DQ102 RESPONSE

Anne Kolsky    3 posts   Re: Topic 10 DQ 2  Importance of EBP for BSN-RN  Sustainability of evidence-based practice has waned. One thing I have noticed in my workplace is that people (including myself) tend to take the path of least resistance. “It’s easier to…” My mentor and I have had many conversations about this. It’s easier to just give a ‘Band-Aid or bag of ice’ then take the time to assess the situation and treat appropriately. Another example, comparing my last workplace to current, one striking difference is stock medications. We did not give out or stock any kind of medication in the former. My new workplace not only stocks but does not require a doctor’s order to administer. Although it is more work, I insist on an order for stock medications. I also call the parent before giving, as appropriate. It is my license and it is for the safety of the students that are at stake.  I have already had conversations with staff and nursing staff about these practices.  Although they know the risks, they are choosing to keep status quo for themselves.  Of 6 nurses on staff, there is one other that holds similar practice.  She stated at our last meeting that “Kids come down asking for a Tylenol, just to get out of class.”  She made it clear that without an order and parent permission, she will not give out any medications.     Another difference noted is charting practices. Currently, other nurses use a one word drop down menu to chart. SOAP notes are not done consistently. I will continue to make notes. I will continue to chart more fully. It has saved my skin more than once when a student, a teacher, or even a parent will claim that “the nurse didn’t do anything.” It gives such good data for what is trending with that student, why wouldn’t one want to do that? I understand that the office is super busy, but so is the courtroom. I’m not here to make friends, I’m here to do my job.   Another practice I will continue to implement, but with a new perspective, are the various screenings given to students. I will make a more concerted effort to make sure the student and family is aware of all the services available. In my former workplace, I compiled a list of resources for families. I need to make a new one for this community. I have a new perspective towards screenings and a fuller understanding of how important these are in the bigger picture.  In the study by Meyer, et al., (2019) of 1,600 clinicians only 51 reported no obstacles to implementing new treatments. The biggest obstacles reported related to time, cost, location for training, demographic mismatch with resources and difficulty finding resources. New trainees are not given evidence-based training nor supervision experiences, either. Participants in the study requested greater access to existing resources. Handouts, journals, training modules, and workshops (Meyer, et al., 2019).   Meyer, A. E., Reilly, E. E., Daniel, K. E., Hollon, S. D., Jensen-Doss, A., Mennin, D. S., … Teachman, B. A. (2019). Characterizing evidence-based practice and training resource barriers: A needs assessment. Training and Education in Professional Psychology. doi:10.1037/tep0000261.supp (Supplemental)

DQ61 RESPONSE

Susan Rowley  
1 posts
Re: Topic 6 DQ 1
There are several aspects to consider when developing and  implementing a standardized patient handoff report sheet to be used for transferring patients from Labor and Delivery (L&D) and the Neonatal Intensive Care Unit (NICU). These include financial, quality, and clinical aspects. The only cost directly involved in developing the quality improvement project is printing the report sheets. The direct cost of implementing the quality improvement project includes compensation of bedside nursing staff to participate in the education of the project. Education can be included in staff meetings. However, some staff may be coming in on their off time to the staff meeting. Therfore, they will be paid for their time. There are indirect financial aspects to consider for this project. For example, by implementing this project, there will be a decrease in medical errors, which will decrease potential for law suits. When considering quality of care aspects of implementing this project, it is important to note that including nurses in evidence based practice increases the culture of performance improvement. Nurses need to understand that quality is directly impacted by improving care during paient handoff. Implementing this project will decrease the risk for missed medications, missed risk factors for sepsis, hyperbilirubinemia, hypoglycemia,and communicable diseases. Patients will have better outcomes due to more timely treatment because such risk factors will not be missed. Implementation of this project directly impacts the clinical aspect of care by making the nurse accountable for giving a thorough report when transferring the patient into the NICU from L&D. The standardized patient handoff report sheet will also help the nurse to give a thorough report so that nothing is missed. ReferenceGiomuso C., Jones L. et al (2014) A Successful Approach to Implementing Evidence Based Practice; Med-Surg Matters Jul/Aug 2014; 23 (4); 4-9 retreived from https://lopes.idm.oclc.org/login?

DQ52 RESPONSE

Profile Picture

Eugenia Uzoechi  
1 posts
Re: Topic 5 DQ 2
Technology and CLABSIs reductionAlthough sophisticated progress has been made in several areas, central line-associated bloodstream infections (CLABSIs) remain a national healthcare problem of crisis proportions. The stakes for healthcare institutions that have not effectively addressed CLABSIs continue to mount (Pageler et al., 2014). Also, the financial stakes for healthcare institutions with CLABSI problems have risen. With the direction from the Congress, the Centers for Medicare and Medicaid Services (CMS) has curbed reimbursing hospitals for hospital-associated conditions, particularly the ones considered preventable. Among the designated preventable conditions is CLABSIs. The above sends a strong message to facilities to implement aggressive CLABSI minimization programs. Among the programs that can be implemented are technological programs (Pageler et al., 2014).An example of a technological program that can be used to address the issue of CLABSIs is a unit-wide patient safety and quality dashboard. This type of technology helps users to measure the outcome metrics such as CLABSI rate, central line utilization and excess cost in relation to the intervention metrics such as hand hygiene and central line maintenance bundle compliance (Field, Fong & Shade, 2018). At the same time, this technology enables users to identify the hospital care location where patients are at increased risk of developing CLABSI. Moreover, it provides infection prevention surveillance teams with automated work lists, and it works by giving the surveillance team the ability to evaluate cases flagged as at-risk, along with supporting clinical details, to make the final determination of the CLABSI case (Field, Fong & Shade, 2018).I plan to use a unit-wide patient safety and quality dashboard because it will provide mw with the ability to rapidly find, assess and document CLABSI cases, efficiently review submission data and CLABSI rates, and easily identify trends in performance and CLABSI prevention bundle compliance. At the same time, this type of technology will help me understand CLABSI risk based on device utilization and bundle compliance a care location to identify and prioritize improvement interventions, and drill down to the facility, unit, service, or patient level to analyze performance, provide feedback, and support measurement of performance improvement interventions.ReferencesField, M., Fong, K., & Shade, C. (2018). Use of Electronic Visibility Boards to Improve Patient Care Quality, Safety, and Flow on Inpatient Pediatric Acute Care Units. Journal of Pediatric Nursing, 41, 69-76.Pageler, N. M., Longhurst, C. A., Wood, M., Cornfield, D. N., Suermondt, J., Sharek, P. J., & Franzon, D. (2014). Use of electronic medical record–enhanced checklist and electronic dashboard to decrease CLABSIs. Pediatrics, 133(3), e738-e746.

DQ31 RESPONSE

Violence Prevention Research articles pertaining to the reporting of workplace violence:     Arnetz, J. E., Hamblin, L., Ager, J., Luborsky, M., Upfal, M. J., Russell, J., & Essenmacher, L. (2015). Underreporting of Workplace Violence: Comparison of Self-Report and Actual Documentation of Hospital Incidents. Workplace health & safety, 63(5), 200–210. doi:10.1177/2165079915574684  This study examined differences between self-report and actual documentation of workplace violence (WPV) incidents in a cohort of health care workers. The study was conducted in an American hospital system with a central electronic database for reporting WPV events. In 2013, employees (n = 2010) were surveyed by mail about their experience of WPV in the previous year. Survey responses were compared with actual events entered into the electronic system. Of questionnaire respondents who self-reported a violent event in the past year, 88% had not documented an incident in the electronic system. However, more than 45% had reported violence informally, for example, to their supervisors. The researchers found that if employees were injured or lost time from work, they were more likely to formally report a violent event. Understanding the magnitude of underreporting and characteristics of health care workers who are less likely to report may assist hospitals in determining where to focus violence education and prevention efforts.  Strength- Approval for study was granted by the Internal Review Board at the University, and the Research Review Council of the hospital system. Article was peer reviewed. Analysis was completed by Chi-Square. The study was aimed at comparing self-report of WPV with actual documentation of violent incidents, it also intended to highlight which care areas had the highest incident of WPV,due to poor responsiveness of participants it highlights underreporting as a critical barrier to developing WPV prevention strategies.  Weakness- questionaires are limited by design, and it is hard to quantify underreporting of workplace violence among healthcare workers. Data collection was completed by a questionaire mailed to the homes of employees. Only 22% of employees responded to the questionaire. The questionaire asked respondents to retrospectively recall incidents from the past year, creating recall bias. Another limiting factor to the study, while hospital policy mandates violent episode reporting there may be underreporting as the study did not examine what types of violent expericences therefor some individuals may not deem certain behaviors as violent, such non-physical incidents,      Campbell, C. L., Burg, M. A., & Gammonley, D. (2015). Measures for incident reporting of patient violence and aggression towards healthcare providers: A systematic review. Aggression & Violent Behavior, 25, 314–322. https://doi-org.lopes.idm.oclc.org/10.1016/j.avb.2015.09.014  Patient violence and aggression towards healthcare providers is a significant health and public affairs problem receiving international attention. Such violence is found to occur regardless of healthcare setting or provider discipline. However, most of the evidence of a high frequency of incidents perpetrated against providers is anecdotal and solid data on the prevalence of these incidents is not yet available. Studies have shown that accurate incident reporting remains one of the primary impediments to creating organizational policies and procedures to ensure the safety of the clinical direct care healthcare provider. Yet there is no clear evidence base currently existing to suggest what measures are of most utility in remedying this underreporting. This article contributes to the literature by conducting a systematic review of existing instruments designed to measure and report incidents of patient violence against health care workers. It is hoped that this review of existing measures will stimulate health care agencies to employ routine provider reporting mechanisms in order to increase provider reporting, improve the data on patient violence and consequentially work towards combatting this public affairs problem.  Strength: This article is a systematic review of literature over the last 20 years. Both conceptual and systematic research articles were utilized for this review. Articles were excluded that were not published in peer review journals. The study included all articles written in English as part of its inclusion criteria. This meta-analysis found that violence in nursing is an international problem. The research did include three large scale studies, two national level studies from Australia and one international study. The conclusion highlights a lack of standardized measures for reporting and no standardized systematic approaches to handle WPV. But findings did suggest that violence is prevalent and underreported.  Weakness: the study was limited to only English written articles.  It is important to note that the research excluded articles of violence perpetuated by patient visitor.   Copeland, D., & Henry, M. (n.d.). Workplace Violence and Perceptions of Safety Among Emergency Department Staff Members: Experiences, Expectations, Tolerance, Reporting, and Recommendations. JOURNAL OF TRAUMA NURSING, 24(2), 65–77. https://doi-org.lopes.idm.oclc.org/10.1097/JTN.0000000000000269  Workplace violence (WPV) is a widely recognized problem in emergency departments (EDs). The majority of WPV studies do not include nonclinical staff and do not address expectations of violence, tolerance to violence, or perceptions of safety. Among a multidisciplinary sample of ED staff members, specific study aims were to (a) describe exposure to WPV; (b) describe perceptions of safety, tolerance to violence, and expectation of violence; (c) describe reporting behaviors and perceived barriers to reporting violence; (d) examine relationships between demographic variables, experiences of violence, tolerance to violence, perceptions of safety, and reporting behaviors; and (e) identify perceptions of viable interventions to improve workplace safety. A cross-sectional design was used to survey ED staff members in a Level 1 Shock Trauma center. Eleven disciplines were represented in 147 completed surveys; 88% of respondents reported exposure to WPV in the previous 6 months. Members of every discipline reported exposure to WPV; 98% of the sample felt safe at work and 64% felt violence was an expected part of the job. Most violence was not reported, primarily because “nobody was hurt.” Emergency department staff members expected and experienced violence; nevertheless, there was a widespread perception of safety. Perceptions of safety and reasons for not reporting did not mirror previous findings. The WPV exposure is not isolated to clinical staff members and occurs even when prevention strategies are in place. The definition of WPV and the individual’s interpretation of the event might preclude reporting.  Strength- this is a cross sectional study making the quality of evidence highly reliable. The study was multifactorial allowing for a broad examination of the perceptions of safety, toleration of violence, reporting behaviors and barriers, as well as demographic variables. It also identified potential interventions to improve workplace safety. One interesting note about the study is that while exposure to WPV was slightly higher than previous studies, respondents also noted a perception of safety greater than the exposure. This bears the question of whether actual versus perceived safety are congruent?  Weakness- small sample size, and only included one facility. Because most of the respondents were at least BSN prepared and were certified in their specialties with more than 11 years of experience, the perceptions and experiences of respondents may be different than nurses with less experience in handling challenging behaviors. Less experienced nurses may not recognize escalating behaviors or know how to de-escalate a situation prior to violence. This may ultimately change perceptions of safety comparable to peers. Because the study was multifactorial it is worth mentioning that there were docuemtned inconsistencies in “formal” reporting.   Hogarth, K. M., Beattie, J., & Morphet, J. (2016). Nurses’ attitudes towards the reporting of violence in the emergency department. Australasian Emergency Nursing Journal, 19(2), 75. Retrieved from https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=edo&AN=115741170&site=eds-live&scope=site  The incidence of workplace violence against nurses in emergency departments is underreported. Thus, the true nature and frequency of violent incidents remains unknown. It is therefore difficult to address the problem. Aim To identify the attitudes, barriers and enablers of emergency nurses to the reporting of workplace violence. Method Using a phenomenological approach, two focus groups were conducted at a tertiary emergency department. The data were audio-recorded, transcribed verbatim and analysed using thematic analysis. Results Violent incidents in this emergency department were underreported. Nurses accepted violence as part of their normal working day, and therefore were less likely to report it. Violent incidents were not defined as ‘violence’ if no physical injury was sustained, therefore it was not reported. Nurses were also motivated to report formally in order to protect themselves from any possible future complaints made by perpetrators. The current formal reporting system was a major barrier to reporting because it was difficult and time consuming to use. Nurses reported violence using methods other than the designated reporting system. Conclusion While emergency nurses do report violence, they do not use the formal reporting system. When they did use the formal reporting system they were motivated to do so in order to protect themselves. As a consequence of underreporting, the nature and extent of workplace violence remains unknown.  Strength: The method utilized for this study was a phenomenological approach, in this context the intention was to have participants describe and attach meaning to their experiences in relation to the underreporting of WPV. Ethics approval was obtained by the Monash University Human Research Ethics Committee and the relevant hospital ethics committee, the study was peer reviewed. Nurses did make reports informally, when nurses did complete formal reports they were able to track the progress and learn the outcomes which they perceived as beneficial  Weakness: Nurses did not formally report because the reporting system was too cumbersome and was not user friendly. Because the study was voluntary, participants may hold a strong degree of bias about the subject. Because the study was conducted in a public forum, some may feel reluctant to speak freely   Findorff MJ, McGovern PM, Wall MM, & Gerberich SG. (2005). Reporting violence to a health care employer: a cross-sectional study. AAOHN Journal, 53(9), 399–406. Retrieved from https://search-ebscohost-com.lopes.idm.oclc.org/login.aspx?direct=true&db=ccm&AN=106545936&site=eds-live&scope=site  The purpose of this cross-sectional study was to identify individual and employment characteristics associated with reporting workplace violence to an employer and to assess the relationship between reporting and characteristics of the violent event. Current and former employees of a Midwest health care organization responded to a specially designed mailed questionnaire. The researchers also used secondary data from the employer. Of those who experienced physical and non-physical violence at work, 57% and 40%, respectively, reported the events to their employer. Most reports were oral (86%). Women experienced more adverse symptoms, and reported violence more often than men did. Multivariate analyses by type of reporting (to supervisors or human resources personnel) were conducted for non-physical violence. Reporting work-related violence among health care workers was low and most reports were oral. Reporting varied by gender of the victim, the perpetrator, and the level of violence experienced.  Strength: this was a cross sectional design, using a random sample of 100 employees from over 21,000 individuals who work for the healthcare organization. Review boards for the university and the healthcare organization approved the survey instrument. Peer reviewed. This study was specific to who was likely to report and how frequently participants had experienced violence.  This study was interesting to discern demographically who was more likely to report and what criteria prompted persons to report.   Weakness: The study size was small with only 100 potential participants out of 21,000 organizational employees. Limitations to the study were modest response and recall bias. Participants may only remember the more serious incidents, and or report the more serious events. Another resulting bias may have been that those who participated in the study may or may not have been more motivated to respond based on their experiences with violence. Interestng, that the researchers attempted to assure confidentiality of the study participants, some staffers expressed concern about how results would be reported to their employer, which does speak to other studies that express fear of retaliation from victims.      Stene, J., Larson, E., Levy, M., & Dohlman, M. (2015). Workplace violence in the emergency department: giving staff the tools and support to report. The Permanente journal, 19(2), e113–e117. doi:10.7812/TPP/14-187  Workplace violence is increasing across the nation’s Emergency Departments (EDs) and nurses often perceive it as part of their job. Through a quality improvement project, reporting processes were found to be inconsistent and nurses often did not know what acts constitute violence. As a result, nurses were under-reporting violence in the ED, and as a direct result resources were not recognized or provided. A staff nurse-led workgroup developed an initial survey to assess the perception and occurrence of violence within the ED in nurses and patient care assistants. This workgroup evaluated the survey responses and identified a need for development of a brief, concise reporting tool and an educational program. A reporting tool was created and education was provided in multiple venues and modalities. A follow up process and support were given from nursing leadership. A post-education survey was completed by nurses and patient care assistants to assess their comprehension of acts of workplace violence, and found their perception that workplace violence was part of their job was reduced by half, along with increased knowledge about what acts constitute workplace violence and what is reportable to law enforcement. As a result of the education, the reporting of the violent acts has increased and staff perceive the ED to be a safer environment. With the appropriate education, reporting tool and leadership support, ED nurses can create a culture with a zero-tolerance policy for violence within the department, creating a safer environment for staff and patients.   Strength- The article was peer reviewed and offered several key insights into the benefit of educational programs that help ED staff understand what constitutes workplace violence and by developing a concise and easy to use reporting tool staff members became more consistent reporters of workplace violence. The educational tool utilized several different modalities that help with retention of knowledge.   Weakness- the study have many different limitations, the study was not approved by a review committee to confirm the reliability of the study questions. The study also only followed a small sample of individual in one hospital, so it is difficulty to generalized the results as a sample of the general target population. The questions on the survery were not reviewed by a review board prior to administration of assure validity of key related items, this may mean that vital information is excluded or it does not represent all of the conditions that the target population may encounter. Not all participants in the before and after survey were the same.            Reply  |  Quote & Reply                               Previous |  Next                                                                                                                                                                                                        © 2019 BNED LoudCloud LLC   Terms & Conditions |    Privacy Policy |      Tech Support        [Ver: 7.1]      Bookmarks   E-mail –  Oct 28, 2019 7:56:13 AM Mountain Standard Time                                                                                                                                                                                                                                                                             Chrome   Firefox   IE Explorer   Safari                               Content loaded successfully

PSY

1. Make sure you read the chapter in the book FIRST regarding operant conditioning and watch this video http://www.youtube.com/watch?v=I_ctJqjlrHA BEFORE you do this activity. If you cannot click on the link, copy and paste into your browser.

2. Go to the following link. http://www.kscience.co.uk/animations/anim_5.htm#top  (There are no instructions other than to select option 1, 2, or 3. It is up to you to figure out how to get things to happen. Some of the things you may encounter are “virtual candy” and noises. Make sure your speakers are on.)  If you have any problems accessing the skinner box, try right clicking in the box and then click play. ALso, use the regular number keys above the letters on your keyboard and not the keypad.

3. What principles of operant conditioning did the activity use (more specifically: positive or negative reinforcement or positive or negative punishment)? Discuss your experiences with the activity (how did you figure it out, etc.). (Warning.. you need to stick with the activity. It can be tricky to figure out, but don’t give up! Stating you could not figure it out will not provide credit for the assignment) 🙂  

4. Provide a real-life example of operant conditioning. Describe the example and identify which principle of operant conditioning were used. 

4. Then for fun (to de-stress from this activity!) , check out this link that demonstrates classical conditioning http://www.youtube.com/watch?v=WfZfMIHwSkU  and this link that demonstrates operant conditioning (primarily positive reinforcement) https://www.youtube.com/watch?v=Mt4N9GSBoMI

Provide a response to a classmate. 

DiscussionDisc1 for $4

Ethical Resource Allocation

Work through the simulation titled Resource Allocation from the end of Chapter 8 of your course text.  Review the various options in the simulation, then select “Your Own Option” to type out your own solution to the scenario.  You will need to copy and paste your response from “Your Own Option” into the discussion board forum.  Here is a brief synopsis of the simulation regarding the hospital’s budget and dilemma:

Hospital costs in millions for one year:

  • One 35-year-old cancer patient who needs significant time with the doctor, medical supplies, tests, and around the clock care: Cost: 100
  • Emergency Room operations for daily care and treatment of about 100 people (~365,000/year) Cost: 100
  • 2 Senior Patients who need hip replacement surgery. Cost: 50
  • 10 patients (ranging in age from 18 to 45) receiving assistance in your inpatient drug/alcohol rehab unit: 100
  • An MRI unit that is on the fritz and could die any day. Replacement Cost: 170
  • One of your two X-ray machines is inoperable and must be replaced: Cost 100
  • Ambulance drive-in area was damaged and needs to be repaired: Cost: 25
  • Training needs for nursing staff for certification requirements: Cost: 55
  • TOTAL: $700 million

For this discussion, address the following:

  • You have $700 million in expenses and only $500 million to work with. How do allocate your resources?
  • Who gets treated and who has to wait?
  • What about your facilities?
  • Determine what you plan to do and explain your reasoning as well as the ethical considerations behind your decision.

Your initial response must be at least 250 words and must use at least two scholarly sources.

Urgent Discussion Main Post Required – 4-5 Hours

Critical Incident

Steve is an experienced licensed professional counselor working in a community clinic. He is by nature outgoing, has friends from many walks of life, and feels confident about his many years of practice with diverse clientele. He recently completed a protracted divorce from his wife of seven years and has no children. A fourth-generation Japanese American, Steve was raised in an uppermiddle-class area of the West Coast. When he glanced at the intake form completed by Riza (the female client described at the start of this chapter), Steve immediately felt concerned about how a recent immigrant from the Philippines might react to him, given that the Japanese occupation of the Philippines in the 1940s must have affected the client’s parents and extended family. In session, Riza haltingly described her difficulties in adjusting to life in the United States. Steve observed that Riza had adopted a coping strategy of avoidance of contact with most Americans after several poignantly negative experiences in which she went away feeling incompetent, despite her high level of occupational qualifications. Riza maintained close contact with friends and family members in the Philippines via the Internet, but she did not socialize with anyone outside her immediate family after work hours. Steve observed that Riza’s strongest emotional reactions occurred when she spoke about her husband. She described circumstances that were very similar to those Steve had experienced in his marriage, but when asked whether she had considered divorce, Riza strongly affirmed her commitment to her husband and his family. Steve was at first surprised that many of Riza’s decisions stemmed from her sincere faith in Catholicism. He fought against his initial reaction to judge Riza’s daily devotions and prayers, and he directed conversations back to what he believed were the central issues for Riza: her social isolation, passivity, and excessive guilt, which seemed to be the primary causes of her depressed moods. Even after specific questioning about those issues, Riza seemed to be holding something back. Steve then raised the issue of their different ethnic backgrounds as part of checking Riza’s perceptions about how things had gone during their initial session together. Riza acknowledged that her maternal grandfather had died during the Japanese occupation, but she said that her family seldom recounted the past and she understood that neither Steve nor his family had any connection to her own past. In fact, she believed that her being assigned to work with Steve was a spiritual metaphor: Having a counselor of Japanese ancestry meant that God brought them together to prove that all things can be healed. After the session, Steve recognized that his personal beliefs about taking the initiative in social settings and about family roles and divorce had made it difficult for him to follow up on Riza’s perspectives. After consultation with a Filipino colleague, Steve started to gain appreciation for the cultural contexts influencing Riza’s actions. 

 

  

Read the Critical Incident.

Answer the following: 

Discuss the materials that you read in your text in chapter four pertaining to the following question.

After becoming more familiar with Catholicism and Filipino culture, list a series of culturally sensitive adaptations that might enable Steve to work effectively with Riza.  Try particularly to point out those adaptations as they apply to your specific field of study (i.e. teachers – classroom adaptations, library media – adaptations within your role).

Read and provide thoughtful response

Part 1

 

As an individual moves through adulthood, stability and change usually results from their personality. Psychologists Robert McCrae and Paul Costa held studies to help understand stability and change, they then came up with the five factors of personality. The five factors, recognized as O.C.E.A.N., involve openness to experience, conscientiousness, extraversion, agreeableness, and neuroticism (emotional stability). The factors and their traits are listed as followed:

 

Openness- imaginative or practical, interested in variety or routine, and independent or conforming

 

Conscientiousness-organized or disorganized, careful or careless, and disciplined or impulsive

 

Extraversion-social able or retiring, fun-loving or somber, and affectionate or reserved

 

Agreeableness- soft-hearted or ruthless,  trusting or suspicious, and helpful or uncooperative

 

Neuroticism-calm or anxious, secure or insecure, and self-satisfied or self-pitying.

 

Each factor has three important traits that coincide with a person’s well-being, health, intelligence, their achievements and even their relationships. Depending on the personality factor, the higher level of the trait, the more improved or corrupt life will pan out. For example, in a decade, four out of five of the factors can predict health outcomes such as high levels of neuroticism being linked to more health concerns. Openness also contributes to cognitive function, increasing IQs and the ability to chase entrepreneurial objectives. I believe this is because once you start to gain knowledge about something new, it expands your crystalized or fluid intelligence. Studies also show that conscientiousness relates to GPA in college students. Lastly, those high on the trait of agreeableness were more likely to have a satisfying romantic relationship (Santrock, 2012).

 

Many lifestyle issues can effect a person’s development whether it’s physical or cognitive. Physically, skin begins to sag and obtain wrinkles, age spots appears and hair becomes thinner and may start to turn gray. Cosmetic surgery, dyeing ones hair and vitamins can help slow down the aging process. Another example includes reducing strength due to loss of muscle mass and degenerating bones. Studies show that keeping off the excess weight by being active and eating healthy can reduce these risks along with reducing dangers of cardiovascular disease. Although cognitively, our memory will start to decline during middle age and to avoid that we should use effective memory strategies like organization and imagery. Simple tasks like organizing lists of phone numbers into different categories or imagining the numbers as representation of object around the house can help improve memory as well (Santrok, 2012). During this time in development it’s mostly about being in control of your health and wellness.

 

According to Levinson, a midlife crisis can be explained as when an adult is reflecting on the past as well as preparing for the future; seeing midlife as an actual crisis. Valliant sees it differently, he believes not everyone has a midlife crisis because they are at their peak of success during this time. It’s viewed as an individual experiencing a crisis event during this time, but they will see to get over it; such as a bad week at work but home life is just fine. Therefore, life itself doesn’t become a crisis just because of the aging process.

 

 

 

Part 2

 

Erikson’s theory- Erikson believes that his seventh stage of development which is Generativity vs. Stagnation is a major issue in middle adulthood. This occurrence is when adults have or have not achieved to pass on their skills, knowledge, and legacies to the next generation.  Generativity incorporates aspiration while stagnation incorporates with “self-absorption”.

 

Helson’s theory-In Helson’s Mills College Study, she examined more than 100 women at different ages from the time they were seniors in college to their thirties, forties and fifties. The study concluded that women don’t go through midlife crisis, but through midlife consciousness. These women had to learn and control their impulses, learn not to be dependent on anyone else, mature their social skills and just work hard to achieve their future goals. If this was not achieved, they would not progress entirely as other women would.

 

Levinson’s theory-As said before, Levinson had the theory that men go through a midlife crisis. He believed if the transition from adolescence didn’t go well, then it will affect the future of adulthood. His theory only occurred men and the conflicts that were possible in adolescents such as: being young vs. being old, being destructive vs. being constructive, being masculine vs. beung feminie, and attatchment vs. separation. A good or bad reflect upon these would determine the midlife crisis for the male.

 

I personally believe that Erikson’s theory is a better explanation of middle adulthood mainly because it’s not biased and can involve both men and women. Unlike Helson whose theory revolved around women and Levinson whose study was all men, Erikson’s idea is general so it can concern normative life events meaning it can occur to anyone. A fine example would be two middle aged adults reflecting on their parenting skills; they may think “have I taught my children the best way I could in order for them to survive on their own?”. Appreciating their job as a parent or regretting their decision to pass more onto the next generation.

 

Pond’s Age-Defying Complex, a cream with alpha hydroxy acid,

Pond’s Age-Defying Complex, a cream with alpha hydroxy acid, advertises that it canreduce wrinkles and improve the skin. In a study published in Archives of Dermatology(recent year), 33 middle-aged women used a cream with alpha hydroxy acid for 22weeks. At the end of the study period, a dermatologist judged whether each womanexhibited skin improvement. The results for the 33 women are listed below.

Improved

Improved

No improvement

Improved

No improvement

No improvement

Improved

Improved

Improved

Improved

Improved

Improved

No improvement

Improved

Improved

Improved

No improvement

Improved

Improved

Improved

No improvement

Improved

No improvement

Improved

Improved

Improved

Improved

Improved

Improved

No improvement

Improved

Improved

No improvement

 

 

 

a) MINITAB Output. Enter these data into a MINITAB worksheet all in onecolumn. Use Skin Cream as your header. Select Stat > Basic Statistics > 1-Proportion… Complete the dialog in order to obtain a 97 percent confidenceinterval.
b) Based on the 97% confidence interval for women exhibiting noimprovement, do you have sufficient evidence to conclude that the creamwill improve the skin of more than 60% of middle-aged women? Explain

Case Study: Clinical Supervision

Case Study: Clinical Supervision

For this assignment, you will refer to the Course Case Study. Reread the case study, looking specifically at issues related to clinical supervision. Examine the ACA’s ethical guidelines related to the issue of supervision in Section F and answer the following questions:

  • Explain the ethical issues related to the supervisor.
  • Explain the ethical issues related to the supervisee/student.
  • Examine the influence of your own personal values as it relates to the issues presented in the case.
  • Compare the violations to the APA’s ethical standards and describe the similarities or differences in the ethical code using the following websites:
    • www.apa.org
    • www.counseling.org
  • Imagine you are a member of the ACA ethics committee. Describe the recommendations you have for the supervisor.
  • Describe the recommendations you have for the supervisee/student.

Save the paper as AU_PSY430_M4_A2_LastName_FirstInitial.doc 

 

CASE STUDY 

Course Case Study Lily began supervising an intern, Jack. A few months after supervision began, Lily discovered that she would need to go on medical leave. Because the leave would only be for about six weeks and she was the only licensed mental health professional in the office, she and Jack decided that he would be fine working without her involvement until she got back. He would simply keep all the reports she needed to sign on her desk, and she would sign them all when she returned. Jack felt very competent in his ability to carry on while Lily was out until he conducted an intake assessment on a client who seemed to be having some breaks from reality. Jack was unsure how to determine if there really was psychosis occurring and what to do about it. He tried to contact Lily but was unable to get in touch. Anxious, he searched online for ideas on how to work with the new client and tried out a few techniques during sessions. He reassured himself that no matter what he did, ultimately Lily was responsible anyway. A week before Lily returned to work, the client was arrested as he tried to “fly” off a building, convinced that he could fly without difficulty. Upon being taken into custody, the client’s demeanor concerned the police officer and he was taken to the emergency room where an evaluation was conducted. It was determined that he was indeed experiencing psychosis, and antipsychotic medication was started. Once the client was stable, he filed a complaint against Jack and Lily with the state licensing board and threatened legal action. Understandably, Jack was scared and Lily was angry. She accused Jack of practicing without her consent, stating that he was to have continued with the clients he had when she left, not accept new ones. She subsequently informed him that she would no longer be his supervisor. Jack was furious that he was put in the position to make decisions on his own and did not receive support from his supervisor. Jack, in turn, filed a complaint against Lily due to lack of supervision.