Purpose: Comment the Discussion (Which theory speaks to your advanced nursing practice?)

 

Thing to Remember:

•   Answer this discussion with opinions/ideas creatively and clearly. Supports post using several outside, peer-reviewed sources.

•   1 References, find resources that are 5 years or less

•   No errors with APA format 6 Edition

Discussion:( Which theory speaks to your advanced nursing practice?)

One of the theorists that speaks to my nursing practice is Madeleine Leininger’s Theory of Culture Care Diversity and Universality otherwise known as transcultural nursing. The theory of transcultural nursing promotes understanding of both the universally held and common understandings of care among humans and the culture-specific caring beliefs and behaviors that define any particular caring context of interaction (Butts & Rich, 2018, p. 572). Culture is the specific pattern of behavior that distinguishes any society from others and gives meaning to human expressions of care (McFarland & Wehbe-Alamah, 2015). This theory is intended to view the patient as a whole being. As an APN, this theory will allow me to be considerate of my patient’s needs. In turn, they will feel respected and listened to and hopefully this will promote a long-lasting relationship. 

            Leininger discovered that inadequate knowledge of cultural factors represented a missing link in her ability to provide care (Nelson, 2006). As a future APN, I recognize the need and sometimes missing component of culture care nursing in our women’s health practice today. For example, in South Dakota we have a lot of Native American reservations. Since we see a number of Native American women, I think it would be beneficial for me to better understand their culture and beliefs related to healthcare in order to offer these women expert care. 

Also, with Leininger’s transcultural nursing theory she believes seeing the patient as a whole and to appreciate that the patient represents a complex constellation of physical, emotional, psychological, spiritual, social, environmental, and economic factors that interact and contribute to the patient’s unique wholeness and influence their ability to participate in health promotion, health maintenance, and disease modifying activities (McFarland & Eipperle, 2008). As an APN, by viewing the patient as a whole and recognizing their diversities, I will provide better patient care in which caring will be the main focus and recognizing that their different beliefs and cultures play a part in their decision making to the different treatment options.  

References

Butts, J. B., & Rich, K. L. (2018). Philosophies and theories for advanced nursing practice. (3^rd ed.). Burlington, MA: Jones and Bartlett Learning. 

McFarland, M. M., & Eipperle, M. K. (2008). Culture care theory: A proposed practice theory guide for nurse practitioners in primary care settings. Contemporary Nurse, (1-2), 48.

McFarland, M. R., & Wehbe-Alamah, H. B. (2015). Culture care diversity and universality: A worldwide nursing theory. (3^rd ed.). Burlington, MA: Jones & Bartlett Learning.

Nelson, J. (2006). Madeleine leininger’s culture care theory: The theory of culture care diversity and universality. International Journal for Human Caring, 10(4), 50-56.

Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

 

 

1. Ms. G. presents with cellulitis of the left leg – this is noted by lab results that indicate infection such as increased WBC, bands >10%, and an 80% left shift of her neutrophils. Ms. G. also has swelling and erythema of her left leg, is unable to bear weight, and is running a temperature. Ms. G. needs more lab work (CMP, ABG, Hgb A1C,CK,  lactic acid, procalcitonin, CRP, pan cultures, and an MRI or CT of left leg), as well as additional vital signs. When a patient is septic their HR is either increased or decreased, patient is generally hypotensive, and patient is tachypneic. Because Ms. G. is diabetic she needs an ABG and CMP to see if she has DKA due to the infection, and an A1C to see how well controlled her blood sugars are. CK should be checked to see if Ms. G. is in rhabdo due to muscle breakdown and possible DKA. Lactic acid and procalcitonin are indicators for sepsis and is something that should be done immediately upon suspecting sepsis. Patient should be pan cultured, however, or at the very least 2 sets of blood cultures should be done prior to starting antibiotics. CRP will be elevated due to the infection and is not a specific test but will show that she has inflammation. MRI or CT to evaluate if there are any other problems associated with her infection other than cellulitis.  Preferably an MRI as it will give better results. Surgery consult should be ordered also. Recommended treatments consist of: IV antibiotics, possible sepsis and dka protocols, as well as possible surgery. Ms. G. also needs to have a wound consult for the wound on her left ankle and an appropriate dressing applied. Marking the margin of the red area is recommended in order to determine if the site has expanded, as well as, measuring ble to see the extent of the swelling. Elevation of left leg above the level of the heart if possible.
2. The muscle groups affected are: Lower leg: gastrocnemius, soleus, extensor digitorum, extensor hallucis longus, extensor hallucis brevis, tibialis posterior. Possible muscles affected in upper leg: gracilis, semimembranosus, bicep femoris, vastus lateralis, rectus femoris, Sartorius, tensor fasciae latae, and adductor longus. Listing muscle groups that are affected is challenging due to the seriousness of the infection. All of the muscle groups in the upper and lower leg could be affected.  While these are all skeletal muscles each of our organs are considered muscles also and when a patient is septic each one can be affected leading to multiorgan system failure.
3. The significance of the data provided shows that Ms. G. has an infection, is likely septic r/t to cellulitis of the left leg, as well as dka, and will probably need to be admitted to the hospital for IV antibiotics, possible insulin infusion and to be stabilized. Follow up labs are listed above and patient should be having a regularly scheduled Hgb A1C with her primary care physician. Patient needs more education on managing her diabetes and proper skin care, especially foot care since she is diabetic. Patient should be seeing a wound nurse for the wound on her ankle, and a podiatrist to have her feet checked and nails cut. Patient also needs to see a diabetic educator and nutritionist to help her understand DM and to help her with a plan of care for weight loss and blood sugar control. Patient also needs homecare and a program such as Meals on Wheels that will deliver her meals for her, at least until she has recovered. If homecare is not an option and she is unable to care for herself at home then placement in a skilled nursing facility is recommended.  
4. Ms. G. is diabetic and this will prevent wound healing. Ms. G. also has a wound on her left ankle that needs to be addressed. Ms. G. needs a significant amount of education and to be seeing specialists. If Ms. G. does not have a proper diet then her wound healing will be delayed also. While nutrition is important long term for her it is also important to help her heal from her current state. DM is a serious disease with debilitating side effects if not managed properly. Uncontrolled DM can lead to organ failure, blindness and loss of limbs.  

 

 

 

 

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Hello i need a Good and Positive Comment related with this argument .A paragraph  with no more  100 words.

 

 

Sarah Turnbull 

 

3 posts

 

Re:Topic 3 DQ 1

 

Having an idea to better the area you work can be a little scary.  There’s the excitement over the prospect of making a change for the better, but then the thought of rejection or failure.  In order to best show an idea to upper management in hopes of support and funding I would research my idea and try to find evidence based practice that backs up why my idea would be successful.  I would then discuss my idea with my peers and get further input on how others feel it may or may not work.  Finally, to present to upper management I would use the ideas of Rupen Sharma (2010) by avoiding information overload, interactive communication, and push and pull communication, all of which require participation from the audience.  I feel an in person meeting would be most successful.  Also, according to Joe Garecht (2014) ,”A better strategy is to, as often as possible, make your first a non-monetary ask.”  Because of this I would try to find a way to implement my idea without funding and show its success, this would make it more easy to fund a project they have already seen working.  

 

 

 

References:

 

Garecht, J. (2014). How to Ask Anyone for Anything. Retrieved from http://www.thefundraisingauthority.com/fundraising-basics/how-to-ask/.

 

 

 

Sharma, R. (2010). The Road to Better Project Communication Management. Retrieved from http://www.brighthubpm.com/certification/85785-the

 

 

 

Research Article Critique, Part Two

Occuaptional Stressors, Stress Perception Levels, and Coping Styles of Medical Surgical RNs: A Gernalized Perscpective

(Wakim, 2014)

 

 

Your assigned article for critique is:

Wakim, N. (2014). Occupational stressors, stress perception levels, and coping styles of medical surgical RNs. Journal of Nursing Administration, 44(12), 632-639. doi:10.1097/NNA.0000000000000140 

 

 

Instructions:  A major skill that is learned in this course is how to critically read and critique nursing research articles.  The purpose for critiquing an article is to critically evaluate the research process followed by the author(s) of the assigned article. This is an information-intensive, time-intensive process that is not learned overnight.   To demonstrate your skill at critiquing an article, you will complete this open-book multiple choice assignment.

Here’s how you should approach completing this week’s assignment to finish critiquing an article:

1.  First, do your assigned reading in Grove, Gray, and Burns (2015) and complete the reading worksheets early in the week.  This will introduce you to the critique skills you will need for the week.

2.  Skim the entire instructor assigned research article that has been posted on Blackboard for you so that you will have an idea of what it is about.  Lightly cross out the abstract for the article (you won’t be using it). Then, for this week, re-read carefully from the study design section through the end of the article.

3.  Print this document and find the best answer to each question below based on your Grove, Gray, and Burns (2015) assigned reading for the week and what you have read in the instructor assigned research article.

4.  Some of the questions in the critique assignment below will seem unfamiliar to you. Look up key terms from the question in your textbook.  Some examples of these terms might be: power analysis, inter-rater reliability, and generalization. You can also look in Chapter 12 for an example of a critical appraisal (or critique) of a quantitative research article.

5. Once you have completed this assignment “on paper”, go into blackboard and enter your answers by the assignment due date and time listed in the syllabus.  Ignore any wording from Blackboard that indicates that “this is a test” and carefully enter your answers from this document. 

6.  You will have two access attempts to record your answers.  This is given to you so that if you encounter technical difficulties on your first attempt, or you would like a second attempt to try to improve your grade, you may do so.  You will not be able to see the questions that you missed when you submit your attempt.  Blackboard will record the highest grade from the two submissions.

If you have questions about this assignment, you can post them to your group discussion board for help.  Please do not post the exact question from the assignment below and ask the group for the answer as this would constitute academic dishonesty.

Questions 1 – 9: Sample.  (For help with these questions, refer to chapters:  9 & 12)

1.  What sampling method or plan was used by the authors in this study?

              a.   Simple random sampling

              b.   Systematic sampling

              c.   Convenience sampling

              d.   Network sampling

             

2.  According to Grove, Gray, and Burns (2015), what are the potential biases of this sampling method?

a.   This is a strong probability sampling method with very little potential for bias

b.   This method is used when an ordered list of all members of the population are available, and provides a random but not equal chance for inclusion in the study.

c.   This method provides little opportunity to control for bias because subjects are included in the study merely because they happen to be in the right place at the right time. 

d.   This method is specific to the individuals who were recruited and the information gained cannot be generalized to others who don’t share these types of experiences.

e.   None of the above biases best describe the sampling method chosen by the author.

 

3.  What was the final sample size reported by the authors for this study?

              a.  200 participants

              b.  84 participants

              c.   159 participants

              d.   161 participants

 

4.  Was a power analysis conducted?  If so, which statement best describes the results of the power analysis?

a.    The authors mention that an a priori power analysis was conducted, and 200 subjects were

       determined to be needed for the study.

b.   The authors mention that a power analysis was conducted using four predictors and 1-way ANOVA using three independent groups for a needed sample size of 159.

c.   The authors do not report that a power analysis was conducted.

 

5.  Which of these statements would be considered an inclusion criterion for the sample in the research article? 

              a.   English-speaking

              b.   Have at least two years of experience as a nurse

              c.   Work on a Medical Surgical unit

              d.   Be a member of the Medical Surgical Nurses Association

             

 

6.  Which of these statements would be considered to be exclusion criterion specifically identified by the author for the sample in the research article?

           a.  The exclusion criteria were explained verbally during recruitment.

              b.  History of depression/ mental health issue.

c.   Report of no stress related problems by the participant. 

d.  Participants only worked on the night shift.

 

7.  What is the refusal rate for this study? (Hint: see page 253 in your text)

              a.   161/200 X 100% = 80%

              b.   84/159 X 100% = 53%

              c.   unknown / cannot be calculated.

              d.   39/200 x 100% = 19.5%

 

8.  Which of the following would be accurate for the attrition rate for this study?

              a.   161/200  X 100% = 80%

              b.   39/200 X 100% = 20%

              c.   84/159 X 100% = 53%

              d.   0%

 

9.   What was the setting for this research study?  Briefly describe the setting and indicate whether it was appropriate for conducting this study.

a.   The setting for this study was a partially controlled setting and was appropriate for this study’s research design.

              b.   The setting for this study was not well described by the authors and therefore not appropriate for 

                     conducting this study.

c.   The setting for this study was a highly controlled setting and was appropriate for this study’s research design.

d.   The setting for this study was a natural or field setting and was appropriate for this study’s research design.

 

Question 10 – 14: Measurement Methods.  (For help with these questions, refer to chapters 10 & 12.)

10.  Which ones of these questionnaires, scales, or physiologic measures is used in this research study?

(Select all that apply).  

              a.   The Ways of Coping Questionaire (WAYS)

b.  The Nursing Stress Scale (NSS)

              c.   The Perceived Stress Scale (PSS)

              d.   The Quality of Life Scale (QOLS)

 

11.  How do the authors describe the reliability of the Nursing Stress Scale (NSS) in previous studies?

a.   Two follow-up emails were sent to potential participants.

       b.   they compared the odd and even questions on the test to determine their equivalence.

c.   a team of staff nurses was trained by the primary investigator to administer the questionnaire.

       d.   they tested a group of subjects twice using the same questionnaire (test-retest reliability).

       e. they computed a Cronbach’s alpha on the Nurse Stress Scale that was administered to this group of subjects.

 

12. How do the authors describe the validity of The Ways of Coping Questionnaire (WAYS).

              a.    discriminant validity demonstrated that each subscale measured the same constructs.

              b.   evidence of validity from contrasting groups because they gave it to spouses of MS nurses.

c.   no was no mention of determining the validity of WAYS questionnaire.

d.   The authors had experience with administering this questionnaire.

 

13.   What types of questionnaires or surveys were used in this research study?  (Select all that apply.)       

               a.  The authors developed the Professional Quality of Life Scale.

               b.  Interviews were reportedly used, but the authors do not explain what was included in them.

 c.  The authors developed their own questions to ask about demographic information.

d.   The authors report adding a few of their own questions at the end of the demographic questionnaire.

e.   This study did not use any questionnaires or surveys.

               f.    The authors used previously developed questionnaires or surveys to measure the study

                   variables.

 

14.   Were any physiological measurements collected from the subjects for the purpose of this study? 

              a.   Yes

              b.   No

 

Question 15- 16: Data Collection. (For help with these questions, refer to chapters 10 & 12)

 

15. Which one of the following best describes the data collection process used in this study?

              a.   questionnaires / surveys were completed via the telephone.

b.   participants were given the questionnaires on enrollment in the study and asked to drop the sealed envelope in a locked box at the nurse’s station.

c.   questionnaires / surveys were mailed to the prospective participants and returned in a self-

      addressed stamped envelope.

              d.   nurse researchers interviewed the study participants in a focus group.

 

16.  If there were more than one data collector for the study, would an estimation of inter-rater reliability be an important concept for the authors to report on for this study?

              a.   yes, and the authors reported their efforts to achieve inter-rater reliability.    

b.   yes, but the authors do not discuss any efforts to achieve inter-rater reliability.

c.   no, the issue of inter-rater reliability does not apply here.

 

Question 17 – 19:  Data Analysis. (For help with these questions, refer to chapters 11 & 12)

17.  What descriptive statistics are used in this study?  (Select all that apply).

              a.   mean

              b.   median

              c.   mode

              d.   standard deviation

              e.   z-scores

              f.   percentage distributions

 

18.  What inferential statistics were used to examine the data obtained from the subjects?  (Select all that apply)

              a.   Bivariate correlational analysis

              b.   Factor Analysis

              c.    t-Test

              d.   Chi-Square

              e.   ANCOVA

              f.   ANOVA

              g.   regression analysis

              h.   None of the above inferential statistics were used in this study.

 

19.  What is the level of significance (alpha) set at for this study?

              a.   .05 or 5%

              b.   .10 or 90%

              c    .01 or 1%

              d.   an alpha level or level of significance chosen by the authors was not specifically mentioned in the text

                      of the article.

 

Question 20-25: Researcher’s Interpretation of the Findings. (For help with these questions, refer to chapters 11 & 12)

 

20.  There are several statistically significant findings in this study. Which of these statements from the article would be considered a significant and predicted result? (select all that apply)

a.   As MS nurses’ perceptions of their stress increases, their use of ways to cope increases (r = .357, P<.00)

b.   Younger nurses have lower levels of perceived stress, per post hoc Tukey analysis.

c.   Baby boomers tend to report higher use of self-controlling behaviors than Gen X and Gen Y nurses when dealing with occupational stressors.

              d.  The stress perception level is thus determined by the type of occupational stressor that the nurse is

                   exposed to.

21.  Which of these statements from the article would be considered a non-significant result. (Select all that apply)

a.   The older the nurse, the higher the level of stress.

b.   There was no difference between the scores on ways of coping related to age cohorts (F₂₁₅₈ = 1.12, P=.33)

c.   Age, years of experience, and educational levels are not significant factors in levels of perceived stress among MS nurses.

              d.   Baby boomers tend to report higher use of self-controlling behaviors than Gen X and Gen Y nurses

                    when dealing with occupational stressors.

 

 

22.  Which one of these statements from the article would be considered clinically important?

              a.    According to this study results, a high level of occupational stress is not a known factor for nursing

                     turnover in MS nurses.

              b.   Younger nurses have better coping skills to combat perceived stress compared to more

                    experienced nurses.

              c.   Baby boomers reported higher use of self-controlling behaviors when dealing with occupational

                    stressors compared with Gen X and Gen Y.

d.   Six participants were removed from the study due to incomplete surveys.

 

23.  Which statements below implied from the article would be considered a limitation of the study? (Select all that apply)

a.   The researchers utilized a qualitative method in the research design.

b.   Lack of standardization of the conditions of administering the instruments.

c.   A small sample size with a low response rate.

d.   A measure of social desirability in giving responses as the participants worked with the researcher.

 

24.  Which one of these statements would be considered a statement regarding generalization of these results?

a.   The results indicated that there were high levels of perceived stress in this group of MS nurses and can be generalized to all MS nurses in the United States.

b.   The survey was mailed only to MS nurses who were members of the Medical Surgical Nurses Association (MSNA).

c.    A convenience sample of MS nurses decreases generalizability.

d.    The use of a power analysis influenced the generalization of the results to all MS nurses.

 

 

25.  Which one of these statements from the article would be considered a recommendation for future studies?  (Select al that apply.)

a.   Future development of programs to help relieve the occupational stress in MS nurses.

              b.   Research to discover why older nurses have a higher perceived stress compared to younger nurses.

c.   Sufficiently educating nursing leaders in generational differences.

d.   Identification of occupational stressors, perceived stress, and coping styles among generational cohorts.

 

 

 I NEED A POSITIVE COMMENT BASED IN THIS ARGUMENT..BETWEEN 120-150 WORDS

 

1.Imagine that a family friend or colleague has just been diagnosed with cancer. Explain how the American Cancer Society might provide education and support. What ACS services would you recommend and why?

The American Cancer Society website is a great resource to start with.  The website also has a helpline number if you are in need of speaking to someone.  You can also utilize the site to find local cancer centers that can help with questions and information you may be looking for.  We have several centers here in Arizona that specialize in oncology that have recently helped my family members in finding out about treatment and quality of life.  It was extremely beneficial for them in order to assist them in making future decisions.  I’ve also lost my aunt to colon cancer when I was very young, she was only 36 years old.  She was so young and naïve about serious health signs and symptoms that she didn’t let anyone know what was going on until it was very late.  By the time she sought out healthcare, the cancer had metastasized.

2.According to statistics published by the American Cancer Society, there will be an estimated 1.5 million new cancer cases diagnosed each year over the next decade. What factors contribute to the yearly incidence and mortality rates of various cancers in Americans? What changes in policy and practice are most likely to affect these figures over time?

Factors that contribute to yearly incidence and mortality rates of various cancers are tobacco use, sun exposure, diet and exercise, and environmental exposures (American Cancer Society [ACS], 2017). In the small mining town in which I was raised, there was much controversy involving the pollutants from the mine and it’s relation to multiple health concerns of people that lived there. The toxic air pollutants, are those pollutants that are known or suspected to cause cancer or other serious health effects, such as reproductive effects or birth defects, or adverse environmental effects. This means that people exposed to toxic air pollutants at sufficient concentrations and durations may have an increased chance of getting cancer or experiencing other serious health effects, such as damage to the immune system or neurological, reproductive, developmental, or respiratory problems.

Long-term inhalation exposure to inorganic arsenic is associated with irritation of the skin and mucous membranes and effects in the brain and nervous system and has been strongly associated with lung cancer. Exposure to lead (inhalation or oral) can cause effects on the blood, as well as the nervous, immune, renal, and cardiovascular systems, and early childhood and prenatal exposures are associated with slowed cognitive development, learning deficits, and other effects (United States Environmental Protection Agency. [EPA], 2017).

 

3.Select a research program from among those funded by the American Cancer Society. Describe the program and discuss what impact the research will have on the prevention or treatment of cancer.

The American Cancer Society’s global program aims to eliminate cancer as a major health problem worldwide through programs that support local cancer organizations, hospitals and government ministries in their efforts to increase awareness about cancer prevention, international cancer advocacy and tobacco control.

Pink Ribbon Red Ribbon is a leading public-private partnership aimed at catalyzing the global community to reduce deaths from cervical and breast cancer in sub-Saharan Africa and Latin America by raising awareness of these diseases and increasing access to quality services to detect and treat them. ACS and PRRR have joint priorities focused on women’s cancer advocacy and planning activities in Ethiopia and Tanzania (ACS, 2017).

 

American Cancer Society. [ACS]. (2017). Healthy. Retrieved from: https://www.cancer.org/healthy.html

American Cancer Society. [ACS]. (2017). Global Health Work. Retrieved from: https://www.cancer.org/health-care-professionals/our-global-health-work/cancer-partnerships.html

United States Environmental Protection Agency. [EPA]. Enforcement. Retrieved from: https://www.epa.gov/enforcement/asarco-llc-settlement