The purpose of this assignment is to explain how the Theory of Chronic Sorrow can be used as a framework for planning care and identifying resources in the following case: You are a case manager for a family with a young child diagnosed with cerebral palsy. Explain how the Theory of Chronic Sorrow can be used as a framework for planning care and identifying resources for this family.

PLEASE RESPOND TO THE FOLLOWING IN 50 WORDS OR MORE:

2. Nursing‐sensitive indicators are the criteria for changes in health status that nursing care can directly affect. Nursing‐sensitive indicators have been increasingly adopted as valid and reliable tools due to their features such as objective assessment, improvement of clinical practice, evaluation of nursing care quality and performance, and informed decision‐making capability for patients in selecting a hospital to receive care. The use of nursing‐sensitive indicators affects the outcomes of nursing care by defining the structure and processes of nursing care. Indicators can be used for quality improvement purposes in applied settings to monitor performance and progress and to support evidence-based decision making, to support informed policy analysis related to regulatory or accreditation requirements, workforce development, and reimbursement, and to research the role of nursing care in determining patient safety outcomes by examining structure-outcome, process-outcome, and structure-process-outcome relationships. I believe that no one nursing sensitive indicator is sufficient on its own for measuring the profession’s impact on patient care and outcomes. Rather, several elements must be considered together to provide a comprehensive view of nursing practices and results, such as patient falls with and without injuries, RN satisfaction survey, nosocomial infections, nursing hours per patient day. Indicators not included in the database statistics, but which professional nurses should consider, nonetheless are patient satisfaction with pain management, patient satisfaction with nursing care. For example, assessment and treatment of pain is complex, and optimal pain care remains elusive. Only 63-74% of patients report that their pain was well-controlled. Personal biases may interfere with healthcare’s ability to accurately assess pain management needs, but nurses who keep in mind the ethical principles of autonomy, beneficence, non-maleficence, and justice will be better equipped to make sound judgments. 

Reference:

Oner, B., Zengul, F. D., Oner, N., Ivankova, N. V., Karadag, A., & Patrician, P. A. (2021). Nursing-sensitive indicators for nursing care: A systematic review (1997-2017). Nursing open, 8(3), 1005–1022. https://doi.org/10.1002/nop2.654

May 2012, Alice Randall wrote an article for The New York Times on the cultural factors that encouraged black women to maintain a weight above what is considered healthy. Randall explained—from her observations and her personal experience as a black woman—that many African-American communities and cultures consider women who are overweight to be more beautiful and desirable than women at a healthier weight. As she put it, “Many black women are fat because we want to be” (Randall, 2012).

Randall’s statements sparked a great deal of controversy and debate; however, they emphasize an underlying reality in the healthcare field: different populations, cultures, and groups have diverse beliefs and practices that impact their health. Nurses and healthcare professionals should be aware of this reality and adapt their health assessment techniques and recommendations to accommodate diversity.

In this Discussion, you will consider different socioeconomic, spiritual, lifestyle, and other cultural factors that should be taken into considerations when building a health history for patients with diverse backgrounds. Your Instructor will assign a case study to you for this Discussion

To prepare:

• Reflect on your experiences as a nurse and on the information provided in this week’s Learning Resources on diversity issues in health assessments.
• By Day 1 of this week, you will be assigned a case study by your Instructor. Note: Please see the “Course Announcements” section of the classroom for your case study assignment.
• Reflect on the specific socioeconomic, spiritual, lifestyle, and other cultural factors related to the health of the patient assigned to you.
• Consider how you would build a health history for the patient. What questions would you ask, and how would you frame them to be sensitive to the patient’s background, lifestyle, and culture? Develop five targeted questions you would ask the patient to build his or her health history and to assess his or her health risks.
• Think about the challenges associated with communicating with patients from a variety of specific populations. What strategies can you as a nurse employ to be sensitive to different cultural factors while gathering the pertinent information?
• CASE STUDY 1
•  John Green, 33 year-old Caucasian male, presents to the office to establish as a new patient. John’s natal sex is female but he identifies as a male. He transitioned from female to male 2 years ago. He has made a full transition with family and socially last year. He just moved back home and is unemployed at this time. He has been obtaining testosterone from the internet to give to himself. He has not had any health care since he decided to change other than getting his suppression medications through Telehealth 3 months ago. His past medical history includes smoking 2 packages of cigarettes per day for the last 10 years, smokes 3-6 marijuana joints every weekend (has an active green card), and does suffer from depression episodes. He is HIV positive for the last 3 years but remains virally suppressed at his last blood draw 6 months ago. He has been feeling very weak over the last few weeks which prompted him to move back home with his parents. He takes Biktarvy once daily that comes in the mail for free, tolerates it well, and 100 mg Testosterone IM every 7 days. His PMH is non-contributory. No past medical history. He has never been married. No significant family history. He is worried since moving back home and unemployed he will be a burden on his family, and he thinks his health may be declining. 

 What would spirituality be according to your own worldview? How do you believe that your conception of spirituality would influence the way in which you care for patients?