QUESTION:Community health nurses practice in a variety of settings. Choose one of the following CH settings, and describe what you have learned about the setting and the role(s) of the nurse in that setting (see Nies & McEwen, 2019, Chapters 30-34). Please do not choose correctional nursing for this discussion because your paper is on correctional nursing.• School nursing• Home health nursing• Occupational health nursing• Forensic Nursing• Hospice nursing• Faith community nursingPLEASE ONLY PICK ONE OF THESE, WHICH EVER ONE YOU PREFER TO TALK ABOUT :)-Next study levels of prevention in this week's lesson (primary, secondary, and tertiary). Note that the term primary is used differently than in normal conversation.-Describe one of the levels of prevention, and discuss how a community health nurse (CHN) in the setting you discussed can implement this level of prevention.Nies, M. A., & McEwen, M. (2019). Community/Public health nursing: Promoting the health of populations (7th ed.). St. Louis, MO: Saunders/Elsevier.*******Please include 2 APA references!, minimum of 3 paragraphs needed, thanks!***********LESSON to help with answering question:Healthy People provides science-based, 10-year health objectives for our nation by gathering data from hundreds of databases, evaluating research evidence, and collaborating with public health experts across the country. These objectives guide our national public health efforts. Healthy People 2020 sets objectives that we are working to achieve by the year 2020. This includes over 1,200 objectives in 42 topic areas (U.S. Health and Human Services [U.S. HHS], 2018). These objectives direct and monitor the progress of key national health outcomes. Healthy People 2020 provides a road map for the health promotion and disease prevention activities of community health nursing. Follow this link https://www.healthypeople.gov/2020/topics-objectives (Links to an external site.) to explore the wide variety of topics covered. Click on a topic, and then the green objectives tab to drill down and see the specific measurable objectives that guide our practice.Levels of PreventionCommunity health nurses work in a variety of settings, but their focus is primarily on health promotion and disease prevention. Health promotion activities are those that improve well-being. Disease prevention activities protect people from disease and the subsequent effects of disease (Nies & McEwen, 2019). Below are examples of the three levels of prevention: primary, secondary, and tertiary.The settings where community health nurses practice are quite varied. They include health departments, schools, factories, correctional facilities, faith communities, and home health settings. Your text provides a wonderful glimpse into nursing practice in these settings (Nies & McEwen, 2019). For example, a newer specialty area is forensic nursing. This field combines forensic science and criminal justice with our nursing practice to assist victims of violence. The Sexual Assault Nurse Examiner (SANE) program is one aspect of this specialty.Although the settings may be different, the nurses who work in these settings have many things in common. They each have a scope and standards of practice for their role and area of focus and typically have a professional organization. This organization may be a special interest group within a larger organization, such as the American Nurses' Association, or it may be a separate organization. The nurses may be specialists or generalists.School nursing is considered a specialty, with a large professional organization—the National Association of School Nursing. Back in the early days of school nursing, communicable disease was rampant, but as times have changed, school nursing has kept up with changes in society and with the needs of the students. School nurses now see multiple health problems in children that involve social, emotional, behavioral, and even technological concerns. These issues need much more than a bandage; today's health concerns require a wide range of services performed by professionals working together as a team.In addition, advances in healthcare have significantly affected the health needs of children in the school setting. School nurses are caring for children with complex medical needs. School nurses are also involved in policy-making activities at both the local and state levels. The role of the school health nurse is not to duplicate services already in the community, but to augment services and help enhance healthcare delivery. The school nurse of today has many roles. Influence of Nursing Theory: Pender’s Health Promotion ModelApproaches to health education take various forms. Nola Pender has developed the health promotion model, which emphasizes cognitive-perceptual factors but also seeks to discover why people make the choices they do and what factors contribute to these choices (Sakraida, 2014). Major concepts in Pender’s model include prior behavior, biological factors, psychological factors, sociocultural factors, perceived benefits of acting, barriers to acting, self-efficiency, interpersonal influences, situational influences, and a commitment to a plan of action. Pender describes how competing demands and preferences may motivate the individual to engage in less healthy behaviors. Factors over which the person has low control may take precedence, whereas those over which the person has high control can be better managed.Health resources for use in community health teaching plans are almost limitless. Professional organizations, health systems, government websites, and health-related databases contain endless resources for use with population-focused education. Nurses also need to consider the literacy level of their audience to find the best materials to match reading and comprehension skills. The CDC (2017) describes its health literacy initiatives at https://www.cdc.gov/healthliteracy/ (Links to an external site.).Using a systematic approach to health communication and education doesn't mean all theory and science and no creativity. In fact, creativity is needed more than ever when it comes to tailoring a framework to each aggregate. Barriers and challenges to effective community health education are many; therefore perseverance, confidence, support, and motivation are needed by both populations and providers in order to enhance wellness. So, use your imagination when developing goals, strategies, and education materials.Evidence-Based Community Health InterventionsHealth education is an important intervention for those working with populations but often more is needed to effect behavior change. The health planning model that we discussed in the Week 2 Lesson illustrates how to apply the nursing process to a community setting. There is a wide range of possible interventions that community health nurses can implement, as you learned when studying the Public Health Intervention Wheel. Interventions can also involve changes in the built environment to encourage healthy lifestyle choices, such as walking paths, bike paths, safe parks, and community gardens. When choosing interventions, given limited resources in our communities, it is crucial that interventions are based on reliable evidence and proven to achieve the desired outcomes.Community health nurses don't have to reinvent the wheel when they see that an intervention is needed. There are many databases of evidence-based interventions focused on improving community health. The Community Guide is one example and is a wonderful resource for locating evidence-based interventions. The Community Guide houses the collection of evidence-based findings from the Community Preventive Services Taskforce commissioned by the U.S. HHS at https://www.thecommunityguide.org/ (Links to an external site.) and choose a topic and explore the evidence-based programs that are available. The site includes amazing resources for all those working to improve the health of our communities.SummaryThis week, we began learning about our nation's roadmap for health promotion and disease prevention, Healthy People 2020. The public health levels of prevention were reviewed, which outline prevention and health promotion strategies. We then focused on exploring a variety of roles and settings of community health nursing, with school nursing used as an example of a community setting. We wrapped up discussing the challenges in health education that are faced in the community as we learned about the important role of community health nurses in improving the health of our communities.ReferencesCenters for Disease Control and Prevention [CDC]. (2017). Health literacy. Retrieved from https://www.cdc.gov/healthliteracy/Guide to Preventive Services. (n.d.). The Community Guide. Retrieved from https://www.thecommunityguide.org/Nies, M. A., & McEwen, M. (2019). Community/Public health nursing: Promoting the health of populations (7th ed.). St. Louis, MO: Saunders/Elsevier.Sakraida, T. J. (2014). Nola J. Pender: Health Promotion Model. In M. R. Alligood (Ed.), Nursing theorists and their work (8th ed.) (pp. 386–416). Maryland Heights, MO: Mosby Elsevier.U.S. Department of Health and Human Services: Office of Disease Prevention and Health Promotion. (2018). Healthy People 2020. Retrieved from https://www.healthypeople.gov/Here is also a helpful article to read and assist with answering the discussion question:Kub, J. E., Kulbok, P. A., Miner, S., & Merrill, J. A. (2017). Increasing the capacity of public health nursing to strengthen the public health infrastructure and to promote and protect the health of communities and populations. Nursing Outlook, 6, 5661–664. doi:10.1016/j.outlook.2017.08.009. Retrieved from https://www-sciencedirect-com.chamberlainuniversity.idm.oclc.org/science/article/pii/S0029655417304086

- Respond to at least two of your colleagues by offering additional insights or alternative perspectives on their analysis of the video, other rating scales that may be used with children, or other treatment options for children not yet mentioned. Be specific and provide a rationale with evidence.-2 paragraphs-5-6 sentences each paragraph- 4 paragraphs in total -3 references each -STUDENT #1-Comprehensive Integrated Psychiatric Assessment Assessing children and adolescents for mental health problems is a challenging process that requires mental health practitioners to be astute and conscientious in obtaining information from several sources, including teachers, parents, the child/adolescent themselves, and other caregivers (Srinath et al., 2019). According to Hilt et al. (2016), most seasoned and skilled practitioners plan their initial assessment by prescreening a mental health concern by using a validated tool, identifying leading concerns, identifying and addressing safety issues, diagnosing a probable disorder- specified or unspecified, and recommending the next step (p. 60). This paper is an analysis of the YMH Boston, Vignette 5 Video.What did the practitioner do well? In what areas can the practitioner improve? The practitioner did really well in building a rapport with the patient. According to Price (2017), “Rapport refers to the ability to open and sustain a relationship”. Building a rapport requires providers to maintain eye contact, communicate openly and with compassion, and practice mirroring (Price, 2017). By building a rapport, patients can feel at ease during stressful circumstances and share their challenges with their providers regardless of their values and beliefs. In the YMH Boston Vignette Video, the nurse can be described as having a natural aptitude for establishing therapeutic relationships with her patients. The practitioner can make improvements in her introductions. Notably, the practitioner did not introduce herself or let the patient introduce himself. During this time, the practitioner should explain the purpose of the interview and why the patient should have the confidence to rely on the practitioner. At this point in the clinical interview, do you have any compelling concerns? If so, what are they? At this point of the clinical interview, the most compelling concern is whether the patient has suicidal thoughts or ideations. The client revealed that he does not want to be alive. Addressing safety issues and eliminating or reducing the risk is the most significant concern for the patient. What would be your next question, and why?The provider should gather pertinent information to narrow down the diagnosis. The next question would be; Do you have suicidal thoughts or ideations. If yes, do you have specific plans? Although it is too early to make a diagnosis at this point, It would be appropriate to find out if the patient is at risk of self-harm or harming others, as is the case for about 15% of individuals with MDD (Li et al., 2017).Other questions will include.Do you ever think of hurting yourself?Have you ever hurt someone on purpose?Explain why a thorough psychiatric assessment of a child/adolescent is important. A thorough psychiatric assessment of a child/adolescent is crucial to fruitfully diagnose common clinical conditions and determining the need for additional diagnostic testing or additional medical care. According to Sadock et al. (2015), the psychiatric interview is the most crucial element in the evaluation of all persons with mental health problems, including children and adolescents. A comprehensive assessment of children and adolescents provides a multidimensional understanding of a disorder’s biopsychosocial elements and allows providers to gather the necessary information to seek interprofessional collaboration and develop a patient-centred treatment plan (Sadock et al., 2015).Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent. One appropriate symptom rating skill would be the child behavior checklist (CBCL)- used in children and adolescents ages 6 to 18 to determine their social competence and whether they are having behavioral problems. Another tool I would use is the Children’s Depression Inventory (CDI). The rating scale is a modification of the Beck Depression Inventory used in adults. CDI can be used for children and adolescents ages 7 to 17 and takes about 15 minutes to administer (de la Vega et al., 2016).Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults. Two treatment options that can be used for children and adolescents and not adults are art and play therapy. During art and play therapy sessions, children/adolescents work together in a playroom. The toys and tools in the room help the child/adolescent to explore their feelings, issues and relationships in a fun and relaxed setting. Explain the role parents/guardians play in assessment. Parents will be amongst the first to note abnormal behavior in their children. For this reason, parents and guardians play an essential role in the gathering of history as they are well aware of their children’s developmental milestones and problems they are having. According to Sadock et al. (2015), the help parents and guardians give to providers through provision of pertinent healthcare information and cooperating with procedures helps alleviate the workload of providers and suggests a shared responsibility in the delivery of patient-centred care. Referencesde la Vega, R., Racine, M., Sánchez-Rodríguez, E., Solé, E., Castarlenas, E., Jensen, M. P., Engel, J., & Miró, J. (2016). Psychometric properties of the short form of the Children's Depression Inventory (CDI-S) in young people with physical disabilities. Journal of Psychosomatic Research, 90, 57–61. https://doi.org/10.1016/j.jpsychores.2016.09.007Hilt, R. J., & Nussbaum, A. M. (2016). DSM-5 pocket guide for child and adolescent mental health (First edition.). American Psychiatric Association Publishing.Li, H., Luo, X., Ke, X., Dai, Q., Zheng, W., Zhang, C., Cassidy, R. M., Soares, J. C., Zhang, X., & Ning, Y. (2017). Major depressive disorder and suicide risk among adult outpatients at several general hospitals in a Chinese Han population. PloS One, 12(10), e0186143. https://doi.org/10.1371/journal.pone.0186143Price, B. (2017). Developing patient rapport, trust and therapeutic relationships. Nursing Standard, 31(50), 52–63. doi:10.7748/ns.2017.e10909 Sadock, B. J., Sadock, V. A., & Ruiz, P. (2015). Kaplan & Sadock’s synopsis of psychiatry (11th ed.). Wolters Kluwer.Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents. Indian Journal of Psychiatry, 61(2), 158–175. http://doi.org/10.4103/psychiatry.IndianJPsychiatry_580_18Srinath, S., Jacob, P., Sharma, E., & Gautam, A. (2019). Clinical practice guidelines for assessment of children and adolescents. Indian Journal of Psychiatry, 61(Suppl 2), 158–175. https://doi.org/10.4103/psychiatry.IndianJPsychiat...-STUDENT #2 -Main Question Post: The purpose of a psychiatric interview is to establish a therapeutic relationship with the patient to collect, organize and formulate a differential diagnosis and treatment plan (Gibbs, n.d.). After viewing the video assigned for this week’s discussion, ‘vignette 5- assessing for depression in a mental health appointment’, the following questions will be answered;1)What did the practitioner do well? In what areas can the practitioner improve?The practitioner (social worker) who interviewed the teenager did well by asking the patient what led to his current mood, anxiety, and lack of interest in activities he enjoyed prior (two months ago). Areas the practitioner can improve on are; during her initial interview, she should have communicated more with the patient to establish rapport. Aside from focusing on the history of present illness, some of the focus of the social worker’s questions could have been centered on the patient’s mental status, history of previous illnesses, family history, personal history, childhood, education, occupation, asking his permission to involve either his parents, guardian, or caregiver, any diagnoses, treatment and progress, prognosis, and the plans for further management (Kuruvilla & Kuruvilla, 2010). Other questions the provider can ask the patient is his social relations, sexual behavior, emotional health, and if he had any positive self-image (Badura-Madej & Modrzejewska, 2009).2)At this point in the clinical interview, do you have any compelling concerns? If so, what are they?Depression is a major risk factor for suicidality in children and adolescence (Jokiranta‑Olkoniemi, Kaljonen, Kronström, Sourander, & Tiiri, 2019). Therefore, I will like to find out if this is an acute or chronic situation? Assess if psychiatric inpatient hospitalization is needed immediately. I will then continue to find out his suicidal tendencies; if he is suicidal (have thoughts, plans, or intents) and if he has attempted suicide in the past as well as what he used. I want to determine if he will be safe going back home without harming himself. Another question to ask is details about his drug and alcohol use. This will help determine if his present feelings are a result of substance abuse. The social worker asked about his substance use but the questions weren’t enough.3) What would be your next question, and why? I will ask if he is currently taking any medications (whether prescribed or not) and how effective are these medications to him? My rationale for asking the patient these questions are to assess if he needs immediate medication adjustment especially on his psycho-active medications.The following questions are answered based on the patient in the YMH Boston video:1.Explain why a thorough psychiatric assessment of a child/adolescent is important.Per studies, clinical assessments with children and adolescents are elaborate and require the clinician to be astute and conscientious in obtaining information from multiple sources and settings, i.e., the child, parents, teachers, and other caregivers. There are bound to be discrepancies in the report; nevertheless, multi-source information is a requirement during diagnosis and management. Assessment and treatment are generally multidisciplinary (Eesha, Gautam, Preeti, & Shoba, 2019).2.Describe two different symptom rating scales that would be appropriate to use during the psychiatric assessment of a child/adolescent.-Two different assessment scales that can be used for the patient are; The Kessler Psychological Distress (K6) scale which is use to assess psychological distress in the past 30 days. The K6 consists of six questions that ask respondents how frequently they had felt (a) nervous, (b) hopeless, (c) restless, (d) depressed (e) everything was an effort and (f) worthless the past 30 days. Response options included: “none of the time”, “a little of the time”, “some of the time”, “most of the time” and “all of the time”. Responses were scored in the range of 0–4, generating a scale with a range of 0–24. The K6 has been shown to have excellent reliability and good validity in previous studies of adolescents. Another effective scale for teenagers / children is the eight-item version of the Patient Health Questionnaire adolescent version (PHQ-A) assessed depression symptoms in the past two weeks. Patients are asked how often they had experienced depressive symptoms such as “feeling down, depressed, irritable, or hopeless?” Response options included: “not at all”, “several days”, “more than half the days” and “nearly every day”. Responses were scored in the range of 0–3, generating a total score with a range of 0–24 (Allsopc, Andrewse, Birrell, Chapman, Hidesd, Mewtona, McBridec, Newton, Shaw, Slade, & Teesson, 2020).3.Describe two psychiatric treatment options for children and adolescents that may not be used when treating adults.-Family counseling; including parents and other members of the family in treatment can help families understand how a child’s individual challenges may affect relationships with parents and siblings and vice versa.-Support for parents: individual or group sessions that include training and the opportunity to talk with other parents can provide new strategies for supporting a child and managing difficult behavior in a positive way. The therapist can also coach parents on how to deal with schools (National Institute of Mental Health, 2018).4.Explain the role parents/guardians play in assessment. The parents, guardians, or caregivers of children and adolescents play an important role in the assessment process because they provide vital information about birth, developmental problems, school issues, and history of the present condition. The parents / guardians are also able to encourage the teenagers to come see a health provider concerning their ongoing problems (Eesha, Gautam, Preeti, & Shoba, 2019). The following PDFs are peer reviewed, evidence-based sources, or scholarly materials because they were studies conducted and they are primary sources. The other study (third PDF icon) was also a comparison of finished cross-sectional surveys from 2000 to 2011;ReferencesAllsopc, S., Andrewse, G., Birrell, L., Chapman, C., Hidesd, L., Mewtona, L., McBridec, N.,Newton, N., Shaw, B., Slade, T., & Teesson, M., (2020). The comorbidity betweenalcohol use and internalizing psychopathology in early adolescence.Retrieved March 1, 2021, fromhttps://pdf.sciencedirectassets.com/282676/1-s2.0-S2212657019X00057/1-s2.0-S221265Badura-Madej, W. & Modrzejewska, R. (2009). Change in self-image in the population ofAdolescents in 15 years – a comparative study. Retrieved March 1, 2021, fromhttps://eds-b-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=20&siEesha S., Gautam, A., Preeti, J., & Shoba S., (2019). Clinical Practice Guidelines forAssessment of Children and Adolescents. Retrieved March 3, 2021, fromhttps://www.ncbi.nlm.nih.gov/pmc/articles/PMC6345125/Gibbs, P. (n.d.). Psychiatric Interview. Retrieved March 3, 2021, from https://physicians.utah.edu/echo/pdfs/psychiatric-interview-module-1.pdfJokiranta‑Olkoniemi, E., Kaljonen, A., Kronström, K., Sourander, A., & Tiiri, E. (2019). Suicidality among child and adolescent psychiatric inpatients:Time trend study comparing 2000 and 2011. Retrieved March 1, 2021, fromhttps://eds-a-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=4&sidKuruvilla, A. & Kuruvilla, K. (2010). Diagnostic formulation. Retrieved March 1, 2021, fromhttps://eds-b-ebscohost-com.ezp.waldenulibrary.org/eds/pdfviewer/pdfviewer?vid=2&siNational Institute of Mental Health (2018). Children and Mental Health- Is This Just a Stage? Retrieved March 3, 2021, fromhttps://www.nimh.nih.gov/health/publications/children-and-mental-health/index.shtmlYMH Boston (2013). Vignette 5 - Assessing for Depression in a Mental Health Appointment. Retrieved March 1, 2021, from https://www.youtube.com/watch?v=Gm3FLGxb2ZU