Fear of Heights
Fear of heights is also known as acrophobia and it been classified as psychological problem. This is one of the phobias and it is the common anxiety disorder that affects human beings significantly. The statistical method used to measure the phobia is administering questionnaires to those suffering from the disorder. The success of the questionnaires is appraised by giving the participants questionnaires, whereby they are asked to rate how fearful they felt when taking into account about 20 situations, which could lead to fear of heights. The cases of such situations entail sitting on an airplane or driving over a bridge.
The participants of the questionnaire were formally asked to rank their experiences using the seven-point scale. The participants were also asked the questions concerning probable consequences of situations, which involve heights. This was meant to evaluate respondent’s attitude to heights and the probability that they would evade being in the situation entailing heights, or their behavior during such scenarios. The participants were also questioned regarding their anxiety levels, while undertaking virtual reality therapy and when undertaking a real life situation relating to height (climbing up an outdoor stairway with three levels). In the real life test (Behavioral Avoidance Test), respondents of the questionnaires were offered one point for each level they climbed and one point for staring down for about 30 seconds at each level. Therefore, in measuring the fear of heights or acrophobia it is advisable to collect the data, using questions, which apply the seven-point scale.
Homelessness has emerged to be one of the most severe examples of social exclusion and poverty in the society at the present as both a cause and a symptom. The social problem has been considered as a subject of particular interest. Homelessness has bothered Western and developing nations since the 1960s. It is a multi-dimensional challenge and it might even comprise of broad a range of shelter and housing results that have unrelated and complex origins. This makes the methods of collecting data become complicated to use. In order to collect data regarding homelessness, it is advisable to use the sampling method, which is a qualitative statistical method of collecting data concerning the homelessness.
The sampling method of data collection will be appropriate, since the homeless people do not stay at one point, therefore, taking a representative sample will be appropriate. These researchers use a ‘stratified-sampling method,’ the sample from which is stratified; it is an expediency sample derived from service facilities for the homeless and archetypal regions where homeless people can be located. The results obtained from the sampling methods demonstrate features of the sample, which comprises of geographical origin, duration, age, marital status and sex. The data collected using the sampling method is unquestionably valuable, it is impossible to generalize the homeless populace.
Self-esteem is one of the powerful research topics in the field of psychology. Researchers have based their work on diverse factors. Self – esteem can be generally defined as the overall assessment of individual in either negative or positive manner. It shows the degree to which a person believes himself or herself to be proficient. Basically put, self – esteem is one’s feeling of self-confidence and self-worth. The statistical method of collecting data is the use of sampling method. Self-esteem is measured using the widely used Persian version of the Rosenberg Self-Esteem Scale (RSES). Items of the RSES are answered on a 4-point scale that ranges from 1 (powerfully disagree) to 4 (powerfully agree). The scale also takes into consideration the interval authenticity and reliabilities of Persian version of the Rosenberg Self-Esteem Scale (RSES). This scale ensures that the level of self-esteem is measured accurately.
The best statistical method to be used to collect data for caloric consumption is use of sampling technique, to get the required data. The proportion of energy from a specific food group was defined as a full amount of calories from that food group in a given sample population, divided by the entirety calories taken by that population. This method is similarly employed to calculate the proportion of fat coming from specific food groups.
Adherence to Medication Regimen
Medication adherence typically refers to whether patients take their medications, as approved by the physician, for instance, twice daily, and whether they keep taking a prescribed medication. Evaluating adherence is tricky for health care researchers and providers. Self-reported medication use is prejudiced, so object methods of data collection for medication use are frequently used in research. The best method to be used to measure the adherence to mediation is use of questionnaires, which involve use of survey method. The questionnaires enable the researchers to give their experience in adherence of the prescribed drugs or not. Participants of the questionnaire are formally asked to rank their experiences using the 5-point scale. The 5-scale used ranges from 1 (powerfully disagree) to 45(powerfully agree).
Quantitative Research Article
The quantitative research article to be studied was published in 2007 by “Research in Nursing and Health,” under the title “A Randomized Controlled Trial to Reduce Delay in Older Adults Seeking Help for Symptoms of Acute Myocardial Infarction”. The article precisely demonstrates the content of the entire article and the study itself. The research uses sampling method as a statistical method to collect data on which the research is focused. It is believed that the statistical method used during the collection of data is an appropriate one for the study. The general research design, used in this study, was suitable for the purpose, and initially a small pilot study was undertaken to appraise the educational involvement, study mechanisms and instruments, and validity and reliability of the measurement tools employed.
Purpose of the Study
The article had the aim of studying the significance of the problem area; older adults have longer pre-treatment hindrances than younger adults when encountering symptoms of severe myocardial infarction (AMI). The authors placed the results of the study into a bigger structure when they suggested that all older adults at risk for AMI should be evaluated for educational needs related to the condition.
Review of the Literature
Though the review of the literature was very brief, the authors employed only primary sources, and there were no intentional omissions of significant references. The review acknowledged past literatures interventions tailored to reduce pre-treatment delays, greatly operationalized via the mass media promotions. The comparative vanity of these interventions made authors of the research hypothesize that the social, emotional, and cognitive factors, entailed in the treatment delay, had been formerly resolved in other researches, hence developing a gap in the literature. The authors of the article further acknowledged the reality of other researches on the whole communities rather than particular populace at risk for AMI. Attitudes, skills, beliefs and knowledge, and the cognitive aspects, researched in the study, were adequately defined and their relationship to treatment delay was discussed.
There are two main hypotheses that were acknowledged in the study. First, the authors hypothesized that older people, who attained an educational intervention, would exhibit increased understanding of AMI symptoms, enhanced positive beliefs and attitudes regarding calling for emergency services fast, and enhanced perceived control. Second, the authors of the study forecasted that the study respondents’ anxiety would not be considerably increased due to the educational intervention. I defend these two hypotheses because they can be tested using the method used to collect data.
The general study design was suitable for the purpose, and initially a small pilot study was undertaken to assess the educational involvement, study mechanisms and instruments, and validity and reliability of the measurement tools, utilized in the research. The average age of population sample researched was 65 or older; however, it comprised of generally Caucasian women and men, and it did not represent the broad populace. An expediency sampling technique was used to choose the participants, which develops a bigger risk of study prejudice. Though the researchers began with a group of over 917 people, the last sample size was comparatively small after the omission criterion was used.
Lastly, the study participants were at random assigned to two research groups, the control group and the group getting the educational intervention. The author explained the educational measurement and intervention mechanisms in detail. The reliability and validity of one tool was confirmed by three “cardiovascular experts”, who contrasted the items on the tool for “clarity and congruence with the theoretical framework”. The absence of documented research testing could bring the reliability and validity and aspects of the study tool into question.
Therefore, the overall structure of the research seems to have an element of internal validity, though the measurement tool could be perceived as a risk. In addition, five of the research participants presented from a higher center, and though researchers tried to control this unrelated variable by coaching them not to discuss the research; the likelihood of infectivity was bounded to result to a risk. The research had, to some extent, a low measure of external validity because of the small corresponding sample. The researchers got approval from the study participants and the participants` ethical and legal rights were clearly protected.
The data collection methods, used in this research article, answered the research questions, and were suitable for collecting the data results of the research. The authors discussed limitations of the study, which include the expediency sampling and general small sample size. Evenness of the results with other research literature and other studies could not be ascertained since there was no any analogous research literature or studies, formerly undertaken. The authors suggest that future studies can be performed in order to ascertain whether the holdup in treatment would be impacted by the educational intervention. The authors linked the research findings to the significance of sufficient health education for older adults. The authors also argued that the number of adults, who are over the age of 65, is expected to double its numbers over the next 20 years, consequently causing the education of older adults to be a bigger precedence for healthcare professionals.
Findings from this research study support the meaning of painstaking education for elderly cardiac victims in the community. Even though the findings are not essentially appropriate to the broad population, they are important and merit further research. The results have been forthcoming because of the effective and appropriate methods used to collect data.
The topic in this questionnaire deals with customer’s satisfaction with health care sector, the aim of which is to promote service delivery. In 2009, the Joint Senior Management Committee (JSMC) started an official procedure of assessing consumer's satisfaction with the social and health services` system. The project was a joint effort between the Authorities and Department of Health and Social Services as part of their continuing dedication to assessment and quality assurance. It also touched Action Plan Item 5.1.4, a dedication by the Minister of Health and Social Services to carry out a customer satisfaction survey.
JSMC felt it would be paramount to obtain feedback from individuals, utilizing two separate parts of the system – community health centers/social services and hospitals. In order to tackle these separate parts of the system, two diverse questionnaires and collection methods were to be employed. The Northwest Territories (NWT) Hospital Satisfaction Questionnaire was designed to assist measure client’s satisfaction with the four hospitals in the NWT, whilst the Community Health and Social Services Client Feedback Form were offered at health centers and social services offices. Consequently, this report aims to obtain the results of the NWT Hospital Satisfaction Questionnaire and the hospital in Fort Smith.
Five Questionnaires (Overall Satisfaction)
- Overall, how would you rate the care you received?
C. Fair to very poor
- How respectful was the administration/ receptionist?
- How clean was the hospital?
- How were of assistance to you the directions/signs?
C. Fair to poor
- How was the hospital food?
The NWT Hospital Satisfaction Questionnaire was distributed to four prime hospitals in the Northwest Territories in October 2011. Patients were offered the questionnaire and persuaded to complete it by front-line hospital staff. Finished questionnaires were taken back to the Department where data analysis, data entry, and the concluding reports of the study were completed. The self-administered and voluntary methodology of the questionnaire led to important feedback from those who participated in the questionnaire; however it does not essentially give a representative sample.
The drawback of using a questionnaire with a volunteer prejudice, instead of random chosen representative sample, is that data collected from each hospital should be approached with prudence; reaction rates cannot be measured and the data cannot be calculated from a defensive standpoint. The results from these questionnaires can be utilized to offer feedback to senior management and hospital staff; besides the results can be used to designate areas of expansion, identify areas that are working well, they could serve as baseline data for prospect customer satisfaction measurements and provide a component of the hospital accreditation process.
Whilst undertaking and administering the questionnaires to different clients of the hospitals I learned several lessons. I was able to understand that a questionnaire-based research study that collects individual information must be tailored and conducted in an ethical and legal manner that will protect the research subjects. Different cultural aspects and standards might be appropriate, based on where the research is taking place. For instance, study participants usually can be paid a sensible compensation for their time and subsidiary expenses (e.g., transportation); however, “the ethical propriety of such inducements…must be assessed in the light of the traditions of the culture.”
I also came to a conclusion that cautious development and accomplishment of the research procedure and questionnaire are fundamental parts of human subjects’ security. Individuals must not be asked to contribute in the research or survey that is critically flawed in structure. Risks, purpose, and benefits of the research must be described to prospective participants of the research in language they can comprehend, hence they will have the information required to make a decision whether to contribute in the research. Offering this vital information enables for the “informed consent” of participants. They must be told that they do not have to contribute, that they can decline to reply any question(s), and that they can leave at any time. Contributors` privacy must be protected to the degree provided by law. The researcher must not assure total privacy, if that is a bigger degree of privacy than the law allows.
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Approximately 60% of participants provided ratings for this question (n=60). An estimated 96% of the respondents rated the overall care in the facility they were offered as good or excellent and about 4% said fair to very poor.
In this question, 96% of the total respondents (n=49) rated respectfulness as excellent and good, while 4% of them responded that respectfulness in the facility was fair.
On how clean was the hospital about 96% of the respondents rated the facilities’ cleanliness as excellent or good, whilst 4% of the respondents said cleanliness was fair.
About 90% of the total respondents (n=48) said that the facility’s signs were good or excellent, whilst the remaining 10% of the respondents said they were fair to poor.
Because there was the very low number of practical responses to this question, it prevents a sufficient analysis. One of the respondent said that there was the need to increase the number of vegetables and fruits be served in the hospitals, however, the respondent said that the food is ever warm.
Revision of the Questionnaire
The administered questionnaire had less weakness and it should be adopted and used to collect information in the hospitals. Only question five must be revised to have multiple choices to get a reliable feedback.
Urinary incontinence is a widespread old age health problem globally and it has significant psychological, social, economic and clinical repercussions. Involuntary loss of urine impacts over 15 million people in the United States, about 30–40% of the populace aged 75 years and over. Urinary incontinence can have a disturbing effect on quality of life, and can influence the physical, psychological, and social aspects of individuals’ lives. Urinary incontinence is linked with urinary tract infections, falls, skin breakdowns, fractures and it is an extrapolative pointer of death. It can also affect the quality of life, as a result of declined psychological and social well-being. Furthermore, urinary incontinence represents a financial trouble. In the U.S, the economic price of urinary incontinence has been projected at $19.5 billion (year 2000 dollars).
Urinary Incontinence might be a warning symptom of weakness in old age and is connected with an increased threat of functional decrease of the muscles. It is defined as "a complaint of any involuntary leakage of urine”. It is projected that approximately 50% of those living in long-stay institutions and 15.0% of elderly persons living in the community experience UI. Though aging is a significant risk factor, since it results to structural and functional changes in the urinary system of the elderly people in the community, which in turn affect individuals to UI, it is not, by itself, the root cause of such a disorder.
Other factors connected to UI stand out amongst elderly people, which include being a woman, obesity, number of pregnancies, smoking, vaginal birth, multiparity, menopause, impaired mobility hampering access to bathroom, and mental impairment, furthermore to receiving medication and undergoing surgeries, which might decrease the pelvic muscle tonus or result to damage to the nervous system.
Those suffering from UI must undergo an essential assessment, which includes physical examination, history, and urinalysis. Extra information from patient’s cotton-swab test, voiding diary, measurement of postvoid residual (PVR) urine volume, cough stress test, urodynamic studies, and cystoscopy might be required in the selected patients. Videourodynamic studies are the criteria principle, which can be used for evaluation of an incontinent victim; however, they are classically reserved for the assessment of complicated cases of the stress urinary incontinence.
Majority of the authorities concur that diagnosis from the history perspective alone is not sufficient in itself to warrant surgical surgery. A review of the responsibility of the patient history in the diagnosis of UI indicated that a history of stress incontinence has a sensitivity value of approximately 0.91, however specificity is only 0.51. Positive prognostic value in range of about 0.75-0.87 has been reported for a history of SI. Specificity and sensitivity will be worst if the history is analytical of mixed or urge incontinence. Since some believe that several failed SI processes are the result of erroneous or imperfect diagnoses, enhancing of the positive prognostic value of history alone appears valuable. Urinary incontinence can also assume emotional toll. Discomfiture connected with the condition can result to social depression, withdrawal, anxiety as well as sexual dysfunction. One research established that women with harsh urinary incontinence were 80% more probable to experience noteworthy depression, compared to those who were not incontinent. In different researches, researchers established that women and men with urinary incontinence had a 50% higher risk of having signs of anxiety, compared to women and men who did not have incontinence.
Pain among the Elderly Persons
Advanced disease states, which include arthritis, peripheral vascular disease, cancer and other musculoskeletal, may cause a lot of debilitating pain. It is approximated that 50% of the elderly population, residing in the community, and about 80% at nursing homes throughout the nation suffer from chronic pain. Untamed pain among the elderly people in the society reduces the level of functioning both physically and mentally, by considerably causing sleep cycle disturbance, poor quality of life, and decreased activity and causes depression. Health care providers, both in acute care settings and primary providers, in the health care settings need to treat both chronic and acute pain so that it can enhance both wellness and function.
Not only is pain an unrelenting challenge amongst the elderly people but, it is more challenging to be treated due to the multifaceted characteristics of the pain; for example, several locations of pain, multiple factors leading to pain and various kinds of pain, which further complicate the treatment. Elderly patients suffering from dementia do not comprehend why they are undergoing the pain and will not take part in activities that could add to their painful sensations, which include rehabilitation. As a result, the victim becomes more incapacitated and has a high risk of increased cruelty of chronic pain. This mismanagement of pain might in some cases when it comes at a time in the patient’s care when the aspect of cormfortability is the best goal.
Treatment is challenging, since old age patients are not capable of expressing their pain satisfactorily, they request for pain medicine, or safely utilize patient controlled analgesia (PCA) pumps for self-medication. The responsibility of the health care provider in managing and evaluating pain in the elderly is very significant because of the high predominance rates of pain and numerous features of pain.
There is an immense call for development of an evaluation and treatment practice for elderly patients suffering from the problem of old age in the society. Comprehensive evaluation techniques in the health care system will ensure that the patients receive all-inclusive care. The elderly populace is rapidly increasing in complications and size from trauma and chronic infection that need regular medical evaluation and management in the acute care settings. The elderly persons suffering from the disorder of the old age provide an extra challenge in the treatment of pain. Pain assessment tools, tailored particularly for use by patients, who are not capable to articulate their pain on a 0-10 scale, have to be established and put into practice. Partnership with relevant health care teams and a patient’s family or prime caregiver is also necessary for efficient pain evaluation strategy.
Furthermore, accomplishment of the proposed practice will reduce barriers to pain evaluation and management, which range from both the practitioners and the patient. All practitioners have to make pain assessment precedence in care, enhancing comfort and promoting quality of life. Acute care nurse practitioners have an implausible chance to execute this practice in the hospital and emergency room environment, educating other health care providers and lowering complications related to uncontrolled chronic and acute pain.
In a clinical setting, precise assessment of pain is vital for the recognition of suitable medical interventions and for evaluating the efficiency of such interventions. Patients must be evaluated frequently for the incidence of pain and for deterioration, improvement, or complications linked to pain treatment. The regularity of the follow-up ought to be a function of the cruelty of pain and prospective for unpleasant impacts of treatment. Documentation of pain evaluation formalizes the pain evaluation procedure and it is necessary in the provision of personalized care from both a professional and a legal standpoint.
Intrinsic in the evaluation of pain amongst older adults is consideration of its potentially treatable aspects. For instance, if a patient has severe pain, evaluation must focus on the fundamental pathology accountable for the pain stimulus. If the patient suffers from chronic pain, evaluation should be geared toward ascertaining the pain-causing pathology and the psychological, physical, and social outcomes of the pain experience. Consequently, all-inclusive pain evaluation frequently comprises the multidimensional measurement of pain intensity and the multidimensional inclusive assessment of pain experience. Multifaceted pain challenges might benefit from a multidisciplinary strategy of the assessment report .
Pain evaluation plan, which depends on a patient’s or a family members’ demand for analgesia will result in intervals of insufficient pain control with associated psychological challenge and loss of function among those suffering the old age disorder. Efficient pain control for all people in the community should become the most important constituent of health care in all treatment settings. A methodical procedure by which pain is acknowledged, evaluated, documented, and reassessed on constant time interval basis will lead to improved pain assessment and management for all patients, particularly older adults. The procedure starts with each member of the health care group becoming “pain vigilant”, being persistently attentive to signs that advise that an older person might be experiencing pain, and adapting evaluation strategies to meet the requirements of each individual. Lastly, intervallic institutional-level assessment studies must be carried out to examine the efficiency of pain assessment and management procedures. This will ensure that the pain assessment techniques are improved, thus effectively dealing with pain among the old people.
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