Assignment: NSGCB 482 Reflection 2

Assignment: NSGCB 482 Reflection 2

Assignment: NSGCB 482 Reflection 2

Enclosed you will find my interview and summary on the meeting with my family. They live in westminster, Maryland 21157

also I uploaded my 2 paper about the family to help with this

Parent interview questions

Father (we will call Matthew SR for privacy) Your child was not taken care of when s/he was sick or injured?

Answer: when the father and mother were going through a divorce, the mother had custody and father had visitation. The child ( we will call Matthew Jr) would show up for visitation with severe diaper rash and prescribed medications would not be open. Matthew Sr started to take pictures for documentation. Shortly thereafter the mother was found deceased and Senior received full custody. Matthew jr has no memory of this.

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Your child was not always provided a safe place to live?

Answer: No. When the Matthew jrs mother left the family home she was living with a known drug addict. Per Matthew Jr sister, they would be locked in the laundry room when the mother and her boyfriend was using. Matthew jr has no memory of this.

Locked him or her up or tied him/her to restrict movement?

Answer: Matthew Jr was locked in the laundry room to prevent him from coming into the living area where the mother was using drugs.

Child interview

Shouted, yelled, or screamed at you very loudly?

Answer, Yes, my father and mother. (aka) girlfriend. Approx. once a month

Explained to you why something you did was wrong?

Answer, Yes, my father and mother

Gave you a reward for behaving well?

Answer: yes, mother and father

Information on my family:

The house is a 3 bedroom 1 bath brick home. In the basement where the laundry room is there is an apartment. The house is in a quite subdivision in Westminster, Maryland. The house is centrally located. Both adults work within two blocks of the home. The home appeared clean but noticed the kitchen floor needs to be replaced along with the refrigerator. There is radiant heat that is controlled by everyroom individually. They do state that it is very expensive to heat the house.

English is the language of the family. There does appear to be some cognitive development from both adults.

Matthew SR (father)

33 years old high school graduate and works full time at as an assistant manager at a pizza delivery chain. His father has been deceased since the age of 12 due to diabetes and kidney failure. His mother is alive and lives in tn currently. He is very close to his mother and lived with her for many years. She was a single mother but had support from his grandfather. His grandfather lived with him till 2020 when he passed away in the home. His ex wife and juniors mother left him when junior was 2 and she passed away 9 months later. The house consists of senior, junior, and his girlfriend Brittany (we will call her for privacy). Matthew Sr states he struggles financially. Housing in Maryland is expensive and with the raising price of groceries and fuel. He is socially withdrawn and does hang out with any friend. His girlfriend is very insecure but he is able to bowl once a week on league to allow him to socialize. He states that he has to leave Matthew jr home alone due to not being able to get help with childcare. He does not qualify for food stamps because he receives a social security check for Matthew jr in the amount of four hundred and fifty dollars. He states he is exhausted a lot because his girlfriend does not drive so he has to get up early to take her to work. He is struggling with needing dental work but can not afford it. He has health insurance through Medicaid but states when he gets a day off he is too tired to tend to his issues. He does all the cleaning and most of the cooking and the grocery shopping due to his girlfriends pain issues. He corrects Matthew Jr when he needs it and assigns chores for him.

Matthew Jr

This is a 10 year old child and going into the fifth grade. It appears that he is happy and loves to talk. He has 2 siblings he has not seen in 7 years since the death of his mother. He has little memory of his brother but states he really misses his sister. He did talk about the loss of his grandfather and his cat. He showed me his grandfathers bedroom that he now sleeps in. There was a motorized scooter in there that the child started beeping the horn stating that is how he knew his grandfather needed something. He also showed me the cats ashes. He currently has a cat but states its crazy. He states he calls his daddy’s girlfriend mommy. He states he takes care of her and reminds her to take her meds including her birth control pills. ( I was a little taken back by this). He states he stays home alone but daddy works two blocks from home. He states he doesn’t really have any friends to hang out with. He said he had one but he was mean to him so he stopped going over there. Child does belong to big brother program and one night a week he comes over. They play games and write in his journal. He also sees a counselor one day a week. He denies being hit every by his parents and is only yelled at once a month if he is bad. He states he feels safe at home.

Brittany

Brittany is 34 years old high school graduate. She recently started working in a Dr office as an Medical assistant. She was in nursing school but dropped out due to pain. She states she has Ankylosing spondylitis for which she takes multiple medications and injections for. There are multiple medications sitting around the house on the end tables. She states she is unable to do most everyday tasks due to pain. While conducting my interview she could not open the childs drink due to pain in her hands. She has a hard time financially due to missing large chunk of time at work due to her flair ups of pain. She also has a difficult time attending any physical therapy due to lack of transportation because she does not have a driver license. She states she is scared to drive. She states that she thinks by the time she is 40 she will be unable to work because of her condition.

Westminster, MD:

Westminster is a smaller older town community. It does consist of farmland. The city section of Westminster consists of approx. 10 blocks. There is small mall but most of the stores are empty. Transportation is limited. The local hospital is 7 miles away and appears to be a smaller hospital. By 8pm the streets had little traffic. The main economic activities are manufacturing and agriculture such as dairy, cattle, oat, and corn. The area is 449 square miles. Per redfin the median price of a home is $385K.

There are local parks but most are not maintained.

Resources found for the family:

Carroll county food bank

Tues, wed, thur 10-11:15am and 1-2:15 pm

Saturday 9-11:15

Silver run community food pantry @ St Marys Evangelical Lutheran church

Drive thru 1st and 3rd Wednesday of each month from 5-6

Part 1:Clinical Activities: Health Promotion and Disease Prevention in the Community   700 word essay

From the results of your windshield survey, you will identify health issues facing people in the community. You will prepare to teach your chosen family how to reduce the risk of and prevent the initiation or exacerbation of health-related problems in the community.

Alternatively, you may choose to work with individuals, families, or groups that access services at a community agency.

Consider the following areas in your community where you might find factors that contribute to health issues in the community:

Healthy food options

Geographic boundaries

Housing and zoning

Open space

Commons

Transportation

Social service centers and their locations

Stores, businesses, and industries

People and animals encountered on the street

Physical condition of the area

Racial and ethnic makeup of the population

Religious institutions/places of worship

Health indicators and morbidity and mortality data

Politics

Media

Signs of decay (e.g., conditions of roads, abandoned buildings)

Crime rate

Employment rate

Schools

Environmental factors (e.g., locations related to water treatment plants, garbage dumps, industrial pollution)

Public services (e.g., fire, police)

In collaboration with your patient population (i.e., individual, family, group), identify 3 current public health issues facing the individual, family, or group in their community. The family will prioritize and select 1 health issue to work on. Select at least 1 intervention for the health issue, including the available community resources. Ensure the chosen interventions are realistic and attainable.

Provide education and/or health counseling to the patient population about the selected health issues. This can be achieved with an individual, family, or group. Limit each teaching session to 30 min. (15 min. teaching plus 15 min. for evaluation).

Evaluate the patient population’s understanding of the provided education or counseling. To do this, ask the participant(s) to tell you at least 3 key points that they learned from the health education/counseling you provided. Note: Key points in this context are elements of the education/counseling that are considered important to both the patient and the nurse.

Write a 350-word summary of your interaction with the family. Include the identified public health issues, the health counseling/teaching delivered, and your evaluation. As you write your summary, be sure to reflect on the clinical objectives for the week; discuss how you met the objective(s).

Note: The time spent writing this summary cannot be included in the calculation/achievement of your direct care hours.

Part 2: Needs of Vulnerable Populations

Defining the needs of a vulnerable population is key to providing the best care.

Research three rural populations in your state.

What was most surprising to you about the demographics and social determinants of health (SDOH) in your selected locations? Why was it surprising?

Using the definition of underserved in which, “Underserved relates to limited access to services that are accessible, acceptable, and affordable, including healthcare” (CDC, 2022), what services were limited, difficult to access, unacceptable, or unaffordable to the patient population?

What relationships do you see between the SDOH and people who are medically and/or socially underserved in your selected locations?

Respond by explaining the data found about the communities. Defining the needs of a vulnerable population is key to providing the best care.

Note: Although references are not required, if you do use references in either section, format your in-text citations and references according to APA guidelines.

Assignment: NSGCB 482 Reflection 2 Sample

Part I: Health Promotion and Disease Prevention in the Community

Nurses play an important role in ensuring that individuals and populations have better health outcomes and acceptable life quality. Therefore, they use various approaches which have been shown to be effective. One such approach is health promotion and disease prevention used in the community. As such, it is important to carry out appropriate family and community assessments to gain insight into the potential problems that may be facing the community (Kuo et al.,2021). Such as assessment can be accomplished through a windshield survey. The windshield survey was conducted in Westminster, Maryland. Therefore, the purpose of this assignment is to formulate a health promotion and disease prevention plan for the community based on the windshield survey and a health promotion and disease prevention plan for a chosen family based on a family interview.

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Health Promotion Plan For the Community

            The windshield survey carried out for Westminster, Maryland, revealed various health issues that should be a center of focus when trying to improve the health outcomes of these community members. Some of the individuals in this region are homeless individuals living in abandoned buildings. It was noted that the rate of drug and alcohol abuse among these individuals is high. This has also had an effect on the community as a substantial number of youths and middle-aged individuals also engage in drug and alcohol abuse. Therefore, the health promotion plan focuses on reducing drug and alcohol abuse rates and using various strategies to help individuals not get into drug and alcohol abuse (Kristjansson et al.,2020).

 The plan will entail a community teaching strategy targeting all individuals. While the greatest target is those who are already abusing drugs and alcohol, other community members will also be involved as they can benefit from the program and participate in the preventive measures. The teaching aspect of health promotion has been shown to be an important part of plans used to address alcohol and substance abuse or use among individuals and communities. It is important that various factors are taken into consideration, for example, the available evidence-based approaches, cultural sensitivity, and target audience (Knox et al.,2019). The objective of the teaching effort is to equip the community with the right knowledge regarding the dangers and disadvantages of alcohol and drug abuse and strategies for preventing alcohol and drug abuse. The other objectives include assisting individuals to develop coping and refusal skills and offering information, support, and resources for people abusing drugs and alcohol.

The teaching session will last for one week, with each session taking a total of 30 minutes. The first day will cover an introduction to alcohol and drug abuse and an exploration of some of the known misconceptions about substance abuse. The second day will entail understanding substance abuse, where the participants will be taught about the science behind addiction and how substances like drugs and alcohol impact the brain, including the mental and physical effects. The third day will cover the risks and consequences of alcohol and drug abuse (Dickerson et al.,2020). Under this subtopic, various aspects will be discussed, including the long-term and short-term consequences and risks. The fourth day will deal with how to develop refusal skills. The fifth session will focus on support and effective coping strategies, where various health coping and stress management strategies will be explored. The last day of the program will focus on how to reduce stigma and a recap session for the week.

The Required Resources and Evaluation

It is important to have relevant resources and materials in place. In addition, it is important to evaluate the program to find out whether the individuals have understood the content. Some of the materials that will be used during the education session include short educational videos on alcohol and substance abuse, online resources such as those published by NIDA and CDS, fact sheets, and pamphlets on alcohol and substance abuse. As part of the evaluation plan, surveys will be administered to the participants before and after the education program to assess any changes in their attitudes and knowledge levels (Knox et al.,2019). Feedback will also be encouraged after every session to improve the chances of the program’s success. As part of the plan, the community members will be informed prior to the start of the program so that they get prepared to attend the week-long program.

Summary Of The Interaction With The Family

The family has three members: father (Mathew Sr), his son, who was three years old when his wife died, and his girlfriend Brittany, who he started relating with after his wife’s death. Mathew Senior struggles financially. Mathew Sr is at risk of diabetes since his father died of diabetes.  Things have not been made easier due to the fact that housing in Maryland is expensive, while there have also been cases of rising costs of grocery and fuel. However, the family does not qualify for food stamps since they get four hundred and fifty dollars for junior. He also cannot afford dental care, which he needs but, due to financial struggles, is unable to obtain. Junior also has to see a counselor every week, pointing to mental health struggles. The girlfriend also experiences pain due to ankylosing spondylitis. She also has financial struggles, and she has a lot of worries that her condition will make her stop working by the time she is forty.

The public health issues included unmaintained public parks and the high cost of housing, which makes individuals look for less expensive houses which are located in areas with high crime rates and poor access to healthy foods. There are also considerably high rates of alcohol and drug abuse. Therefore, the family was counseled on various issues; for example, the family was advised on the need to access healthy foods. Mathew Sr has a car, but the girlfriend does not have one. Therefore, he should use the car to access the food stores as appropriate. The family has a son, Mathew Jr., who is ten years old and quickly approaching teenage, who can easily be influenced to start abusing drugs and alcohol. Therefore, the family was advised to keep an eye on the boy and always teach him the potential dangers of alcohol and drug abuse. The intervention chosen for alcohol and drug abuse is an educational or teaching program that will be used to help equip the family with adequate knowledge (Nawi et al.,2021). The clinical objectives for the week were met. For example, assessing the healthcare needs of families and communities was achieved by conducting an interview with the family members. The other objective of formulation of healthcare plans was also achieved by engaging in health promotion and education and coming up with educational plans.

References

Dickerson, D., Baldwin, J. A., Belcourt, A., Belone, L., Gittelsohn, J., Keawe’aimoku Kaholokula, J., …& Wallerstein, N. (2020). Encompassing cultural contexts within scientific research methodologies in the development of health promotion interventions. Prevention Science, 21, 33-42. Doi: 10.1007/s11121-018-0926-1

Knox, J., Hasin, D. S., Larson, F. R., & Kranzler, H. R. (2019). Prevention, screening, and treatment for heavy drinking and alcohol use disorder. The Lancet Psychiatry, 6(12), 1054-1067. https://doi.org/10.1016/S2215-0366(19)30213-5

Kristjansson, A. L., Mann, M. J., Sigfusson, J., Thorisdottir, I. E., Allegrante, J. P., & Sigfusdottir, I. D. (2020). Development and guiding principles of the Icelandic model for preventing adolescent substance use. Health Promotion Practice, 21(1), 62-69. https://doi.org/10.1177/1524839919849032

Kuo, C. P., Hsieh, P. L., Chen, H. M., Yang, S. Y., Hsiao, Y. L., & Wang, S. L. (2021, August). Community health nursing competency and psychological and organizational empowerment of public health nurses: A cross-sectional survey. In Healthcare (Vol. 9, No. 8, p. 993). MDPI. https://doi.org/10.3390/healthcare9080993

Nawi, A. M., Ismail, R., Ibrahim, F., Hassan, M. R., Manaf, M. R. A., Amit, N., … & Shafurdin, N. S. (2021). Risk and protective factors of drug abuse among adolescents: a systematic review. BMC Public Health, 21(1), 1–15. Doi: 10.1186/s12889-021-11906-2

Part 2: Needs of Vulnerable Populations

            Vulnerable populations form part of most communities, and these communities have different needs and requirements. Therefore, it is important for professionals such as nurses and community health workers to identify the communities and assess their needs as appropriate, as identification and definition of the needs of such populations are important for the provision of the best care (Bantham et al.,2021). Therefore, the purpose of part two of the assignment is to research three rural populations in our states, discuss the most surprising facts regarding demographics and social determinants of health, and discuss various services that are limited, difficult to access, unaffordable, and difficult to access. In addition, this assignment will discuss the relationship between social determinants of health and people who are medically and/or socially underserved.

Most Surprising Aspects About Social Determinants of Health And Demographics

            The three rural communities found in Maryland include Chestertown, Oakland, and Leonardtown. The most surprising aspect of SDOH in Chestertown is income disparities, as others have higher incomes and enjoy comfortable lives. On the other hand, others have huge economic challenges (“UMSRH,” 2019). The other one is racial disparity. In Oakland, the most surprising thing was rural isolation as it is relatively isolated from the main populations such as Washington D.C and Baltimore, which may lead to limited access to healthcare services. For Leonardtown, the most surprising aspect is economic diversity and access to healthcare. These aspects were surprising since I expected them to have influence from bigger cities, such as Washington, D.C., to increase access.

Services Difficult to Access For The Patient Population

            The rural setup of the selected areas means that the populations may have various limited services. For example, while there are hospitals in the county, the big hospitals are located in the urban and semi-urban areas. Therefore, the populations have limited access to referral services offered in these bigger hospitals. Patients who could be living with conditions that need services from the bigger hospitals can find it challenging to access such facilities (Cyr et al.,2019). In addition, a good number of people living in these rural areas have economic challenges. Therefore, they may find affording transport to visit these hospitals challenging, which also makes the access more difficult.

Relationships Between SDOH and Medically And/Or Socially Underserved In The Selected Location

            It was important to explore the medically and/or socially underserved in the selected locations. All three locations are rural areas and have a considerable number of socially and medically underserved. One of the relationships existing between the SDOH and these people was on the economic front. These populations had considerably lower income and finances than the rest of the population, which led to poorer health outcomes. They find it difficult to access healthy food and afford the necessary healthcare services (De Lew & Sommers, 2022). In addition, the selected population also had lower education levels, which negatively impacted their understanding of the need to seek health services timeously.

Conclusion

            Vulnerable and underserved populations need appropriate care to enable them to overcome various barriers to care access and improve their care outcomes and life quality. These communities are more likely to be found in rural areas. Therefore, three rural communities have been discussed in this assignment including Chestertown, Oakland, and Leonardtown. They had various surprising aspects of social determinants of health which have been explored and explained.

References

Bantham, A., Ross, S. E. T., Sebastião, E., & Hall, G. (2021). Overcoming barriers to physical activity in underserved populations. Progress In Cardiovascular Diseases, 64, 64-71. https://doi.org/10.1016/j.pcad.2020.11.002

Cyr, M. E., Etchin, A. G., Guthrie, B. J., & Benneyan, J. C. (2019). Access to specialty healthcare in urban versus rural US populations: a systematic literature review. BMC Health Services Research, 19(1), 1–17. Doi: 10.1186/s12913-019-4815-5

De Lew, N., & Sommers, B. D. (2022, March). Addressing social determinants of health in federal programs. In JAMA Health Forum (Vol. 3, No. 3, pp. e221064-e221064). American Medical Association. https://doi.org/10.1001/jamahealthforum.2022.1064

UMSRH. (2019). Community Health Improvement reporthttps://www.umms.org/shore/-/media/files/um-shore/community/community-health-reports/chir-2016.pdf?upd=20210528155507