Care Giver Perceptions of End of Life Care for COPD Patient

Care Giver Perceptions of End of Life Care for COPD Patient RESEARCH PROPOSAL Title: Exploring the primary family care givers perceptions of care giving for end of life care of COPD ICU patient. Introduction: The world perspective is shifting towards non-communicable diseases, with chronic conditions such as heart disease, stroke and chronic obstructive pulmonary disease (COPD) as chief causes of death globally. COPD is a chronic progressive disease of air flow obstruction which includes emphysema and chronic bronchitis. COPD is predicted as 3rd leading cause of death in 2030 according to 2008 WHO statistics. In terms of social burden of disease quantified by disability-adjusted life-years (DALYs) lost, COPD ranked as the 12th leading cause of DALYs lost worldwide in 1990, but will be the 7th leading cause of DALY lost worldwide in 2030.COPD is more common among world age people due to decreased lung function capacity. The world population above 60 years was1.7% in 2013 and will continue to grow as a reaching 21.1 per cent by 2050 (world ageing population 2013). COPD is one of the major 8th leading causes of death in Singapore. According to MOH 2013 census COPD causes 1.6% of deaths per 18938 populations.COPD is a treatable disease but not a curable one. So ultimately it increases the economic burden of the country by its chronicity, rate of hospital readmission and affects the quality of life activities of daily living of the patient and family members. The total expenditure for COPD was $9.9 million per year. $ 7.2 million accounts for inpatient care cost (W.-S. Kelvinteo et.al, 2011). For last 10 years no studies found in Singapore on family care givers perspectives on end of life care in ICU. Primary family care givers most of the time the spouse are the carer for the COPD patient The Singapore old age percentage is in increasing trend 7.3% in 2000 9.3 in 2011 expected to rise up to 18.7% 2013. When a family member is dying, conversations about the end of life can be uncomfortable and difficult. Still, discussing end-of-life care is important. Patients with end-stage of diseases may suffer from distressful symptoms.The Advanced COPD patient suffer from severe distressful symptoms such a dyspnea anxiety and depression. Palliative care of malignant disorder gained more attention when compare to non-malignant diseases (Blackler et al., 2004; Lynn, 2000; Simonds, 2004).The palliative care needs of patients with end-stage respiratory diseases are increasingly being recognized (Curtis, 2008; Lanken et al., 2008) . The COPD patient experience significant impairment of quality of life and physical and psychological needs when compare to individual with lung cancer (Core et al., 2000; Edmonds et al., 2001; Skilbeck et al., 1998; Tranmer et al, 2003). Why family members? When there is progression of diseases it imposes negative impacts on psychological health of Care givers (Daniela Figueiredo, 2014). Careers are more likely to suffer from anxiety and depressive symptoms providing continuous care during the advance stage of the disease and end of life care (Abebaw Mengistus Yohannes 2007). Preparation for death should include a realistic appraisal of the prospects for dying peacefully at home. (Hansen –Flaschen J .2004) Most of the patients are willing to be housebound at the end stage of life so its responsibility of family cares to provide continuous care and support them White P (2011) stated 45% were housebound, 75% had a career in end stage of COPD . despite no studies have been conducted qualitatively on family care givers perception on End of life care on COPD in Asian countries . Review of literature: â€Å"Palliative care in COPD† search in PUBMED extracted only 285 titles from 1991 to 2011. ( Anirban Hom Choudhuri 2012) .The absence of palliative care services highlights the need for research into appropriate models of care to address uncontrolled symptoms, information provision and end of life planning. (Jones et al 2014). Synthesis of findings: The literature review showed that the family care givers suffer from intense conflict, emotions such as helplessness, guilt, anger, anxiety and frustration. These suffering are due to deterioration of the health of the loved one and cumulative losses over time that the patient illeness affect the care givers the most. The key findings of each study were identified and supplemented based on a review of the full article. Then, categories were derived by grouping the key findings thematically. Lack of support: Most of the family care givers reported they were unaware of the facilities for COPD patient. There was no social or psychological support. If the support is received also this is inadequate or sporadic. They learnt most of the things by their experience regarding prognosis, treatment signs and symptoms, illness. They faced the financial constraint in addition too. They are expecting support from the health care professionals. â€Å"Well, the care from Father’s doctors was extremely basic and, I felt, on the most part extremely uncaring†¦ The doctors really had an attitude of ‘You were a smoker, you’re dying of lung disease, and what do you want us to do about it?’ The way they spoke to him, and the fact that they really weren’t concerned, and they didn’t doo very much for him; anything they did for him, I was disappointed in† – participant from Hasson et al. (2009) Burden of care givers: Burden of care givers are noted in all the studies. Most of the care giver said they are exhausted and need to perform multi task. They need to spend most of time in caring the patient. The involvement in social life is reduced, change of relationship with patient. Mostly they are anxious and frustrated. Sometimes care givers are helpless when they patient are suffering from breathing difficulties. â€Å"It is very frustrating, and you know I don’t know if the government realizes how hard it is for carers..It’s a full-time job. It’s work isn’t it? It’s not something you do because you like it. I mean I care for my Dad, I love him and I want to look after him, but I also need my own time.†- participant from Philip et al. (2014) End of life care and support of Bereavement Mostly family career are involved end of life decision making which lead to a peaceful death and die with dignity for the patient. â€Å"I think the situation was the way is should have been. I think if there had been any external help, it would have been a bit of an intrusion. [Father] did not want to leave the house and that was fine but also whenever he was like that and he was not feeling the best, it was just best to leave him alone† – participant from Hasson et al. (2009) Some said the hospital policy did not allowed us to care for the patient in home during end stage of life. No adequate bereavement support for the family careers after the death. Some had counselling in later part of life. Rewards, meaning, and coping: However, some caregivers described their experiences as positive. Identified positive features include sense of pride, esteem, and mastery as a caregiver a sense of normalcy; being able to demonstrate love and fulfill satisfaction and sense of accomplishment ability to be with and help the patient life-enriching experiences closer relationships a sense that it is important. Some care givers felt that their loved one died with dignity and respect. They were able to provide good care and that provided them a sense of accomplishment. Conclusion: The COPD has a great impact on Family care givers. All the studies stated that there is a lack of support and facilities, unmet needs. There was a lack of knowledge about the available facilities and lack of emotional support .There is a need for supportive and education regarding the palliative and end of life care. Mostly of the careers reported they are helpless when patient suffering from breathlessness and guilt of not doing enough. Caregiver’s involvement in providing care and feeling able to provide quality care, will enhance the coping among the care givers. These four studies were conducted in European countries and thus there is a lack of ethnic diversity which may have an additional impact on caregiving culturally. Many recommendations were made for further research relating to the care givers perspectives. The studies did not discuss if there were any difference in the care provided by spouse/children or by ethnicity. Thus, further research can be done to study the cultural influences on care giving of COPD patients. Research Objectives What are the experiences of Family care givers on end of life care of patient with COPD in ICU? What are the needs of family care givers on end of life care of patient with COPD? What are the barriers of caring family care givers Details of Research Proposal: Aims To explore the needs of Primary family care givers or bereaved careers on end of life care of ICU COPD patient To explore the perspectives of Primary family care givers or bereaved careers on end of life care of ICU COPD Patient. Operational definition: End of life care: The care provided to alleviate the symptoms of patient during the end stage of COPD. Family care givers: Care provided by the Family members other than the health care professionals. Bereaved careers: Bereaved careers are one who suffered from the death family members due to COPD. Research Methodology: Study design: A Phenomenological Descriptive approach will be adopted to explore the perspectives of Family care givers on End of life care. Interviews will be conducted. Sampling: The study will use purposive sampling method to select the participant for the interview. Samples: Primary Family care givers COPD patient who have died in ICU Inclusion criteria: Participant Speak English Participant over 18 years of age Bereaved careers of COPD patient within a year. Exclusion criteria: Bereaved careers of other diseases. Family care givers of other diseases Bereaved and Family care givers of More than one year of COPD patient Sample size planning: Approximately 10-15 primary bereaved careers of COPD patient until the data saturation is obtained Ethical Consideration: The DSRB approval will be obtained before data collection. The purpose of the study will be explained to the participant before informed consents are obtained. The participant will be ensured that the information collected will be kept confidential and it will be used only for research purpose. Data collection: The researcher will get access to the COPD Program coordinator and get permission to conduct a study. After Permission is granted, the COPD patient died in ICU will be identified through the register. The eligible participant will be selected who meet the inclusion criteria. Then the family members will be contacted through telephone by the researcher and if the participant is willing to participate in the research.. The research process will be first explained to the selected participants in an appropriate manner without hurting their sentiments and understanding their difficult situation’s as well. Face to face semi structured interviews will be conducted with the Family care givers. In that interview, a set of general and open ended questions would be asked. And the entire conversation will be audiotaped. Each conversation is assumed to last for 40 to 60 minutes. When the participant become too emotional, the interview will be stopped and reassured by the researcher. Again the interview will be conducted when normality is retained. After the interview, basic demographic data will be collected and the same will be kept confidential. A pilot study will be conducted based on the interview guidelines prepared with 2-3 participants to assess the feasibility of this study. Interview guidelines: Introduction 🙠 2 minutes) Good morning .Thank you for participating in our Research. I Arunadevi graduate student from Alice Lee Center of nursing Studies, National University of Singapore. As a Part of my program I am conducting this Interview. The interviews will be carried out for 45 minutes to an hour. The Questions will be open ended questions. The answers will be audiotaped. Objectives :(1 Minute) To identify the perspectives of primary Family care givers on End of Life care Interview Questions: 45 minutes to One hour) How did you become a Primary care giver? What you understand your role as a care giver? What do you understand about end of life care? How do you experience providing care to family members at the end stage? What helped with the care? What do you felt as lacking while providing the care? What could be improved? Ending session: (5 minutes) Would you like to say anything further? Thanks for sharing your thoughts and views. It would surely help others and provide support when others are facing the same problem. Data analysis: The analysis of the data is based on Colaizzi (1978) which includes various steps such as read and acquire the meaning, organize it into meaningful themes, integrate results, send it to the participant as final validating steps. The recorded interviews will be listened repetitively and transcribed to verbatim by the researcher. The initial impression and reflection will be noted in a separate note book. The themes will be emerged from the transcript. The clustering of the themes with similar context will be made .The thematic analysis will be used to analyses the data. Whenever possible the transcript will be send to the participant to know the meaning or to validate the information. Gaps will be identified as well based on the expectations of the family care givers. Then certain recommendations/suggestions will be generated for the group based on the findings, in addition to the current facilities available. Rigour /Validity: The four essential criteria highlighted by Lincoln and Guba (1985) are as follows: Credibility, Transferability, Dependability and Conà ¯Ã‚ ¬Ã‚ rmability. Credibility refers to the confidence in the truth and interpretation of Data. After transcribing the transcription will be send to the participant when possible to validate the information. To ensure the findings are not modified by the researcher. Reflective Questioning will also be used to ensure the credibility. Transferability of the results generated in the study will be achieved through ‘thick description’, (Lincoln Guba 1985). The study findings will be useful to all the health care professionals family care givers of COPD patient on End of life care. Conformability and dependability rest on the consistency, objectivity and accuracy of the data findings chiefly depends on the data consistency and accuracy and (Richard Morse 2007). Audio recording and supervisor member check in will be done for conformability and dependability.

Racial Ideologies in Frederick Douglass and Linda Brents Narratives Es

Racial Ideologies in Frederick Douglass and Linda Brent's Narratives 4) Slavery was justified by racial ideology. Consider three texts, including one that was written by a former slave. How do the authors either replicate or refute racial ideologies common in the nineteenth century? I am going to focus on the narratives of Frederick Douglass and Linda Brent as examples of a refusal of racial ideologies and Harriet Beecher Stowe’s Uncle Tom’s Cabin as an example of replicating (although attempting to refute) racial ideologies of the day. Douglass’s Narrative and Brent’s Incidents follow them from ignorance to knowledge; knowledge and freedom gained through their own doing. I think that Stowe is in a way both trying to write an anti-slavery novel, however, I can’t see her as anti-racist because Romantic Racialism is what grounds her arguments. In all three, I am going to prove that the relationship between and the representations of the body and the mind are what either refuse or support racial ideologies of the nineteenth century. First, Frederick Douglass’s Narrative introduces the reader to a young Douglass who is ignorant in terms of book knowledge and also lacks practical life experience. He even lacks the knowledge of his own age. But the fact that Douglass is able to educate himself refutes the idea of the time that African Americans were intellectually inferior. By the end of the narrative, he is more educated than someone like Covey, one of his former masters. Kimberly Drake claims that [t]he ability to utilize language, especially written language or literacy, is also portrayed by many ex-slaves as crucial to their quest for freedom, a freedom which in large part is the ability to allow ... ...impulse. All three of these books have really helped me to gain an understanding of what the racial ideologies of the period in which they were written were: Douglass and Brent, through their refusal of these ideologies and Stowe through her inadvertent reinforcement of them. Bibliography: Works Cited Brent, Linda. Incidents in the Life of a Slave Girl. Ed. L. Maria Child. San Diego: Harcourt Brace & Company, 1973. Douglass, Frederick. Narrative of the Life of Frederick Douglass. New York: Dover Publications, Inc., 1995. Drake, Kimberly. â€Å"Rewriting the American Self: Race, Gender, and Identity in the Autobiographies of Frederick Douglass and Harriet Jacobs.† MELUS 22 (Winter 97): 91-109. MacFarlane, Lisa Watt. â€Å"’If Ever I Get to Where I Can’: The Competing Rhetorics of Social Reform in Uncle Tom’s Cabin.† ATQ 2 (June 90): 135-148. Racial Ideologies in Frederick Douglass and Linda Brent's Narratives Es Racial Ideologies in Frederick Douglass and Linda Brent's Narratives 4) Slavery was justified by racial ideology. Consider three texts, including one that was written by a former slave. How do the authors either replicate or refute racial ideologies common in the nineteenth century? I am going to focus on the narratives of Frederick Douglass and Linda Brent as examples of a refusal of racial ideologies and Harriet Beecher Stowe’s Uncle Tom’s Cabin as an example of replicating (although attempting to refute) racial ideologies of the day. Douglass’s Narrative and Brent’s Incidents follow them from ignorance to knowledge; knowledge and freedom gained through their own doing. I think that Stowe is in a way both trying to write an anti-slavery novel, however, I can’t see her as anti-racist because Romantic Racialism is what grounds her arguments. In all three, I am going to prove that the relationship between and the representations of the body and the mind are what either refuse or support racial ideologies of the nineteenth century. First, Frederick Douglass’s Narrative introduces the reader to a young Douglass who is ignorant in terms of book knowledge and also lacks practical life experience. He even lacks the knowledge of his own age. But the fact that Douglass is able to educate himself refutes the idea of the time that African Americans were intellectually inferior. By the end of the narrative, he is more educated than someone like Covey, one of his former masters. Kimberly Drake claims that [t]he ability to utilize language, especially written language or literacy, is also portrayed by many ex-slaves as crucial to their quest for freedom, a freedom which in large part is the ability to allow ... ...impulse. All three of these books have really helped me to gain an understanding of what the racial ideologies of the period in which they were written were: Douglass and Brent, through their refusal of these ideologies and Stowe through her inadvertent reinforcement of them. Bibliography: Works Cited Brent, Linda. Incidents in the Life of a Slave Girl. Ed. L. Maria Child. San Diego: Harcourt Brace & Company, 1973. Douglass, Frederick. Narrative of the Life of Frederick Douglass. New York: Dover Publications, Inc., 1995. Drake, Kimberly. â€Å"Rewriting the American Self: Race, Gender, and Identity in the Autobiographies of Frederick Douglass and Harriet Jacobs.† MELUS 22 (Winter 97): 91-109. MacFarlane, Lisa Watt. â€Å"’If Ever I Get to Where I Can’: The Competing Rhetorics of Social Reform in Uncle Tom’s Cabin.† ATQ 2 (June 90): 135-148.

Timeline of Education

Time Line of Education History of American Education Edu 324 Hernandez Karen Lane 4 March 2013 1647 The General Court of the Massachusetts Bay Colony decrees that every town of fifty families should have an elementary school and that every town of 100 families should have a Latin school. The goal is to ensure that Puritan children learn to read the Bible and receive basic information about their Calvinist religion. 1779 Thomas Jefferson proposes a two-track educational system, with different tracks in his words for â€Å"the laboring and the learned. Scholarship would allow a very few of the laboring class to advance, Jefferson says, by â€Å"raking a few geniuses from the rubbish. † 1785 The Continental Congress passes a law calling for a survey of the â€Å"Northwest Territory† which included what was to become the state of Ohio. The law created â€Å"townships,† reserving a portion of each township for a local school. From these â€Å"land grants† even tually came the U. S. system of â€Å"land grant universities,† the state public universities that exist today. 1790Pennsylvania state constitution calls for free public education but only for poor children. It is expected that rich people will pay for their children's schooling. 1805 New York Public School Society formed by wealthy businessmen to provide education for poor children. Schools are run on the â€Å"Lancasterian† model, in which one â€Å"master† can teach hundreds of students in a single room. The master gives a rote lesson to the older students, who then pass it down to the younger students. These schools emphasize discipline and obedience qualities that factory owners want in their workers. 817 A petition presented in the Boston Town Meeting calls for establishing of a system of free public primary schools. Main support comes from local merchants, businessmen and wealthier artisans. Many wage earners oppose it, because they don't want to pay the taxes. 1820 First public high school in the U. S. , Boston English, opens. 1827 Massachusetts passes a law making all grades of public school open to all pupils free of charge. 1830s By this time, most southern states have laws forbidding teaching people in slavery to read.Even so, around 5 percent become literate at great personal risk. 1820-1860 3. 1 million immigrants arrive a number equal to one eighth of the entire U. S. population. Owners of industry needed a docile, obedient workforce and look to public schools to provide it. 1837 Horace Mann becomes head of the newly formed Massachusetts State Board of Education. Edmund Dwight, a major industrialist, thinks a state board of education was so important to factory owners that he offered to supplement the state salary with extra money of his own. 840s Over a million Irish immigrants arrive in the United States. Irish Catholics in New York City struggle for local neighborhood control of schools as a way of preventing their childr en from being force-fed a Protestant curriculum. 1848 Massachusetts Reform School at Westboro opens, where children who have refused to attend public schools are sent. This begins a long tradition of â€Å"reform schools,† which combine the education and juvenile justice systems. 1851 State of Massachusetts passes first its compulsory education law.The goal is to make sure that the children of poor immigrants get â€Å"civilized† and learn obedience and restraint, so they make good workers and don't contribute to social upheaval. 1865-1877 African Americans mobilize to bring public education to the South for the first time. After the Civil War, and with the legal end of slavery, African Americans in the South make alliances with white Republicans to push for many political changes, including for the first time rewriting state constitutions to guarantee free public education.In practice, white children benefit more than Black children. 1893-1913 Size of school boards in the country's 28 biggest cities is cut in half. Most local district (or â€Å"ward†) based positions are eliminated, in favor of city-wide elections. This means that local immigrant communities lose control of their local schools. Makeup of school boards changes from small local businessmen and some wage earners to professionals (like doctors and lawyers), big businessmen and other members of the richest classes. 1896 Plessy v.Ferguson decision. The U. S. Supreme Court rules that the state of Louisiana has the right to require â€Å"separate but equal† railroad cars for Blacks and whites. This decision means that the federal government officially recognizes segregation as legal. One result is that southern states pass laws requiring racial segregation in public schools. 1905 The U. S. Supreme Court requires California to extend public education to the children of Chinese immigrants. 1917 Smith-Hughes Act passes, providing federal funding for vocational education.Big m anufacturing corporations push this, because they want to remove job skill training from the apprenticeship programs of trade unions and bring it under their own control. 1924 An act of Congress makes Native Americans U. S. citizens for the first time. 1930-1950 The NAACP brings a series of suits over unequal teachers' pay for Blacks and whites in southern states. At the same time, southern states realize they are losing African American labor to the northern cities. These two sources of pressure resulted in some increase of spending on Black schools in the South. 1932A survey of 150 school districts reveals that three quarters of them are using so-called intelligence testing to place students in different academic tracks. 1945 At the end of World War 2, the G. I. Bill of Rights gives thousands of working class men college scholarships for the first time in U. S. history. 1948 Educational Testing Service is formed, merging the College Entrance Examination Board, the Cooperative Test Service, the Graduate Records Office, the National Committee on Teachers Examinations and others, with huge grants from the Rockefeller and Carnegie foundations.These testing services continued the work of eugenicists like Carl Brigham (originator of the SAT) who did research â€Å"proving† that immigrants were feeble-minded. 1954 Brown v. Board of Education of Topeka. The Supreme Court unanimously agrees that segregated schools are â€Å"inherently unequal† and must be abolished. Almost 45 years later in 1998, schools, especially in the north, are as segregated as ever. 1957 A federal court orders integration of Little Rock, Arkansas public schools. Governor Orval Faubus sends his National Guard to physically prevent nine African American students from enrolling at all-white Central High School.Reluctantly, President Eisenhower sends federal troops to enforce the court order not because he supports desegregation, but because he can't let a state governor use military power to defy the U. S. federal government. 1968 African American parents and white teachers clash in the Ocean Hill-Brownsville area of New York City, over the issue of community control of the schools. Teachers go on strike, and the community organizes freedom schools while the public schools are closed. 1974 Milliken v. Bradley. A Supreme Court made up of Richard Nixon‘s appointees rules that schools may not be desegregated across school districts.This effectively legally segregates students of color in inner-city districts from white students in wealthier white suburban districts. Late 1970s The so-called â€Å"taxpayers' revolt† leads to the passage of Proposition 13 in California, and copy-cat measures like Proposition 2-1/2 in Massachusetts. These propositions freeze property taxes, which are a major source of funding for public schools. As a result, in twenty years California drops from first in the nation in per-student spending in 1978 to number 43 in 1998. 1 980sThe federal Tribal Colleges Act establishes a community college on every Indian reservation, which allows young people to go to college without leaving their families. 1994 Proposition 187 passes in California, making it illegal for children of undocumented immigrants to attend public school. Federal courts hold Proposition 187 unconstitutional, but anti-immigrant feeling spreads across the country. Resources: Applied Research Center 2012, Historical Timeline of Public Education in the US Retrieved from: http://www. arc. rg/content/view/100/217/ Gaither, M. 2011 History of American Education Chapters two through eight of book Retrieved from https://content. ashford. edu/books/AUHIS324. 11. 1/ Morgan A Time Rime, Influential Events in the History of American Education Retrieved from: http://timerime. com/en/event/1386863/Latin+Grammar+School/ Sass, Edmund @ College of Saint Benedict/Saint John's University American Educational History: A Hypertext Timeline 2013 Retrieved from: ht tp://www. eds-resources. com/educationhistorytimeline. html

Essay on Analysis of Nonverbal Cues In The Workplace

To be successful in business, one must be able to perceive and use nonverbal cues to one’s advantage. It has been noted by communication experts that when two people have face-to-face communication only a small percentage of the message is delivered through the words they use. The majority of the message is understood and received through nonverbal communication behaviors. These behaviors include gestures, postures, facial expressions, and even clothing; all of which can interfere with the verbal messages that a person is trying to deliver. Although, the importance of nonverbal cues has not been examined extensively in the workplace, it makes sense that they would have a strong impact on any communication both in and out of the realm†¦show more content†¦Eye contact has long been a sign of a man’s good word. The customer would feel important, would feel that his or her time was being valued and that he or she had the full attention of the sales agent. Whe n all of these feelings are put together, there is a good probability that a sale will be made and a satisfied customer will leave with a feeling of good customer service by the sales agent. Posture Posture plays another important role in the workplace as a nonverbal cue. Besides the obvious sloppy, lazy image that poor posture can give off, it also demonstrates one’s confidence or lack thereof. When an individual is standing in a hunched over droopy posture, a vibe is felt by others that the person is either unhappy or insecure. Neither of those qualities makes for a successful person in a business workplace. Additionally, posture holds differently levels of importance in international business dealings as it can be a sign of disrespect and be rather offensive to people of other cultures. Take for instance having your hands in your pockets, this is seen as disrespectful in Turkey (Tidwell). Sitting with your legs crossed is offensive in Ghana and Turkey, while sitting in a way that shoes the soles of your feet is offensive in Thailand and Saudi Arabia (Tidwell). So posture is a highly important nonverbal cue that can have serious implications ifShow MoreRelatedCom munication Is A Fundamental Element Of Any Organization1849 Words   |  8 PagesCommunication in any workplace is a vital skill. In many career fields it is a necessary trait and if done well, can excel a person s carer towards new heights. I have found that communication is a fundamental element of any organization. With communication we are able to achieve our current goals, while planning accordingly for our future goals. This all aligns with a company s overall mission. I have found this to be true when interviewing Chris Coomer a analytics manager from 22Squared. 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Essay about Literature Review - 4068 Words

Abstract Individuals undergoing cardiac surgery can be of any age and functional ability. This literature review examines the correlation between the patient’s ability to engage in self-care behaviors and the efficacy of their rehabilitation. Using Orem’s Self-Care Nursing Deficit Theory and Bandura’s Self-Efficacy Theory peer-reviewed research studies were selected from accredited journals using CINHAL, Ovid, PubMed and Google Scholar ranging from 1988 to 2009. The literature reviewed indicated that the patients’ perceived ability to engage in self-care behaviors impacted their recovery after they were discharge from the hospital. The literature also suggests that nursing interventions can promote and enable self-care while the†¦show more content†¦Search Methods Databases were searched for literature regarding Orem’s Self-Care Nursing Deficit Theory and Bandura’s Self-Efficacy Theory along with any relationship to patients tha t have undergone cardiac surgery. Databases used were CINAHL, Ovid, PubMed and Google Scholar. CINAHL and Google Scholar provided the largest number of useful hits. Keywords or phrases used and the numbers of hits generated by Google Scholar are shown in Table 1. Table of Words/Phrases Used for Google Scholar Database Searches. Table 1. Table of Words/Phrases Used for Google Scholar Database Searches | Keyword/phrase | Number of Hits | Orem’s Theory | 14,000 | Self-Care Nursing Deficit Theory | 7,400 | Self-care with cardiac surgery | 13,900 | Orem and cardiac surgery | 1,120 | Bandura’s Theory of Self-Efficacy | 23,800 | Bandura and cardiac surgery | 2,190 | Self-efficacy theory in cardiac surgery | 4,090 | Self-efficacy and CABG | 2,330 | Orem and CABG | 107 | Self-care deficit and CABG | 279 | Self-care deficit theory and self-efficacy theory | 19,50 | Orem and post-op care | 59 | Orem and coronary artery bypass | 345 | Self-efficacy and coronary artery bypass | 2,890 | Results were reviewed and chosen as to relevant content and application. 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Animal Testing Has Been Bad Of The Years And Itcan Even

Animal testing has been bad of the years and it can even be dated back to the ancient times of the greek. Physicians would dissect animals with the pure interest to obtain knowledge. But even then, one such physician stated that he would rather use a pig as his subject because he wanted to.The ethics of animal testing has always been questioned. Humans do not want to think of animals as on the same level of us. The similarity is terrifying and makes the cruelness obvious. In the 16 century it has been recorded that early vivisectionists, scientists who perform experiments and operations on live animals, did not consider animals to be of the same lineage of us and barely cared for them.The remaining are used as test dummies for products.†¦show more content†¦It breaks one’s heart to know that a family member is being treated cruelly and has to suffer for something they do not deserve.When researching animals many different tests are done in order to predict the effect it will have on humans. One test done is for eye irritancy. A test is performed, often on rabbits, called the Draize eye test. It is a test created by John Draize, a scientist working for the United States Food ,Drug Administration. During the test a substance of some sort will be placed into the rabbit’s eye and the rabbit will be observed in intervals. The rabbits may suffer in such as bleeding, ulcers, and blindness for up to two weeks. At the end of the tests the probable that the rabbits will be killed.Another test is done to determine acute toxicity, which is done when the animals are killed they are put into our food and we get sick and to calculate the danger when a chemical is exposed to the mouth and skin, or is inhaled. It is generally conducted on rats and mice. In the past the test included poisoning a large amount of animals and waiting until at least half of them died. The tests today are less lethal. They now conduct the tests until the animals show signs o f suffering and then the scientist will terminate the experiment. These signs of suffering are severe and include agonizing pain, seizures, and loss of motor function. In the end though the animals are still killed in order

Case Study of Maria-Free-Samples for Students-Myassignmenthelp

Question: Discuss about the Case Study of Maria. Answer: Introduction The current decade has seen an increasing mental stress arising out of peer pressure and lifestyle changes in an individual. The current assignment focuses upon the ill health effects and perils associated with the development of addictive behaviours in a youth. The study here focuses upon the diverse impact produced by alcohol on the body and mind of an individual. The assignment further analyses the different domains, which can be used for gathering sufficient information regarding the support user. The domains have been further elaborated to develop into useful questions, which can be used during the referral. The collective information can be used for proper analysis of the problem situation. Case background Gemma is a 19-year-old AUT student and enjoys her life fully with her friends from college. However, recently her careless and party freak attitude has taken over her studies. This has resulted in Gemma getting behind in her studies. Gemma had also resorted to drinking to cope up with assignment deadlines and the pressure to cope her well in her exams. However, Gemmas mother has come to discover about this drinking problem of Gemma. Additionally, she fears that this tendency to drink might attribute to a strong genetic disposition. This is because Gemmas father was also an alcoholic. Domains of assessment The assessment and intervention for drug addiction can be measured through a variety of factors such as: Family relations Peer pressure Mental health Past history of trauma Medical interventions Role played by family in assessment of addiction Substance abuse and alcoholism is a common peril affecting the current decade. The problem is drastically pertinent in the youth group owing to the huge amount of social and peer pressure that they might be subjected to. However, the role of family is immense in the intervention and treatment of alcohol abuse (Caetano, 2017). The organization of the family as well as the specific structure of the family plays a crucial role in the mental and emotional well being of the children. The disruption in normal elements of the family may subject a child to additional mental and emotional stress(Sibley, 2014) . Therefore, the counselling agency or the care personnel need to ensure that the family of Gemma is actively involved in the care and treatment plan. Children of alcoholics possess a greater risk of being exposed to a range of psychosocial and emotional problems. They are at a greater risk of carrying mental illnesses such as depression into their families. The probability of alcoholism to be present within the next generation is 37% in case of alcoholic parents (Studer, 2014). Reports and evidence have suggested that emotional anxieties, confusion and distress regarding personal role identities are some of the symptoms expressed by an alcoholic. The student services have found Gemma to be coping with the stress of finishing her assignment within deadlines along with the pressure of exams. Thus, unable to cope up with the additional stress Gemma took to drinking. However, in this respect, her father who was also an alcoholic might lay down the example to her. The presence of an alcoholic culture in the family might have triggered Gemma resort such means of stress relief. The inculcation of the family members of an alcoholic in the treatment plan might act as an additional level of security (Georgie, 2016). The student services might also propose a visit to a psychologist by Gemma and her family. This could help in providing the family with an additional amount of emotional care and support needed. In order to gather sufficient and collective information from Gemma, the following questions could be asked to her such as: How would you define your relationship with your family members?...Who is the one closest to you?..........How do you think they affect your thinking and attitude towards life?......Do you think your father is right to profess to alcohols most of the time.....Why or why not? Effect of peer pressure Peer pressure can have a profound effect on the lifestyle options and individual habit of the teenagers. The submission of alcohol or other forms of substance misuse such as drugs is often triggered by social and emotional peer pressure. The disposition to drinking is often developed in an individual out of sheer a competitive spirit. In this respect, the goal is to outdo some of the other friends in the group, which soon becomes a trend(Leung, 2014). The genetic factors also play a crucial role in determining the pattern of individual behaviour. In this context, Gemmas father had been an alcoholic. Therefore, growing up in an environment like that Gemma had been continuously seeing her father. Therefore, she might be pre-disposed to think that being alcoholic has no profound perils associated with the same. In this context, the peer pressure could also be related to social stigma. An individual here is often bullied for the natural behaviour or attitude possessed by them. Thus, constant negative accolades received by may often result in the development of defensive behaviour in an individual(Conway, Journal of American psychology). Here, Gemma had been suffering partying had been seen to develop a tendency of partying hard with her friends. Most of this resulted in Gemma neglecting her studies, which later developed into anxieties and frustrations. The role played by the student support Council is immense in providing additional safeguards against the development of additional mental diseases subjected to chain alcoholism (Ding, 2014). Moreover, the addiction to drinking has resulted in Gemma not being able to remember the past events. This might subject her to security concerns and need to be addressed accurately. The following questions may be put forward to Gemma to understand the influence her peers may have on her decision: Do you like partying with your friends...How often do you party with your friends?... Do you often prefer hard drinks over soft drinks in the parties...Why or why not? Mental health of the support user The sound mental and physical health of the support user is important determining factors in the development or absenteeism from alcoholism. The mental condition of an individual is affected by a variety of factors such as past life history along with present family conditions of an individual. In this context, the failures to meet the pressure of the assignment deadlines as well as the anxieties of the exams have propelled Gemma towards alcoholism. A number of factors affect the mental stability and resilience of an individual. Some of these factors include family history or presence of genetic diseases. It has been found that pre-disposition to drinking and other forms of substance misuse could be attributed to the presence of(Brooks, 2014) depressive attitudes in an individual. Some of the mental diseases such as bipolar disorder and Schizophrenia have shown additional tendency to be subjected towards alcoholism. Mood disorders along with elevated levels of melancholy could be ass ociated higher risk of being subjected to alcoholism. In this context, Gemma had been unable to cope up with the huge backlog in her studies. The pressure had developed into a situation of mental frustrations propelling her towards substance abuse. The student council can act as a support group to the ones suffering from substance abuse. The support of the peer group can act as a motivation for the youngsters suffering from the perils of substance misuse (Human, 2014). Some of the exercises that could be implemented by the student council in order to relieve the situation of Gemma could be to organise group talking within the daily regimens. The plausible questions that could be asked to Gemma in order to investigate the thought process behind the addictive behaviour depicted by her are: How pressurised you feel the burden of the assignment deadline impose upon you?.......What can do you do to cope up with the pressure situation?...... What future strategies you could adopt in order to prevent the recurrence of similar situations? Effect of trauma on drinking Physical and emotional trauma can have a profound effect on the lifestyle choices and mental health of an individual. In this respect, Gemma has grown up in an environment where her father had been a compulsive alcoholic. Thus, such a disturbed environment at home might have affected her moral attributes. The effect of the bad habits and life style patterns adopted by parents often have a dominating effect on the life style options chosen by an individual(De Bellis, 2014). Gemma owing to the lack of parental support and concern might be exposed to feelings of loneliness or isolation. Thus, Gemma may want to be more so in the company of her peers from whom she may get mental and emotional support. However, one of the challenges, which are most often faced by the councillors in dealing with support users such as Gemma, is privacy concerns. It has been found that most of the support users do not wish to open up about their past life experiences or any kind of abuses faced by them. Thus, such confidentiality may often lead to suppression of facts, which are vital to the success of the treatment plan(Haller, 2014). As a student counsellor, a number of questions may be asked to Gemma to understand the perils faced by her in the past: Tell me about your past life experiences... some of the moments which had a profound effect on your life...Good or bad! How do you perceive them? What can you do to change them?" Possibilities of medical intervention A number of possible medical interventions could be applied in order to cater to the need of support requirements of the counselling service users. In this context, behaviour modification can be brought about by counselling. In most cases, a very thin line exists between the motivation to bring in the required changes within the lifestyle of an individual and seeking adequate medical help(Roy-Byrne, 2014). Moreover, behavioural changes through support group assessment where like minds going through similar situations of distress interact as such exercises generate positivity and encouragement within an individual(Mertens, 2015). Additionally, conventional medical interventions might be practised such as acamprosate, which may control the cravings for alcohol in an individual by, restoring certain chemical balances in the brain. The doctors may use naltrexone in order to reduce the dependency for alcohol in an individual(Gustafson, 2014). Moreover, support users like Gemma may be put into a holistic care regimen, which is mainly based upon incorporation of fresh fruits in the diet of an individual. Along with group, talk and light exercises can also help an individual in coping up with the cravings of alcohol. Additionally, positive counselling and sufficient participation and cooperation from the family members of support users like Gemma can also help in aiding the process. In order to analyse the effectiveness of a particular medical intervention and approach in coping up with the alcohol addiction of support users like Gemma, the following questions could be put forward to her: Tell me about the medical help that you have sought for dealing with your alcohol addiction?.........How far have been the approaches helpful in providing you with the required solution?.....Or do you think otherwise? Using the information to analyse the problem situation Detailed assessments of the problem situation of Gemma have presented a number of loopholes. In this respect, Gemma had been addicted to drinking owing to the stress, which was built upon her due to inability to meet up with her required deadlines of submitting the assignment. Moreover, the addiction to alcohol was making her more miserable. Therefore, a number of causative factors could be entailed over here such as impulse to outdo some of her peers with respect to catching up to the modern trends. Additionally, Gemmas father had been a long time alcoholic, which might easily trigger her resorting to alcohol. However, there are a number of other problems where Gemma might be needing help such as help to meet up the additional requirements of her course curriculum. In this respect, a number of additional pre-requisites need to be considered such as the past life history of the service user. The data gathered through such analysis can help in evaluating the cause of worry of the support users. Moreover, maintaining a checklist while gathering responses through the questions framed above can also help in reaching a suitable solution. Bibliography Brooks, S. J. (2014). Childhood adversity is linked to differential brain volumes in adolescents with alcohol use disorder: a voxel-based morphometry study. Metabolic brain disease, 29(2) , 20-27. Caetano, R. S. (2017). Alcohol-related intimate partner violence among white, black, and Hispanic couples in the United States. Domestic Violence: The Five Big Questions , 10-17. Conway, K. P. (Journal of american psychology). 2016. Association of lifetime mental disorders and subsequent alcohol and illicit drug use , 280-288. De Bellis, M. D. (2014). The biological effects of childhood trauma. Child and adolescent psychiatric clinics of North America, 23(2) , 185-200. Ding, W. N. (2014). Trait impulsivity and impaired prefrontal impulse inhibition function in adolescents with alcohol addiction revealed by a Go/No-Go fMRI study. Behavioural anomoly , 10-15. Georgie, J. S. (2016). Peer?led interventions to prevent tobacco, alcohol and/or drug use among young people aged 1121 years: a systematic review and meta?analysis. Addiction, 111(3) , 391-407. Gustafson, D. H. (2014). A smartphone application to support recovery from alcoholism: a randomized clinical trial. JAMA psychiatry, 71(5), , 566-572. Haller, M. . (2014). Risk pathways among traumatic stress, posttraumatic stress disorder symptoms, and alcohol and drug problems: A test of four hypotheses. Psychology of Addictive Behaviors, 28(3) , 841. Human, U. D. (2014). The health consequences of smoking50 years of progress. Disease Control and Prevention , 25-75. Leung, R. K. (2014). The effect of peer influence and selection processes on adolescent alcohol use: a systematic review of longitudinal studies. Health psychology review, 8(4) , 426-457. Mertens, J. R. (2015). Physician versus non-physician delivery of alcohol screening, brief intervention and referral to treatment in adult primary car. 15-25. Roy-Byrne, P. B. (2014). Brief intervention for problem drug use in safety-net primary care settings: a randomized clinical tria. Jama, 312(5) , 492-501. Sibley, M. H. (2014). The role of early childhood ADHD and subsequent CD in the initiation and escalation of adolescent cigarette, alcohol, and marijuana use. Journal of abnormal psychology , 362. Studer, J. B.-K. (2014). Peer pressure and alcohol use in young men: A mediation analysis of drinking motives. International Journal of Drug Policy , 700-708.