Clinical Roles: Coding and Billing

My clinical role largely involves billing, coding, and documentation of patients’ data to facilitate easy communication between insurance companies and the healthcare organization that I currently work for. My healthcare facility often sends the coding and billing information to insurance companies to claim payments. As a coding, documentation and billing specialist, I am charged with the responsibility of keeping clear health data and reviewing those records before assigning proper codes to specific diagnoses (Benoit, Bergeron and Bertrand, 2016; & Deloitte, 2016).

Coding, billing, and documentation of patients’ health data are governed by strict ethical, legal, and regulatory standards because they involve usage of confidential information. In this regard, clinicians have strict ethical and legal responsibilities to observe as far as documentation strategies, coding, and billing are concerned (Benoit, Bergeron and Bertrand, 2016).

Personally, I feel that it is in order for documentation strategies, coding, and billing to be governed by strict ethical, legal, and regulatory standards. Since clinicians have access to private patient’s records, they must maintain total confidentiality in their documentation strategies, coding, and billing (Deloitte, 2016). In addition, these clinicians have an ethical responsibility to access only that information that is related to the issue being addressed at any given time.

Their actions must comply with the ethical standards documented in the American Association of Professional Coders and the American Health Information Management Association (Benoit, Bergeron and Bertrand, 2016). As far as their legal and regulatory responsibilities are concerned, documentation, coding and billing specialists must maintain confidentiality requirements as outlined in the Health Insurance Portability and Accountability Act, (HIPAA). The ethical, legal, and regulatory standards that govern documentation strategies, coding, and billing, play a significant role in minimizing healthcare fraud and abuse (Deloitte, 2016).

Evidence-based research has become an important aspect of the healthcare industry in the recent past due to the role that it plays in improving healthcare delivery. According to JoAnn (2017), evidence-based research is necessary because it helps clinicians to generate the right type of data that they can use to improve the effectiveness of care. Clinicians often rely on different kinds of knowledge for them to make the right decisions in their relationships with sick patients.

Furthermore, they are expected to have a comprehensive understanding of the physiological, psychological, emotional, and social factors affecting their patients’ health for them to deliver the most appropriate care. Although clinicians can quickly obtain this information from existing literature, they must complement it by evidence from empirical research. Evidence-based research, therefore, provides clinicians with practical facts that they can integrate with their experiential knowledge to improve patient care (Kristensen, Nymann and Konradsen, 2015).

I incorporate evidence-based research to a large extent into my role as a clinician. I firmly believe that the safety of my patients depends on the availability of evidence that can adequately support the nature of care that I deliver to them (JoAnn, 2017). For this reason, I rely on data obtained from evidence-based research to improve healthcare services which serve to promote better outcomes for my patients.

I do not only rely on evidence-based research to change my care practices, but I also develop available evidence to fulfill existing knowledge gaps as far as improvement of patient safety is concerned. Over the coming years, I aspire to utilize evidence-based research to improve my skills as a clinician (Kristensen, Nymann and Konradsen, 2015).

Falls are common among seniors, especially those who are suffering from chronic health problems such as diabetes (Graveande and Richardson, 2016). According to Graveande and Richardson (2016), a geriatric fall is a sudden occurrence among the elderly that signifies a decline in their homeostatic reserve. Geriatric falls pose a great risk of loss of independence to the elderly in the society today.

This calls for the greatest need to identity and implements the most appropriate health maintenance strategies that would improve care for this population and their families. Mazur, Wilczynski, and Szewieczek (2016) critically explore the importance of health maintenance specific to geriatric falls as it pertains to the care of the patient and their family.

According to Mazur, Wilczynski, and Szewieczek (2016), exercise is the most appropriate health promotion strategy for geriatric falls because it helps to improve balance and minimize the risks of repeated falls. Exercise is a recommended health promotion strategy for geriatric falls because it serves to generate a greater amount of homeostatic reserve for the elderly patient. In addition to exercise, elderly patients who are at high risks of falling should eat a balanced diet as this provides them with energy that they may need to regain physical activity.

As Mazur, Wilczynski and Szewieczek (2016) explain, social support can help to reduce risk factors for future falls among the seniors because it drives away the fear that typically develops from past falls. Family members of elderly patients who are recovering from the effects of falls should pay attention to physical activity, nutritional strategies, and social support in their effort to promote positive health outcomes for their patients (Mazur, Wilczynski and Szewieczek, 2016).

I agree with the solutions provided by Mazur, Wilczynski and Szewieczek (2016) because they are supported by evidence-based research. In a well-organized research, Burton, Cavalheri and Hill (2015) have revealed that physical exercise programs help to improve balance in older adults who are at risk for falls. These researchers further assert that planned nutritional strategies contribute to induce positive health changes such as improved performance and reduced risk for falls in geriatric patients.

In a similar study, Durbin, Kharrazi and Mielenz (2016) support the use of social support, physical exercise, and dietary supplements in promoting health maintenance to geriatric patients. Since health maintenance solutions for geriatric falls are supported by evidence-based research, clinicians can utilize these ideas to make appropriate healthcare decisions for their elderly patients (Kristensen, Nymann and Konradsen, 2015).

The number of elderly adults who are being diagnosed with diabetes in the society today is on the rise. The major challenge faced by clinicians is defining the therapy goals for geriatric patients due to the existence of limited data about the aging process and drug response of this population (Kazerle, Shalev, and Barski, 2014).

Considering the complexities that surround the health status of geriatric patients, clinicians are charged with the responsibility of choosing a treatment plan that will maximize glycemic control, while at the same time avoiding exposing their patients to increased risks. Due to variations in physiological functions between adults and geriatric patients, the treatment approach for geriatric patients differs significantly from that of an adult (Graveande and Richardson, 2016).

Treatment of geriatric patients involves the use of medication as well as other interventions such as nutritional strategies and psycho-social support (Graveande and Richardson, 2016). This paper will focus on pharmacological or drug treatment alone. The best medication that should be used to treat geriatric diabetic patients includes; metformin, sulfonylureas, meglitinides, thiazolidinediones, alpha-glucosidase inhibitors, dipeptidyl peptidase-4 inhibitors, and sodium glucose co-transporters two inhibitors.

These medications are taken orally at highly controlled doses. Geriatric diabetes patients can also be treated using injectable therapies such as GLP-1 analogs, pramlintide, and insulin. Although similar medications can be used to treat diabetes in adults, the drug dosage differs significantly between the two populations due to variations in pharmacokinetic parameters. In this respect, the drug dosage given to geriatric patients are relatively lower than those administered to adults. The goal of delivering lower doses to geriatric patients as compared to adults is the need to maximize chances of glycemic control, without exposing the elderly adults to additional risks (Kazerle, Shalev, and Barski, 2014).

My learning progress in the course directly correlates to the stages in Benner’s Novice to Expert Theory. Benner’s Novice to Expert Theory assumes that a learner experiences a progressive form of knowledge acquisition that involves five stages namely; novice, advanced beginner, competent, proficient, and expert stages of skill acquisition (Josephsen, 2014). Since I began the course, I have successfully gone through the first stage of Benner’s theory known as novice stage.

When I started the course as a novice, I had no background experience, and I had difficulty differentiating between relevant and irrelevant aspects. Even now, I still take my time to understand course requirements and their significance in shaping my roles as a clinician. After familiarizing myself with a few course concepts, I will move to the second stage of advanced beginner.

At this stage, I will rely on rules provided by my instructor to perform every individual task. Furthermore, I will ask more experienced students to help me integrate practical knowledge and to set priorities for the course (Bowen and Prentice, 2016).

After learning course concepts for two years, I will progress to the competent stage of skill acquisition. Here, I will easily compare situations and make judgments on that scenario that require immediate attention. Additionally, I will integrate devised rules with those learned in the classroom to help solve complex matters. From the competent stage, I will move to proficient stage characterized by critical thinking and individual decision making (Bowen and Prentice, 2016).

While at proficient stage of skill acquisition, I will be able to easily see changes that take place in every situation and implement appropriate responses to promote success. It is at this stage where I will view the course as a whole rather than regarding its small components like I currently do. Later on, I will progress to expert stage of skill acquisition. Here, I will be able to grasp every situation more accurately than now.

Additionally, I will no longer rely on rules and guidelines to make appropriate decisions on how to tackle issues related to the course. Moreover, I will operate from a deep understanding of every situation and make judgments that will generate positive outcomes (Josephsen, 2014).

In conclusion, as a clinician, I have an obligation to observe ethical, legal, and regulatory responsibilities during documentation, coding, and billing. Also, I must acknowledge the importance of evidence-based research by making clinical decisions based on facts obtained from empirical studies. A good example of a health situation in which I can effectively utilize evidence-based research is when designing a health promotion program specific to geriatric falls.

In this case, evidence-based practice will help me to deliver the most appropriate care for the patient and his or her family. Considering the little volume of knowledge that I have gathered as a novice, I believe that my learning progress in the course effectively correlates to the stages of Benner’s Novice to Expert Theory.

References

Benoit, M., Bergeron, J. & Bertrand, G. (2016). Decision-making tool: Telepractice and digital records management in the health and human relations sectors. Quebec: Conseil Interprofessionnel du Quebec.

Bowen, K. & Prentice, D. (2016). Are Benner’s expert nurses near extinction? Nursing Philosophy, 7(2): 144-148. Doi.10.111/nup.12114.

Burton, A., Cavalheri, V. & Hill, K. (2015). The effectiveness of exercise programs to reduce falls in order people with dementia living in the community: A systematic review and meta-analysis. Clinical Interventions in Aging, 10: 421-434.doi:10.2147/CIA.S71691.

Deloitte. (2016). International review: Secondary use of health and social care data and applicable legislation. Author: Deloitte & Touche Oy, Group of Companies.

Durbin, L., Kharrazi, R. & Mielenz, T. J. (2016). Social support and older adult fall. Injury Epidemiology, 3(1):4.doi:10.1186/s40621-016-0070-y

Grave and, J. & Richardson, J. (2016). Identifying non-pharmacological risk factors for falling in older adults with type 2 diabetes mellitus: A systematic review. Disability and Rehabilitation, 39(15): 1459-1465.doi:10.1080/09638288.2016.119974.

JoAnn, M. (2017). Call to action: How to implement evidence-based nursing practice. Nursing, 47(4):36-43.

Josephsen, J. (2014). Critically reflective theory: A proposal for nursing education. Advances in Nursing, 2014: 360-594. Doi:10.1155/2014/594360.

Kazerle, L., Shalev, L. & Barski, L. (2014). Treating the elderly diabetic patient: Special considerations. Diabetes Metabolic Syndromes and Obesity, 7: 391-400.

Kristensen, N., Nymann, C. & Konradsen, H. (2015). Implementing research results in clinical practice: The experience of healthcare professionals. BMC Health Services Research, 16:48.doi:10.1186/s12913-016-1292-y

Mazur, K., Wilczynski, K. & Szewieczek, J. (2016). Geriatric falls in the context of a hospital fall prevention program: Delirium, low body mass index, and other risk factors. Clinical Interventions in Aging, 11:1253-1261.doi:10.2147/CIA.S115755.

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The Research Approval Process

One of the guidelines of the Institutional Review Board (IRB) pertains research expounds about red flags of research that require Research Ethics Consultation. This guideline can affect the research process and the research approval process mainly because if a researcher wants to conduct research and collect data about sensitive topics or vulnerable population he/she is required to obtain ethics guidance that should be incorporated into research planning.

Examples of vulnerable populations that have been stipulated by the Institutional Review Board include the following; minors, that is individuals who are below 17 years, prisoners, mentally impaired or disabled persons, and undocumented immigrants, residents in nursing homes, patients of the research or adult students of the researcher (Chew-Graham, 2016).

Vulnerable populations can affect the research population because one should evaluate the degree to which it is appropriate to include the vulnerable populations in the research or if it is necessary to carry out research using information from individuals who do not have decision-making capacity such as the mentally disabled individuals as required by the research approval process guidelines.

Information from some of these individuals should also not be disclosed to the public; this, therefore, poses a challenge to the researcher when it comes to the presentation of the research findings. Chew-Graham (2016) reports that when dealing with vulnerable groups, it is advisable for one to consider any possible adverse impact that inclusion of the participants such as minors may have in later stages.

The Walden IRB also offers direction on the use of Archival researchers (Beyer et al., 2016). Mostly private or public records are used to provide IRB approval before data is analyzed. The IRB protects the data of the stakeholders. Therefore, when doing research one will ensure that he/she does not use an organization’s data without permission. If so, then the report should indicate the source of the data to avoid plagiarism issues with can prompt stakeholders to press charges against the researcher.

References

Beyer, T., Tiehen, J., Mahato, M., Ferrari, L., & Ramakrishnan, S. (2014). Institutional Review Board.

Chew-Graham, C. A. (2016). Reaching vulnerable groups. Health Expectations, 19(1), 3-4.

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Punishment in the Criminal Justice System

All over the world, the criminal justice system of any state serves two major objectives; enforcement of the law of the land, and correction of offenders through various reform institutions. In this regard, criminal justice can be construed to mean a system governed by standard practices that aim to uphold social control, detecting and preventing crime, and most importantly sanctioning offenders through the use of various forms of punishments.

Significantly, criminal punishment is applied as a way to encourage proper conduct between individuals in the society and at the same time make one take responsibility for a wrongful act committed against another. In this respect, retaliatory acts are avoided because victims of crime will be satisfied that the wrongdoer has faced equal punishment in comparison with the act done. Notably, Lollar (2014) asserts that punishments can also be used as a compensatory tool towards victims of crime.

Retributive punishment

Foremost, this type of punishment is founded on the belief that the best way to respond to a wrongful act is by using a proportionate punishment. According to Flanders (2014) retributivists are of the opinion that when an offender commits an illegal act, the criminal justice system should make such a person suffer an equal and proportionate punishment.

Amusingly, retributivists attach their justification for proportionate punishment from ancient religious laws such as the ones contained in the Holy Bible, for instance, Exodus 21:23 avers that if any person commits harm, then the resulting punishment should be equal, hence the catchphrase “a life for a life, an eye for an eye, tooth for tooth, hand for hand, foot for foot.” Notably, similar sentiments are proclaimed in Biblical verses such as 5:38 and Deuteronomy 19:21.

Retributivists argue that as long as the damage has been done, there is nothing that can be done to reverse such damage hence the only way to administer justice is by giving equal punishment (Flanders, 2014). Seemingly, such reasoning can be said to be backward looking such that it does not take into consideration that at times crime may be committed in a unpremeditated way such that punishing an offender for the same would be harsh or excessive.

Another going concern for this form of punishment is that it may encourage revenge and promote retaliation in the society. Also, in some instances, it may be hard to draw the line between punishment that is sufficient and from the punishment that is excessive.

An example of a retributive form of punishment is the death penalty which according to Luliano (2015) is no punishment at all because it only seeks to insert pain as a measure of administering justice but does not address the root causes of crime or even ways of helping individuals refrain from such crime.

Utilitarian Punishment

First, from a wider scope, the utilitarian theory developed by Jeremy Bentham emphasizes that any action within the society should be directed towards achieving maximum satisfaction and catering for the well being of the majority members of the society. The utilitarian form of punishment, threads on the same footing by asserting that the laws that guide the conduct of the people in the society, should be used to maximize the happiness of the society (FERRARO, 2013).

Hence, crime and punishment should be kept to a minimum because they are inconsistent with happiness which the utilitarian theory of punishment asserts. Importantly, proponents of this theory of punishment recognize that having a crime free society may be a fallacy as such recommend that the form of punishment handed down to a wrongdoer should be directed to producing “good” from the person. In this respect, the punishment should not be unlimited.

Unlike the retributive form of punishment, which is said to be backward looking, the utilitarian form of punishment is largely presumed to be proactive on crime. For instance, the laws that direct how punishment should be handed down on crime should be designed to deter future crimes of the same nature.

Accordingly, rehabilitation of criminal offenders can be said to be one of the methods that the utilitarian form of punishment emphasizes as a way of administering justice. Rehabilitation mainly aims at reforming an offender rather than punish so that they may be integrated back into the society. Equally, jailing as a form of incapacitation of an offender also falls under the utilitarian form of punishment because, by removal of the offender’s ability to commit offenses from the society, future crimes of the same nature may be prevented.

Preferred rationale/form of punishment

First, it is important to appreciate the fact that in certain instances, the commission of a criminal act may not be planned such that one will be deemed unswervingly guilty of the act. Offenses such as murder may happen due to provocation such that one may end up taking another one’s life in the heat of passion. Similarly, minors and persons of unsound mind are not spared either when it comes to the commission of a crime. However, such a category of persons may be deemed to a special group because of the underlying issues such as the lack of understanding of the consequence that a particular act may lead to.

From the examples mentioned above, a retributive form of punishment will certainly administer justice in the wrong way because of its backward-looking nature of offering proportionate punishment. Without taking into consideration factors that may have led to a crime, any form of punishment handed down to an individual may be excessive or uncalled for.

By the same token, criminals are presumed to be ordinary persons such that one factor changed that status, for instance, one may seek to steal due to poverty. Alternatively, another person may engage in crime as an act of revenge for a wrongful act done on them. Under such circumstances, the form of punishment handed down should be directed towards enabling such a person reform and be integrated back into the society so as to continue developing.

Notably, even under religious laws, the principle of forgiveness is widely discussed. In this respect, retributive punishment does not give individuals any opportunity to reform or even afford the wrong persons with the chance to deliberate on pardoning the person after serving their sentence as an act of compassion.

Hence, I will argue that the utilitarian form of punishment stands out as the best-placed method for punishing offenders because it not only takes into considerations of the underlying factors that may have led to a crime but it also focuses on handing down the punishment that in the long run will stem out goodness from a person. Goralski (2015) is of the same views by asserting that models of punishment that presume criminals to be bad people who deserve harsh punishments should be relatively be avoided because this leads to vengeance rather than reform.

Philosophy of Imprisonment

Borrowing meaning from the Law Dictionary (2016), imprisonment means restraining or putting an individual in confinement such that his liberty is subjugated. In this respect, imprisonment can be said to be a tool of crime deterrence going by the fact that is limits one’s movement and activities.

Arguably, the rationale for imprisonment as a form of punishment can be said to have stemmed from the belief that by subjecting a person to a place whereby their rights and freedoms were limited to a minimal level, then people would be careful not to commit crime because of the hardships that one would experience while in prison.

However, one can say that imprisonment only acts as a form of banishment of an individual. This is to say, prisons only act as means of putting an individual away from his ordinary life such that he is disassociated with the society. Hence, for imprisonment to reform an individual, an extra effort must be provided a failure to which the individual will only lack his privileges which may not be enough to deter future crimes.

Stuart Greenstreet (2017) argues that imprisonment does not serve its purpose of preventing crime. In his discourse, “Prison Doesn’t work” he asserts that the reason why prisoners even after being released are likely to commit crime is based on the fact that by putting together equal minded people that share similar criminal mindsets, the likelihood of having a worse crime is high because of the perception that jail is used as a way of punishing them.

Also, innocent persons may be subjected to imprisonment such that if they are not helped in having a changed mentality of a criminal justice system, then the likelihood of prisons remodeling such a person by just having them locked up can be equaled to a time bomb.

From a personal point of view, imprisonment only serves to confine people to a place whereby they can no longer commit the crime, but it is not effective in deterring the occurrence of future crimes. Imprisonment should be supported with other special programs that help prisoners have a different perception of prisons and importantly assist them on being integrated back to the society.

Restorative Justice

Restorative Justice largely emphasizes on the usage of alternative measures to solve crimes and social disorders. According to Walgrave (2013) restorative justice embraces the ideology that wrongdoers should be empowered to rehabilitate, reform and be reconciled back to the community. Seemingly, any form of crime causes harmto another as such focusing on repairing the harm in perceived to be vital in assisting the warring parties. United Nation’s office on drug and crime asserts that restorative justice seeks to put things right between conflicting parties while at the same time preventing occurrences of similar misconducts through the use of corrective strategies and programs.

Nevertheless, this concept has been purported as being too ambitious in a bid to restore ties between the victims of crime and the offenders, especially when compared with traditional models which emphasizes on the punishment of offenders for any crimes committed. However, restorative justice must be applauded for promoting values such as forgiveness, dialogue, accountability and fraternity (Arlene Gadreault, 2015). Evidently, the main aim of restorative justice is to give both the offenders and victims of crime a bigger role to play within the criminal justice system so as to yield positive outcomes and at the same time offer the necessary assistance to both parties.

Notably, restorative justice can be regarded as an alternative dispute resolution mechanism, which uses less punitive channels often in the form of diversion programs under various state agencies that are meant to aid the involved parties to resolve the previous conflict. Accordingly, restorative justice affords offenders with the opportunity to take responsibility for the harm or injuries caused to victims and consequently, make adequate compensation.

Bentham project

Foremost, Bentham being a prominent law scholar that developed various law theories such as the utilitarian school of thought theory, it is then important to have a deep understanding of the message that he intended to put across through the use of his works. Thus, the Bentham project can be said to largely focus on Bentham’s writings and how they can be made relevant to the modern world’s activities.

The Bentham Project also can be said to focus on how to formulate basic codes of conduct within the society. For instance, the utilitarian theory of punishment can be said to follow the guidelines of Bentham’s utilitarian theory.

Lastly, this project is of great significance especially for learners to get to know the foundation and originality of various concepts that are applicable in today’s world. Having a deep understanding of the origin of things or events is important in assisting one to comprehend their significance in the society.

References

Arlene Gadreault (2015, January 7^th). The Limits of Restorative Justice, School of Criminology,

Universite de Montreal, [online]. Retrieved from http://www.victimsweek.gc.ca/symp-colloque/past-passe/2009/presentation/arlg_1.html

FERRARO, F. (2013). Adjudication and expectations: Bentham on the role of the judges. Utilitas, 25(2), 140-160.

Doi: http://dx.doi.org/10.1017/S0953820812000349

Flanders, C. (2014). Can retributivism be saved? Brigham Young University Law Review,

2014(2), 309-362. Retrieved from https://search.proquest.com/docview/1567682599?accountid=45049

GORALSKI, M. W. (2015). LET THE JUDGE SPEAK: RECONSIDERING THE ROLE OF REHABILITATION IN FEDERAL SENTENCING. St. Louis Law Review, 89(4), 1283-1310. Retrieved from https://search.proquest.com/docview/1860286122?accountid=45049

Lollar, C. E. (2014). What is criminal restitution? Iowa Law Review, 100(1), 93-154. Retrieved from https://search.proquest.com/docview/1633992433?acccountid=45049

Luliano, J. (2015). WHY CAPITAL PUNISHMENT IS NO PUNISHMENT AT ALL. American University Review, 64(60, 1377-1441. Retrieved from https://search.proquest.com/docview/1719903823?accountid=45049

The Law Dictionary (2016). What is imprisonment? [Online] Retrieved from https://thelawdictionary.org/imprisonment/

UNITED NATIONS Office on Drugs and Crime (2016), ‘Handbook on Restorative Justice

Programmes’, Vienna. Retrieved from https://www.unodc.org>06-56290_Ebook

Walgrave, L. (2013). Perceptions of justice and fairness in criminal proceedings and restorative

encounters: Extending theories of procedural justice. Tijdschrift Voor Criminology, 55(2), 229-233. Retrieved fromhttps://search.proquest.com/1426081042?accountid=45049

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Personal Reflection: Academic Learning

Personal Reflection

I have had the opportunity to experience two sets of learning that have been pertinent in enhancing not only my academic but also my personal growth. They are distance accessible and face to face courses. The distance accessible courses provided me with the chance to interact with other students via virtual means who are taking similar courses. This widened my circle of academic knowledge as I managed to share my knowledge with students from different countries.

Secondly, it is more affordable an aspect that enabled me to save a lot of money. Lastly, I was a working student and distance accessible courses introduced flexibility as I could easily fit the courses within my schedule. On the other hand, the face to face courses are important as they enhanced my socialization skills as I got to interact with my fellow students and teachers. I admired the way the teachers could motivate each of us in our way to make sure we were able to achieve our full potential.

According to Bain (2004), “They do not teach a class. They teach a student” (p.143). In my case, the instructors presented the lectures in an interactive way where we as the students were actively involved in class discussions. Also, the instructors were cordial and had an open door policy. They allowed students to approach them with any challenges that they faced in their academics.

Benner et al. (2010), “focus on covering decontextualized knowledge to an emphasis on teaching for sense” (p.89). Based on this my instructors approached content analysis by dividing the class into groups of five people based on our strengths and weaknesses. This was done at the beginning of the semester to enable us to help each other in tackling difficult topics. Also, the instructors offered private tuition to weak students who were ready to seek help.

According to Boyer (1990), “Teaching is also a dynamic endeavor involving all analogies, metaphors, and images that build bridges between the teachers’ understanding and the student’s learning” (p. 23). The techniques used by my instructors include group discussions, imagery, virtual learning, engaging class interactions, question and answer session that sparked creativity.

I have learned as can be seen in this personal reflection from Benner, Bain, and Boyer that teaching is an inclusive process that requires the use of creative methods to foster student learning. For me to be present for my students, I plan to incorporate imagery in my presentations to encourage learning, make the class more interactive, focus on sharing life advice that does complement the content I am teaching. This personal reflection highlights just but a few of the learning outcomes that I have received and will use in my career growth.

REFERENCES

Bain, K. (2004). What the best college professors do. Harvard University.

Benner, P. Sutphen, M., Leonard, V., & Day, L. (2010). Educating nurses: A call for radical transformation. The Carnegie Foundation for the Advancement of Teaching.

Boyer, E.L. (1990). Scholarship reconsidered: Priorities of the professoriate. The Carnegie Foundation for the Advancement of Teaching. New York: John Wiley Sons.

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Managing Innovation

Explain the five factors that influence the adoption and diffusion of an innovation

According to Karakaya, Hidalgo, & Nuur, (2014), the adoption and diffusion of innovation is impacted by the cultural, socioeconomic, legal and technological factors. Individual variables also come into play like the demographics, and psychological. The term diffusion from a marketers’ perspective refers to the possibility that the identified customer segment will be able to accept a new or modified product and service that is being delivered to them.

Contrariwise, the term adoption focuses on the rate that the customers will accept the product and service. The process of diffusion and adoption of innovation is dynamic as it alters from one product and service to another (p. 393).

There are five factors that influence the process of adoption and diffusion of innovation; they are relative advantage, compatibility, complexity, trialability and observability. Relative advantage refers to the degree to which an innovation is perceived to be better than a similar existing product or service by the users. The greater the level of perceived value, the higher the rate of adoption.

The relative advantage of a product can result from a lower price, accessibility and enhancement of the features of the product or services. The 4P’s of marketing play an important part in the relative advantage when it comes to innovation adoption price, place, promotion, but most customers concentrate on the productive-based advantages (Oldenburg & Glanz, 2008, p. 314).

An example of relative advantage that has managed to penetrate different parts of the globe is the ATM teller machines that are slowly replacing the bank teller counters. The introduction of the ATM teller machines reduced the long queues in the banking halls in different places of the globe.

Compatibility of the innovation

The second aspect is the compatibility that focuses on how closely the product and service does relate to the past experiences, values, culture and the needs of the potential adopters. The greater the compatibility to factors that the customer can relate to the higher the rate of adoption and vice versa. Incessant and dynamic innovations have a higher compatibility level than the discontinuous innovations when it comes to the diffusion and adoption as more customers can relate with them (Robinson, 2009, p. 2).

A good example is the introduction of fast food restaurants in Asia and Africa took a longer period to record higher returns when compared to the Europeans. The reason being that most of the people grew up eating traditional foods and the culture in the two continents encouraged home cooked meals shared by the entire family.

The third factor is a complexity that focuses on the ease of comprehension, purchase and use of the product and service. When customers understand the importance of the innovation and ways to use it, the level of adoption increases than in areas where they need to acquire new skills and knowledge to operate it. In the adoption of innovation, the complexity of technology often does act as a hurdle to its diffusion.

The notion of complexity when it comes to technology is based on the age group, the youths are more tech savvy when compared to the older generations, hence have a higher adoption rate (Ballard, 2015). A good example is the mobile phone industry, there are two models the complex one and the simpler one for texting, calling and sending SMS.

The fourth factor is trialability, which focuses on the rate at which the innovation is experimented with on a limited basis, increases its rate of diffusion. The notion of tried and tested in various products does appeal to the end customer and endear the innovation to them. Providing the customers with free samples, test-runs, and demos increases their confidence in the product, hence increasing the adoption rate. When it comes to electronic products the introduction of warranty and guaranty does increase the diffusion rate of the customers. An innovation that is trialable has minimal risk and has a high rate of diffusion among the customers (Karakaya et al., 2014, p. 395).

The final aspect is observability, the easier it is for people to see the result of the innovation the greater the likelihood for them to adopt it. Individuals are more attuned to accept things that they can see. It does reduce their rate of uncertainty instilling confidence in the innovation. New innovations that are likely to be diffused at a greater rate have the following properties in them they are tangible, social visible; benefits can easily be viewed within a short period of time. Observability does stimulate peer discussion, which in the end does propagate the diffusion of the innovation to target market (Robinson, 2009, p.2).

Question 4

What are the differences between organizational climate and culture?

Based on Schneider, Ehrhart, & Macey, (2013), organizational climate refers to the perceptions that are shared by the employees with respect to the practices, procedures and policies that guide their daily routines. On the other hand, organizational culture does refer to the shared orientations that glue the organization together based on beliefs, norms, values, and assumptions. They tend to shape the behaviour of the employees when they are working within their operations (p.381).

Secondly, organizational climate is centred on the micro image of the organization while organizational culture concerned with the macro vision of the organization. The macro aspect of culture is centred on the fact that the behaviour is ingrained in employees and is quite difficult to alter unlike organizational climate. Culture refers to the personality of the organization and does unite the members. The micro organizational aspect is centred on the way that the individuals within experience the culture of the organization and it does change quite frequently (Agafonovas & Alonderiene, 2013).

Thirdly, there are four types of organizational culture and climate. In organizational culture we have clan, market oriented, adhocracy and hierarchical culture while in the organizational climate, we have rule, goal, innovation, and people oriented. Fourthly, the management and external forces on the other hand the organizational culture is rarely altered can easily alter organizational climate and it is influenced by all the employees within the organization (Differencebetween.com, 2014).

Organizational culture is more static as it takes a longer time for it to be altered while organizational climate is dynamic and changes more rapidly. Lastly, organizational climate can easily be measured unlike the organization culture that is more based on peoples’ behaviour and perceptions making it difficult to quantify. Organizational culture has its roots in the fields of sociology and anthropology while organizational climate focuses on the psychology sector. On the culture perspective, it does focus on stories, rituals, and physical artefacts while climate focuses on the factors that influence behaviour (Differencebetween.com, 2014).

Discuss five climate factors that influence innovation.

The five climate factors that influence innovations are risk-taking, freedom and autonomy, ideal time and support, challenge and involvement and trust and openness. Risk taking refers to engaging in activities that have a lot of uncertainties with respect to the expected outcome. Innovation and risk are synonymous in the organizational climate. Organizations that are risk takers have a higher chance of investing in progressive unlike risk averse organizations. Risk averse climate often does stall innovation and turns organizations into followers of organizations that have adopted the climate of risk (Bolton, Mehran, & Shapiro, 2011, p.456).

Risk is influenced by a number of factors that are conscious, affective and subconscious. The conscious factors are based on manageability, proximity, severity of the impact to the organization and the society. On the other hand, subconscious factors are heuristics in nature and involve availability, representatives, lure of choice et cetera. Lastly, affective factors focus on the intelligence, fatalism and optimism bias (Crenshaw & Yoder-Wise, 2013, p. 26).

The second aspect is freedom and autonomy, which does focus on the creating a climate that gives the employees in the organization the independence to come up with innovations. The employees have the creative freedom to exploit the resources that are within the organization to come up with new driven products and services. In the spirit of freedom, the management often does create policies that make the innovative process flexible as long as it is in line with the goals and objectives of the organization (Acemoglu, Akcigit, & Celik, 2014).

The third factor focuses on ideal time and support from the organization. An innovative climate often does begin from top management where the employees are given full control of the resources that they need to come up with creative products and services. The organizational structure is often decentralized, hence creating a seamless flow of communication, policies and procedures (Acemoglu et al., 2014).

On the time perspective, most of the procedures are integrated to ensure that there is an easy coordination within the organization that is channelled to facilitate the research and development department. The support also does come from external partners like suppliers, investors, and higher institutions of learning among others. The entrance of partners does provide the organization with financial and academic knowledge that plays an integral role in shaping the innovations that will lead to the creation of new products and services (Zennouche, Zhang, & Wang, 2014).

The fourth factor focuses on challenge and involvement, innovation process does face a large number of hurdles that arise from both the internal and external climate. The internal challenges often deal with limited finances that often do incapacitate the progress of innovation. Innovative climate does require a continuous flow of innovation to ensure that the employees in an organization can formulate products and services.

The second challenge is constant failures in the innovative process that does demoralize the employees in the creation of innovative products and services. Another perspective is that the challenges that individuals face can easily create an innovative climate. Challenges trigger human beings to think analytically in ways they can resolve them resulting in the creation of creative and innovative products (Zennouche et al., 2014). The laptops for example were created to enable human beings to deal with the portability challenges posed by the computers.

On the other hand, the involvement factor does focus on the interpersonal exchange between the employees in the organization. The employees work together to foster an amicable and creative climate that does foster innovation. The employees are willing to share their knowledge and skills in different departments to foster the creation of innovative products that will enhance the competitive advantage of the organization (Axelsson & Sardari, 2011, p. 31).

A good example is the Apple Incorporation; the company has created a climate that enables the employees to willingly share their ideas, hence the increase in the number of innovative technological products coming from the organization.

The last aspect deals with trust and openness that refers to the environment where the employees know each other and have developed a deep relationship. A trust environment goes further to inspire the employees to willingly share their intellectual property with their fellow employees. Additionally, the environment enables the employees to formulate clear, distinctive strategies that are vital in chartering the innovative process (Henry, 2001, p. 35).

Moreover, it does enable the formulation of a common long-term goal that inspires the creation of innovative products and services within the organization. An open climate enables the members in the organization, especially top management to accept the failures that arise in the creation of innovative products and services. The acceptance encourages the employees to overcome their failures and create progressive products (Henry, 2001, p.35).

REFERENCE

Acemoglu, D., Akcigit, U. and Celik, M.A. (2014). Young, restles and creative: Openness to disruption and creative innovations (No. w19894). National Bureau of Economic Research

Agafonovas, A. and Alonderiene, R., 2013. Value creation in innovations crowdsourcing: example of creative agencies.

Axelsson, P., and Sardari, N. (2011). A framework to assess organizational creative climate. Division of management of organizational Renewal and entrepreneurship.

Ballard, J. A. 2015. Decoding the workplace: 50 keys to understanding people in organizations. Santa Barbara, CA: Praeger.

Bolton, P., Mehran, H., and Shapiro, J. 2011. Executive compensation and risk taking. FRB of New York Staff Report, (456).

Crenshaw, J. T., and Yoder-Wise, P.S. 2013. Creating an Environment for innovation: <i> The Risk- Taking Leadership Competency<i>. Nurse Leader, 11(1), pp. 24-27.

Differencebetween.com. (2014). Difference Between Organizational Culture and Climate/ Organizational Culture vs. Climate. [Online] Available at: http://www.differencebetween.com/differenc….between-organizational-culture-and-vs-climate/ [Accessed 11 August, 2017].

Henry, J., 2001. Creativity and perception in management. Sage.

Karakaya, E., Hidalago A. and Nuur, C., 2014. Diffusion of eco-innovations: A review. Renewable and Sustainable Energy Reviews 33, pp. 392-399

Oldenburg, B., and Glanz, K. 2008. Diffusion of innovation. Health behaviour and health education, 4, pp. 313-333.

Robinson, L., (2009). Changeology. A summary of Diffusion of Innovations. Creative Commons Attrribution- Noncommercial. Australia.

Scheider, B., Erhart, M.G., and Macey, W. H. 2013. Organizational climate and culture. Annual review of psychology, 64, pp. 361-388.

Zennouche, M., Zhang, J., and Wang, B. (2014). Factors influencing innovation at individual, group and organisational levels: a content analysis. International Journal of Information System and Change Management, 7(1), pp.23-42.

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Case Study Report: Patient Care Action Plan

Case Study report: Patient Care Action Plan

Case Study Report

Name

Institution

Case Study Report

Patient Care Action Plan for: William

Main Contact: Gladys

Main Contact’s Relation to Client: Wife

Council area where client lives: London

Client Address: 49 Featherstone Street, London, United Kingdom

Background This patient care action plan is for William. William currently has liver cancer and he is very much worried about his condition and how his wife Gladys will cope with the situation. When William was growing up, he thought that he would live to reach ninety years old, like his parents, without any serious illness. His dream of living longer has just been shattered after he recently discovered the presence of blood in his stool. On visiting the hospital, William has received a confirmation from Dr. Maxwell that he has liver cancer. William’s immediate carer is his wife, Gladys, who provides assistance with daily living activities as well as with social support. Since William’s kids have their own families and they are mostly committed to work, he has limited access to family support. His living setting is the home environment, and he frequently visits the hospital from where he is cared for by Dr. Maxwell and nurse Linda. Dr. Maxwell has involved other physicians in William’s care. The doctor is working together with other highly qualified healthcare professionals to ensure that William receives the support that he needs for the longest period possible. William’s health condition is not that severe, and his recent health care trajectory indicates that he has a positive progress. His positive health progress is mainly attributed to good communication and a positive relationship with his healthcare providers, including the social worker. At the moment, William largely depends on services obtained from only one GP healthcare resource.

Needs Assessment From the PCC4U Needs Assessment, it is evident that some of Williams needs have been met while there are others, which have not been effectively addressed.
Needs that are currently met The positive progress that is being observed in the patient is attributed to primary health care services that he is now receiving from the doctors and nurse Linda (Llobera, Sanso, and Leiva, 2017). Through support obtained from the doctors, William has learned and can apply various health promotion options that are available to him. Also, William has been informed about the right people he should approach in case his health condition gets worse. Immediate needs that should be met It is important to prioritize patients’ unmet needs to plan effectively on how to help them manage their health conditions (Khosla, Patel, and Sharma, 2012). There are two major immediate needs that William should be assisted to meet. During his interaction with nurse Linda, William explains that he is in a bit of pain and that he still has a lousy appetite. These conditions are common among older people with terminal illnesses (Goodman, Dening, and Zubair, et al., 2016). In this regard, William should be taught how he can solve his appetite problems and how he can effectively manage pain. Potential needs that might arise William’s healthcare providers should be prepared to address potential needs that might arise in the course of care. It is important to identify possible emotional and physical health problems that may arise to formulate strategies that can be used to prevent them early (Clarke, Bourn, Skoufalos, Beck, and Castillo, 2017). To meet William’s physical and emotional needs, the healthcare providers should engage specialists in palliative medicine and palliative nursing, as well as family members, to provide necessary care as early as possible (Llobera, Sanso, and Leiva, 2017).

Local Resources and Services Scan

Service name and brief description	Address/contact details and website URL (if available)	Opening hours/contact hours	How to access (e.g. is a referral required?)	What needs can this service help to meet?	Healthcare team member responsible for referral/action	Additional Comments
Companions of London	110 Gloucester Ave, London NW1 8HX, +44 020 3519 8001 www.companionsoflondon.com/palliative-care	Every day: 9.00 am to 5.00 pm. Closed on Saturday and Sunday	No referral required	Primary care, including emotional and social support.	Palliative nurses are available even with short notice.	This is a useful back up for William’s primary care and emotional and social support needs.
St. Joseph’s Hospice	Mare St, London E8 4SA, + 44 020 8525 6000 https://www.stjh.org.uk/contact-us	8.30 am to 5.00 pm every day	Referrals are necessary. From 8.00 am to 6.00 pm every day by calling 0300 30 30 400.	Provides all primary care services needed by patients with serious illnesses.	Sharon Finn offers social services support and can connect patients with palliative care specialists in the facility.	This facility provides hospice care that William may need shortly.
Meadow House Hospice	Uxbridge Road, Middlesex, UB1 3HW +44 020 8967 5179 http://www.meadowhousehospice.org.uk/	Open Monday to Friday from 8.30 am to 5.00 pm, Saturday from 12 pm to 2.30 pm, Closed on Sunday.	Referrals are required. From Friday 8.30 am – 16.00 pm by calling 020 8967 5758	Psychiatric and primary care services.	Jane Cowap is the lead clinician who specializes in psychiatric care for geriatric patients.	This facility will be appropriate for William in future when he will be in need of psychiatric support.
Pembridge Palliative Care Unit	Exmoor St, London W10 6DZ, UK +44 20 8102 5000 http://www.cqc.org.uk/location/RYXY2	Open 24 hours daily	No referral required	Psychological and physical support.	Doctor Louise Ashley specializes in the treatment of psychological problems, especially for patients with physical disabilities.	A useful facility for screening and diagnostic procedures.
Marie Curie Hospice, Hampstead	11 Lyndhurst Gardens, Hampstead, London NW3 5NS, UK. +44 20 7853 3400 https://www.mariecurie.org.uk/help/hospice-care/hospices/hampstead	Open Monday to Friday from 8.00 am to 6.00 pm, Saturday 11.00 am to 6.00 pm, and Closed on Sunday	No referrals are necessary	Offers emotional and social support for patients with terminal illness and their families.	Lead nurse Angel and Marilyn can assist patients with making appointments and follow-up.	William can get necessary emotional and social support from this facility.
Hospice UK	34-44 Britannia St, Kings Cross, London WC1X 9JG +44 20 7520 8200 http://www.hospiceuk.org/	Open Monday to Friday from 9.00 am to 5.00 pm, Closed on Saturday and Sunday	No referrals are necessary	Provides all types of home-based care needed by patients with serious illness.	Carol Warlford is the Chief Clinical Officer in charge of all forms of palliative care in the facility.	This facility is appropriate for meeting William’s physical, social, physiological, and emotional needs both now and in future.
St. Christopher’s Personal Care	Sydenham, UK +44 20 8768 4500 http://www.stcpersonalcare.org.uk/	Open every day from 9.00 am to 5.00 pm.	No referrals are required	Offers support with all forms of care including medication, nutrition, activities of daily living, social support, and emotional support.	Denise, Maxine, Tony, and Sandra are highly trained to offer palliative care to all patients with various needs.	The facility is a useful back up for William’s palliative care needs.

Action Plan

Medication: The nurse should plan a visit to the physician to provide the right prescription for William to enable him to manage pain effectively (Ramanayake, Dilanka, and Premasiri, 2016; & Al-Mahrezi, and Al-Mandhari, 2016). This arrangement should be made as soon as possible.

Nutrition: The nurse should contact a nutritionist to help with the development of a feeding plan for William and his wife. Since appetite is one of William’s problems that should be solved urgently, this action should be started as soon as possible (Forbat, Haraldsdottir, Lewis, and Hepburn, 2016; & Caccaialanza, Pedrazzoli, and Zagonel, et al., 2016).

Physical Activity: William’s wife should contact a trainer to help William with physical exercise (Lowe, Tan, Faily, Watanabe, and Courneya, 2016; & Chandrasekar, Tribett, and Ramchandran, 2016). This arrangement should be made before William’s next meeting with the GP.

Counselling: The nurse should plan a visit to a professional psychologist to plan counselling sessions for William and his family (Pino, Parry, Land, Faull, Feathers, and Seymour, 2016). This plan should be ready before William’s next meeting with the GP.

Referral to Hospice: The nurse should contact a social worker to provide William and his wife with detailed legal information related to the procedures he should follow when he will be required to relocate from home-based care to the hospice (Hui and Bruera, 2016). This arrangement should be made when William will no longer be in a position to make decisions by himself.

Reference List

Al-Mahrezi, A. & Al-Mandhari, Z. (2016). Palliative care: Time for action. Oman Medical Journal, 31(3): 161-163. doi: 10.5001/omj.2016.32

Caccaialanza, R., Pedrazzoli, P…& Zagonel, V. (2016). Nutritional support in cancer patients: A position paper from the Italian Society of Medical Oncology (AIOM) and the Italian Society of Artificial Nutrition and Metabolism (SINPE). Journal of Cancer, 7(2): 131-135. doi: 10.7150/jca.13818

Chandrasekar, D., Tribett, E. & Ramchandran, K. (2016). Integrated palliative care and oncologic care in non-small-cell lung cancer. Current Treatment Options in Oncology, 17: 23. doi: 10.1007/s11864-016-0397-1

Clarke, J., Bourn, S., Skoufalos, A., Beck, E. & Castillo, D. J. (2017). An innovative approach to health care delivery for patients with chronic conditions. Population Health Management, 20(1): 23-30. doi: 10.1089/pop.2016.0076

Forbat, L., Haraldsdottir, E., Lewis, M. & Hepburn, K. (2016). Supporting the provision of palliative care in the home environment: A proof-of-concept single-arm trial of a palliative carers education package (PrECEPt). BMJ Open, 6(10): e012681. doi: 10.1136/bmjopen-2016-012681

Goodman, C., Dening, T…& Zubair, M. (2016). Effective health care for older people living and dying in care homes: A realist review. BMC Health Services Research, 16: 269. doi: 10.1186/s12913-016-1493-4

Hui, D. & Bruera, E. (2016). Integrating palliative care into the trajectory of cancer care. Nature Reviews Clinical Oncology, 13(3): 158-171. doi: 10.1038/nrclinonc.2015.201

Khosla, D., Patel, F. D. & Sharma, S. C. (2012). Palliative care in India: Current progress and future needs. Indian Journal of Palliative Care, 18(3): 149-154. doi: 10.4103/0973-1075.105683

Llobera, J., Sanso, N….& Leiva, A. (2017). Strengthening primary health care teams with palliative care leaders: Protocol for a cluster randomized clinical trial. BMC Palliative Care, 17: 4. doi: 10.1186/s12904-017-0217-9

Lowe, S., Tan, M., Faily, J., Watanabe, S. & Courneya, K. (2016). Physical activity in advanced cancer patients: A systematic review protocol. Systematic Reviews, 5: 43. doi: 10.1186/s13643-016-0220-x

Pino, M., Parry, R., Land, V., Faull, C., Feathers, L., & Seymour, J. (2016). Engaging terminally ill patients in end of life talk: How experienced palliative medicine doctors navigate the dilemma of promoting discussions about dying. PLoS ONE 11(5): e0156174. https://doi.org/10.1371/journal.pone.0156174

Ramanayake, R., Dilanka, G. & Premasiri, L. (2016). Palliative care: Role of family physicians. Journal of Family Medicine and Primary Care, 5(2): 234-237. doi: 10.4103/2249-4863.192356

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Patient Care: Nursing Entrance Essay

Question One: Patient care

The patient care that I have provided has greatly influenced my career and my decision to advance my nursing education. Although I am a licensed practical nurse (LPN), the nature of patient care that I have provided is far much above my professional level. Most of the care services I offer perfectly match those that should be performed by a registered nurse. For instance, I have been able to obtain a specialty in allergies just like a registered nurse.

Due to my commitment to patient care, I have been promoted to head the sub-acute unit of the hospital where I currently work. I have frequently had the privilege to train registered nurses who are deployed at my unit despite the fact that I belong to a lower rank than them. Surprisingly, a large percentage of registered nurses whom I have interacted with have succeeded in their careers, not only in my current hospital but also in other facilities.

These achievements have influenced me to continue my nursing education. As Farinaz (2016) explains, there is always a limit of the nature of patient care that an LPN can provide. Being an LPN, there is a limit of what I can do to my patients and my fellow nurses. In this regard, I feel that by advancing my education, I will acquire additional nursing knowledge and skills that will enable me to possess competencies that resemble those of a registered nurse.

With these academic qualifications, I will be in a position to perform more advanced caring roles than the ones that I can offer at the moment. Furthermore, I believe that advancing my nursing education will increase the salary that I shall be able to earn. Being a single mother of three, I honestly think that I should be compensated well to motivate me to work hard because most of the tasks that are delegated to me should be performed by a registered nurse.

Question Two

With the nursing knowledge and skills that are currently possessed, together with those that are yet to be acquired, I see myself contributing positively to the nursing profession. According to Arabi, Rafii, Cheraghi, and Ghiyasvandian, (2014), nurses make an enormous contribution to the nursing profession by protecting the quality of health care. I believe that the goal of a successful nurse is always to make a meaningful contribution to his or her profession.

I am highly committed to achieving this goal, and I increasingly utilize my work experience to make a significant change to nursing. With seven years of professional experience, I stand out as a nurse who can deliver quality patient care. Furthermore, I always strive to provide care by my educational training to protect my licensure. I work hard every day to become part of highly qualified nurses who can deliver the highest quality care as recommended by the Institute of Medicine (The Institute of Medicine, 2010).

Furthermore, I will contribute to the nursing profession by utilizing my skills and knowledge to assist my supervisors as well as my fellow nurses. As I continue to deliver extraordinary care to patients, I extensively interact with my supervisors because this helps me to evaluate my strengths and weaknesses.

I am eager to learn to fill my knowledge gaps and to fit to work in the rapidly changing medical and nursing fields. In this manner, I will be in a position to make meaningful reforms to the nursing profession and to take patient care to a higher level. The contribution that I can make to nursing encompasses both patient advocacy and change implementation (Arabi et al., 2014).

Reference List

Arabi, A., Rafii, F., Cheraghi, M. A. & Ghiyasvandian, S. (2014). Nurses’ policy influence: A concept analysis. Iranian Journal of Nursing and Midwifery Research, 19(3): 315-322.

Farinaz, H. (2016). The effect of mode of nursing care delivery and skill mix on quality and patient safety outcomes. Retrieved from https://open.library.ubc.ca/cIRcle/collections/ubctheses/24/items/1.0340283

The Institute of Medicine. (2010). The future of nursing: Leading change, advancing health. Washington, DC: The National Academies Press.

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Understanding Consumer Behavior

Consumer behavior can best be understood by recognizing that each individual has unique tastes and preferences. In marketing, consumer behavior plays an imperative role in designing marketing strategies, through an understanding of consumer psychology, consumer decision making process, implications of consumer knowledge on decision making, and motivation associated with the purchase of different products (Johnson et al, 2014). This way, marketers can effectively improve their marketing strategies and campaigns to ensure that they appeal to the customer.

In making a decision, customers go through a process that involves need recognition, information search, evaluation of alternatives, purchase and post-purchase evaluation. To influence demand for its products or services, a company must ensure that it maintains quality to meet customer needs and provides adequate information about its products and services.

A useful strategy in understanding consumer behavior is to remain in the limelight so that when customers are in the process of decision making, the company’s product or service comes to mind. Through advertising, marketers can promote brand awareness, reinforce attitude on brands and influence external searches. A company that has successfully achieved this is Proctor & Gamble, which is considered the world’s largest advertiser. Its constant advertisements on television, online, social media and printed media has ensured revenue growth to a great extent.

The #LikeAGirl Always sanitary pads advertisement for example has over 64 million views. The Smell Like a Man, Man advertisement featuring Old Spice products also became widely famous as well as ‘Best Job’ that sought to recognize the importance of mothers. These advertisements by Proctor and Gamble could have easily influenced decision making among customers.

To take advantage of the customer decision making process, companies must design marketing strategies that capture the attention of consumers and thus invoke interest in the program ((Johnson et al, 2014). Coca Cola remains one of the products that has managed to consistently capture the attention of customers. Most of Coca Cola advertisements are a call to action and this plays a major role in influencing decision making. In the advertisement catch phrases ‘Taste the Feeling’, ‘Share a Coke with a Friend’, ‘Obey your Thirst’, all these are aimed at encouraging customers to buy Coca Cola beverages.

Organizations in designing their marketing strategies must establish which of the three types of decision making the consumer is likely to make. Cognitive decision making is a deliberate, sequential and rational process and the effort put towards decision making depends on the degree of involvement. To enhance decision making, companies should design and advertise their products in such a way that it catches the attention of the customer.

In purchasing a car for example, the process of decision making is cognitive and this explains why brands such as Mercedes, Volkswagen, Nissan and Toyota ensure high quality and performance of their cars, given that the customer is likely to check specs and the experience of other users before purchasing. This differs from habitual decision making where the process is mostly unconscious, behavioral and automatic and hence lack evaluation or information search (Ciravegna, Fitzgerald & Kundu, 2013).

Examples include everyday use products such as toiletries and food supplies. While companies may not spend much on advertising for such products, there is need to ensure customer satisfaction because it determines customer retention capability.

Marketing – STP

Customer needs are unique to each individual and no particular product can satisfy everyone, hence the growing importance of segmentation, targeting and positioning (Ciravegna, Fitzgerald & Kundu, 2013). Large conglomerates such as Coca Cola, Walmart, Dell Inc., Apple Inc., Amazon, L’Oreal, H & M, Louis Vuitton, Rolex and Rolls-Royce among others attribute their success to effective market segmentation.

This means that in order for organizations to effectively meet customer needs, they must tailor their products and services to meet different groups of customers. This is known as segmentation and is defined as the process through which a company identifies individuals and organizations whose characteristics are similar; in order to base their marketing strategy on such information.

Segmentation is an important aspect of marketing because it ensures effective identification of target markets, development of marketing mix to suit market characteristics, identification of differentiated marketing strategies and an opportunity to take advantage of marketing opportunities (Kotler & Armstrong, 2015). Rolls Royce, Rolex and Louis Vuitton for example target high end customers who are lovers of luxurious products and are willing to pay high prices in order to gain prestige.

Accordingly, such companies must ensure that their products are expensive when analyzing consumer behavior and that not everyone can afford them. Failure to do so would lead to loss of customers because it is no longer prestigious to own their brands. This means that customer segmentation has helped them in designing a marketing strategy and a marketing mix that works for its customers.

Identifying customer segments may be based on various approaches including geographical segmentation, demographic segmentation, behavioural segmentation and psychographic segmentation. Subway and McDonalds target families, thus indicating demographic segmentation; Target aims at reaching people in urban areas, thus demographic segmentation; Nike targets sports personalities which represents interests and is therefore psychographic segmentation; Mercedes targets brand loyalty and is thus behavioural segmentation.

Customized marketing is growing in popularity and locomotive companies, airplane manufacturing companies and design companies have taken a lead. Customized marketing is used in markets where individual customers have sufficient purchasing power to warrant the design of a unique marketing mix for each (Kotler & Armstrong, 2015).

Ferrari for example specializes in the development of tailor-made cars to provide their clients with unique cars that match their personality. ‘Build your own Ferrari’ is a mantra of Ferrari’s Personalization Programme, which seeks to give a personal touch to all customers (Ferrari, 2017). To achieve this, customers can choose their own fabric, colors, wood, leathers and finishes to suit their individual tastes and desires.

References

Ferrari 2017, Ferrari’s personalization programme, Retrieved from

http://auto.ferrari.com/en_EN/sports-cars-models/personalization/

Ciravegna, L, Fitzgerald, R & Kundu, SK 2013, Operating in Emerging Markets. A

Guide to Management and Strategy in the New International Economy, Pearson, FT Press.

Johnson et al 2014, Exploring Strategy: text and cases, 10th edn, London, Pearson.

Kotler, P, & Armstrong, G 2015, Principles of Marketing, Harlow, UK, Pearson Education.

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PTSD Symptom Cluster: Re-Experiencing, Avoidance/Numbing, Hyper arousal

Abstract

Many people tend to develop Post Traumatic Stress Disorder, (PTSD), after witnessing a life threatening events such as terrorism, road accidents, veteran wars, fire accidents, as well as natural disasters such as earthquakes and floods. While treatment approaches have always been used to help individuals to recover from PTSD symptoms cluster: re-experiencing, avoidance/numbing, and hyper arousal, major aspects of spirituality can also be applied to promote recovery.

In this regard, both Christian counseling and clinical group therapy can help to eliminate the PTSD symptoms cluster: re-experiencing, avoidance/numbing, and hyper arousal. Ideally, Christian counseling and clinical counseling are intended to achieve a common goal about five major areas including; duration of treatment, the relevance of truth, the role of a community of support, possession of faith and motivation to persevere, as well as the role played by acceptance and hope in healing.

Post-Traumatic Stress Disorder Symptom Cluster: Re-Experiencing, Avoidance/Numbing, Hyper arousal

1.0 INTRODUCTION

Following severe traumatic events, victims commonly present with psychological changes that occur as they try to recall either what they saw or felt during the event. These psychological reactions may lessen if proper counseling interventions are applied immediately after the traumatic event. However, if not managed quickly, individuals may suffer constant mental problems accompanied by emotional distress, a condition that is often referred to as post-traumatic stress disorder (PTSD) (Sareen, 2014).

Sareen (2014) defines PTSD as a mental disorder that occurs as a result of either witnessing or directly experiencing a life-threatening event. With the rapid rise in traumatic events such as terrorism, road accidents, veteran wars, fire accidents, as well as natural disasters such as earthquakes and floods, PTSD is becoming a health concern in the society that needs to be addressed with a lot of commitment.

Effective interventions should be implemented to help prevent serious health problems that may occur from PTSD symptoms cluster: re-experiencing, avoidance/numbing, and hyper arousal (Cohen and Scheeringa, 2009; & Wilkins, Lang, and Norman, 2011).

Effective elimination of PTSD symptom cluster requires a combination of, psychological, spiritual, and pharmacological approaches to treatment (Walker, Scheidegger, End, and Amundsen, 2012). The thesis statement that guides current research states that group therapy intervention for managing PTSD symptoms cluster: re-experiencing, avoidance/numbing, and hyper arousal, is based on significant aspects of spirituality.

The purpose of this research is to explore the major aspects of spirituality that are related to group therapy management for PTSD symptoms cluster: re-experiencing, avoidance/numbing, and hyper arousal, while citing teachings of the Bible as well as information obtained from some theoretical resources.

2.0 PTSD SYMPTOMS CLUSTER: RE-EXPERIENCING, AVOIDANCE/NUMBING, AND HYPER-AROUSAL

2.1 Re-experiencing

Before analyzing the significant aspects of spirituality that are related to PTSD symptoms cluster, it is important to understand the specific symptoms that a clinical psychologist and a Christian counselor intend to help their clients to recover from. In the fourth edition of the Diagnostic and Statistical Manual of Mental Disorders (DSM-IV-TR (1), the American Psychiatric Association has documented specific symptoms that clinicians should substantiate during PTSD diagnosis.

According to the American Psychiatric Association’s DSM-IV, PTSD should be diagnosed based on three symptoms cluster namely; re-experiencing, avoidance/numbing, and hyper arousal (Goldstein, Bradley, Ressler and Powers, 2017, p. 319). As far as re-experiencing criterion is concerned, people with PTSD individual persistently recall what was either felt or observed during a traumatic event. To prove that a client regularly recalls the happenings of the traumatic event, he or she must present with at least one of the documented five ways.

The five documented presentations include; repeated and disturbing recollection of the happenings of the traumatic event accompanied by perceptions, images, and thoughts; repeated disturbing dreams related to the event; behaving as if the traumatic event was happening again; severe psychological disturbance whenever one comes across issues that look like the life threatening event; and physiologic disturbance any time an individual comes across things that resemble the life threatening event.

As Kleim, Graham, Bryant, and Ehers (2013) explain, it has been discovered that survivors of traumatic events have a tendency of constantly recalling those happenings, and that people often react differently depending on the degree of psychological impact that they have faced from those events.

2.2 Avoidance/Numbing

Concerning avoidance/numbing criterion, an individual who is suffering from PTSD is believed to have a tendency of constantly escaping from stimuli that are related to the distressing event. Furthermore, these people often become less responsive to activities accompanied with feelings of isolation, which did not occur before the life-threatening event.

An individual must demonstrate at least three of the seven behavioral characteristics that have been documented in DSM-IV regarding PTSD diagnosis. The seven features that have been documented by the American Psychiatric Association include; struggling to avoid perceptions, discussions, or feelings associated with the life threatening event, struggling to keep off people, places, or activities that might remind them of the traumatic event, loss of memory of the crucial aspects of the event, lack of interest in taking part in activities, feeling of isolation, inability to have feelings of affection, and loss of hope to plan for the future.

Several studies have been conducted to confirm the presence of avoidance/numbing characteristics among populations with PTSD. For instance, Naifeh, Tull and Gratz (2012) have found that persistent emotional avoidance is a common problem among patients with severe PTSD.

2.3 Hyper-arousal

As far as hyper-arousal is concerned, individuals who suffer from PTSD often exhibit constant symptoms of excitement, which did not exist before the occurrence of a distressing event. For hyper-arousal to be confirmed in an individual, one must present with at least two of the documented characteristic behaviors. These signs include sleep problems, aggressiveness, extreme alertness, lack of concentration, and extremely astound response. As Weston (2014) explains, of the three signs that form PTSD symptoms cluster, hyper-arousal is the most predominant and that should be eliminated first.

3.0 CLINICAL APPROACH VERSUS SPIRITUAL APPROACH

As they interact with people with PTSD, both the clinical psychologist and the Christian counselor often utilize approaches which are aimed at eliminating PTSD symptoms cluster: re-experiencing, avoidance/numbing, and hyper arousal (Walker et al., 2012). Although the Bible does not give any information concerning PTSD symptoms cluster, Christian counselors often rely on biblical teachings to help individuals to recover from symptoms of PTSD.

Specifically, a clinical psychologist will utilize group dynamics to help their clients to recover from PTSD cluster symptoms, while a Christian counselor will rely on the teachings of the Bible to promote healing for PTSD clients. The use of group dynamics by a clinical psychologist to help eliminate PTSD symptoms cluster: re-experiencing, avoidance/numbing, and hyper arousal, is based on some major aspects of spirituality (Walker et al., 2012).

3.0 THE MAJOR ASPECTS OF SPIRITUALITY INVOLVED IN THE TREATMENT OF PTSD

3.1 Treatment Takes Time

Both the clinical therapist and the Christian counselor strive to help individuals with PTSD to recover from re-experiencing, avoidance/numbing, and hyper arousal symptoms by encouraging them that gaining healthy functioning is a process that will take time. The Christian counselor compares the recovery process to Paul’s teachings in the Bible. In 2^nd Corinthians Chapter 12, from verse 7 to verse 10, Paul has written about “thorn in the flesh” (The New King James Version).

Paul says that God provides healing at a time when He feels appropriate. He further asserts that, during times of painful experiences, God provides the suffering with enough grace to help them bear difficult situations. The Christian counselor compares re-experiencing, avoidance/numbing, and hyper arousal symptoms to the pain of a thorn. By using Paul’s teachings, an individual with PTSD gets to understand the need to be patient and develops a motivation to continue attending counseling sessions repeatedly.

In Lamentations Chapter 3, and in 1^st Corinthians Chapter 1, verse 4 to 9, the Bible says that those who are in suffering should continue to present their problems to God because He is always faithful (The New King James Version). A Christian counselor uses these biblical teachings to help people with PTSD to see the need of remaining focused on the spiritual aspect of recovery.

Like spiritual counseling, group therapy by a psychologist emphasizes the need to be patient if recovery from re-experiencing, avoidance/numbing, and hyper arousal symptoms is to be realized. In psych educational group intervention, the group therapist often encourages individuals with PTSD that recovering from the three symptoms is a process that will take time. For this reason, the therapist always plans to use sessions that are extended over a given period.

This requires the group members to meet on a daily or weekly basis over some time before the three symptoms can be eliminated (Bahredar, Farid, Ghanizadeh, and Birashk, 2014). According to Substance Abuse and Mental Health Services Administration (2014), people who are exposed to traumatic events are likely to experience various impacts based on the nature and degree of the life-threatening situation.

For this reason, a group therapist must take the time to understand individual characteristics as well as the degree of psychological impact that has been created by a traumatic event for him or her to be able to help clients to recover from re-experiencing avoidance/numbing, and hyper arousal symptoms. This will require repeated interactions between the therapist and the affected individuals who will take some time (Bahredar et al. (2014).

3.2 Truth is a Key Component of Recovery

When handling clients with PTSD symptoms cluster: re-experiencing, avoidance/numbing, and hyper arousal, both the Christian counselor and the group therapist inform their clients that they have to tell the truth for them to be able to recover from their psychological problems. Both counselors depend on the true information provided by their clients to develop and implement the best intervention for recovery (Walker et al., 2012).

During spiritual counseling sessions, the Christian counselor reminds clients with PTSD that God is always loving, and since He sees value in His people, He is always ready to forgive everyone irrespective of the nature and degree of sins they have committed (1 John 1:8–9, The New King James Version).

Also, the Christian counselor informs his or her clients that the most important thing that they should consider when evaluating their deeds is to know what God says about them but not what others speak of them. Therefore, instead of viewing themselves as either perpetrators or victims, they should identify themselves as beloved children of God as documented in Ephesians Chapter 1, verse 3 to 6, Romans Chapter 8, verse 14 to 17, and in 1^st John Chapter 3, verse 1-3 (The New King James Version).

For those people who have lost their relatives and loved ones as a result of a traumatic event, the Christian counselor encourages them that God has a purpose for everyone’s life and that He protects His people by the power of the Holy Spirit (Ephesians 1:13-14, The New King James Version). By having a feeling that God loves, values, and forgives, clients can recover quickly from PTSD symptoms cluster: re-experiencing, avoidance/numbing, and hyper arousal (Walker et al., 2012).

Like it is with spiritual counseling, a group therapist in clinical counseling relies on the true statements provided by every group member to establish the most appropriate intervention plans for them (Scott et al., 2016). Ideally, for a group therapy session to be effective in eliminating re-experiencing, avoidance/numbing, and hyper arousal symptoms, clients must identify as either victim of executors of traumatic events.

Furthermore, clients must speak the truth of the specific problem behaviors that they experience as this information helps the therapist to distinguish whether the PTSD symptoms cluster are either mild or severe. The clinical psychologist who is handling PTSD clients in group therapy sessions often formulate interventions based on the truthfulness of the information provided by group members (Asher et. al., 2015).

3.3 Healing is Enhanced by a Community of Support

When handling clients with PTSD symptoms cluster: re-experiencing, avoidance/numbing, and hyper-arousal, both the Christian counselor and the group therapist have an understanding that having a community to offer support will help clients to develop a deep understanding of their problems and to perform tasks that promote recovery. The Christian counselor encourages his or her clients to feel free to disclose their problems to the therapist to receive assistance from the group members.

In Romans Chapter 8 verse 35 to 38, the Bible says that nothing can separate Christians from the love of God. Also, it is documented in Hebrews Chapter 4 verse 14 to 16 that Christians should feel free to approach God and explain their problems to Him (The New King James Version). Since God can use people’s situations for His Glory, He also has the powers to restore healthy psychological functioning in individuals who are suffering from PTSD symptoms cluster: re-experiencing, avoidance/numbing, hyper-arousal (Walker et al., 2012).

The clinical psychologist who is handling PTSD patients in groups relies on support from group members to help clients to recover from re-experiencing, avoidance/numbing, and hyper-arousal symptoms. According to Norton and Kazantzis (2016), one of the advantages of group psychotherapy is the ability to obtain support from the dynamic relationships within the groups.

For this reason, the therapist strives to formulate rules that promote group cohesion as he or she acknowledges the support that every group member is likely to bring to the group (Caqueo-Urizar, Rus-Calafell, Urzua, Escudero and Gutierrez-Maldonado, 2015). As Caqueo-Urizar (2015), point out; having a community of support when caring for people with mental problems is very important because the community helps with establishing whether clients have adhered to tasks that promote healing.

3.4 Faith and a Motivation to Persevere Promote Healing

Success is achieved from Christian counseling and from clinical counseling when clients are encouraged to have faith and to demonstrate a willingness to persevere from PTSD symptoms cluster: re-experiencing, avoidance/numbing, and hyper-arousal. The Christian counselor perfectly understands that managing mental health problems associated with PTSD is a huge challenge for individuals.

For this reason, the counselor repeatedly informs individuals with PTSD that they should surrender their problems to God who is always ready to show His compassion and love to the suffering. In 2^nd Corinthians Chapter 1, verse 3 to 5, Paul says that God is the Father of compassion who always comforts those in trouble (The New King James Version). By relying on this biblical teaching, Christians with PTSD should have faith in God and healing, as they should develop a motivation to share in the suffering of Christ as written by Paul (Walker et al., 2012).

Similarly, the success of group psychotherapy greatly relies on faith and perseverance. People with PTSD symptoms cluster: re-experiencing, avoidance/numbing, and hyper-arousal, should have faith that the tasks that are assigned to them by the group leader will promote healing. Also, they must be ready to face the hardships associated with the assigned tasks as their commitment to adhering to group tasks is what will determine whether they will recover from PTSD or not. Eventually, positive health outcomes are always generated through a combination of faith and motivation to persevere (Reisman, 2016).

3.5 Acceptance and Hope are Key Components of Recovery

Both Christian counseling and clinical counseling emphasize on the need to accept past occurrences and to have hope for the future. According to Wilkins, Lang, and Norman, (2011), re-experiencing occurs in people with PTSD because they have a tendency of recalling what they either saw or felt during a traumatic event.

These re-experiencing symptoms can be eliminated if clients are assisted to come to terms with experiences of a traumatic event, and this can occur if they learn to accept the past. Furthermore, people with PTSD tend to lose hope in the future and lose interest in engaging in activities that promote personal growth (Naifeh, Tull, and Gratz, 2012). Therefore, the goal of the Christian counselor, as well as the clinical group therapist is to help clients to accept the past occurrences and to have hope in the future.

The Christian counselor assists individuals with PTSD symptoms cluster: re-experiencing, avoidance/numbing, and hyper-arousal, that it is important to have Hope in God because He has the powers to provide good health. The Bible says in 1^stPeter Chapter 5 verse 6 to 7 that human beings should humble themselves under the powerful hand of God so that they may be exalted at the right him (The New King James Version).

In addition, in the same verse, the Bible teaches Christians that they should cast their anxieties and troubles on God because He is caring. The Christian counselor helps clients with PTSD to understand that Jesus himself experienced traumatic events and he increasingly approached God for hope. In a similar manner, by seeking help and understand from God, they will be able to recover from the mental impacts of trauma.

Like a Christian counselor, the clinician counselor always strives to assist group members to accept past occurrences and to be hopeful that they can still acquire an improved mental health (Walker et al., 2012).

4.0 CONCLUSION

In conclusion, group therapy intervention for managing PTSD symptoms cluster: re-experiencing, avoidance/numbing, and hyper-arousal, is based on major aspects of spirituality. This paper has critically explored the major aspects of spirituality that are related to group therapy management for PTSD symptoms cluster: re-experiencing, avoidance/numbing, and hyper-arousal. Explanations about the interdependence between major aspects of spirituality and group therapy management for PTSD symptoms cluster have been provided while citing teachings of the Bible as well as information obtained from a number of theoretical resources.

References

Asher, L., Fekadu, A., Hanlon, C., Mideksa, G., Eatom, J., Patel, V. & De Silva, M. (2015). Development of a community-based rehabilitation intervention for people with schizophrenia in Ethiopia. PLoS One, 10(11): e0143572

Bahredar, M. J., Farid, A. S, Ghanizadeh, A. & Birashk, B. (2014). The efficacy of psycho-educational group program on medication adherence and global functioning of patients with bipolar disorder type 1. International Journal of Community Based Nursing and Midwifery, 2(1): 12-19

Caqueo-Urizar, A., Rus-Calafell, M., Urzua, A., Escudero, J. & Gutierrez-Maldonado, J. (2015). The role of family therapy in the management of schizophrenia: Challenges and solutions. Neuropsychiatric Disease and Treatment, 11: 145-151.

Cohen, J. A., & Scheeringa, M. S. (2009). Post-traumatic stress disorder diagnosis in children: Challenges and promises. Dialogues in Clinical Neuroscience, 11(1): 91-99.

Goldstein, B., Bradley, B., Ressler, K. J. & Powers, A. (2017). Associations between posttraumatic stress disorder, emotion dysregulation, and alcohol dependence symptoms among inner city females. Journal of Clinical Psychology, 73(3): 319-330.

Kleim, B., Graham, B., Bryant, R. A. & Ehers, A. (2013). Capturing intrusive re-experiencing in trauma survivor’ daily lives using ecological momentary assessment. Journal of Abnormal Psychology, 122(4): 998-1009.

Naifeh, J. A., Tull, M. T. & Gratz, K. L. (2012). Anxiety sensitivity, emotional avoidance, and PTSD symptom severity among crack/cocaine dependent patients in residential treatment. Cognitive Therapy and Research, 36(3): 247-257

Norton, P. J. & Kazantzis, N. (2016). Dynamic relationships of therapist alliance and group cohesion in trans-diagnostic group CBT for anxiety disorders. Journal of Consulting and Clinical Psychology, 84(2): 146-155.

Reisman, M. (2016). PTSD treatment for veterans: What’s working, what’s new, and what’s next. Pharmacy and Therapeutics, 41(10): 623-634.

Sareen, J. (2014). Posttraumatic stress disorder in adults: Impact, comorbidity, risk factors, and treatment. The Canadian Journal of Psychiatry, 59(9): 460-467.

Scott, D., Reid, J., Hudson, P., Martin, P., & Porter, S. (2016). Health care professionals’ experience, understanding, and perception of need of advanced cancer patients with cachexia and their families: The benefits of a dedicated clinic. BMC Palliative Care, 15:100. Doi: 10.1186/s12904-016-0171-y

Substance Abuse and Mental Health Services Administration (US). (2014). Trauma-informed care in behavioral health services. Center for Substance Abuse Treatment (US): Author

The Bible: The New King James Version

Walker, K. R., Scheidegger, T. H, End, L. & Amundsen, M. (2012). The misunderstood pastoral counselor: Knowledge and religiosity as factors affecting a client’s choice. Retrieved from https://www.counseling.org/resources/library/vistas/vistas12/Article_62.pdf

Weston, C. S. (2014). Posttraumatic stress disorder: A theoretical model of the hyper arousal subtype. Frontiers in Psychiatry, 5:37. Doi: 10.3389/fpsyt.2014.00037

Wilkins, K. C., Lang, A. J. & Norman, S. B. (2011). Synthesis of the psychometric properties of the PTSD Checklist (PCL) military, civilian, and specific versions. Depression and Anxiety, 28(7): 596-606.

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