SECOND: Write your Saudi Women’s Driving School Movie review using the Template provided. For the review, you are asked to respond to the basic information about the film and four prompts that require you to reflect about what you have seen and to respond thoughtfully. One paragraph– no bullet points — for each prompt is fine.
Title of film: Saudi Women’s Driving School
Director:
Release date:
Location of film:
Date you viewed:
How many stars did you award this film (1-5)?
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1. In one succinct paragraph, give an overview of the plot, supplying enough details to demonstrate that you paid attention during your viewing, from start to finish.
2. Which one scene from the entire documentary really struck you and that you thought was particularly powerful? Describe the scene and your reaction to it in one paragraph.
3. Which one scene from the entire documentary did you NOT like or did not convince you for whatever reason. Describe the scene and your reaction to it in one paragraph.
4. And, finally, if you could meet and talk to the director, what question would you ask this person, the “author” of the film? Write the question first, then explain why you want to know in one paragraph.
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Cultural Change Concept
Introduction
The society today has turned out to become in full awareness of its status as a multi-cultural unit that is slowly transformed by the cultural change proponents of globalization that has turned the world into a small village. This has seen several cultural change within the society that include the awareness of the community of their rights and freedoms.
This aspect has been considered as a functional dilemma since it has thwarted the ethnic and cultural change appetites of most of the communities that still embrace the element of traditional customs (Delanty, 2011). Habits have been changed and behaviors transformed as a result of the new wave of transformation that has brought with it the aspect of development.
In a small village, South East of Timbuktu, a society is struggling to embrace the element of change. To this society, the aspect of change being a good element likened to rest does not make any sense. This society in other words has chosen to fight the arsenals of globalization that has wrought change in the community. However, their approaches to fighting these changes are as harmless as a toothless woman.
This paper therefore seeks to develop a fictional story that describes a fictitious persona living within a modern community that is inhibited by several challenges. The paper additionally seeks to inclusively incorporate the proponents of sociological concepts that include social construction of gender, the use of social imagination and the theoretical perspectives included within the fictional story.
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The Natives of Kumbaya
Kumbaya is one of the smallest sections of communities in the South Eastern parts of Timbuktu. This village upholds some of its traditional cultures and believes in the fact that the proponents of globalization are just but the Western approach of colonization. This determines the rationale behind their resistance to accept that changes that globalization is bringing within the towns around them.
This community consequently believes in their inherited traditions and cultures that are tied on by different elements such as language, values and beliefs (Delanty, 2011). The only language known to the natives of this community is Kumbayana that is widely spoken by the inhabitants of this community.
One of the village elders known as Kundida is considered as the right man of their god. Kundida is aged 85 years old and believes that before the community interacts in any activity, prior consultation should be done with their god to approve and consent to their activities. This has seen Kundida consulted to make incantations to their god during planting seasons and in allowing the community to even seek health care and education. Any individual within this community who goes against the directives of Kundida is considered a disgrace and in most instances punished for their actions.
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The village of Kumbaya also has a series of developed norms and values that are developed by the elders within the society before approval by Kundida who is considered as the final say in determining what is right for the people of Kumbaya. These values define the manner in which the population needs to act within the society (Delanty, 2011). In consideration of the norms and values in accordance to the views of this community, women are considered as junior to the male individuals within the society.
The manner in which the society views the women in this case is biased. Kundida has over time refuted the claims of the outside world on the development of their community’s norms and values that are against the freedoms and rights of the women. Women in this community are discriminated and treated as tools of trade that can be exchanged for the furtherance of a family’s objective.
Kundida also believes that education is one of the weapons that is developed by the Western World to negatively influence the minds of the communities younger generation, a factor that would lead to the wrought of their cultural values and norms. In an instance, one of the elites who went through the odds of the society to achieve his goal in pursuing education is considered as an outcast and burnished from the society (Ferreira, 2014).
Tumbali has been in the fore front to transform the manner in which the society views women and other social problems, a factor that has bore no fruits since the community has been trained to believe in their own systems and frown upon cultural change.
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It is also essential to consider the fact that Kundida does not believe in the aspect of his community’s prosperity and cultural change, a factor that determines the manner in which the Kumbayan community is socially stratified (Ferreira, 2014). The inhabitant of this population believe that no wealth belongs to a single individual and when there is a need, the community or the individuals have the authority to get whatever they require to meet these needs.
Poverty has in this case evaded the community of Kumbaya while the other communities that boarder this village prosper. According to Kundida, the accumulation of individual wealth is one of the sources and the root of evils within the society.
However, Kundida has ensured that there are traditions and cultural change that need to be adhered to by the community members. The community is required to daily bring food into his store house and ensure that there is enough for him to feed each and every day (Gangas, 2016). The communities even in abject poverty are forced to adhere to these traditions since there is a belief that individuals who fail to adhere to these traditions are likely to be stricken by thunders.
This has therefore developed a social unrest within the community of Kumbaya who are not allowed to even seek for medical help from intuitions of health within Timbuktu. The sick individuals within the society are required to use herbal medicines and if the situation worsens, they are required to seek prayers and meditations from Kundida who is believed to have access to god.
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Over time, Kundida has been sported as vocal about the changes that are developing within the society around him. In his view, he believes that development is evil, and the society is getting into the Western trap of colonization (Gangas, 2016). As a matter of this fact, the children within this society are only allowed to learn their traditional activities that include firming, fishing and hunting. Education in this community is therefore considered as one of the social evils that washes away the brains of the children and the youth and develops vices and immoral actions that consume the community values and morals.
Several organizations have held talks with Kundida to enlighten him of the important issues that would see the prosperity of his people with focus on education, health care and the well being of the community members. However, the people of Kumbaya believe that the final say rests with Kundida who has access to god and knows what is best for the people of Kumbaya.
Women are used to the manner in which they are viewed and discriminated and consider this as a normal act. On the other hand, the girls within this community are also subjected to such harsh treatments and are trained to take up their responsibilities as women as early as they can walk. The village of Kumbaya is still flowing under the annals of darkness even when there seems to be no hope at the end of a tunnel.
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Conclusion
It is essential to consider that the development of this fictional paper inclusively incorporated the elements of sociological concepts in developing the actions of the fictional character within a fictitious community. Some of the sociological concepts used in depicting the nature of this society include the proponents of values, beliefs, cultures and the language of the community.
On the other hand, the element of social construction of gender in this fictional story can be seen in the manner in which the community of Kumbaya views women, a factor that has resulted in discrimination of this gender. Women are in this case treated as junior to any male individual within the society be it their husbands or their male children, thus pointing out to the element of social construction of gender.
In this fictional story, the element of social imagination is employed in the manner in which this community is trained to believe. Kundida in this case has ensured that there are traditions that need to be adhered to by the community members. The community is required to daily bring food into his store house and ensure that there is enough for him to feed each and every day.
The communities even in abject poverty are forced to adhere to these traditions since there is a belief that individuals who fail to adhere to these traditions are likely to be stricken by thunders. This has therefore developed a social unrest within the community of Kumbaya who are not allowed to even seek for medical help from intuitions of health within Timbuktu. The theory of social stratification is additionally included in the paper.
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Data set
Quantitative Section
Introduction to Data set
Data sets represent collected data from a single database or data matrix. Every column present in data sets represents a particular variable while every row represents a certain member of the data set in question. All values present in data sets are recorded as variables. Each value is referred to as datum. Data sets contain more than one form of data. The term data set was coined to mean a method of data collection from tables which are related and correspond to certain events or experiments (Bryman, 2012). Data sets have been utilised to identify and analyse both qualitative and quantitative data.
Data Management Analysis Technique
Quantitative data analysis bases on different statistical methods. The commonly used methods are measures of central tendency and measures of dispersion. Measures of central tendency include the mean, mode and median. Mean represents an average value while median refers to the centre value (Bryman, 2006). Mode refers to the value with the highest frequency.
The mean is the commonly used method that is used to analyse results since it monitors and determines the exact value that can be used to measure different variables. It can be used to compare different values. Measures of dispersion include variance and standard deviation and inter-quartile ranges (Mugenda, 2009). Measures of dispersion and central tendency are used together to analyse data. Standard deviation and variance are two forms used together with the mean. Variance and standard deviation show how much values differ from the mean.
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Presentation of Data
In this case an example of the disease affecting different parts of the world will be utilised. The data will be based on several continents. All the information that has been provided has been divided into data sets. The sets include the Africa region, western pacific region, South East Asia, Europe, Eastern Mediterranean, and the American region. The data provided included the different diseases that affected different areas in different years. The quantitative method that was used to analyse the data was the mean. It encompassed calculating all the different death values per disease. The following results were obtained
Mean value
Region
134.39
Western pacific region
132.23
South east Asia
194.65
Europe
117.50
Eastern mediterrean
117.92
Region of Americas
208.13
Africa
Table 1. Mean values showing the deaths of different diseases per 100,000 people per population
Description and Interpretation of Data
The above data compares different rates of morbidities across different continents. The average value when all values are incorporated equal 150.22. When this value is compared to mean values, the deviation and variances becomes easily established. The results reveal that Africa has the highest rates of mortality followed closely by Europe (Malterud, 2011). Eastern Mediterranean has the lowest value. All results reveal that the values lie within the accepted deviation standards.
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References to Research Methods
Mean values have been used to compare results from different samples. The mean as is used as a comparison method since it eliminates all outliers present in a set of data. Median and mode are two methods not utilised since they include outliers in their analysis. Additionally, the median shows the number that is in the middle while the mode shows the number appearing in most cases (Creswell & Clark, 2007). Such values cannot be utilised to compare different samples since they show bias in their analysis. Inclusion of standard deviation and variance in the mean provide a better method of analysis.
Relevance of Data to Policy
The above information can be utilised to implement new laws and heath standards that can be utilised to decrease morbidities rates. The above information provides a comparison of different health standards across the world. It can be used by non-governmental organisations health standards across the world (Neuman, 2005). The above information can be used to investigate the underlying the causes of high levels witnessed in some parts of the world.
Policy makers will be keen to address the underlying causes of the diseases. Policy makers may also opt to utilise information provided by the results to address the high levels witnessed in some areas. More specifically, it can utilise some of the policies implemented in areas that have shown low incidences. Policy makers are able to understand the number of people that affected.
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Qualitative Section
Introduction to Qualitative Data Sets
The qualitative section involves analysis of data sets that are not expressed numerically. These data sets will also be expressed in rows and columns. Data sets included in qualitative data sets will not be limited to descriptive and inferential statistics (Creswell, 2013). In this case values that are utilised to analyse the data are in nominal form or ordinal scales. This means that the data to be utilised will not base on number but in certain wordings which either shows the level or degree of sickness in this case or the number of people suffering from a given disease.
Data Management Analysis Techniques.
Two methods have commonly been used to analyse qualitative data. These methods are coding and theming processes (Mays & Pope, 2006). Coding refers to the arrangement of data by combing different aspects such as themes, categories and ideas. Coding as a method has been utilised to bring out certain themes that are dominate in qualitative data (Patton, 2005).
The theming process involves the identification of particular theme that is largely shown in qualitative analysis. It identifies the major themes that are easily brought out in different aspects. It normally focuses on outlining all major themes present in any form of qualitative study.
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Presentation of Data
The information provided below seeks to address the question on the most prevalent disease that affected individuals in the year 2000. The data was selected using the theming process where the disease status of the world was going to be compared. The disease states that are available are the 2000 and 2012. Therefore, one had to be chosen and investigated.
Thus in this case the disease that was investigated was the one shown in 2000. All relevant information containing the different disease that occurred in the year 2000 as well as their levels were analysed. Their means were then identified and formulated into a pie chart to show the levels.
Description and Interpretation of Data
From the above results it can be deduced that all causes of disease were the major contribution to the diseases rates witnessed . it was closely follwoed with cardiovascualr disease, mailgnant diseases, neoplam conditions, HIV/AIDS, malaria and tuberculosis. A pie chart is used to bring out this form of information because it represent one of the best methods that brings out qualititive data. A comparison can thus be carried to identify the disease thataffacted more people in the year 2000. From this information different piechrts can be made depending on the individual gender of individuals.
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References to Research Methods
Pie charts have been used in numerous occassions to bring out a qualititive method of analysis. Unlike other methods, a pie chart can be readily used to identify the disease that affected more people. it can also be further utilised to ideintify other small areas withi basing on other vraibales such as sex and region. From the above pie chart small pieces of infromation regarding the other variables can be easily collcted and utilised.
Qulitative data involves the idenfication of which disease was shon to affect more populations across the world. from the above values, one ca easily identify the differen values belonging to different data sets. For example , one can make a conclusion that cardiovascular diseases make up the huge percentage of diseases affecting people across the world as compoared to any other form of disease. This statement can be made in regard of the disease in the year 2000.
Relevance of Data to Policy
The above information becomes quite important to all policy makers. The identificatoon of the disease that casing more diseases across the world becomes a major concern for all policy makers. Once the disease has been identified, all necesaary measures required to decrease the disease are taken into consideration (Patton, 2005).Some of this measures include health promotion exercises, public awareness on the causes and prevention of some of this diseases.
Policy makers can also come up with laws aimed at decreasing the incidences of all the above diseases. Polyc makers can also manage their budgets so that more cash is allocated n fighting such diseases in the society (Smith, 2013). The piechart provides policy makers with an opportunity to identify disease that require immediate attention. At the same time it tells the polcy makers of the disease status of their society.
The information that has been provided an be used to as a standard measurement against the disease status of different individuals in the society. this is because the values represent the pricture of the world. It can also be used to compare results with the coming years for example the year 2012. Lastly, the pie chart can be dissected to adress all concerns of all parties in the society. It can be dissected basing on regions and gender.
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Sexually Transmitted Infections
This practicum is one of the most fascinating experiences in my clinical practice. Dealing with patients diagnosed with sexually transmitted infections (STIs) is challenging as most of the patient are hesitant to talk openly to a nurse or doctor about their experiences, which makes it challenging during clinical decision making processes (American Congress of Obstetricians and Gynaecologists, 2011).
Mrs. Kate (pseudo name) a 21 year old college student presented to the clinic with complaints of itchiness around her genitalia, sharp burning sensation during sexual intercourse and had noted whitish discharge that had foul smell. From the clinical manifestation, I gathered that the patient is suffering from an infection, which could be either sexually transmitted infections (STIs) or urinary tract infections (UTIs). There is a thin line that separated the two, which indicated the need for further laboratory test.
According to Centre for disease control and prevention (CDC), UTIs and STIs clinical manifestations are non-specific and are a common to problem for females. This highlights the likelihood of misdiagnosis. The common clinical manifestation for the urogenital diseases includes a burning sensation during urination, vaginal discharges and pelvic pain. However, in UTIs infection, vaginal discharge with awful smell is normally absent. The patient with urinary tract infection tends to have fever. A pelvic exam, urine culture and vaginal culture results indicate that the patient had yeast vaginal infection (CDC, 2013).
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One of the challenges experienced during this practicum was during sexual history assessment. Initially, the patient was hesitant to disclose the information because it is a taboo and also she believed that disclosing this information would victimize her. After reinforcing the issue of confidentiality, the patient became relaxed and disclosed the sensitive information.
The sexual history assessment was done using the general guide of the ‘5 Ps.’ This included the number of sex partners, the type of sexual activity, the rates of use of protection, and use of contraceptives. This helped me understand the patient literacy and perspectives about UTI (Schuiling and Likis, 2013).
The patients seemed somewhat distressed when I gave her the diagnosis results. However, she was cooperative all through the care plan. The patient was advised to have regular check up with the gynaecologists. This is because sexually transmitted infections (STIs) have short and long term impacts that can be life threatening. The short term impacts include emotional disturbances due to physical changes.
The long term effects include genital sores, inflammation, infertility issues and pelvic inflammatory reactions. Fortunately, genital yeast infections like other sexually transmitted infections (STIs) is manageable if diagnosed early and proper medication regimen is provided (CDC, 2013).
The patient had tried to manage the itchiness and pain using Tylenol (OTC) and vaginal cream, which yielded little success. The patient was given fluconazole 150 mg and Terconazole 80 mg both orally administered one suppository/day for at least 3 days. The medication ensured that the patient did not get recurrent infection. The patient was encouraged to observe hygiene and practice abstinence during the medication regimen. Other hygiene measures such as mutual monogamy, abstinence and avoid of douching practices.
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This practicum was very enlightening, especially on ways to practice cultural competency. I noticed that sexually transmitted infections (STIs) education focuses in specific information on signs and symptoms which seems to be the worst case scenarios and a taboo to most of the community.
The only down to earth guidance is abstinence and use of condom. If not handled with care, the interaction with the patient could affect patient psychosocial status. I have learnt a lot from this practicum and will use the knowledge to help other patients to identify risk factors and practice preventive measures (Schuiling and Likis, 2013).
References
American Congress of Obstetricians and Gynecologists. (2011). Guideline for adolescent health care (2nd ed.). Retrieved from http://www.acog.org
Centers for Disease Control and Prevention (CDC). (2013). Incidence, prevalence, and cost of sexually transmitted infections in the United States. Retrieved from http://stacks.cdc.gov/view/cdc/13174
Schuiling, K. D., & Likis, F. E. (2013). Women’s gynecologic health (2nd ed.). Burlington, MA: Jones and Bartlett Publishers.
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Back Pain
Introduction
Back pain is a common and costly disorder in Australia. Hoy et al., (2014) report that about 25% of Australians suffer from back pain and approximately half of them seek medical attention. The direct costs for treatment of this condition in Australia have been estimated to be approximately $ 1 billion with an addition of $ 8 used in indirect costs (Buchbinder et al., 2013).
The condition is also prevalent within the healthcare professionals where nurses have a higher likelihood of developing back pains unlike individuals from other professions. In South Australia alone, back injury accounts for over $2 million in every financial year (Lorig et al., 2013). Surveys of patient self-managing their back pain as well as those managed in primary care have indicated that usual care is not often evidence based hence hindering provision of best outcomes to patients.
Consequently, there has been a growing demand to address the ramifications of back pain through changes in health policies, investments, and service delivery. Healthcare providers, are charged with the responsibility of ensuring that patients receive effective prevention and treatment strategies to curb this menace.
In my visit to John’s home, there are a number of activities that I will conduct to examine John’s condition and the proper intervention that he needs for effective management of his condition. Some of these activities that I will examine include;
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Patient Education
In my initial visit, the first is educating John on chronic back pain. I will highlight clearly that the condition may arise due to an injury or diseases on different body structures such as the muscles, joints, ligaments, or nerves. According to Traeger et al., (2014), the type of pain varies and can be felt as muscle pain, bone pain, or nerve pain. I will also emphasize that it is important for patients to seek medical attention the moment they have back pains and not wait until the disorder worsens to promote effective management of the condition.
At this point, it will be of great significance for me to let John know that he is not the only one suffering from back pain. He should understand that back pain is a massive problem in Australia that sends more people to seek medical attention more than any other condition except common cold (Driscoll et al., 2014).
Nutrition and Weight loss
Normally, patients who are overweight and suffer from back pain, such as John, may not be aware their excess weight aggravates their condition (Brady et al., 2016). It is well known that obese patients are at a greater risk for back pain, muscle strain, and joint pain unlike those that are not overweight. Moreover, obese patients also complain of fatigue and shortness of breath which makes them refrain from exercises worsening their back pain (Heuch et al., 2013).
When patients do not get enough exercise for quite some time, the back’s supporting structures become weak, stiff, and deconditioned which further increases pain (Silisteanu & Covasa, 2015, November). It is for this reasons that I will encourage John to have a weight loss program which may involve gentle low-impact activities such as walking, jogging, or water therapy. I will also advise John to avoid eating foods with high fat content. He should also stick to a rational nutrition plan which involves changes in eating habits as a step toward effective management of his back pain.
During the visit, I will observe John’s posture and position. Reviewing of John’s curvature of the spine, shoulder symmetry, and the iliac crest will also be of great importance. I will conduct a physical examination through palpation of John’s paraspinal muscle to identify any form of tenderness and then initiate proper interventions as per the findings.
Pain Alleviation
For pain reduction, I will encourage John to take timed bed rests and adjust his position to improve flexion of the lumbar region. I will teach him to regulate and adjust the pains that traverse through the respiratory diaphragm. Relaxation can also help in reducing muscle tension that contributes to back pain. John should also adjust his sitting position regularly or even engage in other activities such as reading books, watching a movie or take part in yoga.
I will advise John to request his wife, Donna, to gently massage his back. It has been proven by Kumar, Beaton & Hughes, 2013; Schulz et al., 2014) that massage aids in reduction of muscle spasms, reducing damming, and improve blood circulation.
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Depression
Depression is the most common emotion linked to chronic back pain. Patients with chronic back pain have major depression which is said to be four times greater in such patients than in the general public in Australia. John is not an exception from this statistics since he reports that he is depressed because he can no longer take part in activities such as hiking and cycling that he has always loved.
Research has revealed that depression can trigger back pain (Steffens et al., 2012). It affects the intensity, frequency and the rate of healing of back pain. Consequently, I will advise John to communicate about the depression. Mostly, many patients do not talk to their physicians about their depression, anxiety, or stress (Center, 2012). Individuals that are stressed tend to tense their back muscles which in turn trigger the onset of low back pain or make it even worse.
They believe that the emotions will go away once the initial pain problem is solved. Therefore, John should regularly keep me updated about his feelings so that I may provide desirable care to him. I will also recommend John to interact with other people, for instance, he can occasionally visiting his daughter or son or play with his grandchild to avoid being lonely and stressed up.
The two activities that I will give priority in my subsequent visits are;
Adherence to Medication
Generally, healthcare providers are aware of the considerable increase in rates of opioid prescribing. Opioids have long been used as pain management agents. However, they are associated with adverse reactions such as nausea, vomiting, constipation, respiratory depression, addiction, and even death. The side effects usually limit their use by patients. Therefore, in my first visit and subsequent visits, this is an issue I will be reviewing.
In these visits, I will assess the effectiveness of the prescribed analgesics and inquire from John on whether what he feels after taking the drug. I will then initiate appropriate adjustments according to the patient’s condition for effective pain management. Besides, other pain management therapies such as acupuncture, yoga, chiropractic care, and herbal medicines such as ginger, capsaicin and feverfew can be used (Ferreira et al., 2014).
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ii) Exercise
According to Searle et al., (2015)exercise should be the first treatment choice for a patient with back problems such as John. This is because exercise matches the fact that individuals with chronic back pain should be physically active and involve themselves in their management. Moreover, treatments such as massage, acupuncture, and manipulative therapy are passive hence the patient is not involved in the therapy.
Falla et al., (2014) further highlight that exercise provides other health benefits beyond back pain management, for instance, in terms of bone and cardiovascular health. Therefore, I will encourage John to take part in usually low grade oscillatory exercises such as knees side to side rotation, knee to chest stretches, pelvic tilts, and press ups. I will also help John to come up with an exercise program which I will be supervising to ensure he follows it.
There are several forms of exercise and there is no genuine reason of expecting that one approach would be better than the other (O’Sullivan, 2012; Elden et al, 2013). As a result, I will give John a list of beneficial exercises he can engage in and enquire from him which type he would prefer so that it is included in the exercise program. The best form of exercise for any patient is the one they are enthusiastic about and willing to continue with.
For instance, John says he likes cycling; an activity that has been recorded to have desirable outcomes in patients with back pains. This can be included in his program. I will advise John not to take part in heavy physical activities, circular motions, and sways which often worsen the condition. I will encourage John to switch activities while sitting, lying or walking for a long time.
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Conclusion
Back pain is a common health problem in Australia (Cramer et al., 2013). However, its prevalence can be reduced significantly if patients and clinicians work together. Patients, for instance, should seek early medical attention and adhere to the prescribed medications and the recommended activities. On the other hand, physicians should keep a close surveillance on these patients and ensure that desirable patient outcomes are realized.
References
Brady, S. R., Hussain, S., Brown, W. J., Heritier, S., Billah, B., Wang, Y., & Cicuttini, F. M. (2016). Relationships between weight, physical activity and back pain in young adult women. Osteoarthritis and Cartilage, 24, S10-S11.
Buchbinder, R., Blyth, F. M., March, L. M., Brooks, P., Woolf, A. D., & Hoy, D. G. (2013). Placing the global burden of low back pain in context. Best Practice & Research Clinical Rheumatology, 27(5), 575-589.
Center, C., Relief, P., Covington, L. A., & Parr, A. T. (2012). Caudal epidural injections in the management of chronic low back pain: a systematic appraisal of the literature. Pain Physician, 15, E159-E198.
Depression Goesling, J., Clauw, D. J., & Hassett, A. L. (2013). Pain and depression: an integrative review of neurobiological and psychological factors. Current psychiatry reports, 15(12), 1-8.
Driscoll, T., Jacklyn, G., Orchard, J., Passmore, E., Vos, T., Freedman, G., & Punnett, L. (2014). The global burden of occupationally related low back pain: estimates from the Global Burden of Disease 2010 study. Annals of the rheumatic diseases, annrheumdis-2013.
Elden, H., Gutke, A., Kjellby-Wendt, G., Fagevik Olsén, M., Stankovic, N., & Östgaard, H. C. (2013). Back pain in relation to pregnancy: A longitudinal 10-year follow-up of 369 women diagnosed with pelvic girdle pain during pregnancy. In Advances in multidisciplinary research for better spinal/pelvic care. The 8th Interdiciplinary World Congress on Low Back & Pelvic Pain, Oct, 2013. Dubai.
Falla, D., Gizzi, L., Tschapek, M., Erlenwein, J., & Petzke, F. (2014). Reduced task-induced variations in the distribution of activity across back muscle regions in individuals with low back pain. PAIN®, 155(5), 944-953.
Ferreira, P. H., Ferreira, M. L., Maher, C. G., Refshauge, K. M., Latimer, J., & Adams, R. D. (2013). The therapeutic alliance between clinicians and patients predicts outcome in chronic low back pain. Physical therapy, 93(4), 470-478.
Heuch, I., Heuch, I., Hagen, K., & Zwart, J. A. (2013). Body mass index as a risk factor for developing chronic low back pain: a follow-up in the Nord-Trøndelag Health Study. Spine, 38(2), 133-139.
Hoy, D., March, L., Brooks, P., Blyth, F., Woolf, A., Bain, C., & Murray, C. (2014). The global burden of low back pain: estimates from the Global Burden of Disease 2010 study. Annals of the rheumatic diseases, annrheumdis-2013.
Kumar, S., Beaton, K., & Hughes, T. (2013). The effectiveness of massage therapy for the treatment of nonspecific low back pain: a systematic review of systematic reviews. Int J Gen Med, 6, 733-741.
O’Sullivan, P. (2012). It’s time for change with the management of non-specific chronic low back pain. British journal of sports medicine, 46(4), 224-227.
Schulz, C., Leininger, B., Evans, R., Vavrek, D., Peterson, D., Haas, M., & Bronfort, G. (2014). Spinal manipulation and exercise for low back pain in adolescents: study protocol for a randomized controlled trial. Chiropractic & manual therapies, 22(1), 1.
Silisteanu, S. C., & Covasa, M. (2015, November). Reduction of body weight through nutrition intervention reduces chronic low back pain. In E-Health and Bioengineering Conference (EHB), 2015 (pp. 1-3). IEEE.
Steffens, D., Ferreira, M. L., Maher, C. G., Latimer, J., Koes, B. W., Blyth, F. M., & Ferreira, P. H. (2012). Triggers for an episode of sudden onset low back pain: study protocol. BMC musculoskeletal disorders, 13(1), 7.
Traeger, A. C., Moseley, G. L., Hübscher, M., Lee, H., Skinner, I. W., Nicholas, M. K., & Hush, J. M. (2014). Pain education to prevent chronic low back pain: a study protocol for a randomised controlled trial. BMJ open,4(6), e005505.
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Lack of Proper Education on Patient with Type 2 Diabetes
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Lack of proper education on patient with type 2 diabetes
Locating the Best Evidence
Often, type 2 diabetes patients lack proper education mainly because of the different barriers that they face as well as the receiving education that lacks a proper algorithm. Therefore, there is a great need for these measures to be acted upon so that the patients can realize more positive outcomes. Mshunqane, Stewart and Rothberg (2012) indicated that diabetes type 2 is associated with numerous complications, many of which can cause death if not managed appropriately.
In addition to this, at the worldwide level, the disease is acknowledge as a main challenge that nags the policymakers each day. There is presently some staggering statistics of the increasing prevalence as well as the linked economic and health impact.
Further, the World Economic Forum, World Health Organization, as well as the United Nations recognize the challenge. All these bodies suggest for collective dedication to improve the life quality of the patients as well as prevent the disease. They are clear that the challenge is universal, urgent, and critical. There is also the acknowledgment that the disease is serious for two main reasons (Stults-Kolehmainen & Sinha, 2014).
First is the health impacts linked to it which are more critical including increased likelihood for lower limb amputations, blindness, heart attacks, kidney failure, as well as stroke. Second, there are indirect and direct costs which are a major drain on the healthcare budgets as well as productivity.
The issue is very urgent considering that its prevalence is rising. Moreover, managing the complications associated with the disease is very costly, same as incorporating appropriate measures to ensure that the patients lead a high quality and independent life. The mentioned bodies also agree that proper education is one of the strategies through which the disease can be prevented and managed efficiently.
However, there are a number of barriers that prevent this and the education algorithm normally used is inappropriate. Therefore, this systematic review will aim at finding information suggesting the appropriate algorithm as well as the common barriers as well as how they can be addressed.
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Methods
Search strategy
Peer-reviewed academic journals will be sought from different databases, and these will be used to conduct the systematic review (Lee et al., 2013). The intention will be creating a proper algorithm on diabetes type 2 education, as well as identify some of the barriers to proper education and how they can be addressed. The databases to be used for the systematic review are CENTRAL, Social Science Citation Index, Science Citation Index, PSYCLinfo, Medline, ERIC, and CINAHL.
The references to the articles that were selected were also evaluated for leads. Reading the reviews was necessary as it helped identify if the article was appropriate. In relation to the inclusion criteria, there was selection of articles that were not older than five years. Particularly, there was selection of those discussing the barriers to proper diabetes type 2 education and their solutions, and those discussing proper education standards (Kapoor & Kleinbart, 2012).
Critically Analyzing the Evidence and Synthesis
Proper education algorithm
Type 2 diabetes education preventive measures will be informed to all the people through local barazas. This would ensure that all people engage in appropriate lifestyles to prevent the disease. Cultural competent educators, and those with proper listening and communication skills will be used to offer the education so that no one can be left behind (Garber, Gross & Slonim, 2010).
It will be necessary to educate the patients on all aspects of the disease including the causes, risk factors, predisposing factors, preventive strategies, available treatments, and management. In addition, awareness on how a patient can ensure self-care should be offered, same as the complications and the direct and indirect costs that a family can suffer because of the disease.
Moreover, the educator should go into details when elaborating on the preventive measures including the diet and physical activity. The more the patients and all people know about the disease and how it is connected to other chronic conditions, the more efficiently they can engage in self-care (Green, 2014).
Barriers and addressing them for patients to be able to receive the recommended type 2 diabetes education, they should really be concerned about their healthcare and ready to access or seek quality medical education. However, because of the ignorance some patient have, they prefer using over-the-counter medications or seeking traditional medicine men. They never seek the quality healthcare services because of their ignorance and low socioeconomic backgrounds.
Therefore, even the use of preventive services among these patients is very minimal. To address this, the local authorities will be given a chance to mobilize people from their living areas, so that education can start at the grassroots level before even being offered at the healthcare institution (Zoepke & Green, 2012).
In addition, there are many elderly people suffering from type 2 diabetes and with hearing, memory, and vision challenges. These will be offered the education in the presence of caregivers who can assist them around (Chijioke, Adamu &Makusidi, 2010).
Feasibility, Benefits, and Risks
Feasibility
The project of delivering proper education to the type 2 diabetes, patients is feasible, especially if the most appropriate education is being delivered, with a consideration of the personal factors, and if the barriers that might hinder the education have been considered and measures to address these put in place. Healthcare providers would only need to offer patients attending the institution for medical care services the pamphlets containing all the necessary information.
However, when dealing with type 2 diabetes patients, it would be necessary to find out first what they already know and later creating awareness while dispelling the misconceptions. This would be relatively cheap. It would also be necessary to explore other factors that affect individual patients so that advice can be offered (Rosenstock & Owens, 2008).
Barriers
After proper education is offered and the barriers to it addressed, some patients might still lack the funds to purchase even the affordable local foods. Considering that some patients might be elderly, there might be issues such as improper vision, hearing loss, and memory loss, which might influence practice of the education.
Benefits
Ensuring that the patients are receiving proper education and implementing it is essential in that it can go a long way in reducing the high prevalence of the disease, preventing complications, reducing the high costs needed to treat and manage the condition, as well as the losses related to loss of productivity and need for a higher quality of life (Ruffin, 2016).
Risks
Some of the anticipated risks include limited resources to ensure that adequate and proper education on type 2 diabetes is being delivered to the patients (Valencia &Florez, 2014). In addition, there might be absence of cultural competence professionals to deal with patients from different backgrounds. In addition, tracking the patients at their homes to ensure that they are implementing the proper education appropriately can be difficult and costly.
Garber, J. S., Gross, M., & Slonim, A. D. (2010). Avoiding common nursing errors. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins.
Green, B. (June 06, 2014). Diabetes and diabetic foot ulcers : an often hidden problem : review. Sa Pharmacist’s Assistant, 14, 3, 23-26.
Kapoor, B., & Kleinbart, M. (2012). Building an Integrated Patient Information System for a Healthcare Network. Journal of Cases on Information Technology (jcit), 14, 2, 27-41.
Mshunqane, N., Stewart, A. V., & Rothberg, A. D. (January 01, 2012). Type 2 diabetes management : patient knowledge and health care team perceptions, South Africa : original research. African Primary Health Care and Family Medicine, 4, 1, 1-7.
Rosenstock, J., & Owens, D. (January 01, 2008). Treatment of Type 2 Using Insulin: When to Introduce?.
Ruffin, T. R. (January 01, 2016). Health Information Technology and Change.
Stults-Kolehmainen, M. A., & Sinha, R. (January 01, 2014). The Effects of Stress on Physical Activity and Exercise. Sports Medicine, 44, 1, 81-121.
Valencia, W. M., &Florez, H. (January 01, 2014). Pharmacological treatment of diabetes in older people. Diabetes, Obesity & Metabolism, 16, 12, 1192-203.
Zoepke, A., & Green, B. (January 01, 2012). Diabetes and diabetic foot ulcers : an often hidden problem : general review. Wound Healing Southern Africa, 5, 1, 19-22.
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Weight Management for Overweight/Obese Children: Parents Take Charge (PTC)
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Weight Management for Overweight/Obese Children: Parents Take Charge (PTC)
Abstract
This proposal is designed to halt the increasing rate of childhood obesity. Modifications in nutrition, behavior and physical activity are well documented to produce successful outcomes for obesity with the main change agent being the individual. Due to the complexities of childhood obesity, an intervention that includes proven elements that prevent obesity and addresses the special factors that affect children is needed.
Parents Take Charge (PTC) is a multi-component family-based childhood obesity intervention that includes modification in nutrition, behavior and physical activity, but focuses on the parent(s) being the primary change agent for the child, age 10-13 years. Addressed in this evidenced-based proposal are the assessment of need, an analysis of best evidence, design aspects, implementation, evaluation, integration and maintenance of the practice change in a primary care setting.
The focus of the intervention is to teach healthy lifestyle behaviors to the child through parental involvement instead of focusing on weight reduction as the primary outcome.
Weight Management For Overweight/Obese Children: Parents Take Charge (PTC)
Quality care can be defined as appropriately identifying, evaluating, diagnosing and treating patients. The term quality in healthcare is correlated to professional knowledge and desired health outcomes (Institute of Medicine, 2012). It is also defined as being closely associated with patient safety (Mitchell, 2008). Clinical excellence is the goal of providing quality care. The process for achieving clinical excellence includes patient-centered care.
The patient is the focus and includes their concerns regarding their illness, values, beliefs and support network. Making the patient an active participant in their health care results in informed decision-making by the patient. Autonomy, nonmalfeasance, beneficence, justice and fidelity are ethical principles that are addressed as definitions of providing quality care and achieving excellence in primary care.
America Nurses Association, American League of Nursing, and Center for Applied and Professional Ethics are organizations that set guidelines for excellence (Stanley, 2011). Quality and excellence in a clinical site is achieved through appropriate, comprehensive and timely care.
Examples of methods of providing clinical excellence include providing evidence-based treatment, the timely manner in which patients are seen from when they sign in, the offer of generics versus brand-name medications, patient education, open dialogue with patients and referrals to specialist as needed. Ethical considerations taken in account are the patient’s autonomy. The patient is provided information for full understanding of their illness, evaluation, treatment and alternative treatments so that the capability for informed decision-making is established.
Guidelines for the prevention, identification, assessment and management of overweight and obesity in adults and children include how to assess whether people are overweight or obese; what should be done to help people lose weight; how to care for people who are at risk due to their weight and how to help people improve their diets and increase their physical activity (The National Institute for Health and Clinical Excellence NHS, 2012).
The intention of this paper is to present an evidence-based project (EBP) proposal for childhood obesity. Included in this paper is assessing the need for change in practice, appropriate theoretical models and frameworks, statement of problem, intervention, goals, systematic review of current research and design. Assessing the need for change in practice consists of identifying stakeholders, collecting internal data about current practice, comparing external data with internal data, identifying the problem and linking the problem with interventions and outcomes (Larrabee, 2012).
Step 1: Assessing the Need for Change in Practice
Stakeholders
The first step for the model of evidenced-base change is assessing the need for change in practice. To facilitate this, identification of stakeholders is needed. The target population is children, age 10-13 years and their families. Final decisions to change behaviors lies with the children, but parents have great influences over the young child’s meals, snacks and physical activities.
Participating parents therefore, will be the change agent, adding them to the list of stakeholders. Parents make informed decisions regarding the health of their children with the help of a primary healthcare provider (Burns, Dunn, Brady, Starr, & Blosser, 2013). Primary healthcare providers or nurse practitioners (NPs) are stakeholders that will assist in facilitating and implementing change.
Barriers to Change
Barriers for children’s outcomes include their maturity level; ability to understand or commit to the program and their parents, if they are reluctant to participate. The primary barrier to change is participation of the parents. Physical activity and dietary behaviors will need modification in and out of the home. Without the participation of the parents the goal for long lasting results will not occur.
Barriers for the parents include health literacy level; language, if the primary language is not English and attitudes towards modifying foods and physical activity. Another barrier is the participant’s adherences to the nutritional guidelines provided because diet plans do not include the cultural foods that the family consumes.
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Facilitators to Change
Facilitators to change include support from their primary care provider or NP that the participants know and trust, educational classes that will be designed to meet their family’s cultural and specific needs and physical activities that can be done as a family that includes utilizing the workout facilities and pool in the local gym.
Internal Data
Internal data (date retrieved within Porterville Valley PromptCare Medical Center) provides overweight/obesity information that is defined by height, weight, body mass index (BMI), frequency of physical activity and anthropometric measurements of children in rural Tulare County, California.
External Data
External data (data retrieved outside of Porterville Valley PromptCare Medical Center) include the following (Ogden, Carroll, Kit & Flegal, 2012; California Center for Research on Women & Families, 2011):
a). Approximately 31.8 percent of children and adolescents aged 2—19 years are obese in the United States
b). Approximately 1 in 3 (33.2 percent) of children and adolescents age 6 to 19 years are considered to be overweight or obese in the United States
c). An estimated 30.5% of children and adolescents aged 10-17 years are presently overweight or obese in California
d). The total percentage of overweight and obesity from 1999 to 2009 rose from 34.0% to 37.6% for 9-11 year olds in California
e). For teens ages 12-17 years in California, African American youth had the highest percentage of overweight/obesity (39.9%), followed by Latinos (29.4%), Asian/other (18.0%) and white youth (12.0%)
Internal data presents an estimated 30% of the children seen in Porterville Valley PromptCare Medical Center are overweight or obese. When comparing Internal data and External data a change in practice is needed to prevent the incidence of childhood obesity from continuing to grow at an alarming rate.
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Theoretical Model and Framework
Since this EBP proposal involves changes in physical activity and dietary behaviors understanding the effects of behavioral and social aspect of the child is necessary. With this in mind, the Transtheoretical Model will be discussed as an integral element in the design of PTC, an overweight/obese child intervention proposal.
Transtheoretical Model (TM)
The TM integrates clinical psychology and concepts to support a framework to understand the behavior and motivate behavioral change. The concepts of TM are decisional balance, processes of change, self-efficacy and temptation. The five stages of the transtheoretical model are the following: precontemplation (not intending to change), contemplation (considering a change), planning or preparation (actively planning change), action (actively engaging in a new behavior) and maintenance (taking steps to sustain change and resist temptation to relapse) (Kadowki, 2012).
Decisional balance occurs in each stage and involves the weighing of advantages and disadvantages towards changing behavior. The processes of change are the steps that facilitate understanding and behavioral change. Self-efficacy is essential and will vary depending on the TM stage. Temptation to revert back to previous stages will exist throughout the model. Support from the individual’s social network will provide the encouragement to continue within the program’s parameters.
Problem
A correlation between obesity and chronic diseases such as cardiovascular disease, diabetes mellitus and hypertension has been documented. Life expectancy for those who are obese is lower than those that maintain a normal Body Mass Index (BMI) (Centers for Disease Control and Prevention, 2011). Earlier death rates in adulthood have been linked to excess weight in the younger ages (American Heart Association, 2013).
The prevalence of obesity has increased three-fold over the past few decades and is reported as a public health problem within the United States (Singh & Kogan, 2010). The cost of health care for obesity-related diseases (diabetes mellitus, hypertension, cardiovascular disease, etc) has skyrocketed and is predicted to continue to grow.
In the year 2000 an estimated $117 billion and $61 billion was spent both directly (medical costs) and indirectly (lost work time, disability, premature death and subsequent loss of income, etc) on overweight and obese individuals in the United States (Ward Smith, 2010). Chronic diseases linked to obesity were once seen mainly in adults, but are now becoming more and more prevalent in children.
The National Center for Chronic Disease Prevention and Health Promotion (NCCDPHP), Division of Adolescent and School Health (2010) reported “the prevalence of obesity among children aged 6 to 11 years increased from 6.5% in 1980 to 19.6% in 2008…and among adolescents aged 12 to 19 years increased from 5.0% to 18.1%” (NCCDPHP, Division of Adolescent and School Health, 2010). Health concerns for obese children are a reality that must be addressed since the effects of early obesity will impact their health for the rest of their lives.
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Problem Statement
The problem addressed in this EBP proposal is the growing rate of childhood obesity and the negative effects on the child, parents, family and community.
Possible Interventions
Intervention of childhood obesity includes early identification and participating in health promotion activities such as eating healthier and becoming more physically active, as early as possible, to reduce the likelihood of chronic diseases and increase the health in those at risk. Wojcicki and Heyman (2010) stated “studies have shown that early interventions can potentially prevent the development of obesity in school-age children, along with associated health conditions” (Wojcicki & Heyman, 2010, p. 1457).
Interventions of childhood obesity include promoting a balanced diet and increased frequency of physical activity. But, with the complexity behind childhood obesity, it requires other interventions as well. Vos, Wit, Pikl, Kruff and Houdijk (2011) stated their family-based cognitive behavioral multidisciplinary lifestyle treatment “aims to establish long-term weight reduction and stabilization, reduction of obesity related health consequences and improvement of self-image by change of lifestyle and learning cognitive behavioral techniques” (Vos et al., 2011).
Education and physical activity should be provided to the whole family in order to ensure successful lifestyle change to occur for the child. It is hoped that by encouraging whole family participation that a lasting positive outcome would result.
Pender, Murdaugh and Parsons (2011) stated “the significant role the family plays in the development of both health-promotion and health-damaging behaviors, beginning at a very early age is well documented” (p. 243). Golley, Magarey, Baur, Steinbeck and Daniels (2007) stated “parenting-skills training combined with promoting a health family lifestyle may be an effective approach to weigh management in prepurbertal children, particularly boys” (p. 517).
Critical Outcome Indicators
Outcome indicators aim to achieve results that matter to the patient (Larrabee, 2012). Critical outcome indicators include improved BMI, improved laboratory measurements, improved health behavior, improved dietary patterns and increased frequency of physical activity.
Goals and Purpose
The health goal is to improve outcomes of obese children living in rural Tulare County, California. Quality goals are to improve access to diagnostics, early treatment and continuity of care with the use of evidence-based practices that include family participation. Quality measures include the participant’s understanding of the nature of obesity, treatment, the negative impact of obesity on lifestyle and overall health. These aspects will be measured through documentation of BMI status, weight classification, percent of physical activity and nutritional counseling.
Purpose Statement
The purpose of the EBP proposal is to promote health and well being in overweight/obese children and their whole family through participation in a nine-week multi-component, family-based community intervention program.
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Designing a Practice Change
Introduction
Trends have indicated an increase in prevalence in diabetes with 42% of the patients with diabetes aged over 65 years (Chen et al., 2012). Projections have been conducted and proved that this ratio will increase to over 60% by 2050. This increase in diabetes prevalence has also impacted related health care costs.
For instance, the average acute hospital cost for managing diabetic patient with a diabetic foot was estimated to be $9,900 in the USA (Dabelea et al, 2014). According to Wong et al, this rise in the prevalence of diabetes has made it imperious to offer training and practice care for clinicians to manage diabetes (Wong et al., 2015).
This paper is going to focus on the design of Evidence Based Practice training program for practice change that will be aimed at training healthcare practitioners on diabetes and improving the outcomes of patients with diabetes.
Timeline
The training module will involve one basic 50-minute presentation which will be conducted by a well-trained diabetes educator and a physician. The presentation will be conducted on Monday, Wednesday and from 0800hrs to 0850hrs for a period of two months. The presentation will be divided into two parts.
The first part will concentrate on enlightening the trainees on diabetes for practice change, that is, the causes, risk factors, onset, types, signs and symptoms, treatment, and management of this disease. This part will also highlight the complications associated with diabetes. The second part of the presentation will concentrate more on patient education which is an integral component of comprehensive patient care.
Several long term care facilities will be contacted as potential recruitment sites. Comprehensive training modules and assessment measures will also be developed to aid in the evaluation of immediate and long term impact of the training project.
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Key Personnel
To achieve the educational needs of the clinicians the program will focus on training licensed practical nurses (LPNs), registered nurses (RNs), and physical therapists. The module will conduct a follow-up of learning outcomes in one group (RNs). The training will be designed for a small group of between 20-30 trainees in each session. This will ensure that close interaction is maintained between the participants and the instructors, with time set aside for participant comments and questions.
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Supplies Needed
Some of the material that will be required include; PowerPoint presentation, videos, and handouts.
PowerPoint Presentation: Will consist of 40 slides. These slides will entail a brief overview of diabetes, and the associated complications such as foot problems, risk of amputation, blurred vision, and kidney problems. It will also offer information on appropriate history taking, keeping of records, conducting physical examination, and appropriate specialist referral.
Video: This will demonstrate the proper techniques of carrying out patient examination such as conducting a monofilament examination with the aid of a tuning fork.
Handout: Will be issued to the participants for daily patient explaining and for explaining how to conduct physical examination on a patient with diabetes.
An official website that will contain all that will have been taught during this period.
Cost
For successful completion of this module, funds will be used in paying two diabetes instructors, paying the IT technicians who will compile the PowerPoint presentation, the video, creation of website and typing of the handout. Funds will also be used in buying enough training materials such as tuning forks for the monofilament examination and glucometers. All this will be allocated a total of $ 2,000.
How do these items tie up to project goals?
These items will help in achieving the set goal of 10-15% increase in diabetes practice change two month post training. Such training promotes clinical judgment and advance patient care quality. The clinicians will understand how to acquire, interpret, and incorporate the best available research evidence with clinical observations and patient data which are important aspects in clinical practice (Wong et al., 2015).
Dabelea, D., Mayer-Davis, E. J., Saydah, S., Imperatore, G., Linder, B., Divers, J., … & Liese, A. D. (2014). Prevalence of type 1 and type 2 diabetes among children and adolescents from 2001 to 2009. Jama, 311(17), 1778-1786.
Wong, C. K. H., Wong, W. C. W., Wan, Y. F., Chan, A. K. C., Chan, F. W. K., & Lam, C. L. K. (2015). Effect of a Structured Diabetes Education Programme in Primary Care on Hospitalizations and Emergency Department visits among people with type 2 diabetes mellitus: results from the Patient Empowerment Programme. Diabetic Medicine.
Wong, C. K., Wong, W. C., Wan, Y. F., Chan, A. K., Chan, F. W., & Lam, C. L. (2015). Patient Empowerment Programme (PEP) and Risk of Microvascular Diseases Among Patients With Type 2 Diabetes in Primary Care: A Population-Based Propensity-Matched Cohort Study. Diabetes care, 38(8), e116-e117
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Feasibility, Benefits, and Risks
Feasibility of the implementation of change in practice
Undeniably, several studies have reported on the dramatic increase of Diabetes type 2, especially among people below 30 years. This dramatic increase and complications associated with the disease are important public health issues that feasibility must be addressed amicably. Recent surveys have recommended that the application of education strategies facilitates changes in lifestyle among patients diagnosed with diabetes Type 2.
This is specifically in subjects identified as high risk of developing diabetes type 2. Research indicates that integration of the proposed practice in the clinical setting will reduce approximately 60% risk of developing diabetes Type 2 within 3 years of intervention. Secondly, the effects of these interventions are long- term (Inzucchi, et al., 2012).
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Potential barriers for the implementation
One of the major barriers for the implementation of the practice is inadequate resources. This will make it difficult for the healthcare providers to balance between their workloads and the demand of practicing proposed intervention- integrative patient education. Other potential barriers are organizational cultural and policy barriers that could lead to staff resistance.
Due to the low level of research in the clinical setting, most of the healthcare providers would be sceptical regarding the evidence based research. Therefore, prior to the onset of the research, the healthcare providers will be trained to ensure they understand the concept and project outcomes (Inzucchi, et al., 2015).
Main Risks of the integration of the practice
The main risk involved in integration of the practice into the clinical setting is the concern that too much content about diabetes type 2 could result in confusion and reduce its utility. Additionally, communication barriers could reduce the opportunity for the patient-physician interaction, which would make it difficult to realize the project’s objectives (Steinsbekk, et al., 2012).
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Benefits for integration of the practice into the clinical setting
Integrative patient education is beneficial as it will increase the patient’s ability of understanding the disease pathophysiology, and in establishment of the relevant coping strategies. This is because it will facilitate the process of diagnosis and treatment alternatives, as well as the consequences of various patient activities. Additionally, it will help the patient to make appropriate decision, thereby reducing the readmission rates, length of hospitalization and slows the disease progression (Kayshap et al., 2013).
The intervention justifies the time as well as cost toward the improvement of the feasibility of clinical outcomes.
The proposed study is an expensive study as it involves a lot or resources such as educating material, employment of additional nurse assistants and time. However, the outcome of the ontervention justifies these costs as it increases patients satisfaction, improve the patient compliance to the regulatory standards and improve the efficiency of care. Lastly, better informed patients are more alert and attentive, which minimizes the risk of malpractice.
Ethical concerns
The researcher will seek permission from ethical review board committee at the institution. The work will require to be approved by the IRB as it involves interaction with human beings. This is to ensure that the study is safe and does not pose potential dangers to the participants. Each of the participants will be required to fill in a consent form.
Inzucchi, S. E., Bergenstal, R. M., Buse, J. B., Diamant, M., Ferrannini, E., Nauck, M., … & Matthews, D. R. (2015). Management of hyperglycemia in type 2 diabetes, 2015: a patient-centered approach: update to a position statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care, 38(1), 140-149.
Steinsbekk, A., Rygg, L., Lisulo, M., Rise, M. B., & Fretheim, A. (2012). Group based diabetes self-management education compared to routine treatment for people with type 2 diabetes mellitus. A systematic review with meta-analysis. BMC health services research, 12(1), 213.
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