Partner Health Promotion

Kassie Herp
NURS 250
Ferris State University
April 9, 2014








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Abstract
In this paper, a patient was given a test to assess her real-age as i pertains to her health. The
tests results are summarized in the assessment portion, including eating more vegetables,
exercising on a regular basis, maintaining close relationships with friends, and monitoring blood
pressure. From the results of her real-age test, the patient was given two areas of her life to
focus on: sleep and stress. Concerning these areas, the patient was given two wellness
diagnoses. Additionally, she was given interventions, such as implementing ear plugs and a
white noise machine to regulate sleeping patterns, to help improve the areas of her health that
needed to be focused on. The evaluation portion focuses on the patients progress after
applying the interventions. A sleep log constituted empirical evidence used to determine her
progress.






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Assessment
My patient took the real age test, which determines an individuals health age based on
emotional, physical, and dietary elements. She is 25 years old and scored a 32.1 on the exam,
making for a 6.4 year difference.
The test focuses on four main areas: health, feelings, diet, and fitness. For the first section,
health, my patient received several recommendations to increase her wellbeing. One such
recommendation was to watch blood pressure, for if not monitored periodically it could
eventually become an issue. Protecting the joints was another suggestion. Our joints receive a
lot of extra wear and tear over the years, so we need to be mindful of how much stress we
place on them. Recommendation three was to keep watching her waist. Currently my patients
waist size is 27 with a BMI of 23.91. Her scores are not in the overweight range, however they
are approaching that line. Continuous monitoring and maintenance are needed to ensure this
does not turn into a problem. An additional tip was to uphold a consistent sleep schedule. Sleep
is an important factor in sustaining proper fitness and health. The final recommendation for
this section was to get her cholesterol tested. Cholesterol must be maintained at proper levels
to prevent further complications later on in life.
The second area tested was feelings. My patient was recommended to stay socially active with
friends, this will help with stress and controlling emotions. Keeping stress levels low is
particularly important because high levels may cause health complications. One way in which to
decrease such levels is to ease financial worries. Another recommendation is to stay positive.
Staying positive can also help to ease stress and get persons through tough situations. This in
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turn will benefit health in the long run. Maintaining sense of purpose was the last suggestion.
Purpose can have an advantageous effect on lowering stress and depression, leading to
healthier living overall.
The third area was diet. My patient had multiple recommendations, the first of which was to
have a healthy morning meal. This will help her begin her day with the right amount of
nutrients and enough energy to sustain her through her daily activities. Another tip was to
consume more grains to assist in the maintenance of a healthy, balanced diet. Making sure to
include fruit in her diet was also a suggestion. An alternative is juice, however it has more sugar
and less nutrients than fresh fruit. When including vegetables in the diet, my patient was
recommended to vary her intake. Continuing to eat the same vegies everyday may result with a
lack of some basic nutrients. She was suggested also to eat more nuts. They are a good source
of both protein and nutrients, and are beneficial to the heart. Easing up on junk food was
recommended as it does not contain any nutrients and does not help maintain a healthy diet.
Concerning meat, my patient should continue to eat fish and go easy on red meat. Fish is a
good source of omega 3s, while red meat makes you older. Lastly, she should start taking
vitamin D as it is a super nutrient that will help keep her young.
The final section was fitness. My patient was told to boost her cardio to 3 hours a week to
help improve her physical fitness. When creating a workout, she was advised to make one that
works for her; determine the goal, whether that is weight loss, tone, or strength. Perseverance
with exercise is what was emphasized in order to achieve the intended favorable health results.

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Wellness Diagnosis
During the real age test my patient was instructed to keep on top of stress. Stress, commonly
referred to as distress, is a state of mental tension and worry caused by problems in your life,
work, etc. or something that causes strong feelings of worry or anxiety. It has been shown over
time that stress can not only impact you emotionally, but physically as well. Many times
individuals do not understand the ramifications that factors, such as stress, have on their
health. Research into the matter has resulted with the following conclusion that stress can be
linked to heart disease, myocardial infarction, and hypertension (Denollet, Schiffer & Spek,
2010).
Due to the previously stated evidence, the wellness diagnosis for my client is health seeking
behavior related to stress as a risk factor for coronary artery disease. For the assessment part of
this wellness diagnosis, my patients psychosocial status, as well as lifestyle, was recognized as
yielding abnormal amount of stress. The defining characteristic is expressed concern about
current environmental conditions on health status. The expected outcomes for this wellness
diagnosis is that the patient will state ways to maximize positive and minimize negative aspects
of stress.
Another area for concern is my patients sleep pattern. It is easy to let sleep go when you have
more important things going on in your life. For the life of a full time nursing student, who is
also working two jobs, sleep is a luxury. However, even though it seems like a good idea to skip
sleep or cut it short, it is not. Lack of sleep can lead to depression, weight gain, forgetfulness,
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and can cause dangerous driving conditions. Due to these negative aspects that lack of sleep
promotes, a second wellness diagnosis was chosen for the patient.
This second wellness diagnosis for the client is readiness for enhanced sleep. Some assessment
findings that lead to this wellness diagnosis are situational daily stressors, overall quality and
duration of sleep. Defining characteristics of this wellness diagnosis are willingness to enhance
sleep. Expected outcomes for this patient is that she will identify factors that enhance readiness
for sleep, and will express feeling rested after sleep.
Planning
The purpose of the wellness diagnoses are to improve the patients health and the areas
deemed as problematic. This client has been given two wellness diagnoses. The first one being
health seeking behavior related to stress as a risk factor for coronary artery disease and the
second being readiness for enhanced sleep. With these two diagnoses there are overall goals
that are striving to be met.
For the health seeking behavior related to stress as a risk factor for coronary artery disease, the
goal was that the patient will state ways to maximize positive aspects and minimize negative
aspects of stress. In order to reach these goals a plan must executed. The first intervention that
will be implemented is informing the patient that stress is a risk factor for many major health
problems, including coronary artery disease. After the patient has understood that stress is a
risk factor, the patient will sit down and review stressors in her personal and professional life.
She will then evaluate mechanisms used to cope with these conditions, discuss how stress
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affects the body, and how decreasing stress changes these effects. The patient will be asked to
come back in three weeks to track improvements on stress level.
For the readiness for enhanced sleep wellness diagnosis, the goal is to have the patient identify
factors that enhance readiness for sleep and to feel rested after sleep. The plan to get the
patient to feel rested after sleep is to implement a couple of interventions. The first is to ask
the patient to keep a log of sleep and wake times, number awakenings, total time sleep, quality
of sleep, and any precipitating factors that may influence sleep. A behavior modification plan
will be formulated based upon the sleep log findings. The patient will be instructed to do the
sleep log for a week and then follow up for behavior modifications. After the behavior
modifications, the patient will be instructed to do a sleep log for an additional week to track
any improvements.
Transtheoretical Model
The Transtheoretical Model (TTM) is a theory of behavior, developed by Prochaska and
DiClemente, asserting that changes in health behaviors progress through five distinct stages
containing the elements of thought, action, and time that are influenced by experiential and
behavioral processes (Maville & Huerta, 2013). According to Maville and Huerta, the five
stages of this model are: precontemplation, contemplation, preparation, action, and
maintenance. The precontemplation stage has no thought to making change, no action
planned, and no goal timeframes within the next two months. The contemplation stage has
thoughts of making a change, actions considered, and a timeframe within the next six months.
The preparation stage consists of seriously thinking of making a change, actions have been
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identified, and changes take place within the next month. In the action stage, the patient is now
involved and engaged in the change for six months. The maintenance stage is processing effects
of the changes, continuation of behavioral changes, and continuation of these changes
indefinitely (Maville & Huerta, 2013). For the purpose of this assignment, the timeframe has
been shortened from 6 months to 4 weeks. Also, stages 1 and 2 do not apply to the patient
because this is an assignment. The patient did not choose to do these of her own volition.
However, she did participate in stages 3-5 fully and competently.
For the health seeking behavior related to stress as a risk factor for coronary artery disease
wellness diagnosis, the client sat down and differentiated between her negative stressors and
positive stressors. Please see the appendix number 1 and 2.The client identified that money and
school were her major negative stressors. For the money stressor, the suggestion was made
that the client make a budget and try to stick to it, to try and ease financial worries. For the
school stressor, more specifically, loads of homework, the suggestion was made that the client
make to do lists for each week, identifying what is priority and checking off her tasks as they are
completed. This should help her stress level by setting smaller goals that are easier to work
towards, and the workload looks like less for the week, relieving the stress. The client is also
asked to come up with two or more stress relievers that she can use when she feels stressed.
The client is instructed to try these behavior modifications and come back in 3 weeks to see her
progress.
For readiness for enhanced sleep wellness diagnosis, the client had a meeting that looked her
sleep log from the previous week, see appendix number 4. The log shows that she is having
trouble sleeping because of outside noises, mind racing, and it is cold. After seeing her reasons
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for impaired sleep, the client is asked to brainstorm ways to alleviate the distractions. The mind
racing, thinking about the stress, should be relieved with the stress wellness diagnosis behavior
modifications. The client came up with a list of strategies to help with the distractions, see
appendix number 3. The strategies include using white noise to block out background and
outside noises, sleep with ear plugs, or sleeping with a radio on. For the cold, the clients
strategies are turn the heat up at night and sleep with an extra blanket. The hope is that the
stress relievers are going to reduce the mind racing and thinking about the day distractions. The
client is then instructed to pick a strategy for the main distractions and write another sleep log
for another week to see progress, and at the end of that week have a meeting to see the
progress that has been made and see if anything needs to be modified.

Evaluation
The patient decided that she was going to try wearing ear plugs at night to see if that would
drown out the noise, as well as sleeping with an extra blanket and turning up the heat to
combat the cold. After her week of sleep logging, the patient came back in for another visit; see
appendix number 5 and 6. After assessing her sleep log, we see that the extra blanket and
turning up the heat at night helped with her feeling of cold. However, the earplugs did not
assist blocking out the noise because they kept falling out. Due to this negative outcome, the
patient was asked to modify her behavior again and listen to white noise at night to block out
the noises. She was also instructed to come back in another week to see if this behavior
modification helped.
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A week later, the client came back to look at her progress after trying the latest behavior
modification. The client stated that the white noise did help and she no longer woke up to the
background noises. During this meeting, the patients behavior modifications for stress were
also assessed. According to the patient, the budget and to do list helped to alleviate her stress.
When she was feeling distressed, getting active or playing Candy Crush also relieved her
symptoms. She also stated that the behavior modifications for stress helped to ease her late
night worrying and mind racing. The interventions and behavior modifications implemented
showed significant improvements to the patients sleep patterns and stress level.











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References
Denollet, J., Schiffer, A., & Spek, V. (2010). A general propensity to psychological distress affects
cardiovascular outcomes: Evidence from research on the type d (distressed) personality
profile.Circulation: Cardiovascular Quality and Outcomes, doi:
10.1161/CIRCOUTCOMES.109.934406
Maville, J., & Huerta, C. (2013). Health promotion in nursing. (3 ed., pp. 43-45). Clifton Park, NY:
Delmar.
Stress. (n.d.). Retrieved April 8, 2014, from http://www.merriam-
webster.com/dictionary/stress



















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Appendix
1. Sleep log 1
2. Sleep log 1 cont.
3. Stress brain storming
4. Assessment of sleep log
5. Sleep log 2
6. Sleep log 2 cont.








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