Category: Nursing

Botzenhart, U.,Braun, A., & Frentzen, M. (2012). Laser treatment of dentine hypersensitivity

I overview

Fig. 1_Clinical situation of a patient

with gingival recession. The

occurrence of gingival recession is a

precursor to the loss of cement,

owing to poor oral hygiene, the

exposure of tooth necks and dentine

hypersensitivity.

laser treatment of dental hypersensitivity

_Introduction

More than two decades ago, laser applications in

the treatment of dentine hypersensitivity were introduced to dentistry. Many clinical studies using

different laser types have been published since. This

overview summarises the basic and clinical aspects,

including treatment protocols.

_The hypersensitive dental neck

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER NOW

Dentine hypersensitivity is a widespread painful

condition in dentistry (Orchardson et al. 2006;

Schwarz et al. 2002). Unfortunately, this clinical

condition is often poorly understood (Pesevska et

al. 2010). It is important to understand this condition in light of dental therapy because the need for

treatment is increasing (Gerschman et al. 1994;

Miglani et al. 2010). Hypersensitivity occurs when

tooth necks are exposed. Brannström’s hydrodynamic theory describes these mechanisms. Chemical, osmotic, physical or mechanical stimuli induce

movement of fluid in dental tubules, which activates pain fibres—mainly A- fibres—at the pulpdentine border (Brannström 1992). Afflicted patients describe an intense and sharp pain of short

duration that cannot be ascribed to any other form Botzenhart, U.,Braun, A., & Frentzen, M. (2012). Laser treatment of dentine hypersensitivity

of dental defect or disease (Canadian Advisory

Board on Dentin Hypersensitivity 2003). In a huge

number of cases, these symptoms are triggered by

cold and are not related to restorative or caries

therapy. The well-being of patients who suffer from

dentine hypersensitivity is often affected. Daily

stimulation, for example eating or teeth brushing,

could induce considerable pain (Rösing et al. 2009;

Tengrungsun et al. 2008).

Today, more than 30 % of the adult population

of industrialised nations is thought to be affected

(Ritter et al. 2006; Gillam et al. 1997), but the actual

prevalence is still unknown (Rösing et al. 2009). The

reported incidence mainly depends on the population under examination and the methodology of

the studies, which vary a lot. Middle-aged patients

are most often affected (Al Sabbagh et al. 2004), but

a growing number of young persons are affected by

dentine hypersensitivity (Sykes 2007). The higher

frequency of hypersensitivity, even in middle-aged

adults, could be explained by increasing exposure of

tooth necks, which occurs increasingly early on in

young people (Dowell et al. 1983). The main reasons

for exposure are erosion, abrasion and attrition.

However, erosion is most likely to be the main factor (Addy et al. 1994; Gillam et al. 1997). This comes

from an increasing awareness of dental hygiene,

which has resulted in well-intentioned but incorrect brushing (Fig. 1). For these reasons, sensitive

tooth necks frequently occur opposite the hand

that is brushing. The loss of the thin cementum

layer in the tooth-neck area is responsible for more

than 90 % of the hypersensitive surfaces (Orchardson et al. 1987). As a result, dentine hypersensitivity can be characterised as a tooth-wear phenomenon (Bamise et al. 2008). Restorations, functional

overload and bleaching of vital teeth are also

causes of dentine hypersensitivity (Brannström

1992; Jacobsen et al. 2001; Haywood 2002). Nowadays, one therefore speaks of a multifactorial genesis of dentine hypersensitivity associated with

tooth wear.

Despite intensive research, the precise physiological mechanisms of pain production and transmission in the dental pulp have not been sufficiently determined (He et al. 2011; Bal et al. 1999;

Zhang et al. 1998). The surface texture of dentine,

that is the number of open tubules at the root neck,

is of great relevance to the process of dentine hypersensitivity (Absi et al. 1987; Markowitz 1993;

Fig. 2). The extent of hypersensitivity depends on

Laser treatment of

dentine hypersensitivity

An overview Part I

Authors_Dr Ute Botzenhart, Dr Andreas Braun & Prof Matthias Frentzen, Germany

20 I laser

1_2012

Fig. 1 Botzenhart, U.,Braun, A., & Frentzen, M. (2012). Laser treatment of dentine hypersensitivity

overview I

the number of exposed tubules (Ngassapa 1996).

Clinical studies (Narhi et al. 1992) and SEM examinations (Absi et al. 1987) have demonstrated that

the dentine of hypersensitive teeth has a considerably higher number of exposed dental tubules

(eight times the number) with a considerably

greater aperture (twice the size) compared with

teeth with no hypersensitivity symptoms (Absi et al.

1987). Since dentine hypersensitivity can occur

even after the closure of most of the dental tubules,

other factors, like inflammatory mediators, are assumed to be involved in nerve stimulation and pain

(Narhi et al. 1992; Ngassapa 1996) in addition to the

hydrodynamic theory.

_Conventional therapy

Currently, a multitude of desensitising agents

are available on the market. Normally, the therapeutic mechanism is based upon the hydrodynamic

theory. By occluding dentinal tubules, movement of

fluid should be reduced. Furthermore, the reduction of pulpal pain-nerve fibre firing should contribute to reduced sensitivity.

The spectrum of applications ranges from

agents for topical application, dentine adhesives,

light-curing primer systems, mucogingival surgery

for soft-tissue management, conventional fillings,

to endodontics as ultima ratio. Topical applications

are the most important for desensitisation; among

them are fluorides, potassium and calcium compounds, hydroxyapatite, bioactive glass and glassceramics, oxalates, glutaraldehyde, formalin and

chlorhexidine. These ingredients are mostly found

in toothpastes, mouth rinses, gels, suspensions,

varnishes or pastes for topical application. They can

also be applied via chewing gum or iontophoresis.

Today, the application of nano-sized particles of

different mixtures is also very popular.

In 1935, Grossman formulated a set of criteria

that desensitising agents are to fulfil. These criteria

are still valid today (Renton-Harper et al. 1992):

– no irritation of pulp tissue;

– painless application;

– easy to apply;

– rapid in effect;

– sufficient efficiency;

– no side-effects; and

– long-term effectiveness.

The predominant number of compounds lead to

a rapid resolution of symptoms, but often they are

only short-lived. In most cases, a long-term occlusion of dentinal tubules cannot be attained. Thus

far, no desensitising substance or method of application has fulfilled all the criteria Grossmann postulated in 1935. There has been a constant improvement in terms of the available means of treatment and active substances, but the reports still

demonstrate difficulty in relieving the pain (Romano et al. 2011). Until recently, no universally applicable substance was available (Mitchell et al.

2011; Tirapelli et al. 2010; Dabahne et al. 1999).

_Laser application

Precipitates and surface coverings disintegrate

after some time, for example owing to the influence

of acid or toothbrush abrasion (Addy et al. 1983).

Conventional desensitising treatments had to be

applied repeatedly at regular intervals to ensure a

durable analgesia (Gillam et al. 1992; Cuenin et al.

1991). The application of laser beams of different

wavelengths and energy levels, alone or in combination with topical application, for example fluoride, is an alternative method for the treatment of

dentine hypersensitivity. Botzenhart, U.,Braun, A., & Frentzen, M. (2012). Laser treatment of dentine hypersensitivity

_Studies on the effects of

laser application

In vitro and in vivo studies document high effectiveness rates and comparatively long-lasting pain

relief. The most commonly used types of lasers for

the treatment of dentine hypersensitivity already

determined in vivo can be divided into two groups.

Those lasers with a lower output power, low-level

lasers (He-Ne and GaAlAs diode lasers), are applied

to biostimulation and are distinguishable from

laser types with a middle-output power, middleoutput power lasers, which have the ability to morphologically alter dental hard tissue.

The middle-output power lasers include the

Nd:YAG, Er:YAG laser and CO2 lasers (Dederich et al.

1984; Melcer et al. 1985; Featherstone et al. 1987).

The effect of these laser types can probably be attributed to the sealing of the dentinal tubules, nerve

analgesia and placebo effects. The sealing has been

observed to be of long-lasting effect, whereas in

Fig. 2_SEM examination of a human

cervical dentinal surface with open

tubules, after experimental removal

of the smear layer with 50 % citric

acid for one minute

(1,000x magnification).

I 21 laser

1_2012

Fig. 2

I overview

the case of nerve analgesia and placebo effects, the

effects are not durable (Kimura et al. 2000a). Despite the precise mechanisms of laser action, the

long-term value of laser therapy in treating dentine

hypersensitivity is uncertain; current evidence is

based upon a slight superiority compared with conventional topical applications (He et al. 2011).

Laser therapy with low-output power has been

applied to humans since the 1970s and was originally used for wound healing (Kimura et al. 1991,

1993, 1997). In the 1980s, the inhibition of inflammation (Karu 1988, 1989) and the stimulation of

nerve cells were demonstrated (Kimura et al. 1993;

Jarvis et al. 1990).

_Low-level lasers:

GaAlAs laser

Thus far, GaAlAs diode lasers of three wavelengths have been used clinically to treat dentine

hypersensitivity: 780, 830 and 900 nm. The 780 nm

wavelength has been used with good clinical success (30 mW in continuous wave mode [cw] and an

application time of about 0.5 to three minutes;

Matsumoto et al. 1985a). The 830 nm wavelength

for the treatment of dentine hypersensitivity was

first described by Matsumoto in 1990. With an energy setting of 20 to 60 mW in cw mode and an application time of 0.5 to three minutes, the effectiveness of therapy was 30 to 100 %, depending on

the energy level (Matsumoto et al. 1990). The effectiveness of therapy using the 900 nm wavelength

and an output power of 2.4 mW at 1.2 Hz for 2.5

minutes was approximately 73 to 100 % (Kimura et

al. 2000b). Yamaguchi et al. (1990) compared the

application of a GaAlAs diode laser of a wavelength

of 790 nm and an output power of 30 mW and a

placebo in vivo. Significant differences between

laser application and the placebo group were

found. At two hours, one day and five days after

laser application, a significant improvement was

detected (Yamaguchi et al. 1990). Overall, compared with the placebo, an improvement of 60 to

22 % was achieved. GaAlAs laser application with a

maximal energy output of 60 mW did not damage

enamel or dentine surfaces morphologically

(Watanabe et al. 1991).

According to another in vitro study, the application of GaAlAs laser diodes with energy levels of

30 mW (cw, 780 nm), 60 mW (cw, 830 nm) and

10 W (pulsed, 900 nm) did not lead to a significant

increase in the temperature in the dental pulp

(Arrastia et al. 1994). Gerschman et al. (1994) accomplished a clinical double-blind study with

GaAlAs lasers compared with a placebo. During the

therapy, the apical and cervical regions of the tooth

were irradiated for one minute; this procedure was

repeated in one-week, two-week and eight-week

intervals. Dentine hypersensitivity evoked by tactile

and thermal stimuli was measured at each control

and compared with the placebo group. A significant

difference concerning dentine hypersensitivity

was detected during the analysis. It was therefore

deduced that the GaAlAs laser is an effective

method for dentine desensitisation (Gerschman et

al. 1994).

_Combined application of GaAlAs laser

and fluoride Botzenhart, U.,Braun, A., & Frentzen, M. (2012). Laser treatment of dentine hypersensitivity

In another clinical study, a laser with an energy

density of 3 and 5 J/cm2was applied up to six times

in an interval of 72 hours after each application

(Marsilio et al. 2003). Dentine hypersensitivity was

measured initially after each application, and at 15

and 60 days after application. In more than 85 % of

the teeth treated, an improvement was detected.

Side-effects were not observed (Marsilio et al.

2003). In a comparative study of GaAlAs laser application (630–670 nm) at energy levels of 15 mW

in contact mode for 20 seconds and fluoride application (Fluor Protector, Ivoclar Vivadent), significant and complete relief from pain after three sessions was achieved in 86.6 % of the cases compared

with 26.6 % after fluoridation only (Pesevska et al.

2010). The clinical findings of Noya et al. (2004)

proved that just a single application of GaAlAs laser

(670 nm, 15 mW, 5 J/cm2) yields a statistically significant reduction in sensitivity to mechanical and

thermal stimuli and that two applications are

enough to reduce sensitivity to air. No other application led to any additional benefit (Noya et al.

2004).

A significant reduction in VAS scores was also

detected with laser application for 160 seconds at

an energy density of 4 J/cm2 per dental element at

24 hours and seven days after application compared with a placebo application (Orhan et al. 2010).

All teeth remained vital and no adverse effects were

found radiographically, but the results were not

significantly different from any conventional desensitiser (Gluma Desensitizer, Heraeus Kulzer;

Orhan et al. 2010).

A combined application of GaAlAs laser light

with sodium fluoride (NaF) at an energy output of

15 mW and density of 4 J/cm2 led to no statistically

significant differences between laser application

and combined laser and fluoridation treatment

(Corona et al. 2003).

Whether a combined application of GaAlAs laser

and fluoride is effective in treating dentine hyper22 I laser

1_2012

1R3UH 5HJLVWUDWLRQ)HH

7KH/DUJHVW

‘HQWDO0HHWLQJ

([KLELWLRQ &RQJUHVV

LQWKH8QLWHG6WDWHV

FOR MORE INFORMATION:

Greater New York Dental MeeƟ ng®

570 Seventh Avenue – Suite 800

New York, NY 10018 USA

Tel: (212) 398-6922 / Fax: (212) 398-6934 ::: *1<‘0 &20 E-mail: victoria@gnydm.com ScienƟĮ c MeeƟ ng: Friday – Wednesday, November 23 – 28 Exhibit Dates: Sunday – Wednesday, November 25 – 28 MARK YOUR CALENDAR Aãã›Ä Aã NÊ CÊÝã Never a pre-registraƟ on fee at the Greater New York Dental MeeƟ ng MÊٛ ãHƒÄ 600 EXH®B®ãÊÙÝ Jacob K. Javits ConvenƟ on Center 11th Ave. between 34-39th Streets (ManhaƩ an) ,›ƒQçƒÙã›ÙÝ ,Ê㛽 New York MarrioƩ Marquis ,otel L®V› D›Äã®ÝãÙù Aٛă – NÊ Tç®ã®ÊÄ Lƒã›Ýã D›Äヽ T›‘HÄʽʦù Ι S‘®›Ä㮥®‘ AVƒÄ‘›Ý MÊٛ THƒÄ 350 S‘®›Ä㮥®‘ PÙʦكÃÝ Seminars, ,ands-on Workshops, Essays & ScienƟĮ c Poster Sessions as well as Specialty and Auxiliary Programs E瑃ã®Êă½ PÙʦكÃÝ ®Ä VƒÙ®ÊçÝ ½ƒÄ¦çƒ¦›Ý Sʑ®ƒ½ PÙʦكÃÝ ¥ÊÙ ãH› EÄã®Ù› FƒÃ®½ù EĹÊù N›ó YÊÙ» C®ãù ƒã ®ãÝ B›Ýã çٮĦ ãH› ÃÊÝã ¥›Ýã®V› ã®Ã› Ê¥ ãH› ù›ƒÙ! Sponsored by the New York County Dental Society and the Second District Dental Society GNYDM_2012_A4_engn.pdf 1 NYDM_2012_A4_engn.pdf 1 20.03.12 17:34 0.03.12 17:34 I overview 24 I laser 1_2012 sensitivity is questionable. Results are contradictory, often masked by placebo effects and highly dependent on laser parameters and the given circumstances for each patient. Both methods of treatment, GaAlAs laser application and fluoridation, are suitable for dentine hypersensitivity therapy. _Biostimulative mechanisms of GaAlAs lasers The GaAlAs laser mechanism is thought to be biostimulative rather than effecting morphological changes in dentine. It is assumed that the laser energy is transmitted to the dentine–pulp complex, interacts with the pulp tissue and causes a photobiomodulating effect, increasing the cellular metabolic activity of the odontoblasts and obliterating the dentinal tubules by means of tertiary dentine production (Ladalardo et al. 2004; Walsh 1997). Tengrungsun et al. (2008) compared the efficiency of a GaAlAs laser (790 nm, 30 mW, 1 min) with a dentine bonding agent (Scotchbond, 3M ESPE) and found a statistically significant reduction immediately and 15 days after treatment in both of the two groups. No additional reduction in the level of hypersensitivity 30 days after treatment was observed. The dentine bonding agent was significantly superior to the GaAlAs laser within all measuring periods, thus confirming the assumption that laser light may act in a different way from occluding dentinal tubules (Tengrungsun et al. 2008). The immediate laser effect is assumed to be triggered by placebo effects as a result of endorphin release induced by the activation of the pain inhibition system of the organism. This leads to the release of endorphins by the central nervous system, possibly controlling the painful stimulus at the periphery, and causing biostimulative effects that happen gradually within a few days (Tuner et al. 2002; Kimura et al. 2000b; Trowgridge et al. 1990). Another assumption is the blocking of the depolarisation of C-fibre afferences (Wakabayashi et al. 1993). The exact mechanism of action of low-intensity lasers in dentine hypersensitivity is not thoroughly understood (Orhan et al. 2010). _Infra-red wavelengths and highpower density Laser diodes, some of which have already been tested in vitro and in vivo, with wavelengths in the infra-red area and a high-power density are easily available on the market. Because of the laser–tissue interaction of this laser type with high energy per surface density, its results are comparable to that of an Nd:YAG laser. The sealing ability of this laser type was observed with the parameters 810 nm, 2 W and 30 ms, and was found to be less than that of CO2, Er,Cr:YSGG lasers and Nd:YAG lasers (Gholami et al. 2011). Botzenhart, U.,Braun, A., & Frentzen, M. (2012). Laser treatment of dentine hypersensitivity Clinical findings with the use of a GaAlAs laser of a wavelength of 810 nm at 1.5 to 2.5 mW for one minute resulted in a rapid reduction of discomfort, 15 minutes and 30 minutes after laser irradiation (37 % after 15 minutes and 41 % after 30 minutes) compared with placebo laser application with a reduction of 9 %. The improvement remained stable until two weeks (72 %) and two months (66 %) after application compared with placebo laser application (a 28 % reduction at two weeks and 26 % at two months) and the application of 10 % potassium nitrate gel (a 36 % reduction at two weeks and 30 % at two months; Sicilia et al. 2009). _Different effects in different age groups Ladalardo et al. (2004) evaluated the clinical desensitising effect of red and infra-red GaAlAs laser light application (660 nm and 830 nm, 4 J/cm2 , cw, 114 seconds, contact mode) in adult patients of different age groups (25–35 years and 36–45 years) as an immediate (15 minutes and 30 minutes after application; four sessions with intervals of seven days between each session) and late therapeutic effect (15, 30 and 60 days after the conclusion of treatment). Significant desensitising levels were only found in patients aged between 25 to 35 with the 660 nm red laser, which was found to be more effective than the 830 nm infra-red laser immediately after and in the follow-up periods at 15, 30 and 60 days after the conclusion of treatment. In the group of 36- to 45-year-old patients, the effect of the red laser was only moderate, with recurrence of sensitivity, and the infra-red laser was ineffective. The authors concluded that the desensitising effects immediately after laser irradiation resulted from a suppression of evoked potential of the pulp nociceptive nerve fibres, with a better tissue response in the younger group. Pathological processes, regressive or atrophic alterations of the odontoblasts and the dentine pulp complex may lower the reaction potential in older patients, with reduced effectiveness of the laser biostimulation (Ladalardo et al. 2004). A significant clinical improvement was also observed after the combined application of GaAlAs laser (808 nm, cw, contact mode, 25 seconds) and desensitiser toothpaste compared with the toothpaste alone (Dilsiz et al. 2010a). _GaAlAs laser and acid resistance Recently, the GaAlAs diode laser was tested to establish enhancement of the acid resistance of dentine surfaces as a preventive method for hypersensitivity. A degree of improvement in the acid resistance of dentine specimens after laser irradiation (808 mn, cw, 60 J/cm2 ) and erosive challenge (1 M hypochlorous acid for five minutes) was found without creating thermal or structural damage (De-Melo et al. 2010). However, the exact mechanism of action remains unclear. Laser treatment can be a useful tool for rapid reduction in pain, and possibly in the improvement of acid resistance of dentine. Nevertheless, more basic research and longterm clinical trials are needed to evaluate the longterm efficiency of this method and to explain the exact mechanism of action. Botzenhart, U.,Braun, A., & Frentzen, M. (2012). Laser treatment of dentine hypersensitivity _Low-level lasers: He-Ne laser The He-Ne laser has a wavelength of 633 nm (Moritz et al. 2006) and is a low-level laser. The first application of the He-Ne laser in the therapy of dentine hypersensitivity was described by Senda et al. (1985), who used an output power of 6 mW and chose two different modes (cw and pulsed, 5 Hz). Effectiveness ranged from 5 to 100 %. In another study, an effectiveness of 5 to 18 % was achieved (Wilder-Smith 1988). To date, the mechanism of action of the He-Ne laser has not been explained completely (Moritz et al. 2006). An energy level of 6 mW does not alter the enamel or dentinal surface structure morphologically; however, laser energy transmits through enamel and dentine and reaches the pulp tissue (Watanabe 1993). Physiological experiments have shown that the He-Ne laser application does not influence nociceptors of circumferential A– or C-fibres (Jarvis et al. 1990), but it does influence electrical activity (action potential), which in healthy nerves is enhanced by about 33 % after application (Rochkind et al. 1986). The effect is long-lasting and leads to an increase in the action potential of nerve fibres for more than eight months after laser application (Rochkind et al. 1986). _He-Ne laser compared to Nd:YAG laser In a clinical study (Gelsky et al. 1992), which was aimed at testing the effectiveness and confidence of the Nd:YAG laser in the therapy of dentine hypersensitivity in vivo (see below), the He-Ne laser was applied to one group and the He-Ne laser and the Nd:YAG laser were applied to the other group (30–100 mJ, 10 pps increments of ten to 40 seconds, total application time < two minutes, without local anaesthesia). Dentine hypersensitivity was measured mechanically (dental probe) and thermally (stream of cold air) with the aid of a VAS. Additionally, the pulpal sensibility was evoked electrically. Initially and after three months, X-rays were taken to identify possible side-effects of the laser application. Directly after laser application and three months later, a reduction in the level of discomfort was observed. After three months, dentine hypersensitivity evoked by thermal stimuli was scaled back to 63 % and hypersensitivity evoked by mechanical stimulation was scaled back to 61 %. Compared with the combined application of He-Ne and Nd:YAG lasers, there was not much difference (reduction of dentine hypersensitivity evoked by thermal stimulation to 58 %; evoked by mechanical stimulation to 61 %). All of the teeth were vital after application and no side-effects or complications could be detected. If dentine hypersensitivity is conditioned by the hydrodynamic mechanism exclusively, (thermal) effects of Nd:YAG laser application should reduce dentine hypersensitivity primarily (Gelsky et al. 1992). In contrast, He-Ne laser application should not lead to important effects. Thus, it is assumed that a surficial modification is not the only desensitising factor, but that there is apparently also a neurophysiological component (Gelsky et al. 1992), which is affected by biostimulative effects. In a study with a similar design, the reduction of dentine hypersensitivity after He-Ne laser application alone, as well as after combined He-Ne laser and Nd:YAG laser application, was detected. It remained stable for six weeks (Halket et al. 1996)._ Editorial note: To be continued in our next issue of Laser. A list of references is available from the publisher. Botzenhart, U.,Braun, A., & Frentzen, M. (2012). Laser treatment of dentine hypersensitivity overview I I 25 laser 1_2012 Dr Ute Botzenhart Department of Orthodontics Centre of Dentistry and Oral Health Ernst Moritz Arndt University of Greifswald Germany Dr Andreas Braun/Prof Matthias Frentzen Department of Periodontology, Operative and Preventive Dentistry University of Bonn Germany _contact laser Botzenhart, U.,Braun, A., & Frentzen, M. (2012). Laser treatment of dentine hypersensitivity

Title

Your Name

Chamberlain College of Nursing

NR451 RN Capstone Course

Term and Year

Your title here

This paragraph(s) is to introduce the paper.
Explain the type of work setting you are discussing and whether interprofessional teams are present. If present, indicate a team function that could be improved.  If not present, indicate what type of team you think might work well in this setting and how it might function.
Remember this is a scholarly APA assignment so you cannot use first person. Remember also that you will keep all the bolded headings and just remove the non-bolded content when you start your paper.

NR451_iCARE_paper_outline_template__Wk_5

Compassion

In this paragraph, describe
a nursing action that could contribute to compassion
through interprofessional team support; describe how this might impact the culture of your unit or organization; and possible impact on patient outcomes.

Advocacy

In this paragraph, describe
a nursing action that could contribute to advocacy
through interprofessional team support; describe how this might impact the culture of your unit or organization; and possible impact on patient outcomes.

Resilience

In this paragraph, describe
a nursing action that could contribute to resilience
through interprofessional team support; describe how this might impact the culture of your unit or organization; and possible impact on patient outcomes.

Evidence-Based Practice

In this paragraph, describe
a nursing action that could contribute to evidence-based

practice
through interprofessional team support; how this might impact the culture of your unit or organization; and possible impact on patient outcomes.

Summary

Provide a clear and concise summary. Include a summary statement of how iCARE components can support interprofessional teams and patient outcomes through nursing actions.  Address how you may be able to influence this process of support for interprofessional teams on your unit or in your organization.

 

References

Select at least one scholarly nursing article from CINAHL as a resource for your paper. Additional scholarly sources can be used but are optional.

Getting Started: Interprofessional teams are part of practice trends we see developing in all aspects of care delivery. Consider you own work environment (or recent clinical setting).

For this assignment, consider the concept of interprofessional teamwork and patient outcomes.

Look to your current workplace as an example. (If you are not currently employed, look to a past workplace or clinical practice area.)

Apply the components of the iCARE concept to interprofessional teams in a short paper. (Body of the paper to be 3 pages, excluding the title page and references page)

iCARE components are:

C ompassion

A dvocacy

R esilience

E vidence-Based Practice (EBP)

How could you contribute to an interprofessional team and patient outcomes through nursing actions of: compassion, advocacy, resilience, and evidence-based practice?

Select one scholarly nursing article from CINAHL as a resource for your paper. Additional scholarly sources can be used but are optional.

Use APA format throughout, particularly in citations and on the References page.

Please paraphrase throughout. One short quote is permitted.

The prepared
paper template
is RECOMMENDED for this assignment.

 

 

 

 

 

 

Title

Your Name

Chamberlain College of Nursing

NR451 RN Capstone Course

Term and Year

 

 

Your title here

This paragraph(s) is to introduce the paper.
Explain the type of work setting you are discussing and whether interprofessional teams are present. If present, indicate a team function that could be improved.  If not present, indicate what type of team you think might work well in this setting and how it might function.
Remember this is a scholarly APA assignment so you cannot use first person. Remember also that you will keep all the bolded headings and just remove the non-bolded content when you start your paper.

Compassion

In this paragraph, describe
a nursing action that could contribute to compassion
through interprofessional team support; describe how this might impact the culture of your unit or organization; and possible impact on patient outcomes.

Advocacy

In this paragraph, describe
a nursing action that could contribute to advocacy
through interprofessional team support; describe how this might impact the culture of your unit or organization; and possible impact on patient outcomes.

Resilience

In this paragraph, describe
a nursing action that could contribute to resilience
through interprofessional team support; describe how this might impact the culture of your unit or organization; and possible impact on patient outcomes.

Evidence-Based Practice

In this paragraph, describe
a nursing action that could contribute to evidence-based

practice
through interprofessional team support; how this might impact the culture of your unit or organization; and possible impact on patient outcomes.

Summary

Provide a clear and concise summary. Include a summary statement of how iCARE components can support interprofessional teams and patient outcomes through nursing actions.  Address how you may be able to influence this process of support for interprofessional teams on your unit or in your organization.

 

References

Select at least one scholarly nursing article from CINAHL as a resource for your paper. Additional scholarly sources can be used but are optional.

Article One

 

Title

 

Ely J. T. A., Mercury Induced Alzheimer’s Disease: Accelerating Incidence?

 

Purpose

 

The purpose of the study is to determine whether the mercury contained within amalgam restorations increased the likelihood of acquiring Alzheimer’s disease.  The study seeks to bring into light the connection between a condition called micromercurialism, a form of mercury poisoning following low-dose mercury exposure over a prolonged period of time, and amalgam. The study will attempt to support the controversial claim that micromercurialism is one of the main causes of Alzheimer’s disease.

 

Methods

 

The amount of mercury (Hg°) released from amalgams was determined using a Jeronome Model 411 Mercury Vaporizer Analyzer powered by a portable battery. Subjects used in the study were found in a meeting on mental illness and had either requested to participate in the study or consented to it. An initial mercury reading was obtained 30 seconds prior to a gum chewing session and then again after the gum chewing session (for this reading, the participant’s teeth was dried and the participant was asked to hold his or her breath for 10 seconds). By blowing air into the mercury vaporizer, the mercury level contained within the air sample could be determined and displayed as a digital readout. Mercury levels were compared before and after gum chewing (by blowing air into a mercury vaporizer) for two participants.

 

 

 

 

 

Results

 

The study supported the notion that mercury is released from amalgam restorations. Mercury vapour content post gum chewing was at least four times higher than that found before gum chewing. When an individual is chewing gum, mercury-containing vapour is produced in the oral cavity and the individual could then inhale this vapour. Other studies had similar findings; for example, one study-examining cadavers showed that individuals with amalgam restorations had higher levels of mercury in the nucleus basalis of Meynert as compared to individuals without amalgam restorations. It is suggested that perhaps amalgam results in increased incidence of Alzheimer’s disease because the presence of mercury induces the activity of mercury-inactivating enzymes. Mercury-inactivating enzymes have been implicated in slowing down natural neural processes, and thus may be responsible for causing Alzheimer’s disease.

 

Critique

 

Since the sample size was extremely small containing only two subjects, the results obtained cannot be extrapolated to the general population with a high degree of confidence. Increasing sample size would make the results obtained more reliable. Moreover, since the two participants used did not have Alzheimer’s disease, the study cannot conclude directly that mercury from amalgam restorations causes Alzheimer’s disease; rather the study can only claim that the mercury within amalgam restorations can be released into a vapour following chewing. To conclude that amalgam restorations result in increased incidence of Alzheimer’s disease, a long-term study would need to be conducted and the incidence of Alzheimer’s disease in this group would need to be significantly higher than that found in the general population. If empirical evidence supported the idea that amalgam restorations cause Alzheimer’s disease, it would permanently change how dentistry is practiced.

 

Conclusion

 

Using two mental health patients, the study showed that following chewing, mercury could be released from amalgam restorations into the air contained within the oral cavity. However, it cannot be concluded definitively, based on this study that the mercury contained within amalgam restorations causes Alzheimer’s disease. To be able to make such a bold claim, a long-term study involving many individuals with amalgam restorations would need to be conducted, and the incidence level of Alzheimer’s disease would need to be much higher in this group than in the general population to support such a claim. Moreover, part of the author’s claim that the mercury contained within amalgam restorations causes Alzheimer’s disease is based on other studies each using a different set of methods.

How can liver and renal diseases result in abnormal uterine bleeding (AUB)?

 

a.

They cause an imbalance in platelet aggregation.

 

b.

They result in an inability to adequately clear estrogen from the body.

 

c.

They cause thyroid dysfunction, which leads to bleeding abnormalities.

 

d.

They result in elevated prolactin levels, which lead to bleeding abnormalities.

 

 

What is now thought to be the most important causative agent in cervical cancer?

 

a.

PCOS

 

b.

Vulvar cancer

 

c.

Herpes simplex

 

d.

HPV

 

 

An initial or primary genital herpes infection characteristically lasts about:

 

a.

1 week

 

b.

3 weeks

 

c.

1 month

 

d.

6 weeks

 

 

Which contraceptive methods have inherent failure rates?

 

a.

None

 

b.

Some

 

c.

All

 

d.

All except sterilization

 

Why do adolescents have the highest risk of developing pelvic inflammatory disease (PID)?

 

a.

They have the highest risk for bacterial vaginosis.

 

b.

They are the least at risk for developing other STIs.

 

c.

They are the most sexually active.

 

d.

They have decreased immunity to infectious organisms.

 

Exercise-induced amenorrhea is probably due to the combination of low body fat and decreased secretion of:

 

a.

Estrogen

 

b.

Prolactin

 

c.

Progesterone

 

d.

GnRH

 

What can result from an imbalance in the vaginal flora?

 

a.

Herpes simplex virus

 

b.

Human papillomavirus

 

c.

Chlamydia

 

d.

Bacterial vaginosis

 

The most effective means of obtaining the history of abuse is to use a communication model that:

 

a.

Avoids having the patient’s children present during the discussion

 

b.

Signals someone is interested and that the woman is not alone

 

c.

Emphasizes the belief that violence is not acceptable, no matter what the batterer might have said to the patient

 

d.

Allows the patient to talk without interruption and with time to relate, emphasize, and repeat her full story

 

What is the most common STI in the United States?

 

a.

Gonorrhea

 

b.

Chlamydia

 

c.

Syphilis

 

d.

Herpes simplex virus

 

 

Progestin-only pills (POPs):

 

a.

Have no possible side effects

 

b.

Suppress ovulation as reliably as COCs

 

c.

May be taken earlier or later than prescribed

 

d.

In combination with lactation are nearly 100% effective

 

 

According to the World Health Organization (WHO), the presence of a disease state:

 

a.

Necessitates prompt medical attention

 

b.

Excludes a person from being considered healthy

 

c.

Does not exclude a person from being considered healthy

 

d.

Classifies a person as in poor health

 

 

Which of the following might be a sign of hyperandrogenism?

 

a.

Irritable bowel syndrome

 

b.

Decreased sebum secretion in the skin

 

c.

Decreased muscle mass

 

d.

Acne associated with menstrual dysfunction

 

Surgical abortion represents an option for women who desire termination of pregnancy beyond:

 

a.

8 weeks’ gestation

 

b.

12 weeks’ gestation

 

c.

4 weeks’ gestation

 

d.

15 weeks’ gestation

 

How can weight loss specifically control symptoms of polycystic ovary syndrome (PCOS)?

 

a.

It decreases SHBG.

 

b.

It increases insulin resistance.

 

c.

It decreases androgen levels.

 

d.

It increases estrogen levels.

 

 

Why is acknowledging the oppression of women more difficult within Western societies?

 

a.

The multiplicity of minority groups complicates the issue.

 

b.

The availability of health care makes acknowledgment more difficult.

 

c.

The diversity of the news media clouds the issue.

 

d.

Affluence and increased opportunities mask oppression.

 

 

How does vaginosis differ from vaginitis?

 

a.

It must be treated with metronidazole.

 

b.

The discharge does not contain white blood cells.

 

c.

The discharge does not have an odor.

 

d.

It causes itching and/or burning.

 

 

What area of injury prevention is a focus of the USPSTF’s guidelines for counseling all healthy, asymptomatic women?

 

a.

Motor vehicle accidents

 

b.

Falls

 

c.

Domestic violence

 

d.

All of the above

 

 

What approach does Healthy People 2020 use to achieve its goals and objectives?

 

a.

Social determinants of health

 

b.

Evidence-based determinants of health

 

c.

Quality-of-life determinants of health

 

d.

Longevity promotion determinants of health

 

 

Approximately what percentage of women with bacterial vaginosis are asymptomatic?

 

a.

25%

 

b.

40%

 

c.

75%

 

d.

50%

 

The genetic counselor has a significant role in the care of women because BRCA1 and BRCA2 genetic mutations account for 5 to 10 percent of all _______ cancer cases.

 

a.

Breast

 

b.

Ovarian

 

c.

Uterine

 

d.

Pancreatic

Which organism causes 90% of vulvovaginal candidiasis episodes in women?

 

a.

Candida tropicalis

 

b.

Candida albicans

 

c.

Candida glabrata

 

d.

Candida krusei

 

What term refers to the period from about 7 to 10 days before menstrual flow begins until the first or second day of menstrual flow?

 

a.

Amenorrhea

 

b.

Premenstrual

 

c.

Dysmenorrhea

 

d.

Perimenstrual

 

The ParaGard IUD is impregnated with copper and is effective for:

 

a.

15 years

 

b.

3 years

 

c.

5 years

 

d.

10 years

 

What is the danger of giving estrogen replacement therapy (ERT) to menopausal women with an intact uterus?

 

a.

A higher risk of heart disease

 

b.

An increased likelihood of blood clots

 

c.

An increased likelihood of osteoporosis

 

d.

A higher risk of endometrial cancer

 

Although barrier contraception methods are less effective in preventing pregnancy than more modern methods, interest in them is on the rise because they:

 

a.

Can help protect against STIs, including HIV

 

b.

Are coitus dependent and require planning

 

c.

Are nonallergenic and male controlled

 

d.

Involve the use of hormones

 

A risk factor that could lead to endometrial cancer is:

 

a.

Early menopause

 

b.

Late menopause

 

c.

High blood pressure

 

d.

Cervical cancer

 

Of the two intrauterine contraceptive devices currently available in the United States only one provides a local delivery of protestin. It is the:

 

a.

Combined contraceptive patch (Ortho Evra)

 

b.

Copper IUD (T380A, ParaGard)

 

c.

LNG-IUS (Mirena)

 

d.

Dalkon Shield

 

Approximately what percentage of vulvar cancers occur in women older than the age of 50?

 

a.

50%

 

b.

70%

 

c.

85%

 

d.

60%

 

What is the best definition of abnormal uterine bleeding (AUB)?

 

a.

Uterine bleeding for which no pelvic pathology is found

 

b.

Uterine bleeding that is irregular during a woman’s menstrual cycle

 

c.

Uterine bleeding that is irregular in amount or frequency

 

d.

Uterine bleeding that is related to systemic conditions

 

The most common benign breast masses are:

 

a.

Galactoceles

 

b.

Hamartomas

 

c.

Fibroadenomas and cysts

 

d.

Lipomas and phyllodes tumors

 

Which cancer has the highest mortality rate of all gynecological cancers?

 

a.

Vulvar cancer

 

b.

Endometrial cancer

 

c.

Cervical cancer

 

d.

Ovarian cancer

 

Vulvovaginal candidiasis accounts for what percentage of all vaginal infections?

 

A.

10–15%

 

B.

20–25%

 

C.

50–55%

 

D.

60–65%

 

Which type of counseling results in a statistically significant reduction in STIs?

 

a.

Abstinence-only education

 

b.

Counseling delivered in multiple individual or group sessions totaling more than 3 hours

 

c.

Remote counseling via Internet or phone

 

d.

Brief, individual sessions in the primary care setting

 

Which of the following is an ethical issue that is specifically associated with pre-implantation testing with ART?

 

a.

Ownership of frozen embryos after the couple has divorced

 

b.

A surrogate deciding she does not want to relinquish the infant

 

c.

Genetic engineering and the ability to reject embryos affected by inherited disorders

 

d.

The implantation of multiple embryos, which can create high risk for the embryos and the woman

 

What symptom is present in 80 to 90 percent of women with cervical cancer?

 

a.

Abnormal vaginal bleeding

 

b.

Abnormal vaginal discharge

 

c.

Pelvic pain

 

d.

Ectopic pregnancy

 

If a patient has not reported a sexual assault to law enforcement, all of the following clinician actions are important except:

 

a.

Asking if reporting is something she wants to consider

 

b.

Discussing any fears or concerns that she may have about reporting

 

c.

Explaining that only some forced sexual contacts are reportable crimes

 

d.

Telling her that women who report do better psychologically than those who do not

 

What test should be ordered for a woman who is experiencing abnormal uterine bleeding (AUB) as well as headaches and peripheral vision changes?

 

a.

Thyroid-stimulating hormone test

 

b.

Nucleic acid amplification test

 

c.

Complete blood count

 

d.

Prolactin level test

 

What had been a significant problem in medical research well into the 1990s?

 

a.

The focus on randomized clinical trials over epidemiological investigations

 

b.

The lack of representation of women in research trials

 

c.

The lack of research related to gynecology

 

d.

The focus on randomized clinical trials over observational research

 

What is the definitive diagnostic technique for vulvar dermatoses?

 

a.

Pap test

 

b.

Biopsy

 

c.

Colposcopy

 

d.

Physical exam

 

Where in the breast do most malignancies develop?

 

a.

Upper inner quadrant

 

b.

Upper outer quadrant

 

c.

Lower outer quadrant

 

d.

Lower inner quadrant

 

Approximately how many Americans will contract one or more sexually transmitted infections during their lifetime?

 

a.

50%

 

b.

25%

 

c.

40%

 

d.

60%

 

In the GTPAL system for recording pregnancy history, the “T” stands for:

 

a.

Term births

 

b.

Terminal pregnancies

 

c.

Total number of pregnancies

 

d.

Type of birth (spontaneous, assisted, or cesarean)

 

Both very young and elderly sexual assault victims:

 

a.

Are addressed in most state mandatory reporting laws

 

b.

never has any difficulty describing the incident and related symptoms

 

c.

Require the same equipment for proper examination that others do

 

d.

Have fewer injuries than victims of other age groups

 

What is one of the side effects of hormonal contraceptives?

 

a.

Reduction in ovarian cancer risk

 

b.

Increased menstrual blood loss

 

c.

Increased risk of endometrial cancer

 

d.

Heavier menstrual flow

 

Tubal sterilization for women who have completed their families is highly effective, but there are disadvantages such as:

 

a.

Women are less likely to use condoms or return for health services.

 

b.

There is a decreased risk of ovarian cancer and pelvic inflammatory disease.

 

c.

There is a high likelihood of complications and side effects.

 

d.

The surgery is not covered by insurance.

 

What is the current (2006) recommendation by the CDC regarding HIV testing?

 

a.

Test all patients who report risk behaviors associated with HIV.

 

b.

Test all patients unless they explicitly decline to be tested.

 

c.

Test all patients.

 

d.

Test only those patients who ask to be tested.

 

What is generally the cause of Bartholin’s cyst?

 

a.

Complications from gonorrhea

 

b.

Cystic fluid in Bartholin’s gland becomes infected

 

c.

A fungal infection in Bartholin’s gland

 

d.

Obstruction of a duct in Bartholin’s gland

 

Which of the following factors associated with increased risk for developing osteoporosis appears to be the best predictor of risk?

 

a.

Smoking

 

b.

Low body weight

 

c.

Sedentary lifestyle

 

d.

Family history

 

What is the definition of primary amenorrhea?

 

a.

The cessation of menses for an interval of 6 months

 

b.

The failure to begin menses by age 14

 

c.

The cessation of menses due to outflow tract obstruction

 

d.

The failure to begin menses by age 16

 

In respect to an evidentiary examination:

 

a.

The patient may not withhold consent if the clinician is a mandated reporter.

 

b.

The clinician is required to strictly follow local agency protocols, no others.

 

c.

The time frame within which it must take place depends on local standards.

 

d.

Maintaining the chain of custody of all evidence collected is recommended, not required.

QUESTION 1

Which of the following is a diagnostic label that is listed in the Diagnostic and Statistical Manual IV-TR?

a.

Premenstrual dysphoric disorder

b.

Premenstrual magnification

c.

Dysmenorrhea

d.

Premenstrual syndrome

About half of all pregnancies in the United States are unintended and occur most frequently in women who:

a.

Are married or divorced

b.

Have finished high school

c.

Are between the ages of 18 and 24

d.

Are members of the majority group

 

 

 

 

What is one factor that can reduce the risk for the development of ovarian cancer?

 

a.

Multiple pregnancies

 

b.

Transvaginal ultrasounds

 

c.

Identification of recurrence

 

d.

Weight loss

 

 

What percentage of toxic shock syndrome cases are related to menses?

 

a.

50%

 

b.

25%

 

c.

75%

 

d.

90%

Tubal sterilization for women who have completed their families is highly effective, but there are disadvantages such as:

 

a.

Women are less likely to use condoms or return for health services.

 

b.

There is a decreased risk of ovarian cancer and pelvic inflammatory disease.

 

c.

There is a high likelihood of complications and side effects.

 

d.

The surgery is not covered by insurance.

 

Women who report experiencing the most severe symptoms of PMS tend to be: In their late 40s

a.

In their late 40s

b.

In their early 20s

c.

In their late teens

d.

In their late 30s

What is the definition of primary amenorrhea?

 

a.

The cessation of menses for an interval of 6 months

 

b.

The failure to begin menses by age 14

 

c.

The cessation of menses due to outflow tract obstruction

 

d.

The failure to begin menses by age 16

How many stages does the Tanner scale use to stage sexual maturity?

 

a.

3 stages

 

b.

5 stages

 

c.

6 stages

 

d.

8 stages

 

Which contraceptive methods have inherent failure rates?

a.

None

b.

Some

c.

All

d.

All except sterilization

What is the most common type of menstrual dysfunction related to hyperandrogenism?

 

a.

Painful menstruation

 

b.

Absence of menses

 

c.

Irregular bleeding

 

d.

Early menopause

 

Combined oral contraceptives (COCs) are among the most extensively studied medications available. Which one of the following statements about their use has been found to be true?

 

a.

Broad-spectrum antibiotics may enhance their efficacy.

 

b.

They do not increase the risk of venous thromboembolism.

 

c.

They decrease the relative risk of ovarian and endometrial cancers.

 

d.

Among possible side effects are acne, hirsuitism, and benign breast conditions.

 

Many patients experiencing intimate partner violence (IPV) meet the criteria for diagnosing PTSD. Those criteria include all of the following except:

a.

Experiencing a traumatic event

b.

Reexperiencing the traumatic event

c.

Numbness and avoidance

d.

Hypovigilance

Which of the following is an ethical issue that is specifically associated with pre-implantation testing with ART?

a.

Ownership of frozen embryos after the couple has divorced

b.

A surrogate deciding she does not want to relinquish the infant

c.

Genetic engineering and the ability to reject embryos affected by inherited disorders

d.

The implantation of multiple embryos, which can create high risk for the embryos and the woman

The ________ is probably the most widely used intimate partner violence (IPV) screen.

 

a.

Three-question AAS (McFarlane et al., 1992)

 

b.

Campbell’s Danger Assessment (2003)

 

c.

Sheridan’s HARASS Instrument

 

d.

Helton’s nine-question AAS

 

What is the term for the absence of menses for 3 to 6 months in a woman who has previously menstruated and is not pregnant, breastfeeding, or menopausal?

a.

Primary amenorrhea

b.

Initial dysmenorrhea

c.

Secondary amenorrhea

d.

Primary dysmenorrhea

Among women age 55 years and older:

 

a.

Macromastia is the most common cause of breast masses.

 

b.

Breast masses are presumed malignant until proven otherwise.

 

c.

Most breast masses decrease in size over time and many resolve completely.

 

d.

Diagnostic imaging of a breast mass and tissue sampling should be deferred.

 

Both very young and elderly sexual assault victims:

a.

Are addressed in most state mandatory reporting laws

b.

never has any difficulty describing the incident and related symptoms

c.

Require the same equipment for proper examination that others do

d.

Have fewer injuries than victims of other age groups

What is the major source of normal vaginal secretions?

 

a.

Bartholin’s glands

 

b.

Apocrine glands

 

c.

Sebaceous glands

 

d.

Cervical mucosa

 

Which one of the following statements about intimate partner violence (IPV) is false?

a.

It refers to an escalating pattern of abuse.

b.

It includes emotional abuse, such as disregarding what a woman wants.

c.

It includes using physical force to make a woman engage in a sexual act against her will.

d.

It refers to a current or former spouse or dating partner of the opposite sex, not someone of the same sex.

How is being overweight defined on the BMI table?

 

a.

18–29.9

 

b.

20–29.9

 

c.

25–29.9

 

d.

30 or greater

 

What has contributed to the decreased incidence of hepatitis B over the past 20 years?

a.

The decrease in PID

b.

The HBV vaccination

c.

The increase in condom use

d.

More precise screening methods

 

Which are the most common forms of hepatitis seen in women’s health practices?

 

a.

A and B

 

b.

A and D

 

c.

B, C, and D

 

d.

B and C

The factors that enable women to enjoy and control their sexual and reproductive lives, including a physical and emotional state of well-being and the quality of sexual and other close relationships, make up a woman’s:

a.

Sexual health

b.

Gender identity

c.

Gender role behaviors

d.

Psychosocial orientation

What test should be ordered for a woman who is experiencing abnormal uterine bleeding (AUB) as well as headaches and peripheral vision changes?

 

a.

Thyroid-stimulating hormone test

 

b.

Nucleic acid amplification test

 

c.

Complete blood count

 

d.

Prolactin level test

 

Surgical abortion represents an option for women who desire termination of pregnancy beyond:

a.

8 weeks’ gestation

b.

12 weeks’ gestation

c.

4 weeks’ gestation

d.

15 weeks’ gestation

What population of women should be screened for signs and symptoms of thyroid dysfunction?

a.

All women

b.

Older women

c.

Older women, smokers, and women with diabetes

d.

Older women, postpartum women, and women with Down syndrome

 

All of the following diagnostic testing and procedures are now infrequently performed in clinical practice except:

a.

Hysterosalpingogram

b.

Sperm penetration assay

c.

The postcoital test (PCT)

d.

Endometrial biopsy (EMB)

 

The most common site for endometrial implants found in other parts of the body is:

a.

The appendix

b.

The uterus

c.

The ovaries

d.

The fallopian tubes

Women who have had toxic shock syndrome should be instructed not to use tampons or:

 

a.

Barrier contraception methods

 

b.

Hormonal contraception methods

 

c.

Intravaginal antibiotic cream

 

d.

Oral antibiotics

Cyclic mastalgia:

 

a.

More likely causes unilateral, localized pain that is sharp or burning in nature

 

b.

Has an increased risk of occurrence in women whose diets are low in fat

 

c.

Occurs most frequently in women who are 18 to 30 years old

 

d.

Is caused by hormonal changes associated with menstruation

The incidence of uterine fibroids:

a.

Increases with age

b.

Decreases with age

c.

Is often caused by early menopause

d.

Is related to the age of first menses

Patients presenting for STI treatment should be screened for HIV:

 

a.

At each visit

 

b.

At the end of treatment

 

c.

At the beginning of treatment

 

d.

Each year

What screening recommendation is similar across all groups for colorectal cancer?

a.

Screening women age 76 to 85 based on risk factors

b.

Screening only for those women at increased risk

c.

Screening for all women starting at age 50

d.

Against routine screening in adults age 76 and over

 

Approximately what percentage of vulvar cancers occur in women older than the age of 50?

 

a.

50%

 

b.

70%

 

c.

85%

 

d.

60%

 

Signs of endometrial or cervical cancer may present abnormal uterine bleeding, often as heavy, prolonged bleeding or:

a.

Menometrorrhagia

b.

Amenorrhea

c.

Oligomenorrhea

d.

Polymenorrhea

 

In the GTPAL system for recording pregnancy history, the “T” stands for:

 

a.

Term births

 

b.

Terminal pregnancies

 

c.

Total number of pregnancies

 

d.

Type of birth (spontaneous, assisted, or cesarean)

What is now thought to be the most important causative agent in cervical cancer?

 

a.

PCOS

 

b.

Vulvar cancer

 

c.

Herpes simplex

 

d.

HPV

 

The most common sites of metastatic spread of invasive breast cancer include all of the following except:

a.

Bones

b.

Lungs

c.

Pituitary

d.

Lymph nodes

Who should be screened regularly for STIs?

 

a.

Women who have more than one sexual partner

 

b.

Women over the age of 21

 

c.

Women who are sexually active

 

d.

Women over the age of 15

 

What is a common vasomotor symptom of menopause?

a.

Blood clots

b.

Night sweats

c.

Osteoporosis

d.

Hysterectomy

 

What is the best definition of abnormal uterine bleeding (AUB)?

 

a.

Uterine bleeding for which no pelvic pathology is found

 

b.

Uterine bleeding that is irregular during a woman’s menstrual cycle

 

c.

Uterine bleeding that is irregular in amount or frequency

 

d.

Uterine bleeding that is related to systemic conditions

What should be the clinician’s first objective after learning the chief reason the woman desires care?

 

a.

To give the reason or problem a structural and chronological framework

 

b.

To probe for any additional concerns missed

 

c.

To take a family history related to the presenting concern

 

d.

To gain insight into the woman’s cultural and social influences

No risk factors other than age are identifiable in ______ of women with breast cancer.

 

a.

100%

 

b.

85%

 

c.

60%

 

d.

24%

The highest prevalence of human papillomavirus (HPV) is found among women ages:

 

a.

18–20

 

b.

20–24

 

c.

25–30

 

d.

30–35

Although barrier contraception methods are less effective in preventing pregnancy than more modern methods, interest in them is on the rise because they:

 

a.

Can help protect against STIs, including HIV

 

b.

Are coitus dependent and require planning

 

c.

Are nonallergenic and male controlled

 

d.

Involve the use of hormones

Nursing Research Essay Assignment Papers

Nursing Research

Hill, W., Weinert, C., Cudney, S.(2006). Influence of a computer intervention on the psychological status of chronically ill rural women. 
Nursing Research
, 55(1), 34-42.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC1484522/

 
Assignment # 1 

Read the abstract and background (pp.34-38 up to results) of the report by Hill and Colleagues (2006) PROVIDED ABOVE and answer the following questions: Nursing Research Essay Assignment Papers

Is this a qualitative or quantitative study?

What is the purpose of this study?

Does the report specify hypotheses? If there are hypotheses, were they appropriately worded?

If no hypotheses were stated, what would one be?

Did the report present conceptual definitions of key concepts? What are they?

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER NOW

QUESTION 1: IS THIS A QUALITATIVE OR QUANTITATIVE STUDY

Qualitative research design is used for exploratory purposes to gain an understanding into a particular issue, problem or topic. It deals primarily the personal opinions and underlying reasons behind a problem. Data collection for qualitative research is done through the use of largely open ended and unstructured collection instruments to provide the respondents with an unconstrained platform to air the views and opinions (Cresswell, 2013). Data collection instruments utilized in qualitative research include: focus groups, interviews and observation. The sample size required for qualitative research is also relatively small. Results gathered from qualitative research can be used to form hypotheses for further quantitative research in the topic. Nursing Research Essay Assignment Papers.

Quantitative research differs from qualitative in that it deals with numerical data. Quantitative research relies on measurable data that is then subjected to mathematical statistical analysis to uncover fact based patterns and/or trends that offer insight into the research topic. Quantitative research utilizes more structured data collection tools that ensure the respondents’ feedback is standard (Neuman and Robson, 2012). Data collection instruments utilized in quantitative research includes questionnaires, structured interviews surveys, polls and structured observation.

This study utilizes a quantitative research design due to two main reasons. Firstly, the data collection utilized is a structured questionnaire that is designed to collect standardized responses from the responses. Secondly, the study utilizes mathematical statistical analysis to identify patterns for the discussion. Nursing Research Essay Assignment Papers.

 

QUESTION 2: WHAT IS THE PURPOSE OF THIS STUDY

Every research study aims to achieve a certain goal at its conclusion; this is what is referred to as the purpose of the study. As stated in the paper’s introductory chapters (Hill, Winert and Cudney, 2006), participation in support groups has been shown to improve the overall mental health status of chronically ill patients. However, patients in rural areas are geographically isolated from the institution/centres that host these support groups. Mobility issues caused by the chronic illness, whether financially or due to their health statuses, further reduce their access to support group. The purpose of this research study is to identify whether computer delivered support groups platforms could have a positive impact on geographically isolated, chronically ill patients. Nursing Research Essay Assignment Papers.

 

QUESTION 3: DOES THE REPORT HAVE A HYPOTHESIS? IF NOT, WHAT WOULD ONE BE?

A hypothesis is a prediction statement that is provided in the research design phase that will either be supported or disproved by the research findings (Pickard, 2012). Hypotheses can only be applied to quantitative studies as qualitative studies are exploratory in nature and lack the mathematical analysis to test the hypothesis. The opposite outcome of a hypothesis is known as the null hypothesis (Ary et al., 2013).

This research study does not have a specified hypothesis. In the introductory paragraphs establish that support groups have a positive impact on the mental health of chronically ill patients. Therefore, it would be reasonable to expect the computer delivered intervention to also have a positive impact on the mental well being of the rural patients. An appropriate hypothesis for this study would be “computer delivered interventions have a positive impact on the mental health of the intervention group” with the null hypothesis being that “there will be no significant difference between the metal health status of the control group and the intervention group after the research study”. Nursing Research Essay Assignment Papers.

QUESTION 4: DID THE REPORT PRESENT CONCEPTUAL DEFINITIONS OF KEY CONCEPTS? WHAT ARE THEY?

This research study has three conceptual terms that are specifically listed, with their definitions contained in the text’s body. These are:-

Chronic illness: This is defined in comparison with acute illnesses. Chronic illnesses are lifelong, incurable diseases while acute illness is potentially curable. Nursing Research Essay Assignment Papers.

Computer Based Intervention: This is defined as an online provided platform that can act as a substitute for a support group. The research utilizes a computer based intervention that incorporates the functions of a support group as well as simultaneously providing health education. This intervention has a platform for group discussions as well as an inbox feature for private messaging and is available 24 hours a day, 7 days a week.

Psychological outcomes: these are the results from the seven psychological indicators being measured in the study which are: social support, self esteem, empowerment, self efficacy, stress, depression and loneliness. Nursing Research Essay Assignment Papers.
 

References

Ary, D., Jacobs, L. C., Sorensen, C. K., & Walker, D. (2013). Introduction to research in education. Cengage Learning.

Creswell, J. W. (2013). Research design: Qualitative, quantitative, and mixed methods approaches. Sage publications.

Hill, W., Weinert, C., & Cudney, S. (2006). Influence of a computer intervention on the psychological status of chronically iII rural women: Preliminary results. Nursing research, 55(1), 34.

Neuman, W. L., & Robson, K. (2012). Basics of social research: Qualitative and quantitative approaches.

Pickard, A. (2012). Research methods in information. Facet publishing.

 
Chapter 1: The Role of Research in Nursing

The challenges associated with nursing’s rapid pace of growth can best be met by integrating evidence-informed knowledge into nursing practice. Nursing
research provides specialized scientific knowledge
that
empowers nurses to anticipate and meet these constantly
shifting challenges and maintain the profession’s societal relevance. Through the conducting of research, they produce knowledge that is reliable and useful for clinical practice. The methods and findings of studies provide evidence that is evaluated, and their applicability to practice is used to inform clinical decisions. Nursing Research Essay Assignment Papers.

Research is the systematic, rigourous, logical investigation that aims to answer questions about nursing phenomena.

Phenomena can be defined as occurrences, circumstances, or facts that are perceptible by the senses. Phenomena, such as the expression of pain or loss, are the circumstances of interest to nurses.

Much of the evidence used as a basis for practice is from research that has been completed, written about in papers, and then published. Published research studies are assessed so that decisions about application to clinical practice can be made, which results in practice that is evidence based.

Evidence – informed practice; building upon the foundation of evidence-based practice, evidence-informed practice also involves acknowledging and considering the myriad factors beyond such evidence as local indigenous knowledge, cultural and religious norms, and clinical judgement. With evidence-informed practice, the methods for gathering evidence (use of published research studies) are the same as the processes used for evidence-based practice; however, the evidence also incorporates expert opinion, clinical expertise, patient preference, and other resources. It is important to remember that evidence-informed practice focuses on a more inclusive and interactive process:

Evidence-informed decision-making is a continuous interactive process involving the explicit, conscientious and judicious consideration of the best available evidence to provide care. It is essential to optimize outcomes for individual clients, promote healthy communities and populations, improve clinical practice, achieve cost-effective nursing care and ensure accountability and transparency in decision-making within the health-care system.

Research and the evidence-informed practice processes, both begin with a question. The difference is that
in a research study
, the question is tested with a design appropriate for the question and with specific methods (sample, instruments, procedures, and data analysis). In the
evidence-informed practice
process, a question is used to search the literature for studies already completed that you will critically appraise in order to answer your clinical question.

All nurses share a commitment to the advancement of nursing science by conducting research and using research evidence in practice. Scientific investigation promotes
accountability,
which is one of the hallmarks of the nursing profession and a fundamental competency for all registered nurses. Nursing Research Essay Assignment Papers.

Research links theory, education, and practice.

How education in nursing research links theory and practice? First, learning about nursing research will provide you with an appreciation and understanding of the research process so that you can more easily become a participant in research activities. Second, learning the value of nursing research helps you to become an intelligent consumer of research → Nurses must understand all steps of the research process and their interrelationships. The registered nurse interprets, evaluates, and determines the credibility of research findings. The nurse discriminates between interesting findings for which further investigation is required and those that are sufficiently supported by evidence before applying findings to practice. The nurse should then use these competencies to advance the nursing or interdisciplinary evidence-informed practice.

As a professional, you must take time to read research studies and evaluate them, using the standards congruent with scientific research. Also, you will need to use the critiquing process in order to identify the strengths and weaknesses of each study. Bearing in mind that each study has its limitations, you should consider whether sound and relevant evidence from one particular study can be used in other settings as well.

 

Historical Perspective:

Nineteenth Century;
nursing as a formal discipline began to take root with the ideas and practices of Florence Nightingale. Her concepts have contributed to, and are congruent with, the current priorities of nursing research. Promotion of health, prevention of disease, and care of the sick were central ideas of her practice and publications. Nightingale believed that systematic collection and exploration of data were necessary for nursing. Her collection and analysis of data on the health status of British soldiers during the Crimean War led to a variety of reforms in health care.

Twentieth Century;
research focused mainly on nursing education, but some patient- and technique-oriented research was also evident. Nursing Research Essay Assignment Papers.

Changes in the educational system for nurses were crucial for the development of nursing research. In Canada, the establishment of university nursing courses in 1918, followed by master’s degree programs in the 1950s and 1960s and by doctoral programs in the 1990s and 2000s, was key to the development of nursing research.

The two major factors in the development of nursing research have been the establishment of research training through doctoral programs and the establishment of funding to support nursing research.

Growing awareness of the importance of nursing research gradually led to the availability of research funds.

Nursing research has focused progressively on evidence-informed practice in response to demands to justify care practices and systems by improving patient outcomes and controlling costs. Nursing Research Essay Assignment Papers.

The existence of the many nursing journals shows the growth in the variety, quality, and depth of research available for potential use in practice. In a report funded by the CHSRF, an analysis of the CIHR database revealed a wide diversity of nursing research topics in Canada. Of the studies, 67% were conducted in the areas of health issues, health service organizations, and health promotion. Not surprisingly, the research on health issues was dominant; the majority of studies focused on (1) chronic illness; (2) reproductive health; (3) pain; and (4) end-of-life/palliative care.

Future Directions: the continuing expansion of nursing research provides numerous opportunities for nurses to study important research questions, promote health care, and ameliorate the side effects of illness and the consequences of treatment while also optimizing the health outcomes of patients and their families.

Major shifts in the delivery of health care include the following:

An emphasis on community-based care

An emphasis on reducing disparities in health care

A focus on health promotion and risk reduction

An increase in severity of illness in inpatient settings

An increased incidence of chronic illness

An expanding population of older people

An emphasis on provider accountability through a focus on quality and cost outcomes

The use of technology to serve human needs

In accordance with these trends, nurse researchers are beginning to focus on the development of quantitative and qualitative research programs and clinically based outcome studies.

Depth in nursing science becomes evident when research is replicated (research programs that include a series of studies in a similar area, each of which builds on a prior investigation). Moreover, to maximize use of resources and to prevent duplication, researchers must develop intradisciplinary and interdisciplinary networks in similar areas of study (researchers from a variety of professions can come together to delineate common and unique aspects of patient care.

Nurse researchers should also be committed to developing publicly and privately funded research programs and to subscribing to a life of periodic education and retraining supported by awards, grants, and fellowships. Research programs facilitate growth in the depth and breadth of research expertise and recognize that some researchers must be retrained as they develop or shift the emphasis of their research, seek to broaden their scientific background, and acquire new research capabilities. Nursing Research Essay Assignment Papers.

Because of nursing’s emphasis on the cultural aspects of care and the influence of such factors on practice, international research is likely to increase. Access to multiple populations as a function of globalization allows the testing of nursing science from various perspectives. Interaction with colleagues from other countries provides a rich context for the generation and dissemination of research.

Funding agencies often determine research priorities on the basis of their particular needs and interests. These are established after consultation with health sector administrators, policymakers, and researchers across Canada.

Key Points

Nursing research expands the unique body of scientific knowledge that forms the foundation of evidence-informed nursing practice. Research is the component that links education, theory, and practice.

Nurses become knowledgeable consumers of research through educational processes and practical experience. As consumers of research, nurses must have a basic understanding of the research process and must demonstrate critical appraisal skills to evaluate the strengths and weaknesses of research before applying the research to clinical practice. Nursing Research Essay Assignment Papers.

Nursing research blossomed in the second half of the twentieth century: Graduate programs in nursing expanded, research journals began to be published, and funding for graduate education and nursing research increased dramatically.

All nurses, whether they possess baccalaureate, master’s, or doctoral degrees, have a responsibility to participate in the research process.

The role of the baccalaureate graduate is to be a knowledgeable consumer of research. Nurses with master’s and doctoral degrees are obliged to be researchers and sophisticated consumers of research studies.

A collaborative research relationship within the nursing profession will extend and refine the scientific body of knowledge that provides the grounding for theory-informed practice.

The future of nursing research will focus on the extension of scientific knowledge. Collaborative research relationships between education and practice will multiply. Programs of research studies and replication of studies will become increasingly valuable. Nursing Research Essay Assignment Papers.

Research studies will emphasize clinical issues, problems, and outcomes. Priority will be given to research studies that focus on health promotion, care for the health needs of vulnerable groups, and the development of cost-effective health care systems.

Both consumers of research and nurse researchers will engage in a collaborative effort to further the growth of nursing research and accomplish the profession’s research objectives.

Chapter 2 Theoretical Framework

On a daily basis, nurses devise clinical questions that, if answered, improve upon the care they provide to individuals, families, and communities. Each question requires that clinicians/nurse researchers engage in a knowledge development process. Nursing Research Essay Assignment Papers.

 

The process begins with the
identification of knowledge gaps:
the absence of theoretical or scientific knowledge relevant to the phenomenon of interest.

Knowledge generation
next occurs, with the conduct of research that provides answers to well-thought-out research questions.

This knowledge is
then distributed
through journal articles, textbooks, and public presentations to nurses.

Next, the
knowledge is adopted,
as nurses alter their practice on the basis of published information or as health care organizations develop policies and protocols that are informed by newly generated knowledge.

Finally, knowledge is
reviewed and revised
as new health issues arise, advances in clinical practice occur, or knowledge becomes outdated. In this chapter, we focus specifically on theoretical frameworks and how they guide and inform knowledge generation. Nursing Research Essay Assignment Papers.

Theoretical/empirical knowledge is most commonly referred to as scientific knowledge (currently serves as the guide for evidence-informed practice). Theoretical knowing is concerned with developing or testing theories or ideas that nurse researchers have about how the world operates. Theoretical knowing is informed by empirical knowing, which involves observations of reality. Observations may include the following:

Speaking with people about their life experiences (e.g., living with Alzheimer’s disease) and using their responses to specific and general questions to understand the phenomenon

Observing social or cultural interactions (e.g., homeless individuals interacting with service providers) as they naturally occur, interpreting what the interactions might mean for both parties, and using those interpretations to develop theories about health service delivery for that population Nursing Research Essay Assignment Papers

Delivering an intervention (e.g., a school health program for obese children) and assessing changes in health care–related behaviours (e.g., type of foods consumed, amount of daily exercise) after the delivery of the intervention

Using surveys or a questionnaire to ask a large group of men and women questions about experiences of violence and their current symptom levels with regard to pain, digestive problems, or depression.

All research is based on philosophical beliefs about the world; these beliefs are the motivating values, concepts, principles, and the nature of human knowledge of an individual, group, or culture, and they are the basis of a worldview, or paradigm. Nursing Research Essay Assignment Papers.

Paradigms (patterns) represent a “sets of beliefs and practices, shared by communities of researchers” that guide the knowledge development process. Therefore, knowing and comprehending these beliefs and practices is important in understanding and using research findings. These beliefs are not right or wrong; rather, they represent different views of the world, and their use the goals of the research.

Nursing research is guided by
three research paradigms
: post-positivism, constructivism, and social critical theory.

Post – positivism is a philosophical orientation that suggests that a material world exists; that is, things can be sensed (i.e., seen, touched, heard, tasted). Furthermore, it is governed by the expressed belief that although not all things can be understood or explained, many things can be. In fact, our world can be observed, events and phenomena can be categorized, and we can create theories to explain why some things like illness and health occur or do not occur. Post-positivism emphasizes the proving/disproving of theories for the purpose of explaining, predicting, and controlling specific outcomes.
Post-positivism values objectivity (e.g., observations from a neutral rather than a subjective position) and encourages the intense scrutiny of research findings for the purpose of excluding knowledge that was not developed through a rigorous process. Nursing Research Essay Assignment Papers

Constructivism is a philosophical orientation that suggests reality and the way in which we understand our world are largely dependent on our perception. Truth, as viewed by post-positivists, is flawed because truth is never absolute. Truth and our understanding of the world are determined by our life experiences, which in turn inform how we view the world. Knowledge development, from the perspective of the constructivists, is not valuable if it is used simply to prove or disprove theories. Rather,
the value of knowledge development lies in the ability to understand how people perceive their world.
Knowledge development occurs through observation or dialogue with people, or both, and as a result of paying attention to the language people use to describe life experiences
. Constructivists value subjectivity (personal knowing) versus objectivity (quantified knowing), inasmuch as the aim of this form of research is to create an understanding of people and their life experiences from their point of view.

Critical social thought is a philosophical orientation that suggests that reality and our understanding of reality is constructed by people with the most power at a particular point in history. Reality, and our understanding of the world, is always changing, and at all times we have an imperfect understanding of our world.
Critical social thought places a strong emphasis on understanding health and illness within the context of history.
Nursing Research Essay Assignment Papers This perspective supports the understanding that health and other aspects of reality are shaped by numerous social, political, economic, and cultural factors (gender, social and economic status, minority versus majority status, and even a country’s status as a developed versus developing nation).
A strong emphasis is placed on understanding how power imbalances associated with these factors influence health and well-being.
As in constructivism,
objectivity is not a goal.
Rather, understanding people’s experiences from their perspective is highly valued. In addition, the goal of knowledge development is to provide evidence that will support change or the transformation of reality. Critical social thought incorporates feminist theory and what has come to be known as action research.
These approaches to research examine how an individual’s or a group’s position in society shapes that individual’s or group’s experiences and causes differential or unequal access to resources, power, autonomy, and privilege.

The post – positivist paradigm is the basis of most quantitative research and, to a smaller extent, qualitative research. Grounded theory, as originally developed by Barney Glaser and Anselm Strauss  ( 1967 ), is very much based on the cause-and-effect philosophy of the post-positivist paradigm. The constructivist paradigm is the basis of most qualitative research that grants importance to hermeneutics, which is the interpretation of written, oral, and visual communication. In critical social theory, both qualitative and quantitative researches are used to highlight historical and current experiences of suffering, conflict, and collective struggles.

Research Methods: Qualitative and Quantitative

If a researcher wishes to test a
cause-and-effect relationship
, such as how social support (cause) leads to high blood pressure (effect), quantitative methods are most appropriate. If, however, a researcher wishes to
discover and understand the meaning of an experience
or process such as death and dying, a qualitative approach would be appropriate.

Qualitative research is a systematic, interactive, and subjective research method used to describe and give meaning to life experiences. A researcher would choose to conduct a qualitative research study if the question to be answered concerns understanding the meaning of a human experience, such as grief, hope, or loss. Although the methods of qualitative research are systematic, a subjective approach is used; that is, the emphasis is on capturing the personal perceptions of the study participants. Thus, data from qualitative studies help nurses understand experiences or phenomena that affect patients, and this information in turn leads to improved care and stimulates further research.

Quantitative research systematically describes a phenomenon. A researcher would choose to conduct a quantitative research study if the question to be answered concerned testing for the presence of specific relationships, assessing for group differences, clarifying cause-and-effect interactions, or explaining how effective a nursing intervention was. Quantitative methods entail the use of objective, precise, and highly controlled measurement techniques to gather information that can be analyzed and summarized statistically.

The determinant of health framework guides the researcher in addressing the relationship between health and any of the following factors:

Socio-economic environment including income, income distribution, and social status; social support networks; education; employment and working conditions; and social environments

Physical environment

Healthy child development

Personal health practices

Individual capacity and coping skills

Biology and genetic endowment

Health and social services

Gender

Culture/ethnicity

Inductive and deductive reasoning are basic in frameworks for research.
 Inductive reasoning: a process of starting with the details of experience and moving to a general picture, involves the observation of a particular set of instances that belong to and can be identified as part of a larger set. It is the pattern of “figuring out what is there” from the details of the nursing practice experience and is the foundation for most qualitative inquiry. Research questions related to the issue of the meaning of experience for the patient (can be addressed with the inductive reasoning of qualitative inquiry). Nursing Research Essay Assignment Papers.

Deductive reasoning: a process of starting with the general picture (ex, the theory of attentively embracing story) and moving to a specific direction for practice and research. In deductive reasoning, the researcher uses two or more related concepts that, when combined, enable the researcher to suggest relationships between the concepts. Deductive reasoning begins with a structure that guides searching for “what is there.” (would be addressed with the deductive reasoning of quantitative inquiry).

Frameworks, Theories, and Concepts

A theory is a set of interrelated concepts that serves the purpose of explaining or predicting phenomena. A theory is like a blueprint, a guide for modelling a structure. A blueprint depicts the elements of a structure and the relationship of each element to the other, just as a theory depicts both the concepts that compose it and how they are related.

A concept is an image or symbolic representation of an abstract idea. Each concept creates a mental image that is explained further through the conceptual definition.

A hypothesis is a best guess or prediction about what one expects to find about the variable outlined in the study. The variables represent the most concrete components of the ladder of abstraction and are derived from the identified concepts of a theory. They represent the measurable properties (what can be observed, measured, or both) of a quantitative study.

A mismatch between what is known or commonly accepted as fact and what we experience creates a hypothesis-generating moment.

A conceptual framework is a structure of concepts, theories, or both that is used to construct a map for the study. It presents a theory, which explains why the phenomenon being studied exists. Generally,
a conceptual framework is constructed from a review of the literature or is developed as part of a qualitative research project.

A theoretical framework may also be defined as a structure of concepts, theories, or both that is used to construct a map for the study. However, it is based on a philosophical or theorized belief or understanding of why the phenomenon under study exists.

Appraising the evidence: throughout the entire critiquing process, from worldview to operational definitions, you are evaluating whether the theoretical framework is appropriate. At the end of a research article, you can expect to find a discussion of the findings as they relate to the model. This final point enables readers to evaluate the framework for use in further research. The discussion may suggest necessary changes to enhance the relevance of the framework for continuing study and thus focus the direction of future research. Evaluating frameworks for research requires skill that can be acquired only through repeated critique and discussion with other nurses who have critiqued the same publication. The novice reader of research must be patient while these skills are developed. With continuing education and a broader knowledge of potential frameworks, you will build a repertoire of knowledge to enable you to judge the foundation of a research study, the framework for research.

Key Points

The scientific approaches used to generate nursing knowledge reflect both inductive and deductive reasoning.

The interaction among theory, practice, and research is central to knowledge development in the discipline of nursing.

Conceptual frameworks are created by the researcher, whereas theoretical frameworks are identified in the literature.

The use of a framework for research is important as a guide to systematically identify concepts and to link appropriate study variables with each concept.

Conceptual and operational definitions are critical in the evolution of a study, regardless of whether they are explicitly stated.

In developing or selecting a framework for research, knowledge may be acquired from other disciplines or directly from nursing. In either case, that knowledge is used to answer specific nursing questions.

Theory is distinguished by its scope. Grand theories are the broadest in scope and at the highest level of abstraction, whereas microrange theories are the most narrow in scope and at the lowest level of abstraction. Midrange theories are in the middle.

Midrange theories are at a level of abstraction that enhances their usefulness for guiding practice and research.

When you critique a framework for research, examine the logical, consistent link between the framework, the concepts for study, and the methods of data collection.

Chapter 3 Critical Reading Strategies: Overview of the Research Process

Critical thinking is the rational examination of ideas, inferences, assumptions, principles, arguments, conclusions, issues, statements, beliefs, and actions. In other words, being a critical thinker means that you are consciously thinking about your own thoughts and what you say, write, read, or do, as well as what other people say, write, or do. While thinking about all of this, you are also questioning the appropriateness of the content, applying standards or criteria, and seeing how the information measures up.

Developing the ability to critically evaluate research articles requires both critical thinking skills and critical reading skills. Critical reading is “an active, intellectually engaging process in which the reader participates in an inner dialogue with the writer”. Nursing Research Essay Assignment Papers. A critical reader actively looks for assumptions (accepted truths), key concepts and ideas, reasons and justifications, supporting examples, parallel experiences, implications and consequences, and any other structured features of the text so as to interpret and assess the text accurately and fairly.

Preliminary: familiarizing yourself with the content (skimming the article)

Comprehensive: understanding the researcher’s purpose or intent

Analysis: understanding the parts of the study

Synthesis: understanding the whole article and each step of the research process in a study

Critiquing a research study requires several readings (three or four times). The first strategy is to keep your research textbook at your side as you read.

Identify the steps of the research process and how the study was conducted

Clarify unfamiliar concepts or terms

Question assumptions and rationale

Assess the study for validity

 

A critical thinking decision path related to each step of the research process will sharpen your decision-making skills as you critique research articles. Nursing Research Essay Assignment Papers.

This rating system represents an evidence hierarchy for judging the strength of a study’s design, which is just one level of assessment that influences how confident the reader is about the conclusions drawn by the researcher. Assessing the strength of scientific evidence or potential research bias provides a vehicle to guide nurses in evaluating research studies for their applicability in clinical decision-making. In addition to identifying the level of evidence needed to grade the strength of a body of evidence, there are the three domains of quality, quantity, and consistency

Quality: the extent to which a study’s design, implementation, and analysis minimizes bias

Quantity: the number of studies in which the research question has been evaluated, including overall sample size across studies, as well as the strength of the findings from the data analyses

Consistency: the degree to which similar findings are reported from investigations of the same research question in studies that have similar and different designs

 

An abstract is a short, comprehensive synopsis or summary of a study at the beginning of an article. An abstract quickly focuses the reader on the main points of a study. A well-presented abstract is accurate, self-contained, concise, specific, nonevaluative, coherent, and readable. Nursing Research Essay Assignment Papers.

 

Systematic Reviews: Meta-Analyses, Integrative Reviews, and Meta-Syntheses

Systematic reviews include meta-analyses, integrative reviews, and meta-syntheses. The components of these types of articles are as follows:

 

Background: The introduction covers content related to the background of the clinical question and clarifies the specific question that the review answers. The article’s authors clarify the definitions of the concepts in the question so that the reader understands the concepts that were used in assessment.

Method: The methods used for searching the literature are detailed. The exact electronic databases, the dates, and the key words used to conduct the search are provided. In addition, the article details the inclusion and exclusion criteria by which the literature was chosen to review and critique. If a number of articles were found and not used, the authors detail why articles were excluded from the review.

Appraisal of the literature: The articles that are included in the literature review are discussed in the body of the article, and an evidence table is used to present the highlights of each article. The author uses the evidence table to compare and contrast the articles, critique them for scientific validity, and discuss how well they answer the clinical question. If the author uses a meta-analysis format, a summary of the data is presented.

Conclusions/summary: In the conclusions or summary, the strength, quality, and consistency of the data are described as they apply to practice. This section contains recommendations about which aspects of practice are supported by the data in the articles and for which aspects further research is needed to more fully answer the question posed in the review.

Nursing Research Essay Assignment Papers

Clinical guidelines are systematically developed statements or recommendations that serve as a guide for practitioners. Guidelines have been developed to assist in bridging practice and research. Guidelines are developed by professional organizations, government agencies, institutions, and convened expert panels. Guidelines provide clinicians with an algorithm for clinical management or for decision making with regard to specific diseases (e.g., colon cancer) or treatments (e.g., pain management).

 

Key Points

Critical thinking and critical reading skills will enable you to question the appropriateness of the content of a research article, apply standards or critiquing criteria to assess the study’s scientific merit for use in practice, and consider alternative ways of handling the same topic.

Critical reading involves active interpretation and objective assessment of an article and searching for key concepts, ideas, and justifications.

Critical reading requires four stages of understanding: preliminary (skimming), comprehensive, analysis, and synthesis. Each stage is characterized by specific strategies to increase your critical reading skills.

Critically reading for preliminary understanding is accomplished by skimming or quickly and lightly reading an article in order to familiarize yourself with its content and to provide you with a general sense of the material.

Critically reading for a comprehensive understanding is designed to increase your understanding both of the concepts and research terms in relation to the context and of the parts of the study in relation to the whole study, as presented in the article.

Critically reading for analysis understanding is designed to divide the content into parts so that each part of the study is understood. The critiquing process begins at this stage.

Critical reading to reach the goal of synthesis understanding combines the parts of a research study into a whole. During this final stage, the reader determines how each step of the research process relates to all the other steps, how well the study meets the critiquing criteria, and the usefulness of the study for practice.

Critiquing is the process of objectively and critically evaluating the strengths and weaknesses of a research article for scientific merit and application to practice, theory, and education. The need for more research on the topic or clinical problem is also addressed at this stage.

Each article should be reviewed for level of evidence as a means of judging the application of the findings to practice.

Research articles have different formats and styles, depending on journal manuscript requirements and whether they are quantitative or qualitative studies.

The basic steps of the research process are presented in journal articles in various ways. Detailed examples of such variations can be found in chapters throughout this text.

Evidence-informed practice begins with the careful reading and understanding of research articles. Nursing Research Essay Assignment Papers.

 

Chapter 4 Developing Research Questions, Hypotheses, and Clinical Questions

Research questions are usually generated from situations or problems that emerge from practice. These are often articulated in a problem statement.

The research question presents the idea that is to be examined in the study and is the foundation of the research study. Once the research question is clear, the researcher selects the most appropriate research design. If the research question is primarily explorative, descriptive, or theory generating, the researcher opts for qualitative methods. In these studies, a hypothesis is not formulated. For studies in which the researcher is seeking a specific answer to a research question, however, a hypothesis is generated and tested. Nursing Research Essay Assignment Papers.

Hypotheses can be considered intelligent hunches, guesses, or predictions that help researchers seek the solution or answer to the research question. Hypotheses are a vehicle for testing the validity of the theoretical framework assumptions and provide a bridge between theory and actuality.

 

For a clinician making an evidence-informed decision about a patient care issue, a clinical question—such as whether chlorhexidine or povidone-iodine is more effective in preventing infections in central catheters— would guide the nurse in searching for and retrieving the best available evidence. This evidence, combined with clinical expertise and patient preferences, would provide an answer on which to base the most effective decision about patient care for the affected population. Nursing Research Essay Assignment Papers.

Research questions or hypotheses often appear at the beginning of research articles
. However, because of space constraints or stylistic considerations in journal publications, the research question or hypothesis may be embedded in the purpose, aims, goals, or even the results section of the research report. Both the consumer and the producer of research need to understand the importance of research questions and hypotheses as the foundational elements of a research study.

 

A researcher spends a great deal of time refining a research idea or problem into a research question. The final research question usually does not appear in the research article unless the study is qualitative rather than quantitative. Nursing Research Essay Assignment Papers.

The research question should reflect a refinement of the researcher’s initial thinking. The evaluator of a nursing research study should be able to discern that the researcher has done the following:

Defined a specific topic area

Reviewed the relevant scientific literature

Examined the question’s potential significance in nursing

Pragmatically examined the feasibility of studying the research question

Qualitative and quantitative researchers conduct literature reviews differently. For qualitative researchers, the value of the literature review is controversial. Many researchers believe that an extensive literature review causes investigators to develop biases or beliefs that limit their openness to exploring the phenomenon under study. As a general rule, qualitative researchers usually start with a very cursory or general review of the literature to help focus the study, whereas quantitative researchers begin their study with an extensive review of the literature on their research questions and related topics. The literature review also helps researchers determine whether their study can contribute to the field of nursing. Qualitative researchers conduct a literature review during the data analysis or discussion of the findings to “tell the reader how the findings fit into what is already known about the phenomenon”.

As a quantitative researcher finalizes a research question, the following three characteristics should be evident:

The variables under consideration are clearly identified.

The population being investigated is specified.

The possibility of empirical testing is implied.

 

Researchers call the properties that they study variables, for example age, weight, height, religion, and ethnicity

 

An independent variable, usually symbolized by X, is the variable that has the presumed effect on the dependent variable. In experimental research studies, the researcher manipulates the independent variable.

The dependent variable, represented by Y, is often referred to as the consequence or the presumed effect that varies with a change in the independent variable. The dependent variable is not manipulated. It is observed and assumed to vary with changes in the independent variable. Predictions are based on how changes to the independent variable will affect the dependent variable. The researcher is interested in understanding, explaining, or predicting the response of the dependent variable.

 

A research hypothesis, also known as a scientific hypothesis, consists of a statement about the expected relationship of the variables. A research hypothesis indicates what the outcome of the study is expected to be. A research hypothesis is also either directional or no directional. If the researcher obtains statistically significant findings for a research hypothesis, the hypothesis is supported.

 

According to a statistical hypothesis (also known as a null hypothesis), there is no relationship between the independent and dependent variables. If, in the data analysis, a statistically significant relationship emerges between the variables at a specified level of significance, the statistical hypothesis is rejected. Rejection of the statistical hypothesis is equivalent to acceptance of the research hypothesis.

 

A directional hypothesis specifies the expected direction of the relationship between the independent and dependent variables. The reader of a directional hypothesis may observe not only that a relationship is proposed but also the nature or direction of that relationship.

 

A no directional hypothesis indicates the existence of a relationship between the variables; it does not specify the anticipated direction of the relationship.

 

When you evaluate a hypothesis, note that directional hypotheses have several advantages that make them appropriate for use in most studies:

Directional hypotheses indicate that a theory base was used to derive the hypotheses and that the phenomena under investigation have been critically examined and interrelated. You should note that nondirectional hypotheses may also be deduced from a theory base. Because of the exploratory nature of many studies for which the hypotheses are nondirectional, in contrast, the theory base may not be as developed.

Directional hypotheses provide a specific theoretical frame of reference within which the study is being conducted.

They suggest that the researcher believes that the evidence is indicative of a particular outcome, and as a result, the analyses of data can be accomplished in a statistically more sensitive way.

 

The important point about the directionality of the hypotheses is whether the rationale for the choice the researcher has proposed is sound.

 

A clinical question has five components (PICOT):

Population

Intervention

Comparison

Outcome

Time

 

When critiquing the research question, the reader looks for the presence of the three key elements:

Does the research question express a relationship between two or more variables or, at least, between an independent variable and a dependent variable?

Does the research question specify the nature of the population being studied?

Does the research question imply the possibility of empirical testing? Nursing Research Essay Assignment Papers

If this process of developing a research question is clarified at the outset of a research study, the report that follows can develop logically. Readers will have a clear idea of what the report should convey and can knowledgeably evaluate the material that is presented. When you critically appraise clinical questions, remember that they should be focused and specify the patient or problem being addressed, the intervention, and the outcome for a particular patient population. The author should provide evidence that the clinical question guided the literature search and that the question suggests the design and level of evidence to be obtained from the study findings

 

Key Points

Formulation of the research question and stating the hypothesis are key preliminary steps in the research process.

The research question is refined through a process that proceeds from the identification of a general idea of interest to the definition of a more specific and circumscribed topic. Nursing Research Essay Assignment Papers.

A preliminary literature review reveals related factors that appear to be critical for the research topic of interest and helps further define the research questions.

The significance of the research question must be identified in terms of its potential contribution to patients, nurses, the medical community in general, and society. The applicability of the question for nursing practice and its theoretical relevance must be established. The findings should also have the potential for formulating or altering nursing practices or policies.

The feasibility of a research question must be examined in light of pragmatic considerations: for example, time; the availability of participants, money, facilities, and equipment; the nurse’s experience; and ethical issues.

The final research question consists of a statement about the relationship of two or more variables. The question clearly identifies the relationship between the independent variables and dependent variables, specifies the nature of the population being studied, and implies the possibility of empirical testing.

Focused clinical questions arise from clinical practice and guide the literature search for the best available evidence to answer the clinical question.

A hypothesis is an attempt to answer the research question. When the validity of the assumptions of the theoretical framework is tested, the hypothesis connects the theory and reality.

A hypothesis is a declarative statement about the relationship between two or more variables in which an expected outcome is predicted. The characteristics of a hypothesis include a relationship statement, implications regarding testability, and consistency with a defined theory base.

Hypotheses can be formulated directionally or nondirectionally. Hypotheses can be further categorized as either research or statistical (null) hypotheses. Nursing Research Essay Assignment Papers.

Research questions may be used instead of hypotheses in exploratory, descriptive, or qualitative research studies. Research questions may also be formulated in addition to hypotheses to answer questions related to ancillary data.

The purpose, research question, or hypothesis provides information about the intent of the research question and hypothesis and suggests the level of evidence to be obtained from the study findings.

The critiquing criteria are a set of guidelines for evaluating the strengths and weaknesses of the research question and hypotheses as they appear in a research report.

In critiquing, the reader assesses the clarity of the research question and the related subquestions, the specificity of the population, and the implications for testability.

The interrelatedness of the research question, the literature review, the theoretical framework, and the hypotheses should be apparent.

The appropriateness of the research design suggested by the research question is also evaluated.

The purpose of the study (i.e., why the researcher is conducting the study) should be differentiated from the research question. Nursing Research Essay Assignment Papers.

The reader evaluates the wording of the hypothesis in terms of the clarity of the relational statement, its implications for testability, and its congruence with theory. The appropriateness of the hypothesis in relation to the type of research design is also examined. In addition, the appropriate use of research questions is evaluated in relation to the type of study conducted. Nursing Research Essay Assignment Papers.

Chapter 5 Finding and Appraising the Literature

 
Meta – analysis is a statistical technique, not a research design. It is based on a
strict scientific approach in systematic reviews, in which the results of many studies in a specific area are synthesized and statistically summarized to formulate an overall conclusion.
Each study is a unit of analysis. The goal is to read all of the studies concerning a particular clinical question and, using rigorous inclusion and exclusion criteria, to determine which studies are similar and to analyze their results, in order to quantify the effectiveness of the intervention under study. This method is more powerful because it is a rigorous process of summarizing evidence rather than estimating the effect of the results derived from single studies alone. Nursing Research Essay Assignment Papers.

 

A systematic review provides the most powerful and useful evidence available to guide practice. The well-constructed scale, test, interview schedule, or other form of index should consist of an objective, standardized measure of samples of a behaviour that has been clearly defined. Observations should be made on a small but carefully chosen sampling of the behaviour of interest, thus creating confidence that the samples are representative. A new tool should be based on a thorough review of previous theoretical and research literature to ensure validity. The tool should be standardized; that is, a set of uniform items and response possibilities are uniformly administered and scored. Without specific criteria and rating procedures, the evaluations of the items would be based on the subjective impressions, which may have varied significantly between observers and conditions. The items of a measurement tool should be unambiguous; they should be clear-cut, concise, exact statements with only one idea per item. Negative stems or items with negatively phrased response possibilities result in ambiguity in meaning and scoring.

 

When you critically appraise a systematic review, some of the questions to consider are the following:

Does the systematic review address a focused research question?

Does the meta-analysis include specific inclusion and exclusion criteria for judging the studies?

Does a publication bias exist?

Are the included studies homogeneous in terms of purpose, sample, research methods?

Are the designs of the studies similar?

Are the interventions similar?

Are the outcome measures similar?

 

Think about the systematic review as progressively sifting and sorting data until the highest quality of evidence is used to establish the conclusions. First, the researcher combines the results of all of the studies that focus on a specific question. The studies considered of lowest quality are then excluded, and the quality of the remaining studies is reanalyzed. The researcher repeats this process sequentially, excluding studies until only the studies of highest quality available are included in the analysis. An alteration in the overall results as an outcome of this sifting and sorting process suggests the sensitivity of the conclusions to the quality of the studies included in the meta-analysis. Such considerations determine whether it is reasonable to combine the studies for analysis. The consumer of research should note that a researcher who conducts a meta-analysis does not conduct the original analysis of data in the area but instead synthesizes the data from already published studies by following a set of controlled and systematic steps. Systematic reviews with a meta-analysis can be used to synthesize results of both nonexperimental and experimental research studies.

 

Evidence-informed practice methods, such as systematic reviews, increase a nurse’s ability to manage the ever-increasing volume of information produced to develop the best practices that are evidence based Nursing Research Essay Assignment Papers.

 

Meta-analysis is not a type of study design but a research method in which the results of multiple studies (usually randomized controlled trials) are statistically combined to answer focused clinical questions through an objective appraisal of carefully synthesized research evidence. People sometimes use the terms meta – analysis and systematic review interchangeably; however, a meta-analysis is a quantitative analysis used in a systematic review.

 

Systematic review is the process whereby the investigators evaluate all relevant studies, published and unpublished, on the topic or question. At least two members of the review team independently assess the quality of each study, include or exclude studies on the basis of pre-established criteria, statistically combine the results of individual studies, and present a balanced and impartial summary of the findings that represents a “state-of-the-science” conclusion about the evidence supporting the benefits and risks of a given health care practice. Nursing Research Essay Assignment Papers.

Models of School Health Eating Promotion and their Effectiveness Essay

DETAILS

Models of School Health Eating Promotion and their Effectiveness

I need 9 pages double spaced from recent references ( preferably 10-12 references). The topic of this paper is 
“Models of School Health Eating Promotion and their effectiveness”

The requirements of this paper:

Part 1:
 
1 page 
of a table categorizing study design, location, measures and result of school healthy eating interventions.

Part 2:
 
8 pages
 of discussing the approaches used to promote healthy eating and their effectiveness.

I need you to write  part 1 and part 2. APA style and double spaced. From recent references (preferably 10-12 references) and focusing on coordinated school health, health promotion schools comprehensive school health and components. Models of School Health Eating Promotion and their Effectiveness Essay.

See some reference that you can use for part 1 and 2. Can you make part 1 table as portrait orientation.

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER NOW

HELPFUL REFERENCES TO USE ADDITIONAL TO YOURS

 

http://www.
circumpolarhealthjournal.net/
index.php/ijch/article/view/
17999/pdf_1

Home

Cale, L., & Harris, J. (2006). School-based physical activity interventions: Effectiveness, trends, issues, implications and recommendations for practice. Sport, Education and Society, 11(4), 401-420. doi:10.1080/13573320600924890

Cale, L., & Harris, J. (2013). Every child (of every size) matters’ in physical education! Physical education’s role in childhood obesity. Sport, Education and Society, 18(4), 433-452. doi:10.1080/13573322.
2011.601734

Naylor, P.J., & McKay, H.A. (2009). Prevention in the first place: Schools a setting for action on physical inactivity. British Journal of Sports Medicine, 43(1), 10-13. doi:10.1136/bjsm.2008.053447

Naylor, P.J., Macdonald, H.M., Warburton, D.E.R., Reed, K.E., & McKay, H.A. (2008). An active school model to promote physical activity in elementary schools: Action Schools! BC. British Journal of Sports Medicine, 42(5), 338-343. doi:10.1136/bjsm.2007.042036. Models of School Health Eating Promotion and their Effectiveness Essay.

Naylor, P.J., Macdonald, H.M., Zebedee, J.A., Reed, K.E., & McKay, H.A. (2006). Lessons learned from Action Schools! BC – An ‘active school’ model to promote physical activity in elementary schools. Journal of Science and Medicine in Sport, 9(5), 413-424. doi:10.1016/j.jsams.2006.06.
013

Kriemler, S., Meyer, U., Martin, E., van Sluijs, E.M., Andersen, L.B., & Martin, B.W. (2011). Effect of school-based interventions on physical activity and fitness in children and adolescents: a review of reviews and systematic update. British Journal of Sports Medicine, 45(11), 923-930. doi: 10.1136/bjsports-2011-090186.

Pardo, B.M., Bengoechea, E.G., Lanaspa, E.G., Bush, P.L., Casterad, J.Z., Clemente, J.A.J., & Gonzalez, L.G. (2013). Promising school-based strategies and intervention guidelines to increase physical activity of adolescents. Health Education Research, 29(3), 1-9. doi: 10.1093/her/cyt040

van Sluijs, E.M.F., McMinn, A.M., & Griffin, S.J. (2008). Effectiveness of interventions to promote physical activity in children and adolescents: Systematic view of controlled trials. British Medical Journal, 42(8), 703-707. doi: 10.1136/
bmj.39320.843947.BE

 

 

Models of School Health Eating Promotions and their Effectiveness

Today, interventions are being made to promote healthy eating in the society. However, much of the attention has been shifted to schools as they are seen as powerful tools in the society that can best implement healthy eating habits among school going children. The table below indicates the study design, location, measures and results school healthy eating interventions.

PART 2:
Table 1: Study Design, Location, Measures and Result of School Healthy Eating Interventions

Study Design

This study employed retrospective study design to investigate aspects of healthy eating in schools. The study involved secondary collection of published data based on data available on books, journals and internet. Cohort studies and modeling studies were used to capture the approaches used in promoting healthy eating habits. Additionally, this study embraced randomized and non-randomized studies including cluster-controlled and controlled time series. Also, before-after studies with control groups were adopted. In other instances longitudinal and cross sectional study design were used in the study.

Location

The location of this study was in Canada and specifically narrowed down to Rocky View School located in Alberta. The school was chosen due to the fact that they have supported its students in promoting healthy eating habits by coordinating the efforts of people and resources within the school and across the entire division. Models of School Health Eating Promotion and their Effectiveness Essay.

Measures

The study aimed at measuring food intake amongst students on a number of areas such as intake of fruits and vegetables, milk products, junk food and other foods rich in fibre. Overall, the study aimed at measuring the impact of nutritional policies at Rocky View School based on the type of foods provided by the institution at large. Issues such as fat intake, sugar and salt intake formed part of the issues that were to be measured based on food intake.

Results

The primary outcome of the research was the effectiveness of dietary intake to students in Rocky View School. It was evident that the promotion of healthy eating habits had a number of benefits such as reducing obesity and cardiovascular diseases while promoting the well-being of students.

 

PART 3: The Approaches Used To Promote Healthy Eating and Their Effectiveness

Optimum nutrition is essential for the healthy growth and development of everybody in the society. Amongst children, optimum nutrition is essential for their overall growth and development. The adoption of healthy eating behaviors has been seen as a contributing factor that results in the achievement and maintenance of a healthy weight while providing protection against chronic diseases and premature mortality especially in school-going children (Hofman & Martinan, 2014). A child’s preference on food develops during childhood and if proper eating habits are not implemented early enough, such habits will become difficult to change once these children reach the adolescent stage. As we may be aware, unhealthy eating habits or patterns may result in obesity, hypertension, diabetes and osteoporosis amongst others (Hofman & Martinan, 2014). Models of School Health Eating Promotion and their Effectiveness Essay.

As such, it is important for schools to promote or establish healthy eating habits. Schools have been a popular setting for the implementation of health eating habits promotions since they offer continuous and intensive contact with children with the understanding that lifelong health and wellbeing begins with promoting healthy behaviors such as healthy eating early in life (Hofman & Martinan, 2014). To achieve such therefore, a number of approaches used to promote healthy eating must be adopted. Here we are going to identify some of the most common approaches used to promote healthy eating in addition to analyzing their effectiveness.

As we may know, healthy eating at school provides students with nutritional needs while ensuring that they perform better in their studies. Such cannot happen without the implementation of certain school-based interventions meant to achieve such. It has been argued that one of the biggest concerns today is childhood obesity. Today, approximately 17% of the youth between the ages of 6-17 are considered obese (Federal Interagency Forum on Child & Family Statistics, 2009). Such instances are bound to increase. However, schools can play a major role in reversing such trends by implementing education on nutrition. In fact, one of the best-known approaches that promote healthy eating in schools is implementing nutrition education in learning institutions (Federal Interagency Forum on Child & Family Statistics, 2009) Models of School Health Eating Promotion and their Effectiveness Essay.

Studies have shown that nutrition education in schools can lead to healthy eating among students as it may have a positive impact towards improving their dietary habits. In 2005 for instance, The Food and Nutrition Services (FNS) of the United States Department of Agriculture released a report providing clear evidence that well-designed nutrition education programs can lead to instances of healthy eating in schools. Because students spend a significant number of days in schools, such institutions are favorable grounds for teaching them about healthy eating. However, it has been argued that states are beginning to articulate student-learning benchmarks related to nutrition education and its effectiveness being realized as healthy eating patterns are being seen with majority of students in States such as Oregon prefer healthy foods such as vegetables as opposed to junk food (Centers for Diseases Control, 2010). Models of School Health Eating Promotion and their Effectiveness Essay.

Apart from the above, another best-known approach or model that proved effective in promoting effective eating patterns in schools is the creation of supportive environments that provides school-going children with the encouragement, skills and opportunities they require so as to adopt healthy eating patterns (Hofman & Martinan, 2014). Creating a healthy eating pattern in schools is however a responsibility that is shared by schools, communities and families. The administration of Rocky View Schools for instance has been in the lead through promoting and supporting healthy eating in schools by encouraging the staff to lead by example, holding school-wide challenges and sharing several success stories. However, majority of schools in many areas across the globe are lately focused towards the creation of policies that support healthy eating patterns. Such policies are meant to address issues such as access to healthy and safe foods in vending machines across schools, school stores and cafeterias, school events and meetings amongst others (Larsen et al, 2015).

Nevertheless, schools that have implemented meal and snack breaks for students have enabled them practice healthy eating patterns. In elementary grade students for instance, lunch periods put in place gives them enough time to eat and socialize. In addition, schools, which provide safe, clean and orderly eating areas, have seen improvements in the eating habits of their students (Larsen et al, 2015). In some schools, lunchtime is supervised while ensuring that students do not assume basic health and hygiene precautions such as washing their hands before and after the consumption of food. Models of School Health Eating Promotion and their Effectiveness Essay.

The adoption of nutrition-friendly school initiatives is another approach that has proved effective in promoting healthy eating habits amongst students. The provision of healthy food and beverage in schools has been seen as one of the best initiatives that help students meet their nutritional needs while giving them repeated opportunities to practice healthy eating patterns (Larsen et al, 2015). Majority of schools have gone ahead and implemented school meal programs that offer healthy food choices in addition to promoting and supporting safe food handling practices in form of educational materials on proper hand washing, food handling and presentations from health officers or community nutritionists who are knowledgeable in matters to do with healthy eating  (Naylor et al, 2006).

In line with the above initiatives, canteen vendors in schools have been advised to follow food service guidelines, which have proved effective in the promotion of healthy eating habits. For instance, majority of them are expected to follow certain food guidelines that aim to limit the amount of fat, salt and sugar content of the foods and drinks that they serve in schools (Campbell et al, 2016). Food vendors have been encouraged to serve whole-grains, vegetables and fruits in a healthy manner in form of well-balanced set meals. Such initiatives have been termed as being effective as school-going children who order such meals have a higher chance of receiving the right nutrients necessary for their growth (Cale & Harris, 2013). Models of School Health Eating Promotion and their Effectiveness Essay. In other words, such vendors should encourage food alternatives. In majority of schools though, such healthier alternatives have been promoted and as expected, they have proved to be successful. Majority of them discourage students on consuming fizzy drinks, crisps, sweets an chocolate. Instead, they encourage them to choose foods such as unsweetened juice, popcorn and fruits (Campbell et al, 2016).

The establishment of a School Health Team is another approach that has been effective in creating and forming healthy eating habits among students. These teams are responsible for leadership, management and overall coordination of the action plan set. In other words, these teams are responsible for overseeing that policy and programs put in place that aim at promoting and encouraging healthy eating habits are implemented at all times (Peralta et al, 2016). Such teams could include at least one parent, students, a local nurse, a food service provider, administrators and a local food nutritionist. More importantly, it has been argued that school nurses are important leaders and powerful advocates for children’s health and wellness in school (Peralta et al, 2016). For instance, in the event that a student has an asthma attack, gets in an accident on the playground or experiences a sugar spike, it’s the school nurse who will get the child back to class or to a doctor. Additionally, school nurses bring a public health point of view to the school and work with teachers and school leaders to make changes that affect all students’ health while promoting healthy eating habits through a number of health campaigns (Peralta et al, 2016). Models of School Health Eating Promotion and their Effectiveness Essay.

Another approach that has proved very effective in promoting healthy eating patterns in schools is planting of school vegetable gardens (Barbosa et al, 2015). The school garden initiative involves a series of activities that requires students to plant and maintain gardens. Such gardens will ensure that students enjoy fresh kale, potatoes, legumes and other vegetables grown in such fields. As we may be aware, fruits and vegetables are more nutritious and offer a couple of benefits to an individual as opposed to junk food. In many schools across the United States for instance, such vegetable gardens have been seen as being effective in forming healthy eating habits on students as they act as means of educating students on the benefits of fruits and vegetables as opposed to junk food, which is a common preference among many students (Cale & Harris, 2013). additionally, schools can make plans for field trips where students are taken for a visit farms in order to encourage them learn more on the benefits of eating vegetables and fruits hence forming healthy eating habits or patterns among students (Cale & Harris, 2013).

As indicated above, healthy eating among students cannot happen on its own. Teachers and parents have to be involved. Another approach or model that can encourage healthy eating habits is by schools holding a nutritional day for parents and including other activities for children. For instance, schools can plan for games and crafts for children that teach them on the benefits of making healthy food choices. Schools which have held informational seminars for parents on how food choices affect learning have realized success (Barbosa et al, 2015). At such events, healthy food alternatives are offered so as to encourage healthy eating habits especially in children. Children for instance love pizza but at such events, such children can be encouraged to eat pizza with vegetable toppings or whole-grains. By so doing, healthy eating patterns are formed and maintained up to adulthood (Barbosa et al, 2015). Models of School Health Eating Promotion and their Effectiveness Essay.

School feeding of children is one of the best ways or approaches of forming healthy eating patterns in students. Instead of letting students go for lunch at their respective homes, learning institutions can implement school feeding programs where students are fed with healthy food as opposed to junk food that they may get at food stores or at their homes (Larsen et al, 2015). Majority of learning institutions understand the importance of healthy diet to an individual’s well-being and by implementing such programs in schools, students will benefit as healthy food with nutritional value is availed to them. Moreover, recent released reports show that school feeding has played an important role in forming and encouraging healthy eating patterns among students as food offered in school will influence the choices they make on foods to eat once they graduate from elementary level (Dudley et al, 2015).

After school programs have also been seen as one of the approaches that can be used to put children on the path towards productive and healthy lives (Hinkle & Yoshida, 2014). These after school programs are uniquely positioned in order to play a role in the prevention of obesity by providing an environment where children are encouraged to eat healthy while participating in physical activities (Hinkle & Yoshida, 2014). After school programs not only presents an opportunity for children to excel academically but also provides for the inclusion of physical activities in the curriculum. In California for instance, afterschool programs have been termed as influential in playing a major role towards the prevention of obesity as such programs offer vital lessons in choosing the best foods to eat and some of the best physical activities to engage in (Hinkle & Yoshida, 2014). According to Hinkle and Yoshida (2014), physical activity is integral to any healthy eating program and therefore, it should be promoted and encouraged.

One of the most notable approaches to encouraging healthy eating in schools is by teaching the students on the food pyramid. The food pyramid is an educational tool used nationally or internationally for purposes of communicating the healthy eating message. In schools though, the food pyramid has been used as a tool of communicating to the students on the importance of eating healthy (Tarone, 2000). The food pyramid is divided into five shelves with each shelve representing a different food group. On the top shelf, we have foods that should be used in very small amounts. They include foods like chocolate, crisps, fizzy drinks and biscuits amongst others. These are foods high in sugar and fat. The second shelf consists of foods such as meat products that should be served once. The third shelf, just like the second one consists of high protein foods such as milk products that should also be served once. Next are fruits and vegetables which should be served on regular basis. Lastly, we have the final shelf made of foods like pasta, bread potatoes amongst others that should also be served regularly. Commendably, majority of schools across the state have adopted this approach which has proved to be a success as it has influenced the eating habits of majority of school going children (Tarone, 2000) Models of School Health Eating Promotion and their Effectiveness Essay.

Apart from all the above approaches discussed, there are other minor but equally important approaches or models that schools have adopted for purposes of promoting healthy eating patterns among students. For instance, majority of schools have encouraged parents to become involved in supporting healthy food choices in school by attending meetings meant to create such policies. In addition, schools are lately incorporating the discussion on food into other subjects such as geography, English and Geography amongst other lessons. Closely related with this, majority of schools and other learning institutions are lately embracing the idea of having a healthy week with a focus on healthy eating and drinking habits (Pardo et al, 2015). Such themes have been made very important with majority of them included in school calendars urging everybody from the staff to parents and children to attend in order to learn the basics of healthy eating. Such programs and initiatives have not been in vain. It has helped majority of students to form healthy eating habits in schools and in their homes also (Pardo et al, 2015).

School Health eating promotions campaigns have been effective in a number of ways. Evidence gathered from different sources indicates that efforts to promote healthy eating patterns have been successful. For instance, a review by Francis et al (2010) concluded that such educational campaigns have led to reduction of specific unhealthy foods among students. In addition, salt and sugar intake among students is no longer a major problem as such campaigns have raised awareness among students on the dangers of too much salt. Models of School Health Eating Promotion and their Effectiveness Essay.

As of today, it is a common practice seeing students consuming more vegetables and fruits as opposed to junk food. Student behaviors have been modified through such campaigns to promote healthy eating (Carter et al., 2011). In fact, campaigns meant to boost vegetable consumption among students have been a success across schools. In addition, a survey conducted across schools indicated that students diet consist of better nutritional needs required in their diets. Commendably, actions taken by schools to foster healthy eating are changing students’ behavior on how they choose what to eat to the extent of forming such habits as they grow into adulthood (Carter et al., 2011).

Conclusion

In brief, healthy eating is one of the latest phenomena that everybody in the society should embrace. Healthy eating has a higher chance of prolonging life while avoiding common diseases and health problems. In schools, healthy eating leads to successful learning and successful learning supports health. As we can see, education and health are inseparable. The necessary stakeholders in the education sector should therefore encourage and support initiatives that lead to the formation of healthy eating habits among students. Schools should be encouraged to offer such guidelines in a wider scale as they form close associations with students for most of the time. A healthy diet leads to a healthy individual and a healthy learning process free of interruptions. Children are one of the most important natural resources that we can have. They must be at the very heart of progress and development. Their well-being will determine the future of cities, nations and villages in years to come. For that reason, the society should work towards reducing some of the gravest threats to young children’s health by offering them a healthy diet and encouraging them to eat healthy while they are still young. Models of School Health Eating Promotion and their Effectiveness Essay.

 

References

Barbosa Gonçalves, H. V., Thimoteo da Cunha, D., Stedefeldt, E., & de Rosso, V. V. (2015). Family farming products on menus in school feeding: a partnership for promoting healthy eating.
Ciência Rural
,
45
(12), 2267-2273.

Cale, L., & Harris, J. (2013). Every child (of every size) matters’ in physical education! Physical education’s role in childhood obesity. 
Sport, Education and Society, 18
(4), 433-452
. 

Campbell, K. J., Hesketh, K. D., McNaughton, S. A., Ball, K., McCallum, Z., Lynch, J., & Crawford, D. A. (2016). The extended Infant Feeding, Activity and Nutrition Trial (Infant Extend) Program: a cluster-randomized controlled trial of an early intervention to prevent childhood obesity.
BMC Public Health
,
16
1-10.

Carter OB, Pollard CM, Atkins JF, Marie Milliner J, Pratt IS. (2011). We’re not told why–

we’re just told: qualitative reflections about the Western Australian Go for fruit and vegetable campaign. Public Health Nutrition; 14(6):982-988.

Centers for Diseases Control. (2010). Childhood Overweight and Obesity. Health in Balance. Washington, DC: The National Academic Press.

Dudley, D. A., Cotton, W. G., & Peralta, L. R. (2015). Teaching approaches and strategies that promote healthy eating in primary school children: a systematic review and meta-analysis.
International Journal of Behavioral Nutrition & Physical Activity
,
12
1-26.

Federal Interagency Forum on Child &Family Statistics. (2009). America’s Children: Key national indicators of well-being. Washington DC.

Francis M, Nichols SS, Dalrymple N. (2010).The effects of a school-based intervention

programme on dietary intakes and physical activity among primary-school children in

Trinidad and Tobago. Public Health Nutrition; 13(5):738-747.

Hinkle, A. J., & Yoshida, S. (2014). Creating Healthier Afterschool Environments in the Healthy Eating Active Communities program.
New Directions for Youth Development
,
2014
(143), 45-55.

Hofman, K. H., & Mantinan, K. D. (2014). Concerns in measurement of healthy eating and physical activity standards implementation.
New Directions for Youth Development
,
2014
(143), 25-43.

Larsen, A. L., McArdle, J. J., Robertson, T., & Dunton, G. (2015). Four Dietary Items of the School Physical Activity and Nutrition (SPAN) Questionnaire Form a Robust Latent Variable Measuring Healthy Eating Patterns.
Journal of Nutrition Education & Behavior
,
47
(3), 253-258. Models of School Health Eating Promotion and their Effectiveness Essay.

Naylor, P.J., Macdonald, H.M., Zebedee, J.A., Reed, K.E., & McKay, H.A. (2006). Lessons learned from Action Schools! BC – An ‘active school’ model to promote physical activity in elementary schools. 
Journal of Science and Medicine in Sport
, 
9
(5), 413-424.

Pardo, B.M., Bengoechea, E.G., Lanaspa, E.G., Bush, P.L., Casterad, J.Z., Clemente, J.A.J., & Gonzalez, L.G. (2013). Promising school-based strategies and intervention guidelines to increase physical activity of adolescents. 
Health Education Research, 29
(3), 1-9.

Peralta, L. R., Dudley, D. A., & Cotton, W. G. (2016). Teaching Healthy Eating to Elementary School Students: A Scoping Review of Nutrition Education Resources.
Journal of School Health
,
86
(5), 334-345.

Tarone, C. (2000). Consumer Research: Food Guide Pyramid for Young Children.
Family Economics & Nutrition Review
,
12
(3/4), 33. Models of School Health Eating Promotion and their Effectiveness Essay.

Health Education Package Essay Example

DETAILS:

HEALTH EDUCATION PACKAGE

Task

This second assessment follows on from the first assessment (Health education assessment planner  ASSESMENT 2 A) and expands on the chosen topic (Mental Health and how it Impacts on Nursing in Rural Australia) to develop a health education package to be delivered to a virtual audience.

You are now required to submit a virtual health education package to your identified group, based on the literature you found in the essay for 
assignment one
 (ATTACHED), and the 
health education session plan
 you submitted in assessment 
2A
. Your group may be comprised of health professionals, registered nurses, teachers, parents, children, or the general community. How you plan your session will depend on the group you have chosen.

Your Health Education Package should include the following parts:

The first part will be A SUMMARY of the education session plan andInclude a 100 word reflection about how you have incorporatedTHE FEEDBACK FROM the evaluation questions that you had submitted with the education session plan (Approximately 600 words for both the summary and the feedback) Health Education Package Essay Example

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER NOW

the second part is the essay (1500 words). This essay needs to use language that is accessible to the participant group (audience) and include:

A title

The aims and outcomes of the presentation

A content list is able to be included but is not compulsory

Using the APA referencing style with a minimum of 5 references:

 Reference all images and graphs using in text referencing under each image on each slide

You must adhere to correct 6th edition APA referencing conventions. References should be current, contemporary and from credible sources. References are counted in the word count.

Rationale

Health education is an essential element of the nursing process. Health education, health promotion and primary health care are essential components of the Registered Nurse (RN) role. These aspects of health do not focus primarily on disease processes and treatment but rather on prevention, maintenance and engagement in a healthy lifestyle. Health Education Package Essay Example

This health education package will be based on your essay and will demonstrate students’ ability to develop a suitable package on a chosen topic to deliver health education.

 

Health Education Package

Health is one of the most fundamental pillars of life that has the power of dictating the lifespan of any human being. This aspect is directly related to lifestyle in the sense that people that suffer from terminal diseases are less likely to live a longer life when compared to their healthy counterparts. The advancement in globalization and industrialization has caused people to live their lives in the first lane so that they can meet the demands of their families. To that effect, the majority of them are suffering from a number of ailments that affect children and adults in equal measure. Health Education Package Essay Example
.
The understanding of these diseases is the first step towards knowing how to lead a healthy and fulfilling life. This paper is an essay that develops a health education package that can be used to understand the state of mental health and how it impacts on nursing in rural Australia.

Body of the Essay

Summary of the education session plan and feedback from the evaluation questions

The core aim of this health session was to address some of the challenges that are facing people living in rural Australia. The specific area of focus was mental health where the participants were to learn how to identify, assess and evaluate a child who is suffering from Attention Deficit Hyperactivity Disorder or ADHD. This choice was made because statistics indicate that the mental health of school going children has not been given enough or sufficient attention in the rural places within Australia (Atkins et al, 2014) Health Education Package Essay Example. Further, these places are the ones that have a lot of problems when it comes to health care, education and even social growth and expansion. This health session strived to help people understand how they can identify a child who suffers from ADHD.

Hence, the session began by first evaluating the feedback obtained from the questions so that the session planners would know how much their audience knows about mental health.  The first question wanted to ascertain whether people within the Australian community are satisfied with the status of mental health that they receive. The results were astounding since most people confessed that they do not like the health attention and advice that is focused towards improving their mental abilities. Since this question was answered on a yes or no basis, I went ahead to ask the audience the reasons that led them to give these responses. The majority of people stated that doctors and physicians concentrate on their physical health and neglect on mental aspects.            Likewise, the participants stated that they do not think that the services they receive in their mental health clinics had any benefits to them. When it comes to the question of Attention Deficit Hyperactivity Disorder and if the participants thought it is an issue of concern is rural places in Australia, most of them agreed that their children were at risk. This problem was even increased because people did not have a lot of understanding when it comes to matters of mental well-being. The feedback obtained from the health session also showed that psychiatric disorder rates are higher in rural areas as compared to metropolitan areas.

With respect to young school going children, data have for some years shown that Australia experienced an increase in the number of people that suffered from Attention Deficit Hyperactivity Disorder. This directly caused them to develop at a much lower pace because it interferes with the child’s ability to remain attentive either in class or even when playing with other children (Cross et al, 2016). In the rural areas of Australia, the situation is far much worse since there are lesser health facilities, clinics and even hospitals compared to the urban cities. Furthermore, children in their early and preschool years are the ones that are largely affected and this directly means that the future of Australia is at risk if this problem is not tackled Health Education Package Essay Example. Hence, the choice to address ADHD in terms of its symptoms, diagnosis and even treatment is a suitable topic for this health education package. The following part of the essay explores the outcomes of the presentation and the follow ups that need to be made.

b) Title of the presentation:
Status of mental health in rural Australia-Focus on Attention Deficit Hyperactivity Disorder.

c) The aims and outcomes of the presentation

This health education session aimed at demystifying all the issues that revolve around ADHD with specific focus on the rural population living in Australia. The first activity of the presentation was introduction where everybody was given a chance to give their names and specific places that they live Health Education Package Essay Example. This served as the ice breaker so that people could now feel free to interact with each other. The next two sessions focused on proving an in-depth overview of mental health issues with Attention Deficit Hyperactivity Disorder being given first priority.

For this reason, I began by providing statistics to the audience where I showed them that the department of social services pointed out that Australia as a country has many casualties of mental diseases.

This is vivid from the number of children between 8 and 12 who commit suicide due to one reason or the other. Further, rural children definitely experience more troubles with coping and stress when compared with urban children. I also discussed ADHD at length where I began by explaining that this disorder affects the neural and brain functions of a child. Hence, they face a lot of difficulty when they try to stay focused in class, listen to their teachers or even engage in a conversation (Gulliver et al, 2010). Additionally, the mental disease affects children even in their play time such that they fail to focus on a given game.

This directly inhibits their school work and social lives such that most of them tend to develop depression like symptoms. This presentation was laid out such that I began with the facts of the disease, its manifestation and effects before going ahead to receive feedback from the public. I went ahead to explain to the participants that Attention Deficit Hyperactivity Disorder affects nearly ten percent of the children in rural Australia. I also wanted the audience to know that this disorder is high among children because most people do not even know how or are not really aware that their child may actually be having a mental illness. Hence, one of the positive outcomes of this presentation is that I got to educate the audience on how they can identify a person that has this ailment.

The first obvious symptom that I gave is the lack of organization and orderliness when it comes to performing simple tasks. A child that suffers from Attention Deficit Hyperactivity Disorder finds it hard to wake up on their own, dress up on time or even finish up simple homework (McGorry et al, 2007).  This should be used as a signal that people should use to know that the mental wellbeing of their child is not right. What’s more, people with ADHD suffer from a lot of inattention and even excessive excitement. This means that they can be unusually psyched over small things but their attention is really short lived (Patel et al, 2010) Health Education Package Essay Example.

The participants also got to learn that children who develop this mental condition find it very hard to perform well in their classwork. Consequently, some of them end up spending a lot of time in one class or school level since passing exams is such an uphill task for them. I advised the audience to be keen on other signs such as the frequent loss of personal items such as shoes, books and even bags. At times, some children even forget daily activities that they are meant to do such as clean their uniform, arrange their rooms or even brush their teeth (Sawyer et al, 2012).

This happens because their mental efforts are drastically reduced and they cannot remember some things as well as they should. Some other children display an array of symptoms that range from being too restless and they will always fidget with their hands and feet to show that they are tired of doing something for too long. Others will even stand up and run around in places such as the classroom, church or meetings where they are actually supposed to be quiet and seated (Sawyer et al, 2012) Health Education Package Essay Example.

Part of this presentation also strived to link Attention Deficit Hyperactivity Disorder to the nursing practices that take place in rural Australia. I wanted the audience to know more about mental health so that they can take charge when it comes to improving the lives of their children. The first part in ensuring this was learning about the methods of diagnosis that can be simply done in the home setting. The presentation also made use of facts and statistics that would paint a bigger and clearer picture when it comes to ADHD. The Australian Institute of Health and Welfare conducted a survey that showed that at children that are aged between 8 and 12 stand the highest chance of suffering from this condition (Sawyer et al, 2012). Health Education Package Essay Example.

Additionally, most of them are actually in their pre-schooling years where it is very critical for them to receive quality education. The fact that most children living in rural Australia cannot access mental health care is a worrying trend. Likewise, the nursing practices also need to be improved so that they can suit the needs of the wider population. The rationale behind this assertion is that health education is an essential element of the nursing process. In fact, it is the role of all registered nurses or RNs in Australia to improve the standards of primary health care for the benefit of every individual (Atkins et al, 2014).

These aspects of health do not focus primarily on disease processes and treatment but rather on prevention, maintenance and engagement in a healthy lifestyle. This means that mental health is included and subsequently integrated into this approach. For this health education session, the participants got to learn a lot about ADHD in a way that they did not imagine. The open discussion session was supposed to be a platform where people can interact with each other and at the same time ask questions on the topic. The common question that people wanted to know is whether there is any treatment for ADHD. The concerned participants got to know that their children can easily recover from this mental disease if only they seek early treatment (Cross et al, 2016).

Additionally, the outcome of this health session showed that most people were actually willing to improve their mental health but did not know how nursing practices could assist them. The health professionals, nurses and teachers who formed part of the audience gave their input on how best to handle Attention Deficit Hyperactivity Disorder, especially among young children. The inclusion of nursing requirements in the session also meant to educate people on what they should expect from their respective hospitals and clinics (Cross et al, 2016).

The people were assured that the doctors and physicians should be held accountable for all matters pertaining to brain functions. This includes making patients aware of the best ways to handle a mental disorder and how to manage it so that it does not spiral out of control. The entire health session and education package served its purpose of providing crucial information on mental health and how it impacts on people living in rural parts of Australia Health Education Package Essay Example.

Conclusion.

Health education is one of the most vital and essential processes that ensures people are able to live better and fulfilled lives. The rapid change in lifestyle has resulted in a marked increase in the number of mental diseases and the majority of people are not aware of how to manage them. Attention Deficit Hyperactivity Disorder is one of the common mental conditions that actually targets the young generation. In Australia, the statistics paint a clear picture of how children between 8 and 12 stand the risk of suffering from ADHD. This health education session was created and developed with the core aim of educating a virtual audience on mental ailments Health Education Package Essay Example. The focus was given on rural Australia where children in this age brackets are prone to suffer from ADHD. The plenty of information and facts outlined in this essay are a sure way of educating the masses on such an important topic.

References

Atkins D, Heller SM, DeBartolo E, & Sandel M. (2014). Medical-Legal Partnership and Healthy Start: integrating civil legal aid services into public health advocacy, Journal of Legal            Medicine; 35(1): 195-209.

Cross, S. P., Hermens, D. F., Scott, J., Salvador‐Carulla, L., & Hickie, I. B. (2016). Differential    impact of current diagnosis and clinical stage on attendance at a youth mental health service. Early intervention in psychiatry.

Gulliver, A., Griffiths, K. M., & Christensen, H. (2010). Perceived barriers and facilitators to        mental health help-seeking in young people: a systematic review. BMC psychiatry, 10(1),        113. Health Education Package Essay Example.

McGorry, P. D., Purcell, R., Hickie, I. B., & Jorm, A. F. (2007). Investing in youth mental health             is a best buy. Medical Journal of Australia, 187(7), S5-S7.

Patel V, Lund C, Hatheril S, Plagerson S, Corrigall J, Funk M,  (2010). Mental disorders: equity and social determinants. In: Blas E, Kurup AS, editors. Equity, social determinants    and public health programmes. Geneva: World Health Organization; p. 115-34.

Sawyer, S. M., Afifi, R. A., Bearinger, L. H., Blakemore, S. J., Dick, B., Ezeh, A. C., & Patton,   G. C. (2012). Adolescence: a foundation for future health. The Lancet, 379(9826), 1630-            1640. Health Education Package Essay Example.

DETAILS
 

BIOMEDICAL ETHICS PAPER

THIS IS A Persuasive essay

Research a biomedical case or issue and provide an ethical analysis of it. 6 pages long paper

Chosen case/ topic : 
Elizabeth Bouvia

– Right to die case of Elizabeth Bouvia

-Why it is ethically correct for her to have the right to die?

BUY A PLAGIARISM-FREE PAPER HERE

-THIS IS A 
Persuasive essay

MAKE SURE THAT YOUR PAPER MEETS THE BELOW 
GRADING CRITERIA

Grading Criteria:
1. Includes student name, instructor, class name, date.
2. Strong and clear thesis statement (“I will argue…”). Thesis claim also appears in conclusion.
3. 6 pg. of writing double spaced 12pt font Minimum (not 5.1 pages) not including works cited.
4. Correct tone – not informal. All material presented is relevant to your thesis.
5. Correct general format (intro, body [several parts], conclusion). Each paragraph of the body has a mini-thesis sentence. Each section of your body paragraphs should lend support to your thesis.
6. No Fallacies
7. At least two in-text citations of academic philosophy articles from outside the text of the course done correctly. These citations offer supporting evidence for your thesis.
8. Includes a counter argument and rebuttal. Has an accurate and charitable possible objection and a well-argued rebuttal section.
9. Must use one ethical principle or ethical theory to develop your argument. Shows you know how to apply abstract ethical concepts to concrete examples.
10. Argument is clear and convincing (valid argument). All terms used are defined and clearly explained to the reader perhaps through example. (Not all grading criteria are weighted equally. As the list above progresses the criteria are weighted more heavily. For example: getting your name and date on the paper is not worth as much as completing the page requirement or having a convincing argument) BIOMEDICAL ETHICS PAPER

 

Student’s name:

Professor’s name:

Course:

Date:

Biomedical Ethics Paper

Introduction

Among other landmark cases that have been witnessed globally, the Elizabeth Bouvia case was one of the most captivating landmark cases, especially in the right to die movement. The case began in 1983 when Ms. Bouvia voluntarily entered into a Californian hospital having suicidal ideations. Immediately after being hospitalized, Ms. Bouvia made it clear of her intention to stop eating with the hope of dying by starvation (Richard, and Keck 884). She went ahead to request the hospital board and the medical practitioners to only assist her with hygienic care and pain medication until she died. Her point of argument was that she was no longer willing to live due to the fact that she was disabled and physically incapable of committing suicide by herself (Diane 6). Ms. Bouvia went on to argue that due to her disability, she had experienced a miscarriage, a failed marriage, rejection from employment, and inability of her father to accept her back after moving out of her husband’s house. After the hospital refused to grant Bouvia her death wishes, she launched several court cases that were not successful. However, in 1986, Bouvia was granted her wishes by the Supreme Court only for her to overturn her original death wish arguing that the side effects of morphine regimen that she had began made the starvation process unbearable (Dean and Deason-howell 257). Taken from another angle, the right to die is a basic human right that should not be contested by anybody. In fact, it is ethically in order to give an individual the right to die if they so wish. In this paper will argue for the reasons or advantages of the right to die and why such should be a topic of much debate.

The Right to Die: What does it entail?

           
In a nutshell, the right to die is a concept based on the belief that a person can end their lives if they so wish, or voluntary euthanasia in other words. The right to die is mainly a medically assisted type of death that can be performed or carried out at a person’s home or at the hospital (David 6). There are a lot of arguments that surround the debate on matters to do with the right to die. There are those who argue that the right to die is ethically and morally wrong while there are those who bring in religious arguments and opinions saying that God is the only person who can determine whether a person has the right to live or die (Hui-ping, et al 875). In fact, others have gone ahead to argue that nurses, doctors and other healthcare professionals have the mandate of ensuring that they improve the quality of life as opposed to terminating it (Layla and Piazza 89).

Cases that are ripe with issues relating to ethical dilemma have presented the society with some of the most difficult considerations. Certainly, in the case that involved Ms. Bouvia, her physical impairments and her complicated medical history tends to bring forth concern and empathy on grounds of the magnitude of her suffering (Layla and Piazza 90). A lot of people have argued from the legal perspective of the case but this case can be viewed from the ethical perspective in relation to matters such as the rights of individuals, the acts of conscience, and ultimately, the right of a person to die.

Why Everyone Needs to Have The Right To Die

           
Before proceeding, it is important to understand the difference between physician assisted death (the right to die) and euthanasia. For the longest time, the two have always been lumped together but it is important to note that there are striking differences between the two practices. Euthanasia refers to killing an individual with the intention of relieving him of pain. This process is mainly done through lethal injection, ingestion of medication, or passively done by refusing to eat and allowing oneself to pass away (Pragnesh, et al 20). On the other hand, the right to die or assisted death is when an individual goes ahead to provide somebody else with information and help or assistance in taking their own lives. On most occasions, these types of deaths are undertaken with the help of a healthcare professional or a doctor (Diane 6). To this end, everybody has got the right to die, and in the case that involved Ms. Bouvia, doctors and the whole medical fraternity should have allowed her to have her wishes long time ago.

From an ethical perspective, it would have been correct for Ms. Bouvia to have the right to die due to a number of reasons worth noting. Is it ethically right as a doctor, healthcare professionals or prosecutors to see a disabled person suffering too much physical pain when they can end it voluntarily with the help of others? Even though some people may argue against this is wrong, from an ethical perspective, it is correct to assist an individual end his or her own life as long as it is their own solid decision (Pragnesh, et al 22). Ms. Bouvia was born disabled. She could not function like her fellow colleagues with no physical disabilities at all. Despite her failed marriage, no employer was willing to take her in. Her marriage had also failed and both her father and career programs were not willing to accommodate her (Richard and Keck 887). In her defense, this was more than she could bear, and the asked for the right to die. On a closer examination, Ms. Bouvia was right. She was literally on the edge where she could not bear anymore suffering, and at this point, it is ethically correct to give her the right to die (Diane 6).

According to Hui-ping, et al, people are born with dignity, have the right to live with dignity, and also the right to die with dignity (875). There are some conditions that may be painful to bear that the capability of medical profession can assist in alleviating prolonged suffering. It is important to note that intractable terminal suffering is an aspect that robs the victims a significant part of their dignity (Hui-ping, et al 876). Again, Ms. Bouvia disability meant that she required help from those close to her. In the human life, there are private matters that the individual needs to take care of unless they are young or disabled. But to the disabled adults of sound mind, there are certain private bodily matters that make them as if they rob them of their dignity if they are assisted. Such would include taking a bath or using a toilet (Hui-ping, et al 879). Though not mentioned, there are high chances that Ms. Bouvia felt that she had lost her dignity and had the right to die. Ethically, it is not right to see a person losing his or her dignity when he or she can be voluntarily assisted to end the suffering (David 7). To this end too, it would have been correct to give Ms. Bouvia the right to die.

As mentioned earlier, it is the duty of medical professionals to ensure that they alleviate the pain of their patients. If there seems to be no hope, doctors have ethical and moral obligations to end the life a given patient (Dean and Deason-howell 253). Again, Ms. Bouvia was a disabled patient who could not function normally. She had painfully lost her pregnancy and facing the world alone due to rejection that she was subjected to –her father and husband being some of them- by a lot of people across the community that she was living in (Layla and Piazza 92). Ethically, Ms. Bouvia should have been assisted and allowed to end her life long time ago as opposed to prolonging her tribulations which appeared to be bearing no fruits at all.

In the field of medical law and medical ethics, patients are allowed to refuse any kind of treatment or food if this will ultimately lead to their death (Layla and Piazza 93). Layla and Piazza further asserts that patients have the right of determining the moment of their deaths if they are in one of the most unbearable situations. In law, the right to receive medical treatment is well documented even if the medical treatment offered or food is given to a patient to prolong his or her life (94). To this end, there is no reason as to why Ms. Bouvia had to wait for long before having her rights granted. The law should be independent of morality or any other reasoning, and denying Ms. Bouvia part of her rights is wrong. BIOMEDICAL ETHICS PAPER

Decisions that revolve around the right to die are personal and have to be left that way. In deontology (a branch of ethics), this theory would argue or provide that there is no ethical reason that is good enough to go against an individual’s civic and moral duty even if the act means allowing a person to suffer in pain, a move that ignores the right of a patient (Diane 6). In the case that involved Ms. Bouvia, there is no better argument that can be put across of denying her the right to die. After all, it is her life and the decision she took was made with a sound mind. There is no place where she had to face a psychiatrist to examine her mental condition. She was a person of sound mind who just wanted to end her suffering as quick as possible. From an ethical perspective therefore, it is not good to go against the moral and civic duties of a person. Ms. Elizabeth Bouvia was subjected to numerous court proceedings in addition to prolonged suffering until her wishes were granted though she later reversed her decision (Richard and Keck 903). Ethically, it would not have been wrong to deny her of the right to die way early.

Conclusion 

           
In a recap, the truth can be equated to gambling or alcohol. Banning such practices will not bring them to their end. In fact, going ahead to ban certain practices and vices could lead to being abused dangerously. People have always committed suicide. There is an urgent need to allow assisted death or the right for a person to end his or her life in a safe and comfortable environment where families are given chances of saying their final goodbyes in a proper manner of their own choosing. The right to die should be a fundamental right. Medical law recognizes it. There is nothing to be proud of if people who can assist those who cannot just sit back and watch them suffer simply because they are disabled or terminally ill to do it by themselves. To healthcare professionals, among others, it is their ethical duty to alleviate the suffering of a patient especially if they are incapable of doing so, the medicine is not working, the patients voluntarily choose to do so, and the person making the decision is of sound mind. In a nutshell, the right to die should be a personal and a constitutional right that should not be subject to debate.

Work Cited

Blevins, Dean and Lucinda M. Deason-howell. “Legal Implications for Failure to Comply with Advance Directives: An Examination of the Incompetent Individual’s Right to Refuse Life-Sustaining Medical Treatment.” Behavioral Sciences & the Law, vol. 20, no. 3, May/Jun2002, pp. 253-269.

Chen, Hui-ping, et al. “Attitudes of Chinese Oncology Physicians toward Death with Dignity.” Journal of Palliative Medicine, vol. 19, no. 8, Aug. 2016, pp. 874-878.

Coueman, Diane. “Assisted Suicide and Disability.” Human Rights, vol. 27, no. 1, Winter2000, p. 6.

Kurt, Layla J. and Nick J. Piazza. “Ethical Guidelines for Counselors When Working with Clients with Terminal Illness Requesting Physician Aid in Dying.” Adultspan Journal, vol. 11, no. 2, Oct. 2012, pp. 89-96.

Orentlicher, David. “International Perspectives on Physician Assistance in Dying.” Hastings Center Report, vol. 46, no. 6, Nov/Dec2016, pp. 6-7.

Parmar, Pragnesh, et al. “Perceptions of Patients’ Towards Euthanasia – a Medico-Legal Perspective.” International Archives of Integrated Medicine, vol. 3, no. 5, May 2016, pp. 20-23.

Price, Richard S. and Thomas M. Keck. “Movement Litigation and Unilateral Disarmament: Abortion and the Right to Die.” Law & Social Inquiry, vol. 40, no. 4, Fall2015, pp. 880-907. BIOMEDICAL ETHICS PAPER

Health Education Session Planner Example

Health is an essential part of living and its status determines the lifespan of virtually all human beings. This paper is a brief essay that provides a session planner in relation to a provided topic of interest.

Topic of focus for the Essay:
Mental Health and how it Impacts on Nursing in Rural Australia.

Body of the Essay

Section One

ORDER A CUSTOM-WRITTEN, PLAGIARISM-FREE PAPER NOW

Aim: What is the overall purpose of this session?

Outcomes

This session aims at educating the public on the importance of mental health with specific focus on rural Australia. The participants will be taught how to identify, assess and evaluate a child who is suffering from Attention Deficit Hyperactivity Disorder or ADHD (Cross et al, 2016). The people will be expected to carry out an intelligence test that can rate how much a child can focus. This is expected to last for at least 30 minutes since the session only has one outcome. Health Education Session Planner Example.

Where will you be holding the session? Is there anything you need to consider when using this location?

           
The venue of this session shall be the Queensland plenary hall since it is large enough to accommodate all interested participants. In addition, its location is strategic and accessible from all parts of the town.

Who is your audience? Describe them in terms of their demographics. What needs do they have?

The main audience for this session are people within the nursing fraternity, parents and medical students. Their demographics in terms of age is that they are above 20 years and clearly understand issues of mental health (Gulliver et al, 2010). They are also expected to be residing in rural parts of Australia where matters of mental health have taken center stage (Atkins et al, 2014). The audience will also consist of both males and females so as to encourage participation from both genders. Health Education Session Planner Example.

Demographics of culture, behaviors and attitudes of this people are expected to be evaluated briefly prior to the session. The requirements for every person should include a previous background knowledge in mental health and nursing, must have lived in rural Australia and also should have known someone suffering from a mental disorder so that the session can be deemed successful (McGorry et al, 2007).

Time frame

The session is anticipated to last for 30 minutes during which each aspect of the topic is to be covered in brief.

 

Provide an outline of how the session will run.

Content

Activity

Resource

Time

Section 1

Introduction.

Myself

3 minutes

Section 2

Overview of the mental health issues

PowerPoint Presentation

5 minutes

Section 3

Attention Deficit Hyperactivity Disorder in rural Australia: Facts and statistical updates.

PowerPoint Presentation

10 minutes

Section 4

Open discussion

Social interaction

10 minutes

Section 5

Closing session

Myself

2 minutes

What resources will you need for this session?

The resources to be used include:

Laptops and computers

Projectors

Incentives

Time

Session chair.

How will you evaluate your session?

Session one shall be evaluated based on a questionnaire that will seek to determine if the program was successful.

Section Two: Evaluation Question Section

How would you rate the status of mental health among children in your community?

Very Poor

Poor

Average

Good

Very good

1

2

3

4

5

 

Are you satisfied with the services you receive from your nearest mental health clinic? (Tick appropriately in the box). Health Education Session Planner Example.

Yes

No

Do you think that
Attention Deficit Hyperactivity Disorder or ADHD is an issue of concern in rural Australia? (Tick appropriately in the box).

Yes

No

What is your personal understanding on the role of nursing practices in rural Australia in fighting mental diseases?

Have you been a victim of stigma in your community because of a mental disease?

 

References

Atkins D, Heller SM, DeBartolo E, & Sandel M. (2014). Medical-Legal Partnership and Healthy Start: integrating civil legal aid services into public health advocacy, Journal of Legal            Medicine; 35(1): 195-209.

Cross, S. P., Hermens, D. F., Scott, J., Salvador‐Carulla, L., & Hickie, I. B. (2016). Differential    impact of current diagnosis and clinical stage on attendance at a youth mental health service. Early intervention in psychiatry.

Gulliver, A., Griffiths, K. M., & Christensen, H. (2010). Perceived barriers and facilitators to        mental health help-seeking in young people: a systematic review. BMC psychiatry, 10(1),        113.

McGorry, P. D., Purcell, R., Hickie, I. B., & Jorm, A. F. (2007). Investing in youth mental health             is a best buy. Medical Journal of Australia, 187(7), S5-S7. Health Education Session Planner Example