Trust Among Vulnerable Communities Paper

Trust is a delicate balance among all communities, especially when it involves personal aspects of a person’s life, such as health care needs.  Trust is built, earned and maintained which is a difficult part of being a care provider, which is not easily measured or reviewed for consistent performance improvement.  Vulnerable populations in the health care world are categorized in groups such as race, ethnic economic and social circumstances (J. Hosp. Med, 2006). 

Historically, minority race and ethnicities have been the main factors in disparities in comparison to white populations groups.  Past research has shown minorities were the most significantly impacted population of limited access to health care, financial struggles to access health care plans and significant socioeconomic challenges in comparison to predominately white communities (Shi & Singh, 2017).

Trust Among Vulnerable Communities Paper

Ethnic groups, such as Latinos are the most common group identified when attempting to associate vulnerable populations with health care gap analyst.  Research has indicated, minority populations are expected to significantly increase, expanding the disparity gap among the non-Caucasian population by 2050 (Pardasani & Bandyopadhyay, 2014).  As we continue to evaluate trust among vulnerable populations, we must acknowledge the concerns within the care delivery system to identify trust barriers, why trust is necessary and how barriers can be reduced or improved.

As a physician or care provider, establishing trust is not easily achieved simply by being the care provider of a patient. Developing a relationship as a care provider with a patient requires an understanding and acceptance of the difference that is shared between provider and patient, such as religious beliefs, social economics and the belief of personal disconnection due to perceived financial differences.  Often, providers will need to overcome an initial distrust by their patient simply due to a perceived belief from a patient that as a provider there is no possibility to understand their economic, religious beliefs and communication barriers (Pardasani & Bandyopadhyay, 2014).

Another obstacle to trusting care providers has to do with the inability to access care.  As care providers ultimately can choose to accept certain levels of health coverage, such as employer coverage over public insurance, this leads to vulnerable population who access public insurance plans due to financial challenges seeking care in an emergent capacity opposed to preventive since this is the only group of providers obligated to provide care (Zuvekas, 2005).  Care providers must be willing to cross barriers of differences to make an impact, gaining trust among the most vulnerable populations will not be easy but can be achievable.

Trust is a cornerstone to delivering the highest quality of care.  As the health care community continues to evaluate opportunities to improve health care delivery and access to all, improvement of trust among the provider and patient relationship is an essential part of the move for an overall improvement of health care services.  Patients often rely on personal relationships in their decision-making process, usually this connected hold more weight to the patient’s decision-making process over and above the physician managing the care treatment plan (Collado, Oakman & Shah, 2017).

Among the Latino population, decision making tends is based on close relationships that are long-standing and connected with them on a social, economic, language and religious connection, especially significant among the older adults (Collado, Oakman & Shah, 2017).  Often, trust is quickly established when the patient and provider is of like culture, language, and beliefs.  It does not mean a physician that does not share the same cultural background will be unable to build trust, it will just take a deeper connection with their patient and a real understanding of cultural competence to establish trust among their vulnerable patients, effective implementation will ensure a trust connection with their patient (Pardasani & Bandyopadhyay, 2014).

Without trust, a care provider will be unable to gain loyalty by the patient to manage their care properly and seek the medical needs necessary to ensure their health needs are met and handled in the most appropriate manner.  If a physician is unable to establish trust, a patient will not achieve the best level of health care possible.  A solid plan to develop confidence and respect is not available to care providers as a road map, but building trust and breaking down the barriers that a vulnerable population will experience such as the inability to access care is necessary for the betterment of health care of the future (Collado, Oakman & Shah, 2017).

Breaking down the barrier will be a long road but will have a significant impact on the improvement of health care for all, particularly the vulnerable population.  Cultural competence will be vital in removing barriers as care providers continue to improve their understanding of cultural gaps and how these gaps influence the behaviors of the vulnerable population (Pardasani & Bandyopadhyay, 2014).  As health care reform continues to make necessary improvements, extended learning of how to impact the vulnerable people will be essential. 

It will be key to involve people from this diverse communities to be part of the research, asking the hard questions such as their concerns and opinions about accessing health care and making the necessary changes to improve their access for ultimate health care access improvement for all (Pardasani & Bandyopadhyay, 2014 Trust Among Vulnerable Communities Paper).  Yes, a care provider can ultimately treat a patient appropriately without first establishing trust, but the establishment of a trust will ensure the patient is receiving the high level of quality care delivery services and will working very diligently with their care provider to provide treatment plans that are followed and improved health care is achieved.

Trust and respect must be a part of any care delivery treatment plan; otherwise, the program cannot truly achieve the highest quality of care.  The relationship established between care provider and the patient is necessary and will drive how a patient accepts and follows physician medical advice, without the trust a patient will be less likely to support any established treatment plan (Collado, Oakman & Shah, 2017).  Trust, respect and cultural awareness will continue to be critical factors of high-quality care moving forward. 

Our nation has made improvements to the care delivery system over the past few decades, and more needs to be done to continue addressing the health care disparities among the vulnerable populations (Shi & Singh, 2017).  As the health care community evaluates ways to connect further with vulnerable populations, acknowledgment of building trust, maintaining trust and respecting difference will be essential for vast improvements to health care.

Trust Among Vulnerable Communities Paper References

Analysis of Position Papers for Vulnerable Populations

Cancer is a serious problem in modern medicine, and it is seen as a disease of lifestyle. Every year, around 90,000 individuals worldwide die from cancer, and 120,000 new cases are diagnosed (Lewandowska et al., 2020). Cancer-related mortality has more than doubled in women and tripled in men during the previous 40 years (Lewandowska et al., 2020). According to the World Health Organization, cancer is currently more fatal than cardiovascular illnesses, and this statistic is predicted to climb dramatically. 

Cancer diagnoses are expected to rise from 19 million to 21.7 million by 2030 and 24 million by 2035 (Lewandowska et al., 2020). The most frequent cancer in males is lung cancer, which accounts for around 15% of all cancer cases, followed by prostate cancer (13%), colorectal cancer (12%), and bladder cancer (7%) (Lewandowska et al., 2020). Breast cancer is the most frequent cancer in women, accounting for more than 15% of all cancer cases, with colorectal cancer (10%), lung cancer (9%), endometrial cancer (7%), and ovarian cancer (5%) (Lewandowska et al., 2020).

Cancer has a profound effect on patients and their loved ones, producing physical and psychological agony as well as bad social and spiritual experiences. Cancer can undermine a patient’s feeling of security, creating mental anguish and worry. Cancer patients must deal with physical symptoms induced by the disease and its treatment, as well as long-term health problems, disability, exhaustion, and discomfort, in addition to the stress of the diagnosis. Emotional stress and mental health concerns can cause difficulties in everyday life, such as being unable to work, having financial troubles, and lacking social support. 

According to the research, cancer patients have a wide range of requirements since each person reacts differently to the disease’s challenges based on their personality and comprehension of their new circumstances. Time, illness progression, and therapy impact a patient’s mental health. Needs assessment assists in better understanding patients’ and their families’ experiences, as well as determining priorities for resource allocation, planning, and providing holistic care (Lewandowska et al., 2020). Medical personnel are largely accountable for satisfying these demands, as research shows that a lack of appropriate information and psychological support frequently causes patients suffering.

Specific Health Care Issue Being Addressed In The Cancer Patients

The specific healthcare concern in cancer patients that we are addressing is the requirement for a comprehensive and interdisciplinary approach to care. Cancer is a complicated disease that necessitates a multifaceted strategy to satisfy patients’ physical, emotional, and social requirements. Taberna et al. (2020) further state that inadequate treatment can result in poor health outcomes such as decreased quality of life, increased morbidity and death, and increased healthcare expenses. 

A multidisciplinary team of healthcare specialists, including medical oncologists, surgical oncologists, radiation oncologists, nurses, social workers, and other allied health professionals, is necessary for cancer patients. The team should collaborate to establish and implement a treatment plan specific to the particular patient’s needs. Furthermore, the value of psychosocial support in cancer care cannot be emphasized. Cancer patients frequently feel severe emotional discomfort, such as worry, despair, and apprehension about recurrence. These psychological symptoms might have a significant influence on their quality of life and treatment adherence. As a result, psychosocial assistance such as counseling, support groups, and other therapies that might help patients deal with their diagnosis and treatment must be included in cancer care.

Population Affected By The Issue And How The Population Is Relevant

The population impacted by our chosen issue is cancer patients, particularly those in old age. Cancer is more common in older persons, and the risk of developing cancer rises with age. According to the American Cancer Society (2019), adults over the age of 65 account for nearly 60% of all malignancies diagnosed in the United States. Cancer patients over the age of 65 have specific health demands that necessitate a thorough and specialized approach to care. They frequently have comorbidities, including heart disease, diabetes, or arthritis, which can complicate cancer therapy and influence health outcomes. 

Furthermore, older persons may have age-related body changes that influence how they respond to therapy. Cancer patients have special social and emotional demands. Many are retired, and cancer treatment might limit their capacity to engage in social activities or care for themselves. They may also have emotional difficulties as a result of their cancer diagnosis, such as worry, sadness, and fear of recurrence. As a result, it is critical to give special care to older persons with cancer that meets both their physical and emotional needs. Doing so can enhance health outcomes and quality of life for this population.

The Current States Of Care And Health Outcomes Related To The Chosen Issue And Target Population And Position On How To Improve The Care And Outcomes

The present condition of cancer care and health outcomes in old age is ambiguous. While advancements in cancer therapy have resulted in higher survival rates, older persons with cancer continue to face inequities in care and results. Compared to younger patients, they are less likely to obtain adequate cancer therapy, endure more treatment-related toxicities, and have shorter survival rates.

The perspective on how to enhance cancer care and outcomes in old age is to use a multidisciplinary, geriatric-focused approach to care. This method entails a specialized evaluation of the patient’s functional, social, and psychological requirements, careful consideration of comorbidities and medication management, and treatment options suited to the particular patient’s health state and goals. It is critical to take action on this viewpoint since the aging population is increasing and cancer is becoming more common in older persons. We can eliminate health inequities and enhance the quality of life for millions of people by improving care and outcomes for this population. Furthermore, providing high-quality and fair treatment to all patients, regardless of age, is a moral and ethical duty, and a geriatric-focused approach to care can assist in achieving this aim (Taberna et al., 2020).

Role Of The Interprofessional Team In Facilitating Improvements

The interprofessional team’s involvement in encouraging improvements for the need for a comprehensive and multidisciplinary approach to care for older people is critical. An interprofessional team guarantees that patients’ health requirements are handled holistically, resulting in improved health outcomes. Medical oncologists, surgical oncologists, and radiation oncologists are needed to provide specialized cancer treatment, make decisions based on the patient’s health status, and collaborate with other team members to ensure that treatment plans are comprehensive and tailored to the patient’s individual needs (Lee & Kwak, 2020). Nurses are essential in cancer care because they provide direct patient care, administer therapies, monitor for adverse effects, and educate patients and families about cancer therapy and management.

Social workers are critical in treating cancer patients’ psychological needs, including counseling, support groups, and supporting patients navigating the healthcare system. Simultaneously, pharmacists assist in the management of prescription regimens, ensuring that they are appropriate for the patient’s health state and comorbidities (Lee & Kwak, 2020). Physical and occupational therapists help patients retain their physical function and independence during and after therapy.

By ensuring that healthcare professionals collaborate to address the patient’s complicated health demands, an interprofessional approach can better promote advancements in cancer care for older patients. Each team member provides a distinct viewpoint and skill to patient care, allowing for a more thorough and personalized treatment plan that takes into account the patient’s medical, psychological, and social requirements. Given that cancer care in older people necessitates a thorough and specialized strategy, it is critical that our position and engagement take an interprofessional team approach (Fowler et al., 2020). An interprofessional team approach provides the skills and resources required to meet the specific health requirements of older cancer patients, resulting in better health outcomes and quality of life. Furthermore, it guarantees that patients’ care is patient-centered and that their beliefs, preferences, and objectives are respected.

Evidence And Positions Of Others That Support A Team’s Approach To Improving The Quality And Outcomes

Several position papers and evidence-based studies were discovered when researching the literature on enhancing the quality and outcomes of care for elderly cancer patients. A study published in the Journal of Geriatric Oncology in 2019 by Kotwal et al. demonstrated that a multidisciplinary team approach enhanced the quality of treatment for older cancer patients by lowering toxicity rates and length of hospital stays. This study supports our belief that addressing the complex health requirements of older cancer patients requires an interdisciplinary team approach.

Fowler et al. (2020) research published in the Journal of Clinical Oncology 2020 indicated that elderly cancer patients frequently had several comorbidities, increasing the chance of unfavorable outcomes. This study emphasizes the need for an interdisciplinary approach to treating patients’ cancer as well as their general health and well-being.

A position paper published in the Journal of the National Comprehensive Cancer Network in 2020 by Lee and Kwak underlines the necessity for personalized treatment approaches for older cancer patients that take into account their overall health status and comorbidities. This article backs up our contention that a thorough and tailored strategy is essential for improving the health outcomes of older cancer patients.

The evidence and position papers serve as guides in building our position and implementation plans, highlighting the necessity of an interprofessional team approach and the need for personalized treatment plans that address the patient’s entire health and well-being. They also present evidence that this technique is successful in improving health outcomes for older cancer patients (Kotwal et al., 2019). Specific pieces of data and views support the necessity for an interprofessional team approach and comprehensive treatment plans that take the patient’s particular health requirements into account. These data and viewpoints provide a solid support for our perspective, laying the groundwork for the creation and execution of our proposed policy.

Evidence And Positions Of Others That Are Contrary To A Team’s Approach To Improving The Quality And Outcomes Of Care

In the literature review on enhancing the quality and outcomes of care for older cancer patients, some perspectives contradicted previous articles. According to the American Cancer Society (2019) position paper published in the Journal of the American Geriatrics Society in 2019, older cancer patients may be overtreated, resulting in needless toxicities and side effects. This research argues that a personalized strategy that considers the patient’s overall health state is required to minimize overtreatment. 

While this viewpoint is not necessarily opposed to ours, it emphasizes the significance of a customized approach in formulating treatment strategies for aged cancer patients. An interdisciplinary team approach is still required to ensure that all patient care components are considered. However, an interdisciplinary team approach is still required to guarantee that all elements of the patient’s health and well-being are taken into account when designing a customized treatment plan (Kotwal et al., 2019).

Conclusion

Improving the quality and results of care for vulnerable groups like elderly cancer patients is a top focus for healthcare providers. Interprofessional teams can design successful ways to address this group’s particular needs and problems by fully examining current position papers and evidence-based practices. While some may disagree, an interdisciplinary team approach that takes the patient’s total health state and well-being into account is crucial in ensuring that elderly cancer patients receive the comprehensive and coordinated treatment they require. Healthcare professionals may collaborate to design policies and strategies that enhance the quality and results of care for elderly cancer patients, eventually leading to better health outcomes and a higher quality of life.

Trust Among Vulnerable Communities Paper References

American Cancer Society. (2019). cancer facts and figures. Cancer.org. https://www.cancer.org/content/dam/cancer-org/research/cancer-facts-and-statistics/annual-cancer-facts-and-figures/2019/cancer-facts-and-figures-2019.pdf

Fowler, H., Belot, A., Ellis, L., Maringe, C., Luque-Fernandez, M. A., Njagi, E. N., Navani, N., Sarfati, D., & Rachet, B. (2020). Comorbidity prevalence among cancer patients: a population-based cohort study of four cancers. BMC Cancer, 20(1), 2. https://doi.org/10.1186/s12885-019-6472-9

Kotwal, A. A., Presley, C. J., Loh, K. P., Huang, L.-W., Lam, V., & Wong, M. L. (2019). Geriatric oncology research at the 2019 American Geriatrics Society (AGS) annual meeting: Joint perspectives from the Young International Society of Geriatric Oncology (SIOG) and AGS Cancer and Aging Special Interest Group. Journal of Geriatric Oncology, 10(6), 994–997. https://doi.org/10.1016/j.jgo.2019.06.008

Lee, D. Y., & Kwak, J.-M. (2020). A comprehensive approach for older cancer patients: New challenge in an aging society. Annals of Coloproctology, 36(5), 289–290. https://doi.org/10.3393/ac.2020.10.25

Lewandowska, A., Rudzki, G., Lewandowski, T., & Rudzki, S. (2020). The problems and needs of patients diagnosed with cancer and their caregivers. International Journal of Environmental Research and Public Health, 18(1), 87. https://doi.org/10.3390/ijerph18010087

Taberna, M., Gil Moncayo, F., Jané-Salas, E., Antonio, M., Arribas, L., Vilajosana, E., Peralvez Torres, E., & Mesía, R. (2020). The multidisciplinary team (MDT) approach and quality of care. Frontiers in Oncology, 10, 85. https://doi.org/10.3389/fonc.2020.00085

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