Analysis of Positions for Vulnerable Populations

Analysis of Positions for Vulnerable Populations

Analysis of Positions for Vulnerable Populations: PTSD

What is the health issue that is most prevalent or severe in the population?

Post-traumatic stress disorder (PTSD) is a mental health condition often resulting from a terrifying life event. Patients with this condition often present with flashbacks, nightmares, and severe anxiety. Patients also often experience recurring memories of the terrifying experience. In the United States and Canada, the lifetime prevalence rate of post-traumatic stress disorder is estimated to be between 6% to 9%, with the annual prevalence rate estimated to be between 3.5% to 4.7% (Yuan et al., 2021). This condition is found to be particularly prevalent between the ages of 18 to 24 years, with prevalence rates being lower amongst the older population.

How does the health issue impact the daily lives of members of the population?

The constant flashbacks, nightmares, and anxiety greatly reduce the individual’s quality of life. These feelings result in sleep disturbances and greatly affect an individual’s concentration. A study by Lee et al. (2020) established that post-traumatic stress disorder impacts a person’s ability to work and perform other day-to-day tasks, resulting in decreased productivity and overall quality of work. PTSD leads to isolation, which significantly affects the interaction of people with close friends and family, resulting in strained relationships.

How does the care environment in your chosen context impact both the population and the level of care related to the health issue?

The level of education and information that the general population has on post-traumatic stress disorder greatly impacts the level of care offered. Therefore, the care environment should be on the frontline to provide information related to this issue to ensure that more people are made aware and know the necessary measures to take. The care environment is also tasked with offering social and psychological support in delivering care, guaranteeing improved outcomes in relation to PTSD.

What are the biggest challenges you would need to overcome to improve the outcomes for the population related to the health issue?

One of the significant challenges that need to be overcome in improving outcomes of PTSD is stigmatization. Stigmatization often results from failure to acknowledge survivors. This, in turn, impacts help-seeking behaviors, significantly lowering outcomes related to PTSD. Acknowledgment of survivors and overcoming stigma by openly discussing the issue are essential in improving outcomes. The issue of limited resources is another that greatly impacts positive outcomes.

The shortage or complete lack of healthcare professionals in some settings who are qualified and well-versed in trauma-focused treatment is a major barrier to managing PTSD (Lloyd et al., 2018). In addition, poor healthcare infrastructure is another contributor to this poor state. It is imperative to address these issues by improving healthcare facilities and training more healthcare professionals to improve outcomes.

Avoidance, isolation, and disclosure by survivors are other issues that result in poor outcomes in managing this condition. In most instances, survivors fail to share their traumatic experiences and may consequently find it difficult to seek assistance. This means that patients fail to seek professional help even in instances where services are available. Emphasis should be made to encourage survivors to open up and seek professional help. This is key to improving outcomes in the long run.

Role of the Interprofessional Team.

The interprofessional team comprising nursing practitioners, physicians, social workers, and psychiatrists, among other healthcare professionals, is tasked with improving health outcomes. This team is responsible for looking at the patient holistically and ensuring that the care offered guarantees both quality and safety. Improved patient outcomes and the delivery of improved patient outcomes are some of the team’s primary objectives. Fostering an environment facilitating collaboration and open communication is key to improving outcomes.

Supporting Evidence.

A systemic review conducted by the Cochrane organization encompassing 79 randomized controlled trials focusing majorly on interprofessional collaboration in the administration of care for anxiety and depression proved that collaborative care is effective. Of late, four trials focusing on collaborative care for PTSD have been conducted between 2008 and 2016. Two of the four trials yielded positive results regarding interprofessional collaboration for PTSD. According to Hanson et al. (2018), the major cause of the discrepancy was that the care managers could not reach a significant number of individuals in the unsuccessful trials and consequently did not receive the care as intended initially.

A paper published by the International Society for Traumatic Stress Studies focused on treatment guidelines that have improved clinical outcomes recently. The search involved more than five thousand recent studies related to PTSD. Out of these, about 200 meta-analyses were identified in formulating recommendations to improve outcomes.

A total of eight strong, eight standard, five low effects, 26 emerging evidence, and 78 insufficient evidence were identified to inform the guidelines. Among adults, cognitive processing therapy, individual CBT with a trauma focus (undifferentiated), and prolonged exposure were identified as key to improving healthcare outcomes (Bisson et al., 2019).

A paper entitled “Social stigma is an underestimated contributing factor to unemployment in people with mental illness or mental health issues: position paper and future directions” by Brouwers (2020) focuses on the impact of stigma in the workplace regarding mental health issues such as PTSD. It clearly points out the long-term consequences of stigma and stresses the need to focus more studies to understand this issue better.

These papers remarkably confirm my earlier assertions, where I had pointed out the great impact that stigma has on health-seeking behaviors and the importance of interprofessional collaboration in improving care outcomes. The papers point out the most beneficial treatment options and how best to initiate these interventions, considerably guiding the management of the patient with higher chances of improved outcomes.

Contradictory Views.

A paper by the National Library of Medicine entitled “Stuck in the middle: the impact of collaborative interprofessional communication on patient expectations” seems to have an opposing view on the role of interprofessional collaboration in improving health outcomes. In the publication, Stewart (2018) notes that evidence from various research outlets points to numerous cases of lack of patient satisfaction resulting mainly from complaints due to interprofessional collaboration.

The paper points out that, more often than not, patients find themselves at the center of differing opinions, diagnoses, and interventions, ending up being the losers in the long run. This contradicts the aim of healthcare in today’s setting, which is to offer quality and safe healthcare that is patient-centered, fully addressing the concerns and expectations of the patient.

Therefore, there is a need to improve interprofessional collaboration within the care setting. Even though this practice has been embraced in most healthcare settings today, enough evidence is still not available to clearly point out whether this has positively impacted the overall healthcare system.

This is a valid point that focuses on the issue of interprofessional collaboration. However, research from most studies has shown the positive impact of incorporating collaboration and cooperation in the management of patients. In PTSD, this is key in managing the patient holistically and ensuring improved outcomes. Interprofessional collaboration confers several benefits to the patient, and I would encourage those with a different opinion to take this into consideration.

References.

Bisson, J. I., Berliner, L., Cloitre, M., Forbes, D., Jensen, T. K., Lewis, C., Monson, C. M., Olff, M., Pilling, S., Riggs, D. S., Roberts, N. P., & Shapiro, F. (2019). The International Society for Traumatic Stress Studies New Guidelines for the Prevention and Treatment of Posttraumatic Stress Disorder: Methodology and Development Process. Journal of Traumatic Stress, 32(4), 475–483. https://doi.org/10.1002/jts.22421

Brouwers E. (2020). Social stigma is an underestimated contributing factor to unemployment in people with mental illness or mental health issues: position paper and future directions. BMC Psychology, 8(1), 36. https://doi.org/10.1186/s40359-020-00399-0

Hanson, R. F., Saunders, B. E., Peer, S. O., Ralston, E., Moreland, A. D., Schoenwald, S., & Chapman, J. (2018). Community-Based Learning Collaboratives and Participant Reports of Interprofessional Collaboration, Barriers to, and Utilization of Child Trauma Services. Children and Youth Services Review, 94, 306–314. https://doi.org/10.1016/j.childyouth.2018.09.038

Lee, J. Y., Kim, S. W., & Kim, J. M. (2020). The Impact of Community Disaster Trauma: A Focus on Emerging Research of PTSD and Other Mental Health Outcomes. Chonnam Medical Journal, 56(2), 99–107. https://doi.org/10.4068/cmj.2020.56.2.99

Lloyd, B. P., Bruhn, A. L., Sutherland, K. S., & Bradshaw, C. P. (2018). Progress and priorities in research to improve outcomes for students with or at risk for emotional and behavioral disorders. Behavioral Disorders, 44(2), 85–96. https://doi.org/10.1177/0198742918808485

Stewart M. A. (2018). Stuck in the middle: The impact of collaborative interprofessional communication on patient expectations. Shoulder & Elbow, 10(1), 66–72. https://doi.org/10.1177/1758573217735325

Yuan, K., Gong, Y. M., Liu, L., Sun, Y. K., Tian, S. S., Wang, Y. J., Zhong, Y., Zhang, A. Y., Su, S. Z., Liu, X. X., Zhang, Y. X., Lin, X., Shi, L., Yan, W., Fazel, S., Vitiello, M. V., Bryant, R. A., Zhou, X. Y., Ran, M. S., Bao, Y. P., … Lu, L. (2021). Prevalence of posttraumatic stress disorder after infectious disease pandemics in the twenty-first century, including COVID-19: a meta-analysis and systematic review. Molecular Psychiatry, 26(9), 4982–4998. https://doi.org/10.1038/s41380-021-01036-x

NURS-FPX6026 Assessment 1 Instructions

Analysis of Positions for Vulnerable Populations

4pages in length utilizing 3 sources that support position and 2 sources that express oppositional views== total of 5 sources.

Please use Mental Health and PTSD (if possible)

Develop a 4–6-page position about a specific health care issue as it relates to a target vulnerable population. Include an analysis of existing evidence and position papers to help support your position. Your analysis should also present and respond to one or more opposing viewpoints.

Introduction

Note: Each assessment in this course builds on the work you completed in the previous assessment. Therefore, you must complete the assessments in this course in the order in which they are presented.

Position papers are a method to evaluate the most current evidence and policies related to health care issues. They offer a way for researchers to explore the views of any number of organizations around a topic. This can help you to develop your own position and approach to care around a topic or issue.

This assessment will focus on analyzing position papers about an issue related to addiction, chronicity, emotional and mental health, genetics and genomics, or immunity. Many of these topics are quickly evolving as technology advances, or as we attempt to push past stigmas. For example, technology advances and DNA sequencing provide comprehensive information to allow treatment to become more targeted and effective for the individual. However as a result, nurses must be able to understand and teach patients about the impact of this information. With this great power comes concerns that patient conditions are protected in an ethical and compassionate manner.

Position papers are a way for individuals, groups, and organizations to express their views and intentions toward a specific issue. In health care, many position papers address specific policies, regulations, or other approaches to care. As a master’s-prepared nurse, you should feel empowered to express and advocate for your own views on policy and care matters. This is especially important when it comes to populations you or your organization cares for that are not receiving the quality, type, or amount of care that they require.

An important skill in creating a position paper or policy proposal is the ability to analyze and synthesize others’ views about the population or issue of interest to you. By synthesizing the positive and negative views of an issue, you can become better equipped to strengthen your own arguments and to respond to opposing views in an informed and convincing way.

Preparation

As you prepare to complete this assessment, you may want to think about other related issues to deepen your understanding or broaden your viewpoint. You are encouraged to consider the questions below and discuss them with a fellow learner, a work associate, an interested friend, or a member of your professional community. Note that these questions are for your own development and exploration and do not need to be completed or submitted as part of your assessment.

  • What is the vulnerable population that most interests you?
    • What is the health issue that is most prevalent or severe in the population?
    • How does the health issue impact the daily lives of members of the population?
    • How does the care environment in your chosen context impact both the population and the level of care related to the health issue?
    • What are the biggest challenges that you would need to overcome to improve the outcomes for the population related to the health issue?
  • What is your position on how to best work to improve the care and outcomes that the population is receiving?
    • What previously published position papers support your position, or the need to work to improve care and outcomes in general for the population?
      • How do these position papers support your assertions?
      • How could one or more of the position papers help you to form a treatment plan?
    • What previously published position papers contradict your position?
      • What, if any, of these differences would make your position stronger if you incorporated them?
      • How could you respond to any irreconcilable differences in such a way as to encourage buy-in for your position from those opposed?

Assessment 1 will be based on an analysis of position papers that are relevant to a health care issue related to a vulnerable population. Think about your experience working with vulnerable populations, and the issues related to health care you have observed for those populations. Refer to the resources listed below:

Scenario

Pretend you are a member of an interprofessional team that is attempting to improve the quality of health care and the outcomes in a vulnerable population. For the first step in your team’s work, you have decided to conduct an analysis of current position papers that address the issue and population you are considering.

In your analysis you will note the team’s initial views on the issue in the population as well as the views across a variety of relevant position papers. You have been tasked with finding the most current standard of care or evidenced-based practice and evaluating both the pros and cons of the issue. For the opposing viewpoints, it is important to discuss how the team could respond to encourage support. This paper will be presented to a committee of relevant stakeholders from your care setting and the community. If it receives enough support, you will be asked to create a new policy that could be enacted to improve the outcomes related to your chosen issue and target population.

The care setting, population, and health care issue that you use for this assessment will be used in the other assessments in this course. Consider your choice carefully. There are two main approaches for you to take in selecting the scenario for this assessment:

  1. You may use one of the issues and populations presented in the Vila Health: Health Challenges in Different Populations and Vila Health: Resources for Topical Research media pieces. For this approach, you may consider the population in the context of the Vila Health care setting, or translate it into the context in which you currently practice or have had recent experience.
  2. You may select a population and issue that is of interest to you and set them in the context of your current or desired future care setting. While you are free to choose any population of interest, the issue you choose should fall within one of the following broad categories:
    • Genetics and genomics.
      • Sickle cell, asthma, multiple sclerosis, myasthenia gravis.
      • Type 1 diabetes, systemic lupus erythematosus (SLE), congenital neutropenia syndrome.
      • Arthritis, any type of cancer or lung or heart disease, obesity.
      • Abuse of alcohol, prescription drugs, tobacco, illegal substances.
    • Emotion and mental health.
      • Post-traumatic stress disorder (PTSD), depression, eating disorders, psychosis.

Note: If you choose the second option, contact the FlexPath faculty for your section to make sure that your chosen issue and population will fit within the topic areas for this course.

Instructions

For this assessment you will develop a position summary and an analysis of relevant position papers on a health care issue in a chosen population. The bullet points below correspond to the grading criteria in the scoring guide. Be sure that your submission addresses all of them. You may also want to read the Analysis of Position Papers for Vulnerable Populations Scoring Guide and Guiding Questions: Analysis of Position Papers for Vulnerable Populations [DOC] to better understand how each grading criterion will be assessed.

  • Explain a position with regard to health outcomes for a specific issue in a target population.
  • Explain the role of the interprofessional team in facilitating improvements for a specific issue in a target population.
  • Evaluate the evidence and positions of others that could support a team’s approach to improving the quality and outcomes of care for a specific issue in a target population.
  • Evaluate the evidence and positions of others that are contrary to a team’s approach to improving the quality and outcomes of care for a specific issue in a target population.
  • Communicate an initial viewpoint regarding a specific issue in a target population and a synthesis of existing positions in a logically structured and concise manner, writing content clearly with correct use of grammar, punctuation, and spelling.
  • Integrate relevant sources to support assertions, correctly formatting citations and references using APA style.

Example Assessment

You may use the assessment example, linked in the Assessment Example section of the Resources, to give you an idea of what a Proficient or higher rating on the scoring guide would look like.

Additional Requirements

  • Length of submission: 4-6 double-spaced, typed pages, not including the title and reference pages. Your plan should be succinct yet substantive. No abstract is required.
  • Number of references: Cite a minimum of 3-5 sources of scholarly or professional evidence that support your initial position on the issue, as well as a minimum of 2-3 sources of scholarly or professional evidence that express contrary views or opinions. Resources should be no more than five years old.
  • APA formatting: The APA Style Paper Tutorial [DOCX] will help you in writing and formatting your analysis.

Competencies Measured

By successfully completing this assessment, you will demonstrate your proficiency in the following course competencies and assessment criteria:

  • Competency 1: Design evidence-based advanced nursing care for achieving high-quality population outcomes.
    • Evaluate the evidence and positions of others that could support a team’s approach to improving the quality and outcomes of care for a specific issue in a target population.
    • Evaluate the evidence and positions of others that are contrary to a team’s approach to improving the quality and outcomes of care for a specific issue in a target population.
  • Competency 2: Evaluate the efficiency and effectiveness of interprofessional interventions in achieving desired population health outcomes.
    • Explain the role of the interprofessional team in facilitating improvements for a specific issue in a target population.
  • Competency 3: Analyze population health outcomes in terms of their implications for health policy advocacy.
    • Explain a position with regard to health outcomes for a specific issue in a target population.
  • Competency 4: Communicate effectively with diverse audiences, in an appropriate form and style, consistent with organizational, professional, and scholarly standards.
    • Communicate an initial viewpoint regarding a specific issue in a target population and a synthesis of existing positions in a logically structured and concise manner, writing content clearly with correct use of grammar, punctuation, and spelling.
    • Integrate relevant sources to support assertions, correctly formatting citations and references using APA style.

Analysis of Position Papers for Vulnerable Populations Scoring Guide

CRITERIA NON-PERFORMANCE BASIC PROFICIENT DISTINGUISHED
Explain a position with regard to health outcomes for a specific issue in a target population. Does not explain a position with regard to health outcomes for a specific issue in a target population. Attempts to explain a position related to health outcomes, but the position is either unclear, or does not link to a specific issue in a target population. Explains a position with regard to health outcomes for a specific issue in a target population. Explains a position with regard to health outcomes for a specific issue in a target population, and identifies assumptions on which the plan is based.
Explain the role of the interprofessional team in facilitating improvements for a specific issue in a target population. Does not describe the role of an interprofessional team. Describes the role of an interprofessional team, but does not fully explain its role in facilitating improvements for a specific issue in a target population. Explains the role of the interprofessional team in facilitating improvements for a specific issue in a target population. Explains the role of the interprofessional team in facilitating improvements for a specific issue in a target population. Acknowledges challenges that the team may face in working together or in facilitating improvements.
Evaluate the evidence and positions of others that could support a team’s approach to improving the quality and outcomes of care for a specific issue in a target population. Does not explain the evidence or positions of others related to a specific issue in a target population. Explains the evidence and positions of others related to a specific issue in a target population, but does not evaluate the value of these sources, or fails to relate how the sources will support a team’s approach to improving the quality and outcomes of care. Evaluates the evidence and positions of others that could support a team’s approach to improving the quality and outcomes of care for a specific issue in a target population. Evaluates the evidence and positions of others that could support a team’s approach to improving the quality and outcomes of care for a specific issue in a target population. Identifies knowledge gaps, unknowns, missing information, unanswered questions, or areas of uncertainty (where further information could improve the evaluation).
Evaluate the evidence and positions of others that are contrary to a team’s approach for improving the quality and outcomes of care for a specific issue in a target population. Does not explain the evidence or positions of others related to a specific issue in a target population. Explains the evidence and positions of others related to a specific issue in a target population, but does not evaluate the value of these sources, or fails to relate how the sources are contrary to the team’s approach for improving the quality and outcomes of care. Evaluates the evidence and positions of others that are contrary to a team’s approach for improving the quality and outcomes of care for a specific issue in a target population. Evaluates the evidence and positions of others that are contrary to a team’s approach to improving the quality and outcomes of care for a specific issue in a target population. Impartially responds to conflicting data and other perspectives in a way that creates buy-in.
Communicate an initial viewpoint regarding a specific issue in a target population and a synthesis of existing positions in a logically structured and concise manner, writing content clearly with correct use of grammar, punctuation, and spelling. Does not communicate an initial viewpoint regarding a specific issue in a target population and synthesis of existing positions in a logically structured and concise manner, writing content clearly with correct use of grammar, punctuation, and spelling. Communicates an initial viewpoint regarding a specific issue in a target population, but the synthesis of existing positions or the structure of the writing is somewhat unclear. There are mechanical writing errors that reduce the effectiveness of communication. Communicates an initial viewpoint regarding a specific issue in a target population and a synthesis of existing positions in a logically structured and concise manner, writing content clearly with correct use of grammar, punctuation, and spelling. Communicates an initial viewpoint regarding a specific issue in a target population and synthesis of existing positions in a logically structured and concise manner, writing content clearly with correct use of grammar, punctuation, and spelling. Identifies specific strategies or approaches used to ensure clear communication.
Integrate relevant sources to support assertions, correctly formatting citations and references using current APA style. Does not integrate relevant sources to support assertions; does not correctly format citations and references using current APA style. Sources lack relevance or are poorly integrated, or citations or references are incorrectly formatted. Integrates relevant sources to support assertions, correctly formatting citations and references using current APA style. Integrates relevant sources to support assertions, correctly formatting citations and references using current APA style. Citations are free from all errors.