Unit 2health And Wellnesspreparing For Clinical Practicems Thom Age
Unit 2health And Wellnesspreparing For Clinical Practicems Thom Age
Using the health belief model, identify the modifying factors impacting Ms. Thom's likelihood of taking a preventive health action. Which primary intervention activities are important for Ms. Thom? Using the transtheoretical model of change, in which stage is Ms. Thom most likely related to her smoking? Explain your answer.
Mrs. Lowe is a 52-year-old patient being treated for lymphoma (cancer of the lymph nodes) that occurred 6 years after a lung transplant. Mrs. Lowe is discouraged about her current health status and has a lot of what she describes as muscle pain. The unit where Mrs. Lowe is receiving care has a number of very sick patients and is short staffed.
a. You enter her room to do a morning assessment and find Mrs. Lowe crying. How are you going to use caring practices to help her, knowing that your day has just begun and you have many nursing interventions to complete?
b. When you listen to Mrs. Lowe, she explains that her muscle pain is very bothersome and it was worse when she was alone. Both you and Mrs. Lowe determine that an injection for her pain would be beneficial. In what way can you show caring in the way you administer the injection to Mrs. Lowe?
c. Mrs. Lowe's day is getting better. She seems more comfortable and is crying less. You find that your day is more controlled. What else can you do for Mrs. Lowe?
During your next clinical practicum, select a patient to talk with for at least 15 to 20 minutes. Ask the patient to tell you about his or her illness. Review the skills of listening in this chapter and in Chapter 24. Immediately after your discussion, reflect on the discussion with the patient and determine if you have enough information about him or her to answer the following questions:
a. What do you believe the patient was trying to tell you about his or her illness?
b. Why was it important for the patient to share his or her story?
c. What did you do that made it easy or difficult for the patient to talk with you? What did you do well? What could you have done better?
d. Would you rate yourself a good listener? How can you listen better?
Do you have a friend or family member who has cancer and is willing to talk about it? If so, ask the individual to tell you what the experience has been like and what he or she would recommend to help you provide better care for survivors.
Ms. Ritter is a 32-year-old woman who visits the medical outpatient clinic to discuss her treatment options for breast cancer. She is married and has one child, a 6-year-old daughter. She and her husband hoped to have another child in the near future but now wonder if that will be possible. She shares with the nursing staff her concerns about the future and how cancer will affect her and her family.
Identify two follow-up care plan components that would be important when considering Ms. Ritter's role as a wife and parent. What is an appropriate response the nurse might give Ms. Ritter about her fatigue and sleep issues?
Ms. Jackson is a 44-year-old woman diagnosed with diabetes two years ago and now insulin-dependent. She experienced homelessness after losing her job, and she has been unable to afford her medications. She arrived at the ED with a blood sugar of 322 and A1C of 11%. Sam, a nursing student, cares for Ms. Jackson, learns about her fears and social circumstances, and consults with a social worker about community resources.
List some of the social determinants of health that Sam most likely discovered. Using the C-LARA communication mnemonic, plot a discussion that might help Ms. Jackson understand that diabetes is manageable and does not necessarily result in death. Consider how her weight, nonadherence history, and prior ED visits might affect treatment and how self-awareness can help reduce biases in providing care.
Paper For Above instruction
The case of Ms. Thom presents an important opportunity to analyze her health behaviors through the lens of health psychology models, notably the Health Belief Model (HBM) and the Transtheoretical Model of Change (TTM). Understanding the factors influencing her preventive health actions and her stage of readiness regarding smoking cessation can guide targeted interventions to improve her health outcomes. Additionally, addressing emotional support and caring practices in nursing practice emphasizes the holistic approach necessary in patient-centered care, especially for patients like Mrs. Lowe and Ms. Jackson dealing with complex health and social challenges.
Applying the Health Belief Model to Ms. Thom involves examining modifying factors such as her
perceived susceptibility to health risks, perceived severity of conditions like hypertension and weight gain, perceived benefits of quitting smoking, and potential barriers such as fatigue and lack of motivation due to her busy work schedule. Ms. Thom's recent diagnosis of hypertension increases her perceived threat, motivating her to consider health actions. However, barriers such as fatigue and emotional exhaustion decline her perceived self-efficacy, reducing her likelihood of engaging in preventive behaviors like returning to fitness classes or quitting smoking. Important primary intervention activities include personalized education about hypertension's consequences, motivational interviewing to enhance her confidence, and developing manageable lifestyle modifications that align with her busy schedule (Janz & Becker, 1984; Rosenstock, 1974). Behavioral interventions should focus on empowering her with small, achievable goals and supportive follow-up.
Using the Transtheoretical Model, Ms. Thom is most likely in the contemplation or preparation stage concerning her smoking behavior. She has shown some awareness of her health risks by attempting to cut back on cigarettes after watching her mother’s death from emphysema. Nevertheless, her continued smoking indicates she has not fully committed to cessation but recognizes the need for change. This stage reflects ambivalence and readiness to transition into preparation, where she could benefit from targeted counseling, nicotine replacement therapies, or pharmacologic aids (Prochaska & DiClemente, 1983). Her motivation can be enhanced by addressing the perceived benefits of quitting and reducing perceived barriers, thus moving her into the action stage.
The caring practices employed in nursing are vital in holistic patient care, especially in emotionally charged situations like Mrs. Lowe’s. When encountering her crying, establishing trust through empathetic listening, maintaining eye contact, and providing reassurance are essential strategies. Demonstrating genuine concern and validating her feelings conveys compassion, fosters therapeutic rapport, and alleviates emotional distress (Watson, 2008). During pain management, showing caring in the administration of injections involves gentle communication, explaining each step to reduce anxiety, and recognizing her comfort needs. Further, engaging in presence, attentive listening, and comforting touch can significantly enhance her sense of being cared for, contributing to her overall well-being.
As Mrs. Lowe's condition improves, additional supportive actions include encouraging her to express her concerns, arranging for psychological support or counseling, and involving her in her care planning. Facilitating relaxation techniques, involving family members if appropriate, and providing information about pain management options empower her in her recovery process. Such attentive, compassionate
engagement can help her feel cared for and foster resilience amidst her health challenges (Benner et al., 2010).
Listening is a core skill in nursing that extends beyond hearing words—it involves truly understanding the patient’s perspective and emotional state. Conducting a meaningful patient interview requires active listening, open-ended questioning, and reflective summarization. When reflecting on the conversation, it is essential to consider whether the patient felt heard, understood, and comfortable sharing. Effective listening fosters trust, reveals crucial insights into their experience, and informs personalized care (Bulman & Schultz, 2013). Recognizing personal biases and assumptions related to cultural, social, or health behavior differences is equally important. Self-awareness enables nurses to provide nonjudgmental, culturally sensitive care, reducing the risk of misunderstandings or diminished patient engagement (Campinha-Bacote, 2002).
Providing culturally competent care involves understanding social determinants that influence health behaviors, such as socioeconomic status, access to healthcare, housing stability, and health literacy. In Ms. Jackson’s case, factors include her unemployment, homelessness, lack of insurance, and cultural beliefs about diabetes. Using the C-LARA communication mnemonic—Connect, Listen, Acknowledge, Respond, and Add—facilitates a structured, empathetic engagement. For example, connecting with Ms. Jackson by validating her fears, listening to her concerns about mortality, acknowledging her social circumstances, responding with reassurance about diabetes management, and adding information tailored to her situation can foster understanding and motivation (Campinha-Bacote, 2002).
Finally, managing care for Ms. Jackson upon readmission involves recognizing how her weight, nonadherence, and prior ED visits may reflect deeper social and psychological issues impacting her health. Biases regarding her noncompliance might lead to frustration; however, self-awareness about these assumptions helps in adopting a supportive, patient-centered approach. Emphasizing collaborative goal-setting, providing resources, and addressing social barriers are essential in delivering equitable, effective care. Understanding social determinants ultimately enhances health outcomes and supports sustained management of chronic conditions like diabetes (WHO, 2010).
References
Benner, P., Sutphen, M., Leonard, V., & Day, L. (2010). Educating Nurses: A Call for Radical Transformation. Jossey-Bass.
Bulman, C., & Schultz, S. (2013). Reflective Practice in Nursing. Wiley-Blackwell.
Campinha-Bacote, J. (2002). The culturally competent nurse: Model of care. Journal of Transcultural Nursing, 13(3), 181-184.
Janz, N. K., & Becker, M. H. (1984). The health belief model: A decade later. Health Education Quarterly, 11(1), 1-47.
Prochaska, J. O., & DiClemente, C. C. (1983). Stages and processes of self-change of smoking: Toward an integrative model of change. Journal of Consulting and Clinical Psychology, 51(3), 390–395.
Rosenstock, I. M. (1974). The health belief model and preventive health behavior. Health Education Monographs, 2(4), 354-386.
Watson, J. (2008). Nursing: The Philosophy and Science of Caring. University Press of Colorado. World Health Organization. (2010). Social determinants of health. Geneva: WHO.
Additional scholarly references as needed for depth, including recent articles on health models and culturally competent care.