Post a proposed research problem statement, including your study variables and hypothesis to make your problem statement clear. Explain any ethical considerations you should keep in mind in relation to your research problem statement.  

Week 5 Unit 5 Discussion Medications for Depression and Anxiety Related Disorders2 Peer Response 800w. due10-4-23

Instructions:

Please read and respond to the two peers' initial postings for week 2 below. Consider the following questions in your responses.

Compare and contrast your initial posting with those of your peers.  

1. How are they similar or how are they different?

2. What information can you add that would help support the responses of your peers?

3. Ask your peers a question for clarification about their post.

4. What most interests you about their responses? 

5. Summaries at least 1 evidence based article that supports there point.

Please be sure to validate your opinions and ideas with citations and references in APA format.

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Response 1 400 words IA

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This case scenario is quite interesting since this is about a young female patient who reports multiple symptoms starting three weeks ago. This is where one researches and I believe this patient may be having an episode of major depressive disorder. I dare to come to come up with this diagnosis since she presents multiple symptoms starting about three weeks ago. Going over the multiple sections to cover this week in the “Diagnostic and Statistical Manual of Mental Disorders” I found that she presents with subjective information such as having insomnia, diminished ability to concentrate, lack of interest, weight loss due to loss of appetite, crying spells with no apparent reason. This young lady also reports feeling “tired & fatigued” and has lost interest in activities she usually enjoys. The key for me here was finding all these symptoms under the diagnostic criteria for major depressive disorder box (Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR 2022). Although she does not meet all the criteria, she presents more than five symptoms with onset about three weeks ago and according to our manual symptoms must be present at least two weeks (Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR 2022).

Regarding her headache, and according to our book this patient can be reporting somatic complaints such as pain and aches instead of reporting an actual feeling of sadness (Diagnostic and Statistical Manual of Mental Disorders: DSM-5-TR 2022).

The classification of medication that I would recommend for this patient would be antidepressants. Our prescriber's book has a long list such as sertraline, paroxetine, trazodone, and escitalopram among many (Stahl, 2021). I would focus on a common drug that I see very often, and that is sertraline. Sertraline would be a good option for her since is an SSRI (selective serotonin reuptake inhibitor) (Stahl, 2021)

and I remember Dr. Kubiak mentioning that serotonin can be the usual one to blame for depression along with norepinephrine. This drug can boost the neurotransmitter serotonin and can also block the serotonin reuptake pump (Stahl, 2021)

References:

Diagnostic and statistical manual of mental disorders: DSM-5-TR (5th ed.). (2022). . American Psychiatric Association Publishing.

Stahl, S. M. (2021). Stahl’s essential psychopharmacology: The Prescriber’s Guide (7th ed.). Cambridge University Press.

Response 2. 400 words sy

What diagnosis do you believe may apply to this individual?

This patient presented with symptoms of headache, fatigue, sleep disturbance, weight loss, loss of interest in activities, and frequent crying spells, all of which are indicative of major depressive disorder (MDD). Signs that a patient might be suffering from MDD include avoiding certain situations that they enjoy, inability to concentrate, and being unable to go to work due to fatigue. MDD can disrupt the patient's daily life by affecting their home, work, and social life (Salvo et al., 2022). According to the DSM-5, to be diagnosed with MDD, patients must experience 5 or more symptoms in the last week.

What classifications of medications can be used to treat this disorder? Which medication do you recommend and why?

Treatment for this patient will include antidepressants. Antidepressants are classified into different types based on their work and chemical structures. There are four main groups: monoamine oxidase inhibitors (MAOIs), tricyclic antidepressants (TCAs), selective serotonin reuptake inhibitors (SSRIs), and serotonin-norepinephrine reuptake inhibitors (SNRIs).

SSRIs are a broad category of antidepressant medications. Since this patient has no significant past medical or psychiatric history and takes no regular medications, my recommendation would be fluoxetine 10 mg for 4 weeks, then increasing the dose to 20 mg daily if the drug is well tolerated by the patient (Arcangelo et al., 2021). SSRIs tend to be well-tolerated and are relatively cost-effective. Patients who take SSRIs exhibit fewer side effects in comparison to those who take Tricyclic Antidepressants (TCAs) and Monoamine Oxidase Inhibitors (MAOIs). Therefore, SSRIs are often considered the first line and primary choice for the treatment of mood and anxiety disorders. The class of SSRIs includes Fluoxetine (Prozac), Fluvoxamine (Luvox), Paroxetine (Paxil), Sertraline (Zoloft), Citalopram (Celexa), and Escitalopram (Lexapro). Side effects include weight gain, insomnia, sexual dysfunction, gastrointestinal issues, and agitation (Arcangelo & Peterson, 2021).

References

Arcangelo, V. & Peterson, A. (2021). Pharmacotherapeutics for advanced practice: A practical approach. (5th ed.). Wolters Kluwer

Imiuwa, M. E., Baynes, A., & Routledge, E. J. (2023). Understanding target-specific effects of antidepressant drug pollution on molluscs: A systematic review protocol. PLoS One, 18(6) https://doi.org/10.1371/journal.pone.0287582Links to an external site.

Salvo, G. D., Bianco, M., Teobaldi, E., Maina, G., & Rosso, G. (2022). A Psychoanalytic-Derived Brief Psychotherapeutic Approach in the Treatment of Major Depression: Monotherapy Studies. Medicina, 58(10), 1335. https://doi.org/10.3390/medicina58101335

Week 3 – Assignment: Individualize the Role of Stakeholders' Contribution to Healthcare Quality Performance Measures

As a leader in the healthcare field, the assurance of delivering quality health care will remain an important aspect of your work. To understand the organization's performance and its impact on clinical quality and financial stability, in this week's assignment, you will examine and interpret performance measures using the Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) survey results as they relate to patient satisfaction and promote stakeholder confidence in the organization.

There are multiple factors that contribute to healthcare quality and financial stability including the actions of key healthcare stakeholders. Begin your assignment by taking the following steps: 

1. Download the table below from your Weekly Resources to draft the contribution each stakeholder has in healthcare quality and the financial impact on the organization through your research. In the table, write a synopsis of 150-250 words for each stakeholder as it relates to their role. Remember Deming's words that quality is the responsibility of everyone. Be sure to include in your discussion the Centers for Medicare and Medicaid Services (CMS) Hospital Consumer Assessment of Healthcare Providers and Systems (HCAHPS) patient satisfaction survey when you are completing your table.    

2. Once you have completed your table, you will use either
Kaltura Capture to create a videotaped PowerPoint presentation or create a voice-over PowerPoint presentation (with speaker notes)  using the information contained in your table. Each stakeholder will be on a separate slide and your 150-250 synopsis on each stakeholder from your table will be placed in the Speaker Notes on each slide. If you do not wish to be video-taped, you may use the audio recorder in the PowerPoint program instead of
Kaltura Capture.  
( I GOT THE VIDEO AUDIO PORTION)

Your role in your PowerPoint presentation is that of a hospital health administrator who is briefing your hospital board of trustees on the contribution of each stakeholder in assuring quality measures and financial stability in your hospital.  

	Stakeholders	Contribution to Quality Clinical Measures,  Outcomes, and/or Financial Status
1	Patients
2	Clinical providers (physicians, nurses, therapists, etc.)
3	Health administrators
4	Hospital Board of Trustees
	Hospital Regulatory agencies
6	Insurers (private, public governmental)
7	Medical supply/equipment manufacturers
8	Supply chain vendors
9	Educational partners (faculty, students)
10	Community at Large

Length: A minimum of 10 slides in your Voice-Over PowerPoint presentation, not including the title slide and reference slide. Each slide will depict a single stakeholder and will have 150-250-word synopsis in the Speaker Notes.

Include a minimum of 3 peer-reviewed resources. Other scholarly and credible sources may also be used as supplemental support.

 Please replies to these two work with 200 words each one with  a reflection of their response 

FIRST-Screening, a fundamental component of nursing practice, entails administering measures or tests to differentiate individuals who may have a particular condition from those who probably do not. This pivotal healthcare tool offers a multitude of advantages while also presenting some notable disadvantages, requiring nurses to navigate the complexities of its implementation carefully.

One of the most significant advantages of screening in nursing is its potential for early disease detection. This advantage is crucial for conditions like cancer, where earlier identification can significantly improve treatment outcomes (Crosby et al., 2022). By regularly administering screening tests, nurses can identify health issues in their nascent stages, enabling prompt intervention and increasing the likelihood of successful treatment.

Additionally, screening equips nurses to provide preventative care effectively. Healthcare professionals can use screening to find people more likely to develop a specific condition and then take preventative measures to lower that risk. This can entail suggesting dietary adjustments, physical activity, and providing immunizations to lower the chance of contracting an illness. Preventive measures can lower the incidence of various diseases, which can significantly positively impact public health overall.

The potential long-term cost-effectiveness of screening is another benefit. While the initial costs of screening programs might seem high, compared to managing advanced-stage illnesses, early disease detection and treatment frequently necessitate less intensive interventions and resources (van der Aalst et al., 2021). Therefore, early detection and intervention can lead to significant cost savings for patients and healthcare systems, consistent with providing healthcare at a reasonable cost.

Nonetheless, there are some disadvantages to screening in nursing practice. The possibility of false-positive and false-negative results is one major worry. Erroneous results from screening tests can have serious repercussions because they are not perfect (Wikramaratn et al., 2020). False positive results can cause patients to experience needless worry, more diagnostic testing, and higher medical expenses. On the other hand, false negative results may give rise to a false sense of security, postponing required medical intervention and possibly allowing the illness to worsen unchecked.

Another notable disadvantage of screening is the phenomenon of overdiagnosis. Some screening tests may identify conditions that would never have caused harm or required treatment in an individual’s lifetime. This situation can lead to overtreatment, expose patients to unnecessary risks, and escalate healthcare costs. Overdiagnosis underscores the importance of carefully weighing the benefits and harms of screening.

Ethical considerations also loom large in the world of screening. Deciding who should be screened, at what age, and how frequently can be ethically challenging. It involves a delicate balance between potential benefits and harms. In some instances, individuals may feel coerced into screening, infringing on their autonomy and raising ethical dilemmas regarding informed consent.

In conclusion, screening in nursing practice is a powerful tool with a multifaceted impact. Nurses must meticulously evaluate the advantages and disadvantages when implementing screening programs and communicate effectively with patients to make informed decisions. While early disease detection and prevention benefits are undeniable, nurses must also remain cognizant of potential drawbacks to ensure the highest patient care and ethical practice standards.

 

SECOND-In modern healthcare, health promotion and disease prevention are highly emphasized instead of treatment. The premise is that with prevention, healthcare professionals can detect an individual’s disease risk or identify any healthcare concerns early enough to initiate effective treatment protocols. Screening tests are part of the prevention strategies, and they come with some advantages and disadvantages: 

The most common advantage of screening tests is that they can be used to identify disease at its early stages. Screening tests are usually done on patients who do not feel sick. Such patients may have hidden illnesses developing. However, if the illness is identified, it may be treated early to avoid further complications. For example, cancer may be identified at an early stage before it spreads out to vital organs. Treatment at this stage may have a higher likelihood of better patient outcomes. 

Also, screening tests can be used to detect a disease risk, such as the risk of lung cancer in people who smoke (Krist et al., 2021). If found at risk, the patient may be asked to initiate effective lifestyle changes that protect them from developing the disease. In another example, a blood sample may be used to screen for a patient’s cholesterol levels. If the patient is found with abnormal cholesterol levels, they may be rendered at high risk of heart disease (Mortensen et al., 2023). The healthcare professional may recommend a reduction of cholesterol in the diet to prevent the disease. This suggests that screening tests are quite helpful in detecting disease risks. 

However, screening tests may come with certain disadvantages. For example, specific screening tools may expose patients to harmful health effects. Such tools include X-rays, which may emit high radiation levels and increase the risk of radiation poisoning (Jaglan et al., 2019). 

Another con is that screening tests may not be entirely reliable. This is because there are several cases of false positives or false negatives, which may lead to unnecessary treatments or unmet healthcare needs and additional hefty medical costs. Also, screening tests may expose the healthcare system to poor resource management or allocation, especially if the tests are publicly administered but with less health impact on the participants. The premise of this point is that healthcare systems have limited resources and must make decisions based on opportunity costs. If such decisions are not effective, the health system may be deemed inefficient. Therefore, public health decision-makers need to compare the advantages and disadvantages plus costs before making such decisions.