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The attending physician suggested immediate dialysis. After some time of discussion with Joanne
https://lopes.idm.oclc.org/login?url=https://search.credoreference.com/content/entry/galegnaah/euthanasia/0?institutionId=5865
Optional – Topic 4: Optional Resources
For additional information
Christian spirituality and ethics are based on two tenets: belief in God and objective morality. Any Christian’s viewpoint or opinion would look to the Bible as its primary source. The written revelation of God is often known as the Bible. This is where postmodern relativist theory and medical practice diverge most strongly. Postmodernism is based on the idea that truth and objective reality do not exist. It is hard to think of a concept like this when health therapy is based on facts and solid information regarding illness and disease (Brush, 2021). Furthermore, the medical community works tirelessly to enhance patient outcomes by using data and research to guide practice.
The Christian worldview is consistently moral because it is grounded on the experiences of real people. It exemplifies everything that is contrary to postmodern relativism. To describe the negative reaction to postmodern relativism, researchers Braun & Potgieter (2019) coined the term “value vacuum disorder.” Do you think people and societies are never satisfied with the status quo and never stop searching for more stable ideals and fundamental truths by which to ground themselves? Because healthcare is grounded in reality in some way, it can be challenging to apply postmodern relativist theories to the field. When a patient is asked to describe their own experiences, their subjective accounts are taken seriously. However, providing treatment based on relativist assumptions is neither rational nor moral because such beliefs lack facts and have no connection to reality.
Scientism is the belief that all of life’s fundamental problems can be solved via scientific inquiry. For scientists, the ultimate existence and significance of the universe are up to speculation. Christians do not warmly embrace science since it does not account for the phenomena described in the Bible’s account of the beginning of all humankind and the universe (Mazur, 2021). One can argue that Prayer doesn’t work because all that is real are natural objects stretched in a compact chronological space-time framework or that God exists and is a unique creation stretched in space-time, engaging logically with other objects in nature.
Christians tend to downplay the importance of the scientific method. Scientism has few effects on religious belief (Potgieter, 2019). The possibility that God does not exist is abhorrent to Christians. And the idea that God can be found in nature was broadened. Christians generally do not support or even like the idea of space travel. I think it is excellent that there is such a noticeable difference between Christianity, scientism, and the natural sciences. While scientific inquiry leaves room for the possibility of an “other” explanation, the scientism that has come to dominate our culture is fixated on finding a scientific explanation for everything (Roy, 2019).
In the hard sciences, long-held beliefs that have been disproved by subsequent research are not subject to revision as new evidence emerges. This means that data from both the social and natural sciences are susceptible to revision when new evidence becomes available. However, since subjectivism is central to the study of “soft” sciences, it is not unusual for researchers to arrive at contradictory conclusions about the same principle.
This idea that we are all a sum of our experiences in the world is what we consider to be the ultimate reality. My upbringing and experiences in life have shaped me into who I am. My upbringing has been shaped by many different influences, all of which have contributed to the beliefs, habits, and ways of thinking that I currently hold. Since the two theological beliefs have different conceptions of the number of spouses in a lawful marriage, I would be even more accepting of polygamy if I were a Muslim. If I were a Christian, I would be less accepting. Consequently, the study of ultimate reality considers the impact of personal encounters on rationale, choice, and worldview.
One definition of a human being is “any living entity with a soul.” There are many ways for humans to interact with each other, such as through the use of different languages and sign systems. I believe that every person has the capacity to enjoy life. I also think that after individuals have reached a certain level of self-awareness, whether through religion or some other means, they choose a focal point from which to build a guiding principle. From my perspective, engaging in this sort of behavior shapes one’s moral values. Knowledge comes in many forms, including information, expertise, and experience.
Acquiring knowledge can be accomplished in several ways, including through formal education and life experience. It is extremely potent, and its users report experiencing a noticeable increase in the intensity of their corresponding positive or negative energy. Each person misses out on the full advantages of all available information. In most cases, this positively impacts our academic or professional standing, but exceptions exist. Among my goals in life is to increase my knowledge in areas that will make me a better person, parent, and worker. My moral compass points me in the right direction.
Everything in the universe is connected in some way through space and time. The psychic-spiritual nature of the universe has always been present. Rather than being a bunch of things, the cosmos is a community of living, breathing people. The transformation of the world is powered by energy, with the rate and course of transformation being set by biological evolution, natural selection, rivalry, and thermodynamic efficiency. Fighting for access to limited energy forms is a major rivalry component. As time passes, I’ve come to appreciate why it’s crucial to take seriously what scientists have to say about the world and what the word “God” means in context.
In my perception, knowledge refers to the state of being familiar with something on a deep level due to prior exposure or study. Education entails participating in both structured and informal operations to obtain theoretical information, whereas experience is practicing said knowledge to become comfortable with it. The ability to think critically is a byproduct of education and experience. A person well-versed in architecture, for example, may oversee the completion of a building, while a doctorate-holding medical expert can identify and treat illness. In contrast, it is crucial to recognize that not all information now available to humans is beneficial since some actually have a harmful effect. Research has shown that expanding one’s horizons of knowledge leads to greater success in school and the workplace.
The moral core, in my view, is analogous to the earth’s center of mass. This description comes totally from my own experience, in which I have found that whenever I am faced with an ethical problem, there is always some force prompting me to depend on a specific approach. Because His presence convicts us to flow in certain directions, I believe this is wholly the outcome of God and my connection with God. Although everyone has a sense of right and evil, our choices truly reveal our ethics.
My highest calling is to honor God, build meaningful connections with others, and speak up for people who cannot do so on their own. In addition, I hope that how I conduct my life will positively impact others around me and even contribute to the greater good. As a result, I’ve made the conscious decision to ignore the negativity and instead focus on doing what’s right. So, I want to devote all my time and effort to spreading goodness and exemplifying admirable qualities to all the other living things in the universe.
As a society, we tend to ignore the bad and focus instead on the good, but I would advise the wrongdoers to see the truth if they truly want to. Due to my exposure to the negative aspects of life, I can now appreciate the blessings in my life. Despite the enormous difficulties I’ve faced during this dark time, I’ve decided to provide recognition of what has happened and what might follow. And since my life’s significance is ever-changing as I learn more about myself, I’ll never stop praising God for shaping me into the person I am today. I will also encourage people to embrace this bright, hopeful vibe.
Braun, G. J., & Potgieter, F. J. (2019). The worldview of the pilgrim and the foundation of a confessional and narrative philosophy of education. HTS Theological Studies, 75(4).
Brush, J. E. (2021). The Blind Watch: Technological Atheism and the Theology of Nature (Vol. 8). LIT Verlag Münster.
Mazur, L. B. (2021). The epistemic imperialism of science. Reinvigorating early critiques of scientism. Frontiers in Psychology, 11, 609823. https://doi.org/10.3389/fpsyg.2020.609823
Potgieter, F. J. (2019). Towards a narrative vision for philosophy of education: Postmodernism, the pilgrim, and the journey. Bulgarian Comparative Education Society.
Roy C. (2019). Nursing knowledge in the 21st century: Domain-derived and basic science practice-shaped. ANS. Advances in Nursing Science, 42(1), 28–42. https://doi.org/10.1097/ANS.0000000000000240
View Rubric
Requires Lopeswrite
Assessment Description
Based on the required topic Resources, write a reflection about worldview and respond to following:
Remember to support your reflection with the topic Resources.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
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.
REFERENCES MUST BE BETWEEN 2019-2023
Christian Perspective of Spirituality and Ethics in Contrast to Postmodern Relativism
Criteria Description
Christian Perspective of Spirituality and Ethics in Contrast to Postmodern Relativism
Explanation of the Christian perspective of the nature of spirituality and ethics in contrast to the perspective of postmodern relativism is clear, detailed, and demonstrates a deep understanding of the subject. Explanation is supported by topic study materials.
Scientism and Arguments
Criteria Description
Scientism and Arguments
Explanation of scientism is clear and accurate. Explanations of two main arguments against scientism are clear and insightful. Details are clearly supported by topic study materials.
Personal Perspective and Worldview
Criteria Description
Personal Perspective and Worldview
Each of the worldview questions is answered clearly and with deep personal insight.
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
Criteria Description
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
Writer is clearly in command of standard, written, academic English.
Documentation of Sources
Criteria Description
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
Sources are completely and correctly documented, as appropriate to assignment and style, and format is free of error.
Practicing Dignity: An Introduction to Christian Values and Decision-Making in Health Care
Read Chapters 1 from Practicing Dignity
View Resource
Faith and Spiritual Decision-Making in Health Care Professions
View both “Faith and Spiritual Decision-Making in Health Care Professions” video messages to RN to BSN students from Dr. Lisa Smi
… Read More
https://www.gcumedia.com/lms-resources/student-success-center/?mediaElement=7285A42D-1FDE-E811-844B-005056BD1ABC
Literary Styles in the Bible
View “Literary Styles in the Bible” on the Bible Project website (2018).
https://thebibleproject.com/videos/literary-styles-bible/
The Story of the Bible
View “The Story of the Bible” on the Bible Project website (2018).
https://thebibleproject.com/videos/the-story-of-the-bible/
What Is the Bible?
View “What Is the Bible?” on the Bible Project website (2018).
https://thebibleproject.com/videos/what-is-bible/
What Is Scientism?
Read “What Is Scientism?” by Burnett, on the American Association for the Advancement of Science website (2018).
https://www.aaas.org/programs/dialogue-science-ethics-and-religion/what-scientism
10 Things You Should Know About Scientism
Read “10 Things You Should Know About Scientism,” by Moreland, on the Crossway website (2018).
https://www.crossway.org/articles/10-things-you-should-know-about-scientism/
Optional – Topic 1: Optional Resources
For additional information, see the “Topic 1: Optional Resources” that are recommended.
PHI-413V-RS-T1OptionalResources.docx
The Folly of Scientism
“The Folly of Scientism,” by Hughes, from New Atlantis: A Journal of Technology & Society (2012).
https://lopes.idm.oclc.org/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=a9h&AN=84015008&site=ehost-live&scope=site
Blinded by Scientism
“Blinded by Scientism,” by Feser, on the Public Ciscourse: The Journal of the Witherspoon Institute website (2010).
https://www.thepublicdiscourse.com/2010/03/1174/
Is There Truth Beyond Science
“Is There Truth Beyond Science,” by Hutchinson and the Veritas Forum (2013).
http://www.veritas.org/playlist/is-there-truth-beyond-science/
https://www.youtube.com/watch?v=dtB_gnBDq5E&feature=youtu.be
Time for Truth
“Time for Truth,” by Guinness and the Veritas Forum (2018).
http://www.veritas.org/time-for-truth-os/
View Rubric
Requires Lopeswrite
Assessment Description
Based on “Case Study: Fetal Abnormality” and the required topic Resources, write a 750-1,000-word reflection that answers the following questions:
Remember to support your responses with the topic Resources.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
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.
Attachments
PHI-413V-RS-T2CaseStudyFetalAbnormality.docx
Christian View of the Nature of Human Persons and Compatible Theory of Moral Status
Explanation of the Christian view of the nature of human persons and the theory of moral status that it is compatible with is clear, thorough, and explained with a deep understanding of the relationship to intrinsic human value and dignity. Explanation is supported by topic study materials.
Determination of Moral Status
The theory or theories that are used by each person to determine the moral status of the fetus is explained clearly and draws insightful relevant conclusions. Rationale for choices made is clearly supported by topic study materials and case study examples.
Recommendation for Action
Explanation of how the theory determines or influences each of their recommendations for action is clear, insightful, and demonstrates a deep understanding of the theory and its impact on recommendation for action. Explanation is supported by topic study materials.
Personal Response to Case Study
Evaluation of which theory is preferable within personal practice along with how that theory would influence personal recommendations for action is clear, relevant, and insightful.
Organization, Effectiveness, and Format
Writer is clearly in command of standard, written, academic English.
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
RESSOURCES
Practicing Dignity: An Introduction to Christian Values and Decision-Making in Health Care
Read Chapters 2 from Practicing Dignity.
View Resource
Philosophy – Ethics: Moral Status
View the video “Philosophy – Ethics: Moral Status,” by Jeff Sebo, from Wireless Philosophy.
The Image of God, Bioethics, and Persons with Profound Intellectual Disabilities
Read the attached article, “The Image of God, Bioethics, and Persons With Profound Intellectual Disabilities,” by Devan Stahl and
… Read More
JCID 6.1-6.2 – Article – D. Stahl_J.Kilner – Image of God Bioethics and PWIDs.pdf
Optional – Topic 2: Optional Resources
For additional information, see the “Topic 2: Optional Study Resources” that are recommended.
PHI-413V-RS-T2OptionalResources.docx
Optional – Joni and Friends
For additional information, the Joni and Friends website is recommended:
Home
Case Study: Fetal Abnormality
Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the United States for the last three years and have finally earned enough money to move out of their Aunt Maria’s home and into an apartment of their own. They are both hard workers. Jessica works 50 hours a week at a local restaurant and Marco has been contracting side jobs in construction. Six months before their move to an apartment, Jessica finds out she is pregnant.
Four months later, Jessica and Marco arrive at the county hospital, a large, public, nonteaching hospital. A preliminary ultrasound indicates a possible abnormality with the fetus. Further scans are conducted, and it is determined that the fetus has a rare condition in which it has not developed any arms and will not likely develop them. There is also a 25% chance that the fetus may have Down syndrome.
Dr. Wilson, the primary attending physician, is seeing Jessica for the first time, since she and Marco did not receive earlier prenatal care over concerns about finances. Marco insists that Dr. Wilson refrain from telling Jessica the scan results, assuring him that he will tell his wife himself when she is emotionally ready for the news. While Marco and Dr. Wilson are talking in another room, Aunt Maria walks into the room with a distressed look on her face. She can tell that something is wrong and inquires of Dr. Wilson. After hearing of the diagnosis, she walks out of the room wailing loudly and praying aloud.
Marco and Dr. Wilson continue their discussion, and Dr. Wilson insists that he has an obligation to Jessica as his patient and that she has a right to know the diagnosis of the fetus. He furthermore is intent on discussing all relevant factors and options regarding the next step, including abortion. Marco insists on taking some time to think of how to break the news to Jessica, but Dr. Wilson, frustrated with the direction of the conversation, informs the husband that such a choice is not his to make. Dr. Wilson proceeds back across the hall, where he walks in on Aunt Maria awkwardly praying with Jessica and phoning the priest. At that point, Dr. Wilson gently but briefly informs Jessica of the diagnosis and lays out the option for abortion as a responsible medical alternative, given the quality of life such a child would have. Jessica looks at him and struggles to hold back her tears.
Jessica is torn between her hopes of a better socioeconomic position and increased independence, along with her conviction that all life is sacred. Marco will support Jessica in whatever decision she makes but is finding it difficult not to view the pregnancy and the prospects of a disabled child as a burden and a barrier to their economic security and plans. Dr. Wilson lays out all of the options but clearly makes his view known that abortion is “scientifically” and medically a wise choice in this situation. Aunt Maria pleads with Jessica to follow through with the pregnancy and allow what “God intends” to take place and urges Jessica to think of her responsibility as a mother.
Assessment Traits
Requires Lopeswrite
Assessment Description
This assignment will incorporate a common practical tool in helping clinicians begin to ethically analyze a case. Organizing the data in this way will help you apply the four principles and four boxes approach.
Based on the “Case Study: Healing and Autonomy” and other required topic Resources, you will complete the “Applying the Four Principles: Case Study” document that includes the following:
Part 1: Chart
This chart will formalize the four principles and four boxes approach and the four-boxes approach by organizing the data from the case study according to the relevant principles of biomedical ethics: autonomy, beneficence, nonmaleficence, and justice.
Part 2: Evaluation
This part includes questions, to be answered in a total of 500 words, that describe how principalism would be applied according to the Christian worldview.
Remember to support your responses with the topic Resources.
APA style is not required, but solid academic writing is expected.
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.
Attachments
PHI-413V-RS-T3T5CaseStudyHealingAndAutonomy.docxPHI-413V-RS-T3ApplyingFourPrinciplesCaseStudy.docx
Practicing Dignity: An Introduction to Christian Values and Decision-Making in Health Care
Read Chapters 3 from Practicing Dignity.
View Resource
Incorporating Spirituality into Patient Care
Read “Incorporating Spirituality into Patient Care,” by Orr, from American Medical Association Journal of Ethics (2015).
… Read More
https://journalofethics.ama-assn.org/article/incorporating-spirituality-patient-care/2015-05
New Testament Overview
View the online video, “New Testament Overview,” from the Bible Project, located on the YouTube website (2018
… Read More
Read Scripture: TaNaK/Old Testament
View the online video, “Read Scripture: TaNaK/Old Testament,” from the Bible Project, located on the YouTube website (2
… Read More
Sacrifice and Atonement
Explore “Sacrifice and Atonement” webpage and watch the video, on the Bible Project website (2018).
https://thebibleproject.com/explore/sacrifice-atonement/
The Messiah
Explore “The Messiah” webpage and watch the video on the Bible Project website (2018).
https://thebibleproject.com/explore/the-messiah/
Understanding Health and Healing
View the “Understanding Health and Healing” media piece.
https://www.gcumedia.com/tncc/whole-person-care/understanding/
Word Study: Khata/Sin
View the online video, “Word Study: Khata/Sin,” from the Bible Project, located on the YouTube website (2018).
Word Study: Shalom/Peace
View the online video, “Word Study: Shalom/Peace,” from the Bible Project, located on the YouTube website (2017).
Optional – Topic 3: Optional Resources
For additional information, see the “Topic 3: Optional Resources” that are recommended.
PHI-413V-RS-T3OptionalResources.docx
Mike and Joanne are the parents of James and Samuel, identical twins born 8 years ago. James is currently suffering from acute glomerulonephritis, kidney failure. James was originally brought into the hospital for complications associated with a strep throat infection. The spread of the A streptococcus infection led to the subsequent kidney failure. James’s condition was acute enough to warrant immediate treatment. Usually cases of acute glomerulonephritis caused by strep infection tend to improve on their own or with an antibiotic. However, James also had elevated blood pressure and enough fluid buildup that required temporary dialysis to relieve.
The attending physician suggested immediate dialysis. After some time of discussion with Joanne, Mike informs the physician that they are going to forego the dialysis and place their faith in God. Mike and Joanne had been moved by a sermon their pastor had given a week ago, and also had witnessed a close friend regain mobility when she was prayed over at a healing service after a serious stroke. They thought it more prudent to take James immediately to a faith healing service instead of putting James through multiple rounds of dialysis. Yet, Mike and Joanne agreed to return to the hospital after the faith healing services later in the week, and in hopes that James would be healed by then.
Two days later the family returned and was forced to place James on dialysis, as his condition had deteriorated. Mike felt perplexed and tormented by his decision to not treat James earlier. Had he not enough faith? Was God punishing him or James? To make matters worse, James’s kidneys had deteriorated such that his dialysis was now not a temporary matter and was in need of a kidney transplant. Crushed and desperate, Mike and Joanne immediately offered to donate one of their own kidneys to James, but they were not compatible donors. Over the next few weeks, amidst daily rounds of dialysis, some of their close friends and church members also offered to donate a kidney to James. However, none of them were tissue matches.
James’s nephrologist called to schedule a private appointment with Mike and Joanne. James was stable, given the regular dialysis, but would require a kidney transplant within the year. Given the desperate situation, the nephrologist informed Mike and Joanne of a donor that was an ideal tissue match, but as of yet had not been considered—James’s brother Samuel.
Mike vacillates and struggles to decide whether he should have his other son Samuel lose a kidney or perhaps wait for God to do a miracle this time around. Perhaps this is where the real testing of his faith will come in? Mike reasons, “This time around it is a matter of life and death. What could require greater faith than that?”
The practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and understanding of a diversity of faith expressions; for the purpose of this course, the focus will be on the Christian worldview.
Based on “Case Study: End of Life Decisions,” the Christian worldview, and the worldview questions presented in the required topic Resources you will complete an ethical analysis of George’s situation and his decision from the perspective of the Christian worldview.
Provide a 1,500-2,000-word ethical analysis while answering the following questions:
In the case study, different individuals have proposed and utilized several ideas to assist them in assessing the fetus’ moral standing. The fetus’s mother, Jessica, employs the theory of moral agency. This idea suggests that moral standing stems from the capacity to be a virtuous person. She prefers to make her judgments on whether an endeavor is morally justifiable. The other individuals are offering her their ideas, but ultimately the final choice lies with her. The fetus’s father, Marco, is a pro-choice advocate who is currently working with a relationship counseling service.
Since Jessica is his wife, he says he will always stand by her side no matter what she decides. But he thinks the doctor is wrong and that the birth will have negative consequences for both. The husband and wife are undocumented foreign nationals on the verge of becoming economically independent of their families. The child’s well-being and the family’s finances will suffer if it is born. Maria is the aunt to Jessica, and she is pro-life, supported by sentient and human properties. She thinks that the person is entitled to survive as it is God’s intention for the infant to be born without arms and with Down’s syndrome. In addition to urging her sister to act morally, she includes relational qualities by urging her to think about the duty that comes with being a mother.
The case study reveals various actors’ perspectives on the fetus’ moral standing. A close examination of the case study reveals three distinct functions of the fetus. The fetus is not considered a whole person from the liberal viewpoint. The fetus is human in every way except that it cannot yet be regarded as a whole person. Abortion would be legal if held by liberals since, in their opinion, fetuses do not have the same moral stature as adults. Dr. Wilson agrees with this denial of the fetal person’s humanity. Concerning Jessica’s health, he feels obligated to suggest that she think about having an abortion.
Marco agrees with Dr. William that a fetus has a moral standing similar to that of a liberal adult. He is even getting ready to suggest that Jessica have an abortion. In contrast, Maria sees the fetus in an entirely different light. She thinks the unborn baby should be given the same rights as an adult. She thinks of the unborn child as a divine image and considers it our duty to protect them. But Jessica has a more nuanced stance on this issue. To ensure her own safety, she is debating whether to abort the fetus she is currently carrying. Concerning the unborn child, she has conflicting beliefs that range from liberalism to conservatism.
The ethical framework utilized by Dr. Wilson, Jessica, Maria, and Marco. Dr. Williams appears to be constrained by the principles of deontology. The theory is connected to the ethics required by service. As a medical expert, he feels obligated to inform Jessica about the fetal abnormalities he has discovered. He considers it his professional responsibility to inform Jessica that the child cannot fully develop and that she should consider having an abortion to prevent further issues.
With the consequentialist moral theory, you weigh the pros and cons of your actions based on their outcomes (Lewis & Richardson, 2020). Marco urged Jessica to have an abortion because he thought it was in the best interests of the family as a whole. If the fetus is permitted to be born, the family’s financial and social stability will be at risk. On the other hand, spiritual Jessica thinks that people have a need to defend the lives of all sentient creatures and that abortion should not be an option. Maria, too, is morally bound by her spiritual beliefs. So, she tells Jessica to give in to God’s will and let the baby be born.
The more reasonable hypothesis is the one to choose while forming one’s convictions. In my opinion, we can’t save the fetus without considering both the Christian and human perspectives. The fetus has the potential to become a fully formed human being if given enough time. Aborting the fetus might be immoral (Tracy, 2020). In a unique situation like Jessica’s, it could be considered immoral to enable the fetus to be delivered and understand perfectly well that it will not survive. We must not permit this to happen. Even though it is not supported by conservative doctrine, this is a scenario where abortion is necessary.
My opinion and the theory both point to the need to maintain a middle ground. It is unacceptable to take a strong stance on either the left or the right. My situation requires a decision to be made immediately, so it’s important to me that the conclusion be grounded in the facts as they currently stand. Therefore, Jessica should think about having an abortion to avoid the consequences of trying to have a child. She may, however, contemplate having another baby, which would help her become a better mother overall. This will ultimately satisfy the driving force behind why she was created. So, following Dr. William’s recommendation, Jessica should terminate the pregnancy.
Lewis, O., & Richardson, G. (2020). The right to live independently and be included in the community. International Journal of Law and Psychiatry, 69, 101499. https://doi.org/10.1016/j.ijlp.2019.101499
Tracy, D. (2020). Christianity And Suffering. In Fragments (pp. 83-92). University of Chicago Press.
View Rubric
Requires Lopeswrite
Assessment Description
Based on “Case Study: Fetal Abnormality” and the required topic Resources, write a 750-1,000-word reflection that answers the following questions:
Remember to support your responses with the topic Resources.
While APA style is not required for the body of this assignment, solid academic writing is expected, and documentation of sources should be presented using APA formatting guidelines, which can be found in the APA Style Guide, located in the Student Success Center.
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.
Attachments
PHI-413V-RS-T2CaseStudyFetalAbnormality.docx
Christian View of the Nature of Human Persons and Compatible Theory of Moral Status
Explanation of the Christian view of the nature of human persons and the theory of moral status that it is compatible with is clear, thorough, and explained with a deep understanding of the relationship to intrinsic human value and dignity. Explanation is supported by topic study materials.
Determination of Moral Status
The theory or theories that are used by each person to determine the moral status of the fetus is explained clearly and draws insightful relevant conclusions. Rationale for choices made is clearly supported by topic study materials and case study examples.
Recommendation for Action
Explanation of how the theory determines or influences each of their recommendations for action is clear, insightful, and demonstrates a deep understanding of the theory and its impact on recommendation for action. Explanation is supported by topic study materials.
Personal Response to Case Study
Evaluation of which theory is preferable within personal practice along with how that theory would influence personal recommendations for action is clear, relevant, and insightful.
Organization, Effectiveness, and Format
Writer is clearly in command of standard, written, academic English.
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
Practicing Dignity: An Introduction to Christian Values and Decision-Making in Health Care
Read Chapters 2 from Practicing Dignity.
View Resource
Philosophy – Ethics: Moral Status
View the video “Philosophy – Ethics: Moral Status,” by Jeff Sebo, from Wireless Philosophy.
The Image of God, Bioethics, and Persons with Profound Intellectual Disabilities
Read the attached article, “The Image of God, Bioethics, and Persons With Profound Intellectual Disabilities,” by Devan Stahl and
… Read More
JCID 6.1-6.2 – Article – D. Stahl_J.Kilner – Image of God Bioethics and PWIDs.pdf
Optional – Topic 2: Optional Resources
For additional information, see the “Topic 2: Optional Study Resources” that are recommended.
PHI-413V-RS-T2OptionalResources.docx
Optional – Joni and Friends
For additional information, the Joni and Friends website is recommended:
Home
Jessica is a 30-year-old immigrant from Mexico City. She and her husband Marco have been in the United States for the last three years and have finally earned enough money to move out of their Aunt Maria’s home and into an apartment of their own. They are both hard workers. Jessica works 50 hours a week at a local restaurant and Marco has been contracting side jobs in construction. Six months before their move to an apartment, Jessica finds out she is pregnant.
Four months later, Jessica and Marco arrive at the county hospital, a large, public, nonteaching hospital. A preliminary ultrasound indicates a possible abnormality with the fetus. Further scans are conducted, and it is determined that the fetus has a rare condition in which it has not developed any arms and will not likely develop them. There is also a 25% chance that the fetus may have Down syndrome.
Dr. Wilson, the primary attending physician, is seeing Jessica for the first time, since she and Marco did not receive earlier prenatal care over concerns about finances. Marco insists that Dr. Wilson refrain from telling Jessica the scan results, assuring him that he will tell his wife himself when she is emotionally ready for the news. While Marco and Dr. Wilson are talking in another room, Aunt Maria walks into the room with a distressed look on her face. She can tell that something is wrong and inquires of Dr. Wilson. After hearing of the diagnosis, she walks out of the room wailing loudly and praying aloud.
Marco and Dr. Wilson continue their discussion, and Dr. Wilson insists that he has an obligation to Jessica as his patient and that she has a right to know the diagnosis of the fetus. He furthermore is intent on discussing all relevant factors and options regarding the next step, including abortion. Marco insists on taking some time to think of how to break the news to Jessica, but Dr. Wilson, frustrated with the direction of the conversation, informs the husband that such a choice is not his to make. Dr. Wilson proceeds back across the hall, where he walks in on Aunt Maria awkwardly praying with Jessica and phoning the priest. At that point, Dr. Wilson gently but briefly informs Jessica of the diagnosis and lays out the option for abortion as a responsible medical alternative, given the quality of life such a child would have. Jessica looks at him and struggles to hold back her tears.
Jessica is torn between her hopes of a better socioeconomic position and increased independence, along with her conviction that all life is sacred. Marco will support Jessica in whatever decision she makes but is finding it difficult not to view the pregnancy and the prospects of a disabled child as a burden and a barrier to their economic security and plans. Dr. Wilson lays out all of the options but clearly makes his view known that abortion is “scientifically” and medically a wise choice in this situation. Aunt Maria pleads with Jessica to follow through with the pregnancy and allow what “God intends” to take place and urges Jessica to think of her responsibility as a mother.
Death is an unpleasant component of life but unavoidable for all humans. Many unanswered theological and philosophical concerns surrounding the subject of death exist. It is widely agreed that Euthanasia is immoral and has been the subject of harsh criticism. Christians have a unique perspective on death and Euthanasia, which differs from the modern world (Evlampiev & Smirnov, 2021). George, who has amyotrophic lateral sclerosis (ALS), is the subject of this research. The degenerative nature of this illness makes it difficult, if not impossible, to communicate, walk, to inhale, feed, and sustain life. In this essay, I will examine the Christian perspective on Euthanasia and its moral implications in light of George’s impending death.
Christian theology teaches that sin and evil in the universe are inextricably linked to human suffering. This started back in the beginning, in the Garden of Eden, with Adam and Eve. The two had the responsibility of protecting the world that God had made. The task of conquering the planet fell to them. Life was easy and free of pain before Adam and Eve ate the forbidden fruit God had advised them against (Wilhite, 2019). After being deceived by the snake, Eve ate the forbidden fruit, enraging God and forcing Adam and Eve to flee the Garden of Eden.
God allowed Adam and Eve to experience pain because of their role in bringing about the wicked state of the world. Their sinful behavior caused him to distance himself from them. According to Christian teaching, suffering was ushered alongside the world’s fallen state. As punishment for their disobedience, God placed a curse on Adam and Eve (Evlampiev & Smirnov, 2021). The husband had to work hard to provide for the family, while the mother had to endure the agony of childbirth. Therefore, God cursed humanity, and that was a turning point. They had earned God’s wrath.
Thus, George can attribute his adversity to the fact that he is a sinner, as God has identified sin as the primary cause of humankind’s enduring misery. God does not have mercy on the wicked. As a matter of fact, he despises sin. Human beings consistently disobey God by sinning against Him. In many ways, George’s situation is similar to this. George is correct in attributing the suffering in his life to the sinful nature of humankind. Since humanity rejected God in Eden, the curse He placed on the world has become something we all naturally strive to avoid. All that God has given to humanity is in danger of being tainted by corruptible humans. The result was pain, as God had decreed that punishment must always precede human wrongdoing. Every single being is a sinner, George would tell himself, which is why everyone suffers.
Christians believe that God created the universe and humankind and that Jesus came to earth to impart God’s likeness to humans. So, a Christian would say that George’s pain is ultimately what God wants for him. Christians believe that individuals go through trials like George’s to bring them closer to God and increase their hunger for knowledge of God. The pain is designed to teach us about the anguish Jesus endured. Christian teachings claim that Messiah died and rose again on the third day, altering how people think and feel about death.
Despite the tragic nature of death and the explanations offered for it, Jesus triumphed over it on the cross. In light of this victory over death, Christians look forward to the second coming of Christ with the confident expectation that they, too, shall triumph over death at that time. Christians have faith that God will rescue them from death in the future during the resurrection of the church, just as he has always repaid what is wrecked. They anticipate that God will one day return to execute judgment on unrepentant sinners and to welcome into heaven all those who have accepted Jesus as their Lord and Savior.
The importance of maintaining a strong relationship with God and seeking His guidance in all endeavors can be learned from this. Because they think that God allows suffering as a result of their own free will, Christians use adversity to strengthen their convictions (Wilhite, 2019). This has been a major factor in their increased conviction. If Christians truly believe that their pain is the result of some terrible deed they committed in the past, then they will be more likely to repent and seek God’s forgiveness. God’s ordered operation is demonstrated by the fact that he permits human suffering to bring about repentance, turning back to him and experiencing his love. Even though some people may think their suffering is a punishment from God, it is nonetheless evidence that God still loves the human race. These words serve as a call to action toward the goal of conforming one’s life to God’s plan.
The fundamental belief of Christians is that they will rise from the dead one day, just as Jesus did. Once George fully grasps all of these factors, he will be moved to repent and trust that God can and does forgive him of his sins. When George dies, he may be assured that his pain will finally be relieved. Having sought forgiveness for his crimes and been granted God’s pardon, George will be looking forward to the day God returns for His church.
From a Christian perspective, George should treasure his life and regard it as God’s gift, even though he is afflicted with amyotrophic lateral sclerosis. Because of this, no person has the right to end his life. God alone has the ability to do that. In an analogy, George must bear all the anguish and pain that his illness causes, even as it causes him great pain. Nobody should ever consider suicide because of the difficulties they are having in life, even if they are as severe as the ones George is experiencing. Christians are taught to remain resilient in the face of adversity (Mack & Camosy, 2022). George wants to know that he is a good person and that his life is important despite the horrific and crippling effects of his sickness.
Life is a gift from God, and George needs to learn to appreciate it as such. However, since the introduction of sin into the world, suffering has also been a component of human life. George needs to learn that he is priceless in God’s sight and that the Lord has a plan for him even though he must endure amyotrophic lateral sclerosis. George should try to understand why God is allowing him to endure this ordeal in the first place since God may have a specific lesson in mind for him (Evlampiev & Smirnov, 2021). Maybe God has a teaching for him in this, and he is going through it for the sake of His great glory. Because of the Christian belief that every human life is sacred and must be safeguarded, George must accept the necessity of continuing to endure pain to preserve his own.
In light of Jesus’ example of accepting and suffering through his own trials, George must do the same. The anguish Lord Jesus Christ endured before His death on the cross is well known. At one point, He even prayed to God, asking whether it was His will that He have to go through all of this anguish. He even prayed to God to take away his pain (Evlampiev & Smirnov, 2021). Because of this, it is possible that God intends for George to suffer. He must bear the pain and ask God for the strength to bear it. He must learn that God occasionally allows people to experience hardship so that they can get near to Him and develop a longing for Him, which leads to repentance. George needs to take to heart what God is trying to teach him and make a sincere effort to become nearer to Him.
How open someone is to death depends heavily on their inherent disposition toward mortality. If Christians accepted all of their experiences, including pain and misery, as God’s will and looked forward to a resurrection like Jesus did, they would have confirmation that God is monitoring and He is in command of all of it. George must accept his adversity as God’s plan in light of this.
If George were to choose to stay alive until God took his life, he would be doing it morally. Therefore, Euthanasia should not be an alternative for George, according to this ideology. Christians believe that every individual life is a blessing from God and hence, should be treated with the utmost respect. Attempting to end a person’s life and disrupting God’s plan is both immoral and unacceptable. Many Christians see hardship as God’s will and a part of the way of life. Because of this, it is clear how unjust it is for one human to take another’s life. This is why, even in the face of fatal illness, one must be prepared to suffer as Christ suffered on the cross.
Despite my Christian beliefs, I would consider Euthanasia if I were in George’s position and facing the inevitable pain and incapacity of amyotrophic lateral sclerosis. Even if Euthanasia goes against Christian principles, it can be agonizing to see patients in pain. For me, that amount of suffering would be intolerable, and Euthanasia would be a welcome relief. However immoral it may be, the Bible teaches that there is forgiveness for every transgression. There is no wrongdoing that cannot be forgiven.
Christians believe that only God has the right to grant and take life. God allows suffering because he wants a closer relationship with his people through it. It is in a person’s nature to suffer. For his part, George needs to keep going even if ALS is excruciating. Christians should be encouraged to consider Euthanasia as a treatment option for terminal illness. George needs to have this perspective on his life and illness and see that they are all part of God’s plan for him. Despite our hardships, our lives are meaningful in God’s eyes, and he alone is the source of our very being.
Evlampiev, I. I., & Smirnov, V. N. (2021). Dostoevsky’s Christianity. RUDN Journal of Philosophy, 25(1), 44-58. https://doi.org/10.22363/2313-2302-2021-25-1-44-58
Mack, A. N., & Camosy, C. C. (2022). Bioethics for Nurses: A Christian Moral Vision. Wm. B. Eerdmans Publishing.
Wilhite, S. J. (2019). “One of life and one of death”: apocalypticism and the Didache’s two ways. Gorgias Press.
The practice of health care providers at all levels brings you into contact with people from a variety of faiths. This calls for knowledge and understanding of a diversity of faith expressions; for the purpose of this course, the focus will be on the Christian worldview.
Based on “Case Study: End of Life Decisions,” the Christian worldview, and the worldview questions presented in the required topic Resources you will complete an ethical analysis of George’s situation and his decision from the perspective of the Christian worldview.
Provide a 1,500-2,000-word ethical analysis while answering the following questions:
Remember to support your responses with the topic Resources.
Prepare this assignment according to the guidelines found in the APA Style Guide, located in the Student Success Center. An abstract is required.
This assignment uses a rubric. Please review the rubric prior to beginning the assignment to become familiar with the expectations for successful completion.
You are required to submit this assignment to LopesWrite. A link to the LopesWrite technical support articles is located in Class Resources if you need assistance.
Attachments
PHI-413V-RS-T4CaseStudyEndOfLifeDecisions.docx
Practicing Dignity: An Introduction to Christian Values and Decision-Making in Health Care
Read Chapters 4 from Practicing Dignity.
View Resource
Euthanasia
Read “Euthanasia,” by Wells, Frey, and Cataldo, from Gale Encyclopedia of Nursing and Allied Health (2013).
https://lopes.idm.oclc.org/login?url=https://search.credoreference.com/content/entry/galegnaah/euthanasia/0?institutionId=5865
Optional – Topic 4: Optional Resources
For additional information, see the “Topic 4: Optional Resources” that are recommended.
PHI-413V-RS-T4OptionalResources.docx
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Case Study on Death and Dying – Rubric
Suffering and Fallenness of the World
Criteria Description
Suffering and Fallenness of the World
Analysis of how the man would interpret his suffering in light of the Christian narrative and the fallenness of the world is clear and demonstrates a deep understanding that is skillfully supported by topic study materials.
Suffering and the Hope of Resurrection
Criteria Description
Suffering and the Hope of Resurrection
Analysis of how the man would interpret his suffering in light of the Christian narrative and the hope of resurrection is clear and demonstrates a deep understanding that is skillfully supported by topic study materials.
Value of Life
Criteria Description
Value of Life
Analysis of how the Christian worldview of the man might inform his view about the value of his life as a person with ALS is clear and demonstrates a deep understanding that is skillfully supported by topic study materials.
Euthanasia
Criteria Description
Euthanasia
Evaluation of which values and considerations the Christian worldview focuses on when deliberating the option of euthanasia for the man is clear and demonstrates a deep understanding that is skillfully supported by topic study materials.
Morally Justified Option
Criteria Description
Morally Justified Options
Evaluation of which options would be justified in the Christian worldview for the man is clear and demonstrates a deep understanding that is skillfully supported by topic study materials.
Personal Decision
Criteria Description
Personal Decision
Reflection hypothesis of which personal choices would be make if faced with ALS based on personal worldview is clear, relevant, and insightful.
GooThesis Development and Purpose
Criteria Description
Thesis Development and Purpose
Thesis is comprehensive and contains the essence of the paper. Thesis statement makes the purpose of the paper clear.
Argument Logic and Construction
Criteria Description
Argument Logic and Construction
Clear and convincing argument presents a persuasive claim in a distinctive and compelling manner. All sources are authoritative.
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
Criteria Description
Mechanics of Writing (includes spelling, punctuation, grammar, language use)
1Paper Format (use of appropriate style for the major and assignment)
Criteria Description
Paper Format (use of appropriate style for the major and assignment)
Documentation of Sources
Criteria Description
Documentation of Sources (citations, footnotes, references, bibliography, etc., as appropriate to assignment and style)
Creating a question using the PICOT elements will provide a framework for the research you need to conduct an evidence-based study or to make an evidence-based decision.
(P) – Population, Patients or Problem: The sample of subjects used in a study, or the problem being addressed.
(I) – Intervention: The treatment that will be provided to subjects enrolled in your study.
(C) – Comparison or Control: Identifies an alternative intervention or treatment to compare. Many study designs refer to this as the control group. If an existing treatment is considered the ‘gold standard’, then it should be the comparison group. A control group is not required for every type of study.
(O) – Outcome: The clinical outcome that measures the effectiveness of the intervention.
(T) – Time: Duration of the data collection. Some versions don’t include this element, and time may not be specified in cases where the question is focused on prediction or diagnoses.
Running head: USING A PICO(T) FRAMEWORK 1
Using a PICO(T) Framework and Evidence to Develop Care Practices Learner’s Name Capella University
Making Evidence-Based Decisions
PICO(T) Questions and an Evidence-Based Approach January, 2019
USING A PICO(T) FRAMEWORK 2
Using a PICO(T) Framework and Evidence to Develop Care Practices
When developing care practices for patients, the PICO(T) research framework, which expands to Population/Patient, Intervention, Comparison, Outcome, and Time, can be used to create an effective care plan and ensure that patients’ needs are met. Relying on secondary research, the author of this paper will define a practice issue surrounding patients with dementia, apply the PICO(T) process, identify sources of evidence that may provide answers to the research question, explain key findings from articles, and explain the relevance of those key findings.
The practice issue identified for resolution is the need to develop care practices that effectively manage agitation in patients with dementia in nursing homes that are outside of pharmacological approaches. The question being explored is: Is the non-pharmacological approach, specifically an intervention approach, more effective than the pharmacological approach in managing behavioral symptoms (such as agitation) in patients with dementia?
The intervention approach identified is person-centered care or patient-centered care (PCC), an approach that emphasizes more on an individual’s experiences and the communication of his or her needs than on the pure implementation of a health care provider’s expertise (Desai, Wharton, Struble, & Blazek, 2017). The population being studied are patients with dementia with agitative behavioral symptoms in nursing homes. As the objective is to explore care practices that address this issue, only factors related to care in nursing homes are considered. The study does not take into consideration cultural, political, and social factors (Kim & Park, 2017).
DICE Model
USING A PICO(T) FRAMEWORK 3
The DICE (Describe, Investigate, Create, and Evaluate) model is a notable PCC intervention model that identifies optimal treatment options for patients with dementia with neuropsychiatric symptoms. Developed by a panel of interdisciplinary experts at the University of Michigan Program for Positive Aging, the model is constitutive of a four-step approach. The first step of the approach is the accurate description of the patient’s behavior, the second is the identification of possible underlying causes, the third is the creation and implementation of treatment plans, and the fourth is the assessment of the strategies developed (Desai et al., 2017; Kales, Gitlin, & Lyketsos, 2014).
The model’s essential recommendations for facilitating improvement in neuropsychiatric symptoms among patients with dementia are educating the caregiver; forging better communication between the patient and the caregiver; assisting the caregiver in organizing meaningful activities such as cooking, painting, or reading depending on the patient’s interests; and training the caregiver on simplifying his or her work routines (Desai et al., 2017; Kales, Gitlin, & Lyketsos, 2014).
Individualized Intervention Model
The individualized intervention model is a model in which intervention activities are carried out based on the history, needs, abilities, and preferences of patients with dementia. In this model, PCC-based activities are directly carried out by trained health care staff with expertise in social work, recreational therapy, geriatric psychiatry, and psychology (Kim & Park, 2017). Care Staff-Directed Model
In the care staff–directed model, PCC activities are based on the staff’s education and training on empathy and person-centeredness. The model also makes a provision for offering
USING A PICO(T) FRAMEWORK 4
staff regular feedback for their work. The intervention period in such a model ranges from 3 months to 2 years (Kim & Park, 2017).
As PCC is a major nonpharmacological approach to treating agitation in patients with dementia, its effectiveness is studied by making a comparative analysis to the pharmacological approach to manage behavioral symptoms in patients with dementia. Pharmacological treatment in general refers to the use of psychotropic medication to manage agitation or neuropsychotic symptoms (NPS) in patients with dementia (Madhusoodanan & Ting, 2014; Kales et al., 2014). Some of the common pharmacological interventions include the use of antipsychotropics, antidepressants such as sertraline and citalopram, and sedative-hypnotics through the use of benzodiazepines to control acute agitation (Madhusoodanan & Ting, 2014). The use of psychotropic medication poses high risks of mortality and harmful side effects (Kales et al., 2014). Psychotropic medication is also expensive and is restricted by regulatory bodies. However, the use of pharmacological intervention is justified when the benefits outweigh the risks or in situations wherein nonpharmacological interventions have proven unsuccessful (Madhusoodanan & Ting, 2014).
The PCC approach has proven effective in addressing the etiology of aggressive outbursts. Unlike the pharmacological approach, which is based on treating symptoms, the PCC approach contributes to the resolution of underlying causes (Desai et al., 2017). The study by Kales et al. (2014) finds reasonable evidence of the DICE program’s contribution toward better clinical practices and improvement in aggressive behavior, and it observes that the approach results in fewer hospitalizations and readmissions. In their systematic review and meta-analysis of 19 primary studies, Kim and Park (2017) found 15 studies that measure the impact of PCC on
USING A PICO(T) FRAMEWORK 5
agitation using the Cohen-Mansfield Agitation Inventory (an agitation mapping instrument) and the Brief Agitation Rating Scale. They found that 8 of the 15 studies show positive effects on agitation with individualized interventions (with a significant mean difference of -0.513), showing better effects than with care staff–directed interventions (with a significant mean difference of -0.160).
As this paper relies on secondary research on the PCC intervention to manage agitative behavior in patients with dementia in nursing homes, there are multiple time frames for the various intervention studies reviewed. While some studies had a long intervention period ranging from 9 months to 2 years, others had shorter intervention periods of just a few weeks. From the above exploration of the research problem based on the PICO(T) framework, it is clear that this framework has contributed to the delineation of precise intervention practices and has brought conceptual clarity on the issue of agitative behavior in patients with dementia.
The study by Kales et al. (2014) was chosen as it provides a comprehensive explanation of the PCC-based DICE intervention program and its potential outcomes and draws an objective comparison of the program with pharmacological intervention. The study observed that the DICE model was developed by a panel of experts with years of clinical and research expertise in managing NPS in patients with dementia. The strategies formulated in the DICE approach were found to carry a strong evidence base. As it is evidence-informed, the DICE approach could be helpful for clinicians across diverse settings. Kales et al. (2014) conclude their study with a discussion on the potential of the DICE approach in enhancing clinical practices and ensuring the treatment of agitative behavior in patients with dementia.
USING A PICO(T) FRAMEWORK 6
The rationale for selecting the study by Kim and Park (2017) was that it presents a systematic review and meta-analysis of 19 primary intervention studies, of which 17 studies are from long-term care facilities. In their systematic review and meta-analysis of these studies, Kim and Park (2017) found that PCC has a significant impact on reducing NPS in patients with dementia. Kim and Park’s (2017) review found the increased engagement between care providers and patients and the magnitude of the program’s intensity to be the reasons for short- term PCC intervention having greater benefits in comparison to long-term intervention. The findings are relevant because they are based on 17 long-term, clinical PCC intervention studies comprising both controlled and non-controlled cluster-randomized trials conducted over the past 10 years (Kim & Park, 2017).
Kim & Park’s findings prove to be the most credible. In their systematic review and meta-analysis of primary studies, Kim and Park’s findings (2017) adhere to the guidelines of the Preferred Reporting Items for Systematic Reviews and Meta-Analyses. They also utilize analysis tools such as the Cochrane Collaboration’s risk of bias and the risk of bias assessment tool to ensure quality screening of the studies.
There is a need to develop care practices that are outside of pharmacological approaches for managing agitation in patients with dementia. The PICO(T) framework was applied to determine if the intervention approach of person-centered care or patient-centered care (PCC) was more effective than the pharmacological approach by identifying sources of evidence, explaining the findings and proving the relevance of those findings. The articles by Kales et al. (2014) and Kim and Park (2017), provide precise, reliable, and relevant information to adequately explore the effectiveness of the PCC approach.
USING A PICO(T) FRAMEWORK
Learning is an essential aspect of life, demanding both dedication and focus. Identifying the best places to study and complete homework in your vicinity can immensely enhance your concentration, learning efficiency, and memory retention. If you’re wondering where to do homework and study effectively, it’s crucial to consider factors such as the reading environment. Securing the right spot for learning and homework is crucial for academic success.
Students pursuing advanced degrees often seek environments conducive to focusing on their projects. Similarly, for general study, finding the best places to study and do homework is a common pursuit, particularly during peak times like mid-terms and final exams. Common queries include “Which is the best place to study?” and “Where can you study effectively?”
Utilize the insights from this article to identify the best places to study and do homework near you, enhancing your academic journey.
The search for the perfect places to do homework near me is more than just a quest for a quiet corner; it’s about finding an environment that aligns with your learning style and enhances your ability to focus, understand, and retain information. This is important for several reasons:
Identifying a great place to do homework involves considering various features that contribute to an effective and pleasant study experience. Here are key characteristics to look for:
Finding the best nearby places to do your homework can enhance your study experience by providing an environment that suits your learning style and needs. Here are some ideal locations to consider:
Libraries are quintessential havens for students seeking a quiet and focused environment. They offer an abundance of resources, including books, journals, and often access to online databases and e-books. Many libraries also provide private study rooms or carrels, perfect for solo study sessions or quiet group work.
The serene atmosphere, combined with the academic surroundings, can significantly boost concentration and productivity. Additionally, the presence of other people studying can serve as a motivational boost.
Coffee shops have become popular study spots for their relaxed ambiance and background noise, which some find enhances concentration. The hum of conversation, the clinking of cups, and the aroma of coffee create a comfortable yet stimulating environment.
Most coffee shops offer free Wi-Fi, power outlets, and, of course, a steady supply of caffeine and snacks – all conducive to long study sessions. The change of scenery from the usual study spots can also be refreshing and invigorating.
Studying in a local park offers a refreshing alternative to indoor environments. The natural setting, fresh air, and greenery can help reduce stress and increase mental clarity. Outdoor spaces are particularly beneficial for creative tasks or when you need a break from screen-based work.
However, it’s essential to consider the weather and bring necessary supplies, such as a blanket to sit on, sun protection, and perhaps a portable battery pack for your devices.
Community centers often provide quiet, well-maintained spaces for study, free from the distractions of home. They can be especially useful for students who live in noisy households or don’t have access to a dedicated study space at home.
These centers foster a sense of community, providing a safe and inclusive environment for learners of all ages. Additionally, community centers sometimes host study groups and educational workshops, offering extra support for your academic endeavors.
University campuses are not just for enrolled students; they often have spaces open to the public where anyone can come to study. These areas include libraries, outdoor spaces, and common areas with seating. The academic atmosphere is palpable, and being surrounded by other students can be highly motivating.
Furthermore, university campuses often have excellent Wi-Fi, cafes, and other amenities, making them a practical choice for extended study sessions.
For those seeking a uniquely serene and inspiring study environment, museums or art galleries can be ideal. The quiet halls, surrounded by art or historical artifacts, can stimulate creative thinking and provide a peaceful backdrop for reading and writing. This setting can be particularly beneficial for students in artistic or historical fields, offering direct inspiration from the exhibits around them.
Some bookstores, especially larger chains, offer seating areas where customers can read or work. Surrounded by literature, these spaces often exude a quiet, intellectual atmosphere conducive to studying. Additionally, being in close proximity to a wide range of books can be helpful for research or when seeking reference materials.
Co-working spaces are designed with productivity in mind. They offer a professional environment, often equipped with high-speed internet, printing facilities, and even private meeting rooms. While these spaces might require a membership or fee, they provide a distraction-free environment suitable for students who are serious about their studies and prefer a more professional setting.
Studying at a friend’s house or with a study group can offer a supportive and collaborative learning environment. It’s beneficial for group projects, study sessions before exams, or simply when you need motivation from your peers. These sessions can also provide different perspectives on the material, making studying more effective and less monotonous.
While not the first place that comes to mind for studying, some shopping malls have quiet areas suitable for a quick study session. These spots often have seating, are well-lit, and you have easy access to food courts and other amenities. It’s a convenient option if you’re already out and need a place to review notes or catch up on reading.
Studying at home is often considered one of the best options for doing homework due to its convenience and your control over the environment. Here are the potential study spaces at home:
The kitchen offers ample lighting, which is crucial for reading and writing. The kitchen table can provide a spacious work surface, allowing you to spread out your books and materials. Additionally, being close to snacks and beverages can be convenient during long study sessions.
Kitchens also tend to be less isolated than other rooms, which can benefit those who prefer not to study in complete solitude. However, it’s important to consider the potential for distractions in this family-centric space, especially during meal times or when the household is busy.
The bedroom is another popular choice for a study space, primarily due to its privacy and quiet. It’s a personal space where you can control interruptions more effectively. In a bedroom, you can create a cozy yet functional study nook, perhaps near a window for natural light or a well-placed lamp for evening study. The familiarity and comfort of the bedroom can make it easier to relax and concentrate.
However, the key to using a bedroom as an effective study space lies in maintaining a balance between comfort and productivity. It’s essential to have a dedicated study area that is distinct from the space used for sleep to avoid the temptation of napping and to keep a clear separation between work and relaxation.
Exploring unconventional or less traditional spots for learning and completing homework can refresh your study routine. Here are some extra spots worth considering:
The importance of finding good places to do homework cannot be understated, as the right environment can significantly impact your learning efficiency and overall academic performance. Here are some key reasons why finding the right study spot is crucial:
The quest to find the ideal place to do homework is a personal and significant journey for any student or learner. The impact of a well-chosen study environment extends beyond just academic performance; it influences your overall approach to learning and can shape your educational experience.
The key is to recognize what works best for you. Some thrive in quiet, isolated spaces, while others prefer a hint of background noise and movement. Experimenting with various locations can unlock surprising discoveries about how and where you learn best. Moreover, changing your study location can refresh your mind, prevent burnout, and keep you motivated.
Remember, the best place to do homework is one where you feel productive, comfortable, and focused. It should align with your learning style, minimize distractions, and provide the resources you need. By finding and utilizing these spaces, you empower yourself to achieve a more effective, enjoyable, and successful learning experience.
Ethically and academically, it’s important to complete your own homework. Doing your homework yourself helps you learn the material and develop essential skills. However, seeking help or tutoring to better understand the material is a constructive approach.
Yes, you can do your homework at Starbucks or similar coffee shops. These places often provide a comfortable environment with free Wi-Fi, making them popular among students. The ambient noise level in coffee shops can be conducive to concentration for some.
The best time for studying if you need to get some work done varies from person to person. It depends on your individual circadian rhythm and personal schedule. Some people find they concentrate best in the morning when they are fresh, while others may find their peak focus in the afternoon or evening. Experiment with studying at different times to discover when you are most alert and productive.
You can do homework in a variety of places, depending on your preferences and what’s available to you. Popular choices include at home (in a dedicated study space, bedroom, or kitchen), public libraries, coffee shops, parks, university campuses, and co-working spaces. The key is to find a place where you feel comfortable and can focus, with minimal distractions and necessary resources like Wi-Fi and power outlets if needed.
A causal relationship exists between politics and health. In a surficial explanation, better politics leads to better health care services. Towards the election in the United States, potential legislators develop enticing manifestos to use as competitive advantage. Some of the areas often covered include goals to better the existing health care system through the introduction of policies.
For example, the greatest health care achievement during President Obama’s Administration is the implementation of the Affordable Care Act of 2010 (Kominski, Nonzee & Sorensen, 2018). However, due to political idiosyncrasies, there have been tremendous attempts to repeal the ACA during President Trump’s Administration. The purpose of this writing is to address the efforts to repeal the ACA and how the cost-benefit analysis and voters’ views affect the process.
Prior to the Obama Administration, US citizens and limited access to health care and most were uninsured. As such, President Obama considered it wise to develop a policy that would increase health insurance coverage. The birth of the ACA therefore ensued in an attempt to increase coverage, access, and improve health outcomes particularly to low-socioeconomic groups (Kominski et al., 2018). Despite President Obama’s efforts, his successor President Donald Trump, considers the ACA objectives as futile and has attempted to sabotage it in various ways.
Even though his repeal attempts have been largely unsuccessful, some of the sabotage initiatives that emerged from a congregational failure to repeal the ACA include the following: reduced outreach and enrollment opportunities for ACA, cutting ACA subsidies to insurance companies that offer coverage, and expansion of cheap insurance coverage that do not meet the quality standards (Willison & Singer, 2017). Noteworthy is that the sabotage plans have significantly eroded the ACA program gains.
The intent of developing a policy is to improve outcomes in a specific population. For example, following ACA implementation, over 20-million American citizens who were previously uninsured received health coverage (Kominski et al., 2018). This therefore means that the American citizens benefitted the most. However, this might not be the case in all policy implementation.
For instance, the attempts to repeal ACA would mean that more than 20-million people could lose their health insurance coverage. Further, the insurance companies would lose big following the sabotage initiative to cut the ACA subsidies to insurance companies that offer coverage on the exchanges. Thus, while it is the US citizens that reap the most benefits, they are also the most likely group to feel the greatest impact in case a policy implementation fails or gets sabotaged.
Buettgens, et al. (2016) conducted a comprehensive cost-analysis review on the cost of ACA repeal and established that the repeal would reduce the federal government’s medical expenditure for the nonelderly population. The reduction was projected to be by $90.0 Billion in 2021 and $927 Billion between 2017 and 2026 (Buettgens et al., 2016).
However, the reduction would come at a cost in various areas, among them, a rise in uninsured population to 24 million by 2021, 14.5 million fewer individuals with Medicaid insurance in 2021, increased state spending by $68.5 Billion between 2017 and 2026, and less health care to low- or moderate-income families. Weighing the benefits and shortfalls, the reports depict that the repeal of ACA is associated with increased negative financial and health repercussions. This therefore informs the resilience of ACA to date.
The voters’ say is highly revered when it comes to policy implementation. In electoral democracy, voters influence government policy implementation. For example, a recent KFF Health Tracking Polls conducted in October 2020 revealed that majority of the public (55%) have a favorable view on ACA while 39% hold a negative opinion (Mclntyre & Song, 2019)). This is one of the reasons ACA is resilient up to date. This is one of the areas where voters inform governments’ policy implementation.
Regardless of political affiliation, individuals often grow concerned when considering perceived competing interests of government and their impact on topics of interest to them. The realm of healthcare is no different. Some people feel that local, state, and federal policies and legislation can be either helped or hindered by interests other than the benefit to society.
Consider for example that the number one job of a legislator is to be reelected. Cost can be measured in votes as well as dollars. Thus, it is important to consider the legislator’s perspective on either promoting or not promoting a certain initiative in the political landscape.
To Prepare:
By Day 3 of Week 3
Post an explanation for how you think the cost-benefit analysis in terms of legislators being reelected affected efforts to repeal/replace the ACA. Then, explain how analyses of the voters views may affect decisions by legislative leaders in recommending or positioning national policies (e.g., Congress’ decisions impacting Medicare or Medicaid). Remember, the number one job of a legislator is to be re-elected. Please check your discussion grading rubric to ensure your responses meet the criteria.
By Day 6 of Week 3
Respond to at least two of your colleagues* on two different days by expanding on their explanation and providing an example that supports their explanation or respectfully challenging their explanation and providing an example.
As a nurse, how often have you thought to yourself, If I had anything to do about it, things would work a little differently? Increasingly, nurses are beginning to realize that they do, in fact, have a role and a voice.
Many nurses encounter daily experiences that motivate them to take on an advocacy role in hopes of impacting policies, laws, or regulations that impact healthcare issues of interest. Of course, doing so means entering the less familiar world of policy and politics. While many nurses do not initially feel prepared to operate in this space effectively, the reward is the opportunity to shape and influence future health policy.
To Prepare:
The Assignment: (1- to 2-page Legislation Grid; 1-page Legislation Testimony/Advocacy Statement)
Be sure to add a title page, an introduction, purpose statement, and a conclusion. This is an APA paper.
Based on the health-related bill (proposed, not enacted) you selected, complete the Legislation Grid Template. Be sure to address the following:
Based on the health-related bill you selected, develop a 1-page Legislation Testimony/Advocacy Statement that addresses the following:
By Day 7 of Week 4
Submit your completed legislation grid and testimony/advocacy statement.
The county health ranking report reveals that there exists a pattern of healthcare disparities, especially for some demographic groups such as African American females. Other demographic groups that experience unfair differences are people in the low-income cadres. The disparities exist in certain areas, such as access to care, employment opportunities, housing opportunities, and the quality of care (County Health Rankin, 2021). The Mississippi County health report shows that 28% of children in the county live in abject poverty, a figure that is much higher than the national average rate (American Progress, 2020). Disadvantaged communities such as African Americans use the ranking report to mobilize efforts locally and nationally to overcome these unfair patterns.
On its part, the U.S. Census Bureau rank counties based on health factors. The most important health factors used by the Census Bureau to rank the performance include smoking, obesity, physical fitness, the prevalence of STIs, and teen births, among others. Coincidentally, African American females are at the highest risk of the factors mentioned above. The U.S. Census Bureau also ranks counties using the strategy of clinical care, a system that relies on the reported level of clinical care.
The most critical priority health areas in my county area in Mississippi are alcohol and drug abuse, access to healthcare, employment opportunities and income. Concerning alcohol and drug abuse, Mississippi is one of the leading States in America with high rates of alcohol and drug abuse. This level of abuse affects the quality of health for many people in the State, particularly, African Americans. Many black females have taken to alcoholism and drug use as a way of coping with their hard economic situations (Wang et al., 2017).
In terms of access to quality health care, the County Health Report indicates that people in Mississippi, especially African Americans, cannot access quality health care due to lack of finances to pay for the care. Concerning education, employment, and income, Mississippi is one of the high-ranking states with unfair differences in terms of opportunities. African American females are at the bottom of the chain with the lowest education, employment, and income levels. These factors affect their chances of accessing quality healthcare.
The Quad Council Coalition of Public Health Nursing Organizations (QCC) is one of the most active institutions in Mississippi that addresses unfair health differences in communities. The organization is a collection of many nursing organizations such as the Association of Community Health Nursing Educators, American Public Health Association Public Health Nursing Section (APHA PHN), and the Association of Public Health Nurses, among others (KrumHolz et al., 2018). The QCC is one of the organizations leading in community assessment initiatives to evaluate the critical health needs of communities. In Mississippi, the QCC actively participates in assessing the health needs of the most vulnerable demographic groups. In particular, the QCC spearheads efforts to address health disparities within the state. QCC educates African American women on ways to live healthy lives by avoiding the most prevalent health risks such as obesity, cancer, and alcohol and drug abuse.
The County Health Ranking report indicates that African American women record high mortality and morbidity rates. In Mississippi, a combination of sexually transmitted infections and chronic conditions are responsible for the high morbidity and mortality rates among African American women (Carthenon et al., 2018). Cancer and heart problems were the leading cause of deaths for African American women in this State. To address the above problems, the State of Mississippi has prioritized addressing the issues responsible for the prevalent health disparities.
For example, the State together with many partners in the health sector has embarked on a spirited campaign to tackle racial disparities, socioeconomic issues, and access to quality healthcare for African American women. The government prioritizes these issues because they are critical in creating effective interventions that can significantly reduce the risk factors associated with the above health conditions.
The Mississippi State Health Department and the U.S National government have initiated several projects aimed at lifting the lives of disadvantaged communities in the State. The state has come a long way in improving pay disparities between men and women, especially for disadvantaged groups. Noteworthy is that low pay and wages among African American women is one of the issues that prevent them from accessing quality healthcare (Noonan, 2016). Secondly, the State of Mississippi has prioritized the issue of education for African American women, with the goal being to reduce illiteracy levels.
The level of illiteracy in the State dictates the level of awareness on health. The more educated and aware African American women are, the higher their chances of changing their lifestyles. Lastly, the National government and local authorities have prioritized interventions for dealing with alcohol and drug abuse among African American women to reduce risk factors associated with this habit, such as irresponsible sex that exposes them STIs.
Considering the prevalence of unfair differences in healthcare access in Mississippi, it is difficult for any single person/group to solely influence change within the affected populations. However, the people that I would introduce the idea to are our church ministers. I believe that local community leadership offers the most effective forum for reaching the target group, namely African American women.
Further, I would target influential women in the community as most women look up to their successful counterparts for wisdom. Influential women can persuade young girls through education and mentorship to avoid risky behaviors such as irresponsible sex and alcohol and drug abuse. Leading women in local communities can also champion for change within their communities by mobilizing other women to join their efforts in sensitizing the community about healthy living.
The approach is to create meetings frequent meetings with women to educate them. The education given in such sessions touches on many issues such as the opportunities available for women, changing lifestyles, and generating ideas that help girls and women to become financially stable through legitimate work. Through these influential women leaders, the aim of the group is to partners with other organizations determined to address the unfair differences in Mississippi.
Priority areas of concern would be, addressing the socio-economic issues affecting African-American women in the State. Besides, the group will look at getting girls and women from Mississippi to take up education as a way of addressing the inequality gap. Most importantly, I would use these influential women leaders because they are in a good position to push the government to bridge the gap of inequality between African-American women and other demographic groups in the State.
In 2015, chronic diseases such as heart disease, diabetes, and cancer were among the top seven causes of death in the United States (Centers for Disease Control and Prevention [CDC], 2017). Many health care organizations have focused their resources on controlling and preventing chronic diseases among community members through population health management (PHM) strategies (see Appendix, Terms and Definitions). In response to the prevalence of chronic diseases, the Gilbert-Hopes Family Health Center (GHFHC) in Southern Arizona has created a population health improvement plan based on PHM strategies to improve one pervasive health concern in its community—Type 2 Diabetes Mellitus (T2DM). Type 2 Diabetes Mellitus in American Indian (AI) communities is the focus of the plan. The initiatives implemented under the health improvement plan will use the best available evidence on Southern Arizona’s AI communities gained through the evaluation of demographic, epidemiological, and environmental data. Additionally, the plan will apply strategies for communicating health improvement goals with AI communities and health care professionals in an ethical, culturally sensitive, and inclusive way.
According to 2012 data, diabetes is a serious chronic disease affecting 29.1 million people in the United States. It can lead to conditions such as kidney failure, blindness, and heart disease. Diabetes also makes patients vulnerable to infections that require amputation (CDC, 2014). In Arizona, which has the third largest population of AIs in the country, almost 16% of AIs reported having diabetes, especially T2DM (Bass, Bailey, Gieszl, & Gouge 2015). In Southern Arizona, the CDC estimates that about 24.1% of adult AIs have diabetes. The state’s distribution of T2DM is caused by a combination of genetic and environmental factors.
Behavioral risk factors such as smoking, alcoholism, sedentary lifestyles, weight gain, and poor diets can be classified as environmental factors of T2DM and were observed among Navajo Nation and Pima Indians (Arizona Department of Health Services, Bureau of Tobacco and Chronic Disease [AZDHS], 2011; Murea, Ma, & Freedman, 2012). Exposure to pollutants is another environmental factor that can be associated with T2DM because pollutants affect insulin sensitivity and glucose metabolism (Eze et al., 2015). Genetic factors include a family history of obesity or diabetic vascular complications. Individuals with such a family history are at high risk of getting Type 2 diabetes (Murea, Ma, & Freedman, 2012).
The evaluation of epidemiological and environmental data about T2DM in AI communities has revealed several gaps in knowledge. To begin with, most epidemiological data about AIs by federal agencies such as the CDC do not have information on populations living in Indian reservations as reservations are independent governmental entities (AZDHS, 2011). Moreover, further evaluation is needed on the effects of exposure to environmental pollutants; most studies tend to focus on behavioral risk factors. These gaps in knowledge can cause health disparities among urban AIs and those living in reservations, thereby making it difficult to identify chronic disease patterns.
Furthermore, there is a need for further evaluation of sociocultural and linguistic factors that often prevent people from accessing health care. The concept of cultural competence (see Appendix, Terms and Definitions) is imperative if the GHFHC wishes to successfully implement a population health improvement plan that will address the various needs of AI communities.
Among the many models adopted into PHM efforts, the collaborative chronic care model (CCM) framework is successful at managing diabetes and other chronic diseases among affected populations. There are six elements that are essential to the CCM: (a) health systems, (b) delivery system design, (c) decision support, (d) clinical information systems, (e) community resources and policies, and (f) self-management support (Improving Chronic Illness Care, 2003; see Appendix, Terms and Definitions). The GHFHC’s will follow the CCM for its health improvement plan based on certain assumptions about the plan. These assumptions are that the plan (a) needs to be sustained for a long time, (b) needs to comply with evidence-based guidelines for patient care, (c) needs to focus on patient education and lifestyle improvement, (d) needs to provide affordable and cost-effective care for AIs, and (e) needs to be culturally sensitive and equitable for disadvantaged community members.
The CCM’s six elements complement these assumptions and when the model is implemented in a PHM, the CCM will allow an informed, active community to productively interact with a proactive, prepared clinical team to achieve improved outcomes. Key components of the plan that are consistent with the CCM elements and the GHFHC’s assumptions are as follows: (a) establishing a system for collecting data and tracking health outcomes among AI patients; (b) establishing an operational leadership that will change staff management policies to ethnically match ethnicity and language of AI patients; (c) training all health care professionals on the CCM and cultural and linguistic competence; (d) sharing reports, lab-work, and epidemiological data with local health systems; (e) identifying local resources such as community health centers, YMCAs, religious centers, and senior centers that can help connect patients with the GHFHC; and (f) planning regular meetings for all stakeholders to resolve issues, discuss outcomes, and make recommendations.
The different components in the plan will enable health care professionals in diagnosing widespread diabetes in the AI community and ensure that cultural competence is deployed at the patient, health care professional, organizational, and systems levels. The next section will discuss why the CCM was selected over other community-based population health management models. Relevant evidence and examples will be provided.
Since its inception more than 15 years ago, the chronic care model has been for diabetes care in health care organizations across the United States with positive outcomes (Baptista et al., 2016). Most of the evidence supporting the model comes from randomized control trials (RCTs), qualitative reviews, meta-analyses, and systematic reviews of articles on the CCM in health care organizations. The results of one systematic review of 16 studies on the CCM application revealed better diabetes management programs in several health organizations (Stellefson, Dipnarine, & Stopka, 2013). Organizational leaders used the CCM to initiate system-level changes that improved delivery of diabetes care to patients. The organizations introduced disease registries and electronic records to establish patient-centered goals, educate patients on self-management, and train health care professionals in evidence-based care.
Another study evaluated the success of Project Dulce, a CCM-based diabetes care program developed by the Scripps Whittier Diabetes Institute in collaboration with San Diego County, San Diego State University, and federally qualified health centers (Philis-Tsimikas & Gallo, 2014). The project used specially trained teams and peer educators to implement the CCM elements in an ethnically and racially diverse community. The results showed significant cost-effectiveness hospitalizations and emergency visits reduced.
While the CCM has many merits, there are conflicts in the data provided by the aforementioned studies. Health care organizations implement only one or two elements such as delivery design systems or self-management rather than the combined implementation of all six elements. As a result, it is difficult to determine the overall impact of the CCM or identify the combinations of elements that are ideal (Davy et al., 2015). Other conflicting problems are related to the study process of RCTs: participants were sometimes aware of their participation in trials, follow-up periods and sample sizes were insufficient, and study nurses were inadequately trained (Baptista et al., 2016).
Despite these problems, the CCM remains a popular model compared to the acute care model of case management. While the two are similar in terms of care coordination and cost-effective strategizing, the CCM is more overarching, community and population-based, and more proactive in health improvement. Acute care, on the other hand, is case-specific, client-centered, and episodic (Huber, 2017). Because of the reach and magnitude of GHFHC’s health improvement plan, evaluating its outcomes can become a complex task. As the plan follows already established population health management strategies, evaluative criteria will correspondingly borrow from PHM theories of outcomes measurement.
Population health improvement plans are the convergence of different health care roles and resources. To devise an effective PHM plan, GHFHC must identify, define, and assess standards that can evaluate its plan in its entirety. One of the leading organizations conducting research and development on population health programs is Care Continuum Alliance (CCA). The CCA identified key components of PHM (Care Continuum Alliance [CCA], n.d.-a; see Appendix, Terms and Definitions) in its population health improvement model. The model proposed an additional five measures of population health plan outcomes: (a) optimal clinical indicators, including process and outcomes measures; (b) assessment of patient satisfaction with health care; (c) economic and health care utilization indicators; (d) functional status and quality of life; and (e) impact on known population health disparities (CCA, n.d.-a).
These five measures can be supplemented with evaluative criteria adapted from the CCA’s six components of disease management (DM) programs. The DM evaluation criteria can help determine whether the plan objectives are completed and detail the performance indicators or methods used in the process (Huber, 2017; CCA, n.d.-b; see Appendix, Terms and Conditions). The combination of both sets of criteria can provide a well-rounded evaluation and simultaneously consider different components and methods within the GHFHC’s health improvement plan.
Other evaluative criteria that were considered, but rejected, belonged to the RAND Corporation’s DISMEVAL project for chronic disease management. The RAND evaluation is organized under broad categories—input measures, process measures, output measures, outcome measures, and other impacts—with specific dimensions to be selected based on the design and goals of the health intervention (Nolte et al., 2012). However, the criteria do not adequately address sociocultural impacts from the health care intervention. As the health improvement plan specifically targets a vulnerable community, the plan will benefit from an evaluative framework that presupposes cultural disparities and promotes specific steps for optimal social outcomes.
Implementation and evaluation of the population health improvement plan depend on a concrete communication strategy. To coordinate care across different times, settings, providers, and community members, the structure and challenges of its communication plan become even more relevant.
Communication is central to achieving each component of the population health improvement plan. Therefore, communication is a core task for GHFHC’s health care professionals. The biggest communication barriers to be expected in care coordination and self-management are distrust, misunderstanding due to language differences, inappropriate educational methods, a lack of cultural competence, and low levels of interaction between health care providers and patients brought on by language barriers (Tiedt & Sloan, 2015; Ghosh & Spitzer, 2014).
One strategy to remove these barriers is training health care professionals, especially nursing professionals who are primary caregivers, in cultural and linguistic competence. The strategy includes enlisting the expertise of interpreters and hiring staff from AI backgrounds to achieve language concordance (Dauvrin, Lorant, & d’Hoore, 2015). Peer specialist-led interventions are instrumental in communication because they connect with patients through their shared experiences. Peer specialists are individuals who have personal experiences with a health issue such as T2DM and who may belong to the same ethnicity or community as the patient (Cabassa et al., 2015; Dauvrin, Lorant, & d’Hoore, 2015). Cultural tailoring of resources and facilities is a part of this strategy. For example, educational materials and content-based resources for patients can depict substantial graphic content instead of plain text to avoid ambiguity.
Another strategy is to improve interaction between health care providers and patients. Establishing regular contact through telephonic calls and emails, conducting meetings at public or community spaces, and arranging for clinic-to-home services for patients are appropriate communication methods (CCA, 2012). Face-to-face patient follow-ups can be set up on a daily, weekly, or monthly basis determined by the severity and risk of the case (Cabassa et al., 2015). Additionally, interactions are simplified by setting up clinical information systems for sharing all patient-related data among care providers and care coordinators because health care professionals who can answer patients’ queries are more trusted (Dauvrin, Lorant, & d’Hoore, 2015).
Despite these strategies, there is potential for challenges in communication. For instance, many community members may be spread across relatively isolated rural areas and reservations. They may not be able to procure access to health interventions, or health care providers may not be able to go to them. The solution will be enlisting the help of local community leaders and medical centers to bridge the communication gap and execute the communication strategies. Another challenge can arise if health professionals do not involve patients’ families in the health management process. Families play an important role in enforcing behavioral and lifestyle changes and sustaining those changes to improve health outcomes. It is impossible to plan for each problem, communication-related or other, as health care is a high-risk environment. Instead, health care professionals must focus on the professional guidelines on patient-centered care and cultural competence that will help them solve problems as they arise. Health care professionals focused on proactive care delivery are part of what makes a population improvement plan effective.
As chronic diseases such as type 2 diabetes become more widespread, health care professionals and communities must work together to create focused health interventions. However, interventions cannot ignore the cultural contexts that shape individuals and their experiences in health care. Models such as the chronic care model are successful in customizing care for ethnic and racial communities. Yet, experts have voiced a need for improving such models and PHM guidelines that focus on the specific and unique needs of multicultural patients. The GHFHC, through its health improvement plan, will join other health care organizations in promoting research and innovation in an important health care field.