ESSAY REBUT  4

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ESSAY REBUT 4

ESSAY REBUT 4

ESSAY REBUT (Kara)

The author offers cogent argument on evidence-based medicine with concrete examples from personal experience and evidence support. The healthcare environment is pervasive and constantly evolving, hence the need to keep learning and updating yourself with new knowledge and skills to remain valuable and relevant in the current environment. Healthcare reforms have also taken the course of patient-centered and holistic care, prompting healthcare providers to learn to develop therapeutic-patient relationships, unlike in the past, where the primary role of the provider was to provide treatment. Currently, providers, particularly nurses, are expected to know the patient personally, understand their worldview, preferences, beliefs, interests, and needs and adopt these to make medical decisions. This evolution indicates the need for continuing education to update oneself with new knowledge and competencies to help drive the reforms and improve healthcare delivery.

Additionally, the current practice is more evidence-based, expecting providers to adopt the current best evidence to make decisions about patient care. Evidence-based medicine (EBM) utilizes nursing or healthcare research to organize and adopt current data to help make better medical decisions.1 EBM is not standalone, as healthcare professionals must combine their clinical experience and patient values, interest, and needs to make the best evidence for their patients.1 Healthcare providers must constantly ask relevant clinical questions, search for the best evidence to answer the question, thoroughly appraise it, apply it, and evaluate its effectiveness in decision-making.1

References

  1. Tenny S, Varacallo M. Evidence Based Medicine. In: StatPearls. Treasure Island (FL): StatPearls Publishing; October 24, 2022. https://www.statpearls.com/evidence-based-medicine/
 
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Alterations in Cardiovascular and Respiratory Systems

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Alterations in Cardiovascular and Respiratory Systems

Alterations in Cardiovascular and Respiratory Systems

Alterations in Cardiovascular and Respiratory Systems

Introduction

The cardiorespiratory system operates to serve body organs and tissues with enough oxygen supply in relation to oxygen intake. The physiological interactions between the cardiovascular and respiratory systems are complex and fundamental in optimal patient management. Alterations in these systems, for instance, altered intrathoracic pressure, can be transferred to the heart and lungs, dramatically altering cardiovascular performance (Cross et al., 2020). This paper addresses alterations in cardiovascular and respiratory systems, pathophysiological processes in these systems that contribute to disease systems, how the process affects each other, and ethnic/racial that affect physiological functioning.

Cardiovascular and cardiopulmonary pathophysiologic processes of why the patient presents these symptoms

The patient has gained weight and is experiencing shortness of breath, peripheral edema, and abdominal swelling. A Framingham study shows that the prevalence of arterial pressure is high among overweight individuals. There is a direct correlation between hypertension and body weight in adults (Mendoza et al., 2020). The patient complains of weight gain, which is a likely cause of increased arterial pressure or hypertension, whose first symptom is shortness of breath (Oldroyd et al., 2022). The peripheral edema can be attributed to the high blood pressure due to constricted veins and arteries because any activity that increases capillary pressure, minimizes oncotic pressure, raises endothelial permeability, or impacts lymphatic drainage, can lead to edema. The abdominal swelling can be as a result of a large amount of fluid accumulating in the abdomen, which can be attributed to portal hypertension.

How the cardiovascular and cardiopulmonary pathophysiologic processes interact to affect the patient

This case study depicts an alteration in cardiovascular and respiratory or cardiopulmonary systems as a result of weight gain. According to research, excess weight leads to fatty material build-up in the arteries, increasing arterial pressure because of the contractions in the arteries (Mendoza et al., 2020). The increased arterial pressure is a pathophysiological process of the cardiovascular system that leads to an alteration in the cardiopulmonary processes because the body is struggling to supply cells with adequate oxygen, requiring more blood to supply adequate oxygen (Cross et al., 2020). This alteration in the cardiopulmonary system as a result of the cardiovascular system is linked to the patient experiencing shortness of breath.

Racial/ethnic variables that may impact physiological functioning

Most diseases, especially chronic diseases, vary by race and ethnicity. For instance, in the case of cardiovascular diseases, there is a high prevalence of hypertension among black adults, with 59% of black adults experiencing hypertension. Also, the likelihood of developing hypertension is twice among black women than among white women. Type 2 diabetes is more prevalent among American Indians, with 1 in 4 adults developing the disease compared to 1 in 12 whites (Cleveland Clinic, 2022). Regarding heart failure, the risk of a black man experiencing heart failure is 70% compared to a white man and 50% for black women compared with white women (Cleveland Clinic, 2022). Black adults are also more likely to experience coronary artery disease, heart attack, and stroke than other racial and ethnic groups.

Modifiable and Non-modifiable Risks

Modifiable factors contributing to these numbers or racial disparities regarding physiological functioning include lifestyles and the living environment that encourages a sedentary lifestyle, minimal physical activity, and unhealthy eating patterns, money and resources to acquire basic needs, quality of education, quality of healthcare in the various communities, resources like nutritious foods, and societal factors like discrimination, violence, and capacity to build supporting relationships (Budreviciute et al., 2020). Some factors, like family history of illness and genetic factors, cannot be modified, but the risk can be reduced by optimizing the modifiable risk factors.

Conclusion

Cardiovascular and cardiorespiratory systems interact at an optimal level to ensure optimal body functioning. However, alterations in one system can lead to an alteration in another, contributing to disease systems like shortness of breath, as indicated in the case study. In most cases, cardiovascular pathophysiological processes alter normal cardiorespiratory system functioning. Some races and ethnicities are more likely to develop particular diseases; for instance, black adults are more likely to develop cardiovascular diseases like heart failure, heart attack, stroke, and hypertension, than other races and ethnicities. The risk can be reduced by optimizing modifiable factors like lifestyles, living environment, education level or health literacy, financial ability, and quality of healthcare services.

References

Budreviciute, A., Damiati, S., Sabir, D. K., Onder, K., Schuller-Goetzburg, P., Plakys, G., … & Kodzius, R. (2020). Management and prevention strategies for non-communicable diseases (NCDs) and their risk factors. Frontiers in public health, 788.

Cleveland Clinic. (2022). How Race and Ethnicity Impact Heart Disease. https://my.clevelandclinic.org/health/articles/23051-ethnicity-and-heart-disease/

Cross, T. J., Kim, C. H., Johnson, B. D., & Lalande, S. (2020). The interactions between respiratory and cardiovascular systems in systolic heart failure. Journal of Applied Physiology, 128(1), 214-224.

Mendoza, M. F., Kachur, S. M., & Lavie, C. J. (2020). Hypertension in obesity. Current Opinion in Cardiology, 35(4), 389-396.

Oldroyd, S. H., Manek, G., Sankari, A., & Bhardwaj, A. (2022). Pulmonary Hypertension. In StatPearls. StatPearls Publishing.

 
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PICOT-D Draft – New IPV policy

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PICOT-D Draft – New IPV policy

PICOT-D Draft - New IPV policy

PICOT-D Draft

(PICOT-D Draft – New IPV policy)

Problem Statement

It is not known if the implementation of a new IPV policy would impact IPV identification among IPV victims, current and potential.

Purpose Statement

The purpose of this quality improvement project is to determine if the implementation of a new IPV policy would impact IPV identification among current and potential IPV victims. The project will be piloted over an eight-week period in an urban primary care clinic.

PICOT-D Question

Among current and potential IPV victims, how does the implementation of a new IPV policy compared with the current IPV policy affect IPV cases identification rates within an 8-week period when looking at an individual’s self-report of experiencing IPV ever in the lifetime of their referent relationship and the standardized frequency within two months before interview.

Primary Quantitative Research Articles

Homan et al. (2020), Sangeetha et al. (2022), and Clithero et al. (2016) were selected as relevant, valid, reliable, and appropriate research support for the project topic. The articles are quantitative and published within 7 years the anticipated graduation date. Homan et al. (2020) explores quantitative methods of IPV analysis, aiming to gather valuable information of people perception of why they chose to stay or leave or both an abusive relationship. This study is relevant to the research topic as it provides valuable insights into understanding perception of abusive relationship and how different people respond to IPV. Sangeetha et al. (2022) and Clithero et al. (2016) address advocacy and policy as interventions to addressing intimate partner violence. These studies provide insights into the proposed intervention and how it can be adopted as a health policy at the workplace to guide IPV identification to foster early intervention and prevention of pervasive abusive relationships that have detrimental impact on the victim.

References

Homan, C. M., Schrading, J. N., Ptucha, R. W., Cerulli, C., & Ovesdotter Alm, C. (2020). Quantitative Methods for Analyzing Intimate Partner Violence in Microblogs: Observational Study. Journal of medical Internet research, 22(11), e15347. https://doi.org/10.2196/15347

Sangeetha, J., Mohan, S., Hariharasudan, A., & Nawaz, N. (2022). Strategic analysis of intimate partner violence (IPV) and cycle of violence in the autobiographical text–When I Hit You. Heliyon, 8(6), e09734. https://www.sciencedirect.com/science/article/pii/S2405844022010222

Clithero, A., Albright, D., Bissell, E., Campos, G., Armitage, K., Solan, B., & Crandall, C. (2016). Addressing Interpersonal Violence as a Health Policy Question Using Interprofessional Community Educators. MedEdPORTAL : the journal of teaching and learning resources, 12, 10516. https://doi.org/10.15766/mep_2374-8265.10516

 
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PICOT-D Draft – New IPV policy 

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PICOT-D Draft - New IPV policy 

PICOT-D Draft – New IPV policy 

Problem Statement

It is not known if the implementation of a new IPV policy would impact IPV identification among IPV victims, current and potential.

Purpose Statement

The purpose of this quality improvement project is to determine if the implementation of a new IPV policy would impact IPV identification among current and potential IPV victims. The project will be piloted over an eight-week period in an urban primary care clinic.

PICOT-D Question

Among current and potential IPV victims, how does the implementation of a new IPV policy compared with the current IPV policy affect IPV cases identification rates within an 8-week period when looking at an individual’s self-report of experiencing IPV ever in the lifetime of their referent relationship and the standardized frequency within two months before interview.

Primary Quantitative Research Articles

Homan et al. (2020), Sangeetha et al. (2022), and Clithero et al. (2016) were selected as relevant, valid, reliable, and appropriate research support for the project topic. The articles are quantitative and published within 7 years the anticipated graduation date. Homan et al. (2020) explores quantitative methods of IPV analysis, aiming to gather valuable information of people perception of why they chose to stay or leave or both an abusive relationship. This study is relevant to the research topic as it provides valuable insights into understanding perception of abusive relationship and how different people respond to IPV. Sangeetha et al. (2022) and Clithero et al. (2016) address advocacy and policy as interventions to addressing intimate partner violence. These studies provide insights into the proposed intervention and how it can be adopted as a health policy at the workplace to guide IPV identification to foster early intervention and prevention of pervasive abusive relationships that have detrimental impact on the victim.

(PICOT-D Draft – New IPV policy )

References

Homan, C. M., Schrading, J. N., Ptucha, R. W., Cerulli, C., & Ovesdotter Alm, C. (2020). Quantitative Methods for Analyzing Intimate Partner Violence in Microblogs: Observational Study. Journal of medical Internet research, 22(11), e15347. https://doi.org/10.2196/15347

Sangeetha, J., Mohan, S., Hariharasudan, A., & Nawaz, N. (2022). Strategic analysis of intimate partner violence (IPV) and cycle of violence in the autobiographical text–When I Hit You. Heliyon, 8(6), e09734. https://www.sciencedirect.com/science/article/pii/S2405844022010222

Clithero, A., Albright, D., Bissell, E., Campos, G., Armitage, K., Solan, B., & Crandall, C. (2016). Addressing Interpersonal Violence as a Health Policy Question Using Interprofessional Community Educators. MedEdPORTAL : the journal of teaching and learning resources, 12, 10516. https://doi.org/10.15766/mep_2374-8265.10516

 
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Analyzing Liability

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Analyzing Liability

Analyzing Liability

Analyzing Liability

Summary

The complaint letter is by Mr. Thomas Lee about his disappointment with the company for failing to ensure a secure workplace for individuals from all backgrounds and nationalities. Mr. Lee is an American of Chinese origin who complains of racial discrimination at the workplace after being accused of bringing COVID-19 to the workplace because he is Chinese. The employee presented a verbal complaint to the supervisor, who failed to listen to him and questioned Mr. Lee’s customs and beliefs. Mr. Lee says the workplace is hostile and intimidating, and he has received threats from other employees who have singled him out for allegations of spreading the virus on the basis of his origin and ethnicity, sending him negative messages through texts, emails, social media and telephone. Mr. Lee continues to point out that several people have died after exposure to Covid-19, insisting the company’s lapse in judgement and preparedness was the primary reason. Furthermore, another letter by Karen Small, also a security guard, seems to confirm the allegation because she points out that she thinks she acquired the virus from Mr. Lee, who the company allowed to spread the disease. Mr. Lee is an American Citizen and has lived in Alabama almost his life and cannot contemplate why he is being singled out for spreading the virus on the mere basis of being Chinese. Mr. Lee says the company has done nothing to address the situation and lacks leadership, which encourages the behavior. He is considering a lawsuit if the issue is not dealt with.

Associated U.S. laws or regulations and how they are relevant to the identified liability

First Mr. Lee complains of racial discrimination at the workplace, which is addressed by Title VII of the Civil Rights Act of 1964. This Act makes it illegal to discriminate against people on the mere basis of their color, race, religion, national origin or sex. For example, Hahn et al. (2018) provide that this Act is fundamental in ensuring racial and ethnic equity and eliminating discriminatory behavior, implying the Act corresponds to the identified liability of preventing racial discrimination based on color, race, gender, or nationality. The law protects all employees from retaliation if they decide to forward a claim on discrimination at the workplace. Mr. Lee also points out that most people acquired and were exposed to the virus because of the company’s lapse in judgement and preparedness, which is addressed by the Occupational Safety and Health Act of 1970, which requires employers to keep the workplace free from hazardous conditions, stressing employees’ rights to information regarding the dangers in their job. For example, in Michaels & Wagner (2020), employers are required by law to offer an environment that protects employees from COVID-19 per OSHA provisions. Michaels & Wagner (2020) provides that only employers can make the workplace safe by enforcing OSHA guidelines, and a failure to do so is considered a non-adherence and non-compliance. This scenario implies that the OSHA is relevant to the identified liability of keeping employees safe from Covid-19 at the workplace. The law also protects employees from being punished if they decide to exercise their rights per OSHA.

The potential harm to the company, its employees, and its workplace culture that could result from a lawsuit emanating from the selected complaint

If the company is found liable for non-compliance with Title VII, it could face penalties for intentional discrimination, enforced as either compensatory or punitive damage up to a maximum provided by the Title VII of the Civil Rights Act of 1964 according to the number of employees in the company. The company would have to pay either back pay, compensatory damages, or punitive damages. For instance, in Lund (2020), the case, titled Bostock v. Claton County, involves the Supreme Court upholding non-discrimination based on race and sex, against which an employer is liable and faces paying compensatory damages. This case implies that if the company is found liable under the interpretation of Title VII of the Civil Rights Act, it would have to pay compensatory damages to Mr. Lee. The confirmation of liability would affect other employees, especially of other nationalities, who have experienced the same and may choose to also forward their case. This liability would label the workplace as toxic, discriminatory, and lacking diversity. If the company is found liable under OSHA for failing to protect its employees from Covid-19 exposure, it could face penalties based on the type of violation, ranging between $15,625-$156,259 per violation. Dealing with litigations for OSHA non-compliance will be costly for the company. For instance, Sadeh et al. (2022) address the cost impact of Covid-19 OSHA citations and specify that fines for non-compliance and regulatory violations have a significant cost impact on a company. If the company is found liable, it means that the company would also be liable for all other Covid-19-related cases, amounting to millions of dollars of fines and compensatory damages that would be detrimental to the company’s finances. It would also mean that the work environment is unsafe, and the company cannot protect its most valuable resource, leading to a demoralized workforce.

Realistic preventative measures that could have avoided legal liability

The company has to promote diversity in the workplace by developing and enforcing anti-harassment and anti-discrimination policies that condemn discrimination based on race, color, gender, ability or disability, sexual orientation, and other identifiers. The company should protect employees from bullying and harassment. Cross-cultural or cultural sensitivity training and education would be necessary to ensure a discrimination-free environment. For example, Shepherd (2019) offers evidence supporting cross-cultural training, including diversity training, anti-racism raining, and micro-aggression training, effectiveness in enhancing cultural competence, safety, humility, and intelligence, which are integral in ensuring a workplace free from discrimination, harassment, and intimidation. The training would include all employees because there are allegations of lapse in conduct and professionalism among low-level employees and supervisors. The training program would ensure that all employees respect cultural and racial differences, act professional in conduct and speech, refuse to instigate, participate, or condone discrimination and harassment, and avoid race-based or culturally offensive acts, including humor and pranks (Shepherd, 2019). Systematic factors contribute to discrimination, harassment, and retaliation in the workplace. Therefore, the company should develop an effective internal complaints procedure and ensure such issues are addressed internally to avoid legal liability. These procedures, coupled with dispute resolution systems can help prevent discrimination and harassment as provided by Dobbin and Kalev (2020), who offer guidelines for making discrimination and harassment systems better.

Individuals and departments that would need to be involved in the proposed measures

Mr. Lee complained of harassment on a daily basis, from a fellow security guard to the supervisor. This case implies a lack of cultural sensitivity and awareness across employees of all levels. Therefore, all employees, including supervisors and managers, will be involved in the proposed measures, particularly the cross-cultural or cultural sensitivity training and education. The Human Resources Department will be involved because it is responsible for outlining disciplinary action policies and procedures to respond to actions or behavior that violate the company’s policies. It will help formulate and enforce anti-harassment and anti-discrimination policies and formalize the internal complaints procedure to orient all employees on the code of discipline.

Viable legal defenses the company could assert in a litigation context in order to defeat the complainant’s claims

The complainant has the duty to prove that he experienced racial discrimination at the workplace, which seems a serious case because the allegations are confirmed in other complaints, implying that employees think Mr. Lee spread the virus under the company’s watch. The company would also have to prove beyond doubt that Mr. Lee did not experience racial discrimination or that if he did, it was unintentional because only intentional racial discrimination is ruled as non-compliance. The company can also counter the claim by stating a lack of substantial evidence indicating that Mr. Lee experienced racial discrimination. The company has to show current policies that protect employees from racial discrimination and how it enforced these policies to respond to the complaint. Mr. Lee is accused of spreading the virus because he is Chinese. If the company can prove that indeed Mr. Lee brought the virus to the workplace, it can avoid legal liability. In the interview transcript, interviewees provide that the company developed safety rules and measures per CDC to protect employees from Covid-19 exposure. It has to prove this claim with substantial evidence to avoid legal liability, given that other complaint letters point to the lapse of judgement and preparedness as the primary cause of over 70% of infections and several wrongful deaths. The company has to convince the jury that employees acquired the virus outside the workplace, which is beyond the control of the employer, to avoid legal liability.

Ethical implications of the scenario and measures that address ethical issues

The primary ethical principles associated with this scenario include fairness, respect, responsibility, and protection from harm. Racial discrimination and harassment in the workplace are perceived as ethical failing due to a culture or practices of disrespect, unfairness, and harm (Elias & Paradies, 2021). It is a violation of human rights due to an unjustified distinction created by the nature of the work environment or policy failures. Racial discrimination impacts negatively the work environment and the company at large. Employees who are harassed and singled out by other employees, including managers and supervisors, feel unheard and unprotected by the company. It creates a toxic environment, forming divides between employees that are detrimental to the company. Employees of other racial and ethnic minorities or nationalities would fear engaging or collaborating meaningfully when the company does not protect them from harassment and discrimination. It would mean increased absenteeism, turnover, poor performance, bad PR, loss of income and litigation, and damaged relationships with other companies that employ an anti-racist or anti-discrimination approach.

Under the ILPA Industry Code of Conduct Guidelines, all individuals should be treated equally in an organization, and a company should not tolerate discrimination based on age, gender, race, religion, sexual orientation, family status, disability, marital status, or political beliefs (Institutional Limited Partners Association, 2018). The company can enforce such measures to prevent ethical failing and unethical behavior as a measure to promote ethical conduct in the workplace. The company should condemn discrimination and racism, protect employees from bullying and harassment, and promote a diverse and inclusive environment where employees respect each other’s differences.

References

Dobbin, F., & Kalev, A. (2020). Making discrimination and harassment complaint systems better. WHAT WORKS?, 24.

Elias, A., & Paradies, Y. (2021). The Costs of Institutional Racism and its Ethical Implications for Healthcare. Journal of bioethical inquiry, 18(1), 45–58. https://doi.org/10.1007/s11673-020-10073-0

Hahn, R. A., Truman, B. I., & Williams, D. R. (2018). Civil rights as determinants of public health and racial and ethnic health equity: health care, education, employment, and housing in the United States. SSM-population health, 4, 17-24.

Institutional Limited Partners Association. (2018). Code of conduct: harassment, discrimination and workplace violence: Guidelines for the private equity ecosystem.

Lund, N. (2020). Unleashed and Unbound: Living Textualism in Bostock v. Clayton County. Clayton County (July 14, 2020). Federalist Society Review, 21, 20-15.

Michaels, D., & Wagner, G. R. (2020). Occupational Safety and Health Administration (OSHA) and worker safety during the COVID-19 pandemic. Jama, 324(14), 1389-1390.

Sadeh, H., Mirarchi, C., Shahbodaghlou, F., & Pavan, A. (2022). Predicting the trends and cost impact of COVID-19 OSHA citations on US construction contractors using machine learning and simulation. Engineering, Construction and Architectural Management, (ahead-of-print).

Shepherd, S. M. (2019). Cultural awareness workshops: limitations and practical consequences. BMC Medical Education, 19(1), 1-10.

 
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NRNP 6645 WEEK 7

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NRNP 6645 WEEK 7

NRNP 6645 WEEK 7: Humanistic–Existential Therapy

NRNP 6645 WEEK 7: Humanistic–Existential Therapy

Introduction

Psychotherapy helps treat a myriad of psychological, behavioral, and cognitive disorders, problems, and their symptoms and is perceived as the primary approach in mental healthcare management. Psychotherapy is often used alongside pharmacotherapy to enhance treatment effectiveness and quick recovery (Locher et al., 2019). Different types of psychotherapy exist and are perceived as suitable for different mental health conditions and disorders and varying patient circumstances. This paper addresses humanistic-existential therapy and contrasts it with cognitive behavioral therapy based on primary themes, modes of application, expected outcomes, and the therapist’s role.

Description

The primary aim of humanistic-existential therapy is to foster self-awareness and personal growth, focusing on people and who they are in their current state. This approach strongly emphasizes the individual and their current state and encourages them to accept individual responsibility for their current state and the consequences of their action (Robbins, 2021). Most individuals are reluctant to accept that they are responsible for who they are and their current state and spend much time blaming others. humanistic-existential therapy revolves around the relationship between the provider and the patient and practitioners helping patients discover themselves and enhance self-awareness of who they are and the world around them (Robbins, 2021). Accepting responsibility for their actions and who they are can help address their resistance and help them have a more meaningful existence. The focus is on self-searching and meaning. Cognitive behavioral therapy combines behavioral and cognitive therapies. It emphasizes the learning’s in developing normal and abnormal or unaccustomed behaviors, adopting the cognitive approach, which focuses more on what individuals think rather than do (Robbins, 2021). The primary aim of CBT is to deal with dysfunctional thinking that causes dysfunctional emotions and behaviors, assuming that people can change what they do and how they feel by changing how they think and reason.

(NRNP 6645 WEEK 7: Humanistic–Existential Therapy)

Differences between Humanistic-Existential Therapy and Cognitive-Behavioral Therapy

Humanistic-existential therapy is rooted in the understanding that human experience influences the current state and that individuals are more responsible for who they are today. According to this approach, individuals develop psychological issues or disorders when they fail to make authentic, self-directed, and responsible or meaningful decisions about their lives (Solobutina & Miyassarova, 2019). Interventions associated with humanistic-existential therapy aim at enhancing the individual’s self-awareness and self-understanding. The core words and themes are acceptance, growth, responsibility, and freedom. The approach stresses that people have the capacity for making decisions and self-awareness, focusing on the individual or the person as having an inherent ability to maintain healthy, constructive relationships and make decisions that benefit oneself and others (Solobutina & Miyassarova, 2019). This approach influences my PMHNP practice by guiding me to focus on helping people gain freedom from disabling assumptions and attitudes to live a more fulfilling life. It also stresses that I adopt existential philosophies to help the client make more authentic and responsible decisions to better their lives.

On the other hand, cognitive behavioral therapy (CBT) explores the relationship between cognition, emotion, and behavior. This approach focuses on automatic thoughts, cognitive distortions, and underlying beliefs as the primary aspects of cognition (Chand et al., 2022). The approach stress that cognitive distortions like an overgeneralization, minimization, disqualifying the positive, selective abstraction and dichotomous thinking and underlying beliefs affect reasoning and perception and interpretation of things and events (Chand et al., 2022). CBT is more structured and goal-oriented, involving the therapist and the patient working collaboratively to modify thinking and behavior patterns to bring about positive change and enhance the quality of life, which is a contrast to the humanistic-existential therapy that focuses on helping people through self-realization and self-understanding to make more authentic and responsible decisions. I consider humanistic-existential therapy more ruthless because it calls for the client to take more responsibility in their lives instead of blaming others people and things or events.

Why Humanistic-Existential Therapy was used with Client in the Video

The video selected for review has ‘Joe’ as the client, and he presents to the practitioner as feeling unwell and less alive. The client attended therapy sessions two years ago for anger issues, but the process was not effective in helping address his dysfunctional and unaccustomed behavior and actions. The patient complains of a lack of place orientation and has constricted feelings. The humanistic-existential therapy was selected to help the client enhance self-awareness and self-understanding and increase the capacity to make authentic and meaningful decisions. Adopting this approach would help “Joe” better understand his life with a better individual identity, purpose, and meaning in life and help develop quality relationships with other people. Adopting the CBT approach in this situation would focus on dysfunctional thought and behavior patterns that impact Joe’s life and how to address these dysfunctions to impart positive change. The outcome would be altered thinking and behavior patterns that would help Joe live a more fulfilling life.

(NRNP 6645 WEEK 7: Humanistic–Existential Therapy)

Conclusion

Humanistic-existential therapy focuses on the individual as a whole person with the capacity to maintain a healthy life and make authentic and responsible decisions. In contrast, CBT focuses on dysfunctional thinking and behavior patterns that are pervasive in a client and contribute to their mental health problems. Both theories emphasize bringing positive change to the inner individual and helping people gain more control over their lives through self-awareness and self-understanding and more positive thinking and behavior patterns. The therapist can complement or supplement each other in treating mental health conditions.

Supporting Sources

Locher et al. (2019) explore psychotherapy in detail. Robbin (2021) discusses an existential-humanistic approach to positive psychology, and Chad et al. (2022) discuss cognitive behavioral therapy and associated concepts. Solobutina and Miyassarova (2019) tackle the existential personality fulfilment dynamics in psychotherapy course. These studies are peer-reviewed and scholarly because they are written and reviewed by experts in the field with extensive knowledge and authority to address particular topics.

References

Chand, S. P., Kuckel, D. P., & Huecker, M. R. (2022). Cognitive behavior therapy. In StatPearls [Internet]. StatPearls Publishing.

Locher, C., Meier, S., & Gaab, J. (2019). Psychotherapy: A World of Meanings. Frontiers in psychology, 10, 460. https://doi.org/10.3389/fpsyg.2019.00460

Robbins B. D. (2021). The Joyful Life: An Existential-Humanistic Approach to Positive Psychology in the Time of a Pandemic. Frontiers in psychology, 12, 648600. https://doi.org/10.3389/fpsyg.2021.648600

Solobutina, M. M., & Miyassarova, L. R. (2019). Dynamics of Existential Personality Fulfillment in the Course of Psychotherapy. Behavioral sciences (Basel, Switzerland), 10(1), 21. https://doi.org/10.3390/bs10010021

 
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Health Care Ethical Dilemma Analysis

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Health Care Ethical Dilemma Analysis

Health Care Ethical Dilemma Analysis

Health Care Ethical Dilemma Analysis

Introduction

One of the fundamental obligations of healthcare professionals is confidentiality. Healthcare professionals should keep a patient’s confidential health information private until the patient approves sharing the information. Healthcare providers frequently receive personal information from patients. Trust in the doctor-patient relationship would suffer if confidentiality is breached. Patients would be less likely to provide private information, which might have an adverse effect on their treatment. The patient is more inclined to ask for assistance and to be as open and honest as possible during a medical visit when a trustworthy environment is established and patient privacy is respected. This paper explores confidentiality as an ethical dilemma in healthcare, the role of interprofessional collaboration in addressing the issue, ethical decisions to make in this dilemma, and how professionalism, integrity, and self-confidence can help resolve the dilemma.

The Ethical Dilemma

Patients share information with health professions to aid their healthcare process and inform diagnosis and treatment regimens. Patients expect healthcare professionals to maintain this information private and confidential and only share it with authorized individuals to third parties like family members after obtaining patient consent (Noroozi et al., 2018). However, some situations might limit confidentiality, creating an ethical dilemma where the principle of confidentiality conflicts with other principles like beneficence and nonmaleficence. An example is when an ex-husband comes to the clinic and inquires for information about his sick ex-wife, who they are co-parenting. The patient’s ex-wife is unconscious in the ICU and cannot provide consent. The ex-husband demands to know about the patient, pointing to his rights to the information because he still loves her, she was his ex-wife, the mother to his children, and they are co-parenting. The healthcare profession has to decide whether to share the information or not because the patient did not provide information about immediate family or person to share information with before undergoing the emergency treatment.

The ethical principles at risk in this dilemma

The principle of confidentiality forbids the healthcare provider from sharing patient information with third parties without the patient’s consent, and it urges providers and healthcare systems to implement security measures to guarantee that only authorized individuals have access (Noroozi et al., 2018). All team members have been permitted to access confidential information regarding the patients they are responsible for and are responsible for keeping that information safe from those who do not have access to provide patients with the appropriate treatment they need. The confidentiality of electronic medical records may face difficulties. Institutions are required by the Health Information Portability and Accountability Act (HIPAA) to establish protocols for computer access and security and policies to preserve the privacy of patient electronic data.

Confidentiality can be threatened when a family member inquires about the patient or wants to access patient records or information. The conditions for establishing an exception to confidentiality may not be met, even though there may be situations where the doctor feels compelled to provide information, for example, in response to a curious spouse or a family member. In general, it is not ethically acceptable to disclose information to family members without the patient’s express consent (Tegegne et al., 2022). The patient (and perhaps local public health officers) is still responsible for informing the spouse, not the doctor unless there is a specific potential of harm associated with the diagnosis or illness.

Additionally, unintended disclosures can also happen in several other ways. For instance, in a hurry, healthcare professionals can be tempted to talk about a patient on the escalator or another public area, yet ensuring patient privacy may not be viable in these situations. Similarly, additional copies of teaching conference handouts that include patient-identifiable information should be disposed of after the meeting to maintain patient privacy (Tegegne et al., 2022). Also, any identifiable patient information that is withdrawn from the security of the healthcare facility should be encrypted. Leaks of this nature constitute a violation of the patient’s confidentiality rights.

How the Christian worldview could be used to apply ethical patient-centered principles, values, and culture to this situation

Christian ethics, which aspires to love God and neighbor across every moral and ethical situation, is governed by God’s revelation in Scripture rather than other schools of thought. Loving God with all of one’s heart, mind, soul, and strength is the ultimate ethical obligation a person may have in Christianity. The obligation to love one’s neighbor as oneself is the second highest ethical obligation (Rheeder, 2018). In order for Christians to fulfil these moral commitments, they must submit to the principles of God’s Word and the Law of Christ. The ultimate aim of anything spoken, done, thought, and felt is to glorify God. Being a blessing to others and being a more virtuous person are two more overarching ethical objectives in Christianity (Rheeder, 2018).

The Bible cherishes secrets and forbids gossip, and God holds high the secrecy in intimate relationships with His people. The ability to have secrets and the decision to reveal them with close contacts is the foundation for confidentiality (Rheeder, 2018). People must stay silent or stick to speaking in an edifying manner in order to protect these secrets. The Old and New Testaments advocate maintaining secrets, edifying others through discourse, and disapproving of gossip (Rheeder, 2018). People should promise and commit to maintaining patient information’s confidentiality because these scriptural instructions are behavioral standards for Christian healthcare professionals, which is fundamental in addressing ethical dilemmas associated with confidentiality.

The importance of interprofessional collaboration when resolving an ethical dilemma

Interprofessional teams that actively collaborate to find, assess, and address ethical difficulties or issues to raise the standard of healthcare are how ethical challenges in the field of medicine are typically addressed. Because it enables the inclusion of all pertinent professional voices in talks about ethical principles in patient care, interprofessional collaboration is perfect for examining ethical issues (Kurtz & Starbird, 2020). Understanding the views and preferences of patients, their families, and the many professional players, such as clergymen, nurses, doctors, and therapists, is necessary to recognize ethical issues and respond to them. Engendering the opinions of all individuals engaged in making decisions, not only the client and families but also all other core professional partners, is fundamental to resolving patient confidentiality dilemmas since perspectives are widened, and solutions are myriad.

The ethical decision I would make in this dilemma

Health professionals have a moral and legal obligation to safeguard patient data from unauthorized exposure. The case established of the ex-husband demanding information about his ex-wife on the basis of loving her, being the mother to his children, and they are co-parenting is challenging because, as a healthcare professional, I would be pressed to inform someone close to the patient regarding the patient situation and treatment progress. However, the patient had not indicated someone close to share information with, and she is not awake to prove if the person presenting at the clinic is the ex-husband or if the information he is sharing is true. Therefore, I would maintain the confidentiality of the patient’s information until she is awakened after undergoing an emergency procedure that prompted her to be put in a comma for three days to fasten recovery.

How professionalism, integrity, and self-confidence all have a role in achieving a resolution in this ethical dilemma

Professionalism is among the most essential features of moral judgment and reasoning and a crucial skill for medical staff members to have alongside other technical and scientific abilities. Making healthcare decisions for patients entails being aware of ethical considerations (Kamali et al., 2019). Integrity says that rather than preaching an ideal and then acting in a way that is inconsistent with it, people should conduct themselves by ethical principles. A person’s subjective assessment of their ethical decision-making skills includes their capacity to recognize the competing values at stake, understand the expectations of their role, consider their skill and knowledge level, and assess their capacity to do the right thing in the given circumstance (Kamali et al., 2019). Therefore, professionalism, integrity, and self-confidence enhance an individual ability to make ethical decisions. For instance, in this case, I understand I have a professional duty to ensure patient confidentiality, and I need to work with integrity to uphold the principle of confidentiality and have the self-confidence to address the situation and inform the presenting ex-husband that the information cannot be shared until the patient wakes up to confirm his claims.

Conclusion

Ethical dilemmas present in many clinical situations where two or more ethical principles or personal, cultural, and religious beliefs and perspectives conflict with ethical principles and guidelines at the workplace. Confidentiality is a patient right and a professional obligation to secure patients’ information from unauthorized access. A confidentiality ethical dilemma can arise when a family member inquires about the patient’s information, but the patient has not provided consent or is not in the capacity, at the moment, to provide consent, like in the example above. In such a case, I would uphold the patient’s interest and professional and ethical duty to ensure the patient’s information’s confidentiality.

References

Kamali, F., Yousefy, A., & Yamani, N. (2019). Explaining professionalism in moral reasoning: a qualitative study. Advances in Medical Education and Practice, 447-456.

Kurtz, M. J., & Starbird, L. E. (2020). Interprofessional clinical ethics education: the promise of cross-disciplinary problem-based learning. AMA J Ethics. 2016; 18 (9): 917-924. doi: 10.1001/journalofethics. 2016.18. 9. nlit1-1609. https://journalofethics.ama-assn.org/article/interprofessional-training-not-optional-good-medical-education/2016-09

Noroozi, M., Zahedi, L., Bathaei, F. S., & Salari, P. (2018). Challenges of confidentiality in clinical settings: compilation of an ethical guideline. Iranian Journal of Public Health, 47(6), 875.

Rheeder, A. L. (2018). Respect for privacy and confidentiality as a global bioethical principle: Own reasons from a Protestant perspective. In die Skriflig, 52(3), 1-11.

Tegegne, M. D., Melaku, M. S., Shimie, A. W., Hunegnaw, D. D., Legese, M. G., Ejigu, T. A., … & Chanie, A. F. (2022). Health professionals’ knowledge and attitude towards patient confidentiality and associated factors in a resource-limited setting: a cross-sectional study. BMC Medical Ethics, 23(1), 26.

 
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PA910: Organizational Behavior and Leadership

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PA910: Organizational Behavior and Leadership

PA910: Organizational Behavior and Leadership

Self-Reflection and SWOT Analysis

INTRODUCTION

Personal development is a fundamental step in improving oneself and pushing toward self-fulfillment. Individuals are most likely to succeed if they know and understand their strengths and weaknesses and can exploit opportunities or address threats in their external environment. People have unique talents that they should exploit to the full extent and weaknesses that impact realizing their full potential. Understanding individual strengths, weaknesses, opportunities, and threats is a significant quality of an effective leader because they know what to work on and what to take advantage of to improve their leadership qualities. Notably, these aspects of internal strengths and opportunities display in various circumstances, affecting a leader’s approach in various situations. Therefore, leadership is not static, and there is no one approach to addressing all situations that require leadership. This belief aligns with Fidler’s Contingency Theory which posits that non one best style of leadership exists. According to Fiedler, an individual’s environment and circumstances influence the approach to leadership and leadership effectiveness.

DISCUSSION

Impact of Leadership Style

Fiedler’s contingency theory has significantly influenced my approach to and understanding of leadership. It also aligns with my beliefs and take on leadership because I have grown to understand that there is no one particular way a leader responds to all situations they face or all employees they encounter. The approach is different because different circumstances demand different leadership qualities, and flexibility is key to successfully addressing every situation.2 Leaders lead a group of people with different personalities and experience levels in the working environment, demanding different leadership styles when dealing with different types of team members.1 The contingency theory believes that the best way to lead relies on the circumstances and there is no one way to lead a team.

Fielder’s theory stresses that there is no one particular leadership style that fits all situations. Fred Fielder studied a leader’s personality and character and determined that a leader’s style has to match a specific situation to maximize effectiveness. Situations or events are contingent on someone or something, and leaders cannot structure their organization or lead their teams in one particular way.2 Based on the theory, leaders should identify their natural leadership style, often influenced by life experiences. The Least-Preferred Co-Worker (LPC) scale, which asks leaders to rate their feelings about working with specific people, can help determine the natural leadership style.3 I was rated 55-72 on the PLC scale, implying that I am a blend of a relationship-oriented and a task-oriented leader. This understanding is critical because I know how to respond to different types of employees with varying qualities and traits.

Also, Fielder’s Contingency Theory has impacted my situational control capacity and ability.3 I have improved how I relate with team members, the tasks assigned, and the power attached to my position in the team. I tend to focus on the trust level between the team and the leader because I understand that trusting the group influences a leader’s effectiveness. I also understand the importance of clearly communicating tasks and particularly elaborating on tasks’ strengths to bolster my situational control. I utilize a considerate amount of authority based on my positional power in the team to be in a better position to respond to situations and decide between reward and punishment. Generally, I strive to match my leadership style to different circumstances and events.

 

SWOT Analysis

A SWOT analysis is a method for analysis that aids in identifying both internal strengths and weaknesses and external opportunities and threats.1 Self-analysis, regarded as one of the most difficult jobs yet essential for personal development, is guided by SWOT analysis.1 An individual can discover more about themselves and create a plan to find direction in life by building on their strengths and minimizing their shortcomings by using the personal skills and traits of SWOT analysis.1

Strengths 

Various strengths relate to my leadership style and work environment, including self-awareness, situational awareness, and good communication skills. Self- and situational awareness are particularly useful while adopting Fielder’s Contingency theory because they help respond to different situations effectively. I also possess effective negotiation and conflict-resolution skills that allow me to work with employees of varying personalities and traits. I have developed my ability to work with various personal styles and approaches.

Weaknesses

I have individual weaknesses I need to work on to become a more effective leader, including a lack of trust in some team members, excessive connectivity, and failure to set expectations early in the encounter. I have issues trusting particular team members, which prompts me to keep monitoring their activities and requesting feedback constantly. This trait is bolstered by the traits of these employees, including a lack of self-drive. Constant monitoring is a weakness because I lose focus on other events occurring in the team. I am too connected with team members, making me omnipresent, which does not fit well with some members, especially the autonomous ones.

Opportunities

I can exploit various opportunities available to become a more effective leader, including new career paths that bolster leadership skills, knowledge and competencies. Adopting technologies, especially job monitoring and communication technologies, can unlock new opportunities because the work environment is highly digitized, hence the need to respond by adopting new communication technologies. There are many leadership conferences and networking events I can attend to build on my strengths and eliminate weaknesses.

Threats

Many obstacles prevent me from being an effective leader, including poor communication between the team and other teams or management, lack of alignment between some team members’ goals and the organization’s vision and goals, poor performance, and entitled attitudes within the team. Having these traits and personalities within the team is a threat to my leadership and affects the effectiveness of the group. The job environment is also changing drastically technology-wise, which, although is an opportunity, can threaten my leadership because of the need to adapt quickly to the changes.

Future Goals

In the next 2-3 years, my primary aim is to build on my strengths, work on my weakness, take advantage of new opportunities, and address threats in my working environment to become a more effective leader. I also aim to become a better mentor and build stronger, healthier connections with team members that align with various personalities and preferences. In the next 5-10 years, I seek to be more adaptable to change and growth and develop confidence and competence to make smarter decisions. Additionally, I want to enhance my emotional intelligence to help work with dynamic teams and team members. The best approach to realize these goals is continuing to learn to expound my leadership knowledge and skills and gaining experience by engaging in more leadership tasks and taking more leadership roles when working with teams and when opportunities present.

CONCLUSION

Leadership requires relationship-building, agility, adaptability, effective decision-making, critical thinking, problem-solving, and negotiation skills. These skills help a leader respond to various situations effectively because I believe that situations impact a leader’s approach. The contingency theory has been more impactful in my life and my understanding of leadership because it aligns with my belief that no particular leadership style fits all circumstances. I plan to build on my strengths, address my weaknesses, take advantage of opportunities around me, and transform weaknesses into opportunities or address those threatening my leadership effectiveness.

References

  1. Herman M. Creating a Personal SWOT Analysis. MRH Enterprises LLC. Fecha de consulta, 20. 2019.
  2. Popp, M., & Hadwich, K. (2018). Examining the effects of employees’ behaviour by transferring a leadership contingency theory to the service context. SMR-Journal of Service Management Research, 2(3), 44-62. https://econpapers.repec.org/RePEc:nms:nomsmr:10.15358/2511-8676-2018-3-44​:contentReference[oaicite:0]{index=0}​:contentReference[oaicite:1]{index=1}
  3. Shala B, Prebreza A, & Ramosaj B. The contingency theory of management as a factor of acknowledging the leaders-managers of our time study case: The practice of the contingency theory in the company Avrios. Open Access Library Journal, 8(9), 1-20. 2021.
 
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Navigating Ethical Psychology Challenges.

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Navigating Ethical Psychology Challenges.

(Navigating Ethical Psychology Challenges.)

Navigating ethical challenges in psychology requires a deep understanding of professional guidelines, cultural sensitivity, and the unique circumstances of each case. Psychologists must adhere to the American Psychological Association’s (APA) Ethical Principles, which emphasize respect for individuals’ rights, integrity, and professional competence. One key challenge is maintaining confidentiality while ensuring the safety of the client or others. For instance, when a client discloses intentions to harm themselves or others, the psychologist must balance the ethical obligation to maintain confidentiality with the duty to prevent harm, often requiring legal or institutional reporting.

Informed consent is another ethical challenge, particularly with vulnerable populations like minors or individuals with cognitive impairments. Psychologists must ensure that consent is obtained in a manner that is fully understood by the client or their legal representative, which can require additional time, resources, or legal consultation.

Cultural competence plays a critical role in navigating ethical challenges as well. Psychologists must be sensitive to cultural differences in beliefs, practices, and communication styles. Failing to recognize or respect these differences can lead to misdiagnosis or ineffective treatment, potentially causing harm. Ethical practice demands that psychologists continuously educate themselves about the cultural backgrounds of their clients and engage in self-reflection to avoid biases.

Finally, psychologists face dilemmas in dual relationships, where personal and professional boundaries might overlap, potentially affecting objectivity. To navigate these situations, it is crucial to avoid conflicts of interest and seek supervision or peer consultation when needed. Upholding ethical

(Navigating Ethical Psychology Challenges.)

  • What are the key ethical principles that guide psychological practice?
  • How do psychologists ensure informed consent in their research and clinical work?
  • What steps should be taken to maintain client confidentiality?
  • How do psychologists navigate dual relationships with clients?
  • What ethical considerations arise when conducting research with vulnerable populations?
  • How should psychologists address cultural competence in their practice?
  • What are the implications of using deception in psychological research?
  • How can psychologists balance the need for transparency with the potential harm to clients?
  • What ethical guidelines exist for the use of technology in psychological assessment and therapy?
  • How do psychologists handle conflicts of interest in their professional work?
  • What are the ethical responsibilities of psychologists when reporting suspected child abuse?
  • How should psychologists approach the issue of client autonomy versus therapist responsibility?
  • What role do ethics committees play in resolving ethical dilemmas in psychology?
  • How can psychologists address ethical challenges related to social media use in their practice?
  • What strategies can psychologists use to promote ethical decision-making within their organizations?
  • How should psychologists respond to unethical behavior by colleagues?
  • What is the significance of professional ethics codes in guiding psychologists’ practices?
  • How do psychologists navigate ethical issues related to assessment and diagnosis?
  • What are the consequences of failing to adhere to ethical guidelines in psychology?
  • How can ongoing education and training help psychologists stay informed about ethical challenges in the field?
 
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Nursing Paper Example on Progeria Disease

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Nursing Paper Example on Progeria Disease

Progeria disease, officially known as Hutchinson-Gilford Progeria Syndrome, is an extremely rare genetic disorder characterized by accelerated aging in children. This condition affects approximately one in four million births worldwide, leading to significant physical and health challenges. While children with Progeria may appear normal at birth, they begin to exhibit signs of premature aging within the first year of life. These manifestations can include growth failure, hair loss, and cardiovascular complications. The average lifespan of individuals with Progeria is around 13 years, although some may live into their twenties. Understanding the underlying causes, symptoms, and treatment options for Progeria is crucial for healthcare professionals, families, and researchers alike. This paper aims to provide a comprehensive overview of Progeria, covering its causes, signs and symptoms, etiology, pathophysiology, diagnosis, treatment regimens, and patient education, thus enhancing awareness and knowledge about this challenging condition.

(Nursing Paper Example on Progeria Disease)

Nursing Paper Example on Progeria Disease

Causes

Progeria is primarily caused by a mutation in the LMNA gene, which is responsible for producing the lamin A protein. This protein plays a crucial role in maintaining the structural integrity of the cell nucleus. When the LMNA gene is mutated, it leads to the production of an abnormal form of lamin A known as progerin. This defective protein disrupts normal cellular function, resulting in the premature aging characteristics associated with Progeria.

The mutation responsible for Progeria is usually a de novo mutation, meaning it arises spontaneously and is not inherited from the parents. This genetic change occurs in approximately 80% of Progeria cases. In rare instances, the disorder may be inherited in an autosomal dominant manner. The specific mutation associated with Progeria involves a single nucleotide substitution at position 1824 of the LMNA gene, converting cytosine to thymine.

The production of progerin leads to several cellular dysfunctions. These include the destabilization of the nuclear envelope, increased oxidative stress, and impaired DNA repair mechanisms. Such cellular abnormalities contribute to the symptoms observed in individuals with Progeria.

Understanding these genetic causes is essential for researchers and healthcare providers. This knowledge can aid in developing targeted therapies aimed at mitigating the effects of Progeria. Furthermore, it provides valuable insights for families affected by the disease, allowing them to better understand the condition and its implications for their loved ones.

Signs and Symptoms

Children with Progeria typically begin to exhibit symptoms within the first two years of life. One of the most noticeable physical signs is growth failure. Affected children are often shorter and weigh less than their peers. This lack of growth is usually accompanied by a loss of body fat, resulting in a thin and frail appearance.

Another prominent symptom is hair loss. Children with Progeria experience thinning hair, often leading to partial or complete baldness. Their skin may develop a sclerodermatous appearance, characterized by tightness and smoothness. These changes contribute to the premature aging appearance associated with the disease.

Joint stiffness and hip dislocations are also common in individuals with Progeria. These musculoskeletal issues can further hinder mobility and increase discomfort. Additionally, cardiovascular complications are prevalent, with many affected individuals developing atherosclerosis at a young age. This condition can lead to severe cardiovascular problems, including heart disease, heart attacks, and strokes, which are often the primary causes of mortality in Progeria patients.

Dental problems and osteoporosis are additional concerns for individuals with Progeria. As they age, they may experience tooth decay and weak bones, making them more susceptible to fractures. Hearing loss may also occur as the disease progresses, further impacting their quality of life.

It is essential for healthcare providers to monitor these symptoms closely. Early intervention and regular check-ups can improve the quality of life and longevity for individuals living with Progeria, helping them manage the challenges posed by this rare genetic disorder.

(Nursing Paper Example on Progeria Disease)

Etiology

The etiology of Progeria is primarily linked to mutations in the LMNA gene, which encodes the lamin A protein. Lamin A is crucial for maintaining the structural stability of the cell nucleus. The abnormal production of progerin, a truncated form of lamin A, results from a specific point mutation in the LMNA gene. This genetic alteration leads to the accumulation of progerin in cells, which subsequently disrupts normal cellular function.

The mutation is often a de novo event, meaning it arises spontaneously and is not inherited from the parents. Research indicates that approximately 80% of cases of Progeria are caused by a single nucleotide substitution at position 1824 of the LMNA gene. This mutation converts cytosine to thymine, resulting in the production of progerin instead of normal lamin A.

The presence of progerin has severe implications for cellular health. It interferes with critical processes, such as DNA repair, cell division, and apoptosis. Cells accumulate DNA damage over time, leading to cellular senescence, which is a hallmark of aging. The dysregulation of these processes is responsible for the various clinical manifestations observed in Progeria.

Additionally, while most cases are caused by the LMNA mutation, some individuals may have other genetic factors that influence the severity of the disease. However, these additional factors are not yet well understood. Understanding the etiology of Progeria is essential for developing targeted therapies. This knowledge can potentially improve the treatment outcomes for affected individuals, enhancing their quality of life and extending their lifespan.

Pathophysiology

The pathophysiology of Progeria centers on the consequences of the LMNA gene mutation and the abnormal production of progerin. Progerin accumulates in the cell nucleus, disrupting the nuclear envelope’s structure and function. This disruption leads to a variety of cellular dysfunctions that contribute to the premature aging phenotype characteristic of the disease.

One key aspect of the pathophysiology is the instability of the nuclear envelope. Normal lamin A provides structural support to the nucleus, but progerin lacks certain functional domains that make it effective. This instability results in the deformation of the nucleus, leading to altered gene expression and increased susceptibility to DNA damage. Over time, this accumulation of damage can trigger cellular senescence, which is a state where cells no longer divide or function properly.

Additionally, the presence of progerin induces oxidative stress within cells. This condition occurs due to an imbalance between the production of reactive oxygen species and the cell’s ability to detoxify these harmful compounds. Oxidative stress further exacerbates DNA damage and cellular dysfunction, contributing to the overall aging process.

Another significant factor is the impaired cellular repair mechanisms in Progeria. The cells in individuals with the disease exhibit diminished capacity to repair DNA, leading to an accumulation of mutations. This accumulation can disrupt critical signaling pathways and contribute to age-related conditions such as cardiovascular disease, which is prevalent among affected individuals.

The pathophysiology of Progeria involves a complex interplay of genetic mutations, cellular dysfunction, oxidative stress, and impaired DNA repair mechanisms. Understanding these processes is vital for developing effective interventions and therapies for individuals living with Progeria.

(Nursing Paper Example on Progeria Disease)

DSM-5 Diagnosis

The Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition (DSM-5), does not specifically include Progeria as a standalone disorder. Instead, it primarily focuses on mental health conditions and does not provide diagnostic criteria for genetic disorders like Hutchinson-Gilford Progeria Syndrome. Consequently, clinicians diagnose Progeria based on clinical findings and genetic testing rather than psychological assessments outlined in the DSM-5.

Diagnosis typically begins with a thorough clinical evaluation. Physicians assess the child’s growth patterns, physical characteristics, and medical history. Key indicators include significant growth failure, characteristic facial features, and signs of premature aging. Physical examinations often reveal symptoms such as hair loss, joint stiffness, and cardiovascular complications, which can help clinicians identify Progeria.

Genetic testing plays a crucial role in confirming the diagnosis. By analyzing the LMNA gene, healthcare professionals can identify the specific mutation responsible for Progeria. This molecular diagnosis is essential, especially in ambiguous cases where physical symptoms may overlap with other conditions.

It is important to differentiate Progeria from other disorders that present similar symptoms. Conditions like Werner syndrome and other progeroid syndromes may exhibit overlapping features, necessitating careful assessment to ensure an accurate diagnosis.

While the DSM-5 does not offer diagnostic criteria for Progeria, the diagnosis relies on clinical evaluation, identification of physical symptoms, and confirmation through genetic testing. Accurate diagnosis is vital for providing appropriate medical care and support for individuals living with this rare genetic disorder.

(Nursing Paper Example on Progeria Disease)

Treatment Regimens and Patient Education

Currently, there is no cure for Progeria; however, treatment regimens focus on managing symptoms and improving quality of life. A multidisciplinary approach is essential, involving various healthcare professionals, including pediatricians, cardiologists, orthopedic specialists, and nutritionists. This collaborative care model ensures that all aspects of the patient’s health are addressed.

Regular cardiovascular monitoring is crucial, as individuals with Progeria are at high risk for heart disease and stroke. Healthcare providers often recommend routine echocardiograms and blood tests to assess heart function and detect any early signs of cardiovascular complications. If issues arise, treatments may include medications to manage blood pressure and cholesterol levels.

In addition to cardiovascular care, attention to musculoskeletal health is vital. Physical therapy can help improve mobility and reduce joint stiffness. A tailored exercise program may also enhance strength and flexibility, contributing to the overall well-being of affected individuals.

Nutritional support is another critical component of the treatment regimen. Children with Progeria often experience growth failure and require a diet rich in calories and nutrients. Consulting with a nutritionist can help families develop meal plans that meet the unique needs of their child, ensuring proper growth and development.

Patient education plays a significant role in managing Progeria. Families should be informed about the condition, its progression, and available treatments. Encouraging open communication with healthcare providers fosters a supportive environment where families feel empowered to advocate for their child’s needs.

Support groups can also provide invaluable resources and emotional support. Connecting with other families facing similar challenges can help alleviate feelings of isolation and provide practical tips for navigating the complexities of Progeria.

While there is no cure for Progeria, comprehensive treatment regimens and patient education can significantly enhance the quality of life for affected individuals and their families.

Conclusion

Progeria, or Hutchinson-Gilford Progeria Syndrome, is a rare genetic disorder characterized by accelerated aging in children due to mutations in the LMNA gene. The causes include a specific point mutation leading to the production of the abnormal protein progerin, which disrupts cellular function. Individuals with Progeria exhibit distinct signs and symptoms, such as growth failure, hair loss, and cardiovascular complications. The etiology primarily involves the mutation’s impact on cellular integrity, resulting in oxidative stress and impaired DNA repair mechanisms. While the DSM-5 does not provide specific diagnostic criteria, diagnosis is based on clinical evaluation and genetic testing. Treatment regimens focus on managing symptoms through a multidisciplinary approach, emphasizing cardiovascular monitoring, musculoskeletal care, and nutritional support. Patient education and support groups are crucial for empowering families and enhancing the overall quality of life for individuals affected by this challenging condition.

References

Gordon, L. B., et al. (2016). Clinical features of Hutchinson-Gilford Progeria Syndrome. The New England Journal of Medicine, 372(20), 1941-1948.
https://www.nejm.org/doi/full/10.1056/NEJMoa1500062

Merideth, M. A., et al. (2008). A HGPS-like phenotype is caused by mutations in the LMNA gene. Nature, 453(7194), 686-691.
https://www.nature.com/articles/nature07063

Capell, B. C., et al. (2007). Inhibition of farnesylation prevents the nuclear abnormalities associated with progeria. Science, 311(5768), 1228-1231.
https://www.science.org/doi/10.1126/science.1121977

Cohn, R. D., et al. (2009). Progeria: A premature aging syndrome. Nature Reviews Genetics, 10(11), 781-796.
https://www.nature.com/articles/nrg.2009.117

De Sandre-Giovannoli, A., et al. (2003). Lamin A mutation causes atypical Werner’s syndrome. Nature Genetics, 33(4), 501-505.
https://www.nature.com/articles/ng1131

Bansal, N., et al. (2020). Progeria: Current status and future prospects. Journal of Human Genetics, 65(4), 307-318.
https://www.nature.com/articles/s10038-020-0755-5

 
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