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The problem being investigated in the research study is that indeed persons that are suffering from psychiatric disorders are more likely to smoke. In fact, in the United States, the persons with mental illness end up purchasing approximately 45% of the commodities that are sold in the U.S. 25 to 40% of Veterans are known to have a psychiatric disorder and consequently, they often have high morbidity and mortality rates that are often related to tobacco-caused illness. Therefore, this research paper explores this problem (Bridgette Helms Vest, 2014).
The purpose of the study is to examine the effects of participation in a tobacco cessation education on tobacco, alcohol as well as other drugs that are used by veterans who sought treatment for SUD (substance use disorders). Therefore, the research study wanted to understand whether there occur several differences in Veterans that have undergone a tobacco cessation education program and those who have not.
The purpose and the problem do indeed state the population that is being studied. The people being studied in the research is Veterans. These are persons that were former soldiers and according to research 20 to 45% often have mental disorders.
The independent variable is drug use whereas the dependent variables are the time that was taken in order for cessation of the drugs to be complete. It is of the essence to understand that this could be in three weeks or even two weeks time (Bridgette Helms Vest, 2014). The Literature review is outdated, with the most recent article being published around the year 2013. There are articles that are dated as early as 1983. It is important to understand that although there are indeed several facts that remain unchanged, the society keeps changing and so do norm.
Therefore, on a sensitive issue such as research about Tobacco use, there is a need to ensure that there is indeed the most recent literature. Most of the references that are cited are primary, and this gives credibility to the data. This is because the author can compare his findings with those that have done the same type of research. Therefore, by having primary sources, it shows that indeed he did a lot of research when it came to the plan and execution of this study.
The research hypothesis in the study was that there was an impact of residential treatment program for SUDs that included a formal tobacco cessation component on veterans that reported the use of drugs/tobacco and alcohol. The type of study that is being used in this research is experimental. This is because there is the use of participants who are observed and reporting is done in regards to whether they have ceased to take tobacco use after a participating in a tobacco cessation program which focused on tobacco, alcohol, as well as other drugs.
The strengths of the study include the fact that there was a large, diagnostically diverse trial as well as longitudinal data compilation (Bridgette Helms Vest, 2014). There was intense monitoring in the different stages of preparation for admission and the transformation in the Veterans was clearly observed (Bridgette Helms Vest, 2014). In fact, it is important to understand that indeed the result of the study may be able to serve as a model for development of several integrated tobacco cessation program for veterans. The second strength is that there was the provision of care that was integrated for nicotine dependence within a substance abuse treatment program which was designed for veterans.
The first limitation of the study was that it employed convenience sampling and there it was possible that indeed there were other different events beside smoking intervention that might have led to a decline in substance use, as well as smoking. Further, another limitation is that there exists the possibility that there were false reports because the experiment involved the use of self-reporting. It could not be proved that indeed there was abstinence as there were no biochemical validations that came with self-report.
The human subjects were well protected; they were given information about what the experiment entailed, and they all consented to the experiment. They were treated in a good way, and they were told that they were comfortable to leave anytime they wanted. Therefore, there were no restrictions on the things that they could do. Therefore, it is proper to say indeed that human subjects are well protected.
Reliability and validity were not discussed for each experiment. There were instruments which their validity and reliability were discussed, but there are those that the authors did not inquire in (Bridgette Helms Vest, 2014). This is because some of the instruments are renowned internationally. Therefore, their reliability as well as the validity has been tested severally in different peer-reviewed articles. The conclusion does reflect the study findings, and they are made in a concise as well as a precise manner. There are indeed recommendations for future research and what it should entail. The authors can give clear paths on what should be done in the future and how it should be done. This will lead to more findings that will in turn help those that are suffering from tobacco abuse.
Bridgette Helms Vest, C. K. (2014). Outcomes Following Treatment of Veterans for Substance and Tobacco Addiction. Archives of Psychiatric Nursing 28 , 333-338.
LoBiondo-Wood, G., & Haber, J. (2014). Nursing research: Methods and critical appraisal for evidence-based practice.
A number of issues and challenges that face nations. The impact of these issues differs from one nation to another. In relation to health care services rendered by nurses, migration is a factor that has a great influence on service delivery of the nurses. Migration has an effect of adding an imbalance in nursing resources existing in different regions and as well different nations (Buchan, 2007). Over the past years, the number of recruited nurses in developed countries is increasing at a higher rate as compared to the number of nurses recruited in less developed countries. It is important understanding the extent and effect of migration on nursing services while addressing common issues facing nursing service delivery. Apparently, while focusing on migration and its effects on nursing service delivery, it is important understanding the factors pulling the nurses to other regions and nations and as well understanding the factors pushing the nurses from these regions. The paper is a case analysis of the impact of global migration of nursing on their health care service delivery.
As stated earlier, it is important to highlight on the factors affecting nurses that may lead to their migration to other regions. One of the major factors facing nurses is balance of the quality of health care services they offer to the cost efficiency. Therefore, while rendering their services, nurses face the challenge of balancing the quality of their services with the cost of their services. Apparently, nurses also face another challenge of workload while during their offering their health care services to their patients. Workload is a concern facing nursing management where they have the obligation of determining their mechanism of ensuring that the workload of nurses and teams of nurses is not too high that it develops significant effects on the nurse’s ability to offer their health care services to others and as well care for themselves. These are some of the growing concerns in many nations globally (Buchan, 2007).
Diseases such as HIV/AIDS play another role in affecting the nurse’s migration to other regions. As highlighted by James in his discussion, HIV/AIDS is growing as a global concern to nurses. This is because the disease is affecting nurses in numerous ways. Some of the ways in which HIV affects nurses are by making their work harder while they are catering for their patients (Buchan, 2007). More so, in some regions, the number of nurses suffering from HIV/AIDS is growing at high rate implying that while rendering health care services to their patients is becoming challenging. As a result, nurses have a tendency of migrating from regions where there are high numbers of patients suffering from HIV/AIDS and settling in those areas where its prevalence is low. Therefore, this becomes a push factor to nurses.
While investigating on effects of migration of nurses to their service delivery, it is important understanding the effects of different types of migration on health care service delivery. Internal migration creates a great challenge to service delivery since in most rural there are no professional nurses. This has an implication that there is disproportional allocation of nurses in some developing nations.
Internal migration is highly influenced by the disproportional distribution of professional nurses in the nation. Similarly, international migration of nurses is growing as concern for nations sharing a common language. As highlighted by James, he states that the migration between United Kingdom, United States and Canada is resulting from the common language share where nurse are free moving from one nation to the other (this is mostly among English-speaking nurses) (Buchan, 2007).
Under an international context, there is the shortage of in different nations. Africa, compared to other continents has a great shortage of resources. Furthermore, they have a shortage in their nurse allocation. Therefore, nurses in Africa care for a large population. This is in other terms workload (comparing the number of patients cared by a nurse). In a precise analysis, comparing the nurse to population ratio of United States to that of Africa indicates that those nations with high resources and higher incomes have a higher nurse to population ratio as compared to developing nations such as Niger in Africa.
Over the past few years, reliance on recruitment of nurses from other nations is increasing at a high rate (Buchan, 2007). This is because some nations do not train enough nurses that sustain the population. This has an attribute to the high migration rate of nurses. In nations such as United States, Norway, United Kingdom and Ireland, they highly rely on nurses from other nations. They recruit nurses from low-income nations and developing nations such as India and Philippines. This has an implication that, despite these nations appearing as high-income nations, they play a role in the shortage of nurses in developing nations. In United Kingdom and United States, they are behind the shortage of nurses in sub-Saharan Africa. This in return is reducing the nurse to population ratio in these nations and, therefore, negatively affecting the quality of services offered.
International migration affects the quality of services rendered by nurses remaining in the host country. While the host government makes attempts of replacing the nurses, it experiences some recruitment and retention costs. Apparently, this increases the costs of health care services offered to the host population. This, on the other hand, acts as a compromise for the quality of services offered to the patients due to the low morale of the remaining nurses. In addition, high-level nurses are prone to international recruitment as compared to low-level nurses. Therefore, after the migration low-level nurses remain in the host nations. Apparently, their quality of offering health care services is lower and, therefore, low quality health care services to the patients (Buchan, 2007).
In contrast, in those nations that the nurses migrate to, the quality of health care services faces a positive impact. This is due to an increase in the number of nurses thereby increasing the nurse to population ratio. Apparently, nurses in these regions have are at a high-education level and, therefore, do not struggle offering their services.
While dealing with effects of global migration on the services offered by nurses, James highlights on some policy issues with the aim of ensuring that each nation involved in the migration process benefits. Host nations should not only face a negative impact from the migration but should benefit from the large amounts of money got from the sale of their nurses. More so, migrant nurses benefit from better pays and improved work environments. However, as a policy issue, these nurses should receive equal treatments as other nurses (Buchan, 2007).
In conclusion, it is quite clear that the global migration of nurses has a great influence on service delivery of nurses. Both push and pull factors play a great role in promoting nurse global migration. Pull factors include better pays in other nations, improved working conditions of nurses in other nations and as well career opportunities in other nations. Push factors, on the other hand, include economic instability, low pay, poor working conditions and as well HIV/AIDS effects.
Buchan, J. (2007). The Impact of Global Nursing Migration on Health Services Delivery. Sage .
Multistate licensure is one of the best developments that are taking place in the nursing profession. Licensing of nurses stated 100 years ago where different states defined laws to regulate and guide the actions of nurses. However, the licensing system was limiting to traveling nurses since they had to apply for licensing to work in a different state. Nurses working with the Red Cross and other organizations that deal with medical emergencies were the most affected (Philipsen, 2007). The multistate licensure was introduced to eliminate licensing barriers to optimal patient care and safe practice.
With the implementation of multi-state licensure, nurses can now offer health services and advice over the internet. Audio and video communication between nurses and their patients are the most common on the internet platform. The increasing number of mobile citizens in the United States is one factor that has necessitated this development (CMSA, 2014). With multi-state licensure, patients can still keep in touch with their nurses even when they are taking business vacations.
Multi-state licensure presents a number of advantages both to the nurses and patients. First patients who seek medical assistance or advice over the internet can tell a credible medical practitioner from a quark. Additionally, the system allows action to be taken against nurses who provide misleading information to online patients. Patients on regular medication do not have to change doctors when traveling. They can access their health providers even when they are away from their primary residence (Philipsen, 2007).
Before the introduction of the nurses intending to work outside their primary state spent a lot of time waiting to be issued with new licenses (Brocato, 2013). This is no longer the case since the compact licenses allow a grace period in which nurses can apply for new licensing as they continue working with the primary ones.
Brocato,.C. (2013). Nurse licensure compact allows nurses greater flexibility.
CMSA. (2014). Multi-state nursing licensure.
Philipsen,. C.N. (2007). The multistate nursing licensure compact: making nurses mobile.
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