Health Promotion Activity and Obesity
Obesity is a disease categorised by some writer as epidemic whereas some classify it as a life style disease (Doyle, 2001). Doyle (2001) & Blaxter (1990) cited behavioural diseases related to aetiology of lifestyle disease as poor product, lack of physical activity and cigarette smoking. Mrs B was 48 a years old lady, presented in hospital with the problem of severe headache and confusion. She was admitted to the ward and diagnosed of Type II Diabetes Mellitus and Urinary Tract Infection (UTI). After a week on admission, Mrs B’s health improved and was well. Mrs B was overweight as her weight was 100kg and her height was 5’4”, her blood glucose also shows high blood sugar.
Concentrating on Mrs B and considering her situation, it is very obvious that in order to prevent complications, many factors such as weight loss Hughes (2002) and degree at which she can control her blood sugar in long term Stratton et al. (2000) will be considered. To Promote Mrs B’s Health is to educate and advice her on weight reduction and to improve her diabetic management (Terry et al., 2003).
Definition of Health in Relation to Mrs B’s Problems
World Health Organisation (1992) defined health as a situation of being mentally fit, physically fit, good well being and not only the exemption of disease or ill health. It was also re-instated as been far from accurate in-spite of its’ undeniable inclusion of both sociologically and physiological component of health (WHO, 1996). Wellbeing, identified by Freud (1975) was more equated to happiness whilst compare to health in years before. Referring to his condition in his observation, suggestion was raised towards him stopping cigarette for his health, his thought was he is without doubt in good health but not as much of happiness (Saracci, 1997). In the world of today, it could be seen as a condition many people were going through in confused the hunt for pleasure with the quest for health. (Kemm, 2001). Mrs B diagnosis shows type II diabetes, considering her mental and social wellbeing in her assessment many other problems could be revealed.
Strategy for Health Promotion
It is important to realise that early responses to evidence that obesity is influenced by behaviour will be the focus on well-informed health promotion awareness that made individual reflect and decides on their behavioural imperfections (Upton &Thirlaway, 2010). Regarding Mrs B condition, weight reduction is something to be considered in order to achieve a measurable and realistic goal. Her body mass index (BMI) should also be aim for 23-24 as been overweight is BMI of 25-30, this is a target as it is not always easy to achieve NICE (National Institute for Health and Clinical Excellent 2001). To best achieve the goals, education and empowerment are the key important factors to consider (Peile, 2004).
For people to make informed decision about their behaviour, health education is one of the important instruments because it builds up necessary skills, makes available knowledge and provides information. Empowering is an approach that involves equipping people by increasing their ability towards changing their social realism. There is no doubt that Mrs B would not comply with a recommended treatment regime if it is a well informed regime, clearly understandable and given the tool to achieve it (McDonald et al. 1999). Empowerment and education are the two important concepts in management of patient on clinical issues and without doubt will benefit Mrs B in both areas of weight loss and diabetic control (Fealy 1997 & Carter 1996).
Planning Implementing and Evaluating the Strategy
Evidence-based health promotion was a readiness in contributing to building up the evidence based health promotion (Perkins, 1998). Evidence could also be described as an instrument such as piece of information used in formulating a decision or problem solving McQueen & Anderson 2001 cited in (Butcher 1998). Evidence gives answers to question of reason for a problem and period of problem existence. In Goodman et al. (1997) evidence was defined as provision of theoretical certification for some conclusion. The focus of evidence-based practice in relation to Mrs B issues tends to be evidence-based policy and practice in speaking about effectiveness. As a result, the evidence of effectiveness and risk of harm are part of strings of information that could give theoretical permission to health promotion action decision.
Deciding on evidence based treatment, problems identifying, planning, implementation and evaluation are the key important factors in intervention. To ensure adequate and obtainable plan of treatment in audit and successful investigation, evaluation is a vital factor (Venning et al., 2000). Assuming Mrs B treatment was not fully planned on admission, there is possibility to instigate it. Nevertheless the task of review and implementation could be for diabetic hospital and primary care team. Mrs B will be referred to dietician team for stable weight reduction and diabetic control because these are specialist nurses to provide counsel in terms of diet manoeuvring.
Being a skilled healthcare worker, first factor to be considered in Mrs B situation would be how to manage the reduction of her weight and concentrates on her improvement to quality of life and her long life expectancy (Alder et al., 2000). Number of questions and concern should be expected from Mrs B, encouraging her to discuss her concern is as important as understanding the ingredient of compliance (Marinker, 1997).
Reviewing Mrs B’s improvement over a certain period of time could be seen as a retrospect way of exploring effectiveness of her strategy but does not exclude generalisation of some facts. However comparison could be made to the study of (UKPDS) United Kingdom Prospective Diabetes study. According to Investigation, effectiveness of range of treatment in Type II diabetes over some period of years was looked at in clinical results of patient similar to Mrs B when assessed. A vital part of the evidence produced was directly linked of weight loss in association to reduction in long term complication. Consequently a major element of treatment strategy when advising Mrs B will be weight reduction.
Intervention Concept of Need
Examining Mrs B concept of need in association to Mrs B would be supposed complicated. Some assumptions will not be ruled out about Mrs B and her reasons for increase in weight. Nicholls and Viners (2005) defined Obesity as a difficult and incompletely understood happening. Referring to Obesity could be as an outcome of overeating or metabolism problems. Many text books have discussed and argue it vast majority of authorities have discussed and agreed that weight loss programs was considered in management of patient with Type II diabetes (Edmunds et al. 2001). Promoting Mrs B lifestyle change focusing on educating her to realise she needs to change will also be of motivating her to change. Nevertheless, Getting Mrs B to adopt her improve habit will be at expense of how she maintain recently accepted habit (Nigg et al. 2008).
Factors that could be of influence and should be considered in Mrs B lifestyle changes to her health includes her physiology concept and related intervention. For instance; awareness of risk and benefit is in relation to educating Mrs B and obstacles, social customs, social support, fright and self worth will be in association to intervention given such as structural change, policy, advising, motivation interviews, goal settings and risk communication (Upton & Thirlaway 2010).
Principle of Health Promotion Intervention
Small change big reward , changes do not have to be drastic to make a difference in re-enforce messages, relapse are common and should not be seen as failure, Simplistic that is small alterations are easier to remember and adapt to one thing at a time. It is important to aim for one change and then when comfortable make another change. This is health determinant so as to take control of total individual environmental factors favourable to health. It is, bringing about changes that individual could maintain. It includes all stages of process like the multidisciplinary team such as dietician, pointed out was Martyn (1999), emphasising on importance of instructive approach from healthcare staff whereby patient were given instructions and were expected to comply. But Richards (1999) supported the modern practice where an agreement was reached between the patient and healthcare professionals after a discussion thereby, involving the patient as much as the healthcare professionals.
Discussed earlier on was the concept of empowerment and education, description was given on the importance of these in making the most of patient conformity. All the same patient holds the bigger part of control as it is for them to decide on the extent of agreement with their treatment plan. Royal Pharmaceutical Society of Great Britain (RPSGB) (1997) suggested healthcare worker, a resources of knowledge that allows process of agreement to take place between the patient and healthcare professional.
Health Promotion Ethical issues
The principle of ethic issues decides on what was expected and not expected of healthcare professional in the pursuit of making better population health. Husted & Husted (2008) Described ethics as making decision and taking action in the presence of adversity, a moral philosophy involving what is good for individual and society. A moral is referring to beliefs and behavior of people (Naidoo & Wills, 2000). Setting out fundamental principle is one of the approaches that has gained widespread, in making ethical judgment four principles to be considered are: Principle of respect for autonomy, principle of nonmaleficence, principle of beneficence and principle of justice (Tingle & Cribb, 2002).
The principles that guard our action as health professionals include been expected to respect autonomy of patient and prevent harm. Your decision should benefit and considerably fair. The highlighted ways health promoter impede their client rather than respect their autonomy identified by Ewles & Simnett (1999) are; Enforcing their judgmental problem solutions to patient, giving instructions to their clients on what to do with the hope of reducing elongated time it will take their client to work out and lastly diminishing patient idea without justifiable reasons. Enforcing regimes that restrict enjoyment with holding treatment (unnecessarily) until behaviour change is achieved, removing person from friends as they might influence behaviour and breaking confidentiality by discussing behaviours with family and friends were also categorised as Non maleficence doing harm to patient.
It is a crucial part of healthcare practice and procedure to obtain the consent of a patient to treatment. Two roles Healthcare assistant or nurses in consent process are; to act as a primary carer, to give patient treatment when patient are confused to take treatment or not clear about treatment when doctor was taking her consent as a result, patient will have to ask nurse or healthcare assistant for clarity (Tingle & Cribb, 2002). Arguably some healthcare professional believe consent is not a problematic issue as long as patient choices is to their satisfaction. Concerning Mrs B treatment, she may decide not to go for the treatment regime, hence health professionals were to acknowledge the right to accept and to refuse treatment. Refusal for some patient could be as a result of misinformation and ignorance and for others, their strong attachment to spiritual and cultural beliefs could be the result (Gillon, 1996).
Ethical practice whilst uses in theories make available individual judgemental behaviour. Argued by philosophy is that human beings behave irrational when they are aware it is morally good to do things and irrational for person not to do it. Humans follow their gut nature with their head suggesting a different course of action. Ethical principles promote, prevent and remove harm to patient. Mrs B weight reduction, would eradicate possibility of her sustaining diabetes death with the omission of compulsion (Tingle & Cribb, 2002). Moral map are being provided in the process of putting ethical procedure in practice and people gets upset with the issues of moral concepts. Take for instance, a case of pregnancy termination which is an act of killing and an emotional issues. Philosopher’s opinion would be the ethical rules and principles which as a result dealing with difficult issue could sometime be put through with application of ethical judgement in practice.
Behaviour that Influence Patient Health Promotion Advice
Kawachi, (2002) identifies types of health behaviour models that absorb health promotion advice. Ethical or cultural model was recognised (Ewels & Simmet 2003). However, patient recognises and complies with concept of treatment that fundamental with what they belief in and own cultural background (Enright, 1996). In Africa, some culture beliefs obesity is a good health, social status and wealth comparing to western societies that obesity is attached to a disease. These two compares the relevance of behavioural model (Steptoe et al., 1999). Mediatisation model is a vital strategy to be considered in Mrs B strategy so as to appeal to her for consciousness of weight that was linked directly to her diabetes complications.
Budd et al. (1996), states Prochaska and DiClemente’s model of readiness to change was a good example of Mrs B Obesity. Because interest and readiness of Mrs B to receive advice should be recognise before she could be considered for advice. It cannot be disputed that Mrs B would not have received awareness or uninformed from medical media regarding risk factor associated with being obsess and associated complications, but the reality is she might decided not to change with her lack of concern, education or different reasons which has left her in the same position.
