Transcultural Perspectives in the care of Older Adults.

Review the attached PowerPoint presentation.  Once done, read the following clinical case below and answer the questions;

Diabetes has been emerging as a major public health concern among Native American communities in the United States for the past 40 years. The Pima Indians in Arizona currently have the highest recorded prevalence of diabetes in the world. On average, American Indian and Alaska Native adults are 2.6 times more likely to have diabetes than non-Hispanic Whites of similar age. Diet is a key factor in controlling blood glucose levels and preventing serious cardiac, renal, peripheral vascular, and retinal complications such as heart attacks, renal failure, limb amputations, and blindness.

An Indian Health Service (IHS) nurse visits a patient in her mobile home, located on an Arizona Indian reservation. The patient is a 72-year-old, obese, female Pima Indian with a blood glucose level of 280. She is at risk for serious complications of type 2, or non–insulin-dependent, diabetes mellitus. With type 2 diabetes, the body either resists the effects of insulin or doesn’t produce enough insulin to maintain a normal blood glucose level. The patient lives with her adult daughter, two grandchildren, and five great-grandchildren. The nurse’s goals are to use culturally appropriate diet education to repattern the patient’s eating habits for the purpose of reducing the blood glucose level to normal (between 70 and 110 mg/dL); promoting steady sustained weight loss (5 pounds per week); encouraging increased exercise and activity. The nurse also asks the patient to participate in group sessions at the Pima Community Center focused on healthy food preparation and eating a balanced meal.

1. If you were a nurse who just began doing home health care on the Pima Reservation, how would you learn about the specific cultural beliefs and practices related to nutrition and diet for this patient as a member of the Pima Indian Nation, versus stereotypes about the diet of Native Americans in general?
2. Given that the patient’s family doesn’t own a vehicle, how will you encourage her to shop for healthy foods, prepare them, and actively participate in weight loss and exercise programs held free of charge at the Pima Community Center?
3. How would you assess the patient’s eating habits, for example, type of food, method of preparation, amount eaten, etc.?
4. Each of the patient’s children, grandchildren, and great-grandchildren is obese. How would you involve the patient’s family in the plan of care and motive them to lose weight as well?

800 WORD COUNT

3 CITATIONS WITH REFERENCES

A.  Write a summary of the significance and background of a healthcare problem by doing the following:

1.  Describe a healthcare problem that can be used to develop a PICO question.

Note: You may use the same topic and the same research articles that were used in Task 1 provided they support the proposed intervention. Or you may choose a different topic and select articles focusing on one of the following topics: falls and fall prevention, pain management in children, opioid abuse, hepatitis C, catheter-associated urinary tract infections, and hand hygiene and infections in hospitals.

2.  Explain the significance of the problem from part A1.

3.  Describe the current healthcare practices related to the problem from part A1.

4.  Discuss how the problem affects the organization and patients’ cultural background (i.e., values, health behavior, and preferences).

B.  Complete a literature review by searching for a total of seven articles consisting of five research articles and two non-research articles related to the healthcare problem from part A1, and describe the search strategy you used to conduct the literature review by doing the following:

1.  Discuss two research evidence sources and two nonresearch evidence sources that you considered.

Note: Please do not use the same primary author for more than two articles. Articles must not be more than five years old.

C.  Use your research articles to develop a PICO (patient/population, intervention/indicator, comparison/control, and outcome) question based on the topic.

D.  Complete the attached “Evidence Matrix,” using the five research evidence sources from scholarly journal sources you located during the literature review in part B. For each article, address the following points:

Note: You may submit your completed matrix as a separate attachment to the task, or you may include the matrix within your paper, aligned to APA formatting standards.

Note: Upload a copy of the full text of the articles with your submission.

•  author, journal name, and year of publication

•  research design (e.g., quantitative, qualitative, mixed design, systematic review)

•  sample size (e.g., numbers of study participants, number of articles, number of control group participants)

•  outcome variables measured (e.g., identify what the research is measuring)

•  quality (using the following scale: A, B, C) 

•  results/author’s conclusions (e.g., briefly summarize the outcome)

E.  Recommend a practice change that addresses the PICO question, using the evidence collected in the attached “Evidence Matrix.” You must use all five research articles from the “Evidence Matrix” attachment to support this recommendation via in-text citations.

F.  Describe a process for implementing the practice change from part E in which you do the following:

1.  Explain how you would involve three key stakeholders in the decision to implement the recommendation from part E.

2.  Describe two specific barriers you may encounter when implementing the practice change from part E in the nursing practice setting.

3.  Identify two strategies that could be used to overcome the barriers described in part F2.

4.  Identify one indicator to measure the outcome (the O in PICO question) of the recommended change practice from part E.

G.  Acknowledge sources, using APA-formatted in-text citations and references, for content that is quoted, paraphrased, or summarized.

H.  Demonstrate professional communication in the content and presentation of your submission.