hirsutism (presence of excess body and facial hair), stress incontinence (urine leakage caused by weak pelvic-floor muscles), psychological disorders such as depression and increased surgical risk.

It affects more than a quarter of the American population. Obesity may also causes other serious medical conditions e.g. cancer, heart diseases, diabetes, etc.

LOGIC ARGUMENTATION

Examining the work of the the above mentioned authors on the childhood obesity issue, there are a genuine challenge to achieving, legitimate, cost-efficient progress on childhood obesity. And if we are honest about why the childhood obesity problem needs to be at the

top of policymakers’ agenda, the most compelling answer comes back to money.

It is a serious medical disease that affects over a quarter of adults in the United States, and about 14% of children and adolescents. It is the second leading cause of preventable death after smoking.

Berg makes a compelling and convincing argument that “the dangers of childhood obesity are real” by highlighting the increased risks overweight and obese American children face for obesity-related health problems such as type 2 diabetes, hypertension, and psychological disorders. She notes, for example, that from 1979 to 1981, the annual hospital costs related to obesity among children and adolescents were $35 million; from 1997 to 1999, these costs rose to $127 million.

Evidence from the literature provides proof of Berg’s claims about the reality of the dangers of childhood obesity and further supports her reasonings that American society must take responsibility to “reclaim the health of generations to come.”

There are many arguments that obese children will be stigmatized and that this will increase bullying, as well as leading to an increased number of children suffering from eating disorders in the future. A number of people In addition, feel that parents should be able to tell that their child is overweight and that the money could be put to better use by doing something to help change the situation.

Many consider obesity an individual matter. However, children cannot be accountable for their weight. The children have little knowledge about the anatomy of their bodies. Children will keep eating if they see that junk food is advertise all over and ok. There are two main arguments on this issue: 1) Child obesity is mostly caused by food advertisements, and 2) Parents are not doing their jobs.

Some argue that children are growing obese, because of the exposure to food advertisements. They believe that the government should step in and regulate food advertisements on children.

A child becomes obese not because he or she watches advertisements, but because they sit in front of a television all day with no exercises or any other physical activities. In addition, it is believed that the schools as well as government is obligated to fix the epidemic. The generation has a major problem that will result in statistical records of people with heart disease, high blood pressure, and diabetes. A solution to the epidemic can be the corporation between parents, the industries, and the government.

Dr. Peter Nieman, (2004) a practicing pediatrician, has identified three main causes of childhood obesity: genetics, overeating and lack of exercise. He emphasizes that it is important to understand that the causes of obesity are often a combination of these three factors. Obesity if just not the result of a single factor.

As the government becomes more aware of the serious problem of childhood obesity, schools in the UK are now planning to weigh and measure all children at the ages of

4-5, when they start primary school and again at 10-11, when they are about to leave for secondary education.

Van Staveren.and Dale’s (2004) article: Childhood Obesity: Problems and Solutions

discusses the problems related to the epidemic of Childhood Obesity. There are many problems that could have led to this epidemic but in their article, they only discuss the main four problems.

The Authors feel that the following are the main causes for Child Obesity:

Unhealthy food in schools

No policies on good dietary in schools

Unhealthy food in family life and

A Lack of family responsibility towards children regarding their diets.

There are many arguments that obese children will be stigmatized and that this will increase bullying, as well as leading to an increased number of children suffering from eating disorders in the future.

A number of people, feel that parents should be able to tell that their child is overweight and that the money could be put to better use by doing something to help change the situation.

Being parents, most of the people ask what they can do to help their children keep their weight under control.

Parents can set a good example by providing healthy nutritious meals and not eating junk food themselves, but it is important to allow some treats, as being over strict is likely to cause friction.

If the whole family learns about healthy nutritious eating and try cooking new healthy recipes together, kids won’t feel they are being singled out. It is also very essential not to focus too much on food. Although it is an important part of life and can never be avoided, it should not be made the main topic of discussion in the family.

If the overweight children are constantly reminded of their weight and what overeating can do to them, they could develop an unhealthy attitude towards food. So the parents must be sure to focus on other things, certain areas of life which are not stressful and which their child enjoys as well as good activities with the children e.g. jogging all together as a family in a park.

People might believe that children eat no more calories than children 20 years ago. The fact is that, the increasing obesity rates are likely due to a combination of changes in both eating and exercise habits. Although the increase in calories has been difficult to define due to imperfect assessment methods, it has become very clear that children eat much more processed starch and sugar especially in the form of soda coldrinks and other sugary drinks than in past years.

Parents often need to compromise or negotiate with children in regard to their food intake, and teenagers certainly make many of their own food-purchasing decisions on the basis of, in part, advertising. Marketing food to children dramatically worsened their nutritional intake.

The issue on obesity continues to grow everyday, especially in newer generations. Many are saying generation x and future generations as well are going to be the only generations that are not going to outlive their parents.

Childhood Obesity is a major contribution to these assumptions, it causes diseases and many other health problems.

Dr William J. McCarthy uses logical argumentation with his audience by saying many children in this generation are becoming over weight.

During McCarthy’s interview in the video Project 1a, he tries to warn parents as well and, with the use of pathos, (Pathos is a communication technique used to represents an appeal to the audience’s emotions ) by frightening parents into believing their child is at a high risk of a disease. He states, they are “starting to see diseases, which were really unheard,”

This causes parents to worry about their children and want to reduce the risk of them obtaining a disease. After hearing these facts parents may help their children eat healthier so they are not overweight and have a less chance of obtaining a disease.

CONCLUSIONS

From this review, it is apparent that obesity in South Africa is a growing problem in all sectors of the community, yet a particular challenge in children and urbanised black women. To address this problem and the associated morbidities in South African communities, a multi-sectoral approach is needed.

This should include changes in policy aimed at creating an environment conducive and supportive for change, such as the promotion of physical activity and dietary education in schools. In addition,

The opportunity for primordial prevention of obesity, particularly in children, should be promoted.

These prevention strategies should be culturally sensitive and encompass programmes to improve the Education, status and economic empowerment of women.

This assignment highlights the strengths and weaknesses of the systematically reviewed literature relating to the prevention and treatment of childhood obesity. Prevention is not realy discussed in the existing literature and no specific approach to intervention can be recommended. As prevention is generally considered the most effective, economical and socially acceptable approach to addressing the “obesity epidemic”, the need for clear principles upon which to base prevention strategies must be considered an urgent research priority.

The reviewed literature can provide an evidence-based framework for preventative interventions. It is clear that preventative programs should include strategies to address diet, physical activity and behavioural change.

With the development of guidelines in school health care the authorities should have a better understanding for the optimal spending of public money for the sake of the health of the childhood

With the development of a guideline on the prevention of overweight and obesity in childhood representatives of school health care in three European countries (i.e. Croatia, flanders and slovenia) can use the same methodology in order to elaborate common evidence-based recommendations for school health services in their countries. On top of these common recommendations, some specific advices were added in accordance with the organisation of health care and school health care in the respective countries.

Any country that has a high rate or increasing rate of childhood obesity must acknowledge core factors that contribute to this serious health problem. Furthermore, public policy and community involvement that include all health professionals have a responsibility in the prevention of childhood obesity. This can be implemented through education, research and advocacy of all nurses involved with children and families.

Guidelines on school health care aim at increasing the effectiveness, efficiency and quality of the preventive health care as it is delivered to school aged children and adolescents. They should contribute to a better health, growth and development of children, on an individual as well as on a population level.

After being informed about the principals of the guidelines, parents and children should have a clearer idea about what to expect from the school health service, and become more conscious of their own and their children’s health.

Any country that has a high rate or increasing rate of childhood obesity must acknowledge core evidences that contribute to this serious health problem. This can be implemented through education, research and health education by all the nurses involved with children and families.

Obesity effects thousands of Americans every year. In order to maintain a healthy weight and stop the spread of this chronic disease is by exercising and eating a balanced

diet.

Don’t become a victim of such a deadly disease!

If changes to scope-of-practice regulations could help to abate health care worker shortages, why are such changes not made?

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If changes to scope-of-practice regulations could help to abate health care worker shortages, why are such changes not made?

Question1

Is the growth in health care costs a real concern for the United States? Why or why not?

Question2

What mechanisms of accountability are most effective for nonprofit HCOs? Explain and elaborate in your response.

Question 3

Why is it difficult to forecast health care delivery in the United States?

please answer each question with a minimum of 300 words. Each should be in apa format. Each question should have at least two references

Discuss the process and significance of a mental health assessment and possible findings from the case study for the purpose of treatment and recovery.

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Discuss the process and significance of a mental health assessment and possible findings from the case study for the purpose of treatment and recovery.

 

Case Study – Altered mood (depression)
Case details below:
– Mary, 41 year old female
– Lives with her husband and three children ( John 17, Philip 14 and Sarah 10)
– Mary works as an accounts manager in a large organisation and loves her work.
– Supportive husband and married for 18 years.
– Mary has moments of despair, she is tearful, has little or no energy to move from her bed.
– Mary believes she is a burden to her family.
– Lacks motivation to complete simple activities such as eating and getting dressed.
– In the past, she looked smart, showered on a daily basis, over the last month family have noticed her personal hygiene has deteriorated.
– Mary is currently on sick leave from work.
– Often talks of feeling worthless and hopeless.
– She is having difficulty sleeping.
– Mary belongs to the local church and attends every week.
– She is physically well with no known medical history.
– At 39 she was diagnosed with clinical depression. She was hospitalised for 5 weeks, however no further admissions.
– Mary has previously taken Citalopram antidepressant but not for over 12 months as she feels she does not need it.
– She has achieved appropriate developmental milestones.
– Mary has no drug, alcohol or smoking history.
– Care is self-managed in collaboration with her doctor.
– Her mother has lived with depression for 35 years.
– Family are concerned and reluctant for her to be re-admitted against her wishes as she feels there is nothing wrong with her and doesn’t want to cause anyone any trouble.
– Introduction: (5%) sound grasp of case, outline scope and purpose, description of steps that will be implemented to reach conclusion.
Clearly link, identify and address the following points (relate to specific case):
Body:
– A comprehensive understanding of mental health, mental illness and the principles of recovery. (20%)
– The connection between mental health and physical health. (20%)
– Recognises, identifies and responds to the mental health needs of the identified person, that are nursing and case study specific, strategies supported by references (20%) i.e. must include implications for practice as a future health professional. (10%)

Conculsion: (5%) logically drawn from discussion, related to case study’s aims, summary of main points.

References: extensive range of peer-reviewed (journal articles) sources appropriate to case study. Preferably Australian references were possible and no older than 5 years, 8 years at the very most. No less than 10 references.

Below is a list of 10 possible areas to help guide the essay.
You will need to identify, explore and critically analyse a maximum of THREE (I have picked 1, 2, & 3) of the following themes to add depth to the essay. Each theme must be linked to the above discussion points and the chosen case study:

1. Discuss the common presentations of the mental illness related to the case study and the stigma or attitudes that can impact on care. (write about this one please)

2 Discuss the process and significance of a mental health assessment and possible findings from the case study for the purpose of treatment and recovery.

3 Discuss the required interventions and management of the mental, physical social and cultural issues for the chosen case study.

4 Discuss the quality of life effects for the person in the case study and their carers within a recovery framework.

5 Discuss specific issues relating to the case study, e.g. safety issues, multidisciplinary involvement, consumer and carer education and community resources.

6 Discuss likely outcomes and best practice recommendations for managing the care of the person experiencing mental illness in the chosen case study.

7 Discuss contemporary issues in providing care such as access to services, consumer and carer perspectives, indigenous mental health.

8 Discuss the use of communication strategies and other therapeutic modalities in stabilising a therapeutic relationship with the person in the chosen case study.

9. Discuss the responsibilities of registered nurses to the person in the case study experiencing mental illness.