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PUBH 6127 Public Health Policy
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PUBH 6127 Public Health Policy
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Course Code: PUBH6127
University: Walden University
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Country: United States
Question:
What is your role as a healthcare provider, in helping a patient move along the continuum of change?Give an example of how you might help a patient/family (since interconnected!) move from one stage on the TTM continuum to the next—use an evidence based approach, cited from the literature, and a real life example from your own personal or professional experience if possible. Would Nurse Coaching help this? the article: Nurse Coaching; ATTACHES IN THE ARTICLE.Student 1:What is your role as a healthcare provider, in helping a patient move along the continuum of change?Give an example of how you might help a patient/family (since interconnected!) move from one stage on the TTM continuum to the next—use an evidence based approach, cited from the literature, and a real life example from your own personal or professional experience if possible. Would Nurse Coaching help this? Remember the articles assigned this week on Nurse Coaching and the web site on Nurse CoachingAs healthcare providers, it is our responsibility, and this responsibility must be shared with patients, so both provider and patient can identify risk factors and health behaviors that may need to be changed, in order to prevent further or chronic illnesses. “Behaviors affect morbidity, and unhealthy behaviors may lead to mortality (Nash, Fabius, Skoufalos, Clarke, and Horowitz, 2010, p.116).The Transtheoretical Model (TTM) uses stages of change and those are precontemplation, contemplation, preparation, action, maintenance, and termination (Nash et al., 2010). The willingness to change is one of the key factors to a successful process and the more information (pros and cons) that one has, the better it is for that person to make commitment to change. “Having an intention to change behavior is vital to promoting change and without a positive intention, only 7 percent of people take action” (Sheeran, 2002).I like to approach a patient who is overweight by asking if he or she is happy with the current weight. I also ask what she thinks her appropriate weight should be and what she thinks that she can do to lose some weight. I like for my patients to come up with reasonable and doable plan that she can achieve in a short term. Patient’s initiation and participation is very important, so patient will take ownership and be motivated to initiate steps to change.Nurse Coaching is also very useful to educate and support patients. “Health coaching is emerging as an effective coaching to improve patients’ behavior by empowering them to be the center of their health care need” (Jeon & Benavente, 2016).Student 2:What is the provider role in helping a patient move along the continuum of change?If a patient or family is in the precontemplation or contemplation stage, the provider can increase the amount of pros of changing the behavior. Nash et al. (2017) states, “to progress from precontemplation, the pros of changing must increase; to progress from contemplation, the cons must decrease; and to progress to action, the pros must exceed the cons,” (p. 123-124). For example, a patient with poorly controlled diabetes should start exercising. You would want to increase the pros by educating them on endorphin rush, may need less medications, could lead to weight loss, and so on. You must also decrease their cons by adding that time could be saved by less provider visits and so on, if their blood sugars are better controlled through lifestyle modification.Example from readings of how a provider helps a pt/family along the TTM?Crittenden et al. (2017) looked at health couching effects on HTN management. Specifically, they coached on medication compliance and lifestyle modification. This is something that is encountered daily in primary care clinics but time is limited. According to The American Holistic Nurses Association, coaching identifies readiness for change, identifies opportunities and issues related to client growth, helps create goals, helps empower and motivate the patient, and assist the client to evaluate progress. Determining where the patient is on the TTM, will help determine next plan of action.Example from personal experience? Would nurse coaching help this?I try to empower patients to make healthy lifestyle choices on a daily basis. Whether we are talking about weight management, smoking, substance abuse, high risk sexual behavior, or simply following up with a primary care provider, change is hard for patients unless they are ready. Nurse coaching would be very beneficial to my population here at the health department especially because I deal mostly in prevention. I try to keep young people young and healthy. I look at what is their biggest threat and try to start with making a small change for that purpose. It is difficult and I still struggle. I would benefit from extra training for sure.
Answer:
Population Healthcare Nursing
My role as a healthcare provider in helping patient move a long with the continuum of change
The Transtheoritical Model has been in place for over 35 years and it uses different stages of change to incorporate theories of counselling and behavior change .The model has five stages that include precontemplation, contemplation ,preparation, action and finally maintenance. As a healthcare provider, I have the role of identifying risk factors, providing patient education and interventions to prevent chronic diseases.
There are different ways in which I can incorporate the TTM and a good example is If I come across a patient who is suffering from type 2 diabetes and he is overweight and does not take part in physical exercise (Crittenden, Seibenhener, & Hamilton, 2017) .I will approach him and ask him if he thinks that the being overweight and not participating in physical activities could a risk factor for the type 2 diabetes .I would then ask him if he would consider improving on that and some of the strategies that he would use. Since patients understands themselves more than we do as healthcare providers, they are in a better position to come up with modifications about their health status. Studies show that patient participation in the formulation of their care plan is associated with better outcomes. That is why I will ensure that the patient himself participates in the TTM (Jeon & Benavente, 2016). According to Jeon and Benavente, nurse coaching is an essential tool and in this case, I feel it would be very important especially coaching the diabetic patient on how to participate in physical exercise since the patient has the chance to get first-hand information from the nurse.
Response to student one
The author has introduced very well the responsibilities of the nurse in integrating the TTM. Some of the responsibilities mentioned is identifying risks and prevention of chronic conditions .The author has also brought in evidence from readings about how behaviors by both the nurse and patient affect the rate of morbidity and mortality. The author has also explained the stages of the TTM that include precontemplation, contemplation etc. The author has also illustrated how he would use the model in real life by asking an overweight patient how he feels about his weight then participating with the patient to initiate change. The author has also talked of how nurse coaching is useful when it comes to educating and supporting the patients.
Response to student two
Student two has done a commendable job. He has provided the subtopics within the essay and this therefore makes it easier for the reader to know what exactly is being explained in the subsequent sections. The author has provided a good explanation of the role of the provider in assisting patients to move along with continuum of change. The author has also provided the stages of TTM though he didn’t mention all of them. The author only mentioned precontampletion stage. The author has also interconnected readings from the literature material and real life experiences .Finally, the author has provided a good personal experience and the importance of nurse coaching. This has been illustrated through empowering the patients to make healthy choices.
References
Crittenden, D., Seibenhener, S., & Hamilton, B. (2017). Health Coaching and the Management of Hypertension. The Journal for Nurse Practitioners, 13(5), e237-e239. doi:10.1016/j.nurpra.2017.02.010
Jeon, S. M., & Benavente, V. (2016). Health Coaching in Nurse Practitioner–led Group Visits for Chronic Care. The Journal for Nurse Practitioners, 12(4), 258-264. doi:10.1016/j.nurpra.2015.11.015
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