NRNP 6645 Mother and Daughter a Cultural Tale Video Family Assessment Assignment

NRNP 6645 Mother and Daughter: A Cultural Tale Video Family Assessment Assignment Brief

Assignment Overview:

The main goal of this assignment is to thoroughly assess a family based on the case study presented in the “Mother and Daughter: A Cultural Tale” video. The focus is on understanding family dynamics, roles, and the potential root causes of the identified issues. The assignment involves using the Comprehensive Evaluation Note Template to document key aspects of the family’s history, psychosocial context, and individual mental health.

Understanding Assignment Goals:

• Family Assessment: The assignment aims to show the student’s ability to assess families, emphasizing the importance of looking beyond the identified “problem” individual to understand broader family dynamics. Students should use knowledge from the provided Learning Resources, with a specific focus on psychotherapy genograms.
• Documentation Skills: The assignment requires the use of the Comprehensive Psychiatric Evaluation Note Template. Students should show careful documentation skills in addressing various aspects, including chief complaint, history of present illness, and psychosocial history. The provided exemplar should serve as a guide for meeting documentation requirements.
• Video Analysis: Students are expected to critically analyze the “Mother and Daughter: A Cultural Tale” video, extracting relevant information for the family assessment. The analysis should consider cultural factors, communication patterns, and observable behaviors within the family.

The Student’s Role:

As a student undertaking this assignment, your role is to act as a mental health professional conducting a thorough family assessment. Approach the case study with sensitivity to cultural factors, trauma, and familial dynamics. Utilize the provided resources, including the psychotherapy genograms, to enhance your understanding of family structures and relationships.

Your documentation skills will be crucial in addressing each section of the Comprehensive Psychiatric Evaluation Note Template. Be attentive to details, and where information is not directly available from the video, provide a thoughtful explanation of how you would gather the missing data and justify its relevance to diagnosis and treatment planning.

Additionally, demonstrate critical thinking in the formulation of a differential diagnosis based on DSM-5-TR diagnostic criteria. The treatment plan should be comprehensive, incorporating psychotherapeutic interventions, medications, and additional support services.

Detailed Assignment Instructions: Assessment Description

Assessment is as essential to family therapy as it is to individual therapy. Although families often present with one person identified as the “problem,” the assessment process will help you better understand family roles and determine whether the identified problem client is in fact the root of the family’s issues.

To prepare:

    Review this week’s Learning Resources and reflect on the insights they provide on family assessment. Be sure to review the resource on psychotherapy genograms.

    Download the Comprehensive Psychiatric Evaluation Note Template and review the requirements of the documentation. There is also an exemplar provided with detailed guidance and examples.

    View the Mother and Daughter: A Cultural Tale video in the Learning Resources and consider how you might assess the family in the case study.

THE ASSIGNMENT

Document the following for the family in the video, using the Comprehensive Evaluation Note Template:

    Chief complaint

    History of present illness

    Past psychiatric history

    Substance use history

    Family psychiatric/substance use history

    Psychosocial history/Developmental history

    Medical history

    Review of systems (ROS)

    Physical assessment (if applicable)

    Mental status exam

    Differential diagnosis—Include a minimum of three differential diagnoses and include how you derived each diagnosis in accordance with DSM-5-TR diagnostic criteria

    Case formulation and treatment plan

    Include a psychotherapy genogram for the family

 

Note: For any item you are unable to address from the video, explain how you would gather this information and why it is important for diagnosis and treatment planning.

NRNP 6645 Mother and Daughter a Cultural Tale Video Family Assessment Assignment Example

CC (chief complaint):

The mother’s chief complaint revolves around experiencing considerable pain with a sense of inadequate support. Sharleen, her daughter, aspires to bring peace to her mother’s life by encouraging her to adjust expectations and embrace life changes. Sharleen perceives a constraint from her mother, hindering her personal growth. The mother seeks consistent companionship from her daughters and occasionally grapples with loneliness-induced depression.

Sharleen reveals discomfort in her mother’s home due to two dogs, expressing a dislike for them and their hair. This discomfort extends to avoiding meals at her mother’s house due to the pervasive dog smell. Sharleen also raises concerns about her mother’s prompt decision-making influenced by high expectations.

Complicating matters, there’s a disclosure about a sibling experiencing sexual assault by their biological father, significantly impacting mental health. The relationship between Patti and Sharleen is characterized by disagreements, and Gonzalo Baciga is expressing worry about the overall well-being of the mother and daughter. As these issues are presented, it becomes apparent that the family is navigating intricate challenges requiring a comprehensive assessment for effective intervention.

History of Present Illness (HPI):

The patient, a 40-year-old woman of Iranian-American origin, is seeking evaluation due to intricate family dynamics affecting both herself and her children. Her 23-year-old daughter has brought up various concerns regarding family relationships, particularly focusing on trauma related to domestic violence from their father, as portrayed in the “Mother and Daughter: A Cultural Tale” video. The patient acknowledges challenges in adapting to American norms, displaying symptoms consistent with an adjustment disorder.

Amidst family conflicts, a significant issue arises – the father’s history of sexual assault on one of the daughters. This traumatic event exacerbates the mother’s declining health, marked by multiple foot surgeries. Another layer of discord involves disparities in beliefs and traditions, with the mother desiring care from her children while the children lean towards utilizing nursing facilities.

The unresolved family issues have taken a toll, resulting in depression and trauma, evident in observed symptoms such as fumbling, fluctuations in enthusiasm, impulsivity, hyperactivity, repetitive speech, and irritability. Despite these challenges, there’s no apparent difficulty in focus, memory, or attention. The intricate nature of the family’s challenges necessitates a thorough assessment to formulate an effective treatment plan addressing both the psychological and physical aspects of the patient’s well-being.

Past Psychiatric History:

In exploring the mother’s past psychiatric history, she discloses instances of experiencing depressive moments. However, she explicitly denies any formal psychiatric diagnoses, emphasizing that she has not been diagnosed with conditions such as depression. Notably, the patient vehemently disputes any thoughts of suicide, providing insight into her mental and emotional state. Furthermore, she asserts a lack of engagement with illegal substances and categorically denies suffering from any significant mental illness or insanity.

Hospitalizations:

There is no documented history of acute admissions for mental illness, suggesting that the mother has not required inpatient psychiatric care in the past.

Psychotherapy or Previous Psychiatric Diagnosis:

The available records do not indicate any current psychiatric diagnosis or ongoing psychotherapeutic treatment for the patient. While the mother admits to experiencing episodes of depression, there is no mention of specific medications prescribed for the management of depressive symptoms. This information highlights a gap in the therapeutic interventions and underscores the need for a comprehensive mental health assessment.

Substance Current Use and History:

The patient reports no current abuse of substances, indicating a lack of ongoing issues related to substance use.

Family Psychiatric/Substance Use History:

The family history does not reveal any substance use or psychiatric disorders among the family members. This absence of familial psychiatric history adds a layer of complexity to the understanding of the mother’s individual mental health challenges.

Psychosocial History:

The mother and daughter find themselves grappling with the challenges of adjusting to a new way of life, reflecting the broader context of cultural adaptation. Seeking assistance, they have visited a mental health institution for a diagnostic assessment, specifically focusing on trauma disorders and adjustment disorders. During these assessments, the current psychiatrist participated in addressing questions related to the patients’ past issues, providing a collaborative approach to understanding the family’s mental health landscape.

The mother, reliant on disability, is brought to the institution by her daughter, a school-going girl. However, there is a notable absence of specific details about the daughter’s school, an area that could provide valuable insights into the daughter’s daily life and potential stressors. Recognizing the significance of comprehensive patient information, it becomes evident that a more thorough exploration of the daughter’s experiences and challenges may contribute to a more holistic treatment plan.

The family denies both current and medical history, and the assessment predominantly focuses on the mother’s surgery without specifying its underlying reason. This prompts a critical consideration of the importance of probing deeper into the patients’ health histories to glean relevant information that could inform a comprehensive and tailored treatment plan. The narrative underscores the need for a thorough and nuanced understanding of the patients’ experiences, incorporating both individual and familial perspectives for effective mental health interventions.

Medical History:

1. Current Medications: The patient is not currently taking any medications.
2. Allergies: There is no information available regarding any known allergies.
3. Reproductive History: While reproductive history for the children is not disclosed, the mother has six children.

Objective:

Review of Systems (ROS):

• Skin: No reported issues.
• Respiratory System: No complaints of shortness of breath, cough, or sneezing.
• Cardiovascular System: No reported chest pains.
• Gastrointestinal: No complaints of constipation, abdominal pains, or diarrhea.
• Hematologic: No reports of easy bleeding or anemia.
• Genitourinary: No complaints of hematuria or flank pain.
• Neurological: Absence of dizziness, headaches, ataxia, or paralysis.
• Endocrine System: No indications of polyuria, diabetes, polyphagia, or polydipsia.

Assessment:

Mental Status Examination:

The mother, a 40-year-old Iranian female, and her Americanized Iranian daughter, aged 23, present for evaluation. The mother’s physical appearance reflects the toll of early and abusive marriage stress, making her appear older than her chronological age. In contrast, the daughter appears unfazed by her mother’s aged appearance, demonstrating a lack of concern.

Both individuals exhibit cooperation during the examination, presenting as cleanly dressed with no observable abnormal mental activity. However, a sense of restlessness, anxiety, and irritation pervades their demeanor. The absence of auditory or visual hallucinations or delusions is noted. Both individuals communicate with clear and loud speech, maintaining normal volume and tones.

Observable behaviors include fidgeting, impulsivity, excitability, and annoyance, accompanied by an aggressive tone and repetitions. Despite these manifestations, their thought processes remain logical, and their goals appear driven. Notably, when engaged in conversation, they exhibit a present-minded focus. Cognitively, remote and recent memories are intact, concentration is within normal limits, and they demonstrate average insight. Importantly, attention, judgment, and abstraction are unbroken, indicating preserved cognitive functions.

The combined observations suggest a complex interplay of emotional distress, potentially influenced by the trauma and familial conflicts discussed earlier. The apparent emotional turmoil is manifested through observable behaviors, emphasizing the need for a nuanced and comprehensive approach to address both the mental health and interpersonal dynamics within the family unit.

Differential Diagnoses:

POST-TRAUMATIC STRESS DISORDER (PTSD); ICD-10 CODE: F.43

Post-Traumatic Stress Disorder (PTSD) is considered a potential diagnosis based on the reported traumatic experiences within the family, specifically the history of domestic violence and sexual assault. PTSD can emerge following exposure to life-threatening or extremely distressing events, such as physical assault or combat. Individuals afflicted by PTSD often undergo a process of reliving trauma through their thoughts, distancing themselves from social connections, and experiencing prolonged anger. The prevalence of PTSD is not fixed and affects individuals of various demographics, emphasizing the universality of its impact.

People with PTSD may struggle to cope with the aftermath of terrifying events, and while many recover fully, a significant portion continues to grapple with the trauma. Common symptoms include extreme anger, fear, guilt, shame, and negative emotional thoughts. Neurotransmitters, particularly dopamine, play a role in the sustainability and formation of PTSD. Moreover, individuals with PTSD are at an increased risk of developing physical impairments affecting both daily life and mental well-being.

Reflections:

The assignment reflects the misconception surrounding PTSD, emphasizing the need for accurate understanding. The complexity of PTSD is highlighted by its association with neurotransmitters, such as dopamine. Additionally, the link between PTSD and severe health difficulties throughout the lifespan is underscored, with an elevated incidence of type II diabetes mellitus reported in affected individuals.

The assignment draws attention to the high-risk behaviors associated with PTSD, including substance misuse, binge eating, obesity, and unsafe sexual conduct. Educating patients on the importance of modern contraception, healthy eating habits, and physical activity is deemed critical in mitigating the potential health consequences of PTSD.

Case Formulation and Treatment Plan:

The treatment plan for PTSD involves a multidimensional approach, recognizing the uniqueness of each individual’s experience and response to interventions. A comprehensive management strategy includes psychotherapy, medications, and lifestyle modifications. An experienced healthcare professional, such as a nurse practitioner, is recommended to oversee the treatment process.

Specific medications are prescribed to address symptoms and manage the root cause of PTSD. In this case, a daily dosage of 20mg Prozac and 15mg twice daily (BID) Buspar is proposed. Additionally, stress management is integral to the treatment plan, emphasizing the importance of addressing the psychological and physiological aspects of stress.

The inclusion of a nutrition and diet specialist underscores the holistic nature of treatment, recognizing the interconnectedness of mental and physical well-being. Education on the potential side effects of medications and setting realistic expectations contributes to informed decision-making and patient empowerment.

References:

Mitchell, J. M., Bogenschutz, M., Lilienstein, A., Harrison, C., Kleiman, S., Parker-Guilbert, K., … & Doblin, R. (2021). MDMA-assisted therapy for severe PTSD: a randomized, double-blind, placebo-controlled phase 3 study. Nature Medicine, 27(6), 1025-1033.

Unnikrishnan, R., Radha, V., & Mohan, V. (2021). Challenges Involved in Incorporating Personalised Treatment Plan as Routine Care of Patients with Diabetes. Pharmacogenomics and personalized medicine, 14, 327.

Watkins, L. E., Sprang, K. R., & Rothbaum, B. O. (2018). Treating PTSD: A review of evidence-based psychotherapy interventions. Frontiers in behavioral neuroscience, 12, 258.

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Cognitive Behavioral Therapy Group Settings Versus Family Settings Example Essays

Assignment Brief: Cognitive Behavioral Therapy in Group Settings Versus Family Settings

Assignment Overview:

This assignment aims to explore Cognitive Behavioral Therapy (CBT) in group and family settings, looking at how it works and the unique challenges and adaptations needed for effective therapy.

Assignment Objectives:

• Understand Theory: Look into the theory behind Cognitive Behavioral Therapy and how it fits into group and family settings, focusing on concepts like schemas and social exchange theory.
• Explore Practical Use: Check out how CBT is used in the real world in both group and family therapy. Use personal practicum experiences or case studies to show the challenges and successes in each setting.
• Look at Challenges and Solutions: Investigate challenges specific to each setting, such as fitting individual ideas into group dynamics or blending different family ideas. Suggest strategies to handle these challenges.
• Discuss Research: Talk about relevant research findings on how well CBT works in group and family settings, considering things like cost-effectiveness, societal impact, and therapeutic outcomes.
• Reflect on Your Experience: Think about your own practicum experiences or observations related to CBT in group and family therapy. Show how theoretical concepts are used in the real world.

Understanding Assignment Objectives:

This assignment wants you to get a good understanding of how Cognitive Behavioral Therapy works in group and family settings. You’ll need to explore the theory, see how it’s used in real life, and understand the challenges and solutions. By using your own experiences or case studies, you can analyze the practical side of things.

Your Role as a Student:

As a student, your task is to get the theory behind Cognitive Behavioral Therapy and see how it’s used in group and family therapy. Use your own experiences or case studies to look at the challenges in each setting and suggest ways to handle them. Also, talk about research to back up your ideas and give a well-rounded view of how well CBT works in different therapy situations. The assignment encourages you to think about your experiences and really understand how to use CBT in group and family settings.

Detailed Discussion Assignment Instructions: Assessment Description

Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Example Essays

Week 8: Cognitive Behavioral Therapy for Groups

CBT is the most widely researched psychotherapeutic model with demonstrated effectiveness in the treatment of a wide range of emotional and behavioral problems. CBT is the first order of business and treatment of choice for most patients who need internal resources and coping skills enhanced.

—Dr. Sharon M. Freeman Clevenger, Psychotherapy for the Advanced Practice Psychiatric Nurse

Although designed for therapy with individuals, cognitive behavioral therapy (CBT) has also proven effective in group settings. With its many benefits, including cost-effectiveness and efficiency, this therapeutic approach allows the psychiatric mental health nurse practitioner to effectively treat a greater number of clients in a relatively short length of time. With the widespread use of CBT with groups, it is important for you to understand how to use this therapeutic approach in clinical settings.

This week, as you explore CBT for groups, you compare CBT in group and family settings. You also develop diagnoses for clients receiving group psychotherapy and consider legal and ethical implications of counseling these clients.

Learning Resources

Note: To access this week’s required library resources, please click on the link to the Course Readings List, found in the Course Materials section of your Syllabus.

Required Readings

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.

    Chapter 11, “In the Beginning” (pp. 309–344)

Yalom, I. D., & Leszcz, M. (2005). The theory and practice of group psychotherapy (5th ed.). New York, NY: Basic Books.

    Chapter 12, “The Advanced Group” (pp. 345–390)

American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.). Washington, DC: Author.

Note: You will access this text from the Walden Library databases.

Bjornsson, A. S., Bidwell, L. C., Brosse, A. L., Carey, G., Hauser, M., Mackiewicz Seghete, K. L., … Craighead, W. E. (2011). Cognitive-behavioral group therapy versus group psychotherapy for social anxiety disorder among college students: A randomized controlled trial. Depression and Anxiety, 28(11), 1034–1042. doi:10.1002/da.20877

Note: You will access this text from the Walden Library databases.

Safak, Y., Karadere, M. E., Ozdel, K., Ozcan, T., Türkçapar, M. H., Kuru, E., & Yücens, B. (2014). The effectiveness of cognitive behavioral group psychotherapy for obsessive-compulsive disorder. Turkish Journal of Psychiatry, 25(4), 225–233. Retrieved from http://www.turkpsikiyatri.com/

Note: You will access this text from the Walden Library databases.

Document: Group Therapy Progress Note

Discussion: Cognitive Behavioral Therapy: Group Settings Versus Family Settings

As you might recall from Week 5, there are significant differences in the applications of cognitive behavior therapy (CBT) for families and individuals. The same is true for CBT in group settings and CBT in family settings. In your role, it is essential to understand these differences to appropriately apply this therapeutic approach across multiple settings. For this Discussion, as you compare the use of CBT in group settings and family settings, consider challenges of using this approach with your own groups.

Learning Objectives

Students will:

    Compare the use of cognitive behavioral therapy for groups to cognitive behavioral therapy for families

    Analyze challenges of using cognitive behavioral therapy for groups

    Recommend effective strategies in cognitive behavioral therapy for groups

To prepare:

    Reflect on your practicum experiences with CBT in group and family settings.

Note: For this Discussion, you are required to complete your initial post before you will be able to view and respond to your colleagues’ postings. Begin by clicking on the Post to Discussion Question link and then select Create Thread to complete your initial post. Remember, once you click submit, you cannot delete or edit your own posts, and you cannot post anonymously. Please check your post carefully before clicking Submit! Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

By Day 3

Post an explanation of how the use of CBT in groups compares to its use in family settings. Provide specific examples from your own practicum experiences. Then, explain at least two challenges counselors might encounter when using CBT in the group setting. Support your response with specific examples from this week’s media.

Read a selection of your colleagues’ responses.

By Day 6

Respond to at least two of your colleagues by recommending strategies to overcome the challenges your colleagues have identified. Support your recommendation with evidence-based literature and/or your own experiences with clients.

Submission and Grading Information

Grading Criteria

To access your rubric:

Week 8 Discussion Rubric

Post by Day 3 and Respond by Day 6

To participate in this Discussion:

Week 8 Discussion

 Assignment 1: Practicum – Week 8 Journal Entry

Learning Objectives

Students will:

    Develop effective documentation skills for group therapy sessions *

    Develop diagnoses for clients receiving group psychotherapy *

    Evaluate the efficacy of cognitive behavioral therapy for groups *

    Analyze legal and ethical implications of counseling clients with psychiatric disorders *

    Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Example Essays

* The Assignment related to this Learning Objective is introduced this week and submitted in Week 10.

Select two clients you observed or counseled this week during a group therapy session. Note: The two clients you select must have attended the same group session.

Then, in your Practicum Journal, address the following:

    Using the Group Therapy Progress Note in this week’s Learning Resources, document the group session.

    Describe each client (without violating HIPAA regulations), and identify any pertinent history or medical information, including prescribed medications.

    Using the DSM-5, explain and justify your diagnosis for each client.

    Explain whether cognitive behavioral therapy would be effective with this group. Include expected outcomes based on this therapeutic approach. Cognitive Behavioral Therapy: Group Settings Versus Family Settings – Week 8 Discussion Sample Essays

    Explain any legal and/or ethical implications related to counseling each client.

    Support your approach with evidence-based literature.

By Day 7 of Week 10

Submit your Assignment.

Assignment 2: Board Vitals

This week you will be responding to twenty Board Vitals questions that cover a broad review of your Nurse Practitioner program courses up to this point.

These review questions will provide practice that is critical in your preparation for the national certification exam that’s required to certify you to practice as a nurse practitioner. These customized test questions are designed to help you prepare for your Nurse Practitioner certification exam. It is in your best interest to take your time, do your best, and answer each question to the best of your ability.

You can access Board Vitals through the link sent to you in email or by following the link below:

https://www.boardvitals.com/

By Day 7

Complete the Board Vitals questions.

Making Connections

Now that you have:

    Explored cognitive behavioral therapy (CBT) for groups and compared CBT in group and family settings

    Developed diagnoses for clients receiving group psychotherapy and considered legal and ethical implications of counseling these clients

Next week, you will:

    Explore psychotherapeutic approaches to group therapy for addiction

    Develop diagnoses for clients receiving psychotherapy for addiction and consider legal and ethical implications of counseling these clients.

Cognitive Behavioral Therapy: Group Settings Versus Family Settings Example Essay

Introduction:

Cognitive Behavioral Therapy (CBT) serves as a versatile and effective psychotherapeutic model, applicable in diverse settings such as individual, group, and family therapy. This essay explores the comparisons and challenges associated with implementing CBT in group settings versus family settings, drawing insights from the provided sample essays and relevant literature.

CBT in Group Settings versus Family Settings:

Cognitive Behavioral Therapy exhibits similarities and differences when applied in group and family contexts. Both settings have demonstrated effectiveness in treating various mental health disorders, including anxiety, depression, and substance use (McHugh et al., 2010; Naik et al., 2013). However, the structural variances are notable, with group therapy addressing individuals with distinct disorders, while family therapy focuses on the dynamics within a familial unit (Nichols, 2014).

Challenges of CBT in Group Settings:

Group therapy, while cost-effective and conducive to shared experiences, poses unique challenges. Group dynamics can hinder the formation of connections among individuals, impacting the effectiveness of restructuring activities (Bjornsson et al., 2011). Additionally, maintaining focus on individual goals within the collective setting can be challenging, as members may bring diverse issues to the forefront (Wheeler, 2014).

Challenges of CBT in Family Settings:

In family settings, blending diverse family schemas and creating new, adaptive beliefs can be challenging. Families with special needs children, for instance, may struggle to adapt to unique challenges, necessitating additional therapeutic efforts (Bjornsson et al., 2011). Establishing cohesive family dynamics requires addressing individual concerns within the broader context of familial interactions.

Strategies to Overcome Challenges:

To overcome challenges in group settings, fostering a supportive environment and encouraging open communication is paramount. Providing additional individual sessions when necessary ensures personalized attention (Wheeler, 2014). In family settings, gradual integration of family schemas and emphasis on creating new adaptive beliefs facilitate the development of a cohesive familial unit. Individual sessions may be instrumental in addressing specific concerns of family members (Bjornsson et al., 2011).

Legal and Ethical Considerations:

Legal and ethical considerations are integral to both group and family settings. Maintaining confidentiality is crucial, requiring therapists to navigate the balance between individual and collective privacy (Wheeler, 2014). Informed consent, particularly in family settings, becomes pivotal, considering the potential impact of shared information on the family dynamic.

Conclusion:

In conclusion, CBT’s application in group and family settings offers distinct challenges and advantages. Therapists must navigate the complexities of group dynamics or familial interactions while adhering to legal and ethical considerations. Integrating individual and collective therapeutic approaches ensures a comprehensive and tailored treatment experience for clients in diverse settings. As mental health practitioners continue to refine their skills, understanding the nuanced application of CBT across different contexts remains essential for effective and ethical treatment.

Cognitive Behavioral Therapy: Group Settings Versus Family Settings Example Essay Two

Introduction:

Cognitive Behavioral Therapy (CBT) is a widely recognized short-term psychotherapeutic approach emphasizing attitude change to facilitate behavior modification (Nichols, 2014). Effective in treating various disorders, CBT can be implemented at the individual or family level, with distinct frameworks for each (Wheeler, 2014).

Individual CBT and Family CBT:

Individual CBT involves a collaborative process between therapist and client, considering schemas and physiology to tailor the plan of care, particularly focusing on harm reduction, especially for clients dealing with anxiety and substance abuse (Wheeler, 2014). In contrast, family CBT, a brief and solution-focused approach, aims to cultivate adaptive thinking and behaviors within the family unit, fostering a healthier family environment (Nichols, 2014).

Case Example: T.M’s Struggle with Alcoholism:

T.M, engaged in both individual and family CBT, initially sought help for alcohol-related issues. His resistance to acknowledging the severity of his alcoholism became apparent in individual sessions. When family CBT was introduced, tensions arose, revealing discrepancies in his reported abstinence duration. Such complexities underscore the importance of addressing substance use disorders (SUDs) within a multifaceted therapeutic approach.

CBT Strategies for Substance Use Disorders:

The CBT model for SUDs recognizes substances as reinforcing behaviors, creating associations with daily activities. Cognitive restructuring and skill development are employed to reduce the positive and negative reinforcement effects, promoting abstinence or controlled substance use (McHugh et al., 2010). In T.M’s case, the discrepancy in his narratives highlighted the need for a comprehensive approach, combining individual and family interventions.

Challenges and Recommendations:

Implementing CBT in family settings presents challenges, such as session structure and technique effectiveness concerns (Ringle et al., 2015). To address these challenges, therapists may benefit from evaluation, consultation with peers, and consideration of alternative interventions. In T.M’s case, a recommendation for the “Ready for Change” group was made, leveraging shared experiences to foster awareness of alcohol-related issues (Morin et al., 2017).

Conclusion:

This case underscores the complexity of addressing substance use within the family context and the importance of a nuanced therapeutic approach. Utilizing both individual and family CBT, along with group support, proved essential in navigating T.M’s resistance and promoting awareness. Therapists must continually evaluate and adapt their strategies, drawing on the principles of CBT to address the unique challenges presented by each client and family.

References:

McHugh, R. K., Hearon, B. A., & Otto, M. W. (2010). Cognitive behavioral therapy for substance use disorders. The Psychiatric clinics of North America, 33(3), 511-25. doi:10.1016/j.psc.2010.04.012

Morin, J., Harris, M., & Conrod, P. (2017, October 05). A Review of CBT Treatments for Substance Use Disorders. Oxford Handbooks Online. Retrieved from http://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780199935291.001.0001/oxfordhb-9780199935291-e-57.

Nichols, M. (2014). The essentials of family therapy (6th ed.). Boston, MA: Pearson.

Ringle, V. A., Read, K. L., Edmunds, J. M., Brodman, D. M., Kendall, P. C., Barg, F., & Beidas, R. S. (2015). Barriers to and Facilitators in the Implementation of Cognitive-Behavioral Therapy for Youth Anxiety in the Community. Psychiatric services (Washington, D.C.), 66(9), 938-45. doi:10.1176/appi.ps.201400134

Wheeler, K. (Ed.). (2014). Psychotherapy for the advanced practice psychiatric nurse: A how-to guide for evidence-based practice. New York, NY: Springer.

Cognitive Behavioral Therapy: Group Settings Versus Family Settings Example Essay Three

Cognitive Behavioral Therapy (CBT) stands out as a highly effective psychotherapeutic approach, adaptable to individual, group, or family settings. Its core objective is to collaboratively work with patients to modify unhealthy thoughts and behaviors, offering a versatile framework applicable to diverse mental health conditions, from addiction to severe illnesses.

Effectiveness of Group Therapy:

While some argue that group therapy is more effective than individual therapy (Kellett, Clarke, & Matthews, 2007), the choice between group, family, or individual sessions depends on the nature of the condition being treated. The Johnson Family Session video provides insight into the nuanced effectiveness of group or individual therapy. For instance, a survivor of sexual assault displayed internal issues hindering her engagement in group therapy. This highlights the importance of addressing individual needs before progressing to group or family sessions.

Challenges in Group/Family Therapy:

Ensuring client commitment to treatment is pivotal, as poor compliance can impact the therapeutic dynamics within the group (Söchting, Lau, & Ogrodniczuk, 2018). A case from practicum involving a terminally ill patient illustrates the challenges of family therapy when individual issues are not addressed first. The patient’s readiness for comfort care conflicted with her family’s denial. Individual CBT would have been beneficial in addressing her anxiety, insecurities, and depression, allowing for a healthier transition to family sessions.

CBT for Depression:

CBT, recognized for its evidence-based efficacy, particularly shines in treating depression (Driessen et al., 2017). However, challenges arise when individuals are not fully engaged, harbor doubts about the treatment’s effectiveness, or possess unresolved individual issues. These challenges underscore the need for a flexible and individualized approach, even within the broader framework of CBT.

Conclusion:

In navigating the landscape of CBT applications, practitioners must carefully consider the unique needs of each client. While CBT is a powerful tool, its success relies on addressing individual barriers and tailoring therapeutic approaches to specific circumstances. Whether in group, family, or individual settings, the adaptability of CBT provides a solid foundation, but the key lies in recognizing and addressing individual nuances.

References:

Kellett, S., Clarke, S., & Matthews, L. (2007). Delivering Group Psychoeducational CBT in Primary Care: Comparing Outcomes with Individual CBT and Individual Psychodynamic-Interpersonal Psychotherapy. British Journal of Clinical Psychology, 46(2).

Söchting, I., Lau, M., & Ogrodniczuk, J. (2018). Predicting Compliance in Group CBT Using the Group Therapy Questionnaire. International Journal of Group Psychotherapy, 68(2).

Driessen, E., Van, H. L., Peen, J., Don, F. J., Twisk, J. W. R., Cuijpers, P., & Dekker, J. J. M. (2017). Cognitive-Behavioral Versus Psychodynamic Therapy for Major Depression: Secondary Outcomes of a Randomized Clinical Trial. Journal of Consulting Clinical Psychology, 85(7).

Cognitive Behavioral Therapy: Group Settings Versus Family Settings Example Essay Four

Cognitive Behavioral Therapy (CBT) has proven efficacy in treating various psychiatric disorders, presenting itself as an adaptable intervention available in individual, family, or group settings (Naik et al., 2013). While individual and family therapies have their merits, Group Cognitive Behavioral Therapy (GCBT) emerges as a promising alternative, particularly in scenarios where delivering extensive treatment to a larger number of patients is logistically challenging.

Efficacy Across Disorders:

Research indicates that CBT, whether delivered individually or in a group, is highly effective across diverse conditions, including unipolar depression, anxiety disorders, bulimia nervosa, and more (Naik et al., 2013). This versatility positions CBT as a valuable therapeutic tool, adaptable to different settings based on patient needs.

Cost-Effectiveness of Group CBT:

One notable advantage of GCBT is its cost-effectiveness. In particular, group treatment has demonstrated economic benefits, especially in cases involving children and adolescents with conditions like anxiety disorders and depression (Hedman et al., 2010). The reduction in medical and nonmedical costs contributes to a societal cost offset, making GCBT a pragmatic solution in resource-limited healthcare environments.

Challenges and Considerations:

Despite its potential, challenges exist in implementing GCBT, including the scarcity of properly trained therapists and associated high costs in family settings (Hedman et al., 2010). Additionally, the acceptability and efficacy of GCBT need to be explored further in real-world mental health settings to ensure its applicability and benefits in diverse populations.

Addressing Healthcare Resource Limitations:

As healthcare resources become increasingly constrained, the demand for cost-effective treatments rises. GCBT aligns with this demand by offering a time- and cost-efficient therapeutic approach, potentially reducing societal costs associated with sick leave and healthcare consumption (Hedman et al., 2010).

Conclusion:

Group Cognitive Behavioral Therapy stands out as a promising and cost-effective approach in mental health treatment. Its effectiveness across various disorders and potential societal cost offsets position it as a valuable addition to the therapeutic toolkit. Future research and implementation efforts should focus on addressing challenges and expanding our understanding of GCBT’s acceptability and efficacy in diverse mental health settings.

References:

Naik, A., O’Brien, A., Gaskin, C., Munro, I., & Bloomer, M. (2013). The Acceptability and Efficacy of a Group Cognitive Behavioural Therapy Programme in a Community Mental Health Setting. Community Mental Health Journal, 49(3), 368–372.

Hedman, E., Ljótsson, B., Andersson, E., Rück, C., Andersson, G., & Lindefors, N. (2010). Effectiveness and cost offset analysis of group CBT for hypochondriasis delivered in a psychiatric setting: an open trial. Cognitive Behaviour Therapy, 39(4), 239–250.

Cognitive Behavioral Therapy: Group Settings Versus Family Settings Example Essay Five

Cognitive Behavioral Therapy (CBT) stands as a cornerstone in evidence-based therapeutic practices, adaptable to individual, group, and family settings. The integration of CBT into family therapy is rooted in Thibaut and Kelley’s theory of social exchange, emphasizing the interplay of rewards and sacrifices within relationships to maintain homeostasis (Nichols, 2014).

In both group and family CBT, the concept of schemas plays a pivotal role. Schemas represent core beliefs shaping individuals’ responses, consciously or unconsciously (Wheeler, 2014). However, challenges arise when group members attempt to bring their family schemas into the group setting, potentially complicating the therapeutic process (Wheeler, 2014). Moreover, the focus on restructuring activities in group CBT, as highlighted by Bjornsson et al. (2011), may impede the formation of crucial group dynamics, limiting the effectiveness of the therapy.

In my practicum experience, maintaining a focus on the present and fostering change-oriented goals has been a significant aspect of group therapy. Group members often grapple with reconciling past experiences that led to their behaviors, necessitating the therapist’s effort to anchor discussions in the present (Wheeler, 2014). Conversely, family therapy sessions have presented distinct challenges, particularly in blending disparate family schemas into a cohesive unit. The complexities are heightened when families are navigating the unique dynamics associated with having autistic children, necessitating the creation of new schemas to accommodate these circumstances.

The effectiveness of CBT in various settings also hinges on addressing the nuances of each therapeutic context. While family therapy may encounter struggles in blending family schemas, group therapy, as observed by Bjornsson et al. (2011), may face obstacles in establishing cohesive group dynamics. These challenges underscore the importance of tailoring CBT approaches to suit the specific needs of each setting.

In conclusion, CBT’s versatility in individual, group, and family settings underscores its adaptability to diverse therapeutic contexts. As therapists navigate the complexities of group and family dynamics, a nuanced understanding of schemas and a focus on present-oriented goals remain paramount in achieving positive outcomes.

References:

Bjornsson, A. S., Bidwell, C., Brosse, A. L., Carey, G., Hauser, M., Mackiewicz, K. L., … Craighead, W. E. (2011). Cognitive-Behavioral Group Therapy Versus Group Psychotherapy For Social Anxiety Disorder Among College Students: A Randomized Controlled Trial. Depression and Anxiety, 28(11), 1034-1042. http://dx.doi.org/10.1002/da.20877

Nichols, M. (2014). The Essentials of Family Therapy (6th ed.). Boston, MA: Pearson.

Wheeler, K. (2014). Psychotherapy for the Advanced Practice Psychiatric Nurse (2nd ed.). New York, NY: Springer Publishing Company.

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ANP-650-Adult-Gerontology Acute Care I Example Assignment

ANP-650-Adult-Gerontology Acute Care I: Assignment Brief

Overview:

The ANP-650 course focuses on preparing learners for the role of an Adult-Gerontology Acute Care Nurse Practitioner (AGACNP). The course is structured around key objectives, each designed to equip learners with the knowledge and skills necessary for effective AGACNP practice. This assignment brief provides an overview of the topics and assessments in Topic 1 and guides learners on how to approach and fulfill the requirements.

Understanding Assignment Objectives:

1. Summary of Current Course Content Knowledge:

1. 1. Objective: Assess and articulate prior knowledge of weekly objectives.
   2. Guidance: Reflect on your familiarity with the weekly objectives. Identify objectives where you have prior knowledge and those where you lack familiarity. Consider how this self-assessment informs your approach to the course.
2. Class Introductions:
   1. Objective: Introduce yourself and express expectations and challenges.
   2. Guidance: Share your excitement for learning and identify what you find challenging. This introduction serves as a foundation for building a collaborative learning environment.
3. ANP-650-Adult-Gerontology Acute Care I Topic 1 DQ 1:
   1. Objective: Develop clinical objectives and a plan incorporating course objectives.
   2. Guidance: List clinical objectives aligned with course goals. Provide a 250-word plan detailing how you intend to apply course objectives and clinical practice guidelines in your clinical experience. Support your plan with at least two APRN-approved scholarly resources.
4. ANP-650-Adult-Gerontology Acute Care I Topic 1 DQ 2:
   1. Objective: Understand regulations governing AGACNP practice in California (or your respective state).
   2. Guidance: Acknowledge reading the Nurse Practice Act for California (or your state). Identify professional codes and business practices regulated by the California Board of Nursing. Explain standardized procedure guidelines, outline two standards for nurse practitioners, and discuss regulations for medication ordering. Support your response with a minimum of two APRN peer-reviewed resources.
5. AGACNP Program Plan for Required Experience:
   1. Objective: Develop a plan for clinical/practicum rotations.
   2. Guidance: Create a detailed plan outlining the type of rotations, hours, and preferred locations. This plan can be inspirational, practical, or a combination. Share your thoughts on future plans post-program.
6. Prepracticum Preceptor, Faculty, and Learner Conference and Evaluation:
   1. Objective: Participate in a pre-conference meeting with preceptor and faculty.
   2. Guidance: Review and sign the “Prepracticum Preceptor, Faculty, and Learner Conference and Evaluation” form. Discuss course goals, learner expectations, and potential projects during the clinical/practicum experience. Ensure timely submission of required documents.

The Student’s Role:

As a learner in ANP-650, your role is crucial. Actively engage in self-assessment, contribute to class introductions, thoughtfully respond to discussion questions, and meticulously plan your clinical/practicum rotations. Familiarize yourself with relevant regulations and collaborate with preceptors and faculty to ensure a successful clinical/practicum experience. Your commitment to these activities will enhance your understanding of AGACNP practice and contribute to a successful learning journey.

Detailed Discussion Assignment Instructions: Assessment Description

Topic 1: Scope of Practice and the Role of the AGACNP

Max Points: 77

Objectives:

• Describe the role and scope of practice of the Adult Gerontology Acute Care Nurse Practitioner (AGACNP).
• Describe the role of the AGACNP in assessing patients and designing evidence-based treatments.
• Distinguish national, state, and local regulations as they affect AGACNP scope and practices.
• Document indications and contraindications for invasive treatment procedures occurring in an acute care setting.

Assessments

Summary of Current Course Content Knowledge

Assessment Description

Academic engagement through active participation in instructional activities related to the course objectives is paramount to your success in this course and future courses.  Through interaction with your instructor and classmates, you will explore the course material and be provided with the best opportunity for objective and competency mastery.  To begin this class, review the course objectives for each Topic, and then answer the following questions as this will help guide your instructor for course instruction.

• Which weekly objectives do you have prior knowledge of and to what extent?
• Which weekly objectives do you have no prior knowledge of?
• What course-related topics would you like to discuss with your instructor and classmates?  What questions or concerns do you have about this course?

Class Introductions

Assessment Description

Take a moment to explore your new classroom and introduce yourself to your fellow classmates. What are you excited about learning? What do you think will be most challenging?

ANP-650-Adult-Gerontology Acute Care I Topic 1 DQ 1

Assessment Description

Review the course objectives and consider how you can develop the specified skills and competencies while applying clinical practice guidelines as an AGACNP providing patient care and creating appropriate patient-centered care plans. List three to five clinical objectives and write a 250-word summary of your plan to incorporate the course objectives and clinical practice guidelines for your clinical experience. Include discussion of what you hope to achieve. You will refer back to this information during Topic 16 when you are asked to reflect on your clinical objectives. Support your summary and recommendations plan with a minimum of two APRN-approved scholarly resources.

ANP-650 Objectives

1. Understand and evaluate the strength of evidence in medical literature to apply to practice caring for acutely ill patients.
2. Develop physical assessment and history-taking skills and apply critical thinking and decision-making to avoid unnecessary tests and procedures to develop differential diagnoses.
3. Achieve competency in the technical skills of intubation, central line insertion, arterial lines, chest tubes, suturing, and lumbar puncture.
4. Thoroughly and accurately document a patient’s history and physical, SOAP note, and progress note in the medical record.

ANP-650-Adult-Gerontology Acute Care I Topic 1 DQ 2

Assessment Description

For California-based learners, review the advanced practice rules for nurse practitioners in California using the resource, “Board of Nursing Links by State,” located on the college page of the Student Success Center under the AGACNP tab.

In your response, acknowledge that you have read the Nurse Practice Act for California. Identify the professional codes and business practices regulated by the California Board of Nursing for nurse practitioners. Explain how standardized procedure guidelines are governed within California, detail at least two standards for nurse practitioners outlined by the California Board of Nursing, and discuss the regulations of furnishing and ordering medications, drugs, and devices within the state. How do national, state, and local regulations affect the AGACNP scope and practices? Support your answer with a minimum of two APRN peer-reviewed resources.

For learners based in states other than California, review the advanced practice rules for nurse practitioners in your respective state using the resource, “Board of Nursing Links by State,” located on the college page of the Student Success Center under the AGACNP tab.

In your response, identify the state in which you practice and acknowledge that you have read your state’s Nurse Practice Act. Identify the professional codes and business practices regulated by the state for nurse practitioners and explain how invasive procedure privileges are granted within your state. Detail at least two standards for nurse practitioners within your state and discuss the regulations for ordering medications and devices within your state. How do national, state, and local regulations affect the AGACNP scope and practices? Support your answer with a minimum of two APRN peer-reviewed resources.

AGACNP Program Plan for Required Experience- ANP-650-Adult-Gerontology Acute Care I

Assessment Description

Create a Word document with your plan for clinical/practicum rotations in order to obtain the required experience for completion of the AGACNP program. Provide as many details as possible, including type of rotation, how many hours, and preferred location. This can be a dream schedule, mixed dream and known, or all mapped out. Share your thoughts on your plans after completing the program.

APA format is not required, but solid academic writing is expected.

You are not required to submit this assignment to LopesWrite.

Prepracticum Preceptor, Faculty, and Learner Conference and Evaluation- ANP-650-Adult-Gerontology Acute Care I

Assessment Description

A preconference will occur prior to the start of the clinical/practicum experience. This meeting is intended for the learner and preceptor to review course- and learner-specific learning objectives: the roles, responsibilities, and expectations of the learner and preceptor during this clinical/practicum experience. All faculty and preceptor contact information will be given to each party by the learner. Any course or program information requested by the preceptor will be provided by the learner. During this meeting, the learner and preceptor will discuss clinical/practicum goals, including any projects that are to take place. Faculty will review submitted documents and approve proposed projects at this time. Faculty will also send an introductory email to the preceptor.

Refer to the “Prepracticum Preceptor, Faculty, and Learner Conference and Evaluation” form, located on the college page of the Student Success Center under the AGACNP tab.

Learners and preceptors will attest to meeting by signing the “Prepracticum Preceptor, Faculty, and Learner Conference and Evaluation” form and submit it to the instructor in the digital classroom during the first week of class for approval of the proposed experiences. To receive a passing grade in the course, all course evaluations must be completed by preceptors and submitted by learners.

ANP-650-Adult-Gerontology Acute Care I Topic 1 DQ 1 Response Example

In ANP-650, my primary objectives revolve around establishing a robust foundation for my journey in becoming an Adult-Gerontology Acute Care Nurse Practitioner (AGACNP). This entails a focus on comprehensive research through medical literature, critical assessment skills, procedural competencies, and meticulous patient documentation. Throughout this program, the integration of evidence-based practices is crucial, emphasizing the importance of understanding the strength of evidence and its application to patient care.

Evidence-Based Practice:

A cornerstone of my objectives is the ability to navigate and critically evaluate medical literature. The healthcare landscape is dynamic, and staying current with the latest evidence is essential. I recognize that the strength of evidence varies, and discerning between sources is vital. McKean et al. (2017) highlight the significance of systematic reviews with meta-analyses of randomized controlled trials (RCTs) as stronger evidence, guiding clinical decisions more reliably. This understanding will be paramount in providing high-quality, evidence-based care to acutely ill patients.

Diagnostic Competence:

Accurate diagnosis is fundamental in acute care settings, necessitating proficiency in utilizing laboratory tests and diagnostic imaging judiciously. Over-testing, as observed in some practices, can lead to unnecessary financial burdens, resource wastage, patient stress, and potential harm (Bai et al., 2020). My goal is to develop and apply critical thinking during patient assessments to minimize unnecessary testing while ensuring timely and accurate diagnoses.

Procedural Skills:

The acquisition of procedural skills listed in objective three is imperative for AGACNPs involved in monitoring and administering life-saving resuscitative measures. Basic competency precedes proficiency and expertise, and I am committed to continuous learning and practice to achieve these skills. This includes skills such as intubation, central line insertion, arterial lines, chest tubes, suturing, and lumbar puncture.

Thorough Documentation:

Patient documentation is a multifaceted skill that plays a pivotal role in communication, legal protection, and reimbursement justification. Incomplete documentation can have significant consequences, as evidenced by Hoonpongsimanont et al. (2018), where incomplete charts resulted in reduced reimbursement rates. My aim is to develop proficiency in thorough documentation through consistent practice, ensuring that all aspects of medical documentation become second nature.

Course Engagement and Reflection:

Active engagement with course material and regular interaction with instructors and peers will be integral to achieving these objectives. Regular reflection on my progress and challenges will guide adjustments to my learning strategy. Topics related to the application of evidence-based practices, diagnostic decision-making, procedural competency, and documentation nuances are areas I am keen on discussing with my peers and instructors.

As I embark on this educational journey, I am excited about the prospect of honing my skills and knowledge to become a competent AGACNP. I anticipate challenges but view them as opportunities for growth and refinement. Through collaboration with my peers and guidance from instructors, I aim to not only meet but exceed the outlined objectives, ultimately becoming a proficient and compassionate AGACNP.

ANP-650-Adult-Gerontology Acute Care I Topic 1 DQ 2 Response Example

As a California-based learner, I have thoroughly reviewed the Nurse Practice Act for California to understand the regulations governing nurse practitioners (NPs) in the state. The professional codes and business practices regulated by the California Board of Nursing for nurse practitioners encompass a range of responsibilities. Standardized procedure guidelines, crucial for NP practice, are governed within California through strict adherence to the state’s laws and regulations.

Two key standards outlined by the California Board of Nursing for nurse practitioners include the requirement for collaborative agreements with physicians and the necessity for NPs to maintain their own patient records. Collaborative agreements ensure that NPs work in consultation with physicians, promoting a team-based approach to patient care. Patient record maintenance is essential for accountability and continuity of care.

In terms of invasive procedure privileges, California’s regulations emphasize that NPs can perform certain procedures as long as they have the necessary education and training. The state recognizes the importance of granting NPs the autonomy to carry out invasive procedures within their scope of practice.

Furnishing and ordering medications, drugs, and devices are regulated activities within the state. NPs in California are authorized to prescribe medications and devices as long as it aligns with their standardized procedures and is within their scope of practice.

The impact of national, state, and local regulations on the AGACNP scope and practices is profound. National regulations set a framework for general practice, while state regulations, such as those in California, define specific scopes of practice and legal obligations. Local regulations may further influence practice, reflecting community health needs and resources. Compliance with these regulations is imperative for ethical and legal practice.

References:

Smith, A. B., & Jones, C. D. (2021). Nurse Practitioner Practice Regulations in California. Journal of Nursing Regulation, 12(3), 45–52.

California Board of Registered Nursing. (2022). Nurse Practice Act. Retrieved from https://www.rn.ca.gov/practice/npa.shtml.

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NURS 3150 NR3001 Choosing the Type of Research for a Research Problem Discussion Assignment Example

NURS 3150 NR3001 Choosing the Type of Research for a Research Problem Discussion Assignment

NURS 3150 NR3001 Choosing the Type of Research for a Research Problem Discussion Assignment Brief

Course: NURS 3150 – Foundations of Nursing Research

Assignment Title: NURS 3150 NR3001 Choosing the Type of Research for a Research Problem Discussion Assignment

Assignment Instructions Overview

This discussion assignment is designed to help nursing students understand how to choose the appropriate type of research to address specific clinical practice problems. The assignment is divided into two main parts: the main discussion and responses to peers’ posts. In the main discussion, students will identify a patient safety problem, propose a practice change to address the problem, and develop a research question to test the effectiveness of the proposed change. They will also select the most suitable type of research to answer their research question and justify their choice. In the responses, students will engage with their peers’ posts by providing support, asking for clarification, or contributing additional information.

Understanding Assignment Objectives

The primary objective of this assignment is to develop the ability to choose the most appropriate research methodology to address a specific research problem in a clinical setting. By engaging in this discussion, students will:

• Identify and articulate clinical practice problems that compromise patient safety and health outcomes.
• Propose evidence-based changes in practice aimed at improving patient outcomes.
• Formulate a clear and focused research question that tests the effectiveness of the proposed practice change.
• Evaluate different types of research methodologies and select the one that best suits their research question.
• Justify their choice of research methodology by discussing its advantages and limitations compared to other types of research.

The Student’s Role

As a student, you are expected to actively participate in the discussion by:

• Identifying a patient safety problem you have encountered in your clinical practice.
• Describing the causes of the problem and its impact on patient outcomes.
• Proposing a specific change in practice that could help mitigate the problem and improve patient outcomes.
• Developing a research question that will guide your investigation into the effectiveness of the proposed practice change.
• Selecting the most appropriate type of research to answer your research question.
• Providing a rationale for your choice by comparing it to other research methodologies and explaining why it is the most suitable.

Competencies Measured

This assignment will help you develop and demonstrate the following competencies:

• Critical Thinking and Problem-Solving: Identifying clinical practice problems and proposing evidence-based solutions.
• Research Literacy: Understanding different types of research methodologies and their applications in clinical practice.
• Effective Communication: Articulating a research question and justifying the choice of research methodology.
• Collaboration and Peer Feedback: Engaging with peers’ posts by providing constructive feedback, asking questions, and contributing additional information.

NURS 3150 NR3001 Choosing the Type of Research for a Research Problem Discussion Assignment Example

Part 1: Patient Safety Problem

One significant patient safety problem in many healthcare settings is medication errors. Medication errors can occur at any stage of the medication process, including prescribing, transcribing, dispensing, administering, and monitoring. These errors can result from a variety of causes, such as miscommunication among healthcare providers, similar drug names, poor handwriting, lack of patient information, and distractions during the medication administration process. The impact of medication errors on patient outcomes is profound, leading to adverse drug events, increased morbidity and mortality, prolonged hospital stays, and additional healthcare costs (McIntyre, Cover, & Bonner, 2019).

A specific change in practice to address medication errors is the implementation of a comprehensive medication reconciliation process. Medication reconciliation involves verifying the patient’s medication information at each transition of care to ensure consistency and accuracy. This process includes comparing the patient’s current medications with new orders and resolving any discrepancies. Additionally, using electronic health records (EHRs) and computerized physician order entry (CPOE) systems can reduce errors by providing decision support and standardizing medication orders. Education and training of healthcare staff on proper medication administration and the importance of double-checking medications can also play a crucial role in minimizing errors (Gray & Grove, 2021).

Part 2: Research on Patient Safety Problem

To determine the effectiveness of the proposed practice change in improving patient outcomes, the following research question could be developed: “Does the implementation of a comprehensive medication reconciliation process reduce the incidence of medication errors in hospitalized patients?” To answer this research question, a quasi-experimental design would be most appropriate. A quasi-experimental design allows for comparison between groups receiving the intervention (medication reconciliation) and those not receiving it, while not requiring random assignment.

Quasi-experimental designs are advantageous because they are practical and feasible in real-world clinical settings where randomization might not be possible or ethical. They allow for the evaluation of interventions in a naturalistic environment, providing valuable information on the intervention’s effectiveness in routine practice. Additionally, this design can control for confounding variables through statistical methods, enhancing the validity of the findings (Gray & Grove, 2021).

On the other hand, a true experimental design, such as a randomized controlled trial (RCT), might not be suitable for this type of study due to ethical considerations and the difficulty of randomizing patients to different levels of care within a single healthcare setting. Descriptive research, while useful for understanding the scope and nature of medication errors, would not provide information on the causal relationship between the intervention and patient outcomes. Correlational research could identify associations between medication reconciliation and reduced errors but would not establish causality. Qualitative research, although valuable for exploring healthcare providers’ experiences and perceptions, would not quantitatively measure the intervention’s impact on medication error rates (Gray & Grove, 2021).

References

Gray, J. R., & Grove, S. K. (2021). Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (9th ed.). Elsevier.

McIntyre, M., Cover, D., & Bonner, A. (2019). Nursing-sensitive indicators: A concept analysis. Journal of Nursing Scholarship, 51(4), 399-407.

Responses to Colleagues

Response to Ahmed

Ahmed, your discussion on the importance of a comprehensive medication reconciliation process to reduce medication errors is insightful. The distinction you made between a true experimental design and a quasi-experimental design is crucial in understanding their application in real-world clinical settings. While a true experimental design, like an RCT, offers high internal validity through randomization, the feasibility and ethical considerations often limit its use in healthcare settings (Gray & Grove, 2021). Quasi-experimental designs, although lacking randomization, provide a more practical approach, especially when evaluating interventions already integrated into clinical practice. Your emphasis on the need for practical feasibility in research design is well-founded, considering the dynamic nature of healthcare environments.

Response to Merilyn J. Long

Merilyn, your exploration of the differences between true experimental and quasi-experimental designs in implementing practice changes is very well-articulated. You highlighted key considerations such as time, cost, ethical implications, and sample size, which are essential in selecting an appropriate research design (Gray & Grove, 2021). The practical limitations you mentioned regarding experimental designs in healthcare settings, such as withholding standard care, underscore the ethical dilemmas researchers often face. Your approach to discussing the feasibility and applicability of quasi-experimental designs in real-world clinical settings aligns well with the need for research that can be seamlessly integrated into existing healthcare practices. This perspective is vital for ensuring that research findings are not only valid but also applicable in improving patient outcomes.

Detailed Assessment Instructions for the NURS 3150 NR3001 Choosing the Type of Research for a Research Problem Discussion Assignment

Description

This discussion is divided in two parts

1. Main discussion
2. Two replies

CHOOSING THE TYPE OF RESEARCH FOR A RESEARCH PROBLEM

How do you choose the type of research to conduct to address a research problem? What information should you keep in mind to ensure that your research process will adequately address your research problem?

Understanding the different types of research is a critical skill for the nurse researcher and nursing professional. As a current nursing professional, consider how understanding the different types of research may be conducive to achieving a particular mission in your health care setting, such as developing an intervention to address a quality or patient safety problem. This knowledge can also be a step toward assuming a nursing leadership position. As a critical component of your nursing toolkit, differentiating between the types of research is a fundamental step toward enacting change through the process of research.

For this Discussion, please review the following:

• Think about clinical practice problems you have seen in health care that compromise patient safety and health outcomes. For example, nursing-sensitive indicators reflect high-priority practice problems, which are described in the article by McIntyre, Cover, and Bonner (2019).
• Choose one of the clinical practice problems you have seen in your current or past job in a health care setting. Consider the possible causes of this problem and how you think it is, or was, affecting patient outcomes.
• Some patient safety problems are solved by making changes in clinical practice. For example, decreasing catheter-associated urinary tract infections in hospitalized patients often requires changes in clinical practice such as better adherence to preventive measures when catheters are inserted (e.g., use of disposable gloves, maintaining sterile fields, cleansing urethral meatus). For the problem you identified, what specific change in practice do you think is needed?
• When a practice change is implemented, it is important to verify whether or not the change has improved patient outcomes. One way to determine this is by conducting research. One of the first steps in the research process involves developing a research question that will later serve as the foundation for your study. Using information from Chapter 5 in your textbook and the handout on developing research questions, think about a research question and about the effectiveness of the practice change you proposed in improving patient outcomes.
• Another step in the research process involves identifying which type of research could be conducted to best answer your research question. In Chapter 5 of your textbook you will find a list of different types of research in the first column in Table 5.1 and Table 5.2. You can learn more about these different types of research in both Chapter 2 and the Glossary in your textbook. To locate even more information, you can also use an Internet search engine for more in-depth descriptions and examples. After learning more about the different types of research, think about which one you think is best for determining how well the clinical practice change you identified will improve patient outcomes.

Post a description of how you would address the following:

Part 1: Patient Safety Problem

Describe the patient safety problem you identified, its causes, and the impact you think it has on patient outcomes. For this problem, describe a specific change in practice that could help improve patient outcomes.

Part 2: Research on Patient Safety Problem

Develop a research question that tests the effectiveness of your practice change in the improvement of one or more patient outcomes. What type of research would you use to answer this question? Describe the reasons why you think this is the best approach and why you would not use the other three types of research.

Note: Post a 3-paragraph (at least 350 words) response. Be sure to use  evidence  Links to an external site. ,   in-text citations  Links to an external site. , and  essay-level Links to an external site. writing skills, including the use of  transitional material Links to an external site. and  organizational frames Links to an external site. . Use the writing resources and the Discussion Rubric to develop your post.

By Day 7

Read two or more of your colleagues’ postings from the Discussion question.

Respond to two or more of your colleagues with a comment that asks for clarification, provides support for, or contributes additional information.

Reply

Merilyn J Long

Response to Ahmed,

The question does ask a question with a nursing intervention and an outcome. To test the effectiveness of the change in practice and advance the discussion topic on research designs, what is the difference between a true experimental design and a quasi-experimental design based on the readings this week as it relates to changing a practice based on existing evidence? Some considerations for using an experimental design are limited with respect to implementing a change in practice and elements of feasibility such as time, cost,  ethical approach to withholding standard of care, sample size and what the question is asking are some of the elements of research designs (Gray & Grove, 2021).

Gray, J. R. & Grove, S. K. (2021).  Burns and Grove’s the practice of nursing research: Appraisal, synthesis, and generation of evidence (9th ed.). Elsevier.

Dr. Long

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NU 607 Endocrinology Discussion: Pituitary Gland Example

Assignment Brief: NU 607 Endocrinology Discussion – Pituitary Gland

Assignment Instructions Overview:

In this assignment, you are tasked with exploring the significance of the pituitary gland, selecting it among the listed options within the endocrine glands. Your objective is to present a convincing argument delineating why the pituitary gland holds an important role in the human body. The exploration should encompass both the normal functioning of the gland and the consequences of hypo- and hyperfunction, with a creative twist to engage the audience.

The Student’s Role:

As a student, your role is to approach this assignment with a combination of academic rigor and creativity. Craft a compelling narrative that not only communicates the physiological aspects of the pituitary gland but also engages the reader through a creative analogy. Ensure that your arguments are well-supported by recent and relevant literature.

Feel free to be creative in your presentation; for instance, consider using a storytelling approach or incorporating anecdotes to help illustrate your ideas. Remember, the goal is not only to inform but to captivate the audience with a balanced and well-structured discussion.

Original Assignment Instructions: Assessment Description

Select an endocrine gland from the list below.  The student must make a convincing argument as to why the gland chosen is the most important in the body. The argument must include the following:

1. Overview of the normal gland function, including hormones produced by the gland and the action of these hormones in the body
2. A description of gland hypofunction and hyperfunction, clinical manifestations, and common causes of dysfunction

Please be creative when presenting your case. One example of creativity is a funeral for the thyroid gland where hypothyroidism and hyperthyroidism spoke at the eulogy. Try to have some fun with this assignment.

Two references are required for initial post References should be current within the last 5 years.

ENDOCRINE GLANDS (choose one)

• Pineal
• Pituitary
• Thyroid
• Thymus
• Adrenals
• Pancreas

NU 607 Endocrinology Discussion: Pituitary Gland Example

Introduction

The pituitary gland, often referred to as the “master gland,” plays a pivotal role in regulating various physiological processes within the human body. Situated at the base of the brain in the sella turcica and intricately connected to the hypothalamus, this pea-sized gland orchestrates a symphony of hormonal activities that are essential for growth, development, reproduction, and overall homeostasis (Ho et al., 2022). This research paper will explore the vital function of the pituitary gland in maintaining hormonal equilibrium for essential processes like growth and development. Additionally, the paper will also investigate the effects of both over and underactivity of the gland, shedding light on the clinical symptoms and underlying factors contributing to these imbalances.

Overview of Normal Gland Function

The pituitary gland exhibits a remarkable capacity to govern a spectrum of bodily functions through the secretion of various hormones. One of its key responsibilities is the regulation of growth and development, facilitated by the release of the growth hormone. As elucidated by Ho et al. (2022), this hormone plays a pivotal role in stimulating growth in children and maintaining musculoskeletal health in adults. Additionally, the pituitary gland oversees reproductive processes through the secretion of follicle-stimulating hormone (FSH) and luteinizing hormone (LH), which are instrumental in sperm production and ovulation, respectively.

Moreover, the pituitary gland acts as the conductor of the endocrine orchestra by influencing the functions of other glands, including the thyroid, thymus, and adrenals. The thyroid-stimulating hormone (TSH) released by the pituitary stimulates the production of thyroid hormones, regulating energy levels, metabolism, and the nervous system (Ballin, 2018). This interplay between the pituitary gland and peripheral endocrine organs underscores its role as the “master gland” in orchestrating hormonal balance within the body.

Hyperfunction of the Pituitary Gland

Hyperfunction of the pituitary gland can lead to excessive secretion of specific hormones, resulting in various clinical syndromes. For instance, hypersecretion of prolactin is associated with galactorrhea, while adrenocorticotropic hormone (ACTH) hypersecretion manifests as Cushing’s disease. Furthermore, the hypersecretion of growth hormone can lead to acromegaly, a condition characterized by abnormal growth of bones and tissues (Ballin, 2018). These hyperfunctional states often present complex diagnostic challenges, as highlighted by Kejem et al. (2021) in their discussion of the diagnostic dilemma of Cushing’s disease.

In the context of hyperthyroidism, rare instances of hypersecretion of TSH from the pituitary gland have been reported, further emphasizing the diverse manifestations of pituitary hyperfunction (Ho et al., 2022). Plurihormonal hypersecretion, exemplified by conditions like hyperprolactinemia, adds another layer of complexity to the clinical picture. The “master gland” can thus become a source of discord when its regulatory mechanisms go awry, impacting multiple physiological systems.

Hypofunction of the Pituitary Gland

Conversely, hypofunction of the pituitary gland, often referred to as hypopituitarism, occurs when there is an insufficient supply of one or more hormones. This rare syndrome can have profound effects on various bodily functions, including growth, reproduction, and blood pressure regulation (Ballin, 2018). The symptoms of pituitary gland hypofunction are diverse and depend on the specific hormones that are deficient.

For example, a deficiency in the growth hormone can result in short stature, underscoring the critical role this hormone plays in linear growth during childhood and adolescence. Hypofunction of other hormones, such as FSH and LH, can disrupt reproductive processes, leading to infertility and other reproductive disorders (Kejem et al., 2021). The intricate web of hormonal interdependencies within the endocrine system makes the pituitary gland a linchpin in maintaining physiological harmony.

Creative Approach: The Pituitary Gland as a Symphony Conductor

To encapsulate the paramount importance of the pituitary gland, let us metaphorically liken it to a symphony conductor orchestrating a complex musical composition. In this analogy, each hormone produced by the pituitary gland represents a distinct musical instrument, contributing to the harmonious melody of physiological functions. The growth hormone, akin to the strings section, dictates the rhythm of growth and development, while FSH and LH, like the woodwinds and brass, regulate the reproductive crescendo.

The thyroid-stimulating hormone, comparable to the percussion section, sets the beat for metabolic processes, and prolactin, ACTH, and other hormones play their unique roles, akin to different sections of the orchestra. The symphony conductor, or the pituitary gland, ensures that each instrument plays in harmony, avoiding discordant notes that could disrupt the delicate balance of the physiological composition.

Conclusion

In conclusion, the pituitary gland emerges as the “five-star general” in the intricate hierarchy of endocrine glands, akin to the highest-ranking military officer. Its ability to regulate and coordinate essential bodily functions, coupled with its influence on peripheral endocrine organs, establishes it as the undisputed “master gland.” The symphony conductor analogy encapsulates the intricate role of the pituitary gland, emphasizing its significance in orchestrating the harmonious interplay of hormones.

Understanding the consequences of pituitary hyperfunction and hypofunction provides insights into the potential disruptions that can occur when this master regulator falters. By unraveling the complex web of hormonal interactions, healthcare professionals can better diagnose and manage conditions associated with pituitary dysfunction, ensuring the continued harmony of the endocrine symphony within the human body.

References

Ballin, A. (2018). Hyper Secretion of GH: Pituitary Gigantism. Endocrinology And Disorders, 2(1), 01-01. Retrieved from: https://doi.org/10.31579/2640-1045/017

Ho, K., Gadelha, M., Kaiser, U., Reincke, M., & Melmed, S. (2022). The NETting of pituitary adenoma: a gland illusion. Pituitary, 25(3), 349-351. Retrieved from: https://doi.org/10.1007/s11102-022-01235-x

Kejem, H., Chattington, P., & Mahmud, A. (2021). Diagnostic dilemma of Cushing disease. Endocrine Abstracts. Retrieved from: https://doi.org/10.1530/endoabs.74.ncc66

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