Is Wealthier Healthier?

African nations tend not to have lower health outcomes, experiencing epidemics of infectious and non-communicable diseases across the continent. There is substantial health inequality among and within many nations in Africa. Similar disparities in health also exist in Latin America. Cuba, Costa Rica, and Chile have health outcomes comparable to the United States, while Haiti’s health outcomes are comparable to the less healthy parts of Africa.

A variety of arguments can be made for the reasons why there is great health inequity in these regions. Some relate to the different colonial histories since health is transmitted inter-generationally. Colonization, neoliberal globalization, including free market, free trade, and the unrestricted flow of capital with little government influence, has resulted in large wealth inequalities. Some countries have cut their government spending on health programs, which has led to devastating health outcomes.

For this Discussion, examine countries and their health problems.

To prepare for this Discussion, review Week 10 and Week 11 Learning Resources. Select two countries with different per-capita income levels such that one could be classified as a “high income” nation and the other would not be classified in the same income category. Note: You may use The World Bank website in your Learning Resources to identify countries and their income levels.

Post a brief summary comparing the two countries and their health problems. Also, compare how the economic level and income inequality in each country influenced other social determinants (social dynamics, the status of women, education, or violence/homicide, etc.) for each country. Then, explain the impact of the determinants on the health outcome in each country. Expand on your insights utilizing the Learning Resources.

Use APA formatting for your Discussion and to cite your resources.

 Identify a quality improvement opportunity in your organization or practice. In a 1,000 to 1,250 word paper, describe the problem or issue and propose a quality improvement initiative based on evidence-based practice. Apply “The Road to Evidence-Based Practice” process, illustrated in Chapter 4 of your textbook, to create your proposal.

Include the following:

1. Provide an overview of the problem and the setting in which the problem or issue occurs.
2. Explain why a quality improvement initiative is needed in this area and the expected outcome.
3. Discuss how the results of previous research demonstrate support for the quality improvement initiative and its projected outcomes. Include a minimum of three peer-reviewed sources published within the last 5 years, not included in the course materials or textbook, that establish evidence in support of the quality improvement proposed.
4. Discuss steps necessary to implement the quality improvement initiative. Provide evidence and rationale to support your answer.
5. Explain how the quality improvement initiative will be evaluated to determine whether there was improvement.
6. Support your explanation by identifying the variables, hypothesis test, and statistical test that you would need to prove that the quality improvement initiative succeeded.

attachment

Week 2: Racial Disparities of COVID-19 Reflection Questions

Purpose: The racial and health disparities related to COVID-19 are staggering. This ANA (American Nurses Association) Webinar will address this particular topic.  Along with this webinar, the article by McNeely et al. (2020) further examines this issue.  Here are just a few of the concepts that will be addressed: 

• The magnitude and origins of COVID-19 racial disparities
• Addressing the roots of the problem
• Facing Implicit Bias: An effort we all must make
• How to translate insight and knowledge into life-saving actions
• Points of intervention when caring for a COVID-19 patient and how you can make an impact on each step of the way (nursingworld.org, n.d.)

Directions: Watch this ANA Webinar and read the article by McNeely et al. (2020) related to racial and health disparities during the pandemic. Once completed, answer the following reflection questions and upload them to the dropbox. 

Webinar link: Racial Disparities of COVID-19 (Links to an external site.)

Article link: McNeeley et al. (2020). Social Determinants and COVID‐19 Disparities: Differential Pandemic Effects and Dynamics (Links to an external site.)

Reflection Questions: ANA Webinar Reflection Questions-student.docx

Rubric

Health Disparity ReflectionHealth Disparity ReflectionCriteriaRatingsPtsThis criterion is linked to a Learning OutcomeReviews video webinar and questions50.0 ptsSatisfactoryReviews video case study and satisfactorily completes the questions.25.0 ptsNeeds ImprovementUnsatisfactorily completes the questions.0.0 ptsUnsatisfactoryDoes not complete the case study questions50.0 pts
Total Points: 50.0

Topic: Linked Application

A middle-range theory has fewer concepts and propositions than a grand theory which align with nursing practice and guide research. Conceptual models guide the direction of the propositions and empirically testable hypotheses used to create or refine middle-range theories. The progression from conceptual model to middle-range theory can be identified by reviewing King’s theory of goal attainment (middle-range theory) which is derived from King’s conceptual system (conceptual model).

Choose a conceptual model and middle-range theory. Explain how the concepts of the conceptual model and middle-range theory are consistent and are linked.

Health History

Mr. C., a 32-year-old single male, is seeking information at the outpatient center regarding possible bariatric surgery for his obesity. He currently works at a catalog telephone center. He reports that he has always been heavy, even as a small child, gaining approximately 100 pounds in the last 2-3 years. Previous medical evaluations have not indicated any metabolic diseases, but he says he has sleep apnea and high blood pressure, which he tries to control by restricting dietary sodium. Mr. C. reports increasing shortness of breath with activity, swollen ankles, and pruritus over the last 6 months.

Objective Data:

1. Height: 68 inches; weight 134.5 kg
2. BP: 172/98, HR 88, RR 26
3. 3+ pitting edema bilateral feet and ankles
4. Fasting blood glucose: 146 mg/dL
5. Total cholesterol: 250 mg/dL
6. Triglycerides: 312 mg/dL
7. HDL: 30 mg/dL
8. Serum creatinine 1.8 mg/dL
9. BUN 32 mg/dl

Critical Thinking Essay

In 750-1,000 words, critically evaluate Mr. C.’s potential diagnosis and intervention(s). Include the following:

1. Describe the clinical manifestations present in Mr. C.
2. Describe the potential health risks for obesity that are of concern for Mr. C. Discuss whether bariatric surgery is an appropriate intervention.
3. Assess each of Mr. C.’s functional health patterns using the information given. Discuss at least five actual or potential problems can you identify from the functional health patterns and provide the rationale for each. (Functional health patterns include health-perception, health-management, nutritional, metabolic, elimination, activity-exercise, sleep-rest, cognitive-perceptual, self-perception/self-concept, role-relationship, sexuality/reproductive, coping-stress tolerance.)
4. Explain the staging of end-stage renal disease (ESRD) and contributing factors to consider.
5. Consider ESRD prevention and health promotion opportunities. Describe what type of patient education should be provided to Mr. C. for prevention of future events, health restoration, and avoidance of deterioration of renal status.
6. Explain the type of resources available for ESRD patients for nonacute care and the type of multidisciplinary approach that would be beneficial for these patients. Consider aspects such as devices, transportation, living conditions, return-to-employment issues.

You are required to cite to a minimum of two sources to complete this assignment. Sources must be published within the last 5 years and appropriate for the assignment criteria and relevant to nursing practice.

 Topic 3:  Claire runs cross country in college, and lately, her times have not improved.  She knows she needs adequate carbohydrates to keep her body fueled.  Typically, her food intake consists of cheese sticks and a glass of orange juice for breakfast; a peanut butter sandwich, apple, bag of pretzels, and sweetened tea for lunch; spaghetti with marinara sauce, garlic, bread, salad, and a glass of milk for dinner; and orange for her evening snack.  Lately, she is feeling tired and has to wear a sweatshirt in class to keep warm. She is also having trouble concentrating.  What do you think is causing Claire’s problem, and why?  What would you recommend? 

Reply 1

According to Schmidt (2018), validity and reliability are crucial components to a well-developed research study. Validity refers to how much a concept relates to real life, whereas reliability is how much an experiment yields the same results when repeated. Qualitative and quantitative studies, though different in approach, still draw validity and reliability. Quantitative research is structured and objective, relying on data and measurements. Qualitative research is less structured and more subjective, relying on text, in depth information, and can include focus groups or interviews (UTA, 2020). Benefits to utilizing both qualitative and quantitative research in point towards each method filling in the gaps of where the other seems to lack. “Quantitative data can give baseline information to aid researchers in selections of patients to interview, while qualitative data can provide researchers understanding of barriers and factors to patient recruitment and retention” (Doorenbos, 2014). However, if a study is utilizing both methods of research, there might be a mix of data collection leading to inconsistencies in objective collection and issues with validity (McNiff and Petrick, 2018).

Doorenbos A. Z. (2014). Mixed Methods in Nursing Research : An Overview and Practical Examples. Kango kenkyu. The Japanese journal of nursing research, 47(3), 207–217.

McNiff, P. and Petrick, M. (2018). Quantitative research: ethics, theory, and research. In Grand Canyon University (Ed). (2018). Nursing research: Understanding methods for best practice. Retrieved from https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1

Schmidt, M. (2018). Measurement, statistics and appraisal. In Grand Canyon University (Ed). (2018). Nursing research: Understanding methods for best practice. Retrieved from https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1

University of Texas Arlington. (2020). Qualitative vs quantitative research. https://libguides.uta.edu/nursingresearch

Reply 2

Nursing research is conducted by using different types of methods such as qualitative, quantitative, experimental, quasi-experimental, correlation, and descriptive method. Qualitative research is considered as exploratory research for the deep understanding of the research problem and provides a way for quantitative research. In some studies, both qualitative and quantitative methods used in the studies are called Mixed methods of study.

Advantages of Mixed Method:

• Using both qualitative and quantitative method minimizes the weakness of the study. It increases the exploration and statistical analysis of the study.
• Mixed method increases the availability of research tools that helps to collect more comprehensive data.
• The results are validated more accurately and show additional evidence for supporting.
• Mixed methods combine thinking as well as reasoning.
• The findings are illustrated in both words as well as number.
• Mixed method reduces personal biases.

Disadvantages of Mixed method:

• Using both qualitative and quantitative method is time-consuming.
• Researchers need to be well-versed in both the data.
• More resources to be used for collecting both types of data.
• The result findings should be illustrated clearly for the better understanding of the audience.

References:

Rahman, M. S. (2020). The advantages and disadvantages of using qualitative and quantitative approaches and methods in language “testing and assessment” research: A literature review.

Queirós, A., Faria, D., & Almeida, F. (2017). Strengths and limitations of qualitative and quantitative research methods. European Journal of Education Studies.

Driscoll, D. L., Appiah-Yeboah, A., Salib, P., & Rupert, D. J. (2007). Merging qualitative and quantitative data in mixed methods research: How to and why not

Reply 3

To start, when both qualitative and quantitative research methods are used together, they make up what is referred to as mixed methods (Helbig, 2018). “This type of research study is common in health care because emotions and feelings may play a part in the study being performed: love, anger, or pain cannot easily be quantified” (Helbig, 2018, para 54).

A major benefit of using the mixed method in combination of the qualitative and quantitative method is that when using all three, or triangulation design, is its efficiency because you kill two birds with one stone, collecting both sets of data simultaneously, which can also be a disadvantage (Doorenbos, 2014). Afterwards, when the data has been collected, a team of researchers including those with expertise in qualitative and quantitative data can have access to the data and interpret it in a more efficient manner (Doorenbos, 2014).

Disadvantages of using mixed methods for research include the great amount of effort needed as well as the expertise of the researcher to collect both qualitative and quantitative data simultaneously (Doorenbos, 2014). At the same time of the data collection, the difficulty of giving each kind of data an equal amount of importance when collecting it provides another disadvantage or difficulty for the researcher.

References

Doorenbos, A. Z. (2014). Mixed Methods in Nursing Research : An Overview and Practical Examples. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4287271/.

Helbig, J. (2018). History and process of nursing research, evidence-based nursing practice, and quantitative and qualitative research process. In Grand Canyon University (Ed.)., Nursing research: Understanding methods for best practice.. Retrieved from https://lc.gcumedia.com/nrs433v/nursing-research-understanding-methods-for-best-practice/v1.1

population

Write a 750- to 1,000-word summary of recommendations to your manager. Complete the following in your summary:

• Identify the potential challenges around collaboration this group might experience.
• Describe collaborative skills you would use to create a more positive atmosphere.
• Explain what would comprise effective communication for this group.

Cite a minimum of one reference to support your assignment.

Format your assignment according to APA guidelines.