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There are several vulnerable populations that have a chronic illness (older; homeless; and lesbian, gay, bisexual, and transgender populations) that face challenges when it comes to care. Choose one vulnerable population and discuss what can be done to help alleviate these challenges

“More than 80% of homeless people have at least one chronic health condition & more than 50% have a mental health disease” (Chronic Disease Management in the Homeless, 2014). Of the populations there are about 40-60% that suffer from substance abuse.

Some of the risk factors of those that are homeless are tobacco abuse, alcohol abuse, malnutrition, exposure to the environment, IV drug use, trauma, stress and suppressed immunity.

Some of the barriers to treatment are no access to medications, medication storage, no transportation, no financial resources, no housing, and poor nutritional access.

Treatment approaches for the homeless that have chronic disease are to discuss in detail the patient’s limitations to follow the treatment plan. You should also try to empower the patient by helping them set goals and set priorities that they will be able to obtain. There are also homeless assistance programs that would benefit those that were willing to receive it like HUD and the National Coalition for the Homeless.

The American Cancer Society (ACS) is a nationwide, community-based, voluntary health organization dedicated to eliminating cancer as a major health problem. Together with its supporters, ACS is committed to helping people stay well and get well by finding cures and by fighting back.Critical Thinking Questions:

1. Imagine that a family friend or colleague has just been diagnosed with cancer. Explain how the American Cancer Society might provide education and support. What ACS services would you recommend and why?
2. According to statistics published by the American Cancer Society, there will be an estimated 1.5 million new cancer cases diagnosed each year over the next decade. What factors contribute to the yearly incidence and mortality rates of various cancers in Americans? What changes in policy and practice are most likely to affect these figures over time
3. Select a research program from among those funded by the American Cancer Society. Describe the program and discuss what impact the research will have on the prevention or treatment of cancer.

Module 2 DQ 1 and DQ 2

Tutor MUST have a good command of the English language

These are two discussion questions

Your DQ1 and DQ2 posts must be at least 150 words and have at least one reference cited for each question. In-text citation, please

Tutor MUST have a good command of the English language

Sources need to be less than five years old and journal/Scholarly articles. 

No textbook or direct quotes 

Topic 1 DQ 1

Which research methodology would be the most appropriate for your project and how does it align with your clinical question, data collection, and data analysis? Demonstrate an example of when you might use the opposite methodology in your EBP projects and why.

Topic 2 DQ 2

Within nursing, the patient’s perception is recognized as the patient’s reality. How does this way of knowing in nursing fit within an objective or subjective paradigm of the world? Explain your reasoning.

APA format 1 and half pages long MSN degree 3 peer review references

Week 2-Main Post-Jamie Michalski

Diversity and Health Assessments

            Caring for patients in healthcare today, providers will encounter many different patient populations that come from a diverse set of cultures, lifestyles, and backgrounds that have beliefs and practices regarding health and illness which may be different from the provider. Providers must first examine their own beliefs, values, and culture for self-awareness and to examine for potential bias. Approaching individuals from a variety of cultures and backgrounds also requires flexibility and the ability to adapt the health history and physical exam to the patients’ needs or culture. Having an understanding of the patient’s beliefs, lifestyle, culture, and background and how they impact the patient is necessary for providers to provide culturally competent care.

 The patient selected for this discussion is MR, a 23-year-old male patient, complaining of anxiety.  

Identifying Information: MR is a 23-year-old Native American male seen in the office on September 5, 2018. The history is obtained from both a written questionnaire filled out before the visit and from the patient, and he is considered a reliable historian.

Chief Complaint–“I’ve been anxious lately and used both pot and alcohol to help me feel better” and is concerned about “not getting into heaven.”

History of Present Illness: a 23-year-old male patient that uses both marijuana and alcohol for anxiety symptoms. MR describes the anxiety as starting when he lost his job one month ago. MR describes the anxiety occurring on 4-5 days during the week, and MR describes it as a “feeling of fear about providing for my family,” and on 4-6 days/per week he uses alcohol and smoking “pot” to “feel better.”

Current Medications-None

Family History- Diabetes-Father, Hypertension-Mother, and Alcoholism-Father.

Social History-smokes marijuana –per patient written questionnaire: typical amount described as 1 “joint”; with use of 6-7 times per month. Drinks alcohol, described as beer; amount varies from 36-64 ounces 3-6 times per week. Occasional use of liquor; the typical amount is 3-8 ounces per week usually with beer. Smokes cigarettes with a six pack year history.

Questions to ask MR:

1. Do you use any herbs for spiritual practices?
2. What is your spiritual or religious heritage?
3. Do your beliefs help you handle stress?
4. What do you consider drugs?
5. What practices prevent admission to heaven?
6. How long have you been drinking alcohol? Smoking marijuana?
7. When did you begin feeling this way?
8. How have you been sleeping?
9. Do you have thoughts to harm yourself?
10. What worries you?
11. How are things at home? Work?
12. How would you like me to help you with your anxiety?

Native American patients may have a lower socioeconomic status with the median annual household income is $ 37,353 for Native American households compared to $ 56,565 for non-Hispanic whites (US Department of Health and Human Services [HHS], Office of Minority Health [OMH], 2018).  Patients with lower socioeconomic status may not seek medical care due to lack of insurance, ability to pay insurance premiums, have transportation issues, not fill prescription medications, or take prescribed medications sparingly with the belief to “make the medication last longer.”

Native American patients’ spirituality is also a cultural factor that requires cultural competence for the practitioner to understand how the patients’ spiritual practices influence his care and how the provider can assist the patient. The practitioner must have an understanding of the relationship between spiritual beliefs and health practices and how beliefs relate to illness, health, family, symbols, and taboos (Sullivan, 2012). The patient’s spiritual belief may include that mental health issues are viewed as spiritual punishment that is unable to be healed.

Native American patients have twice the rate of diabetes than non-Hispanic white patients (HHS, OMH, 2018). The influence of both smoking cigarettes, marijuana and a family history of diabetes and hypertension concerns for the development of diabetes and hypertension in the future.

The Native American culture has undergone a significant shift in the past 30 years. Nearly 60% of Native Americans now live in major metropolitan areas, and 22% still live on reservations (HHS, OMH, 2018). This shift from reservations to metropolitan areas has changed the Native American lifestyle and culture which strives to find harmony and live with nature (Ball, Dains, Flynn, Solomon & Stewart, 2015). Native Americans have higher rates of alcoholism, and chronic liver disease either from alcoholism, obesity, and exposure to hepatitis B and C virus is the leading cause of death (HHS, OMH, 2018).

References

Ball, J. W., Dains, J. E., Flynn, J. A., Solomon, B. S., & Stewart, R. W. (2015). Seidel’s guide to physical examination (8th ed.) St. Louis, MO: Elsevier Mosby

Sullivan, D. D. (2012). Guide to clinical documentation (2nd ed.). Philadelphia, PA: F. A. Davis.

US Department of Health and Human Services, Offices of Minority Health. (2018). Profile: American Indian/Alaskan Native Profile. Retrieved from https://minorityhealth.hhs.gov/omh/browse.aspx?lvl=3&lvlid=62