Case Study: Chapter 5

Objective: The students will complete a Case study tasks that contribute the opportunity to produce and apply the thoughts learned in this and previous coursework to examine a real-world scenario. This scenario will illustrate through example the practical importance and implications of various roles and functions of a long-term care settings. As a result of this assignment, students will be better able to comprehend, scrutinize and assess respectable superiority and performance by all institutional employees.

ASSIGNMENT GUIDELINES (10%):

Students will critically measure the readings from Chapter 5 in your textbook. This assignment is planned to help you examination, evaluation, and apply the readings and strategies to your of a long-term care settings
You need to read the PowerPoint Presentation assigned for week 3 and develop a 3-4 page paper reproducing your understanding and capability to apply the readings to your long-term care settings. Each paper must be typewritten with 12-point font and double-spaced with standard margins. Follow APA Style 7th edition format when referring to the selected articles and include a reference page.

EACH   PAPER SHOULD INCLUDE THE FOLLOWING:

1. Introduction (25%) Provide a brief synopsis of the meaning (not a description) of each Chapter and articles you read, in your own words that will apply to the case study presented. 

2. Your Critique (50%)

Case study: Patient-Centered Care: Case Studies on End of Life in elderly

Background

Ms. L is an 87-year-old African American woman who was diagnosed with vulvar cancer at the beginning of 2017. She is also HIV-positive. By the time Ms. L engaged in care, the cancer had proliferated quite quickly in the setting of a compromised immune system. Upon discovery of the Stage 4 cancer, doctors recommended a dose of radiation and chemotherapy. However, during the course of this episode Ms. L was struggling with substance use. During her hospitalization, she tested positive for a number of substances, including heroin and cocaine. As a result, care providers had many discussions about pain management and which pain medications could be given to her. She was not on methadone treatment maintenance at first, so she was self-medicating to address her pain. While Ms. L wanted to seek help for her addiction to substances, some of the traditional models were not appropriate given the magnitude of her physical issues. There were expectations that she would get into outpatient treatment but she did not follow through, primarily because it was difficult for her to tolerate being in groups for long periods. (Given the location of her cancer, she could not sit upright for long periods or on the bus for transportation.) Ultimately, Lawanda Williams, Director of Housing Services at Health Care for the Homeless in Baltimore, Maryland, and her team were able to provide Ms. L with transportation and cab vouchers so she could access the full course of radiation that doctors had recommended. Her pain was never well controlled, because her physician refused to prescribe her any pain medications, due to the magnitude of her substance use. The radiation center gave her Percocet while she was there but would not give her anything that could not be directly supervised. After treatment, they sent her home with prescriptions for Tylenol and instructions to return and follow up with pain management teams, which she was unable to do because of her difficulties with transportation and sitting. Ms. L completed radiation and is in a period of holding to assess effectiveness of the initial course of radiation, but she still does not have a prescription for her significant pain and, as a result, continues to use substances to manage her pain. Ms. Williams observes, “I have been able to see how managing withdrawal and managing substance abuse in the context of a palliative care treatment plan does not always exist for patients experiencing homelessness. She does not fit very neatly into any mainstream treatment model.”

CASE STUDY CHALLENGE:

1. Harm reduction: How can care providers best advocate for a harm reduction approach while seeking to deliver palliative care services, including hospice care?

2. What ethical arguments can you make base on the case study? 

3. Why do you think that long-term care and palliative care insurance lacks of popularity among older Americans.

3. Conclusion (15%)

Briefly summarize your thoughts & conclusion to your critique of the case study and provide a possible outcome for Aging in America base on Health ethics Context?

Evaluation will be based on how clearly you respond to the above, in particular:

a) The clarity with which you critique the case study;

b) The depth, scope, and organization of your paper; and,

c) Your conclusions, including a description of the impact of these Case study on any Health Care Setting.

Quantitative research utilizes a systematic way in an orderly manner to determine a problem and a subsequent solution to the issue (McNiff, Petrick, 2018).
Experimental researches are the gold-standard for research in medicine, biology, and so on. In an Experimental study, researchers can manipulate one or more independent variables, randomly assign participants to control or experimental group (treatment group), and compare them (Statistics Solutions 2020). If done accurately, experimental studies will provide evidence for cause and effect. Highly controlled environment (McNiff, Petrick, 2018). Example: effect of smoking cessation program on smoking pregnant women. A sample of 30 women from the same hospital (or GI clinic) was assigned to an experimental or control group. Smoking status was measured by self-report and biochemical measures. Data were collected before random assignment to groups and after three follow up points: after the first week of the session, in five months and after delivery of the baby. During educational sessions, nicotine replacement gum was provided fo the experimental group while the control group received brochures about how smoking affects pregnancy and lactation.
Non-experimental research can be just as impressive, but we cannot draw the same conclusions from it as we can with experimental research. The non-experimental study is usually descriptive or correlational. That means that we are either describing a situation or phenomenon just as it is, or we are defining a correlation between two or more variables. All without any intervention from the researcher meaning that we do not manipulate any variables (e.g., change the conditions that an experimental group undergoes) or randomly assign members to a control or treatment group. Without this level of control, we cannot determine any causal effects. High chance of bias (McNiff, Petrick, 2018). While validity is still a concern in non-experimental research, the concerns are more about the validity of the measurements, rather than the validity of the effect.
Example of correlational research: a randomized trial of 100 breastfeeding mothers, we arranged to determine the relationship of maternal age and anxiety in breastfeeding women during the immediate postpartum period. The result would be: A weak but significant negative relationship exists between age and anxiety; as age increases, anxiety decreases. As we can see Correlational research measures the statistical relationship between two or more variables and the degree of the relationship (cause/effect).
References
McNiff, P., Petrick, M. (2018). Quantitative Research: Ethics, Theory, and Research. In Nursing research: Understanding methods for best practice. Retrieved from: https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1/#/chapter/3.
Statistics Solutions. (2020). Research Designs: Non-Experimental vs. Experimental. Retrieved from: https://www.statisticssolutions.com/research-designs-non-experimental-vs-experimental/

Experimental research is the most powerful qualitative method.it has a rigorous control of the variables.it It is an objective, systematic, and highly controlled investigation conducted for predicting and controlling phenomena. During the experimental design, the researcher uses a random assignment. they also manipulate a must be randomization, control a group, and manipulation of a variable while examining the direct cause or predicted relationship between variables.

Non-experimental research is research that lacks the manipulation of an independent variable, random assignment of participants to conditions or orders of conditions, or both.it focuses on examining variables as they would naturally occur. Some of the examples of experimental research are surveys, case studies, comparative studies, and descriptive studies. This research design has no random assignment, no control groups, and no manipulation of variables. The research method is observation only.

Experimental research provides convincing evidence that changes with an independent variable. this it results in the differences in a dependent variable. on the other hand, non-experimental research does not cause any change in the independent variables.

Reference: Dawson R, Algozzine R. Doing Case Study Research: A Practical Guide for Beginning Researchers. 2006. New York, NY: Teachers College Press. Qualitative content analysis in nursing research: concepts, procedures, and measures to achieve trustworthiness. Nurse Educ Today. 2004 Feb; 24(2):105–12.