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  • [Solved] WK 5 RESP DATA 2

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    Executive Solution Overview

    – 2 years ago **files (1)** – ## WK5DISDATA.docx **## WK5DISDATA.docx** Self-Study: Comparison of Means, Comparison of Means, Part II: ANOVA and Kruskal Wallis Throughout the course, there will be a self-study Discussion pertaining to an important concept or topic covered within the assigned week. T…

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    Assignment Prompt & Instructions

    – 2 years ago

    **files (1)**

    – ## WK5DISDATA.docx

    **## WK5DISDATA.docx**

    Self-Study: Comparison of Means, Comparison of Means, Part II: ANOVA and Kruskal Wallis

    Throughout the course, there will be a self-study Discussion pertaining to an important concept or topic covered within the assigned week. These Discussions are designed to give you the opportunity to collaborate with your peers and faculty, test your knowledge, ask questions, practice research analysis, and assist your peers.

    You are not required to post to this forum; however, you are encouraged to post, review the posts of others, as well as answer questions and/or provide clarity and collaboration with your peers. Discussions will be graded as either Complete or Incomplete.

    Resources

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/157739/modules/items/6373726)

    [Required Resources](https://waldenu.instructure.com/courses/157739/pages/week-5-learning-resources?module_item_id=6373726)

    · Laerd Statistics: Sign up for a one-month plan using this link
    [https://statistics.laerd.com/sign-up.php?code=LS-USD-1M-599Links to an external site.](https://statistics.laerd.com/sign-up.php?code=LS-USD-1M-599)

    ·
    [One Way ANOVA in SPSSLinks to an external site.](https://statistics.laerd.com/premium/spss/owa/one-way-anova-in-spss.php)
    https://statistics.laerd.com/premium/spss/owa/one-way-anova-in-spss.php

    ·
    [Kruskal-Wallis Test in SPSSLinks to an external site.](https://statistics.laerd.com/premium/spss/kwht/kruskal-wallis-test-in-spss.php)
    https://statistics.laerd.com/premium/spss/kwht/kruskal-wallis-test-in-spss.php

    · Salkind, N., & Frey, B. (2019).
    _Statistics for people who (think they) hate statistics_ (7th ed.). SAGE Publications.

    · Chapter 14, “Analysis of Variance: Two Groups Too Many?” (pp. 269–273, 279)

    ·
    **Document:** [Statistical Output: Kruskal-Wallis (Word document)](https://waldenu.instructure.com/courses/157739/files/12465876?wrap=1) [Download Statistical Output: Kruskal-Wallis (Word document)](https://waldenu.instructure.com/courses/157739/files/12465876/download?download_frd=1)

    ·
    **Document:** [Statistical Output: ANOVA (Word document)](https://waldenu.instructure.com/courses/157739/files/12465878?wrap=1) [Download Statistical Output: ANOVA (Word document)](https://waldenu.instructure.com/courses/157739/files/12465878/download?download_frd=1)

    [Required Media](https://waldenu.instructure.com/courses/157739/pages/week-5-learning-resources?module_item_id=6373726)

    **Niedz, B. (2024).**
    **_Comparison of means, part II: ANOVA and Krustkal Wallis_ [Video]. Walden University Canvas. https://waldenu.instructure.com**

    [PowerPoint Presentation](https://waldenu.instructure.com/courses/157739/pages/week-5-learning-resources?module_item_id=6373726)

    **Document:** [**Comparison of Means, ANOVA and Kruskal Wallis (PowerPoint presentation)**](https://waldenu.instructure.com/courses/157739/files/12465889?wrap=1)

    [Required Resources for Topic: ANOVA](https://waldenu.instructure.com/courses/157739/pages/week-5-learning-resources?module_item_id=6373726)

    · Turgut, M., & Yıldız, H. (2023).
    [Investigation of grief and posttraumatic growth related to patient loss in pediatric intensive care nurses: A cross-sectional studyLinks to an external site.](https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=a9h&AN=174028410&site=eds-live&scope=site&custid=s6527200).
    _BMC Palliative Care, 22_(1), 195.

    **To prepare:**

    · Read and view the Learning Resources in Doherty and Skalsky, and Dang et al. (2021) in Required Readings.

    · View the video on comparison of means.

    **Use** this Discussion to collaborate with your peers and faculty as an open office hours/ Q&A forum.

    **Post** answers to the following:

    · Summarize the ANOVA or the Kruskal-Wallis output after completing the self-learning module and completing the Required Readings.

    · Turgut and Yıldız (2023) used both a
    _t_ test and an ANOVA and presented these findings in Table 2 on page 5.

    · Compare and contrast the comparisons for the impact of
    _duration of work on the unit_, on the Texas Revised Inventory of Grief (ANOVA), and the
    _education on terminal period and grief_ (
    _t_ test).

    · Were these the correct tests to be used in these analyses? Explain why.

    For this Self-Study Discussion, you may post throughout Week 5. You are not required to post to this forum; however, you are encouraged to post, review the posts of others, as well as answer questions and/or provide clarity and collaboration with your peers. Discussions will be graded as either Complete or Incomplete.

    **Use** this Discussion to collaborate with your peers and faculty as an open office hours/ Q&A forum.

    **Post** answers to any or all of the following:

    · Summarize the ANOVA or the Kruskal-Wallis output after completing the self-learning module and completing the Required Readings.

    · Turgut and Yıldız (2023) used both a
    _t-test_ and an ANOVA and presented these findings in Table 2 on page 5.

    · Compare and contrast the comparisons for the impact of
    _duration of work on the unit_, on the Texas Revised Inventory of Grief (ANOVA), and the
    _education on terminal period and grief_ (
    _t-test_).

    · Were these the correct tests to be used in these analyses? Explain why.

    Our interactive discussion addresses the following learning objectives:

    · Differentiate between ANOVA and Kruskal-Wallis tests of significance

    · Summarize statistical findings for ANOVA and for Kruskal-Wallis

    RESPOND TO THIS DISCUSSION POST

    Reply from Tania

    After reviewing the learning resources by Doherty and Skalsky (2021), Dang et al. (2022), and Turgut and Yıldız (2023), I have analyzed the appropriate application of ANOVA and t-tests in healthcare research, specifically in the context of evaluating grief among healthcare professionals.

    **Summary of ANOVA and Kruskal-Wallis Output**

    ANOVA (Analysis of Variance) compares the means of three or more independent groups to determine whether they have statistically significant differences. It assumes normal distribution and homogeneity of variances. When these assumptions are violated, the non-parametric alternative's Kruskal-Wallis test is appropriate because it does not require normality and

    can be used with ordinal data (Ghasemi & Zahediasl, 2021). Doherty and Skalsky (2021) highlight that selecting the correct test depends on the measurement and data distribution level, emphasizing that ANOVA is effective for parametric data. Kruskal-Wallis’s test is more robust when assumptions are unmet.

    **Comparison of ANOVA and t-Test in Turgut and Yıldız (2023)**

    Turgut and Yıldız (2023) used both an independent t-test and ANOVA to assess different variables affecting grief among healthcare workers:

    **Impact of Work Duration on the Texas Revised Inventory of Grief (ANOVA):**

    The study applied a one-way ANOVA to analyze differences in grief scores based on the duration of work on the unit. Since the work duration was categorized into multiple groups (e.g., short-term, mid-term, and long-term experience), ANOVA was the correct choice for comparing mean grief scores among three or more independent groups (Kim, 2017).

    **Impact of Education on Terminal Period and Grief (t-Test):**

    An independent t-test was employed to compare grief scores between two groups: those who received education on terminal care and grief and those who did not. Since this analysis involved only two independent groups, the t-test was the appropriate statistical method to determine whether education significantly influenced grief scores (McDonald, 2019).

    **Appropriateness of the Statistical Tests**

    The statistical tests used in Turgut and Yıldız’s (2023) study were appropriate. ANOVA was correctly used to compare means among multiple independent

    groups, while the t-test effectively assessed differences between two distinct groups. Doherty and Skalsky (2021) emphasize the importance of ensuring statistical assumptions are met before applying parametric tests. If assumptions such as normality and homogeneity of variances were violated, the Kruskal-Wallis test could have been an alternative to ANOVA, and the Mann-Whitney U test could have replaced the t-test (Ghasemi & Zahediasl, 2021).

    **Insights from Dang et al. (2022)**

    Dang et al. (2022) highlight the role of evidence-based practice in healthcare research, stressing the need for rigorous statistical analysis. Their framework aligns with the approach used in Turgut and Yıldız (2023), where statistical tests were chosen based on data structure and research questions, ensuring reliable findings that inform nursing and healthcare practices.

    **Conclusion**

    Turgut and Yıldız (2023) appropriately applied ANOVA and t-tests to analyze the impact of work duration and education on grief among healthcare workers. The discussion from Doherty and Skalsky (2021) and Dang et al. (2022) reinforces the importance of selecting the correct statistical tests based on data characteristics. Ensuring that statistical assumptions are met is essential for the validity of findings, and when necessary, non-parametric alternatives such as the Kruskal-Wallis test should be considered.

    **References**

    Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2022
    _). Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals: Model and Guidelines_ (4th ed.). Sigma Theta Tau International Honor Society of Nursing.

    Doherty, C., & Skalsky, K. (2021).
    _Statistics and Research Design for the DNP Project_. DEStech Publications.

    Ghasemi, A., & Zahediasl, S. (2021). Normality tests for statistical analysis: A guide for non-statisticians.
    _International Journal of Endocrinology and Metabolism, 19_(2), e110979.

    Kim, H. Y. (2017). Statistical notes for clinical researchers: Understanding one-way ANOVA.
    _Korean Journal of Anesthesiology, 70_(1), 22-26.

    Kim, H. Y. (2017). Statistical notes for clinical researchers: Understanding one-way ANOVA.
    _Korean Journal of Anesthesiology, 70_(1), 22-26.

    McDonald, J. H. (2019). Handbook of biological statistics (4th ed.). Sparky House Publishing.

    Turgut, M., & Yıldız, H. (2023). Investigation of grief and posttraumatic growth related to patient loss in pediatric intensive care nurses: A cross-sectional study.
    _BMC Palliative Care, 22_(1), 195.

    **## WK5DISDATA.docx**

    Self-Study: Comparison of Means, Comparison of Means, Part II: ANOVA and Kruskal Wallis

    Throughout the course, there will be a self-study Discussion pertaining to an important concept or topic covered within the assigned week. These Discussions are designed to give you the opportunity to collaborate with your peers and faculty, test your knowledge, ask questions, practice research analysis, and assist your peers.

    You are not required to post to this forum; however, you are encouraged to post, review the posts of others, as well as answer questions and/or provide clarity and collaboration with your peers. Discussions will be graded as either Complete or Incomplete.

    Resources

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/157739/modules/items/6373726)

    [Required Resources](https://waldenu.instructure.com/courses/157739/pages/week-5-learning-resources?module_item_id=6373726)

    · Laerd Statistics: Sign up for a one-month plan using this link
    [https://statistics.laerd.com/sign-up.php?code=LS-USD-1M-599Links to an external site.](https://statistics.laerd.com/sign-up.php?code=LS-USD-1M-599)

    ·
    [One Way ANOVA in SPSSLinks to an external site.](https://statistics.laerd.com/premium/spss/owa/one-way-anova-in-spss.php)
    https://statistics.laerd.com/premium/spss/owa/one-way-anova-in-spss.php

    ·
    [Kruskal-Wallis Test in SPSSLinks to an external site.](https://statistics.laerd.com/premium/spss/kwht/kruskal-wallis-test-in-spss.php)
    https://statistics.laerd.com/premium/spss/kwht/kruskal-wallis-test-in-spss.php

    · Salkind, N., & Frey, B. (2019).
    _Statistics for people who (think they) hate statistics_ (7th ed.). SAGE Publications.

    · Chapter 14, “Analysis of Variance: Two Groups Too Many?” (pp. 269–273, 279)

    ·
    **Document:** [Statistical Output: Kruskal-Wallis (Word document)](https://waldenu.instructure.com/courses/157739/files/12465876?wrap=1) [Download Statistical Output: Kruskal-Wallis (Word document)](https://waldenu.instructure.com/courses/157739/files/12465876/download?download_frd=1)

    ·
    **Document:** [Statistical Output: ANOVA (Word document)](https://waldenu.instructure.com/courses/157739/files/12465878?wrap=1) [Download Statistical Output: ANOVA (Word document)](https://waldenu.instructure.com/courses/157739/files/12465878/download?download_frd=1)

    [Required Media](https://waldenu.instructure.com/courses/157739/pages/week-5-learning-resources?module_item_id=6373726)

    **Niedz, B. (2024).**
    **_Comparison of means, part II: ANOVA and Krustkal Wallis_ [Video]. Walden University Canvas. https://waldenu.instructure.com**

    [PowerPoint Presentation](https://waldenu.instructure.com/courses/157739/pages/week-5-learning-resources?module_item_id=6373726)

    **Document:** [**Comparison of Means, ANOVA and Kruskal Wallis (PowerPoint presentation)**](https://waldenu.instructure.com/courses/157739/files/12465889?wrap=1)

    [Required Resources for Topic: ANOVA](https://waldenu.instructure.com/courses/157739/pages/week-5-learning-resources?module_item_id=6373726)

    · Turgut, M., & Yıldız, H. (2023).
    [Investigation of grief and posttraumatic growth related to patient loss in pediatric intensive care nurses: A cross-sectional studyLinks to an external site.](https://search.ebscohost.com/login.aspx?direct=true&AuthType=shib&db=a9h&AN=174028410&site=eds-live&scope=site&custid=s6527200).
    _BMC Palliative Care, 22_(1), 195.

    **To prepare:**

    · Read and view the Learning Resources in Doherty and Skalsky, and Dang et al. (2021) in Required Readings.

    · View the video on comparison of means.

    **Use** this Discussion to collaborate with your peers and faculty as an open office hours/ Q&A forum.

    **Post** answers to the following:

    · Summarize the ANOVA or the Kruskal-Wallis output after completing the self-learning module and completing the Required Readings.

    · Turgut and Yıldız (2023) used both a
    _t_ test and an ANOVA and presented these findings in Table 2 on page 5.

    · Compare and contrast the comparisons for the impact of
    _duration of work on the unit_, on the Texas Revised Inventory of Grief (ANOVA), and the
    _education on terminal period and grief_ (
    _t_ test).

    · Were these the correct tests to be used in these analyses? Explain why.

    For this Self-Study Discussion, you may post throughout Week 5. You are not required to post to this forum; however, you are encouraged to post, review the posts of others, as well as answer questions and/or provide clarity and collaboration with your peers. Discussions will be graded as either Complete or Incomplete.

    **Use** this Discussion to collaborate with your peers and faculty as an open office hours/ Q&A forum.

    **Post** answers to any or all of the following:

    · Summarize the ANOVA or the Kruskal-Wallis output after completing the self-learning module and completing the Required Readings.

    · Turgut and Yıldız (2023) used both a
    _t-test_ and an ANOVA and presented these findings in Table 2 on page 5.

    · Compare and contrast the comparisons for the impact of
    _duration of work on the unit_, on the Texas Revised Inventory of Grief (ANOVA), and the
    _education on terminal period and grief_ (
    _t-test_).

    · Were these the correct tests to be used in these analyses? Explain why.

    Our interactive discussion addresses the following learning objectives:

    · Differentiate between ANOVA and Kruskal-Wallis tests of significance

    · Summarize statistical findings for ANOVA and for Kruskal-Wallis

    RESPOND TO THIS DISCUSSION POST

    Reply from Tania

    After reviewing the learning resources by Doherty and Skalsky (2021), Dang et al. (2022), and Turgut and Yıldız (2023), I have analyzed the appropriate application of ANOVA and t-tests in healthcare research, specifically in the context of evaluating grief among healthcare professionals.

    **Summary of ANOVA and Kruskal-Wallis Output**

    ANOVA (Analysis of Variance) compares the means of three or more independent groups to determine whether they have statistically significant differences. It assumes normal distribution and homogeneity of variances. When these assumptions are violated, the non-parametric alternative's Kruskal-Wallis test is appropriate because it does not require normality and

    can be used with ordinal data (Ghasemi & Zahediasl, 2021). Doherty and Skalsky (2021) highlight that selecting the correct test depends on the measurement and data distribution level, emphasizing that ANOVA is effective for parametric data. Kruskal-Wallis’s test is more robust when assumptions are unmet.

    **Comparison of ANOVA and t-Test in Turgut and Yıldız (2023)**

    Turgut and Yıldız (2023) used both an independent t-test and ANOVA to assess different variables affecting grief among healthcare workers:

    **Impact of Work Duration on the Texas Revised Inventory of Grief (ANOVA):**

    The study applied a one-way ANOVA to analyze differences in grief scores based on the duration of work on the unit. Since the work duration was categorized into multiple groups (e.g., short-term, mid-term, and long-term experience), ANOVA was the correct choice for comparing mean grief scores among three or more independent groups (Kim, 2017).

    **Impact of Education on Terminal Period and Grief (t-Test):**

    An independent t-test was employed to compare grief scores between two groups: those who received education on terminal care and grief and those who did not. Since this analysis involved only two independent groups, the t-test was the appropriate statistical method to determine whether education significantly influenced grief scores (McDonald, 2019).

    **Appropriateness of the Statistical Tests**

    The statistical tests used in Turgut and Yıldız’s (2023) study were appropriate. ANOVA was correctly used to compare means among multiple independent

    groups, while the t-test effectively assessed differences between two distinct groups. Doherty and Skalsky (2021) emphasize the importance of ensuring statistical assumptions are met before applying parametric tests. If assumptions such as normality and homogeneity of variances were violated, the Kruskal-Wallis test could have been an alternative to ANOVA, and the Mann-Whitney U test could have replaced the t-test (Ghasemi & Zahediasl, 2021).

    **Insights from Dang et al. (2022)**

    Dang et al. (2022) highlight the role of evidence-based practice in healthcare research, stressing the need for rigorous statistical analysis. Their framework aligns with the approach used in Turgut and Yıldız (2023), where statistical tests were chosen based on data structure and research questions, ensuring reliable findings that inform nursing and healthcare practices.

    **Conclusion**

    Turgut and Yıldız (2023) appropriately applied ANOVA and t-tests to analyze the impact of work duration and education on grief among healthcare workers. The discussion from Doherty and Skalsky (2021) and Dang et al. (2022) reinforces the importance of selecting the correct statistical tests based on data characteristics. Ensuring that statistical assumptions are met is essential for the validity of findings, and when necessary, non-parametric alternatives such as the Kruskal-Wallis test should be considered.

    **References**

    Dang, D., Dearholt, S. L., Bissett, K., Ascenzi, J., & Whalen, M. (2022
    _). Johns Hopkins Evidence-Based Practice for Nurses and Healthcare Professionals: Model and Guidelines_ (4th ed.). Sigma Theta Tau International Honor Society of Nursing.

    Doherty, C., & Skalsky, K. (2021).
    _Statistics and Research Design for the DNP Project_. DEStech Publications.

    Ghasemi, A., & Zahediasl, S. (2021). Normality tests for statistical analysis: A guide for non-statisticians.
    _International Journal of Endocrinology and Metabolism, 19_(2), e110979.

    Kim, H. Y. (2017). Statistical notes for clinical researchers: Understanding one-way ANOVA.
    _Korean Journal of Anesthesiology, 70_(1), 22-26.

    Kim, H. Y. (2017). Statistical notes for clinical researchers: Understanding one-way ANOVA.
    _Korean Journal of Anesthesiology, 70_(1), 22-26.

    McDonald, J. H. (2019). Handbook of biological statistics (4th ed.). Sparky House Publishing.

    Turgut, M., & Yıldız, H. (2023). Investigation of grief and posttraumatic growth related to patient loss in pediatric intensive care nurses: A cross-sectional study.
    _BMC Palliative Care, 22_(1), 195.

  • [Solved] WK 5 RESP 2 EPID

    ✓ Verified Academic Solution Available

    Executive Solution Overview

    – 2 years ago **files (1)** – ## WK5DISEPID.docx **## WK5DISEPID.docx** Measures Used in Epidemiology ![A group of people sitting at a table AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/wk-5-resp-2-epid)One important application of epidemiology is to identify factors …

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    $6.99

    Immediate access to the full model answer, formatted citations, and rubric breakdown.

    Need a Fresh Custom Paper?

    Have this question answered from scratch according to your specific instructions and deadline.

    Order on TutorsGallery →

    Assignment Prompt & Instructions

    – 2 years ago

    **files (1)**

    – ## WK5DISEPID.docx

    **## WK5DISEPID.docx**

    Measures Used in Epidemiology

    ![A group of people sitting at a table AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/wk-5-resp-2-epid)One important application of epidemiology is to identify factors that could increase the likelihood of a certain health problem occurring within a specific population. Epidemiologists use
    _measures of effect_ to examine the association or linkage in the relationship between risk factors and emergence of disease or ill health. For instance, they may use measures of effect to better understand the relationships between poverty and lead poisoning in children, smoking and heart disease, or low birth weight and future motor skills. The following are some common measures used in epidemiology:

    ·
    **Odds ratio**: The odds ratio quantifies the association between an independent variable (exposure) and a dependent variable (outcome). It is calculated as the odds that an effect will occur given the presence or exposure to a studied variable, compared to the odds when there is no exposure (e.g., lung cancer and smoking)

    ·
    **Risk ratio (also called relative risk)**: Also quantifies the association between an independent variable and a dependent variable. The risk of an effect occurring in one population versus another population (e.g., preeclampsia in women <35 versus >35). Risks greater than one suggest that exposure to a given variable is associated with an increase in the risk of the outcome, and a risk ratio of less than one indicates that the exposure is associated with a decrease in the risk of the outcome.

    ·
    **Mortality**: Measure of deaths in a particular population during a specified time interval. If this is attributed to a specific cause, it is referred to as cause-specific mortality.

    ·
    **Morbidity**: Measure of instances of illness or disability in a population from a given cause (e.g., heart disease) during a specified time interval

    ·
    **Incidence**: The occurrence of new cases of an effect or disease in a population over a defined time period relative to the size of the population at risk (e.g., new cases of COVID-19 in a population over a 7-day period/1000 people)

    ·
    **Prevalence**: The number of all cases of an effect or disease, not just new ones, in a population at a given time relative to the size of the population (e.g., number of people with autism/1000)

    What is the significance of these measures of effect for nursing practice? In this Discussion, you will consider this pivotal question.

    Resources

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/155998/modules/items/6259844)

    [Required Readings](https://waldenu.instructure.com/courses/155998/pages/week-5-learning-resources?module_item_id=6259844)

    · Curley, A. L. C. (Ed.). (2024).
    _Population-based nursing: Concepts and competencies for advanced practice_ (4th ed.). Springer.

    · Chapter 4, “Epidemiological Methods and Measurements in Population-Based Nursing Practice: Part I” (pp. 68-105)

    · Friis, R. H., & Sellers, T. A. (2021).
    _Epidemiology for public health practice_ (6th ed.). Jones & Bartlett.

    · Chapter 3, “Measures of Morbidity and Mortality Used in Epidemiology”

    · Chapter 9, “Measures of Effect”

    To prepare:

    · Select item 1, 2, or 3 to use for this Discussion. Consider the definitions, differences, and utility of the two terms listed under your item selection. Your response will need to include both terms in the item selected.

    1. Odds ratio and risk ratio

    2. Mortality and morbidity

    3. Incidence and prevalence

    · Consider how these epidemiologic measures strengthen and support nursing practice.

    · Assess practice limitations of not using these measures in nursing practice.

    · Conduct additional research in the Walden Library and other credible resources, and then locate two examples in the scholarly literature that support your insights.

    By Day 3 of Week 5

    **Post** a cohesive scholarly response that addresses the following:

    · Explain how your selected measures of effect strengthen and support nursing practice. Provide at least two specific examples from the literature to substantiate your insights.

    · Assess limitations of
    **not** using measures of effect in nursing practice.

    By Day 6 of Week 5

    **Respond** to
    **at least two** colleagues on
    **two different days** in one or more of the following ways:

    · Ask a probing question, substantiated with additional background information, evidence or research.

    · Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    · Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    · Validate an idea with your own experience and additional research.

    · Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    · Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    RESPOND TO THIS DISCUSSION POST

    **Mortality and Morbidity**

    Mortality and Morbidity are two key terms used in Epidemiology to define the numbers of deaths and the frequency of illness respectively (Friis & Sellers, 2021). Mortality rate is the number of deaths in a population over a specific time, usually expressed as deaths per unit population (Curley et al., 2024). Meanwhile the morbidity rate is the frequency of disease within a population over a specific time, usually expressed as a percentage, a proportion, or a rate per unit population (Curley et al., 2024).

    **How Mortality and Morbidity Strengthen and Support Nursing Practice**

    Epidemiological surveillance, whether in a large community or within a healthcare facility, provides important information on health outcomes. Mortality and morbidity surveillance is necessary to understand the impact and find ways to improve public health.
    Moreover, mortality rates compare death rates among and within populations therefore providing evaluation and comparing data within the populations (Curley et al., 2024). Likewise, morbidity rates can help us to compare risk factors, prevent and manage modifiable risk factors, and decrease mortality rates. These measures strengthen nursing practices such as surveillance systems to reduce hospital-acquired infections and conditions, find innovation, develop policies, and protocols, and evaluate the system.

    For example, about 70% of urinary tract infections (UTIs) developed in the hospital are associated with a urinary catheter, and catheter-associated urinary tract infections (CAUTIs) are associated with increased mortality and morbidity as well as healthcare costs (The Centers for Disease Control and Prevention, n.d.). Mitchell et al. (2016) evaluated incidence, mortality, and length of hospital-acquired UTIs, and hospital stay (Mitchell et al., 2016). In this large multi- state model, the authors found that the length of stay was up to four days due to UTIs, and the incidence of CAUTIs was related to antimicrobial resistance organisms. The study further suggested that surveillance and intervention to reduce CAUTIs are necessary. Likewise, Van Decker et al. (2021) implemented a bundle care approach to reduce CAUTIs over five years in an acute care hospital (Van Decker et al., 2021). Their bundle included processes for insertion and maintenance of Foley catheters, catheter indications, appropriate testing for CAUTIs, alternatives to indwelling devices, and sterilization techniques. With these interventions, the number of CAUTIs decreased from 83% to 33% over the five years.  Therefore, mortality and morbidity surveillance of HAIs such as CAUTIs can strengthen nursing practice to reduce such incidences.

    **Practice Limitation of Not Using These Measures in Nursing Practice**

    It is important to have accuracy in reporting data for mortality and morbidity, as healthcare workers should know what to report, provide diagnosis correctly, and report requirements (Curley et al., 2024). Not having surveillance data or the lack of available data makes it harder to find ways for improvement in nursing practice, and to assess the measures of success. The Centers for Medicare and Medicaid (CMS) penalizes acute general care hospitals applicable to HAI reduction programs based on quality and safety care scoring system (Vsevolozhskaya et al., 2021). The CDC calculates a standardized infection rate for each facility based on the facility’s presumed characteristics and types of patients. Furthermore, if mitigation or risk adjustment is not calculated or is not adjusted, it can lead to inaccuracy. Therefore, hospitals submit their observed HAI cases, as well as data on the population at risk (i.e., the denominator) for risk adjustment, through the National Healthcare Safety Network, both can be misleading if not taken carefully. Researchers, quality leaders, and bedside caregivers play key roles in the success of quality measurement by observing and recording the events, vigilance, surveillance, compliance, and adherence to evidence-based guidelines and documentation.

    **References**

    Curley, A. L. C., Niedz, B. A., & Erikson, A. E. (2024).
    _Population-based nursing: Concepts and competencies for advanced practice (4th ed.)._ Springer
    _._

    Friis, R. H., & Sellers, T. A. (2021).
    _Epidemiology for public health practice (6th ed.)._ Jones & Bartlett.

    Mitchell, B. G., Ferguson, J. K., Anderson, M., Sear, J., & Barnett, A. (2016). Length of stay and mortality associated with healthcare-associated urinary tract infections: a multi-state model.
    _J Hosp Infect_,
    _93_(1), 92-99.
    [https://doi.org/10.1016/j.jhin.2016.01.012Links to an external site.](https://doi.org/10.1016/j.jhin.2016.01.012)

    The Centers for Disease Control and Prevention. (n.d.).
    _Urinary Tract Infection._ [_https://www.cdc.gov/uti/hcp/clinical-safety/_ Links to an external site.](https://www.cdc.gov/uti/hcp/clinical-safety/)

    Van Decker, S. G., Bosch, N., & Murphy, J. (2021). Catheter-associated urinary tract infection reduction in critical care units: a bundled care model.
    _BMJ Open Qual_,
    _10_(4).
    [https://doi.org/10.1136/bmjoq-2021-001534Links to an external site.](https://doi.org/10.1136/bmjoq-2021-001534)

    Vsevolozhskaya, O. A., Manz, K. C., Zephyr, P. M., & Waters, T. M. (2021). Measurement matters: changing penalty calculations under the hospital acquired condition reduction program (HACRP) cost hospitals millions.
    _BMC Health Serv Res_,
    _21_(1), 131.
    [https://doi.org/10.1186/s12913-021-06108-wLinks to an external site.](https://doi.org/10.1186/s12913-021-06108-w)

    ## image1.jpeg

    **## WK5DISEPID.docx**

    Measures Used in Epidemiology

    ![A group of people sitting at a table AI-generated content may be incorrect.](https://www.sweetstudy.com/questions/wk-5-resp-2-epid)One important application of epidemiology is to identify factors that could increase the likelihood of a certain health problem occurring within a specific population. Epidemiologists use
    _measures of effect_ to examine the association or linkage in the relationship between risk factors and emergence of disease or ill health. For instance, they may use measures of effect to better understand the relationships between poverty and lead poisoning in children, smoking and heart disease, or low birth weight and future motor skills. The following are some common measures used in epidemiology:

    ·
    **Odds ratio**: The odds ratio quantifies the association between an independent variable (exposure) and a dependent variable (outcome). It is calculated as the odds that an effect will occur given the presence or exposure to a studied variable, compared to the odds when there is no exposure (e.g., lung cancer and smoking)

    ·
    **Risk ratio (also called relative risk)**: Also quantifies the association between an independent variable and a dependent variable. The risk of an effect occurring in one population versus another population (e.g., preeclampsia in women <35 versus >35). Risks greater than one suggest that exposure to a given variable is associated with an increase in the risk of the outcome, and a risk ratio of less than one indicates that the exposure is associated with a decrease in the risk of the outcome.

    ·
    **Mortality**: Measure of deaths in a particular population during a specified time interval. If this is attributed to a specific cause, it is referred to as cause-specific mortality.

    ·
    **Morbidity**: Measure of instances of illness or disability in a population from a given cause (e.g., heart disease) during a specified time interval

    ·
    **Incidence**: The occurrence of new cases of an effect or disease in a population over a defined time period relative to the size of the population at risk (e.g., new cases of COVID-19 in a population over a 7-day period/1000 people)

    ·
    **Prevalence**: The number of all cases of an effect or disease, not just new ones, in a population at a given time relative to the size of the population (e.g., number of people with autism/1000)

    What is the significance of these measures of effect for nursing practice? In this Discussion, you will consider this pivotal question.

    Resources

    Be sure to review the Learning Resources before completing this activity.
    Click the weekly resources link to access the resources.

    [**WEEKLY RESOURCES**](https://waldenu.instructure.com/courses/155998/modules/items/6259844)

    [Required Readings](https://waldenu.instructure.com/courses/155998/pages/week-5-learning-resources?module_item_id=6259844)

    · Curley, A. L. C. (Ed.). (2024).
    _Population-based nursing: Concepts and competencies for advanced practice_ (4th ed.). Springer.

    · Chapter 4, “Epidemiological Methods and Measurements in Population-Based Nursing Practice: Part I” (pp. 68-105)

    · Friis, R. H., & Sellers, T. A. (2021).
    _Epidemiology for public health practice_ (6th ed.). Jones & Bartlett.

    · Chapter 3, “Measures of Morbidity and Mortality Used in Epidemiology”

    · Chapter 9, “Measures of Effect”

    To prepare:

    · Select item 1, 2, or 3 to use for this Discussion. Consider the definitions, differences, and utility of the two terms listed under your item selection. Your response will need to include both terms in the item selected.

    1. Odds ratio and risk ratio

    2. Mortality and morbidity

    3. Incidence and prevalence

    · Consider how these epidemiologic measures strengthen and support nursing practice.

    · Assess practice limitations of not using these measures in nursing practice.

    · Conduct additional research in the Walden Library and other credible resources, and then locate two examples in the scholarly literature that support your insights.

    By Day 3 of Week 5

    **Post** a cohesive scholarly response that addresses the following:

    · Explain how your selected measures of effect strengthen and support nursing practice. Provide at least two specific examples from the literature to substantiate your insights.

    · Assess limitations of
    **not** using measures of effect in nursing practice.

    By Day 6 of Week 5

    **Respond** to
    **at least two** colleagues on
    **two different days** in one or more of the following ways:

    · Ask a probing question, substantiated with additional background information, evidence or research.

    · Share an insight from having read your colleagues’ postings, synthesizing the information to provide new perspectives.

    · Offer and support an alternative perspective using readings from the classroom or from your own research in the Walden Library.

    · Validate an idea with your own experience and additional research.

    · Make a suggestion based on additional evidence drawn from readings or after synthesizing multiple postings.

    · Expand on your colleagues’ postings by providing additional insights or contrasting perspectives based on readings and evidence.

    RESPOND TO THIS DISCUSSION POST

    **Mortality and Morbidity**

    Mortality and Morbidity are two key terms used in Epidemiology to define the numbers of deaths and the frequency of illness respectively (Friis & Sellers, 2021). Mortality rate is the number of deaths in a population over a specific time, usually expressed as deaths per unit population (Curley et al., 2024). Meanwhile the morbidity rate is the frequency of disease within a population over a specific time, usually expressed as a percentage, a proportion, or a rate per unit population (Curley et al., 2024).

    **How Mortality and Morbidity Strengthen and Support Nursing Practice**

    Epidemiological surveillance, whether in a large community or within a healthcare facility, provides important information on health outcomes. Mortality and morbidity surveillance is necessary to understand the impact and find ways to improve public health.
    Moreover, mortality rates compare death rates among and within populations therefore providing evaluation and comparing data within the populations (Curley et al., 2024). Likewise, morbidity rates can help us to compare risk factors, prevent and manage modifiable risk factors, and decrease mortality rates. These measures strengthen nursing practices such as surveillance systems to reduce hospital-acquired infections and conditions, find innovation, develop policies, and protocols, and evaluate the system.

    For example, about 70% of urinary tract infections (UTIs) developed in the hospital are associated with a urinary catheter, and catheter-associated urinary tract infections (CAUTIs) are associated with increased mortality and morbidity as well as healthcare costs (The Centers for Disease Control and Prevention, n.d.). Mitchell et al. (2016) evaluated incidence, mortality, and length of hospital-acquired UTIs, and hospital stay (Mitchell et al., 2016). In this large multi- state model, the authors found that the length of stay was up to four days due to UTIs, and the incidence of CAUTIs was related to antimicrobial resistance organisms. The study further suggested that surveillance and intervention to reduce CAUTIs are necessary. Likewise, Van Decker et al. (2021) implemented a bundle care approach to reduce CAUTIs over five years in an acute care hospital (Van Decker et al., 2021). Their bundle included processes for insertion and maintenance of Foley catheters, catheter indications, appropriate testing for CAUTIs, alternatives to indwelling devices, and sterilization techniques. With these interventions, the number of CAUTIs decreased from 83% to 33% over the five years.  Therefore, mortality and morbidity surveillance of HAIs such as CAUTIs can strengthen nursing practice to reduce such incidences.

    **Practice Limitation of Not Using These Measures in Nursing Practice**

    It is important to have accuracy in reporting data for mortality and morbidity, as healthcare workers should know what to report, provide diagnosis correctly, and report requirements (Curley et al., 2024). Not having surveillance data or the lack of available data makes it harder to find ways for improvement in nursing practice, and to assess the measures of success. The Centers for Medicare and Medicaid (CMS) penalizes acute general care hospitals applicable to HAI reduction programs based on quality and safety care scoring system (Vsevolozhskaya et al., 2021). The CDC calculates a standardized infection rate for each facility based on the facility’s presumed characteristics and types of patients. Furthermore, if mitigation or risk adjustment is not calculated or is not adjusted, it can lead to inaccuracy. Therefore, hospitals submit their observed HAI cases, as well as data on the population at risk (i.e., the denominator) for risk adjustment, through the National Healthcare Safety Network, both can be misleading if not taken carefully. Researchers, quality leaders, and bedside caregivers play key roles in the success of quality measurement by observing and recording the events, vigilance, surveillance, compliance, and adherence to evidence-based guidelines and documentation.

    **References**

    Curley, A. L. C., Niedz, B. A., & Erikson, A. E. (2024).
    _Population-based nursing: Concepts and competencies for advanced practice (4th ed.)._ Springer
    _._

    Friis, R. H., & Sellers, T. A. (2021).
    _Epidemiology for public health practice (6th ed.)._ Jones & Bartlett.

    Mitchell, B. G., Ferguson, J. K., Anderson, M., Sear, J., & Barnett, A. (2016). Length of stay and mortality associated with healthcare-associated urinary tract infections: a multi-state model.
    _J Hosp Infect_,
    _93_(1), 92-99.
    [https://doi.org/10.1016/j.jhin.2016.01.012Links to an external site.](https://doi.org/10.1016/j.jhin.2016.01.012)

    The Centers for Disease Control and Prevention. (n.d.).
    _Urinary Tract Infection._ [_https://www.cdc.gov/uti/hcp/clinical-safety/_ Links to an external site.](https://www.cdc.gov/uti/hcp/clinical-safety/)

    Van Decker, S. G., Bosch, N., & Murphy, J. (2021). Catheter-associated urinary tract infection reduction in critical care units: a bundled care model.
    _BMJ Open Qual_,
    _10_(4).
    [https://doi.org/10.1136/bmjoq-2021-001534Links to an external site.](https://doi.org/10.1136/bmjoq-2021-001534)

    Vsevolozhskaya, O. A., Manz, K. C., Zephyr, P. M., & Waters, T. M. (2021). Measurement matters: changing penalty calculations under the hospital acquired condition reduction program (HACRP) cost hospitals millions.
    _BMC Health Serv Res_,
    _21_(1), 131.
    [https://doi.org/10.1186/s12913-021-06108-wLinks to an external site.](https://doi.org/10.1186/s12913-021-06108-w)

    ## image1.jpeg

  • [Solved] W-DISC WEEK 5

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    #### **Addressing Stigma and Barriers to Substance Use Treatment** **Objective:** This discussion post aims to foster a reflective and empathetic understanding of the stigma associated with substance use treatment and to identify potential barriers to accessing mental health services. By considering…

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    Assignment Prompt & Instructions

    #### **Addressing Stigma and Barriers to Substance Use Treatment**

    **Objective:** This discussion post aims to foster a reflective and empathetic understanding of the stigma associated with substance use treatment and to identify potential barriers to accessing mental health services. By considering both personal and marginalized perspectives, you will gain insights into the challenges faced by individuals seeking help for substance use-related issues.

    **Assignment Instructions:**

    **Introduction:**

    – **Contextualize the Issue:**
    – Begin by discussing the significant stigma surrounding receiving treatment for substance use-related issues. Reference relevant studies or reports that highlight how stigma can impact individuals seeking help and the broader implications for public health.

    **1. Personal Reflection:**

    – **Reflect on Your Social Circle and Community:**
    – **Receptivity and Support:**
    – Reflect on your personal experiences and consider whether your friends and family would be receptive and supportive if you sought treatment for drug use issues. Discuss factors that might influence their reactions, such as cultural beliefs, awareness of substance use issues, and prior experiences with mental health treatment.
    – **Questions to Consider:**
    – Would your loved ones understand the importance of seeking treatment, or might there be misunderstandings or judgments?
    – How might your social circle's values and attitudes shape their support or lack thereof?
    – **Barriers to Accessing Treatment:**
    – Identify potential barriers you might experience when attempting to schedule an appointment with a behavioral health treatment center or provider. Consider logistical, financial, and social factors.

    – **Questions to Consider:**
    – Are there long wait times for appointments in your area?
    – Are there financial constraints, such as a lack of insurance coverage or high out-of-pocket costs?
    – Are there cultural or societal stigmas that might deter you from seeking help?

    **2. Empathetic Perspective:**

    – **Putting Yourself in the Shoes of Someone Marginalized:**
    – **Identifying Additional Barriers:**
    – Imagine being someone who is marginalized in your social circle or community. Discuss additional barriers they might experience when attempting to access mental health services.
    – **Factors to Consider:**
    – **Socioeconomic Status:** How might limited financial resources and lack of insurance exacerbate barriers to treatment?
    – **Cultural and Linguistic Barriers:** How might language differences and cultural misunderstandings hinder access to care?
    – **Social Isolation:** How might a lack of social support and networks contribute to feelings of helplessness and prevent individuals from seeking help?
    – **Discrimination and Prejudice:** How might experiences of discrimination or prejudice in healthcare settings discourage marginalized individuals from pursuing treatment?
    – **Questions to Consider:**
    – What specific challenges might someone face if they belong to a racial or ethnic minority group, LGBTQ+ community, or are living with a disability?
    – How can systemic issues, such as institutional biases or lack of culturally competent care, impact their ability to access services?

    **3. Critical Analysis and Solutions:**

    – **Analyze the Impact of Stigma and Barriers:**
    – Critically analyze how stigma and barriers to accessing treatment can affect the health outcomes and well-being of individuals with substance use-related issues. Use evidence from scholarly sources to support your analysis.
    – **Consider Broader Implications:**
    – Discuss how addressing stigma and improving access to treatment can benefit public health and reduce the overall burden of substance use disorders in communities.
    – **Propose Solutions:**
    – Suggest strategies to overcome the identified barriers and reduce stigma associated with substance use treatment. Consider the roles of healthcare providers, policymakers, and community organizations.
    – **Examples of Strategies:**
    – **Education and Awareness Campaigns:** Promote understanding and acceptance of substance use treatment through public education initiatives.
    – **Culturally Competent Care:** Advocate for training healthcare providers in cultural competency to better serve diverse populations.
    – **Policy Changes:** Support policies that increase funding for mental health services, reduce financial barriers, and ensure equitable access to care.

    **Conclusion:**

    – **Summarize Key Points:**
    – Recap the main insights gained from reflecting on personal and marginalized perspectives regarding the stigma and barriers to substance use treatment.

    As a reminder, all discussion posts must be a minimum of 350 words initial ,references must be cited in APA format 7th Edition, and must include a minimum of 2 scholarly resources published within the past 5 years.

    DUE DATE MARCH 28. 2025

    – 2 years ago

  • [Solved] Unit 1 DB: SDLC Process

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    Executive Solution Overview

    **Primary Task Response:** Within the Discussion Board area, write 400–600 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas….

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    Assignment Prompt & Instructions

    **Primary Task Response:** Within the Discussion Board area, write 400–600 words that respond to the following questions with your thoughts, ideas, and comments. This will be the foundation for future discussions by your classmates. Be substantive and clear, and use examples to reinforce your ideas.

    Agile development methodologies have become very common in software development and information technology (IT) departments. Agile methodologies provide many advantages in terms of flexibility and adaptability. Complete the following for this assignment:

    – Explore agile development and agile IT approaches that are specific to healthcare organizations.
    – Explain 3 advantages of using an agile approach, and identify 2 challenges of an agile approach.
    – Explain the differences between using agile for project-based work and operational-based IT work.

    **Note:** Use APA style, 7th Edition, to cite at least 2 scholarly sources from the last 5 years.

    – 2 years ago

  • [Solved] SOAP NOTE PEDIATRIC PATIENT

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    Executive Solution Overview

    MUST FOLLOW TEMPLATE A SOAP note is a method of documentation employed by healthcare providers to record and communicate patient information in a clear, structured, and in an organized manner. This assignment will provide students with the necessary tools to document patient care effectively, enhanc…

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    Assignment Prompt & Instructions

    MUST FOLLOW TEMPLATE

    A SOAP note is a method of documentation employed by healthcare providers to record and communicate patient information in a clear, structured, and in an organized manner. This assignment will provide students with the necessary tools to document patient care effectively, enhance their clinical skills, and prepare them for their roles as competent healthcare providers.

    #### **Instructions:**

    SOAP is an acronym that stands for Subjective, Objective, Assessment, and Plan. The episodic SOAP note is to be written using the attached template below.

    For all the SOAP note assignments, you will write a SOAP note about one of your patients and use the following acronym:

    **S** =Subjective data: Patient’s Chief Complaint (CC). **O** =Objective data: Including client behavior, physical assessment, vital signs, and meds. **A** =Assessment: Diagnosis of the patient's condition. Include differential diagnosis. **P** =Plan: Treatment, diagnostic testing, and follow up

    [Click here to access and download the SOAP Note Template](https://stu.instructure.com/courses/44799/files/3407778?wrap=1) [Download Click here to access and download the SOAP Note Template](https://stu.instructure.com/courses/44799/files/3407778/download?download_frd=1)

    #### **Submission Instructions:**

    – Your SOAP note should be clear and concise and students will lose points for improper grammar, punctuation, and misspellings.

    – [\
    \
    SOAPNoteTemplate-1.docx](https://www.sweetstudy.com/files/soapnotetemplate-1-docx-10239633 "SOAPNoteTemplate-1.docx")

    – 2 years ago

  • [Solved] work study

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    – 2 years ago **files (1)** – ## WEEK5DISCUSSIONRESPOND.docx **## WEEK5DISCUSSIONRESPOND.docx** Respond to at least two of your colleagues by recommending strategies to overcome the challenges your colleagues have identified. Support your recommendation with evidence-based literature and/or your own…

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    Assignment Prompt & Instructions

    – 2 years ago

    **files (1)**

    – ## WEEK5DISCUSSIONRESPOND.docx

    **## WEEK5DISCUSSIONRESPOND.docx**

    Respond to at least two of your colleagues by recommending strategies to overcome the challenges your colleagues have identified. Support your recommendation with evidence-based literature and/or your own experiences with clients.

    Eva H

    Cognitive Behavioral Therapy (CBT) can be administered in various settings, including individual, group, or family formats. Each of these approaches has distinct characteristics that influence the results of therapy. While group CBT can foster social support, it may also pose particular challenges for psychiatric mental health nurse practitioners (PMHNPs) responsible for executing these interventions.

    A noteworthy distinction between group and individual therapy lies in the dynamics of interaction. In a group context, individuals can gain from collective experiences, which enhances peer support and encourages the demonstration of positive behaviors. Research has shown that group CBT effectively decreases alcohol consumption among participants by fostering a sense of community and accountability (Ayub et al., 2023).

    Although CBT offers numerous advantages, its application in group settings presents certain challenges for psychiatric mental health nurse practitioners (PMHNPs). A primary difficulty lies in addressing the varying degrees of participant engagement and willingness to share. For instance, while some individuals may more willing to share their experiences, others may feel intimidated or hesitant to engage, which could hinder the overall effectiveness of the therapy (Bourdon et al., 2023). It is important for PMHNPs to encourage an inclusive atmosphere that supports active participation from all members of the group, while also ensuring that quieter participants do not feel disregarded (Belay et al., 2024). Another challenge involves meeting the diverse therapeutic needs of a varied group. Participants may exhibit different degrees of addiction severity, levels of motivation, and comorbid psychological conditions, which can hinder the PMHNP's capacity to effectively address individual requirements.

    These complications highlight the importance for PMHNPs to possess strong group facilitation skills and to employ strategies that promote engagement and inclusivity, while also being attentive to the distinct needs of each participant. Employing methods such as open dialogues, tailored homework tasks, or dividing larger groups into smaller subgroups can alleviate some of these difficulties. Effectively managing these challenges can lead to better treatment results for clients dealing with addiction.

    K SCOTT

    Cognitive behavioral therapy (CBT) can alter one's emotions, thoughts, and resulting behavior by examining distorted core beliefs about self that affect self-perception, which in turn dictate how we engage with the world.  Examining emotions and reframing thought processes can lead to healthier mindsets and behaviors that foster a more advantageous self-image and self-identification.  One CBT technique called laddering explores surface thoughts and delves into the underlying, deeper thought patterns that drive surface cognition, directly relating to the relationship with the self.  Automatic thoughts dictate our feelings, actions, and perceptions.  Therefore, CBT trains the client to observe their automatic thoughts and teaches them to reframe their cognition to achieve life fulfillment and satisfaction rather than depressed viewpoints.  The laddering technique breaks down what the thoughts mean to the individual and their self-perception based on the thought distortions that may affect several life domains (Chand et al., 2023).

              Furthermore, CBT therapy can be highly personal, and different techniques may be more appropriate in a group or family setting than the laddering technique that requires extreme vulnerability that the client is not ready to share in a group or family setting.  According to Ezhumalai et al. (2018), specific considerations and progression stages are unique to group therapy.  Establishing trust, defining roles, and maintaining confidentiality may pose a more significant challenge than individual therapy, particularly in larger groups and when involving strangers.  For example, the storming stage can be particularly prominent during group and family sessions due to the involvement of others, heightened concerns about confidentiality, and increased vulnerability among group members.  The storming stage is characterized by group members resisting the group's therapeutic influence; however, this resistance can also occur during individual therapy.  Although there are no group dynamic considerations, the therapist should still establish trust and allow the client to adjust to the new therapeutic relationship during the forming, bonding, and norming stages.

             .

    Likewise, the CBT approach can be used in family therapy sessions and has other considerations for successful use within family dynamics that are in play during therapy sessions.  According to Jabbari et al. (2023), family dynamics can play a significant role in whether clients seek mental health services and can pose challenges in psychotherapy.  Unhealthy family relationships can lead to resistance to therapy and be perceived as a threat to the family dynamic, or they may prioritize family loyalty to protect secrets within the unit.  The therapist may consider exploring the family dynamics before initiating a treatment plan and suggest the family sculpting technique to increase awareness of familial relationships and subsequent narratives.  However, CBT in family group sessions may expose traumatic events experienced within the family and cause emotional distress for some clients, which the therapist should take into consideration.  Each type of psychotherapy session has distinctive concerns that dictate the ebb and flow of treatment.  The resources used in the discussion were peer-reviewed scholarly articles from academic journals.

    **## WEEK5DISCUSSIONRESPOND.docx**

    Respond to at least two of your colleagues by recommending strategies to overcome the challenges your colleagues have identified. Support your recommendation with evidence-based literature and/or your own experiences with clients.

    Eva H

    Cognitive Behavioral Therapy (CBT) can be administered in various settings, including individual, group, or family formats. Each of these approaches has distinct characteristics that influence the results of therapy. While group CBT can foster social support, it may also pose particular challenges for psychiatric mental health nurse practitioners (PMHNPs) responsible for executing these interventions.

    A noteworthy distinction between group and individual therapy lies in the dynamics of interaction. In a group context, individuals can gain from collective experiences, which enhances peer support and encourages the demonstration of positive behaviors. Research has shown that group CBT effectively decreases alcohol consumption among participants by fostering a sense of community and accountability (Ayub et al., 2023).

    Although CBT offers numerous advantages, its application in group settings presents certain challenges for psychiatric mental health nurse practitioners (PMHNPs). A primary difficulty lies in addressing the varying degrees of participant engagement and willingness to share. For instance, while some individuals may more willing to share their experiences, others may feel intimidated or hesitant to engage, which could hinder the overall effectiveness of the therapy (Bourdon et al., 2023). It is important for PMHNPs to encourage an inclusive atmosphere that supports active participation from all members of the group, while also ensuring that quieter participants do not feel disregarded (Belay et al., 2024). Another challenge involves meeting the diverse therapeutic needs of a varied group. Participants may exhibit different degrees of addiction severity, levels of motivation, and comorbid psychological conditions, which can hinder the PMHNP's capacity to effectively address individual requirements.

    These complications highlight the importance for PMHNPs to possess strong group facilitation skills and to employ strategies that promote engagement and inclusivity, while also being attentive to the distinct needs of each participant. Employing methods such as open dialogues, tailored homework tasks, or dividing larger groups into smaller subgroups can alleviate some of these difficulties. Effectively managing these challenges can lead to better treatment results for clients dealing with addiction.

    K SCOTT

    Cognitive behavioral therapy (CBT) can alter one's emotions, thoughts, and resulting behavior by examining distorted core beliefs about self that affect self-perception, which in turn dictate how we engage with the world.  Examining emotions and reframing thought processes can lead to healthier mindsets and behaviors that foster a more advantageous self-image and self-identification.  One CBT technique called laddering explores surface thoughts and delves into the underlying, deeper thought patterns that drive surface cognition, directly relating to the relationship with the self.  Automatic thoughts dictate our feelings, actions, and perceptions.  Therefore, CBT trains the client to observe their automatic thoughts and teaches them to reframe their cognition to achieve life fulfillment and satisfaction rather than depressed viewpoints.  The laddering technique breaks down what the thoughts mean to the individual and their self-perception based on the thought distortions that may affect several life domains (Chand et al., 2023).

              Furthermore, CBT therapy can be highly personal, and different techniques may be more appropriate in a group or family setting than the laddering technique that requires extreme vulnerability that the client is not ready to share in a group or family setting.  According to Ezhumalai et al. (2018), specific considerations and progression stages are unique to group therapy.  Establishing trust, defining roles, and maintaining confidentiality may pose a more significant challenge than individual therapy, particularly in larger groups and when involving strangers.  For example, the storming stage can be particularly prominent during group and family sessions due to the involvement of others, heightened concerns about confidentiality, and increased vulnerability among group members.  The storming stage is characterized by group members resisting the group's therapeutic influence; however, this resistance can also occur during individual therapy.  Although there are no group dynamic considerations, the therapist should still establish trust and allow the client to adjust to the new therapeutic relationship during the forming, bonding, and norming stages.

             .

    Likewise, the CBT approach can be used in family therapy sessions and has other considerations for successful use within family dynamics that are in play during therapy sessions.  According to Jabbari et al. (2023), family dynamics can play a significant role in whether clients seek mental health services and can pose challenges in psychotherapy.  Unhealthy family relationships can lead to resistance to therapy and be perceived as a threat to the family dynamic, or they may prioritize family loyalty to protect secrets within the unit.  The therapist may consider exploring the family dynamics before initiating a treatment plan and suggest the family sculpting technique to increase awareness of familial relationships and subsequent narratives.  However, CBT in family group sessions may expose traumatic events experienced within the family and cause emotional distress for some clients, which the therapist should take into consideration.  Each type of psychotherapy session has distinctive concerns that dictate the ebb and flow of treatment.  The resources used in the discussion were peer-reviewed scholarly articles from academic journals.

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