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Promoting Individual Health Assessment Scenario – Molly (Case Study Sample)



Promoting Individual Health Assessment scenario – Molly
1 .Introduction
Health Promotion is a discipline that enables people to attain optimal heath levels by guiding them in making lifestyle changes, which eventually improve their well-being. Ideal health is a combination of proper spiritual, social, intellectual, emotional, and physical health. Three stages of health promotion exist and they include the primary, secondary, and tertiary phases. Firstly, the primary process involves averting the contraction of diseases. If diseases already infect a patient, secondary health promotion will focus on controlling the effects of the malady. Thirdly, the tertiary phase aims at aiding a patient to control long-term diseases such as diabetes mellitus and heart disease. (AJHP) (2009) .Since the patient in our sample scenario has type 2 diabetes; she falls into the third category of care.
2. Literature review
Tertiary health promotion centers on patients living with chronic diseases. It educates them on ways of managing their lifestyles in order to improve their health. (McManus A) (2013). To achieve this, health professionals use various approaches and strategies that best suit the particular case. To understand approaches and strategies we first have to explain theories and models as used in health promotion procedure. Earp and Ennett define a model as the visual representation of a theory’s components. It often derives information from more than one theory, and it permits the addition of methods and features not based on formal theory but from experimental findings or sourced from working professionals. (Earp & Ennett) (1991).A theory on the other hand is a general idea, which explains or signifies reality from the point of view of a particular discipline. (Earp & Ennett) (1991). Thus, the concepts ideas and that form models originate from theories.
Professionals are yet to conduct comprehensive testing of most of the theories utilized in health promotion because health promotion is a social science and therefore, a theoretical model is the more appropriate designation for these theories. (Nutbeam and Harris) (1991). The phrase “approaches” is also used by some scholars to refer to health promotion theories. An approach is a method one can use to handle Health Education practice. The approaches that can be used include “Medical” approach, which involves encouraging patients to seek medical attention, and “Societal Change” approach, which emphasizes improving the social and physical environment of a patient. (Ewles and Simnett) (1985).
Other than theories, models are applied in the field of health promotion. Numerous types of models exist and their use depends on the type of problem to be solved. As Nutbeam and Harris asserted in 1985, we cannot apply a single theory universally in the field of health promotion because there is a wide range of health problems and their causes, the variety of people and their surroundings, and different levels of sophistication and skills among health workers. Models can be categorized into individual, community, communication, and organizational change models. (Nutbeam and Harris) (1985).
Since in our sample scenario we aim at improving the health of a single individual, the Individual models will be more relevant to our case. The individual models include the Health Belief model; Stages of Change/model; Social Learning Theory and Theory of Reasoned Action. The above models are concerned with the state of an individual’s health and behavior. The Stages of Change model and Health Belief Model are in this group. They encourage behavior change at the inter-personal level or the intra-personal level of a patient.
The models take into account factors such as people’s expertise, values, and mindsets concerning health. Moreover, they concentrate on the difficulties and advantages that people understand to be bettering their well-being along with the issues that lead to behavior change at personal level and in coexisting with the environment. They also rely on self-efficacy or the confidence in one’s capacity to take steps towards behavioral change. Concerning behavioral change, according to Prochaska and DiClemente (1992) there exist the following stages of behavioral change: pre- meditation, deliberation, planning, action, and preservation.
The role of a nurse in health promotion is to first identify a patient in the community or in hospital who is in need of support. The nurse then determines the patient’s and their family’s individual health requirement according to the client’s understanding of their particular needs and is acquainted with their position in society. After that, the nurse formulates a health promotion plan, sets realistic targets, and schedules systematic follow-up visits to supervise improvement. A health professional is also supposed to educate and empower clients and encourage any relevant environmental, social, or political adjustments needed to achieve the set objectives. (Whitehead) (1999).
3. Discussion
The nurse is to analyze the following sample scenario. Molly is a 35-year’s old married woman with two children aged 8 and 3 years old respectively. Her husband works away from home and her father has been diagnosed with dementia .She is therefore a single parent tasked with the responsibility of taking care of two children. The eldest child Eric is afflicted with mild autism and younger child has been suffering from numerous incidents of tonsillitis and earache. Since she is a single parent with an autistic child who is in need of specialized care, she needs extra social support to take good care of her children. She is also in the third trimester of her pregnancy and was diagnosed with type 2 diabetes two years ago and she is therefore prone to developing health complications that result from diabetes. The aforementioned factor necessitates medical support for Molly. She once experienced postnatal depression following the birth of her second child and she needs emotional support to prevent a reoccurrence of the depression. Outlined above are the mental, physical, emotional, and social needs of Molly that put her in need of health promotion.
3.1 Bio-psyco-social factors
Before the health promotion process can commence, we have to identify the bio-psycho social factors that influence our subject’s health. In the last few decades, there has been growing public and scientific curiosity over the likely effect of social and psychological factors on human health, and a research conducted on the matter has given proof of mental and social effects on human health. The connections between the human brain, immune system and behavior, has influenced greatly the study of social and biological processes relating health, disease and psychosocial factors (Zachariae), (1996). By questioning the notion that the immune system is an independent defense mechanism, there is a change from a mainly biomedical model of health to a multidisciplinary bio-psycho-social method (Engel, 1977).
The bio-psycho-social factors include. The biological factors that influence Molly’s health include living with type 2 diabetes, and being pregnant. The cause of type 2 diabetes is comparative insulin shortage and individuals with this kind of diabetes are impervious to the effects of insulin (Defronzo et al) (1997), (Lillioja et al) (1993).Initially, people with this condition do not require insulin medication to live. This type of diabetes can be left undetected for a long period because hyperglycemia is still not serious enough to instigate observable signs of diabetes. Despite this, patients are at a great risk of contracting micro vascular and macro vascular complications (Mooy JM) (1995), (Harris) (1993) .Most patients having this type of diabetes are obese, and the obesity leads to and worsens insulin resistance. (Campbell and Carlson) (1993), (Borgadus et al) (1985).Pregnant women with type 2 diabetes should be treated or else their babies might have congenital anomalies. Other dangers they might face include miscarriage, preterm birth, the development of large babies and high blood pressure. There is also a risk of perinatal mortality for these babies. (EUROCAT)(2002).
The added risk of complications is mainly for congenital heart problems (3.4 times greater risk) and problems of the nervous system (2.7 times elevated risk). Above all, the danger of neural tube defects is three to four times more than normal. Women living with diabetes are given a higher dose of dose of folic acid (5 mg) starting before conception and up to the twelfth week of pregnancy in order to avert the risk of congenital anomalies. The patients are also encouraged to engage in physical exercise to lower their weight and increase insulin sensitivity. Hospitalized treatment of hyperglycemia is also recommended (Simonson et al) (1984), (Wing et al) (1994).
The psychological factors influencing Molly’s health include stress and anxiety. The stress might be caused by the fact that her father has recently been diagnosed with dementia which might cause her to worry about him. The second cause of stress is that she is expected to take care of her children alone despite the fact that one of them is in poor health and the other requires specialized care due to his autism. The anxiety might be caused by fear that she might get depressed again after childbirth since she was previously diagnosed with post-natal depression.
The social factors affecting Molly’s health is mainly the strength of her social ties to her friends and family. Molly seems to be isolated from her husband and this might affect their relationship negatively. Poor social support from her husband will ultimately lead to psychological stress and, which will lead to the rise of her blood sugar level...
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