This document discusses substance abuse and polypharmacy among older adults. It begins by defining polypharmacy as the use of multiple medications concurrently. It then identifies several risk factors for substance abuse and polypharmacy in older adults, such as taking 5 or more medications, cognitive impairment, and lack of social support. The document outlines holistic interventions that can address issues like physical limitations, psychological well-being, social support and cultural practices. It concludes by stating that polypharmacy is a major quality-of-care concern for older adults and that early interventions can help older adults avoid health problems from misusing drugs or medications.
Multiple Chemical Sensitivities - A Proposed Care Model v2zq
Multiple Chemical Sensitivities - A Proposed Care Model - Resources for Healthy Children www.scribd.com/doc/254613619 - For more information, Please see Organic Edible Schoolyards & Gardening with Children www.scribd.com/doc/254613963 - Gardening with Volcanic Rock Dust www.scribd.com/doc/254613846 - Double Food Production from your School Garden with Organic Tech www.scribd.com/doc/254613765 - Free School Gardening Art Posters www.scribd.com/doc/254613694 - Increase Food Production with Companion Planting in your School Garden www.scribd.com/doc/254609890 - Healthy Foods Dramatically Improves Student Academic Success www.scribd.com/doc/254613619 - City Chickens for your Organic School Garden www.scribd.com/doc/254613553 - Huerto Ecológico, Tecnologías Sostenibles, Agricultura Organica www.scribd.com/doc/254613494 - Simple Square Foot Gardening for Schools - Teacher Guide www.scribd.com/doc/254613410 - Free Organic Gardening Publications www.scribd.com/doc/254609890 ~
CHD Secondary Prevention Clinics in Primary Care; a critical assessmentJosep Vidal-Alaball
There is a need for CHD secondary prevention in primary care. This need has been addressed providing specialized clinics run by nurses or GPs. Whether with this clinics we are meeting this need is a question to be answered.
Multiple Chemical Sensitivities - A Proposed Care Model v2zq
Multiple Chemical Sensitivities - A Proposed Care Model - Resources for Healthy Children www.scribd.com/doc/254613619 - For more information, Please see Organic Edible Schoolyards & Gardening with Children www.scribd.com/doc/254613963 - Gardening with Volcanic Rock Dust www.scribd.com/doc/254613846 - Double Food Production from your School Garden with Organic Tech www.scribd.com/doc/254613765 - Free School Gardening Art Posters www.scribd.com/doc/254613694 - Increase Food Production with Companion Planting in your School Garden www.scribd.com/doc/254609890 - Healthy Foods Dramatically Improves Student Academic Success www.scribd.com/doc/254613619 - City Chickens for your Organic School Garden www.scribd.com/doc/254613553 - Huerto Ecológico, Tecnologías Sostenibles, Agricultura Organica www.scribd.com/doc/254613494 - Simple Square Foot Gardening for Schools - Teacher Guide www.scribd.com/doc/254613410 - Free Organic Gardening Publications www.scribd.com/doc/254609890 ~
CHD Secondary Prevention Clinics in Primary Care; a critical assessmentJosep Vidal-Alaball
There is a need for CHD secondary prevention in primary care. This need has been addressed providing specialized clinics run by nurses or GPs. Whether with this clinics we are meeting this need is a question to be answered.
Evaluating the Quality of Life and Social Support in Patients with Cervical C...CrimsonpublishersTTEH
Aims: Purposes of this descriptive correlational research were to 1) describe quality of life and social support and 2) look at the correlation of certain factors and quality of life in women with cervical cancer after treatment. Methods: Fifty-three women diagnosed with cervical cancer who were followed up after finished the treatments at the Gynecological outpatient department of a university hospital in 2016.They were asked to fill 3 questionnaires; 1) the general information; 2) Social support; and 3) Functional Assessment of Chronic Illness Therapy (FACT-Cervix). Alpha Cronbach’s coefficients for the social support was .73 and for the FACT-Cervix was .91. Data were analyzed by descriptive statistic and Spearman Rank Test.Result: Results showed that participants’ age was ranged from 30 to 86, mean=55.15 (SD=10.05). Social support was about 29 to 59, mean=48.23 (SD=6.76). Symptom distress was from 0 to 9, mean=3.36 (SD=2.83). For quality of life was diverted from 75 to159, mean=126.02 (SD=21.09). The results discovered that there was no correlation between age and social support with the quality of life, however, there was negative correlation between symptom distress and quality of life with r=-.40 at p=0.003.Conclusion: This study disclosed that social support for this women’s group could not help to improve their quality of life. Their symptom distress seems to have a direct effect on their QOL. Thus, the healthcare team needs to alleviate patients’ distress in order to improve the quality of life in cervical cancer survivors.
2014 Cancer Survivorship Conference at Jefferson University Hospitalsjeffersonhospital
Jefferson's Cancer Survivorship Program will help you understand what it means to be a cancer survivor and what to expect from your cancer diagnosis, treatment and follow-up care. This Program is for current patients, cancer survivors and loved ones who have lived with a cancer diagnosis or have undergone cancer treatment at Jefferson.
Clients Presentation Your client can make up whatever they want.WilheminaRossi174
Clients Presentation: Your client can make up whatever they want. They can be as dramatic as they want to be. Have fun with it!
Subjective Data (4 points): (Review History questions in power point and on page 534-535 of text.)
Objective Data (4 points):
Inspection: What is the shape and size of the abdomen? Any masses or pulsations upon inspection? Skin smooth? Striae, scars, lesions?
Auscultation: Bowel Sounds Present in all 4 quadrants? Hypoactive, Normoactive, etc. Any bruits upon auscultation?
Percussion: Tympany in all 4 quadrants?
Palpation: Abdomen soft, firm? Any enlarged organs? Masses? Tenderness?
Any other objective data you found important to document?
Describe 2 Actual/Potential Risk Factors (2 points):
CHAPTER 15
15.1 INTRODUCTION
Although in some cases behavioral and psychiatric/mental are grouped under the same broad
category, behavioral health problems are generally effectively treated on an outpatient basis with
combination psychotherapy and pharmacotherapy (medications). Behavioral health professionals
are licensed by the state in which they reside to practice, and they collaborate on the management
of clients’ behavioral problems. These professionals include psychiatrists, psychologists,
psychiatric nurse practitioners, social workers, family counselors, and drug/alcohol and mental
health counselors (Parker, 2002). Such chronic problems as dementia and mental retardation are
considered psychiatric/mental problems rather than behavioral.
There is a distinct interconnectedness between mental health and health in general. The WHO
defines health as, “a state of complete physical, mental, and social well-being, and not merely the
absence of disease and infirmity” (WHO, 2001b, p. 1). Mental health on the other hand is defined
as, “a state of well-being in which the individual realizes his or her own abilities, can cope with the
normal stress of life, can work productively and fruitfully, and is able to make a contribution to his
or her community … it is determined by socioeconomic and environmental factors and it is linked
to behavior” (WHO, 2001a, p. 1; WHO 2010, p. 1). For example, people are generally resilient
enough ...
Evaluating the Quality of Life and Social Support in Patients with Cervical C...CrimsonpublishersTTEH
Aims: Purposes of this descriptive correlational research were to 1) describe quality of life and social support and 2) look at the correlation of certain factors and quality of life in women with cervical cancer after treatment. Methods: Fifty-three women diagnosed with cervical cancer who were followed up after finished the treatments at the Gynecological outpatient department of a university hospital in 2016.They were asked to fill 3 questionnaires; 1) the general information; 2) Social support; and 3) Functional Assessment of Chronic Illness Therapy (FACT-Cervix). Alpha Cronbach’s coefficients for the social support was .73 and for the FACT-Cervix was .91. Data were analyzed by descriptive statistic and Spearman Rank Test.Result: Results showed that participants’ age was ranged from 30 to 86, mean=55.15 (SD=10.05). Social support was about 29 to 59, mean=48.23 (SD=6.76). Symptom distress was from 0 to 9, mean=3.36 (SD=2.83). For quality of life was diverted from 75 to159, mean=126.02 (SD=21.09). The results discovered that there was no correlation between age and social support with the quality of life, however, there was negative correlation between symptom distress and quality of life with r=-.40 at p=0.003.Conclusion: This study disclosed that social support for this women’s group could not help to improve their quality of life. Their symptom distress seems to have a direct effect on their QOL. Thus, the healthcare team needs to alleviate patients’ distress in order to improve the quality of life in cervical cancer survivors.
2014 Cancer Survivorship Conference at Jefferson University Hospitalsjeffersonhospital
Jefferson's Cancer Survivorship Program will help you understand what it means to be a cancer survivor and what to expect from your cancer diagnosis, treatment and follow-up care. This Program is for current patients, cancer survivors and loved ones who have lived with a cancer diagnosis or have undergone cancer treatment at Jefferson.
Clients Presentation Your client can make up whatever they want.WilheminaRossi174
Clients Presentation: Your client can make up whatever they want. They can be as dramatic as they want to be. Have fun with it!
Subjective Data (4 points): (Review History questions in power point and on page 534-535 of text.)
Objective Data (4 points):
Inspection: What is the shape and size of the abdomen? Any masses or pulsations upon inspection? Skin smooth? Striae, scars, lesions?
Auscultation: Bowel Sounds Present in all 4 quadrants? Hypoactive, Normoactive, etc. Any bruits upon auscultation?
Percussion: Tympany in all 4 quadrants?
Palpation: Abdomen soft, firm? Any enlarged organs? Masses? Tenderness?
Any other objective data you found important to document?
Describe 2 Actual/Potential Risk Factors (2 points):
CHAPTER 15
15.1 INTRODUCTION
Although in some cases behavioral and psychiatric/mental are grouped under the same broad
category, behavioral health problems are generally effectively treated on an outpatient basis with
combination psychotherapy and pharmacotherapy (medications). Behavioral health professionals
are licensed by the state in which they reside to practice, and they collaborate on the management
of clients’ behavioral problems. These professionals include psychiatrists, psychologists,
psychiatric nurse practitioners, social workers, family counselors, and drug/alcohol and mental
health counselors (Parker, 2002). Such chronic problems as dementia and mental retardation are
considered psychiatric/mental problems rather than behavioral.
There is a distinct interconnectedness between mental health and health in general. The WHO
defines health as, “a state of complete physical, mental, and social well-being, and not merely the
absence of disease and infirmity” (WHO, 2001b, p. 1). Mental health on the other hand is defined
as, “a state of well-being in which the individual realizes his or her own abilities, can cope with the
normal stress of life, can work productively and fruitfully, and is able to make a contribution to his
or her community … it is determined by socioeconomic and environmental factors and it is linked
to behavior” (WHO, 2001a, p. 1; WHO 2010, p. 1). For example, people are generally resilient
enough ...
The pharmaceutical industry has made it very difficult to know what the clinical trial evidence is regarding psychotropics. As a consequence, primary care physicians and other front-line practitioners are at a disadvantage when attempting to adhere to the ethical and scientific mandates of evidence-based prescriptive practice. BARRY DUNCAN and DAVID ANTONUCCIO call for a higher standard of prescriptive care derived from a risk/benefit analysis of clinical trial evidence. The authors assert that current prescribing practices are often empirically unsound and unduly influenced by pharmaceutical company interests, resulting in unnecessary risks to patients. In the spirit of evidenced-based medicine’s inclusion of patient values as well as the movement toward health home and integrated care, a patient bill of rights for psychotropic prescription is presented. Guidelines are offered to raise the bar of care equal to the available science for all prescribers of psychiatric medications. This is a Psychotherapy in Australia reprint of an earlier article.
Click here for a video of the presentation http://heartandsoulofchange.com/content/resources/viewer.php?resource=video&id=97
Click here for a pdf of the slides: http://heartandsoulofchange.com/content/resources/viewer.php?resource=handout&id=127
An Interprofessional Approach to Substance Abuse in Primary CareASAMPUBS
An integrated model of treatment improves care by recognizing that patients need clear and consistent care from their primary care provider “in a way that thoroughly considers biological, social, behavioral, and psychological components of their presenting complaint” by integrating psychological, addiction, and other treatments into a cohesive whole.
Running Head FINDINGS USED TO MAKE PUBLIC HEALTH PLANNING AND POL.docxcowinhelen
Running Head: FINDINGS USED TO MAKE PUBLIC HEALTH PLANNING AND POLICY DECISIONS 5
Findings Used to Make Public Health Planning and Policy Decisions
Unit 4 - HA560
March 28, 2016
There has been increased concern among policy makers, scientists and communities that health is greatly affected by a number of factors that occur in a person’s lifetime and in multi levels. Prevention is sententious to curb occurrence of any disease within the population, and it has to come first even if access to quality healthcare services is provided. To adequately promote health and prevent diseases, certain policies and factors need to be addressed mostly factors that are related to health behaviors.
Social psychology is all about understanding individuals’ behavior specifically in a social setting. Basically, social psychology focuses on factors that influence people to behave in certain ways in presence of others. The two greatest contributors in the field of social psychology were Allport (1920) and Bandura (1963). To begin with, according to Allport; he argued that the interaction of individuals with others or the presence of social groups can encourage the development of certain behaviors (Kassin, 2014). This is what Allport referred to as social facilitation, in his research he identified that an audience will facilitate the performance of an actor in a well learnt and understood task; however the performance of the same actor will decrease in performance on difficult tasks which are newly learnt, and this is contributed by social inhibition. The second contributor in the field of social psychology is Bandura (1963), in his work he developed a notion that behavior in the social world could be possibly modeled, and this is what he referred to as social learning theory. He gave his explanation with three groups of children who were watching a video where in the video an adult showed aggressiveness towards a “bobo doll” and the adults who displayed such behavior were awarded by another adult or were just punished. Therefore Bandura found that children who saw the adult being rewarded were found to be more likely to imitate that adult’s behavior.
Certain theories plays important roles in health assessment, and a theory is defined as a collection of concepts in specific area of concern or interest in the world that need explanations, intervening and prediction. Theories need to be backed up with evidence that tend to explain why things will happen in relation to current situations, and followed with some actions to turn situations in certain desirable ways. Health assessment can be defined as a plan of care that recognizes specific person’s health needs and how such needs will be addressed by healthcare system or any other health institutions (Jarvis, 2008). Generally, health assessment is the evaluation of health status through examination of physical and psychological concerns after looking at the health history of the victim assess ...
Treatment Programs HARPS Program (Helping At-Risk Pregnant Women Succeed) - C...ErikaAGoyer
NATIONAL PERINATAL ASSOCIATION CONFERENCE 2014 - Treatment Programs HARPS Program (Helping At-Risk Pregnant Women Succeed)
- Chris Cooper, MSN, NNP-CB, APRN and Dawn Forbes, MD
Running Head ADVANCE NURSING RESEARCH 1 .docxtoddr4
Running Head: ADVANCE NURSING RESEARCH
1
ADVANCE NURSING RESEARCH 2
Week #6 Assignment 1: The Details of Your EBP Project.
EBP Project Proposal Draft
Research topic
To assess the role of stigma towards mental health patients in help seeking.
Research problem
Most studies have shown that stigmatization towards mental health patients have been present throughout history and even despite the evolution in modern medicine and advanced treatment. Stigmatization have resulted from the belief that those with mental problem are aggressive and dangerous creating a social distance (Szeto et al., 2017). Also, mental health-related stigma has become of major concern as it creates crucial barriers to access treatment and quality care since it not only influences the behaviour of the patients but also the attitude of the providers hence impacting help-seeking. Most studies have identified stigma as a barrier that is of significance to care or help seeking while the extent to which it still remains a barrier have not been reviewed deeply. Therefore, this study will assess the role contributed by stigma in help seeking in depth.
Research purpose
The intention of the research study is to review the association between stigma, mental illness and help seeking in order to assess in depth the role that mental-health stigma contribute in help seeking.
Research objectives
a) To review the background history of mental-health related stigma and mental problem or illness
b) To explore the impacts of stigma
c) To assess an association between the contributing factors of stigma to help seeking
d) To assess the extent in which these factors of stigma contribute to help seeking.
e) To assess the risk factors influencing help seeking with regard to stigma
Research questions
a) What is the association between stigma towards mental health patients and help-seeking?
b) To what degree does stigma constitute a barrier to the search for help among mental health patients?
c) Are there populations that are more deterred from seeking help due to stigma?
Research Hypothesis
Ho: stigma towards mental health patients have a significant role in influencing help seeking
Ha: the extent to which stigma influences help seeking is not significant
Theoretical framework
Stigma has been described as a negative effect of a label and the product of disgrace that makes a person to be apart from others (Henderson et al., 2013). It is built upon distinct constructs prejudice, discrimination, and stereotypes (Henderson et al., 2013). For example, believing that those people diagnosed with mental illness is stereotype. Also, agreeing with the fact that those with mental problem are indeed dangerous with a resultant fear or anger is prejudice while discrimination is the total avoidance to those with mental conditi.
Running Head ADVANCE NURSING RESEARCH 1 .docxhealdkathaleen
Running Head: ADVANCE NURSING RESEARCH
1
ADVANCE NURSING RESEARCH 2
Week #6 Assignment 1: The Details of Your EBP Project.
EBP Project Proposal Draft
Research topic
To assess the role of stigma towards mental health patients in help seeking.
Research problem
Most studies have shown that stigmatization towards mental health patients have been present throughout history and even despite the evolution in modern medicine and advanced treatment. Stigmatization have resulted from the belief that those with mental problem are aggressive and dangerous creating a social distance (Szeto et al., 2017). Also, mental health-related stigma has become of major concern as it creates crucial barriers to access treatment and quality care since it not only influences the behaviour of the patients but also the attitude of the providers hence impacting help-seeking. Most studies have identified stigma as a barrier that is of significance to care or help seeking while the extent to which it still remains a barrier have not been reviewed deeply. Therefore, this study will assess the role contributed by stigma in help seeking in depth.
Research purpose
The intention of the research study is to review the association between stigma, mental illness and help seeking in order to assess in depth the role that mental-health stigma contribute in help seeking.
Research objectives
a) To review the background history of mental-health related stigma and mental problem or illness
b) To explore the impacts of stigma
c) To assess an association between the contributing factors of stigma to help seeking
d) To assess the extent in which these factors of stigma contribute to help seeking.
e) To assess the risk factors influencing help seeking with regard to stigma
Research questions
a) What is the association between stigma towards mental health patients and help-seeking?
b) To what degree does stigma constitute a barrier to the search for help among mental health patients?
c) Are there populations that are more deterred from seeking help due to stigma?
Research Hypothesis
Ho: stigma towards mental health patients have a significant role in influencing help seeking
Ha: the extent to which stigma influences help seeking is not significant
Theoretical framework
Stigma has been described as a negative effect of a label and the product of disgrace that makes a person to be apart from others (Henderson et al., 2013). It is built upon distinct constructs prejudice, discrimination, and stereotypes (Henderson et al., 2013). For example, believing that those people diagnosed with mental illness is stereotype. Also, agreeing with the fact that those with mental problem are indeed dangerous with a resultant fear or anger is prejudice while discrimination is the total avoidance to those with mental conditi ...
Running Head SOCIOLOGY IN NURSING 1 SOCIOLOGY IN NURSING .docxtodd521
Running Head: SOCIOLOGY IN NURSING
1
SOCIOLOGY IN NURSING
2
Sociology in nursing: A look from different perspectives
Name
Institution
Introduction
Health literacy is the acquisition and application of knowledge to daily practices for the improvement of the general health of an individual as well as the community. This influences the response to symptoms of illness, approach to treatment and preventive measures. While it may seem like common knowledge, the difference in the cultural and social background comes into play during the stated health literacy skills. Nurses are tasked with the provision of elementary care to culturally diverse communities and thus necessitating cultural competency.
Different concepts exist with regard to cultural composition and diversity in the community under evaluation. Singleton & Krause (2009) identify these to include: Magico-religious, biomedical and deterministic concepts. These concepts are always evolving with arising situations. Regular training on cultural competence is recommended as it is considered a threat to patients (Kaihlanen, Hietapakka & Heponiemi, 2019). This paper will look at nursing from different sociology perspectives to demonstrate the need for training.
Health literacy from sociological perspectives
Functionalist perspective
Health concepts are shared among a group of people sharing in other aspects of life as well. This is a source of continuity in identity recognized from doing things in a certain way. This is well demonstrated in Mayhew (2018), where an initial visit to a health facility, the nurse provides treatment options, which is met by indecisiveness, which turns around on the second visit following consultation with family members on the best course of action (Mayhew, 2018) for the ailing family member. The consultation gives the young mother confidence and a sense of unity in the family due to their collectivist approach. The institution of marriage is revered as well as nursing, as the mother takes time to understand all that pertains to the provided options.
Conflict perspective
Cultural diversity presents different approaches to decision making on health issues. Despite expert knowledge, a nurse must operate under ethical codes by respecting the patient's autonomy. This means that the decision reached, and failure thereof, must be upheld. For instance, a magico- religious culture may bar ailing members from procuring blood transfusions, even though their condition may only be helped by one. A nurse, while offering this option to them, can only do so much but respect this culture.
Conflict may also arise when actions taken in an emergency situation, maybe in opposition to patient beliefs, such as first aid to the opposite sex.
Symbolic interactionism perspective
This perspective demonstrates the difference in dialects and jargon used by different societies. Nursing uses professional language and jargon, which patients may not decipher. Equally, nurses are fac.
Running Head SOCIOLOGY IN NURSING 1 SOCIOLOGY IN NURSING .docxjeanettehully
Running Head: SOCIOLOGY IN NURSING
1
SOCIOLOGY IN NURSING
2
Sociology in nursing: A look from different perspectives
Name
Institution
Introduction
Health literacy is the acquisition and application of knowledge to daily practices for the improvement of the general health of an individual as well as the community. This influences the response to symptoms of illness, approach to treatment and preventive measures. While it may seem like common knowledge, the difference in the cultural and social background comes into play during the stated health literacy skills. Nurses are tasked with the provision of elementary care to culturally diverse communities and thus necessitating cultural competency.
Different concepts exist with regard to cultural composition and diversity in the community under evaluation. Singleton & Krause (2009) identify these to include: Magico-religious, biomedical and deterministic concepts. These concepts are always evolving with arising situations. Regular training on cultural competence is recommended as it is considered a threat to patients (Kaihlanen, Hietapakka & Heponiemi, 2019). This paper will look at nursing from different sociology perspectives to demonstrate the need for training.
Health literacy from sociological perspectives
Functionalist perspective
Health concepts are shared among a group of people sharing in other aspects of life as well. This is a source of continuity in identity recognized from doing things in a certain way. This is well demonstrated in Mayhew (2018), where an initial visit to a health facility, the nurse provides treatment options, which is met by indecisiveness, which turns around on the second visit following consultation with family members on the best course of action (Mayhew, 2018) for the ailing family member. The consultation gives the young mother confidence and a sense of unity in the family due to their collectivist approach. The institution of marriage is revered as well as nursing, as the mother takes time to understand all that pertains to the provided options.
Conflict perspective
Cultural diversity presents different approaches to decision making on health issues. Despite expert knowledge, a nurse must operate under ethical codes by respecting the patient's autonomy. This means that the decision reached, and failure thereof, must be upheld. For instance, a magico- religious culture may bar ailing members from procuring blood transfusions, even though their condition may only be helped by one. A nurse, while offering this option to them, can only do so much but respect this culture.
Conflict may also arise when actions taken in an emergency situation, maybe in opposition to patient beliefs, such as first aid to the opposite sex.
Symbolic interactionism perspective
This perspective demonstrates the difference in dialects and jargon used by different societies. Nursing uses professional language and jargon, which patients may not decipher. Equally, nurses are fac ...
Recovery from Addictions in Healthcare workers - by Ann Sparks (research synt...Ann Hinnen Sparks
Research Proposal of Experiential responses for various levels of health care workers who are in active recovery from addictions to mood altering substances.
Running Head ADVANCED NURSING RESEARCH1ADVANCED NURSING RES.docxtoddr4
Running Head: ADVANCED NURSING RESEARCH
1
ADVANCED NURSING RESEARCH
4
Advanced Nursing Research (Research Study)
Student Name
Institution-Affiliated
Different Parts of a Research Study
Research topic
A systematic review of the association between stigma and or on help-seeking among mental health patients.
Research Problem
Stigma or the process of labelling, discrimination and prejudice towards individuals suffering from mental health problems is considered to have numerous adverse consequences compared to the health conditions themselves according to Thornicroft, Mehta, Clement, Evans-Lacko, Doherty, Rose & Henderson, (2016). In addition, research has found stigma to be responsible for the failure of numerous individuals suffering from mental health to seek help from both their close relatives or trusted individuals and from healthcare providers (Clement, Schauman, Graham, Maggioni, Evans-Lacko, Bezborodovs, Thornicroft, 2015).
Given an increase in mental health disorders and the challenges that such disorders pose to both individuals and society, numerous studies have been conducted to examine the association between stigma and help-seeking among mental health patients. However, research has largely focused on the attitudes that constitute stigma towards mental health patients and little on the interventions required to reduce or eradicate stigma. Moreover, since the failure to reduce stigma prevents mental health patients from seeking help and hence worsening their conditions, there is need for further studies regarding the association between stigma and help-seeking and the need to reduce stigma making the study not only relevant but significant.
Research purpose
The purpose of this paper is to explore the association between stigma and help-seeking among mental health patients and to identify proven strategies or actionable recommendation for reducing stigma.
Research objectives
The objective of the study will be to (1) Explore the extent to which stigma posses a barrier to help-seeking among mental health patients, (2) Identify whether stigma affects certain populations more than others and (3) propose strategies that can help reduce stigma.
Research question
The study will aim to answer the following questions (1) What is the association between stigma towards mental health patients and help-seeking? (2) To what extent does stigma constitute a barrier to the search for help among mental health patients and (3) Are there populations that are more deterred from seeking help due to stigma?
Research hypothesis
Ho: Stigma towards mental health patients deters them from seeking help
Ha: There is no association between stigma and the search for help among mental health patients.
In addition, the study hypothesizes that a reduction in stigma would result in increased help-seeking among mental health patients.
References
Clement, S., Schauman, O., Graham, T., Maggioni, F., Evans-Lacko, S., Bezborodovs, N., ... & Thornicroft, G. (2.
Pharmacology and Diverse Populations Scoring GuideCRITERIA.docxmattjtoni51554
Pharmacology and Diverse Populations Scoring Guide
CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Describe the health
concerns and issues
for a population.
Does not describe
the health concerns
and issues for a
population.
Identifies the health
concerns and issues
for a population.
Describes the health
concerns and issues
for a population.
Describes the health
concerns and issues
for a population and
includes information on
rates of occurrence,
severity, and mortality.
Describe current
pharmacological
treatment regimens
for the health
concerns and issues
of a population.
Does not describe
current
pharmacological
treatment regimens
for the health
concerns and issues
of a population.
Lists current
pharmacological
treatment regimens for
the health concerns
and issues of a
population or describes
pharmacological
treatment regimens
that are not current.
Describes current
pharmacological
treatment regimens
for the health
concerns and issues
of a population.
Describes current
pharmacological and
non-pharmacological
treatment regimens for
the health concerns
and issues of a
population.
Explain traditional
beliefs and practices
of a population with
regard to health
concerns and
issues.
Does not explain
traditional beliefs and
practices of a
population with
regard to health
concerns and issues.
Identifies traditional
beliefs and practices of
a population with
regard to health
concerns and issues.
Explains traditional
beliefs and practices
of a population with
regard to health
concerns and
issues.
Explains traditional
beliefs and practices of
a population with
regard to health
concerns and issues
and includes how the
beliefs and practices
are carried out and
their effect on the
health concerns.
Explain how the
cultural values and
traditional practices
of a population
affect the
acceptance and use
of pharmacology.
Does not explain
how the cultural
values and traditional
practices of a
population affect the
acceptance and use
of pharmacology.
Explains how the
cultural values and
traditional practices of
a population affect the
acceptance and use of
pharmacology, but the
explanation is
incomplete or missing
supporting evidence.
Explains how the
cultural values and
traditional practices
of a population affect
the acceptance and
use of
pharmacology.
Explains how the
cultural values and
traditional practices of
a population affect the
acceptance and use of
pharmacology and
discusses how culture
and traditional
practices can impact
the efficacy of
prescribed
medications.
Identify evidence-
based, culturally
sensitive strategies
an organization can
use to educate a
population about the
appropriate use of
pharmacology.
Does not identify
evidence-based,
culturally sensitive
strategies an
organization can use
to educate a
population about the
appropriate use of
pharmacology.
Identifies cultura.
2. 2
INTRODUCTIONINTRODUCTIONINTRODUCTION
What is Polypharmacy?
It is the practice of administering or using multiple medications especially concurrently
(as in the treatment of a single disease or of several coexisting conditions)
(Polypharmacy, 2014)
Medications, when used correctly in older adults, can maintain or improve quality of life;
however it may lead to adverse drug reactions if used incorrectly (Hanlon, Schmader, & Sem-
la, 2013, p. 1365).
Many older adults struggled with substance abuse or dependence due to misdiagnosed or
overlooked (Briggs, et al., 2011).
Substance abuse affects millions of adults each year, of whom one in five are older adults
(Morgan, Brosi, & Brosi, 2011, P. 444).
The Wear and Tear Theory focuses on the idea that practicing harmful habits and behaviors
will disrupt our biological well-being, which can alter our body’s cells and tissues (Saxon, Et-
ten, & Elizabeth, 2010, P. 10)
Wear and Tear Theory is directly related to substance abuse/misuse and polypharmacy be-
cause some people who abuse their medications, tends to believe that through eating numer-
ous prescribed or over the counter medication, their chances of living a longer life would be
extended (Sergi, De Rui, Sarti, & Manzato, 2011, P. 509)
3. 3
FACTSFACTSFACTS
RISKS FACTORSRISKS FACTORSRISKS FACTORS
More than 19 million Americans experience substance
abuse and it is estimated that 20 percent of those affected
are older adults (as cited in Morgan, Brosi, & Brosi, 2011,
p. 445)
Drug side effects are responsible for at least 30,000 deaths
and 1.5 million admissions to hospitals each year, and elders are much more likely to
experience toxic effect from drugs than are younger people (Saxon, Etten, & Perkins., 2010,
p. 365)
Polypharmacy contributes to falls and hip fractures, which are associated with high morbidity and
mortality rates in the elderly (Sergi, De Rui, Sarti, & Manzato, 2011, p. 511)
Among older adults, 40% are unable to read prescription labels and 67% are unable to understand the
information given to them about their prescriptions (Benza, Calvert, & McQuown, 2010, p. 1009).
DRINK AND drug misuse among people with serious mental illness is an increasing challenge, af-
fecting up to one third of mental health service users (as cited in Sheret, Lewis, & Warr, 2013, p. 28).
Taking five or more drugs, which may result in increased risk for inappropriate drug
use and adverse drug reactions (Olsson, Runnamo, & Engfeldt, 2011, p. 6)
Stressors in late life, including loss and grief, decreased social support, social isolation,
and financial hardship (Namkee, & DiNitto, 2013, p. 439)
Older adults living alone and experiencing isolation, feeling of loneliness, and depression may be
more at risk for excessive substance use as a way to manage life stressors (Briggs, et al., 2011, p. 112)
Older adults who aren’t compliant with medication may be influenced by a variety of factors such as:
medication schedules, lack of doctor-patient discussion, memory impartment, inability to hear or see
well, loss of hand and finger dexterity, and not being given adequate information about drugs ( Saxon,
Etten, & Perkins, 2010, p. 366)
PRIMARY HOLISTIC NEEDS & INTERVENTIONSPRIMARY HOLISTIC NEEDS & INTERVENTIONSPRIMARY HOLISTIC NEEDS & INTERVENTIONS
Rationale: As people age, their body goes through changes such as skin wrinkle, loss of hair, slower heart
rate, decreased lung capacity, weaker gastrointestinal system, weaker endocrine system, and slower nervous system
(Saxon, Etten, & Perkin, 2010). According to the Wear and Tear Theory by Dr. August Weismann, our body will
eventually deteriorate due to being overworked or used (Saxon, Etten, & Perkins, 2010, P.10). To assist with cer-
tain chronic disease or diagnoses people sometimes take a variety of medication to assist with their health condition.
Older adults are at high risk of adverse reactions or substance abuse due to the amount of medications they intake.
The interventions we have seen to be most useful in regards to polypharmacy and substance abuse/misuse among
the eight Holistic Parameters are Physical, Psychological Well-being, Social Support, and Cultural Practices.
4. Client/Family Needs/Concerns
&Holistic Parameter
Interventions
Performance of Activities of Daily Living
(Physical)
Fall Risk Assessment
(http://consultgerirn.org/uploads/File/trythis/
try_this_8.pdf, 2013)
1) Physical activities also helps prepare the body to fight certain acute
and chronic diseases along the way. Some other benefits that aging
people may not realize are: being physically active will slightly im-
prove some cognitive functions and may prevent falls (Hutzler, 2011).
(Client)
2) The Physical Therapist or family will be able to understand if they
need to purchase certain walking aids for their loved one’s safety
(Quadagno, 2011). (Physical Therapist, Family)
3) A physical therapist will perform the test to evaluate the patients
walking ability and balance (Lee, Yoon, Lee, Yoon, & Chang, 2012).
(Physical Therapist)
Cognitive Impairment & Sleep Disturbance
(Psychological)
Mini Cognitive Assessment (http://
consultgerirn.org/uploads/File/trythis/
try_this_3_2.pdf, 2012)
Sleep Disorder Screening Questionnaire
(http://www.emoryhealthcare.org/saint-josephs
-hospital-atlanta/downloads/Sleep%
20Disorder%20Screening%20Questionnaire.pdf,
2014)
1) A nurse will assess if the patient has the ability to take their own
medications the correct time, route, and dosage (Sheret, Lewis, &
Warr, 2013). (Psychiatric Nurse)
2) The mini cognitive assessment should be performed to evaluate
how cognitive the older adult is (Namkee & DiNitto, 2013).
(Psychiatric Nurse)
3) A specialist will assess the older adult’s sleep disorder and find out
what’s causing the sleep disturbance (Sheret, Lewis, & Warr, 2013).
Patient will be able to rule out any possible outcome of a certain sleep
disorder: Sleep Apnea, Insomnia, Narcolepsy, Periodic Limb Move-
ment or Misuse of Drugs. (Stress Management, Family)
Lack of social network supports and miscommu-
nication between providers and patients can lead
to substance abuse of drugs, polypharmacy, and
misuse of medication causing the body to deteri-
orate (Carlson, 1994, p. 8).
(Social & Psychological)
1) Evaluate the patient’s social behavior and use instrumental screen-
ings to determine whether the patient is suffering from a substance
abuse disorder (Benshoff et al., 2003, p. 46). (gerontologist, nurse,
caregiver, social worker)
2) Monitor the individual when using medications, examine the medi-
cations use, and impose medication management for the older adult to
diminish harms to the body (Carlson, 1994, p. 28). (nurse, gerontolo-
gist, caregiver)
3) Refer patient to behavioral therapy, self-report, and urine drug
screens to meet treatment needs of the patient (McHugh et al., 2014).
(nurse, physical therapist, social worker, gerontologist, counselor)
Sociocultural beliefs, values, and languages often
shape the approach and behaviors of substance
abuse of drugs, medication misuse, and
polypharmacy amongst older adults of different
cultural backgrounds. Excessive use of drugs
and substances intake may be a cultural norm in
treating chronic illnesses or in relation to tradi-
tional culture (Abbott & Chase, 2008).
(Culture)
1) Provide cultural assessments and screening for effective diagnosis
and care of older adults with a different cultural background (Abbott
& Chase, 2008). (gerontologist, nurse, care Manager, social worker)
2) Offer cultural competent in providing substance abuse treatment
services to patients with a different cultural background or bilingual
older adults (Steinhagen & Friedman, 2008). (gerontologist, social
worker, nurse)
3) Refer patient to drug counseling and collaborate with similar cultural
groups in the recovery process of substance abuse and inform the risk
factors of harmful substances that can affect the body (McHugh et al.,
2014). (counselors, gerontologist, case manager, social worker)
5. FIND LOCAL HELP AND SUPPORTFIND LOCAL HELP AND SUPPORTFIND LOCAL HELP AND SUPPORT
Outpatient Treatment
Treatment Associates Inc.
Sacramento Treatment Clinic
Address: 7225 East Southgate Drive
Telephone: (916)-394-1000
www.crchealth.com
Provides community outpatient treatment clinics for people in need of recovery
Operates several programs in behavioral health to assist individual in attaining quality of
life.
Provides resources to help individual in the achievement of a lasting recovery.
Offers a contact number at 1-877-637-6237 to speak with a specialist in finding a facility
for individual in need of substance abuse treatment services and other behavioral health care
services (CRC Health, 2011).
Substance Abuse Treatment Options
National Council on Alcohol and Drug Dependence
1446 Ethan Way
Sacramento, CA 95825
Telephone: (916) 924-4818
http://ncaddsac.org/
Provide services to families, friends and individual seeking
for help in substance abuse of residential treatment, intensive outpatient treatments, transi-
tional living, and case management services.
Organization also operates several services to individual in the early stage of substance
abuse and treatment options for recovery.
Provides information on substance abuse and description of programs services within the
organization.
Offers a 24/7 hope line at (916) 922-5122 for individual in need of help in substance abuse
and for families seeking help for someone whom they are concern about (NCADD Sacra-
mento, 2014).
Counseling
Effort Counseling Center
1820 J Street
Sacramento, CA 95811
Telephone: (916) 313-8400
www.theeffort.org
Effort Counseling Center is a non-profit agency that strives to help patient with Medi-Cal
and Medicare to received access to health services.
Offers inpatient and outpatient, addiction treatment, and mental health counseling for
person in need of help.
Appointments can be arrange at 916-737-5555 for health care services
Operates a 24 hour suicide crisis line at 916-368-3111 and 1-800-273-8255 (WellSpace
Health, 2014)
6. 6
WEBSITES:WEBSITES:WEBSITES:
SUBSTANCE ABUSE SERVICES AND TREATMENT OPTIONSSUBSTANCE ABUSE SERVICES AND TREATMENT OPTIONSSUBSTANCE ABUSE SERVICES AND TREATMENT OPTIONS
Substance Abuse Treatment Services Locator
Substance Abuse and Mental Health Services Administration (SAMHSA) provides a
treatment services locator to individuals seeking out for services within the community
of one’s choice. https://findtreatment.samhsa.gov/
Provides a 24/7 Treatment Referral Line
to individuals in need of help and services
at 1-800-662-HELP (4357)
Includes several information regarding
self-care group programs, treatment ser-
vices, agencies, and other informational
websites on substance abuse of drugs, misuse of medications, and polypharmacy
(SAMHSA, 2014).
Non-Profit Referral and Placement Services
Drug-rehab.org provides assistance to individuals affected
by drug addiction to seek out for help.
http://www.drug-rehab.org/
Provides services and assessments to individuals in need of
help.
Refers individuals to rehab facilities and programs within the
community that meet the needs of the person.
Offers a contact number to individuals seeking for help and services at 1-888-233-9731
(Drug-Rehab, 2014).
Information and Services
Recovery Connection provides treatment services and materials on Substance Abuse
and Addiction of drugs to help individuals in need of assistance.
http://www.recoveryconnection.org/substance-abuse/
Recovery Connection includes interventions, information, treatment programs, links to
other sources, and a 24/7 contact number for individuals seeking out for treat services at
1-800-993-3869.
Offers a live chat line 24/7 to answer any questions or concerns regarding treatments,
addiction, or problems of substance abuse (Recovery Connection, 2014).
7. 7
COSTSCOSTSCOSTS
Approximate Cost of Substance Treatment Services
Treatment services in smaller programs are more expensive and hold a longer stay.
The average cost of substance abuse treatments services is between $3,754 and is 75%
effective in the treatment provided.
A 28-day treatment is range between $860 (Barnett, 1997, p 615).
Average cost of treatment for outpatient facilities is estimate between $1, 433.
Cost for residential treatment of alcohol or substance abuse is $3,840 per admission
Non-hospital residential treatment is range between $76.13 per day (SAMHSA, 2007)
Payment/Insurance Accepted for Substance Abuse Services
Private health Insurance
Medicaid/Medicare
Self-payment /Cash
Sliding fee scale (payment is determined based on income for certain clinics)
Military Insurance (SAMHSA, 2014)
CONCLUSIONCONCLUSIONCONCLUSION
Polypharmacy, or multiple drug use, is a major quality of-care concern for older adults,
as a recent issue of clinics of geriatric medicine devoted to the topic evidences (Hanlon,
Schmader, & Semla, 2013, p. 1367).
The Wear and Tear Theory is based on the assumption that continued use of the body
leads to worn out or defective parts of the body (Saxon, Etten, & Perkins, 2010, p.10).
Many factors associated with substance abuse and misuse of drugs or medications can
lead to health factors of polypharmacy, effects of drugs, adverse reactions, and further
health complications (Hanlon, Schmader, & Semla, 2013,
p. 1365).
Early interventions such as counseling will allow individuals
to adapt to a safer and healthier life by avoiding health prob-
lems from misusing drugs or abusing medications (Carlson,
1994).
8. 8
References
Abbott, P., & Chase, D. M. (2008, Jan 1) Culture and substance abuse: Impact of culture affects approach to treat-
ment . Psychiatric Times. Retrieved fromhttp://www.psychiatrictimes.com/articles/culture-and-substance-
abuse-impact-culture-affects-approach-treatment
Barnett, P. G. & Swindle, R. W. (1997, December). Cost-Effectiveness of inpatient substance abuse treatment. NCBI
32(5), 615-629 . Retrieved fromhttp://www.ncbi.nlm.nih.gov/pmc/articles/PMC1070218/pdf/
hsresearch00037-0078.pdf
Benza, A., Calvert, S., & McQuown, C. (2010). Prevention BINGO: Reducing medication and alcohol use risks for
older adults. Aging & Mental Health, 14(8), 1008-1014. doi:10.1080/13607863.2010.501067
Beshoff, John J. & Harrawood, Laura K. (2003). Substance abuse and the elderly: UniqueIssues and Concerns. Jour-
nal of Rehabilitation, 69(2), 43-48. Retrieved fromhttp://www.kvccdocs.com/KVCC/2013-Fall/MHT216-
OLA/content/L-19/SubstanceElderly.pdf
Briggs, Wanda P., Magnus, Virginia A., Lassiter, Pam., Patterson, Amanda., & Smith, Lydia. (2011, April 1). Sub-
stance use, misuse, and abuse among older adults: implications for clinical mental health counselors. Jour-
nal of Mental Health Counseling, 1-16. Retrieved from https://www.ceunits. com/trainings/
pdf_download/183/
Carlson, K. A. (1994, September). The prevention of substance abuse and misuse among the elderly. Department of
Social and Health Services. Retrieved from http://www.adai.washington.edu/pubs/reports/elderly.pdf
CRC Health. (2014).CRC Health: Specializing in behavioral health care for 30+ years. CRC Health Group, Inc. Re-
trieved from www.crchealth.com
Drug-Rehab. (2014). Drug Rehabilitation Program Referrals. Drug-Rehab.Org.Retrieved from http://www.drug-
rehab.org/
Hanlon, J. T., Schmader, K. E., & Semla, T. P. (2013). Update of studies on drug-related Problems in Older
Adults. Journal Of The American Geriatrics Society, 61(8), 1365-1368. doi:10.1111/jgs.12354
Hutzler, Y. S. (2011). Evidence-based practice and research: A challenge to the development of adapted physical
activity. Adapted Physical Activity Quarterly, 28(3), 189-209.
Lee, E., Yoon, H., Lee, J., Yoon, J., & Chang, E. (2012). Body-Mind-Spirit practice for healthy aging. Educational
Gerontology, 38(7), 473-485. doi:10.1080/03601277.2011.567182
McHugh, R. K., Niesen, S., & Weiss, R. D. (2014). Prescription drug abuse: from epidemiologyto public poli-
cy. Elsevier, 48(1). doi:10.1016/j.jsat.2014.08.004
Morgan, M. L., Brosi, W. A., & Brosi, M. W. (2011). Restoring older adults' narratives about self and substance
abuse. American Journal Of Family Therapy,39(5), 444-455. doi:10.1080/01926187.2011.560784
Namkee G., C., & DiNitto, D. M. (2013, October). Mental health & substance use: Challenges for serving older
adults. Indian Journal of Medical Research. pp. 439-442.
NCADD Sacramento. (2014). National council on alcoholism and drug dependence. NCADD Sacramento Region
Affiliate. Retrieved from http://ncaddsac.org/
Olsson, I. N., Runnamo, R., & Engfeldt, P. (2011). Medication quality and quality of life in the elderly, a cohort
study. Health & Quality of Life Outcomes, 9(1), 95-103. doi:10.1186/1477-7525-9-95
Polypharmacy. (n.d.). Retrieved December 1, 2014, from http://www.merriam-webster.com/dictionary/
polypharmacy
Quadagno, J. S. (2011). Caring for the frail elderly. Aging and the life course: an introduction to social gerontology (5th
ed., ). New York, NY: McGraw-Hill.
Recovery Connection. (2014). Substance abuse and addiction. LakeView Health. Retrieved from http://
www.recoveryconnection.org/substance-abuse/
SAMHSA. (2007, December 31).The costs of alcohol and drug treatment. About Health. Retrieved from http://
alcoholism.about.com/od/pro/a/blsam040527.htm
SAMHSA. (2014). Behavioral health treatment services locator. SAMHSA. Retrieved from https://
findtreatment.samhsa.gov/
Saxon, Sue V., Etten, Mary Jean.Perkins, Elizabeth A. (2010) Physical change & aging: A guide for the helping profes-
sions, New York : Springer Pub. Co.
Sergi, G., De Rui, M., Sarti, S., & Manzato, E. (2011). Polypharmacy in the elderly can comprehensive geriatric as-
sessment reduce inappropriate medication use?. Drugs & Aging, 28(7), 509-518.
Sheret, C., Lewis, M., & Warr, J. (2013). A substance use monitoring tool for people with serious mental health
problems. Mental Health Practice, 17(3), 28-31.
Steinhagen, K. A., & Friedman, M. B. (2008). Substance abuse and misuse in older adults. AgingWell, 3, 20. Re-
trieved from http://todaysgeriatricmedicine.com/archive/071708p20.shtml
WellSpace Health. (2014). The effort is now wellspace health. WellSpace Health, Inc. Retrieved from
www.theeffort.org