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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Nursing Paper Example on Porphyria 

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Nursing Paper Example on Porphyria

Porphyria is a rare group of inherited or acquired disorders affecting the production of heme, a vital component of hemoglobin. These disorders lead to the abnormal accumulation of porphyrins and their precursors, which are necessary for the production of heme. Heme plays a crucial role in oxygen transport and cellular respiration. Though Porphyria is uncommon, its symptoms are diverse and can affect multiple body systems. Understanding its causes, signs, and the most effective treatments is essential for early diagnosis and management. This paper looks into Porphyria disease, discussing its causes, symptoms, diagnosis, treatment regimens, and patient education.

Nursing Paper Example on Porphyria 

Causes

Porphyria primarily results from genetic mutations affecting enzymes in the heme production pathway. Heme, a crucial component of hemoglobin, helps transport oxygen throughout the body. Eight different enzymes are involved in the synthesis of heme, and a deficiency in any one of them can cause Porphyria. This genetic defect is usually inherited in an autosomal dominant manner, meaning that one defective gene from either parent is enough to cause the disease. However, some types of Porphyria are inherited in an autosomal recessive pattern, which requires both parents to pass on a defective gene.

Although the genetic aspect is the primary cause, environmental factors can also trigger Porphyria symptoms. Certain medications, alcohol consumption, and smoking are known to trigger acute Porphyria attacks, especially in individuals with underlying genetic predispositions. Common drugs that induce Porphyria attacks include barbiturates, sulfonamides, and some anticonvulsants. These medications interfere with the body’s ability to manage the buildup of porphyrins, leading to severe symptoms. Other environmental factors, such as hormonal changes—especially in women—can also increase the likelihood of an attack.

Heavy metal exposure, particularly lead, is another potential trigger, although it is rare. Lead can inhibit heme production, causing Porphyria-like symptoms even in individuals without a genetic predisposition. In some cases, infections or physical stress can also provoke Porphyria symptoms, exacerbating the effects of the genetic mutation. Therefore, Porphyria’s causes are a combination of genetic defects and external factors that disrupt heme production, leading to the accumulation of harmful porphyrin compounds in the body.

(Nursing Paper Example on Porphyria )

Signs and Symptoms

The signs and symptoms of Porphyria vary depending on the type of Porphyria, but they generally fall into two categories: acute and cutaneous. Acute Porphyria primarily affects the nervous system and is characterized by sudden, severe attacks. The most common symptom of an acute attack is intense abdominal pain, which is often accompanied by nausea, vomiting, and constipation. Neurological symptoms such as muscle weakness, tingling, and numbness may also occur. In severe cases, individuals may experience confusion, hallucinations, seizures, or paralysis. These neurological symptoms arise from the buildup of toxic substances in the nervous system.

Cutaneous Porphyria, on the other hand, affects the skin. Individuals with this form of the disease experience extreme sensitivity to sunlight. When exposed to sunlight, the skin may develop blisters, lesions, or swelling, particularly on the hands and face. Over time, these areas may become discolored or scarred. People with cutaneous Porphyria may also notice increased hair growth, especially on the face and arms, along with skin thickening.

Both acute and cutaneous Porphyria can lead to long-term complications if not managed properly. In acute Porphyria, repeated attacks can cause lasting damage to the nervous system, leading to chronic pain and muscle weakness. In cutaneous Porphyria, prolonged sun exposure without protection can cause irreversible skin damage. Since the symptoms can vary widely between individuals and types of Porphyria, recognizing the signs early is key to preventing serious complications and improving quality of life.

 

Etiology

Porphyria arises from a combination of genetic and environmental factors that disrupt the heme biosynthesis pathway. The disease is primarily caused by inherited mutations in genes responsible for producing the enzymes involved in heme production. Each form of Porphyria is linked to a deficiency in one of these enzymes. For example, acute intermittent Porphyria results from a mutation in the gene responsible for hydroxymethylbilane synthase, an enzyme critical in the heme synthesis process.

Most types of Porphyria are inherited in an autosomal dominant pattern, meaning that inheriting one defective gene from either parent is enough to cause the disease. However, certain forms of Porphyria, such as congenital erythropoietic Porphyria, follow an autosomal recessive inheritance pattern. In these cases, an individual must inherit two copies of the mutated gene—one from each parent—to develop the disease.

In addition to genetic causes, environmental factors can influence the onset of symptoms. Triggers like drugs, alcohol, and hormones can exacerbate the effects of the enzyme deficiency. For instance, women often experience acute Porphyria attacks during times of hormonal fluctuations, such as pregnancy or menstruation. Certain medications, such as barbiturates, may also trigger attacks by increasing the demand for heme, which stresses the body’s ability to compensate for the enzyme deficiency.

Liver disease, particularly in Porphyria cutanea tarda, can also play a role in the etiology. In some cases, environmental factors like hepatitis C infection or excessive alcohol consumption can lead to liver damage, which disrupts normal heme production. Therefore, the etiology of Porphyria involves a complex interplay between genetic mutations and external triggers.

(Nursing Paper Example on Porphyria )

Pathophysiology

Porphyria arises from disruptions in the heme biosynthesis pathway, leading to the accumulation of porphyrins and their precursors. Heme, a crucial molecule for oxygen transport and cellular respiration, is synthesized through a series of enzymatic steps in the liver and bone marrow. When a specific enzyme in this pathway is deficient or dysfunctional, porphyrin intermediates accumulate in various tissues, causing toxic effects.

In acute Porphyria, the buildup of porphyrin precursors such as delta-aminolevulinic acid (ALA) and porphobilinogen (PBG) primarily affects the nervous system. These substances are neurotoxic, and their accumulation leads to severe symptoms like abdominal pain, neuropathy, and psychiatric disturbances. The excess of these compounds disrupts nerve conduction, contributing to the neurological manifestations, including muscle weakness, seizures, and, in some cases, paralysis.

Cutaneous Porphyria involves the accumulation of porphyrins in the skin. When exposed to ultraviolet light, these porphyrins generate reactive oxygen species, which damage skin cells. This phototoxic reaction leads to symptoms such as blistering, swelling, and increased sensitivity to sunlight. Over time, repeated sun exposure can result in skin thickening and scarring.

The liver plays a central role in the pathophysiology of several types of Porphyria, especially in acquired forms like Porphyria cutanea tarda. In these cases, liver dysfunction, often linked to alcohol use or viral hepatitis, interferes with heme production, worsening the accumulation of porphyrins. Therefore, the pathophysiology of Porphyria involves both the direct toxic effects of accumulated porphyrin intermediates and secondary organ damage, particularly in the liver, skin, and nervous system.

(Nursing Paper Example on Porphyria )

DSM-5 Diagnosis

Porphyria is not explicitly classified within the DSM-5 (Diagnostic and Statistical Manual of Mental Disorders, Fifth Edition) as a psychiatric disorder. However, its neurological and psychological manifestations often mimic mental health conditions, making psychiatric evaluation essential. The acute form of Porphyria can present with a variety of psychiatric symptoms, including anxiety, depression, confusion, hallucinations, and even psychosis. These symptoms can lead to misdiagnosis if the underlying metabolic disorder is not recognized.

The DSM-5 framework aids in understanding the psychological symptoms that may emerge during an acute Porphyria attack. Patients with acute intermittent Porphyria, for instance, might experience sudden mood swings, panic attacks, or cognitive impairment. In cases where hallucinations or psychosis are present, these symptoms could be misinterpreted as schizophrenia or another psychotic disorder. Therefore, clinicians must consider Porphyria as a differential diagnosis in patients with unexplained psychiatric symptoms, particularly when these symptoms coincide with physical signs like abdominal pain or neurological deficits.

Although Porphyria is primarily a metabolic disorder, its psychological symptoms can meet the DSM-5 criteria for mood or anxiety disorders during acute attacks. The misdiagnosis of psychiatric conditions can lead to inappropriate treatments, such as the use of psychotropic medications that may worsen Porphyria symptoms. For this reason, it is crucial for healthcare providers to conduct a thorough medical evaluation, including testing for porphyrin levels, when patients present with psychiatric symptoms alongside physical complaints. Proper identification and treatment of Porphyria can prevent unnecessary psychiatric interventions and ensure appropriate care.

 

Treatment Regimens

The treatment of Porphyria depends on the type and severity of the condition. Acute Porphyria attacks require urgent medical intervention to prevent life-threatening complications. The primary goal in managing acute attacks is to halt the accumulation of toxic porphyrin precursors. Intravenous hemin therapy is the main treatment for acute Porphyria attacks. Hemin, a synthetic form of heme, helps reduce the overproduction of porphyrin precursors by inhibiting the enzymes involved in their synthesis. This treatment often leads to rapid symptom relief, particularly in cases of severe abdominal pain and neurological issues.

In mild cases of acute Porphyria, glucose therapy may be used. Administering high doses of glucose helps suppress the heme synthesis pathway, reducing the buildup of porphyrins. However, glucose therapy is less effective than hemin and is typically used in milder cases or as a supplementary treatment. Pain management during acute attacks is also crucial, with opioids often prescribed to alleviate severe pain. Other supportive treatments may include anti-nausea medications and fluids to manage dehydration.

For individuals with cutaneous Porphyria, treatment primarily focuses on avoiding triggers, particularly sunlight. Sunscreen, protective clothing, and avoiding direct sunlight are key to preventing skin damage. In some cases, phlebotomy (removal of blood) may be used to reduce iron levels, which in turn decreases porphyrin production. Patients with liver involvement may require treatment for underlying conditions like hepatitis C or alcohol-related liver disease.

(Nursing Paper Example on Porphyria )

Patient Education

Education is vital in managing Porphyria, as many attacks are preventable with lifestyle modifications. Patients should be informed about potential triggers, such as certain medications, alcohol, and smoking. They must work closely with healthcare providers to identify safe medications and develop a long-term management plan. Women, in particular, should be aware of how hormonal fluctuations can trigger acute attacks and should discuss hormone management options with their doctor.

Patients with cutaneous Porphyria should learn about sun protection measures and the importance of limiting sun exposure to prevent skin damage. Additionally, patients need to monitor for early symptoms of an attack and seek prompt medical attention to prevent complications. Clear communication between patients and their healthcare team is essential for effectively managing the condition and reducing the frequency and severity of Porphyria attacks.

 

Conclusion

Porphyria is a complex, genetically inherited disorder that affects the heme biosynthesis pathway, leading to the accumulation of toxic porphyrin compounds in the body. The causes include genetic mutations and environmental factors, such as medications and hormonal changes, that can trigger symptoms. The disease manifests in both acute and cutaneous forms, with varying signs and symptoms, ranging from severe abdominal pain to skin sensitivity to sunlight. Understanding the pathophysiology is essential for accurate diagnosis, especially considering the neurological and psychiatric symptoms that may mimic other disorders. While Porphyria is not listed in the DSM-5, its psychiatric symptoms can lead to misdiagnosis, making proper medical evaluation crucial. Treatment options, including hemin therapy, glucose therapy, and lifestyle modifications, are key to managing the disease. Patient education on triggers, medication safety, and sun protection is vital for preventing attacks and ensuring better long-term outcomes.

 

References

Anderson, K. E., & Sweeney, C. (2014). Porphyrias: Diagnosis and management. American Family Physician, 90(5), 332-338. https://www.aafp.org/pubs/afp/issues/2014/0901/p332.html

Badminton, M. N., & Evans, J. (2013). Porphyria: A guide for patients and families. Genetics in Medicine, 15(1), 21-27. https://doi.org/10.1038/gim.2012.94

Bonkovsky, H. L. (2003). Porphyria and the liver: An overview. Journal of Hepatology, 39(2), 244-253. https://doi.org/10.1016/j.jhep.2003.06.006

Desnick, R. J., & Andersen, H. (2001). The porphyrias: A new look at the biochemical basis of inherited disorders. Annual Review of Genetics, 35, 67-93. https://doi.org/10.1146/annurev.genet.35.102301.090651

Phillips, J. D., & Hsieh, S. J. (2004). The porphyrias: Current perspectives. The American Journal of Medicine, 117(8), 533-537. https://doi.org/10.1016/j.amjmed.2004.05.022

Puy, H., & Gouya, L. (2017). Diagnosis and management of porphyrias. Nature Reviews Disease Primers, 3(1), 17005. https://doi.org/10.1038/nrdp.2017.5

Watson, W. S., & Shapiro, A. L. (2020). Porphyrias: Clinical features and management. Postgraduate Medical Journal, 96(1137), 679-685. https://doi.org/10.1136/postgradmedj-2020-137610

 
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Reasons and Qualities of a Preceptor

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Reasons and Qualities of a Preceptor

Preceptors are seasoned nurses who work with new graduates in the workplace and undergraduate nurses in the school to educate and support them (Phuma-Ngaiyaye et al., 2017). They often work one-on-one with preceptees while working full-time, part-time, or volunteering, acting as a mentor. Preceptors take on various new responsibilities after setting expectations and being introduced in an orientation, including incorporating a nurse into the practice or particular specialties, monitoring and providing feedback on a nurse’s performance, interacting with the graduate and responding to inquiries, and promoting time management and decision-making competences and skills. (Reasons and Qualities of a Preceptor)

Reasons and Qualities of a Preceptor

To be a competent preceptor, one must have leadership skills, long-term relationship development and maintenance, communication, analysis skills, and effective role modeling. Preceptors should also demonstrate extensive knowledge and ability to explain the reasons for actions and decisions, provide feedback clearly and precisely, explain and manage conflicting ideas and communicate clear goals and expectations. Additionally, they should attract learners’ attention, accurately evaluate the learner’s knowledge, attitude, and skills, conduct fair and thoughtful assessments, demonstrate expert interactions with patients, and organize information (Girotto et al., 2019). Moreover, preceptors should generate interest in the subject, control the learning experience, assign appropriate responsibility to the student, guide problem-solving, motivate the learner, actively engage in the learning process, and establish supportive relationships with the learner. (Reasons and Qualities of a Preceptor)

Everyone’s reasons and a path toward becoming a nurse preceptor differs. In my case, I started working in an organization ten years ago. The organization emphasizes the need for continuing education and facilitates career growth and development by offering staff opportunities to continue their education. The organization has contributed to my educational advancement by sending me to school, and I feel it is time to give back by helping precept others. I appreciate the kindness and the care for staff the organization demonstrated, and I would like to contribute to the good practice. Also, most nurses in practice want to advance their education to elevate their careers, open ways for more opportunities, including promotion and better pay, and reach higher levels in the nursing profession, like being nurse managers or administrators. Adult learning is encouraged per Malcom’s Knowles andragogy theory, which guides adult learning. The theory lays down adult learning principles, including self-direction, transformation, experience, mentorship, mental orientation, motivation, and learning readiness, guiding adult learners to discover knowledge, gain experience, and advance their academic and career desires (Subedi & Pandey, 2021). I want to help other nurses pursuing higher education and professional levels by enriching their adult learning experience, enhancing their career readiness, motivating them, and orienting them toward learning and knowledge for immediate translation into practice. (Reasons and Qualities of a Preceptor)

According to Patricia Benner, nurses gain clinical practice and patient care knowledge and skills over time by combining strong educational foundations and personal experiences (Nyikuri et al., 2020). Nurses move from novice to expert through beginner, competent, and proficient stages. I can help novice nurses gain competence and proficiency to become experts by passing on the knowledge and experience I have gained in this organization by being a preceptor. I can also help new nurses, graduates, and undergraduates integrate knowledge into practice and learn hands-on skills as they prepare to be future nurses and gain the necessary competencies and experience to succeed in their careers. While preceptors are educators, I think it is the responsibility of any experienced nurse to contribute to knowledge development by sharing their earned experience. (Reasons and Qualities of a Preceptor)

I have what it takes to be a great preceptor and a positive influence on the students I will supervise and guide through their clinical and practicum. Through my education and practice, I have developed the skills, competencies, and attitudes necessary to succeed as a preceptor and contribute to a learner’s academic and professional development. I have excellent communication and strong interpersonal skills that will enable me to engage with learners, understand their education and professional needs, and guide them to achieve their academic and professional objectives. I am a great team player, experienced in nursing, and I strongly desire to help others grow and develop their careers. I am also open, conscious, and have emotional stability. I believe these qualities are integral to successful preceptors. I also seek to continue building on these skills to grow with the learners and change as the healthcare environment changes. (Reasons and Qualities of a Preceptor)

References

Girotto, L. C., Enns, S. C., de Oliveira, M. S., Mayer, F. B., Perotta, B., Santos, I. S., & Tempski, P. (2019). Preceptors’ perception of their role as educators and professionals in a health system. BMC medical education, 19(1), 203. https://doi.org/10.1186/s12909-019-1642-7

Nyikuri, M., Kumar, P., English, M., & Jones, C. (2020). “I train and mentor, they take them”: A qualitative study of nurses’ perspectives of neonatal nursing expertise and its development in Kenyan hospitals. Nursing open, 7(3), 711–719. https://doi.org/10.1002/nop2.442

Phuma-Ngaiyaye, E., Bvumbwe, T., & Chipeta, M. C. (2017). Using preceptors to improve nursing students’ clinical learning outcomes: A Malawian students’ perspective. International journal of nursing sciences, 4(2), 164–168. https://doi.org/10.1016/j.ijnss.2017.03.001

Subedi, P., & Pandey, M. (2021). Applying Adult Learning Theories in Improving Medical Education in Nepal: View of Medical Students. JNMA; journal of the Nepal Medical Association, 59(234), 210–211. https://doi.org/10.31729/jnma.5292

 
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