I need a 200 word reply to this
Table of Contents
Research Article
Ulrich and colleagues (2014) noted that many primary care services are provided by nurse practitioners (NPs) and physician assistants (PAs), and it is important for them to have ethical knowledge in managing challenging practice issues. However, little is known about the relationships between ethics and other work-related factors with the delivery of quality care. Thus the purpose of this study was to describe how NP and PA perceptions of their ethics preparedness, confidence, physician collegiality, and autonomy, along with the patient demands they encountered, influence perceived quality of care in their clinical practice (Ulrich et al., 2014, p. 153). The findings from this correlational study were as follows: Ethics preparedness and confidence were significantly associated with perceived quality of care (p < 0.01) as were work-related characteristics such as percentage of patients with Medicare and Medicaid, patient demands, physician collegiality, and practice autonomy (p < 0.01)….The researchers concluded that providing ethics education and addressing restrictive practice environments might improve teamwork, collaborative practice, and quality of care (Ulrich et al., 2014, p. 152).
Relevant Study Results
Three-quarters of respondents reported that they could provide high quality care to all their patients. However, 33.4% also indicated that cost concerns influence the degree to which they can provide quality care, and one of four (25.3%) did not feel that they could make clinical decisions without cost pressures. Higher levels of ethics preparedness, ethics confidence, practice autonomy, and physician collegiality were significantly associated with better perceived quality care (p < 0.01; Table 2). Two-thirds of practitioners (65.9%) reported a high level of physician support, reporting that their physician colleagues 132valued their unique perspective, were a good source of professional stimulation, and provided an important source of personal support. Nonetheless, 31.6% of respondents reported feeling overwhelmed by the needs of their patients, and 40.8% described patient relationships as becoming more adversarial than they used to be. Overall, those respondents who reported higher patient demands (e.g., adversarial patient relationships, patients requesting unnecessary treatments) in their practice also tended to report lower quality care (r = 0.42, p < 0.01). Most respondents felt prepared to handle the ethical issues that might arise in their primary care practice (63%); and both ethics preparedness and respondents’ degree of ethics confidence were positively associated with perceptions of quality care (Ulrich et al., 2014, p. 154).
I also need a 200 word reply to this
Using the research article found in Exercise 15, discuss what are the most significant predictors of Post-Traumatic Stress Symptoms. What other predictors would you have added to this study and why? Is the data in this study supported by other studies?
HERE IS THE RESEARCH ARTICLE
Source
Franck, L. S., Wray, J., Gay, C., Dearmun, A. K., Lee, K., & Cooper, B. A. (2015). Predictors of parent post-traumatic stress symptoms after child hospitalization on general pediatric wards: A prospective cohort study. International Journal of Nursing Studies, 52(1), 1021.
Introduction
Post-traumatic stress symptoms (PTSS) are an issue for some parents of children hospitalized in intensive care settings. However, limited research has been conducted to examine either PTSS in parents of children hospitalized in nonintensive care settings or PTSS in parents after a child’s hospital discharge. conducted a prospective cohort study for the purpose of identifying the predictors of parental PTSS following a child’s hospitalization. A convenience sample of 107 parents of children hospitalized in a general (nonintensive care) ward in a United Kingdom hospital completed the initial in-hospital assessment and 3 months postdischarge follow-up. Three months after hospital discharge, 32.7% of parents (n = 35) reported some degree of post-traumatic stress symptoms, and 21.5% (n = 23) had elevated scores (34) consistent with a probable diagnosis of post-traumatic stress disorder…Parents’ hospital-related anxiety, uncertainty, and use of negative coping strategies are potentially modifiable factors that most influence post-traumatic stress symptoms (, p. 10). These researchers recommended future studies to assess interventions such as psychological support to address modifiable factors of PTSS identified in their study.
Relevant Study Results
A hierarchical multiple regression analysis was conducted to determine the unique contributions of parent distress during the child’s hospitalization, as well as coping strategies and resources, to subsequent PTSS, while controlling for relevant, but largely unmodifiable demographic or child health and hospitalization-related factors. Variables from that were significantly correlated (r 0.25, p < 0.1) with PTSS were entered into the model in three steps: (1) single parent status, child hospital length of stay, and the parent’s rating of the child’s health three months after discharge were entered first because they were non-modifiable factors in this model; (2) parent use of negative coping strategies and optimism were entered next as potentially modifiable dispositional factors; and (3) parent anxiety, depression, and uncertainty during the child’s hospitalization were entered last as modifiable hospital experiential factors. Each step resulted in a significant (p < 0.05) increase in the model’s R2, with 5 of 8 predictors uniquely and significantly associated with PTSS: being a single parent, the parent’s perception of their child’s health three months after discharge, use of negative coping strategies, and parent anxiety and uncertainty during the child’s hospitalization. Moderating effects were then explored and two significant two-way interactions were found, between negative coping strategies and anxiety and between negative coping strategies and depression. These findings indicate that the effect of parental use of negative coping strategies on PTSS is amplified in the context of anxiety and attenuated in the context of depression () (, p. 15).
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