Where Law and Ethics Meet

Where Law and Ethics Meet

Introduction

In many instances, the law and ethics do not agree as the law would permit some things that are morally wrong. The law also depends on evidence adduced and a judgment could acquit a criminal just because he or she managed to put up a winning defence.

Where Law and Ethics Meet

The son will need to first importantly set a specific time with the parents by requesting them for the best time they could discuss the matter without first making reference to the matter. When the time for the discussion of the matter come, the son should introduce the discussion by explaining how he discovered about the crime committed by the parents. The son should then give the parents a chance to explain to him what they think of the matter. The parents could react differently in this matter. They could either deny knowledge and/or commission of the crime or they could admit guilt and take responsibility. If they deny, then son should explain to the parents the consequences of their actions as well as the ones of denying the guilt and failing to take responsibility. If the parents accept guilt and take responsibility, then the son should ask the parents about their opinion regarding the way forward.  The parents could either decide not to let the company know about their crime or they could decide that they would let the company know. If they refuse to let the company know, then the son should explain to the parents the consequences of that action. The son should then try as much as possible to persuade the parents to let the company know how important it is to admit guilt and subsequent ask for pardon.

If the parents do not accept to talk to the company managers then the son should explain to them why it would be very important for them to admit guilt so as to save the company from collapse and loss of employment for many workers including the parents. The son should explain that the penalty against the parents could be lighter (possibly including full or partial pardon). If the parents do not agree with the son, then the son should inform that he would conscientiously report the matter to the managers of the company so as to save the parents, the company and the jobs.

Most certainly, at this point the parents could possibly concede and accept to report the matter to the company by themselves. But if the parents refuse to rescind their decision, then the son should inform them that the law would then take its full course. Ethics is about what ought to be done right so as to promote well being, resolve conflicts of interest as well as encourage social harmony. In some cases, the law could allow some things that are morally and ethically wrong, for instance, abortion. (Pojman, 2011).  The son should not allow himself to be part of what is morally and ethically wrong even if the law could vindicate the parents.

Conclusion It is very important to stick to ethics even if the law could vindicate someone. This is because some of the consequences of one’s actions could affect many innocent people

Understanding and Managing People

Understanding and Managing People

An understanding and managing person is a core mandate of the management in various organizations. Most of these management practices begin with the identification of a challenge in the work environment, which acts as the starting point to additional assessment. This paper emulates the same process by identifying a workplace challenge prior to a review of various leadership approaches and interventions that are useful in addressing various workplace challenges and assessment of progress and learning. The creation of a personal learning plan exemplifies the importance of learning in the improvement of operational and managerial efficiency amongst managers.

Understanding and Managing People

The approach to understanding and managing people may take on different approaches. Of these approaches is the use of interventions by the management of various corporations, especially those going through workplace challenges. This paper looks into the various interventions and approaches used by management, as well as the process of creating a personal development plan that should guide management in personal and professional learning that should boost the understanding and management of people.

Identification of a workplace challenge

Deducing from previous personal and professional experiences, a workplace challenge that is applicable to the management of employees is the merger of a company. The process of conducting a merger between two previously independent corporations presents a challenge to a company in the sense that there are many impending changes with the merger, most of which directly influence the operational capacity of the employees in the company (Bansal, 2017, pp. 423 – 424). In this regard, practical examples of the necessary approaches and interventions by line managers and leaders in the organization is required to show the attempts to ensure the employees remain motivated, engaged and committed to the organization. The section below outlines the various approaches used by management as well as the expected outcomes of the approaches and interventions.

Evaluation of leadership approaches and interventions

The smooth continuity of operations is vital in a company that undergoes various types of workplace challenges. Continuing with the previous example of a merger between the firms as the workplace challenge, there is a need for management to assume various approaches and interventions in order to ensure smooth continuity. Such approaches and interventions are meant to ensure the employees in such an organization maintain high levels of motivation, engagement, commitment, and retention at the company. The following are approaches and interventions that are applicable by the managers in such an organization in order to ensure, among others, employee retention during and after workplace challenges.

Kirkpatrick approach

Among the most effective classical approaches to leadership intervention is the use of a four step approach to managing and understanding people. The process, developed by Kirkpatrick, presents a hierarchical model that is useful in guiding the interventions in organizations. In spite of the various criticisms of the model, it has remained effective and useful to date. Primarily, the Kirkpatrick approach, as well as various other descendant models, involves a four step process with each having different variables at each level (Tamkin, Yarnall, & Kerrin, 2014).

The first step in the Kirkpatrick approach involves the use of a reactionary approach, where the leader evaluates the reactions of the employee to assess their level of comfort or disturbance by the prevailing event. The second step, known as the learning stage, involves acquiring and administration of new information. Such information should be assessed by the leadership to ensure it is useful in weathering the new challenges at the workplace (Tamkin, Yarnall, & Kerrin, 2014).

The third step involves the use of a behaviour approach, where the leaders or management assess the changes in behaviour, which usually result from the changes from the previous steps. Management will ordinarily make use of various assessment methods such as observation of productivity as well as data analysis to determine the changes in the behaviour of employees (Tamkin, Yarnall, & Kerrin, 2014). The final step within the Kirkpatrick approach involves an analysis of the results to determine the effectiveness of the approach. Such methods as return on investment, and measures of quality and costs are useful at this level of the approach.

In the case of the workplace challenge described above, the management may decide to adopt the Kirkpatrick approach in assessing the impact of the merger between the companies on the employees. They begin the assessment through the measurement of reactions of the employees to the idea and process of the merger, which may be achieved using tools such as a reaction questionnaire. This is followed by instilling changes in knowledge, skills, and attitudes. Such changes are assessed using various types of performance tests applicable to the type of business and changes within the organization (Tamkin, Yarnall, & Kerrin, 2014).

The third stage would involve the management assessing the changes in the employees with regard to the new information instilled in the previous step. Such changes may include the understanding of the purpose, as well as the new goals of the merger. The management finally commences on the assessment of the results from the intervention process, whose goal is to determine the effectiveness of the approach (Tamkin, Yarnall, & Kerrin, 2014). This involves measuring of costs of the merger, the quality of changes to the employees, and potential returns on the investment involved in the merger.

The Hamblin Approach. An alternative approach to the Kirkpatrick model is the Hamblin approach, which is an extension of the Kirkpatrick approach. This model uses the same base model as the Kirkpatrick approach, with the exception of the inclusion of an additional fifth step. This additional step involves the assessment of final value, where the management determines the impact of the changes of the process to the organization, the employees, and the economy at large (Tamkin, Yarnall, & Kerrin, 2014, pp. 5 – 6). In the identified workplace challenge of the merger, the fifth stage introduced by Hamblin would effectively measure the impact of the merger on the economy, the employees and the organization through a financial point of view.

A number of alternative approaches that have a similar base to the Kirkpatrick approach exist. These include the social impact approach developed by Kaufman, Keller, and Watkins, the business and social impact approach by Molenda, Pershing, and Reighuluth, the CIRO approach by Warr, Bird, and Rackham, and the ROI approach by Phillips and Holton among others (Tamkin, Yarnall, & Kerrin, 2014).

The Carousel of Development Approach

The Carousel of Development Approach was developed by the Industrial Society as a means to evaluate the process of learning and adapting to changes within the organization. The precept for the Carousel of Development approach is that the process of change and evaluation ought to take place a substantial period both before and after training and education on new issues of concern to the organization (Tamkin, Yarnall, & Kerrin, 2014, pp. 7 – 8).

The Carousel of Development approach makes use of a circular model where the process begins with the planning stage, whose target is to identify the business needs of the organization. The second stage of this approach involves the process of defining and developing of specific objectives for the organization. The third stage in the process is one where the management designs the learning process for the employees and various other stakeholders. The fourth stage follows the process by implementing the learning process developed in the previous stages (Tamkin, Yarnall, & Kerrin, 2014).

A fifth stage within the Carousel of Development approach involves the implementation of the information absorbed from the learning process in the third and fourth stages. This stage involves the use and reinforcement of the learning process. The sixth stage of this approach involves judging the benefits of the process to the various stakeholders; the organization, the employees, and the economy at large. This stage involves the use of varying measures of assessing such benefits to the stakeholders. Such measures include the financial benefits drawn from the process, the satisfaction of the customer, and measures of quality of both the process and the resulting product (Tamkin, Yarnall, & Kerrin, 2014, pp. 7 – 9).

In the case of the merger scenario as a workplace challenge, the management may choose to adopt the Carousel of Development Approach in managing the people as well as the resultant changes. In this context, the identification of the business need represents the needs for the merger. This stage occurs a period prior to the learning and change phase as prescribed by Andrew Forrest (Tamkin, Yarnall, & Kerrin, 2014). The development objectives, in this case, may include the unification of the goals of the different firms. This approach enforces the learning process as it divides the learning process and the planning phase for the learning in a bid to ensure efficiency.

Once the planning is concluded, the learning process commences, which is aimed at ensuring the employees experience the learning process in its entirety. The fifth phase involves a reinforcement of the learning and change process. This includes the use of testing procedures to ensure the employees grasp and reinforce the learned materials over time. The final stage in this process involves the deployment of checks to ensure the merger process, as well as the learning and change processes, provide various classes of benefits to the organization. The primary checks used are measures of quality, customer feedback, as well as the economic and financial benefits of the merger.

Expected outcomes of leadership approaches and interventions

The various approaches outlined above have a focus on the learning and change process during and after a challenge in the workplace. In such a scenario, the interventions apply the focus to the employees since they are the first line of contact for the business’ customers. In addition, the employees present an important task to the managerial team in the case of a challenge such as a merger, since they ought to manage the people and seek to understand the views and feelings of the employees – since such may translate, either negatively or positively to the customers. This, in effect, has the potential to influence the performance of the business both in the long term and the short term. As such, there are various expected outcomes of the various leadership approaches and interventions outlined above. These expected outcomes are expounded below.

Employee motivation. A focus on the employees is critical for the approaches outlined above. Considering the workplace challenges of an impending merger, it is important to have the employees motivated throughout the process. In such a development, some employees may be worried about their prospective employer, or the chances that the security of their jobs may be undermined under the new structure (Conrad, Ghosh, & Isaacson, 2015; Lazaroiu, 2015). It is imperative, therefore, that the management ensures that the employees maintain a high level of motivation.

Employee engagement. In terms of employee engagement, the line managers expect to create an environment that is conducive for work. Within such conditions, the employees are expected to have a sense of daily engagement, where they give their best to achieving the goals, visions, mission, objectives, and targets of the organization (Allen & Turner, 2017; Guaspari, 2015). In the scenario of the merger as a work place challenge, the management will need to develop a culture that ensures the employees understand the need for the change, as well as their role in enabling the success of the new organizational structure. In this regard, taking the Carousel of Development Approach as an example, the line managers need to take the respective employees through the various stages to enable for a smoother and better adoption of the new organizational structure (Allen & Turner, 2017).

Employee commitment. A key task for the management of the organization is to ensure the members of staff are ready and willing to offer themselves fully to achieving the laid out organizational objectives. The actions and behaviour of management towards the employees is an important factor that heavily influences the commitment of the employees (Lam, O’Donnel, & Robertson, 2015). In this regard, and in continuity with the example of a merger as a workplace challenge, the organization may choose to make use of the various leadership approaches and interventions in a bid to drive the employees to improve on their commitment (Lam, O’Donnel, & Robertson, 2015).

Employee retention success. Given the changes and workplace challenges in most organizations, coupled with the changing global needs and employment metrics, there is a need for companies to increase their employee retention levels. The high levels of expectations in terms of learning and adapting to various changes in the company will usually lead to a low retention rate in most modern firms (Younge & Marx, 2016; Ahammad, Tarba, Liu, & Glaister, 2016). However, with the implementation of the various leadership approaches and interventions outlined above, the organization, in spite of the prevailing workplace challenges, is able to improve on the levels of employee retention (Cloutier, Felusiak, Hill, & Pemberton-Jones, 2015; Younge & Marx, 2016).

Design and justification of a personal learning plan

Summary of the learning plan

Justification of the learning and development activities

The need to develop a personal learning plan stems from the requirement of continuous progress and assessment by managers (Tamkin, Yarnall, & Kerrin, 2014). Given the need to improve, therefore, a personal development plan is required to outline the various areas that need focus. In addition, the plan shows the necessary actions to achieve the required goals, as well as the resources and support needed to achieve such objectives. The learning plan requires the leader to outline the important areas that call for an improvement in learning. Once the key learning areas are listed, the necessary actions that lead to the achievement of the main goals are identified. A list of the necessary resources and support requirements for each learning objective is then compiled, before the assessment criterion are determined.

In this case, the personal objective of the manager, and therefore the objective of the personal development plan, is to create a set of learning requirements that develop personal learning as well as growth as a manager. To create the effectiveness of management, the learning requirements include the need to learn and develop a strategic approach towards the leadership and management of the organization. This is important owing to the need to develop strategic plans for the company, which is only applicable with the requisite information and experience. The actions for this objective include reading widely and evaluating the workplace to assess the strategic measures employed as well as the readiness to adopt to new strategic measures from the management.

A second learning requirement in this personal development plan is to improve on the leadership intervention measures used. In this case, the manager aims to learn the best approach to use given the current set up and challenges arising in the workplace. The required actions for this objective is to assess the challenges of the work environment in order to determine the appropriate approaches and intervention measures that apply to the given scenario. A key prerequisite for the successful implementation of this learning requirement is the cooperation from the members of staff since one needs to assess the challenges on the ground in order to have a better understanding of the applicable intervention measures.

A third requirement in this personal learning and development path is the understanding of the influence of behaviourism at the work place. This learning objective requires that the manager take action through conducting continuous research that should provide guidance on the impact of behaviourism in management on the organization. This objective also requires support in the form of cooperation from the members of staff since a lot of research is required to determine the influence of behaviourism in the workplace.

Measuring the effectiveness of the personal learning plan

Once the learning plan is rolled out, there is a central need to determine the effectiveness of the various approaches adopted. Given the various objectives adopted in the plan, there are individual measures applicable to each objective. However, there is also a need to indicate overall and generalized measures that help to determine the overall effectiveness of the development plan. Such measures comprise of measurable assessments such as the changes in the output and efficiency of the organization, specific measures such as the assessment of specific intervention measures such as the views of the employees after the mergers of the two firms. In addition, there will be a measure of time, where there will be evaluations on a periodic schedule for the next twelve months.

Conclusion

The development of learning and intervention approaches by management is critical to weathering the workplace challenges that rise consistently over time. As such, the review of several of these approaches and intervention methods is critical to the understanding of how to effectively manage people. The review of several of these approaches and intervention methods such as the Kirkpatrick approach, the Carousel of Development, and the Hamblin approach exposes their similar and variant views on the steps taken to handle issues within the work environment. In addition to such measures, continuous learning is important to developing the ability to effectively manage people and situations in the workplace. As such, the development of a personal learning plan is essential to the process of understanding and managing people.

References

Ahammad, M. F., Tarba, S. Y., Liu, Y., & Glaister, K. W. (2016, February). Knowledge transfer and cross-border acquisition performance: The impact of cultural distance and employee retention. International Business Review, 25(1), 66 – 75. doi:10.1016/j.ibusrev.2014.06.015

Allen, J. M., & Turner, A. (2017). Employee Engagement, Feedback, and Instructional Design. Performance Improvement Quarterly, 30(3), 161 – 164. doi:10.1002/piq.21253

Bansal, A. (2017). A revelation of employee feelings of alienation during post-mergers and acquisition: An outcome of perceived organizational justice. Journal of Organizational Change Management, 30(3), 417 – 439. doi:10.1108/JOCM-06-2016-0122

Cloutier, O., Felusiak, L., Hill, C., & Pemberton-Jones, E. J. (2015). The Importance of Developing Strategies for Employee Retention. Journal of Leadership, Accountability and Ethics, 12(2), 119 – 129. Retrieved January 7, 2018

Conrad, D., Ghosh, A., & Isaacson, M. (2015). Employee motivation factors: A comparative study of the perceptions between physicians and physician leaders. International Journal of Public Leadership, 11(2), 92 – 106. Retrieved February 7, 2018

Guaspari, J. (2015). Why employee engagement isn’t working. Strategic HR Review, 14(6), 243 – 245. doi:10.1108/SHR-09-2015-0070

Lam, M., O’Donnel, M., & Robertson, D. (2015). Achieving employee commitment for continuous improvement initiatives. International Journal of Operations & Production Management, 35(2), 201 – 2015. Retrieved February 7, 2018, from https://doi.org/10.1108/IJOPM-03-2013-0134

Lazaroiu, G. (2015). Employee motivation and job performance. Linguistic and Philosophical Investigations, 14(1), 97 – 102.

Tamkin, P., Yarnall, J., & Kerrin, M. (2014). Kirkpatrick and beyond: A review of training evaluation. Retrieved from Institute for employment studies: http://www.employment-studies.co.uk/system/files/resources/files/392.pdf

Younge, K. A., & Marx, M. (2016). The Value of Employee Retention: Evidence From a Natural Experiment. Journal of Economics & Management Strategy, 25(3), 652 – 677. doi:10.1111/jems.12154

Schizophrenia

Schizophrenia

Abstract

The paper evaluates three articles on schizophrenia disorder, and the first article addresses the use of medication as a tool in the recovery of schizophrenic patients while the second article is a review of the costs arising from schizophrenic patients particularly those linked to related comorbidities. The third article describes a study on the challenges of a diagnosis of childhood-onset schizophrenia and the need to apply medication-free period to diagnose the disease. Finally, a brief description of teaching plan that can be used when teaching a community or patients regarding the schizophrenia disorder and the best way to diagnose, treat and improve the lives of the affected individuals. The teaching plan considers the best ways to assess their learning needs, factors affecting their learning abilities and the best way to adapt the teaching to yield best learning outcomes.

Introduction

The paper uses information derived from the three identified articles to describe schizophrenia, which is a chronic mental disorder that impacts on the way an individual behaves, feel and makes them appear to have lost connection with reality. People suffering from the disorder have confused or unclear thinking, false beliefs, reduced emotional expression, or social engagement and are not motivated. The disorder starts in young adulthood and lasts for a longer time. Peak periods for the onset of schizophrenia are during late adolescence and at times early adulthood, which is vital for the vocational and social development of young adults. Statistics reveal that about forty percent of men and twenty-three percent of women suffer from the disorder often manifesting itself before nineteen years of age (Mas-Expósito, Amador-Campos, Gómez-Benito & Lalucat-Jo, 2011). The onset of schizophrenia is earlier in men than in women and pre-onset, or prodromal phase is detected up to thirty months before the symptoms manifest.

 Besides, the disease is caused by a combination of environmental and genetic factors with people having a family history of the disorder having a transient psychosis of twenty to forty chances of getting the disorder within a year.  According to Harrow, Jobe & Faull (2014), approximately 0.3% to 0.7% of people get diagnosed with the disorder, and as of 2013, there were about 24 million people affected by schizophrenia worldwide. The paper discusses various studies on Schizophrenia in different populations, and it is vital because despite that it does not occur often, its impacts are serious and last longer negatively impacting the lives of those affected. Early diagnosis of the disease paves the way for earlier intervention minimizing its effects with about fifty percent getting permanent impairment and about twenty percent doing well leading to full recovery. Furthermore, people living with the disorder live ten to twenty years lesser than the life expectancy of that of the general population.

Selected Articles

Article One

The first article on schizophrenia is titled Effective strategies for nurses empowering clients with schizophrenia: medication use as a tool in recovery authored by Irma Mahone, Fasching Chris, and Snow Diane. It was published in 2016 on the issues of Mental Health Nursing. The article provides an outline of some of the effective methods used by nurses in collaboration with individuals who have schizophrenia relating to the use of medication as a recovery tool. The article offers information on an overview of the shared decision-making in various psychiatric nursing and techniques aimed at improving patient follow-through while undergoing their psychotic treatment regimen (Mahone, Maphis & Snow, 2016).   Additionally, the authors offer a case study aimed at demonstrating the various strategies in nursing practice. The article uses a single case study of a twenty-nine years old white male to demonstrate the use of medication as a tool of recovery among schizophrenic patients. The study described in the article is qualitative and uses real-life situations to offer a detailed clinical image of shared decision-making. From the case, it is evident that chronic schizophrenia needs a continued engagement between the treatment team and the patients and psychiatric nurses are of vital significance in the process.

Article Two

The second article is a research report authored by Marie-Helen Lafeuille and friends and published in 2014 in the Expert Reviews Pharmaecon. Outcomes Resource. It is titled Burden of schizophrenia on selected comorbidity costs and targets at evaluating the various health care costs linked to schizophrenic patients and that of the general population with regards to particular commodities. The study uses claims in the Medicaid, and the data is derived from five states in the United States between 2001 and 2010. The comorbidities identified in the study include diabetes, substance abuse, and hypertension. The study involves the evaluation of Medicaid databases comprising of medical claims, prescription drug claims, and eligibility information from the states of Missouri, Iowa, Florida, Kansas and New Jersey (Lafeuille et al., 2014). From the study, it is evident that schizophrenia is linked to higher costs related to comorbidities and it is an indication that schizophrenic patients and those with associated comorbidities incur higher comorbidity and all case costs linked to healthcare when compared to non-schizophrenic patients with similar comorbidities.

Article Three

The third article on schizophrenia disorder is titled childhood-onset schizophrenia: The challenge of diagnosis and authored by Peter Gochman, Judith Rapoport, and Rachel Miller. The article is a publication of Curr psychiatry Rep. and was published in 2012. The study involved the evaluation of the salient clinical features of ninety-three children who have been admitted in the last ten years to gain further understanding of the various factors vital for validation of Childhood-onset schizophrenia (COS) diagnosis (Gochman, Miller& Rapoport, 2011). Study results indicate that patients suffering from early-onset psychosis must be observed medication free and more significant consideration should be given to children with sporadic hallucinations or depression.

Teaching Plan

a.    From the analysis of the three articles, subjects of interest to teach about schizophrenia disorder are:

•    Medication aids in the recovery of schizophrenia disorder.

•    Schizophrenic patients incur higher costs linked to associated comorbidities.

•    Medication free period is vital in treating childhood-onset schizophrenia.

The subjects listed above when taught to the patients or the community is essential considering that all of the subjects are useful in regards to diagnosis, treatment, and recovery of patients who have schizophrenia. Both the patients, medical professionals and the community at large play a vital role in the treatment of patients.

b.     The best way to assess the understanding levels of the community and patients on the subject is through effective use of questions. Asking questions is vital in assessing their knowledge on the topic, promotes understanding and stimulates their thinking on the subject. Right questions generate discussion, the creation of new insights and promote a detailed exploration of the subject at hand. Questions should cover what they already know, what they need to learn, their capability to learn and the proper technique to teach the team (Harrow, Jobe & Faull, 2014).

c.    The potential problem of low literacy levels among the patients is poor communication leading to poor teaching outcomes. It can be addressed by allowing more time for interaction to promote effective communication between the patients and the nurses and other healthcare providers. Low literacy levels can be minimized by raising awareness of matters via incorporation of health content into the teaching programs. Additionally, using translators during the teaching process will help in making the target population to understand these subjects.

d.    Some of the psychological factors impacting on patient’s readiness to learn to include anxiety, fatigue, fear or pain, these affect their motivation to learn. The problems can be averted by matching the teaching content to the current state of readiness of the patient with the main aim of ensuring the patient moves along with the teaching.

e.    The learning needs of the patients can be assessed using the Learning Needs Assessment tool (LNAT) and comprises three main areas, namely current knowledge, environment and family and learning style.

Conclusion

From the analysis of the three selected articles, it is evident that schizophrenia is a serious disease that negatively impacts the lives of those affected and there is a need to diagnose it early to ensure that the best interventions are applied to promote recovery and improve lives. Schizophrenia affects a considerable percentage of the population. Thus there is a need for collaboration between patients and healthcare providers to manage it, especially considering that schizophrenic patients incur higher costs linked to related comorbidities. The use of a medication-free period is an essential tool in the recovery of schizophrenic patients. Finally, an effective teaching plan for patients or community must consider their varying learning needs, thus the prerequisite for an assessment to ensure that the teaching plan is adapted to promote the well-being of the targeted learning outcomes.

References

Gochman, P., Miller, R., & Rapoport, L. (2011). Childhood-onset schizophrenia: the challenge of diagnosis. Current psychiatry reports, 13(5), 321.

Harrow, M., Jobe, T. & Faull, N. (2014). Does treatment of schizophrenia with antipsychotic medications eliminate or reduce psychosis? A 20-year multi-follow-up study. Psychological Medicine, 44(14), 3007-3016.

Lafeuille, H., Dean, J., Fastenau, J., Panish, J., Olson, W., Markowitz, M., & Lefebvre, P. (2014). Burden of schizophrenia on selected comorbidity costs. Expert review of pharmacoeconomics & outcomes research, 14(2), 259-267.

Mahone, H., Maphis, F. & Snow, E. (2016). Effective strategies for nurses empowering clients with schizophrenia: medication use as a tool in recovery. Issues in mental health nursing, 37(5), 372-379.

Mas-Expósito, L., Amador-Campos, J. A., Gómez-Benito, J., & Lalucat-Jo, L. (2011). The World Health Organization quality of life scale brief version: a validation study in patients with schizophrenia. Quality of Life Research, 20(7), 1079-1089.

Tuberculosis

Tuberculosis

Abstract

The paper aims to analyze three articles on tuberculosis and present the most appropriate teaching plan for the community or patients regarding tuberculosis. The first article presents a review of the role migration plays in increasing the risk for a migrant to get tuberculosis and the need for implementation of End TB strategy to prevent and treat tuberculosis on a national level. The second article presents a case study highlighting the relationship between tuberculosis awareness and various socioeconomic characteristics of the population. The third article is an evaluation of the application of tuberculosis preventive treatment concerning prevention and treatment of TB. Finally, a teaching plan for patients or the community at risk of getting TB is created with the specific aim of drafting a plan that promotes effective learning.

Introduction

Tuberculosis is considered to be among the ten most killer diseases in the world. Tuberculosis (TB) is caused by Mycobacterium tuberculosis. The disease mainly attacks the lungs (World Health Organization, 2016). TB is spread from an infected person to another healthy person via the air. In 2016 alone, almost 10.5 million people were infected with tuberculosis (TB), leading to about 1.7 million deaths from the disease, including approximately 400,000 people who had HIV (World Health Organization, 2018). Facts show that over 95.0% of these deaths happen in the low and middle-income countries. Regarding children, approximately 1 million children fell ill in 2016 resulting in about 250,000 deaths (World Health Organization, 2018). Making matters worse is the fact that TB is the leading cause of deaths in people living with HIV.  In the United States, 82.0% of all reported instances of TB was in the racial and ethnic minorities; 29.0% Hispanic, 28.0% non-Hispanic African-Americans, 23.0% Asian, 1.0% American Indians while less than 1.0% Native Hawaiian while 18.0% of TB cases occurred in non-Hispanic whites (World Health Organization, 2018).

The World Health Organization has set eradicating TB as one of the health targets, and it has been recently adopted as one of the Sustainable Development Goals. The target of realizing 95% reduction in deaths and a 90% decline in TB incidence has been set for 2035 (World Health Organization, 2018). However, this might not be possible if the contributing factors for TB among the minorities are not adequately addressed, and their attitudes towards TB are not well understood. Similarly, proper educating and awareness programs that are tailored to address the needs of these communities ought to be well thought-out (World Health Organization, 2016).

Article One

Dhava, P., Dias, H., Creswell, J. & Weil, D. (2017). An overview of tuberculosis and migration. Int J Tuberc Lung Dis, 21(6): 610–623

The main purpose of the article was to provide readers with a global overview of migration trends, migration pathways and social determinants and impacts on TB. Efforts are also directed towards outlining a framework to prevent and reduce the TB burden among the migrants. The authors hold the view that the strategy of the World Health Organization if implemented can significantly contribute to ending TB. The strategy is in line with the sustainable development goals, agenda and the TB partnership global plan. The overview reiterates on the requirement for a migrant-inclusive countrywide TB strategy and the need for action to be taken across all the three End TB strategic pillars targeting at prevention and treatment of TB (Dhaya et al., 2017). From the overview, there are various ways in which determinants of health and tuberculosis interact at different phases of migration pathways leading to increased risk of migrants contracting TB infection, disease as well as the reported poor treatment results. For the End TB strategy to be implemented successfully within the five year period. It is vital that the migrant-inclusive national strategic plans (NSPS) are designed and implemented based on the adapted principles and interventions stipulated in the Global Plan.

Article Two

Suleiman, A., Sahal, N., Sodemann, M., Elsony, A., & Aro, A. R. (2014). Tuberculosis awareness in Gezira, Sudan: Knowledge, attitude and practice case-control survey. Eastern Mediterranean Health Journal, 20(2), 120-129

The article is a case study attempting to assess awareness of tuberculosis and the related sociodemographic traits in Gezira, Sudan. The study sample involved new smear-positive in TB patients who were registered in the state between January and June of 2010 and the age-matched control that sought services from the same healthcare facility for different reasons. The study was aimed at assessing TB awareness among TB controls and TB cases in Gezira region and the relationship existing between the level of awareness of the respondents and their sociodemographic characteristics (Suleiman et al., 2014). The study results reveal that the sex of the respondents was linked to awareness among the study control and that the type of residence, level of education, type of occupations as well as age had significant relations with TB awareness levels while no effect on awareness was found on the marital status of the respondents.

Article Three

Çakar, B., Demir, N., Karnak, D., & Özkara, Ş. (2014). Tuberculosis preventive treatment in a single medical center and evaluation of the results. Experimental and therapeutic medicine, 8(6), 1874-1878.

The authors examined the use of the tuberculosis preventive treatment (TB-PT). The study involved evaluation of indications, and demographic data results for all the tuberculosis cases in Ankara tuberculosis control dispensary number seven who received tuberculosis preventive treatment between 2008 and 2011. The study established, that there was a reduction of the percentage of TB for those who received TB-PT during the study period while there was an increase in the percentage of cases with immunosuppression especially among patients using TNF-α inhibitors (Cakar et al., 2014). Finally, the study recommends that TB patients under TB-PT should be followed-up and monitored carefully to ensure that side effects resulting from the development of active TB and treatment is controlled.

Teaching Plan

a.    The three subjects of interest that patients or community would be taught about tuberculosis include the following:

I. Migrations increase the risk of contracting tuberculosis.

II. Factors impacting on TB awareness.

III. The effectiveness of Tuberculosis preventive treatment.

b.    Before commencing teaching the level of patients’ understanding of the selected topics can be assessed by asking them well-crafted questions. This can be done through a survey or informal interview with the targeted population. This is critical in enabling the educator to gain knowledge of what they already know about the subjects, the areas to cover, willingness to learn, and the expectations of the learners

c.    One problem with literacy issues during teaching among patients relates to low literacy levels that reduce the level of communication during the teaching. The problem of low literacy levels among patients can be minimized by considering various means of promoting effective communication such as using native language, verbal and nonverbal communication as well as using images and charts.

d.    Psychological factors affect learning among patients and include depression, anxiety, pain, and fatigue. For example, pain reduces learning ability by diverting attention from learning and reduces concentration levels.

e.    Learning can be assessed by giving patients a questionnaire with well-drafted questions targeting at gauging their understanding of the subject upon completion of teaching. The questionnaire must derive information of learners’ new understanding of the subject and knowledge gained.

Conclusion

Analysis of the three articles reveals that tuberculosis is one of the leading killer diseases in the world and various factors increase the vulnerability of the population to getting the disease as evident by the role that migration increases risks of migrants to get infected. Socioeconomic factors of the population determine their level of awareness about the disease, thus the need for designing and implementation of End TB strategy to ensure prevention and effective treatment of the disease. Finally, teaching the population about TB requires a teaching plan that takes into consideration of the needs of the patients including the expected learning outcomes. Ideally, all these will go an extra mile in ensuring that the target set by WHO of reducing death by 95.0% and incidences of TB by 90.0% will be met.

References

Çakar, B., Demir, N., Karnak, D., & Özkara, Ş. (2014). Tuberculosis preventive treatment in a single medical center and evaluation of the results. Experimental and therapeutic medicine, 8(6), 1874-1878.

Dhava, P., Dias, H., Creswell, J. & Weil, D. (2017). An overview of tuberculosis and migration. Int J Tuberc Lung Dis, 21(6): 610–623

Suleiman, M. M. A., Sahal, N., Sodemann, M., Elsony, A., & Aro, A. R. (2014). Tuberculosis awareness in Gezira, Sudan: knowledge, attitude and practice case-control survey. Eastern Mediterranean Health Journal, 20(2), 120.

World Health Organization, (2016). Global tuberculosis report 2016.

World Health Organization, (2018). Tuberculosis fact sheet. Retrieved on 13^th Feb. 2018 from http://www.who.int/mediacentre/factsheets/fs104/en/