Introduction to social policy Essay Example | Topics and Well Written Essays - 2500 words

Introduction to social policy - Essay Example Indeed, whatever one's position in relation to globalization the concept/debate is a significant one for this field, and even 'septic internationalists' who otherwise deny the fundamental precepts of the globalization thesis would agree there is a need to address the wider global contexts and dimensions of social policy. In fact, used carefully, 'globalization' presents many new opportunities to critically interrogate social policy to think about how we construct fields of enquiry, the concepts and theories we use, the areas and issues we examine, and the types of questions we ask. (Nicola Yeates) One basic illustration of how a globalization perspective 'disrupts' the precepts of social policy is to consider how it challenges the basic unit of analysis the national welfare state. Thus, academic social policy has essentially been concerned with variations in how welfare services are financed, organized, delivered, and consumed within these political territories as well as with the effects of these services on the social structure, social relations, and quality of life of their resident populations. Whether the variations are between social groups, over time, or between countries, the nation-state and the social policies enacted within it have framed the analysis. In many ways, this is sensible: after all, most welfare services are organized, funded, regulated, and delivered by governmental and non-governmental entities based and operating within the territorial boundaries of individual countries, while the services provided are usually accessed by people living in those same countries. Yet in other ways this orientation unnecessarily restricts, even distorts, the field of enquiry by focusing our gaze on the national context to the detriment of the transnational and global ones. In particular, it presumes that the forces shaping the social structure are primarily local and national ones and that the entities involved in formulating and implementing social policy operate purely on a national basis. It obscures the various transnational sites and spaces in which social policies are formulated, and the social impacts of 'our' domestic and foreign economic and development policies on other countries and populations. In essence, it problematically assumes that social policy exists within an impermeable national container space, and that it develops with little or no reference to the global circumstances of 'our' country or its relationship to other countries, or to developments and events elsewhere in the world. (C Murray, 1984) Globalization brings new concerns and perspectives to social policy. A globalization perspective also brings new perspectives and subject matter to social policy, extending its field of enquiry. To begin with, it opens up to enquiry the ways in which the content of social policy and the distribution of welfare are shaped by: governmental and non-governmental organizations responding not only to domestic issues and sources of pressure but also to circumstances, events, and developments in other countries; the policies of foreign governments, international organizations, and financial institutions;

Information based decision making Unit 5002 Essay

Information based decision making Unit 5002 - Essay Example Quality Business management is one of the most important business exceptionality of this century. It has added a thoroughly stranded manner to compact by means of imperfections in fabrication, focused attentiveness on clients, as well as painted participative organizational carry outs in business. In this research I will present the main ideas regarding effective decision making through the use of the organizational business information. This research is basically aimed to discuss the overall process and implementation of the business information regarding the effective decision making. The better decision in the organizational environment is very essential and its effectives provide the business better management and handling overall tasks. There have been efforts to reproduce its accomplishment in community services, run associations also information systems. Despite the fact that, business quality management has its main drawing out point in collection of the better and functional information for the better decision making and enhanced project management (Lillrank, 2003). A number of researches pointed out that deprived, defective, not on time or missing information is supposed as a the majority severe business quality crisis. It is emphasized that business information should not be handled the same as a plain by-product of a variety of actions on the other hand by means of the similar significance as products. Quality of information, though, appears to be a subtle theory (Salmela, 1997). Quality of the information is an expression to demonstrate the significance of the most important elements of the organizational information systems. It is frequently described as: â€Å"The potency for utilization of the business information present (Garvin, 1988)" Though this is working for the majority daily functions, experts frequently make use of additional complex models anticipated for business information quality. The greater part of

Morality and Relagion Essay Example for Free

Morality and Relagion Essay Morality refers to a set of principles that guide an individual on how one evaluates right and wrong. People believing in religion consider morality is shaped by religion because they believe that morality can be understood only in the context of religion; therefore, those religious people insist if there were no religion, people would be out of control. However, religious beliefs give people a wrong definition of moral value, indeed, morality is shaped only by instinct and environment. Regardless of religion, morality comes from instinct. Human beings are social creatures; they have to live in groups for reproduction and survival that has not changed at all since the ancient time. Looking back to history, people live in groups to share food, to take care of infants and build social networks to meet the daily challenges of their environment. Similarly, at the present time, people value their society for the same purposes. Even though the way to live has changed for instance, in the Stone Age people hunted and shared foods for their living, unlike people who do business for their living nowadays; they still depend on each other for reproduction and survival. Therefore, people instinctively have to keep their relationship between each other, and morality is formed to maintain the relationship. Consequently, every human being has morality regardless of religious beliefs. If the religious people insist that religions shape morality, non-religious people or atheists shouldn`t have morality. However, those people do have morality and they can judge the things right or wrong like other people who believe in religion. Furthermore, people who believe in religion said that the religion shapes morality, yet there are so many different religions around the world. Some people believe in Christianity, other believes in Buddhism, Hinduism, and Islam etc. Each religion worships different Gods, and has difference belief systems. Christians, for instance, believe in Jesus Christ while Buddhists venerate Gautama. Even though the same religion, there are different branches. Christianity, for instance, has Catholics and Protestants; on the other hand, Buddhism separate to Mahayana and Theravada. Therefore, if the morality is formed base on religion, the definition of morality should vary since there are many different regions. However, morality that people use in an attempt to do the right thing is the same. â€Å"Trolley Problem†, posted by Phillipa Foot in her 1967 paper, â€Å"Abortion and the Doctrine of Double Effect† help for clear understanding about morality (Clark). She was a British philosopher, and she explained if a person put in dilemma to choice for saving five people`s lives or a person`s life, he or she must choose five people`s lives to save instead of one no matter whatever religion he or she believes. Therefore, religion does not affect morality. If the religions control people`s moral values, different religions will define different moral values, and the answer about â€Å"Trolley Problem† may vary. On the other hand, not only humans but also animals have morality. Frans de Waal, Charles Howard Candle professor of Primate Behavior in the Emory University, shared the experimental results that showed the moral behavior in animals. Chimpanzees help each other to get food, and they reconcile after fighting. Those behaviors pretty much indicate their morality (Waal). Since both human and animals have morality, religion that only existence in human world could not be a source of forming moral. Environment shapes moral values. Religion does not affect moral values, but environment does affect because adaption on environment is very important for survival. Darwin`s evolutionary theory â€Å"Natural Selection† proved that all living organisms modified to adapt the environment. Consequently, moral value is different from each environment where people live. Western countries are more individualistic while Asian countries are more collectivistic. Americans, for example, individuality is a moral value; however, helping each other is a moral value in China. Mr Meier, ESL 33B professor, who has an experience for teaching both American and Asian students, mentioned that American students do not willing help each other during the test because they believe self-1 / 2 reliance as a moral value. Contrast, Asian students prefer to help each other during the test because using each other to achieve their gold is a moral value for Asian countries. Consequently, governments get involved in defining the different moral values. The US government has less control on the society; therefore, people have more freedom, and it leads to enhance the self- reliance as a moral value. However, Asian countries, where government strictly controls various aspects, have less freedom and people in those countries have to rely on each other to get to their goals. Therefore, those people regard helping each other as a moral value. In addition, cultures, which co-exist in different environments, also define the moral values. In Asian cultures, people are taught to respect and care elder people. Therefore, people from Asia believe respecting the elder and taking care of those people as a moral value. For instance, in Japan, national health insurance system is running very well because people are willing to pay insurance fees, which helps elder people who need health care services. People consider even though they do not need health services right now, elder people who need health care gain the benefits from insurance system, and they are happy to help those people by paying monthly insurance fees. However, in Western culture, people regard self-belief as a moral value, and they do not prefer to help elder people. Therefore in the US, national health insurance system does not exist, and even though President Obama tried to construct the health insurance system, it did not work well because of different moral values. Therefore, moral value is pretty much related to environment. Religious beliefs exacerbate the collapse the morality. Religion controlled its believers, and people believing in religion tend to believe whatever the rules that religion lay down. For instance, sky burial, which is take place in Tibetan Buddhism, is the most gross burial way if we think from our common sense of morality. Human corpses are placed on a mountaintop as a prey for birds such as vultures, eagles and other scavengers. Buddhist monks are subjected to the sky burial funerary. They go to the mountaintop by themselves to conduct the funeral ceremony. However, that is normal for people who believe in Tibetan Buddhism because religion teaches the believers â€Å"Humans are part of nature. (People) arrive in the world naturally and they leave it naturally. Life and death are part of a wheel of reincarnation. Death is not to be feared. † (Xinran 159). Therefore, they were controlled by religion to believe conducting sky burial is the way to return the body back to the nature. On the other hand, religious belief ignite the people`s competitive spirit that lead to break morality. Islamic State of Iraq and Syria (ISIS) is one of the examples that easy to understand for how religious belief stir the people`s competitive spirit. ISIS, the biggest Islamic terrorist group, attempts to create a new Islamic country in Middle East. ISIS has rapidly expanded by taking over Iraq and Syria territories. ISIS has killed so many innocents who do not follow Islam. This immoral behavior occurred because of ISIS, which was created by extreme Muslim believers, who regard their religion as the best on the world. They want to spread their religion; therefore, they force other people to become a part of Muslim believer by using immoral ways. Therefore, religious beliefs lead people to collapse the morality. In conclusion, morality is important to maintain our society. Every living organism that depends on each other to maintain life cannot survive without morality. However, humans misunderstand that religion shapes morality, but if we think critically, we can understand that morality is formed not because of religion but because of instinct and environment. Works Cited Clark, Josh. â€Å"How the Trolley Problem Works. † How Stuff Works. N. p. ,n. d. Web, 24 Oct. 2014. Waal, Frans De. â€Å"Moral Behavior in Animals. † TED. N. p. , Nov. 2011. Web. 24 Oct. 2014 Xinran, Xue. â€Å"Sky Burial. † Sky Burial. New York: Anchor Books, July. 2006. Print. POWERED BY TCPDF (WWW. TCPDF. ORG).

Relevance of Psychology in Primary Health Care Delivery

Relevance of Psychology in Primary Health Care Delivery Critically discuss how an understanding of psychology can enhance the delivery of primary health care. (District Nursing) Essay The concept of psychology as relevant to district nursing and the primary healthcare team can be examined on a number of different levels. An understanding of psychology is clearly important to the nurse when she interprets a patient’s reaction to events in their personal illness trajectory. (Yura H et al. 1998). It is equally important as she considers her professional approach to the patient and the understanding of how a patient will react to the delivery and impact of healthcare, particularly in her considerations of how to achieve maximum patient compliance in any given therapeutic regimen. (Dean A. 2002).There are other, arguably less immediately obvious, ramifications of the impact of psychological implications in the delivery of primary health care when one considers the interactions and dynamics of the primary healthcare team and the interplay between various members of the team. In this essay we shall consider all of these implications. We start with the general plan that the topic of psychology in this context is potentially vast and for this reason we shall consider individual illustrative episodes in some detail in order to demonstrate an overall understanding of the area. The perception of any given situation and indeed, the evaluation of the probabilities that arise from it, are generally dependent on its presentation. This in turn gives rise to differences and variations in the number and scope of the possible outcomes from that situation. This is the so called Theory of Rational Choice (De Martino B et al. 2006). The perception of a situation is dependent on its â€Å"framing†. It therefore follows that the outcome is also dependent on the same concept of framing of the presentation. This has great relevance to our question, as the District Nurse can make decisions that are influenced by the â€Å"framing† of the presentation by the patient, but more significantly, she can seek to modify the decisions that a patient ultimately makes by framing her presentation of the situation in a number of different ways. There is a substantial evidence base in the literature which cites examples of how decisions can be changed or even reversed if t hey are presented with different emphasis on different factors in the presentation (van Osch S M C et al. 2006). A full consideration of the implications of this statement will suggest that these psychological concepts will have a direct bearing on other professional considerations such as autonomy and other ethical issues. (Hendrick, J. 2000). How can a patient be considered to be making a truly autonomous decision if that decision is being influenced by the abilities of a nurse to â€Å"frame† the presentation of the relevant factors in order to suggest that one outcome is better than another? (Green J et al. 1998). How can a patient be considered to be â€Å"empowered and educated† about a course of treatment if the nurse has been selective in the way that treatment has been explained to the patient? (Sugarman J Sulmasy 2001). We do not presume to suggest that such concepts are necessarily wrong. It may be entirely reasonable for a nurse to use her professional skill and judgement to suggest to a patient that one particular course of action is preferable to another by framing the presentation in such a way that the patient is guided towards a certain decision. In a commonly experienced clinical situation such as a frightened patient with an extensive skin wound to the leg which clearly requires suturing and who is saying that they don‘t want anything to be done, we could probably all agree that it would be quite appropriate for a nurse to suggest that the procedure of suturing is not very painful and will give a good cosmetic result whereas to leave the wound open will give rise to infection and other difficulties. From an analytical viewpoint, this approach could be viewed as detracting from the patient’s autonomy and ability to make their own valid consent. (Gillon. R. 1997). A pragmatist mi ght equally suggest that the nurse is employing valid psychological principles in her professional desire to achieve what is probably the best outcome for the patient (Coulter A. 2002) One of the major areas that we shall consider in this appreciation of the significance of psychology in the delivery of healthcare, is that of attitude of those delivering the particular intervention to the patients concerned. This area is examined in commendable detail by the paper by Johansson (K et al. 2002) which specifically considered the effectiveness of the delivery of alcohol awareness programmes in a group of problem drinkers. The reason that we have selected this paper for an initial consideration is that, unusually for a research paper, it does not simply consider the efficacy of a particular healthcare package, but it reviews and critically analyses the attitudes of the healthcare professionals on the overall outcomes with specific focus on their readiness to participate in such a venture. This is seminal to the major thrust of this essay and therefore merits a detailed examination. In essence, the entry cohort to this study was a collection of about 150 primary healthcare team workers who could potentially be involved in the delivery of an alcohol awareness programme. Each was asked to fill in a questionnaire which was designed to evaluate a personal profile of the respondent and covered areas such as: experiences with patients with alcohol-related health problems, knowledge and perceived capacity concerning early identification and intervention, attitudes towards the role of primary care staff in early identification and intervention and current intervention methods in use at the health centre. The results are interesting insofar as there was general agreement that the likelihood of a patient generating or triggering an enquiry into their alcohol usage was most likely to be when issues relating to the alcohol-related health-risks were perceived by the healthcare professionals. The relevance of the psychological aspects of such an enquiry became clear when it was found that nurses were more likely to enquire than the doctors in the sample and that on average, nurses tended to drink less alcohol than doctors. (Dihn-Zarr, T et al. 1999) Those who drank the least were more likely to be concerned about the health risks than those who drank more. Clearly the effects of alcohol in any individual patient are specific, but the willingness of a healthcare professional to instigate healthcare measures to minimise the health-related effects of alcohol appears to be dependent on their own attitudes towards alcohol and this may be reflected in their own levels of consumption. There is an old adage that the definition of an alcoholic is a patient who drinks more than their doctor. (Fleming, M et al. 1999). In the light of this study, this comment may not be as flippant as it initially appears. In alcohol-related problems, there is frequently an element of denial, both in terms of alcohol intake and its effects. (Herbert, C et al. 1997). If the healthcare professional involved has a degree of denial of their own intake, clearly this will have repercussions on their presentation of the problem to the patient and their subsequent evaluation and willingness to invoke therapeutic or interventional measures for that patient. (Kaner, E. F. S et al. 1999) Other significant factors that contributed to the likelihood of a healthcare professional instigating therapeutic measures were found to be their individual perception of their own degree of knowledge on the subject, both in terms of the effects of alcohol on the body and also in terms of the interventions that were available. (Aalto, M. et al. 2001) Many nurses expressed the fact that they were concerned that patients might react negatively to such enquiries and that this would affect the degree of patient empathy. Doctors appeared to be generally more confident about handling the possibility of a negative reaction. The same study pointed to the fact that it appears that such fears were unfounded in reality, as the same proportion of patients reacted in a negative way in both groups. >From this brief overview, it can be seen that psychology plays a role at many different levels in what is basically a fairly straightforward healthcare professional / patient interchange, and the attitudes of both patient and healthcare professional can have a profound impact on the eventual outcome of the care package for the individual patient. The paper itself makes the comment that: Nurses appear to be an unexploited resource, in need of training and support. Nurses may need to be convinced that an active role does not interfere with the nurse–patient relationship. Building teams of GPs and nurses in primary care might enhance the dissemination of alcohol prevention into regular practice. A further psychological input that is relevant in this area is the perception of the healthcare professional of just how effective the intervention that is proposed is likely to be. A previous paper on the same subject (Andrà ©asson S et al. 2000), concluded that healthcare professionals were much more likely to recommend a healthcare intervention that they had personally experienced or witnessed as successful, with greater frequency than one which had been shown to have a secure evidence base in published literature. The paper concludes with the suggestion that specific training in the subject needs to be implemented and this training not only needs to address the knowledge gap that has been identified, but also the belief systems and attitudes of the healthcare professionals in the primary healthcare team in order that it can reach its maximum potential. Although this paper was targeted and written in relation to a specific alcohol related intervention, it is reasonable to assume that the selected comments cited in this essay are sufficiently general to apply to most specific health related interventions and we will consider and explore other psychological rationales in specific relation to Health Promotion initiatives together with the inferences that can be drawn in relation to team building issues at greater length later in this essay. One of the major areas where psychology is relevant to the success (or otherwise) of a particular treatment is encapsulated in the concept of empowerment and education. (Howe and Anderson 2003). The patient who is both empowered and educated by the nurse will approach their illness trajectory in a completely different psychological frame of mind than one who is not. Time spent in explanation to a patient of the parameters and reasons for their treatment is rarely wasted. (Holzemer W et al. 1994). Marinker’s concept of the differentiation of compliance and concordance. (Marinker M.1997) is particularly useful in this respect. Although his original paper was written with specific regard to the taking of medication, the principles that it expounds are sufficiently general that they are now commonly extrapolated to cover most aspects of the interaction between the healthcare professionals and the patient. The patient who understands why he is being asked to undergo a particular th erapeutic regimen is far more likely to complete is successfully than one who is simply told what to do. This can be encapsulated in the professional advice on the subject from the RCN Patients are as fully involved as practicable in the formulation and delivery of their care (e.g. through the use of self-care plans) Where appropriate, patients are offered treatments other than medication Treatment plans are individually tailored for each patient Patients are involved, unless impracticable, in any decisions about referral Where practicable, patients are informed of the reasons for referral to specialists or other professionals (cited in CSAG 1999) This element of compliance is frequently cited in many of the tools of quality indication that are used in formal studies in this area. The degree to which a patient complies (or concords) with instructions can be viewed as a measure of success of the presentation of that treatment directly to the patient. (Campbell S M et al. 2000) As we have intimated in the introduction, the title of this essay can be interpreted at several different levels. In this segment we shall consider the impact of formal psychology services in primary health care. The rationale for our consideration of this topic specifically lies in the fact that an understanding of basic psychological principles is fundamental in allowing the nurse to appreciate the elements of treatment commonly undertaken in a psychology clinic. The excellent and informative article by Sobel (A B et al. 2001) provides a good starting point for this consideration. In practical terms, the average attendance at a psychology clinic is about five outpatient attendances. (Arndorfer, R. E et al. 1999). This means that the contact of a patient with the primary healthcare team is likely to outnumber the attendances at the clinic over a period of time. To give a specific example, it is clearly important for the nurse, who may come into contact with (for example) an anorexic adolescent, to understand the issues revolving around body dysmorphia, self-image enhancement and self-esteem (Lavigne, J. V. et al. 1999) if they have been undergoing treatment, if the nurse is to consider giving any degree of holistic consideration to whatever problems are being presented to her at the time. It is clearly of little value, if requested to give advice on the subject of weight loss (which is a common enquiry at nurse-run clinics), (Hogston, R et al. 2002) . to attempt to give such advice without a background knowledge of the psychological principles that have been employed in trying to restore the patient’s eating habits to a more normal pattern. (La Greca, A. M. 1997). Equally the parents of a child who is undergoing treatment for enuresis may have questions that they have not felt able to ask at a busy clinic and these may be presented to the practice nurse. A background knowledge of current treatment (both interventional and behavioural) is clearly vital t o being able to answer the questions with a degree of professional confidence. Another area where the nurse’s knowledge of psychological issues may be important is that, given the fact that a comparatively high number of patients default from follow up before being formally discharged, the nurse should know that psychological treatment is rarely successful if the â€Å"less than optimum† course of treatment is completed. (Sobel, A. B et al. 2001). Encouragement to return to complete the full course may be a useful remit for the nurse confronted by a patient in this situation. It follows that a sensitive exploration of the reasons for default my also be helpful and a knowledge of the subject is clearly helpful here as well. The patient who has defaulted from follow up through apathy needs completely different handling from the patient who has defaulted because of a resurgence of painful or difficult memories during a course of cognitive behavioural therapy. (Street, L. L.et al. 2000). In the latter case, empathetic handling is of great importance a s the issues involved may have a deep significance for the patient and completion of the course may be fundamental to a complete resolution of the issues involved. (Mitchell M C et al. 2004). When dealing with the patient who has specific emotional or psychological issues, the professional nurse would commonly have to employ a degree of psychological understanding which may be deeper than in many other cases for both of the reasons set out above. Let us now consider a different aspect of psychology and its relevance to nursing practice in primary care. A large proportion of the work of the district nurses can be taken up with the care of the dying patient. The dying, or terminally ill patient typically has a psychological profile that is quite different to the â€Å"average† patient. This was explored in the fascinating and very well written paper by The (The et al. 2000) who considered the elements of denial and cognitive distortion exhibited by a patient when being given news that they do not want to hear. The diversity of psychology shown by these patients is virtually unique to this group and a firm grasp of the essential elements is vital if the district nurse is going to handle the situation both professionally and well. The concept of â€Å"a good death† (Seale C et al. 2003) is one that is frequently cited in the modern literature and a fundamental prerequisite to a good death is that the patient is surr ounded and treated by healthcare professionals who have broad understanding of the psychological issues that are relevant to this spectrum of patient. (Wilkerson, S. A et al. 1996) There are many patients who confront the inevitability of death with a stoical inevitability that makes their management a relatively straightforward matter (Wadensten et al. 2003). The patients that we shall specifically consider in this segment however, are those who have a positive diagnosis of a life threatening condition but employ a number of coping mechanisms so that they do not have to directly confront the possibility of imminent death. These mechanisms can range from false optimism right through to frank and abject denial (Weeks et al 1998). We have already considered some of the ethical implications of autonomy and consent earlier in this essay, but they also are of great relevance in this section. It follows that if a patient is to have any degree of meaningful input into their treatment plans and consideration of the various options that are open to them, they must be both fully aware of, and quite prepared to confront, the implications of the situation that they find themselves in. If they chose to distort some or any of the relevant facts of the case, it equally follows that they cannot make a reasoned and rational decision about the options and choices that they have in front of them. Once again we return to the issue and concept of framing the presentation, the only difference here is that it is generally the patient who deliberately distorts the frame rather than it being distorted or manipulated by the healthcare professionals. This specifically is the issue that The and his colleagues considered in their paper (The et al. 2000). We should start a consideration of this issue however, with a reference to an earlier paper by Jennings (1997) who described the â€Å"emotional roller coaster† experienced by patients who deal with a malignant diagnosis and that this â€Å"evolution of emotional landscapes† can be predicted with a degree of certainty. This can be best examined with a verbatim extract from the The paper which refers to patients with small cell carcinoma of the lung: â€Å"False optimism about recovery is usually developed during the (first) course of chemotherapy and was most prevalent when the cancer could no longer be seen in the x ray pictures. This optimism tended to vanish when the tumour recurred, but it could develop again, though to a lesser extent, during further courses of chemotherapy. Patients gradually found out the facts about their poor prognosis, partly because of physical deterioration and partly through contact with fellow patients who were in a more advanced stage of the illness and were dying. False optimism about recovery was the result an association between doctors activism and patients adherence to the treatment calendar and to the recovery plot, which allowed them not to acknowledge explicitly what they should and could know. The doctor did and did not want to pronounce a death sentence and the patient did and did not want to hear it. Clearly an understanding of the psychology of what colours the patient’s reactions is vital to the district nurse if she is to handle this type of situation both professionally and empathetically. If we take a completely detached and dispassionate consideration of this situation the healthcare professional can say with almost complete certainty, that the patient with a positive diagnosis of small cell carcinoma of the lung is going to die. Statistically we know that over 90% of patients are dead within two years of diagnosis and the overall five year survival figures are nil. (Seale C et al. 2003) The practicality of the situation is therefore that it clearly makes sense to discuss options in terms of treatment, palliation and support as soon as a positive diagnosis is made. In real terms, this is rarely done because healthcare professionals frequently find it difficult to effectively pronounce a â€Å"death sentence† on patients. In this respect the psychology of the situation is as much a reflection of the attitudes and feelings of the healthcare professionals as it is of the patient. On a fictional level one can cite the classic literary example of A J Cronin’s Dr Findlay (Cronin A J 1934) who disagreed with his partner Dr Cameron. Dr Findlay felt strongly that the eponymous Mrs McIver should be told of her hopeless prognosis on the grounds of being completely truthful with the patient and this was against the advice of the older, more experienced partner, Dr Cameron who had been hitherto managing the situation by keeping the lady’s spirits high by telling her how well she was looking at each occasion he had contact with her. Dr Findlay confronts the situation by telling Mrs McIver the truth and within a few days she has died. The relevance of the story is seen at the end where Dr Findlay is depicted talking to the dead lady’s husband and Dr Findlay expresses his shock at the speed at which the old lady died and the husband concludes the episode by observing that: â€Å"She was doing really well until you took away from her the one thing that she had left – and that was hope†. In short, this episode highlights some of the difficulties and dilemmas that are frequently faced by healthcare professionals in general and district nurses in particular. The practicality of the situation could have been handled better with a more thorough understanding of the thought processes and psychological mechanisms employed by Mrs McIver in her last few weeks. One can see the point of view of Dr Findlay who took the view that the lady would not have been in any realistic position to make appropriate arrangements to confront her own death if she had never faced the possibility in the management plan that Dr Cameron had adopted. Dr Findlay’s approach could be argued to have allowed her to consider a number of timely treatment options if the truth was confronted. The fact of the matter was that she chose to actively collude with the optimistic approach of Dr Cameron and she derived strength and the ability to cope from the transparent belief (a cognitive distortion) that her prognosis was not hopeless. Dr Cameron was clearly of the opinion that this was of greater benefit to her than confronting her imminent death. What the story does not tell us (and we can only surmise) is that Dr Cameron, in common with many other real healthcare professionals, also has psychological difficulties in dealing with the subject himself. A number of different mechanisms may be active in this situation. It is possible that, by telling a patient that they are soon to die, it may challenge the notion that medical science can cure everything and that healthcare professionals are infallible (sadly, a still all to common belief). Equally it could be that the healthcare professionals involved do not like to be vicariously reminded of their own mortality and therefore collude willingly with the patient’s false optimism. Others again may take a rational view that â€Å"if the patient wants to know the truth then they will ask, if they don’t want to know then they won’t ask† and thereby actively avoid confronting the situation (Curtis J R. 2000) The The paper examines this issue in considerable depth with a commendable degree of scientific scrutiny. In the words of the paper, the authors suggest that: The problem of patient / doctor collusion does actually require an â€Å"active, patient orientated approach from the doctor†. A practical and novel solution to this problem is suggested in the form of the use of a â€Å"treatment broker† who is defined as: â€Å"a person who is trusted by both patient and doctor and who can help both parties to clarify and communicate their (otherwise implicit) assumptions and expectations†. The’s analysis suggested that the majority of patients in the study did actively want to know if the illness that they had was terminal with over 85% stating that they would wish to be told the truth rather than be given false optimism in an unrealistic fashion. This is contrasted with the finding that, in the study, when a patient was given a terminal diagnosis, the next question was almost invariably a variation of â€Å"what are the chances of a cure?† (Meredith et al 1996). It is also the case that other studies on the psychology of this type of situation have shown that when patients ask about their condition (and this applies not specifically to terminal conditions) they do not want to hear anything other than good news (Costain et al 1999). This argument is extrapolated even further in a study by Leydon and his co-workers (Leydon et al 2000) who provide an excellent qualitative study into patient’s reactions and they cite examples of patients who were interviewed directly after a recorded conversation with a healthcare professional and who overtly denied that they had been given a terminal diagnosis even though this was demonstrably not true. An interesting twist in these discussions of the psychology of the situation is provided by Dean (Dean 2002), who offers a specific insight into the way patients perceive the differences between nurses and other healthcare professionals. He takes the arguments of false optimism and overt denial and examines them further. Again, this paper is specifically concerned with the patient with a terminal diagnosis, and it looked at the differences in the content and tone of the conversations that patients had with both doctors and nurses. A significant finding from this paper was that a patient may choose to overtly collude with the doctor during discussions of â€Å"a cure† but within a very short space of time may choose to talk in a much more open way with a nurse when pretences of a cure are actively dropped. Dean suggests that â€Å"such a dichotomy of approach is not unusual†. He suggests that: Patients may well feel a need for a theatrical faà §ade to bolster their own psychological states as well as to collude with the doctor and indicate that they are remaining positive and confident in the doctor’s ability to try to achieve a cure. And this suggestion is echoed and expanded in the Curtis paper (Curtis 2000) with the observation that, in their more candid moments patients may well wish to get a more â€Å"down to earthâ€Å" response, which they perceive that they will get from the nurse, who they think may not require a faà §ade or even indulge in the sophisticated game play of the doctor. Lynn (Lynn 2001) adds a counter-intuitive note of caution for the nurse with the thought that this situation requires a great deal of careful handling by the nurse, as the psychological mechanism that underlies the nursing approach is that the patient may actually be looking for reassurance and (possibly unexpected) reinforcement of their own false optimism. This is an exemplification of the constant calls in the literature for a holistic and patient centred approach to patient care rather than a blanket approach to this type of clinical problem. The rest of The’s paper is concerned with the psychological theory behind the explanations of just why it is that patients do adopt these defensive positions and just why it is that healthcare professionals frequently collude with them on this issue. It is not particularly relevant to explore this in any further detail as the point is clearly made that a basic understanding of the mechanisms by which patients cope with their adversity and the psychological constructs that are frequently presented in these circumstances is of great importance to the nurse who has to deal with, interpret and empathise with the patient’s particular needs at any given time in their illness trajectory. Nurses are often involved, both overtly and in their everyday work, in the business of Health Promotion. Psychology plays a very important part in the overall success and implementation of health promotion strategies on a both a population and an individual level. The theoretical basis of much recent work in the field of Health Promotion is in the concept of the Attitude-Behaviour theory (A-B theory) (Rise J 2000). This theory suggests that the optimum change in behaviour patterns (at least in the field of health and self-interest) is achieved with the optimum change in attitude (or â€Å"realignment† in the jargon). We opened this essay with a reference to the Theory of Rational Choice. An offshoot of this theory (the Theory of Reasoned Action) modifies the A-B Theory to the extent that it provides a model framework by which one can assess the many divergent processes by which attitudes guide behaviour. The hypothesis states that if people can become highly motivated to make a correct decision and are in a position (because they have been given relevant information), then they are likely to spontaneously engage in a â€Å"deliberate and thoughtful process in deciding how to behave† (Rise J 2000). In the context of Health Education (which was the field that the theories were originally developed in) the theory suggests that if people are given sufficient and persuasive information in relation to their health, then a significant proportion will spontaneously indulge in lifestyle changing activity which can be consistent with healthier living. The significance of these theories is that, if t he nurse has a remit to promote a healthier lifestyle (which is arguably part of a professional remit), she is most likely to have the greatest success in providing significant amounts of information to patients rather than simply dictating to them how they should alter their lifestyle without any significant explanation. This comment effectively brings us full circle to the concept of compliance and conformance as postulated by Marinker. Another issue that has deep seated psychological implications, is the current trend towards teambuilding in primary health care. The ramifications of this concept are huge, and therefore we intend to only discuss the issue by considering a number of the most relevant points. To a large extent, team building overlaps with the concept of multidisciplinary team working. This move has required a redistribution of both power and authority (and thereby a redistribution of responsibility) within the team. (Shortell S M et al. 1998).The psychological implications of this are that if one considers the NHS of more than about twenty years ago its structure was more isolationist and based on individual practice (DHSS 1988). Individual speciality teams and individuals worked in a degree of comparative isolation and this also implied a greater degree of individual responsibility than they have at present. This change has brought about a number of major changes in areas such as ethics and work prac tices which are not particularly relevant to our topic in this essay (and therefore will not be discussed further), and also the psychology of working, which clearly is. The first consideration is the psychology behind the concept of leadership. Leadership is clearly important if one is to have an effective team. In psychological terms styles of leadership can be divided into several categories. The two most prominent being congruent leadership and transformational leadership. A full discus

Comparing Little House on the Prairie and Sarah Plain and Tall :: Compare Contrast Comparison

Comparing Little House on the Prairie, written by Laura Ingalls Wilder, and Sarah Plain and Tall, Written by Patricia MacLachlan Little House on the Prairie, written by Laura Ingalls Wilder, bears some resemblance to Sarah Plain and Tall, written by Patricia MacLachlan. Within both of the texts one can find two families that are adjusting to life out on the Prairie. Even though the books are written some fifty years apart they still portray the aspects of living on the prairies in the Midwest. In both books the parents seem equally important to the plot, while the point of view enhances the importance of the children within the books. In Little House on the Prairie the family is already formed, but the homestead is not. The opposite situation occurs in Sarah, Plain and Tall, where the homestead is in place but the family is not quite complete until Sarah travels from Maine to live with Jacob, Anna and Caleb. In both books, all of the characters are very similar. Charles and Jacob, the fathers in the books, are seen as very strong willed, loving and appear to be capable providers. The fathers in both of these books are in control of their families and do whatever is necessary to provide. On many occasions Charles travels to Independence to get food for his family and he also hunts and traps animals to sell their fur. Although Jacob's acts of providing for his family are more stationary, he works hard on their farm to provide for them. The men may be hard workers and do the main part of the manual labor, but the women also do their share to contribute to the success of the family. In Sarah, Plain and Tall the roof needs repaired and a storm is on the way. Jacob tells Sarah that he needs to fix the roof and she replies, "We will fix the roof." (46). Sarah and Caroline are both willing to do their share of work on the prairie. Caroline helps Charles build their house on the prairie. "Pa lifted one end of a log onto the wall, then Ma held it while he lifted the other end"(58). Sarah also insists that Jacob should teach her how to drive the wagon because she wants to go into town to get supplies.

Essay --

According to our research, our analysis and our experiences, we can assume that the following statements could help us to have a better understanding on how and why there is such a big difference of suicide rate at workplace between two companies competing in the same sector: The following statements are based on Geert Hofstede organizational dimensions model and on Trompenaars and Hampden-Turner’s different researches about organizational culture and management style. Between those two research projects, not all of the statements would be relevant for our research, so we will highlight the ones that can give us some answers about the reason of a higher suicide rate in France Telecom than in Claro even though both are competing in the same sector. 1. Means vs Goal oriented culture This first aspect is directly related to the effectiveness of the organization. Hence, in a means oriented culture, people identify with the â€Å"how†, in other words, how they will carry on a project, while in a goal oriented culture, people identify with the â€Å"what†, that is to say that they need to achieve a specific task or results within the organization. According to our research, we can say that Claro (Colombia) is a means oriented culture while France Telecom (France) is a goal oriented culture, the â€Å"what† and the obsession of achieving goals no matter how, gives stress and pressure to the employee. â€Æ' 2. Internally driven vs externally driven With this aspect, the idea of satisfaction is not about the employee, but about the customer. In an internally driven culture, honesty and business ethics matters, while in an externally culture, the only important thing is to meet the customers’ requirements. In Colombia, the employee feel like that if they r... ...anagement orders, while the solar system tends to have an impersonal bureaucracy and a high individualism within the different management levels. 8. Deal vs relationship management In deal-oriented cultures, managers tend to focus on the task and on the project itself and want to keep the head down to business. At the extreme, some of those managers may even avoid discussions with their employees. France is a good example of deal oriented culture; indeed, managers care more about business than about people. On the other hand, in a relationship oriented culture, as it is in Colombia, managers care more about people and put value on relation with them. It is important for managers to build a trustworthy relationship with their employees and to get to know each of them in order to understand how each of them work and therefore create a nice atmosphere within the team.

Han China and Imperial Rome Essay

Imperial Rome and Han China are both well recognized empires, known as strong and fairly successful. Although the empires had some differences they also had similarities in their methods of political control. Similarities between these empires include the belief that leaders had connections to God, religious tolerance, and public works provided to citizens. Along with the similarities in political control the differences include Rome having a democracy while China had a centralized bureaucracy, Rome had lesser domestic repercussions while China had harsh punishments, and Rome offered assimilation to become a citizen while China did not need to offer assimilation because it conquered states that were already chinese. Imperial Rome and Han Dynasty are similarly structured societies. Both empires believed that their leaders had some sort of connection with God. Rome believed that their emperors were to be viewed as â€Å"god-like† individuals and were to guide them unto the right path. China called their emperors â€Å"God of Heaven† and the emperors had to follow the â€Å"Mandate of Heaven† which states God would bless the authority as leader, and if an emperor did not provide adequately for their empire they could be replaced. Han China and Rome both also tolerated religion. Rome integrated Christianity into its culture while Han China allowed for Buddhism to become integrated. Neither empire persecuted due to religion. The last similarity between Han China and Imperial Rome is the fact that both empires decided public works were important enough to spend quite a bit of money on and to provide to the citizens. These public works included roads, bridges, canals, and aqueducts. All of these were an important part of society as they allowed for transportation, communication, and sanitation. The government in both societies decided how to view the leaders, what they would permit as far as religion, and what to spend government funding on. As well as these similarities, Rome and China had their differences. Imperial Rome differed from Han China in some aspects. For instance, Rome had divided the empire into smaller sections so it could be easier to manage, as each sector had a branch of government to control it. China did not have a Democratic approach, but a Bureaucratic approach. There was one emperor that controlled the entire empire, and the government was highly centralized. Another difference between the government in Rome and China were punishments. Imperial Rome had short and superficial domestic repercussions compared to the strict legalism society of China. Punishments in China were swift and harsh to persuade citizens to stay in order. The Chinese believed humans were dumb and short sighted and had clearly defined laws and rules that were strictly enforced. Rome did not focus so much on punishments as China did. The last difference between these two empires are their allowance or need for assimilation. Rome conquered Germanic tribes that refused to conform to society, even though Rome offered assimilation. This would eventually lead to the end of Rome. China, however, did not need to offer assimilation due to the fact that the conquered nearby states had already accepted chinese culture to be their own, therefore having one culture throughout the empire instead of a mixture of cultures. Han China and Imperial Rome are comparable in political standards in the means of the view of leaders, that they were closest to God, how they decided to spend political funding, on public works for citizens, and their tolerance for religions, Rome allowing Christianity and China allowing Buddhism. Rome and China are contrastable in the sense of Rome being Democratic while China was Bureaucratic, Rome being lenient with punishments compared to China’s strict legalism beliefs, and Rome offering assimilation to conquered Germanic tribes while China conquered already Chinese states and did not need assimilation. Both empires are valued respectively for their contributions to modern society, including their similarities and differences.