Molecular Regulation of Actin Dynamics in Breast Cancer - Essay Example

Molecular Regulation of Actin Dynamics in Breast Cancer Introduction Reproductive health has been declared not only to be a personal issue, but a general societal concern. It should be noted that reproductive health should not be seen as fundamental responsibility of the health sector only (Abuidhail, 2009). It is relevant to extend partnership with other public, private sectors and also the civil society. When all this sectors join hands in promoting reproductive health, then our societies will bear healthy responsible generations. In addition to this, reproductive health should also engage professionals precisely when it comes to consultation. This is the most difficult step as far as sexual health care is concerned (Abuidhail, 2009). Openness and trust is a major attribute toward a successful consultation between the professional and the client. Discussion Several studies have shown that poor communication with the health professionals have contributed adversely toward low consultation or sexual health from professionals (Mwaikambo, Speizer, Schurmann, Morgan & Fikree, 2011). It has also been noted that communication barrier has also kept young people away from seeking the service due to mistrust and fear of exposure. On the other hand, the clinicians have also directed the blame to themselves for low consultation on issue related to sexual health. It is shown that clinician discomfort with lack of training to address sexual health among other related issues has resulted in the above failure (Mwaikambo et al, 2011). Sexual health is a very sensitive topic which needs to be discussed in a free environment. The key role played by the health providers as far as sexual health is concerned is to adhere to professional core values. In search for better communication opportunity, the clinician should adhere to beneficence principle (Mwaikambo et al, 2011). This principle ensures that each consultant clinician at all time act in the best interest of the patient and his welfare (Mwaikambo et al, 2011). The clinician is obligated to fulfill the mission and do no harm to whoever the client is. This assures every client that there are obligations protecting them. Moreover, there is assurance that the service will ensure no taking advantage to harm or misuse them. This mainly encourage young people especially girls. This is precisely because young girls may think that the clinician if male; may take advantage of their sexual activeness to humiliate or exploit them (Mwaikambo et al, 2011). The clinicians are also required by law of practice to abide on promoting respect for autonomy (Mwaikambo et al, 2011). This is at the heart of the obligation and aim at obtaining informed consent to respect the client and promote non-discrimination attitude (Mwaikambo, 2011). The clinician should at all time use polite words to convince their client or people accompanying the client. This should target on the consultation goals and rights of everybody. It is known that in most cases parents do insist to sit in their daughter’s consultation session without consent. It is upon the clinician never to be harsh on anybody. The professional should employ calmness and convince the parents of the recommended policy concerning sexual health care (Mwaikambo et al, 2011). Communication also promotes friendly sexual health consultation most specifically between youth and health professionals (Landry, Wei & Frost, 2008). Confidentiality is another key character that must be portrayed through communication for trust to exist between the health professionals and the clients. Confidentiality means keeping the clients private issue that arose during the consultation session in strict confidence (Landry et al, 2008). This means that such sensitive information must forever remain between the client and the health provider. This should not only affect the clinician in-charge of the consultation, but is a policy that must be adhered to by all staffs including nurses and receptionists (Landry et al, 2008). Proper communication will result in perfect assessment of the client and thereafter best solution. However, in some cases, privacy is compromised due to accompaniment by the client. To be specific, most parents insist to be present in their children consultation. This may or may not affect the communication between the client and the health provider. It is due to this barrier to communication that minor’s right to confidential services was developed (Payne & Edwards, 2009). The clinician should elaborately inform the client and his/her accompaniment about the rights of the client to confidentiality. The law has even guaranteed minor‘s of their rights to request for a private session with health providers (Payne & Edwards, 2009). This is because; when it comes to issue related with sex, many adolescents have difficulties in sharing the same challenges in front of people they know (Payne & Edwards, 2009). In fact many will never speak about the problem in front of their parents. This is why despite their minority in age; they have a right to request for private session (Payne & Edwards, 2009). In addition to that, the clinician should also explain to the client of the entailment. For example, an adolescent client who is a minor is entitled to consent to contraceptives services (Caffo, Forresi & Lepri, 2010). This is not all; the minors are also entitled to confidentiality for contraceptive services that is recommended to them by the clinician (Caffo et al, 2010). The clinician has to engage the minor client and establish the need to apply the law. Furthermore, the law allows the clinician to engage the parent in cases where the minor is seeking sexual health despite the decision remaining purely for the clinician (Caffo et al, 2010). In one study, a parent suspected the daughter of active engagement in sexual activities. Fearing early pregnancy, she hurriedly took the daughter to sexual health care clinic. The mother wanted both emergency contraceptives and combined oral contraceptive to be recommended for the daughter. The mother was also insisting to participate in the consultation session. However; when the clinician closely examined the girls face, the body language was communicating with a strong “NO.” It was the duty of the clinician to describe the policy regarding minor confidentiality entitlement and the mother had no option but to respect. Later after a clear open conversation, the truth came out and the girl was assisted. In this scenario, if the clinician would not have had the skills to read and interpret client’s body language and mood, then the solution would have never been reached. The girl would have suffered before the mother and maybe misdiagnosis occurred. This is also another error that can contribute to misjudgment and implementation of unsatisfied decision to the client (Dunning, Heath & Suls, 2004). When the client visits sexual health practitioner alone or accompanied with parents or family or friend, before anything takes place, the clinician has the obligation to secretly declare the rights of the client of having a private consultation (Landry et al, 2008). If it is the wish of the client to have accompaniment during the session, then the decision from the client is upheld. This is the first step toward a successful consultation session. There are factors that will help the clinician in making the right solutions after a consultation session with the client. When there is need revealed, before the clinician makes attempt to offer solution, he should ensure that the client is satisfied with the case analysis. Researchers have demonstrated that for a successful implementation of strategies regarding sexual health, the perception of the client should support the initiative (Landry et al, 2008). It is evident that cultural values and previous experiences have an adverse effect on implementation of sexual health care in regard to solution to the problem. The clinician should also confirm the clients consent and perception toward the proposed options, risks and benefits of solutions offered by the clinician (Garber, Gross & Slonim, 2010). There is also need of confirming from the client approval and satisfaction with the consultation outcomes and options offered by the clinician. This will help in arriving at an agreement thus getting solution to the problems. The clinician must confirm the truth from the client in-agreement to whatever the solution. This is so because; another case in Bangladesh, a woman in the same condition accepted everything from the doctor in order to be given free medicine due to poverty (Garber et al, 2010). In another scenario, a client agreed to everything the clinician proposed just to please them. This happened due to fear that the clinician will expose or the health care maybe withheld in the future when negativity is exhibited from the client (Garber et al, 2010). Cultural and religious fear is also some of the factors that can contribute to failure of complaining or negotiating with the clinician on issue related to the solutions proposed. The clinician should never take advantage of any situation to imposed forced decision on the client (Garber et al, 2010). Clinicians have a duty and responsibility of listening to the views of the client and respect them or advice humbly. The method of choice should also be a key strategy used by the clinician to arrive at the solution to the identified needs. It is prudent for the clinician to explore wider range of options regarding the use of contraceptives methods which are essential to the client needs (Garber et al, 2010). This should be done after assessing the client’s conditions and matching them with the proposed contraceptives options (Garber et al, 2010). The variety of these options will help the client assess and consider the one that best suits her health condition and way of life (Garber et al, 2010). The openness in the above strategy is to also enable the client choose a method that is cost effective and affordable. The clinician will also be able to advice on the availability and medical ineligibility of the methods proposed to the client. It will also be upon the client to choose freely with the help of the clinician the appropriate solution to the health need. Honesty in offering solution for the client need is also very important (Soleim, 2001). The truth is that most clients believe and trust their clinician to an extent of revealing confidential information. Therefore, the clinician should be honest and truthful in everything discussed. In a survey done in Kenya, a woman complained that she asked for injectable contraceptive but the clinician insisted that pills were okay (Soleim, 2001). This definitely bridges the code of conduct and is also a barrier to successful implementation of the solution to the needs. The other risk to unsatisfactory services offered to clients is that they may turn away without receiving solutions and even never seek sexual health care again. To achieve satisfactory solution, the clinician is expected to use trained professionalism skills to properly inform and counsel the client on the options. Most clients differ in terms of reproductive intentions, attitude and ability to make decision (Fung & Paynter, 2006). Such clients need sufficient information that is tailored to the individual needs (Fung & Paynter, 2006). On the other hand, the client who is well informed and perhaps well educated may not required much detailed information. Such clients do make their own choices and decisions. The other type of client are those who may only request information about procedures, treatment and risks attached to each type of contraceptive being offered (Fung & Paynter, 2006). It is upon the clinician to assess the type of client present and counsel them based on the result of the consultation. This should also rhyme with the health need assessed and its technicality should not be overruled by client’s commands. Research has shown that in most scenarios, many clients are always satisfied when the consultation is accompanied with elaborate and detailed information dissemination. Evidence based practice is a process mostly employed by most practitioners; which integrates the overall information from the client needs and values with knowledge of the effective interventions to be applied (Chib, 2011). The ability to critically evaluate evidence based contraception care depends on experience and the level of knowledge of the clinician. This ability comes forth with prior understanding on how to construct well structured questions directed to the client (Chib, 2011). It is from the questions asked by the clinician where the evidence will start emanating from. The questions asked will also guide the practitioner toward arriving at a practical decision. It should be noted that specific questions asked by the clinician during the assessments will aid both the practitioner and the client to define the primary goal of presenting the problems (Chib, 2011). This will also help in selecting the appropriate intervention strategy. The practitioner needs to bring out the objective of the questions by use of simple and direct language (Chib, 2011). The clinician also needs to have variety of known evidences based cases that he can choose and used it to answer questions. This can be done by accessing records from the registry and online resources. The clinical practitioner also has to apply critical and creative thinking when analyzing the evidence gathered from the client in the consultation session (Underhill, Montgomery, & Operario, 2009). This should strictly and carefully be conducted for the purpose of determining its validity. The critical analysis of evidence will also help when determining the impact of proposed strategies on the client prior before its application (Underhill et al, 2009). This actually calls for extra energy employed by the clinician. They need to do thorough reading on research journals to acquire knowledge of various evidence based case and their outcomes. This will equip the clinician with knowledge and skill to even propose confidently intervention strategies. The skills will also help the practitioner in evaluating other option and predict an intervention strategy with its possible outcomes (Underhill et al, 2009). Moreover, the clinical practitioner could also choose to employ critical analysis of research to guide on practical decision (Linsley, Kane & Owen, 2011). This is another critical analysis of evidence based evaluation strategy which requires the practitioner to decide whether the intervention to be used is relevant for the client or not (Linsley et al, 2011). This evaluation also scrutinizes the client’s problems being presented and comparing them with existing research to assess whether the evidence is supported. This is done when considering the values and preferences of the client (Linsley et al, 2011). To critically evaluate evidence based information from a client, there is need to employ a strategy that will evaluate the effectiveness of the intervention with the client subjected within the practice (Linsley et al, 2011). This evaluation strategy requires the clinician to incorporate the client when consulting with the research support to determine the best strategy to follow (Linsley et al, 2011). This means that the intervention the practitioner may propose to the client may affect the clients differently. Therefore, it is adversely recommended to regularly measure the client’s progress toward the achievement of their desired outcomes (Linsley et al, 2011). This should strictly be adhered to by the practitioner even if other researches have confirmed success in employing that very intervention strategy. It has been shown that in health care practice, the practitioners has to develop internal values and belief that is very essential when its come s to developing strategies that will overcome potential barriers (Hannum, 2010). This is something that is intrinsically impacted within the practitioners. This means for the practitioners to develop such strategies without bridging the codes of conduct, he/she must know who he is, who the client is and how the gap between him and others could be bridged (Hannum, 2010). Personal values are very important especially when working in an environment faced with vast cultural challenges. The challenges are mostly associated with working across cultures and need strong support and skill to be able to solve such problems (Paul & Samson, 2010). The most important note most health practitioner need to focus on is to always practice client-centered care strategies (Paul & Samson, 2010). The clinician has to have respect and recognize each client’s culture and the culture of everybody around him. This means that there is no single right approach or strategy for all cultures. This is due to vast cultural background most people come from. The clinician just need to be focusing on the client culture and needs emanating for independent assessments (Paul & Samson, 2010). Self reflection is an important value the clinician has to incorporate in every interaction with clients. This is because each person has his/her own beliefs and values (Parry, 2009). Self reflection will help the practitioner in identifying the client’s values and avoid breaking those values during the consultation. This self reflection is critical when analyzing how their clients respond toward certain circumstances and help prevent a problem from emanating (Parry, 2009). Some practitioners bridge the culture and beliefs of clients without consent. Therefore it is relevant for practitioners to employ self –reflection strategy to overcome such problems. Personal values and belief is an important tool that when best used can help in problem solving. The health practitioner has to bear these values that will rate him/her as a friend, humble and harmless (Parry, 2009). The practitioners also need to have a strong understanding of various cultural approach, values and practices as a measure of preventing conflicting behavior with a client (Parry, 2009). In addition to this, the practitioners need to have open values like honesty, trustworthy and respectful. This will help much in winning the client trust to share true confidential information (Parry, 2009). It is only when the client opens up for an open discussion; when solutions can be arrived at. This will be contributed with the personal values of the practitioner. The other thing than need strong personal values and belief is sensitivity to power and intimacy relationship with clients and other staff (In Edelman, In Mandle & In Kudzma, 2013). These character and values will kill the trust and respect practitioners should have when abused. The practitioner has to be a good listener and never be judgmental in every occasion. When dealing with clients, the practitioner has to employ open-ended questions with an intention of eliciting the client’s perception which will reveal his/her beliefs (In Edelman at el, 2013). This is relevant because the clinician has to learn certain beliefs from the client to avoid conflict or creating a problem. This will also make it easy for the clinician in solving the challenges faced by the client (In Edelman at el, 2013). Acceptance and beliefs is an important personal value that is essential during service delivery in a health care (In Edelman et al, 2013). This is because personal belief and attitudes impact greatly and significantly on the way most practitioners behave (In Edelman at el, 2013). In reality, many health care practitioners may find it very difficult to accept new guidelines if it is in conflict with other guidance issued by professional bodies or even opinion from fellow colleagues (Susanne, 1992). It takes personal initiative based on intrapersonal values to ensure that as a practitioner, the regulation and guidelines are followed to the later (Susanne, 1992). This decision will help prevent possible challenges and problems likely to come out when professional ethics are not followed. The changes will also ensure clients are well served (Susanne, 1992). In summary, when personal challenges like communication barrier exist during a session with the client, then it is the role of the practitioner to think of a better strategy that will solve the problem by not creating another (Susanne, 1992). When it comes to confidential information, language barrier is potential barrier that when lightly handled can result in great problem. It takes positive initiative of the clinician to come up with a communication plan that will benefit everybody (Susanne, 1992). Personal values of the clinician should direct when selecting the best communication plan with awareness of the client. To this effect, the clinician after approval from the client is allowed to engage professional interpreter or a sign language expert in case of deaf client (Susanne, 1992). References Abuidhail, J. (January 01, 2009). Womens Health and Health Informatics. Caffo, E., Forresi, B., & Lepri, G. (January 01, 2010). How to Train Professionals to Effectively Manage Child Abuse Cases. Chib, A. (January 01, 2011). Promoting Sexual Health Education via Gaming. Dunning, D., Heath, C., & Suls, J. M. (December 01, 2004). Flawed Self-Assessment: Implications for Health, Education, and the Workplace. Psychological Science in the Public Interest, 5, 3, 69-106. Edelman, C., Mandle, C. L., & Kudzma, E. C. (2013). Health promotion throughout the life span. Fung, M. Y. L., & Paynter, J. Y. L. (January 01, 2006). The Impact of Information Technology in Healthcare Privacy. Garber, J. S., Gross, M., & Slonim, A. D. (2010). Avoiding common nursing errors. Philadelphia: Wolters Kluwer Health/Lippincott Williams & Wilkins. Hannum, W. (January 01, 2010). Using Portable DVD Players to Deliver Interactive Simulations for Training Health Care Workers in Kenya. Landry, D. J., Wei, J., & Frost, J. J. (January 01, 2008). Public and private providers involvement in improving their patients contraceptive use. Contraception, 78, 1, 42-51. Linsley, P., Kane, R., & Owen, S. (2011). Nursing for public health: Promotion, principles, and practice. Oxford: Oxford University Press. Mwaikambo, L., Speizer, I. S., Schurmann, A., Morgan, G., & Fikree, F. (June 01, 2011). What Works in Family Planning Interventions: A Systematic Review. Studies in Family Planning, 42, 2, 67-82. Parry, E. (January 01, 2009). The Electronic Health Record to Support Womens Health. Paul, B., & Samson, L. (January 01, 2010). The Internet and Adolescent Sexual Identity. Payne, C., & Edwards, D. (January 01, 2009). What services and supports are needed to enable trauma survivors to rebuild their lives? Implications of a systematic case study of cognitive therapy with a township adolescent girl with PTSD following rape. Child Abuse Research in South Africa, 10, 1, 27-40. Soleim, K. (January 01, 2001). Sexual pleasures and the logic of excess in the era of AIDS. Institute of African Studies Research Review, 17, 2, 73-81. Susanne, O. (September 06, 1992). Education for Marriage and the Family in the Polish School. European Education, 24, 2, 79-93. Underhill, K., Montgomery, P., & Operario, D. (June 01, 2009). Cochrane review: Abstinence- plus programs for HIV infection prevention in high-income countries. Evidence-based Child Health: a Cochrane Review Journal, 4, 2, 400-815. Read More