Running Head: OUTLINE/ANNOTATED BIB 1 2 OUTLINE/ANNOTATED BIB I. Introductory Paragraph Ella’s case study raises a lot of concern on the rising cases on the use of alternative medicine rather than convention based on scientific backing. The scenario is related to the current increase of the patients seeking traditional medicine rather than hospital prescribed drugs. Ella had gone for remission for quite a while until when the disease became chronic when she returned to the hospital. Many people have continually sought alternative and complementary medicine because of they believe in their treatment. Ella sought alternative treatment to heal her emotionally and physically. The social, cultural background and religious beliefs of her family are also another factor that led to seeking this alternative form of treatment. It is also quite evident that cultural beliefs and other micro, mezzo, and macro factors that became a major influence in the way she made her decisions. A. Thesis: The aim of this paper is to examine and understand how the various influences clearly depicted in Ella’s scenario would help in formulation of intervention strategies and their families deal illness situations in a proper manner. II. Cultural or traditional issues and the integration of alternative and complementary medicine and beliefs (Holosko & Dulmus,2013). Supporting Evidence: a. Insistence by the American Indian grandfather on the use of the alternative medicine based on traditional healing practices b. Cultural/traditional rituals and practices are not backed by scientific background c. Cultural beliefs undermines the healing process of the patient Explanation: The book is related to this scenario because it defines what alternative medicine and how the culture of a person influence the king d of healthcare they receive. So what: Alternative and complementary medicine and beliefs, mainstream medical practices due to their safety and effective III. Biological basis for care and impact on other family members (Gallant, Spitze & Grove,2010, p.381). Supporting Evidence: a. Empower patients and supporting them through proper nursing techniques b. Knowing the patho-physiological aspect of the disease helps understand on how it is caused and how well it is important to nurse the patient well. Explanation: There is an outline on the basis of biological care on families. So what: Good care lead to a reduction on depression and taking of drugs IV. Micro, mezzo and macro influences (WHO,2002). Supporting Evidence: 1. Micro influences a. Preference by Ella on her role in managing her condition b. Attitudes that were showed by the family members could have some influence on the health care delivery in the hospital c. Extend family believed in alternative medicine, which therefore undermined the provision of better nursing and treatment of the patient 2. Mezzo influences a. Availability of vibrant information systems f.

1. Running Head: OUTLINE/ANNOTATED BIB
1
2
OUTLINE/ANNOTATED BIB
I. Introductory Paragraph
Ella’s case study raises a lot of concern on the rising cases on
the use of alternative medicine rather than convention based on
scientific backing. The scenario is related to the current
increase of the patients seeking traditional medicine rather than
hospital prescribed drugs. Ella had gone for remission for quite
a while until when the disease became chronic when she
returned to the hospital. Many people have continually sought
alternative and complementary medicine because of they believe
in their treatment. Ella sought alternative treatment to heal her
emotionally and physically. The social, cultural background and
religious beliefs of her family are also another factor that led to
seeking this alternative form of treatment. It is also quite
evident that cultural beliefs and other micro, mezzo, and macro
factors that became a major influence in the way she made her
decisions.
A. Thesis: The aim of this paper is to examine and understand
how the various influences clearly depicted in Ella’s scenario
would help in formulation of intervention strategies and their
families deal illness situations in a proper manner.
II. Cultural or traditional issues and the integration of
alternative and complementary medicine and beliefs (Holosko &
Dulmus,2013).
Supporting Evidence:
a. Insistence by the American Indian grandfather on the use of
the alternative medicine based on traditional healing practices
b. Cultural/traditional rituals and practices are not backed by
scientific background
c. Cultural beliefs undermines the healing process of the patient

2. Explanation: The book is related to this scenario because it
defines what alternative medicine and how the culture of a
person influence the king d of healthcare they receive.
So what: Alternative and complementary medicine and beliefs,
mainstream medical practices due to their safety and effective
III. Biological basis for care and impact on other family
members (Gallant, Spitze & Grove,2010, p.381).
Supporting Evidence:
a. Empower patients and supporting them through proper
nursing techniques
b. Knowing the patho-physiological aspect of the disease helps
understand on how it is caused and how well it is important to
nurse the patient well.
Explanation: There is an outline on the basis of biological care
on families.
So what: Good care lead to a reduction on depression and taking
of drugs
IV. Micro, mezzo and macro influences (WHO,2002).
Supporting Evidence:
1. Micro influences
a. Preference by Ella on her role in managing her condition
b. Attitudes that were showed by the family members could
have some influence on the health care delivery in the hospital
c. Extend family believed in alternative medicine, which
therefore undermined the provision of better nursing and
treatment of the patient
2. Mezzo influences
a. Availability of vibrant information systems for a coordinated,
evidence-based and integrated care
b. Availability of community resources such as consumer
groups, non-governmental agencies and patient advocates
3. Macro Influences
a. The existence of a stringent legislative framework for
enhancing quality of health care services (WHO, 2002, p.267)
b. Emphasis on continued education for health care providers
across the nation

3. Explanation: The information in these sources depicts the
various influences that affect the healthcare services in the
national to community level.
So what: The government should prioritize the allocation of
resources for management of chronic conditions
V. Advantages and Disadvantages of Hospital versus Home Care
(Davidson, K. (2014, p.89).
Supporting Evidence:
1. Advantages of hospital care
a. Specialized equipment and medical care for cancer treatment
are available immediately (Davidson, 2014)
b. Constant monitoring by medical staff round the clock
2. Disadvantages
a. There may be little patient privacy
b. Family members may not be able to participate actively in
care giving at the hospital setting (Smyer & Stenvig, 2007)
1. Advantages of home care
a. Ella might feel most secure, comfortable, relaxed and loved
at home
b. The home environment offers flexibility for the patient and
the family in their daily routines (Holosko & Dulmus, 2013)
2. Disadvantages
a. It may be problematic to handle emergencies at home
b. Many home environments do not have adequate facilities
required for effective health care delivery
Explanation: The book source shows a number of advantages
and disadvantages of both homecare and hospital care
So what: The patient should be allowed to choose the best place
she would like to be taken care of without any coercing
IV. Psychological and social issues evident in the scenario
(Gallant et al., 2010)
Supporting Evidence:
1. The prospects of Ella’s death is emotionally burdening to the
family members
2. Drug problems by Sam, Lucy and Josh might be interfering
with their mental and psychological health

4. 3. The ongoing illness of Ella has rendered the family members
hopeless and contributed to increased fears among all members
Explanation: The information in this source describes how the
socioeconomic status of the family might be affecting the
family member’s access to quality care
So what: The government should therefore come up with
strategies that are affordable to provide for the health services
to all people.
V. Current situation as Pertains to Diversity as well as to
cultural, psychological and social perspectives (Smyer &
Stenvig, 2007, pp.90)
Supporting Evidence:
1. As American Indian family, there is more strain to maintain
cultural practices. People view community or family needs as
more important than individual needs
Explanation: The book describes the scenario about Ella and
how well the issue can be considered to be based on cultural,
psychological and social perspectives
So what: Emotional and physical health also has more priority
than physical health among American Indians.
VI. Conclusion
1. Grandmother Ella’s condition presenting various dilemmas
and affecting the diverse family
2. Cultural and traditional influences significantly affect the
decisions of where to provide care, in the hospital setting or in
the home environment
3. Other micro, mezzo and macro influences as well as
perceptions of family members might influence the dispensation
of care to the patient with chronic illness
4. Care should be provided where it is in the best interest for
the patient and the family members

5. IV. References
Davidson, K. (2014). Social Work in Health Care: A Handbook
for Practice. New York, NY: Routledge.
Gallant, M., Spitze, G., & Grove, J.(2010). Chronic Illness Self-
care and the Family Lives of Older Adults: A Synthetic Review
Across Four Ethnic Groups. J Cross Cult Gerontol, 25 (1), 21-
43.
Holosko, M., & Dulmus, C.(2013). Social work practice with
individuals and families : evidence-informed assessments and
interventions. Hoboken, N.J.: John Wiley & Sons.
Smyer, T., & Stenvig, T. (2007). Health care for American
Indian elders: An overview ofcultural influences and policy
issues. Home Health Care Management & Practice, 20, 27–33.
WHO. (2002). Innovative Care for Chronic Conditions:
Building Blocks for Action. Retrieved June 27, 2014, from
http://www.who.int/chp/knowledge/publications/iccc_ch2.pdf