Analyze and apply critical thinking skills in the psychopathology of mental health patients and provide treatment and health promotion while applying evidence-based research

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Analyze and apply critical thinking skills in the psychopathology of mental health patients and provide treatment and health promotion while applying evidence-based research.Scenario:

Jax is a 66-year-old Caucasian female whose wife has encouraged her to seek treatment. She has never been in therapy before, and has no history of depression or anxiety. However, her alcohol use has recently been getting in the way of her marriage, and interfering with her newly-retired life. She describes drinking increasing amounts over the last year, currently consuming approximately a six-pack of beer per day. She notes that this amount “doesn’t give me the same buzz as it used to.” She denies ever experiencing “the shakes” or any other withdrawal symptoms if she skips a day of drinking.

Jax comments that her wife is her biggest motivation to decrease her alcohol use. She tells Jax that she gets argumentative and irritable when she drinks, though she does not always remember these incidents. She has also fallen while intoxicated twice, causing bruises both times and hitting her head on one of the occasions.

Questions:

Remember to answer these questions from your textbooks and NP guidelines. At all times, explain your answers.

  1. Describe the presenting problems/issues. Is there any information that was not provided that you would need to formulate a diagnosis?
  2. Generate a primary and differential diagnosis using the DSM5 and ICD 10 codes.
  3. What physiological and psychological processes lead to substance dependence?

Submission Instructions:

  • Your initial post should be at least 500 words, formatted and cited in current APA style with support from at least 2 academic sources.  Your initial post is worth 8 points.
  • You should respond to at least two of your peers by extending, refuting/correcting, or adding additional nuance to their posts. Your reply posts are worth 2 points (1 point per response.)
  • All replies must be constructive and use literature where possible.
  • Please post your initial response by 11:59 PM ET Thursday, and comment on the posts of two classmates by 11:59 PM ET Sunday.
  • Late work policies, expectations regarding proper citations, acceptable means of responding to peer feedback, and other expectations are at the discretion of the instructor.
  • You can expect feedback from the instructor within 48 to 72 hours from the Sunday due date.

 

Presenting Problems/Issues:
Jax, a 66-year-old Caucasian female, has sought treatment due to her escalating alcohol use, which is negatively impacting her marriage and her retired life. The key presenting problems and issues in this scenario include:

1. Alcohol Use Disorder (AUD): Jax has been consuming approximately a six-pack of beer per day, indicating a significant and problematic level of alcohol consumption. This has been ongoing for the past year, and she reports a diminished effect, suggesting tolerance.

2. Interference with Daily Life: Her alcohol use is interfering with her marriage and her newly-retired life. Her wife has observed that she becomes argumentative and irritable when drinking, which is affecting their relationship.

3. Physical Consequences: Jax has experienced two falls while intoxicated, resulting in bruises and a head injury on one occasion. These incidents demonstrate the potential physical harm associated with her alcohol consumption.

4. Motivation to Change: Jax identifies her wife as her primary motivation to reduce her alcohol use. This suggests an awareness of the negative consequences of her drinking and a willingness to seek help.

Additional Information Needed:
To formulate a diagnosis and treatment plan, it would be helpful to gather more information, including:

1. Detailed history of alcohol use: A more comprehensive history of her alcohol use, including when it started, any prior attempts to cut down or quit, and whether she experiences cravings, is essential for a diagnosis.

2. Assessment of withdrawal symptoms: Although Jax denies experiencing withdrawal symptoms, a thorough assessment of her physical and psychological symptoms during periods of abstinence is important.

3. Co-occurring mental health issues: It is necessary to explore whether there are underlying mood or anxiety disorders contributing to her alcohol use, as well as any family history of mental health issues.

Primary Diagnosis (DSM-5 and ICD-10 Codes):
Based on the information provided, the primary diagnosis for Jax can be Alcohol Use Disorder (AUD).

DSM-5 Criteria for AUD:
A diagnosis of AUD is made when an individual meets at least two of the following criteria within a 12-month period:

1. Taking the substance in larger amounts or over a longer period than intended.
2. Persistent desire or unsuccessful efforts to cut down or control substance use.
3. A great deal of time spent obtaining, using, or recovering from the effects of the substance.
4. Craving or a strong desire or urge to use the substance.
5. Recurrent alcohol use resulting in a failure to fulfill major role obligations at work, school, or home.
6. Continued alcohol use despite having persistent or recurrent social or interpersonal problems caused or exacerbated by the effects of the substance.
7. Important social, occupational, or recreational activities are given up or reduced because of substance use.
8. Recurrent alcohol use in situations in which it is physically hazardous.
9. Continued alcohol use despite knowledge of having a persistent or recurrent physical or psychological problem that is likely to have been caused or exacerbated by the substance.
10. Tolerance, as defined by either a need for markedly increased amounts of the substance to achieve intoxication or desired effect or markedly diminished effect with continued use of the same amount of the substance.
11. Withdrawal, as manifested by the characteristic withdrawal syndrome for the substance.

ICD-10 Code: F10.2 – Alcohol Dependence Syndrome

Differential Diagnosis:
It is important to consider other potential diagnoses or contributing factors:

1. Major Depressive Disorder: Although Jax has no history of depression, her increased alcohol use and irritability could be indicative of an underlying mood disorder. Further assessment is needed to rule this out.

2. Adjustment Disorder: Given her recent retirement and the impact on her marriage, an adjustment disorder could be contributing to her symptoms. It is crucial to assess her emotional response to these life changes.

3. Medical Conditions: Some medical conditions can mimic symptoms of alcohol use disorder. Comprehensive medical evaluation is necessary to rule out any underlying medical issues.

Physiological and Psychological Processes Leading to Substance Dependence:
Substance dependence, including alcohol use disorder, is influenced by a complex interplay of physiological and psychological processes. These include:

1. Neurochemical Changes: Repeated substance use leads to alterations in brain chemistry, particularly in the reward pathway. The brain becomes accustomed to the presence of the substance and may require increasing amounts to achieve the desired effect.

2. Tolerance: Tolerance develops as the body adapts to the substance, requiring higher doses to achieve the same effect. This can lead to escalated substance use over time.

3. Withdrawal: Physiological and psychological withdrawal symptoms can be distressing, reinforcing continued substance use to avoid or alleviate these symptoms.

4. Cravings: Psychological cravings are intense desires or urges to use the substance, often triggered by environmental cues or emotional states.

5. Coping Mechanism: Substance use may serve as a coping mechanism to deal with stress, negative emotions, or life changes, as seen in Jax’s case with retirement-related stress.

6. Social and Environmental Factors: Social and environmental factors, such as peer influence, family dynamics, and availability of the substance, play a significant role in the development and maintenance of substance dependence.

In conclusion, Jax’s presentation is indicative of Alcohol Use Disorder, and further assessment is needed to determine the severity and formulate an appropriate treatment plan. Understanding the physiological and psychological processes underlying substance dependence is essential for providing evidence-based treatment and health promotion interventions.

      The flexibility of the SEM is helpful in the context of investigating healthcare disparities.

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Please Reply to the following 2 Discussion posts:

 

Requirement

 

APA format with intext citation

Word count minimum of 160 words per post, not including references

References at least one high-level scholarly reference per post within the last 5 years in APA format.

Plagiarism free.

Turnitin receipt.

 

DISCUSSION POST # 1. Reply to Jinkee

The Social Ecological Model (SEM) has been selected as my theoretical framework for the Family Nurse Practitioner (FNP) capstone project.

Relevance of the SEM to the Phenomenon of Interest

The SEM is relevant to the focal subject of inquiry in the FNP capstone project, which centers on mitigating healthcare inequities within marginalized populations (Mahmudiono et al., 2019). The selected framework exhibits a direct correlation with the phenomenon at hand:

Holistic Perspective

The SEM is characterized by its notable attribute of including various levels of influence, which is highly congruent with the intricate nature of healthcare access challenges encountered in marginalized areas. This is consistent with the program’s objective to tackle healthcare inequalities, as it acknowledges that various contextual circumstances influence individual behaviors. These groups’ healthcare access and utilization can be considerably affected by factors such as limited health literacy, cultural barriers, and socioeconomic position (Nonyel et al., 2021). The SEM approach offers a comprehensive viewpoint by recognizing and tackling these variables at multiple levels.

Flexibility in Research Approaches

The flexibility of the SEM is helpful in the context of investigating healthcare disparities. The study framework provides flexibility for employing both quantitative and qualitative research methodologies, enabling the research team to customize their approach based on the specific aims and challenges of the investigation (Mahmudiono et al., 2019). For example, using quantitative research methodologies, such as questionnaires and record reviews, enables data collection pertaining to healthcare accessibility and health outcomes. Simultaneously, qualitative methodologies such as focus groups and interviews can effectively explore the social and cultural factors that impact the accessibility of healthcare. The inherent versatility of this characteristic facilitates a thorough investigation of the phenomenon.

Contextual Relevance

The SEM strongly advocates the examination of contextual factors, as it plays a critical role in effectively addressing healthcare inequities. Underserved communities exhibit distinct social, economic, and cultural circumstances that influence their ability to obtain healthcare services. The SEM framework comprehensively examines the distinct requirements and obstacles encountered within a community by considering the individual, interpersonal, organizational, community, and policy dimensions (Mahmudiono et al., 2019). The presence of contextual relevance in interventions guarantees that they are customized to address the inequities experienced by these populations effectively.

In conclusion, the SEM provides a thorough and appropriate theoretical framework for the FNP capstone project, enabling a comprehensive comprehension of healthcare disparities in marginalized areas. Careful planning and resource allocation are necessary to fully utilize the SEM’s potential in solving these communities’ complicated healthcare access concerns despite the model’s complexity and resource requirements posing hurdles.

 

DISCUSSION POST # 2 Reply to Moruph

 

For my capstone project, I am going to be writing about the Diabetes Mellitus treatment’s non-adherence, its implications, and resolutions. A theoretical framework I am going to use for this project is the Orem-Self-Care deficit theory. According to Utley et al., (2018), Dorothy Orem’s Nursing System theory, Self-Care, and Self-Care Deficit theory are interrelated and like vast networks with connected parts (Utley et al., 2018). Dorothy Orem’s Self-Care Deficit Theory states that an individual’s inability to care for oneself is the reason why they would need help from others (Yip & Yuk 2021).  For example, in its application to practice- if a diabetic patient is unable to check his blood sugar level and administer his metformin or insulin without needing the assistance of others. Then we say that this individual has a self-care deficit then he may have medical diabetic complications related to self-care deficit.   This framework is related to my research topic because, applying Orem’s self-care deficit approach, the APN will be able to assess this self-care deficit in this patient and prescribe actions and behaviors to prevent diabetic complications in this patient. The APN prescribes that the patient will need assistance such as home health services to help the patient comply with his diabetic management (Yip & Yuk, 2021). All these self-care behaviors are essential to improving the health outcomes of the diabetic patient. By this, we can say that the Orem-Self Care deficit has been effectively applied to practice because the APN was able to identify the cause of the problem and prescribe interventions to maintain safety and improve the patient’s health outcomes.

Impact On World Health Due To Disappearing Borders

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Give 2 examples (1 negative, 1 positive) of how you feel the impact the disappearing borders is impacting world health.

(1 paragraph for each)

Negative Impact: The disappearance of borders has had a negative impact on world health by exacerbating the spread of infectious diseases. With increased global travel and trade, pathogens can quickly cross borders, making it more challenging to contain outbreaks. For instance, the rapid transmission of diseases like COVID-19 showcased how interconnected our world has become, as the virus spread from one country to another with alarming speed. The lack of coordinated international response and inconsistent border controls have hampered efforts to contain and manage such health crises, leading to prolonged and more severe global health impacts.

Positive Impact: On a positive note, the disappearance of borders has facilitated greater international collaboration in the field of healthcare and medical research. Scientists and healthcare professionals from different countries can more easily share information, research findings, and best practices, leading to advancements in the treatment and prevention of diseases. This collaboration has accelerated the development and distribution of vaccines, diagnostic tools, and medical treatments, as seen in the swift global response to COVID-19, where researchers worldwide collaborated to develop and distribute vaccines in record time. This increased global cooperation holds the potential to improve overall global health outcomes by harnessing the collective expertise of the international community.

How does nursing diversity lead to a positive impact on patient outcomes and healthcare quality? 

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How does nursing diversity lead to a positive impact on patient outcomes and healthcare quality?

 

Nursing diversity plays a crucial role in improving patient outcomes and healthcare quality in several ways:

1. Cultural Competence: Nurses from diverse backgrounds bring a deep understanding of various cultures, languages, and belief systems. This cultural competence is vital for providing patient-centered care, as it helps healthcare professionals tailor their approach to meet the unique needs of each patient. When patients feel understood and respected within their cultural context, they are more likely to engage in their care, leading to better health outcomes.

2. Improved Communication: Diverse nursing teams can communicate effectively with a wider range of patients. Language barriers can be a significant challenge in healthcare, and having nurses who are fluent in different languages can bridge these gaps, reducing the risk of miscommunication or misunderstanding. Effective communication leads to better care coordination and patient education, which are essential for healthcare quality.

3. Reduced Health Disparities: Nursing diversity can help address health disparities that exist among different racial and ethnic groups. Minority populations often face unequal access to healthcare and poorer health outcomes. When nurses reflect the diversity of the communities they serve, it can help build trust and improve access to care, ultimately reducing health disparities.

4. Enhanced Problem Solving: Diverse teams bring a variety of perspectives and experiences to the table, which can lead to more innovative and effective problem-solving. Healthcare is complex, and having a range of viewpoints can help healthcare providers develop more comprehensive and patient-centered approaches to care.

5. Cultural Sensitivity: Diverse nursing staff are more likely to be attuned to the unique cultural norms and preferences of their patients. This sensitivity can extend to issues like dietary restrictions, religious practices, and end-of-life care preferences. When patients feel that their cultural values are respected, they are more likely to engage in their care and follow treatment plans.

6. Reduced Bias and Stereotyping: Diverse nursing teams can help reduce bias and stereotyping in healthcare. Stereotypes and biases can lead to disparities in the treatment of patients based on race, ethnicity, gender, or other factors. Nurses who have been trained to be culturally sensitive and are themselves from diverse backgrounds are more likely to provide equitable care.

7. Higher Job Satisfaction and Retention: A diverse nursing workforce can lead to higher job satisfaction and retention rates among healthcare professionals. When nurses feel valued and respected for their unique backgrounds, they are more likely to stay in their positions, reducing turnover rates. This continuity of care can contribute to better healthcare quality.

In conclusion, nursing diversity contributes to a positive impact on patient outcomes and healthcare quality by promoting cultural competence, improving communication, reducing health disparities, enhancing problem-solving, fostering cultural sensitivity, reducing bias, and increasing job satisfaction and retention among healthcare professionals. Embracing diversity in nursing is not only an ethical imperative but also a strategic approach to improving the overall quality of healthcare delivery.