Theory, Research, and Practice Assignment

Theory, Research, and Practice Assignment

Theory, Research, and Practice. Considering the priority issue you identified in Week One as a foundation for your Research Proposal, respond to the following:
• Briefly summarize the problem you are planning to investigate for the Research Proposal.
• What search terms will you use to find credible evidence? To help with this task, view the Keywords are Critical tutorial in the University Library.
• Based on your review of the evidence, identify theories others have cited, noting and discussing any common themes.
• Identify an appropriate theoretical framework or model to use in your research proposal.
• Discuss your rationale for this selection.
• How will your study contribute to nursing knowledge and practice? Theory, Research, and Practice Assignment

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Discussion Guidelines: Support your responses with credible or scholarly academic references, using proper APA style citations. The Scholarly, Peer Reviewed, and Other Credible Sources table offers additional guidance on appropriate source types, and the In-Text Citation Helper: A Guide to Making APA In-Text Citations tutorial can clarify further questions you might have on APA. Assigned course readings and University Library resources are preferred. In your first post, provide a substantive exposition that illustrates a well-reasoned and thoughtful response to the topic, is factually correct, provides examples, and demonstrates a clear connection to the readings.

Guided Response: In your responses to at least two of your peers, provide feedback and suggestions related to search terms and selections of the theoretical framework. Discuss the relevance of your colleagues’ topics to nursing knowledge and practice. Your response must display reflective thought that illustrates an understanding of the topic under discussion and be supported with relevant evidence. Theory, Research, and Practice Assignment

French Canadian and German Health Care Beliefs discussion

French Canadian and German Health Care Beliefs discussion

Transcultural Health Care: A Culturally Competent Approach, 4th Edition German American Culture Larry Purnell,

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PhD, RN, FAAN Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German American Overview/Heritage ▪ Over 50 million Americans are of Germans heritage. ▪ The first wave of German immigrants came to the USA for religious freedom. ▪ The second wave arrived between 1840 and 1860 and was fleeing political persecution, poverty, and starvation. ▪ Many worked as indentured servants. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German American Overview/Heritage ▪ The 1930s and 1940s saw a third wave because of the rise of fascism in Germany. ▪ Germans receive a stronger education than Americans. ▪ The German undergraduate degree is equal to the American master’s degree, except for nursing which is at a lower level than that of the USA. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Communication ▪ German is the official language of Germany. ▪ German is a low-contextual language, with a greater emphasis on verbal than nonverbal communication. ▪ A high degree of social approval is shown to people whose verbal skill in expressing ideas and feelings is precise, explicit, and straightforward. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Communication ▪ For traditional Germans, sharing one’s feelings with others often creates a sense of vulnerability or is looked on as evidence of weakness. ▪ Expressing fear, concern, happiness, or sorrow allows others a view of the personal and private self, creating a sense of discomfort and uneasiness. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Communication ▪ “Being in control” includes harnessing one’s emotions and not revealing them to others. ▪ Newer generations are more demonstrative in sharing their thoughts, ideas, and feelings with others. ▪ In families where the father plays a dominant role, little touching occurs between the father and children. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Communication ▪ Affection between a mother and her children is more evident. ▪ Germans generally are careful not to touch people who are not family or close friends. ▪ Most individuals place a high value on privacy. People may live side by side in a neighborhood and never develop a close friendship. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Communication ▪ Germans would never consider dropping in on another German neighbor because this behavior is incongruent with their sense of order. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Communication ▪ Even looking into a room from the outside is considered a visual intrusion. ▪ Eye contact is maintained during conversations, but staring at strangers is considered rude. ▪ A closed door requires a knock and an invitation to enter, regardless of whether the door is encountered in the home, business, or in-patient facility. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Communication ▪ To focus on the present is to ensure the future. ▪ The past, however, is equally important, and Germans often begin their discussions with background information. ▪ There are rarely good excuses for tardiness, delays, or incompetence that disturbs the “schedule” of events. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Communication ▪ Those in authority, older people, and subordinates are always addressed formally. ▪ Younger generations or the more acculturated may be less formal in their interactions. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Family Roles and Organization ▪ Traditional families view the father as head of the household. ▪ In the USA, the husband and wife are more likely to make decisions mutually and share household duties. ▪ Older people are sought for their advice and counsel, although the advice may not always be followed. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Family Roles and Organization ▪ Helping parents or grandparents to remain in their own home is important to families. ▪ Prescriptive behaviors for children include using good table manners, being polite, doing what they are told, respecting their elders, sharing, paying attention in school, and doing their chores. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Family Roles and Organization ▪ Prescriptive behaviors for adolescents include staying away from bad influences, obeying the rules of the home, sitting like a lady, and wearing a robe over pajamas. ▪ Restrictive and taboo behaviors for children include talking back to adults, talking to strangers, touching another person’s possessions, and getting into trouble. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Family Roles and Organization ▪ Restrictive and taboo behaviors for adolescents include smoking, using drugs, chewing gum in public, having guests when parents are not at home, going without a slip (girls), and having run-ins with the law. ▪ One’s family reputation is considered part of a person’s identity and serves to preserve one’s social position. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Family Roles and Organization ▪ Because families are concerned about their reputations in the community, an unwed mother taints their reputation and may result in the family being ostracized by others. If marriage follows the pregnancy, less sanctioning occurs. ▪ The fact that pregnancy existed before marriage creates a stigma for the woman, and sometimes for the child, that may last the rest of their lives. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Family Roles and Organization ▪ Many older gays and lesbians may fear exposure because of the extreme discrimination homosexuals experienced in Nazi Germany. ▪ Younger generations of gays and lesbians are less likely to fear exposure of their sexuality. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Workforce Issues ▪ For Germans being on time is important. ▪ Business communication should remain formal: shaking hands daily, using the person’s title with the last name, and keeping niceties to a minimum. ▪ Employees are not addressed by their first names. Transcultural Health Care: A Culturally Competent Approach, 4th Edition ClickerCheck Common German cultural individualist is values include a. Timeliness and sharing emotions. b. Timeliness and direct communication. c. Smooth inexact communication and readily sharing emotions. d. Readily sharing emotions and present orientation. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Correct Answer Correct answer: B German and German Americans value direct communication and timeliness in work and in social engagements. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Biocultural Ecology ▪ Germans range from tall, blond, and blue-eyed to short, stocky, dark-haired, and brown-eyed. ▪ Common health conditions for German Americans include cardiovascular disease, stomach cancer, muscular dystrophy, hereditary hemochromatosis, sarcoidosis, Dupuytren’s disease, peyronie’s disease, cystic fibrosis, hemophilia, and cholelithiasis. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German High-Risk Health Behaviors ▪ Smoking and excessive alcohol consumption remain high-risk behaviors for most Germans. ▪ Most individuals enjoy the outdoors, fresh air, and exercise. ▪ Sports are played for exercise and the pleasure of participating in group activities. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Nutrition ▪ Food is a symbol of celebration for Germans and is often equated with love. ▪ Children are rewarded for good behavior with food. ▪ Real cream and butter are used. ▪ Gravies, sauces, fried foods, rich pastries, and sausages are only a few of the culinary favorites that are high in fat content. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Nutrition ▪ Foods are also fried in butter, bacon fat, lard, or margarine. ▪ Traditional food preparation methods use highfat ingredients that add to nutritional risks. ▪ Garlic and onions are eaten daily to prevent heart disease. ▪ Those who are ill receive egg custards, ginger ale, or tomato soup (without cream) to settle their stomach. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Nutrition ▪ Ginger ale or 7-Up relieves indigestion and settles an upset stomach. ▪ After gastrointestinal illnesses, a recuperative diet is administered to the sick family member beginning with sips of ginger ale over ice. ▪ Coddled eggs, a variation of scrambled eggs prepared with margarine and a little milk, is used for recuperation. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Pregnancy and Childbearing Practices ▪ Heterologous artificial insemination, use of contraceptive pills, and unnatural contraception are forbidden among strict Catholic Germans. ▪ Therapeutic or direct abortion is forbidden as the unjust taking of innocent life. ▪ Prescriptive practices during pregnancy include getting plenty of exercise and increasing the quantity of food to provide for the fetus. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Pregnancy and Childbearing Practices ▪ Restrictive practices during pregnancy include not stretching and not raising the arms above the head to minimize the risk of the cord wrapping around the baby’s neck. ▪ Prescriptive practices for the postpartum period include getting plenty of exercise and fresh air for the baby. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Death Rituals ▪ Death is a transition to life with God. ▪ Because illness is sometimes perceived as a punishment, the duration and intensity of the dying process may be seen as a result of the quality of the life led by the person. ▪ Careful selection of the clothes to be worn by the deceased and the flowers that represent the immediate family is important. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Death Rituals ▪ The body of the deceased is prepared and “laid out” in the home where support from family and friends is readily available ▪ A short service is held in the home before the body is taken to the church, where family and friends can attend a funeral service. After the church services, the body is taken to the cemetery for burial. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Death Rituals ▪ After a short graveside service, the minister invites everyone at the graveside service to go to the home of the deceased for food. ▪ The viewing provides an opportunity for family, friends, and acquaintances to view the body. ▪ Crying in public is permissible among some families, but in others the display of grief is private. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Death Rituals ▪ A tradition of wearing black or dark clothing when attending a viewing or a funeral may be expected of both family and friends. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Spirituality ▪ Major religions among Germans include Roman Catholicism, Methodism, and Lutheranism. ▪ Other religions, such as Judaism, Islam, and Buddhism, have substantial membership. ▪ Prayers are often recited at the bedside with all who are present joining hands, bowing their heads, and receiving the blessing from the clergy. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Spirituality ▪ Family and other loved ones are also sources of support in difficult times. ▪ Home, family, friends, work, church, and education provide meaning in life for individuals of German heritage. ▪ Family loyalty, duty, and honor to the family are strong values. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Health-care Practices ▪ In traditional families, the mother usually ensures that children receive check-ups, get immunizations, and take vitamins. ▪ Women in the family often administer folk/home remedies and treatments. ▪ German Americans use a variety of over-thecounter drugs, believing that individuals are responsible for their own health. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Health-care Practices ▪ Common, natural folk medicines include roots, herbs, soups, poultices, and medicinal agents such as camphor, peppermint, and spirits of ammonia. ▪ Folk medicine includes “powwowing,” use of special words, and wearing charms. ▪ Many value being stoic when experiencing pain. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Health-care Practices ▪ Mental illness may be viewed as a flaw, resulting in this group being slow to seek help because of the lack of acceptance and the stigma attached to needing help. ▪ Physical disabilities caused by injury are more acceptable than those caused by genetic problems. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Health-Care Practices ▪ Blood transfusions, organ donation, and organ trans-plants are acceptable medical interventions unless a religious choice contradicts them. Transcultural Health Care: A Culturally Competent Approach, 4th Edition German Health-care Practitioners ▪ Health-care providers hold a relatively high status among Germans. ▪ This admiration stems from the love of education and respect for authority. ▪ Most individuals accept care from either gender. Some younger and older, more traditional women prefer intimate care from a same-sex health-care provider. Transcultural Health Care: A Culturally Competent Approach, 4th Edition French Canadian Culture Larry Purnell, PhD, RN, FAAN Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview/Heritage ▪ More than 2.2 million people of French Canadian descent reside in the United States. ▪ Nowadays, French speaking Canadians, unlike those of the 19th century living in the USA, may have been raised within the French culture but descended from a variety of ethnicities. ▪ The Multiculturalism Canada Act of 1988 provides guidelines for implementing policies regarding multicultural diversity. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview/Heritage ▪ Before the latter half of the 18th century, most French immigrating to Canada were Catholics. ▪ French Protestants tended to come directly to the United States. ▪ After the French Revolution, more Catholics sought shelter in the US, most coming via Canada settled in the New England states and later dispersed throughout the United States. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview/Heritage ▪ The Métis, descendants of Native Americans and Europeans, are mainly, though not entirely, Frenchspeaking. ▪ Another major portion of Canada’s French-speaking population are the Acadians who are the descendants of the early French colonists. ▪ Canadians whose first language is French are called Francophones. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Overview/Heritage ▪ Canada has become an increasingly diverse society composed of various ethnocultural groups with more than 100 different languages as mother tongue. ▪ Much like that of the US, interethnic marriage patterns have dramatically changed from a multiethnic society to multiethnic individuals. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communication ▪ Canada has two official languages, French and English. ▪ In many homes in the US and in Canada English and French may be used equally. ▪ The French-speaking population may lack sufficient knowledge of the English language to access the workforce and other material. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communication ▪ Among French Canadians, a conversation may be conducted with high voice crescendos, which do not necessarily mean anger or violence. ▪ Volume can increase with the importance and the emotional charge invested in the content of the message. ▪ French Canadians encourage sharing thoughts and feelings. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communication ▪ Using hand gestures for emphasis when speaking is common. ▪ Facial expressions for men and women of all ages are a part of communication, often replacing words. ▪ Spatial distancing for differs among family members, close friends, and the public. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communication ▪ When in the intimacy zone, people may touch frequently and converse in close physical space; however, they tend to avoid physical contact in public. ▪ When greeting another person, men usually shake hands. ▪ Close female friends and family members may greet each other with an embrace. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communication ▪ Maintaining eye contact is an important French Canadian value. ▪ Most French-speaking Canadians have a past, present, and future orientation in their worldview. ▪ More traditional people, and many from rural backgrounds, attach primary importance to living in the present. Copyright © 2013 F.A. Davis Company Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communication ▪ Until the late 1970s, women and children took the father’s surname. ▪ Today, under Quebec law, a woman keeps her maiden name throughout her lifetime, although in other parts of Canada this practice is decided between the spouses. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Communication ▪ Québécois family of two spouses and two children may well include four different surname combinations: one child may have the father’s surname or the mother’s surname alone or a hyphenated or non-hyphenated surname composed of those of the father and mother. For a second child, the surnames are the same, but in reverse order. ▪ The decision for using surnames rests entirely with the parents. Transcultural Health Care: A Culturally Competent Approach, 4th Edition ClickerCheck The Métis in Canada are a. Mostly English Speaking. b. Mostly speak an indigenous dialect. c. Descendants of Native Americans and Europeans. d. Descendents of French and Arabic. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Correct Answer Correct answer: C a. Descendants of Native Americans and Europeans. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles and Organization ▪ Many older people with a strong religious background maintain a future worldview regarding life after death. ▪ Many of the younger generation reject past traditions and attempt to maintain a balance by enjoying the present, working, and planning for their future. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles and Organization ▪ Traditionally, in French-speaking Canadian families, the man was seen as the moral authority and responsible for material wellbeing, such as economic provider and purveyor of affection and security. ▪ The woman served as the family mediator and social director as well as being responsible for household activities, child care, and health care. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles and Organization ▪ With more women working, family roles are becoming more egalitarian. ▪ French Canadians have always attributed great value to family relationships and obligations. ▪ Research reports that Francophones are less committed than Anglophones to with respect to marriage, sexual activity, and non-married parenthood. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles and Organization ▪ The greatest source of pride for French Canadian families is to see their children well established with a good education. ▪ The French Canadian family is more nuclear and autonomous than its counterpart in France. ▪ French-speaking Canadian family is known for its closeness, and some families are a “closed” family system. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles and Organization ▪ Traditionally, the Catholic Church dictated the parameters of sexual behavior for French Canadians. ▪ There is a growing trend for couples to live together without marrying. ▪ Many young couples answer that they cannot financially afford to get married. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Family Roles and Organization ▪ In 1996, the Canadian government extended health, relocation, and other job benefits to same-sex partners of federal employees. ▪ The Ontario Court of Appeals ruled that samesex couples must be treated as common-law couples under the Family Leave Act. ▪ Canada is one of the few countries in the world where same-sex marriage is legalized. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Workforce Issues ▪ Opportunities for Francophone nurses to function successfully outside Quebec and in the US are limited if they have not mastered the English language. ▪ Because Francophone culture is more collevistic than individualistic, some may initially have difficulty adapting to an environment where autonomous decision-making is required. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Biocultural Ecology ▪ Canadians of French descent are white or Caucasian; however, Francophones, as a linguistic group, represent a mosaic of ethnocultural characteristics, including racial differences prompted by acculturation, adoption, and the children of mixed marriages. ▪ Assess individuals for biological risks according to their racial and cultural heritage. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Biocultural Ecology ▪ Higher incidences of prostate and breast and ovarian cancers have been seen among Francophones. ▪ A high rate of suicide and suicidal ideation, particularly among Francophone adolescents and young adult males, is seen in Canada. It is unknown if this extends in the US. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Biocultural Ecology ▪ Genetic and hereditary diseases include spastic ataxia Charlevoix-Saguenay type, cystic fibrosis, tyrosinaemia, cytochrome lipase deficiency, familial chylomicronemia resulting from the lipoprotein lipase (LPL) deficiency, hyperlipoproteinemia type I which has been traced to migrants from the Perche region of France. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Biocultural Ecology ▪ An increased incidence of cystic fibrosis and muscular dystrophy occurs among Frenchspeaking Canadians. ▪ Sickle cell anemia is also higher among Francophones than the general population. Transcultural Health Care: A Culturally Competent Approach, 4th Edition High-Risk Health Behaviors ▪ Misuse of alcohol, tobacco, marijuana, and psychotropic drugs are major health problems. ▪ Tobacco and alcohol use is highest among French-speaking males and is associated with masculine sex roles, higher self-esteem, and an external locus of control. ▪ The rate of individuals who do not exercise on a regular basis has increased over the last decade. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Nutrition ▪ For French Canadians, food is associated with hospitality and warmth. Food is part of all meetings and celebrations. ▪ Common vegetables enjoyed by French Canadians include potatoes, turnips, carrots, asparagus, cabbage, lettuce, cucumbers, and tomatoes. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Nutrition ▪ Meat choices are mainly beef, pork, and poultry. Lately, however, lamb has gained popularity. ▪ In Acadia, due to the proximity of the coastal areas, fresh fish and seafood are part of the diet. ▪ Common foods include fricot (stew made with a special spice called summer savory). ▪ French Canadians do not escape the overall trend toward being overweight. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Pregnancy and Childbearing Practices ▪ Until the middle of the 20th century, French Canadians maintained high fertility rates, which is uncommon for a population living in an industrialized country. ▪ This phenomenon, called the “revenge of the cradles,” has never been explained. ▪ The number of children per family has been declining since the mid-1960s. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Pregnancy and Childbearing Practices ▪ Effective contraception and family planning methods such as the pill, intrauterine devices, and tubal ligation have become available to all women. ▪ The pill remains the primary reversible method for birth control. ▪ On the basis of relative frequency, tubal ligation and vasectomy follow the pill as nonreversible methods of fertility control. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Pregnancy and Childbearing Practices ▪ Diaphragms, foams, and creams are not commonly used for birth control, partially because perceptions imply that women are not supposed to, or do not like to, touch their genitals. ▪ The beliefs that condoms reduce the level of sexual feeling during intercourse, or that contraception is not a man’s responsibility, are inversely proportionate to the age of men. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Pregnancy and Childbearing Practices ▪ Few French Canadians practice natural childbirth. ▪ Men are welcomed and encouraged to be in the delivery room with their wives. ▪ Breastfeeding has regained importance after years of bottle feeding. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Pregnancy and Childbearing Practices ▪ In Canada, maternity and paternity leaves are available with pay for a period ranging from 6 to 20 weeks. ▪ Although the movement used in washing a floor resembles that of an exercise aimed at strengthening the perineal muscles, this activity in the past was associated with the onset of labor and early or preterm deliveries. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Pregnancy and Childbearing Practices ▪ French Canadians do not differ from Canadians and others of European origins on issues related to death and death rituals. Expectations are closely related to Christian religious practices, in particular, those of the Roman Catholic Church. ▪ Whether one is an active church-goer or not, religious funerals are the norm. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Death Rituals ▪ Cremation is an acceptable practice. ▪ Supports for those who have lost a family member include openly acknowledging the family’s right to express grief, being physically present, making referrals to appropriate religious leaders, and encouraging interpersonal relationships. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Spirituality ▪ While most French Canadians identify themselves as Roman Catholic and are baptized at birth, they may or may not remain active church members. ▪ Older adults are more inclined to use prayers for finding strength and adapting to difficult physical, psychological, and social health problems. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Spirituality ▪ In times of illness and tragedy, French-speaking Canadians use prayer to help recovery. ▪ Many of the younger generation are not strongly influenced by religious values, beliefs, and faith practices. ▪ The younger generations turn towards spirituality rather than religion. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Health-care Practices ▪ Canada’s ensures free, universal health coverage at any point of entry into the system. ▪ Many people in the upper socioeconomic classes call on their family physicians instead of the local community service centers. ▪ Many lower socioeconomic individuals many do not seek health care until their health becomes a crisis situation. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Health-care Practices ▪ French-speaking Canadians have joined the current trend toward over-the-counter drug use. ▪ Language differences may be a barrier to accessing health care. ▪ French-speaking subjects rate acute pain as more intense than chronic pain, and more affectively laden than the English-speaking subjects. Transcultural Health Care: A Culturally Competent Approach, 4th Edition ClickerCheck ▪ On issues of death and dying, which religion most influences French Canadian’s decision making? ▪ Baptist ▪ Methodist ▪ Catholic ▪ Islamic Transcultural Health Care: A Culturally Competent Approach, 4th Edition Correct Answer Correct answer: C The Catholic religion has the most influence on decision making for death and dying issues for French Canadians. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Health-care Practices ▪ As a cultural group, French Canadians have no official proscriptions against receiving blood or blood products. ▪ The decision to donate or receive an organ is an individual decision without cultural influence for French Canadians. Transcultural Health Care: A Culturally Competent Approach, 4th Edition Health-care Practitioners ▪ Health-care providers hold a favorable status in the eyes of French Canadians, especially among older people. ▪ The universal health insurance system in Canada makes the folk practitioners less appealing. ▪ Professionals throughout Canada are vigilant in trying to avoid exploitation by traditional and folk healers, who are viewed as practicing outside the law.
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Questions on whether to leave earlier to be in class on time

Questions on whether to leave earlier to be in class on time

1. Try taking a different route to class the next time it meets. Before you do this, think about how many changes, large and small, you will have to make to do this.

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a-Will you have to leave earlier to be in class on time?

b-Will you meet different people on your way to class?

c-See different sights?

d-Would you change your route to class on the day of the final exam?

e-Why or why not? Summarize the positives and negatives of this small change. Relate your responses to this change to the way staff nurses feel when an administrator makes what he or she thinks is a “minor” change.

2. Think about a change that has occurred in your life. Some examples may be a change of role, a move, a marriage, a birth, a divorce, or a death.

a-How did you react to the change?

b-Would you have reacted differently if you had had more information?

c-Using Lewin’s model, describe the basic elements in the situation and how you eventually achieved a comfortable outcome.

Tags: leadership APA format nursing change Discussion Questions

Cystic Fibrosis Pathophysiology Assignment

Cystic Fibrosis Pathophysiology Assignment

Cystic Fibrosis Pathophysiology

Pathophysiology – Cystic Fibrosis

DISCUSSION ONE

  1. Find an article on a genetic disorder (use article above about Cystic Fibrosis), and

1.1. Summarize in two or three paragraphs the genetic component causing the disorder and any         multifactorial inheritance components that may contribute to the disorder.

Cystic fibrosis is a genetically inherited disease to imply that its cause has a genetic component. In fact, the disease expression is linked to the CFTR gene whereby two parents with the carrier genes will produce an offspring that inherits both carrier genes thus expressing the disease. Having one faulty gene identifies the individual as a carrier whereby the disease is not expressed. The disease is only expressed if two faulty genes are inherited, one from each parent. Population estimates postulate that 3.2% of the US population are cystic fibrosis carriers who will not express the symptoms associated with the disease (Cleveland Clinic, 2018). As such, homozygosity for the faulty CFTR gene results in cystic fibrosis expressing as a phenotype Cystic Fibrosis Pathophysiology.

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1.2. Discuss the usual age of disease onset and if the sex-specific threshold model fits the disorder.

Unlike other medical ailments that may show age- or sex-specific peculiarities, cystic fibrosis can occur at any age and occurs equally in both males and females. To be more succinct, the genes that cause the disease are not impacted by gender. This is explained by the fact that the genes causing the disease must be inherited from both the mother and father who are carriers. Still, it must be noted that gender variations exist for symptoms presentation. In fact, females who present the disease at a young age have trouble with meeting growth milestones and experience more breathing related problems when compared to their male counterparts. Additionally, the females live for four years fewer than their male counterparts. Besides that, females who begin presenting disease symptoms while under 20 years of age present 60% mortality (owing to disease complications) when compared to their male counterparts. The implication is that males with the disorder have a greater advantage when compared to females with the disorder (Acton, 2013) Cystic Fibrosis Pathophysiology.

1.3. What education could you present to high-risk patients to reduce the risk of disease onset if a multifactorial component exists.

High risk patients must understand that other than genetics, multifactorial components may exist in the environment to affect disease onset. For instance, the presence of certain ailments or a particular climate could speed up the disease onset. As such, it is important for the patient to identify all the multifactorial components that could influence disease onset then control these components to reduce the risk of disease onset. For instance, if a particular climate could speed up disease onset, then the patient should identify a climate that reduces that onset (Quinn, de Paor & Blanck, 2015). Cystic Fibrosis Pathophysiology Assignment

DISCUSSION QUESTION 2

  1. Genetic screening has become widely available to the public including prenatal screening of the fetus in utero to screening adults for genetic disorders, such as Parkinson’s disease and breast cancer.

2.1. Share your thoughts on the legal, ethical, and social implications that may be related to genetic screening.

Although genetic screening has improved the medical management of genetic disorders, it has legal, ethical and social implications. Firstly, it raises the question of how the screening information should be handled in terms of confidentiality and access. This is an important concern since this information can be used inappropriately Cystic Fibrosis Pathophysiology. For instance, insurers and employers can use the information to discriminate against persons whose genetic profile identify them as being high risk individuals. Secondly, the screening presents some social concerns, particularly when the patient is turned into a second-class citizen and victimized because of having a particular genetic anomaly. Finally, it presents an ethical concern when the test results are used to influence reproduction decisions such as getting an abortion (McCance et al., 2013).

2.2. How would you educate your patient that is considering having genetic screening?

Any patient considering genetic screening should first understand what the screening entails. It is useful when the family history identifies the patient as being at risk for an inborn condition. In this case, the patient should understand that genetic screening can act as a confirmatory test so that the patient gets to prepare for any eventualities. This is particularly true when the disease onset is dependent on multifactorial components. By conducting the test, the patient can confirm the presence of the disease and control the multifactorial components to reduce the risk of disease onset (McCance et al., 2013).Cystic Fibrosis Pathophysiology Assignment

References

Acton, A. (2013).  Cystic fibrosis: new insights for the healthcare professional (2013 Edition). Atlanta, GA: ScholarlyEditions.

Cleveland Clinic (2018). Cystic Fibrosis. Retrieved from https://my.clevelandclinic.org/health/diseases/9358-cystic-fibrosis

McCance, K. L., Huether, S. E., Brashers, V. L. & Rote, N. S. (2013). Pathophysiology: The biologic basis for disease in adults and children (7th ed.). St. Louis, MO: Mosby Elsevier.

Quinn, G., de Paor, A. & Blanck, P. (2015). Genetic discrimination: transatlantic perspectives on the case for a European-level legal response. New York, NY: Routledge Cystic Fibrosis Pathophysiology

German and French-Canadian health beliefs

German and French-Canadian health beliefs

People of French Canadian Heritage.

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People of German Heritage.

Read chapter 14 and 29 of the class textbook and review the attached PowerPoint presentation. Read Content chapter 29 in Davis Plus Online Website. Once done answer the following questions;

1. Describe the health care beliefs of the German and French Canadian heritages and mention the influence in the delivery of evidence-based health care.

2. Discuss if there is any similarity in the health care beliefs and practices of the German and French Canadian heritage with the health care beliefs of your heritage.

3. If you have to change your health care beliefs for any of one study this week, which one will you choose and why?

References must be no older than 5 years. A minimum of 700 words is required. Please follow the instructions on how present a first page and the name of the

Tags: healthcare nursing culture culture in nursing health beliefs

Response to DQ 1

Response to DQ 1

Adolescent pregnancy is viewed as a high-risk situation because it poses serious health risks for the mother and the baby. Describe various risk factors or precursors to adolescent pregnancy. Research community and state resources devoted in adolescent pregnancy and describe at least two of these resources. Research the teen pregnancy rates for the last 10 years for your state and community. Has this rate increased or decreased? Discuss possible reasons for an increase or decrease.

*******please respond to the discussion above, add citation and references 🙂 ********

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Response to DQ2

Response to DQ2

Describe two external stressors that are unique to adolescents. Discuss what risk-taking behaviors may result from the external stressors and what support or coping mechanism can be introduced.

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Conducting an Environmental Analysis Paper

Conducting an Environmental Analysis Paper

Environmental Analysis

The reimbursement of health care services under the U.S health care system has come under severe downward pressure in the recent past due to various factor including internal as well as external factors.

Prior to this, there was a widespread criticism about the “greed” of hospitals and others health care providers leading to a severe rise in the cost of healthcare in the U.S. To this; the U.S Congress reacted by instituting health care payments control.

The consequence of this has been the decreased payments within the health care system, including to both the provider as well as the receiver.(Association, 1997)

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External environment forces

The providers of health care which includes hospitals, physicians and others today are facing hurdles in receiving their deserved reimbursements as the receivers’ payer now have cut reimbursement rates and have also put up stricter standards for making claim submission and payments processes.

The greatest financial challenges’ faced by healthcare provider in the U.S health care system today is the declining reimbursements.

This challenge has been impacting public as well as private health care providers in the U.S and has been true across all the payers. Conducting an Environmental Analysis Paper

This has resulted in a severe decline in the margins that the healthcare providers have been receiving in the past. Along with this, the patient co-pays have also been increasing gradually.

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The dual problem has compounded by an increase in the number of patients who are either uninsured or underinsured.

The worst consequence of this overall situation is that many of the health care organizations in the U.S healthcare sector are now forced into a financial debt cycle.

It was during the 2008 Presidential elections that health care insurance reforms came to be one of the most debated issues for the future President to work on.

In 2008, according to estimates, over 46.3 million citizens of the U.S were out of the protection ambit of healthcare insurance. The then President Barak Obama thus took on the challenge to drastically overhaul the entire healthcare system in the U.S.

Declaring that he was determined to the last, then President Barak Obama signed the Patient Protection and Affordable Care Act of 2010 (PPACA) into law and thus bringing in a new era in U.S healthcare.

Internal environment forces

The Patient Protection and Affordable Care Act of 2010 (PPACA) represented a significant healthcare policy initiative in the history of the U.S health care systems.

The act provided for extending healthcare coverage to all Americans by removing pre-existing healthcare conditions and regulations and also by reviewing the standards of health care in order to enhance coverage in the system. Conducting an Environmental Analysis Paper

 

It is true that some of the features of the Act did result in increased availability and efficiency of healthcare in the U.S health care system. However, there are various other provisions that have drastically affected the delivery of the health care in the U.S. Especially the provisions regarding the physicians and their reimbursement. This has affected the ability of physicians to in continuing to provide for better healthcare.

The Patient Protection and Affordable Care Act of 2010 (PPACA) makes changes to the health care profession and economic factor by making drastic changes to the reimbursement provisions. Prior to the act, physicians worked under the fee for the service system under which the bill was reimbursed by the insurance company for the service provided.

Under the new system, the Patient Protection and Affordable Care Act of 2010 (PPACA) formulates a value-based reimbursement system. It provides for the calculation of the payment based upon the quality of the work furnished than less quantity. Conducting an Environmental Analysis Paper

It requires the physicians and the hospitals involved in the service of the patient to provide a report of the outcomes of their patients to government bureau which according to the value provided will determine the reimbursement by a quality index that is predefined.

Although the traditional view of, the Patient Protection and Affordable Care Act of 2010 (PPACA) includes terms that deal directly with patients, both of these changes to reimbursement will eventually affect the average physician and impact the margins of health care organizations like hospitals’, nursing homes and others. (Kulshrestha, 2013)

 

The Impact of internal and external forces

In the backdrop, these external factors affecting the profitable of the organizations involved in healthcare, adjusting internal factors and considering them according to the situation can help prepare the organization for better future.

Any successfully integrated institution has a very well developed and a broadly shared institutional culture which is deeply rooted into the common vision and values. Upholding these values religious in the operation of the institution serves as a touch point to help resolve the inevitable internal conflicts that arise among the multiple actors involved.

Such vision and values include a broader concern for both quality of the service provided and also the costs associated with the same delivery. Internalizing a sense of long-term responsibility and reputation among the workforce makes the workforce feel a sense of ownership of the organization and enhances commitment to performance.

Transparency and collective actions to improve overall performance can also be a significant internal factor to enable the organization to better prepare for the future.

Internally, enhancing the brand loyalty of the organization for quality and cost effectiveness is another consumer-oriented move that can help the organization prepare better for the future and help overcome the hurdles’ posed by external environment factors, including the impact of the Protection and Affordable Care Act of 2010 (PPACA).

Private capital also tends flow readily to support organizations that deliver a positive consumer experience.(Jarousse, 2014)

 

The manager’s strategy

The organizational manager plays a vital role in overseeing multiple departments and functions that are part of the regular operations of any healthcare providing organization.

Coordinating teams and implementing innovative approaches on a day-to-day basis are among the core practices that are part of the role of a healthcare manager in order to ensure that hospitals are successful as well as profitable.

Health care organizational managers juggle with several responsibilities including planning, directing, and coordinating other practitioners, departments, and groups.

It is this multi-perspective role of an organizational manager that becomes a pivotal point in implementing and maintaining the momentum of the strategic plan.

Further, another important aspect of the healthcare organizational manager’s role which involves driving healthcare innovation in the hospital can also play a crucial role in the entire process of implementation and maintenance of the momentum of the strategic plans.

For instance, reducing death rates among emergency and trauma care patients as the result of management led innovation, could be such an indicator. Conducting an Environmental Analysis Paper

“Eradicating waste of all kinds is at the core of lean management approaches. Healthcare managers are needed to facilitate the implementation of these innovative approaches”. (“What do hospital health care managers do?” 2016)

 

 

References:

Association, A. S.-L. (1997). ASHA corporate partners. Retrieved January 25, 2017, from http://www.asha.org/Articles/Health-Care-Economics-The-Real-Source-of-Reimbursement-Problems/

SPi Healthcare,Insights. Retrieved January 25, 2017, from http://www.hfma.org/brg/pdf/Insights%20-%20Declining%20Reimbursement%20and%20the%20Physicians_89A10412-E469-ECA9-B0A0CC017A883888.pdf

Kulshrestha, S. (2013). From physician to patient: The effects of the patient protection and affordable care act (PPACA). Inquiries Journal, 5(06), . Retrieved from http://www.inquiriesjournal.com/articles/741/from-physician-to-patient-the-effects-of-the-patient-protection-and-affordable-care-act-ppaca

Jarousse, L. A. (2014, September 8). Take A look at how market forces will impact health care. Retrieved January 25, 2017, from http://www.hhnmag.com/articles/4012-take-a-look-at-how-market-forces-will-impact-health-care

What do hospital health care managers do? (2016, August 31). Retrieved January 25, 2017, from http://programs.online.utica.edu/articles/what-do-hospital-health-care-managers-do. Conducting an Environmental Analysis Paper

GCU Contemporary Issues Among Adolescents & Assessment Strategies

GCU Contemporary Issues Among Adolescents & Assessment Strategies

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Research the range of contemporary issues teenagers face today. In a 500-750-word paper, choose one issue (besides teen pregnancy) and discuss its effect on adolescent behavior and overall well-being. Include the following in your submission:

Describe the contemporary issue and explain what external stressors are associated with this issue.
Outline assessment strategies to screen for this issue and external stressors during an assessment for an adolescent patient. Describe what additional assessment questions you would need to ask and define the ethical parameters regarding what you can and cannot share with the parent or guardian.
Discuss support options for adolescents encountering external stressors. Include specific support options for the contemporary issue you presented.
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.

You are required to submit this assignment to LopesWrite. Refer to the LopesWrite Technical Support

Topic 5 DQ 1

Topic 5 DQ 1

Please respond with a paragraph to the following post, add citations and references:

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Nurse managers are the agents of change for health care going into the future. Nurse managers are responsible for creating safe, working environments and advocating for patients, staff and the organization alike (Duquene University 2109). Nurse managers must have strong leadership and communication skills and have a responsibility for leading their staff in the rapidly changing environment of health care. Nurse leaders or managers have multiple responsibilities. The nurse leader is responsible to the staff to introduce legal and ethical change to staff when change is necessary (GCU 2013). They are responsible to the organization for budgeting, recruitment, supplies and to the patient for advocacy and education of health decisions.

As health care changes and reforms the nurse leaders must recognize the need for change in the way we provide care. Often time upper administration is either disconnected from the need for change or distracted by other priorities, at least until monthly financial come out. The nurse leader must bring to light concerns from the front line staff regarding failing processes and the need for change of those processes. The nurse manager must not only identify problems but must have suggestions for change of processes and ideas for implementing that change, along with a way to evaluate the effectiveness of the change. The nurse manager will have to balance administrative duties with patient care responsibilities. Nurse leaders will have to mentors for new nurses as the current work force ages and experienced nurses leave the field. Nurse leaders will need to mold new nurses to fit the mission and values of the organization in order to maintain engaged staff. With younger less experienced staff the nurse leader must understand the needs of this staff and not set expectations of them to point they can’t achieve, while at the same time challenging them, coaching them and mentoring them. The nurse leader is essentially the eyes and ears of upper administration and the liaison if you will to the front line staff who are doing all of the work. Health care will continue to change and re engineering of the change will be a challenge. As my facility adopted Total Patient Revenue (TPR) several years ago we have had to change the way we deliver our care to be more cost efficient.In just three short years we are once again adapting to a Total Cost of Quality (TCOC) model. Medicaid waivers may change or go away and reimbursement will become the topic for survival. The nurse leader is always on the front line of change and must be an excellent communicator to both staff and upper administration. Its my opinion that health care will continue to change as fast as technology that we use to deliver it and as fast as the political atmosphere changes as well.

Reference

Duquene University School Of Nursing. 2019. The Roles fo a Nurse Manager: Leading the nursing profession into the future. Retrieved from: https://onlinenursing.duq.edu/blog/roles-nurse-man…