DNP 825 Benchmark – Population Heath Part II

Sample Answer

Lung Cancer

Lung cancer is a common cause of morbidity and mortality worldwide. The risk factors for lung cancer are well documented and these include but are not limited to cigarette smoking, family history of lung cancer, indoor exposure to radon and occupational exposure to carcinogens such as asbestos and nickel.

Moreover, group 1 carcinogens have been implicated in many cancers and air pollution belongs to this group. Air pollution from factories has been established as a risk factor for lung cancer. The relative risk of lung cancer in cigarette smokers is 60-fold compared to non-smokers (Kumar et al., 2021).

The effect of carcinogens has been widely studied and they can predispose non-smokers to lung cancer while being synergistic with cigarette smoke in cancer development for cigarette smokers. Asbestos exposure can lead to a 5-fold risk of lung cancer in exposed individuals while if the exposure occurs in a cigarette smoker, the risk is 55-fold (Kumar et al., 2021).

Lung cancer is a major public concern as a majority of patients are diagnosed late when the prognosis is poor and have evidence of metastases. Interventions should be developed to improve the health outcomes of cigarette smokers and address the issue of lung cancer.

Addressing Lung Cancer in Cigarette Smokers

Cigarette smoking has been identified as the cause of 87% of deaths in the United States due to lung cancer (O’Keeffe et al., 2018). Various interventions may be applied to curb lung cancer. A viable intervention would be to address the major cause of lung cancer, cigarette smoking.

A probable intervention to reduce the prevalence and incidences of lung cancers in cigarette smokers is quitting cigarettes. Cigarette cessation programs can be developed to help cigarette smokers. Cigarette cessation can reduce the morbidity, mortality, prevalence and incidences of lung cancer.

The deaths from lung cancer can be reduced by 38% if smoking cessation is combined with routine lung cancer screening in smokers (Tindle et al., 2018). Screening for lung cancer alone has been attributed to a reduction of cancer deaths by 20%. The dangers of continual cigarette consumption during lung cancer treatment include the risk of recurrence, treatment side effects and diminished treatment response (Minnix et al., 2018).

These are indicators that quitting cigarettes is a viable option for tackling lung cancer incidence and prevalence. It has been identified that the deaths from lung cancer can be decreased by about 30-40% if smokers quit when they are diagnosed with lung cancer (Minnix et al., 2018). It is also relevant that the benefits of cigarette cessation may be similar to cancer treatment and in some cases may be superior to some of the treatment options available.

Cessation may therefore increase survival rates, improve treatment response, decrease morbidity from symptoms, improve life quality and reduce the chances of recurrence after lung cancer treatment.

Plan for a Smoking Cessation Program, Stakeholders Needed and Potential Challenges
The smoking cessation program will entail education sessions, telephone calls and medication administration. The education programs will include outreach programs, seminars and health fairs.

Participants will be educated on the various risk factors for lung cancer, prevention strategies and management of the health risks brought about by cigarette smoking. Cigarette smoking has been implicated in many cancers other than lung cancer and passing this information may evoke a choice for cessation.

The participants and general public will also be educated on coping strategies and possible medication interventions to help in the management of tobacco addiction. Participants will also be given newsletters, brochures and placards detailing the effects of cigarette smoking on health. Participants will be required to a small commitment fee of 20$.

This fee is more of a registration fee and not a fee to suffice the interventions in the program as it would be insufficient. The program is set to run for 1 year. The estimated budget for the intervention program is about 500,000$. Telephone calls will be scheduled between qualified smoking cessation counsellors and cigarette addicts to hold one on one cessations to provide support for quitting. Various stakeholders will be involved in the program.

The program will require the input of physicians, pharmacists, registered nurses, trained smoking cessation counsellors, permission from local authorities to hold public gatherings, public health specialists, health educators and volunteers. Physicians can provide referrals for potential participants. The professionals in the health field can provide health education and health promotion messages to participants.

Pharmacists can provide various medications that can assist in tackling tobacco addiction. These include therapeutic options such as nicotine replacement therapy. They can also offer medical advice to participants already displaying effects and diseases related to cigarette smoking.

Various challenges may be encountered in the implementation of this program. This program may be inaccessible to others who may benefit from it (Minnix et al., 2018). This may stem from geographical barriers and travel costs which may not be feasible. This program can be tackled by offering online support opportunities and maximizing telephone calls. Toll-free numbers can be provided to ease this.

Registration fees can also be moderated based on income estimations (Chiu et al., 2021). The awareness of the program may be an issue. This can be broadened by the promotion of the program. Promotion can be done through televised advertisements, radio advertisements and billboards. Moreover, social media pages can also be developed to create public awareness. Physicians and other healthcare professionals can play a central role in promotion (O’Keeffe et al., 2018).

They can target possible patients with tobacco addiction in the hospital setting, discuss the program with other health providers during hospital meetings and dispense brochures regarding the program to patients and other caregivers. The financial requirements may be significant. This may need the involvement of potential donor organizations and other forms of charity.

Health Promotion Theory

A theory that can be applied is the health belief theory (Pribadi & Devy, 2020). Participants in the program can be educated regarding cigarette smoking and its potential consequences. They can be educated on lung cancer risks related to cigarette smoking behaviour.

They can also be educated on the benefits of cessation. They can also be enlightened on challenges to cessation and the coping strategies that can be applied (Upadhyay et al., 2019). With this information, tobacco addicts can gain insight into their susceptibility to cigarette diseases including lung cancer, the consequences of continual smoking, the benefits of cessation and some of the challenges in cessation and coping difficulties (Pribadi & Devy, 2020).

These may provide the addicts with information to evaluate their risk for lung cancer and other consequences to enable them to make informed decisions regarding their smoking behaviour (Upadhyay et al., 2019). It may spark a drive to quit smoking behaviour and the potential to seek cigarette cessation programs.

Expected Outcomes

The expected outcomes include an increased number of participants enrolled with time, decreased incidences and prevalence of lung cancer and decreased prevalence of smoking (Minnix et al., 2018). Moreover, the focus, efficiency and quality of the telephone sessions are expected to improve as counsellors gain more experience with time.

The number of clients supported through telephone sessions is expected to increase. Awareness and access to the program are also expected to increase. If the expected outcomes are not realised, the promotion of the program can be increased to create more awareness.

The participants can be given evaluation forms to assess their satisfaction. The participants can also be questioned on the challenges that hinder cessation and the potential triggers for relapse (Tindle et al., 2018). Moreover, new processes and strategies can be developed to promote the growth and success of the program.

Contributors to Lung Cancer in Cigarette Smokers

The influence of environmental pollution plays a key role in lung cancer incidences in smokers. These pollutants increase the risk of progression to malignancy. Genetic differences among smokers can play a role. Some groups of smokers are at more risk of developing cancer due to genetics.

Moreover, individuals with a family history of lung cancer may compound their risk of lung cancer with cigarette smoking (Kumar et al., 2021). Poverty may deny smokers access to screening programs and interventions such as curative surgery for early lesions.

Low levels of income may also deny this vulnerable population access to preventive programs and medications to manage addiction (Minnix et al., 2018). A low level of education impacts awareness of the consequences of cigarette smoking and access to health promotion information.

Advocacy for Cigarette Smokers

I can support labour laws that mandate employers to provide safe working conditions for employees to mitigate occupational exposure to carcinogens. Carcinogens may increase their risk of lung cancer. Some of these individuals live in poverty. I can support family income supplementation programs and these can reduce the inequality in income (Oerther & Rosa, 2020).

This can enable them to afford screening programs and curative treatments, especially at the early stages of disease. I can also take part in health education programs that educate them on prevention measures, the dangers of cigarette smoking, coping strategies and the benefits of cigarette cessation (Chiu et al., 2021). I

can also collaborate with other health professionals to provide the best care and education for this group to ensure that they make informed decisions about their care. I can also support organizations and agencies that advocate for insurance for marginalised groups (Oerther & Rosa, 2020).

Different areas of health can advocate for equity by maintaining the ethical principles of autonomy, beneficence, justice and non-maleficence. Additionally, I can consult management teams to include disadvantaged groups in their budgets to help in minimizing health care costs and provide treatment waivers (Chiu et al., 2021). These can improve health of these groups.

Conclusion

Lung cancer can cause significant morbidity and is a common cause of mortality among cigarette smokers. Cigarette cessation has been identified as a viable option to reduce the incidences, prevalence and mortality of lung cancer in cigarette smokers.

Various stakeholders such as health professionals and donors may be needed for the success of cessation programs. Identification and management of potential challenges in cessation programs may promote the success of such programs.

Various patient inequalities exist and this may predispose them to various diseases. Tackling patient inequalities and upholding ethical considerations can improve access to quality care and lead to improved patient outcomes.

References

Chiu, P., Cummings, G. G., Thorne, S., & Schick-Makaroff, K. (2021). Policy advocacy and nursing organizations A scoping review. Policy, Politics & Nursing Practice, 22(4), 271–291. https //doi.org/10.1177/15271544211050611
Kumar, V., Abbas, A. K., & Aster, J. C. (2021). Robbins Basic Pathology (V. Kumar, A. K. Abbas, & J. C. Aster, Eds.; 10th ed.). Elsevier – Health Sciences Division.
Minnix, J. A., Karam-Hage, M., Blalock, J. A., & Cinciripini, P. M. (2018). The importance of incorporating smoking cessation into lung cancer screening. Translational Lung Cancer Research, 7(3), 272–280. https //doi.org/10.21037/tlcr.2018.05.03
Oerther, S. E., & Rosa, W. E. (2020). Advocating for equality The backbone of the Sustainable Development Goals. The American Journal of Nursing, 120(12), 60–62. https //doi.org/10.1097/01.NAJ.0000724256.31342.4b
O’Keeffe, L. M., Taylor, G., Huxley, R. R., Mitchell, P., Woodward, M., & Peters, S. A. E. (2018). Smoking as a risk factor for lung cancer in women and men a systematic review and meta-analysis. BMJ Open, 8(10), e021611. https //doi.org/10.1136/bmjopen-2018-021611
Pribadi, E. T., & Devy, S. R. (2020). Application of the Health Belief Model on the intention to stop smoking behavior among young adult women. Journal of Public Health Research, 9(2), 1817. https //doi.org/10.4081/jphr.2020.1817
Tindle, H. A., Stevenson Duncan, M., Greevy, R. A., Vasan, R. S., Kundu, S., Massion, P. P., & Freiberg, M. S. (2018). Lifetime smoking history and risk of lung cancer Results from the Framingham heart study. Journal of the National Cancer Institute, 110(11), 1201–1207. https //doi.org/10.1093/jnci/djy041
Upadhyay, S., Lord, J., & Gakh, M. (2019). Health-information seeking and intention to quit smoking Do health beliefs have a mediating role? Tobacco Use Insights, 12, 1179173X19871310. https //doi.org/10.1177/1179173X19871310