Tag: Clinical-Nursing

  • Practicum: Planning Learning Objectives Essay Assignment

    Practicum: Planning Learning Objectives Essay Assignment

    Practicum: Planning Learning Objectives

    The practicum experience allows you to develop and expand your advanced nursing knowledge and skills at the aggregate, organizational, or policy level. During week 1 you will submit two to three individual learning objectives that you wish to achieve during this practicum experience.  You should prepare a set of measurable learning objectives, using Bloom’s Taxonomy. Your practicum objectives should reflect your interest in expanding knowledge. They are not to include activities related to your DNP project. Practicum: Planning Learning Objectives Essay Assignment. These objectives will be identified during your mentoring course (NURS 8700P, 8700, 8701).  Practice experiences should be
    designed
     achieve specific learning objectives related to the DNP Essentials and specialty competencies (AACN, 2006).

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    Your practicum objectives should include the following:

    Two to three learning objectives using Bloom’s Taxonomy.

    Description of how these objectives will expand your advanced nursing knowledge and skills at the aggregate, organizational, or policy level.

    Relationship of the learning objectives to the DNP Essentials.

    Practicum: Planning Learning Objectives Essay Assignment

    NOTE: Learning objectives must be submitted using 
    APA
     style. Points may be deducted for lack of references, writing style, and APA format.

    Applying Bloom’s Taxonomy to Nursing Learning Objectives

    Learning objectives help nursing students to remain focused to the goals of their professional and academic careers Practicum: Planning Learning Objectives Essay Assignment. The Bloom’s Taxonomy makes it easier for the students to identify the key competencies and fundamental purpose of general and specific objectives (Crowe, Dirks & Wenderoth, (2008). This paper outlines three learning objectives using Bloom’s Taxonomy, linking the objectives to the DNP Essentials and specialty competencies.

    Learning objectives with the use of Bloom’s Taxonomy

    Su, et al., (2004) describe Bloom,s Taxonomy as a framework for classifying educational goals. The concept was first used in 1950s; however, there is a revised edition, which is a more dynamic framework of classification. Bloom’s Taxonomy entails: Remembering, Understanding, Applying, Analyzing, Evaluating and Creating.

    Learning Objective I: To Explicate the Significance of Evidence-Based Practice (EBP). Practicum: Planning Learning Objectives Essay Assignment.

    EBP is fundamental to the DNP scientific foundations of nursing. Hence, this objective with expand my understanding of nursing knowledge, both at the organizational and policy level (Yaeger et al., 2004).

    Understanding of the objective using Bloom’s Taxonomy

    This objective basically emphasizes on the concept of understanding. It is integral to understand the importance of EBP, which calls for investigation of the history of nursing practice (Su & Osisek, 2011).

    Learning objective II: To Systematically Examine Team of Nurses

    Leadership skills are integral to success in nursing. The DNP stresses on expanding and developing nursing leadership through education. Accordingly, this learning objective will enable me to execute the art of performance evaluation by practicing my leadership skills. Practicum: Planning Learning Objectives Essay Assignment.

    Understanding of the objective using Bloom’s Taxonomy

    This learning objective essentially addresses the concept of evaluation as one of the elements and action words of Bloom’s Taxonomy.

    Learning objective III: to gain sound knowledge in healthcare policy for advocacy in the health care organizations. This objective can be understood through Bloom’s Taonomy because it addresses the concept of identification in education. I will engage actively in the healthcare policy, where I will learn to identify the problems in the healthcare system.

    References

    Su, W. M., Osisek, P. J., & Starnes, B. (2004). Applying the Revised Bloom’s Taxonomy to a medical-surgical nursing lesson. 
    Nurse Educator
    , 
    29
    (3), 116-120.

    Su, W. M., & Osisek, P. J. (2011). The revised Bloom’s Taxonomy: Implications for educating nurses. 
    The Journal of Continuing Education in Nursing
    , 
    42
    (7), 321-327. Practicum: Planning Learning Objectives Essay Assignment.

    Crowe, A., Dirks, C., & Wenderoth, M. P. (2008). Biology in bloom: implementing Bloom’s taxonomy to enhance student learning in biology. 
    CBE—Life Sciences Education
    , 
    7
    (4), 368-381.

    Yaeger, K. A., Halamek, L. P., Coyle, M., Murphy, A., Anderson, J., Boyle, K., … & Smith, B. (2004). High-fidelity simulation-based training in neonatal nursing. 
    Advances in Neonatal Care
    , 
    4
    (6), 326-331 Practicum: Planning Learning Objectives Essay Assignment.

  • DeVry nr501 Application of Nursing Theory Essay Assignment papers

    DeVry nr501 Application of Nursing Theory Essay Assignment papers

    Week 6 assignment

    Application of Nursing Theory

    PURPOSE

    The purpose of this assignment is to use nursing theory as a way to resolve a problem or issue occurring within nursing leadership, nursing education, nursing informatics, health policy, or advance clinical practice DeVry nr501 Application of Nursing Theory Essay Assignment papers.

    COURSE OUTCOMES

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    Through this assignment, a student will demonstrate the ability to:

    (CO#1) Analyze theories from nursing and relevant fields with respect to their components, relationships among the components, logic of the propositions, comprehensiveness, and utility to advanced nursing. DeVry nr501 Application of Nursing Theory Essay Assignment papers (PO1)

    (CO#3) Communicate the analysis of and proposed strategies for the use of a theory in nursing practice. (PO3, 7, 10)

    (CO#4) Demonstrate logical and creative thinking in the analysis and application of a theory to nursing practice. (PO4, 7)

    DUE DATE: Sunday 11:59 PM MT at the end of Week 6

    TOTAL POINTS POSSIBLE: 275

    REQUIREMENTS

    Description of the Assignment:

    One nursing theory will be presented as a framework to resolve a problem occurring within one of the professional areas of leadership, education, informatics, healthcare policy or advance clinical practice. The same nursing theory selected in Assignment One may be used to resolve the identified problem DeVry nr501 Application of Nursing Theory Essay Assignment papers.

    A specific nursing theory must be used. No non-nursing theories are permitted. A category of nursing theory (grand, middle range, practice) may not be used—only a specific, published nursing theory is to be selected and applied to the issue or concern important to the profession of nursing as documented in the nursing literature.

    Please note: Do not rely on .com sites to identify the nursing theory as they do not provide accurate information in all cases.

    Content

    1. Introduction:

    The introduction for this paper includes:

    • A nursing theory is required; non-nursing theories may not be used.

    • General statements on the idea of nursing theory being applied to solve problems/issues in nursing practice. You do not need to go into the specialty area of practice in-depth as this will be covered in another section of the paper. DeVry nr501 Application of Nursing Theory Essay Assignment papers.

    • A one-paragraph summary of the selected specific nursing theory is required.

    • Information identifying the sections of this assignment.

    • References from nursing literature are required.

    2. Description of Issue or Concern:

    The selected issue or concern must be clearly identified as being significant to the professional area of either leadership, education, informatics, healthcare policy or advance clinical practice. The issue or concern must be presented comprehensively, but concisely by answering each of the following questions DeVry nr501 Application of Nursing Theory Essay Assignment papers.

    • What is the specific issue or concern being presented?

    • Why should the nursing profession care about this issue or concern?

    • What does the nursing literature have to say about this issue or concern including its frequency of occurrence?

    • Who are the stakeholders or the people affected by the issue or concern?

    References from nursing literature are required.

    3. Application of Selected Nursing Theory to Issue or Concern:

    This section of the assignment focuses on using the selected nursing theory to resolve the described issue or concern. Required information includes:

    • Restating the selected nursing theory to be used DeVry nr501 Application of Nursing Theory Essay Assignment papers.

    • Identification of one strategy useful in resolving the identified issue or concern.

    • The strategy should be presented in depth with the following information being required:

    o A specific description of how the selected nursing theory can help to resolve the issue or concern

    o A specific and detailed description of the strategy to be used

    o A specific and detailed description of how the strategy can be implemented

    o A specific and detailed description of one suggestion for future research into either the selected nursing theory or selected issue or concern.

    References from nursing literature are required DeVry nr501 Application of Nursing Theory Essay Assignment papers..

    4. Conclusion:

    This section provides a summary or review of the key elements of the assignment including theselected nursing theory and its application to the issue or concern.

    The concluding statements include self-reflection on the new knowledge gained about applying nursing theory to a professional issue or concern. DeVry nr501 Application of Nursing Theory Essay Assignment papers.

    PREPARING THE ASSIGNMENT

    Format and Special Instructions

    1. A nursing theory is required; non-nursing theories are not allowed to be used.

    2. Paper length: 6 pages minimum; 8 pages maximum, excluding title page and reference page. Points will be deducted for not meeting these requirements.

    3. A minimum of 6 (six) scholarly references are required. References must be current – not older than 5 years, unless a valid rationale is provided and the instructor has approved them.Consult with the course instructor about using an older source. DeVry nr501 Application of Nursing Theory Essay Assignment papers.

    4. A dictionary, required textbooks for this course and Chamberlain College of Nursing lesson information, may NOT be used as scholarly references for this assignment. For additional information regarding scholarly references, please review “What is a scholarly source?” located in the Course Resource tab. Information from .com websites may be incorrect.

    5. Title page, running head, body of paper, and reference page(s) must be in APA format as presented in the 6th edition of the manual DeVry nr501 Application of Nursing Theory Essay Assignment papers.

    6. Ideas and information from readings and other sources must be cited and cited correctly.

    7. Grammar, spelling, punctuation, and citations are consistent with formal academic writing as presented in the 6th edition of the APA manual DeVry nr501 Application of Nursing Theory Essay Assignment papers.

  • HLT 555 Week 2 Environmental Epidemiology Essay Assessment Paper

    HLT 555 Week 2 Environmental Epidemiology Essay Assessment Paper

    Environmental Epidemiology Assessment Details:

    Complete the “Environmental Epidemiology Assessment.”

    APA format is not required, but solid academic writing is expected.

    HLT555.v10R.EnvironmentalEpidAssessmen_student.docx

    HLT 555 Week 2 Discussions

    Discussion 1

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    Why are studies on the health effects of smoking among individual who smoke not a concern of environmental epidemiology? Explain the reason why exposure to secondhand cigarette smoke is a concern of this discipline.Environmental Epidemiology Assessment HLT 555 Week 2 Environmental Epidemiology Essay Assessment Paper

    Discussion 2

    Explain why you and your classmates may have a different response to the same exposure to a chemical. Provide a specific example.Environmental Epidemiology Assessment

    HLT 555 Week 3 Discussions

    Discussion 1

    What are some examples of environmental sources of exposure of populations to toxic heavy metals? What factors can exacerbate the effects of toxic exposures on populations with low socioeconomic status? HLT 555 Week 2 Environmental Epidemiology Essay Assessment Paper.

    Discussion 2

    What types of injury of public health concern are associated with exposure to each of the different forms of radiation? How does the risk of each injury vary with the dose of the radiation in question?

    HLT 555 Week 3 Exposure and Risk Assessment

    Details:

    This assignment is in two parts:

    Part 1: Exposure Assessment Case Study

    Read “Cross-sectional Exposure Assessment of Environmental Contaminants in Churchill County, Nevada” by the Centers for Disease Control and Prevention (2003). Use this case study to complete the Exposure Assessment form. HLT 555 Week 2 Environmental Epidemiology Essay Assessment Paper.

    Part 2: Risk Assessment Case Study

    Read “Illness Associated with Drift of Chloropicrin Soil Fumigant Into a Residential Area – Kern County, California, 2003.” Use this case study to complete the Risk Assessment assignment.

    HLT555.v10R.RiskAssessment_student.docx HLT555.v10R.ExposureAssessmentCaseStudy_student.docx

    HLT 555 Week 7 Reducing the Risk of Foodborne Illnesses

    Details:

    The Hazard Analysis Critical Control Plan (HACCP) is a system used to reduce the risk of foodborne illnesses in the United States. Preventing problems from occurring is the paramount goal underlying any HACCP system. The principles employed in the development of HACCP plans meet the goal of preventing foodborne illnesses.

    In a PowerPoint presentation of 5-10 slides, describe the history and application of the HACCP system, addressing the following:

    Provide a brief history of HACCP.

    Describe the steps involved in the development and implementation of a HACCP plan.

    What are the advantages of using HACCP rather than traditional food safety programs in retail food establishments? HLT 555 Week 2 Environmental Epidemiology Essay Assessment Paper.

    Describe critical control points and critical limits as they are used in HACCP programs and what happens when there is a deviation. HLT 555 Week 2 Environmental Epidemiology Essay Assessment Paper.

    Why is monitoring an important step in the HACCP system?

    You are required to use a minimum of three additional references in preparing your presentation.

    APA format is not required, but solid academic writing is expected.

    This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

    You are not required to submit this assignment to Turnitin, unless otherwise directed by your instructor. If so directed, refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin. HLT 555 Week 2 Environmental Epidemiology Essay Assessment Paper.

    HLT 555 Week 7 Discussions

    Discussion 1

    Describe the categories of hazards that may be present in foods and suggest methods for their control and prevention.

    Discussion 2

    How do food recalls contribute to the safety of our nation’s food supply? What do you think are some strengths and weaknesses of this process? HLT 555 Week 2 Environmental Epidemiology Essay Assessment Paper.

  • NR447 Nursing Care Models Paper

    NR447 Nursing Care Models Paper Guidelines

    Purpose

    The purpose of this assignment is to identify nursing care models utilized in today’s various health care settings and enhance your knowledge of how models impact the management of care and may influence delegation. You will assess the effectiveness of models and determine how you would collaborate with a nurse leader to identify opportunities for improvement to ensure quality, safety and staff satisfaction. NR447 Nursing Care Models Paper.

    Course Outcomes

    Completion of this assignment enables the student to meet the following course outcomes.

    CO1: Apply leadership concepts, skills, and decision making in the provision of high quality nursing care, healthcare team management, and the oversight and accountability for care delivery in a variety of settings. (PO2)

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    CO2: Implement patient safety and quality improvement initiatives within the context of the interprofessional team through communication and relationship building. (PO3)

    CO3: Participate in the development and implementation of imaginative and creative strategies to enable systems to change. (PO7)

    CO6: Develop a personal awareness of complex organizational systems and integrate values and beliefs with organizational mission. NR447 Nursing Care Models Paper (PO7)

    CO7: Apply leadership concepts in the development and initiation of effective plans for the microsystems and/or system-wide practice improvements that will improve the quality of healthcare delivery. (PO2, and 3)

    CO8: Apply concepts of quality and safety using structure, process, and outcome measures to identify clinical questions as the beginning process of changing current practice. (PO8)

    Directions

    Read your text, Finkelman (2016), pp- 111-116.

    Observe staff in delivery of nursing care provided. Practice settings may vary depending on availability NR447 Nursing Care Models Paper.

    Identify the model of nursing care that you observed. Be specific about what you observed, who was doing what, when, how and what led you to identify the particular model.

    Write a 5-7 page paper that includes the following:

    Review and summarize two scholarly resources (not including your text) related to the nursing care model you observed in the practice setting.

    Review and summarize two scholarly resources (not including your text) related to a nursing care model that is 
    different
     from the one you observed in the practice setting.

    Discuss your observations about how the current nursing care model is being implemented. Be specific.

    Recommend a 
    different
     nursing care model that could be implemented to improve quality of nursing care, safety and staff satisfaction. NR447 Nursing Care Models Paper Be specific.

    Provide a summary/conclusion about this experience/assignment and what you learned about nursing care models.

    Write your paper using APA format using Microsoft Office 2010 or later NR447 Nursing Care Models Paper.

    Nursing Care Models Paper Guidelines

    Purpose

    The purpose of this assignment is to identify nursing care models utilized in today’s various health care settings and enhance your knowledge of how models impact the management of care and may influence delegation. NR447 Nursing Care Models Paper. You will assess the effectiveness of models and determine how you would collaborate with a nurse leader to identify opportunities for improvement to ensure quality, safety and staff satisfaction.

    Course Outcomes

    Completion of this assignment enables the student to meet the following course outcomes.

    CO1: Apply leadership concepts, skills, and decision making in the provision of high quality nursing care, healthcare team management, and the oversight and accountability for care delivery in a variety of settings. (PO2)

    CO2: Implement patient safety and quality improvement initiatives within the context of the interprofessional team through communication and relationship building. (PO3)

    CO3: Participate in the development and implementation of imaginative and creative strategies to enable systems to change. (PO7) NR447 Nursing Care Models Paper.

    CO6: Develop a personal awareness of complex organizational systems and integrate values and beliefs with organizational mission. (PO7)

    CO7: Apply leadership concepts in the development and initiation of effective plans for the microsystems and/or system-wide practice improvements that will improve the quality of healthcare delivery. (PO2, and 3)

    CO8: Apply concepts of quality and safety using structure, process, and outcome measures to identify clinical questions as the beginning process of changing current practice. (PO8)

    Directions

    Read your text, Finkelman (2016), pp- 111-116.

    Observe staff in delivery of nursing care provided. Practice settings may vary depending on availability NR447 Nursing Care Models Paper.

    Identify the model of nursing care that you observed. Be specific about what you observed, who was doing what, when, how and what led you to identify the particular model.

    Write a 5-7 page paper that includes the following:

    Review and summarize two scholarly resources (not including your text) related to the nursing care model you observed in the practice setting.

    Review and summarize two scholarly resources (not including your text) related to a nursing care model that is 
    different
     from the one you observed in the practice setting.

    NR447 Nursing Care Models Paper Discuss your observations about how the current nursing care model is being implemented. Be specific.

    Recommend a 
    different
     nursing care model that could be implemented to improve quality of nursing care, safety and staff satisfaction. Be specific.

    Provide a summary/conclusion about this experience/assignment and what you learned about nursing care models.

    Write your paper using APA format using Microsoft Office 2010 or later NR447 Nursing Care Models Paper.

  • HLT 555 Week 4 Global Warming and Vector-Borne Diseases (Benchmark Essay Assignment Paper)

    HLT 555 Week 4 Global Warming and Vector-Borne Diseases (Benchmark Essay Assignment Paper)

    Global Warming and Vector-Borne Diseases (Benchmark Assignment) Details:

    In this two-part assignment.

    Global Warming and Vector-Borne Diseases (Benchmark Assignment) Part 1: Illustration

    Illustrate a particular environmental agent and its effect on the environment. You may use a flow chart, diagram, pictorial, or other instructor-approved format. HLT 555 Week 4 Global Warming and Vector-Borne Diseases (Benchmark Essay Assignment Paper). The illustration should show:

    The vector-borne disease.

    The pathway or chain of the disease.

    The factors that contribute to the spread of the disease.

    The effect of the disease.

    Global Warming and Vector-Borne Diseases (Benchmark Assignment) Part 2: Narrative

    In a short narrative (750 words maximum), do the following:

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    Identify the vector-borne disease.

    Explain in detail the factors contributing to global warming.

    Describe the effect of global warming on the incidence and prevalence of the disease.

    Utilize a minimum of three references to support your claims.

    HLT 555 Week 4 Global Warming and Vector-Borne Diseases (Benchmark Essay Assignment Paper)

    Prepare the narrative portion of the assignment according to APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

    This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the Global Warming and Vector-Borne Diseases (Benchmark Assignment) assignment.

    You are required to submit teh narrative portion of this assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin.

    HLT 555 Week 4 Discussions

    Discussion 1

    How do vectors play a role in the transmission of disease? What are some procedures for control and prevention? Provide a specific example. HLT 555 Week 4 Global Warming and Vector-Borne Diseases (Benchmark Essay Assignment Paper).

    Discussion 2

    Unlike other toxins or contaminants with which the public can come into contact, pesticides are intentionally applied to food, living spaces, and people. What are some of the risk-benefit issues in the application of pesticides? Is the risk justified? Explain your position.

    HLT 555 Week 5 Discussions

    Discussion 1

    Explore the following statement: “The answer to a waterborne disease outbreak is to ‘shock’ chlorinate.” What health risks would be mitigated with this approach? What new health risks might emerge from the application of large doses of chlorine?

    Discussion 2

    What actions can be taken to lower air pollution emissions? Consider actions that can be taken at the individual, community, and government levels. HLT 555 Week 4 Global Warming and Vector-Borne Diseases (Benchmark Essay Assignment Paper).

    HLT 555 Week 6 Discussions

    Discussion 1

    What are the different types of solid waste and how are they identified? What are the different approaches to solid waste management?

    Discussion 2

    What are some alternatives to sewer systems for disposal of human waste? To what extent could these alternatives replace municipal sewer systems? Discuss their advantages and disadvantages.

    HLT 555 Week 5 Public Service Health Announcement

    Details:

    This is a two-part assignment. Part 1 is a narrative report and Part 2 is a public service health announcement. HLT 555 Week 4 Global Warming and Vector-Borne Diseases (Benchmark Essay Assignment Paper). You will identify and explain the effect of the water supply on the development of cholera in developing countries.

    Part 1: Report

    In a report of 750-1,000-words, address the following:

    The agent responsible for cholera.

    The symptoms, treatment, and diagnosis of cholera.

    Relationship between the water supply and cholera.

    Public health efforts to reduce cholera illness in developing countries.

    Utilize a minimum of three references to support your claims.

    Prepare this part of the assignment according to the APA guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is not required.

    Part 2: Public Service Health Announcement

    Develop a public service health announcement. The PSHA should:

    Have a clear message.

    Be targeted toward a specific audience.

    Be persuasive in nature.

    Grab the viewer’s attention.

    Be brief.

    Support statements with evidence.

    Contain photos and text (voice and music are optional).

    Observe all copyright laws.

    You may use iMovie, iPhoto, Photostory for Windows, Windows MovieMaker, Adobe Premiere Elements, or Web 2.0 tools such as JayCut or Animoto. HLT 555 Week 4 Global Warming and Vector-Borne Diseases (Benchmark Essay Assignment Paper).

    Post the PSHA to TeacherTube or SchoolTube. If you do not have an account, create one and post the PSHA.

    APA format is not required for the PSA, but solid academic writing is expected.

    This assignment uses a grading rubric. Instructors will be using the rubric to grade the assignment; therefore, students should review the rubric prior to beginning the assignment to become familiar with the assignment criteria and expectations for successful completion of the assignment.

    You are required to submit the report portion of this assignment to Turnitin. Refer to the directions in the Student Success Center. Only Word documents can be submitted to Turnitin. HLT 555 Week 4 Global Warming and Vector-Borne Diseases (Benchmark Essay Assignment Paper).

  • R447 Week 5 Nursing Care Models Worksheet Essay Assignment papers

    R447 Week 5 Nursing Care Models Worksheet Essay Assignment papers

    Nursing Care Models Worksheet Guidelines

    Purpose

    The purpose of this assignment is to identify nursing care models utilized in today’s various health care settings and enhance your knowledge of how models impact the management of care and may influence delegation. You will assess the effectiveness of models and determine how you would collaborate with a nurse leader to identify opportunities for improvement to ensure quality, safety and staff satisfaction. R447 Week 5 Nursing Care Models Worksheet Essay Assignment papers.

    Course Outcomes

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    Completion of this assignment enables the student to meet the following course outcomes.

    CO1: Apply leadership concepts, skills, and decision making in the provision of high quality nursing care, healthcare team management, and the oversight and accountability for care delivery in a variety of settings. (PO2) R447 Week 5 Nursing Care Models Worksheet Essay Assignment papers.

    CO2: Implement patient safety and quality improvement initiatives within the context of the interprofessional team through communication and relationship building. (PO3)

    CO3: Participate in the development and implementation of imaginative and creative strategies to enable systems to change. (PO7)

    CO4: Apply concepts of leadership and team coordination to promote the achievement of safe and quality outcomes of care for diverse populations. (PO4)

    CO6: Develop a personal awareness of complex organizational systems and integrate values and beliefs with organizational mission. (PO7)

    CO7: Apply leadership concepts in the development and initiation of effective plans for the microsystems and/or system-wide practice improvements that will improve the quality of healthcare delivery. (PO2, and 3)

    CO8: Apply concepts of quality and safety using structure, process, and outcome measures to identify clinical questions as the beginning process of changing current practice. (PO8) R447 Week 5 Nursing Care Models Worksheet Essay Assignment papers.

    Due Dates

    Submit by Sunday, 11:59 p.m. MT, end of Week 5.

    Points

    This assignment is worth 200 points.

    Directions : Use this form to complete the Week 5 Nursing Care Models Assignment: Nursing Care Models Worksheet (Links to an external site.)Links to an external site.

    Read your text, Finkelman (2016), pp- 111-116.

    You are required to complete the assignment using the template.

    Observe staff in delivery of nursing care provided. Practice settings may vary depending on availability.

    Identify the model of nursing care that you observed. Be specific about what you observed, who was doing what, when, how and what led you to identify the particular model

    Review and summarize one scholarly resource (not your textbook) related to the nursing care model you observed in the practice setting. R447 Week 5 Nursing Care Models Worksheet Essay Assignment papers.

    Review and summarize one scholarly resource (not including your text) related to a nursing care model that is different from the one you observed in the practice setting.

    Discuss a different nursing care model from step #3, and how it could be implemented to improve quality of nursing care, safety and staff satisfaction. Be specific.

    Summarize this experience/assignment and what you learned about the two nursing care models.

    Submit your completed worksheet no later than 11:59 p.m. MT on Sunday by the end of Week 5.

    Please see the grading criteria and rubrics on this page.

    Nursing Care Models Worksheet

    Identify the model of nursing care that you observed. Be specific about what you observed, who was doing what, when, how and what led you to identify the particular model R447 Week 5 Nursing Care Models Worksheet Essay Assignment papers.

    Review and summarize one scholarly resource (not including your text) related to the nursing care model you observed in the practice setting.

    Review and summarize one scholarly resource (not including your text) related to a different nursing care model that you observed in the practice setting R447 Week 5 Nursing Care Models Worksheet Essay Assignment papers.

    Discuss a different nursing care model from step #3 of the directions and how it could be implemented to improve quality of nursing care, safety and staff satisfaction. Be specific.

    Summarize this assignment and what you learned about the two nursing care models discussed. R447 Week 5 Nursing Care Models Worksheet Essay Assignment papers.

  • Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video

    Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video

    Discussion: Comprehensive Integrated Psychiatric Assessment

    The comprehensive integrated psychiatric assessment of a child or adolescent consists of gathering information from not only the child but from several sources, most notably the family members, caregivers, and the child’s teacher or school counselor. Because of this, the diagnostic assessment becomes more complicated. Issues of confidentiality, privacy, and consent must be addressed. Also, the PMHNP must take into consideration the impact of culture on the child.

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    In this Discussion, you review and critique the techniques and methods of a mental health professional as he or she completes a comprehensive integrated psychiatric assessment of an adolescent.

    Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video Learning Objectives

    Students will:

    Evaluate comprehensive integrated psychiatric assessment techniques

    Recommend assessment questions

    To Prepare for the Discussion:

    Review the Learning Resources concerning the comprehensive integrated psychiatric assessment.

    Watch the
    Mental Status Examination
    video.

    Watch the two YMH Bostonvideos.

    Note:
    For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the “Post to Discussion Question” link and then select “Create Thread” to complete your initial post. Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video. Remember, once you click submit, you cannot delete or edit your own posts and cannot post anonymously. Please check your post carefully before clicking
    Submit
    !

    By Day 3

    Based on the YMH Boston
    Vignette 4
    video
    , post answers to the following questions:

    What did the practitioner do well?

    In what areas can the practitioner improve?

    At this point in the clinical interview, do you have any compelling concerns? If so, what are they?

    What would be your
    next
    question, and why?

    By Day 6

    Respond
    to at least
    two
    of your colleagues by offering additional insights or alternative perspectives on their diagnosis or provide alternate next questions and why you selected those. Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video.

     

    Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video 1

    Based on the YMH Boston Vignette 4 video, post answers to the following questions:

    •
    What did the practitioner do well? The practitioner built report with the client and informed Sean of his right to privacy and confidentiality. By building trust with the client, it allows the client to be honest and more open during the evaluation process. The practitioner also asked questions that lead to the client stating what he felt the problem at hand was before giving feedback. During the evaluation process, the practitioner was able to aid the client into revealing his prospective of the current situation such as his mother’s nagging behaviors and the client revealing that he does not feel comfortable opening up to his mother. Further on in the evaluation process, the practitioner identified what makes the client feel comfortable talking to others such as his coach giving him advice, someone being there to listen, and not feeling pressured into following the advice. Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video.

    •In what areas can the practitioner improve? In the evaluation process, I didn’t observe any information given on the parents/family health or psychiatric history.  More information should have been given about the adolescent’s health, illness, treatment, and current medications.

    •At this point in the clinical interview, do you have any compelling concerns? If so, what are they? No, there are no compelling concerns. Since the problem was identified during the evaluation, a treatment plan can be established.

    •What would be your next question, and why? The next question would be if the client or parents have any concerns regarding the evaluation. “Parents are often worried about how they will be viewed during the evaluation. Child and adolescent psychiatrists are there to support families and to be a partner, not to judge or blame. They listen to concerns, and help the child or adolescent and his/her family define the goals of the evaluation” (American Academy of Child and Adolescent Psychiatry, 2018). By asking questions about any concerns, it helps to address any worries that might hinder treatment Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video.

    American Academy of Child and Adolescent Psychiatry. (2018).

    Comprehensive Psychiatric Evaluation. Retrieved from
    https://www.aacap.org/aacap/families_and_youth/facts_for

    _families/fff-guide/Comprehensive-Psychiatric-Evaluation-052.aspx

    Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video Response 1

    A concern that I had after watching the scenario was the patient’s anger.  The reason for referral was that the patient’s mother thinks that he has an anger management problem and the patient confirmed that he“loses his temper” (YMH Boston, 2013). The initial session is identified as a key time to focus on specific problems and previous interventions ( Nichols, 2014). My next question regarding his anger would be what does it look like when he loses his temper? How does his mother respond? The practitioner helped to identify persons with whom the patient was comfortable talking to. The patients identified hid coach as “ Yoda” this was also mildly concerning related to the” myth of the hero” ( Nichols, 2014).

     

    References

    Nichols, M (2014).
    The Essentials of Family Therapy
    (6
    th
    ed).  Upper Saddle River, NJ: Pearson Education

    YMH Boston. (2013c, May 22).
    Vignette 4 – Introduction to a Mental Health Assessment
    [Video file]. Retrieved from https://www.youtube.com/watch?v=JCJOXQa9wcE

     

    Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video Response 2

    I agree the counselor was informative from the beginning about confidentiality; however, he could have improved his initial interview with the client by asking more questions his and his mother’s relationship.  The client expressed annoyance towards his mother, but the counselor failed to explore this further.  The counselor could have asked how many times per week do you disagree with your mother and how do you feel afterward if an argument results?  The question is quantitative but nonjudgmental, creating an effective therapeutic alliance between client and counselor.  Carlat (2017) described the therapeutic alliance as a feeling one should create over the course of the diagnostic interview, a sense of rapport, trust, and warmth (p. 17).

     

    Reference

    Carlat, D.J. (2017).
    The psychiatric interview
    (4
    th
    ed.). Philadelphia, PA: Wolters Kluwer.

     

    Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video 2

     
    What the Practitioner did Well

    Sean is a 16 year old client who presented for evaluation. The practitioner after watching the YMH Boston
     Vignette 4 
    Video did some few good things.

    Firstly, he set up a comfortable relaxing environment for Sean.

    He told Sean all about the procedure of the therapy process; by explaining his privacy rights. When dealing with teenagers, using this approach will let them feel comfortable and at ease and ready for the therapy.

    The practitioner’s initial approach was honest when he made Sean to understand that whatever he says here will be private. Private except when it is absolutely necessary as an exclusion to confidentiality to disclose in the event that it might be a threat or harm towards Sean or others. This gave Sean enough confidence to feel free. Teenagers like their things kept secret and in confidentiality. Client confidentiality is the basis of a healthy therapeutic relationship and the therapist has an ethical and legal responsibility to protect the confidentiality and privacy of his/her clients ( Pope & Vasquez, 2016).

    Areas to Improve on

    There are also some few things that need improvement on. The practitioner did not greet or introduce himself to Sean. Not greeting or introducing oneself can always be seen as arrogance especially when culture has to be taken into consideration. Not greeting and introducing oneself can be negative and can sometimes cause a barrier to a successful therapeutic approach. It is always advisable to master the questions to be asked a client and let writing be very minimal. The practitioner could be seen writing during this interview, causing distractions  and communication breakdown. Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video..

    Sean does not like school but the practitioner did not ask about his school and why he hates school. More could have been gotten just by asking that question. Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video. Another ignored spot was his relationship with his mother. The practitioner should have been able to get more from this too. Allowing Sean to participate by encouraging him to use his own words in describing his problem would have led to more information. As said and emphasized by Goldstein, & Findling (2006), an open inquiry followed by more focused questions later in the interview provides the most information and how a provider should also seek detailed descriptions of the behavioral or emotional symptoms and ask for specific examples of the behavior.

    Another area where the practitioner needs improvement is to avoid asking leading questions. He asked Sean “I bet that really made you angry, right?” An obvious answer is “yes.” A better question would be, “How did you feel when that happened?

    Compelling Concerns during the Clinical Interview

    Sean’s deep rooted anger  towards his mom is a compelling concern. Knowing that Sean has this deep rooted anger should have led to more questions to find out why. Knowing that many teenagers do not like to confide in or talk to their mothers, the practitioner should not have seen it as a reason not to ask, but instead find out if Sean’s mother even  know about this deep rooted anger and why. Also, the practitioner should be concerned about the coach being his father figure. Where is his biological father, and how often if at all do they see each other, and why? Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video.

    Next Question and Reason Behind the Question

    Just for curiosity sake, questions like what makes Sean angry, if angry does he feel like hurting himself or someone or not, if he likes his life, what he enjoys doing besides basketball and talking with his girlfriend, and also get more insight into his relationship with his girlfriend and its seriousness. His performance in school, questions like “what is going on at school that makes you hate it so much?” According to (American Psychiatric Association, (2013), struggling academically may indicate an inability to concentrate which may point to a psychiatric diagnosis such as depression, anxiety, or attention-deficit hyperactivity disorder. Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video.

     

    References

    American Psychiatric Association. (2013).
    Diagnostic and statistical manual of mental

    `           disorders
     (5th ed.). Washington, DC: Author.

    Goldstein, A., & Findling, R. (2006). Assessment and evaluation of child and adolescent

    psychiatric emergencies. 
    Psychiatric Times
    , 
    23
    (9), 76-111.

    Pope, K. S., & Vasquez, M. J. (2016). 
    Ethics in psychotherapy and counseling: A practical guide
    . John Wiley & Sons.

     

    Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video response 1

    Thanks for your nice post. I concur with all you said and also believe that Sean is depressed too. Depression may have an influence in the adolescents’ abhorrence for school or may even piece of his reaction to the enthusiastic issue caused by the pressure he is experiencing at the time the practitioner saw him. “SIG E CAPS” is a simple and fast strategy for evaluating for depression particularly in the medicinal setting (Carlat, 1998). They are the abbreviation for Sleep, Interest, Guilt, Energy, Concentration, and Appetite, Psychomotor, and Suicidal Ideation. For the diagnostic criteria of depressive disorder, the client, must have somewhere around five out of nine symptoms, and the client(s) are also required to have lost interest in generally agreeable interests as one of the five manifestations.

    Something like 5 of the symptoms must be available for no under about fourteen days for the diagnosis to be positive. Thanks for you good posting Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video.

    Reference

    Carlat, D. J. (1998). The Psychiatric Review of Symptoms: A Screening Tool for Family Physicians Retrieved from https://www.aafp.org/afp/1998/1101/p1617.html

     

    response 2

    Great post. I like how you really observed the questions and how the practitioner asked the questions when interviewing the client. Open-ended questions help you establish a working relationship with your patient:

    • They give the patient the greatest possible latitude in coming up with a response, so you don’t limited the scope of your information.

    • They serve as bait when you are fishing for the sorts of problem you’ll need to explore.

    • Because the patient does most of the talking, they allow you to assess your patient’s thought and speech patterns.

    • Patients who are encouraged to talk freely tend to like the person doing the encouraging (Morrison, 2018).

    Reference:

    Morrison (2018). Retrieved from https://www.ohsu.edu/xd/education/schools/school-of-medicine/departments/clinical-departments/psychiatry/education-and-training/medical-students/upload/MSE-Psychiatric-Interviewing.pdf

     

    response 3

    I enjoyed reading your post! It contained a lot of information in it regarding the evaluation.  I totally agree that confidentiality is the basis for a healthy therapeutic relationship. “Privacy rights and protection of health information take on special meaning in mental health care, whether because of the stigma associated with mental health conditions, or issues of family dynamics, or a variety of other reasons” (Bernstein, 2017).However, the practitioner could have asked more questions concerning the client’s family relationship and client’s mental health history.

     

    Bernstein, J. (2017). Patient Privacy in Mental Health:vBalancing Rights while Trying to Ensure Appropriate Treatment.vRetrieved from
    https://careforyourmind.org/patient-privacy-in-

    mental-health-balancing-rights-while-trying-to-ensure-appropriate-treatment/

    post

    A Mental Health Assessment is one of the most important parts in diagnosing; it allows the provider to evaluate needs, level of impairment or detailed picture of what the person may need (Hill, 2014). Based on the YMH Boston
    Vignette 4 video:

    What did the practitioner do well?
      I feel the practitioner explained to the client of the right of protection/privacy, “A special issue concerning confidentiality is when the patient indicates that he or she intends harm” (Sadock, Sadock, & Ruiz, 2014). He did notify the client of his rights and everything is confidential unless there are any safety issues of the client discussing wanting to hurt him or others.

    Also the practitioner was able to make the conversation at ease to understand why the client’s mother scheduled the appointment. I liked how he transitioned to find out more like why did he think his mom want him to come or if he has any support systems (coach and girlfriend) seeing he doesn’t feel comfortable talking to his mom, the practitioner also validated the client’s thoughts “you just want someone to listen and not be a parent”

    In what areas can the practitioner improve?
     Suggested in our reading from Kaplan & Sadock’s states of “Premature Advice” and “Judgmental Question/Statements” I feel the piece of how the client thinks his mom is just nagging and doesn’t listen to him.  I understand where the provider is trying to make it comfortable to get the client to talk but he never speaks how your mom is your parent and making sure he understands even at his older teen age she is doing what she is to be doing parenting not being a friend.  And encourage him to still talk to his “mom” and perhaps they can both work on communication of listening

    At this point in the clinical interview, do you have any compelling concerns? If so, what are they?
      Not really a compelling concern but I would like to see an overview of what
    the client
    wants to work on during his time, making reasonable goals possibly in communication with mom and/or work on coping strategies with his anger.

                What would be your next question, and why?
      I would want to find out more of his temper/anger; how well can he control it, does he becomes physically aggressive (throw items, break things, hit/ punch people or objects), how does he control himself (at home or school).  If this maybe problem that can be solved with therapy like CBT or does he possibly need medication along with therapy.  “Anger control training (ACT) aims to improve emotion regulation and social-cognitive deficits in aggressive children. Children are taught to monitor their emotional arousal and to use techniques such as cognitive reappraisal and relaxation for modulating elevated levels of anger” (Sukhodolsky & et al., 2016).

     

     

     

    Reference:

    Hill,T. (2014). Preparing for a Mental Health Evaluation. PsychCentral. Retrieved from www.psychcentral.com

    Sadock, B.J., Sadock, V. A., & Ruiz, P. (2014). Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry (11
    th
    ed.). Philadelphia, PA: Wolters Kluwer.

    Sukhodolsky, D. G., Smith, S. D., McCauley, S. A., Ibrahim, K., & Piasecka, J. B. (2016). Behavioral Interventions for Anger, Irritability, and Aggression in Children and Adolescents. 
    Journal of child and adolescent psychopharmacology
    , 
    26
    (1), 58-64.

     

    Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video response 1

    Thanks for sharing your thoughts on the video. At first, when I watched it all I did not see anything wrong with the approach of the clinician. Mary L (2015) says, anger causes distress and family dysfunction and often leads to more serious issues. It is overwhelming, can produce physical and emotional discomfort and the way of expressing it can be a source of problems. It leads to acting rather than thinking and thus the difficulty. Having anger is not a problem for most people, the problem is expressing it. Seppalla, (2018) says that the direct expression of anger while intending to convey a point often leads the confronted party being defensive when emotional centers of the brain flare up and both parties not able to think clearly. It would, therefore, be important for the counselor or nurse also meet with the parent to find out the root of the cause of his problem. This is just but the introduction of the video the continuation would have been interesting. Thanks once Beth and all the best in the rest of the semester. Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video.

    References

    Lowth, M. (2015). Managing anger in adolescents. 
    Practice Nurse
    , 
    45
    (12), 18–23. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=111561584&site=ehost-live&scope=site

     

    SEPPÄLÄ, E. M. (2018). How to Express Anger. 
    Psychology Today
    , 
    51
    (4), 44–46. Retrieved from https://ezp.waldenulibrary.org/login?url=https://search.ebscohost.com/login.aspx?direct=true&db=rzh&AN=130238138&site=ehost-live&scope=site

     

     

    Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video response 2

    Your point on the practitioner needing to improve on encouraging communication between the minor client and the parent is a valid one, while I do not think the intention of the practitioner was negative, through his statements he actually encouraged further contention between the client and his mother. Adolescents are at a phase of development where they seek validation for their feelings and actions and the practitioner gave validation to the feelings of the client that were negative towards the mother without first seeking clarification or at the very least having a family session with the mother present to observe the family dynamics before giving a premature analysis. According to Karver, De Nadai, Monahan & Shirk (2018), “although parents occupy varied roles in youth therapy ranging  from the youth’s transport to collateral participation, failure to maintain a strong alliance with parents/caregivers can have serious implications for treatment continuation and early dropout.” Seeing as though the practitioner discussed with the client that he would maintain confidentiality regarding their conversations unless the risk of imminent danger to the client or others, how would the client go about discussing the concerns of the client with the mother without breaking confidentiality? Would this create further bias against the mother if the practitioner cannot delve deeper into the family dynamics without discussing what the client has said in the private sessions? Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video. Does the mother even know what is contributing to her son’s increasing anger? According to Sadock, Sadock & Ruiz (2014), “in some cases, especially with older children and adolescents, the parents may be unaware of significant current symptoms or social difficulties of the child.

     

    References

    Karver, M.S., De Nadai, A.S., Monahan, M., & Shirk, S.R. (2018). Meta-analysis of the prospective relation between alliance and outcome in child and adolescent psychotherapy. 
    Psychotherapy, 55
    (4), 341-355.

    Sadock, B.J., Sadock, V.A., & Ruiz, P. (2014). 
    Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry 
    (11th ed.). Philadelphia, PA: Wolters Kluwer.

     

    Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video response 3

    Thanks for your post! Yes, a thorough mental health assessment is crucial to accurately diagnosing the client. Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video. “Assessment is a process for defining the nature of that problem, determining a diagnosis, and developing specific treatment recommendations for addressing the problem or diagnosis” (U.S. National Library of Medicine, 1989). Furthermore, during the assessment process the practitioner could have asked more questions about Sean’s anger problems and ways that he manage his anger. Knowing about Sean’s relationship with his family is also important.

     

    U.S. National Library of Medicine. (1989). Screening and Assessment.v Retrieved from
    https://www.ncbi.nlm.nih.gov/books 
     /NBK83253/

     

    Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video -Main Question Post:

    What did the practitioner do well?

    Began the interview in a relaxed, non-structured manner to establish rapport and build therapeutic alliance.  Spoke in language appropriate to client’s developmental age. Addressed privacy concerns and limits to confidentiality.

    In what areas can the practitioner improve?

    Greet client and introduce self; ask how the client wants to be addressed.

    Relieve client anxiety and diffuse tension/strangeness of the situation by asking how client feels about coming in; and by explaining the assessment process and duration of the interview.

    At this point in the clinical interview, do you have any compelling concerns? If so, what are they?

    Interviewer does not clearly identify the reasons and factors leading to referral; does not obtain an accurate picture of the clients developmental function, nature, and extent of the behavioral issues, functional impairments, and/or subjective distress; and does not identify potential individual, family, or environmental factors that may be influencing difficulties. Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video.

    Interviewer does not follow client’s lead and moves to questioning other topics (i.e. When asking about how client is doing in school, client responds with negative comment “Kinda sucks” but is not asked to elaborate by interviewer).  Interviewer switches back and forth between topics (i.e. school and leisure activity) that appears to provoke annoyance and confusion in client.

    What would be your 
    next
     question, and why?

    What would you like to see different from coming in today? Open-ended question that provides client time to tell their story.  Creates a level of comfort and helps to build/strengthen rapport; gives client sense that you are interested in listening.  Provides insight into what issues client views as most distressing Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video.

    References

    Carlat, D. J. (2017).
    The Psychiatric Interview
    (4
    th
    ed.). Philadelphia, PA: Wolters Kluwer. Sadock, B. J. & Sadock, V. A. (2003).
    Kaplan & Sadock’s synopsis of psychiatry:
    Behavioral sciences/clinical psychiatry
    (9th ed.). Philadelphia, PA: Wolters Kluwer.

     

    YMH Boston. (2013c, May 22).
    Vignette 4 – Introduction to a mental health assessment
    [Video

    file]
    .
    Retrieved from https://www.youtube.com/watch?v=JCJOXQa9wcE

     

    Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video response 1

    You have good insight on what this provider could have improved on his mental status exam.  This provider does neglect to take any action or inquire about more information when the client brings up different subjects. The client also portrays a negative attitude when speaking of his mother and the responses by the provider do not offer insight to the parent/ son relationship.  Instead his responses could almost show acceptance of the possible poor relationship.  These types of lack of response, initiation of conversation, and supporting negativity can affect the provider’s credibility.  A therapeutic bond is very important in psych, in fact it can be the most important factor in being successful in providing mental health care/ therapy. Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video. Factors that influence a therapeutic bond include: credibility, trustworthiness, and expertise (Ardito & Rabellino, 2011).  When any of these factors are lacking the relationship can be negatively affected.

    When I viewed this video I felt as though the provider was trying to build a therapeutic relationship through identification with the client.  I felt he was trying to identify with the client by offering a nonjudgement, supportive, reaction.  However, I feel he was going about this in the wrong manner.  What do you think?

    References

    Ardito, R. B., & Rabellino, D. (2011). Therapeutic Alliance and Outcome of Psychotherapy: Historical Excursus, Measurements, and Prospects for Research.
    Frontiers in Psychology,

    2
    . doi:10.3389/fpsyg.2011.00270 Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video

     

    Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video response 2

    Excellent Post! Your further assessment question was admirable.  When speaking with an adolescent in therapy, the experience can be unsettling for the client. Teens are sometimes unaware of the benefits of therapy and find the experience useless. When interviewing an adolescent, some methods can be implied to help the process. Motivational Interviewing is a method that can be used that has been proven to be favorable.  Motivational Interviewing allows the client to see that the provider is advocating for them to be better individuals. The client can recognize their mannerism that is problematic and modify their performance (Brakman & Gold, 2014). This therapy would provide aid for the teen being counseled and boost the individual’s self-esteem and receptiveness to treatment. Psychotherapy has been determined to be useful in releasing tension and managing quandaries (Mayo Clinic, 2016). Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video.  These were some of the issues the client was dealing with and causing problems of concerns.

    References

    Brakman, A., & Gold, M. (2014). Use motivational interviewing with teens.
    Contraceptive Technology Update
    , 35(12), 142–143.

    Mayo Clinic. (2016).
    Psychotherapy
    . Retrieve from https://www.mayoclinic.org/tests-procedures/psychotherapy/about/pac-20384616

     

    Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video response 3

    Your post was very informative and brought some valuable points pertaining to the clinical interview of adolescents.   Adolescents obtain their health information from a number of sources. Health care providers are high on the list of the most valued of these sources. Therefore, providers must develop an approach and communication skills with their adolescent patients. One of the challenges of adolescent medicine is helping your patients in finding a path to a healthy lifestyle they are comfortable with. It is essential to get the information needed to assess and diagnose health issues, and for the patient to get the information he/she needs to deal effectively with (these) health issues. Adolescents want very much to show they are mature and ‘can handle things themselves’, but at the same time, some of the medical and psychosocial issues they confront may require them to be more dependent. The health care provider must deliver information in such a way as to allow the patient to participate in their own care to the limit of their capabilities developmentally, physically and emotionally, whether they have a short-term, chronic or life-threatening condition (Sacks, 2015).

    Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video Confidentiality is the cornerstone of any therapeutic relationship with youths. Without clarifying the limits of confidentiality you may well get incorrect or incomplete information during history taking. A great concern is often about treating adolescents without parental or guardian consent for fear of being sued. Start the interview with an adolescent by detailing the law and the facts of confidentiality and its exceptions in the circumstances of serious thoughts of homicide or suicide, or recent physical or sexual abuse. This is important to be repeated often at subsequent visits. It is possible to get the youth to disclose to the family something that is appropriate or that would be helpful for them to know; however, this may take some time to get to the appropriate trust level.  The confidentiality of the visit is reinforced by having the interview in a room that ‘feels’ private, ie, with a door, not a curtain, and far enough away from the waiting area so that the discussion cannot be overheard (Sacks, 2015).

    The Home, Education/Employment, Activities, Drugs, Sexuality, Safety, (violence and abuse), and Suicide (HEADSSS) mnemonic is very useful to remind us of important information we need to obtain from adolescent patients. This approach starts with nonthreatening, open-ended, nonjudgmental questions and progresses to more sensitive areas such as sexuality, feelings of depression and thoughts of suicide. The discussion of the presenting complaint or reason for the visit should be addressed at some time during the visit even if other important issues are brought forward. Ensure the youth that all the questions are asked in an attempt to help the adolescent improve their health (Sacks, 2015).

     

     

    Reference

    Sacks, D. (2015). An approach to interviewing adolescents.
    U.S. National Library of Medicine
    .Retrieved fromhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC2794315/

     

    Comprehensive Integrated Psychiatric Assessment of YMH Boston Vignette 4 Video

    The objective of the patient interview is to elicit a description of their experience(s) as to why they have presented for treatment and their own viewpoint on the treatment they will receive. The psychiatric interview of children and adolescents can be more complex due to the fact that the information will not just come from the client themselves but also from the viewpoint of the parent or guardian and other resources such as teachers or guidance counselors that can offer information that will allow the practitioner to have a greater understanding of the minor client. According to Sibeoni et al. (2018), “in adolescent psychiatry, the lived experience and the expectations of patients and their parents have a central role in treatment.” Based on the topic video, the practitioner quickly established the terms of the interview with the client including the terms of what is protected by confidentiality. Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video. By doing so, the practitioner established a connection with the minor client that is supportive, reciprocal and non-judgmental. According to Pumariega et al. (2013), clinicians should explain the importance of confidentiality in psychotherapy to the family, so that they are not perceived as “driving a wedge” between the child and the family or used by the patient to resist dealing with family issues. The adolescent client is in a period of transition in their identity where they desire more autonomy in decision making and want to be seen as a separate individual from their parents. The practitioner placed attention on validating the viewpoint of the client by asking open-ended questions which allowed for the client to explore the reasons that may have led to the need for mental health services. The practitioner can improve in his interaction with the client when discussing his grievances with his mother as he seemed to give several premature interpretations. According to Sadock, Sadock & Ruiz (2014), “even if it is accurate, a premature interpretation can be counterproductive as the patient may respond defensively and feel misunderstood.” While the client did discuss his reasons for frustration with his mother and did not respond in a defensive manner, the practitioner made comments that placed the blame on the mother without fully exploring all of the variables that led to the compounding issue and also gave more credence to his belief that his increased anger is warranted. The successful mental health evaluation/assessment of the minor client is unique as it requires that the practitioner maintain objectivity with both the client and the parents/guardians Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video.

    At this point in the interview, one concern that I would have would be his potential for violence towards his mother. My next question for this client would be, “Could you help me understand what changes within yourself when you get frustrated?” I would ask this type of question because it is an open-ended question which do not lead the client into a specific direction for an answer and also requires more than a yes or no response. This question posed to the client in an open-ended format would illustrate the central issue for treatment which was his anger management but also left an arena for the client to discuss from his point of view not only what triggers his frustration, but also what happens when he reaches his frustration threshold. Furthermore, this question acknowledged why the client presented for services, however it did not place blame on any other party and would require the client to verbalize his emotions in his own words.

    References

    Pumariega, A.J., Rothe, E., Mian, A., Carlisle, L., Toppelberg, C., Harris, T., …Smith, J. (2013). Practice parameter for cultural competence in child and adolescent psychiatric practice. 
    Journal of the American Academy of Child & Adolescent Psychiatry, 52
    (10), 1101-1115. Retrieved from http://www.jaacap.com/article/S0890-8567(13)00479-6/pdf

    Sadock, B.J., Sadock, V.A., & Ruiz, P. (2014). 
    Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry 
    (11th ed.). Philadelphia, PA: Wolters Kluwer. Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video.

    Sibeoni, J., Orri, M., Podlipski, M.A., Labey, M., Campredon, S., Gerardin, P., & Revah-Levy, A. (2018). The experience of psychiatric care of adolescents with anxiety-based school refusal and of their parents: A qualitative study. 
    Journal of the Canadian Academy of Child & Adolescent Psychiatry, 27
    (1), 39-49.

     

    Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video Great post! You are right to mention that one of the interviewing skills the practitioner employed in the video is the use of open-ended questioning. The purpose of an open-ended question is

    to inspire the client to provide an answer by looking into his own knowledge, interests, feelings, and thoughts in ways that are more expansive

    (Weller, Vickers, Bernard, Blackburn, Borgatti, Gravlee and Johnson, 2018). Open-ended questions require more than ’yes’ or ‘no’ responses and allow clients to uncover more about themselves or their concerns.

    Prior to responding to open-ended questions, a client would need to articulate his perception about the issue in order to reveal more about how he see things allowing both the practitioner and the client to take the conversation to a deeper level (Lewis-Beck, Bryman and Futing Liao, 2004). Since the client’s issues are centered around his frustration and anger toward his mother, asking him questions that are open-ended will allow him enough room to explore his own feelings and verbalize his thoughts from his own point of view (YMH Boston, 2013c). This client’s responses gave the practitioner some insight into the possible cause and the underlying reason for the client’s outbursts toward his mother (YMH Boston, 2013c). It is obvious that some tension exists between the client and his mother, and so, the practitioner has a responsibility to explore the feelings that trigger the client’s frustrations and anger

    before they get out of control and evolve into more volatile situations (YMH Boston, 2013c). At some point during future sessions, the need to recommend family psychotherapy for the client, his mother, and other family members may become necessary to address their family issues and to provide a significantly therapeutic outcome (Ezpeleta, Granero, de la Osa, and Domènech, 2015) Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video.

    References

    Ezpeleta, L., Granero, R., de la Osa, N., & Domènech, J. M. (2015). Clinical Characteristics of Preschool Children with Oppositional Defiant Disorder and Callous-

    Unemotional Traits. Plos One, 10(9), e0139346. doi:10.1371/journal.pone.0139346

    Lewis-Beck, M. S., Bryman, A., & Futing Liao, T. (2004). 
    The SAGE encyclopedia of social science research methods
     Thousand Oaks, CA: Sage Publications, Inc.

    doi: 10.4135/9781412950589

    Weller, S. C., Vickers, B., Bernard, H. R., Blackburn, A. M., Borgatti, S., Gravlee, C. C., & Johnson, J. C. (2018). Open-ended interview questions and saturation. 
    PloS

            one
    , 
    13
    (6), e0198606. doi:10.1371/journal.pone.0198606

    YMH Boston. (2013c, May 22). Vignette 4 – Introduction to a mental health assessment [Video file]. Retrieved from https://www.youtube.com/watch?v=JCJOXQa9wcE

    Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video response 2

    Hello Dr. Fleming,

    While the questions were posed in an open-ended format, the tone of the questions seemed ”leading” and gave the client cause to feel that his anger issues primarily stemmed from being stifled by his mother. The interviewer’s first task is to engage the child and develop a rapport so that the child is comfortable (Sadock, Sadock & Ruiz, 2014). When watching the interview, the practitioner wanted to establish a rapport with the adolescent client and used aggreeing with all of the client’s summations of the issues as a way to establish therapeutic alliance. In the long-run this tactic could have a negative impact on the therapeutic outcome when the times comes for the practitioner to confront the client on negative behaviors or does not agree with all of the clients thoughts or perspectives.

    Reference

    Sadock, B.J., Sadock, V.A., & Ruiz, P. (2014). 
    Kaplan & Sadock’s synopsis of psychiatry: Behavioral sciences/clinical psychiatry 
    (11th ed.). Philadelphia, PA: Wolters Kluwer Comprehensive Integrated Psychiatric Assessment discussion essay examples – YMH Boston Vignette 4 video.

  • Caring for Populations NR 443 sample essay assignment: Assessment and Diagnosis

    Caring for Populations NR 443 sample essay assignment: Assessment and Diagnosis

    Welcome to the ‘Venice of America’. Fort Lauderdale is located in Broward County in Florida and is 36 square miles.  It was named after Major William Lauderdale who fought the Seminoles and captured their land. There were forts that were erected that were named after the Major but none of them survived (City of Fort Lauderdale, 2013). The city of Fort Lauderdale sees a lot of tourists visiting is boundaries and plays hosts to millennials to Baby Boomers. The city began its transformation into a top spring holiday location and college students the beaches that exists along the eastern border of this friendly city. Caring for Populations NR 443 sample essay assignment: Assessment and Diagnosis. The local economy is numbered in the billions and the local government seeks to boost the image of the city as well as the well-being of residents. The purpose of the paper is to examine the community within which one lives and or works. It will present an overview of the community, demographic data, epidemiological data, a windshield survey which will identify community health nursing problem for diagnosis. The problem identified will be assessed and a rationale why this is an issue within the community. A summary of the issue identified will be presented.

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    Community Overview

    The community of Fort Lauderdale is diverse and offers varying activities for individuals of all ages. It is the home of the very rich to the very poor. It has high rises and single family homes as part of its skyline.  It is located on the eastern cost of the United States and its shores are lapped by the Atlantic Ocean. The city is known for its beaches and boating waterways. The most popular strip is found along A1A which runs along the coast with the ocean in sight. As previously stated Fort Lauderdale remains a popular spring break destination. “An advantageous economic climate is helping the City of Fort Lauderdale establish itself as a world-class international business center and one of the most desirable locations for new, expanding or relocating businesses” (City of Fort Lauderdale, n.d.).  The entertainment strip is lined with bars, hotels, and high end hotels. There is also a gateway port that is a hub to shipping both commercial and pleasure in the form of Port Everglades. The community has several hospitals, pharmacies, banks and schools. Caring for Populations NR 443 sample essay assignment: Assessment and Diagnosis.

    Demographic Data

    The city of Fort Lauderdale is a potpourri of culture and peoples from varying parts of the world. The population of Fort Lauderdale which is located in Broward is a blend of varying cultures and races. However, there are some ethnicities that sustain an elevated existence in the city. The population is 176, 013 at last census conducted in 2014. In 2010, the white only population was 62.6% and the Black or African American alone stood at 31.0 %. In comparison the national census stood at 72.4% (Whites) and 12.6% (Blacks) respectively. Caring for Populations NR 443 sample essay assignment: Assessment and Diagnosis. The American Indian and Alaska Native only percentage during 2010 stood at 0.3% in comparison to the national levels of 0.9% The Asian community alone represented 1.5 % while the national rate stood at 4.8%. Hispanics or Latinos represents 13.7% of the Fort Lauderdale community compared to the national average of 16.3%.

    The blend of two or more races stood at 2.1% in 2010 which is less than the national numbers measured at 2.9%.  The population that is 18 years and younger is 17.6% but the national population is 24.0%. The number of individuals over 65 years of age is 15.3% which us higher than the national demographics at 13.0%. A total number of 47.2% of the population is female. The number of veterans that lived in Fort Lauderdale in 2010 stood at 11,315 between 2010-2014. The number of individuals who were foreign makes up 22.8% of the Fort Lauderdale populace. Some 85% of the population was deemed to have education at the high school level or higher and are over the age of 25 years old which is 1.6 % less than the national rate at 86.6 %. Individuals over 25 years who had a bachelor’s degree stood at 33.9% which was higher than the national rate at 29.3% and this was registered between 2010-2014. Persons in poverty was at 21.2% compared to rates at the national level of 14.8% (United States Census Bureau, 2014). Caring for Populations NR 443 sample essay assignment: Assessment and Diagnosis.

    Epidemiological Data

    In the city of Fort Lauderdale, the population is impacted by varying illnesses and this is reflected in the epidemiology of the community. As a whole, Broward County exhibits good health status and good access to care on many measures when compared to Florida and to the U.S.  (Verite Healthcare Consulting LLC, 2013). Data suggests that here are certain chronic diseases that impact the Fort Lauderdale population including Zika, heart disease, diabetes, obesity, sexually transmitted disease especially HIV and drug abuse. It has been shown that these chronic health conditions have noteworthy impact on morbidity and mortality and associated treatment costs (Verite Healthcare Consulting, LLC, 2013, p.7).  Research shows that 65% of adults in 2010 were reported as being overweight or obese and 82% were more than non-Hispanic Black adults.  The goal as listed by People 2020 is 30.5 %. The mortality rate for diabetes among Blacks stands at 79% between 2010 to 2012. This is twice the rate of Whites in the county. Diseases like HIV and other chronic illnesses add to the increased mortality rate. The HIV incidence rate is high and stood at 79% which is higher than the state’s rate. The mortality rate stands at 60 % which is worse than that of the state (Verite Healthcare Consulting, LLC, 2013, p.8). Caring for Populations NR 443 sample essay assignment: Assessment and Diagnosis.

    Windshield Survey

    Exploring the city Fort Lauderdale community via car will highlights is good and bad aspects. There are neighborhoods that house the elite and those that serve as home to the middle class and the poor. Caring for Populations NR 443 sample essay assignment: Assessment and Diagnosis. There are areas within which the poor can access public housing including Kennedy Homes.  There are also signs of dereliction with boarded up homes due to numerous foreclosures which displaced many individuals and their families. There is a high incidence rate of homelessness and the veteran population among that demographic is high. The homeless can seek help from the Salvation Army.

    Access to public transportation is apparent and many within the community use this service for their commute to school or work and so on. Many school buses can be seen while school is in session and often times they are seen dropping off children who walk home. Schools range from day cares, community colleges and universities namely FAU. There are several hospitals including Broward General and Kindred Hospital which are located in the downtown vicinity of the city. Residents have access to health clinics and varying types of doctors as well. The elderly population is high and is seen in the high number of assisted living facilities. There are supermarkets and food stores as well as farmers’ markets from which residents can purchase goods for consumption.

    Problem Diagnosis

    As stated earlier there are there are many issues that impact our community but one of the health concerns is the impact of substance abuse in Fort Lauderdale. “Substance abuse has a major impact on individuals, families, and communities. The effects of substance abuse are cumulative, significantly contributing to costly social, physical, mental, and public health problems” (U.S. Department of Health and Human Services,2016). The issue of overdose and or misuse of drugs be it prescribed or street derived negatively impacts individuals. Caring for Populations NR 443 sample essay assignment: Assessment and Diagnosis. The number of individuals who die from drug overdose is increasing, too often one wakes up to hear that a celebrity or someone known or close passed due to drug use and or overdose. Individuals like Whitney Houston, Heath Ledger, Michael Jackson and Anna Nicole Smith. Caring for Populations NR 443 sample essay assignment: Assessment and Diagnosis.

    The truth is that many are dying and are not just being impacted by street drugs like Flakka but “a majority of which are from prescription drugs – in Florida doubled since 1999” (TFAH, 2014). It is estimated that 6.4 individuals out on every 100,000 is impacted but the abuse of prescribed medications. Caring for Populations NR 443 sample essay assignment: Assessment and Diagnosis. Many Americans are impacted and this issue is not restricted by color and or class; anyone can become a victim of this strong and potentially detrimental addiction.  Thompson, Tommasello & Long, (2012) states that, an “… increased availability, lack of education about addictions, new pain management standards, and a drug-taking culture help to explain prescription drug misuse and abuse.” Many are turning to prescription drugs and ‘pill mills’ make this option a possibility for many. The authorities have moved to close many pills mills but with the need for more policing of the manner in which prescriptions are dispensed the issue continues to negatively impact individuals who are substance abusers. Caring for Populations NR 443 sample essay assignment: Assessment and Diagnosis.

    Summary

    The city of Fort Lauderdale affords many a great place to live and several opportunities to pursue varying areas of interests. But there are issues that impacts the community and drug/ substance abuse is one that is very visible. The city of Fort Lauderdale was among those that saw a spike in the use of ‘Flakka’ a street drug that left its victims completely unaware of themselves, their environment and what they are doing while under the influence. There are those who are abusing prescription pills and it impairs their ability to contribute substantially to the community and that of their families’ lives. The spike in such substance abuse saw an increase in crime, public disorder, several victims have stripped naked and ran down the middle of the street; one even impaled himself. The need to find solutions is urgent and as community health nurses the onus falls with the scope of practice. Help is on the way.

     

    References

    City of Fort Lauderdale. (n.d.). About Fort Lauderdale. Retrieved from:
    http://www.fortlauderdale.gov/government/about-fort-lauderdale

    Thompson, M.E., Tommasello, A., & Long, B. (2012). The prescription drug misuse and abuse epidemic.
    Journal of American Pharmacists Association, 52
    (5), 564-568. doi:10.1331/JAPhA.2012.1253

    Trust for America’s Health[TFAH] (2014). Prescription drug abuse: Florida reports
    http://healthyamericans.org/reports/drugabuse2013/release.php?stateid=FL

    U.S. Department of Health and Human Services. (2016. May 27,). Substance abuse. Retrieved from
    http://www.healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=40

    United States Census Bureau. (2014, January 6). State & county quick facts: Fort Lauderdale, Florida. Retrieved from
    http://quickfacts.census.gov/qfd/states/12/1224000.html

    Verite Healthcare Consulting LLC. (2013). Community health needs assessment. Retrieved from
    https://my.clevelandclinic.org/florida/ccf/media/Files/About-Cleveland-Clinic/chna/2013-Florida-CHNA-and-ISR.pdf?la=en 
     Caring for Populations NR 443 sample essay assignment: Assessment and Diagnosis.

  • CARING FOR POPULATIONS SAMPLE ESSAY: COMMUNITY WINDSHIELD SURVEY FORM

    CARING FOR POPULATIONS SAMPLE ESSAY: COMMUNITY WINDSHIELD SURVEY FORM

    Caring for Populations: Milestone1: Community Windshield Survey Form

    For Use May 2019

    Directions
    : Please refer to the Milestone 1: Community Windshield Survey Guidelines and grading rubric for specific instructions in order to complete the information below. This assignment is worth 150 points.

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    Type your name, date, and observations directly on this form. Click Save as and save the file with the assignment name and your last name; for example, NR443 Windshield Survey Form_Smith. When you are finished, submit the form to the Week 2 Caring for Populations: Windshield Survey Dropbox by the deadline indicated in your guidelines. Caring for populations sample essay: community windshield survey form.

    Your Name:
    xx                                 
    Date:

    COMMUNITY WINDSHIELD SURVEY FORM

    Criteria

    Your response

    1. Introduction of Community (20 points)

    Identify the city and state of your community and briefly describe the community you will be using for this assignment. It should be the area where you live or the area surrounding your work setting but must include a residential area. Demographic data are not needed.

    I live in the city of Weatherford, TX. Weatherford is a historic town situated 25 miles west of Fort Worth and is known as the cutting horse capital of the world. I live just outside the city limits but am still considered as part of Weatherford.  The city of Weatherford has a country town feeling rather than that of city living. People are outside in the parks and also playing in their yards. We have seven elementary schools, two middle schools, one ninth grade center, a high school, a college, and three private schools. There are multiple grocery stores, shopping centers, restaurants, and churches for different affiliations. Weatherford is home to the Parker County Hospital District. Caring for populations sample essay: community windshield survey form. There are four fire stations, emergency medical services, and a hospital within the city. Weatherford has a police department, jail and the Parker County Sherriff Department.  There are five parks with areas for walking, playgrounds and two dog parks.

     

    2. Windshield Survey (75 points)

    a. Vitality:
    Use a majority of the questions from Box 6-2 in your text to describe your observations about the community vitality.

    People are noted to be walking in the parks and going in and out of the stores and restaurants. The people in my neighborhood are mostly families with a few elderly couples. The age ranges vary but I would say that it is predominantly school-aged children. The community is predominantly white with few minorities noted. The general appearance of the population is varied but seems to be either physically fit to obese. There are some in wheelchairs, utilize walkers, and some with mental disabilities. Most of the people live in homes but there are three apartment complexes in the area. Several of the residents appear well nourished, obese, vigorous, clean and appropriately dressed. Of course there are a few that look unkempt and scantily dressed. I do not notice tourists in the area. I have never noticed anyone under the influence of drugs but have noted some under the influence of alcohol. There are pregnant, as well as women pushing young children in strollers.

    b. Indicators of social and economic conditions:
    Use a majority of the questions from Box 6-2 in your text to describe your observations about the social and economic conditions.

    The majority of homes appear to be well kept but there are a few who are in need of repair. Most homes in the area are single family homes and there are three apartment complexes. There is a tiny portion of dilapidated homes. There are some section eight houses but no large public housing units. The section eight homes are not as nice or as well kept. Most people have their own vehicles, there is a taxi service, a small bus that picks up the riders at their home but there is no public transit. There are no factories or military installations but plenty of small business and restaurants in the area Caring for populations sample essay: community windshield survey form. I rarely see a homeless person. I do not notice any men congregating in groups on the street. Weatherford is a city with a rural feel, there are farms and are two agricultural businesses. I do not note any seasonal workers or day laborers. I do not see any women hanging out alone on the streets. I see a few children out with the adults during the daytime. There were some election signs a few weeks ago but none today. The main health advertisements I see are for the hospital, as it has been recently bought out by a new company. These advertisements are for oncology and cardiac care. I think this is appropriate as the previous hospital did not have a good reputation and they are trying to promote the services they offer to inform the public. I do see a sign at the Parker County Hospital District about vaccines. I think this sign is pertinent but it needs to be placed on a busy street, not on the side of the building. We have seven elementary schools, two middle schools, one ninth grade center, a high school, a college, and three private schools. There are several day care centers and mother’s day out programs to choose from. The private schools, most of the day care centers and mother’s day out programs are Christian based.

    c. Health Resources:
    Use a majority of the questions from Box 6-2 in your text to describe your observations about the health resources.

    There is one 103 bed hospital in Weatherford and one free standing ER. There are several clinics in the area that serve patients seeing specific physicians such as pulmonary, wound care, etc. There is one family planning clinic. There are several doctor’s and dentist offices that are both specialists and generalists. There are six nursing homes, two rehabilitation centers, one mental health clinic, one alcohol and drug treatment center, alcohol anonymous, no homeless shelter, one shelter for abused women, no wellness clinics, one health department facility, two urgent care centers, no mobile health, one Carter Bloodcare center, and several pharmacies. Obesity and physical inactivity are major problems in this region in spite of the fact that there are several fitness centers, parks with walking trails and weight loss programs available.

    d. Environmental conditions related to health:
    Use a majority of the questions from Box 6-2 in your text to describe your observations about the environmental conditions.

    I do not see any signs of ground pollution. The tap water tastes terrible but there is no foul smell or unwanted colonization noted. There are some air pollutants and the levels are put a billboard and on the radio with recommendations for activity levels. The majority of the housing appears sanitary but there are a few homes need of repair. Most of the windows are screened. Currently there is road work being done to widen the highway, some of the streets do have potholes. There are no low water crossings. The traffic lights, signs, sidewalks and curbs appear to be adequate for the area. Warnings and barriers are present at all railroad crossings. The streets and parking areas look as though they are well lit. There are areas of heavy traffic and rural roads. There are a couple of curved roads and there are warnings for them. All the buildings, sidewalks and streets are handicap accessible. Weatherford has a department of parks and recreation which manage the parks, the community pool, and have programs for children and adults. We do not have a YMCA/YWCA. There are multiple day cares and preschools. I see children playing in yards and parks. There are several restaurants in area. Twice a month there is food truck lounge night at a park and live music. People are eating in this area; there are trash cans, places to sit and public restrooms. This time of year the mosquitos are not out yet, there are fire ants, and some flies. There is the occasional stray animal noted.

    e. Social functioning:
    Use a majority of the questions from Box 6-2 in your text to describe your observations about the social functioning.

    I see many families in neighborhoods playing in yards. I observe a variety of family structures such as the nuclear family, single parent family, and extended family. I see men, women and grandmothers caring for the children. Some parents are sitting back and watching the children while others are actively interacting with them. A few families have more than one generation present. Caring for populations sample essay: community windshield survey form. I am unable to identify if any of the subgroups are related to one another either socially or geographically. In one neighborhood, I saw two neighbors having a conversation at their mailboxes. I saw a sign for a community meeting but nothing about improving the conditions of the neighborhood or no neighborhood watch. My neighborhood also has a Facebook page in which we communicate. There are approximately 20 churches in Weatherford; the majority are Baptist, some Church of Christ, Presbyterian, United Methodist, Lutheran, and one Catholic Church. There are no synagogues or other places of worship. I do not see any signs of gang activity and juvenile delinquency. I observed a few pregnant teenagers. I am aware that there is a drug problem and it is common knowledge that drug deals take place in the Walmart parking lot at night. There have been some drug busts at meth houses in Weatherford.

    f. Attitude toward healthcare:
    Use a majority of the questions from Box 6-2 in your text to describe your observations about the attitudes toward healthcare.

    Weatherford has two health food stores. There are several chiropractors, massage therapy places and yoga places that promote health and wellness. I am unsure of how well utilized the health resources are. Prevention and wellness is promoted by most insurance companies. The Parker County Hospital District provides free flu shots to the schools to help prevent the spread of the flu. I do not see any efforts to improve the health of the neighborhood. I haven’t seen any or heard of any planned health fairs, clinics or lectures.

    3.  Vulnerable population (20 points)
    Describe a vulnerable population or aggregate that you identified during your survey. What did you observe about this group such as their appearance and actions?

    The vulnerable population I observed is those will a low income. Limited income puts people at a disadvantage because they do not have the funds for proper nutrition, housing, the ability to seek medical attention, transportation to work and the potential to become a victim of crime.

    4. Conclusion (20 points)

    Provide a summary of your findings. Describe several potential community health problems for the vulnerable population that you identified.

    Weatherford is a small city in Texas.  The majority of the population is middle to upper class with a small portion of low income. That being said it is probably not near the extent of larger cities and there are also fewer resources available. The potential health problems are obesity, starvation, drug abuse, depression, dental issues, diabetes and cardiovascular disease.

    5. References:

    References are not required for this survey:
    If you used references, they must be listed in APA format. If you include any references here, you must also include an in-text citation (author, year) in the body of the form. Caring for populations sample essay: community windshield survey form

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  • Determinants of Health NR 443 essay assignment discussion papers

    Determinants of Health NR 443 essay assignment discussion papers

    Determinants of Health (graded)

    Healthy People 2020 identified four Foundation Health Measures (FHM) that reflect the major health concerns in the United States. The third FHM is Determinants of Health. The description of Determinants of Health is:

    “A range of personal, social, economic, and environmental factors that influence health status are known as determinants of health. Determinants of health include such things as biology, genetics, individual behavior, access to health services, and the environment in which people are born, live, learn, play, work, and age” (U.S. Department of Health and Human Services, n.d., About Determinants of Health section, para. 1).

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    Go to the “Learn More About Determinants of Health” ( http://www.healthypeople.gov/2020/about/DOHAbout.aspx ) and choose one of the five Determinants of Health that you feel is most important for community health. In your posting, share the determinant of health and the rationale for your choice. Remember to cite any references used for developing your rationale.

    Please note:

    There is a helpful “Orientation to Healthy People 2020” document in Doc Sharing.

    Our textbook, Community/Public health nursing: Promoting the health of populations (5th ed.) was published prior to the final version of Healthy People 2020 resulting in some of the book content differing from the Healthy People 2020 website.

    Respond

    This section lists options that can be used to view responses.

    Collapse All         Print View          Show Options

    Responses

    Responses are listed below in the following order: response, author and the date and time the response is posted.

    Sort by Read/Unread    Sort by Response  Sorted Ascending, click to sort descending      Sort by Author  Sort by Date/Time* Determinants of Health NR 443 essay assignment discussion papers.

    (an instructor response)

    Collapse              Mark as Read    Determinants of Health                Instructor Hamilton Email this Author     2/17/2015 8:27:50 PM

    Class,

    As mentioned there are five determinants of health.  As you look at these and view the website and the video which of these determinants do you consider to be the most important?  We probably all have one that we feel is the most important.  There are some of the determinants which our populations have no control over.  How is this important in public health nursing?  Your thoughts?~Dr Hamilton

    Please remember to cite your sources.

    Class: You may begin posting in this TD on Sunday, March 1, 2015 for credit.

    Respond

    Collapse              Mark as Unread               RE: Determinants of Health         Erica Meyerhofer Email this Author         3/1/2015 6:56:17 AM

    Main Post Determinants of Health Week 1

     

    Professor Hamilton and Classmates

     

    The five determinants of health according to Healthy People 2020 are policymaking, social factors, health services, individual behaviors, and biology and genetics.   Determinants can be applied to answer why some people are healthier than others and what can we do in the medical profession to build a society where everyone can live a long healthy life (HealthyPeople.gov).

     

    Health Services tops the list for me.  Even with Obama’s health care reform many American’s are still without insurance.  Contrary to the believe affordable health care it is not affordable for all.  Public health relies on a preventative approach to health (Nies & McEwen, 2011).  If health services cannot be obtained by the public due to lack of coverage, high costs, and lack of availability we will not be able to apply a preventative approach (HealthyPeople.gov).  There are three levels of prevention.   Primary which focuses on prevention before the problem occurs. Secondary prevention refers to screening exams to monitor a problem before signs and symptoms begin.  Tertiary Prevention attempts to avoid the progression of the disease or injury the patient has experienced (Nies & McEwen 2011).  If the public does not have access to quality health services the preventative approach to public health cannot exist that is why I feel health services is most important. Determinants of Health NR 443 essay assignment discussion papers.

     

    Social and physical determinants cannot be entirely controlled by population.  Public health nursing brings nursing to the people.  Many times people do not have transportation to access health care by offering it in the homes of those who cannot drive or walk to a health care facility can positively impact the health of all community members.  This philosophy dates back to 1877 when Frances Root was providing in-home care to the sick (Nies & McEwen, 2011).  Where we can afford to live can control our ability to live a long healthy life if we live in a high crime area we are subjected to crime by violence.

     

    Erica Meyerhofer

     

    References:

     

    Nies, M. A. & McEwen M. (2011).  Community/Public health nursing: Promoting the health of populations (5th ed.). St Louis, MO: Saunders/Elsevier.

     

    HealthyPeople.gov. (2015). Determinants of health. (n.d.), http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

     

     

     

    Respond

    Collapse              Mark as Unread               RE: Determinants of Health         Arthel Tamakloe Email this Author           3/4/2015 11:12:12 PM

    Determinants of health include things such as biology, genetics, individual behavior, access to health services, and the environment in which people are born, live, learn, play, work, and age. These are all important but I chose to write biology and genetics.

    Biology refers to things both inside and outside of our bodies. The biological determinants outside of our bodies are living things that we come in contact with.  These could be anything from bacteria, bugs, or animals. These things can affect us in good and bad ways.  If we are exposed to something harmful, our body’s immune system will respond and fight off the infection.

    Genetic is the things that are passed down from parents and ancestors. Things can be physical characteristics as well as hereditary health issues. Things like allergies or other diseases can be passed generation to generation.

    The knowledge of biology and genetics are in important in public health nursing because early intervention is very important. Some genes do not necessarily cause disease, and instead predispose a person to a disease such as heart disease, cancer, and diabetes.

     

    References

     

    HealthyPeople.gov (2015). Determinants of Health. Retrieved from: http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

     

    http://www.ouragenda.ca/resource/Resources/TabId/234/PostId/7/Biologyandgeneticendowment

     

     

     

     

     

     

     

     

    Respond Edit

    Collapse              Mark as Read    Determinants of Health                Anzhelika Antyasova Email this Author   3/1/2015 1:16:06 PM

    Dr.Hamilton and class,

     

    5 Determinants of Health are policymaking, social factors, health services, individual behavior, biology and genetics.

    Individual Behavior

    Determinants of Health NR 443 essay assignment discussion papers Individual behavior is very important aspect in health outcomes. As I already spoke about tobacco use in my  TD#1 I think this is the great example in individual behavior. If an person quits smoking, risk of heart disease or respiratory diseases  reduced. Public health and health care concentrates on changing individual behaviors as diet, physical activity, hand washing, alcohol, cigarets use. Thereby, reduce health risk, and improve health status positively. It is very important to remain physically active , it will help to reduce the risk of cardiovascular deceases. Hand washing will help to avoid infections disease.

    Retrieved from:

     

    http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health#health%20services

     

     

     

    Respond

    Collapse              Mark as Read    RE: Determinants of Health         Erica Meyerhofer Email this Author         3/2/2015 9:17:38 PM

    Modified:3/2/2015 9:18 PM

    Anzhelika

     

    Individual behavior I have to agree is very important but what if the person was unable to obtain the resources required to quit smoking, join an exercise club, or afford healthy food for diet?  Are their free services offered to these individuals in your area?  I know we have a 1-800 quit line for smoking that offers some assistance to patients within our practice.  We live in Wisconsin so weather is not always the best for outdoor exercise and the health clubs in this area are not affordable.  I deal with many patients that would love to go to the gym to swim or walk indoors but simply cannot afford to do so. I am fortunate I can afford to buy healthy food choices for my family but I work with many who are not so fortunate and there are not programs out there for people to afford to buy proper food choices.  Of course then there are people who can afford to smoke and drink but claim they cannot afford to buy fruit and vegetables or buy a gym membership and that is where behavior choices play a major factor in optimize health.

     

    I was an ex-smoker there were two things that made me quit.  First being policymakers the cost was outrageous so I am VERY thankful for the taxes they added to cigarette (healthypeople 2020) and the second reason was I knew better as a nurse  you see patients everyday struggling to breath and like you said everyday they do not smoke reduces their risk for cardiovascular and respiratory disease.

     

    Erica

    Refhttp://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Healtherences:

     

     

     

     

    Respond

    (an instructor response)

    Collapse              Mark as Read    RE: Determinants of Health         Instructor Hamilton Email this Author     3/3/2015 4:58:27 PM

    Anzhelika, Erica, and Class,

    What changes would need to happen in the community for the determinant of health you chose to improve?  You selected some common barriers allowing me to reflect back on my days as a public health nurse…Feel free to jump in class, share what you may be witnessing in your own community…I see farmers markets, COOPs and SHARE programs, energy assistance, diaper drives, holiday baskets, all with the intention those with limited incomes can apply their finances toward health care and living expenses if needed, or save some money for future needs. But again these have limitations.~Dr Hamilton

     

     

     

     

     

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    Collapse              Mark as Read    RE: Determinants of Health         Anzhelika Antyasova Email this Author   3/4/2015 8:25:25 PM

    Erika, I agree with you, there is people on the street with low income, and they can not afford quitting , buy patches, or anything else. Unfortunately in my practice people are trying to quit when already diagnosed with certain disease, and were told by the doctor that the life is in their hands. So far, this is the one of the main  reasons for some people to quite smoking. You asked me if we have free services? I should say there is a lot of websites with a offers of free kits, phone lines. For example http://myquitkit.org, and there is not the only one.

    Determinants of Health NR 443 essay assignment discussion papers I am lucky that I never smoked, and never will, simply because I just Do not like it. And I understand that it is easy to say then do. At the same time I believe quite smoking  is possible if person really needs and wants. As my friend did when his child made a wish for his birthday that wants his Daddy to quite smoking. That was the last day when my friend smoked. And at this point income and free services were not necessary.

     

    Thank you.

     

     

     

    Respond

    Collapse              Mark as Read    RE: Determinants of Health         Erica Meyerhofer Email this Author         3/6/2015 5:27:29 PM

    Anzhelika you are absolutely correct when someone really wants to quit they do.  I smoked from the age of 17 until I was 35.  I had my children at 26 and never a day in their lives did they know that I smoked only until after I quit.  I never wanted my children to know that I smoked. I grew up in a house where my father smoked and hated it that is why my mom was so surprised that my sister and I choose to smoke.  My calling was when my daughter started to smell smoke on me and found a lighter in my purse.  One could only lie so long so that was it for me

     

     

     

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    Collapse              Mark as Read    RE: Determinants of Health         Kathryn Dore Email this Author  3/7/2015 1:19:57 PM

    Erica,

     

    I want to say to you great job on quitting smoking.  Whatever the reason was you stopped and are taking action in your health.  I agree with the higher taxes on cigarette.  I think for a lot of people they start when they are young and don’t think about the health risks.  They will see it when it impacts their money.  Although, I have seen smoking affect people in high school, at gym they can’t run as well as they used to, coughing more.  I wish that there is more out there to get kids not to start smoking.  I know that there is a lot out there, but I feel that there could always be more.

     

     

     

    Respond

    Collapse              Mark as Read    RE: Determinants of Health         Vanessa Machado Email this Author        3/8/2015 9:24:43 PM

     

    Erica,

     

    I agree that individual behavior is a key factor regarding health wellness and promotion.  As you stated, though, upon further questioning, does that person have what they need to positively act on their behavior. Determinants of Health NR 443 essay assignment discussion papers. This is where the determinants of health overlap.  Individual behavior for example, is influenced by the person or community’s knowledge level.  First, one must assess the community’s knowledge base and then ask are people being educated adequately regarding key health issues in their community?  Are they aware of the resources that a community has to assist them in achieving their health and wellness goals-as you stated-maybe related to assistance from their city or town in regards to ways to attain affordable healthy foods.  As Atrash & Carpentier state, “Three services support the core function of Policy development: informing, educating and empowering people about health issues; mobilizing community partnerships to identify and solve health problems; and, developing policies and plans that support individual and community health efforts. And, four services support the core function of Assurance: enforcing laws and regulations that protect health and ensure safety; linking people to needed personal health services and assuring the provision of health care when otherwise unavailable” (2012).

     

    The Institute of Medicine (IOM) further identified two functions provided by all public health agencies and include “Policy development, defined as formulating public policies, in collaboration with community and government leaders, to solve identified local and national health problems and priorities, and, Assurance, defined as assuring that all populations have access to appropriate and cost effective care, including health promotion and disease prevention services, and evaluation of the effectiveness of that care” (Atrash & Carpentier, 2012).

     

    Although the main responsibility for public health resides with the departments of health at the local, state or national levels, the success of public health depends on the coordination of efforts and collaboration between these departments and workers in other components of the health care system, other government agencies, community-based organizations, as well as private organizations.

     

    Thank You,

    Vanessa Machado

     

     

     

    Reference:

    Atrash, K., & Carpentier, R. (2012). The evolving role of public health in the delivery of health care. Revista brasileira de crescimento e desenvolvimento humano, 22(3), 396-399. Retrieved from:  http://pepsic.bvsalud.org/scielo.php?pid=S0104-12822012000300017&script=sci_arttext

     

     

     

     

     

     

     

     

     

     

     

     

     

     

     

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    Collapse              Mark as Read    Health Services Jessica Parker Email this Author 3/1/2015 2:11:02 PM

    Professor Hamilton & Class:

     

    Under Determinants of Health (HealthyPeople.gov), I chose Health Services.  If there is a lack of services or lack of health insurance coverage for services, people will be less likely to get the preventative care they need.  We, as nurses, can work to provide interventions to help improve health in our communities (CCN, 2015).  If the services are not available or not affordable, people cannot be provided the needed services.

     

    As stated by Nies & McEwen (2011), people are many times more concerned with quality-of-life ideals rather than their health.  Although, having access to quality healthcare can add to the quality (& quantity of years) of a healthy life.

     

    Chamberlain College of Nursing. (2015). NR-443 Week 1: Introduction and History of Public/Community Health Nursing [Online lesson]. Downers Grove, IL: DeVry Education Group.

     

    HealthyPeople.gov (2015). Determinants of Health. Retrieved from: http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

     

    Nies, M. A., & McEwen, M. (2011). Community/Public health nursing: Promoting the health of populations (5th ed.). St. Louis, MO: Saunders/Elsevier.

     

     

     

     

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    (an instructor response)

    Collapse              Mark as Read    RE: Health Services          Instructor Hamilton Email this Author     3/2/2015 5:47:40 PM

    Thanks for the post Jessica, This leads me to the question …what consequences would the community face if the determinant of health you chose does not improve? I am wondering if corrective measures are currently introduced or if you are witnessing any community health nurse or public health initiatives?~Dr Hamilton

     

    ORDER A CUSTOM-WRITTEN PAPER NOW

     

    Respond

    Collapse              Mark as Read    RE: Health Services          Jessica Parker Email this Author 3/3/2015 6:26:45 PM

    Professor Hamilton & Class:

     

    I am seeing more people without insurance that would rather pay the fine for not having health insurance than to pay for the government provided insurance that does not have very good coverage.

     

    Our community offers a lab one day quarterly at a discounted rate (only $25!) that will show results for some basic labwork (lipids, glucose, CBC).  Many do not take advantage of this service though.

     

    Jessica

     

     

     

     

    Respond

    Collapse              Mark as Read    Determinants of Health                Tasha Forehand Email this Author            3/2/2015 3:10:10 PM

    Class and Dr. Hamilton,

     

    I believe that Individual Behavior is the most important determinant for community health.  After looking through the list I strongly believe that this determinant is the one that the individual absolutely has the most control over.  We as individuals have to make a decision to be healthy or we won’t be.  There are factors that affect us that we have no control over but this particular determinant is completely in each individuals control in my opinion.  The Individual Behaviors that were listed were diet, physical activity, alcohol, cigarette and other drug use, and hand-washing.  These are all things that we can choose to do or not to do.  There are an abundance of online resources to look at in order to determine what a healthy diet is, how much physical activity we should engage in, the use of alcohol and the risks and benefits associated with it, the use of cigarettes and other drugs and the risks associated with them, as well as the importance of hand-washing to stop the spread of bacteria and germs.  It seems like everywhere I go there are teaching tools to encourage a healthy lifestyle.  As nurses in the community it is our job to make certain that the people in the community are well-educated on these topics.  The hospital in the town that I live in often offers free classes for the community in regards to these topics.  They also have a class that you can take where you go and prepare a week’s worth of healthy meals that can be frozen so that you have healthy meal options for your family.  The resources are endless and I believe it truly is based on making the decision that you are going to live a healthy lifestyle to the best of your control.  We cannot control our genetic makeup but we certainly control how we feed in to it.

     

    Reference:

     

    http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health#individual behavior

     

     

     

    Respond

    (an instructor response)

    Collapse              Mark as Read    RE: Determinants of Health         Instructor Hamilton Email this Author     3/2/2015 5:45:44 PM

    Tasha

    Great post, Behavior I agree but cycling around to challenge the others are affordability of housing, need for public transportation, and job market. Rural compared to Urban will vary, where are the social supports of the family, and is the job market comparable to the cost of living…you made me think 🙂

    Dr Hamilton

     

     

     

     

    Respond

    Collapse              Mark as Read    RE: Determinants of Health         Pamela Mintz Email this Author 3/7/2015 4:13:18 PM

    Tasha – You hit a lot of great points in your post. Individual behavior is a huge! The new year is always one that you can see the diet and physical activity aspect in full force. People will sign up for a gym, trying to exercise more and watch their diets. Then a few weeks or months later, they aren’t using that gym membership anymore. Bachman wrote that “the decline starts as early as the third week in January” (2015, para.  4). Determinants of Health NR 443 essay assignment discussion papers. Why? It’s their own individual behavior. You have to be the one to drive your own ambitions, your health.

     

    I have been around two males that used tobacco products. They knew the negative health effects of smoking/chewing, but still engaged in it. It was interesting to see that something finally motivated each one to quit. Whether it was another person, or for their own health, they quit using tobacco – they changed their individual behavior in regards to it. No one could do it for them – they individually had to.

     

    I agree with what you wrote about resources. Some communities are abundant with them – I know I see and hear about resources in my county quite often. Sometimes they are visible, but other times you may need to search a bit (online, library, hospitals, etc.).  I feel there is lot of teaching a community nurse could do in regards to individual behavior. One of my nurses at work does this every single day. She’s visiting patients in their homes, teaching them ways to eat healthier, live healthier, and assisting them with finding resources to help.

     

    Pam

     

    Reference

     

    Bachman, R. (2015, January 19). The Week Your New Year’s Resolution to Exercise Dies. The Wall Street Journal. Retrieved from http://www.wsj.com/articles/the-week-your-new-years-resolution-to-exercise-dies-1421703411

     

     

     

     

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    Collapse              Mark as Read    Individual Behavior         Stephanie Stalter Email this Author          3/2/2015 7:39:44 PM

    Dr Hamilton and Class,

     

    The one “Deteminants of Health” that I really appreciate is the “Individual Behaviors” section. I feel that people need to be responsible for their own health, especially the parts that they can control. I understand that many people have diagnosis that are related to heredity or circumstance, but individuals need to be responsible for what they can be. According to HP2020, “Individual behavior also plays a role in health outcomes… Positive changes in individual behavior can reduce the rates of chronic disease in this country. ”

    Healthy People 2020 identify some of these changes as:

    Diet

    Physical activity

    Alcohol, cigarette, and other drug use

    Hand washing

    The entire culture of health care is moving towards “wellness”  as a goal. Maintaining and returning to wellness. But, people need to take responsibility for their own health. They need to be educated to make decisions which support and encourage a healthy lifestyle, rather than allowing problems to occur and then trying to fix them. Additionally, according to the United States Department of Labor Fact sheet, “Implementing and expanding employer wellness programs may offer our nation the opportunity to not only improve the health of Americans, but also help control health care spending.”

     

    Thank you,

     

    Stephanie Stalter

     

     

    United States Department of Labor: The Affordable Care Act and Wellness Fact Sheet. 2015

     

     

     

    Respond

    Collapse              Mark as Read    RE: Individual Behavior  Ashley Peterson Email this Author           3/4/2015 9:37:46 PM

    Stephanie,

    I agree individual behavior is key to the determinants of health. If a person doesn’t have a positive attitude toward their health, it will reflect in their health. For example you stated diet, if a person doesn’t have concern or positive attitude and good behaviors when eating they are more likely to have heart disease, obesity, and type two diabetes. If a person doesn’t have the right attitude, you’re not going to change their health behaviors.

     

    Ashley

     

     

     

    Respond

    (an instructor response)

    Collapse              Mark as Read    RE: Individual Behavior  Instructor Hamilton Email this Author     3/5/2015 6:25:30 PM

    Stephanie

    Sometimes this seems like there’s no hope, but there are cities that have rallied and worked together to make changes step-by-step to turn things around. This involves forming coalitions with key stakeholders in the city and getting the citizens involved and motivated. Public health nurses can play a key role in leading revitalization efforts, development of self help initiatives, and community support groups.There are government grants and private funding available for city revitalization projects which may include neighborhood watch, planting community gardens, etc. but it does take time to decide on the top priorities and apply for available funds. You may find that there are those in your community who have started these efforts as you begin your assessment of your community. Determinants of Health NR 443 essay assignment discussion papers. Excellent post, thanks for the topic!~Dr Hamilton

     

     

     

    Respond

    Collapse              Mark as Read    RE: Individual Behavior  Jeremiah Ozuna Email this Author            3/6/2015 3:11:44 PM

    Hello Stephanie,

     

    I really enjoyed your post. I completely agree it is a persons responsibility for their health. What is difficult to do is, yes we can educated people, but how can we ensure that they are actually trying to get healthier. Also how do we continue getting people to keep healthy? As professor said in my post, most people find it easy to gravitate back to their old ways of eating and lifestyle. What are ways to keep people on track?

     

    Jeremiah

     

     

     

    Respond

    Collapse              Mark as Read    RE: Individual Behavior  Erica Meyerhofer Email this Author         3/6/2015 5:33:45 PM

    Jeremiah and Class –

     

    In today’s world everyone has a cell phone and for those who want to continue a healthy life style there are many apps to keep people on track. In our practice when people arrive asking for help in weight loss we explain the obviously health eating and exercise but we also encourage them to use My Fitness Pal. Determinants of Health NR 443 essay assignment discussion papers. It can help track caloric intake, exercise, to reach a weight loss goal.  People often do not realize how many calories they actually consume until they start tracking it, it can be a real eye opener.  I recently purchased a fitbit and absolutely love it.  I know they are not affordable to all but the My Fitness Pal is a free app that most can download on their cell phones that they already carry around with them.

     

     

     

    Respond

    Collapse              Mark as Read    RE: Individual Behavior  Danielle Devito Email this Author              3/6/2015 3:45:21 PM

     

    Stephanie,

     

    I agree with you that Individual behavior is such an important determinant of health.  What is that saying, you can lead a horse to water but you can’t make it drink?  Working in healthcare we see so many people that are in the hospital over and over again because we treat them and educate them, but then they go home and eat Chinese food, even though they have CHF, or continue to smoke even though they have COPD.  But then they are angry that they are always in the hospital and why aren’t we doing anything to help them?  According to Nies and McEwan (2011) 20% of the annual deaths in the United States were due to smoking, 14% of deaths were related to poor diet and activity, and 5% of deaths were from alcohol (either because of accidents, homicides or diseases caused by alcohol).  These are all deaths that are due to individual behavior, that are preventable by a change in lifestyle.  All we can do as nurses is educate and hope that someone learns from us and decides to change their ways.

     

    References

     

    Nies, M. A., & McEwan, M. (2011). Health: A community view. In Community/Public health nursing: Promoting the health of populations (5th ed. (pp. 2-17). [VitalSource]. Retrieved from www.vitalsource.com Determinants of Health NR 443 essay assignment discussion papers

     

     

     

     

    Respond

    Collapse              Mark as Read    Individual behavior         Jemima Gutierrez Email this Author         3/2/2015 11:53:29 PM

    Hello Dr. Hamilton and class,

    A determinant that I choose has a lot to do with individual behavior which account for seventy-percent of all premature deaths in the United States (USDHHS, 2000). It will have the biggest impact on the person’s well being and its impact on the community health as a whole. Poverty, a key health determinant in the rural area is not controllable and so as lack of physicians in the rural area that are not easily available and are more available specialty physicians and transportation into than the urban areas. Individual behaviors that are controllable and can be changed, such as improvement of health condition with the help of changes in the diet, smoking cessation, and refraining from alcohol consumption that leads to diseases can be reduced if the individual makes the willingness to change behavior for the better of their health. Diet alone makes up of about 300,000 per year of deaths and alcohol with 5% of deaths because it becomes associated with suicides, homicides, and cirrhosis or chronic liver disease (Nies, 2011). Determinants of Health NR 443 essay assignment discussion papers Disparities such as the socially disadvantage may not have the medical insurance, lack of money to pay medical physician, transportation to get to the medical health facility or medication contributing to the problem. According to Nies, public health nurses is defined as “the practice of promoting and protecting the health of populations using knowledge from nursing, social, and public health sciences” (ANA/APHA, 1996, p. 5). It is essential for the community health nurse to understand the determinants of health and recognize the interaction of the factors that lead to disease, death, and disability The nurse plays pivotal role in their community outreach, engaging in activities that increase knowledge, motivating, adapting to the health education, to each person from infants, children or adult helping these information accessible for the public and facilitating implementation of the process to help the community get the information and education”(Nies, 2011).

     

    American Nurses Association: In Public health nursing: scope and standards of practice. 2007, American Nurses Publishing, Silver Spring, MD.

     

    Nies, M. A., & McEwen, M. (2011). Community/Public health nursing: Promoting the health of populations (5th ed.). St. Louis, MO: Saunders/Elsevier.

     

    U.S. Department of Health and Human Services: In Healthy People 2000 objectives. 1989, The Author, Washington, DC.

     

     

     

     

    Respond

    Collapse              Mark as Read    Determinants of Health                Danielle Devito Email this Author              3/3/2015 1:52:23 PM

    Dr. Hamilton and Class,

     

    I chose Biology and Genetics because I feel like it is one of the most important factors. “Some biological and genetic factors affect specific populations more than others,” (HealthyPeople.gov, 2015). Many people feel that they are ‘stuck’ with their health issues sometimes because of their genetics, but this is not the case. Lifestyle changes can still help to improve their overall health, even when they have issues that are inherited, such as sickle-cell anemia, breast cancer genes, or family histories of heart disease. Knowing that you are predisposed to these things is actually a benefit, because you know what to look for and hopefully how to treat it. You are not stuck with these diseases. If you have a family history of heart disease, you can go to the doctor regularly, have your cholesterol checked, blood pressure checked, and stress tests done regularly. This does not change your family history, but it puts you in charge of your health.

     

    References

     

    HealthyPeople.gove. (2015). Determinants of health. Retrieved from http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health#biologyandgenetics.

     

     

     

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    Collapse              Mark as Read    RE: Determinants of Health         Jessica Parker Email this Author 3/3/2015 6:31:15 PM

    Danielle:

     

    I agree with your comment about how beneficial it is to know your family history.  It is helpful to know what you may be predisposed to develop.  People need more education about knowing family history and what health issues are genetic and what to ask the doctor to check for in possible health problems.

     

    Jessica

     

     

     

     

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    (an instructor response)

    Collapse              Mark as Read    RE: Determinants of Health         Instructor Hamilton Email this Author     3/6/2015 4:33:37 PM

    Danielle and Class: thanks for the post all nurses should consider joining a professional nursing organization who uses lobbyists and research departments to support/address/propose legislation for best practice in patient care as well as job safety/satisfaction of nurses.~Dr Hamilton

     

     

     

     

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    Collapse              Mark as Unread               RE: Determinants of Health         Arthel Tamakloe Email this Author           3/8/2015 7:50:02 PM

    Daniell I chose Biology and Genetics as well. Yes I agree with you on the fact if someone knows that they have genes that predispose them to a particular disease then they can be more vigilant to other symptoms of that disease and seek help.Preventing the disease in the first place is by far, the best way to reduce health care costs.

     

     

     

    Respond Edit

    Collapse              Mark as Read    Health Services Lisa Robinson Email this Author 3/3/2015 2:06:22 PM

    Professor Hamilton and fellow classmates-

     

    I chose health services for a couple different reasons. I personally deal with patients that are upset because of access issues in healthcare. I believe that this revolves around a few different issues that could be changed or modified. I believe, at least in the area that I live in, there a number of people that are on Badgercare (state assistance) and who have no co-pays for the visits that they do have in healthcare or even see a bill to see what the visits are costing. This is payed by taxpayers and hardworking people so that they can have insurance coverage. The other reason that I chose this topic is because whereas this is a problem for a lot of different reasons, it is our job as nurses to ensure that patients in our community are able to receive the best care possible and at the appropriate times.

     

    I personally think that people that are state assistance for an extended period of time tend to take advantage of the “free” services available to them and end up taking up a good number of visits for things that really either are not appropriate to be seeking medical care for or could wait to be addressed in a clinic visit versus an ED visit. Determinants of Health NR 443 essay assignment discussion papers.

     

    I believe that we as nurses, especially community health nurses, need to be aware and educating the patients that are on state assistance on what is appropriate and maybe even providing them with a number for a triage nurse or screening process to call prior to making an appointment or going to the ED for something that really isn’t classified as a true emergency.

     

    Lisa

     

    Reference:

     

    http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health#health%20services

     

     

     

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    (an instructor response)

    Collapse              Mark as Read    RE: Health Services          Instructor Hamilton Email this Author     3/6/2015 3:53:49 PM

    Lisa and Class: here is a link for you to explore as well….Upstream thinking~Dr Hamilton

     

    http://www.cdc.gov/pcd/issues/2010/jul/09_0249.htm

     

     

     

    Respond

    Collapse              Mark as Read    Week 1 Jeremiah Ozuna Email this Author            3/3/2015 2:27:15 PM

    Hello Prof and Class,

     

    After reading the article the 5 determinants of health include policymaking, social factors, health services, individual behavior, and biology and genetics.

     

    Of the five different determinants of health the one that mostly appealed to me is individual behavior. Yes all 5 are important and play vital roles in community health, but the one that stands out the most personally is individual behavior. Regardless of genetics, environment, or social factors I believe it all comes down to personal and individual behavior. People have to want to change in order to change. “For example, if an individual quits smoking, his or her risk of developing heart disease is greatly reduced” (Healthy people 2020). It is the community health nurses job to almost appeal to all people depending on the environment and economic status of the area. To change individual behavior one has to appeal and motivate them to want to change. To show them the benefits, but to also determine what is holding people back from making life altering decisions.

     

    Resources

     

    Healthy People 2020. (2015). Determinants of Health. Retrieved from http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

     

     

     

    Respond

    (an instructor response)

    Collapse              Mark as Read    RE: Week 1         Instructor Hamilton Email this Author     3/3/2015 5:00:33 PM

    Jeremiah

    Thanks for the post…as a seasoned CHN I always kind of lean toward the social components as being a huge factor.  It is so difficult to teach a patient something different than their culture has to offer.  I find they seem to easily gravitate back to those early teaching especially with diet and healthy lifestyles~Dr Hamilton

     

     

     

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    Collapse              Mark as Read    RE: Week 1         Jeremiah Ozuna Email this Author            3/6/2015 3:07:02 PM

    Hello Prof,

     

    What kind of social component do you use that appeal to all generations? I agree that most find it easier to gravitate back to those early teachings especially with diet. I believe it is the life styles that people have to day. Everyone is looking for a short cut or easy way to do things. We find what is convenient and readily available. What are methods you have used to keep people motivated with healthy diets and life styles, it almost everyone needs to have a significant event from them to realize how important a healthy life style is. Is it easier to appeal to younger or older generations?

     

    Jeremiah

     

     

     

    Respond

    (an instructor response)

    Collapse              Mark as Read    RE: Week 1         Instructor Hamilton Email this Author     3/6/2015 4:08:46 PM

    I sooo agree Jemimah. My son is a physical therapist who puts out an ad in the local paper announcing “Boot Camp” he does this for teens and tweens, beginners, advanced, and seniors. He organizes a Spartan Run once a year he had 8 participants the first year, and now has almost 100 participants, he and those who finish go back and make sure everyone finishes by encouraging, assisting, etc…at the end of the day everyone crosses the finish line somehow, someway.  He usually runs his programs from April-October. For one hour and in small groups of 10 he trains them at the city park, or the high school track, and uses the town as his “gym”. What he commonly has happen after the 8 week sessions is people may or may not resign up but you will see them develop relationships and they go through the motions without his guidance….He charges $5 a person per session which lasts an hour. Determinants of Health NR 443 essay assignment discussion papers. His motto is people need to be able to pull themselves out of a hole if they fall in so he works on strength training with some cardio. He is a paramedic on the side and does B/P and Pulse checks, he also discusses a topic of the week and provides one heart healthy recipe or a smart thinking snack suggestion as a takeaway. He has a release form and is structured in his sessions. I am proud of him and his ability to make a difference.~Dr Hamilton

     

     

     

    Respond

    Collapse              Mark as Read    RE: Week 1         Erica Meyerhofer Email this Author         3/6/2015 5:46:00 PM

    That is wonderful.  This past summer we had a disabled police officer offer the to the children of our community a free 8 week course on speed and agility.  This was the first in our community.  I wish it would have been offered for the older adults in our community. Sometimes it just takes someone to offer to help “pull you out of a whole”.  The fitness center in our area is expensive and you must be over 15 to join. Unfortunately for our youth there is not a community center to expend energy at and if your family cannot afford to pay for you to ski, join club sports, or school sports for that matter you are just out of luck.

     

     

     

    Respond

    Collapse              Mark as Read    Determinants of Health                Michelle King Email this Author  3/3/2015 6:20:18 PM

    Professor Hamilton and Classmates,

     

    Of the five determinants of health identified by Healthy People 2020 (2015), the one that seems to be able to have the strongest impact on all of the others is policymaking.  One clear example of pubic policy making a great impact is the tobacco tax which was a very effective incentive to decrease tobacco use in the United States.  Not only can policymaking greatly influence health by altering individual behavior, but it can also dramatically change social factors and health services.  If, in turn, for example, health services to future and expectant mothers and newborns improve, then so can we improve biology and genetics.

     

    We have all seen how much the federal healthcare laws can generate widespread and far reaching change in our implementation and delivery of health care services across our nation, but other laws that are not directly related to health care can also change the health outcomes of our nation.

     

    Immigration reform, for example, could have a dramatic impact on the undocumented workers pouring across our nation’s borders.  In Washington DC, the federal government’s decision not to enforce immigration laws have led to a massive number of young immigrant teens living in crowded conditions in apartments and busing into Washington to clean the offices and hotels by night.  They sleep up to 30 people in a one room apartment, and work 7 days a week, 365 days a year with no paid sick leave, no vacation, no overtime pay, no education and no future.  If they are injured or sick, they are replaced so they come to work in all levels of illness.  Many of these youth end up homeless if they do become ill.  The spread of lice, bedbugs, and even more serious illnesses such as tuberculosis is epidemic among these young paperless workers.  The number of these workers has grown to such levels that Washington DC has taken the policy decision to issue driver’s licenses to undocumented people.  The policy-making angles around this issue are endless and nurses must weigh in, because the health care needs of everyone in the United States, documented or not documented, fall to our shoulders.

     

    When I think about it, it seems there really is no policy issue that is not health-related.  Certainly the looming nursing shortage is an area that all nurses should follow with great interest, and a great resource is the National League for Nursing’s website:  http://www.nln.org/publicpolicy/.

     

    Michelle

     

    Resources

     

    Healthy People 2020. (2015).  Determinants of Health.  Accessed online at http://www.healthypeople.gov/2020/about/foundation-

     

    health-measures/Determinants-of-Health

     

    National League for Nursing. (2014) Public Policy Agenda: 2013-2014.  Accessed online at

     

    http://www.nln.org/publicpolicy/pdf/ppagenda2013.pdf

     

     

     

     

     

    Respond

    (an instructor response)

    Collapse              Mark as Read    RE: Determinants of Health         Instructor Hamilton Email this Author     3/6/2015 4:36:12 PM

    Great point Michelle, I believe nurses have a voice, we often see e-mails from agencies to contact our local representatives because a bill is going to the house for vote, I will be participating in political action day on March 24, this gives opportunity for health care professionals to meet legislators and show solidarity. Schools of nursing are there, professional nurses are there, and lobbyists. ~Dr Hamilton

     

     

     

    Respond

    Collapse              Mark as Read    Determinants of Health                Jeremy Langley Email this Author             3/3/2015 9:06:38 PM

    Dr. Hamilton and Class,

     

    I feel the most important is individual behaviors and I know there are cases where an individual may have a mental or physical handicap that would prevent them from being mentally or physically active. I’m not talking about these individuals which is very low when compared to the overall population. I think as humans that we have a responsibility to take care or body and our mind and teach our children to do the same. It’s doesn’t mean that because I eat right and exercise and have a great group of friends that I won’t be diagnosed with a disease or fall ill but it does decrease my chances if I assumed the responsibility to promote my own well-being. My reaction to bad news and how I deal with the news is greatly affected by my mental health as well. If someone quits smoking or begins to exercise and eat a well-balanced diet this behavior can greatly reduce the rates of chronic disease in this country. The other 4 are important but I’ve always said that we can have the best healthcare in the world that’s free of charge but until an individual is ready to take that step toward good health and well-being then we can’t treat someone who is not ready to make the necessary changes.

     

    Reference

     

    http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

     

     

     

     

    Respond

    Collapse              Mark as Read    RE: Determinants of Health         Stephanie Stalter Email this Author          3/5/2015 1:07:04 PM

    Jeremy,

     

    you make some very good points. I agree with you that people need to take some responsibility for their own health. Sometimes, and I say this to you and not the patients, it can be incredibly frustrating that patients can be so non-compliant with their plan of care. The problem is identified, a plan is made to improve one’s health, and the patient continues the same lifestyle from which they developed these problems in the first place. Patients can be educated, medicated, and treated… but unless they are willing and committed to a lifestyle change, nothing will improve. Have you ever seen someone with an oxygen tank and a cigarette? I have. Or worse, I saw someone smoking through a tracheotomy once.  Unbelievable.  However, I must give so much credit to patients who take ownership of their health, they can be quite impressive at times. Determinants of Health NR 443 essay assignment discussion papers.

     

    Very Good Post!

     

    Stephanie Stalter

     

     

     

    Respond

    Collapse              Mark as Read    RE: Determinants of Health         Cherry Jaudalso Email this Author             3/7/2015 1:09:02 AM

    Hello Stephanie and Jeremy,

     

    Wow, smoking through a trach??? You’re right, that is incredulous. Once in awhile, I get patients that come in a state of panic because they’re having a hard time breathing. As soon as we stabilize them and they feel better, they try to sneak out to smoke. I’m not really sure what goes on in these patients’ minds, smoking must be that addicting. As public health nurses, there must be something we can do to make smoking a thing in the past for these patients and for the public. I agree that every individual is responsible for their well-being, but it’s hard to quit when everybody else still smokes. Determinants of Health NR 443 essay assignment discussion papers. The other day, I met this young man with a heart disease and he had recently quit smoking. But his wife still smokes (but trying to quit) so its been very hard for him. He said some triggers give him urges to start back again, but he’s been fighting it.

     

    Cherry

     

     

     

    Respond

    Collapse              Mark as Read    Determinants    Mary Anderson Email this Author             3/3/2015 10:04:08 PM

    Dear class,

    I chose to do my topic on Barriers to access health care with the rising cost of insurance and health care cost. People still can not afford healthcare. Behavior of a person in their lifestyle also plays a role. Do they warrens risky behavior? is this a barrier to health care services? The next to this piece of the puzzle would be genetics. Though this can not be changed, we can inform others to test their family members. They can do genetic counseling. There are alot of programs out there to help combat barriers to healthcare. The biggest is the advancement of free healthcare programs and low cost prescriptions.

     

    Mary

     

    Determinants of Health. (n.d.). Retrieved March 4, 2015, from http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health#health services

     

     

     

    Respond

    Collapse              Mark as Read    Determinants of Health                Claudia Rudd Email this Author  3/4/2015 8:31:56 AM

    Dr Hamilton and Class,

    The most important Determinant of Health in my opinion is Individual behavior. The old saying you can not control what others do only what you do applies here. One of the most important behaviors that individuals can do to benefit their health is hand-washing. I currently work with infection control and monitor hand hygiene in our facility. Our hands are the most common mode of transmission of infectious organisms and observing proper hand hygiene is the number one way to prevent the spread of infection. Today when you go to the grocery store most of them now have antiseptic wipes to use on the grocery cart handles. Would I love to culture one of those during flu season! Encouraging and education the public on proper hand hygiene would be a step in the right direction to controlling the spread of common cold and flu.

     

     

    Reference:

    http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

     

     

     

     

     

     

    Respond

    Collapse              Mark as Read    RE: Determinants of Health         Mary Anderson Email this Author             3/4/2015 3:49:19 PM

    Modified:3/4/2015 3:50 PM

    Dear Claudia,

     

    This is often an unlooked over fact about determinants of Health. A simple hand wash is so very effective at preventing a lot of infections and spread of disease. If we as parents and families start at home teaching our kids and at school we can get them off to a great start. In the work place we can teach proper procedure and technique. Determinants of Health NR 443 essay assignment discussion papers. We can follow up on our work colleagues and hold them accountable for their actions. We post pictures of an infant or a picture of a grandma type person at work in various places and a caption on the photo might be-My life is in your hands! Or you can save a life by your hand hygiene. Skills fairs are a great way to accomplish this also.

     

     

    Mary

    Determinants of Health. (n.d.). Retrieved March 4, 2015, from http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health#health services

     

     

     

    Respond

    Collapse              Mark as Read    Determinanta-(WK1)-Coppee    Rose Coppee Email this Author  3/4/2015 11:50:51 AM

    Professor and class,

     

    Health Services would be my most important determinant.  If the services are not there, people obviously won’t use them.  If there is no health coverage, the common person is not going to, or able to spend that amount of money to see a provider.  Healthy People 2020 mentions barriers to receiving health services and what these barriers can lead to.  If a person cannot receive preventable care for hypertension, it can lead to many other conditions, including death.  Hypertension is preventable, treatable, and reversible.  The community needs to take accountability for their own health to improve themselves and hopefully extend their lives.

     

    Retrieved from http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

     

     

     

    Respond

    (an instructor response)

    Collapse              Mark as Read    RE: Determinanta-(WK1)-Coppee            Instructor Hamilton Email this Author     3/6/2015 4:38:40 PM

    Rose

    You make some valid points, I would like to add there are modifiable and unmodifiable risk factors. What is important to note the unmodifiable risk factors can have less of an impact if certain behavior modifications are implemented. Thanks for sharing.~Dr Hamilton

     

     

     

     

    Respond

    Collapse              Mark as Read    RE: Determinanta-(WK1)-Coppee            Jemima Gutierrez Email this Author         3/7/2015 4:59:40 AM

    Dr Hamilton and class,

    In 1996, the Public health Services developed the Bureau of Primary Health Care to increase access to comprehensive primary and preventive health care and to improve the health status of populations defined as medically underserved (BPHC, 1996b). It is defined by Hawkins that “Medically undeserved as individuals and families who lack adequate access to primary care” (Hawkins, 1993, p. 49).Barriers to access exist such as low income, lack of health insurance, old age, poor health outcomes, inadequate health infrastructure, and insufficient supply of primary physicians, as well as cultural, attitudinal, and linguistic differences (Hawkins, 1993). Here in Florida we have health center called Primary Care Health center that offers Pediatric, Family practice, dental, Obtetrics  & gynecology and Mental health services that served the non-insured, low income and also those who has medical insurance. I was fortunate enough to serve as a Board member to this local facility in 2003 for 1 year. This health service center has a big impact into this community because of the services it offers. As a community health nurse, we can continue to discovery of ways to increase collaboration within and across various federal branches and departments that affect the availability of health professions in underserved areas. It will also help in finding ways to collaborate with churches, medical professionals into health fairs, giving fee vaccinations and teaching importance of childhood, adult vaccinations to prevent disease. Determinants of Health NR 443 essay assignment discussion papers.

     

    Reference:

     

    Gaston, M. H., Barrett, S. E., Johnson, T. L., & Epstein, L. G. (1998). HEALTH CARE NEEDS OF MEDICALLY UNDESERVED WOMEN OF COLOR: The Role of the Bureau of Primary Health Care. Health & Social Work, 23(2), 86-95.

     

    http://web.a.ebscohost.com.ezproxy.cc.andrews.edu/ehost/detail/detail?vid=3&sid=378a12a2-a2d7-4a5e-9435-4a75e51d9e33%40sessionmgr4004&hid=4214&bdata=JnNpdGU9ZWhvc3QtbGl2ZQ%3d%3d#db=a9h&AN=590881

     

    Hawkins, D. R., & Rosenbaum, S. (1993). Lives in the balance: The health status of America’s medically underserved populations. Washington, DC: National Association of Community Health Centers, Inc.

     

     

    Jemima

     

     

     

    Respond

    Collapse              Mark as Read    RE: Determinanta-(WK1)-Coppee            Rose Coppee Email this Author  3/8/2015 7:46:37 PM

     

    Jemima,

     

    I agree. We need more involvement in the community,…..such as you mentioned…Churches, health fairs, especially free vaccination for children. It is truly sad that we are now living in a world that parents are questioning or refusing vaccinations for children altogether. I don’t believe the community truly understands the importance of child vaccinations and the future effects of it.

     

     

     

     

    Respond

    Collapse              Mark as Read    Determinants of Health                Ina James Moore Email this Author          3/4/2015 12:46:30 PM

    Dr. Hamilton and class,

     

    The questions that the Determinants of Health ask are what makes some people healthy and others unhealthy? Also, how can we create a society in which everyone has a change to live long, healthy lives?

     

    The determinant of health that I feel is most important is health services. “Lack of access, or limited access, to health services greatly impact an individual’s health status (www.healthypeople.gov)”. I believe that this statement is 100% correct. Determinants of Health NR 443 essay assignment discussion papers. This is most important for community health because if the resources are not available for people or they are unaware of the resources that are available to them, the health of the community is going to continue to deteriorate. According to Nies & McEwen, people are more concerned with their quality of life rather than their health, but if given the resources, I believe that health could become more important to them. Working in an ER, I hear many say if these patients have Obama care, where are they still here? It is because many do not know the importance of preventive medicine or how to access it and then end up in the ER because they are requiring emergent care, thereby, increasing health care cost due to something that could’ve been effectively managed by a pcp.

     

    Ina

     

    Reference

     

    Nies,M. & McEwen,M. (2011). Community/Public health nursing: Promoting the health of populations. Elservier:St. Louis, MI

     

    http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health retrieved on March 4, 2015.

     

     

     

     

    Respond

    Collapse              Mark as Read    RE: Determinants of Health         Gloria Rundle Email this Author 3/5/2015 8:36:33 PM

    Ina

     

    I agree that people are more concerned about quality of life and not there health. I have also seen people that would come into our clinic with there hair done nails done and designer bags and clothes complaining that they can not afford their blood pressure medication. The medication being on a $4.00 list wanting us to ” fix them”. Of course damage is done and not reversible when they have already had a stroke due to not taking there blood pressure medication and has affected their kidneys as well. Having Obama care has not been the answer for many of our patientss because alot of them refuse to use there insurance wisely and would rather get a prn pain medication filled for free than fill there insulin for free.

     

    Gloria

     

     

     

    Respond

    Collapse              Mark as Read    RE: Determinants of Health         Claudia Rudd Email this Author  3/7/2015 11:33:34 AM

    Ina,

    Access to health care is definitely something that needs to be worked on in our country. I live in a city with a large hospital/medical school facility that has a number of outlying clinics and smaller hospitals as part of the whole. However like you I see a lot of patients here that do not seek medical care until their disease process is far advanced. This is a great area in which community health nurses can help to improve the quality of health for those patients we serve.

    Good post

    Claudia

     

     

     

    Respond

    Collapse              Mark as Read    Determinants of Health                Rachel Foreman Email this Author            3/4/2015 4:11:21 PM

    According to Healthy People 2020, there are five determinants of health. The five determinants of health are policy making, social factors, health services, individual behavior, and biology/genetics. According to Healthy People 2020 “the range of personal, social, economic, and environmental factors that influence health status are known as determinants of health.”

     

    The topic that I choose to discuss is health services. I decided to talk about this specific topic because I think it is extremely important. A lot of individuals do not go to the doctor until they are extremely ill or in dire need of help at that moment. I think that if more people had access to available resources or services the community (and country) would be healthier, or have the knowledge to access whenever they needed it. According to Healthy People 2020 “the lack of access, or limited access, to health services greatly impacts an individual’s health status.” There are several barriers that prevent individuals to have access to health services in their community. According to Healthy People 2020, “lack of availability, high cost, lack of insurance, and limited language access” are some of the barriers that affect why people cannot/do not utilize or have access to health services. According to Healthy People 2020, the barriers to accessing health services can lead to “unmet health needs, delays in receiving appropriate care, inability to get preventive services, and hospitalizations that could have been prevented.” if we had more available access to health services the community would be healthier and in the long run, cheaper. If we caught someone blood sugar rising, we could teach diet changes rather than treating them in the hospital from a diabetic comma.

     

    Health People 2020 (2015). Determinants of Health. http://www.healthypeople.gov/2020/about/DOHAbout.aspx

     

     

     

    Respond

    Collapse              Mark as Read    RE: Determinants of Health         Gloria Rundle Email this Author 3/6/2015 8:02:57 PM

    Rachel

     

    I agree when you state that if we had more available access to health services the community would be healthier. But I also think that teaching parents the importance of getting health care for their children at a young age and ongoing care for school age children would also help a community be healthier,

     

    In Illinois I think that people that are receiving state aide should be required to attend educational programs that will help educate and provide health care for children. I have seen young mothers not have a clue on how to provide appropriate care for their children and these young mothers have more than one child.

    I feel in Illinois state aide is easily obtainable and these people receiving this aide are not required to do much in order to continue to recieve this aide. I think if it was more difficult to receive aide and harder to continue to recieve this aide the more people would be more compliant to participate in their childrens and their own health.

     

    Gloria

     

     

     

    Respond

    Collapse              Mark as Read    RE: Determinants of Health         Rachel Foreman Email this Author            3/8/2015 7:04:17 PM

    I area that I work in treats patients for the surrounding 17 counties. The majority of these counties, and primarily the ones directly connected to our county, are extremely poor, the poorest counties in Florida. The majority of our patients do not have insurance, they are on Medicare and Medicaid. Most of the children are sent home from school on the ‘backpack’ program. It is a program that the children are put on so they have food to eat on the weekend when they are home because their families cannot afford food, and they get breakfast and lunch at school during the week. With these types of situations the children are less likely to come to the doctors until their situation is to the extreme.

     

     

     

    Respond

    Collapse              Mark as Read    Determinants of Health                Christina Segura Email this Author            3/4/2015 4:31:51 PM

    Dr. Hamilton and Class,

     

    Per the U.S. Department of Health and Human Services (HHS) initiative, Healthy People 2020, “The range of personal, social, economic, and environmental factors that influence health status are known as determinants of health” (HHS, n.d.).   These determinants are included in five categories; policymaking, social factors, health services, individual behavior, and biology and genetics. Because these categories are interrelated, interventions that target more than one are most effective (HHS, n.d.).

     

    However, if I had to choose one determinant as the most important for community health, it would be social and physical determinants of health.  Social and physical determinants are highly influential in health as they impact daily lives, survivability, outlook on life, and exposures.  Examples of these determinants are education, employment opportunities, income, safety, social norms, discrimination, quality schools, transportation, and overall social and living physical environment (HHS, n.d).  These factors have a critical role in the individual’s priority of health, access to health options, and understanding of health and choices.   Financial survivability, education, safe environment (social and physical) provides the opportunity for the individual have access to health services and have growth in their individual behaviors. These factors also lend hand to better management and resources in the event of a biologic or genetic circumstance.  Education and finance also give way for policymaking influences.   “Community and public health nurses, therefore, must align themselves with public health programs that promote and preserve the health of populations by influencing sociocultural issues such as human rights, homelessness, violence, and stigma of illness. This allows nurses to be positioned to promote the health, welfare, and safety of all individuals”  (Nies & McEwen, 2011).

    Think back to nursing school when we all learned about Maslow’s Hierarchy of needs.  If the basic needs of shelter, food, safety, etc aren’t being met, does the individual really care about making healthy choices?

     

    Christina

     

     

    Nies, M., & McEwen, M. (2011). Community/Public Health Nursing: Promoting the Health of Populations, 5th Edition. [VitalSource Bookshelf version]. Retrieved from http://online.vitalsource.com/books/978-1-4377-0860-8/id/B9781437708608000253_p1045

     

     

    U.S. Department of Health and Human Services. (n.d.). Healthy People 2020: Determinants of Health. Retrieved from http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

     

     

     

     

    Respond

    (an instructor response)

    Collapse              Mark as Read    RE: Determinants of Health         Instructor Hamilton Email this Author     3/5/2015 6:17:27 PM

    Christina

    I am wondering what you would propose or develop to empower clients in the community, is there currently a program in your area? Sometimes programs do not specifically state “empowerment” but the this is the purpose..does that make sense? Parenting classes and the YMCA are two in my area…~Dr Hamilton

     

     

     

    Respond

    Collapse              Mark as Read    RE: Determinants of Health         Mary Anderson Email this Author             3/5/2015 7:07:09 PM

    Dear Instructor Hamilton,

     

    Christina and Class, I love the fact that nurses and community programs are working together to help the public health programs and patients.  Nurses should encourage volunteer work in the community. I have heard of visiting nurses associations.  In my research, visiting nurses associations are for nurses who want to work and volunteer in a visiting area or state. These are the programs that encourage nurses and healthcare professionals in my area: NAMRC-North Alabama Medical Reserve Corp (Healthcare professionals volunteer for public health issues and in disasters)(I am a part of this already), Red Cross, and the Free Medical Clinic (Healthcare workers volunteer). It is amazing what a few hours of your free time can accomplish. Thank you to whoever volunteers.

     

    Mary

     

    Volunteer Organization North Alabama Medical Reserve Corps. (n.d.). Retrieved March 6, 2015, from http://www.northalabamamrc.com/

     

    VNAA – The Visiting Nurse Associations of America. (n.d.). Retrieved March 6, 2015, from http://vnaa.org/

     

     

     

     

    Respond

    Collapse              Mark as Read    RE: Determinants of Health         Christina Segura Email this Author            3/6/2015 1:21:19 PM

    Dr. Hamilton and Class,

    Unfortunately, the area I currently live in is a small community that somewhat thrives because of its proximity and support to a military installation (the reason I live here).  As with many communities, it’s easy to identify the areas that are underserved.  Certain schools are even considered undesirable to military families that move to the area thus making certain neighborhoods prestigious and costly.  The only “empowerment” programs I have been able to locate are typically offered through local churches.  These are essentially programs offered by non-professionals, doing their best to try to provide a service to those in need because of the obvious deficit.  Local hospitals offer classes but these are typically advertised directly to their current patients.   Occasionally, I see a local OBGYN doctor offer a free seminar for mothers and daughters called “Girl Talk,” to address topics of the female body and preventative medicine.  Our YMCA only offers sports and recreation.  Local food pantries, pregnancy assistance, and cost free drug/alcohol recovery programs are all run through Church organizations.

    My daughter is a member of The Beta Club and she must complete volunteer hours each month.  Because of her age, I always volunteer with her.  We often find it difficult to find organizations to assist with our volunteer time.  We often end up assisting the religious organizations’ efforts, visiting a nursing home, or a pet shelter.  There is an obvious need for structured outreach and empowerment programs in this area.

     

    ORDER A CUSTOM-WRITTEN PAPER NOW

     

    Respond

    Collapse              Mark as Read    Determinants of Health: Policymaking    Vanessa Machado Email this Author        3/4/2015 5:03:05 PM

    Dear Professor and Classmates,

     

    The range of personal, social, economic, and environmental factors that influence health status are known as determinants of health. According to Healthy People 2020, “it is the interrelationships among these factors that determine individual and population health. Because of this, interventions that target multiple determinants of health are most likely to be effective.”

     

    One important determinant relates to policymaking.  According to Gnadinger, “Knowledge of the relative importance of health determinants can help design programs that prioritize interventions in areas where they are likely to have the greatest impact” (2014).  In a community, resources are limited and a community must come together to focus on what problems related to health care need addressing, and this could include areas related to social detriments of health, such as safe housing, transportation, availability of healthful foods, education opportunities, and early education programs.  Change occurs and these problems are addressed through allocation of available resources.  These resources are then distributed based on policies which are made to address each problem, with the highest ranking, first.  As Conrad and colleagues’ assert, “Very clearly focused interventions targeted to a clearly defined community population, and implemented and managed by a small number of clearly accountable organizational entities, are more likely to produce community health improvement (as cited by Gnadinger, 2014).

     

    Policymaking addresses the determent of health care access as well.  The passage of the Patient Protection and Affordable Care Act (ACA) addresses population health by expanding health care coverage and  aims to improve population health by improving access to the health care delivery system, which is a critical component of a community’s population health production system (Stoto, 2013).

     

    Overall, determinants of health are addressed according to a community’s major concerns, which can be related to social factors of health care access for example, but in order to address any of these determinants, a policy needs to be formed in order to address the concerns Determinants of Health NR 443 essay assignment discussion papers.

     

     

     

    References:

     

    Gnadinger, T. (2014). Health Policy Brief: The Relative Contribution Of Multiple Determinants To Health Outcomes. Retrieved from: http://www.healthaffairs.org/healthpolicybriefs/brief.php?brief_id=123

     

    Healthy People 2020. (2015).  Determinants of Health.  Retrieved from: http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

     

    Stoto,M.A. (2013). Population Health in the Affordable Care Act Era. Retrieved from: http://www.academyhealth.org/files/AH2013pophealth.pdf

     

     

     

     

     

     

    Respond

    (an instructor response)

    Collapse              Mark as Read    RE: Determinants of Health: Policymaking            Instructor Hamilton Email this Author                3/4/2015 7:13:13 PM

    Excellent post Vanessa

    Class: What are your thoughts about the public health nurse becoming politically active, do you see certain barriers and facilitators in your community…for example in my small community there is one public health nurse who also works in the school system, I can see where a conflict of interest may come into play if there is a school board issue that conflicts with a county issue…especially if grants and funding are involved.~Dr Hamilton

     

     

     

    Respond

    Collapse              Mark as Read    RE: Determinants of Health: Policymaking            Jeremy Langley Email this Author                3/6/2015 5:23:18 PM

    Hello Vanessa,

    I think you make a great point and policymaking as it relates to health has been mostly positive. “Look at Highway Safety Act and the National Traffic and Motor Vehicle Safety Act set up by the Federal Government that helps regulate standards for motor vehicles and highways. These standards led to an increase in safety standards for cars that included seat belts, which in turn, reduced rates of injuries and deaths from motor vehicle accidents”(Healthy People 2020). I’m old enough to remember when cars were built without seat belts and almost every car bought in the 70’s and 80’s had a cigarette lighter. Most cars built today don’t even have cigarette lighters because of the changes in the tobacco policies and the taxes on tobacco products which reduced the number of people using tobacco. Determinants of Health NR 443 essay assignment discussion papers.

     

     

     

    http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health#policymaking Retrieved on March 6, 2015.

     

     

     

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    Collapse              Mark as Read    Determinants of Health                Kathryn Dore Email this Author  3/4/2015 5:36:18 PM

    The 5 determinants of health are policy making, social factors, health services, individual behavior, biology and genetics.  I chose Individual behavior.  I think that people need to be accountable for their own health.  People can reduce their risk with cardiovascular disease by quitting or not smoking, by the foods that they eat, their exercise routines.  Any person can help themselves, by parking at the end of the parking lot and walking a further, walk stairs.  People can avoid eating fast foods, processed food, and choice healthier options.  Theses are a few things that don’t cost tons of money for people who are on a lower incomes.

     

     

    Reference:

     

    https://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health

     

     

     

     

     

     

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    Collapse              Mark as Read    RE: Determinants of Health         Jemima Gutierrez Email this Author         3/6/2015 4:30:03 AM

    Hello Dr Hamilton and class,

    I agree with your rationale and there are so many thins that one can do to improve their health like walking. Individual behavior is so important because one can improve their health if lifestyle change is done. Smoking cessation,healthy eating,exercise,refraining from use of illegal drugs and alcohol consumption. As a community health nurse, encouraging policy changes inter own neighborhood in increase of use of public parking,improving sidewalks and getting local gym to have lower  fees so community people can access it. Local parks can have health fair and health teaching including lectures of health topics . It is very important for the community to be involved into their own health.

     

     

     

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    Collapse              Mark as Read    RE: Determinants of Health         Ina James Moore Email this Author          3/8/2015 10:19:22 AM

    Hi Kathryn,

     

    Thank you for your post. I agree, individuals do have control over the choices that they make with regard to health. In addition to your suggestions, as a community health nurse, we have to show the patients what a small change in their lifestyle does for their health. Unfortunately for some people, just telling them if you walk up the stairs instead of taking the elevator could improve your health status, doesn’t work. They have to see evidence, which is where we come in. Numbers, charts, people who have gone through the same things, pamphlets, are just some of the things that have to be available as well when educating patients on the importance of what a small change in their habits can do for their life.

     

    Ina

     

     

     

     

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    (an instructor response)

    Collapse              Mark as Read    RE: Determinants of Health         Instructor Hamilton Email this Author     3/8/2015 11:07:41 AM

    Ina and Class, I agree we provide the teaching and education. Sometimes though we expect patients to be able to perform certain tasks which to them are not achievable, I remember mentioning to a gentleman who came to the office about increasing his activity provided some suggestions without really delving into in abilities/capabilities. Determinants of Health NR 443 essay assignment discussion papers. He tried the activity twice and became frustrated and stopped. The next time I saw him he told me he was doing the activity well his daughter refuted the fact and I asked him about this, he came clean and together we developed a plan which he could be successful doing. Your post reminded me of this story and the importance of sharing the abilities and capabilities.~Dr Hamilton

     

     

     

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    Collapse              Mark as Read    Determinants of Health                Gloria Rundle Email this Author 3/4/2015 7:34:00 PM

    There are 5 determinants of health according to Healthy People 2020. The five determinants of health are policy making, social factors, health services, individual behavior, and biology/genetics.

     

    The determinant of health that I chose was Social factors. Working in a free clinic I have seen how many low income families that struggle by limited availablity of resources. Our clinic provided alot of resources o help our patients get to the clinic especially families with children. We provided cab vouchers or bus passes for transportation as well as medications or sample medications for patients struggling to get medications due to no insurance or no income to afford medications.

     

    Now with the Affordable Care Act in place people are still struggling to afford medications and other services that were once provided by our clinic. The Affordable Care Act was a good attempt to help provide insurance for everyone but alot of people are still struggling to afford medications and copays for services they are needing. Alot are struggling due to a lack of knowledge and unable to understand how insurance works and what is covered and what is not covered.

     

    Our clinic did provide education to help patients better understand their conditions. We helped patients to access services needed for their conditions

     

     

     

    Reference:

    http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health#social

     

     

     

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    (an instructor response)

    Collapse              Mark as Read    RE: Determinants of Health         Instructor Hamilton Email this Author     3/5/2015 6:21:17 PM

    Good topic Gloria! Last fall on the news an issue pertaining to school children not having services to prepare them for school and parents needing to choose between access and cost…I wondered with the state of the economy if this is seen more now than ever…how much is this truly in their control…someone forwarded this to me in a previous course, the schools in my area became influxed with issues pertaining to children who were in desperate need of school physicals, immunizations, and dental services…we had tried to secure volunteer services but the major concern is ongoing and not just this year…what is our long range plan…this is the question…as well as where is our funding going to come from…thanks for the post~Dr Hamilton

    School Context as Social Determinants.pdf

     

     

     

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    Collapse              Mark as Read    Determinants of Health                Pamela Mintz Email this Author 3/4/2015 7:57:22 PM

    Class & Dr. Hamilton –

     

    I personally feel that Individual Behavior is the most important, but I noticed this was already discussed about by a large number of classmates, so I will discuss the social factors (social and physical determinants). I feel this is another very important category as well. Determinants of Health NR 443 essay assignment discussion papers.

     

    “Even in the most affluent countries, people who are less well-off have substantially shorter life expectancies and more illnesses than the rich. Not only are these difference in health an important social injustice, they have also drawn scientific attention to some of the most powerful determinants of health standards in modern societies” (Marmot & Wilkinson, 2003, p. 7). Marmot & Wilkinson (2003) went on to describe some of the research methods used as evidence to back this up – some data even followed thousands of people over decades, through their socio-economic status versus their health and wellness.

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    Looking at Healthy People’s website, some of the social determinants included things such as exposure to crime, violence, and social disorder, such as the presence of trash, public safety, and availability of resources to meet daily needs (Healthy People, 2015). Think of child #1 who maybe lives in a “slum” part of town, is exposed to gang violence, drug selling and using while he walks down the street, and an abusive boyfriend that hits his mother and yells at the child. Then consider child #2 who say only has a single parent, but lives in maybe a middle class suburban home, with freshly manicured yards and friendly neighbors, with children riding their bicycles up and down the street. Knowing how stress levels can impact one’s health, both mentally and physically, think of these two children. One would assume child #1 deals with a higher level of stress than child #2, and maybe could have some emotional problems in regards to authority figures.

     

    Looking at physical determinants, things are mentioned such as exposure to toxic substances and other physical hazards, and natural environment, such as plants, weather, or climate change (Healthy People, 2015). An adult in Alaska may have different physical ailments than if he lived year round in Florida. Determinants of Health NR 443 essay assignment discussion papers. Even something such as allergies, which I can attest to first hand, are varied depending on the environment. Using my brother as an example (who has severe allergies to both foods and environmental allergens): when moved to Florida for college for a few years, his Ohio allergies almost completely vanished. His breathing was amazing and he could stop his medication.

     

    Although Individual Behavior is very important (like the saying goes, “you are what you eat”), I believe that social and physical determinants play a huge role in health. Many of these social and physical determinants cannot be easily changed, or individuals may not have full control over.

     

     

    Pam

     

     

    References

     

    Healthy People. (2015). Determinants of Health. Retrieved from http://www.healthypeople.gov/2020/about/foundation-health-measures/Determinants-of-Health#social

     

    Marmot, M. & Wilkinson, R. (2003). Social Determinants of Health: The Solid Facts (2nd ed.). Copenhagen, Denmark: World Health Organization Determinants of Health NR 443 essay assignment discussion papers