Assignment:

Respond to at least two of your colleagues by providing an additional scholarly resource that supports or challenges their position along with a brief explanation of the resource.

Each response must have at least 2 references no more than five years old

Colleagues Response # 1

Psychotherapy and biological basis

         I believe that psychotherapy has a biological basis and there continues to be emerging evidence supporting this. Psychotherapy has ability to touch many aspects of the clients lives to include self-esteem. Family, work, and relationships (Laureate Education, 2016). Psychotherapy can work alone or in conjunction with psychopharmacology and it is often the first line of treatment (Laureate Eductaion, 2016).

         There have been studies on brain changes after psychotherapy for depression, anxiety disorders, and borderline personality disorder that have been published (Karlsson, 2011). Studies have focused on comparing behavior therapy against psychopharmacologic agents such as antidepressants and the changes in the brain with both modalities. “In the recent study by Karlsson and colleagues, clear differences emerged between short-term psychodynamic psychotherapy and fluoxetine among patients with MDD” (Karlsson, 2011).

           Many psychotherapies attempt to enhance patients’ problem-solving capacities, self-representation, and regulation of affective states. The brain areas that play a role in these functions include the dorsolateral prefrontal cortex, ventral anterior cingulate cortex, dorsal anterior cingulate cortex, ventral and dorsal subregions of the medial prefrontal cortex, posterior cingulate cortex, precuneus, insular cortex, amygdala, and ventrolateral prefrontal cortex. For example, the mechanism behind the effectiveness of cognitive therapy for patients with MDD could be through an increase in prefrontal function, which is involved in cognitive control, while antidepressant medications operate more directly on the amygdala, which is involved in the generation of negative emotion (Karlsson, 2011).

Culture, religion, and socioeconomic influences on the perception of psychotherapy treatment

It is important for the advanced nurse practitioner to always treat each client in a holistic manner because each client differ, based on their cultural, religion beliefs, and socioeconomic background. Culture and beliefs affect many aspects of psychosocial intervention, and cultural assessment will be imperative during the initial treatment phase. This assessment will facilitate the groundwork for treatment outcomes and interventions, indicated to tailor the treatment plan to the individual treating. Cultural evaluations completed by the healthcare professional will promote the trust that is imperative in a professional therapeutic relationship (Wheeler, 2014).

Some patient’s may have strong spiritual beliefs which provides stabilization in the treatment hierarchy framework for practice (Wheeler, 2014). And individuals’ spiritual beliefs are often a significant strength and/or protective factor that the health professional can utilize to assist with recovery or coping and in addition, incorporating the spiritual aspect of life into therapy ensures that existential needs are not swept under the carpet with psychological/psychiatric terms (such as depression) (Brown, Elkonin,  & Naicker, 2013).

Socioeconomic factors may determine if the client would have access to care, if the client would be adherent to the treatment and if the outcome would be successful or not. According to Hawley, Leibert, & Lane, (2014), socioeconomic Status affects therapeutic outcomes and significance of therapeutic intervention because client’s educational level and benefits of health insurance have shown greater compliance with the treatment regimen, therefore, improving client outcome and follow-up.

For Nurse Practitioners to successfully diagnose and treat mental illness ethnicity, religion, race, social, economic Status, and culture are imperative to address, and with the competence gained during the initial goal setting and assessment all the factors above must be thoroughly assessed and discussed (Wheeler, 2014). Preparing for successful intervention will encompass the whole patient to include support, socioeconomic means to healthy living and personal spiritual beliefs will identify what drives the client internally for holistic health.

Colleagues Response # 2

Explanation of Whether Psychotherapy Has a Biological Basis

           Psychotherapy is an interaction between a trained professional and a patient to explore thoughts, feelings, and behaviors with the goal of problem-solving or achieving higher levels of functioning (American Psychiatric Association, 2016). Psychotherapy can be helpful with problems like issues in coping with daily life; traumatic life event, medical illness or loss of a loved one; and specific mental disorders, like depression or anxiety (American Psychiatric Association, 2016).  For example, to show that psychotherapy has a biological basis on the brain and the body, In a study with a client suffering from PTSD who participate in psychotherapy show marked improved dysfunctional cognitive coping strategies and blood pressure  compare with those with no therapy (Schubert et al., 2019). Just like learning to perceive and incorporate new informations, views, and internal processing, psychotherapy produces lasting, detectable physical changes in the brain (Kandel, 2014).

Cultural influences on Psychotherapy Treatments

For an APPN to treat and diagnose mental illness effectively, the APPN must consider the patient culture, religion and socioeconomics influences to recommend the appropriate psychotherapy treatments (Wheeler, 2014). Although it is not possible to have a vast knowledge base regarding all cultures, practitioners should have a working knowledge of the client’s background and research their culture (Wheeler, 2014). Using generalized knowledge of culture will not be appropriate to work with diverse population.  If the practitioner has conflicting information of the client’s culture, asking question will help build a rapport with the client. For example, a Spanish woman hearing voices of her death husband does not mean she is psychotic. As a practitioner, with the knowledge of different culture, he will not prescribed treatment since what the patient is experiencing is cultural related (Wheeler, 2014).

Religious influences on Psychotherapy Treatment

           It is important to consider religion in psychotherapy sessions.  Some therapeutic tools such as meditation, prayer, spiritual journaling, forgiveness protocols, using biblical texts to reinforce healthy mental and emotional habits can lead clients to let go of unhealthy anger and move past an abusive situation without justifying the abuse (Kersting, 2015). Clients with religious or spiritual background will be sensitive and willing to interact religiously. Thereby helping them to trust the therapist and hence brings some positive aspect of the human experience in the therapy room. Some people describe the beauty of spiritually guided therapy as experiencing a third presence in the room a spiritual presence or a God presence. There’s a mystery being revealed to the patient in that presence; it is a sort of an epiphany that can be extremely useful in therapy (Kersting, 2015). As being religious can shape culture, being empathetic to patient’s beliefs and incorporating them into therapeutic plan enhances professional dialogue in a therapeutic meaning (Dilip, Barton & Elyn, 2017).When  the client have a relationship of confidence and empathy with their psychotherapist, there is an efficacy of the treatment

Socioeconomics Influences on psychotherapy Treatment

Socioeconomic factors can hinder clients from getting psychotherapy. Most client who don’t have insurance are unable to pay for services, they are more likely to be discouraged from seeking treatment.  Hawley, Leibert, and  Lane, (2014), noted that social, economic status has a significant influence on therapy. In a research study, results show that  with higher education and access to health insurance even at a free counseling clinic may improve counseling outcome and retention.  The study also pointed out individuals with lower social, economic status levels as having greater dysfunction and greater goal disagreement about treatment has less successful counseling outcomes. These patients are less motivated and lack social support (Hawley, Leibert & Lane, 2014). There are community based services that are also offer for free or low cost based on income. It is also important to know that those with low income have life problems and mental illness as well as client with higher income. ( Jeste, Palmer, Rettew & Boardman, 2015).

Conclusively, for an PMHNP to diagnose and treat mental illness effectively,  they must considered the ethnicity, religion, race, social, economic status, and culture of the client Even though, it is not possible to culturally be competent in all cultures, a working knowledge of the backgrounds of those who most seek treatment is essential (Wheeler, 2014).

Introduction

• Provide a brief, general discussion of your personal philosophy of nursing (such as its purpose, relevance and/or importance) and the purpose of the paper. Content must be paraphrased. Never copy/paste from a source even if you give credit.

Personal Philosophy

• Thoroughly describe each major concept in the metaparadigm (i.e., nursing, person, environment, and health) as they are incorporated within your own personal philosophy. You may use a nursing theorist from your book or other source as a guide.
• Provide a brief and concise, clinical example of how each concept in the personal philosophy is demonstrated within your own nursing practice, i.e., how do you incorporate your beliefs about nursing, health, environment, and person into your nursing practice on a routine basis? For example, if you believe the person is composed of body/mind/spirit, describe the exact ways you apply that belief in your care.

Values Clarification

• Using the ‘Values Clarification Exercise’ on page 155 of the 7th edition of the Friberg text, select your top 3 values of importance to you and discuss how they affect your interactions with clients.

Here are the three values Loyalty, health and time freedom

Conclusion

• Logical closure to the full scope of ideas presented by reemphasizing the main points of the paper and/or providing suggestions. Content must be paraphrased. Never copy/paste from a source even if you give credit. This should not be an editorial commentary on nursing but rather a summation of the main points of the paper.

REQUIRMENTS

• The paper should be 3-5 pages in length (excluding the title page and references). Do not exceed the page limit. Content exceeding the 5 page limit will not be graded.
• Students must use the APA book as a guide when writing.

comment1

Home Care is found to be more desirable than assisted living for many who can afford it, and “according to AARP, more than 95 percent of seniors want to stay in their home as long as possible, even if they need help with day-to-day activities” (First Light Home Care, 2014). If we are paving the way through home care for elderly, and other vulnerable individuals to stay in the community, where they can be safe at home and be around things which they love and are familiar to them, then we have to get behind the science of how to keep them safe through the same EBP we take pride into when it comes to research topics (North Dakota Center for Nursing, n.d.), such as “spinal immobilization and pressure ulcers”, or EBP for complementary and alternative medicine “cinnamon and Diabetes Mellitus” are example of different areas EBP research is conducted. However, very little about homecare can be found from that same website.

  

comment2

One of the main issues for my organization in addressing a solution in evidence-based nursing practice is due to the fact that we do not have a designated educator that has the time or the job in educating and introducing how evidence-based practice (EBP). The organization has educators but they focus on orienting the new hires and asking about online education modules that need to be completed. I believe that if the organization would set aside time for an educator to provide the nurses and staff with education on EBP to incorporate into our practice it would be a good and effective way to learn.

The first step in addressing and resolving this issue is by having one of the four educators we assigned to teach and implement new EBP as approved by nursing leadership and the medical board.

According to a journal article, it states that a way to overcome the barrier of time constraints is by providing an EBP facilitator. This might be a staff educator, manager, or an interdisciplinary team member. The facilitator can present evidence review for the busy provider. 

 

1. Identify the following as an observation (O), a hypothesis (H), an experiment (E), or a conclusion (C).2

a. While conducting a new procedure to peel oranges, John noted that it was faster than the traditional one

b. After repeating a new procedure to peel oranges several times, John realized that it is faster than the traditional procedure.

c. John decided to repeat a new procedure to peel oranges several times to evaluate whether it was faster than the traditional one.

d. John believes that a new procedure to peel oranges will be faster than the traditional one 

2. Solve each of the following for x

a.   x/2 + 2 = 5

b.  4x – 8 = 24

c. 3x + 4 = 13

d. 7a = 49

e. 2b + 5 = b + 9

3. Write the following in scientific notation

a. 4900000

b. 0.0000347

c. 676000000

d. 0.00000908

e. 0.00050

f. 5006000

4. Which number in each of the following pairs is larger?     

a. 2.3 x 107  or  65300

b. 0.0004  or  5.0 x 10-6

c. 2.54 x 103 or  254

d. 4.5 x 10-5  or  7.4 x 10-6

5. How many significant figures are in each of the following?

a. 2.0004

b. 0.00000345

c. 42.000

d. 43000

e. 0.00004200

6.  A sculptor has prepared a mold for casting a bronze figure. The figure has a volume of 675 mL. If the bronze has a density of 7.8 g/mL, how many ounces of bronze are needed in the preparation of the bronze figure?

Assignment 3: The Convergence of Healthcare Financing and Economic Trends and Forces

Due Week 8 and worth 100 points

Note: Use the textbook, course readings, Strayer online library, and other reputable online sources to complete this assignment.

Prepare a fifteen to twenty (15 to 20) slide Microsoft® PowerPoint® presentation with detailed scholarly speaker notes in which you: 

1. Compare the three (3) current health care financing and funding models (i.e., employee based, government based, and individual based) used with the healthcare delivery system of the United States.
2. Compare and contrast key economic goals of public and private health insurance plans.  Evaluate the success potential of key economic goals in terms of populations covered, services included, financing arrangements, reimbursement strategies, and economic competition policies.
3. Analyze the key effects of labor market, insurance market, and competitive market factors on health care delivery requirements at your current or previous organization of employment.
4. Determine what changes are occurring in the economy or concerning labor and regulatory factors that must be considered in the future.
5. Suggest the key national trends that you believe currently affect competition and pricing initiatives. Justify your response.
6. Suggest the main quality indicators that typically affect health insurance pricing at the local level. Justify your response.
7. Use a minimum of six (6) reputable references sources including three (3) sources from peer reviewed journals.

Your assignment must follow these formatting requirements:

• Be typed, double spaced, using Times New Roman font (size 12), with one-inch margins on all sides; citations and references must follow APA or school-specific format. Check with your professor for any additional instructions.
• Include a cover page containing the title of the assignment, the student’s name, the professor’s name, the course title, and the date. The cover page and the reference page are not included in the required assignment page length. 

Rubric attached!!!

The specific course learning outcomes associated with this assignment are:

• Assess current economic trends that influence the cost, quality, and access to care.
• Analyze the impact of managed care on cost, quality, and access within managed care organizations and the health insurance market.
• Use technology and information resources to research issues in health economics.
• Write clearly and concisely about health economics using proper writing mechanics.