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Health Promotion Plan Angela McCollFerris State UniversityAbstractIn this paper I will introduce my individualized health promotion plan based on my health needs, which is exercise and healthy eating. I will discuss assessment tools used to drive my health promotion plan, which are health beliefs survey, and journal logs. I will address my readiness to change based on the transtheoretical model and a wellness-oriented nursing diagnosis of health-seeking behaviors related to sedentary activities and imbalanced nutrition as a risk factor for unhealthy body weight. I will use nursing interventions and outcomes will be measurable and evaluated. Health Promotion PlanThe purpose of this paper is to develop a health promotion plan individualized specifically to my personal health needs based on my health assessment. Health and health behavior assessments, “provides the database for making clinical judgments about the client’s health strengths, health problems, nursing diagnosis, and desired health or behavioral outcomes, as well as the interventions likely to be effective” (Pender, Murdaugh, & Parsons, 2011, p.89). I will asses my health using three different self-assessment tools and develop a health promotion plan based on the results of these assessments. Interventions and measurable outcomes will be made based on the wellness nursing diagnosis.Self-Assessment ToolsI used the health beliefs survey (see Appendix A) for my health self-assessment. This assessment tool allowed me to assess how I perceive my health and the level of control I believe I have over my own health. The results indicate I scored high in the internal subscale for the survey. Meaning I believe I have more personal control over my own health rather than chance and others controlling my personal health. From these results I chose to assess my eating and exercise habits. These are two areas that have an effect on my health and I am in complete control over.To assess my current exercise and eating routine I used a daily journal log for exercising (see Appendix C) and food journal (see Appendix B). The daily food journal I chose provides a total caloric intake per day and what was actually consumed throughout the day at mealtimes. These two aspects were important for me, because I would like to cut out the processed food from my diet, increase my water intake and keep my calorie count below 1300 per day. With this journal I am able to monitor what I have been consuming and how much I have been consuming. “Several studies have shown that people who keep food journals are more likely to be successful in losing weight and keeping it off” (WebMD, 2008). Being aware of exactly what and how much I am consuming in a day will help prevent me from overeating and mindless snacking during the day. It is also providing a timeline of when the food was consumed in a 24hour period. This will allow me to measure if I am eating too much at certain times, or not enough during the day and overeating at night.The exercise journal will allow me to assess how much I am exercising per week, how many hours, type of exercise and if I did not exercise why I did not and how I felt on the days I did and did not work out. I will also demonstrate what time of the day am I more likely to work out. I would like to at least be exercising eight hours a week and this journal will give me a good indication if I am already meeting this goal. Keeping an exercise log will allow me to see what times I am more likely to work out, if I am working out with anyone and how long am I actually exercising in a week. It also allows me to see on the days that I do not work out what the reasoning is and how it makes me feel. Keeping an exercise log for a long period of time also provides a way to keep track of changes and endurance in exercise routine. ResultsThe results of the daily food journal (see Appendix B) self-assessment tool I used demonstrated that I am not keeping my calorie count below 1300 in a 24hour period. It also demonstrated that I am consuming too much processed foods, fast foods and sugary drinks while not drinking nearly enough water. I have not been able to drink a lot of water lately but after looking at the results there are days when I do not drink water at all. It also revealed that I am not eating enough vegetables in my diet, but that I do eat enough fresh fruit. The results also revealed that I do eat periodically throughout the day, and I am not waiting until night time and overeating.The results of the daily exercise journal (see Appendix C) self-assessment tool demonstrated that I have not been exercising enough during the week and my main excuse has been that I have too much homework. It also demonstrated that I feel bad on the days that I am not able to do any physical activity, because of the anxiety I get from needing to get all of my homework done. Usually summertime I am road biking at least five times a week, but as the journal shows I am not getting any biking in this summer. It showed that I am more likely to work out later in the day, and not on the days that I work. The results of my exercise journal made me realize that I need to give myself at least two hours on my days off for the exercise that makes me feel good. Readiness for ChangeThe transtheoretical model describes health behavior changes that are progressive and maintained. “The premise of the model is that health-related behavior change progresses through five stages, regardless of whether the client is trying to quit a health-threatening behavior or adopt a healthy behavior” (Pender, Murdaugh, & Parsons, 2011, p. 51). The five stages include:?Precontemplation: no intention to take action?Contemplation: intends to change?Planning or preparation: making small or sporadic changes?Action: actively engaged in behavior change?Maintenance: sustaining the change over time (Pender, Murdaugh, & Parsons, 2011). Based on the transtheoretical model I am in the planning stage. While in the planning stage I have made a decision to change and have been working toward this goal. I have known that I would like to start making changes in my eating and exercising habits for a couple months now. I was in the contemplation stage as I was intending to start making changes. As I move forward and develop my health promotion plan consisting of interventions and outcomes I will move into the action stage, and as I maintain my long term goals and sustain this new healthy eating and exercise routine I will be in the maintenance stage. I have recognized a need for change and have started making slight changes within the past month in my healthy eating and exercise routines. I am usually a really active individual who eats healthy, but ever since I have become pregnant my eating and exercise habits have completely changed for the worse. The first three months I was only able to eat processed foods, fast food, and drink sugary drinks. I was also not able to exercise at all due to nausea. Now that I am out of the first trimester and feeling a lot better I have started to slowly get back into a routine of healthier eating and exercising. I have been making slight changes here and there and I am working toward sustaining one hundred percent a healthy eating and exercise routine.Health PlanThe health promotion plan will consist of a nursing diagnosis, goals, measurable outcomes, interventions and evaluation. The North American Nursing Diagnosis Association (NANDA) diagnosis I choose is health-seeking behaviors related to sedentary activities and imbalanced nutrition as a risk factor for unhealthy body weight. I choose the health-seeking behavior diagnosis, because I would like to alter my health habits and work toward a healthier lifestyle. With this diagnosis I can work towards and achieve both goals.My wellness goal is to increase my exercise and healthy eating habits and maintain these modifications to meet my long-term goal of weight control. My healthy eating goal consists of increasing my water intake, cutting out processed foods and fast food, and not exceeding 1300 calories per day. I can meet my fitness goal by exercising on my days off and putting aside at least two to three hours for my time to do the exercise that I enjoy doing. I am ready to make a change in my health and work towards a more health promoting behavior.OutcomesMeasureable outcomes that I will implement into my health promotion plan include:Demonstrate healthy eating habits by maintaining the daily food journal log Maintain a total caloric intake of 1300 or under in a 24 hour periodDemonstrate an intake of sugary drinks to 8 ounces or less per dayDemonstrate adequate water intake of at least 1 liter a dayDemonstrate the elimination of processed foods and fast foods from my dietDemonstrate a healthy exercise routine by maintaining the daily exercise journal Actively exercise at least three to four times per weekDemonstrate use of personal time to allow for time to exerciseMaintain a healthy body weight and be knowledgeable of a nutritious diet and healthy exercise routineMaintain dietary and exercise modifications to meet long-term goal of weight controlInterventionsInterventions that I will implement into my health promotion plan will include:Identify barriers and benefits to being healthyIdentify barriers for healthy eating and exercisingEncourage use of daily food and exercise journal logsDesign a long term exercise and nutrition program based on the food journal logsLimit the amount of sugary drinks to 8 ounces per a 24 hour period by substituting with water or unsweet teaIncrease my water intake to at least one liter per dayEliminate processed foods and fast foods from my dietEncourage intake of at least one serving of vegetables into my diet dailyEngage in more physical activities and reduce sedentary activitiesEngage in one hour or more of moderate-intensity physical activity above usual activity at least four times a weekSet aside two to three hours on each day I have off for personal time to engage in exercise Set aside time for homework and keep separate from time set aside for exercise Plan a specific time with my husband in the evenings to either go for walks or bike ridesEvaluationBased on the outcomes and interventions I have implemented for myself I have had roughly eight days to perform these tasks. The daily food and exercise journals are a great tool to keep me reminded when I have to write something down if I am following my health plan or not. This is going to be a great tool to maintain my long term goals of maintaining my exercise and dietary modifications. Although, at this point with the nausea still being off and on I am currently still in the planning stage of the transtheoretical model. I have incorporated more water into my diet and limited my sugary drink intake to 8 ounces, and I have been able to cut out fast food from my diet. Just incorporating these two tasks has helped lower my daily caloric intake to closer to the 1300 calories I made as a goal for myself.One of the hardest tasks has been setting aside time specifically for exercise on my days off. This is still something I am really struggling with that I have complete control over. Whenever I have a homework assignment I know needs to be done I seem to stew on it until I have it complete and I do not allow myself any time for myself until this is done. I have become more active in the daily house chores and I have not been as sedentary as I have been, and I have allowed myself a couple hours on my days off for physical activity. Over the years of obtaining my Bachelor of Science (BSN) and associates degree in nursing (ADN) I have noticed that I put on about ten pounds during the times I am actively taking classes and will lose it while not in school. This is something that I have always struggled with during school. Overtime, I believe my interventions of setting aside time on my days off are going to greatly benefit my overall health and well-being especially since on plan on continuing my education to become a nurse practitioner (NP).ConclusionAs a nurse my main focus is health promotion and prevention. In order for my patients to take me seriously I feel I should demonstrate healthy choices and lifestyle as that is what I am teaching my patients every day. Based on my health self-assessment I scored high in the internal subscale meaning I believe I have personal control over my own health rather than chance and others controlling my personal health. I chose to assess my eating and exercise habits. These assessments demonstrated that I was not eating healthy and I was not getting adequate exercise in each week. I implemented a health plan with outcomes and interventions to help reach my short and long term goals of maintaining healthier eating habits and a healthy physical lifestyle. After implementing this health plan into my life I have successfully met my goal of decreasing sugary drinks, I have increased my water intake, and I have cut fast foods out of my diet. I am still incorporating some processed foods into my diet so that is an area I still need work on. I have also increased my physical activity and have been setting aside time on my days off of work for exercise with my husband in the evenings. ReferencesFerris State University (FSU) (2014). NURS 310 Population Based Health Promotion (course syllabus). Retrieved from Ferris State University MyFSU course page. , N., Murdaugh, C. & Parsons, M.A., (2011). Health promotion in nursing practice. Upper Saddle River, NJ: Pearson Education, Inc.WebMD. (2008). Can a Food Diary Help You Lose Weight? Retrieved from A Health Beliefs Survey The questionnaire is designed to determine the way in which different people view certain important health-related issues. Each item is a belief statement, with which you may agree or disagree. Beside each statement is a scale that ranges from strongly disagree (1) to strongly agree (6). For each item, choose the number that represents the extent to which you disagree or agree. This is a measure of your personal beliefs; obviously, there are no right or wrong answers.Please answer these items carefully, but do not spend too much time on any one item. As much as you can, try to respond to each item independently. When making your choice, do not be influenced by your previous choices. It is important that you respond according to your actual beliefs and not according to how you feel you should believe or how you think we want you to believe.1 - Strongly Disagree; 2 - Moderately Disagree; 3 - Slightly Disagree; 4 - Slightly Agree; 5 - Moderately Agree; 6 - Strongly Agree 1 2 3 4 5 6If I get sick, it is my own behavior that determines how soon I will get well again.xNo matter what I do, if I am going to get sick, I'll get sick.xHaving regular contact with my physician is the best way for me avoid illness.xMost things that affect my health happen to me by accident.xWhenever I don't feel well, I should consult a medically trained professional.xI am in control of my health.xMy family has a lot to do with my becoming sick or staying healthy.xWhen I get sick, I am to blame.xLuck plays a big part in determining how soon I will recover from an illness.xHealth professionals control my health.xMy good health is largely a matter of good fortune.xThe main thing that affects my health is what I myself do.xIf I take care of myself, I can avoid illness.xWhen I recover from illness, its usually because other people have been taking good care of me (doctor, nurses, family members).xNo matter what I do, I’m likely to get sick.xIf it’s meant to be, I will stay healthy.xIf I take the right actions, I can stay healthy.xRegarding my health, I can only do what my doctor tells me to do.xDirections on how to score: These three subscales, and the items included in each, are as follows:?Internal Items: 1, 6, 8, 12, 13, 17?Chance Items: 2, 4, 9, 11, 15, 16?Powerful-others items: 3, 5, 7, 10, 14, 18The score on each subscale is the sum of the values for each item in that subscale multiplied by 2. Scores within each subscale can range from 12 to 72. The higher the score on the internal subscale, the more personal control clients believe that they exercise over their own health. The higher the scores on the chance subscale and powerful-others subscale, the higher the beliefs in the importance of chance and others respectively in controlling personal health. Normative means for adults on each subscale are as follows: Internal, 50.4 My score- 60Chance, 31.0 My score- 28Powerful-others, 40.9 My score- 28Appendix BFood Journal ConsumedBreakfastSnackLunchSnack DinnerCalorie CountSunday 6/08Bagel thin, cup of grapes, medium apple, cup of orange juiceCheese stickCup sweet teaCup sweet tea, medium peach, three graham crackersTwo cups trail mix, 1 cups of waterThree slices thin crust pineapple pizza, 2 cups Hawaiian punch1892Monday 6/092 eggs, Bagel thin, medium peach, cup of orange juicePita chips and hummus2 Cups sweet tea, medium nectarine No SnackCan of spaghetti O’s, grilled cheese sandwich, 2 Cups of Hawaiian punch1568Tuesday 6/103 Blueberry pancakes, 2 cups skim milk, ? cup sugar free syrup No Snack1 Cup Sweet tea, 1 cheese stick2 cups grapes, three graham crackers 1 Cup macaroni, 5 pieces asparagus, 1 large baked potato, 2 Cups sweet tea1656Wednesday 6/111 Bagel thin, 1 large orange, 1 large apple, 1 cup grapes, 1 cup apple juiceNo Snack2 cups watermelon, 2 graham crackers, 2 cups Hawaiian punchNo SnackVeggie 6 in sub on flat bread from subway, 1 20 fluid oz sprite1372Thursday 6/122 blueberry waffles, 2 cups skim milk, ? cup sugar free syrup1 large appleVeggie 6 in sub on flat bread from subway, 20 fluid oz cokeNo snackChinese healthy choice microwave dinner, 2 cups Hawaiian punch 1478Friday 6/131 Cup of oatmeal with blueberries, 2 slices low calorie wheat bread, 1 cup orange juiceNo Snack1 can of canned pears, 3 cups of water, 1 cheese stick, small salad with 6 tbls salad dressingNo SnackMcDonalds grilled chicken club sandwich minus bacon medium meal with sprite1780Saturday 6/141 Bagel thin with 2 tbls cream cheese, 1 cup Hawaiian punch4 graham crackers, 2 cups waterMediterranean deli sandwich on wheat bread, 1 bag of sun chips 2 Cups fresh fruit, 1 Cup trail mix4 Slices pineapple pan crust from pizza hut, 2 cups Hawaiian punch2300Sunday 6/152 Cups grapes, 1 bagel thin, two fried egg whites, 1 cup apple juice16 ounces spritePeanut butter and jelly sandwich, 1 medium apple, 2 cups cheese gold fish1 snack bag of salt and vinegar chips1 Cheese quesadilla, 1 cup Spanish rice, 1 cup refried beans, 2 cups sweet tea2500Monday 6/161 cup apple juice, 2 waffles, ? cup sugar free syrup1 cup cottage cheese, 1 cup grapesPeanut butter jelly on 1 bagel thin, 1 snack bag of salt and vinegar chips, 2 cups cranberry juice1 rice crispy treatMcDonalds fish filet meal with sprite1725Tuesday 6/172 cups of grapes, 1 Bagel thin, 1 medium peach? cream puff2 cups unsweet tea, 4 inch mustard/pickle sandwich on Italian bread 2 cups Rice and broccoli and chesse8oz turkey breast, 2 cups mashed potatoes, 1 cup corn, 2 cups unsweet tea1516Appendix CExercise Journal Date/TimeType of Exercise/Why did not exerciseAmount of Time SpentAlone/With SomeoneFeelingsSunday 6/08Did not exercise Did not have time between work and school workFeeling bad that I did not have time to work out. Puts me in a bad moodMonday 6/09Walked with husband around our 10 acres 1 hrFeel good about getting outside and getting some physical activity inTuesday6/10Did not work out, worked and had school workFeeling bad about not working outWednesday 6/11Worked an evening shift did not have time to work outBad mood that I did not work outThursday 6/12Worked an evening shift did not have time to work outFelt ok about not working out since I was so tiredFriday 6/13Did not exerciseSpent the day with my dad for father’s day Felt good because I got to spend the day with familySaturday 6/14Walked around Saugatuck with my sister3 hrFelt good, spent time with family and was able to do some walkingSunday 6/15Worked and had school work did not exerciseFelt ok about not working out since I walked so much the day beforeMonday 6/16Worked, but still walked around the field with my husband1 hrFelt good to get out and do some physical activityTuesday 6/17Worked evening shift and did not have time to work out between work and homeworkFelt ok about not working out since I had the next few days off ................
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