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Discussion post replies Instruction: The response is a substantive interaction that builds on the ideas of others, delving deeper into the discussion ques

October 04, 2021

Discussion post replies Instruction: The response is a substantive interaction that builds on the ideas of others, delving deeper into the discussion question and course content in response to a colleague. The response includes one reference from a professional peer-reviewed scholarly journal.
· Describe a patient-centered care approach when providing health promotion services to a rural health issue.
· How does the cultural and socioeconomic status of the rural community affect the provision of nursing health services in rural or migrant populations?

Reply to Jenny B
In rural Appalachia, USA, the prevalence of cervical cancer is 35% higher than the national average, which may be due to lower cervical cancer screening  participation caused by the lack of access to cervical cancer screening services. Some of these barriers may be more pronounced for women in rural and remote areas due to increase barriers to accessing healthcare services (Majid et al.,2019).
 Barriers particularly relevant to women in rural areas may include the limited availability of healthcare providers in their area, the need to travel long distances to receive necessary care, and a rural culture that may inculcate beliefs that seeking care may affect their physical ability to earn a livelihood, thereby discouraging women from participating in cervical cancer screening services. Access to healthcare services requires a negotiation between rural healthcare provider and urban healthcare facilities, the availability of adequate transportation to healthcare facilities, a rural culture that supports and advocates for preventive health, financial capital and insurance status, and patient-centered care (Majid et al.,2019).

Majid, U., Kandasamy, S., Farrah, K., & Vanstone, M. (2019). Women’s preferences and experiences of cervical cancer screening in rural and remote areas: A systematic review and qualitative meta-synthesis. Rural & Remote Health, 19(4), 30–40. https://doi.org/10.22605/RRH5190 (Links to an external site.)

Zangerle, C. M. (2016). Care coordination in rural areas. Nursing Management, 47(4), 28–29. https://doi.org/10.1097/01.NUMA.0000481843.42424.66 (Links to an external site.)


Reply to Erin
According to Raingruber (2017), there is no place more in need of nursing health promotion services than in the “underserved and often disadvantaged rural communities.” Evidence indicates that rural Americans face greater mortality rates from multiple diseases, including cancer (Dwyer-Lindgren et al., 2016). Wheeler and Davis (2017) describe several opportunities for advancement of the practice and science of rural cancer control. One patient-centered care approach they detail is the expansion of evidence-based interventions utilizing multidisciplinary strengths. Teams consisting of primary care, public health, and community stakeholders could use partnered approaches to understand determinants of poor maintenance and intervene appropriately.
An example of cultural status affecting nursing health services would be an area where indigenous practices are more prevalent, as there may be increased use of alternative health services consistent with that cultural orientation (Raingruber, 2017). Political beliefs, traditions, and religious faith would also affect the provision of nursing health promotion services in rural populations. Long et al. (2018) utilized recursive partitioning to fit models predicting premature mortality across countries in the United States. They concluded from that study that socioeconomic variables explain substantial variation in life expectancy across United States counties. They proposed that addressing poverty and other socioeconomic determinants could decrease premature mortality in rural areas.
Dwyer-Lindgren, L., Bertozzi-Villa, A., Stubbs, R. W., Morozoff, C., Kutz, M. J., Huynh, C., Barber, R. M., Shackelford, K. A., Mackenbach, J. P., van Lenthe, F. J., Flaxman, A. D., Naghavi, M., Mokdad, A. H., & Murray, C. J. L. (2016). U.S. county-level trends in mortality rates for major causes of death, 1980-2014. JAMA Network Open, 316(22), 2385-2401. https://doi.org/10.1001/jama.2016.13645 (Links to an external site.)

Long, A. S., Hanlon, A. L., & Pellegrin, K. L. (2018). Socioeconomic variables explain rural disparities in US mortality rates: Implications for rural health research and policy. SSM – Population Health, 6, 72-74. https://doi.org/10.1016/j.ssmph.2018.08.009 (Links to an external site.)

Raingruber, B. (2017). Contemporary health promotion: In nursing practice (2nd ed.). Jones & Bartlett.
Wheeler, S. B., & Davis, M. M. (2017). “Taking the bull by the horns”: Four principles to align public health, primary care, and community efforts to improve rural cancer control. The Journal of Rural Health, 33(4), 345-349. https://doi-org.ezproxylocal.library.nova.edu/10.1111/jrh.12263

Reply to Yakoska
Patient-centered care is consistent with patients’ values, needs, and desires. It is achieved by involving patients in healthcare decisions and discussions. Patient-centered care is achieved by understanding what patients undergo with illness and disease. It is considered to have many benefits and could help achieve better health outcomes, reduced health care costs, and enhanced patient satisfaction. In trying to promote rural health, there needs to be effective communication, health promotion, and partnership to ensure that healthcare plans assist in understanding previous healthcare experiences. This can help minimize the risk of failed treatments while optimizing resource use in the rural setting (Dintino et al., 2019).
The cultural and socioeconomic status of the rural community can affect the provision of nursing health services in rural and migrant communities. Rural communities encounter barriers to healthcare that may prevent them from obtaining critical care. To access proper healthcare, such communities need financial resources to pay for services and the ability to reach and use them (Dintino et al., 2019).
Dintino, R., Wakely, L., Wolfgang, R., Wakely, K. M., & Little, A. (2019). Powerless facing the wave of change: the lived experience of providing services in rural areas under the National Disability Insurance Scheme. Rural and Remote Health, 19(3), 5337. https://doi.org/10.22605/RRH5337

Instruction: The response is a substantive interaction that builds on the ideas of others, delving deeper into the discussion question and course content in response to a colleague. The response includes one reference from a professional peer-reviewed scholarly journal.
Locate and share a ToolKit from the CDC, WHO, United States Preventative Services Taskforce, Million Hearts, or Healthy People 2030. Detail how an advanced practice nurse can utilize the tool kit for a specific population that is affected by health care inequities.
Reply to Pamela
The issue of antibiotic resistance has become a major health challenge worldwide. The practice of overuse and over prescribing could eventually lead patients without a healthy immune system to fight off illness that may not require antibiotic therapy. The focus on the under-served population regarding this issue of overuse of antibiotics would increase healthcare needs where disparities to quality care exist. Adopting the Target Antibiotic toolkit  supported by the World Health Organization and Department of Health can benefit health promotion and advance practice nurse patient-centered approach. The purpose of this specific toolkit is to assist those who prescribe and commissioning organizations to the attentive responsibility in prescribing antibiotics in primary care settings ( Jones et al., 2018). Overuse of antibiotics expose patients to risk factors that may result in adverse drug-reactions leading to increased healthcare cost and individual antibiotic resistance.(Meeker et al., 2016). Antibiotic surveillance for medication therapy is essential to destruct growth of pathogens non-satisfying to the immune system. Ensuring best practice and best care is being implemented, the toolkit ( TAT) is warranted as a guideline to  patient safety and outcome.
Jones, L. F., Hawking, M. K. D., Owens, R., Lecky, D., Francis, N. A. Butler, C., Gal, M., & McNulty, C. A. M. (2018). An evaluation of the target (treat antibiotics responsibly; guidance, education, tools) antibiotics toolkit to improve antimicrobial stewardship in primary care-is it fit for purpose? Family Practice, 35(4),  461-467. https://doi.org/10.1093/fampra/cmx131
Meeker, D., Linder, J. A., Fox, C. R., Frieberg, M. W., Persell, S. D., Goldstein, N. J., Knight, T. K., Hay, J. W., & Doctor, J. N. (2016). Effects of behavioral interventions on inappropriate antibiotic prescribing among primary care practices. JAMA, 315(6), 562. https//doi.org/10.1001/jama.2016.0275

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