Research Articles Base: Diabetes Term Papers

JOURNAL CRITIQUE

Problem statement and or hypothesis             The purpose of the study was to examine how job-related stress manifests itself among Certified Registered Nurse Anesthetists (CRNAs) regarding their ability to relate to their peers. The title of the article – The Certified registered Nurse Anesthetist: Occupational Responsibilities, Perceived Stressors, Coping Strategies, and Work Relationships – is very broad. It does not concisely represent the content of the study. The study presented four research questions which are found in the title itself and which are discussed in the article. The research questions are the following: (1) What are the roles and responsibilities of the CRNAs as they see them? (2) What are the CRNAs’ perceived stressors encountered on the job? (3) What are their coping strategies related to the perceived stressors? (4) What is the relationship between CRNA job stress and interpersonal work connections? Literature review             There has been increased concern in recent years about occupational stress as a major cause of work-related illness, notably in the service professions,  including the nursing profession. The nursing profession faces a significant problem with turnover, absenteeism, and work-related injuries which are commonly attributed to the stressful nature of the job. Occupational stress is at least partially responsible for much of the health claims, absenteeism and turnover in the workplace and has also been established as a precipitating factor in injury occurrence at work .             Stress is a contributing factor to organizational inefficiency, high staff turnover, absenteeism because of sickness, decreased quality and quantity of care, increased costs of health care, and decreased job satisfaction. Studies of occupational stress in nurses have uncovered a number of common stressors in this population. In the particular field of CRNAs, the common stressors as found out in the study are patient-related stressors (e.g. death of a patient), administrative stressors (e.g. work schedule and staffing issues), interpersonal relationships, and the operating room (OR) environment (the environment is depressing). To assist organizations with assessing and managing workplace stress, researchers have devised a number of general stress scales and occupational stress scales. In recent years researchers have argued that occupation-specific and industry-specific stress scales are more reliable and valid predictors of stress and effects of stress than general occupational stress scales. As a result of this argument, a great deal of recent stress research on various occupational groups (e.g. teachers, nurses, and police officers) has used occupational stress scales specifically designed for these groups. For example, in this particular study regarding CRNAs, an occupation-specific stress scale – the Nursing Stress Scale – was used specifically as a guide for the author in constructing the interview tools used.             Though stressors in the workplace cause stress which, in turn, leads to strains (negative effects on health and quality of work), researchers have identified a number of moderating variables which can reduce the experience of stress or reduce the negative effects of stress. Some examples of these variables are coping strategies, social support, and hardiness. This particular study tackled coping strategies as a variable in reducing occupational stress. The participants identified several coping strategies designed to counteract the job-related stressors. The study deals only with the CRNAs and not all the nurses in general so it is understandable that the occupational responsibility is already narrowed down. The article presented an abstract that represents a rather vague summary of the purpose, method, results and the conclusions of the study. Take for example the perceived stressors – in the abstract it mentioned six different stressors. In the results of the study, it only presented 4 major stressors of which the others are a part of. Theoretical and conceptual framework             Existing literature are rich with studies on occupational-related stress in the nursing profession, nonetheless there is a scarcity of research on the particular issue of occupation-related CRNA stress. For this reason most of the CRNAs are unaware of the perceived stressors and the best way to handle stress in their environment, leading to a shortage of registered nurses and anesthetists. To address this gap in the literature, this particular study was conducted which specifically explored the roles and responsibilities of the CRNAs, the perceived stressors associated with the job, the coping strategies related to the perceived stressors, and the relationship between CRNA job stress and interpersonal work connections. Research Design             For this particular study, the author employed a qualitative research design utilizing interviews, observations and artifact data to answer the research questions. The chief method for data collection that was used was a semi-structured interview of the participants. Two types of nonprobability, purposive sampling was used. The study participants are 20 CRNAs composed of 16 women and 14 men. The area where these CRNAs work was chosen for its traveling convenience.             The interview tools were created by the author after researching the literature and using the Nursing Stress Scale as a guide in constructing interview questions that are tailored for CRNAs. Data collection procedures There was no mention of obtaining an approval from an ethics committee before the study was conducted. However, an informed consent was acquired from the participants before any data were gathered. This includes informing the participants of the purpose of the study, the methods that will be used, the significance of doing such a study and confidentiality of their participation. Permission was also sought from the investigator’s university and the hospital where the observations were conducted. The name of the hospital was changed to protect the privacy of the hospital and the participants involved in the study. Each CRNA was interviewed once personally, either at their personal residences or at work. All the interviews, except one, were recorded on tape with the participants’ permission and then transcribed. The participants were then offered the opportunity to read the transcription and make amendments to any of their statements. Five of the twenty participants who were interviewed were also observed for an accumulated 65 hours of clinical observation at the hospital. They were observed at the OR, staff lounge, recovery room, magnetic resonance imaging room, and when the nurses make their preoperative rounds. Qualitative analysis             A constant comparative method of analysis was used. The analysis was conducted as the data was obtained. The information gathered was coded and the data constructed into categories or themes by analyzing information in relation to the research questions. Profiles and brief essays of the participants’ experiences were also created from the results obtained in the study. Interpretation of results             The study presented three major roles of the CRNAs: (1) typical anesthesia duties – e.g. making preoperative and postoperative rounds & difficulties encountered with patient care; (2) offering assistance or being a reliable coworker – anesthetists believe that it is part of their job to help others especially their peers; and (3) collaborator – collaboration is so ingrained in the work life of the nurse anesthetists. Three major responsibilities are also revealed: patient care and safety, continuing education and administrative duties.             Perceived stressors are patient-related stressors, administrative stressors, interpersonal relationships, and the OR environment. Production pressure and workload are the major stressors the participants identified. The coping strategies used by the CRNAs include remaining calm, internalization, spiritual beliefs and prayers, internal reflection, making jokes or funny comments, and participating in hobbies outside the scope of their work. The study also found out that relationships and alliances that the participants form with other staff persons can be stressful. Data Quality / Importance of the topic to nursing practice and/or research             The data is of high quality since it can be used by fellow nurses and future nurses in the field of anesthesiology. This can ultimately improve the effectiveness of care and health outcomes in patients requiring the aid of a nurse anesthetist. The CRNA can be better prepared for his/her role by knowing the findings of this article. This way, he/she can be ready for the stress it brings and also be aware of how to cope with them. Although personally I think that the research is very broad, it is still quite relevant to the nursing staff especially to the CRNAs. The answers to the findings/conclusions to the research questions can be very helpful to the nurse anesthetist. The findings can help the CRNA in many ways such as knowing what to do when faced with occupational-related stress and to be able to carry out their specific duties. Coping strategies are very helpful and knowing what strategies the CRNAs used can be helpful to other nurse in the field. The study is also useful in that the findings can help solve the increasing number of nurse shortage as a result of occupational stress. By knowing the roles and responsibilities, the perceived stressors, and the coping strategies that can be used, the nurse anesthetist can be better prepared for his/her role. By letting nurses participate in the design and carrying out of multidisciplinary scientific research projects such as this particular study regarding occupational stress in CRNAs, aspects regarding job performance as well as satisfaction could be increased, the nursing shortage could be decreased, and ultimately there would be an improvement in client care. Credit:ivythesis.typepad.com

JOURNAL CRITIQUE

Problem statement and or hypothesis The purpose of the study was to examine how job-related stress manifests itself among ...

Mother Infant Relationship Case Study

A three-month-old infant and his mother were observed for this study. The infant’s cognitive, emotional and social development was observed through the infant’s responsiveness with his mother. The responsiveness of the infant’s mother to her baby’s cues was also measured.             There is a significant impact of the mother-infant relationship on the social competency of an infant to the people around them. Evaluation of the mother-infant relationship was made at three months. Social competency was evaluated in three-week day camp sessions when the children were about three months old. The mother’s receptiveness at three months was associated to the child’s social skill with adults, while the infant’s receptiveness to mother at three months was not connected with procedures of social competence with any adults or with peers. Organization at one year was correlated to the achievement of offers for relations, intricacy of bids, and whether the child spent time near peers or near adults at three years, as well as to camp staff members’ ratings of social competence with peers and with adults. Staff ratings of social competence with both peers and adults consistently correlated positively with more objective behavioral measures. Mothers were asked to feed their babies during a 30-minute observation. The observation took place in a hospital clinic when the mother conveys her baby for a three-month check up with his doctor. There were two observers, employing a catalog of around 120 pre-determined behavioral codes, documented the incidence of particular behaviors of the mother and the infant each focusing attention on one member of the group. The infant’s skill in feeding, responsiveness, frequency of cues to the mother and general temperament were measured using a six-point scale. The mother was also evaluated through the her skill in feeding baby, responsiveness to her baby’s cues, interest in her infant, amount of talking to her baby, face-to-face contact, closeness in cuddling and expression of positive emotion. The scores of both the mother and the infant’s responsiveness were all computed using a mean, resulting to a responsiveness score for the mother and a responsiveness score for the infant at three months of birth life. Because of their face validity, these measures and not measures derived from frequencies and durations of discrete behaviors are analyzed. Mothers and their babies were also observed and rated just before hospital discharge Credit:ivythesis.typepad.com

Mother Infant Relationship Case Study

A three-month-old infant and his mother were observed for this study. The infant’s cognitive, emotional and social develop...

Factors Affecting the Development of Coronary Heart Disease

Coronary heart disease (CHD), also called coronary artery disease or arteriosclerotic heart disease, is the leading cause of death in the United States for men and women. It accounts for approximately 1 of every 5 deaths. According to the American Heart Association, about every 29 seconds someone in the US suffers from a CHD-related event, and about every minute someone dies from such event. Approximately 13.9 million adults (7.1 million men and 6.8 million women) have a history of myocardial infarction (MI), angina, or both, and these figures do not include patients with clinically silent disease. Studies indicate that 25% of men and 38% of women will die within 1 year after having recognized MI In the United States, a coronary event occurs every 29 seconds and an MI occurs every minute. The incidence of coronary heart disease is increased in the presence of certain biochemical, physiologic, and environmental factors, known as risk factors. The well established risk factors are high blood pressure, dyslipidemia/high blood cholesterol, tobacco use/cigarette smoking and diabetes mellitus. Other factors that may increase or affect the risk for heart attack are obesity, a sedentary life-style, an aggressive response to stress, and certain drugs. Some of the most common risk factors that can be changed or modified include obesity, smoking, high cholesterol, hypertension, diabetes, excessive alcohol intake, stress, and a lack of physical activity. Other factors such as age, gender (male) and heredity or family history of CHD cannot be changed or altered. Age and family history are also considered major risk factors. Although these factors cannot be changed they should be looked at carefully. People affected by these risk factors should be even more on the observant to protect themselves against coronary heart disease. The presence of one or more of these factors in an individual increases the possibility that a person will suffer from coronary heart disease and its complications. It is also suggested that removal or modification of the risk factors in a population will diminish the incidence of developing coronary heart disease. The succeeding paragraphs will present a brief discussion on some of the risk factors of coronary heart disease. Obesity or being overweight has many negative side affects that could in turn directly increase a person’s chance for developing a coronary heart disease. It is established that an overweight person even without any other risk factors for CHD is at a higher risk for a heart attack or stroke. Obesity also increases the workload of the heart (increased oxygen delivery for fat metabolism), increases blood pressure, increases cholesterol, and increases a persons risk for developing diabetes mellitus. Actually, all of the potential side effects of obesity are also risk factors for developing coronary heart disease. Hypertension or high blood pressure means that the mean arterial pressure is greater than the upper range of the accepted normal measure. High blood pressure places constant stress on the heart and as a result the heart becomes thicker and stiffer. Excess workload on the heart in hypertension leads to early heart failure and coronary heart disease, often causing death as a result of a heart attack. High blood pressure mixed with obesity, smoking, high blood cholesterol levels or diabetes mellitus increases the risk of heart attack or stroke by several times. Dyslipidemia refers to abnormal levels of total cholesterol, low density lipoprotein (LDL) cholesterol, and high density lipoprotein (HDL) cholesterol. Cholesterol is present in the diet of all people, and it can be absorbed slowly from the gastrointestinal tract into the intestinal lymph. The body has two main types of cholesterol, HDL/good and LDL/bad. The problem arises when there is too much cholesterol floating around in the body. High blood cholesterol is a major risk factor. Desirable levels of LDL are those less than 130 mg/dL. HDL cholesterol is protective at levels of 60 mg/dL or more and causes major risk if levels fall below 35 mg/dL (Ganong, 2001). Any cholesterol above 200 mg/dl (for total body cholesterol, HDL + LDL) is considered a moderate to high risk factor for coronary heart disease. An estimated 96.8 million persons (51%) in the United States have total cholesterol levels greater than 200 mg/dL and 37.7 million persons (20%) have levels greater than 240 mg/dL. A person’s cholesterol level is also affected by age, sex, heredity and diet. In some people who have genetic predisposition to coronary heart disease or in people who eat excessive quantities of cholesterol and other fatty substances, large quantities of cholesterol gradually become deposited beneath the endothelium at many points in arteries throughout the body. Gradually these areas of deposit are invaded by fibrous tissue and frequently become calcified. The net result is the development of atherosclerotic plaques that protrude into the vessel lumens and either block or partially block the flow of blood to the heart . Diabetes mellitus dramatically increases the risk for heart disease even when a persons blood glucose levels are well maintained. About 75-80% of all diabetics die of some type of heart or blood vessel disease. Smoking and physical inactivity are two almost obvious risk factors. Consistent moderate to intense physical activity and not smoking will reduce a person’s risk factors. In fact, smokers are four times as likely to die of a sudden heart attack then are non-smokers. For years, the American Heart Association has recommended 30-60 minutes of aerobic exercise three to four times per week to promote cardiovascular fitness. This has been shown to help a person loose or maintain weight, lower blood pressure, increase their HDL (good) cholesterol and lower their LDL (bad) cholesterol. Such activities could include aerobics, jogging, running, swimming, and sports such as tennis, racquetball, soccer, and basketball. Any individual starting a new exercise program with one or more of these risk factors must first get written approval from their doctor. Advancing age is a CHD risk factor for both men and women because of the inevitable atherosclerosis that comes with the normal aging process. Age 45 years or older in men and 55 years or older in women (or premature menopause without hormone replacement therapy) is associated with greater risk of CHD. The lifetime risk of having coronary heart disease after age 40 is 49% for men and 32% for women. As women get older, the risk increases almost to that of men. Men in their early and mid-adult years are several times more likely to develop atherosclerosis (which can lead to the development of CHD) than women. This suggests that male sex hormones might be atherogenic or, conversely, that female sex hormones might be protective. Tobacco use or cigarette smoking is, by far, one of the most powerful CHD risk factors. It is currently estimated that 25.9 million men (27.8%) and 23.5 million women (23.3%) in the United States use tobacco products and that 90% of them began before the age of 21. In the United States, tobacco use causes 2 out of 5 cardiovascular-related deaths. Evidence indicates that chronic exposure to environmental tobacco smoke by second-hand smoke or passive smoking also increases the risk of developing coronary heart disease. Individuals who have strong family histories of CHD are four times as likely to have the disease, compared with those with a weak history. The risk is increased 27 times if three or four risk factors are present – such as DM, hypertension, high cholesterol, and obesity – given a strong familial CHD risk, compared with those with a weak family history of heart disease and no risk factors. If only two risk factors are present in addition to genetic factors, then the risk is increased 19 times, and if no risk factors are present, then the risk for CHD associated with genetic CHD is increased only twofold. Credit:ivythesis.typepad.com

Factors Affecting the Development of Coronary Heart Disease

Coronary heart disease (CHD), also called coronary artery disease or arteriosclerotic heart disease, is the leading cause of death in ...

Scoliosis

Introduction             Hippocrates first used the term scoliosis which implies abnormal curvature of the spine. This skeletal problem is primarily a disorder of children whose spine is still growing. Scoliosis is the most common and serious of the spinal curvature disorders. It is defined as a lateral curvature of the spine greater than 10 degrees accompanied by vertebral rotation (1). Numerous theories exist on the origin of scoliosis, but the true causative factors remain unknown; thus this disorder cannot be prevented. Treatment essentially consists of early recognition, correction of existing curves, and prevention of the further progression of the curves. Treatment is considered when a lateral curvature of more than 10 degrees is present. Lateral curvature of the spine is often accompanied by rotation of the vertebral bodies. Functional scoliosis is flexible and can be caused by poor posture, leg length discrepancy, poor postural tone, hip contractures, or pain. Congenital scoliosis is usually structural in nature, caused by abnormal spinal or spinal cord structure. Most scoliosis has no known cause (2). Idiopathic scoliosis is a complex three-dimensional deformity of the trunk, characterized by lateral deviation and axial rotation of the spine, usually accompanied by a rib cage deformity. Adolescent idiopathic scoliosis is present in 2 to 4 percent of children between 10 and 16 years of age (1). Literature Review Over the years, many forms of treatment have been supported for scoliosis, and supporters of every form of treatment are found in various literature. Treatment strategies for idiopathic scoliosis include conservative treatment and surgery (3). Some aspects and principles of most concepts of treatment have merit and influence today’s concept of correct treatment.             The objective of the treatment is to make sure that the person with scoliosis (usually a child) reaches maturity with a straight, balanced, and stable spine. In minimal scoliosis that has been diagnosed early, this objective is accomplished by treatment aimed at preventing progression of the deformity. In more advanced cases of scoliosis the treatment objectives are correction of the lateral curving and rotational deformity to the greatest possible degree and holding the correction achieved for the remainder of the spinal growth. Treatment either for prevention or correction of scoliosis is either nonoperative or operative.             External orthotic devices advocated in the treatment of scoliosis are numerous and many have therapeutic value. These appliances include various forms braces. These kinds of external devices are intended to correct curvatures or to maintain correction achieved by other means.             External orthotic devices have their effect on the scoliosis by application of corrective forces. From the literature, orthotic devices generally present pressure that is exerted against the convex side of the curve with counterpressure applied against a fixed portion of the skeleton such as the pelvis and rib cage. Pressure is also applied against the convex aspect of rib rotation in an attempt to cause derotation.       External correction devices can be divided into passive and kinetic in their action. Passive devices apply the principle of steadily applied pressure with no effort required on the part of the patient. Kinetic correction involves active participation by the patient. The passive form of correction is used in the nonoperative-treatment approach but also has significant application in preoperative correction and postoperative maintenance of scoliosis correction. Passive corrective devices include braces and casts.             Braces are constructed of many materials such as leather, metal, or plastic. They may be constructed so as to be worn constantly or they may be removable. Treatment interventions in the form of braces include the Milwaukee Brace, Boston and TLSO Braces, The Charleston Bending Brace, and some new braces like TriaC.             A kinetic form of brace correction is currently exemplified by the Milwaukee brace – a custom-built brace that embodies pelvic support and static correction of the rotatory deformities such as rib angulation and pelvis rotation. Cervical distraction against the occipital pad elongates the spine and by traction decreases the curves. The lateral pads tend to prevent further lateral curving and rotation by a restraining pressure. It is conceivable that these pads also exert corrective passive forces but restraint of progression of curves is their more probable effect. Thus, all that can be expected of these lateral pads is that they hold curves, not necessarily correct them. These braces are made upon plaster positive mold made from a cast accurately applied to the patient. The positive mold is poured into the cast, which is then bivalved and removed; the brace is then made upon this mold. The Milwaukee brace is used in high thoracic and cervical curves, most often for congenital and juvenile-onset scoliosis (4).             The value of the Milwaukee brace lies primarily in maintenance of the current curve status and the prevention of further progression. Various authors have claimed correction of scoliosis of both the lateral curves and rotational deformities, but this correction is minimal. Prevention of progression, however, of both lateral curving and especially rotational deformity is extremely desirable and justifies the use of the Milwaukee brace. The Boston brace is a low-profile thoracolumbar-sacral orthosis (TLSOs) that provides passive correction while the brace is worn, generally 16 hours a day (4). It comes up to beneath the underarms and can be fitted to be worn close to the skin so that they don’t show under clothes like that of the Milwaukee Brace. It appears to be effective for mid-back and lower curves and is worn only for 16 hours a day to achieve benefits. The Milwaukee Brace on the other hand has to be worn 23 hours in a day. Single thoracolumbar curves can be treated with nighttime bracing with the Charleston side-bending brace (4). Since this kind of brace is worn only at nights, it appears to be suitable only for small, flexible curves.             In one literature, it mentions of a new orthotic device in the non-operative treatment of idiopathic scoliosis – the TriaC brace. Based from the literature, its name is derived of the three C’s of comfort, control and cosmesis. In this new orthosis, continuous correction forces on the trunk need to be applied, with the aim to reverse the progression process during the growth period. The result of the study regarding the use of the TriaC brace shows that it has prevented further deterioration of scoliotic curves in 28 out of 35 patients. This type of brace is extra effective as a result of the greatly increased comfort it offers. These braces are constructed so that it is adjustable to curve changes of the scoliosis and to height growth and change in weight of the child. A brace is worn until skeletal maturity is reached (Risser grade 4 or 5) or until no growth has occurred for 6 months. Brace fit and curve progression are evaluated every 4 to 6 months (4). Wearing the brace for the prescribed time is difficult but is essential for any success. A team approach, with several health professionals involved, is beneficial and often necessary to support the patient through the process of wearing a brace. Each member of the treatment team plays an important role in the success of the bracing program. A physician or orthopedic surgeon interprets the x-rays, assesses the potential progression of the scoliosis, performs a clinical assessment, and plans the treatment with the patient and family. Through both a physical evaluation and an x-ray assessment, the physician determines whether any orthotic treatment is recommended, and if so, which treatment. It is the physician’s responsibility to recognize curve patterns, growth potential, and coronal and sagittal balance. If a brace is used, an orthotist measures, facilitates and fits the patient with the device. The orthotist is responsible not only for providing the product but also for following through with the entire treatment plan. The orthotist should have knowledge of the referring physician’s treatment protocol and be able to provide a full physical examination to allow the orthosis to fit correctly. The orthosis design and fit will be a key factor in patient compliance. The more streamlined and comfortable the orthosis is, the more likely it will be worn as prescribed. The physical therapist performs a comprehensive assessment, interprets the results, and tailors an individual exercise program best suited for the patient based on the findings. A nurse may also get involved to coordinate the treatment plans. The nurse coordinates the clinic, instructs the patient in brace application and skin care, and provides the patient with a schedule for adjusting to the brace. The nurse also provides support and information and is the patient’s and family’s contact for any questions or concerns. The nurse often provides written information with regard to diagnosis and treatment plan. The team makes the long-term management of these patients not only successful but also very rewarding. Each team member provides a great deal of emotional support to both the patient and family throughout the course of treatment. A highly motivated, enthusiastic team can have a very positive influence on both patients and families. Patients and their families gain knowledge and support from the professional team as well as from other children and families undergoing similar treatment. The education of the patient and family starts even before the initial fitting of the orthosis. There should be a complete understanding of what the patient is being treated for and what is expected of the patient and the family. One study implied that in order for an orthosis to be effective in the management of scoliosis in the long term, it must at least demonstrate the ability to control the curve in the short term while the patient is wearing the orthosis. Overall efficacy is dependent on many additional factors that include compliance, length of time the patient is compliant with a bracing program, weaning, as well as numerous selection criteria in the first place, such as curve size, and skeletal and endocrinologic maturity (5). Conclusion The literature found are rich in information of the various orthotic devices used in the treatment of scoliosis. Although there are many types of braces to be used for the patient with scoliosis, they all use the same working principle – to use the orthotic device in order to obtain correction by applying forces on the sides of the body. The correction forces induce a bending movement on the spine in order to correct the lateral curves. Continued wearing of the brace will facilitate prevention of further curving of the spine. A complete disappearance of the curve after wearing the brace for a significant period of time is not an end result of wearing braces. Therefore, it is important for patients and families to understand that a brace will not correct the curve but may prevent the curve from progressing. In order to achieve progression, compliance is an important factor. The patient has to follow what his or her care team instructed. The number of hours for which it is to be worn should be followed. Aside from that, another important factor in the treatment of scoliosis with the use of orthotic devices is the team that manages the patient. There should be an all-out support from the team and the patient should be guided and educated with his or her condition and also with the orthotic device that is used. After all, it is not easy to be wearing an orthotic device – physically or emotionally. Credit:ivythesis.typepad.com

Scoliosis

Introduction Hippocrates first used the term scoliosis which implies abnormal curvature of the spine. This skeletal proble...

Person In Environment

table border=”0″ cellpadding=”0″ cellspacing=”0″ style=”border-collapse: collapse” bordercolor=”#111111″ width=”100%”> The study of human systems began in the twentieth century in the introduction of General Systems Theory.  This is a cross-discipline field assuming that social science can pin down the living and non-living and treat them as systems.  A Person In Environment (regarded as PIE) yields the suggestion of existing in a system that may be organized and arranged through social means.  By system, similarities are determined with relations to patterns, unities and connecting to a whole. Systems can be a group of people, or units such as “families, organizations, communities, societies, and cultures”.  It is important to see the origin of social systems theory as beginning on Systems theory that came out influenced by various fields post-World War II.  To approach social science by systems has been a debate of scholars.  Systems itself is a vague term that may be employed and applied in several manners but what remains true is how they consistent of components or parts that function to form a whole in their own interdependent manner. Systems to put more simply and bluntly describe relationships and the workings of interactions.  The smallest unit of society is not the individual that will consist of the society as a collective but the most basic interaction or relationship the individual is able to bridge that will then form sequences, “patterns of exchange that occurs between individuals”.  According to Jacob and Tennenbaum, the smallest unit of society then is “the system of members in mutual and interdependent relationships with one another, not individual behaviour in isolation of context”.  Thus, a social system.  It then proceeds to say that society or the world’s root is not the person but the relationship and interaction this person forms with another.  The world, or society to say, cannot exist without communication.  This remains to be a general or broad take of what a system is supposed to be.  Systems may still be divided into levels or ranked to consist of suprasystems and subsystems according to Joan Jurish and Karen Myers-Bowman (1998).  Jurish and Myers-Bowman explain this configuration through the systems that consist a human body such as the “circulatory, digestive, neurological”, which may be regarded as subsystems consisting a whole suprasystem which is the human body.  Systems Theory has various assumptions:  First, it believes in holism which focuses on the sum whole than its parts (and which would be expounded further in Parsons’ section).  In holism, each interaction is an event that builds up to a pattern and forming a whole.  Secondly, it assumes that Living Systems are open in a way that it would actively initiate and bring forth exchanges and interactions rather merely taking the role of responsive individuals.  Human beings are also deemed to be intelligent enough to be reflective on what they do and know.  Reality is consequently a construct, subjective rather objective.  Systems Theory may educate how reality is perceived according to how it is organized and understood.  Above all, Society is self-sustaining on its own.       General Systems Theory may be considered as founded by Ludwig von Bertalanffy during the earlier half of the 20th century.  Bertalanffy became considered how the study of living beings can be so technical, scientific and mechanical.  This is said to limit and “neglect” as well as “deny” to how life functions.  Bertalanffy would rather for the perspective on Biology to be a living organism which cannot be pinned down by laws and concepts.  His theories were then published after the World War where systems theory began to be embraced by various cross-disciplines. Add that the second World War in itself was a “major impact on the development of systems theory” where new fields such that of Norbert Wiener’s cybernetics was invented in order to further boost the defense weaponries of an army.  Cybernetics emphasized on “feedback systems and communication technology” which allowed a further appreciation of the systems theory as an appreciation of electronics lead to a re-evaluation of how the human brain functions. This application of systems theory was further expounded by Gregory Bateson who integrated both the cybernetic processes to that of human processes which further led to the utilization and application of systems theory to the social science especially the family.     The idea of social activity as identifiable and possibly treated as a system began in the ancient times when Greeks initially perceive of systems as resembling a body, each part with its own role to contribute to this body.  Then Thomas Hobbes was said to have taken the idea of society as an organism in his book, Leviathan.  These efforts inspire the idea of society as living and working together to sustain itself. The first to apply systems theory in American society.  In the book, “The Social Systems”, he proposed the idea of organizing society in to systems as a viable and autonomous guide for research and study and not merely as limiting as “extensions of psychology or manifestations of culture”.   The actions of the individuals consisting a society is towards societal goals, “people are determined by society”.  Parsons emphasis is that people sum up to a whole and thus a system can only be understood in its whole than in dividing it into isolated parts.  What was prioritized then is the relationships between This is also called the Macro point of view.  Another proponent is Habermas who promotes the Action Theory which has to do with the necessity of communication in the existence of a society.  By this, individuals need to interaction with each other and form a culture that would stress the importance of roles and functions in order to sustain society in its ongoing processes.  This is a more interaction based point of view that emphasizes on the units that comprise society than the society that is collected and built up.  By emphasizing on parts, the point of view becomes the atomic.  In this regard, it is people who determine society than societal norms, culture and goals determining how people should function.  Society is dependent to the people that exist within it and thus, it is dependent on how the individual functions or behaves so to speak.  This behaviour may comprise of a pattern that will then comprise of a system.    Thus maintaining the system can be performed in four ways.  Firstly is to maintain the sense of pattern through stability and institutionalizing such pattern (which may be a challenge to do in curbing the individual to the patterns.  The maintenance of the system may also be expressed by goal orientation wherein society is motivated towards the attaining of goals for the sake of the system.  Thirdly there is maintenance through adaptation which is through the sacrifice or disposal of some goals in respect to a more necessary one to maintain the organization.  Then fourthly there is the integration which is supposed to be the integration of the functions of pattern and goal orientation.  By integration, adjustment also becomes essential in order to fully accept goals towards the effectiveness and stability of a pattern.  It is what eventually keeps the system intact in its whole self.    The critique with the General Social System Theory was that it idealizes society as that is quiet, peaceful and orderly.  Society also comprises of stable and rational individuals all working towards unity.  It fails to include the possibilities of chaos, inequality and instability.  Scholars dispute that Social Systems are in reality, chaotic and complex as systems are subjected to constant change.  While General Systems Theory supposes that societies will proceed to one end, the Complex theory proceeds with the notion of multiple ends.  There is no circular motion nor is there a way to go back to where society started.  “Once a system has developed along a given path it cannot simply go back again.” This is because relationships upon interrelationships would have formed to “complicated and interwoven” heights.   This theory actually disputes the existence of a systems theory as it postulates human beings as inability to be contained and covered by science and unable to supply the multiple levels and dimensions which will enrich it.  It regards social systems as too complicated an understanding that cannot be pinned down.             In the application of System approaches to School District Management, systems theory holds that schools are managed in such a way that they would resemble “organizations, where teachers are accountable for their students’ results”.  Systems Theory also promote personalized, subjective and one on one learning where the learning is performed by the student and not provided by the mentor.  The philosophy behind this is that the school is a sum of a whole, of each student working positively.  Systems theory would make effective and efficient the educational institution through its arrangement of levels supra-systems and subsystems.  Because relationships and interactions are emphasized, teachers are encouraged to build relationships with students as students are also necessary in building relationships with each other.  With systems theory, students can indeed become “active learners seeking knowledge” because of the personal attention granted to them.  This means the school needs to be self-sufficient, open and reflective.             Systems Theory calls for schools to be synchronized and united in one clearly defined purpose each subsystem with their purpose and functions to meet in order to allow the suprasystem to meet the said goal (through a feedback system).  Systems are also supposedly dynamic that will consist of “cycles and trends”.  School systems are also by assumption rational thus each child is worthy of such a treatment as rational beings.          Credit:ivythesis.typepad.com

Person In Environment

table border=”0″ cellpadding=”0″ cellspacing=”0″ style=”border-collapse: collapse” bordercolor=”#111111″ width=”100%”> The study of human...

Research Proposal Example

Alcohol Treatment in Primary Care   Abstract This is a research proposal example on the effectiveness of alcohol intervention. This particular research aims to establish the effectiveness of brief intervention in the prevention and treatment of alcohol abuse in the primary care setting. The term “brief intervention” refers to a time-limited, patient-centered counseling strategy that focuses on changing patient behavior and increasing patient compliance with therapy. The use of brief intervention for changing alcohol use patterns is not unique to the treatment of alcohol problems. In fact, physicians and other health care professionals widely employ this technique to help patients change a variety of behaviors – to modify dietary habits; stop smoking; and reduce weight, cholesterol levels, or blood pressure. The researchers would also like to know what other forms of interventions the participants find effective in the treatment and prevention of alcohol abuse. The study population will be a group of alcohol-dependent patients who are voluntarily seeking treatment at an alcohol dependence unit at a local hospital. The study will be conducted at the alcohol dependence units of five local hospitals during the span of treatment. The qualitative method of data collection will be employed, using the interview method specifically. The time frame for the collection of data is 12 months. Analysis of the data consists of grouping the data into meaning units. Research question or objective In this particular study, the researchers would like to know how effective is the use of brief intervention in prevention and treatment of alcohol abuse in primary care. Additionally, the researchers would also like to know what other interventions are used by the patient in prevention and treatment of alcohol abuse. Scientific rationale or relevant theory In this particular research, the goal of brief intervention with this study population is to reduce alcohol use to low-risk levels, in the process minimizing the drinkers’ risk of developing alcohol-related social and medical problems. The researchers would like to find out, through study participants and the qualitative method of research the effectiveness of brief intervention in the primary care setting within a one-year period. Other than establishing the effectiveness of brief intervention in the primary care setting within a one year period, the researchers would also like to know what other interventions or treatment options the participants find effective in treating alcohol abuse/dependence. This will provide further insight to the medical community on how to best treat the alcohol dependence/abuse and the various problems it brings with it. Selection of research design/methodology              Methodologies are perspectives on research; they set out a vision for what research is and how it should be conducted. Qualitative research methods are those generally subsumed under the heading ethnography. Other headings and names include case studies, field studies, grounded theory, document studies, naturalistic inquiry, observational studies, interview studies, and descriptive studies. Qualitative research designs in the social sciences stem from traditions in anthropology and sociology, where the philosophy emphasizes the phenomenological basis of a study, the elaborate description of the “meaning” of phenomena for the people or culture under examination. This is referred to as the verstehen approach. Often in a qualitative design only one subject, one case, or one unit is the focus of investigation over an extended period of time. For this research proposal, the authors will employ the qualitative method. Qualitative research is multimethod in focus, involving an interpretive, naturalistic approach to its subject matter. This means that qualitative researchers study things in their natural settings, attempting to make sense of, or interpret, phenomena in terms of the meanings people bring to them. Qualitative research involves the studied use and collection of a variety of empirical materials–case study, personal experience, introspective, life story, interview, observational, historical, interactions, and visual texts –the described routine and problematic moments and meanings in individuals’ lives. Phenomenological research is of great value to clinicians, policy makers, and ordinary persons because of its distinctive emphasis on making human behavior and experience intelligible with reference to the point of view of the actor. It is a qualitative research method founded by Edmund Husserl as a reaction against the empiricist conception of the world as an “objective universe of facts”.             Phenomenology is the belief that the object of interest be examined without any preconceived notions or a priori expectations. Researchers attempt to get inside the mind of the actor to understand what the actor sees and believes. This understanding leads the researcher to explain how the actor constructs reality and why the actor behaves as he or she does. In phenomenology, the researchers should not have preconceived notions about the phenomenon, but keep themselves open to the experience fully.             There are three ways in which phenomenological research can be useful. First, by providing a deeper understanding of what certain kinds of experiences (e.g., depression) are like, this type of research can be helpful to practitioners, be it nurses or psychologists, who work with persons having these experiences. Second, through its exploration of situated human consciousness, phenomenology can help to make sense in psychological and human terms of some of the findings of traditional research, which are typically presented in statistical language. These findings may be intriguing, but it is difficult to make sense of them. It is one thing to discern a pattern, it is quite another to grasp its meaning. Third, social action and public policy can be informed by this type of research. In fact, neither form of intervention is likely to be successful unless it is based on genuine insight into the lives of those people and groups one wants to help. The phenomenological approach will be used in this research. The study participants will be asked of their experiences and if they feel there is a significant improvement in their problem of alcohol abuse. The effectiveness of brief intervention will be gauged by how the participants experience during the treatment. The participants will also provide answers to what other treatments they are using while under brief intervention which they find effective in curing alcohol abuse. In-depth interviewing is the most commonly used data collection approach in qualitative research and this will be how data will be obtained in this study. This is hardly surprising, given the common concern of qualitative researchers to understand the meaning people make of their lives from their own perspective. The in-depth interview takes seriously the notion that people are experts on their own experience and so best able to report how they experienced a particular event or phenomenon. If we interview different people about the same event or phenomenon, we will inevitably get a range of perspectives. Where the research question requires it, the perspectives of members of a range of groups, such as clients and workers, or teachers, students and parents, should be obtained. In-depth interviews are particularly useful when the phenomena under investigation cannot be observed directly. Thus they are an excellent means of finding out how people think or feel in relation to a given topic. They also enable us to talk with people about events that happened in the past and those that are yet to happen. These retrospective and anticipatory elements open up a world of experience that is not accessible via methods such as observation. Other than through diaries or other records made at the time, interviews in the present are the only way to access a person’s perceptions of past events. Qualitative research is, however, labor intensive and time consuming, from data collection through to analysis, so there will often be practical constraints on the number of people who can be interviewed. For this reason, the study will randomly select 50 participants for this study. These 50 participants will be selected from five local hospital’s alcohol dependence unit. It is a must that these patients have to voluntarily enrolled in brief intervention programs. This means that the study participants are willing to overcome their problem of alcohol abuse. Other than that, the participants are allowed to utilize other options in the prevention and treatment of alcohol abuse, as long as it is within the primary care setting. Collection of data will take place in the hospitals. Experienced researchers will know, however, that potential research participants are not always easy to find. Participation in qualitative research requires a considerable commitment of time and energy and, often, the willingness to commit to reflection on deeply personal experiences. Researchers often have to take as many participants as they can get, within the constraints of time and other resources. It is common to have to try a number of avenues, each with its own pros and cons. Design outline             This research aims to establish the effectiveness of brief intervention in the prevention and treatment of alcohol abuse in the primary care setting. Also, this research aims to find out what other treatment options are helpful for the participants while they are undergoing brief intervention.             This particular topic is important not only for those who are patients of alcohol abuse but also for medical professionals. Understanding and knowing what the alcohol-dependent patients feel regarding the treatment they receive gives the medical community a better understanding on what treatment options are best and what kind of care is best suited for these patients. This could ultimately improve treatment options/choices of the patients.             There is a vast array of literature that covers this area of concern. Brief interventions are gaining favor as a means of addressing the problems associated with hazardous and harmful drinking. Brief interventions commonly target people whose levels or patterns of use are not diagnosable as alcohol abuse or dependence.             Brief interventions represent one of these “newer treatment modalities” and have received attention at this time because of their cost-effectiveness. Although brief interventions are intended for individuals who present with less severe drinking problems, and not for those in the late stages of alcohol dependence or abuse, accommodations are made as will be done in this study. Exceptions are justified on the basis of accessibility to treatment, cost, client preference, and the need for problem determination.             Two medications–disulfiram and naltrexone–have been approved by the FDA for the treatment of alcohol dependence in the United States. Some other medications, such as the selective serotonin reuptake inhibitors (SSRIs) and buspirone, have been used empirically studied by clinicians to treat alcohol dependence. A medication available in Europe (ie, acamprosate) is still under investigation.             Psychotherapy is also another form of treatment option for patients of alcohol abuse or dependence. Some common roles and indications for psychotherapy include: setting the resolve to stop substance abuse, teaching coping skills, changing reinforcement contingencies, fostering management of painful effects, and improving interpersonal functioning and social supports.             Pharmacologic interventions can also be used in addition to psychotherapy in prevention and treatment of alcohol abuse and dependence in the primary care setting.  This type of complementary relationship between psychotherapy and pharmacotherapy in treatment of alcohol dependence has been supported by a recent study combining naltrexone and CBT which demonstrated that motivated individuals with moderate alcohol dependence can be treated with greater effectiveness when naltrexone is used in conjunction with weekly outpatient CBT.             The research methodology that will be used in answering the research questions will involve phenomenological qualitative methods of research and data collection. In-depth interviews will be conducted to gather data. The participants of the study will be randomly selected from alcohol dependence units of five local hospitals within the local vicinity. The data collected will be analyzed into meaning units and synthesized. Approval to conduct the study will be obtained from an ethics committee and the participants of the study will be assured confidentiality and anonymity through identification coding and reports of aggregate data. The participants will also be notified of the aims, methods, expected outcome, benefits and potential hazards of the study conducted Data collection tools/technique Before the study will be conducted, an approval to perform the study will be obtained.           An informed consent will also be obtained by the researchers from all the study participants. There is a wide range of data-gathering techniques mentioned in the qualitative literature. A qualitative method of data collection will be employed in the study. Data will be collected using in-depth interviews. The participants will be interviewed alone using similar questions being posed several times in each interview. A total of 4 interviews per participant will be conducted within the period of one year. Each interview will last between 60-90 minutes. The interviews will be audio-taped and transcribed verbatim. Most researchers would agree that any audio-recorded data that are to be systematically analyzed will need to be transcribed. The rationale behind the timing of the interviews is to include periods of improvement in alcohol treatment in both the short and the long term.             The first interview will be held at the beginning of the study. This is before the patients’ start with brief intervention. The participants will be asked of their drinking habits, lifestyle and all the factors relevant to the subject. The succeeding three interviews will be held every three months. More or less, the same questions will be asked in each interview. There will be emphasis more on what the participant has experienced during the treatment. There is a need for systematic follow up because clinical impressions are often misleading.             Leading alcohol researchers have speculated that the protocols used to study various treatments affect clinical outcomes. Researchers argued that the research follow-up interview advantageously affected both attrition rates and data reliability. The research follow-up interview is an important component of treatment that increased its effectiveness. Other researchers also reported that the majority of individuals they interviewed indicated that “frequent follow-up contacts functioned as a `continuing care’ process having beneficial and desirable consequences.” These researchers hypothesized that the follow-up interview functioned as aftercare and contributed to patient improvement After the one-year study period, all the data that were obtained will be reviewed, compared and analyzed. A review of the data allows for a description of the general characteristics of the phenomena. Analysis             Qualitative analysis is generally concerned with identifying patterns in the data—different ways in which the data relate to each other. The kinds of patterns identified depend very much on the focus of the study. There are many ways to do qualitative analysis. While there are many different approaches to qualitative data analysis, in practice most approaches involve similar stages. Whatever the research purpose and question, certain analytic choices have to be made—what data to collect, from whom, how to focus the analysis and how to structure the research report. Data analysis will be carried out in a stepwise manner. Every interview that was conducted will be read in order for the researchers to get an idea of the content of the data results as a whole. The data collected will then be divided into meaning units. Each protocol will be separated into meaning units, meaning each response written by each participant was divided into a series of expressions, which, if read consecutively, match the original protocol. The next step is the condensation of each meaning unit to its central theme (e.g. what the participants experience during the treatment, or what other forms of intervention they found effective in treating alcohol abuse). The central themes will then be combined and form the final formal step in this qualitative analysis, namely, the demarcation of the typical components of “what people experience after brief intervention (either they find it effective or not)” and “what other interventions did the participants find helpful in prevention and treatment of alcohol abuse” for this sample of participants with alcohol abuse. This will then be condensed and integrated into syntheses. The syntheses will then be checked and validated by the other researchers to eliminate any discrepancies in the results. Credit:ivythesis.typepad.com

Research Proposal Example

Alcohol Treatment in Primary Care Abstract This is a research proposal example on the effectiveness of alcohol intervention. This par...

Criminal Behavior

This paper will discuss the different positions and perspective of today’s society with regards to the novel bioengineering practice of examining, modifying and using human genes to alter or to find out irregular behaviors like criminality. This paper will argue that people must have limits and boundaries in unlocking the mysteries of the human genome. It will also content that a defendant’s genes do not excuse criminal behavior.             With regards to the second argument I believe that a composition of genes of a defendant does not excuse him/her for a crime. Although various studies and researches have showed that genes and genetics have a direct relationship with criminal behavior, crimes and illegal behaviors are not only pushed by what kind of genes a person has. The composition of our genes makes up who we are. Genes govern the color of our skin, hair and other physical attributes. Genes therefore has a direct hand in our physical appearance. But this fact cannot be directly tied to criminal or illegal behaviors. Other factors must be considered when studying the behaviors of criminals. One important factor that defines and influences why an individual commit a criminal behavior is his environment. His surroundings have a big impact on issue of developing criminal traits and personality. A boy can have no “criminal genes” in his makeup but if he is brought up on a family or a society that advocates and promotes violence and lawlessness, it is possible that this boy will grow up shouldering the influences of his environment. An individual can have criminalistic tendencies if he lived in a neighborhood where violence, fear, intimidation and frequent law breaking are exhibited. Childhood experiences, past behaviors and family problems are frequent reasons why individuals commit crime. Serial killers and other famous criminals usually do not have criminal genes in them. The case of the Unabomber illustrates this point. Theodore Kaczynski was a brilliant mathematician and a university professor who in the age of 10 has an I.Q. of 170 and whose family has no serious violation of the law. Then he grew dissatisfied and disillusioned against society’s dependence to computers and started to produce bombs that were sent via mail to his victims.             If the genes of an individuals will be the standard or basis of classifying and labeling criminals from non criminals, this practice would be unfair, prejudicial and would entail massive administrational problems. It would label and brand people with “criminal genes” criminal while disregarding other factors like nature and environment as part of becoming a criminal.             On the subject of the first issue that is in this paper, I believe that there are limits and boundaries to the means on which scientist probe the intricacies and knowledge regarding human genes. First of all, studies with regards to human genes must have limitations since scientist and biotechnologist are in a thin line that separates morality from immorality, sanity from insanity and ethical from unethical. Human experiments on genes and DNAs disrupt the natural flow of life. Biotechnology that seeks to lengthen the life of an individual in the short run can in fact hurt the society and other cultures in the long run. Longer living individuals will presents problems like the growing source of food supplies, larger budget for health care and greater improvement in the health sector. This scenario will also disrupt the natural ecological balance of the world since the world cannot support the larger population due to increase of life span. Human being should abide by the laws of nature and must not create laws that will only benefit them but will inflict damage to its surroundings.             With regards to identity chips that would contain all history and DNA information about an individual, I am equally opposed to it. This practice would violate the constitutional rights of an individual since his personal information can be viewed through legitimate or illegitimate means. This concept would also violate the privacy of an individual since information and other important facts about the individual can be obtained. I am also opposed to the proposed practice of using genetics to screen future employees and applicants for insurance policies since this concept will entail massive negative labeling and prejudice to the people who were found to have genes that makes them highly susceptible to certain disease. The probability of contracting a disease based on the genes that is in the individual does not directly translate that the individual mentioned will certainly develop the disease. This practice would also be unfair since companies will be denying benefits to individuals due to their perceived vulnerability to the disease just to cut expenses and avoid paying insurance benefits. Credit:ivythesis.typepad.com

Criminal Behavior

This paper will discuss the different positions and perspective of today’s society with regards to the novel bioengineering practice o...

Diabetes Type 2 Education in Native Americans

DIABETES TYPE 2 EDUCATION IN NATIVE AMERICANS   INTRODUCTION   This study investigates the education of Native American regarding Type 2 Diabetes Mellitus. It explores how much knowledgeable Native Americans are about the disease as being such is one of the most important factors in the management of the disease. The aim of the study is to build a plan that would educate Native Americans about Diabetes Mellitus. In order to do so, the study also explores the barriers to healthcare and uncovers the best education approach to the group. The reason this topic is explored is because of the perception that minorities are uneducated and are often misinformed about the dangers of chronic diseases and how they can be managed. Furthermore, Native Americans have their own traditional practices in healthcare, which stands somewhat as a barrier for them to accept proper healthcare practices. Through this study, those issues will be explored. It will greatly help the Native Americans in understanding basic facts about diabetes and how it should be managed. The plan will be helpful in being able to penetrate deep into their culture and embed basic modern treatments and management of diabetes. BACKGROUND OF THE STUDY Diabetes is one of the most pervasive and worsening health problems facing the world today. The disease afflicts a broad swath of people, young and old. In the United States, there is at least 15.7 million people, have diabetes; of these, 5.4 million are unaware that they have the disease. Diabetes is among the leading cause of death. If inadequately treated, diabetes can cause blindness, kidney disease, nerve disease, amputations, heart disease, and stroke. Even conscientious and well-treated diabetics frequently suffer from these complications and have above-average medical costs. The United States provide basic healthcare education to its citizens about the dangers of diabetes. However, special programs are made to educate minority groups such as the Native Americans. If observed, the Native Americans have many barriers to health education, which basically involves their culture, lifestyle, accessibility and socio-economic status. For instance, Native Americans are currently experiencing a crisis of hunger and poverty. The Native Americans suffer from a much higher rate of food insecurity and poverty than the general population (Henchy et al, 2000). Furthermore, because of poverty and living in rural areas, Native Americans mostly consume less expensive and often high fat foods, and less fruits and vegetables (Henchy et al, 2000). It has been reported that 40% of Native American diets are derived from fats (Henchy et al, 2000). Because of lack of financial capabilities, Native Americans usually do not have access to a decent hospital or doctor to consult their conditions. Also, because of lack of transportation and being far away in the rural area, there is a great difficulty in visiting doctors at urban locations (Henchy et al, 2000). Approaches to Native Americans in terms of healthcare education are usually intervened by the government through the programs they develop. One example of these programs is the National Diabetes Education Program (NDEP), a program that delivers culturally and linguistically appropriate prevention and control messages through trusted and valued community-based delivery channels and intervention approaches (Vinicor, 1999). These approaches are usually common and are planned to be culturally sensitive enough to relate with the Native Americans so as they can absorb what the program tries to teach. Traditional Healthcare Practices of Native Americans Culture is an important issue in educating Native Americans about Type 2 diabetes. Native Americans have their own traditional healthcare beliefs that are deeply embedded within them. Their faith in these beliefs is one of the strongest barriers in educating them to embrace the modern methods of combating and preventing Type 2 diabetes. Native Americans beliefs are as diverse as the numbers of their tribes. However, majority of tribes have the following beliefs in common: they believe in the supreme creator; man is made up of body, mind and spirit; plants and animals are part of the spirit world; the spirit world exists side by side and intermingles with the physical world; illness affects the mind and the spirit as well as the body; wellness is harmony of body, mind and spirit; unwellness is disharmony in body, mind and spirit; natural wellness is a cause of witchcraft, and; each of us is responsible for our own wellness (Schrader and Schrader, 1997). Native Americans believe that they can acquire disease from the vengeful spirits of animals as well as disrespect towards nature. They believe they can also acquire diseases from a powerful spell casts by a witch. Diseases are not handled by modern nurses or doctors, but by traditional medicine men trained to perform ‘healing ceremonies’ (Schrader and Schrader, 1997). Ceremonies include ritual chants and some herbal remedies (Schrader and Schrader, 1997), which is overall based by faith and can be branded as ‘faith healing’. Methods to Approach the Group   According to Schrader and Schrader (1997), and based on the discussion above, the most important concept of health education to Native Americans is the overlapping of religion and medical treatment since such link is embedded within their belief system. This should be the basis in determining what type of adult learning education should be used so as to implant to them the basic ideas of diabetes implications management. In this lieu, the humanistic approach of learning should be applied to them. This may include the three basic types of learning: affective; behavioral; and cognitive learning. Affective learning is necessary to form their attitudes, feelings and preferences (Leith, 2002). Behavioral learning, on the other hand, is necessary to develop their actual performance on the methods and procedures (Leith, 2002). Finally, cognitive learning is necessary to ensure that they will remember basic knowledge and concepts (Leith, 2002).               One of the concepts of learning that should be addressed among Native Americans is the learning environment. The learning environment should be comfortable in a sense that there is mutual trust, respect, mutual helpfulness, freedom of expression, and acceptance of difference (Leith, 2002). Such learning environment approach should promote a humanistic type of learning, where Native Americans will be respected of their culture, and at the same time will accept the modern concepts that are being taught to them (Leith, 2002). Another humanistic learning concept that should work with Native Americans is the acceptance of shared responsibility (Schrader and Schrader, 1997). The learner should develop a strong sense of responsibility to self and to others with the ability to develop towards one’s fullest potential (Schrader and Schrader, 1997). In other words, the Native Americans to be educated about diabetes should have responsibility for planning and operating the learning experience (Leith, 2002). PLAN FOR IMPLEMENTATION OF HEALTH PROGRAMS One focus that will be emphasized in the plan is that management of nutrients in the body is important for a person with Type 2 Diabetes. In his journal article, Decoster (20002) presents challenges to diabetic patients posed by type 2 diabetes. A section reviewing literature on diet and exercise states that medical nutritional therapy (MNT) is often the first-line therapy of choice, and that its goal is to maintain near-normal glucose levels by matching dietary consumption with actual caloric needs, necessitating that the right foods in correct proportions be eaten at prescribed times. Another goal is weight loss. In meeting either goal, the person must become aware of his or her individual food consumption patterns and basic caloric needs for height, weight, age, and level of activity; be able to prepare and plan well-balanced meals using fresh foods as often as possible; be able to read and interpret nutritional information on food labels; and be able to incorporate regular meal times into work and home schedules. The problem however is that these management techniques may contradict with the basic beliefs of Native Americans. Thus, the following objectives below will be implemented. The aims of the study are: to know if Native Americans are well-educated about the basic facts of Type 2 Diabetes; how it can be managed to avoid and prevent the different complications associated with it; and to present a plan on how to educate them effectively despite of the barriers to learning that were identified earlier.  The plan is to divide the learning experience into three sections: 1.      Development of attitude of Native Americans about the modern management of diabetes. This will be done by doing a simple analogy of the modern management process effects using basic Native American beliefs. Since there are many beliefs among different tribes, the main task then is to retrieve the basic beliefs of each tribe that will be addressed. Afterwards, analogies will be developed so as to relate situations with their culture. 2.      Applying a humanistic approach on teaching. This means ensuring that the teacher will reach out to the students individually. It will be ensured that a comfortable physical environment will be provided. Teachers should act as resource and co-learners. Mutual trust should be gained by respecting the basic beliefs of the Native Americans and commenting anything negative about them. Furthermore, responsibilities should also be developed. The students must be able to share their options in design and experience and selection of methods and procedures. 3.      Finally, the development of cognitive knowledge. After attuning to their behavior and attitude, the cognitive side of learning will be targeted. This will be done by conducting daily tests that will monitor the progress of the students on learning. Tests will be graded typically through percentage analysis. Overall, the following is the list of important points in the plan: 1.      The program should last a month and should address families with or without diabetes. It should focus on one tribal group at a time (other groups that will be addressed will also be for a month). 2.      The approach should be humanistic, but also incorporates cognitive development. 3.      The focus of the education is on how Type 2 diabetes can be prevented and personally managed. 4.      The Native American culture should be respected. 5.      Growth and progress should be monitored. FOLLOW-UP             To monitor the progress and effectiveness of the program, a simple quantitative research will be conducted a few months after it.      For this task, a structured questionnaire will be constructed. The questionnaires will be sent to those who attended the programs.             A 5-point Likert Scale will be used to measure the degree of agreement on each question or statements on the questionnaires.             Data will be analyzed with the use of the latest SPSS. The percentage and weighted mean of each response on statements will be presented on tables. Conclusions will be given to confirm the change in attitudes among them and how they embraced the new knowledge that was taught to them.   Credit:ivythesis.typepad.com

Diabetes Type 2 Education in Native Americans

DIABETES TYPE 2 EDUCATION IN NATIVE AMERICANS INTRODUCTION This study investigates the education of Native American regarding Ty...