This chapter reviews prevention, including genetic counseling. It discusses genetic testing for diagnosis as opposed to screening and the treatment for genetic disease. Methods of prevention begin with education of the public and health care professionals and identification of those at risk. Genetic counseling is the process of helping people understand and adapt to the medical, psychological, and familial implications of genetic contributions to disease. The malignant cells often exhibit aneuploidy as well as translocations that are found only within the tumor cells. Genetic errors that arise from specific cell lines are somatic mutations. It is suggested that there is a thorough collection of family, genetic, and medical history for children entering the adoption process. Nurses may play a variety of roles in genetic counseling that reflect their preparation, area of practice, primary functions, and setting. The chapter explains the incidence of chromosome abnormalities.
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Nurses working in the field of obstetrics must have a greater depth and breadth of genetic knowledge over any other subspecialty. In gestation, nurses should include education on the effects of teratogens, prenatal screening options, and prenatal diagnoses. After delivery, early recognition of genetic disorders is important for immediate initiation of potentially life-saving therapies. Preconception education is a critical component of health care for women of reproductive age. The Centers for Disease Control and Prevention (CDC) recommend that all women of childbearing age consume 0.4 mg of folic acid daily to prevent neural tube defects (NTDs). Counseling can still be useful in terms of optimum pregnancy management in a setting best able to cope with any anticipated problems. Complex and multifaceted maternal and fetal factors influence the consequences of drugs, radiation, and chemical and infectious agents to the developing fetus.
This chapter examines pre- and postconference expectations and activities, explores forms to be used by the professor and the students, suggests care plans and patient assignments, and describes sample concept maps and a math skills assessment. A student with no experience in health care may be shy or sheepish when it comes to hands-on care. It may be of benefit for the students to be paired in the first few weeks of clinical classes. The care plan forms can help guide the student through the nursing process. Medication forms will help the student learn about various medications. Nursing education has adopted the use of concepts maps to assist students in gathering patient information. Patient safety is the number one priority for all health care professionals. Dose calculations are a daily activity for nurses.
Multiple physical changes can impair the mental health of the aging individual. These changes include: acid-based imbalances, dehydration, electrolyte changes, hypothermia or hyperthermia, and hypothyroidism. This chapter reviews the most common mental health disorders affecting the elderly population and trends affecting care delivery. Moreover, chronic, unresolved pain has been associated with an increased risk of a mental health disorder such as depression, suicide, or anxiety. The aging individual may exhibit signs and symptoms of insomnia such as sleeping for short periods during the night, sleeping during times of normal social activities, arising early in the morning while others sleep, and experiencing daytime sleepiness. The chapter concludes by applying the nursing process from an interpersonal perspective to the care of an elderly patient with a mental health disorder.
This chapter focuses on the following topics: demography, gender, age at diagnosis/onset of cardiovascular disease (CVD), Medicare usage, work and retirement, social support, social context and neighborhoods, ethnography of families, qualitative research, and social policy. These topics constitute some of the key areas that should be the focus of future research on the sociology of minority aging. The chapter provides a rich description of trends in the ethnic and racial composition of older cohorts to illustrate the dramatic changes that have taken place in the United States in the past century. The rising costs of health care and the increasing older minority population, additional reform will be needed to maintain the sus-tainability of the program. Additional work examining within-race group differences is key to understanding minority aging issues given the large amount of cultural diversity in the United States.
Neurorehabilitation has become more of a global phenomenon and is not necessarily limited to industrialized or Westernized societies. Culture often connotes concepts of race and ethnicity when discussed in the context of health care disparities. Socioeconomic and other demographic variables make up the majority of the balance on discussion regarding culture in health care. Multicultural neurorehabilitation must emphasis “multiple”, and do so in a dynamic manner. In other words, at any given time, multiple cultures operate in each interaction and in each therapy delivered in the neurorehabilitation setting. Recently, there has been increased interest and research into the newly developing field of cultural neuroscience. Several models are available to conceptualize the influence of culture in human functioning. The most persuasive model is one that mirrors a dynamic, ecological system.
This chapter focuses on aging and health issues in all of America’s major minority populations including African Americans, Hispanics/Latinos, Asian Americans, as well as Native Americans. It addresses the issues of health inequality and health advantage/disadvantage. The chapter introduces relatively new areas of inquiry including long-term care, genetics, nutrition, health interventions, and health policy issues. In addition to possible genetic factors, the literature has emphasized the influence of poverty and socioeconomic status as well as stressors associated with minority group status. The system of long-term care services will need to be restructured to take into account issues affecting minority populations such as health care coverage, housing and income supports, as well as cultural issues as filial piety and trust. The field of minorities, aging, and health has been dominated by a health inequality perspective that has been illustrated by the application of cumulative disadvantage/cumulative inequality theory.
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Does Health Care Quality Contribute to Disparities? An Examination of Aging and Minority Status Issues in America
This chapter focuses on the changing health care policy climate. These changes can either reduce current barriers or create new challenges to health care. The Patient Protection and Affordable Care Act (ACA) has reformed the Medicare payment system and incorporated the voice of older minority adults in shaping the performance of their local health care delivery system. Health care access inequity and policy-based remedies have historic roots in U.S. civil rights legislation. The civil rights of older adults and their access to health care were resolved through Medicare. ACA policy creates an opportunity to reframe health disparities research as a consumer issue. However, the terms health disparities, older minorities, and barriers to care are not usually viewed as consumer issues. Standardization of health care practice creates research opportunities for social gerontologists to evaluate policy and its impact on health care access disparities.
This book provides a multidisciplinary compendium of research pertaining to aging among diverse racial and ethnic populations in the United States. It focuses on paramount public health, social, behavioral, and biological concerns as they relate to the needs of older minorities. The book is divided into four parts covering psychology, public health/biology, social work, and sociology of minority gang. The book focuses on the needs of four major race and ethnic groups: Asian/Pacific Islander, Hispanic/Latino, black/African American, and Native American. It also includes both inter- and intra-race and ethnic group research for insights regarding minority aging. The chapters focus on an array of subject areas that are recognized as being critical to understanding the well-being of minority elders. These include psychology (cognition, stress, mental health, personality, sexuality, religion, neuroscience, discrimination); medicine/nursing/public health (mortality and morbidity, disability, health disparities, long-term care, genetics, nutritional status, health interventions, physical functioning); social work (aging, caregiving, housing, social services, end-of-life care); and sociology (Medicare, socioeconomic status (SES), work and retirement, social networks, context/neighborhood, ethnography, gender, demographics).
This chapter provides a review of public policy and public programs related to important aspects of the welfare state in the United States, with particular attention to the impact of various policies and programs related to income support, health care, and housing on low-income and minority Americans. It focuses on the guiding principles that motivate the various parties in today’s welfare state debates and investigate how the basic structure of the way social welfare is guaranteed in the United States affects low-income and minority individuals. The chapter also focuses on the general features of our economic, political, and social systems that place minority Americans at serious risk of poverty and ill health throughout life, including its waning years. The welfare state represents a relatively late development in human social, economic, and political history. Social Security is particularly important for minority Americans.