Monday, January 27, 2020

Concept Analysis Pain In The Oncology Patient Nursing Essay

Concept Analysis Pain In The Oncology Patient Nursing Essay Are you having any pain. These are most likely the first words from a registered nurse to an oncology patient. Pain is a concept that creates many challenges for medical professionals. In a review of patients with cancer, pain was reported in 33% of patients after treatment to cure cancer, 59% of patients given anti-cancer treatment with the aim of either curative or palliative treatment, 64% of patients having advanced, metastatic or terminal cancer and 53% of patients with all stages of the disease (Chapman, 2012a). Pain management is a common reason an oncology patient is admitted as an inpatient to a hospital. Nurses are at the forefront of assessing and managing pain to achieve adequate therapy. However, in order to reach this outcome, nurses need to understand the types and causes of pain, assessment tools, non-pharmacological treatment and action of pain medications (Casey, 2011). Nursing staff and other medical professionals need to act as patient advocates when dealing with pain so that symptoms can be managed. Nevertheless, within the healthcare system, the prevalence of pain is increasing and pain is a complex issue that is not always well understood or managed by healthcare professionals and patients (Shaw, 2006). Issues with Pain Nurses are constantly faced with managing pain and need to develop skills to identify when pain is not adequately controlled in order to make recommendations to alleviate a patients pain. Unfortunately, there are many times when both nurses and physicians are not well educated in pain management and are not successful in decreasing an individuals pain level. Regardless of the variety of treatment options, cancer pain is not always effectively managed due to several barriers that include poor assessment, insufficient knowledge about pain and treatment and specific concerns about dependence, tolerance, addiction and drug-related side effects (Chapman, 2012b). In addition, many medical professionals hold inappropriate beliefs and attitudes toward pain management, which can affect providing pain relief for patients (Naylor, 2003). Some practitioners are fearful of prescribing or administering pain medications at a high level that might be required due to a patients tolerance. This create s many challenges in providing adequate pain control for patients that are able to verbalize their pain, as well as those patients who are not able to verbally express their pain levels. Significance in Nursing Pain is a significant concept in oncology nursing. Physicians and nurses working with this population need to be experts in pain management. It is critical for medical professionals to understand the different types of pain that oncology patients can experience. There are several pain management treatments available and not every medication will work effectively for a patient. It is important for nurses to recognize differences so that patients can be effectively managed. When pain is not adequately controlled, patients can become withdrawn and unable to focus on important aspects of their quality of life including activities of daily living and sexual and social relationships (Chapman, 2012a). In addition, mood, sleep patterns, cognition and existential beliefs can be affected (Chapman, 2012a). There are several types of pain that an oncology patient can experience. The most common types of pain are chronic pain, acute pain and breakthrough pain. Chronic pain is a constant pain. Acute pain can last anywhere from a few days to a few months and typically resolves when the underlying condition is treated (Chapman, 2012). Breakthrough pain happens briefly with moderate-to-severe flare-ups that occur even when a patient is taking long acting pain medication to address their chronic pain (Kedziera, 1998). Understanding these types of pain is pivotal to determine medications to be prescribed and implement non-pharmacological therapies. When medical staff understands the causes and types of cancer pain, they can individualize pain management strategies in order to improve the quality of patient care as well as provide sufficient pain relief (Chapman, 2012a). Oncology patients pain can be caused by several factors. Pain can be caused by tumors, surgery, chemotherapy and radiation which can affect different parts of the human body (Chapman, 2012a). When staff is knowledgeable about disease processes and treatments, medical professionals can prescribe medications to address specific pain. Nurses must assess an individuals pain management regimen at home so that dosing can be adjusted when admitted to the hospital. Nurses must be diligent in comparing prescribed medications to home medications. There have been instances when physicians will fail to order a long acting pain medication that a patient might take at home that can result in inadequate relief. Pain Assessment Assessing an individuals pain is a key component in achieving pain management. Nurses need to evaluate a patents pain when considering pain therapy and the nurse needs to focus on the following factors: (1) consistency in pain control, (2) taking action in response to an individuals pain assessment, (3) maximize effectiveness of medications while reducing side effects and (4) avoid gaps in pain control (Casey, 2011). Physicians do not spend as much face-time with patients as nurses, therefore, nurses have the responsibility to understand a patients pain and verbalize to the physician to achieve adequate pain control. An accurate and detailed assessment can provide guidance in creating an individualized treatment plan (Naylor, 2003). Each persons pain is going to be different and it is important to utilize assessment tools to implement the most effective pain management plan. When determining ways to manage pain based on the assessment, nurses need to not only focus on the physical as pects but also include pharmacological and non-pharmacological treatments to reach optimal comfort (Naylor, 2003). Education and training on different types of pain assessment tools and scales that are utilized in practice is essential to effectively manage pain levels of each patient. Without the ability to adequately assess a patients pain, there will be profound negative effects on comfort levels and the ability to meet health goals. Nurses have a pivotal role in addressing pain in oncology patients. It is essential for nurses to realize that managing pain goes beyond administering medication and that utilizing a holistic nursing care approach can allow a nurse to better understand a patients individual pain. Pain responses can be affected by psychological, social and cultural influences, such as anxiety, anger and fear that may enhance an individuals perception of pain (Naylor, 2003). In addition, cultural beliefs, upbringing and social situations may be the reason for certain expressions of pain (Naylor, 2003). Nurses need to be vigilant in recognizing factors that affect a patients pain and the meaning that an individual attaches to pain (Chapman, 2012a). A nurses role goes beyond completing tasks on a checklist but having the ability to connect with their patients to identify root causes of pain. It has been found that in order to reach a goal of effective symptom management, the multidisciplinary team must c reate a positive therapeutic relationship with the patient (Chapman, 2012a). Many times a patient is looking for the opportunity to express themselves and nurses have the ability to provide an environment that allows patients to open-up and verbalize their feelings. Changes to Nursing Practice The concept analysis has brought heightened awareness to the idea of pain. When assessing pain, there are many factors to be considered as addressed in the concept analysis. The analysis opened a door to look beyond what medical practitioners physically assess but also the importance of listening and understand the patient. The nurse must reflect on experiences he/she has with patients to improve their ability to effectively manage pain. Nurses need to realize that in order to implement appropriate nursing activities to meet a patients pain needs requires an ongoing learning process to truly understand the concept of pain (Cheng, 2003). Nurses have the ability to manage pain by getting to know their patients to be able to implement change. Nurses need to work on their listening skills so that patients feel that they can openly express their feeling and concerns. This allows the nurse to help guide the patient to becoming involved in his/her care. It is clear that when pain is not ade quately controlled it can have negative consequences on not only the patient but the entire family unit. Anticipated Outcomes Through the use of reflecting, provides the opportunity to anticipate outcomes and create successes in managing pain. One tool to achieve effective pain management and evaluate strategies is by conducting pain assessments (Naylor, 2003). Through these assessments, a nurse can identify physical effects of pain and understand both location and intensity. To know if a nurse is successful, the nurse will see a change in level of reported pain or physical attributes that a patient might exhibit. By changing current practice methods, nurses will be able to create an environment where patients will verbally express feelings which will be a sign of progress in better meeting patient needs. In addition, through these encounters nurses will be able to identify their patients use of coping mechanisms to address pain. Nurses can also see success when utilizing a holistic nursing approach by looking beyond everyday tasks and viewing the patient as a human being. As nurses identify factors that af fect pain management, they will be able to better meet patient needs. Nurses will have the education and skills to recognize and alleviate pain before it occurs by utilizing pain management interventions, methods and medications. Concept Analysis The analysis has relevance to understanding the concept of pain, while also isolating it from other concepts. The concept analysis regarding pain was intended to increase awareness and understanding pain by clarifying the defining attributes of pain, identifying antecedents that affect the perception of pain and the possible consequences of pain (Cheng, 2003). It is clear that pain is a concept that is not always well understood and requires analysis that others can become more conscious and responsive to addressing patients pain needs. The model case discussed pain using a scenario regarding an oncology patient. The model case included all the defining attributes: (a) unpleasant and distressful experiences originating from physical sensation and having both positive and negative meanings for an individual; (b) an individual human experience; (c) a state of feeling in both sensation and emotion (verbal), and behavioral components; (d) physical and psychological responses to the stimulus; (e) function of pain, including protective and warning signs; (f) pain responses and learned and influenced by personality, environment, emotions, social and cultural (Cheng, 2003). This example supported the concept of pain and clearly stated the characteristics of the case to addressing all the points regarding the concept of pain. Due to each patients individuality, personal experiences and views, there are several types of scenarios that could have been utilized as a model case. The model case creates awareness for nurses of all the factors to consider when understanding a patients pain. Nurses have to be able to use the skills to visually assess and listen to patients while understanding a patients history and the events that have taken place to bring the patient to the point of the pain that they are reporting. Understanding a patients culture and individual beliefs can provide insight regarding a patients response and expression of pain. Nurses need to be aware of potential patterns in certain cultural groups, however, nurses should not over generalize or stereotype that everyone within a culture will behave in the same manner (Davidhizar, 1997). This emphasizes the complexities when assessing and understanding a patients pain, and nurses need to go beyond the basic assessment tools and understand the individual to achieve effective pain control. The use of a borderline case and contrary case were used to distinguish the concept of pain from the model case (Cheng, 2003). The cases are important in differentiating the concept of pain from other closely related concepts, as seen in the additional cases. The borderline case did not meet all the elements of the model case and the contrary case addressed the concept of fear related to pain (Cheng, 2003). These cases enhance the model case and allow the reader to see alternate examples of situations that may arise in a clinical setting. Conclusion Pain is a universal part of the human experience and will continue to be an integral part of providing nursing care (Shaw, 2006). Pain is a complex concept that does not have one specific answer to meet all patient needs. Pain management requires assessment skills, knowledge and a holistic approach to nursing care to be successful at eliminating or effectively controlling pain in oncology patients. Nurses have both technical and moral tasks in the management of pain because they are the ones conducting assessments, administering pain medications and evaluating effectiveness, as well as, determining which pain relief measures and interventions are provided to patients (Shaw, 2006). Nurses need to continue to expand their knowledge base and be aware of their own values and beliefs in order to be successful in managing the dynamics and complexities of pain.

Saturday, January 18, 2020

Victimless Crime

Victimless crime is a term that is used to refer or to explain the behavior that is illegal but does not violate or threaten the rights of anyone else. It means that one person may be involved who is the person committing the crime on his own without affecting anyone else in the process. It can also include acts in which two or more persons agree to commit a criminal offense in which no other person is involved. Sometimes in situations of victimless crimes society has grown to call these events consensual crimes. One good common example that describes victimless crimes could be considered prostitution. Prostitution is described as offering sexual favors in exchange for money and is considered a crime in many places. Both the solicitor which is the person asking for the favor or the offering, and the prostitute can be arrested for violating public decency laws. If both people involved are deemed to have committed the illegal act consensually or willingly, then neither person may be considered victims in the eyes of the law and police officials. â€Å"While prostitution may contribute to other domestic problems or personal vices, the act itself, if entered into consensually, is usually considered a victimless crime† (Liberal Democrat Party). Victimless crimes are not always so weighty or so bad in the sense that it has to be as punishable but still breaks the law. Some examples of low level victimless activities or crimes on the states eyes that may be criminalized could simply include riding a motorcycle without a helmet. In some states, for example Florida it is not illegal to do, but as for the California it is against the law to ride a motorcycle without a helmet and the person will be cited for the act. Even tho that person is not harming or endangering anyone else but his own self the law still holds it as a crime in which breaks the law. Same as Mexico, it is legal to ride in the back of a truck without seat belts or other safety harnesses but here in California it is illegal. Another example is base jumping off of buildings. this is no harm to society or anyone else but the jumpers own life. a very common example of victimless crimes which could be punished by fines or even incarceration is the individual buy and consumption of recreational drugs. Here in the United States it is against the law to smoke marijuana and yet so many people still seem to do it. The law prohibits people from doing the act even though its being consumed by the individual himself, the individual is only harming his own body but the law sees it as a violation of the constitution and its law. â€Å"The idea of a victimless crime often plays a role in the proposed repeal of certain laws, especially the criminalization of drugs, prostitution and other vices† (Halexandria). The argument that has been presented by civil libertarians is that such laws only serve to punish citizens for personal lifestyle decisions in which none of these acts violate the legal rights of others. A citizen should be allowed to buy and smoke marijuana legally because its that persons private consumption in a private home and it does not affect anyone else. Decriminalizing certain victimless crimes would reduce the prison population and take significant pressure off an overworked judicial system (Liberal Democrat Party).

Friday, January 10, 2020

Marx and Locke

Miriam D. Knox Dr. Soupios Political Science 304 April 6, 2010 Karl Marx’s and John Locke’s Ideologies The Communist Manifesto, written by Karl Marx and Fredrich Engels and The Second Treatise of Government written by John Locke are two distinct written pieces that describes their ideas and their philosophical beliefs regarding how society would function at its best. Moreover, both writers offer a detailed explanation about the many struggles that man has encountered regarding his existence in the world. In addition, they suggested political concepts whereby they felt it would help man to bring about socialization that would allow man to live a fair and qualitative life. In The Communist Manifesto, Marx uses a large portion of the book to give a historical perspective of society. He emphasizes from the very beginning that most of mans history has been based on economic pursuits and economic gains. As a result, he says that â€Å"all hitherto existing society is the history of class struggles† (50). Throughout history, social change occurred when the productive forces in society clashed with the conditions of production, resulting in massive social upheaval. This was always to the benefit of one social class at the expense of another. Modern society was the result of a long series of revolutions in the modes of production, of which the bourgeois class was the main beneficiary. Marx wrote in the Communist Manifesto, â€Å"Society as a whole is more and more splitting up into two great hostile camps, into two great classes directly facing each other: bourgeoisie and proletariat †(51 ). The bourgeoisie, or capitalist class, consists of the relatively small number of people who owned or controlled the means of creating wealth including land and raw materials; mines, factories, and offices; machinery and technology and who could employ wage laborers to work for them. Proletarians perform most of the work in capitalist economies, but they had little or no control over their work-lives or over the wealth that they produced. The relationship between the bourgeoisie and the proletariat is an exploitative one because the latter is paid less than the value that its labor creates, with the surplus of economic profits being kept by the bourgeoisie. While wages may rise if workers are well organized and during periods of economic growth, competition between capitalists compels employers to reduce labor costs as much as possible, particularly during recurring periods of capitalist economic crisis. Historically, the bourgeoisie had played a quite revolutionary role. Whenever it has gained power, it has put to an end all â€Å"feudal, patriarchal, idyllic relations. â€Å"(53). It has eliminated the relationships that bound people to their superiors, and now all remaining relations between men were characterized by self-interest alone (53). In addition, religious fervor, chivalry and sentimentalism had all been sacrificed. Personal worth is now measured by exchange value, and the only freedom is that of Free Trade. Thus, exploitation that used to be veiled by religious and political â€Å"illusions† is now direct, brutal and blatant (53). The bourgeoisie has changed all occupations into wage-laboring professions, even those that were previously honored, such as that of the doctor. Similarly, family relations have lost their veil of sentimentality and have been reduced to pure money relations (53). Marx continues to describe that the bourgeoisie had only one thing in mind, and that was how to increase their economic status. Subsequently concerns and issues regarding mans overall well being was ignored and had no significance within society. The bourgeoisie made it clear that they were only concerned with increasing their political power. Furthermore, human conditions or any means of making humanity better was never considered nor important. In fact, Marx emphatically reminds us that money and political power was the bourgeoisies’ primary interest. The Manifesto then discusses the relationship of the Communists to the proletarians. Marx says that Communists have been â€Å"reproached† for desiring to abolish the â€Å"right† of acquiring private property through the fruits of one's labor (67). However, he points out, laborers do not acquire any property through their labor. Rather, the â€Å"property† or capital they produce serves to exploit them. This property, controlled by the bourgeoisie, represents a social power and not a personal power. Changing it into common property does not abolish property as a right, but merely changes its social character, by eliminating its class character. Marx also points out that the â€Å"[The bourgeoisie] is unfit to rule because it is incompetent to assure an existence to its slave within his slavery, because it cannot help letting him sink into such a state, that it has to feed him, instead of being fed by him. Society can no longer live under this bourgeoisie, in other words, its existence is no longer compatible with society† (65). The bourgeoisie wanted man to exist in a subservient state of mind and wanted man to accept the exploitative lifestyle they were providing for their daily existence. Moreover, â€Å"What the bourgeoisie, therefore, produces, above all, is its own grave-diggers. Its fall and the victory of the proletariat are equally inevitable† (65). Marx reminds us that it was impossible for man to continue to work and survive in such limited and harsh conditions successfully. If man continued to live like this it would lead to severe suppression and eventually to mans own demise. Therefore, Marx stresses in order for the proletariat to survive, they must revolt against the bourgeoisie. Marx states, â€Å"The immediate aim of the Communists is the same as that of all the other proletariat parties: formation of the proletariat into a class, the overthrow of the bourgeois supremacy, conquest of political power by the proletariat† (66). Marx understood that the proletarians had to revolt in order to experience freedom from their enslaved environment and develop a communistic society. According to Marx, † the theory of the Communists may be summed up in the single sentence: Abolition of private property† (67). Marx felt in order for the proletarians to escape the bondage they were encountering and to establish a Communist society this theory had to be implemented. This theory was not an option, but in fact a necessity for the proletarians to develop a communistic society. Marx ends Communist Manifesto in stating â€Å"Let the ruling classes tremble at a communist revolution. The proletarians have nothing to lose but their chains. Working men of all countries unite! (91). Marx strongly felt that man united throughout the universe and living in a Communist society would offer man the opportunity to live with the prospect of both justice and a qualitative lifestyle while living in the world. He new this type of revolution would make the bourgeoisie fall and crumble. The Second Treatise of Government written by John Locke places sovereignty into the hands of the people. Locke's fundamental argument is that people are equal and invested with natural rights in a state of nature in which they live free from outside rule. Locke addresses the state of nature in order to define political power. In Chapter 2, Locke explains the state of nature as a state of equality in which no one has power over another, and all are free to do as they please(4). He notes, however, that this liberty does not equal the license to abuse others, and that natural law exists even in the state of nature. Each individual in the state of nature has the power to execute natural laws, which are universal (5). Locke's theory includes a host of moral beliefs and moral practices. Moreover, Locke points out and wants us to understand that the state of nature derives from a theory of justice and from a set of rights. No one would have any â€Å"rights† at all in the absence of a moral code applicable to human actions or any standard of â€Å"just† punishment. One topic that Marx and Locke had different views points on was whether private property was a natural right or not. John Locke believed that private property was a natural right, in fact he believed owning property was one of the most important possessions that mankind should seek and obtain. Locke emphasized that all men have the right to â€Å"life, liberty and possessions â€Å"(5). One of man’s best attributes as well as his down fall is having freewill, whereby man has the option in making a good or bad choice regarding his actions. Keeping this in mind, Locke realizes the importance of establishing clear and precise rules for man to abide by. Locke emphasizes that, in any civil society, situations will arise that have to be dealt with before the legislative can be assembled to provide laws for them. In these instances, the executive may exercise executive prerogative or simply â€Å"good judgment† (95). The executive is qualified to take actions that are outside the framework of the laws (not breaking them, just not provided for by them), if their actions advance the society's best interest. He defines this prerogative as â€Å"nothing but the power of doing public good without rule†(95). Overall Locke believed this rule of thumb avoided chaos and would provide peace and order. Ultimately this thought process was for man’s overall good and for his general welfare. Locke defines tyranny as â€Å"the exercise of power beyond right† (112). A just leader is bound by the laws of the legislative and works for the people, whereas a tyrant breaks the laws and acts on his own behalf. Locke notes that any executive body is not just a monarchy, but in fact ceases to function for the benefit of the people are a tyranny. Locke implies when the government is dissolved, the people are free to reform the legislative in order to recreate a civil state that works in their best interest before they fall under tyrannical rule. In addition, He expressed the radical view that government is morally obliged to serve people, namely by protecting life, liberty, and property. He explained the principle of checks and balances to limit government power. He favored representative government and a rule of law. However he denounced tyranny. He insisted that when government violates individual rights, people may legitimately rebel (126). Overall Locke believed that men were, by nature, born free and independent, meaning every person was a law unto themselves. That meant that they couldn't be subjected to political power without their own consent. Since every individual had consented being part of the community, they had the power, and the will to act as a whole. By consenting to being in a community, man is obliged to be a part of it, and to support whatever the general will is, for his fellow citizens. Hence, Locke was asserting that government had to be fair and equitable towards all its citizens. In addition, Locke believed it was crucial for citizens had the right to revolt if government was not meeting their needs. Marx and Locke were aligned along these terms although the ideas of Karl Marx did not have the same implicit trust in the inherent â€Å"good† of government that Locke had. According to Marx, government was not an entity through which change could be brought about. Rather, for change to happen and for the class struggles to be resolved it was necessary for the people to rise up and bring about the necessary adjustments to society. Works Cited Locke, John. The Second Treatise of Government. 1997 Prentice Hall Engels, Friedrich & Marx, Karl. The Communist Manifesto. 1998 Signet Classics

Thursday, January 2, 2020

Impact of Celebrity Endorsement on Consumer Buying...

A Grand Project on Impact of Celebrity Endorsement on Consumer Buying Behavior with respect to Soft Drinks Prepaid by Guided by Hardik D Jani (Roll no: 35) Prof .Kruti Patel MBA Semester 4 Submitted to S K P I M C S DECLARATION We/ I, hereby, declare that the Comprehensive Project report Project titled, â€Å"Impact of celebrity endorsement on consumer buying behavior with respect to soft drink industry † is original to the best of our/ knowledge and has not been published elsewhere. This is for the purpose of partial fulfillment of Kadi Sarva Vishwa Vidhyalaya University requirements for the award†¦show more content†¦They worship celebrities.Celebrities which might be cricket stars like Sachin Tendulkar, Mahinder Singh Dhoni or Film Stars like Shah Rukh Khan or John Ebrahim. They treat them as God. Marketers use this very preposition so as to influence their target customers may exist or potential ones. For this they rope in these celebrities and give them whopping amount of money. They believe that by doing this they can associate their products with their target customers. This is called celebrity endorsement. The field of consumer behavior is the study of individuals, groups or organizations and the processes they use to select, secure, use and dispose of product, services, experiences, or ideas to satisfy needs and impacts that these processes have on the consumer and society. And understanding the consumer behavior is the prime and toughest task in front of every marketer. There are a lot of factors, which influence consumer buyer behavior. This study aimed at to understand the influence of celebrity endorsement on consumer buying behavior. 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