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Health Promotion: Aerobic ExerciseKathryn BertkeFerris State UniversityAbstractThe author discusses her current health status and the implementation of daily aerobic exercise. The author has become more focused on her work and her obligations and therefore has let her self-care routine lack daily aerobic exercise. As the author has calculates her BMI and Waist to Height ratio, she is able to set goals related to her daily exercise routine and implement the needed changes to improve her health. Health Promotion: Aerobic ExerciseExercise is an important aspect of one’s overall health. It seems that the author has become accustom to working hard during the day and then working hard at night leaving little time for daily exercise. The plan is to re-introduce aerobic exercise into a daily routine as it was at one time an important part of the author’s self-care routine. By focusing on exercise, the author believes that it will decrease the risk of heart disease, decrease stress throughout the week and lead to a long term healthy lifestyle. Health Beliefs SurveyUpon completion of the Health Beliefs Survey which is listed in Appendix A, the author was able to evaluate how much she feels she controls her health. The author had the following scores:Internal: 50Chance: 18Powerful-Others: 30This indicates the author believes that she has the power to keep herself healthy. By engaging in self-care activities that promote positive health outcomes, the author feels that she can stay healthy and avoid most illnesses. Although the author does feel that she has the most control over her lifestyle, she is aware that others influences may be helpful when it comes to staying healthy. This is indicated by scoring 30 points related to the Powerful-Others category. The author identifies this as a component of social support in which she refers to the support of her family when it comes to healthy choices and a healthy lifestyle. According to the text, Health Promotion in Nursing Practice written by Nola Pender, Carolyn Murdaugh and Mary Ann Parsons, “Social support fosters successful coping and promotes satisfying and effective living.” (Pender, p. 217) While support is an important aspect of health, the author promotes ownership of one’s lifestyle and accountability for the decisions that are made through out that life. Instruments of ChoiceThe author has chosen methods to help encourage and maintain the new exercise plan. First the author has chosen to review the current state of her overall health by completing a health diary and a review of her current BMI, Waist to Height ratio and the healthy weight range for her age, height and sex. This information is located in Appendix B and has helped the author focus on why it is important to incorporate exercise into her daily routine. The main goal of re-introducing exercise is to increase the author’s overall health, by reviewing her current health, she is able to set realistic goals to accomplish this task. The health diary includes aspects of health such as a weight goal, daily caloric goal, initial BMI and Waist to Height ratio. Once these measurements have been made, the author was able to set up an exercise plan that included the activities she will incorporate and the goal of how often they will occur. Once these goals were made, the author made the choice to keep track of the activities in an exercise journal; an excerpt of this can be found in Appendix C, and include her husband and her dog to help keep the activities fun. The author chose these tools because they each offered concrete evidence of health and progress. There validity is proven based on the fact that BMI and Waist to Height ratio are two tools used by medical professionals to assess their patient’s health status. These findings are significant for the author because it has served as a baseline from which she can improve her health and focus on a clear goal. By creating an exercise journal, she is able to track her progress and see clearly how much activity she is engaging in daily; she then can use this information to set more goals and focus on attaining them. Transtheoretical ModelAccording to the Transtheoretical Model for behavior changes, there are five stages the person must go through to actually make a lifestyle change. They are as follows as outlined in the text Health Promotion in Nursing Practice:1. Pre-contemplation - this is the stage where no action is actually taken.2. Contemplation - this is the stage where the person starts thinking about change.3. Planning - this is when the person starts to make little changes in an effort to make a bigger change. 4. Action - the change has occurred and has been maintained for less than six months. 5. Maintenance - the change has been taking place for more than six months and continues. (Pender, p. 51)Pre-contemplationThe author has let her normal exercise routine laps since she completed a major goal related to fitness. The author competed in the Tough Mudder challenge three months ago, since that time, she has had no drive or desire to maintain her exercise routine. This has led to the development of a bad habit and an unwillingness to correct it. ContemplationThree and a half months later, the author has realized that not only has she let her health go by the wayside, she is also gaining some weight and experiencing more stress. Tight clothing has led her to start thinking about her past exercise routine and the benefits it had for her health and her stress level. Out of curiosity, the author calculated her BMI and Waist to Height ratio and found that there was work to be done. She was able to use this information as a motivator to begin the steps that are necessary to improve her health and incorporate daily aerobic exercise. PlanningThe author has started to make changes to better her health. The first thing that the author has incorporated into her daily activities is walking her dog through the woods at her home. This was not done on a daily basis, however, the author did feel better once she did engage in physical activity and noticed her stress level on those days was decreased and this was a positive step towards increasing her health. The author plans to incorporate aerobic exercise daily and will pay more attention to the food that is eaten to nourish the body instead of fueling her body with junk food. ActionThe author has taken the initiative and started to engage in aerobic exercise daily. Some of the activities she completes include hiking with the dog and yoga. These activities decrease stress and help to maintain a healthy lifestyle. The author will be going back to the gym to use the weights and elliptical machines and commits to setting aside time during the week to complete this goal. The author plans on maintaining these activities with the support of her family and has committed to not letting the winter months interfere with her goal for a healthy lifestyle and aerobic exercise daily. MaintenanceThe author is not currently in this stage because she has only been able to maintain this behavior for a few weeks. During the last few weeks, the author has increased her exercise and has the support of her husband. The two are committed to maintaining a healthy lifestyle and are looking forward to the benefits of maintaining this lifestyle. Nursing DiagnosisThe author has chosen the following nursing diagnoses that are related to the changes she has made. Health Seeking Behaviors r/t absence of aerobic activity as a risk factor for Coronary Artery DiseaseHealth Seeking Behaviors r/t stress as a risk factor for Coronary Artery Disease(Sparks, 2010)The author believes that both of these nursing diagnoses are suitable for the goals she has set for herself. The author has a family history of high cholesterol and high blood pressure; by increasing her aerobic exercise the author is decreasing her chances for high cholesterol and high blood pressure thus decreasing her risk for Coronary Artery Disease [CAD]. By seeking out the tools listed in Appendix B to see where her current state of health is the author is able to take steps to increase her physical activity and lower her risk for heart disease. According to the American Heart Association [AHA], “Physical activity improves heart function and lipid profile by lowering total cholesterol while raising HDL. It lowers blood pressure and resting heart rate.” (AHA, 2012) Increasing aerobic exercise is an easy way to lower the risk for CAD; by increasing the author’s physical activity, she is able to improve her health, lower her stress level and lower her risk for CAD. Outcomes and GoalsIn terms of short term goals, the author has set the goal of daily aerobic exercise. Since this goal has been made, the author has been able to engage in aerobic exercise 9/12 days as shown by the excerpt of her exercise journal in Appendix B. The author feels that these small steps will lead to long term goal setting and attainment of those goals. In the next week, the author plans to engage in aerobic exercise every day. The activities may vary, however, the author will consult an activity counter to evaluate how many calories she is burning daily. There are many websites that offer this tool, most recently she has used WebMD’s calorie burning calculator. Long term goals have been set as well. These goals include decreasing the author’s BMI to under 25.0 and decreasing the Waist to Height ratio to under 0.50. Other goals include decreasing the author’s weight, and maintaining the daily aerobic activity. An important aspect of this plan includes the author setting up an appointment with her doctor and having blood work drawn. This would let the author know where her cholesterol levels currently are and would let her consult with her physician regarding other ways to help lower her cholesterol if it is needed. ConclusionsBy evaluating the current state of the author’s heath and by acknowledging that her daily exercise has been missing out of her self-care routine, the author has been able to accept the changes that need to be made. Accountability for one’s own health and well-being are important to the author and she promotes these behaviors to her patients; the author feels that it is time she follow her own advice. The author is committed to changing this aspect of her lifestyle and plans to continue the exercise journal to help track this process. Health promotion is an important aspect of nursing and the author would like to be a positive role model when it comes to this avenue of health care. The author is committed to these changes and has accepted the realities of her current state of health. The author realizes that she will increase her health by engaging in regular aerobic exercise which in turn will decrease daily stresses that pop up. By following through with attaining these goals, the author will be a positive role model for self-care and will decrease her own risks of Coronary Artery Disease. ReferencesAmerican Heart Association [AHA]. (2012, June 1). Physical Activity. In . Retrieved September 29, 2013Pender, N. J., Murdaugh, C. L., & Parsons, M. A., (2011). Health promotion in nursing practice (6th ed.). Upper Saddle River, NJ: Pearson Education.Sparks, S., & Taylor, C. (2010). Nursing diagnosis reference manual (8th ed.). Philadelphia, PA: Lippincott Williams & Wilkins.Ursuy, P. (2013). NURS 310 Class Syllabus. Big Rapids, MI: Ferris State University.Weight Loss & Diet Plans (2008). In WebMD. Retrieved September 23, 2013Appendix AHealth Beliefs SurveyEveryone must use this tool; include it in your Personal Health Assessment & Health Promotion Plan (Paper #1) as Appendix A.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 Disagree 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, it’s usually because other people have been taking good care of me (doctor, nurses, and 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.XInternal: 50Chance: 18Powerful-others: 30*The results of my survey indicate that the author believes she has control over her health. Reference:Ursuy, P. (2013). NURS 310 Class Syllabus. Big Rapids, MI: Ferris State University.Appendix BPersonal Health DiaryNAME: Katie BertkeDATE: 9/23/13Target Weight : 135Nutrition Targets:Calories/Day:1305Initial Weight - Height Ratio: 0.56Initial BMI: 31 Exercise Plan:Resting Pulse: 86 bpmTarget Heart Rate: 196-144 bpmActivities:When & How Often:1. Hiking in the woods1. 3 Times per week after work with my dog and husband2. Yoga2. 2 Times per week to start, then increase to 3 times per week3. Go to the gym & use elliptical machine3. Before work or possibly after work depending on the weekly scheduleWeight Loss & Diet Plans: BMI Plus CalculatorYour Personal SummaryGender: FemaleHeight: 5' 3"Age: 28Current Weight: 175Current Pant Size: 14Weight Goal: Lose 2 pounds per weekBMI: 31Waist to Height Ratio: 0.56Healthy Body Weight Range: 104 and 141Target Heart Rate: 96?to 144Target Caloric Intake to Meet Weight Goal: 1200 Reference:Ursuy, P. (2013). NURS 310 Class Syllabus. Big Rapids, MI: Ferris State University.Weight Loss & Diet Plans (2008). In WebMD. Retrieved September 23, 2013Appendix CEXERCISE JOURNALDate/TimeType of ExerciseAmount of Time SpentAerobic / Non-AerobicAlone/With SomeoneFeelings9/24/13Yoga25 min.AerobicActivity Completed aloneRelaxed, rejuvenated9/25/13Walking in the woods20 min.AerobicGroup9/26/13No Activity------------------------------------------------------------------9/27/13No Activity------------------------------------------------------------------9/28/13Walking in the woods40 minAerobicGroup,Tired, relaxed9/29/13Walking in the woods1 ? hoursAerobicGroup,Relaxed, rejuvenated9/30/13Walking in the woods25 minAerobicGroup,Relaxed, 10/1/13No Activity Today----------------------------------------------------------------10/2/13Walking in the woods20 min.AerobicGroup,Anxious - 1st night on-call at the hospital10/3/13Trimming trees along the road in our woods. Hiking and lifting involved2 hoursAerobicGroup activity, tired, relaxed, ready for bed! 10/4/13Yoga20 min.Aerobicrelaxed10/5/13Trimming trees along the road in the woods, hauling brush 3 hoursAerobicStrong, energizedReference:Ursuy, P. (2013). NURS 310 Class Syllabus. Big Rapids, MI: Ferris State University. ................
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