improving health in your community, psychology homework help

improving health in your community, psychology homework help improving health in your community, psychology homework help Using each source attached write an 8 page research paper on the topic: How religiosity/spirituality affect the quality of life as well as survival in cancer patients. Follow these directions: A little over half of your paper (4-5 pages) should be devoted to the summary of the literature on your topic. You should include at least 11 peer-reviewed sources (these files are attached). Don’t just list the main findings of each study one by one, try to integrate the findings and critically review the research. For example, it might be that three studies found the same thing, so you could summarize the main ideas from all three together. When critically reviewing the research, describe what you think were some of the main ideas, limitations, or strengths from the research as a whole . This should represent your own ideas . In this section, I am looking for integration, synthesis, and critical analysis. In the next section of your paper (2-3 pages), you will be translating the research you read to improving health in the real-world. How can you use the research to design an intervention for improving health in your community? You should not just restate what another study did, but take it to the next level, describe how you would do it differently and why, make a case for why your plan for change represents is the best direction for impacting health out in the real-world. Be creative! For example, if you reviewed cell-phone based interventions to prevent smoking initiation among adolescents and found that the interventions were only somewhat helpful, this is your chance to describe a plan that you believe would work better based on the limitations of the studies you reviewed. Some things to consider: What were the biggest shortcomings of the research you reviewed and how would you improve on these shortcomings? How could you apply what you learned in your literature review to improve health in the real-world ? A suggested outline for the paper is as follows: improving health in your community, psychology homework help Introduction (1 page or less) Background and introduction to your topic. Some things to include: i.Disease or prevalence rates in your population; Who is affected?; How prevalent is it? ii.Introduce your specific topic; Explain why your topic is important *** Background articles used in the Intro should not be used in Section II, Lit Review Literature review (4-5 pages) Summary, synthesis and critical analysis of the research i.Include at least 11 references ii.Integrate and synthesize the results of the 11 studies you have read iii.Identify the strengths and weaknesses of the literature you read (in your own words!) Translating research into practice: developing a plan to improve health (2-3 pages) Describe your plan to improve health i.Drawing from the research you reviewed, design a plan to impact the health outcome you chose. What would it look like? Where/how would you implement it? ii.Consider: What were the biggest shortcomings of the research you reviewed and how would you improve on these shortcomings in designing your own plan for change? How could you apply what you learned in your literature review to improve health in the real-world ? merged_document_4.pdf ORDER NOW FOR CUSTOMIZED AND ORIGINAL ESSAY PAPERS Annals of Oncology letters to the editor introduction Measurement of religion, religiousness, and spirituality for the purposes of health research has been an evolving enterprise. Beginning with Durkheim’s Suicide (1897/1951), and continuing through the 1960s and 1970s, epidemiological studies focused on mortality or health differences among religious affiliations. A second wave of studies beginning in 1979 [1] took an entirely different approach. Religiousness was measured with a single item asking about attendance at services or membership in a congregation; the individual’s specific religious affiliation, the basis for all the previous research, was now usually absent [2]. Also, Volume 21 | No. 4 | April 2010 letters to the editor | 907 Downloaded from http://annonc.oxfordjournals.org/ at CSU Humboldt on November 27, 2016 Spirituality and religion in cancer letters to the editor Annals of Oncology spirituality is an essential component of the care of patients with cancer and those that are dying. spirituality and cancer Cancer patients do not expect spiritual solutions from oncology team members, but they wish to feel comfortable enough to raise spiritual issues and not be met with fear, judgmental attitudes, or dismissive comments. Spiritual needs may not be explicit in all illness phases, yet spirituality is not only confined to the areas of palliative or end-of-life care [3]. Lopez et al. showed that the level of overall spiritual well-being was high, as were the levels of self-efficacy and life scheme (meaningfulness), as measured with two subscales [4]. religion and cancer Downloaded from http://annonc.oxfordjournals.org/ at CSU Humboldt on November 27, 2016 The relationship between religion and health has been studied in several countries and the results were positive. An association between religious affiliation, behavior, and lifestyle indicating that, even in relatively secular societies, it is a population attribute that should be given more consideration in studies of population health [5]. Understanding of a patient’s religious status and information relating to the spiritual domain can be useful to clinicians working in chronic illness, surgery of cancer, and terminal care, where it can effect patient morale [6]. S. R. Mousavi* & M. E. Akdari Shahid Beheshti University of Medical Sciences, Cancer Center, Tehran, Iran (*E-mail: [email protected]) references 1. Berkman LF, Syme SL. Social networks, host resistance and mortality: A nine-year follow-up of Alameda County residents. Am J Epidemiol 1979; 109: 186–204. 2. Idler E. Religious observance and health: theory and research. In Warner Schaie KW, Krause N, Booth A (eds): Religious Influences on Health and Well-Being of the Elderly, New York: Springer 2004; 20–43. 3. Surbone A, Baider L. The spiritual dimension of cancer care. Crit Rev Oncol Hematol 2009. 4. Lopez AJ, McAcuffrey R, Quinn Griffin MT, Fitzpatrick JJ. Spiritual well-being and practices among women with gynecologic cancer. Oncol Nurs Forum 2009; 36(3): 300–305. 5. O’Railly D, Rosato M. Religious affiliation and mortality in Northern Ireland: beyond Catholic and Protestant. Soc Sci Med 2008; 66(7): 1637–1645. 6. O’Connell KA, Skevington SM. improving health in your community, psychology homework help To measure or not to measure? Reviewing the assessment of spirituality and religion in health-related quality of life. Chronic Illn 2007; 3(1): 77–87. doi:10.1093/annonc/mdp604 Published online 20 January 2010 908 | letters to the editor Volume 21 | No. 4 | April 2010 symposium article Annals of Oncology 23 (Supplement 3): iii49–iii55, 2012 doi:10.1093/annonc/mds088 Spirituality in the cancer trajectory C. M. Puchalski* George Washington University School of Medicine and The George Washington Institute for Spirituality and Health (GWish), Washington, USA Spirituality is an integral dimension of human beings and has been recognized as a critical factor in the health and well-being of patients. Numerous studies have demonstrated a relationship between spirituality and a variety of patient outcomes including quality of life, and coping with illness. Spiritual practices such as meditation have also demonstrated some health bene?ts. Spirituality is also part of patients’ experience with illness, such as cancer [1–3]. From initial diagnosis, through treatment, survivorship, recurrence, and dying, cancer patients’ understanding of their illness and their lives with their illness range from the physical, social, emotional, and spiritual. A diagnosis raises spirituality-related questions and concerns, both existential and religious [4–8]. Diagnosis of cancer changes the lives of patients forever, the diagnosis often triggering deep questions of meaning and purpose, and with the journey through treatment, deep issues of hope and ful?llment. The uncertainties and myriad decisions may raise spirituality-related issues more often in persons diagnosed with cancer than with other long-term illnesses [9]. Spirituality is also an important component of quality of life of patients with cancer. Quality of life for patients with cancer includes spiritual well-being as well as physical and psycho-social wellbeing [10–12], with spiritual well-being in one study found to be as signi?cant as physical well-being [13]. A literature review found half of the identi?ed quality of life instruments include items on spirituality, with most focusing on the existential aspects of spirituality related to meaning or purpose in life [14]. *Correspondence to: Prof. C. M. Puchalski, The George Washington Institute for Spirituality and Health (GWish), 2030 M Street, NW, Ste. 4014, Washington, DC 20052, USA. E-mail: [email protected] For many years, a diagnosis of cancer signaled a short life span, or what many called a death sentence. But, scienti?c advances have resulted in longer life for patients with cancer, many of whom are now considered survivors. With more than 10 million cancer survivors in the United States today [15], a cancer diagnosis now means many will live with the disease or with the sequelae of treatment for a long time. Thus, in the clinics today patients’ issues are not just about planning for an imminent death, but rather about living well with the disease through the trajectory of their cancer. With an estimate that 41% of people born today will be diagnosed with cancer during their lifetime [16], the National Cancer Institute and cancer organizations are shifting their focus to longevity and quality of life across the continuum of cancer care. improving health in your community, psychology homework help Therefore, it is critical that health systems ?nd ways to integrate spirituality more fully in patient care. spirituality Spirituality is de?ned as the way people ?nd meaning and purpose, and how they experience their connectedness to self, others, the signi?cant, or sacred [17]. Spirituality is seen as a universal human characteristic [18]. Spirituality can be understood as one’s relationship with the transcendent, expressed through one’s attitudes, habits, and practices [19]. Religion, one type of expression of spirituality, is a set of organized beliefs about God that is shared within a community of people. Spirituality also embraces the arts and humanism, as well as cultural beliefs and practices. Spirituality can be understood as the inner life of a person. Having a strong sense of spirituality helps patients adjust to and cope with illness [20]. Spirituality may affect how a patient © The Author 2012. Published by Oxford University Press on behalf of the European Society for Medical Oncology. All rights reserved. For permissions, please email: [email protected] symposium article introduction Downloaded from http://annonc.oxfordjournals.org/ at CSU Humboldt on November 27, 2016 Spirituality is an essential element of person-centered care and a critical factor in the way patients with cancer cope with their illness from diagnosis through treatment, survival, recurrence and dying. Studies have indicated a signi?cant relationship between spirituality and quality of life. Spirituality, in its broadest sense speaks to the meaning patients ?nd in their lives especially during times of stress, illness and dying. Illness can trigger deep existential issues that could trigger profound suffering and distress. A model is presented that describes the role of each member of the healthcare team in addressing patients’ spirituality. Spiritual distress, as a diagnosis, requires attention and treatment just as any other clinical symptom. Spiritual resources of strength need to be identi?es and recognized as positive factors in patients’ coping. Finally a treatment plan needs to include the spiritual as well as the physical and psychosocial issues of patients. Chaplains and other spiritual care professionals need to be recognized as the experts in spiritual care and should be integral members of the healthcare team. Integrating spirituality as an essential domain of care will result in better health outcomes, particularly quality of life for patients across the trajectory of cancer care. Key words: spirituality, religion, cancer, health, spirituality and health, spiritual issues, spiritual stress symposium article iii?? | Puchalski second most important factor in their decision-making, more so than the ef?cacy of treatment [4, 34]. Religious and/or spiritual beliefs can impact many healthcare decisions and are particularly important in end-oflife decisions. Personal philosophies may also impact decisionmaking. For example, a naturalist may decline medications in favor of dietary and other interventions. Patients may also delay treatment choices in order to participate in spiritual rituals such as celebration of the solstice in the woods or participation in a religious ceremony [35]. spiritual distress: a clinical diagnosis? Spirituality, as discussed, impacts coping, decision-making, and quality of life. But, spirituality may also be a source or contributor to distress. Examples of spiritual distress are listed in Table 1. Spiritual suffering also may in?uence how a person experiences and expresses pain, with a spiritual intervention as effective as a medical intervention in pain management [36, 37]. Untreated spiritual suffering may worsen the pain experience [38, 39]. For some cancer patients spiritual suffering/distress may be of greater concern than physical symptoms [40, 41]. Cancer patients report feelings of anger and diminished self-esteem, which may be spirituality-related [42].improving health in your community, psychology homework help One study found that 73% of cancer patients expressed at least one spiritual need [4] and that up to 40% of individuals with newly diagnosed and recurrent cancer showed a signi?cant level of spiritual distress [43]. Cancer patients with low levels of spiritual well-being were more likely to express hopelessness and a desire for hastened death [44] and may have more frequent follow-up visits [45]. Studies show individuals may have elevated levels of spiritual distress and clinical depression after a cancer diagnosis, and that spiritual distress also increases at the end of active treatment when predictable routines end [46]. Thus identifying spiritual distress can have important implications for health outcomes, including improved quality of life for patients. The National Comprehensive Cancer Network (NCCN) identi?es spiritual distress that may extend along the continuum of care from ‘common, normal feelings of vulnerability, sadness, and fear, to problems that become disabling such as depression, anxiety, panic, social isolation, and existential spiritual crises’ [47]. Studies show that spirituality is an integral component of cancer care, with an intrinsic signi?cance to caring for and respecting patients as whole persons [48–50]. The Joint Commission requires spiritual assessments [4]. The National Quality Forum (NQF) identi?es spiritual, religious, and existential aspects of care as one of eight domains of quality palliative and hospice care [51]. Individuals diagnosed with cancer understand the signi?cance of their spirituality in helping them plan for treatment, experience survivorship, and prepare for eventual death. The majority of cancer patients want their oncologists and healthcare professionals to inquire about their spirituality and to integrate their spiritual strengths and needs in the treatment plan [4, 31, 52–55]. These ?ndings are reported in the Spirituality in Cancer Care (PDQ®): Relation of Religion and Spirituality to Adjustment, QOL, and Health Indices on the NCI website [56]. Volume 23 | Supplement 3 | June 2012 Downloaded from http://annonc.oxfordjournals.org/ at CSU Humboldt on November 27, 2016 copes with the cancer experience, ?nds meaning and peace, and de?nes wellness during cancer treatment and survivorship despite fatigue or pain, and may assist patients in ?nding a sense of health in the midst of disease [13, 21– 23]. Brady et al. [13] found that patients with cancer who had high levels of spiritual well-being reported more enjoyment in life, and higher levels of meaning and peace, even in the midst of cancer-related symptoms such as fatigue or pain. Other studies have shown that spiritual well-being in cancer patients has been associated with lower levels of depression, better quality of life near death, and protection against end-of-life despair and desire for hastened death [24, 25]. Cancer patients report their spirituality helps them ?nd hope, gratitude, and positivity in their cancer experience [26– 28], and that their spirituality is a source of strength that helps them cope, ?nd meaning in their lives, and make sense of the cancer experience as they recover from treatment [29]. Spiritual well-being has been associated with lower levels of distress and greater quality of life across life expectancy prognoses [30]. Spirituality can therefore be a resource of strength for patients. Spirituality may impact patient quality of life and adjustment by providing a context in which to derive hope and meaning. A cancer diagnosis, as with any serious illness, triggers deep existential questions: Why me? Why now? Why would God allow me to suffer this way? What will happen to me after I die? [31]. Answers to these questions are not immediate, nor are they obvious. But with support, patients can reframe a negative experience into one with a potentially positive meaning. improving health in your community, psychology homework help Patients talk of an illness as a blessing or an opportunity to see life in a different, perhaps more meaningful way. It is not uncommon for people with cancer to make major changes in their lives—changing jobs, recommitting to a relationship or making a decision to leave a relationship, making life-style changes—as they begin to prioritize what is important in the face of what might be a terminal illness. Religions help people with spiritual suffering by offering them historical understandings of suffering and ways to reframe their distress. For example, Christians may relate to the suffering of Jesus Christ, which might give them solace or a path to acceptance of their own suffering. Rituals and spiritual practices are taught as a way to help people cope with suffering and eventual dying. Practitioners of Buddhism practice meditation as a way to achieve detachment from suffering and eventual enlightenment [32]. Muslims believe in life after death and see death not as an end, but as a transition from this life to the next [31]. Religious teachings also may help people ?nd hope in the midst of despair. In Judaism, people are not taught that there is no hope, but what they can reasonably hope for [32]. Non-religious patients may ?nd their meaning through philosophical ideologies, or through their relationships with others or nature. Numerous studies have reported that spirituality and/or religion may be important to cancer patients and may in?uence medical decision-making. One study found 88% of cancer patients considered spirituality to be at least somewhat important in their treatment decisions and frequently of extreme importance [33]. In a study of patients with advanced lung cancer, patients reported that after the recommendation of their oncologist, belief in God was the Annals of Oncology Annals of Oncology symposium article Table 1. Spiritual diagnoses Key feature from history Existential concerns Lack of meaning Questions meaning about one’s own existence Concern about afterlife Questions the meaning of suffering Seeks spiritual assistance Lack of love, loneliness Not being remembered No sense of relatedness Displaces anger toward religious representatives or others Inability to forgive Desires closeness to God, deepening relationship Verbalizes inner con?icts or questions about beliefs of faith Con?icts between religious beliefs and recommended treatments Questions moral or ethical implications of therapeutic regimen Expresses concern with life/death or belief system Hopelessness about future health, life Despair as absolute hopelessness No hope for value of life The feeling and process associated with the loss of a person, health, relationship Feeling that one has done something wrong or evil Feeling that one is bad or evil Need for forgiveness or reconciliation from self or others Separated from religious community or other community Ritual needs Unable to perform usual religious practices Loss of faith or meaning Religious or spiritual beliefs or community not helping with coping Abandonment by God or others Anger at God or others Concerns about relationship with deity Con?icted or challenged belief systems Despair/hopelessness Grief/loss Guilt/shame Reconciliation Isolation Religious speci?c Religious/spiritual struggle attending to cancer patients’ spiritual issues The need to attend to the psychosocial-spiritual needs as well as physical needs of cancer patients across the continuum of care is well documented, both from the perspective of patient desire and the bene?ts to patients’ quality of life of [57, 58]. Clinician inquiry into patients’ spirituality is also important in terms of building trust with the patient as well as ensuring treatment plans are congruent with patients’ beliefs and values [59]. Not addressing spirituality could result in poorer outcomes, increased non-compliance with the treatment plan, and failure to help patients ?nd effective coping mechanisms [17, 35]. In one study, failure to attend to spiritual needs resulted in lower quality-of-care ratings and less satisfaction with care [4]. Attending to an individual’s spiritual distress and/or spiritual resources of strength correlates with quality of life across the trajectory of the cancer experience [10, 20–21, 27, 60–63]. Inquiring about a cancer patient’s spirituality also correlates with a whole-person healthcare model that shifts care from a focus on disease cure to one that addresses how an individual cancer patient de?nes wellness in the context of the disease experience [64, 65]. Wellness, de?ned by the World Health Organization (WHO), is the ‘dynamic state of complete physical, mental, spiritual, and social well-being and not merely the absence of disease or in?rmity’ [66]. Thus, spiritual Volume 23 | Supplement 3 | June 2012 well-being is a determinant of whole health and, by extension, quality of life. Currently, attention to spiritual needs is most prevalent at end of life. A study of physicians found 85% acknowledged they should be aware of their patients’ religious or spiritual beliefs, but only 31% said they should ask about these beliefs during a routine of?ce visit, though the percentage increased to 74% when the person was dying [51]. Evidence shows, however, that addressing spiritual distress and spiritual resources of strength are integral to care across the trajectory of illness. 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