Archives: Samples

1. What preliminary Axis I diagnosis would give JKF and why? Use the DSM IV to look up the Axis I disorders and select one or two that best fit the clinical picture.
2. What, if any, medical danger(s), do you see or should you consider for either patient? Why?
3. What transference and countertransference issues would you expect to be present in working with Patient A? What Transference and countertransference issues might present themselves with Patient B?
4. Finally, based on all the above information. Who gets the available bed and why?

Introduction:

A disturbed state of mind predominated by negative feelings is called anxiety. Studies show that about 18% females and it is more prevalent in women who have gone through separation or divorce and 11% males are a victim of anxiety globally. 28% of the global population has experienced depression, emotional turmoil and anxiety in some form or the other. According to studies there are four kinds of four kinds of anxiety (Khoury et al., 2013). They are as follows:

• Generalized anxiety disorder
• Social anxiety disorder or Phobia
• Panic disorder

Post-traumatic disorder:

Anxiety is a product of a deep environmental episode and can trigger at any age and is not specific for a particular place or age group. A deep understanding is required to deal with anxiety as the symptoms may not be physical; one has to take the psychological symptoms into consideration. It should be noted that professional help must be advised if any symptoms are noticed and dealing with such victims and symptoms should be taken seriously and with utmost sincerity.

In this report a case study of a subject named ‘Sarah’ has been discussed who has recently experienced a breakup and has shown multiple symptoms of anxiety. In this report there is a thorough discourse on the key facts of the subject and the case study and a complete understanding on the effective implementation of the cognitive behavioural therapy to advocate standard healing.

Case Scenario:

In this segment the key features of the case study has been discoursed. In the case study it has been stated that the subject ‘Sarah’ has recently experienced a breakup. Having gained that information, her friends have invited her to a party as a sympathetic gesture and to help her recover from the sensitive event. In the party the subject meets a man named Tom and enjoys his company. Out of the fondness for each other’s company they decided to exchange numbers in the hopes for a prolonged connection. The subject consumes a significant amount of alcohol at the party. The next day she had hopes to get messages from Tom but no such thing happens due to which the subject feels further violated and rejected. Out of anxiousness she refuses to go to work by reporting being sick and further the subject starts consuming alcohol hoping that to be a source of distraction and out of the feeling of rejection and anxiousness she breaks all tie with her social life.

Two serious risk areas can be identified from this case study. First, the feeling of rejection and anxiousness making the subject separate her from all social communications which is quite a grave situation. Second,consumption of alcohol (substance abuse) which could lead to severe physical and mental issues.

There are three ways I which assessment criteria can be made. They are, through screening, comprehensive assessment and formal diagnosis.

Cognitive Behavioural Therapy:

A psychological therapeutic intervention that significantly mends mental health issues is called Cognitive Behavioural Therapy (CBT). Studies show that CBT helps to cultivate a positive perspective towards life on the basis of positive thoughts, coping tactics and emotional stability (Ehde et al., 2014); (Gu et al.,2015). The idea of CBT is to focus on positive thoughts and eliminate all the negative thoughts and develop complete mental wellbeing (Eysenck, 2014).

Foundation Of Administering CBT:

Reports suggests that CBT helps in yielding  positive results in treating anxiety and other disorders related to depression. If the case study in hand is taken into consideration, we’ll be able to understand and appreciate the need of CBT for victims of anxiety. In this case the subject ‘Sarah’ has gone through a breakup and is in complete emotional turmoil and it got elevated and worsened when she felt ignored by Tom, a feeling of distress and rejection, which has made her socially isolated and pushed her into substance abuse. All the consequences of her breakup and anxiety have led to an integration of negative thoughts and actions.

You are to write an essay which analyses a case study in order to discuss appropriate biopsychosocial factors and nursing management or interventions relevant to that case. Recent and relevant literature must be used to support your discussion.

Instructions:
1) Select a case study provided.

2) Use recent literature to support your discussion:

2.1) Identify and discuss biopsychosocial factors that contribute to the development of the selected disorder.

2.2) Describe and discuss nursing management or interventions appropriate for your selected case study.

2.3) Outline and discuss ethical implications for the selected case study.

Introduction

In recent world, being in a good shape and physically attractive determines the holistic fitness level to attain which millions of younger individuals are suffering from several disorders or illness, which is known as eating disorder (Colton et al., 2013). This is characterized by persisting irregular diet, unscientific eating habits and concerning stress and distress due to such strange lifestyle habits. As per Brooks et al. (2012) eating disorder can be the reason of excess and irregular inadequate eating habit which can affect the wellbeing of individuals affected with it. Ferguson et al. (2014) determines that eating disorders are of three types such as Anorexia Nervosa,  Binge Eating Disorder and the Bulimia Nervosa, of which the ability to harm ranges for both males and females. Lock and Le Grange (2015) also mentions that such disorder emerges during the teenage of life and it requires appropriate nursing interventions. As per the data of World Health Organization present in the research of Stice, Marti & Rohde, (2013), more than 30% of people around the world are currently suffering from such disorder. In this case study discussion, the case of Charlie (19) and her eating disorder related condition will be discussed and her concerns such as eating disorder, stress, depression, low self-esteem and the pressure of responsibilities will be discussed. As a daughter of successful parents and her ever so high self-esteemed in studies., she feels stressed as well as she also thinks that her weight makes her unattractive. Hence she isolated herself from her flat mates and spends hours at washroom after eating minimal food and laxatives, resulted in loss of 10kgsin last three months.  Hence, the primary goal of this assignment is to provide the details about biopsychosocial factors influencing the development of eating disorder, and depression and it will be discussed with appropriate use of nursing management and interventions. Finally, the ethical inferencerequired for the patient condition will also be discussed in this assignment.

Analysis- Biopsychosocial

As the ‘world mentality’ is shifting sharply from ‘being alright with the body to being fit is the only motif of the body’, scientists and healthcare physicians are unable to detect the primary reason for emergence of eating disorder throughout the world. However, Dakanalis et al. (2015) mentions that eating disorder can properly be described by the relation between two factors psychosomatic and psychiatric and due to this a relationship between body mind and brain created which creates all the confusion in the brain of the patient regarding the weight and appearance compared to others. Hence the biopsychosocial factor should be used to understand the effect of the condition on patient, determine the best intervention regardless of it being biological social or psychological and manage the condition. in the case study, Charlie’s friend Jo mentioned that from last four months, Charlie has separated herself from her friends and do not go out to have dinner with them (Udo et al., 2013). It was also mentioned that she thinks she is too much overweight and need to lose much more weight so that she can become attractive and smart. This event determined her mental stress, hopelessness and less confidence and self-esteem that make her feel inferior to others. Further, in the case study, it was also mentioned that she has lots of pressure for studies and performed really well in her educational career. However she now feels that she need to become much more focused and successful like her parents (Rodgers, Paxton & McLean, 2014). This also determines the pressure which she feels on her shoulder prior to make any action. This is one of the primary reason for her depression and eating disorder related condition as Winkler et al. (2014) has mentioned that people who suffer from mental stress or pressure generally end up losing their appetite level and hence, they need to take support of laxatives and other components.  It was evident from the case study as Charlie used to eat less food and after that smaller amount of food she used to go to the washroom and spend hours as well as used to take laxatives daily (Udo et al., 2013).

Besides this, the bio-psychosocial context of disease should be inclusive of the social effect as society has a major impact on the human activities. Specifically, in teen age, it is evident from the research by Gearhardt et al. (2012) that teenagers are much more prone to social and communicable comments and due to this they develop negative thinking and perceptions about their action and develop suicidal ideations. In his case of Charlie, she had several negative thoughts about herself in her mind, she felt she is worthless as she was not smart like her brother, she was unable to make her parents proud or she was not at all attractive so that society can praise her smartness and beauty (Sarafino & Smith, 2014). These above mentioned events and thinking made her negative perception in her own mind and she lost all her confidence and self-esteem which is important to live a determined life. Further, she eventually developed her depression level due to which as per Winkler et al. (2014), she lost her appetite and was forced to take laxatives for her heath conditions. Further, her biological analysis should involve the after effects of her eating disorder due to which she lost her 10 kg of weight in last 4 months, her menstrual cycle was badly affected and she started developing pale skin and dry brittle hair. This analysis was important as due to such appearance she started believing on her thinking and her physical appearance made her confident that she is not appropriate and worthless to her smart and successful family due to such health condition (Stice, Marti & Rohde, 2013).

Question:

Is the idea of objective scientific observation of children a myth? What is the value of subjectivity in understanding children’s learning and development?

Pedagogy is a broad term which is defined as a set of teaching practices and strategies that is used to engage children and subsequently encourage them to learn. It other words it can be said that pedagogy is educational choices that is being made by the teachers or the educators in order to promote academic and mental health development of the children (Cagliari et al., 2016). According to the Early Years Learning Framework (EYLF) (2009) pedagogy is composed of three interrelated concepts of principles, practices and learning outcomes which help the teachers or the educators in framing their curriculum. The following essay aims to analyse importance of subjectivity in pedagogy in order to understand children learning and development. Having a proper understanding about of the subjectivity in pedagogy will help to frame children specific educational framework that will promote quality mental, cognitive and academic development of the children during early years of their life.

According to Cagliari et al. (2016), subjectivity is a philosophical term and has no direct relation to science. This is because, science is more about facts, figures and data whereas, philosophy is about critical or effective thinking. In relation to the philosophical views of subjectivity, Loris Malaguzzi forwarded one fundamental idea which highlights that subjectivity in pedagogy promotes critical thinking and subsequent reflection in relation to specific child activity and behaviours and then utilizing it in the process of curriculum decision making. This approach is further embraced by Reggio Emilla which argues that observation is more effective than science and theory of device students study curriculum (Edwards & Gandini, 2018). Edwards and Gandini, 2018 stated that proper observation helps in devising children specific curriculum via understanding the perspective of children thinking process and this in turn helps to increase the overall outcome of the curriculum.

Another interpretation of subjectivity is undertaking proper judgements about what is desirable on the educational ground in relation to the children rather than focusing on the outcomes (looking ahead in the future) or norms (looking behind at what was happening in the past) (Allal, 2013). According to the EYLF (2009), a child has a strong sense of identity and this identity helps in the generation of belonging. Children learn and construct their own identity under the context of their families and communities in which they resides. This helps in the promotion of their relationships with others and their actions in responses of others. This identity is not fixed and varies from child or child based on their surrounding experiences. Thus making situated judgements help to promotes children specific curriculum which take the preference of the belonging of the children in to active consideration.

In relation to the subjectivity and theory, it can be said that pedagogy is developed via the use of theory as one of the principal source of information and this information is based on the particular images of children. These theories can give proper meaning and provide satisfactory explanations but this is provisional. The images of the children are further influenced by the individual thinking, personal interpretations, and application of the predetermined standards in order to interpret the results. For examples, according to the EYLF, children are connected with and make significant contribution to their world. This observation to their contribution in their surrounding world like their families communities help to devise the pedagogy plan for the children learning and development (Broström et al., 2014). Here comes the relation of the science in philosophy of subjectivity. It is the duty of the educators to generate environments under which the experience of the children is mutually enjoyable caring and respectful relationships. This generation of children specific environment is based on application of scientific theories based on children specific observation (Broström et al., 2014).

In relation of subjectivity versus objectivity, it can be said that subject is what acts and object is what acted upon. Under the subjective approach, children are recognised as an agency which plays an active role in their own learning. According to Zimmerman (2013), According to the theory of self-regulated learning, neither the mental ability nor the academic performance promotes learning. The self-regulation is driven by self-directive process by the help of which the children gradually transform theory mental abilities into the task-related to academic skills. This approach views their overall process of learning as an activity that students perform for themselves in a proactive way thus here the students or the children acts as subject (Zimmerman, 2013).

Thus considering the children as the main subject of the educational curriculum, it can be said that the educational practice is grounded over the reflective and critical thinking approaches. The education approach must be devised in child-centred manner rather than teacher-directed manner. According to Liston and Zeichner (2013), the child centre educational approach take active consideration of the child-specific requirement like mental, emotional, cognitive and physical demand. This child-specific education approach is based on objective of improving outcome in early life developmental framework. Under child-centred educational approach, the children can never be considered as an “empty-vessels” rather they should be considered as active agents in their own ideas. According to EYLF (2018) children have a strong sense of well-being. This well-being is connected with the social and the emotional well-being. They also have an increase in the responsibility of the own health related well-being as well. So in order to promote a comprehensive well-being to the child via the pedagogical approach, the thought process of the child must be taken under active consideration.

Considering children as the main subjective in the educational planning, it can be said that “child psychology” plays an important role in understanding how a child promotes their emotional and physiological well-being (Eisenberg, Spinrad & Knafo?Noam, 2015). Understanding child psychology draws a direct significance of scientific methods in relation to subjectivity in pedagogical approach. Here considering the child as the main subject and then understanding the psychology of child in promoting his or her well-being promotes self-organized approach of learning. Self-organized approach of learning further upholds the importance of child-centre learning and curriculum planning (Thomas & Harri-Augstein, 2013).

You are to write an essay which analyses a case study in order to discuss appropriate biopsychosocial factors and nursing management or interventions relevant to that case. Recent and relevant literature must be used to support your discussion. Instructions:

1) Select a case study provided.

2) Use recent literature to support your discussion:

2.1) Identify and discuss biopsychosocial factors that contribute to the development of the selected disorder.

2.2) Describe and discuss nursing management or interventions appropriate for your selected case study.

2.3) Outline and discuss ethical implications for the selected case study.

John is a school student of 18 years and has admitted to the mental health centre for the primary episode psychosis. Psychosis refers to a damaged relationship with the society and reality. It is a sign of a critical mental disorder. Psychotic disorder People who are suffering from this disease may have the problem of hallucination or delusion. John has the hallucination problem. In this assignment, the biopsychosocial factors of John’s primary psychosis are described. Along with this, the role of nurses in managing this disease of John and ethical issues related to the treatment of this disease is also defined. The psychosis disorder of John is related to the drugs and alcohol. John is admitted to the hospital with the problem of hallucination. Hallucination is a sensory disorder that allows the person to experience a virtual stimulus that is they feel actual stimulus although there is no real stimulus. The level of hallucination, in this case, is also described.

The bio psychosocial factors is quite responsible for John’s disease. Biological factors are those, which is carried forward from his parents to John. These are mainly genetical characteristics of John’s father or mother.Any disease that is carried by John’s parents can be crucial biological factor. John is currently suffering from the problem of hallucination that is he is assuming somebody and continue talking with him or her. He is roaming around the house ad he thinks that somebody is talking with him.It is the sign of complete hallucination. In case of psychotic disorder,the brain of a human being is directly involved.the brain consists of nerve cells,named neurons and as well as with some chemical ,called neurotransmitter.The imbalance of these neurotransmitter is directly responsible for such kind of psychotic disorders.The neurotransmitter which is thought to be responsible is the dopamine.Dopamine is responsible for transmission of signal from nerve to the brain.

It is predicted that people with psychotic disorder produces too much dopamine than normal individual.However there is various evidence to support the Dopamine theory of psychotic disorders.In various research it is seen that drugs dopamine receptor blocker are quite successful in case of psychotic disorder.The anti-psychosis drugs used to treat this disorders mainly block the binding site for the dopamine.As a result the dopamine cannot bind to its adjacent receptor and failed to transmit the signal. In case of primary psychosis,like schizophrenia there is more dopamine. Moreover ,if they bound to the receptor continuously,the result will be the primary psychosis.In case of dopamine receptor blocking,in spite of huge dopamine concentration,they unable to bind with the proper receptor.This mechanism is used to treat primary psychosis (Uchida,2017). On the other hand, many drugs like amphetamine, also responsible to hike the level of dopamine and this can also cause psychotic symptoms. According to the John’s case study,John consumes amphetamines on a regular basis.Amphetamines increases the level of dopamine in his body and that results in such symptoms.The regular intake of amphetamine also increased level of serotonin which is also responsible for the onset of psychotic disorder (Ahnaou et al.,2017).

Excessive amount of serotonin can overexcite the nerve tissues and produces uncertain spikes in neuron activity.This over-excitement can cause psychotic disorders (Fjukstad et al.,2017). John was addicted to marijuana when he was in grade 9.It is said that marijuana can hike the chances of psychotic disorder and the persons who have a family history of a of schizophrenia or psychotic disorder are in great danger. Marijuana and its role in schizophrenia is directed to Cannabis and which may hike the chances psychiatric disorders. The cannabinoid receptors mainly include two receptors and they are CB1 and CB2.The marijuana directly affects the endocannabinoid (ECB) system. Most neurotransmitters are synthesized in presynaptic neurons and works through a calcium ions.ECBs that are synthesized in the postsynaptic region releases in the synaptic cleft and binds to CB1.In the brain ECB deals with neurotransmission systems like dopamine.The cannabinoid receptor THC are responsible for binding of endogenous cannabinoid in the brain.The area like hippocampus are supposed to be responsible for the psychotic disorders and it is found that the concentration of cannabinoid receptors are very high in thise region.On the other hand cannabis receptor are directly directly associated with the increasing activity of dopamine receptor.The increase activity of dopaminergic receptor results in the development of psychotic disorders.The hippocampus has a high concentration of glucocorticoid receptor and it is a part of hypothalamic-pituitary-adrenal (HPA) axis activation.Subsequent relarase of glucocorticoid helps in activation of HPA axis. This biological aspects is related to the development of Psychotic disorder (Desfossés et al.,2010).

Sometimes he is talking with himself also. After admission to the hospital, he started to hear voices of a group of a woman and two men. As per the case study, John’s biological father has a medical history of Schizophrenia, which is one of the major psychotic disorder. From his father, the schizophrenic gene has come to John (van, Kenos & Rutten, 2010). It increases the John’s probability of being a schizophrenic patient. According to the symptoms of John got his aggressive and violent behavior also from his father, as his father was brutal to his wife and to his children. The key factor of John’s disease is the psychological factor. From his childhood faced several psychological trauma. In several studies it is seen that child who are under the age of 16 and were abused, have the higher risk of developing psychosis.Childhood trauma is another key factor for developing psychosis.The children who have been physically abused in their childhood has significantly developed psychosis disorder in later age. The psychological factors are the most important in case of John. John’s father was schizophrenic and he used to be violent.John also was abused by his father.From childhood, John had experienced such abusive behavior of his father. These factors are also responsible for the disease. Such early events causes the neurological imbalance that gives rise to the altered neurological connections that maximizes the chance of psychotic disorder.The imbalanced neural structure is directly responsible for such psychotic disorders. A disturbing life event is another crucial factor responsible for John’s disease.And it is evident that John has a very disturbing tragic life event at his childhood.His father divorced her mother when he was only 8.This affects the child’s mind. John missed his parental care as well.

The effect of this thing has a very long-term effect.Migration is another key issue that is considered as a reason for psychotic disorder. After the divorce of their parents, they migrated to a new city and had to change his school. In a new city John was very alone at first and it is quite evident that in a new city everyone will discriminate a new person from the older one.This migration is also have a evident role in psychotic disorder of John. As a result, John lost all his close friends and after that, he failed to make new close friend.These psychological factors are responsible for John’s present condition. John was very fun loving and socially active. Since last seven months, he started to isolate himself from other and started to develop symptoms of psychotic disorder.

Purpose

The aim of this essay is to enable students to demonstrate an understanding of and ability to apply the Transtheoretical Model of Change (Stages of Change Model) within an evidence based framework. In addition to this, students will identify components of Motivational Interviewing which could be utilised to assist with enabling a patient to change their health behaviours.

Task

Alistair is a 55 year old male who has been admitted to the orthopaedic ward on which you are working for a total knee replacement (TKR). You have been allocated to care for him for the next 4 days as part of a trial of team nursing. He weighs 160kg and is due to have the TKR tomorrow. He states “I am bit worried about my health, I have been overweight for years and wonder if that is the reason my knee has given way”.

Using the Transtheoretical Model of Change and Motivational Interviewing techniques, describe how you could support Alistair through the Stages of Change cycle to maintenance.

Utilise evidenced based literature to support your discussion. For the purposes of this paper, while seminal work (early literature) may be referenced, current literature is a requirements.

Introduction

Transtheoretical Model of Change (TMC) is used as the foundation for increasing appropriate interventions that will enhance health behavior adjustment. The TMC describes the modification of problem behavior or how people acquire helpful behavior. The model mainly focuses on the individual capacity to make the decision; it involves behavior, cognition, and emotions of the individual.  The stages of TMC includes; the precontemplation stage, the contemplation stage, the preparation stage, the action stage and maintenance stage. Motivational Interviewing is essential because it ensures that people undergo the steps of change effectively. Motivational Interviewing is a patient-centered style of counseling for enhancing behavior change by assisting patients to resolve and explore ambivalence. Motivational Interviewing involves principles like; avoiding arguments, supporting self-efficacy, showing and expressing empathy, supporting and developing discrepancy and dealing with resistance.

Transtheoretical Model Of Change

Precontemplation. During the precontemplation stage, individuals are not ready to take any change due to fear or inadequate information concerning the behavior change. Raising consciousness through increasing awareness of the individual can help him or her to adjust the negative thoughts. Raising consciousness involves rising information concerning cures, consequences and causes for a particular behavior problem. Raising awareness can be through interpretation, confrontation, personal experiences and feedback. Alistair is worried about the Total Knee Replacement surgery, and he feels that overweight might be the cause of the condition it portrays that he is not ready for the operation. As the nurse in the orthopedic ward, I would try creating awareness to Alistair on the importance of the surgery (Wadden, Butryn, Hong & Tsai, 2014).

Contemplation. During the stage of contemplation, people are willing to change after six months. At six months they are aware of the advantages and disadvantages of changing, the advantages must outweigh the disadvantages of the behavior change. It is at this stage that individuals become aware that their actions may cause difficulties in the future and affect their social environment but still are not fully ready to take appropriate actions. Family interventions, training and role-playing, are essential to ensure that people experience dramatic relief of the emotions. Alistair requires training to understand the importance of knee replacement and also the importance of healthy eating to reduce his weight (Meisel, Beeken, van Jaarsveld & Wardle, 2015).

Preparation. During the stage of preparation, people are willing to undertake actions in the immediate future, usually the next month. People start taking small steps and actions to effect change in their behaviors; they believe that changing their way of lifestyle will ensure a healthy outcome. The individual should now start taking actions that address their conditions, for example, people consulting a counselor, join health education programs, self-change approach and talking to their physician. It involves counter conditioning that requires acquiring health behaviors that can replace the problem behaviors. Educating and motivating Alistair towards activities that he can undertake to reduce weight could be helpful in assisting him to achieve weight loss. Activities that can help Alistair in reducing his weight include; joining the gym and eating healthy food. Also, motivating Alistair to undertake the operation is essential in addressing the issue of overweight (Mastellos, Gunn, Felix, Car & Majeed, 2014).

Action. The action is the stage that people have made modifications to their lifestyles to enhance behavior change. In the action stage since actions can be observed, behavior change is connected with the actions. Action stage involves people altering their old behaviors and adopting healthy and new ways of life.  During the action stage, reinforcement management is significant because it ensures and encourages consequences of actions that promote the specific behavior change. Group recognition, rewards and positive statements are procedures that can help in increasing reinforcement and also increases the chances of the desired outcomes to be repeated. Alistair requires to eat food that is low in cholesterol and foods that contain a low content of fats to reduce weight (Johnson et al, 2014). As the nurse I would applause Alistair through recognition after he manages to reduce weight, recognition can help him to continue with the positive behavior.

Maintenance. During the maintenance stage, individuals have the confidence to continue with the change that has occurred. The individual has sustained the behavior modification for than six years and is intending to adopt the changed behaviors. People during the maintenance have fewer desires to their unhealthy behaviors. Self-liberation plays a significant role in the maintenance stage. Self-liberation is the belief that an individual acquires in believing he or she can change and the commitment and recommitment towards the belief of change. Public testimonies and year’s resolutions help in attaining self-liberation. As the nurse, I would encourage Alistair to adopt the new and current behaviors like small meals and not to turn back to fatty foods (Burgess, Hassmén, Welvaert & Pumpa, 2017). Encouraging and helping Alistair in physical exercise can help in maintaining health wellbeing and status of Alistair.

Principles Of Motivational Interviewing

Showing and expressing empathy toward the patients. The nurses should ensure that they express and reveal compassion towards their patient. The nurse should show acceptance to their clients; acceptance facilitates the process of change. Empathetic Motivational Interviewing builds a safe therapeutic condition and environment that enables the patients to discover issues including methods of change and their personal experiences (Bonde, Bentsen & Hindhede, 2014).

Introduction

The current study takes into consideration two important aspects of professional nursing which are clinical governance and maintaining effective quality and safety standards.

Clinical Governance

The clinical governance is the amalgamation of integrated systems, processes, effective leadership and cultural sensitivity which are the pivotal in providing   quality healthcare services. As mentioned by, effective clinical governance practices helps in implementing a person centred approach. The key systems and practices are required to provide safe care within an acute healthcare setup.  The guidelines as mentioned under the rules for clinical governance states that all the nurses and the midwives should take an active part in the patient safety processes. The guidelines also mentions that the all the incident s of clinical accidents need to be reported actively, as it helps in focussing upon the safety loopholes. As mentioned by Cleary and Duke (2017), it helps in supporting the organizational and community priorities by implementing some of the effective practices such a patient centred approach,  practice of informed decision making etc. Some of the most important aspects as mentioned within the clinical governance guidelines are that the patient issues need to be escalated to the managers. As reported by Maier (2015), a number of incidences of breach of ethical and legal guidelines have been reported in an acute healthcare setup. Hence, provision of effective training to the healthcare professionals regarding the clinical guidelines and practices including the reporting standards could prevent the occurrence of any untoward incidents within an acute healthcare setup.

Some of the responsibilities and roles of nurses and midwives as stated under clinical governance are actively taking part in the development of an organizational culture which promotes patient safety. Additionally, encouraging, mentoring and guiding colleagues in the delivery of high quality and safe healthcare practices fall under the guidelines as stated under clinical governance (Knight, Kenny & Endacott, 2015).

The clinical governance practices could be further discussed in the light of the Djerriwarah health services or the Bacchus Marsh healthcare service. In 2015, large number of medical casualties at the Bacchus Marsh hospital came to notice.  This led the department of health and human services Victoria take a number of actions including review of hospital safety and quality assurance. The matter had been notified to the department of health and human services by the Consualtive Council on Obstetric and Paediatric Mortality and Morbidity (CCOPMM).

Your evaluation and sustainability plan should include the following parts:
a) Include an overview of your program (based on your health promotion campaign you developed in AT2);
b) Describe and justify the purpose of the evaluation, and identify the audience for the evaluation;
c) Develop a program logic model. You can use the same aims, objectives and outcomes from your AT2, however, you might consider improving your aims and objectives based on the feedback you received in AT2:
d) Develop evaluation plan (process, impact and outcome) that includes the following:
a. Evaluation questions, see example provided below:
b. Evaluation design and data sources;
c. Potential risks;
d. Resources and roles;
e. Governance.
e) Create a simple ‘gantt’ chart showing the development, implementation and evaluation timeframes, see example:
f) Describe how you will report, disseminate and use evaluation findings;
g) Describe your program sustainability plan.

Introduction

This report is designed for purpose of preparing an evaluation plan for a marketing campaign project that was designed in the previous assignment. The name of that project was Think! Before You Drink. Core purpose of this program was to encourage responsible consumption of alcohol among people. This evaluation plan is designed to track the progress of performance of this program. This report will focus on designing a program logic model for the marketing campaign program. It will also focus on depicting different details of this project like potential risks, evaluation design and data source, resources and roles and the governance. In addition to this, the report will also emphasize on creation of Gantt chart for the program. Final section of this report present the ways of reporting, disseminating and using of evaluation findings and the sustainability plan for this program.

The name of program that was designed in the previous assignment is “Think! Before You Drink”. Main purpose of this program or campaign was to develop awareness among people living in Australia about the responsible alcohol drinking. This program has been designed to encourage responsible consumption of alcohol across Australia1. The target audience for this marketing campaign is the individuals belonging to age group of 16-24 years. The purpose of this report is to develop evaluation plan for this marketing campaign.

Target Audience: The target audience of this marketing campaign is individuals belonging to age group of 16-24 years. It is so because the adults belonging to 16 to 24 years of age are more exposed to negative aspects in the society. At this level of age, the adolescents are attracted towards bad habits and harmful drinking habits. The individuals belonging to this age group believes in spending more time in leisure and fun. The social marketing campaign in this plan will encourage these audiences to adopt responsible drinking habits.

Dimensions Related to Health: There are different health issues that may be faced by the individuals with the harmful drinking habits. Over consumption of alcohol can damage the functioning of liver and kidney. Over consumption of alcohol can also cause the risk of mouth, throat and esophagus cancers among people. Breast cancer issue is common among women exposed to excessive drinking of alcohol. The over consumption of alcohol also hamper the memory, and thinking ability of individuals 2. Drunk driving can increase threat to life of the person that may result from accidental incidents on the road.

Marketing Mix:

Product: Use of promotional strategies to increase the awareness about losses and risks of harmful drinking through marketing campaign. Main aim of this campaign is to encourage people for responsible drinking habits.

Price: Price of participation in this will be very low and affordable for a person.

Place: This campaign has been planned and designed to target the target people living in Northern Territory of Australia.

Promotion: This marketing is itself a promotional program. This promotion campaign should be beneficial for the society. The advertising of campaign through online and offline mediums of communication can help to meet this goal.

Strategies for this program are:

• Identification of audience and target groups
• Development of objective and effective campaign message
• Developing various social media presence through various tools
• Circulating the objectives and health information to target people
• Initiating retrospective effect

Stakeholders for this campaign are:

• Health sector
• Government and non-government organizations
• Community or society
• The individuals exposed to issue of overconsumption of alcohol

Purpose Of Evaluation Plan And Identification Of Audience

Main purpose of this evaluation plan is to monitor and track the progress of performance of planned marketing campaign. The tracking of performance and progress of a project or plan is very important in order to achieve the long term objectives in effective and efficient manner. Due to an evaluation plan, it is easy to cross check that all the planned project activities are going on right track planned for them. If any deviation is recorded in any activity, then corrective actions can be taken into account at right time before huge losses in the entire project or plan. These deviations may occur in terms of cost overrun issue or time overrun issue in the project 3. These both kinds of issues can hamper the success of project. So, these both issues should be diagnosed and resolved at the right time. The target audience of this evaluation plan would be the owner and sponsor of this project, project team and the potential readers of this report. Different staff of this project includes marketing head, operational head, PR manager, innovation head manager and the digital marketing head.

Development Of Program Logic Model

Program logic model can be defined as the graphical presentation of the way, in which a project or business plan will work. In other words, it shows the causal links and logic/ sequence of different activities. Following diagram summarizes the program logic model for the plan of marketing campaign entitled as “Think! Before You Drink”:

Evaluation Plan

A. Evaluation Question

Type of Evaluation	Focus	Typical Questions
Process	· Examining the ways to deliver the campaign (campaign qulaity, campaign activities, and target audiences) · Recognizing the shortcomings in execution 4	· How is the campaign being came into being? · Is the campaign delivering flawless customer experience? · Is the campaign successful in creating a single marketing view of audiences?
Impact/Outcome	· Determining the likely outcomes of the campaign · Measuring the long term results of the campaign	· Is the campaign producing the desired results in the short or long term? · In what ways, for whom, and in which state? · What peculiar characteristics of the campaign are like to make a difference · What was the role of other aspects in campaign’s success?
Economic	· Considering the effectiveness by which standardizing results, in terms of dollar value · Examining the aspects related to the value for money and or cost-benefit	· Is the intervention is non-expensive as compared to other Alternatives? · Were the benefits higher than the costs?

B. Evaluation Design And Data Sources

• In this marketing campaign, I want to take into account the survey technique for purpose of evaluating the effectiveness of designed marketing campaign. The survey technique is selected in this plan, because this technique is a cost effective technique and can be carried out in shorter time span. The survey will be conducted at two times such as one survey as the baseline survey and another survey after the intervention. This will help to assess, whether the marketing campaign has proved to be effective to meet the goal of developing responsible drinking habits among target audience or not. This survey will be conducted by one of our team members. This survey will be face to face survey. This survey will be conducted over 20 people belonging to age range of 16-24 years of age that have participated in the planned marketing campaign.

You are required to prepare a research proposal – a document that informs others of a research project that you intend to conduct. This would typically be used when applying for a postgraduate psychology degree or when working in industry. This proposal should highlight the potential significance and feasibility of the research project. Moreover, writing a research proposal often helps individuals to structure their thoughts, identify the purpose of their research and what is involved to conduct the project, as well as help to develop a plan and specify the expected outcomes.

Answer:

Learning outcomes and their relationship to your course level outcomes can be found on the Postgraduate vUWS site.

Learning outcomes for the unit are outlined below.

1 Discuss the principles and processes of evidence-based practice.

2 Critically discuss the importance of individual patient preferences when making clinical judgments about the implementation of research findings.

3 Critically discuss barriers and facilitators to implementing evidence based practice in the clinical arena.

4 Conduct a comprehensive literature search on a clinical question.

5 Apply critical appraisal techniques to a range of research methodologies.

6 Critically appraise research for its application to practice.

Introduction

Substance use is a critical public health crisis that calls for dire attention (Krasikova, Lester and Harms, 2015). Substance abuse remedies play a significant role in minimizing the symptomatic effects associated with recurrent use of drugs. According to O’Leary?Barrett et al. (2017), persistent substance users are faced with clinical and functional impairments as well as alterations in their abilities to accomplish societal functions. Researchers and practitioners dealing with drug addicts have strived to advance proper ways of fostering improvements in the processes of delivering effective services (Neger and Prinz, 2015). Despite the efforts adopted, Yang, Perkins and Stearns (2018) reveal that premature dropout among the targeted populations is considered to be the greatest impediment to effective adoption of the therapeutic initiatives se to target drug addicts.  For instance, Sullivan, Messer and Quinlivan (2015) report that inpatient rehabilitation programs encounter dropout rates ranging between 20% and 70% with the first month being considered as a critical period and determinant of the efficacy of the treatment initiatives put in place. As a consequence, Yang et al. (2018) establish a research aimed at investigating the factors that act as facilitators and barriers to effective treatment of inpatient substance use clients. The current study applies the consolidated criteria for reporting qualitative research (COREQ) to analyze the article by Yang et al. (2018).

The study was conducted by three researchers; Yang Yang, David R. Perkins and Elizabeth Sterns. Yang and Perkins are assistant and associate professors of Psychology at the University of Louisiana at Lafayette. On the other hand, Elizabeth Stearns is an assistant professor in the Department of Criminal Justice at the University of Louisiana at Lafayette. While Yang and Stearns are females, Perkins is a male. Elizabeth Stearns boasts of her long   research interests in Corrections as well as Women & Criminal Behavior and Feminist Criminology. The fact that the three researchers share a similar workplace reveals that their relationship was established before the commencement of this study. The participants carried out the research to foster the advancement of knowledge and to contribute to the advancement of clinical practice when dealing with substance use clients.

Research Approach

The study established by Yang et al. (2018) proceeds with the aim of exploring the factors that impede or expedite short-term treatment inpatient treatment programs among clients exposed to substance use. To attain the desired levels of effectiveness, the scholars adopted a thematic analysis to evaluate the barriers and facilitators of treatment among inpatients seeking substance abuse remedies. The scholars’ move to analyze crucial organizational factors such as inadequacies in the treatments offered, the inability of these institutions to include remedies and infrastructure that are gender responsive and poor communicational strategies adopted by the nonclinical members of staff acts as an eye opener to players such as hospital administrators and physicians to uphold organizational cultures that aimed at fostering positive collaborations and teamwork. Similarly, the study acts as an operational blueprint aimed at facilitating the efficacy of caregivers working with patients suffering from substance use disorders in strengthening the institutional activities that facilitate treatment engagements through peer inspiration as well as the trust and affinity among the physicians.

Yang et al. (2018) adopt a qualitative approach based on thematic analysis to investigate the factors that act as treatment impediments and facilitators among inpatient substance use clients. According to Lewis (2015), qualitative approaches play an effective role in demystifying the possible causes of the challenges faced by patients in clinical settings based on their optimal levels of efficacy in fostering explorations that depict higher degrees of patient centeredness. Similarly, Bryman (2017) commends qualitative approaches due to their inherent abilities in availing recovery experiences that embrace higher degrees of validity.

Methodological Orientation And Theory

Thematic analysis was applied to foster the advancement of the premises on which the study would be anchored. According to Rauch, van Doorn and Hulsink, W. (2014), thematic analysis is one of the most effective instruments of fostering the processes of analyzing qualitative data. Similarly, Cresswell and Cresswell (2017) applaud this approach based on its higher levels of efficacy in allowing the researchers to gather systematic information and knowledge concerning certain designated situations, institutions and cultures. On the other hand, Braun, Clarke and Terry (2014) demystify that the thematic approach guides scholars by narrowing their investigations from a broader viewpoint of data while moving towards a narrow emphasis of the information collected based on a certain specified research question.

An analysis of the methodological approach applied by Yang et al. (2018) reveals the scholars’ effectiveness in moving from a broader substance use perspective to a narrower research question that is aimed at establishing the impediments and facilitators to treatment among substance use inpatients.  Further, the strength of the thematic approach adopted by the researchers emanates from their inherent abilities to adopt and apply coding. According to Braun and Clarke (2014), coding does not only allow the researchers to implement modifications in qualitative studies in ways that are iterative and explicit but also play a critical role in revealing the qualitative wealth of the phenomenon under investigation. Similarly, Braun and Clarke (2016) demystify that the codes adopted in thematic analyses form the bases of the themes that are analyzed by the researchers.

In their study, Yang et al. (2018) adopt a sample of 60 male participants. One of the greatest strengths reveal by the composition of the respondents used in the investigation is the ability of the scholars to recruit based on multiple characteristics. According to Bryman (2017), adoption of a sample space comprising of multiple characteristics plays an essential role in broadening the topic of study based on the variations in viewpoints.

The site of the research was an inpatient public funded treatment initiative conducted in association with the Sheriff’s Office in one of the mid-sized city located in the southern part of the United States of America. The participants in this study were classified based on their racial boundaries, marital statuses, number of children, educational attainments and history of incarceration. However, the weakness of the sample used for this study emanates from the fact that the scholars only adopted male participants. There are tendencies that inclusion of a population comprising of female and transgender participants would yield different results. On the other hand, the sample size (n = 60) was a bit narrow to guarantee higher levels of validity and reliability of the results obtained. Similarly, Creswell and Creswell (2017) explain that a smaller sample size limits the efficacy of a study to be used in making generalizations. The fact that the scholars did not embrace distinct inclusive and exclusive criteria when recruiting the participants reveals its weakness. There are tendencies that some of the respondents adopted for the scholarly work may not have met certain set policies and guidelines set to underscore clinical investigations.

The scholars adopted interviewing as the major primary method of collecting data. One-on-one semi structured interviews were implemented to recruit eligible participants for this research. An analysis of the procedure adopted to collect data for this study reveals some levels of inefficiencies. For instance, the one-on-one and face to face interviews adopted by the scholars are time consuming (Creswell and Creswell, 2017).

Learning outcomes and their relationship to your course level outcomes can be found on the Postgraduate vUWS site.

Learning outcomes for the unit are outlined below. Outcome

1 Explain the ways in which governments have attempted to structure health and community support services for older people and their families.

2 Analyse the impact of health and community support services for older people on national economies, public policy, health and community services, health staff, older people and their families.

3 Discuss the degree to which health and community support services for older people can evolve as complex, adaptive systems capable of self-organisation and co-operation.

4 Evaluate processes designed to enhance continuum in care – how these are funded, supported and managed.

5 Utilise theoretical models to analyse issues associated with reform agendas and policies focused on efficiency, effectiveness and productivity in aged care services, e.g change theory

6 Analyse the way that primary health care can be employed with older populations to enhance community capacity building and emancipation in health and community services.

Supporting Aged Communities

Policies in the healthcare departments have been changing daily. Behaviours of people have been changing and this affects their health and social well-being. The health of the elderly has been a key issue in every nation of the world. Thus, nations that value the health sector must take a keen interest on the health of the elderly (Murphy, 2012). These changing policies are very vital in a society, as they ensure an effective and a better way of delivering the best health care to the older people who are prone to health challenges. People in the health sector have to continue developing health models which take a keen interest in the health of the elderly. It is significant for the people in the health sector to consider much on how to change lifestyles of every cohort of life among individuals to ensure that their lives are impacted positively (Thomas, Jefferson, and Lasserson, 2013).

There is keen interest on every life age groups and the modes of taking care of the demographic cohort to continuously help people live positively. The interests of the elderly prove to be very key to every nation of the world. My topic of discussion will help people work and improve the health sector. Organisations dealing with health like the World Health Organisation (WHO) are keenly focusing on how to improve the health of the elderly. They have strategies and important moves aimed at improving health care delivery to the elderly (Writer, 2016). This essay will give a clear explanation an explanation of the healthy ageing model, a discussion and analysis of how aged care services are provided that support healthy ageing, an explanation of how aged care services have evolved and changed to meet the needs of older people and finally will summarise the ways of improving health of the elderly.

Based on the needs of the aged people, there ought to be an ageing model as given by WHO that sets up principles to be followed when dealing with this group of people. In this case, an ageing model is needed to set procedures that ought to be applied to ensure that these people stay healthy and have no challenges in their remaining part of live. Ethical principles, service programs and ways of reaching the services are well defined in the model. The ways of living are also well outlined including keeping physically fit.

Rowe and Kahn defined successful ageing as avoidance of disease and disability. However, they expanded their definition to include keeping physical and engagement of social and also productive activities. Generally, the ageing model is not well defined and future study is a necessity for clarity. However, ageing is dependent on all the aspects of the body, soul and the spirit of a man (Oudijk, Woittiez, & de Boer, 2011). Health ageing model shows resilience as the power and ability to keep, maintain or improve functionality in times of adversity. People may either do this through adaptation, resistance or recover from adversity. The health and ageing of a person are affected significantly by genes, the social activities they engage themselves in and the environment they live. It is also the capacity of a person to endure challenges and recover from adversities.

Religion is a set of beliefs, practices, rituals and faith based on a supernatural life and a divine God. These beliefs help a person to have hope in life and increase his/her lifespan. This is a good way to resist ageing for people without hope keeps worried in times of adversity reducing their lifespan. Spirituality is the personal will that makes someone to understand the issues of life in a personal way. They make one able to relate with the belief of the existence of a supernatural life. This is a very key factor in the ageing model of an individual (Koening et al. 2000, p.18-19)

The aspects of genetic makeup help a person to resist disease and biological changes. The inherent genetic makeup of an individual is very crucial for the survival and for the way such a person resists adversity. By chance and luck some people inherit resistance genes which make them able to cope with changing circumstances.

Positive spirituality is also another factor that influences the ageing model of an individual. This is an internalized individual relationship which is sacred that is never influenced by race, economics, ethnicity and neither class and improves the wellness and the welfare on a person as well as of the other. This is the greatest deep of intimacy with the supernatural. It consists of the aspects of religion and spirituality. Some religious beliefs have adverse mental and physical health. Spirituality may be hurting rather than helping people and this affects much the ageing model of an individual.

Coping with religion, psychological and physical health outcomes have adversely affected people and how people age. This is also a model of ageing affecting the lives of people. Improvement of health is determined by positive belief on a certain religion. Positive spirituality has been seen to promote health (Schluchter, Hack, Taylor, Drotar, Cartar, Andreias, & Klein, 2015). Old and traditional ways of doing things which were hurting have been replaced by modern methods of improving health. Cultures and beliefs have changed over time making people adapt to the changes. Religion has been a key propagate and a channel of teaching people on the important aspects of health. This is because spiritual leaders are mostly and freely accept by people in all races.

The ageing model focuses on the aspects of Religion, spirituality genetic inheritance and positive spirit. In these aspects, the inner person or the intrinsic factors seem to take much of the discussion (Lihong, 2013). Environmental factors that affect the life of an individual are centred on the resources and needs of the society, the relationship and interactive nature among the elderly and the changes that occur with people and places over time. These factors are key contributors to the ageing style of an individual. However, the abilities that help people cope with the challenges include; ability to move around, make, maintain and build strong relationships, meeting their own basic needs without dependency and ability to learn to grow and make sound decisions. This all revolves around the factors which the elderly take as a matter of priority which includes role, how possible it is for them to enjoy, relationships and issues of security (Macias, Hunicken, Sow, Guerrero, & Muñoz, 2009).

Generally, the ageing models affect the way people age. Moreover, the aged can be helped to improve their lives. People in the health sector have a lot to do to improve the lives of people. Analysis of how aged care services are provided that support healthy ageing. Support for the aged in Australia is centralized and are provided by a large number of Government agencies like commonwealth, the state and all other locals. Programs by the society also provide support for the elderly. Both private profitable and none profitable organizations also give a helping hand in support to the elderly (Hollander, Liu, & Chappell, 2009).

There are various ways involving the organization of aged care support and services as follows. Governments of New South Wales and Victoria provide a pension for people as early as at 65 years of age. This has made the aged dependent on themselves. Commonwealth also has helped these governments in paying pension for the elderly. Women from age 60 years also have been able to get pensions to help them in the day to day lives. Government Current support ensures that the Commonwealth is able to give acute medical and pharmaceutical services to the elderly in Australia. In addition, they have been giving monetary benefits which help to support the elderly (Fuster, 2014). The carers of the elderly also get support from the Commonwealth government. Generally, the Commonwealth provides the following to the ageing in Australia; pensions to the aged, assisting in rent and giving disability benefits, residential services, public housing, acute care among many other. Commonwealth also gives other support services that directly help the aged such as financial counselling, providing programs that promote health, giving rehabilitation services, retirement benefits for farmers and also educate the elderly on government programs. State and territories provide health facilities, housing and welfare services as well for the aged. They offer respite care for the aged, assistance to the carers, dementia programs, transportation, home help and senior’s cards for discount services.

The local or municipal government provide also specific services to the aged which are funded by Commonwealth. The services, however, are connected to the government for easy monitoring. They mostly help in coordinating the aged care services provided by the state and commonwealth. Support from non-Government Agencies is also active. As well as the government, there exist non-governmental organizations which also provide support services to the elderly. These organizations are run by the community and other charitable organizations. This sector funds from its resources 20% of the total cost of all welfare services (Froutan, Khankeh, & Mohammadi, 2013). The profit private sector also makes efforts to fund organizations for the elderly. This helps much in the social welfare that fund services for the elderly. The role of carers is noted since carers are the most important people in supporting the elderly in Australia. They play a very major role in helping the aged of which most of them are family and friends. They offer this willingly because the people may be relatives and morally the old are respected.

There is also community care such as the Commonwealth and the state government have enacted policies which take care of the elderly. This emphasizes much on taking care of the elderly and it’s taken keenly by everyone in Australia.  The frail people are mostly on the emphasis of being taken care of by the government and all other agencies. Some of the community care organizations include; Home and Community Care Program (HACC), Community Aged Care Packages (CACPs) and Extended Aged Care at Home Program Pilot (EACH).

Effective organization for the aged is given to take care of health and disability issues. Health care is provided by the mainstream programs of the government such as government hospital systems, services offered by medical practitioners and pharmaceutical schemes. Australia has a Universal Health Care system which provides the aged with easy access to medical and healthcare services (Iliffe, et al. 2014). There are also community-rated insurance services aimed at helping the aged. The premiums charged are low to cater to the needs of the elderly. In general, the aged in Australia are well taken care of. The governments are very keen to take care of the aged citizens. Policies are well developed and instituted to take care of all the aged citizens of Australia. Every Government agencies and mostly commonwealth is keen on the interest of the elderly. This has made it easy for the states of Australia to make the elderly live longer.

The Commonwealth government takes Social security as one of the major responsibility. They help much in funding the Australia elderly people much in providing nursing home beds in high care places and hostel beds in low care places. However, it is only about 6% who live in these facilities. Moreover, this is the people prone and they need a lot of care. The costs for services of aged persons are normally catered for by the commonwealth government in Australia by covering a good portion of the cost (Windle, 2012). This depends on the financial position of the victim in need and this means one may end up paying something little for personal care, daily living and accommodation.

Health services for the aged have changed over time.