Upon consideration of a patient who was overweight, I have considered the application of the Pender’s Health Promotion Model (HPM). Some of the concepts from Pender’s theory suggests that individuals seek to regulate their behavior, interact with the environment and are influenced by health providers (Nursing Theory, 2015). In addition, humans seek to self-initiate and self-regulate changes in behavior (Nursing Theory, 2015). This model can be utilized to create a framework that will address the factors associated with at-risk behaviors related to obesity.
The framework from Pender’s HPM can serve as the structure of an individualized treatment plan for each patient. According to Valek, Greenwald, and Lewis (2015), certain psychological factors impact a patient’s ability to achieve weight loss and maintenance. These factors include “internal drive, ongoing selfmonitoring, long-term flexibility, positive mood, emotions, appropriate goals, and management of external stimuli” (Valek et al. , 2015, p. 129). Integrating these factors in a weight loss and maintenance program is essential to success.
With this being said, holistic interventions that address each feature should be considered when caring for patients who are overweight. Application of Pender’s Health Promotion Model Internal drive is an important aspect to address with each patient. Taking the time to better understand each patient’s personal values and beliefs related to health and weight is central. When values and beliefs are known, then the provider can have an insight into the internal motivational factors that are meaningful to patients. Self-monitoring is an intervention that can help them identify their barriers and daily progress.
This action could be accomplished with journaling of intake. Conversation related to flexibility and adaptation is necessary (Valek et al. , 2015). Discussion about maintaining a positive attitude and discovering ways to divert stress is crucial. Setting individual goals of weight is the next step. Goal setting can help to give control to the patient (Valek et al. , 2015). Coaching related to the processing of external stimuli can help individuals identify elements in the environment that interfere with their goals.
These steps will involve planning ahead for beverages, snacks, and meals. In addition, making a calendar that tracks exercise and activity can help to identify when goals for weekly exercise is being met or not met. Preparing patients to manage their weight maintenance involves a lifetime commitment and lifestyle change. Application of Pender’s HPM can help patients become empowered to control their health risk behaviors. Patient Experience Upon reflection, I have cared for many individuals who could benefit from the application of Pender’s HPM to lifestyle behaviors.
Specifically, I can recall one particular patient who was a thirty-five-year-old female who struggled with weight maintenance throughout her life. Her body mass index was 30. 9 kg/m2. She had previously tried many diets and was unable to find anything that worked. As I began talking with her, I discovered her perceptions were not optimal. She felt she was dealing with her weight issue alone. She verbalized that she had been told she needed to eat right and exercise. She mentioned that I was the first person to discuss her goals and barriers.
Health maintenance should be a partnership between the provider and patient. I continued to examine her personal successes and challenges related to diet and exercise. I mentioned tracking her weekly exercise and planning meals ahead. As I reflect back, the application of Pender’s model was utilized. Our discussion influenced the concepts of self regulation and environmental control. Summary When caring for patients that have at risk health behaviors, it is essential to reflect on tools such as theories to help build a framework for a comprehensive health plan.
An integration of theory to the individualized needs of each patient is essential to our practice. Week Four Journal After an examination of the patient profile at my practicum setting, I began to pay attention to the strategies utilized to assess and promote health. The practicum setting is located in Flint, Michigan. This city has the fifth highest crime rate in the nation (Centers for Disease Control and Prevention, 2015). In addition, 41. 5 % of the population live in poverty (United States Census Bureau, 2015).
Moreover, the median income per household was $24,834 (2009-2013) (United States Census Bureau, 2015). With this being said the windshield survey revealed a city that is underserved, disadvantaged, and has limited access to health services. In addition, in 2012 the crime rate was six-hundred times the national average (City Data, 2015). Flint had a higher prevalence of rapes and assaults than the nation did in 2012 by three to four times (City Data, 2015). It became evident that the manner to which we should approach patients who live in this community would need to be tailored to address the barriers that exist.
According to the Neighborhood Effects on Health and Well-being (NEHW) Study, researchers linked “neighborhood social disorder, cumulative poverty, and crime to poor mental health such as depression and anxiety” (O’ Campo et al. , 2015, p. 71). Mitchell, Richardson, Shortt, and Pearce (2015) found a similar connection between neighborhoods and mental health. According to their findings, access to green/recreational areas versus poorer access led to an increase in mental health disparity (Mitchell et al. , 2015).
Therefore, paying attention to the influence of environmental factors became a priority for the patients seen at the practicum setting in Flint, Michigan. These social determinants of health will influence the manner of which we support, educate and deliver care. Patient Assessment The assessment process in the clinical setting included a comprehensive evaluation of the patient’s physical, social, environmental, and cultural needs. The intake assessment included an assessment of access to health services. The office staff gave attention to assuring a connection with community resources.
Consistent education was shared related to family planning and sexual relations. When young mothers became pregnant, the office offered hospital sponsored classes on parenting skills. I was impressed with how much time my preceptor spent with each patient. She sat with them and developed relationships with the patients in her care. They were able to have honest discussions about their lifestyle. Enhanced Patient Assessment Considerations for any optimizations to this process was difficult. The current process was genuine, personal, individualized, and tailored to the patient population.
However, due to the research findings discussed related to mental health, one enhancement may include depression and partner violence screening. Even though a lot of time was spent during the assessment period, very few questions focused on mental health assessment and the potential presence of partner violence. Due to the level of evidence that links social discord to mental health, the patients in Flint may be at a greater risk for depression than individuals in other safer communities. In addition, women may be at a higher risk for partner violence.
Precautionary measures should be in place to screen for these red flags to prevent a further disadvantage. Summary In the review of Flint’s windshield survey, the conclusion was insightful. The challenges these patients may face may be different than other communities. In order to successfully meet the needs of the population, it is essential to understand and interpret the social and environmental constructs of the neighborhood of which we practice. Adding additional components to the intake assessment such as depression screening and partner violence evaluation may prove to be beneficial in this setting.