Nursing

Assigned Patient: Adolescent Hispanic/Latino boy living in a middle-class suburb
Effective communication is vital to constructing an accurate and detailed patient history. A patient’s health or illness is influenced by many factors, including age, gender, ethnicity, and environmental setting. As an advanced practice nurse, you must be aware of these factors and tailor your communication techniques accordingly. Doing so will not only help you establish rapport with your patients, but it will also enable you to more effectively gather the information needed to assess your patients’ health risks.
For this Discussion, you will take on the role of a clinician who is building a health history for a particular new patient assigned by your Instructor.
To prepare:
With the information presented in Chapter 1 of Ball et al. in mind, consider the following:
By Day 1 of this week, you will be assigned a new patient profile by your Instructor for this Discussion. Note: Please see the “Course Announcements” section of the classroom for your new patient profile assignment.
How would your communication and interview techniques for building a health history differ with each patient?
How might you target your questions for building a health history based on the patient’s social determinants of health?
What risk assessment instruments would be appropriate to use with each patient, or what questions would you ask each patient to assess his or her health risks?
Identify any potential health-related risks based upon the patient’s age, gender, ethnicity, or environmental setting that should be taken into consideration.
Select one of the risk assessment instruments presented in Chapter 1 or Chapter 5 of the Seidel’s Guide to Physical Examination text, or another tool with which you are familiar, related to your selected patient.
Develop at least five targeted questions you would ask your selected patient to assess his or her health risks and begin building a health history.
By Day 3 of Week 1
Post a summary of the interview and a description of the communication techniques you would use with your assigned patient. Explain why you would use these techniques. Identify the risk assessment instrument you selected, and justify why it would be applicable to the selected patient. Provide at least five targeted questions you would ask the patient.
Please use a Heading for each major part of the assignment!
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Solution
Building A Health History: Adolescent Hispanic/Latino Boy Living in A Middle-Class Suburb
Building a Health History
Building a comprehensive and reliable patient health history is the foundation for developing a successful plan of treatment for each patient and is a skill expected of the APRN (Ewulonu, 2021). In this way, we gain a better understanding of our patients, their previous concerns and problems, and how those issues impact their current functioning. Considering that the patient is an adolescent Hispanic male, I begin by inquiring whether he is well acquainted with English, and in case he doesn’t, I will consider hiring an interpreter. I have to be culturally proficient to avoid unnecessary misunderstandings. I may be able to achieve this through sympathizing with his ancestry, sexuality, social status, race, and ethnic background.
Communication Techniques
Adolescence is a period of growth and development that occurs between childhood and adulthood. It is the most vulnerable stage in life for young adults as most of them are often unwilling to participate in any kind of communication. Therefore, obtaining information from them can be challenging. If the patient’s parents are present, I will inquire about the patient’s chief complaints thereafter request their permission to examine the patient their absence (Khullar, 2019). I will initiate the conversation by asking the patient about his day-to-day activities. I have to respect his opinions to acquire his trust. If I am confronted with quietness, I must appreciate it while also discerning whether the quietness is the result of anger, remorse, or simply an unwillingness to converse. My primary aim will be to learn more about his concerns and to show genuine interest and inquiry. I will use comprehensible language. I shall strive to preserve the peace. I will listen carefully to what the patient would have to say. After discovering the major concern, I would go on to more sensitive areas such as sex, drug, or alcohol use.
Risk Assessment Tool
Since adolescents are prone to risky behavior, it is critical to screen him for it. For his case, I would utilize the HEEADSSS screening tool for adolescence. This will help me to understand more about his upbringing, education, employment, eating habits, hobbies, and aspirations (Smith & McGuinness, 2017). I may also discover about his drug use, sexuality, and suicidal thoughts, as well as if he is safe from danger and aggression.
Some of the questions I would ask the patient are as follows:
How is life at home?
How are things going at school?
Tell me about your acquaintances.
What kind of computer and electronic games do you enjoy playing?
What are your key skills?
These open-ended questions will allow my patient to express concerns that are bothering him (Harrison & Handley, 2017).
References
Ewulonu, U. C. (2021). Utility of a psychosocial assessment during an acute care hospitalization. Current Problems in Pediatric and Adolescent Health Care, 100998.
Harrison, D. S., & Handley, M. (2017). Evaluation of a new genetic family history screening questionnaire for identifying Lynch syndrome. The Nurse Practitioner, 42(8), 48-51.
Jamalimoghadam, N., Yektatalab, S., Momennasab, M., Ebadi, A., & Zare, N. (2019). Hospitalized adolescents’ perception of dignity: a qualitative study. Nursing Ethics, 26(3), 728-737. https://journals.sagepub.com/doi/abs/10.1177/0969733017720828
Khullar, D. (2019). Building trust in health care—why, where, and how. JAMA, 322(6), 507-509. https://jamanetwork.com/journals/jama/article-abstract/2738392
Smith, G. L., & McGuinness, T. M. (2017). Adolescent psychosocial assessment: the HEEADSSS. Journal of psychosocial nursing and mental health services, 55(5), 24-27. https://onlinelibrary.wiley.com/doi/full/10.1111/jpc.14675

Select an adult or older adult client with an obsessive-compulsive disorder you have seen in
your practicum.
In 3 pages, write a treatment plan for your client in which you do the following:
Describe the HPI and clinical impression for the client.
Recommend psychopharmacologic treatments and describe specific and therapeutic
endpoints for your psychopharmacologic agent. (This should relate to HPI and clinical
impression.)
Recommend psychotherapy choices (individual, family, and group) and specific therapeutic
endpoints for your choices.
Identify medical management needs, including primary care needs, specific to this client.
Identify community support resources (housing, socioeconomic needs, etc.) and community
agencies that are available to assist the client.
Recommend a plan for follow-up intensity and frequency and collaboration with other
providers.

Application and interpretation of Public Data-TOPIC 5 DQ 1-
QUESTION-TOPIC 5 DQ 1
Compare the various types of ANOVA by discussing when each is most appropriate for use. Include specific examples to illustrate the appropriate use of each test and how interaction is assessed using ANOVA.
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Solution
Analysis of Variances-ANOVA Testing
Analysis of Variance tool entails statistical data analysis techniques used in studying and comparing experimental and observational outcomes in research (Nowakowski, 2019). Thus, it qualifies as an effective approach for examining several groups of people by studying the effect of multiple factors on them: independent variables over multiple dependent variables. Analysis of Variances focuses on establishing any existing relationship among data sets. Therefore, the test method determines if there is any relation in the grouped data set in one way or another and the effects of variables on each other (Nowakowski, 2019).
Types of Analysis of Variances
Analysis of Variances uses a set of statistical techniques to examine the average value in population groups. For this tool to be effective in a study, two types can be used: the one-way and two-way analysis of variances. In one-way, the variance comparison is done within three or more categories in consideration of only one independent variable (Mackenzie, 2018). The analysis of variance is a hypothesis-based test. Generating of hypothesis entails developing data questions (Mackenzie, 2018). For example, a group of researchers studying the prevalence rate of babies having flu, the hypothesis question would be; “does the number of babies having flu increase in winter or summer seasons, “both winter and summer mean the same thing. Thus categorically grouped into three or more months to represent both summer and winter seasons (Mackenzie, 2018).
Two-way analysis of variances is more likely the same as one-way. The test is hypothesis-based, but the variance comparison is done in two ways, considering two independent variables (Mackenzie, 2018). For instance, in the case of babies having flu, it will be; “does the number of babies having flu increase in winter or summer seasons and which gender in particular tends to be high.” In this situation, there are two independent variables. That is, ‘the seasons and the gender’; thus, two independent variables in testing over the dependent variable are the number of babies (Mackenzie, 2018).
Application of Analysis of Variance Test
In the one-way analysis of variances, the comparison occurs categorically among three or more groups. For instance, the analysis is categorically done in February, March, September and October to show any differences among the observations, who are the babies. On the other hand, the two-way analysis of variances analyzes the effect of the two variables on another, that is, seasons and gender, and if they have a different effect on the number of babies. Thus, both types of analysis of variances tend to examine the dependent and independent variables to determine an outcome of a study in different groups of populations.
References
Mackenzie, R. J. (2018). One-way vs two-way ANOVA: Differences, assumptions and hypotheses. Technology Networks. https://www.technologynetworks.com/informatics/articles/one-way-vs-two-way-anova-definition-differences-assumptions-and-hypotheses-306553
Nowakowski, M. (2019). The ANOVA method as a popular research tool. Studia i Prace WNEiZ US, (55), 67-77. https://wnus.edu.pl/sip/file/article/view/16104.pdf

Basic Concepts in Public Health Statistics topic DQ 2
Basic Concepts in Public Health Statistics
QUESTION- TOPIC 1 DQ 2
Describe the difference between quantitative and qualitative methods. Explain how each are used in public health.
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Solution
Qualitative and Quantitative Method
Qualitative and quantitative research methods both produce factual, reliable information, which is useful when collecting data in large populations. Commonly, research is naturally categorized as qualitative or quantitative (Rutberg & Bouikidis, 2018). However, these two methods contrast in different ways. They bring different assumptions about research (Hammersley, 2017).
The quantitative method applies the use of numbers and accuracy, while the qualitative method mainly deals with the experience and perception of humans. The main word used in quantitative is “measure,” while the primary term used in the qualitative method is “perception” (Rutberg & Bouikidis, 2018).
A Qualitative Method in Public Health
This method of research has affected public health just as it has in various professions. It has also become increasingly visible and valuable in this field as it has become central to research (Tolley & Mark, 2016). The qualitative method enables various researchers to investigate or traverse issues and behaviors related to public health that cannot be achieved through quantitative method (Armstrong-Moore & Burgoine, 2021). Understanding multiplex issues through this method is easy.
It is usually used in different circumstances; to study cultural and socio-economic issues that affect health and diseases, scrutinize relations between partners in matters involving public health, and traverse how different people and communities understand various health and diseases (Armstrong-Moore & Burgoine, 2021). Therefore, this method helps interpret socio-economic and cultural factors of health and diseases (Armstrong-Moore & Burgoine, 2021).
A Quantitative Method in Public Health
Most public health researchers frequently use the quantitative method to assess variables and analyze their investigations and findings (McLaren, 2017). Quantitative is used to get statistics of people infected by various diseases in public health (Peters & Chernak, 2019). The quantitative method is also used in quantifying public health risks on multiple illnesses (Peters & Chernak, 2019).
References
Armstrong-Moore, R., White, M., & Burgoine, T. (2021). Stakeholder experiences of using online spatial data visualization tools for local public health decision support: A qualitative study. Health & Place, 71, 102648. https://www.sciencedirect.com/science/article/pii/S1353829221001441
Hammersley, M. (2017). Deconstructing the qualitative-quantitative divide 1. In Mixing methods: Qualitative and quantitative research (pp. 39-55). Routledge.
https://www.taylorfrancis.com/chapters/edit/10.4324/9781315248813-2/deconstructing-qualitative-quantitative-divide-1-martyn-hammersley
McLaren, L. (2017). A space for critical quantitative public health research?.
https://www.tandfonline.com/doi/full/10.1080/09581596.2017.1326214
Peters, R., Hipper, T. J., Kricun, H., & Chernak, E. (2019). A quantitative public health risk assessment tool for planning for at-risk populations. American journal of public health, 109(S4), S286-S289 https://ajph.aphapublications.org/doi/full/10.2105/AJPH.2019.305181
Rutberg, S. & Bouikidis, C. D. (2018). Focusing on the fundamentals: A simplistic differentiation between qualitative and quantitative research. Nephrology Nursing Journal, 45(2), 209-213.http://www.homeworkgain.com/wpcontent/uploads/edd/2019/09/20181009143525articl2.pdf
Tolley, E. E., Ulin, P. R., Mack, N., Robinson, E. T., & Succop, S. M. (2016). Qualitative methods in public health: a field guide for applied research. John Wiley & Sons.
https://books.google.co.ke/books?hl=en&lr=&id=L0NICgAAQBAJ&oi=fnd&pg=PR13&dq=how+qualitative+is+used+in+public+health&ots=j6BuqVyvEJ&sig=_DCstWIOH1cn3gWZON2QzhYu5N4&redir_esc=y#v=onepage&q=how%20qualitative%20is%20used%20in%20public%20health&f=false

What can the bedside nurse or the nurse, at the point of service, do to facilitate change in effort to prevent negative occurrences and promote patient safety?
What can the bedside nurse or the nurse, at the point of service, do to facilitate change in effort to prevent negative occurrences and promote patient safety? I will upload the rubric as a document. One of the reference is textbook. I will give the writer my vital source information to locate the textbook
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Solution
Bedside nurses’ roles in facilitating change
Bedside nurses have proven to be more effective in ensuring the patients’ nursing care is adhered to and assigned as per the requirements of the diagnosis. Thus, bedside nurses hold a magnitude role in the healthcare sector in ensuring quality healthcare and patient outcome and their safety. Most of the time, these nurses act as a strategy 9in apprehending the main fundamentals of healthcare facilities; for instance, providing effective medication and counseling to their families to understand their conditions and know how to care for their sick family members, especially those in critical conditions. Therefore, bedside nurses provide all-around care to the patients.
Bedside nurses need to have an adequate scope of knowledge and skills in their career, especially on the caring concept, to deal with their patients and their families. Most times, the victims of such patients are their family members that need to be guided by the nurses on how to take care of their critically ill family members without giving up. Therefore, the focus is to ensure that bedside nurses understand the importance of caring for patients and improving the patient’s well-being (Kennedy,2020).
The number of bedside nurses needs to be increased to help manage the safety of the patients. Staffing and scheduling have to be critically enhanced to enable the nurses to manage the number of patients and appropriately provide their nursing care needs (Yoder-Wise et al.,2019). For instance, the nursing ratio to patient care should be observed, and more bedside nurses are scheduled for different shifts. In addition, health organizations should address bedside nursing roles as important in patient safety as this can be an effective strategy in improving the health organizations (Farokhzadian et al., 2018).
References
Farokhzadian, J., Nayeri, N. D., & Borhani, F. (2018). The long way ahead to achieve an effective patient safety culture: challenges perceived by nurses. BMC health services research, 18(1), 1-13. https://bmchealthservres.biomedcentral.com/articles/10.1186/s12913-018-3467-1
Kennedy, M. S. (2020). Who Will Be Left to Care?.https://journals.lww.com/ajnonline/Fulltext/2020/02000/Who_Will_Be_Left_to_Care_.1.aspx
Yoder-Wise, P. S., Waddell, J., & Walton, N. (2019). Leading and Managing in Canadian Nursing E-Book. Elsevier Health Sciences. Yoder-Wise, P. S. (2014). Leading and managing in nursing-E-Book. Elsevier Health Sciences. https://bookshelf.vitalsource.com/reader/books/9780323449137/epubcfi/6/4[%3Bvnd.vst.idref%3Db978032344913709982]!/4

Orem’s Self Care Deficit Theory and Theory of Comfort- Katherine Kolcaba PO
Based on the reading assignment (McEwen & Wills, Theoretical Basis for Nursing, Unit II: Nursing Theories, chapters 6–9), select a grand nursing theory. CITE THIS SOURCE AS WELL PLUS 3 MORE SOURCES
After studying and analyzing the approved theory, write about this theory, including an overview of the theory and specific examples of how it could be applied in your own clinical setting.
Based on the reading assignment (McEwen & Wills, Theoretical Basis for Nursing, Unit II: Nursing Theories, chapters 10 and 11), select 2 middle-range theories- OREM’S SELF CARE DEFICIT THEORY AND THEORY OF CONFORT-KATHERINE COLCABA
After studying and analyzing the approved theories write about this theory, including an overview of the theories and specific examples of how it could be applied in your own clinical setting.
The following should be included:
An introduction, including an overview of both selected nursing theories
Background of the theories
Philosophical underpinnings of the theories
Major assumptions, concepts, and relationships
Clinical applications/usefulness/value to extending nursing science testability
Comparison of the use of both theories in nursing practice
Specific examples of how both theories could be applied in your specific clinical setting
Parsimony
Conclusion/summary
References: Use the course text and a minimum of three additional sources, listed in APA style
The paper should be 8–10 pages long and based on instructor-approved theories. It should be typed in Times New Roman with 12-point font, and double-spaced with 1? margins. APA style must be used, including a properly formatted cover page, in-text citations, and a reference list. The proper use of headings in APA style is also required.
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Solution
Introduction
There are several mid-range nursing theories in nursing. Mid-range theories possess a specific focus while offering strong connections between grand nursing theories and nursing. The various concepts in mid-range nursing theories are more verifiable through testing and are less abstract. Middle-range theories provide an easy way of describing, explaining, and predicting various phenomena in clinical practice settings (McEwen & Wills, 2018).
Orem’s self-care deficit theory is an example of a grand nursing theory. Orem’s theory covers a wide scope and provides a general concept applicable to various instances of nursing practice. Orem’s theory highlights different incidences where patients need to bring out the best of themselves despite being ill. This is normally the case in various healthcare settings where patients will be entitled to remaining more independent after receiving adequate care from nurses and physicians (Borji et al., 2017).
On the other hand, Kolcaba’s Theory of Comfort is considered a middle-aged theory. This theory can therefore be applied in specific situations in Healthcare practice research and education. Kolcaba’s Theory of Comfort places comforts at the center of health care practices. According to Kolcaba, comfort will be the immediate desirable outcome of all nursing interventions (Pinto et al., 2017).
Background of the Theories
Orem’s Self Care Deficit Theory
Orem’s theory was developed by Dorothea Elizabeth Orem, who had a distinguished career in nursing. Orem nursing theory views nursing as a discipline entails helping others in the providing and managing of self-care and in improving and maintaining of human functioning at effectiveness of home level. Orem’s theory evaluates the ability of an individual to perform different self-care activities which are described as activities individuals may begin and perform effectively to contribute to personal life, health, and well-being (Younas, 2017). Dorothea Orem published her work titled ‘Nursing: Concepts of Practice’ in 1971, where she outlined her nursing theory. The success of the self-care deficit theory highlighted by Orem in her 1971 work established her as the leading theorist in nursing education and practice (Younas, 2017).
Kolcaba’s Theory of Comfort
Kolcaba drew up the theory of comfort in the 1990s through concept analysis of comfort and examination of literature from different disciplines such as nursing, medicine, psychiatry, ergonomics, psychology, and English. Eventually, Kolcaba developed three forms of comfort, and four contexts of holistic human experience and a taxonomic structure to guide in the measuring, assessing and evaluating the comfort of patients. According to Kolcaba, comfort will therefore be a product of the holistic art of nursing (Pinto et al., 2017).
Philosophical Underpinnings of the Theories
Orem’s Theory
When evaluating Orem’s theory, it is important to consider the philosophical framework on which the theory was built and the pre-existing theoretical foundations. Orem’s theory was established in various stages, with each stage involving creating new sets of tenets through which various theoretical principles would be applied. In this regard, Orem’s theory included three more theories that consider the application of the framework to the various unique needs of patients and making the theory extremely applicable to increasing efficiency (Didisen et al., 2017). Orem’s theory can therefore be viewed as the original theory that led to an increased interest in the establishment of a comprehensive framework related to individual caring of one’s health. The concept of self-care is therefore central to Orem’s theory and includes the behaviors and activities that various patients have to initiate in order to maintain their health at required levels. Although the general assumption is that the need for healthcare will be inherent among everyone, individuals will need directions from various Healthcare providers So that the efforts to maintain proper health levels will have a tangible effect. In Orem’s theoretical framework, the ability of a patient to recognize their own health care needs and cater for them is defined as a health care agency. According to Orem, therapeutic self-care demand will be the different actions that need to be taken so as to meet certain health standards. Self-care requisites is, therefore, the process that is needed to perform various actions related to healthcare (Didisen et al., 2017).
Kolcaba’s Theory
Kolcaba utilized logical reasoning to draw up the theory of comfort. Kolcaba argued that we live on deduction induction and reduction in her theory. Kolcaba also relied on a pre-existing framework from the exploration in a personality book written by Henry Murray as her antecedent. In his book, Murray highlighted that psychologists should take time to study the personality of individuals holistically (Pinto et al., 2017). Murray’s observations laid a foundation for the theory of comfort, as comfort is mostly achieved from holistic treatment of the individual. In the formulation of her theory, Kolcaba conducted the concept of analysis of the term comfort. The comfort theory also relies on the metaparadigm propositions of various nursing actions (Oliveira et al., 2020). This is because the theory of comfort tries to evaluate the lack of comfort among an individual and also monitors patients to evaluate actions or implementations that are made. A philosophical claim can therefore be made that the comfort theory is based on human needs. The core components can therefore be explored in the philosophical underpinnings of the theory of comfort. The first component is that cultural and social politics will go a long way in influencing patient expectations. The second is that there will be a significant motivation in human behavior. The comfort needs of various patients will therefore be determined by specific expectations of holistic nursing care is and the competence of such nursing care (Oliveira et al., 2020).
Major assumptions, concepts, and relationships
Orem’s Theory
Orem’s self-care deficit theory makes several assumptions which include that humans need to connect constantly and communicate among themselves and their environment to remain functional and stay alive (Younas, 2017). Orem also makes an assumption that human beings have power to act intentionally in the making of needed judgments and identifying needs. Orem’s theory assumes that adult human beings will experience different actions that involve making function regulating actions and life-sustaining actions for themselves and for others. Orem also provides an assumption that in a group with structured relationships, human beings will allocate responsibilities and tasks of providing care to various group members. Finally, human agency will be exercised in the transmission, discovery, and development and other ways involved in the identification and making input to others and self (Didisen et al., 2017).
Relating to the major concepts of the self-care deficit theory Orem defines nursing as an art that involves a healthcare practitioner giving professional assistance to patients to enable them to meet their self-care needs. On the other hand, Orem defines humans as recipients of care either individually or in social units and will be the material objects for those who provide direct care and nurses. On the other hand, Orem defines the environment as having various features, including the culture, family, and the community (Borji et al., 2017). Orem also views health as being structurally or functionally sound. Health is also a state that will include both the health of groups and individuals and the ability of human beings to symbolize experiences that reflect on oneself and effectively communicate with others according to Orem. Self-care is the performance of activities that individuals initiate or perform in the maintenance of health, life, and well-being (Borji et al., 2017).
According to Orem, all human beings will have self-care agency which is the ability to engage in various self-care activities. The self-care agency of every individual will therefore be affected by the basic conditioning factors. The basic conditioning factors of an individual include gender, health state, developmental state, health care system factors, sociocultural orientation, patterns of living, family system factors, resource adequacy, resource availability, and environmental factors (Didisen et al., 2017). On the other hand, therapeutic self-care demand will be the total Self-care actions that can be performed at a given time to meet the self-care requisites by utilizing different sets of actions, methods, and operations. Self-care deficit will therefore cause the need for nursing. Nothing will therefore be required when an adult or individual is incapable or limited to provide effective and continuous self-care.
Kolcaba’s Theory
The central assumption of Kolcaba’s theory of comfort are that human beings possess a holistic response to complex stimuli. In this regard, comfort will be the desirable holistic outcome to the discipline of nursing. Comfort is also an essential human need that every human being will struggle to meet or have met. By possessing enhanced comfort, patients will be able to engage more in health-seeking behavior of their choice (Sharma & Kalia, 2021).
On the other hand, the major concepts in Kolcaba’s theory of comfort.
Include healthcare needs intervening variables, comfort interventions, comfort, and health-seeking behaviors. Kolcaba defines healthcare needs as the needs of comfort that might not be met by the traditional support system of a given patient. This includes sociocultural needs, psycho-spiritual needs, physical and environmental needs. On the other hand, comfort interventions are the various actions that are designed to address the specific comfort needs of a patient. Intervening variables will be the various forces that will interact to influence the perception of recipients of what is referred to as total comfort (Sharma & Kalia, 2021). These include past experiences, attitudes, support system, emotional state, education, and finances. On the other hand, comfort is the immediate and holistic experience that is normally strengthened when the needs related to ease, relief, and transcendence are addressed. Finally, health-seeking behavior other behaviors that individuals perform to pursue health (Oliveira et al., 2020).
Clinical applications
Orem’s Theory
The clinical applicability of Orem’s self-care deficit theory is in outpatient settings. Healthcare practitioners can therefore evaluate the effectiveness of the theory by comparing the post-discharge outcomes of patients which occur as a result of self-care and the outcomes of patients in healthcare settings that are as a result of patients receiving care from nurses. Such an evaluation can therefore help healthcare practitioners to understand whether patients are able to effectively meet the health care needs of patients (Borji et al., 2017).
Kolcaba’s Theory
The theory of comfort does not highlight a specific evaluation process that can be used in nursing processes. However, following processes, a nurse will know if they have achieved adequate comfort with various nursing assessments. The best way to measure comfort in patients, therefore, is to use the various assessments to evaluate various interventions. However, as a high middle-range theory, the theory of comfort is quite abstract and is difficult to evaluate definitively (Oliveira et al., 2020).
Parsimony
Orem’s Theory
Orem’s theory does not have numerous assumptions and explains its concept clearly, with the main points that are highlighted being self-care needs. All the concepts of Orem’s self-care deficit theory seek to explain how individuals satisfy their self-care needs and causes of self-care deficit.
Kolcaba’s Theory
Kolcaba’s Theory of Comfort possesses the meaning of clarity. However, the conceptual diagram and the propositions in theory are the clearest components. I believe that the theory would have been more understandable if it had been explained in more clear terms.
Comparison of the use of both theories in nursing practice
In nursing practice settings, Orem’s theory can be used by healthcare practitioners to understand the healthcare needs of patients by determining their self-care deficit. Utilizing Orem’s theory, healthcare practitioners can therefore focus on addressing the specific self-care deficit of patients while giving such patients the autonomy to address the health care needs that they possess the ability to address (Didisen et al., 2017). On the other hand, Kolcaba’s Theory of Comfort can be used in nursing practice settings by healthcare practitioners to understand the various interventions that they can adopt to improve the comfort of their patients utilizing Kolcaba’s theory nurses and therefore to understand the main goal of nursing practice is to provide comfort to patients (Oliveira et al., 2020).
Application of theories in my clinical setting
In my clinical setting of an acute care facility, Orem’s self-care deficit theory can be used by healthcare providers to understand the specific needs of various patients and the self-care deficits that make them visit the health care facility. Healthcare practitioners can then focus on the specific Healthcare deficits of the patients in the acute care facility.
On the other hand, Kolcaba’s theory of comfort can be applied in an acute care facility to promote comfort among patients, such as establishing a conducive Healthcare environment that promotes active recovery in patients.
Conclusion
In summary, there are several middle-range nursing theories in nursing. Middle-range nursing theories tend to have a more specific focus and also offer more concrete connections between grand nursing theories and nursing practice. The various concepts of middle-range nursing theories are more verifiable through testing and less abstract. Middle-range theories provide an easy way of describing, explaining, and predicting various phenomena in clinical practice settings. Orem’s self-care deficit theory is an example of a grand nursing theory. Orem’s theory covers a wide scope and provides a general concept that can be applied to all instances of nursing practice. On the other hand, Kolcaba’s theory of comfort is considered a middle-aged theory. This theory can therefore be applied in specific situations in healthcare practice, research, and education. Kolcaba’s theory of comfort, therefore, places comfort at the center of health care practices.
References
Borji, M., Sharifi, A., Otaghi, M., & Kazembeigi, S. (2017). The Impact of Orem’s Self-Care Model on the Quality of Life in Patients with Type II Diabetes in Ilam. Biomedical and Pharmacology Journal, 10(1), 213–220. https://doi.org/10.13005/bpj/1100
Didisen, N. A., Binay, S., & Yardimci, F. (2017). Orem’s Self-care Deficit Theory and Nursing Care in Relation to Pneumonia: A Case Report. Studies on Ethno-Medicine, 11(4), 311–317. https://doi.org/10.1080/09735070.2017.1357223
McEwen, M., & Wills, E. M. (2018). Theoretical Basis for Nursing (5th ed.). LWW.
Pinto, S., Fumincelli, L., Mazzo, A., Caldeira, S., & Martins, J. C. (2017). Comfort, well-being and quality of life: Discussion of the differences and similarities among the concepts. Porto Biomedical Journal, 2(1), 6–12. https://doi.org/10.1016/j.pbj.2016.11.003
Sharma, M. C., & Kalia, R. (2021). Testing Katharine Kolcaba Theory of Comfort. Journal of Pediatric Surgical Nursing, Publish Ahead of Print. https://doi.org/10.1097/jps.0000000000000320
Younas, A. (2017). A Foundational Analysis of Dorothea Orem’s Self-Care Theory and Evaluation of Its Significance for Nursing Practice and Research. Creative Nursing, Oliveira, S. M. D., Costa, K. N. D. F. M., Santos, K. F. O. D., Oliveira, J. D. S., Pereira, M. A., & Fernandes, M. D. G. M. (2020). Comfort needs as perceived by hospitalized elders: an analysis under the light of Kolcaba’s theory. Revista Brasileira de Enfermagem, 73(suppl 3). https://doi.org/10.1590/0034-7167-2019-0501

NUR 674 Week 3
Journaling provides a valuable tool for recording, reflecting on, and reviewing your learning. This approach provides an opportunity for you to “connect the dots” and observe the relationships between and among activities, interactions, and outcomes.
Unlike a personal journal of thoughts and feelings, this leadership journal is a record of your activities, assessments, and learning related to this academic experience.
Journal entries should include a record of the number of hours spent with your nurse leader each week.
Write a journal entry of 750-1,500 words on the subject of power, including the following:
Practicum Activities Reflection: Provide observations and thoughts on the activities in your practicum setting during Topics 1 and 2.
Application of Leadership: Professional responsibility and power, authenticity, integrity, and emotional intelligence are key factors of multiple leadership styles. Discuss how you have observed your preceptor or your nurse leader in your professional setting integrate these elements into leadership styles.
Practicum Project Preparation: What are your ideas for your practicum project? How does this project refine and build skills related to your career goals?
Leadership Video Reflection: Reflect on at least two things you learned from the “Servant Leadership – Issue of Power” video.
Use the “Leadership Journal Template” to complete this assignment.
APA style is not required, but solid academic writing is expected.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Leadership Journal Template
Name:
Weeks Covering:
Preceptor/Mentor:
Clinical/Practicum Site:
Hours Worked (past 2 weeks):___
Total Hours: ____/150 total of all hours worked up to this point
Practicum Activities Reflection:
Discuss some of your activities with your preceptor/mentor, what projects you are working on, and what observations about leadership you have made during the past two weeks. This does not need to be a step-by-step diary. Instead, this is a place to reflect on how your observations and activities have compared to what you have learned in your courses thus far.
Application of Leadership:
Each Leadership Journal assignment will include specific questions for you to answer.
Practicum Project Preparation:
Each Leadership Journal assignment will include specific questions for you to answer.
Leadership Video Reflection:
Each Leadership Journal assignment will include specific questions for you to answer.
References
(Please make sure all references are in APA format.)

Case management: nursing
440 Week 7 question 1 due Dec 23rd
Read Ferrier, G. D., & Trivitt, J. S. (2013). Incorporating quality into the measurement of hospital efficiency: A double DEA approach. Journal of Productivity Analysis, 40(3), 337-355. https://search.proquest.com/docview/1448800469?accountid=169658
Search the site for US Department of Health and Human Services “Hospital Compare” and use the interactive database to compare and contrast health plans, hospitals, etc. How might you use this site with patients as a case manager?
What is demand management and how does it increase consumer involvement in healthcare? What is disease management? How can disease management be used to further increase consumer involvement in their healthcare?
Discussion Question #2 Due Dec 27th
Read: Bressi Nath, S., Alexander, L. B., & Solomon, P. L. (2012). Case manager’s perspectives on the therapeutic alliance: A qualitative study; Social Psychiatry and Psychiatric Epidemiology, 47(11), 1815-1926.
Have you or have you known a close friend or relative who has used case management services in the acute, primary, or home care settings? Briefly describe the process. Reflect on the learning in this course. Would you change any of the process based on your learning in this course? Why or why not?
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Solution
Question 1
In healthcare, demand management can be described as a process in which patients are empowered to effectively make wiser health care decisions. Demand management includes engaging patients in the quest for appropriate care as opposed to reducing the demand for health care services or trying to keep patients out of healthcare facilities (Giesen et al., 2017). Demand management works to empower patients to effectively make wiser health care decisions. Demand management helps to improve patients’ health by reducing the need for health care services with different strategies such as health promotion wellness, prevention, risk reduction, and early detection. Secondly, demand management works by attempting to improve patients’ decisions. Demand management can therefore Involve educating patients in a way that they understand when they require self-care and when they require to see a health caregiver. Demand management can therefore leverage skills such as telephone advice lines in the decision-making process and other forms of patient education materials. Demand management increases consumer involvement in healthcare through patient education and presenting advice to patients (Tiedemann, 2020).
On the other hand, disease management is a concept that entails trying to improve the quality of life for individuals struggling with chronic conditions while at the same time reducing healthcare costs by minimizing or preventing the effect of diseases through integrated care (Giesen et al., 2017). Disease management programs are designed in a way that they post the health of individuals suffering from chronic conditions and therefore reduce costs associated with avoidable complications through the identification and treatment of chronic conditions are lead and more effectively and prevent the progression of such diseases. Disease management also entails the implementation of self-care efforts. Disease management can therefore be used to increase consumer involvement in healthcare through different health promotion efforts (Tiedemann, 2020).
References
Giesen, M. J., Keizer, E., van de Pol, J., Knoben, J., Wensing, M., & Giesen, P. (2017). The impact of demand management strategies on parents’ decision-making for out-of-hours primary care: findings from a survey in The Netherlands. BMJ Open, 7(5), e014605. https://doi.org/10.1136/bmjopen-2016-014605
Tiedemann, F. (2020). Demand-driven supply chain operations management strategies – a literature review and conceptual model. Production & Manufacturing Research, 8(1), 427–485. https://doi.org/10.1080/21693277.2020.1856012
Question 2
Case Management involves assessment planning, care coordination advocacy and various services and options to meet the comprehensive health needs of an individual or a family through clear communication and utilization of available resources. Case Management seeks to improve the quality of care, promote patient safety and enhance cost-effective outcomes among patients (Lukersmith et al., 2016). Case Management acts as a way of improving the wellness of a client and the autonomy through communication, advocacy education, service facilitation and identification of service resources. A case manager helps patients to identify appropriate health care facilities and providers to ensure that all the available resources are utilized effectively in a cost-effective and timely manner so as to obtain optimal value forgo the investment sources and the client. The case management services environment allows direct communication between the client and case manager so as to enhance the optimization of all kinds for all involved parties (Fabbri et al., 2017). Justification of case management services requires that case managers who possess the skills and education and also the experience are required to provide the necessary services based on sound principles and practice (Lukersmith et al., 2016).
Based on the learning I have acquired from this course, I believe that case management should involve more patient education. In addition to helping patients in the utilization of available healthcare resources and providing service facilitation services, case managers should also be actively involved in patient education. The incorporation of patient education in case management helps to promote self-care among patients and improve the outcomes of such patients.
References
Fabbri, E., de Maria, M., & Bertolaccini, L. (2017). Case management: an up-to-date review of literature and a proposal of a county utilization. Annals of Translational Medicine, 5(20), 396. https://doi.org/10.21037/atm.2017.07.26
Lukersmith, S., Millington, M., & Salvador-Carulla, L. (2016). What is Case Management? A Scoping and Mapping Review. International Journal of Integrated Care, 16(4), 2. https://doi.org/10.5334/ijic.2477

Diabetes pharmology
One page discussion – you may pick the type of diabetes to discuss it is either type 1. type2 or gestational
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Solution
Type 1 diabetes results from the destruction of beta cells by the immune cells and is also associated with some viruses. The condition is chronic and is usually diagnosed during childhood or adolescence but can also occur during the adult stage. Currently, there is no cure for diabetes type 1, and it is mainly managed through insulin injections and lifestyle modification, including diet to control blood glucose levels (Beck et al., 2019).There are five types of insulin for type 1 diabetes patients, including rapid-acting insulin, which works within 15 mins after the injection, reaches the peak in 1 hour, and is effective for up to 4 hours. Short-acting or regular insulin, effective starting 30 mins after injection, reaches a peak after 3 hours, and is effective for up to 6 hours. Intermediate-acting insulin takes effect 4 hours after injection, remains at peak for up to 12 hours, and the impact lasts up to 18 hours. Long-acting usually takes several hours and is effective even after 24 hours. To use insulin, the patient must regularly monitor blood glucose levels 30 minutes before they eat; depending on the type of insulin, they can administer insulin 30 minutes before the meal or immediately they start the meal. Long-term use of insulin is associated with increased weight gain, severe hypoglycemia, increased risk of cardiovascular incidents such as heart attack, and development of pancreatic cancer (Warshauer et al., 2020).
Dietary consideration for type 1 diabetes patients includes eating 3 balanced meals simultaneously every day, reducing the intake of drinks with high sugar content and fatty foods, ensuring that one does not skip meals, and eating foods low in sodium. Long-term impacts of type 1 diabetes include nephropathy and neuropathy such as foot damage, cardiovascular diseases, such as heart attack and stroke, and eye damage including retinopathy, glaucoma, and cataracts (DiMeglio et al., 2018).
References
Beck, R. W., Bergenstal, R. M., Laffel, L. M., & Pickup, J. C. (2019). Advances in technology for management of type 1 diabetes. The Lancet, 394(10205), 1265-1273. https://www.sciencedirect.com/science/article/abs/pii/S0140673619311420
DiMeglio, L. A., Evans-Molina, C., & Oram, R. A. (2018). Type 1 diabetes. The Lancet, 391(10138), 2449-2462. https://www.sciencedirect.com/science/article/abs/pii/S0140673618313205
Warshauer, J. T., Bluestone, J. A., & Anderson, M. S. (2020). New frontiers in the treatment of type 1 diabetes. Cell metabolism, 31(1), 46-61. https://www.sciencedirect.com/science/article/pii/S1550413119306242

Management Of Pediatric And Adolescent
1. Review the Modified Checklist for Autism in Toddlers, Revised, with Follow-Up (M-CHAT-R/F) (see attached) on administering and scoring the M-CHAT tool.
2. Administer the questionnaire to the parent of a child aged 15 months to 3 years old.
3. Write a 175-word minimum reflection on your experience, including a summary of the results.
4. Resources:
M-CHAT Questionnaire (see attached)
M-CHAT Questionnaire (Spanish)
5. Substantive Posts:
A substantive post should follow these criteria:
• At least 175 words
• Integrate theory, research, and/or professional experience
• Include specific examples and/or substantiating evidence
• Include in-text citations and references in 7th edition APA format
• Stay on topic and address the course objectives
• Demonstrate proper spelling, grammar, and scholarly tone You MUST include a question with every post to receive full credit.
Textbook for NRP/543:
Burns, C. E., Dunn, A. M., Brady, M. A., Barber Starr, N., Blosser, C. G., & Garzon, D. L. (2017). Pediatric primary care (6th ed.). Elsevier.
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Solution
Autistic spectrum disorder (ASD) is one of the most well-known neurodevelopmental disorders. It is marked by difficulty in social contact as well as the ability to communicate and a predominance of common and limited hobbies and interests (Bjørklund et al., 2020). Autism spectrum disorder (ASD) has become more common in recent years, with one out of every 88 children expected to be affected. In most circumstances, taking active action early is connected with the best long-term success. According to Coelho-Medeiros et al. (2019), medical practitioners may often detect autism before a child reaches the age of three. The American Academy of Pediatrics advises that children get a specific screening for autism at 18- and 24-month during their hospital visits. On the other hand, the common age of diagnosis is when the child turns four years, and sometimes later for minors from low socioeconomic backgrounds or minorities.
M-CHAT is presently among the most extensively used autistic spectrum disorder testing devices in America and across the globe, according to Coelho-Medeiros et al. (2019). It is a simple and inexpensive alternative for universal toddler screening, and it is one of the most extensively used ASD screening tools in the world. In my experience with the use of the tool, the M-CHAT that has the Follow-Up (M-CHAT/F) has proven to be sufficient on sensitivity and accuracy. A majority of my patients who were grouped as at risk on the M-CHAT/F were determined to have autistic spectrum disorder, and almost all of those who tested positive for ASD had developmental delays or fears. However, the tool needs to be redesigned. This will help to lower the proportion of patients who initially tested positive and required further testing while retaining high sensitivity.
References
Bjørklund, G., Meguid, N. A., El-Bana, M. A., Tinkov, A. A., Saad, K., Dadar, M., … & Chirumbolo, S. (2020). Oxidative stress in autism spectrum disorder. Molecular neurobiology, 57(5), 2314-2332.
Coelho-Medeiros, M. E., Bronstein, J., Aedo, K., Pereira, J. A., Arraño, V., Perez, C. A., … & Bedregal, P. (2019). M-CHAT-R/F Validation as a screening tool for early detection in children with autism spectrum disorder. Revista chilena de pediatria, 90(5), 492-499.