...Treatment Introduction Generalized anxiety disorder (GAD), defined as worry lasting six months or longer that cannot be explained or rationalized by a precipitating traumatic event (Townsend, 2015), is the second most commonly diagnosed psychological disorder (Antai-Otong, 2003). Often presenting with other psychological conditions, the symptoms leading to impairment of the patient compound and increase the complexity of treatment (Antai-Otong, 2003). The standard method of care remains a combination of both pharmacological and cognitive behavioral therapy (CBT) interventions. However, research regarding the incorporation of the patient’s religious/spiritual beliefs into their course of treatment have demonstrated favorable results as an additional method of intervention (Antai-Otong, 2003; Koszycki, D., Bilodeau, C., Raab-Mayo, K., & Bradwejn, J., 2014; Ramos, K., Barrera, T., Stanley, M., & DeBakey, M., 2014;...
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...UNIVERSITY OF CALGARY FACULTY OF NURSING SPRING SESSION 2008 NURSING 607.57 ASSIGNMENT # 3 SCHOLARLY PAPER title: sound, spirituality and Healing for the family experiencing terminal cancer: a case study of the application of mantras Submitted by: Rosato, Mr. Giuseppe Date of Submission: July 18th, 2008 Submitted to: Dr. Carole-Lynne Le Navenec sound, spirituality and Healing for the family experiencing terminal cancer: a case study of the application of mantras ABSTRACT Given the growing interest in North America for CAM, complementary and/or alternative medicine (diverse medical and health care systems, practices, and products that are not presently considered to be part of conventional medicine) and holistic healthcare, health care professionals within the regulation imposed by their professional organization, have the ability to expand the realm of conventional medicine (medicine as practiced by holders of M.D. [medical doctor] or D.O. [doctor of osteopathy] degrees and by their allied health professionals, such as physical therapists, psychologists, and registered nurses) to a holistic healthcare system by integrating CAM modalities such as acupressure, guided imagery, humor, massage, meditation, therapeutic touch/healing touch, prayer and arts in general into their profession. This paper explores a CAM and holistic treatment/healing modality, Mantra Therapy, that conforms to three types of CAM as defined by the United States government...
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...end of life care, they and their families are faced with difficult choices. During this time it is important to have a support system. In the case study Janelle decided against medical treatment and relied on her religious belief. Therefore it is necessary to use her personal strengths in interventions and to empower her when intervening. Her self-determination towards treatment should be respected, According to (NASW 2008), Social workers respect and promote the right of clients to self- determination and assist clients in their efforts to identify and clarify their goals. As social workers we will advocate Janelle’s position not to seek treatment to the other members of the interdisciplinary team; in doing so we will explore ways to decrease the tension between her and the other members. Janelle has a strong religious belief that she will be healed. As members of her interdisplinary team we will education her family on the pros and cons of relying on spirituality only for healing. We will communicate with Janelle by being open and honest in planning and assessing care for her and her family. Woodhouse (2011) suggested that effective communication has the potential to engender a therapeutic environment and relationship. Good communication skills are vital for spiritual carers in supporting patients, families, and the multidisciplinary team in dealing with issues such as denial and confusion. According to Amoah (2011), Spirituality is central to palliative care implies that...
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...Satisfaction with Care at the End of Life Sydney Morss Dy, MD, MSc,Ã wz Lisa R. Shugarman, PhD,§ Karl A. Lorenz, MD, MSHS,§ k Richard A. Mularski, MD, MSHS,# and Joanne Lynn, MD, MA, MS,§ for the RANDFSouthern California Evidence-Based Practice Center (See editorial comments by Dr. Jean S. Kutner, pp 160–162) The objective of this study was to systematically review the literature to better understand the conceptualization of satisfaction with end-of-life care and the effectiveness of palliative care interventions on this outcome. Data sources included Medline and the Database of Reviews of Effects. The review included relevant qualitative studies and intervention studies using satisfaction as an outcome from 1990 to 2005. Reviewing 24,423 citations yielded 21 relevant qualitative studies, four systematic reviews, and eight additional intervention studies. The qualitative literature described the domains of accessibility and coordination; competence, including symptom management; communication and education; emotional support and personalization of care; and support of patients’ decision-making. For collaboration and consultation interventions, eight of 13 studies showed a significant effect on satisfaction. A metaanalysis found that palliative care and hospice teams improved satisfaction, although most studies did not include satisfaction as an outcome. For other types of interventions, only two of six showed a significant effect. For heart failure coordination of care, only seven...
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...of 29 questions designed to determine a patient’s ethnic, cultural, and religious background. The tool gives nurses an understanding of the patient’s traditional health and illness beliefs and practices so that culturally appropriate interventions can be initiated (Flowers, D.L., 2005). The following paper summarizes the assessment results of three culturally different families, and uses those results to show how the nurse would proceed with health promotion based on the differences in health traditions between the three cultures. Health Maintenance The value a patient places on family values and their perceived support system can greatly influence their overall health maintenance. With two of the families interviewed, one with a Hispanic ethnic background and the other from an American Indian background, both families placed great value in their family relationships. Both families were able to express knowledge of an extended family network and were active participants of that social system. The family unit is the most important support system to both cultural groups. Askim-Lovseth & Aldana (2009) explains that in an extended family network all “family members are expected to help each other during difficult times, and provide aid in case of health or financial problems” (p. 359). The third family interviewed placed a very different value on their family system. Both members of this family unit were younger than 25 years of age and stated having grown up in single parent...
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...developed from the belief that reducing these stressors could reinforce healing through specific interventions targeting the patient’s stress (Turner & Kaylor, 2015). Through the coursework in NUR-145, I have learned about Betty Neuman’s model and how it is used to plan patient care. Though I have only learned briefly about the Neuman Systems Model, I can see how useful it is in carrying out care for patients in a holistic way. The Neuman Systems Model begins with viewing the client, or patient, as an open system that interacts and reacts to the environment in which he...
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...The Holistic Assessment: Psychological, Physiological, Cultural, Spiritual and Psychosocial Wilfredo Mamaril Sternberg College The holistic assessment is an essential component of quality care that allows a psychiatric nurse to identify, diagnose and treat their patients based on every individual’s specific needs. A comprehensive assessment of a client’s health across multiple dimensions, such as their physiological, psychological, spiritual, cultural and psychosocial domains, are important “prerequisites for formulating an appropriate nursing diagnosis and plan of care” (Carniaux-Moran) particular to each patient. This assessment is achieved through interviews and assessments between the nurse and the client that “[varies] according to the state of the participants and the context in which the interview takes place” (Carniaux-Moran). It assists a nurse towards a more proficient and thorough diagnoses. For one, it is vital to consider a client’s past and present physical condition in order to determine if any of these medical disorders have an impact on their mental health. For example, patients who present symptoms for some common psychiatric illness such as nervousness, irritability and insomnia, can actually be suffering from underlying medical condition such as hypothyroidism or low lithium levels. In order to overcome the shortcomings of the visual observation of symptoms, nurses often perform a medical workup to rule out organic illnesses and ensure that the client...
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...Orientation to course 1. Course descriptions 2. Course outcomes/competencies 3. Textbooks B. Course Requirements 1. Student assignments and responsibilities 2. Minimum level of achievement 3. Evaluation tools C. Course/ Clinical Assignments and Evaluation D. Major Concepts 1. Caring 2. Clinical judgment, clinical reasoning, and nursing judgment 3. Clinical microsystem 4. Collaboration 5. Critical thinking 6. Cultural competence and Diversity 7. Ethics 8. Evidence-based care 9. Healthcare environment 10. Human flourishing 11. Informatics and Information management 12. Integrity 13. Knowledge, skills, and attitudes 14. Leadership 15. Nursing and Nursing Process 16. Nursing-sensitive indicators 17. Patient and Patient-centered care 18. Personal and Professional development 19. Professional identity 20. Quality improvement 21. Relationship-based care 22. Safety Teaching-Learning Strategies * Review course syllabus distributed by instructor * Read requirements and policies related to program found in Nursing Student Handbook (NSH) * Review course supplemental learning guide (SLG) * Text for course * Read definitions of Major Concepts used in the Program...
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...disease in humans, thus leading to the main question being studied: what interventions reduce osteoporosis in older Canadian adults? This subject holds great importance in nursing practices, in that nurses are able to facilitate client protection through promotion of interventions, early detection and overall management of said disease. This nurse-driven public education on the importance of interventions allows people...
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...health care provider in assuring emotional and physical comfort and in adjusting the patient's environment. For example, in 1926, Harmer advocated that nursing care be concerned with providing an atmosphere of comfort. In the 1980's, a modern inquiry of comfort began. Comfort activities were observed. Meanings of comfort were explored. Comfort was conceptualized as multidimensional (emotional, physical, spiritual). Nurses provided comfort through environmental interventions. It was in this decade that Kolcaba began to develop a theory of comfort when she was a graduate student at Case Western Reserve in Cleveland, Ohio. She is currently a nursing professor at the University of Akron in Ohio. Kolcaba's (1992) theory was based on the work of earlier nurse theorists, including Orlando (1961), Benner, Henderson, Nightingale, Watson (1979), and Henderson and Paterson. Other non-nursing influences on Kolcaba's work included Murray (1938). The theory was developed using induction (from practice and experience), deduction (through logic), and from retroaction concepts (concepts from other theories). The basis of Kolcaba's theory is a taxonomic structure or grid that has 12 cells (Kolcaba, 1991; Kolcaba & Fisher, 1996). Three types of comfort are listed at the top of the grid and four contexts in which comfort occurs are listed down the side of the grid. The three types are relief, ease and transcendence. The four contexts are physical, psycho-spiritual, sociocultural...
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...knowledge. These knowledge is acquire through years of formal educational and preparation, through the development of a deeper mode of critical thinking, through life experiences, through the desire to achieve and provide the best one can offer, and through the final understanding that one does not have all the answers or the power but one can help others to alleviate their pain. Advance practice nursing preparation is a journey that takes the nurse through different paths designed to provide understanding to how nursing science has developed and continues to evolve. Nursing science has made great advances-this thanks to the many theorists that thought their theories have guided, provided, and developed essential concepts now use in nursing care delivery. The following will be a discussion about concept analysis and how this lead to the development of theories. The concept of healing will be discussed as it applied though Barbara Dossey’s Theory of Integral Nursing. Third, the concept will be evaluated using the concept analysis process, and the conclusion will be a summary of how the healing concept is utilized within the broad scope of advance nursing practice. Concept Introduction Healing is Barbara Dossey’s Theory of Integral Nursing core concept. According to Dossey we all have the capacity to heal but the process becomes entangled in the intricacies one experiences through everyday life. To truly understand illness one has to view it through the concept of healing; this...
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...and change. Thus, the purpose of this literature review is to establish the current perspectives of patients, family and nurses on the factors that improve dignity in the end of life. Resultantly, this literature review will explore the role of nurses’ based on the findings of the perspectives that patients, family and health professionals have concerning the issue of dignity in the end of life care. In that regard, the paper follows a systematic approach which involves an introduction that explains the concept of end of life and the types of end of life care available. The paper then proceeds to explore the concept of dignity as viewed from several perspectives through the use of literature on the models of dignity means of measuring dignity and the themes associated with this conception. Consequently, the factors that improve dignity are laid out and discussed at length. Eventually, the paper will achieve its secondary goal which is to determine and expound on the topic of the roles that a nurse plays in end of life care not only for the patient but also for their family. End of life care Before the discussion of the main topic of this literature review which is determining the factors that promote dignity in the end of life in order to determine the role of nurses in the end of life, there is need to understand the meaning of the concepts of end of life and dignity. It is imperative...
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...Case study #1 1. The priority teaching would be to never abruptly stop taking the medication especially without consulting your physician, but try to take it in the morning so she would not have to get up a lot during the night to empty her bladder. 2. Decreased cardiac output r/t increased vasoconstriction aeb variations in blood pressure readings a. Monitor and measure blood pressure in both arms, using a manual technique for an accurate reading b. Monitor response to medication to control blood pressure. Give fluid and sodium restriction as indicated Disturbed Sleep Pattern r/t use of prescription diuretic aeb awaking various times in the middle of the night * instruct patient to take hctz in the morning to avoid waking up at night * assist the patient to identify envoiormental factors that make sleep difficult. Knowledge deficit related to lack of information about the disease process and self-care as evidence by patient lack of complaiance with medications. * Describe the nature of the disease and the purpose of the procedure and the treatment of hypertension * Explain the importance of a peaceful environment and theraupetic, and management of stressors. 3. Two non pharmacologic ways of managing hypertension include limiting your alcohol intake and the DASH diet which includes a diet that encourages you to reduce sodium intake and eat foods rich in nutrients such as potassium, calcium and magnesium. ...
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...Opioid Administration and Pain Management in the Terminally Ill Cancer Patient: Case study of a patient in the terminal phase of breast cancer. This case study is based on Ms. D, a 48-year-old married woman diagnosed with Bilateral Breast Cancer. She underwent a bilateral mastectomy 4 years ago. Lymph involvement was noted at the time of the surgery. Recent metastases of the bone has been diagnosed and she is in the terminal phase of the disease process. Up to this point, she has been on a regimen of Oxycodone 5 mg P.O. every 6 hours as needed for pain, Zantac 150mg P.O daily for heartburn, Docusate 100mg P.O. twice a day to promote bowel movements, Celexa 40mg PO daily for depression and enteric coated aspirin 81mg PO daily for prophylaxis of transient ischemic attacks and MI. She remains in her home and is receiving care at home. Ms. D has complained recently of significant increased pain and trouble sleeping, most likely due to the bone metastases in the area of the lumbar spine. She has stated that the pain has dramatically decreased her quality of life recently also. She has expressed the desire to remain at home during the terminal phase of her disease, but needs more adequate pain management to preserve her quality of life for as long as possible. She is married and her husband is very loving and supportive of her desire to stay in the home during this phase. He has voiced some concerns about drug dependency if the patient were to receive stronger pain medication...
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...TREATING A PATIENT WITH CANCER: MAINTAINING PATIENT QUALITY OF LIFE Introduction Cancer is one of the most prevalent diseases in the U.S. Case (2011) noted that the 2010 report of the American Cancer Society (ACS) indicated that more than a million an d a half new cases of cancer are diagnosed every year. Along with physical disease, cancer also brings a significant impact on the patient’s overall quality of life (QOL). This paper asserts that for optimal patient outcome, healthcare workers, particularly nurses, need to attend to the cancer patient’s overall QOL rather than simply focusing on the physical disease of cancer. This essay will first address the issue of understanding what constitutes the patient’s QOL. Then key factors that directly affect the QOL are reviewed in the context of current best evidence. That will be followed by a section that addresses the nursing implications of this subject. The paper concludes with a brief summary and conclusion about the importance of maintaining patient QOL in cancer patients. The first element, is thus to define what is meant by “quality of life.” The next section of this paper addresses that specific issue. Defining Patient Quality of Life Before patient QOL can be addressed in a nursing practice, it is essential to understand what is meant by QOL. Bahrami (2011) has noted that no specific, well accepted definition of patient QOL exists. One reason for this lack of consensus on QOL is that life quality is a highly...
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