JNC1 Data Collection Methodology

When identifying uses and meanings of ‘self-care’, I first looked in a dictionary. The concept was defined in the Shorter Oxford dicitonary as, “Self-care (noun) taking care of one-self; self-interested behavior.” I searched the internet to get a generalized view of how the concept was being used and it was defined on Wikipedia as, “Self-care refers to actions and attitudes which contribute to the maintenance of well-being, personal health, and promotion of human developent.” I searched data bases for scholary peer reviewed articlew and retrieved limited amount of English articles on self-care. Key word searches consisted of self-care, self-care maintenance, and self-management. The definitions and uses of the concept were fairly broad. I narrowed the search to post-op patients and self-care. The two uses for the concept in the post op patient would be self-care of the post op patient and also supportive care to promote self-care of the post-op patient. The supportive care could be from a nursing system or a family member.

The aim of this essay is to consider approaches to promoting the self-management of a long-term condition. The focus will be linked to module content and based on a patient that I have provided nursing care for during my clinical practice. There will be a brief introduction of the patient and the context in which I was involved in their nursing care. The pathophysiology of the chosen LTC along with the related physical, psychological and social needs of the patient will be considered. There will be a discussion of principles of self-management that will link to national LTC policies. This will also include initiatives and analysis of the evidence of the underlying principles for an approach to providing self-management support, for the

Understanding whether education and self-efficacy increases adherence to health behavior modification is significant in the nursing world, because it suggests that nurses play a dominant role in patient teaching. As nurses, it is crucial to utilize patient teaching and supporting skills to ensure quality care and better health outcomes in the long run. When a patient is educated, it increase’s their confidence to participate in treatment, improves outcomes, and encourages better health habits. Feeling confident in one’s abilities is key to maintaining adherence to medical regimens, and health behaviors. Patient education can be done in various ways including, PowerPoint’s, handouts, and videos.

Hypertension is a developing problem worldwide associated with an increased risk of cardiovascular morbidity and mortality. In 2020, the world population will be approximately 7.8 billion people, and there will be 1 billon people who may be affected by hypertension (Tomson & Lip, 2005). One in three adults in the United States has high blood pressure. According to the report “Health, United States, 2010 with Special Feature on Death and Dying,” the prevalence of hypertension among adults 20 years old or older increased from 24% to 32% during 1988-1994 and 2005-2008. The African-American population has a higher prevalence of this health condition than white Americans do. In 2005 to 2008, the prevalence of hypertension among black males (41.4%) was more than 10%,

Centers for Disease Control and Prevention defines High Blood Pressure as the force of blood pushing against the walls of your arteries, which carry blood from your heart to other parts of your body. Blood pressure normally rises and falls throughout the day. But if it stays high for a long time, it can damage your heart and lead to health problems. High blood pressure raises your risk for heart disease and stroke, which are leading causes of death in the United States. One out of every three adults over the age of twenty- that’s nearly eighty million Americans have high blood pressure. What’s more interesting is that nearly twenty percent don’t even know they don’t have it. Consequently, African American suffer more from this disease than any other race. According to the American Heart Association, forty percent of African American men and women have high blood pressure (AHA, 2016). Notably, adults twenty years and older consist of 42.6 percent are men and 47.0 percent are women that have this illness. For years’ researchers, have tried to understand why High Blood Pressure affect the African American at a higher rate than others. As a

Tu, K., Chen, Z., Lipscombe, L. L., & for the Canadian Hypertension Education Program Outcomes,Research Taskforce. (2008). Prevalence and incidence of hypertension from 1995 to 2005: A population-based study. CMAJ : Canadian Medical Association Journal, 178(11), 1429-1435.

African Americans are known to struggle with hypertension more than any other race. The social problem described by the Centers for Disease Control and Prevention (2010) stated, African American men are more likely to have high blood pressure than whites, Hispanics, or Mexican American men and are more likely to be known as having high blood pressure. This difference steadily persists over time, from approximately 1988 through 2006 (pg.12). Studies have consistently reported a higher frequency of hypertension in blacks than in whites. In relations to these studies as mentioned by Fuchs (2011), There is a long list of putative causes for this higher prevalence proposes that the real reasons African Americans are rated higher with hypertension issues are still unknown. Biological differences are viewed in the mechanisms of blood pressure control or in the environment and habits of whites and blacks are named as the potential causes. Socioeconomic status plays a part in the outcomes of health and wellness and is measured mainly by health behaviors (education), health status (income), and health inequities. Income has been identified as a crucial factor affecting

Some African American, especially those in low resource communities, do not know how routine visit to the doctor and taking their medication on a regular basis can be beneficial to their health. Missing appointment are often time associated with increased risk of hospitalization. By missing appointment, doctor are not able to provide the proper care to their patient, which is often time result in poor control of chronic illness, hospitalization and sometime death if proper medical care is not given in time. Often time African American in low resource community have a hard achieving normal blood pressure as appose to other ethnic group. Even though several intervention programs are set in place to improve appointment adherence, many individual still missed schedule appointment, which remain a problem because proper healthcare and treatment is not given. Many individual does not know about the importance of appointment adherence, but despite its importance, not much information or data exist about the risk factors associated with non-adherence among hypertensive African American. “Therefore, to fill this gap, this study examined factors associated with patient-reported appointment adherence among African-Americans with severe, poorly controlled hypertension, using data from the Inner City Hypertension and Body Organ Damage (ICHABOD) - a cross-sectional survey of urban African-Americans hospitalized with severe, poorly controlled

The convenience sampling that was used in recruiting all male patients who were on blood pressure medications is a glaring bias in this study. There was no information provided addressing why the patients were presenting to the clinic. There are many interventions that can raise blood pressure. For example, the study conducted by Marshall, Anantharachagan, Choudhary, Chue and Kaurhis, (2002) investigated the effect of situational anxiety on blood pressure experienced in anticipation of a blood test. Marshall, et. al., (2002) found that anticipation of a blood test can raise blood pressure. Foster-Fitzpatrick, et. al., 1999 did not address the purpose of the patient’s visit to the clinic.

This led to the conclusion that a stress belief model should be adopted. Under this approach, the three common causes of hypertension in African Americans are combined into one protocol. Then, health care professionals work with patients to introduce solutions that will tackle the root causes of these problems. (Heckler, 2008)

The authors indicate that the intention of all these new systems/strategies is to increase the available programs for sustaining self-management. Another purpose is the establishment and employment of a series of interferences that make use of new media to amplify evidence-based strategies of patient intervention and assessment that previously have occurred within the medical setting rather than the everyday environments in ways that are complimentary to the age, lifestyle and cultural setting of a patient. The basis for the new interference is that

For our smoking cessation community project, we will be using the Orem Self-Care Deficit Theory which was developed by Dorothea Orem to improve the quality of nursing in general. The goal is to guide and improve the practice of nursing which must be consistent with other validated theories, laws and principles. The theory of self-care is a practice of activities that an individual, like in our case the cigarette or tobacco smoker to initiate or perform in his or her own behalf to maintain a healthy well-being. This includes stopping smoking by using different available resources and a therapeutic self-care demand to be performed over a specific duration to meet the self-care

ENVIRONMENT Context where self-care occurs. Can hinder or support self-care activities. Includes the family, work, community, health care system. Person (client/patient) self-care deficits are the result of environmental situations. HEALTH Promoted by adequate self-care Major areas for "self-care" patient education Maintaining health Enhancing health Includes: exercise & physical fitness nutrition and weight control stress management maintenance of social support systems environmental control

At the outset of treatment, the patient and health care provider should discuss and agree upon goals. The goals must take into account the food habits, exercise behaviors, psychological outlook and support systems of the individual. Realistic expectations, short- and long-term, may be promoted by a discussion of a healthy weight versus an ideal body weight. Features of weight management

Factors that contribute to hypertension are age, ethnicity, gender, and lifestyles as shown in Figure 1 (Yoon, Burt, Louis, & Carroll, 2012). While the prevalence of hypertension is relatively equal among men and women, certain ethnicities have a higher propensity for developing hypertension. The prevalence of hypertension in African-Americans is among the highest in the United States for a single ethnic group (Ferdinand & Armani, 2007). In the United States, around 78% of people suffering from hypertension are aware of their condition, with only 68% using hypertensive medications to control their blood