A Cry for Deliverance Essay - 1263 Words

When Upton Sinclair’s novel The Jungle was published in February 1906, it provoked outrage among the American public and prompted much needed legislative reform within America’s meatpacking industry. Responding to public pressure, President Theodore Roosevelt launched a government investigation. The ensuing report, â€Å"Conditions in the Chicago Stock Yards,† confirmed many of Sinclair’s accusations and quickly led to the passage of the Meat Inspection Act and Pure Food and Drug Act of 1906. However, the legislation â€Å"contained no labor protection whatsoever† and it ignored the â€Å"‘workingmen of America’ to whom [Sinclair] had dedicated his novel† (Phelps 14). Bemoaning the book’s limited success, Sinclair stated, â€Å"I aimed at the public’s heart,†¦show more content†¦Arriving in Packingtown, America’s industrial center for the processing and packing of meat, Jurgis’ youthful vigor and large physique quickly secure him a position at Brown’s, one of the three major meatpacking companies in Chicago (70). Energetic and strong, enthusiastic and optimistic, Jurgis initially holds firm to the ideal that hard work leads to success (58, 61, 108). Little by little, a continuous stream of misfortune befalls Jurgis and his family, gradually chipping away at his physical and emotional well-being, not to mention his faith in the American dream. First, Jurgis’ father Antanas, while only sixty years old, cannot find work on account of his age (83). Although he eventually secures a position, it is only because he is willing to pay someone for it (97-99). Nevertheless, the cold and damp working environment damages his health and hastens his premature death (114). While the loss of Antanas grieves the family, the subsequent birth of Jurgis’ son brings some sense of joy. But, it also creates an added financial burden (142). Because of this, Jurgis’ wife Ona returns to work before adequately recovering from childbirth. Like Antanas, her job adversely affects her health and in spite of her youth, Ona never completely recovers (143). Within two years, she diesShow MoreRelatedWhat Do The Experiences Of Ancient Prophets And Joseph Smith `` Sinking `` Essay895 Words   |  4 Pagesfound that there were connections between the conversion of Alma the younger and deliverance of Joseph Smith from the adversary, as Alma describes being racked with torment and wishing to be utterly destroyed before he thought of Jesus Christ, his soul crying out for mercy and was suddenly filled with joy and light. Joseph also felt overpowered by a destructive darkness and exerted all his soul to cry out for deliverance and was immediately encompassed by light and a sense of peace. There were alsoRead MoreExegesis : Isaiah 43 : 14-21 Exegesis992 Words   |  4 PagesStructure: Isaiah 43:14a – Sender of the message Isaiah 43:14b – Prophecy of destruction of God’s people’s enemies Isaiah 43:15 – Sender of the message Isaiah 43:16-17 – Account of God’s power against his people’s enemies Isaiah 43:18-21 – Promise of deliverance of God’s people General Topic The general topic in this text is that God uses his power for the good of his people. Throughout the text, there is emphases on God as the Lord, the redeemer, the Holy One of Israel, the creator of Israel, the KingRead MoreAnalysis Of The Book Judges 1298 Words   |  6 PagesIsraelites rejection of Yahweh and abandonment of their faith often led to their oppression and cries to God for deliverance. 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Assisted suicide, self-deliverance, auto euthanasia, aid-in-dying are all terms that deal with the choice of achieving a good death; the choice of deciding for oneself when it is time to escape unimaginable pain and have the chance to die with the dignity we all deserve. AccordingRead MoreMoses The Christ Like Man943 Words   |  4 Pagesthere was a decree to have all male children killed. Without the wisdom and knowledge of God, these kings could not touch or kill the promises of God. Moses was born and adopted into a land that was predestined by God’ plan. God heard the Israelites’ cries of their oppression and bondage. The struggles of the Israelites were greatly under a wicked and evil Egyptians’ power. â€Å"Egyptians were exploiting the people as slave labor. Their whips lashed out to exploit, to torture, and abuse† (Clowney, E., 2013Read MoreEssay on The Effect of God on Robinson Crusoe1066 Words   |  5 Pagesadventure and wealth. 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Role Play Free Essays

Reflection Paper Counseling Session Role Play Between Kristen (student/client) and Tiffany Ellison (Therapist) Tiffany Ellison Barry University Identifying health risk behavior My client Kristen came in for a follow-up session to focus on codependency issues, feeling overwhelmed with her mother, and not having time to focus on her. Kristen seems to be focusing all of her time on her mother and less time to herself. Kristen is aware that she is not strong enough to deal with overwhelming situations and realizes she needs to be focusing more on herself instead of trying to prove her strengths to everyone else. We will write a custom essay sample on Role Play or any similar topic only for you Order Now Kristen has many obligations to her mother; however in reality, she is giving an excessive amount of responsibility, commitment, and worries for another person, when she needs to be more focused on herself and her strengths. Kristen understands everything that a codependent person does is done to further establish self pitying thoughts of overdoing and of being taken advantage of and for granted. Kristen is also showing signs of intense emotional feelings and is completely overcome in mind and emotion and feels ill-equipped to cope with her stressors. Level of competence demonstrated Throughout the session, as the therapist I felt confident that I would be able to grasp the real true related issues that were affecting her life. I expressed empathy towards the client, by listening to her expressed thoughts and feelings while communicating back to her a desire that I can understand the client’s perspective completely. I also felt the need to express my feelings on her mother; however I did not do so and immediately reflected critical motivational interviewing skills by avoidance of arguing with the client about their need for her to change, by not answering the phone when her mother needs her at any given moment. Through this session I supported self-efficacy by helping the client believe in oneself and become confident that they can carry out the changes the client has chosen to pursue. At this point, in the session, it was very important to me to summarize the important components and how they collaborate with one another. My strong asset as a therapist is that I try to grasp a hold of one of the major issues discussed in the therapy session, and help the client elaborate more in detail, so I may then get a better understanding on each individual issue as it comes along. My client has a lot going on in her life at the moment, and by grasping onto one of her strengths out of her whole story she can reflect on, seemed to make her laugh and smile. Through out this part of the session, I could then have a better trusting relationship with the client by evoking the client’s views. Assessing client readiness Throughout this critical time during our session, I knew at a point that I was able to determine weather my client was ready for change. This point was determined when the client stated Client: â€Å"I enjoy salsa lessons; it’s a stress reliever for me† Therapist: â€Å"What can you do to get yourself more involved with things that you enjoy†? Client: â€Å"I could research for when they are having one†. Therapist: â€Å"Yes, you could† Client: â€Å"I can do that†. Therapist: â€Å"do you think that will help†? Client: â€Å"yes, I love to dance†. During this time, my client seemed honest in her exploration to research on what makes her happy. She was very eager and motivated to learn about the different options that she might have, to give time for herself. The stages of change have inspired instruments for assessing readiness to change or a client’s motivational change state. Depending on the level of readiness-or change stage- different motivational intervention strategies will be more or less effective† (Cox et al. , 2002). â€Å"Your clients m ust value a treatment goal to progress toward it. In fact, unless clients value them, they are not goals from the clients’ perspectives† (Rollnick Moyers, 2006). From a motivational standpoint, one should understand what the clients’ goals are and what they value in life. I was able to pinpoint this by acknowledging her strengths and how could the client research the area for any socializing events particular to her interests. Identifying Change Talk As discussed by Rollnick and Miller (2009), motivational interviewing is directed toward particular behavior change goals. A primary process in motivational interviewing is to help clients resolve ambivalence by evoking their own intrinsic motivations for change. When MI is done well, the client rather than the counselor voices the arguments for change. Throughout MI, particular attention is given to the client â€Å"change talk† which includes verbalizations that signify desire, ability, reasons, need, or commitment to change (Miller and Moyers, 2006). An example used to evoke change talk during the session was very direct: Client: â€Å"Should I not answer the phone every time that my mother calls me? Therapist: â€Å"What do you think you should do? † Client: â€Å"Probably, it might give me some quiet time†. Throughout this conversion, as the therapist, I responded with reflective statements, which summarized the change talk statements the client made. During this process, it was very important to me to understand that I acknowledged her ambivalence, but tried to reinforce the change talk. The point here is that when people talk or ask about what they think they should do, they are more likely to answer the questions themselves, which at that point initiates change talk. Identifying treatment approaches During my time in this session, I have identified many treatment options for this client. This client needs to continue more one-on-one individual therapy sessions, but also initializing journaling to be completed at home. With this specific homework assignment, I wanted her to express her feelings on paper by keeping a journal. During the session, speaking about a journal really seemed to make her laugh and smile. The purpose of this assignment is to make time for her; by identifying that she has a lot going on in her life and by putting aside a little extra time to reflect on her in writing, I feel would help make her aware of the feelings that seem to be so overwhelming. Another treatment approach I could identify is making a commitment to look into a women’s support group in her area. Not only will this give her time to reflect on herself, but also will help empower her to live a fulfilling and purposeful life of self-love. This will also give her a chance to socialize, and network. I feel as if the client will benefit from this experience overtime if the commitment is there. â€Å"Components of intrinsic motivation for change include both the client’s perception of the importance of change as well as his or her confidence that change can be achieved† (Miller and Rollnick, 2009). References Cox, W. M. Klinger, E. ; and Blount, J. P. Alcohol use and goal hierarchies: Systematic motivational counseling for alcoholics. In: Miller, W. R. , and Rollnick, S. , eds. Motivational Interviewing: Preparing People To Change Addictive Behaviors. New York: Guilford Press, 1993. pp. 260-271 Miller, W. R. and Rollnick, S. (2009). Ten things that motivational interviewing is not. Behavioral and Cognitive Psychotherapy, 37, 129-140. Miller, W. R. , Moyers, T. B. (200 6). Eight stages in learning motivational interviewing. 5, 3-17. How to cite Role Play, Essay examples

Factors That Complicate Adherence to Medication-myassignmenthelp

Question: Write about theFactors That Complicate Adherence to Medication. Answer: Introduction This essay explores health factors that might complicate a mentally ill person from not complying to a prescribed medication. It focuses on a case scenario of George a 27- year old male patient who has had multiple admissions in the past to a local acute mental health service. He (George) is admitted to an acute unit on assessment order due to his non-adherence to Risperidone, a medication he has been prescribed to treat Schizophrenia. In earlier past, George has been diagnosed with Schizophrenia, a condition he has not agreed with nor being comfortable with that is why he prefers to use cannabis to treat his condition rather than the pharmacological medication prescribed by his psychiatrist. Schizophrenia is a severe mental illness that affects how a person thinks, manages emotions and relate to others (Minzenberg Carter, 2012). Although there are different treatments to patients with Schizophrenia, George is prescribed Risperidone, an antipsychotic medication usually taken daily e ither in syrup or pill form. George has failed to comply with the medication because he believes cannabis works in his favour than Risperidone. According to Minzenberg and Carter, (2012) adherence to medications is vital for the alleviation of psychotic symptoms associated with schizophrenia such as distorted thoughts, paranoia, hallucinations and feelings of fright. Factors that Might Complicate Georges Compliance to Medication Non-adherence to medication is a complex as well as a multidimensional health care challenge that has been witnessed by George during healthcare delivery. Gearing et al., (2011) holds that the decision on whether to take prescribed medications or not by the people with schizophrenia is a hard phenomenon involving different patients plus medication related facets. For the patient related factors, they include population characteristics such as drug and substance abuse as it is evident in the case of George using Canabis, alcohol dependence, those newly starting the treatment, younger age at the outset of illness, and low-level involvement in the social activities (Gearing et al., 2011). Another great contributor to poor adherence to medication is a membership to the minority ethnic sects. Belief about illness and treatment are also other crucial factors that determine adherence to medication. For instance, adherence to medicines is higher among individuals with schizophrenia who are i nsightful and aware of the purpose of drugs to alleviate symptoms of an illness or shun from being admitted to the hospital. This is evident in the case scenario where George prefers to user cannabis than the recommended medication. According to him, he believes that cannabis can suppress pain and be used to cure illnesses rather than the prescribed Risperidone. Also the attitude towards mediation and belief that medications are much effective in lowering symptoms is another aspect that contributes to adherence to medicines. Intolerable symptoms and side effects are another health factors that might complicate Georges compliance to the prescribed medication. For instance, adverse effects due to antipsychotics such as prolactin levels sedation and extra pyramidal symptoms are somehow problematic. On the other hand, adverse metabolic effects of typical antipsychotics such as an increase in body mass index also contribute to non-adherence to medications (Teter et al., 2011). According to research, understanding the benefits of taking medication to alleviate problematic psychotic symptoms helps to improve willingness to allow the side-effects burden for mental wellness. Lots of research holds to the fact that the need for strong plus active therapeutic relations is vital for the promotion of adherence to medication. Other studies also suggest that therapeutic alliance is highly connected to medication adherence among the persons with Schizophrenia. On the same note, other studies suggest that lack of adherence to medication among people increases with the low level of therapeutic alliance among individuals with schizophrenia (Subotnik et al., 2011). Research also points out that mentally ill people value help from pharmacologists about medication especially when they provide them with information concerning the adverse effects of the drugs show a good understanding of the persons perspective as well as listens to the patients grievances regarding the medication (Velligan et al., 2010). Also, the experience of admission to the health centers is another crucial factor that determines willingness to take medics; lack of involvement in decision making w hen treating the patients, negative pressure when entering the health centers and the aspect of coercion are all connected to the lack of adherence to medications as Velligan et al, (2010) suggests. Studies also show that people having a small extent of illness awareness, as well as of a disease are much likely to demonstrate poor/lack of compliance to medication. Moreover, beliefs and perceptions towards adhering to drugs is also based on earlier experiences, socioeconomic and cultural aspects are also associated with lack of compliance to medication. According to Dunbar-Jacob et al., (2012) these factors may result in the fact that the younger the age, the earlier the age of onset of schizophrenia and the shorter the lifespan of illness, the poorer the compliance rates become. Nursing strategies to assist George Gain better adherence to his prescribed medication The problem of patients non compliance to medication has been widely researched and the rates of lack of compliance have not changed much for the past decades (Australian, 2017). For the case of George, Nurse should adopt the following strategies to help him gain better compliance to medication. Simplifying regimen characteristics. Although patients usually misinterpret medication instructions, nurses should use simple language and have the patient repeat the instructions for proper understanding (Gearing et al., 2011). For the case of George, the nurse can use compliance aids to assist him organize his medication such as medication boxes and alarms to recall dosage times. The Nurse can also use microelectronic kit to know whether George has been taking the drugs as per the prescription. Patients like can also use instruments made to boost physical dexterity especially when administering injections. Imparting crucial knowledge According to research, many patients do not understand prescription instructions and usually forgets lots of what their nurses tell them. To solve this problem, the nurse should provide George with education by limiting instructions to key points in every discussion, and use simple language particularly when giving instructions or explaining diagnosis. Another key thing here would be to involve Georges Family and friends as well as emphasize on the key points discussed. Modify Patients Beliefs/human behavior For complex interventions that require lifestyle changes, it is vital to address the patients intentions, beliefs, and the ability to perform an action. This is due to the fact that knowledge is not enough to boost compliance in recommendations pertaining complex behavior change (Bosworth et al., 2011). The nurse would optimize Georges behavior change by ensuring that he perceives his medical condition to be serious, have channels to address his fears/concerns and see him as having requisite skills needed to perform health behavior. Evaluating adherence Ideally, physicians underestimate the issue of lack of compliance in patients. When a nurse cannot detect non compliance, it becomes difficult for her to correct the problem. Therefore, it becomes hard to measure as well as evaluate patient compliance reliably. The nurse can achieve this through self reports, drug counting as well as urine and serum drug levels. Moreover, the physician should ensure regular examination of the patient to increase his adherence to medication. Counseling A comprehensive dialogue of the merits and demerits of a prescribed medication during patients consultation is regarded as the foundation for the growth of medication compliance (Di Matteo et al., 2012). In this case motivational interviewing can be very helpful to frame a discussion of the patients fears, treatment rationale and social pressure. Hardeman et al., (2010) holds that the value of the patients choice need to be strengthened and rules for the pills consumption be in written formats. Moreover, the aspect of reminders also comprises of the patients family, the nurse and the pharmacologist. A patient needs not to be given the information alone about the effects of a certain medication, the dosage and time of intake, but also be provided with information regarding the meaning as well as chances of side effects and interactions (Gearing et al., 2011). Compliance to medication needs to be discussed every time the patient goes back to the therapist as much as possible. For examp le, this can be done by requesting the patients to submit the medical joint boxes for discussion and joint inspection. Studies have shown that forgetfulness is an integral element leading to lack of compliance. This is an explanation for the study that many effects of counseling are transient and the challenge is to implement continuous counseling technique. According to Di Matteo et al., (2012) telephone counseling as a measure to boost medication compliance has been shown very useful in a two-year randomized controlled trial in more than 400 non-adherent patients receiving four or more drugs prescribed for the treatment of a chronic disease Therapeutic approaches Successful treatment is all about engaging the patients in a healthcare process according to their psychiatric diagnosis as well as cognitive level. The five As of a basic outpatient care are approachability, availability, appropriateness, affordability, acceptability. According to Bubalo et al., (2010) caring for a person with a chronic condition cannot happen unless a health care officer is readily accessible. Afternoon hours may work well for patients who do not prefer morning visits especially when circadian rhythms are not properly aligned. In case the nurse is not approachable, he cannot be successful in handling patients intimate plus complicated mental disorders over a long time (Bosworth et al., 2011). Besides, it is hard to establish a beneficial alliance when the patient finds it hard to see the physicist.c Conclusion The chronic aspect of mental illnesses like schizophrenia calls for a regular engagement between the person with schizophrenia and the treatment staff. Transparency when sharing information, communicating or involvement in decision making is critical to the establishment of treatment decisions that can help a patient in his/her personal goals. Since nurses are some of the most trusted healthcare professionals, skills and expertise at soliciting clients beliefs and perceptions for a plan of care are vital, and psychiatric healthcare staff are in the utmost position to educate the patients about the need for shared decision making in conjunction to the prescribing pharmacologist. Most importantly, helping a schizophrenia person identify his/her medicine, choose targeted psychological interventions as well as select a medication that best suits his lifestyle and objective are some of the strategies that can boost adherence to medication. In the case study presented, George admitted to n ot taking the prescribed antipsychotic Risperidone. In an attempt to treat his conditions he (George) chose to use cannabis which he was positive it could cure his condition. All in all, psychiatric health officers and pharmacologists need to educate people with schizophrenia about the need for adherence to medication. References Australian, R. (2017). Royal Australian and New Zealand College of Psychiatrists clinical practice guidelines for the treatment of schizophrenia and related disorders. Australian New Zealand Journal of Psychiatry. Bosworth, H. B., Granger, B. B., Mendys, P., Brindis, R., Burkholder, R., Czajkowski, S. M., ... Kimmel, S. E. (2011). Medication adherence: a call for action. American heart journal, 162(3), 412-424. Bubalo, J., Clark, R. K., Jiing, S. S., Johnson, N. B., Miller, K. A., Clemens-Shipman, C. J., Sweet, A. L. (2010). Medication adherence: pharmacist perspective. Journal of the American Pharmacists Association, 50(3), 394-406. Gearing, R. E., Townsend, L., MacKenzie, M., Charach, A. (2011). Reconceptualizing medication adherence: six phases of dynamic adherence. Harvard review of psychiatry, 19(4), 177-189. Hardeman, S. M., Harding, R. K., Narasimhan, M. (2010). Simplifying adherence in schizophrenia. Psychiatric Services, 61(4), 405-408. DiMatteo, M. R., Haskard-Zolnierek, K. B., Martin, L. R. (2012). Improving patient adherence: a three-factor model to guide practice. Health Psychology Review, 6(1), 74-91. Dunbar-Jacob, J., Schlenk, E., McCall, M. (2012). 12 Patient Adherence to Treatment Regimen. Handbook of health psychology, 271. Minzenberg, M. J., Carter, C. S. (2012). Developing treatments for impaired cognition in schizophrenia. Trends in cognitive sciences, 16(1), 35-42. Subotnik, K. L., Nuechterlein, K. H., Ventura, J., Gitlin, M. J., Marder, S., Mintz, J., ... Singh, I. R. (2011). Risperidone nonadherence and return of positive symptoms in the early course of schizophrenia. American Journal of Psychiatry, 168(3), 286-292. Teter, C. J., Falone, A. E., Bakaian, A. M., Tu, C., ngr, D., Weiss, R. D. (2011). Medication adherence and attitudes in patients with bipolar disorder and current versus past substance use disorder. Psychiatry research, 190(2), 253-258. Velligan, D., Sajatovic, M., Valenstein, M., Riley, W., Safren, S., Lewis-Fernandez, R., ... Jamison, J. (2010). Methodological challenges in psychiatric treatment adherence research. Clinical schizophrenia related psychoses, 4(1), 74-91. Zeber, J. E., Manias, E., Williams, A. F., Hutchins, D., Udezi, W. A., Roberts, C. S., ... ISPOR Medication Adherence Good Research Practices Working Group. (2013). A systematic literature review of psychosocial and behavioral factors associated with initial medication adherence: a report of the ISPOR medication adherence persistence special interest group. Value in health, 16(5), 891-900.