Tag: Clinical-Nursing

Age-related changes that affect the lifestyle of the elderly essay

What do you think are the two most prevalent age-related changes that affect the lifestyle of the elderly? How would you help an elderly patient adjust to the two changes you identified?

Discussion

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As individuals age, they are faced with age-related changes that affect their lifestyle. These changes are in the form of cognitive, physical and income declines. There is a correlation between completion of cognitive tasks and age. In fact, persons of advanced age will typically underperform their younger counterparts in recall and memory tasks. The performance difference is blamed in cognitive decline, except for habitual and instinctive tasks that are conducted subconsciously and do not engage recall or memory. As such, cognitively decline makes it difficult for elderly persons to complete tasks adequately and competently, thus affecting their lifestyle. This is addressed by implementing a reminder system (such as notes and alarms) that simplifies recall and memory (Dhami, Schlottmann & Waldmann, 2012). Age-related changes that affect the lifestyle of the elderly essay. Other than cognitive declines, elderly persons also face physical declines that reduce their mobility and make them prone to injury. Although not much can be done about cognitive declines except to conduct memory exercises, physical declines can be addressed in a more direct manner. Addressing physical declines would entail actively maintaining peak physical condition as a tactic for reducing the risk of falls. This would occur by making the individuals more nimble at navigating physical obstacles and developing greater physical awareness. Exercise programs present a good opportunity for maintaining peak physical condition as well as developing greater physical awareness that improves balance, back strength, lower extremity strength and flexibility, while reducing the fear of falling. This occurs by training the muscles and bone structures to be resilient and stronger. Besides physical and cognitive declines, elderly persons also face income declines that are compounded by inflation making it difficult for them to maintain the same lifestyle. This can be addressed through better investment management (Pitta, 2015) Age-related changes that affect the lifestyle of the elderly essay. In this respect, elderly persons face physical, income and cognitive declines that affect their lifestyles.

References

Dhami, M., Schlottmann, A. & Waldmann, M. (2012).
Judgment and Decision Making as a Skill: Learning, Development, and Evolution
. Cambridge: Cambridge University Press.

Pitta, P. (2014).
Solving modern family dilemmas: an assimilative therapy model
. New Yor, NY: Routledge Age-related changes that affect the lifestyle of the elderly essay.

Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person

Choose an older adult to interview. This cannot be a patient in your clinical setting. You can use a friend, family member, or co-worker. The older adult should be 65 years or older. Use the format provided to record the responses. A list of questions is available for you to start with. Include 2–3 questions of your own to get a complete picture of the older adult. Summarize your findings and also contrast the responses with findings in your readings and other current literature Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

This form should be used as an example:

[Patient Questionnaire

INTERVIEW OF CHOSEN ELDER ADULT

Name:

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Age:

Brief Introduction (Background information):

1. Philosophy on living a long life:

2. Thoughts about when a person is considered “too old”:

3. Opinion on the status and treatment of older adults:

4. Beliefs about health and illness:

5. Health promotion activities he or she participates in:

6. Something special that helped the person live so long:

7. Life span of other family members:

8. Special dietary traditions in patient’s culture attributed with aiding long life:

9. Any remedies/medications that have been handed down in family/group. If yes, describe.

10. Patient’s description of current and past health status

11. The values that guided life so far Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person

Additional Questions

1.

2.

3.

Summary:

Contrast of client’s responses with findings in current literature:]

After gaining permission, conduct a physical and mental functional assessment of the older adult you have chosen. Review your readings for the process of functional assessment.

Make use of the tools discussed this week to complete a comprehensive assessment of your patient. Search the Internet for resources on these tools.

Tinetti Balance and Gait Evaluation

Katz Index of Activities of Daily Living

Assessment of Home Safety

The Barthel Index

Make sure the older adult is clearly identified on the tools. Do not include their name, but do include professional or other designation, and age. Your name should also be identified on the tool. (This should be a part of your Appendix.)

Compare and contrast the age-related changes of the older person you interviewed and assessed with those identified in this week’s reading assignment. During this data analysis process provide at least 4–6 preliminary issues that you have identified. Identify three alterations in health that you would propose and describe them. Identify a minimum of three comprehensive interventions for each problem. Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

Make sure that you integrate personal cultural awareness and cultural competency.

Paper should be 5–6 pages, not including the questionnaire or tools used. These should be attached as an Appendix. Remember to use headings to identify the different sections in your paper.

On a separate references page, cite all sources using APA format.

Patient Questionnaire

Name:

Age: 80

Questionnaire and the responses

What is your philosophy on longevity of life?

“Living a long life means you led or living a good life. Those who die early have a bad life”

2. What are your thoughts about when a person is considered “too old”?

“A person is considered too old when they become less functional and start depending on others. They start getting memory problems. They start having many illnesses and have less comfortable life.”

3. What is your opinion on the status and treatment of older adults?

“Treatment of elderly people should be holistic and should start from preventive stages. Diseases of old age can be predicted and so physicians must prepare to handle them”.

4. What are your beliefs about health and illness in the elderly?

“The old get sick often and their diseases are frequently more than one.”

5. Do you participate in any health promotion activities? Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

“I help young women try to lose their weight. We have a group that meets weekly to discuss progress of weight loss over the week. I mostly play passive role though but keep the younger ones in check to achieving their target.”

6. Is there anything special that has helped you live long?

“I successfully controlled my smoking and was always watching on my diet. I also have my blood pressure under control.”

7. How many years have your other family members lived?

“My wife is 60 years old and alive. My dad died at 100 years. My mother is alive and 105 years old. My siblings are 67 and 60 years old.”

8. Is there any special dietary tradition in your culture that has contributed to your long life?

“There are nothing written by the book but we always encourage vegetarian diet. We only take meet and junk foods after the church service on Sundays.”

9. Are there any remedies that have been passed down the generation that is responsible for longevity?

“There are no medications or any other remedy that is passed down the generation tree”

10. Can you kindly describe your current and past health condition/status?

“I have high blood and that is under control. I was admitted once for very high blood pressures in the recent past. I also had Chronic Obstructive Pulmonary Disease but I stopped smoking 5 years ago and I am doing well.”

11. What are the values that have guided your life so far?

“Love for my wife and family. We always are happy and happiness lengthens our lives. We are still a strong family.” Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

12. Do you believe that the elderly are useful in the society?

“The elderly, even though dependent on people, play a crucial role in society. They have experience and have good advice for the younger ones. Even though, passively, they can play other important roles for example what I do to help people lose weight”

Do you think having non-communicable diseases as you shorten life?

“I think things such as high blood pressure, diabetes take a toll on us as they are present for lifetime. They make us go to hospital many times.”

14. Why do people want to live long life?

“I do not really know. It could be because old age is associated with good life or because they want to accomplish everything they wanted to have.”

Do you think that the population of elderly people will rise in future?

“Yes. I think many people are increasingly becoming old. So yes, the older people will be many in future.” Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

Summary

Most of the interviewer’s views are in tandem with the literature. For example, it is true that most elderly are prone to getting illnesses. Their health deteriorates over time. Singh & Misra (2009) asset that the elderly experience many social, psychological and physical challenges in life that impact on their sense of capacity and self. They experience depression and loneliness (Singh &Misra, 2009). His view that the elderly population will rise in the near future is also true. Most of his family members are also elderly. The elderly population is growing due to advance in the level of care and health education. For example, the population of elderly has risen from 5 % in 1960 to 23% in 2010. It is also true that the elderly get many diseases. Non-communicable diseases are also on the rise. Social and psychosocial problems in the elderly hamper their ability to live a healthy life (Isaacowitz& Smith, 2003) Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person. Another research also found poor health disproportionally affects the elder although the mean-level age difference in well-being is positive or null (Arai et al., 2012).

Tinetti Balance and Gait Evaluation

Tinetti Balance and Gait score assess the chances of an elderly falling within the next one year. Each variant is given a score from 0-2 and higher scores have better outcome in terms of risk of fall.  It has a total score of 28 with values less than 19 being indicative of high risk of fall. Any value from 19 is considered to have risk of fall. Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

Tinetti Balance and Gait Evaluation

Interviewer:

Date:

BALANCE

ACTIVITY

SCORE

Balance when sitting

1

Can rise with arm support

1

He rises with single attempt

2

Standing balance is firm without support

2

Standing balance is steady with wide stance

2

Steady on nudging

2

Balance intact with eyes closed

2

Has discontinuous steps on 360 turn

0

Non-smooth motion on sitting down

1

SUB-TOTAL

13/16

 

 

GAIT

ACTIVITY

SCORE

Patient can initiate gait immediately

1

Step length and height for left and right swing foot-passes stance to the opposite

1,1

Has equal left and right step symmetry

1

Has continuous step

1

No deviation in path

2

Has no sway on trunk but slight flexion of knees

1

Heels almost touch on walking

1

SUB-TOTAL

9/12

TOTA TINNETI SCORE

22/28

INTERPRETATION

RISK FOR FALL

 

(Elsawy, & Higgins, 2011)

Katz Index of Activities of Daily Living

Interviewer:

Interviewee:

Age:

Profession:

The Katz index of independence in Activities of Daily Living was 5/6 for this patient. The points are as follows Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

 

ACTIVITY

SCORE

Baths without any help

1

Dresses without any help

1

Does toileting on his own

1

Can transfer himself without help

1

Has partial urinary incontinence

0

Feeds himself without help

1

TOTAL

5/6

INTERPRETATION

Patient is independent

 

(Elsawy, & Higgins, 2011)

Assessment of Home Safety

The assessment of home safety for this elderly person will be considered under the living room, the status of the bathroom, bedroom and outside the house

LIVING ROOM

Has doorways are appropriately wide

The living room has loose electrical cords that are unsafe

The pathways in the living room are clear

The electrical cables are not overloaded and the switch is within acceptable reach.

BEDROOM

The bed is set low enough to be freely accessible

There is no installation of night light

There are no loose area rugs and carpet sections

There is no stable chair in the room to make dressing safer and easy

There is no rolling furniture Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person

BATHROOM

There are no grab handles near sink, toilet or shower

The water heater temperature had not been set to less than 120 degrees

There are loose rugs on the bathroom floor

Toilet sit is raised well

No phone or waterproof medical alert device for emergency call

OUTSIDE HOME

The sidewalk is in appropriate condition

The front door is in good condition

There is adequate lighting

There are railings along the front steps

 

(Tomita et al., 2014)

Interpretation: Outside the home is safe. The bathroom is unsafe. The living room is safe. The bedroom is 50% safe.

The Barthel Index assesses functional independence.

THE BARTHEL INDEX SCORE

ACTIVITY

SCORE

INTERPRETATION

Feeding

10

Independent

Grooming

5

Independent

Toileting

10

Independent

Bowel Control

10

Has continence

Dressing

10

Independent

Transfers

15

Independent

Bladder control

5

Occasional accident

Bathing

5

Independent

Mobility on flat surface

15

Independent

Stair case movement

5

Needs help

TOTAL SCORE

95

Fully independent

MINI-COGNITIVE ASSESSMENT INSTRUMENT

Assesses for presence of dementia

ITEMS RECALLED

DRAWING OF CLOCK

INTERPRETATION

0

A

P

1

n

N

1

A

P

2

n

N

2

A

P

3

n

N

3

A

N

KEY

ITEMS RECALLED-the number of three unrelated items that the interviewee recalls

DRAWING-ability to draw clock

A-abnormal

n-Normal

P-Positive

N-negative

INTERPRETATION

The patient is at the red line where he recalls only two unrelated words (dog and table) and has abnormal clock drawing and therefore tests positive for dementia

Whole Analysis-comparison

The patient tested positive for dementia. He was able to recall two unrelated words; dog and table. His clock drawing result was abnormal and therefore he tested positive for dementia on the mini-cognitive assessment. Dementia refers to progressive decline in the cognitive functions of an individual. Symptoms such as apathy, depression, agitation and other neuropsychiatric symptoms are common. With this loss of function, the patient looses independence and may require placement in home care. Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person. The age-standardized prevalence of dementia from 11 European countries based on population studies was at 6.4% for all cases and 4.4 % for Alzheimer’s disease. The prevalence is higher in women than in men and nearly doubled every five-year increase in age.  For the population above 90 years, close to 30% of them had dementia. Alzheimer’s disease was present in 54% of the patients who have dementia. Thus, it is normal for the interviewee to have some form of cognitive impairment. Another important finding is the occasional loss of bladder control. This is also an expected finding in male patients of that age. Most times it can be from bladder outlet obstruction secondary to Benign Prostatic Enlargement. Other symptoms of Benign Prostatic Enlargement should be sought. The levels of the PSA will also be valuable in the further assessment of the patient. The patient should be seen by the urologist for further assessment. If enlargement is found he can be given medications or have urinary catheter in situ for symptomatic relief before prostatectomy is carried out. On physical evaluation, it was also found that, the interviewer had difficulty in climbing stairs. He has strong balance control for his age and his gait is normal for the age. Home safety found the bathroom is unsafe. To make his home safer for his age, there is need to install grab handles near the sink, toilet and the shower. The water heater also needs to be set to less than 120-degree for the maximum temperature. Further, there is need to eliminate loose throw rugs on the bathroom floor. Lastly, there is need to install a phone in the bathroom or have a waterproof medical alert device for emergency calls. The patient has Chronic Obstructive Pulmonary Disease that he has acquired due to long-standing cigarette smoking. It is commendable that he has quit smoking. However, COPD is a chronic disease and elderly patient are at risk of developing acute exacerbations. He has to be taught appropriate inhaler technique. His role in helping others lose weight is also recommendable. He plays a passive role despite being overweight. Moderate exercise is advisable for him. Apart from weight loss, it will also help him to control his blood pressures well. He is a vegetarian. DASH diet will be recommendable for him. Residential nursing care is not recommended for him as he has fairly good physical and mental functions. Further, he has a fairly young and supportive wife who can take good care of him Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

.

References

Arai, H., Ouchi, Y., Yokode, M., Ito, H., Uematsu, H., Eto, F., … & Tsubota, K. (2012). Toward the realization of a better aged society: messages from gerontology and geriatrics. 
Geriatrics & gerontology international
, 
12
(1), 16-22.

Elsawy, B., & Higgins, K. E. (2011). The geriatric assessment. 
Am Fam Physician
, 
83
(1), 48-56.

Isaacowitz, D. M., & Smith, J. (2003). Positive and negative affect in very old age. 
The Journals of Gerontology Series B: Psychological Sciences and Social Sciences
, 
58
(3), P143-P152.

Singh, A., & Misra, N. (2009). Loneliness, depression and sociability in old age. 
Industrial psychiatry journal
, 
18
(1), 51. Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

Tomita, M. R., Saharan, S., Rajendran, S., Nochajski, S. M., & Schweitzer, J. A. (2014). Psychometrics of the Home Safety Self-Assessment Tool (HSSAT) to prevent falls in community-dwelling older adults. 
American journal of occupational therapy
, 
68
(6), 711-718 Older Adult Interview/Patient Questionnaire/Assessing and Planning Care for an Elderly Person.

PICO analysis of depression essay

A PICO analysis is used to pose a focused clinical question to which you find appropriate evidence-based answers. The PICO question should include the patient or population (P), anticipated intervention (I), comparison group or current standard (C), and outcome desired (O). In this Assignment, you develop a question related to dementia, delirium, or depression. Through your PICO analysis, you explore various resources and examine current evidence to answer the question you develop.

To prepare:

Select one of the following disorders as your topic: dementia, delirium, or depression.

Review the guidelines in the “Literature Review Matrix” document in this week’s Learning Resources.

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Think about a research question around your issue as indicated in Part I: PICO Analysis of Research Topic. PICO analysis of depression essay.

Consider the resources you will use, search terms and criteria, and Boolean search strings as indicated in Part II: Search Strategy.

Using the Walden Library and other appropriate databases, locate five articles related to your PICO question. At least one article must be a systematic review. All of the articles should be primary sources.

Reflect on the five articles you selected as indicated in Part III: Analysis of Literature. Consider the conceptual framework/theory, main finding, research method, strengths of study, weaknesses, and level of evidence for each article PICO analysis of depression essay.

Consider how to use the summaries in Part III to create an evidence table. Use this evidence table to determine appropriate treatment options for patients who present with the disorder you selected as your topic.

To complete:

Formulate a question around the disorder you selected as indicated in Part I: PICO Analysis of Research Topic. PICO analysis of depression essay.

Identify the resources you will use, search terms and criteria, and Boolean search strings as indicated in Part II: Search Strategy.

Summarize the five articles you selected as indicated in Part III: Analysis of Literature. Describe the conceptual framework/theory, main finding, research method, strengths of study, weaknesses, and level of evidence for each article.

Create an evidence table based on the article summaries in Part III. Describe appropriate treatment options for patients based on this evidence table.

Managing Depression among Pregnant Women

Part I and II

This study investigated the need and strategies to manage depression cases among pregnant women. For this study, five sources were selected from varying databases after entering several search terms and search strings. The key search term deployed for the study included pregnancy, prenatal, depression, exercise. Consequently, the search strings for the study included maternal depression, pregnancy depressive symptoms, child outcomes, pregnancy and prenatal depression, and pregnancy depressive disorder. PICO analysis of depression essay. The resources selected were all primary sources and had a time range of not more than five years. Moreover, two of the articles were systematic reviews.

Part III: Analysis of Literature.

Gentile (2017) conducted a systematic review investigating the effect of Untreated depression during pregnancy with emphasis on both the Short-and long-term effects to the offspring. In the study, Forty-three articles were selected from varying databases since August 2015. This studies revealed that untreated depression during pregnancy had adverse effects on the developing fetus, newborns and young children, a factor which facilitated including hyperactivity, and irregular fetal heart rate, and resulted to premature deaths PICO analysis of depression essay. Consequently, untreated depression during pregnancy had a significant effect on children in later development ranging from “increased salivary cortisol levels, internalizing and externalizing problems, and central adiposity.” The study highlighted a controversy on the correlation between gestational depression and an increase in prematurity and low birth weight.

Another study by Glover, (2014) investigating on the measures that should be enacted to address “Maternal depression, anxiety and stress during pregnancy and child outcome” from the study Results revealed that even though other factors such as genetics and postnatal care were at play, prenatal anxiety and depression played a significant role facilitating the child’s behavioral and psychological outcomes PICO analysis of depression essay.

The study by Perales, Refoyo, Coteron, Bacchi, and Barakat. (2015) was a randomized controlled trial investigating whether “Exercise during pregnancy attenuates prenatal depression.” the sample for this study was 184 pregnant women selected from Fuenlabrada Hospital. Two groups EG supervised exercise and CG control group were developed and 90 women from the sample were allocated to the EG while the other 77 women were included in the control group (CG). From this study, it was observed that “supervised physical exercise during pregnancy curbed depression and its incidence in pregnant women.”(Perales et al., 2015)

The other study selected was a systematic review conducted by Staneva, Bogossian, Pritchard, and Wittkowski, (2015) investigating “The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth” in this study Four databases were searched in a bid to select articles “focusing on the association between antenatal depression, anxiety, and stress, and preterm birth published in English between 1980 and 2013.” The study result highlighted a strong correlation between antenatal distress during the pregnancy and preterm birth.

The article by Woolhouse, Gartland, Mensah and Brown (2015) “Maternal depression from early pregnancy to 4 years postpartum in a prospective pregnancy cohort study: implications for primary health care” sort to highlight the prevalence and the underlying  risk factors for depressive symptoms employing a cohort study for a 4 years nulliparous women as the study design. The sample was 1507 women whereby the resultant data highlighted a mean gestation of 15 weeks PICO analysis of depression essay. From the study 1 in every three women reported a case of depression symptom in the first four months and the resultant depression prevalence in this study was at 14.5%.

Appropriate treatment options

From the analyzed literature its evident that prevalence of depressive symptoms among pregnant women is high. Moreover, Woolhouse et al. (2015) observed that depression symptoms were also likely to extend to the early years of postpartum heightening the negative impact of depression. Consequently, the articles recommend several interventions to curb the depression symptoms and manage stress and depression cases related to pregnancy PICO analysis of depression essay. However, Gentile’s study also cautions the medical practitioners to weigh out possible effects of some intervention strategies especially the antidepressants which have been highlighted as harbouring utero exposure risks (Gentile, 2017). In this regard, following the literature analysis, this study has highlighted four interventions strategies as adequate to manage pregnancy depression cases.

Notably, depression symptoms in women are high in pregnancy and early years of parenting and pose a significant risk to both the mother and the child (Woolhouse et al., 2015). As such, healthcare services should scale up surveillance of depressive symptoms to all women in this categories. In this regard, this study suggests that free depression medical checkups should be enacted in health centres to cater for the pregnant women and those in early years of postpartum.

Consequently, psychological distress manifest in varying ways including anxiety and stress was shown to be highly correlated with depression (Staneva et al., 2015). As such, this paper proposes that any form of psychological distress evident in pregnant women should be handled with heightened caution and curbed adequately. The Health practitioners especially those engaged perinatal care to women should be adequately informed to work in corroboration and share information amongst them self to ensure that all symptoms have been assessed and adequate intervention measures enacted as deemed appropriate (Glover, 2014). This intern will improve outcomes for both mothers and infants.

Lastly, a notable intervention strategy that had a significant positive outcome in the reduction of depression in pregnant women was evident in Perales et al. (2015) study. According, to the study, supervised physical exercise during pregnancy was shown to significantly lower the level of depression and probability of depression incidence in the pregnant women (Perales et al., 2015). The efficacy of the approach was also heightened by the possibility of negative effect both to the mother and the fetus accrued with depressants PICO analysis of depression essay.

According to Gentile (2017), several studies have pointed out on the possibility of negative outcome associated with in utero exposure to antidepressants. However, the study also emphasizes that if untreated dare consequences are likely to befall the mother and the child extending to later years in life. According to the study possible effects of depression in pregnancy to the child in later years include “increased salivary cortisol levels, internalizing and externalizing problems, and central adiposity” (Gentile, 2017, p 157). As such, this study proposes that healthcare institutions should enact programs or collaborate with professional physical exercise providers to ensure the pregnant patients get supervised physical exercise sessions as a means to curb depression cases and symptoms

References

Gentile, S. (2017). Untreated depression during pregnancy: Short-and long-term effects in offspring. A systematic review. 
Neuroscience
, 
342
, 154-166.

Glover, V. (2014). Maternal depression, anxiety and stress during pregnancy and child outcome; what needs to be done. 
Best practice & research Clinical obstetrics & gynaecology
, 
28
(1), 25-35.

Perales, M., Refoyo, I., Coteron, J., Bacchi, M., & Barakat, R. (2015). Exercise during pregnancy attenuates prenatal depression: a randomized controlled trial. 
Evaluation & the health professions
, 
38
(1), 59-72 PICO analysis of depression essay.

Staneva, A., Bogossian, F., Pritchard, M., & Wittkowski, A. (2015). The effects of maternal depression, anxiety, and perceived stress during pregnancy on preterm birth: a systematic review. 
Women and Birth
, 
28
(3), 179-193.

Woolhouse, H., Gartland, D., Mensah, F., & Brown, S. J. (2015). Maternal depression from early pregnancy to 4 years postpartum in a prospective pregnancy cohort study: implications for primary health care. 
BJOG: An International Journal of Obstetrics & Gynaecology
, 
122
(3), 312-321 PICO analysis of depression essay.

Social Challenges of Aging Essay

Conduct in-depth analysis of a pertinent topic related to aging. Define the problem, specific population affected, cultural implications, and financial/legal/ethical implications. What interventions can be used to improve the problem? What resources are available? What are the associated costs? Is this idea sustainable? Social Challenges of Aging Essay.

Submit your paper in a 6–7-page Microsoft Word document.

Support your responses with examples.

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References must be within 3 years.

Social Challenges of Aging

Introduction

The subject of aging garners greater debate when it concerns the elderly and aged persons who are often considered unproductive but requiring a large proportion of the health resources to maintain a high-quality life, health education and long-term care plans. In fact, the attention focus on the gaps in income, housing and other relevant social and community elements. The reality is that elderly persons require input from multiple stakeholders before these gaps can be addressed (von Homboldt, 2016). Social Challenges of Aging Essay. This then leaves us with the question of what consequences will be faced by both the present and future populations with regards to the existing gaps as pertains a population composed of elderly persons. The present paper explores these notions by talking of the implications of aging and associated social challenges of an aging population.

Discussion

Social challenges of aging

The elderly population has far-reaching implications for any country. This is because it presents direct challenges to the medical system to include the increasing cost of healthcare, rising demand for medical services use, and shifting health profiles. This can be presented as a rapidly increasing group of elderly persons with a larger burden of lifestyle-related medical conditions (such as diabetes) and typical age-based medical issues (that include cancer, dementia, arthritis, and so on) when compared to preceding generations. In addition, the social variations that the next generation of elderly persons will experience (to include an enhanced awareness and understanding of medical issues, as well as greater expectations of medical services) poses added challenges. These challenges are likely to have an effect on future health care engagement and delivery models (Tomczyk & Klimczuk, 2015). Social Challenges of Aging Essay.

The major social challenge is shifting health profiles, with the issue being how medical systems will meet the health needs of the aging population that is increasingly impacted by chronic ailments. The prevalence of many medical conditions is greater for older age groups. Besides that, it is noted that elderly persons are more likely to report multiple long-term medical disorders. Despite the rising incidence of ill health and disease among elderly persons with the condition worsening with age, most persons in that age group believe that they are in good health Social Challenges of Aging Essay. The implication of these awareness is that older individuals have a higher prevalence of chronic self-reported health conditions, terminal conditions, and high risk of injury, thereby showing that they are prone to shifting health profiles requiring greater medical care (Tomczyk & Klimczuk, 2015).

Another challenge is the rising demand for medical services. It is increasingly apparent that the demand for medical services is affected by a range of social factors, but elderly persons are typically higher users of medical services when compared to their younger counterparts. As such, medical services demand is anticipated to rise with the aging population. The increased use of medical services and facilities by elderly populations has implications for medical personnel that is diverse and large, encompassing many occupations that range from volunteers to support staff and highly qualified professions Social Challenges of Aging Essay. The aging population needs an adequate medical labour force to handle its needs (to include skill set, distribution, and numbers) to meet the heightened demand and shifting needs. The future scarcity of appropriately skilled health workers is also anticipated to be a particular challenge (Tomczyk & Klimczuk, 2015).

Yet another challenge is the rising cost of health care. With elderly persons being high users of medical services and facilities, and medical costs being higher for the same population subset, it is prudent to have concerns about the possibility of elderly persons placing an unsustainable strain on available resources. The relationship between medical costs and aging is complex. Still, there is considerable evidence to show that growth in health care spending (both current and projected) are attributable to aging. As such, there is little doubt that medical policies and systems should be adapted in response to the significant shift in population demographics. Part of this understanding includes the awareness that health care funding is collected from a range of sources to include private individuals, insurers, government, and non-governmental sources (Michel et al., 2018).

The government is the principal source of health funding, accounting for as much as 70% of funding needs. It is important to note that the high expenditure has been matched by increasing tax revenue. Whether the same trend will be noted in the future is difficult to predict since labour productivity and supply patterns are likely to undergo change even as education levels rise and diversification occurs in the economy (von Homboldt, 2016). Social Challenges of Aging Essay Private individuals account for 17% of medical funding, with the elderly who tend to have lower incomes and greater wealth also reporting higher costs and spending although these figures are distributed unevenly. More than 50% of their personal wealth (for the elderly) constitutes property. Although it would be logical to assume that elderly persons can easily access their wealth (such as property through reverse mortgage), this wealth is not readily accessible to fund medical needs. Besides that, elderly persons who do not own their accommodation end up having to rent and spend a large proportion of their income on housing thereby leaving a very small proportion for medical costs and other expenditures (von Homboldt, 2016).

The next generation of elderly persons (the baby boomer cohort) is anticipated to have higher levels of wealth and income when compared to past generations. However, the unequal distribution of wealth and income will continue whereby 25% of the wealthy elderly persons will account for 60% of the income and wealth while the poorer 25% will account for 4% of the income and wealth for that age group (von Homboldt, 2016). In addition, the elderly are also increasingly becoming active in the labour force, thereby helping to offset their expenditure growth and bring about better retirement balances (Paltasing & Tyagi, 2015) Social Challenges of Aging Essay. On the other hand, a large number of elderly persons have never contributed to retirement schemes or have only made minimal contributions for a limited time. Increased retirement savings is not anticipated to have an impact in decreasing the number of persons who receive pensions, but it is anticipated to cause a greater shift away from full pensions and towards partial pensions. This means that this population will be unable to meet their health care costs even as they age (Michel et al., 2018).

It is important to note that the challenge presented by an elderly population is acute for certain demographic groups, thereby explaining why the demand for medical service types and locations vary. The higher incidence of disability and life expectancy reported among elderly women (when compared to their male counterparts), along with differences in workforce participation and earnings means that women are more vulnerable to economic uncertainties. Although retirement payment coverage is rising, there remains a significant disparity between superannuation coverage for both male and female elderly persons (Rajan & Balagopal, 2017). Social Challenges of Aging Essay.

At the core of the focus on social factors and pressures is the awareness that socioeconomic factors, including their related handicaps, are important health determinants. In general, there is a tendency for health status to improve with a rise in the economic data. This phenomenon is typically referred to as the socioeconomic gradient of health. Rajan and Balagopal, (2017) puts the issue into perspective by reporting that health inequalities impose costs on any country, both regarding losing productivity and medical care. The very existence of such inequalities is an indication that there is room for health gains to be realized (Rajan & Balagopal, 2017).

Responding to the social challenges

As has been established, an aging population presents some social challenges. This implies that the combination of medical services needed and offered, as well as the way in which they are delivered and funded needs to undergo some radical changes in response to the aging population. At the core of this awareness is the knowledge that aging is linked to heightened risk of dependency, disability and plethora of medical conditions, although the situation is variable since most of the chronic conditions can be postponed or even prevented thereby determining that they are not an inevitable consequence of aging (von Humboldt, 2016). The postponement and prevention to promote good health across the lifespan occur through reduction of morbidity from diseases, disease prevention after the onset, reducing risk factors prevalence before disease onset, and prevention of disease risk factors (Paltasing & Tyagi, 2015) Social Challenges of Aging Essay. Overall, encouraging wellbeing across the different age groups is intended as a strategy for ensuring that future generations of elderly persons are healthy.

Another response is enabling healthy aging, which involves improving and maintaining quality of life and health of elderly persons through the management of multi-morbidity and chronic conditions to enable active and healthy aging (Rajan & Balagopal, 2017). The medical sector plays a principal role in supporting and promoting healthy aging, with medical professionals being instrumental in averting or avoiding disease complications, managing the risks of diseases, and offering advice on lifestyle. Care programs for aged persons also offer a setting for preventive medical care, particularly in avoiding the occurrence of fractures and falls since they are common among elderly persons and are associated with high costs (von Humboldt, 2016).

Supporting and better enabling the social and economic participation of elderly persons within their communities is anticipated to mitigate the challenges of an aging population. This is because health is positively linked to engagement in paid employment (Paltasing & Tyagi, 2015). As a result, promoting good health among elderly persons presents the possibility of triggering health gains and increasing the capacity to actively participate in both the community and workforce.

Conclusion

One must accept that aging attracts debate since the population is linked to heightened risk of dependency, disability and plethora of medical conditions. Also, the population is considered unproductive and yet require considerable resources to maintain. In addition, one must acknowledge that this population faces significant social challenges. Social Challenges of Aging Essay To be more concise, aging population faces social challenges in terms of shifting health profiles, rising demand for medical services, rising cost of health care, funding sources, and unfavorable socioeconomic gradient of health. There is a need to respond to these social challenges through postponement and prevention to promote good health across the lifespan, enabling healthy aging, and supporting increased social and economic participation of elderly persons. In this respect, an aging population introduces unique social challenges that should be addressed.

References

Michel, J., Beattie, L., Martin, F. & Walston, J. (2018).
Oxford Textbook of Geriatric Medicine. Oxford Textbook of Geriatric Medicine
(3
rd
ed.). Oxford: Oxford University Press.

Paltasing, T. & Tyagi, R. (2015).
Caring for the elderly: social gerontology in the Indian context
. New Delhi: SAGE Publications India Pvt Ltd.

Rajan, I. & Balagopal, G. (2017).
Elderly care in India: societal and state responses
. Singapore: Springer Nature.

Tomczyk, L. & Klimczuk, A. (2015).
Aging in the social space
. Bialystok-Krakow: The Association of Social Gerontologists. Social Challenges of Aging Essay.

von Humboldt, S. (2016).
Conceptual and methodological issues on the adjustment to aging: perspectives on aging well
. Dordrecht: Springer.

Develop a Wellness Program Essay with a holistic approach for the older adult you identified, using resources available in your community (Thomasville, GA). Discuss how this approach will prove an optimum level of well-being.

Citations should conform to APA guidelines.

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Teleadult program has been proposed as a wellness program that makes it conceivable for older adults to access health care in the face of outwardly overwhelming obstructions that comprise isolation, limited movement, and being invalids. The program makes use of phone messaging services to a dedicated site that has medical personnel on standby to offer health care advice to include taking vital readings at regular intervals to be accompanied by customized questions and graphics. In this case, the program would involve using communication technologies to expedite healthcare delivery without regard for distance Wellness Program Essay. This occurs even as communication between medical personnel and the population is enabled. For that matter, the program assigns priority to advance treatment, prevention and ensuring wellness. In fact, the program would be applied to carry out patient evaluation, offer interventions (health and psychological), caregiver education, and real-time monitoring of the patients. This occurs even as it creates a feedback mechanism that guarantees an efficient flow of information between the medical personnel and patient (Harris, 2015). The program can be considered as a multidimensional treatment model that focuses on older adults who are homebound and frail. It evaluates issues that influence the quality of care and their connection with care outcomes thus guaranteeing that the population receives the recommended care with enhanced participation from all stakeholders. Even as the program is applied, a likely obstacle to its implementation is meaningful use by the older adult population. The obstacle will be preempted through offering detailed tutorials to the population explaining what the program entails before its implementation. Also, verbal prompts would be included to allow the patient make good use of the program (Harris, 2015). In this respect, Teleadult program is a wellness program that presents an opportunity for older adults to addresses the communication concerns of health care delivery. Wellness Program Essay.

Reference

Harris, M. (2015).
Handbook of Home Health Care Administration
(6
th
ed.). Burlington, MA: Jones & Bartlett Learning Wellness Program Essay.

Quantitative research that has health care implications

Provide an example of a societal trend that will likely impact nursing education and patient education in the future. Provide a multidisciplinary strategy that would maximize the positive impact the trend will have. There are numerous examples that are available; therefore, it is not appropriate to repeat one that has already been provided, unless approved by the instructor. When responding to a post, provide feedback on the strategy suggested and add an additional strategy that may be effective as well. Quantitative research that has health care implications. The Future of Nursing Education and Patient Education

NUR 649E Week 7:

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Question 1=

Read “Thirty-Two Trends Affecting Distance Education: An Informed Foundation for Strategic Planning,” located on the Online Journal of Distance Learning Administration website at 
http://www.westga.edu/~distance/ojdla/fall63/howell63.html
. Select one of the trends and explain how you think it will impact nursing education. This article was written in 2003. Is there a need to update the trend to make the article relevant for today? How? Quantitative research that has health care implications.

Anxiety Among School Children Discussion – Choose articles (peer reviewed and 4 years old ) that will answer answer this questions. Reference APA format.

My Title is: Anxiety Among School Children

Please attach pdf versions of articles used.

Level 1 Questions

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How do personal or family religious preferences affect on anxiety level at school?

Will cultural or sport activities reduce anxiety level among students?

Does spiritual education reflect on anxiety level during academic activities?

Level 2 Questions

How can cultural or spiritual activities effect on anxiety treatment?

Can cultural or lifestyle preference become a way of reducing anxiety and outcome to higher results on tests?

Will marijuana or smoking as a cultural preference become a legal treatment against anxiety at schools? Anxiety Among School Children Discussion

NUR 649E Nursing Education Seminar II Essay Assignments

NUR 649E
 
Weekly Assignments

Week 3:

(Application of Technology in Nursing and Patient Education)

Each student will select one technology application and describe its use within nursing in general or in patient education. Address the significance of the selected technology, attributes of the selected technology (i.e., accuracy, cost, accessibility, etc.), and provide specific examples with rationale of situations in which the technology application as an educational tool would provide advantages as well as disadvantages. In addition, relate the use of the selected technology application to the appropriate professional standards and competencies. NUR 649E Nursing Education Seminar II Essay Assignments.

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This assignment may be completed in one of the following formats (with quantitative criteria) listed below:

1.APA-formatted paper (1,000-1,250 words)

2.PowerPoint presentation with comprehensive speakers’ notes (12-15 slides)

3.Podcast (10-15 minutes)

4.Blog or Web page (1,000-1,250 words)

5.Any other technology application as approved by the instructor

After you have completed this assignment, you will further post the assignment to the Topic 4 Discussion Forum as specified by the instructor. Within the Topic 4 forum, select and review four technology applications that are new to you in that you have not experienced them in the nursing environment. Explain how each of the four reviewed applications may be modified or adapted for your specific field or to a specific patient population. Ask questions as needed to each classmate about the application. In addition to providing constructive feedback to your peers, your posts should include responses to any questions asked, as well as replies. NUR 649E Nursing Education Seminar II Essay Assignments.

APA format is required for essays only. Solid academic writing is always expected. For all assignment delivery options, documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

NUR 649E Week 1 
Question 1

Find a research article on designing learning activities that promotes critical thinking. Summarize the article for your classmates in 1-2 paragraphs. Explain why you chose this study and how this information could be used in your selected area of education (academic, staff, or patient). Be sure to include the entire citation in APA format. The article you select cannot be from any of the course materials or supplemental readings. NUR 649E Nursing Education Seminar II Essay Assignments. (Note: It is a violation of copyright law to post the entire text of an article to an online discussion board. Post only the citation information so that it can be referenced by others. Use correct APA format for citations.)

Question 2

Teaching in Nursing: A Guide for Faculty lists several principles for selecting learning activities. Select one of the principles and explain why it would be important to you in your selected area of education (academic, staff, or patient).

NUR 649E
 
Week 2: NUR 649E Nursing Education Seminar II

Question 1=

Review “Code of Fair Testing Practices in Education,” located on the American Psychological Association website at 
http://www.apa.org/science/programs/testing/fair-code.aspx
. What are your thoughts after reading the document? Did you realize it existed? How does the code apply to nursing education? The Code of Fair Testing Practices in Education is over 10 years old. Is it still relevant today? Why? If not, how should it be revised? Use correct APA format when citing.

Question 2=

What would be a reasonable evaluation strategy for patient education?

NUR 649E
 
Week 3:

Question 1=

Chapter 20 in Teaching in Nursing: A Guide for Faculty discusses the use of technology in nursing education. In addition to the technology mentioned in that chapter, there are many other types of technology devices available today such as eReaders, smartphones, and net books, to name just a few. Select one type of technology application and explain how it is changing the nature of the learning environment and/or the learner’s experience in it. NUR 649E Nursing Education Seminar II Essay Assignments.

Question 2=

Select a specific technology and describe how the use of that technology in nursing education would differ with different types of students.

Note: You may not select a technology that has already been posted by another student; you must select a different one. (This discussion question should be done in advance so that there will be no confusion on whatever technology is chosen).

NUR 649E Week 4: NUR 649E Nursing Education Seminar II

Question 1=

Review four new technology applications posted that you have not had experience with in the nursing environment. For each technology application, explain how it may be modified or adapted for your specific field or patient population. NUR 649E Nursing Education Seminar II Essay Assignments. Feel free to ask questions about the application as well. As classmates post to your assignments or ask questions, respond to each.

Question 2=

Present the history of one form of distance learning (other than online learning). Explain how the distance learning format originated. Would you consider using it in your practice? Address the advantages and disadvantages of the selected distance education format.

NUR 649E
 
Week 5:

Question 1=

Identify the personal characteristics of a student that would support his/her success in distance education. Faculty and students may need different competencies. Choose to discuss the competency needed by either faculty or students; you do not have to do both. NUR 649E Nursing Education Seminar II Essay Assignments.

Question 2=

What is the role of faculty in distance education?

NUR 649E
 
Week 6:

Question 1=

How might assessment of quality in distance education differ from assessment of quality in a traditional classroom setting?

Question 2=

Many schools hire adjunct faculty to fill online teaching positions. How might that practice impact the quality of the online education?

NUR 649E Week 7:

Question 1=

Read “Thirty-Two Trends Affecting Distance Education: An Informed Foundation for Strategic Planning,” located on the Online Journal of Distance Learning Administration website at 
http://www.westga.edu/~distance/ojdla/fall63/howell63.html
. Select one of the trends and explain how you think it will impact nursing education. NUR 649E Nursing Education Seminar II Essay Assignments. This article was written in 2003. Is there a need to update the trend to make the article relevant for today? How?

Question 2=

Provide an example of a societal trend that will likely impact nursing education and patient education in the future. Provide a multidisciplinary strategy that would maximize the positive impact the trend will have. There are numerous examples that are available; therefore, it is not appropriate to repeat one that has already been provided, unless approved by the instructor. When responding to a post, provide feedback on the strategy suggested and add an additional strategy that may be effective as well. NUR 649E Nursing Education Seminar II

NUR 649E
 
Week 8:

Question 1=

Discuss whether there should be additional criteria to become a distance nurse educator. Explain your response. If you agree that there should be additional criteria, what standards would you set?

Question 2=

Predict the career potential for nurse educators in online education. Justify your response by referring to societal trends as studied in Topic 7. NUR 649E Nursing Education Seminar II Essay Assignments.

NUR 649E
 
Week 5: NUR 649E Nursing Education Seminar II

(Distance Education Learning)

Describe an issue that impacts distance-education learning. The selected issue can be a faculty issue, student issue, or administrative issue. Examine the issue and its significance to distance education.

Assume that you are in a leadership position for the development of either nursing or patient education. Propose strategies on how your organization can meet challenges posed by the issue you selected in order to continue providing quality distance-education learning. Support your proposal by incorporating evidence-based literature and relevant professional standards.

This assignment may be completed in one of the formats (with quantitative criteria) listed below (Note: You must select a format different than the format you submitted for the Topic 3 assignment):

1.APA-formatted paper (1,000-1,250 words)

2.PowerPoint presentation with comprehensive speakers’ notes (12-15 slides)

3.Podcast (10-15 minutes)

4.Blog or Web page (1,000-1,250 words)

5.Any other technology application as approved by the instructor

APA format is required for essays only. Solid academic writing is always expected. For all assignment delivery options, documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.

NUR 649E
 
Week 7:

(Personal Class Design Project: Part 2) This is a group project. I will let you know what part in the team assignment I have. NUR 649E Nursing Education Seminar II Essay Assignments.

Using the “Personal Class Design Project – Part 1” assignment you began in NUR-647E, you will complete the course design to include learner objectives, outline, teaching strategies, and associated evaluation, and method.

Using Part I, write and revise the original learner objectives submitted.

Use the A-B-C-D method of writing objectives. The objectives should incorporate Bloom’s taxonomy, be written at the appropriate level for the audience, and include at least two learning domains (cognitive, psychomotor, and affective). Refer to “NUR-649E – Nursing Education Seminar II: A-B-C-D Approach to Objective Writing” and “NUR-649E – Nursing Education Seminar II: Learning Domains.”

Map out a class time frame, outlining when to cover each of the content areas. Refer to “NUR-649E – Nursing Education Seminar II: Lesson Plan Template.”

In addition to the content area, include the class time frame:

1.Time frame for covering each topic area

2.Teaching strategy for each objective

3.How the learning will be evaluated

Include rationale for each selected instruction and the evaluation method used.

There is no predetermined length for this assignment. It is intended that each student will develop a class that can be utilized in the student’s selected area of education.

Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. NUR 649E Nursing Education Seminar II Essay Assignments. An abstract is not required.

NUR 649E
 
Week 8: NUR 649E Nursing Education Seminar II

(CLC – Critical Thinking Strategies Case Study)

This is a Collaborative Learning Community (CLC) assignment.

Each CLC group will design a case study (1,750-2,000 words) of an educational situation in an academic nursing or hospital-based educational setting. When designing the case study, do the following:

1.Identify the educational setting: Is it an academic setting as in a university, or is it hospital based?

2.Identify the educational needs that will be addressed using distance education.

3.Develop learner objectives and evaluation strategies specific to the case study situation.

4.Explain what technological applications will be utilized.

5. Include an assessment model as the basis for the evaluation plan (refer to Chapter 25 in Teaching in Nursing: A Guide for Faculty).

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

This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion. NUR 649E Nursing Education Seminar II Essay Assignments.

Topic: New preceptors in hospital setting, hospital setting for new preceptors”. A case study for inpatient nurses for becoming new preceptors

Assignment: Develop at least 3 learner objectives for developing a preceptor class and develop critical thinking skills + Describe the advantages and disadvantages of the evaluation methods for the preceptor class (2 slides each part=4 slides) NUR 649E Nursing Education Seminar II Essay Assignments.

SOWK 627 Assignment 1: 
Policy Analysis

General Information about Course Assignments 1-4

The assignments for this course include a combination of individual assignments (1 and 2) and group assignments (3 and 4), all done in collaboration with an assigned Content Cluster (groups of 4-5 students) focused on one of five broad content areas (Child Welfare, Juvenile Justice, Education, Health/Mental Health, and Poverty), a common social problem and an identified area of systemic reform. For example, a content cluster focused on Child Welfare may identify the social problem of Transition Age Youth and Homelessness upon exiting the foster care system. Cluster members as their focus area. SOWK 627 Assignment 1: Policy Analysis. They should then begin by assessing what type of systemic reform is happening around their identified issue and then each member should choose a policy that contributes and/or is related in some way to the social problem, population and area of systemic reform. Content Cluster areas/groups will be decided on no later than Class Session 2 and Content Cluster. SOWK 627 Assignment 1: Policy Analysis.

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Assignment 1 will be an individual assignment focused on a policy change in support of an identified target population within the assigned content area. Assignment 2, also an individual assignment, will build off of Assignment 1 and asks students to research available quantitative and qualitative data (obtained through informant interviews) to support implementation of their chosen policy at the organizational level (agency or system). SOWK 627 Assignment 1: Policy Analysis. Assignments 3 (Capstone paper) and 4 (Capstone presentation), both group assignments, ask content clusters to shift their research from individual policy change to large scale reform, identifying relevant policy changes and available data in support of a previously identified area of systemic reform related to their content area. Groups will also be responsible for developing and presenting an innovative model for change to address the identified area of systemic reform based on one of the models/approaches discussed during class sessions 8-11. The focus should be on systemic reform rather than a specific program for a specific agency. Because group assignments 3 and 4 build off of individual assignments 1 and 2, it is essential that content clusters consult early on in the semester with one another and throughout the semester to ensure that their individual work completed for Assignments 1 and 2 will contribute to successful completion of Assignments 3 and 4. Content Clusters should identify and determine no later than Week 3  what their common social problem and large scale reform area will be and no later than Week 4 what their individual policy topics for Assignments 1 and 2 will be. SOWK 627 Assignment 1: Policy Analysis.

Assignment 1 Guidelines

Provide an analysis of a recent policy (policies may include an enacted law, resolution or ordinance) approved at the federal, state level (state legislature) or County level (County governing body) that is related to your identified content cluster area, target population and agreed upon (by content cluster) area of systemic reform SOWK 627 Assignment 1: Policy Analysis. The policy should have been enacted within the last 5 years. We will spend some time in class discussing strategies for identifying and researching relevant policies.

Each Content Cluster should email their instructor by Week 4 with this information to ensure that the individual policies chosen by each cluster member for Assignments 1 and 2 will serve as a foundation for the successful completion of Assignments of 3 and 4.

Your paper should follow the below outline:

Introduction, Social Issue and Context for change
 – (Suggested 2-3 pages)

Introduction, title and summary of the chosen policy

What need/social problem and target population(s) does the policy seek to address? Provide relevant research/data to help the reader understand the need for the policy and who it was intended to help.

Discuss the context for change – was it driven by demographic or socioeconomic changes? By lawsuits or complaints from the field? Was it informed by human rights or social justice concerns? SOWK 627 Assignment 1: Policy Analysis. Describe the relevant historical and social context.

Is this policy part of a larger reform effort or was it developed to address a single issue? If part of a larger reform effort, briefly discuss the larger reform effort and how this policy fits into these efforts?

Explain why/how you chose this topic? What if any connection does the policy/ topic area have to you personally and/or or professionally?

Key elements of the legislative decision making process
.  (Suggested 2-3 pages)

When, where (decision making body) and by whom (author) was it introduced?

Summarize the most relevant parts of the policy (what it aims to do and how)?

Describe the legislative process from idea to enactment. Who were the key decision makers? How long did it take to go through the legislative process? Describe any barriers the policy took toward enactment.

What is the current status of the policy? Is it time limited?

Who are the proponents/opponents of the policy and what are key arguments?

What is the budget/fiscal impact for this policy? What resources will be needed to ensure implementation of the policy? SOWK 627 Assignment 1: Policy Analysis.

What impact or outcomes are expected and/or have been seen since implementation? (Suggested 1-2 pages)

Based on available research, has the policy met its intended goal(s) and/or is it likely to address the intended goal(s)?

In what ways might/are social workers be involved in the implementation of this policy?

If the policy is already in implementation, discuss briefly what implementation has been like thus far, including any challenges/barriers to implementation. If it has not yet been implemented, discuss what is expected?

Conclusion- discuss the implications of this policy for social work, social workers or and/or intended target populations. In what way does/will this policy advance social justice? SOWK 627 Assignment 1: Policy Analysis.

SOWK 627 Assignment 1: Policy Analysis

POINT ALLOCATION RUBRIC

Section 1

                       7 points

Section 2

                       7  points

Section 3

                       4 points

APA, General Grammar, Structure and Flow

                       2 points

TOTAL

                            20 points

The paper should:

Be APA-formatted throughout and include a title page, reference page(s), running header and page numbers. Use of first person should be avoided per APA.

Use double spacing, 12-point font and 1 inch margins all around

Be between 6-8 pages, not including references and appendices. Points will be deducted for papers that exceed the page limit.

Include a minimum of 7 academic references. Academic references may include journal articles, policy/research reports/data from state, county or non-profit/private agencies and/or documents obtained from government/policy source as well as course readings.

Include a link to your policy in the reference section OR include a copy of your policy as an attachment to your paper.

Late submissions will result in a 5% deduction for each day of late submission (absent prior agreement between student and instructor)

Unit 4 Activity

What is AB 12?

AB 12 is the bill that allows foster care for eligible youth to extend beyond the age of 18 and up to age 21.

Who led the Implementation Planning?

Implementation Planning was led by was led by the California Department of Social Services (CDSS), and involved a diverse group of stakeholders. CDSS and the Administrative Office of the Courts (AOC) SOWK 627 Assignment 1: Policy Analysis.

What are the elements of their proposed four-tiered framework?

The first tier is made up of stakeholders and informants which sustained the vision. The second tier is made up of a coordinating leadership team which was responsible for overseeing implementation. The third tier was made up of the Five Focus Area Teams which was responsible for guiding the efforts around the bill. The fourth tier was for stakeholder input. SOWK 627 Assignment 1: Policy Analysis.

For this Cultural Awareness and Health Literacy Level Essay Assignment Discussion, you will analyze a health-related scenario to determine how differences in health literacy levels may affect the success of a public health outreach program. In addition, you will consider the appropriateness of the outreach material from a cultural awareness standpoint, and how you might apply the lessons learned from the scenario to improve additional outreach efforts.

With these thoughts in mind:

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Consider the following scenario:

You are a public health or healthcare administration professional charged with implementing a new outreach program for colorectal cancer in an urban population. You are handed materials and protocols used in a previous outreach program targeting college-educated white adults. Be sure to take into account health literacy levels in your Discussion. Cultural Awareness and Health Literacy Level Assignment

Submit a 3- to 4-paragraph post that includes the following:

Explain how differences in health literacy levels may affect the success of your outreach program.

Next, using the concept of culturally competent care covered in this week’s Learning Resources, identify two ways in which the outreach material or protocols may not be appropriate for your population. Cultural Awareness and Health Literacy Level Assignment

What lessons can you take from this experience with colorectal outreach efforts, and how might you apply these lessons to improving breast cancer screening?

Refer to the Hasnain, Menon, Ferrans, and Szalacha (2014) article found in this week’s Learning Resources. Cultural Awareness and Health Literacy Level Assignment

JOURNAL OF WOMEN’S HEALTH Volume 23, Number 7, 2014 ª Mary Ann Liebert, Inc. DOI: 10.1089/jwh.2013.4569 Breast Cancer Screening Practices Among First-Generation Immigrant Muslim Women Memoona Hasnain, MD, MHPE, PhD,1 Usha Menon, PhD, RN, FAAN,2 Carol Estwing Ferrans, PhD, RN, FAAN,3 and Laura Szalacha, EdD 4 Abstract Background: The purpose of this study was to identify beliefs about breast cancer, screening practices, and factors associated with mammography use among first-generation immigrant Muslim women in Chicago, IL. Methods: A convenience sample of 207 first-generation immigrant Muslim women (Middle Eastern 51%; South Asian 49%) completed a culturally adapted questionnaire developed from established instruments. The questionnaire was administered in Urdu, Hindi, Arabic, or English, based on participant preference. Internalconsistency reliability was demonstrated for all scales (alpha coefficients ranged from 0.64 to 0.91). Associations between enabling, predisposing, and need variables and the primary outcome of mammography use were explored by fitting logistic regression models. Cultural Awareness and Health Literacy Level Essay Assignment. Results: Although 70% of the women reported having had a mammogram at least once, only 52% had had one within the past 2 years. Four factors were significant predictors of ever having had a mammogram: years in the United States, self-efficacy, perceived importance of mammography, and intent to be screened. Five factors were significant predictors of adherence (having had a mammogram in the past 2 years): years in the United States, having a primary care provider, perceived importance of mammography, barriers, and intent to be screened. Conclusions: This article sheds light on current screening practices and identifies theory-based constructs that facilitate and hinder Muslim women’s participation in mammography screening. Our findings provide insights for reaching out particularly to new immigrants, developing patient education programs grounded in culturally appropriate approaches to address perceived barriers and building women’s self-efficacy, as well as systemslevel considerations for ensuring access to primary care providers. Introduction B reast cancer is a leading cause of death and disability globally and is the most commonly diagnosed cancer in women, regardless of race or ethnicity, in the United States.1 Early detection of breast cancer is a key to reducing morbidity and mortality. Substantial increases in mammography use in the 1990s resulted in up to 30% reduction in mortality attributed to breast cancer.2–8 Despite these advances, segments of our population have not benefited from cancer prevention and control efforts, and disparities in breast cancer screening and health outcomes persist for minority groups.1,9–15 Low mammography use has been associated with a variety of factors, including not having a medical home, not having health insurance, being a recent immigrant, and having low levels of knowledge and awareness about breast cancer.16–18 Migration to Western countries and increased length of stay are associated with increased risk of breast cancer,19 which in turn is attributed to a number of factors and is compounded by barriers to timely screening.20 Ethnicminority women residing in Western countries are more likely to be diagnosed with advanced-stage disease and hence have higher mortality rates.21 This often results from lower utilization of timely breast cancer screening services.22–26 Personalizing or tailoring education about mammography to 1 Department of Family Medicine, College of Medicine, University of Illinois at Chicago, Chicago, Illinois. College of Nursing, The Ohio State University, Columbus, Ohio. 3 College of Nursing, University of Illinois at Chicago, Chicago, Illinois. 4 Center for Research and Transdisciplinary Scholarship, College of Nursing, The Ohio State University, Columbus, Ohio. Cultural Awareness and Health Literacy Level Essay Assignment. This research was presented at Women’s Health 2012: The 20th Annual Congress in Washington, DC, and received the First Place Award in Community & Public Health Research from the Office of Research on Women’s Health, National Institutes of Health. 2 602 BREAST CANCER SCREENING FOR MUSLIM WOMEN patients’ culture and beliefs has the potential to increase breast cancer prevention awareness and screening utilization.27–33 The purpose of this study was to identify beliefs about breast cancer, screening practices, and factors associated with mammography use among first-generation immigrant Muslim women (born outside the United States) in Chicago, IL. In the United States, immigrant Muslim women represent a fastgrowing and understudied population whose healthcare behaviors and utilization of health services, including cancer screening, are influenced by religious and cultural beliefs.34–38 There is a paucity of rigorous theory-based, descriptive, and intervention research on this population, and few studies have evaluated breast cancer incidence, stage, treatment, and mortality rates for Muslim women. Preliminary evidence suggests that Muslim women underutilize mammography.34,39–40 More importantly, lack of cultural accommodation hinders Muslim women’s utilization of mammography services. When breast cancer screening programs are not structured in a manner consistent with their beliefs and customs, Muslim women choose not to participate.34,39–40 The number of Muslims in the United States is estimated to be 2–6 million (47% women) and growing.41–43 African American Muslims indigenous to the United States comprise the largest number of American Muslims. Apart from these, immigrant Muslims are extremely varied ethnically, coming from virtually every country where Muslims live. The largest group of Muslim immigrants in the United States is from South Asian (SA) countries (33%), followed by the Middle Eastern (ME) countries (25%).44 Hence, these two immigrant groups were the focus of our research. The limited literature on ME women indicates that breast cancer is a leading cause of cancer-related mortality in this group in their home countries, as well as when they immigrate to Western countries.45–51 Within the United States, breast cancer is the most frequently diagnosed cancer among SA women in California.52 In the United Kingdom, the risk of breast cancer among SA women differs according to their specific ethnic subgroup; Muslim women from India and Pakistan are almost twice as likely to develop breast cancer as their counterparts.53 In Australia, immigrants from Pakistan, a country with a predominantly (95%) Muslim population,54 present with the highest age-standardized breast cancer mortality rate.55 Multiple factors, such as language barriers; lack of medical insurance; geographical barriers; and limited knowledge, education, and access to healthcare services, contribute to barriers faced by immigrant women in accessing and utilizing healthcare.56 In order to identify factors that influence Muslim women’s decision making to engage in breast cancer screening, our study had the following three primary objectives: 1. Develop a culturally relevant survey to assess screening practices and to identify factors associated with mammography use by Muslim women. 2. Confirm psychometric properties of survey subscales in differing languages. 3. Explore the associations between mammography use and predisposing, enabling, and need variables. Cultural Awareness and Health Literacy Level Essay Assignment. Three theoretical models—the Andersen Behavioral Model of Health Services Utilization,57,58 the Health Belief 603 Model,59–61 and the Transtheoretical Model62–64—were used to guide the development of the study. Materials and Methods Study design and setting A cross-sectional study design was used to survey 215 first-generation immigrant Muslim women. The study was conducted in Chicago, IL, home to a large number of immigrant Muslims. According to estimates by the Council of Islamic Organizations of Greater Chicago, approximately 400,000 Muslims live in the Chicago area. Recruitment sites were several Chicago-based community agencies and faithbased institutions. Data collectors were bilingual or trilingual females and were trained research interviewers. Survey development and translation took place in 2008 and 2009; survey administration and data collection, in 2009 and 2010. The Institutional Review Board of the University of Illinois at Chicago approved this study. Measures and survey development A written survey was developed to collect information on two sets of core measures: 1. Breast cancer screening practices, with mammography the primary dependent variable. Participants were asked about their past mammography use and future intent to screen in order to assess stage of readiness. Mammography use was categorized as (a) never having had a mammogram (never-screened group), (b) having had at least one mammogram but none in the past 2 years (overdue group), and (c) having had a mammogram in the past 2 years (adherent group). For our study, the National Cancer Institute recommendations for breast cancer screening were used to define adherence: mammogram screening every 1–2 years, beginning at age 40.64 2. Predictors of mammography screening, organized into predisposing, enabling, and need categories (see Table 1). Three instruments—the Champion Breast Health Survey,65 Ferrans Cultural Beliefs Scale,66 and Suinn-Lew Asian SelfIdentity Acculturation Scale (SL-ASIA)67—were adapted, combined into one survey, and translated into the study languages (Urdu, Hindi, and Arabic). Focus groups were conducted to confirm that the survey items were understandable and culturally relevant to the target population (described later). Champion Breast Health Survey. The widely used subscales for breast cancer screening beliefs (perceived susceptibility, perceived benefits, perceived barriers, and perceived self-efficacy), with established reliability and validity,68 were included in our study. All subscales have good internal consistency reliability (Cronbach’s alphas greater than 0.70) and construct validity (demonstrated by confirmatory factor analysis; all subscales were unidimensional). Ferrans Cultural Beliefs Scale. This scale, which measures cultural beliefs about breast cancer, has previously been tested with African American, Hispanic, and Caucasian women. The instrument focuses on beliefs in three content 604 HASNAIN ET AL. Table 1. Predictors of Mammography Use Predisposing a Perceived risk (susceptibility) for developing breast cancer Perceived benefitsa— positive outcomes associated with screening for breast cancer Perceived barriersa—obstacles associated with breast cancer screening Self-efficacya—self-confidence in one’s ability to get a mammogram Knowledgea—cognitive information about breast cancer risk, screening recommendations, causes, treatment, and cure Emotional factors—fear and shame associated with breast cancer and mammography screening Cultural factorsb—cultural beliefs regarding breast cancer Global rating of importance of mammography—self-perceived overall importance of the need for getting a mammogram Enabling Need Education Income Insurance—third-party payer of healthcare costs Acculturationc—modification of the culture of a group or individual as a result of contact with a different culture Self-perceived health status Physician recommendation— patients’ perception of recommendation by their respective providers to screen a Source: Champion Breast Health Survey65 modified/refined via focus groups. Source: Ferrans Cultural Beliefs Scale.66 c Source: Suinn-Lew Asian Self-Identity Acculturation Scale (SL-ASIA).67 b areas: those that make women feel less vulnerable to breast cancer, those that discourage participation in breast cancer screening, and those about the lack of efficacy of breast cancer treatment. Higher scores on the Ferrans scale indicated that more cultural myths inhibiting screening were believed Cultural Awareness and Health Literacy Level Essay Assignment. The scale has demonstrated reliability (alpha = 0.73) and validity in the populations tested.69 Suinn-Lew Asian Self-Identity Acculturation Scale. The SL-ASIA67 was originally modeled after the Acculturation Rating Scale for Mexican Americans70 and has been developed for and extensively tested with East Asian groups. The measurement approach recognizes the multidimensionality of the acculturation process and takes into account the issue of bicultural development. The instrument assesses cognitive, behavioral, and attitudinal areas, and its 21 multiple-choice questions yield five factors and a single acculturation score that range from 1:00 (low acculturation) to 5:00 (high acculturation). The scale demonstrated internal consistency reliability (Cronbach’s alpha: 0.88–0.91 in two studies) and concurrent validity.67 The questions in the scale are generic; to make the scale more relevant to our study population, we changed country/region names to represent those of our study population. Global rating of importance of mammography screening. A 10-point Likert-type scale measuring global rating of the importance of regularly getting mammograms (ranging from ‘‘not at all important’’ to ‘‘very important’’) developed for this study was also included in the survey. Cultural adaptation and refinement of survey via focus groups. To account for regional and ethnic differences in beliefs and to add culturally relevant content, two focus groups were conducted (one each for SA and ME women), with 10–12 participants in each group. To be eligible to participate in the focus groups, participants had to be female, Muslim (defined as those who self-identify with the Islamic faith), aged 40 years or older, first-generation immigrants (18 years or older on arrival in the United States) from the Middle East or South Asia and able to read, write, and speak English and one of the study languages (Urdu, Hindi, Arabic). Two of the study authors (Memoona Hasnain and Usha Menon, who are fluent in Urdu and Hindi), moderated the focus groups. An Arabic-language translator participated in the Middle Eastern focus group. We used a semistructured format to refine survey items and to identify new items. The process was used to confirm that the survey items were understandable and culturally relevant to the target population. Cultural Awareness and Health Literacy Level Essay Assignment. Based on participant input, the Champion scales were adapted; some of the items were reworded, some items were removed, and others were added. See Appendix 1 for the modified Champion scales. No changes were made to the Ferrans Cultural Beliefs Scale and SL-ASIA; both were determined to be understandable and culturally appropriate by the focus groups in their original form. Translation of survey. To address language barriers, the culturally adapted survey and other study documents (informational flyer and consent brochure) were translated into Urdu, Hindi, and Arabic. The committee-translation method71 was utilized, as it is a more rigorous process than using a single translator. A translation team consisting of three translators and a language expert (adjudicator) was established for each language to guide the translation. This systematic development of study survey and other documents BREAST CANCER SCREENING FOR MUSLIM WOMEN increased the likelihood of developing a culturally appropriate and psychometrically sound survey. Sample and data collection Sample size. Cultural Awareness and Health Literacy Level Essay Assignment. A sample size of 230 participants (115 per ethnic group) was planned on the basis of recommendations by Nunnally72 for measurement reliability. To account for incomplete data, we planned to oversample by 9% for a total 250 participants. First-generation immigrant Muslim women (same eligibility criteria as for those who participated in the focus groups) were eligible for the study. Given the exploratory nature of this study, self-reported mammography-screening practices were not verified via medical records. Recruitment and data-collection procedures. Participants were selected from a purposive sample of Muslim women residing in Chicago, IL. Participant recruitment and datacollection procedures were standardized and kept similar for both SA and ME women. Study flyers, in English and translated languages, inviting participation were circulated electronically and posted in community agencies and mosques. Trained research assistants approached women at community sites and used snowball sampling to accrue the proposed sample size. After obtaining full written informed consent, the in-person survey was administered to eligible participants at data-collection sites. Participants received a small monetary incentive to participate in the study. Statistical analyses In addition to psychometric assessment (reliability and validity) of the various scales used in each of the three language groups, descriptive statistics, bivariate correlations, contingency-table analyses, analyses of variance (ANOVAs), and hierarchically nested logistic regression models were conducted. Owing to the significant differences in screening behavior based on ethnicity, we stratified by ethnicity for all bivariate analyses. For each outcome—(1) ever having had a mammogram versus not and (2) adhering to mammogram guidelines (mammogram within the past 2 years) versus not—modeling began with all sociodemographic characteristics. Model 2 contained only cultural and health-related predictors. Model 3 included all sociodemographic and cultural and health-related predictors significant in Models 1 and 2 at alpha = 0.10. We then tested for statistical interactions as was necessary. The sample size was insufficient to fit separate logistic models for ME and SA women. Therefore, we tested for ethnicity in the models. Finally, only one participant completed the survey in Hindi, precluding psychometric analysis for data collected in that language; hence, data from the Hindi survey were not included in the analysis. Data analysis was performed using SPSS v. 21 (IBM, New York). Psychometric analyses Each of the established scales, translated into Urdu and Arabic from English, was examined for reliability (internal consistency) and validity (correlations) within and across each language group. More than one-third of the participants 605 completed the survey in English (38.2%, n = 79), one-third in Arabic (35.3%, n = 73), and about one-fourth in Urdu (26.1%, n = 54). Every subscale was internally consistent, with alpha coefficients ranging from 0.72 to 0.92, and constructs expected to be related were significantly appropriately correlated (e.g., benefits and self-efficacy r = 0.53, p < 0.001, barriers and cultural beliefs r = 0.39, p < 0.001). There were no significant differences based on the language of the survey, so we analyzed the combined data. Results Sample characteristics The 207 participants had emigrated from 13 South Asian and Middle Eastern nations: The largest proportions were from Pakistan (30%, n = 65), Palestine (21%, n = 45), and India (17%, n = 37). Although 37% (n = 80) spoke primarily English, 35% (n = 75) spoke primarily Arabic, and 27% (n = 59) spoke primarily Urdu. The majority of participants were married (85%, n = 183), with a mean age of 52 years (standard deviation [SD] = 10.0). Almost one-third of the participants (31%, n = 66) were college graduates, and onethird (30%, n = 65) had a high school diploma. More than one-third (42%, n = 90) reported incomes less than $20,000, and one-third (34%, n = 70) reported having health insurance. In terms of mammography-screening practice (Table 2), 32% (n = 66) had never had a mammogram (never-screened group); 17% (n = 37) had had a mammogram but more than 2 years prior to the survey (overdue group); and 52% (n = 112) had had a mammogram within the past 2 years (adherent group). Only 20% (n = 44) reported a family history of breast cancer. Bivariate analyses There were significant differences in mammographyscreening practice based on sociodemo … Cultural Awareness and Health Literacy Level Assignment