Misdiagnosis of Bipolar Disorder With Unipolar Depression - Free Essay Example

Sample details Pages: 9 Words: 2567 Downloads: 8 Date added: 2019/08/07 Category Medicine Essay Level High school Tags: Bipolar Disorder Essay Did you like this example? Bipolar disorder, formerly known as manic depression, is a mental illness that causes shifts in mood and energy and interferes with the ability to carry out day-to-day tasks. All types of bipolar disorder have an unknown cause but researchers know that there is a relationship between genetic and environmental factors. It is suspected that people are born vulnerable to the disorder and huge stressors such as death, trauma, or alcohol/drug abuse can trigger it. Don’t waste time! Our writers will create an original "Misdiagnosis of Bipolar Disorder With Unipolar Depression" essay for you Create order Researchers also suggest that bipolar disorder is due to abnormalities in the way the brain functions with neurotransmitters that then results in communication problems within the brain. There are four types of bipolar disorder: Bipolar I, Bipolar II, Cyclothymia, and Bipolar Disorder Not Otherwise Specified (NOS). All four types include two types of episodes, manic and depressive. Manic episodes are considered to be periods of energized behavior, while depressive episodes are feelings of extreme sadness and hopelessness. To specify the type of bipolar disorder a person may have normally depends on the period of time that the individual experiences the manic and depressive episodes and the severity of them. Bipolar I disorder is the most severe of the four and is a combination of extreme manic episodes that will last at least one week and depressive episodes that last at least two weeks. The other type of bipolar disorder, cyclothymia, is a milder and chronic form. Those with cyclothymia experience brief periods of hypomania and mild depression that are ongoing for at least two years in adults and one year in children. Cyclothymia can also be prevented from developin g into a more severe form of bipolar if treatment is sought out. The last type of bipolar disorder that a patient may be diagnosed with, bipolar disorder not otherwise specified, is when the symptoms do not exactly match any of the other three types. Those with bipolar disorder not otherwise specified still experience days of manic and depressive episodes, but these episodes rapidly alternate over a few days and the symptoms of the episodes are different than the other three. Bipolar II disorder is considered to be a milder form of bipolar I disorder that consists of a combination of depressive and hypomanic episodes that last one to three days. Hypomanic episodes have the same symptoms as a manic episode, but are less severe and do not last as long. This type of bipolar is also most commonly misdiagnosed as unipolar depression because it is harder to determine a state of hypomania in an individual as it doesnt typically impair day-to-day functioning, therefore focusing on the depre ssive episodes, hence the misdiagnosis. In todays society, the desire for optimum health is unparalleled to any other time period in U.S. history. Americans are continuously bombarded with groundbreaking medical technology, fitness promotions, and the overwhelming vision of improved quality/availability of healthcare. However, despite extensive investments, attitude changes, and development of new policies, these notable health contributions have fallen flat. It is striking to add that mental health, mood disorders such as bipolar disorder and depression, are among the most prevalent and costly problems in the U.S (Shippee et al., 2011). The Stigma associated with mental illness creates health inequity for the mentally ill population, in general, by preventing them from achieving optimal health and creating preventable differences in managing these diseases. More specifically, the examination of the misdiagnosis of bipolar disorder (BD) and unipolar depression (UD) as a health disparity is defined by differences in both po pulations in terms of socioeconomic status, employment, social inclusiveness of the affected/misdiagnosed population. The differences between bipolar disorder and unipolar depression are significant and a misdiagnosis can result in suboptimal symptom resolution, induction of manic switch, mixed state, or accelerated cycling. According to Nisha er al.(2015), 40% of patients are misdiagnosed with unipolar depression. His study concluded that accurate bipolar disorder diagnosis is hindered by three major factors- assumptions of similar phenomenology, failure for therapist to note previous hypomanic symptoms, and failure for patient to report them ( Nisha et al., 2015). When considering the socioeconomic status and employment status, both bipolar disorder and unipolar depression groups, 56.7% and 53.3%, belonged to lower middle class status, while 16.7% bipolar disorder groups were also unemployed ( Nisha et al., 2015). The overrepresentation of the lower middle class indicated that both mood disorders are unevenly distributed in the general population. It coincides with what is typically true; low soc ioeconomic status is a predictor for low anticipation for good general health. Higher unemployment rates and the build of chronic stress has also been associated with worse health outcomes, and in this case, leads to the loss of productivity, a sense of inclusiveness, and significantly worse symptom resolution for both bipolar disorder and unipolar depression. Nathan D. Shippee, assessed the financial limitations and subsequent inequity between being misdiagnosed with either bipolar or unipolar depression. Results showed that generally high unemployment rates of both populations are due to disabelment in social, cognitive, and work limitations (2011). Although unemployment rates are noted for both bipolar disorder and unipolar depression, it is significantly higher for those with bipolar, which has created a larger gap between availability of social and financial resources ( Shippee et al., 2011). The isolation due to the stigma of mental health disorders infringes on the idea tha t these individuals are treated equally and are in fact more vulnerable in the workforce than both non-mood disorder and unipolar depression groups. Termination of their employment increases limitation to resources, especially, social capital and emotional support systems which are crucial in proper psychological health. Professor Barr states, in addition to demonstrable effects on physical health, those with more regular social engagement also tend to display better mental health (2014). The misdiagnosis of bipolar disorder and unipolar depression create stark inequities in several unique aspects of each of the affected populations, such as low socioeconomic status, high unemployment, and harsh limitation of social capital. It is imperative that health professionals embrace this public health issue and attempt to close the gap of inequity between misdiagnosis of both mood disorders and address mental health as a whole, and allow these preventable burdens to be solved. When looking at health disparities in misdiagnosed bipolar patients, it was found that some of those disparities are due to race and gender/marital status. First, looking at race in misdiagnosed bipolar disorder patients it can be seen that between African Americans individuals and white individuals, there was a higher rate of African Americans being initially diagnosed with something other than bipolar disorder. This misdiagnosis delays the individual from getting the proper treatment which can directly address illness morbidity (Akinhanmi, Margaret 2018). The Depression Bipolar Support Alliance conducted a survey in 1994 and again 10 years later that showed a delay in getting accurately diagnosed with bipolar disorder. This finding is important because most of the time patients get misdiagnosed with unipolar major depressive disorder instead of bipolar disorder. Research shows that being treated for unipolar depression by taking antidepressants would increase the likelihood of trea tment nonresponse or antidepressant induced mania/mood destabilization (Akinhanmi, Margaret 2018). In a study reported in 2002, the study showed that 24 African-Americans with bipolar I disorder received antipsychotics at a greater percentage of follow-up visits (44%/70 visits) that 34 white individuals (40%/34 visits) (Akinhanmi, Margaret 2018). In a similar study with 34 bipolar patients taking lithium carbonate demonstrated African-Americans had a higher mean lithium red blood cell to plasma ratio than white patients even though the dosage was the same for the two races.During another similar study researchers did take into account that symptoms reports during the clinical assessments from some African-Americans may be misattributed to psychopathology instead of sociocultural background. When taking sociocultural into consideration researchers found that they may have been able to more accurately diagnose the patient. Based on this study culturally competent treatment in populations of different sociocultural background may help address racial bias and decrease the misdiagnosis rate. A different disparity to consider when looking at bipolar disorder is gender and marital status. Bipolar disorder was found to be more common among individuals who were never-married. Among the married bipolar individuals marital functions were said to be impaired. In a 2-year study conducted with 282 bipolar individuals, the study showed that bipolar women were more likely to be married. The study also showed that married women had fewer episode of depression than non-married women. When looking at men the data showed that never-married men were more likely to have an earlier age of onset bipolar I disorder in comparison to married men (Lieberman, Daniel 2010). Based on the study conducted by Lieberman, it showed that more men were diagnosed with bipolar I in comparison to women and more women were diagnosed with bipolar II in comparison to men. Another interesting factor was that women in this study who were married had usually completed fewer years. All other demographics in this study seemed to have been the same for both men and women. A study in Denmark found that after an individuals first mood episode, never-married bipolar individuals were at risk of recurrence about 3 times greater than individuals who were married, divorced, or widowed (Lieberman, Daniel 2010). As stated previously, there is obviously a health disparity for bipolar disorder sufferers being misdiagnosed with unipolar depression. Fortunately, there is hope on the horizon for better diagnostic procedures. There have been changes made to the DSM-5 to help better identify and differentiate bipolar disorder and unipolar depression. These changes include separating bipolar disorder and related conditions into their own chapters and the criteria necessary to diagnose bipolar disorder (changes in mood and changes in activity or energy are now included). The criteria needed to diagnose a mixed mood episode has also been changed. According to Kupfer and Philips, Previously, the diagnosis of a mixed mood episode required a patient to simultaneously meet the full criteria for both mania and major depression-however there is a new specifier that allows clinicians to report up to three manic symptoms during a depressive episode. These changes to the DSM-5 indicate good test-retest reliabi lity of adult bipolar disorder type I, suggesting that DSM-5 could be a positive step towards improved accuracy of bipolar disorder (Kupfer, Phillips 2013). A new way of diagnosing bipolar disorder takes a biological approach. Scientists are using neuroimaging to look for differentiation with biomarkers between bipolar disorder and unipolar depression. These images look for any abnormality in the brain regarding white matter connectivity, grey matter, and functional abnormalities in neural circuitry (Kupfer, Phillips 2013). Research has also taken an integrative approach to tackling this issue. According to Kupfer and Phillips, this integrative approach has the greatest potential to identify biological targets for personalised treatment and new treatment developments for all such illnesses. This integrative approach looks at genetic, molecular, cellular, neural circuitry, and behavioral measures. By combining all of these different factors, Integration across these scales could thus yield different biosignatures that represent dimensions of underlying pathophysiological process in bipolar disorder and other affective disorders (Kupfer, P hillips 2013). In 2018 a new study actually identified a difference in neural activity between patients with bipolar disorder and those suffering from depression. The scientists who conducted this study looked at amygdala activation while patients were processing facial expressions. According to the study, patients who had bipolar disorder had lower activation in the left amygdala in comparison to patients who had depression (Korgaonkar, et al., 2018). Based on this information there is definitely progress being made to help accurately diagnose those suffering from bipolar disorder. In conclusion, bipolar disorder is a major public health issue that involves extreme mood swings from mania to deep depression. Bipolar disorder II is more commonly misdiagnosed as unipolar depression because it is hard to distinguish a state of hypomania in these individuals. When considering the disparities, it can be seen that race, socioeconomic status, and gender/marital status do play a role in diagnosing an individual with bipolar disorder. Looking at these individuals it was noticeable that individuals who are minorities are for the most part misdiagnosed when compared to non-minorities. Also, looking at socioeconomic status one notices that individuals of a lower socioeconomic status were more likely to be misdiagnosed than those higher on the socioeconomic scale. However, individuals with from a higher socioeconomic status tend to be diagnosed with bipolar disorder more often than those of lower socioeconomic status. Finally, looking at marital status/gender studies conducted showed that bipolar disorder was more prominent in individuals who were never-married compared to married individuals. However, the study also showed that bipolar women were more likely to be married. Bipolar disorder has no cure but with proper diagnosis the individual can start taking steps to develop insight as to when they might be having an episode and receiving the correct treatment. This is why it is important for mental illnesses to be taken seriously and for more research to be conducted so that the gap in misdiagnoses can be lessened, especially when misdiagnosing could hinder the individuals treatment response. Luckily, there are many improvements and changes happening so that individuals can be diagnosed properly. References Akinhanmi, Margaret O, et al. Racial Disparities in Bipolar Disorder Treatment and Research: a Call to Action. Bipolar Disorders, vol. 20, no. 6, Sept. 2018, pp. 506â€Å"14, doi:10.1111/bdi.12638. Barr, D. A. (2014). Health disparities in the United States: Social class, race, ethnicity, and health. Baltimore, MD: Johns Hopkins University Press.Bipolar Disorder. (n.d.). Retrieved from https://www.nimh.nih.gov/health/topics/bipolar-disorder/index.shtml Hook, D. B. (2018, April 30). The Different Types of Bipolar Disorder, Including Cyclothymia | Everyday Health (K. Keegan MD, Ed.). Retrieved from https://www.everydayhealth.com/cyclothymia/ Kaye, N. S., MD. (2005). Is Your Depressed Patient Bipolar? The Journal of the American Board of Family Medicine,18(4), 271-281. doi:10.3122/jabfm.18.4.271 Korgaonkar, M. S., Erlinger, M., Breukelaar, I. A., Boyce, P., Hazell, P., Antees, C., . . . Malhi, G. S. (2018). Amygdala Activation and Connectivity to Emotional Processing Distinguishes Asymptomatic Patients With Bipolar Disorders and Unipolar Depression. Society of Biological Psychiatry, 10. doi: 10.1016/j.bpsc.2018.08.012 Kupfer, D. J., Phillips, M. L. (2013). Bipolar disorder diagnosis: Challenges and future directions. The Lancet, 381(9878), 2nd ser., 1663-1671. doi:10.1016/S0140-6736(13)60989-7 Leahy, R. L. (2007). Bipolar disorder: Causes, contexts, and treatments. Journal of Clinical Psychology,63(5), 417-424. doi:10.1002/jclp.20360 Lieberman, D., Massey, S., Goodwin, F. (2010). The role of gender in single vs married individuals with bipolar disorder. Comprehensive Psychiatry, 51(4), 380â€Å"385. https://doi.org/10.1016/j.comppsych.2009.10.004 M. (2017, February). Bipolar Disorder: What causes bipolar disorder? Retrieved from https://www.heretohelp.bc.ca/factsheet/bipolar-disorder-what-causes-bipolar-disorder Nisha, A., Sathesh, V., Punnoose, V. P., Varghese, P. J. (2015). A comparative study on psycho-socio-demographic and clinical profile of patients with bipolar versus unipolar depression. Indian journal of psychiatry, 57(4), 392-6 Omrin, D., Kirilenko, D., Timmins, V., Goldstein, B. (2016). 5.12 CORRELATES OF SOCIOECONOMIC STATUS AMONG ADOLESCENTS WITH BIPOLAR DISORDER. Journal of the American Academy of Child Adolescent Psychiatry, 55(10), S187â€Å"S187. https://doi.org/10.1016/j.jaac.2016.09.271 Shippee, N. D., Shah, N. D., Williams, M. D., Moriarty, J. P., Frye, M. A., Ziegenfuss, J. Y. (2011). Differences in demographic composition and in work, social, and functional limitations among the populations with unipolar depression and bipolar disorder: results from a nationally representative sample. Health and quality of life outcomes, 9, 90. doi:10.1186/1477-7525-9-90. Singh, T., Rajput, M. (2006). Misdiagnosis of bipolar disorder. Psychiatry (Edgmont (Pa. : Township)), 3(10), 57-63. Smith, K., PhD. (2018, February 13). Causes of Bipolar Disorder: Understanding the Risk Factors. Retrieved from https://www.psycom.net/bipolar-disorder-causes Towbin, K., Axelson, D., Leibenluft, E., Birmaher, B. (2013). Differentiating bipolar disorder-not otherwise specified and severe mood dysregulation. Journal of the American Academy of Child and Adolescent Psychiatry, 52(5), 466-81.

American and German Propaganda of WWI Essay - 553 Words

American propaganda during WWI was used to spread ideas and information for the purpose of helping the American cause, specifically through, songs, posters, pamphlets and leaflets. America joined the Allies forces in 1917 in Europe to fight against the Central Powers. The American government needed something to spark the peoples interest in the war. The most effective tool the government found and used was propaganda. The American government used propaganda to reach out to the people. The government wanted to reach people of all ages. Similarly, Germany fought back with her own propaganda, by purposely dropping leaflets and pamphlets on the ground to try and convince American soldiers, especially blacks, to join their side. In my opinion†¦show more content†¦The pamphlets were a direct link to get they Boy Scouts active. Pamphlets were also used to reach the average American citizen. Also the Germans tried to use propaganda against the U.S. by attempting to convince American soldiers to join Germany in its war efforts. German soldiers would purposely drop pamphlets onto the ground in hopes that American soldiers would come across them and read them. On the pamphlets were saying such as Do you think it honorable to fight the country that has given birth to your fathers or forefathers? (Brainz) The Germans also attacked the African-Americans with phrases such as Do you enjoy the same rights socially and before the law? Do you enjoy the same rights as the white people do in America the land of Freedom and Democracy? Or arent you rather treated over there as second class citizens? (Brainz) With these, the Germans tried to persuade the African-Americans that the U.S. was not treating them with respect and were not equal, but if they went to the German side they would be treated like average citizens. I feel it was a valiant effort for the Germans, but was not very pro ductive. Although I feel the German propaganda may have done some to attract American soldiers, in my opinion American propaganda was much more persuasive. I feel this way, because the material and the way the American government used propaganda did more to restore patriotism in the lives of Americans. It also put fear into many Americans, withShow MoreRelatedAmerica s False Freedoms During World War One Essay1049 Words   |  5 Pagesnew American population was made up of immigrants. America was still working on the path to grant freedom to all who considered the United States their home. Many immigrants primarily came to America in search of true freedom and to gain opportunities that they otherwise could not have access to in their homeland. World War One; however, made it extremely difficult for some immigrant Americans and African Americans to receive the true freedom that they came in search for. 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The use of oratory skills, in conjunction with his knowledge and use of propaganda and his suppression of details of the Holocaust, created a vibe of â€Å"electric excitement† for Germany. (Fritzsche, 1998) His targeting of the German minority and his radical push for anti-Semitism allowed HitlerRead MoreThe Holocaust : The Barbaric Nature Of Man876 Words   |  4 Pagesterrible because individuals, organizations, and governments made choices that fostered hatred, legalized discrimination, and ultimately, allowed mass murder to occur. Art Spiegelman, author of Maus I and Maus II, does a great job illustrating how good Germans were at doing everything very systematically. 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A night in the hills free essay sample

Gerardo Luna, a jewelry store salesman in his 30’s, has always dreamed to go to the forest which he regards as a beautiful place. One day, when Ambo, an orchid gatherer who buys some jewelry for his wife’s store, tells Gerardo about living in the forest for weeks at a time, the latter gets more interested, and tells his wife about it. However, his wife is eyeing only the business aspect of such idea. Hence, he never mentions his dream again. Then Gerardo’s wife dies. At last, he can fulfill his long-time dream, especially that Ambo has come again, with stories regarding newly opened public land on a forest plateau. So, the two of them plan to go to the forest. Before actually going to the planned trip, Gerardo’s Ate Tere is not so keen on the idea. She wants him to marry Peregrina who will surely take him the minute he proposes. We will write a custom essay sample on A night in the hills or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page Ambo and Gerardo go to the hills, and it is among the foothills where they spend noontime. Gerardo is tired and sweaty, and he asks for water, which, according to Ambo is ten minutes away. They walk and walk, and along the way Gerardo experiences nature in a manner that is not that wonderful for him. Finally they enter the dim forest. Gerardo is uncomfortable on his bed of small branches and twigs. He cannot sleep that night; he thinks of his wife, not fondly, though. He also thinks of God. He is oppressed by nostalgia. There is an eerie light in the forest, and Gerardo hears strange sounds that are caused by tree worms. Then he hears water from afar. All in all, he feels that he will never understand the forest. Gerardo goes home, first getting his house’s key from his Ate Tere. There he meets Peregrina whom he tells â€Å"Pereg, as soon as I get these clothes off I shall come to ask you a question that is very—very important to me. † As she smiled eagerly but uncertainly into his face, he heard a jangling in his hand. He felt, queerly, that something was closing above his hand, and that whoever was closing it, was rattling the keys. III. SHORT STORY ELEMENTS A. CHARACTERS 1. Gerardo Luna a jewelry store salesman in his 30’s, Protagonist, Developing 2. His wife – Antagonist, Flat 3. Ambo an orchid gatherer who buys some jewelry for his wife’s store. Who act as the fulfiller of the protagonist dreams, he lead Gerardo to his dream-the forest 4. Ate Tere or Sotera – Gerardo was a younger brother to the former mistress of her also younger brother. Contradicting his brothers dream 5. Peregrina – the one that Sotera want to marry by his brother. B. PLOT Linear a) Introduction Gerardo Luna is being introduced, with the mention of his secret long-time dream of going to the forest. b) Rising Action He tells her wife about such dream, but she brushes it off; thus, he forgets about that dream. Then she dies. c) Climax The peak of this short story is when Gerardo is finally in the forest, and he experiences things that he has never though the forest has. d) Falling action Things start to â€Å"fall† when Gerardo realizes that the forest is not exactly what he has always dreamed. e) Denouement When he goes back home, Gerardo feels he should get back to reality. C. SETTING a) place – in Intramuros, Manila, Philippines b) time- a long time ago c) weather conditions- fine d) social conditions- Gerardo has a nice job e) mood or atmosphere- light D. POINT OF VIEW The Point of View used in this short story is the Omniscient Limited The author tells the story in third person (using pronouns they, she, he, it, etc). We know only what the character knows and what the author allows him/her to tell us. We can see the thoughts and feelings of characters if the author chooses to reveal them to us. E. LITERARY DEVICES A night in the Hills is in a form of allegory in which the forest is defined by Gerardo as heaven , where he can find things he missed and so he wish to have. Allegory is a literary device in which characters or events in a literary, visual, or musical art form represent or symbolize ideas and concepts. Allegory has been used widely throughout the histories of all forms of art; a major reason for this is its immense power to illustrate complex ideas and concepts in ways that are easily digestible and tangible to its viewers, readers, or listeners. An allegory conveys its hidden message through symbolic figures, actions, imagery, and/or events. Allegory is generally treated as a figure ofrhetoric; a rhetorical allegory is a demonstrative form of representation conveying meaning other than the words that are spoken. For me, the literary devices used in this story are Symbolism and Irony. Gerardo’s dream of going to the forest symbolizes the freedom he has always longed for. Meanwhile, this dream is ironic because the forest is not what he thinks it is. F. THEME In my opinion, the theme things are not always as they appear to be is applicable to this story. Living your dreams by embracing changes and realization G. CONFLICT The conflict here is Internal, that of Man vs. Himself. Gerardo has always dreamed of going to the forest, and he has kept this within himself. ARV

Nurse caring paper Essay Example

Nurse caring paper Essay Examples of three different articles were compared and contrasted, all studying the concept of raring in nursing with different approaches to understand this concept more deeply, and find both similar and differing themes in their conclusions. The first of these three articles, Descriptions of Caring Uncovered in Students Baccalaureate Program Admission Essays, is by Judith J. Sadler in the International Journal for Human Caring. This article is unique amongst the 3 that are being compared in that since they are statements written by those who are not yet nurses, they represent conjecture of what these would-be nurses think nurse caring looks like, rather than actual experiences that have occurred (Sadler, 2004). Its method was extracting themes from the 250-300 word essays that 302 applicants wrote for application into a BBS program. This made its central question to ask what did the applicants who wish to become nurses perceive the qualities of a good nurse to be. The central theme of these admission essays emerged as identifying compassion as a characteristic of a good nurse; while breaking down the attributes of a nurse further into the five sub- categories of Multidimensional work, Creative process of using presence, Holistic injection, and Individually and socially defined. We will write a custom essay sample on Nurse caring paper specifically for you for only $16.38 $13.9/page Order now We will write a custom essay sample on Nurse caring paper specifically for you FOR ONLY $16.38 $13.9/page Hire Writer We will write a custom essay sample on Nurse caring paper specifically for you FOR ONLY $16.38 $13.9/page Hire Writer The best part of this kind of study seemed to be that although these students definitions were ignorant of what it is like to actually be a nurse, their idealism about nurse caring without the knowledge of the balance of time constraints and the desire to be perceived as a good nurse was what shone through. The second article considered, The Little Extra That Alleviates Suffering by Maria Raman and Earn Reinserted was published in Nursing Ethics. This study was also unique in that it examined verbal interactions between both racing nurses to their patients, and also between clinical nursing students and their patients. Its method was a hermeneutic method, assuming the theoretical perspective of creative caring and ethics of understanding life. A central theme that was found in this study was that the caregivers offering the little extra were able to offer more caring than the ideal nursing model perspective, in that the patients were being truly seen in this interaction as a fellow human being, deserving of caring and ultimately respect of their humanity (Raman Reinserted, 2007). It goes on to be able to recognize what this looks like in a clinical setting, identified by verbal or non- verbal willingness to go beyond the bare minimum of Just fulfilling the necessary required tasks of the Job of a nurse, which resulted in the patient feeling that the caregiver cared about them as a person. My general impression of these nurses in this study is the ones with the demonstrated desire to show their patients that they were willing to do more, were the ones the study authors identified as caring nurses. The third and final article examining caring in nursing, Beyond empathy: expanding expressions of caring by Janice Morse in the Journal of Advanced Nursing. Unlike the first two, this study only examined the actual working and licensed nurses who were already done being nursing students, and therefore had more actual real world knowledge of what nurse caring is like after the nursing textbooks and idyllic nursing theories are but a past memory. This study examines nurse caring by describing nurse responses to patients who are suffering, and the ruses level of engagement was largely classified by the author by whether the caregiver is focused on him or herself or the patient, and whether the caregiver responded reflexively or with a learned response. The method for this study centered around examining the nurses response to their patients suffering in an alternative communication model, which sorts these responses into the four quadrants of patient-focused, self-focused (self being defined as the caregivers own self), first- level or reflexive or natural responses, and second-level Learned responses. It was interesting to read this authors take on the caregiver focusing on their own or their patients feelings largely determined their perceived level of caring; and that the least caring response was a learned professional response, but was considered to be seemingly almost cold when the caregiver was self-focused on their own feelings on the patients suffering instead of the patients own feelings. In each of these 3 articles, a common theme that runs between each of them is that the caring nurse is considered to be synonymous with a good nurse, which each of the participants whether aspiring-nursing student, actual nursing student, or an actual practicing nurse desired to be. They are each different in the groups of caregivers studied, from idyllic nursing-student hopeful, to clinical nurse, and to practicing nurse. With each of the articles and caregiver populations, it seemed to be a foregone conclusion that each of these levels of nurses had the end desire to be a caring nurse, as opposed to treating it as a decision that a nurse had to think over the merit of being a caring nurse or not.

buy custom Health Care Issues and Cultural Effects essay

buy custom Health Care Issues and Cultural Effects essay Research on to the health disparities has shown that, patients who receive culturally sensitive care show an increased adherence to medical advice and report higher satisfaction with the services. Therefore, with the increased growth in the cultural diversity and related health disparities in society, the rise in academic interest in examining the interrelationship between health and culture has also increased. This has led to the realization of the benefits of cultural competency program. The cultural competency training program produces measurable changes in the knowledge and skills of the health practitioners (Khanna, Cheyney, Engle, 2009, p. 886). Although the debate still continues on its effectiveness, a general agreement among the scholars is that, it improves the patient-provider communication, and in the long term, it improves on the patient satisfaction and compliance. This has led to many health care organizations, medical schools and providers integrating the cultural competency training into their training programs or curricula. In one study conducted on the 43 healthcare professionals, participants indicated an enhanced understanding of the healthcare experiences of patients with diverse backgrounds. This study involved health care providers and health administrators for a four (4) hour cultural competency workshop. In addition to the enhanced understanding of health care experiences these health care professionals, reported improvement in their cross-cu ltural working skills (Khanna, Cheyney, Engle, 2009, p. 886). According to them, the post then pre method of evaluation used is reliable, innovative, and time-saving. According to them, these training programs should be implemented so as to inform the health care providers on the role of culture in service delivery. Factors like, ethnic medical belefs, use of folk medicine, health beliefs and worldview, cultural values and norms influence the offering and perception of the services. In addition, gender and religion also play a vital role. The Health Resources and Services Administration (HRSA) advocates for the inclusion of the cultural and linguistic competency training and assessment protocols in health care systems (Khanna, Cheyney, Engle, 2009, p. 887). The Office of Minority Health has been on the forefront in advocating for the National Standards for culturally and Linguistically Appropriate Services (CLAS) in the Health Care Systems. These standards take into account the social context and interaction and thus, form the benchmarks in the provision of the competent services to patients from all cultural backgrounds. This arises from the fac t that, the cultural characteristics of the patient and the health care provider influences the manner in which different people seek, access, and utilize these services (Khanna, Cheyney, Engle, 2009, pp. 887-888). The study used post then pre method to evaluate the outcomes of the training. In a typical pre then post evaluation, participants subject themselves to a set of questions before and after the training program. Post then pre method helps in controlling response shift bias got in the traditional pre then post method. In the post then pre method, gauging of the respondents perceptions occur at the end of training. This reduces the respondents perspective on the construct measured between pre-test and post-test situation. In addition, use of the post then pre reduces the problems of over and ideal reporting associated with pre then post reporting (Khanna, Cheyney, Engle, 2009, p. 889). The limitation of this evaluation method is the inability recall knowledge and skills before the instruction accurately. The social desire of the respondents to fulffill the expectations of the training programs also manifests itself among the respondents. At the end of training, all participants had a ch oice of completing a 29-item Cultural Competency Assessment (CCA). Of the sixty that had originally joined the training, only forty-three (n=43) completed the test without errors. The CCA developed reflected on intercultural and intra-cultural diversity. It involved 3 parts- demographic data (5 items), knowledge (19 items) and skills (5 items). The results indicated that the participants indicated a positive change in their knowledge and skills in the cross-cultural provision of health care. They acquired a more nuanced understanding of individual terms associated with culture, race and ethnicity. They also self-reported improvements in the role of cultural factors in the patient-provider communication, and importance of nonverbal clues in patient-provider interaction. These results indicated the need to raise awareness regarding the importance of cultural learning. The health beliefs and cultural healing practices involvement in the collection of the case histories are essential. This helps in the conducting of the clinical examinations and development of culturally based care plans with the patients from diverse cultural backgrounds (Khanna, Cheyney, Engle, 2009, p. 890). This study indicated that, for cultural competency to be successful, it needs to go beyond the racial and ethnic differences. It should incorporate issues pertaining to sexual orientation, socioeconomic status, health insurance status and type/ timing of care in the provision of health care services. It is also a dynamic process rather than 1-time, structured training endeavor lending itself to rigorous, quantitative analysis. It should be expanded to include multiple markers of differences (Khanna, Cheyney, Engle, 2009, p. 891). Buy custom Health Care Issues and Cultural Effects essay

Philosophy Critical Thinking Scholarship Essay Example | Topics and Well Written Essays - 1500 words

Philosophy Critical Thinking - Scholarship Essay Example 1: You left your mobile at work. 2:1 To call home you would have to find a pay phone. 2:2 There are not any payphones around here. C: Without a mobile phone you cannot call home from anywhere. The premises are convergent. In the first argument the movement is 1.1, 1.2 and 2 and in the second argument the movement is 1, 2.1 and 2.2. Both arguments have two premises. The first argument has two parts of the first premises and the second argument has two parts in the second premises. Since the structure is different of the two premises, they are convergent on the same level. QUESTION 3: [5 marks] Standardize the target argument and counterargument in the following passage. Include any counterconsiderations and state whether any premises on the same level are linked or convergent. Supporters of the Atkins diet argue that following a high protein, low carbohydrate diet such as the Atkins diet is the best way to lose weight, since on that diet you cut out carbohydrates and it is carbohydrates that are responsible for weight gain. Further evidence they give that the Atkins diet is the way to go is the large number of celebrities who follow it. But nutritionists argue that although the Atkins diet may show immediate results, it is not the best way to lose weight. It is not safe, since eating a lot of protein-rich foods can increase the risk of heart disease, and cutting out carbohydrates increases the risk of some forms of cancer. Also, people who lose weight gradually on more conventional weight-loss plans are more likely to keep the weight off in the long term. Argument: (Atkins Diet) 1: On that diet you cut out carbohydrates and it is carbohydrates that are responsible for weight gain. 2: There is a large number of...The statement here is not trying to convince you rather it provides the logical reasoning behind the unhappiness. The premises are convergent. In the first argument the movement is 1.1, 1.2 and 2 and in the second argument the movement is 1, 2.1 and 2.2. Both arguments have two premises. The first argument has two parts of the first premises and the second argument has two parts in the second premises. Since the structure is different of the two premises, they are convergent on the same level. Supporters of the Atkins diet argue that following a high protein, low carbohydrate diet such as the Atkins diet is the best way to lose weight, since on that diet you cut out carbohydrates and it is carbohydrates that are responsible for weight gain. Further evidence they give that the Atkins diet is the way to go is the large number of celebrities who follow it. But nutritionists argue that although the Atkins diet may show immediate results, it is not the best way to lose weight. It is not safe, since eating a lot of protein-rich foods can increase the risk of heart disease, and cutting out carbohydrates increases the risk of some forms of cancer. Also, people who lose weight gradually on more conventional weight-loss plans are more likely to keep the weight off in the long term. The counterargument does not react directly to the one premise given.

The Impact of Christianity Response Essay Example | Topics and Well Written Essays - 1000 words

The Impact of Christianity Response - Essay Example Philosophy is a way of life for the people in the society. Through, the people are finding their way in their lives and enacting their roles as member of the significant member of the society. With consideration to the personal philosophy they adhere with, people are finding answers and to their crucial and critical questions mainly on the concept of man’s purpose for existence. This is where the religion of Christianity affects the philosophy of the humanity in a critically significant way. The beliefs and principles of Christianity address much the dominant philosophies during the past and until the present generations wherein they seek to answer the most important questions of the humankind. With the teachings of this religion, peoples’ views and ideas regarding humanity’s purpose was significantly enlightenment giving the people a new life philosophy and hope through spirituality. The religious teachings of Christianity generally originated from the three-year ministry of Jesus Christ himself, which is critically highlighted, and emphasize with His death. During this time, the laws and principles of the God concretely reported in the Hebrew testament of the Holy Scripture were clearly explained and elaborated for the humanity to understand their significance. Inspired and proclaimed at the present by the Holy Bible, Christianity’s teachings give the people a new way in life to follow by adhering to the guiding principles inspiringly explained by Jesus Christ himself. ... With this principle, the religion of Christianity has given a new philosophy for the humanity during their time of turmoil and disparity. With this philosophy, Christianity has able to bind the people in the spirituality perspective of living in faith with God and the salvation that awaits them in return. Important Aspects of Christianism "Why do Christians consider the Beatitudes (Matthew 5-7) some of Jesus' most important teachings'" During the ministerial and theocratic mission of Jesus on the face of the Earth, he continuously nourished his disciples and believers moral thoughts and encouragement regarding the morally inclining and spiritual enriching Words of God. He elaborated and thoroughly discuss to the common public the meaning and value of the principles embedded in the Words of God. Hs wisdom regarding these matters are very much unsurpassable and that they are spiritually inclining especially to the common public thus his teachings was widely accepted by the people. Among Jesus' teachings, his Sermon on the Mount becomes mostly strengthening because of the principles embedded on it. This discussion is commonly termed to be the Beatitudes where Jesus explicitly relates to the common public the true meaning and relevance of the Word of God. Through the said teaching, Jesus was able to capture the hearts and spirits of the people because his sermon showed deep emotions of concern and empathy to the weak and poor. His Words contain hope for happiness for the poor, weak, deceased families and weak but all spiritual conscious and have faith with the Word of God. (Matthew 5: 1-11). The Beatitudes generally are for the oppressed and weak people in the society that