Critical Appraise

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April 19, 2024
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Critical Appraise


Critical appraise involves the application of relevant rules in the field of nursing. This method is transparent, and the data accessed is published. Critical appraise also circulate in the clear evidence to the factors that are available such as personal existence. Therefore, it is necessary to know the significance of the evidence-based practice connected with the critical appraise and the research. The evidence-based practice is essential in the decision making by giving clear reasons for specific research that is being carried on. The evidence practice has three fundamental principles that guide it through. First, is the identification of the patient status to enhance diagnosis. Second, is to illustrate and explain why the certain treatment works on a patient. Lastly, is to respect the client values and the best alternative foregone.

Therefore, critically appraise skill programme will aid to manage the psychological symptoms of dementia. Dementia is not a specific disease that a person suffers, but it involves the affection of the mind and social abilities (Bleuler,1950). Similarly, by it including the account, the infected person must have a memory loss. In most cases, the defect affects older people. Thus, dementia has the following signs and symptoms; cognitive change and psychological changes.

The characters that are noted in the psychological changes are depression, having a lot of anxiety, frequent hallucination and even the evolution of personality in a person. The cognitive change also has some notable symptoms that are seen in a person who has dementia. Firstly, having memory loss in a person are among the signs that are noted. Secondly, there is a loss of speech, a lot of dilemma in a person by not knowing how to make proper judgments. And finally the inability to perform any complex task by own self.



Additionally, the dementia disorder involves brain cells. Therefore, the nerve cells in the brain occur in several areas of the brain. The infection affects the person differently depending on the area of the brain that is affected. There are several types of progressive dementias which some of them are irreversible

Therefore, vascular dementia occurs as a result of the veins in the brain being affected. The blood vessels that transport blood to the brain is damaged. The problem may change the volume output and the stroke volume to the mind. However, the most common type of dementia is Alzheimer’s disease which occurs in older people. According to the research that has been carried out the cause of the disease is not yet known. Although the genetic factors may contribute to these type of disorder to persist in a specific lineage.

Consequently, there are types of dementia that are more as progressing dementia. The Lewy body dementia form abnormal clumps that are seen in the anterior part of the brain. Frontotemporal dementia is characterized by the lysis of the cells in the nerves (Ratnavalli et al,2002). There is damage of the nerve endings in both the posterior and anterior ends of the frontal and the temporal lobes of the brain. The affecting of these part of the brain may affect the loss of memory, change of the personality and the behavioral change in general. The cause of the frontotemporal dementia is not known but can be treated by the doctors once it has noted. Also, mixed dementia is the one that has combined diseases such as vascular dementia, Lewy body dementia, and Alzheimer’s disease.

Similarly, some disorders are associated with dementia — the Huntington’s disease which is primarily influenced with the genotypes in most cases. The disease damages specific nerve cells in the brain and the spinal cord. The second one is the traumatic brain injury which is primarily caused by swelling in the brain. Others are Parkinson’s disease, and the Creutzfeldt-Jakob disease is usually rare in people.


Consequently, some causes of dementia can be treated and be reversed. Conditions like the infections and the immune disorder always cause high fever because the body is trying to fight back the disease — also, the defect of not enough nutrition value in the body system. Poisoning, metabolic reasons, and brain tumors can cause symptoms like dementia that can be reversed and treated.

Moreover, the research was carried out to study a group of sixty older adults. There was the division of the group into three. In the first group, there was the implementation of aroma massage with acupressure and the exercise. The second group, cognitive training and use of activity was used. While the third group, the aroma massage combined with acupressure and cognitive training (Hanchiski et al, 1975). The groups were put in the number of twenty and were placed under observation for a certain period. Therefore, the cognitive study was used to expose the behavior and all symptoms of dementia.

Henceforth, after some time, the result was found on different groups. The first and third group had a similar effect. There were some signs of improvement among the members of the first and the third group of people. The level of distress and symptoms of dementia had reduced significantly while the older adults in the second group showed no significant reduction in the severity and pain amongst them.

Consequently, the analysis was done to show evidence that aroma massage with acupressure was the most effective way of reduction of severity and distress on the patients. The older adults on aroma acupressure showed definite improvement as compared to other techniques used in the decline and agitation of dementia in the body. Although cognitive training referred to as the active way and behavioral way of treatment of dementia on older adults, it had no positive effect. Thus aroma acupressure remained the most effective and easy way to reduce severity and distress on the older people who have dementia.

Moreover, the aroma acupressure was found to use some principles. The principles were applied to help in bringing calmness and the relaxation of the body. In ancient Chinese culture, it was thought to be like acupuncture of the pressure without the use of the needles. The aroma massage and acupressure is known to help in restoring health and balance in the body. Usually, the aroma massage is done by use of the fingers, elbows and the palms in restoring fitness in the body. The person applying the method has to do it gently on the points of the patients’ body.

Besides, nursing and managing patients with dementia are necessary; hence we have to find the best methodology to apply in managing the disease. The method to be used has to sufficient, safe and also standard for many people. But there may lack the complete treatment of some of the affection. However, they can be managed effectively to bring not only financial effectiveness but also immediate clinical effectiveness. Hence these can help to bring calmness to life and also reduce stress and severity.

Comparatively, it is essential to know the better ways of managing the cognitive and psychological signs of dementia. Subsequently, nursing management of dementia has to do with the behavioral functions (Cumming & Benson, 1992). Maintaining the functions helps to calm the situation of the patient. The nurse has to be calm and gentle to reduce the chaotic environment surrounding the patient. Also, it is necessary to have things that could help the patient to remember the activities of the day and the past. By having memory storage devices, it will assist in retaining the memory of each day activities. Also, the environmental cues of the patient have to protect. Time for the administration of the drugs needs to be appropriate. A balanced diet and warm food need to be given to the patient to provide maximum protection to the patient.


Furthermore, it helps in maintaining the psychological functioning of the patient. Ensure you practice patient to the frequent loss of memory of the patient. Also, the patient with dementia has to be subjected to regular easy questions and be engaged to daily activities need to be those that are repetitive each day to enhance the retaining of daily activities in mind. The businesses need to be done in a well-scheduled plan for each day continuously. You should also be near the patient to guide him/her to offer some moral support. Help to bring good memories and avoid the past weird and bad memories which might make the patient to be annoyed.

Moreover, verbally and gentle exchange of the ideas with the patient will turn to healthy. Try to use simple conversation to the patient to enhance faster interpretation of the patient. Other ways to manage the dementia symptoms psychologically are by improvising the simplest way to express the message with ease. Besides that, the provision of freedom and independence on each day events are paramount. Ensuring the hygiene of the patient is up to the standard will help to improve the condition the body system of the patient. Also, remind the patient on the necessary directions, such as the direction of the bedroom, toilet and even into the house. Therefore, in the quantitative design, the aroma massage with acupressure tended to be the most effective way of managing the psychological and behavioral defects of dementia.

Caregiving role perception

Caregiving entails the qualitative design in helping solving dementia. Therefore, there are many problems that one faces on the caregiving. Persons who have dementia have a big issue of memory loss hence become a hard task to remember daily activities. Also, the loss of speech and internalize responsibilities well.

Additionally, it is worth to note that dementia can bring emotions to a person hence alter with the general behavior and personality of a person. However, caregiving roles always change from time to time. Therefore, they vary from one family to another because of the adaptability of the norms in a family. Caregiving roles thus show that when there are similar life experiences under one area, the characters also become similar and the perception of caregiving being positive.

Chinese culture has therefore influenced on the caregiving roles perception in many ways. First, the culture and the ethnic issues are seen to bring different impact to the caregiving roles. The position is greatly influenced by giving different and context.Secondly, there is a tremendous relationship between the current caregiver and the ways of the past and the Chinese culture. Henceforth, the expectation of the family caregivers is having the base on the tradition of the Chinese people. Therefore, these traditions tend to govern the way of decision making, belief, and even behavior.

Nevertheless, on implementing a study that on twenty-five family caregivers, it was worth noting that most of the percentage was on the spouse caregivers. Therefore, on the ethnicity and culture of the Chinese, the caregiving roles were subjected to most mature adult. The was a manifest subjection of the ethnicity and religion on the dynamic characters (Skaff & Pearlin, 1992). The purpose of the caretaking perception has the basis of life. Thus all human beings are urged to practice the role to their level best to match the mental and physical capacity. Similarly, the part of caregiving helps the patient suffering from dementia or the older person to have improved status of spiritual, physical, emotional and even emotional. Because of the trends in the current society, the population of older people has increased compared to past years.

Therefore, these trends have brought some challenges to the roles of the caregiving to older people. However, the Republic of China enforced a law on the rights of older people in society. The bill has been put to safeguard the older people in China by putting the roles of caregiving to the younger members of the family. Besides, the adhering of law is compulsory and failure to adhere to it a penalty will be acted upon you. Due to the population of the young generation being less, he has been pressure on the role of caregiving in China and many of the western countries. Thus there is a need to build an arena to safeguard the interest of the older people in the society well. The borrowing of cultural behavior will help in finding a better platform of caregiving roles to the older people and the ill. However, the project was set to contribute to funding to provide for older people in China. The collaboration of the united states with china bore fruits. The provision of nursing foundation for the older people in the society will provide informal caregivers. However, the change of the model has to fit the culture and the traditions of China people.

Coping strategies.

Coping involves putting efforts to find solutions of both the personal and interpersonal problems. The significance of dealing can wipe away stress and conflicts in society. Therefore, the mechanisms that are put to cope with all these situations is called coping strategies. The caregivers help in a great deal in guiding older people and the ill in Chinese families. Thus the family caregivers face some severe challenges. The caregiving role may bring burden and coping pressure in the provision of the family members who are older or suffering from any disease. In Chinese societies, the part of caregiving is bound culturally on the family members. Therefore, the family members who are married have to stay near or with the aged parents to provide caregiving roles. The impact of strain also proved that the mental health among the caregivers had become a heavy burden of care to bear.

Additionally, various strategies are being used to cope with different kinds of illness in Chinese families. The mechanisms of coping can entail the emotional part of it, sensible strategies, sensitive and even the psychological approach (Chen et al, 2015). The arrangements that is put to empathy to bring the problem to a central platform for sharing is commonly known as emotional strategy. The emotional policies help the caregivers of stroke survivors to have a solved burden on caregiving families. The other mechanism which involves the stretching of the body, nutritional diet on the patient, the time is taken to relax and knowing oneself is commonly termed as the real coping strategies.

Lastly, psychological and problem-oriented strategies involve both tangible and intangible things. The patient can receive moral support and advice to recognize the real extent of the disease. The coping skills are essential to be able to find a better way to manage mental problems in the families. According to the study carried out, most of the Chinese people tend to use most the coping skills. Nevertheless, most people in China believed that suffering is part of their life. Thus, the misfortunes that happen to people have no control beyond any limit. The study also indicates that there is a correlation between gender and coping skills in people. The results show that there are more female caregivers than their counterparts. Also, there is a more significant percentage of female caregivers providing for spouse caregivers to children caregivers. Hence it was suggesting that many people suffering from a stroke in Chinese society are the older people. Henceforth, support should be given to not only to stroke survivors but also the caregivers who are affected by the form of depression and severity from their patients.


In most cases the action of self-sacrifice become expensive. Also, the situation may become overburden if it persists over a long period. Stroke survivors need a lot of care. Time spent might affect caregiver emotionally and psychologically. Therefore, the caregiving role is a moral thing but a difficult task for one to undergo. Self-sacrifice in caregiving entails making individual efforts for another human being without considering the challenges in the provision. The study shows that the burden of severity is not only to the stroke survivors but also the caregivers who take self-sacrifice (Furlong & Wuest, 2008). In Chinese culture, the grown-up children are the ones that are supposed to sacrifice and offer caregiving roles to the aged parents and the stroke survivors. The Chinese givers almost spent all their time at the patients. The other counterparts in the western countries are more likely to have weekly leisure time compared to Chinese caregivers.

However, the system of formal caregivers needs to be adopted. A formal caregiver is a person that the job of taking care of the elderly or the sick to be paid at the end. The perception of caregiving in china is different from western countries. The tradition is that older people need to be taken care of because they also provide to society during their fruitful period. Therefore, regardless of the burden the role bear, the Chinese caregivers have to sacrifice to ensure for the older. The self-sacrifice shown in the Chinese is good, and it shows signs of love among the community. However, it is better option to adopt the new system of the formal caregiving services also to safeguard own health and some peace of mind. The Chinese culture and traditions set up an excellent platform on how the elderly and the ill should be treated. So it is essential for cross culturing of the rituals but at the same time modernize them to minimize the burden that the caregivers usually bear.











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Cummings, J. L., & Benson, D. F. (1992). Dementia: a clinical approach. 2. Butterworth-Heinemann.

Chen, H. M., Huang, M. F., Yeh, Y. C., Huang, W. H., & Chen, C. S. (2015). Effectiveness of coping strategies intervention on caregiver burden among caregivers of elderly patients with dementia. Psychogeriatrics15(1), 20-25.

Furlong, K. E., & Wuest, J. (2008). Self-care behaviors of spouses caring for significant others with Alzheimer’s disease: the emergence of self-care worthiness as a salient condition. Qualitative Health Research18(12), 1662-1672.

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Ratnavalli, E., Brayne, C., Dawson, K., & Hodges, J. R. (2002). The prevalence of frontotemporal dementia. Neurology58(11), 1615-1621.

Skaff, M. M., & Pearlin, L. I. (1992). Caregiving: Role engulfment and the loss of self. The Gerontologist32(5), 656-664.