Assignment Prompt & Instructions
– ## DecisionMakingProcessPaperDue.docx
– ## AdvancedPracticeNursing_ClinicalDecision-MakingandLeadership2.pdf
– ## AdvancedPracticeNursing_ClinicalDecision-MakingandLeadership2.pdf
**## DecisionMakingProcessPaperDue.docx**
**Decision-Making Process Paper**
Instructions
In this assignment, you will be writing a 6–8-page paper identifying [
**maximum page limit is 8 pages- do not exceed as it will incur a penalty**], comparing and contrasting at least 3 different decision-making approaches of care from a multidisciplinary perspective using a pertinent and significant topic in nursing [The following topics are NOT allowed and will not be approved: shortage and nurse turnover, nurse staffing ratios, unit closures, and restructuring, use of contract employees (i.e., registry and travel nurse)]. The topic
**MUST BE APPROVED** **by your nursing instructor before writing the paper. Your topic was approved in week 3- please refer to week 3's approved topic.** You are
required to use APA 7th edition format, and the page count, appropriate headings, the title page, and the reference page. Reflect on your decision-making practices and the implications this will have regarding differing approaches taken by nursing leaders and staff nurses/clinical practitioners in decision-making regarding issues in practice. To complete this assignment, do the following:
1. Select and describe an issue in nursing that impacts nurses at all levels from bedside to advanced practice. Make sure to provide an adequate background and its significance to all levels of nursing using a strong review of the literature. Additionally, this should include a thorough literature review that provides a good understanding of what the cause of this problem is; what is suggested to address this problem. Essentially, this review must support your choices of the decision-making models and this needs to include how all levels of nursing practice (the bedside nurse to the APN are impacted by the problem).
2. Identify how you would expect a nurse leader/manager, a bedside/staff nurse and an Advanced practice nurse (CNO or NP) to address your selected issue using at least 2 [3 ideal] different decision-making approaches which are clearly supported by the literature review. This must first include aa detailed analysis/overview of the selected decision making models and how they are used in practice. Then a detailed analysis of how these decision-making approaches/models would address the problem/along with a detailed analysis of how each of the three selected models would be applied to address the selected issue/problem making sure to incorporate this at all levels of practice. One of the decision-making models may be more applicable to the bedside nurse; whereas the other more applicable to the APN; however, all levels of nursing practice need to be addressed with at least one of the chosen 3 decision-making models. However, this does not mean that each decision-making model will apply to all levels of practice only that in this discussion needs to include how each level of nursing practice would utilize the decision-making model to address the problem. For instance, one decision making model may apply to the bedside nurse; the second decision making model may be more applicable at the level of APN (CNO, NP, etc) and the other decision-making model may be best applied to the nurse manager. This section should be detailed; meaning specific, well thought out, realistic solutions of how the nurse (at the level identified; this may include more than one level for the same decision-making model or not) would address the problem using the decision-making model is provided and well supported by the literature. of the benefits and limitations of various decision-making approaches that are applied appropriately to the level of nursing practice to address the selected issue/problem. This is informed from course readings, literature, clinical scenarios and other evidence-based and scholarly sources.
3. Prioritize the best decision-making approach/model to address the selected problem that is grounded in best practice. This should provide a well-supported rationale for this choice that includes a good comparison and contrasting of the 3 chosen decision-making models that clearly illustrates why the choice was made, that is consistent with the decision making model and how it would address the chosen topic or problem.
4. Identify a possible funding source that would addresses your approach to solving the problem. For instance, if the best approach to solving the nurse-to-patient ratio problem is through the use of SDM and shared governance, perhaps you may seek a local funding source to provide you with funding to implement a small EBP or research project that would be funded by a local nursing organization such as Sigma Theta Tau or perhaps if it was geared more towards assessing the value of this model towards NP in practice than seeking a local organization that supports funding for projects being implemented by practicing NP? If seeking money for research this would need to be overseen by a nurse with a DNP or a PhD or someone with the credentials to do so that are part of their scope of practice. Consider looking at federal, state, or local organizations. For example: There are many grants available through the CDC,HRSA, etc. Again, this need to be specifically applied with sufficient details
5. Use at least
**10 current scholarly references** [not older than 5 years] other than your main text. Uses APA 7th edition formatting.
**## AdvancedPracticeNursing_ClinicalDecision-MakingandLeadership2.pdf**
1
The Use of Yoga to Manage Symptoms in Patients with Multiple Sclerosis
Marcos Martin Bello
Florida National University
Decision Making-DBX-DL01
Dr.Nora Hernandez-Pupo
November 12, 2025
2
The Use of Yoga to Manage Symptoms in Patients with Multiple Sclerosis
I. Introduction
A. Background Information: Multiple sclerosis (MS) is a chronic autoimmune
disease affecting the central nervous system, leading to symptoms such as fatigue,
pain, spasticity, balance issues, and depression (Graves et al., 2023). Complementary
therapies, such as yoga, are increasingly being explored in nursing practice to improve
quality of life.
B. Statement of the Problem: Traditional pharmacological interventions often
inadequately address non-motor symptoms and side effects, prompting the need for
integrative, nurse-supported interventions like yoga.
C. Thesis Statement: Yoga, as a mind-body intervention, offers a safe, accessible,
and evidence-based approach for bedside nurses and advanced nurses to
collaboratively manage MS symptoms, enhance patient autonomy, and inform clinical
decision-making through biopsychosocial and self-efficacy frameworks (Naisby et al.,
2023).
II. Literature Review/Background
A. Overview of Existing Research: Review of randomized controlled trials and
systematic reviews (Lysogorskaia et al., 2023) demonstrating yoga’s effects on
fatigue, mobility, mood, and pain in MS populations.
B. Key Theories and Models
3
1. Biopsychosocial Model (Engel, 1977): Frames symptom management as an
interplay of biological, psychological, and social factors; yoga addresses all
three domains (Lugg, 2022).
2. Self-Efficacy Theory (Bandura, 1997): Yoga practice enhances patients’
confidence in managing symptoms, supporting long-term adherence and self-
care (Su, 2024).
III. Main Body/Discussion
A. Section One Clinical Context and Symptom Burden in MS
1. Prevalence and impact of fatigue, spasticity, and depression in MS.
2. Limitations of pharmacological management and role of non-pharmacological
interventions.
B. Section Two Comparative Analysis of Nursing Roles in Yoga Integration
1. Bedside Nurse Role: Patient education, safety screening, gentle pose
modifications, and monitoring during inpatient or outpatient sessions.
2. Advanced Practice Nurse/Nurse Leader Role: Protocol development,
interprofessional collaboration (e.g., with physical therapists), outcome tracking,
and policy advocacy for yoga programs.
C. Section Three Application and Implications
1. Case example: 6-week adapted yoga program in an outpatient neurology clinic.
2. Benefits: Improved fatigue scores (MFIS), balance (Berg Balance Scale), and
mood (PHQ-9).
4
3. Limitations: Accessibility, contraindications (e.g., severe spasticity), and need for
trained instructors.
4. Recommendations: Nurse-led training modules, tele-yoga options, and integration
into care plans.
IV. Conclusion
A. Summary of Key Points: Yoga serves as a multidimensional intervention aligned
with biopsychosocial and self-efficacy principles, supported by nursing leadership at
all levels.
B. Implications and Next Steps: The Final paper will propose a nurse-driven yoga
protocol with measurable outcomes, advocating for institutional adoption and further
research on long-term adherence.
5
References
Graves, J. S., Krysko, K. M., Hua, L. H., Absinta, M., Franklin, R. J. M., & Segal, B. M.
(2023). Ageing and multiple sclerosis. The Lancet. Neurology, 22(1), 66–77.
https://doi.org/10.1016/S1474-4422(22)00184-3
Lugg W. (2022). The biopsychosocial model – history, controversy and Engel. Australasian
psychiatry : bulletin of Royal Australian and New Zealand College of
Psychiatrists, 30(1), 55–59. https://doi.org/10.1177/10398562211037333
Naisby, J., Wilson-Menzfeld, G., Baker, K., Morris, R., Robinson, J., & Barry, G. (2023).
Yoga and Multiple Sclerosis: Maintaining engagement in physical activity. PloS
one, 18(7), e0288319. https://doi.org/10.1371/journal.pone.0288319
Su, F. (2024). Students' Self-Control and Self-Efficacy Through Yoga Practices and Their
Influences on Academic Performance. Pacific International Journal, 7(3), 171-176.
https://doi.org/10.55014/pij.v7i3.554
[https://doi.org/10.1016/S1474-4422(22)00184-3](https://doi.org/10.1016/S1474-4422(22)00184-3)
[https://doi.org/10.55014/pij.v7i3.554](https://doi.org/10.55014/pij.v7i3.554)
– Su, F. (2024). Students' Self-Control and Self-Efficacy Through Yoga Practices and Their Influences on Academic Performance. Pacific International Journal, 7(3), 171-176. https://doi.org/10.55014/pij.v7i3.554
**## AdvancedPracticeNursing_ClinicalDecision-MakingandLeadership2.pdf**
1
The Use of Yoga to Manage Symptoms in Patients with Multiple Sclerosis
Marcos Martin Bello
Florida National University
Decision Making-DBX-DL01
Dr.Nora Hernandez-Pupo
November 12, 2025
2
The Use of Yoga to Manage Symptoms in Patients with Multiple Sclerosis
I. Introduction
A. Background Information: Multiple sclerosis (MS) is a chronic autoimmune
disease affecting the central nervous system, leading to symptoms such as fatigue,
pain, spasticity, balance issues, and depression (Graves et al., 2023). Complementary
therapies, such as yoga, are increasingly being explored in nursing practice to improve
quality of life.
B. Statement of the Problem: Traditional pharmacological interventions often
inadequately address non-motor symptoms and side effects, prompting the need for
integrative, nurse-supported interventions like yoga.
C. Thesis Statement: Yoga, as a mind-body intervention, offers a safe, accessible,
and evidence-based approach for bedside nurses and advanced nurses to
collaboratively manage MS symptoms, enhance patient autonomy, and inform clinical
decision-making through biopsychosocial and self-efficacy frameworks (Naisby et al.,
2023).
II. Literature Review/Background
A. Overview of Existing Research: Review of randomized controlled trials and
systematic reviews (Lysogorskaia et al., 2023) demonstrating yoga’s effects on
fatigue, mobility, mood, and pain in MS populations.
B. Key Theories and Models
3
1. Biopsychosocial Model (Engel, 1977): Frames symptom management as an
interplay of biological, psychological, and social factors; yoga addresses all
three domains (Lugg, 2022).
2. Self-Efficacy Theory (Bandura, 1997): Yoga practice enhances patients’
confidence in managing symptoms, supporting long-term adherence and self-
care (Su, 2024).
III. Main Body/Discussion
A. Section One Clinical Context and Symptom Burden in MS
1. Prevalence and impact of fatigue, spasticity, and depression in MS.
2. Limitations of pharmacological management and role of non-pharmacological
interventions.
B. Section Two Comparative Analysis of Nursing Roles in Yoga Integration
1. Bedside Nurse Role: Patient education, safety screening, gentle pose
modifications, and monitoring during inpatient or outpatient sessions.
2. Advanced Practice Nurse/Nurse Leader Role: Protocol development,
interprofessional collaboration (e.g., with physical therapists), outcome tracking,
and policy advocacy for yoga programs.
C. Section Three Application and Implications
1. Case example: 6-week adapted yoga program in an outpatient neurology clinic.
2. Benefits: Improved fatigue scores (MFIS), balance (Berg Balance Scale), and
mood (PHQ-9).
4
3. Limitations: Accessibility, contraindications (e.g., severe spasticity), and need for
trained instructors.
4. Recommendations: Nurse-led training modules, tele-yoga options, and integration
into care plans.
IV. Conclusion
A. Summary of Key Points: Yoga serves as a multidimensional intervention aligned
with biopsychosocial and self-efficacy principles, supported by nursing leadership at
all levels.
B. Implications and Next Steps: The Final paper will propose a nurse-driven yoga
protocol with measurable outcomes, advocating for institutional adoption and further
research on long-term adherence.
5
References
Graves, J. S., Krysko, K. M., Hua, L. H., Absinta, M., Franklin, R. J. M., & Segal, B. M.
(2023). Ageing and multiple sclerosis. The Lancet. Neurology, 22(1), 66–77.
https://doi.org/10.1016/S1474-4422(22)00184-3
Lugg W. (2022). The biopsychosocial model – history, controversy and Engel. Australasian
psychiatry : bulletin of Royal Australian and New Zealand College of
Psychiatrists, 30(1), 55–59. https://doi.org/10.1177/10398562211037333
Naisby, J., Wilson-Menzfeld, G., Baker, K., Morris, R., Robinson, J., & Barry, G. (2023).
Yoga and Multiple Sclerosis: Maintaining engagement in physical activity. PloS
one, 18(7), e0288319. https://doi.org/10.1371/journal.pone.0288319
Su, F. (2024). Students' Self-Control and Self-Efficacy Through Yoga Practices and Their
Influences on Academic Performance. Pacific International Journal, 7(3), 171-176.
https://doi.org/10.55014/pij.v7i3.554
[https://doi.org/10.1016/S1474-4422(22)00184-3](https://doi.org/10.1016/S1474-4422(22)00184-3)
[https://doi.org/10.55014/pij.v7i3.554](https://doi.org/10.55014/pij.v7i3.554)
– Su, F. (2024). Students' Self-Control and Self-Efficacy Through Yoga Practices and Their Influences on Academic Performance. Pacific International Journal, 7(3), 171-176. https://doi.org/10.55014/pij.v7i3.554
**## AdvancedPracticeNursing_ClinicalDecision-MakingandLeadership2.pdf**
1
The Use of Yoga to Manage Symptoms in Patients with Multiple Sclerosis
Marcos Martin Bello
Florida National University
Decision Making-DBX-DL01
Dr.Nora Hernandez-Pupo
November 12, 2025
2
The Use of Yoga to Manage Symptoms in Patients with Multiple Sclerosis
I. Introduction
A. Background Information: Multiple sclerosis (MS) is a chronic autoimmune
disease affecting the central nervous system, leading to symptoms such as fatigue,
pain, spasticity, balance issues, and depression (Graves et al., 2023). Complementary
therapies, such as yoga, are increasingly being explored in nursing practice to improve
quality of life.
B. Statement of the Problem: Traditional pharmacological interventions often
inadequately address non-motor symptoms and side effects, prompting the need for
integrative, nurse-supported interventions like yoga.
C. Thesis Statement: Yoga, as a mind-body intervention, offers a safe, accessible,
and evidence-based approach for bedside nurses and advanced nurses to
collaboratively manage MS symptoms, enhance patient autonomy, and inform clinical
decision-making through biopsychosocial and self-efficacy frameworks (Naisby et al.,
2023).
II. Literature Review/Background
A. Overview of Existing Research: Review of randomized controlled trials and
systematic reviews (Lysogorskaia et al., 2023) demonstrating yoga’s effects on
fatigue, mobility, mood, and pain in MS populations.
B. Key Theories and Models
3
1. Biopsychosocial Model (Engel, 1977): Frames symptom management as an
interplay of biological, psychological, and social factors; yoga addresses all
three domains (Lugg, 2022).
2. Self-Efficacy Theory (Bandura, 1997): Yoga practice enhances patients’
confidence in managing symptoms, supporting long-term adherence and self-
care (Su, 2024).
III. Main Body/Discussion
A. Section One Clinical Context and Symptom Burden in MS
1. Prevalence and impact of fatigue, spasticity, and depression in MS.
2. Limitations of pharmacological management and role of non-pharmacological
interventions.
B. Section Two Comparative Analysis of Nursing Roles in Yoga Integration
1. Bedside Nurse Role: Patient education, safety screening, gentle pose
modifications, and monitoring during inpatient or outpatient sessions.
2. Advanced Practice Nurse/Nurse Leader Role: Protocol development,
interprofessional collaboration (e.g., with physical therapists), outcome tracking,
and policy advocacy for yoga programs.
C. Section Three Application and Implications
1. Case example: 6-week adapted yoga program in an outpatient neurology clinic.
2. Benefits: Improved fatigue scores (MFIS), balance (Berg Balance Scale), and
mood (PHQ-9).
4
3. Limitations: Accessibility, contraindications (e.g., severe spasticity), and need for
trained instructors.
4. Recommendations: Nurse-led training modules, tele-yoga options, and integration
into care plans.
IV. Conclusion
A. Summary of Key Points: Yoga serves as a multidimensional intervention aligned
with biopsychosocial and self-efficacy principles, supported by nursing leadership at
all levels.
B. Implications and Next Steps: The Final paper will propose a nurse-driven yoga
protocol with measurable outcomes, advocating for institutional adoption and further
research on long-term adherence.
5
References
Graves, J. S., Krysko, K. M., Hua, L. H., Absinta, M., Franklin, R. J. M., & Segal, B. M.
(2023). Ageing and multiple sclerosis. The Lancet. Neurology, 22(1), 66–77.
https://doi.org/10.1016/S1474-4422(22)00184-3
Lugg W. (2022). The biopsychosocial model – history, controversy and Engel. Australasian
psychiatry : bulletin of Royal Australian and New Zealand College of
Psychiatrists, 30(1), 55–59. https://doi.org/10.1177/10398562211037333
Naisby, J., Wilson-Menzfeld, G., Baker, K., Morris, R., Robinson, J., & Barry, G. (2023).
Yoga and Multiple Sclerosis: Maintaining engagement in physical activity. PloS
one, 18(7), e0288319. https://doi.org/10.1371/journal.pone.0288319
Su, F. (2024). Students' Self-Control and Self-Efficacy Through Yoga Practices and Their
Influences on Academic Performance. Pacific International Journal, 7(3), 171-176.
https://doi.org/10.55014/pij.v7i3.554
[https://doi.org/10.1016/S1474-4422(22)00184-3](https://doi.org/10.1016/S1474-4422(22)00184-3)
[https://doi.org/10.55014/pij.v7i3.554](https://doi.org/10.55014/pij.v7i3.554)
– Su, F. (2024). Students' Self-Control and Self-Efficacy Through Yoga Practices and Their Influences on Academic Performance. Pacific International Journal, 7(3), 171-176. https://doi.org/10.55014/pij.v7i3.554
**## DecisionMakingProcessPaperDue.docx**
**Decision-Making Process Paper**
Instructions
In this assignment, you will be writing a 6–8-page paper identifying [
**maximum page limit is 8 pages- do not exceed as it will incur a penalty**], comparing and contrasting at least 3 different decision-making approaches of care from a multidisciplinary perspective using a pertinent and significant topic in nursing [The following topics are NOT allowed and will not be approved: shortage and nurse turnover, nurse staffing ratios, unit closures, and restructuring, use of contract employees (i.e., registry and travel nurse)]. The topic
**MUST BE APPROVED** **by your nursing instructor before writing the paper. Your topic was approved in week 3- please refer to week 3's approved topic.** You are
required to use APA 7th edition format, and the page count, appropriate headings, the title page, and the reference page. Reflect on your decision-making practices and the implications this will have regarding differing approaches taken by nursing leaders and staff nurses/clinical practitioners in decision-making regarding issues in practice. To complete this assignment, do the following:
1. Select and describe an issue in nursing that impacts nurses at all levels from bedside to advanced practice. Make sure to provide an adequate background and its significance to all levels of nursing using a strong review of the literature. Additionally, this should include a thorough literature review that provides a good understanding of what the cause of this problem is; what is suggested to address this problem. Essentially, this review must support your choices of the decision-making models and this needs to include how all levels of nursing practice (the bedside nurse to the APN are impacted by the problem).
2. Identify how you would expect a nurse leader/manager, a bedside/staff nurse and an Advanced practice nurse (CNO or NP) to address your selected issue using at least 2 [3 ideal] different decision-making approaches which are clearly supported by the literature review. This must first include aa detailed analysis/overview of the selected decision making models and how they are used in practice. Then a detailed analysis of how these decision-making approaches/models would address the problem/along with a detailed analysis of how each of the three selected models would be applied to address the selected issue/problem making sure to incorporate this at all levels of practice. One of the decision-making models may be more applicable to the bedside nurse; whereas the other more applicable to the APN; however, all levels of nursing practice need to be addressed with at least one of the chosen 3 decision-making models. However, this does not mean that each decision-making model will apply to all levels of practice only that in this discussion needs to include how each level of nursing practice would utilize the decision-making model to address the problem. For instance, one decision making model may apply to the bedside nurse; the second decision making model may be more applicable at the level of APN (CNO, NP, etc) and the other decision-making model may be best applied to the nurse manager. This section should be detailed; meaning specific, well thought out, realistic solutions of how the nurse (at the level identified; this may include more than one level for the same decision-making model or not) would address the problem using the decision-making model is provided and well supported by the literature. of the benefits and limitations of various decision-making approaches that are applied appropriately to the level of nursing practice to address the selected issue/problem. This is informed from course readings, literature, clinical scenarios and other evidence-based and scholarly sources.
3. Prioritize the best decision-making approach/model to address the selected problem that is grounded in best practice. This should provide a well-supported rationale for this choice that includes a good comparison and contrasting of the 3 chosen decision-making models that clearly illustrates why the choice was made, that is consistent with the decision making model and how it would address the chosen topic or problem.
4. Identify a possible funding source that would addresses your approach to solving the problem. For instance, if the best approach to solving the nurse-to-patient ratio problem is through the use of SDM and shared governance, perhaps you may seek a local funding source to provide you with funding to implement a small EBP or research project that would be funded by a local nursing organization such as Sigma Theta Tau or perhaps if it was geared more towards assessing the value of this model towards NP in practice than seeking a local organization that supports funding for projects being implemented by practicing NP? If seeking money for research this would need to be overseen by a nurse with a DNP or a PhD or someone with the credentials to do so that are part of their scope of practice. Consider looking at federal, state, or local organizations. For example: There are many grants available through the CDC,HRSA, etc. Again, this need to be specifically applied with sufficient details
5. Use at least
**10 current scholarly references** [not older than 5 years] other than your main text. Uses APA 7th edition formatting.
**## AdvancedPracticeNursing_ClinicalDecision-MakingandLeadership2.pdf**
1
The Use of Yoga to Manage Symptoms in Patients with Multiple Sclerosis
Marcos Martin Bello
Florida National University
Decision Making-DBX-DL01
Dr.Nora Hernandez-Pupo
November 12, 2025
2
The Use of Yoga to Manage Symptoms in Patients with Multiple Sclerosis
I. Introduction
A. Background Information: Multiple sclerosis (MS) is a chronic autoimmune
disease affecting the central nervous system, leading to symptoms such as fatigue,
pain, spasticity, balance issues, and depression (Graves et al., 2023). Complementary
therapies, such as yoga, are increasingly being explored in nursing practice to improve
quality of life.
B. Statement of the Problem: Traditional pharmacological interventions often
inadequately address non-motor symptoms and side effects, prompting the need for
integrative, nurse-supported interventions like yoga.
C. Thesis Statement: Yoga, as a mind-body intervention, offers a safe, accessible,
and evidence-based approach for bedside nurses and advanced nurses to
collaboratively manage MS symptoms, enhance patient autonomy, and inform clinical
decision-making through biopsychosocial and self-efficacy frameworks (Naisby et al.,
2023).
II. Literature Review/Background
A. Overview of Existing Research: Review of randomized controlled trials and
systematic reviews (Lysogorskaia et al., 2023) demonstrating yoga’s effects on
fatigue, mobility, mood, and pain in MS populations.
B. Key Theories and Models
3
1. Biopsychosocial Model (Engel, 1977): Frames symptom management as an
interplay of biological, psychological, and social factors; yoga addresses all
three domains (Lugg, 2022).
2. Self-Efficacy Theory (Bandura, 1997): Yoga practice enhances patients’
confidence in managing symptoms, supporting long-term adherence and self-
care (Su, 2024).
III. Main Body/Discussion
A. Section One Clinical Context and Symptom Burden in MS
1. Prevalence and impact of fatigue, spasticity, and depression in MS.
2. Limitations of pharmacological management and role of non-pharmacological
interventions.
B. Section Two Comparative Analysis of Nursing Roles in Yoga Integration
1. Bedside Nurse Role: Patient education, safety screening, gentle pose
modifications, and monitoring during inpatient or outpatient sessions.
2. Advanced Practice Nurse/Nurse Leader Role: Protocol development,
interprofessional collaboration (e.g., with physical therapists), outcome tracking,
and policy advocacy for yoga programs.
C. Section Three Application and Implications
1. Case example: 6-week adapted yoga program in an outpatient neurology clinic.
2. Benefits: Improved fatigue scores (MFIS), balance (Berg Balance Scale), and
mood (PHQ-9).
4
3. Limitations: Accessibility, contraindications (e.g., severe spasticity), and need for
trained instructors.
4. Recommendations: Nurse-led training modules, tele-yoga options, and integration
into care plans.
IV. Conclusion
A. Summary of Key Points: Yoga serves as a multidimensional intervention aligned
with biopsychosocial and self-efficacy principles, supported by nursing leadership at
all levels.
B. Implications and Next Steps: The Final paper will propose a nurse-driven yoga
protocol with measurable outcomes, advocating for institutional adoption and further
research on long-term adherence.
5
References
Graves, J. S., Krysko, K. M., Hua, L. H., Absinta, M., Franklin, R. J. M., & Segal, B. M.
(2023). Ageing and multiple sclerosis. The Lancet. Neurology, 22(1), 66–77.
https://doi.org/10.1016/S1474-4422(22)00184-3
Lugg W. (2022). The biopsychosocial model – history, controversy and Engel. Australasian
psychiatry : bulletin of Royal Australian and New Zealand College of
Psychiatrists, 30(1), 55–59. https://doi.org/10.1177/10398562211037333
Naisby, J., Wilson-Menzfeld, G., Baker, K., Morris, R., Robinson, J., & Barry, G. (2023).
Yoga and Multiple Sclerosis: Maintaining engagement in physical activity. PloS
one, 18(7), e0288319. https://doi.org/10.1371/journal.pone.0288319
Su, F. (2024). Students' Self-Control and Self-Efficacy Through Yoga Practices and Their
Influences on Academic Performance. Pacific International Journal, 7(3), 171-176.
https://doi.org/10.55014/pij.v7i3.554
[https://doi.org/10.1016/S1474-4422(22)00184-3](https://doi.org/10.1016/S1474-4422(22)00184-3)
[https://doi.org/10.55014/pij.v7i3.554](https://doi.org/10.55014/pij.v7i3.554)
– Su, F. (2024). Students' Self-Control and Self-Efficacy Through Yoga Practices and Their Influences on Academic Performance. Pacific International Journal, 7(3), 171-176. https://doi.org/10.55014/pij.v7i3.554
**## AdvancedPracticeNursing_ClinicalDecision-MakingandLeadership2.pdf**
1
The Use of Yoga to Manage Symptoms in Patients with Multiple Sclerosis
Marcos Martin Bello
Florida National University
Decision Making-DBX-DL01
Dr.Nora Hernandez-Pupo
November 12, 2025
2
The Use of Yoga to Manage Symptoms in Patients with Multiple Sclerosis
I. Introduction
A. Background Information: Multiple sclerosis (MS) is a chronic autoimmune
disease affecting the central nervous system, leading to symptoms such as fatigue,
pain, spasticity, balance issues, and depression (Graves et al., 2023). Complementary
therapies, such as yoga, are increasingly being explored in nursing practice to improve
quality of life.
B. Statement of the Problem: Traditional pharmacological interventions often
inadequately address non-motor symptoms and side effects, prompting the need for
integrative, nurse-supported interventions like yoga.
C. Thesis Statement: Yoga, as a mind-body intervention, offers a safe, accessible,
and evidence-based approach for bedside nurses and advanced nurses to
collaboratively manage MS symptoms, enhance patient autonomy, and inform clinical
decision-making through biopsychosocial and self-efficacy frameworks (Naisby et al.,
2023).
II. Literature Review/Background
A. Overview of Existing Research: Review of randomized controlled trials and
systematic reviews (Lysogorskaia et al., 2023) demonstrating yoga’s effects on
fatigue, mobility, mood, and pain in MS populations.
B. Key Theories and Models
3
1. Biopsychosocial Model (Engel, 1977): Frames symptom management as an
interplay of biological, psychological, and social factors; yoga addresses all
three domains (Lugg, 2022).
2. Self-Efficacy Theory (Bandura, 1997): Yoga practice enhances patients’
confidence in managing symptoms, supporting long-term adherence and self-
care (Su, 2024).
III. Main Body/Discussion
A. Section One Clinical Context and Symptom Burden in MS
1. Prevalence and impact of fatigue, spasticity, and depression in MS.
2. Limitations of pharmacological management and role of non-pharmacological
interventions.
B. Section Two Comparative Analysis of Nursing Roles in Yoga Integration
1. Bedside Nurse Role: Patient education, safety screening, gentle pose
modifications, and monitoring during inpatient or outpatient sessions.
2. Advanced Practice Nurse/Nurse Leader Role: Protocol development,
interprofessional collaboration (e.g., with physical therapists), outcome tracking,
and policy advocacy for yoga programs.
C. Section Three Application and Implications
1. Case example: 6-week adapted yoga program in an outpatient neurology clinic.
2. Benefits: Improved fatigue scores (MFIS), balance (Berg Balance Scale), and
mood (PHQ-9).
4
3. Limitations: Accessibility, contraindications (e.g., severe spasticity), and need for
trained instructors.
4. Recommendations: Nurse-led training modules, tele-yoga options, and integration
into care plans.
IV. Conclusion
A. Summary of Key Points: Yoga serves as a multidimensional intervention aligned
with biopsychosocial and self-efficacy principles, supported by nursing leadership at
all levels.
B. Implications and Next Steps: The Final paper will propose a nurse-driven yoga
protocol with measurable outcomes, advocating for institutional adoption and further
research on long-term adherence.
5
References
Graves, J. S., Krysko, K. M., Hua, L. H., Absinta, M., Franklin, R. J. M., & Segal, B. M.
(2023). Ageing and multiple sclerosis. The Lancet. Neurology, 22(1), 66–77.
https://doi.org/10.1016/S1474-4422(22)00184-3
Lugg W. (2022). The biopsychosocial model – history, controversy and Engel. Australasian
psychiatry : bulletin of Royal Australian and New Zealand College of
Psychiatrists, 30(1), 55–59. https://doi.org/10.1177/10398562211037333
Naisby, J., Wilson-Menzfeld, G., Baker, K., Morris, R., Robinson, J., & Barry, G. (2023).
Yoga and Multiple Sclerosis: Maintaining engagement in physical activity. PloS
one, 18(7), e0288319. https://doi.org/10.1371/journal.pone.0288319
Su, F. (2024). Students' Self-Control and Self-Efficacy Through Yoga Practices and Their
Influences on Academic Performance. Pacific International Journal, 7(3), 171-176.
https://doi.org/10.55014/pij.v7i3.554
[https://doi.org/10.1016/S1474-4422(22)00184-3](https://doi.org/10.1016/S1474-4422(22)00184-3)
[https://doi.org/10.55014/pij.v7i3.554](https://doi.org/10.55014/pij.v7i3.554)
– Su, F. (2024). Students' Self-Control and Self-Efficacy Through Yoga Practices and Their Influences on Academic Performance. Pacific International Journal, 7(3), 171-176. https://doi.org/10.55014/pij.v7i3.554
**## DecisionMakingProcessPaperDue.docx**
**Decision-Making Process Paper**
Instructions
In this assignment, you will be writing a 6–8-page paper identifying [
**maximum page limit is 8 pages- do not exceed as it will incur a penalty**], comparing and contrasting at least 3 different decision-making approaches of care from a multidisciplinary perspective using a pertinent and significant topic in nursing [The following topics are NOT allowed and will not be approved: shortage and nurse turnover, nurse staffing ratios, unit closures, and restructuring, use of contract employees (i.e., registry and travel nurse)]. The topic
**MUST BE APPROVED** **by your nursing instructor before writing the paper. Your topic was approved in week 3- please refer to week 3's approved topic.** You are
required to use APA 7th edition format, and the page count, appropriate headings, the title page, and the reference page. Reflect on your decision-making practices and the implications this will have regarding differing approaches taken by nursing leaders and staff nurses/clinical practitioners in decision-making regarding issues in practice. To complete this assignment, do the following:
1. Select and describe an issue in nursing that impacts nurses at all levels from bedside to advanced practice. Make sure to provide an adequate background and its significance to all levels of nursing using a strong review of the literature. Additionally, this should include a thorough literature review that provides a good understanding of what the cause of this problem is; what is suggested to address this problem. Essentially, this review must support your choices of the decision-making models and this needs to include how all levels of nursing practice (the bedside nurse to the APN are impacted by the problem).
2. Identify how you would expect a nurse leader/manager, a bedside/staff nurse and an Advanced practice nurse (CNO or NP) to address your selected issue using at least 2 [3 ideal] different decision-making approaches which are clearly supported by the literature review. This must first include aa detailed analysis/overview of the selected decision making models and how they are used in practice. Then a detailed analysis of how these decision-making approaches/models would address the problem/along with a detailed analysis of how each of the three selected models would be applied to address the selected issue/problem making sure to incorporate this at all levels of practice. One of the decision-making models may be more applicable to the bedside nurse; whereas the other more applicable to the APN; however, all levels of nursing practice need to be addressed with at least one of the chosen 3 decision-making models. However, this does not mean that each decision-making model will apply to all levels of practice only that in this discussion needs to include how each level of nursing practice would utilize the decision-making model to address the problem. For instance, one decision making model may apply to the bedside nurse; the second decision making model may be more applicable at the level of APN (CNO, NP, etc) and the other decision-making model may be best applied to the nurse manager. This section should be detailed; meaning specific, well thought out, realistic solutions of how the nurse (at the level identified; this may include more than one level for the same decision-making model or not) would address the problem using the decision-making model is provided and well supported by the literature. of the benefits and limitations of various decision-making approaches that are applied appropriately to the level of nursing practice to address the selected issue/problem. This is informed from course readings, literature, clinical scenarios and other evidence-based and scholarly sources.
3. Prioritize the best decision-making approach/model to address the selected problem that is grounded in best practice. This should provide a well-supported rationale for this choice that includes a good comparison and contrasting of the 3 chosen decision-making models that clearly illustrates why the choice was made, that is consistent with the decision making model and how it would address the chosen topic or problem.
4. Identify a possible funding source that would addresses your approach to solving the problem. For instance, if the best approach to solving the nurse-to-patient ratio problem is through the use of SDM and shared governance, perhaps you may seek a local funding source to provide you with funding to implement a small EBP or research project that would be funded by a local nursing organization such as Sigma Theta Tau or perhaps if it was geared more towards assessing the value of this model towards NP in practice than seeking a local organization that supports funding for projects being implemented by practicing NP? If seeking money for research this would need to be overseen by a nurse with a DNP or a PhD or someone with the credentials to do so that are part of their scope of practice. Consider looking at federal, state, or local organizations. For example: There are many grants available through the CDC,HRSA, etc. Again, this need to be specifically applied with sufficient details
5. Use at least
**10 current scholarly references** [not older than 5 years] other than your main text. Uses APA 7th edition formatting.
**## AdvancedPracticeNursing_ClinicalDecision-MakingandLeadership2.pdf**
1
The Use of Yoga to Manage Symptoms in Patients with Multiple Sclerosis
Marcos Martin Bello
Florida National University
Decision Making-DBX-DL01
Dr.Nora Hernandez-Pupo
November 12, 2025
2
The Use of Yoga to Manage Symptoms in Patients with Multiple Sclerosis
I. Introduction
A. Background Information: Multiple sclerosis (MS) is a chronic autoimmune
disease affecting the central nervous system, leading to symptoms such as fatigue,
pain, spasticity, balance issues, and depression (Graves et al., 2023). Complementary
therapies, such as yoga, are increasingly being explored in nursing practice to improve
quality of life.
B. Statement of the Problem: Traditional pharmacological interventions often
inadequately address non-motor symptoms and side effects, prompting the need for
integrative, nurse-supported interventions like yoga.
C. Thesis Statement: Yoga, as a mind-body intervention, offers a safe, accessible,
and evidence-based approach for bedside nurses and advanced nurses to
collaboratively manage MS symptoms, enhance patient autonomy, and inform clinical
decision-making through biopsychosocial and self-efficacy frameworks (Naisby et al.,
2023).
II. Literature Review/Background
A. Overview of Existing Research: Review of randomized controlled trials and
systematic reviews (Lysogorskaia et al., 2023) demonstrating yoga’s effects on
fatigue, mobility, mood, and pain in MS populations.
B. Key Theories and Models
3
1. Biopsychosocial Model (Engel, 1977): Frames symptom management as an
interplay of biological, psychological, and social factors; yoga addresses all
three domains (Lugg, 2022).
2. Self-Efficacy Theory (Bandura, 1997): Yoga practice enhances patients’
confidence in managing symptoms, supporting long-term adherence and self-
care (Su, 2024).
III. Main Body/Discussion
A. Section One Clinical Context and Symptom Burden in MS
1. Prevalence and impact of fatigue, spasticity, and depression in MS.
2. Limitations of pharmacological management and role of non-pharmacological
interventions.
B. Section Two Comparative Analysis of Nursing Roles in Yoga Integration
1. Bedside Nurse Role: Patient education, safety screening, gentle pose
modifications, and monitoring during inpatient or outpatient sessions.
2. Advanced Practice Nurse/Nurse Leader Role: Protocol development,
interprofessional collaboration (e.g., with physical therapists), outcome tracking,
and policy advocacy for yoga programs.
C. Section Three Application and Implications
1. Case example: 6-week adapted yoga program in an outpatient neurology clinic.
2. Benefits: Improved fatigue scores (MFIS), balance (Berg Balance Scale), and
mood (PHQ-9).
4
3. Limitations: Accessibility, contraindications (e.g., severe spasticity), and need for
trained instructors.
4. Recommendations: Nurse-led training modules, tele-yoga options, and integration
into care plans.
IV. Conclusion
A. Summary of Key Points: Yoga serves as a multidimensional intervention aligned
with biopsychosocial and self-efficacy principles, supported by nursing leadership at
all levels.
B. Implications and Next Steps: The Final paper will propose a nurse-driven yoga
protocol with measurable outcomes, advocating for institutional adoption and further
research on long-term adherence.
5
References
Graves, J. S., Krysko, K. M., Hua, L. H., Absinta, M., Franklin, R. J. M., & Segal, B. M.
(2023). Ageing and multiple sclerosis. The Lancet. Neurology, 22(1), 66–77.
https://doi.org/10.1016/S1474-4422(22)00184-3
Lugg W. (2022). The biopsychosocial model – history, controversy and Engel. Australasian
psychiatry : bulletin of Royal Australian and New Zealand College of
Psychiatrists, 30(1), 55–59. https://doi.org/10.1177/10398562211037333
Naisby, J., Wilson-Menzfeld, G., Baker, K., Morris, R., Robinson, J., & Barry, G. (2023).
Yoga and Multiple Sclerosis: Maintaining engagement in physical activity. PloS
one, 18(7), e0288319. https://doi.org/10.1371/journal.pone.0288319
Su, F. (2024). Students' Self-Control and Self-Efficacy Through Yoga Practices and Their
Influences on Academic Performance. Pacific International Journal, 7(3), 171-176.
https://doi.org/10.55014/pij.v7i3.554
[https://doi.org/10.1016/S1474-4422(22)00184-3](https://doi.org/10.1016/S1474-4422(22)00184-3)
[https://doi.org/10.55014/pij.v7i3.554](https://doi.org/10.55014/pij.v7i3.554)
– Su, F. (2024). Students' Self-Control and Self-Efficacy Through Yoga Practices and Their Influences on Academic Performance. Pacific International Journal, 7(3), 171-176. https://doi.org/10.55014/pij.v7i3.554
**## AdvancedPracticeNursing_ClinicalDecision-MakingandLeadership2.pdf**
1
The Use of Yoga to Manage Symptoms in Patients with Multiple Sclerosis
Marcos Martin Bello
Florida National University
Decision Making-DBX-DL01
Dr.Nora Hernandez-Pupo
November 12, 2025
2
The Use of Yoga to Manage Symptoms in Patients with Multiple Sclerosis
I. Introduction
A. Background Information: Multiple sclerosis (MS) is a chronic autoimmune
disease affecting the central nervous system, leading to symptoms such as fatigue,
pain, spasticity, balance issues, and depression (Graves et al., 2023). Complementary
therapies, such as yoga, are increasingly being explored in nursing practice to improve
quality of life.
B. Statement of the Problem: Traditional pharmacological interventions often
inadequately address non-motor symptoms and side effects, prompting the need for
integrative, nurse-supported interventions like yoga.
C. Thesis Statement: Yoga, as a mind-body intervention, offers a safe, accessible,
and evidence-based approach for bedside nurses and advanced nurses to
collaboratively manage MS symptoms, enhance patient autonomy, and inform clinical
decision-making through biopsychosocial and self-efficacy frameworks (Naisby et al.,
2023).
II. Literature Review/Background
A. Overview of Existing Research: Review of randomized controlled trials and
systematic reviews (Lysogorskaia et al., 2023) demonstrating yoga’s effects on
fatigue, mobility, mood, and pain in MS populations.
B. Key Theories and Models
3
1. Biopsychosocial Model (Engel, 1977): Frames symptom management as an
interplay of biological, psychological, and social factors; yoga addresses all
three domains (Lugg, 2022).
2. Self-Efficacy Theory (Bandura, 1997): Yoga practice enhances patients’
confidence in managing symptoms, supporting long-term adherence and self-
care (Su, 2024).
III. Main Body/Discussion
A. Section One Clinical Context and Symptom Burden in MS
1. Prevalence and impact of fatigue, spasticity, and depression in MS.
2. Limitations of pharmacological management and role of non-pharmacological
interventions.
B. Section Two Comparative Analysis of Nursing Roles in Yoga Integration
1. Bedside Nurse Role: Patient education, safety screening, gentle pose
modifications, and monitoring during inpatient or outpatient sessions.
2. Advanced Practice Nurse/Nurse Leader Role: Protocol development,
interprofessional collaboration (e.g., with physical therapists), outcome tracking,
and policy advocacy for yoga programs.
C. Section Three Application and Implications
1. Case example: 6-week adapted yoga program in an outpatient neurology clinic.
2. Benefits: Improved fatigue scores (MFIS), balance (Berg Balance Scale), and
mood (PHQ-9).
4
3. Limitations: Accessibility, contraindications (e.g., severe spasticity), and need for
trained instructors.
4. Recommendations: Nurse-led training modules, tele-yoga options, and integration
into care plans.
IV. Conclusion
A. Summary of Key Points: Yoga serves as a multidimensional intervention aligned
with biopsychosocial and self-efficacy principles, supported by nursing leadership at
all levels.
B. Implications and Next Steps: The Final paper will propose a nurse-driven yoga
protocol with measurable outcomes, advocating for institutional adoption and further
research on long-term adherence.
5
References
Graves, J. S., Krysko, K. M., Hua, L. H., Absinta, M., Franklin, R. J. M., & Segal, B. M.
(2023). Ageing and multiple sclerosis. The Lancet. Neurology, 22(1), 66–77.
https://doi.org/10.1016/S1474-4422(22)00184-3
Lugg W. (2022). The biopsychosocial model – history, controversy and Engel. Australasian
psychiatry : bulletin of Royal Australian and New Zealand College of
Psychiatrists, 30(1), 55–59. https://doi.org/10.1177/10398562211037333
Naisby, J., Wilson-Menzfeld, G., Baker, K., Morris, R., Robinson, J., & Barry, G. (2023).
Yoga and Multiple Sclerosis: Maintaining engagement in physical activity. PloS
one, 18(7), e0288319. https://doi.org/10.1371/journal.pone.0288319
Su, F. (2024). Students' Self-Control and Self-Efficacy Through Yoga Practices and Their
Influences on Academic Performance. Pacific International Journal, 7(3), 171-176.
https://doi.org/10.55014/pij.v7i3.554
[https://doi.org/10.1016/S1474-4422(22)00184-3](https://doi.org/10.1016/S1474-4422(22)00184-3)
[https://doi.org/10.55014/pij.v7i3.554](https://doi.org/10.55014/pij.v7i3.554)
– Su, F. (2024). Students' Self-Control and Self-Efficacy Through Yoga Practices and Their Influences on Academic Performance. Pacific International Journal, 7(3), 171-176. https://doi.org/10.55014/pij.v7i3.554
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