Running Head: TAKING CONTROL FOR A HEALTHER LIFESTYLE

Taking Control for a Healthier Lifestyle Jennifer Mynhier Ferris State University NURS 250

TAKING CONTROL FOR A HEALTHER LIFESTYLE

Taking Control for a Healthier Lifestyle Health promotion is a very important aspect of nursing care. It is vital to the prevention of many health conditions which can help to keep patients healthier and out of hospitals, thus also helping to lower the raising healthcare costs common today. A quote by Sparks and Taylor (2010), states for decades, nurses have striven to promote health in an illness-oriented model of health care. Now, the opportunity to work actively in a more holistic model is not only accepted but encouraged (p. 825). The patients or clients nurses work with should demonstrate the willingness to change and the education level to support change in order to best promote a healthier lifestyle. RealAge Results The Sharecare website (2013) is a health and wellness social media platform that connects people with top-ranking experts ranging from doctors and specialists to hospitals, healthcare companies and health-conscious consumers (Arnold & Oz). One feature of the Sharecare website is the RealAge test. This is a questionnaire that an individual can take that, based on the users answers, will identify problem areas in that persons lifestyle that may contribute to short or long term health problems. The subject M.M. is a very healthy twenty-two year old female nursing student. According to the results of her RealAge test, M.M.s RealAge is 16.2 which is 6.7 years younger than her actual age (Appendix A). This is a very good number, however there is always room for improvement when it comes to healthiness. Several RealAge (2013) responses that contribute to M.M.s low age include a healthy waist size and body mass index (BMI). This reduces risk of cardiovascular problems and diabetes. M.M. is a nonsmoker and avoids second hand smoke. She has a healthy sleep pattern which allows the body to rest and rejuvenate, and also helps the person function at their best

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while awake. Her positive emotions, according to RealAge, cause chemical and neurological changes in the body that help keep the bodys functions in balance. M.M. eats a healthy amount of fish, which is a good source of protein and vitamins; and not a lot of red meat, which often contains a lot of saturated fat. She has a good exercise regime, which includes cardio, flexibility exercising and walking. Good exercise among other things, promotes cardiovascular health, can reduce stress, helps with circulation and improved brain function, and benefits the digestive system (RealAge Test). M.M. also had some negative factors that would contribute to a higher RealAge (2013). One being an elevated blood pressure. A high blood pressure puts excessive strain on the heart and arteries. Some consequences of long term hypertension include stroke, kidney disease, and cardiovascular disease. Although M.M. has positive emotions, she did answer that she has financial worries and she realizes that she needs to have better coping mechanisms for stress. Stress can cause secondary problems such as overeating, overdrinking, depression, or migraines. If stress is dealt with in the wrong way it can disturb sleep, weaken the immune system, contribute to cardiovascular issues, and cause weight gain. Many of the responses that negatively affect M.M.s RealAge include problems with her diet. She should be eating a healthy meal for breakfast every day, which can help with energy and stabilize blood sugar. Eating more whole grains would help support the cardiovascular system. M.M. needs to include more fruit and a wider variety of colored veggies into her diet, both of these steps have countless benefits including lower blood pressure and healthier immune system. An improvement to her diet would also include consuming less junk food. Processed foods have many negative effects that include aging arteries, skin wrinkling and memory loss. A daily vitamin D supplement would be

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advantageous as it can keep the risk for certain cancers, osteoporosis, asthma, and high blood pressure down (RealAge Test). Due to the responses of the RealAge test indicating an issue with stress, M.M. also took a stress assessment on the Mayo Clinic website (Appendix B). Her results showed a moderate stress level, which most likely stem from being in nursing school and also her concern for her financial situation. Long term stress is hard on the body and mind. Working on better coping mechanisms such as working out or eating less junk food may benefit M.M. as some of her external stressors may not be able to be eliminated at this point in her life. Wellness Diagnoses Sparks and Taylor (2010) created many wellness diagnoses that can be applied to patients. One of these diagnoses that applies to M.M. is health seeking behaviors related to stress as a risk factor for coronary artery disease (p. 853). The assessment data for this diagnosis includes blood pressure, stressors, exercise, history of smoking, and current health status, all of which were addressed in the RealAge test. M.M. has shown a desire to improve and control her health. A second wellness diagnosis that could relate to M.M. is readiness for enhanced decision making (p. 835). M.M. needs to make better decisions in relation to her diet. She should be eating less junk food, more grains, fruits and veggies. She needs more reliable information on how to better improve her food choices (Sparks & Taylor, 2010). Goal Planning and Nursing Interventions As related to the wellness diagnosis of readiness for enhanced decision making, a goal that was set for M.M. was to plan her daily diet according to the USDA Choose My Plate (19942013); for a 2000 calorie diet, she should consume six ounces of grains, two and a half cups of vegetables, two cups of fruits, three cups of dairy, and five and a half ounces of protein foods

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each day by June 15th, 2013 (Appendix C). The client is well educated and showing eagerness for improvement. Nursing interventions include giving the client the Choose My Plate website as a guideline to making better food choices. There are many resources and information in easy to read and easy to access format on this site. It was recommended to the patient to keep a food diary to better keep track of what she is consuming (USDA Center for Nutrition Policy and Promotion, 1994-2013). Education for the patient can include an explanation that making better food choices is a long term process and should be consistently monitored in order to promote a healthier lifelong diet. The second recommendation for health promotion in the client is more effective coping with stress. This is supported by the wellness diagnosis of health seeking behaviors related to stress as a risk factor for coronary artery disease. One outcome for the patient related to this diagnosis is for the client to make a list of all the aspects of her current situation that are causing stress, this should be completed by June 2nd, 2013 and should include at least ten items. She should also be able to list five different things she can do that she believes help reduce her stress level by June 5th, 2013. A study done by Welle & Graf (2011) gives some recommendations for positive coping strategies including feeling well supported, enough social interaction, and regular contact with family all are connected with a strong social network. Getting 8+ hours of sleep a night, having a balanced diet, getting regular exercise, and being involved in an extracurricular sport (p. 102). Some nursing interventions can include informing the patient all of the health risks that are associated with long term stress including coronary artery disease. It would be recommended to discuss the patients lists made as a part of her goal outcomes. The patient should be encouraged to discuss the factors causing stress with a trusted family member, peer, or counselor as one coping mechanism. She could also be educated to better time management

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skills, using relaxation techniques, and appropriate goal setting. A great place for the client to start would be improved diet and exercise habits. A Transtheoretical Model of Change, as stated by Velicer, Prochaska, Fava, Norman & Redding (1998) is a model of intentional change. It is a model that focuses on the decision making of the individual. It is made up of five steps: precontemplation, contemplation, preparation, action, and maintenance. It is a process involving progress through a series of five stages (Velicer, Prochaska, Fava, Norman & Redding, 1998). M.M. displayed the ability to follow these steps. A patient or client would most likely subconsciously follow these steps when making a change in lifestyle which may include quitting smoking, exercising more regularly, consuming an improved diet. Evaluation The clients set goal of she should consume six ounces of grains, two and a half cups of vegetables, two cups of fruits, three cups of dairy, and five and a half ounces of protein foods each day by June 15th, 2013 was met according to her food journal (Appendix D). This is a good start, but nutrition is a lifelong conscious process and the patient should be educated to that fact. The patient displayed an inclination for change, so having the patient keep a permanent food diary may help to improve her diet, which in turn will promote a healthier lifestyle. The goals set to make a list of all the patients current stressors, and the list of coping mechanisms that she feels lower her level of stress were also met by M.M. A letter was written to the client and is included (Appendix E). Conclusion Taking the RealAge test could be beneficial to promoting health and wellness in patients. It is a straightforward, easy to understand questionnaire, which may help patients to realize that

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certain aspects of their life could be improved to reduce the risk for certain long term health issues such as cardiovascular disease, diabetes, and hypertension. There are many resources that can be given to the patient along with the test to help guide the patient in making better choices. Only a small handful are demonstrated. There is some willingness involved on the patients part, as you cannot force someone to change, they have to want to make an improvement, and the nurse is there to encourage and guide the patient on an individualized basis.

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References Arnold, J. & Oz, M. (2013). Sharecare: About us. Retrieved from: http://www.sharecare.com/static/about Arnold, J. & Oz, M. (2013). Sharecare: RealAge test. Retrieved from: http://www.sharecare.com/assessments/realagetest/completed?recpage_id=745450 Mayo Foundation for Medical Education and Research. (1998-2013). Mayo Clinic: Stress assessment. Retrieved from: http://www.mayoclinic.com/health/stressassessment/SR00029 Sparks, S. & Taylor, C. (2010.) Nursing diagnosis reference manual. New York, NY: Lippincott & Williams. USDA Center for Nutrition Policy and Promotion. (1994-2013). USDA Choose My Plate. Retrieved from: http://www.choosemyplate.gov/foodgroups/downloads/results/MyDailyFoodPlan_2000_18plusyr.pdf Velicer, W. F, Prochaska, J. O., Fava, J. L., Norman, G. J., & Redding, C. A. (1998). Smoking cessation and stress management: Applications of the Transtheoretical Model of behavior change. Homeostasis, 38, 216-233. Retrieved from: http://www.uri.edu/research/cprc/TTM/detailedoverview.htm Welle, P. D., & Graf, H. M. (2011). Effective lifestyle habits and coping strategies for stress tolerance among college students. American Journal Of Health Education, 42(2), 96-105. Retrieved from CINAHL.

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Appendix A RealAge Test Results

Retrieved from: http://www.sharecare.com/assessments/realagetest/completed?recpage_id=745450

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Appendix B Mayo Clinic Stress Assessment

Retrieved from: http://www.mayoclinic.com/health/stress-assessment/SR00029

TAKING CONTROL FOR A HEALTHER LIFESTYLE Appendix C Daily Food Plan from Choose My Plate

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Appendix D Food Diary

Date: Food Group Ideal Amount Grains 6 ounces Vegetables 2.5 cups Fruits 2 cups Dairy 3 cups Protein foods 5.5 ounces

Sunday 6/9/13 5 ounces 2.5 cups 3 cups 4 cups 3 ounces

Monday 6/10/13 4 ounces 3 cups 2.5 cups 4 cups 4 ounces

Tuesday 6/11/13 5.5 ounces 2.5 cups 2 cups 3.5 cups 8 ounces

Wednesday 6/12/13 6.5 ounces 2 cups 2.5 cups 3 cups 4 counces

Thursday 6/13/13 5.5 ounces 3.5 cups 1 cup 3.5 cups 6 ounces

Friday 6/14/13 6 ounces 3 cups 3 cups 4 cups 6.5 ounces

Saturday 6/15/13 6.5 ounces 3 cups 2 cups 3.5 cups 6 ounces

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Appendix E Letter to Client

M.M., You were able to meet the goals that we set together 100%. This shows that you have accepted the challenge of trying to live a healthier lifestyle. I recommend that you keep a long term food diary. It will help you to really pay attention to the foods you are eating and guide you to make more positive choices in the grocery store or at a restaurant. I believe you have the desire to change your habits to help improve your health. This is especially important as a longterm goal. The lists you made in regards to your stress were hopefully an eye opener. Long term stress is known to have negative effects to ones health. You should continue to practice some of the positive coping mechanisms we discussed such as exercise, healthy diet (two birds with one stone!), deep breathing techniques, continuing to get a solid amount of sleep each night, and confiding in someone you trust about the things that are causing you stress. I believe you are well on your way to leading a life that will be more beneficial to your health for the short and long term. I encourage you to contact me if you need any encouragement, advice or have any questions. Keep up the good work! Jennifer