Health Promotion In Relation To Holistic Care

Health Promotion In Relation To Holistic Care This essay will attempt to discuss the significance of the link between health promotion and holistic care for the patient. Firstly, the patient will be introduced and a definition of holistic care and assessment will be given. Secondly, the health promotion model and nursing interventions will be described and discussed. Finally this essay will reflect on the effectiveness utilising of health promotion models care; rounded up by a conclusion of the findings. Names in this essay have been changed to protect the patients identity and maintain confidentiality in accordance with the nursing and midwifery councils guidelines (NMC, 2008). Verbal consent was obtained by the client and her family, to use their basic anonymised details. The patient, who for the purpose of this essay shall be known as Jane, is 21 years old and has an acquired brain injury (ABI) following a road traffic accident. An ABI is defined by Headway (2010), the brain injury association, as an injury caused to the brain since birth. Jane has problems remembering information and continually repeats what she says, and also repetition of speech, known as perseveration. Jane was originally admitted onto the neuro rehabilitation ward to address challenging behaviours at home and following successful interventions was due to be discharged when an appropriate care package could be put into place. Due to the complexity of Janes condition her care package was taking longer than planned. While waiting for discharge, Jane, who usually lives at home with her mother, has undertaken many home visits. It then became apparent that Jane was losing weight to the extent that she had become underweight and it became necessary for this to be addressed before Jane could be discharged. It was important that Janes weight was addressed as after a Malnutrition Universal Screening Tool (MUST) assessment was carried out it was concluded that Jane was at high risk from malnutrition. MUST is a screening tool that recognizes malnutrition and those at risk of malnutrition. It encourages multidisciplinary working which improve clinical outcome (BAPEN 2003). At 5 foot 7 inches and weighing 53 kilograms Janes body mass index (BMI) was 19. She also had lost approximately 0.5 kilograms a week for the prior four weeks meaning she had lost nearly 5 percent of her body weight. Best (p.23, 2008) states that malnutrition is caused by an inadequate availability of nutrients, because of either poor intake or deficiency as a result of disease. It is widely accepted that adequate nutrition plays an important role in maintaining optimal health. Following a healthy diet has lots of benefits, not only physically but mentally too. According to the World Health Organization (1948) health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity. Following this a complete holistic assessment was carried out. The world health organisation (WHO, 2004), states that holism is a concept which takes into account a patients mind, body and spirit. It includes all aspects of the client and carers life, for example, account of problems from both person and carer, psychiatric and physical health history, medication and compliance, social history, past and current hobbies and interests, daily living skills, driving and faith/religion. Each of these elements is seen as inter-related and as equally important so when any of the elements are compromised there will be an inevitable effect on the others (Ellis 1999, Brooker Waugh 2007). The assessment used for the patient is a trust based holistic assessment founded on the Roper-Logan-Tierney Activities of Daily Living Model. Although published in 1980 this first model of nursing is just as relevant today. The model identifies the 12 activities of daily living as: communication; breathing; eating and drinking; eliminating; sleeping; dying; mobilisation; managing a safe environment; personal cleansing and dressing; work and play; expressing sexuality. These activities identify the basic health needs with the emphasis on assessing the effect of the mind, body and soul of each activity in relation to the persons health. They note how the activities are inter-related and not mutually exclusive (Roper et al 2000). They expanded on the inter-linked relationship between the patient, activities of daily living, factors which influence these activities (for example environmental factors), the lifespan and our level of dependence. It is because of these views that this model has been utilised as a true holistic assessment. Hinchcliff et al (2008), Brooker Waugh (2007) and Dougherty Lister (2008) substantiate that assessment is an ongoing, complex, systematic and interactive process. It involves gathering a range of information from and about the client and then using that information to decide the care, support and intervention that is required. The information is then clearly documented as in line with the Nursing and Midwifery Councils guidelines (NMC 2005). Subsequent to the assessment, Jane was discussed at the weekly multi-disciplinary team (MDT) meeting, as in accordance with the NMC code which states that nurses must work together with other professionals as a team whilst sharing and valuing each others skills and knowledge (NMC, 2008). The nurse is at the core of the clients care and can therefore communicate and negotiate the clients needs and preferences to other members of the interprofessional team (Day, 2006). Following the meeting various interventions were put in place: Blood tests were ordered to check for any underlying medical causes (test results were negative). Janes weight was to be monitored on a weekly basis, food and drink charts as well as nutritional supplement charts were to be completed by nursing staff and Janes relatives who often took her out for meals. The Royal College of Nursings campaign Nutrition Now (RCN 2007) suggests that patients are also monitored to make sure that they are eating the food they are offered. Protected mealtimes on the ward would be observed by all members of the multidisciplinary team as sometimes this was not adhered to. Nutrition Now (2007) also highlights the need for protected mealtimes so that there is a more relaxed atmosphere for patients to eat their meals and that they are assisted by nurses as well as healthcare staff to eat their meals. The dietician would review Janes nutritional intake: Speech and language would assess Jane for any s wallowing difficulties: Occupational therapy would observe Jane eating and drinking before making any recommendations: Janes weight would be monitored and reviewed at following MDT meetings. Auty Rennie (2007) suggest that professionals working in isolation with a client rather than in a team struggle to achieve the optimum outcome for the client as any treatment provided could be ineffective. Janes named nurse explained to Jane issues that had been discussed at the MDT meeting and that Janes weight would need to be stabilised before she could be discharged. Also a care plan would be put in place to address this issue. Nursing staff had already identified that Jane would be worried about becoming overweight as this was something she relayed often during conversations with them. Rosenstockss health belief model (1952) cited in Glanz (2005) works by exploring peoples perception and ways to inform, encourage and motivate change. There are six steps contained in this model: Perceived susceptibility; perceived severity; perceived benefits; perceived barriers; cues to action; self-efficacy. These steps were applied to the issue of Janes weight. Jane was worried about becoming overweight (perceived susceptibility) and she was informed of the risk to her health because of not eating enough. Janes understanding and judgement of the severity of the situation were difficult. Short-term memory problems and the inability to process information and make informed decisions are common problems associated with ABI (Headway 2009). Because of this the nurse clarified to Jane how her health would be affected and that she would not be well enough to be discharged (perceived severity). Jane appeared to understand that she needed to put on weight before she could return home, it was explained that her food intake would be monitored and that the dietician had revised her diet to include high calorie foods and supplements. Jane was happy to comply with the interventions as she knew she would be discharged but she was worried that she would not be able to eat and drink enough even if she wanted to (perceived benefits). Jane was reassured that she would be given support and guidance to ensure the best possible outcome (perceived barriers). Although cues to action are directed more towards people living in the community it was adapted to meet Janes needs, she was given information in a format she could understand and also took part in Health Eating Sessions with patients from other wards. Jane was supported and encouraged to eat snacks as well as her regular meal, food she enjoyed was made available to her at anytime. She also had regular motivational chats with her named nurse (self-efficacy). The Tannahill model (1985) cited by Downie et al (2002) was also utilised. This model defines health promotion as an approach to improving health and diminishing the risk of ill health through incorporating three processes; health education; prevention; protection. Health education: influencing peoples behaviour and attitudes; encouraging positive well being and diminishing ill health. Prevention and protection: to diminish the risk of disease developing by interventions, that is, primary: Giving people the knowledge to make better choices with regard to their health, for example, risks related to smoking; immunization. Secondary intervention: Health screening for early detection, for example, smear tests, smoking cessation. Tertiary: Managing established disease and preventing complications, for example, rehabilitation advice after stroke or serious injury. Protection: through government policies: public health and health promotion programmes can improve health, reduce disease risks , manage chronic illness, improve wellbeing, promoting self-sufficiency of individuals. In conclusion the holistic assessment and health promotion and belief models have worked well for the patient. It allowed the multidisciplinary team to put together an effective care plan. The nurses involved with Janes care gave lots of encouragement and advice to Jane and because nursing staff followed the care plan Jane began putting weight on. Although the reason why she needed to do so and the reassurance that she would not become overweight had to be explained to Jane continually because of her short term memory problems. The effectiveness of the care plan is apparent as despite NICE bringing in Providing nutritional support for adults guidelines and the introduction of specialist nutrition teams, being brought in over the last twenty years there are still patients who are somehow being missed and are under-nourished (Holder 2009). Additionally NICE guidelines (2006) state that knowledge of causes, effects and treatment of malnutrition among healthcare professional in the UK is poor. It goes on to say that all health professionals linked with patient care should be trained in knowing how to provide ample nutrition for peoples needs. This can be seen to still be a major factor in the improvement of nutrition for health. Holder (2009) asserts that nurses need to be aware of all initiatives nationally, regionally and within their own trust so they are able to provide better nutrition for their patients. 1943 words

Creating an Engaging Reading

If it’s tough to write it’s even tougher to write one that engaging, or is it? I have evidenced two types of writing that work for me. 1. Writing as execution of Play[wild-fire] 2. Writing as execution of Plan[following] The first one is my choice whether its philosophy or science, I prefer the first method. And to be engaging 1. It should start from the reader, creating a wonder in him 2. It should continue creating wonder. . . 3. It should be short, one-sitting reading. Now creating an engaging reading is very much a question of how to make people wonder and curious every time. And one can’t create wonder for the sake of it, only an insight can create that. Ie insight creates a broad POV with respect to the topic which can then be used to project it. Wild fire thinking is essential in this regard. And nothing comes out of thin air without thinking, so all in all it does takes time to make a really good engaging read, but that time is not addition to the thinking time? And the thought of making the really dry non fiction, makes it to get integrated with the fiction. And embodied metaphors are also worthy in this regard. In this regard a good writing comes out of play, just as the poet who said , one should keep writing and writing and writing till it causes, pain infact what he saying is that to let the mind to play and get some data which you can then organize and play the game. Can science be like that, can we make the objective data subjective. No matter what you are trying to say, if you are trying to make sense, make meaning then you must log on to philosophy, fiction, poetry because that what builds and inspires the meaning it’s not logic and reason as said in ‘Mind in society’ , ‘homo ludes’ and in ‘man play and games’. What does it mean to have an insight, to have an insight is to have an wonderful understanding of something, to have an unusual understanding of something, and the good news is its always a result of Play. Resumes, News papers atc are written to spread information while few others are written to spread the meaning. In such cases the best practice would to mirror the writer’s own mind as he writes. Articles written to spread the meaning are more engaging than the articles written to spread the info. Highly cited research articles regardless of their field are found in agreement with this. I. e the piece the writer writes should be a live recorded footage of his learning, so it’s a matter of play and a little game. Whatever that gets through his head while he is at play, Conversations, pictures, anecdotes etc would be the best thing and best order but one should be aware whether it’s authentic content or not. And one should decidedly remove stuff which is unauthentic in this regard. A good article/book will be reflection of writer’s learning, Writer’s learning as it happened. So writing is not different from learning and it’s not an extra burden as usually thought. Follow the sense, sound will follow: poet Follow the thought with pen, engaging reading will follow: Writer

The Manufactured Crisis Essay - 1510 Words

The Manufactured Crisis written by David C. Berliner and Bruce J. Biddle is a book disproving the horrible reputation America’s education system has been given by the media and by the government. Americans have almost been programmed to believe that the public school systems are failing and that in order to make their children successful they have to be sent to private schools. The Manufactured Crisis is a well written book jammed packed full of research and observation that overwhelming disproves the myths and bashing of public school systems. In chapter one Biddle and Berliner grab you attention right away this throwing a number of news headings at you. Most of these headings read something like, â€Å"Fourteen-year-old student,†¦show more content†¦The amount of charts and cited documents that are included in this book are uncountable. The myth that I think has the greatest effect of this is when they prove the myth wrong about dropping SAT scores nation wide. The graph that I found the most inveigling was exhibit 2.5. It is in this graph that shows that nationwide from the year of 1976 to the year 1993 all the races Black, Asian American, Native American, Mexican American, and Puerto Rican showed some type of advancement in achieving higher grades. All accept the white population who in fact scored 6 points lower on average. I am not saying that Biddle and Berliner are raciest, but in fact made me think that the reason why the media says we are in an education crisis is because the white population is dr opping in progress where the so called â€Å"minorities† are advancing, and in the case of the Asian Americans are exceeding us in scores. Very intriguing that there is now an education crisis since the â€Å"minorities† are catching up to the â€Å"superior† white race in testing grades. 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