Running head: Partner Health Plan of Care 1

Partner Health Plan of Care

Joshua M. Vrona

Ferris State University

Running head: Partner Health Plan of Care 2

Health Assessment and Risk Reduction

Eleanor Roosevelt once said, “In the long run, we shape our lives, and we shape ourselves. The

process never ends until we die. And the choices we make are ultimately our own responsibility.”

(Anderson, E., 2013). This quote perfectly describes the topic of health promotion and education, which,

is important in helping people maintain the best optimal health. People often do not think about how their

physical actions, such as diet, exercise, or emotional relationships with others, can affect their overall

health. The doctor Oz Real Age Test allows people to compare their chronological age to their overall

health age, and visualize how certain factors contribute to their overall health. The test focuses on four

sections including health, feelings, diet, and fitness showing that each area plays a specific role in overall

well-being. (Roizen and Oz, 2013). By utilizing the Real Age Test and using the nursing process that

includes forming an assessment of health, establishing a diagnosis, creating a plan, implementation of the

plan, and preforming an evaluation to assess if the plan is working to its desired effects, the best course of

action for optimal health can be found for this individual. The purpose of this paper is to create a nursing

process that can easily be followed by the partner in hope to modify their health for the better.

Positive Health Practices

CT is a twenty-five year old nursing student at Ferris State University. He completed the Real

Age test on 6/6/2014 and through many healthy lifestyle behaviors; he has decreased the overall age of

his body by 3.3 years, showing a real age of only 22.3. These results show that the individual is already

building healthy measures to maintaining optimal fitness. Looking through the results from CT’s Real

Age test there are many sectors of good health behavior that can be noted.

Firstly, CT reports getting seven to eight hours of sleep a night, which, is marvelous considering

he is a full time student and works part-time as well. Timothy Morgenthaler M.D. states, “The

recommended amount of sleep for adults is from seven to eight hours a night.” (Morgenthaler, T., 2013).

Nurses know that adequate rest is important for the maintenance of the clients overall physical and

psychological health. Positive effects of sleeping include, increased immune system function, decreased

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accidents, retention and formation of knowledge and memories, and even decrease stress. CT has

developed a healthy sleep cycle, allowing him to get enough sleep even with a busy schedule.

The next area of positive health behavior shown by CT, is exercise both cardio and strength

building. Cardio exercises are those that work the heart and arteries, and is considered the best form of

exercise to lose weight. Examples of cardio exercise include running, cycling, and swimming. CT logs

around 360 minutes of cardio exercises per week. “Regularly getting your body moving makes your heart

and arteries younger and stronger, enhances your immune system, protects you from stress and

depression, and boosts your brainpower.” (Roizen and Oz, 2013). Strength building exercises include

those that work on increasing muscle mass. Common exercises to build muscle include weight lifting,

push-ups, sit-ups, and pull-ups. CT reported he performed these types of exercises two to three times a

week, which allows for not only muscle growth, but also relaxation time for muscles to heal. Exercise is

important in maintaining a healthy lifestyle and is a major factor in health promotion. The American

Heart Association reports, “As many as 250 000 deaths per year in the United States are attributable to a

lack of regular physical activity.” (Myers, J., 2014) As shown by CT’s Real Age results he maintains

adequate exercise to maintain a healthy lifestyle.

The results of CT’s Real Age test show many other positive health behaviors, such as eating

breakfast, keeping stress to minimum, and maintaining healthy cholesterol levels. As shown by the results

of the test these actions lead to the decreased effect of age on the body. It is important for CT to continue

these actions to remain healthy in the future.

Health Issues

Environmental and physical stressors all take a toll on the human body. People often make

decisions that negatively affect their health and CT is no exception. Included in the Real Age test areas of

needed improvement or risks that cause increased age of the individual. The test uses this as a guide to

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inform and curb poor health activities, while educating people on ways to change their lifestyles for the

better. In the following section, CT’s negative health behaviors will be discussed.

Maintaining a healthy diet is important to the overall health of an individual; The President’s

Council on Fitness, Sports, and Nutrition states “… a poor diet is associated with major health risks that

can cause illness and even death. These include heart disease, hypertension (high blood pressure), type 2

diabetes, osteoporosis, and certain types of cancer.” (2014). CT’s results show that he has difficulties

getting the correct number of fruits and vegetables needed daily, and an overabundance of junk food

within his diet. The Center for Disease Control reports eating a diet high in fruits and vegetables provides

a person with the vitamins and minerals required for proper body function (2013). It is important for CT

to maintain a diet of four pieces of fruit and at least five servings of vegetables daily, while cutting back

on the amount of junk food ingested.

Another area of concern for CT is poor stress controllers in the form of smoking, or over

consumption of alcohol. Smoking causes numerous deteriorations to a person’s overall health such as,

lung cancer, gum disease, and heart disease. In an article from the Journal of American Medical

Association it states, “Smoking causes more deaths than HIV, illegal drug use, alcohol use, motor vehicle

injuries, and fire-arm related injuries combined.” (Mokdad, AH. Marks, J., 2004). CT reports smoking

about half a pack a day and smoking more under situations he finds stressful. It is important to find

positive coping mechanisms for stress that are healthier than smoking. Both exercise and social

interactions with others can help reduce stress while increasing physical and emotional health. It is

important for CT to find what methods of stress relief work best while reducing or even eliminating his

use of tobacco.

The final area of concern for CT is increased exposure to UV radiation from the sun, while being

unprotected by the use of sunscreen. Exposure to ultraviolet radiation from the sun or tanning beds is the

major cause of skin cancer. An important measure in preventing these risks include, wearing proper

clothing or sunscreen for extended periods of time outdoors, complete skin checks to look for cancerous

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moles, and avoid the sun after a sunburn. By monitoring the amount of sun CT gets, he can keep his skin

looking young, prevent discomfort, and skin impairments associated with sunburns.

Wellness Diagnosis

Wellness diagnosis are identifiable areas of growth or potential growth that a patient takes in

order to work towards a healthier lifestyle. Nicole Etolen states, “A wellness diagnosis indicates a

readiness to advance from the current level of health to a higher level.” (2008). After taking the Real Age

test two wellness diagnosis were created in order to help him start healthier behaviors. The first diagnosis

is readiness for information pertaining to enhanced nutritional intake. CT fits this diagnosis, because of

his increased interest in asking questions about increasing vegetables in his diet and actively looking for

recipes for healthy snack alternatives such as “celery and peanut butter” to replace his snacking on junk

food.

The second wellness diagnosis that was identified for CT was readiness for enhanced coping

measures related to stress. CT fits this criterion with the understanding that smoking is an unhealthy

behavior. He expresses in the future he would like to quit smoking and for the moment decrease the

amount, he smokes. Exercise and emotional support can be used as healthy alternatives to the stress that

occurs from studying, working, and other areas. These are examples of ways in which CT plans to

improve in order to increase his overall health.

Goals

The Acronym SMART stands for (specific, manageable, attainable, realistically-time-bound)

goals which are specific, manageable, attainable, and realistically-time-bound , and is a used as a system

for the creation and attainment of goals. By examining the results from CT’s Real Age Test, two areas of

improvement can be put into action by formulating a plan of action. The first goal created is focused on

the decrease of unhealthy stress relief i.e. smoking or drinking. The client states, “I will work to reduce

the amount of cigarettes I smoke per day, while increasing my social circle to combat stress.” A journal of

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the overall feelings related to stress and reminders of healthy behaviors will be created as a nightly event.

The second goal is based on a nutritional change to the clients overall diet. CT states, “I will increase the

number of fruits and vegetables in my diet and reduce the risk of junk food.” A list of healthy snacks will

be created and planned for throughout the week to replace unintended junk food eating. Overall, these

goals should have CT working towards positive health behaviors.

Transtheoretical Model

In an article from the American Journal of Health Promotion, it states, “The transtheoretical

model posits that health behavior change involves progress through six stages of change:

precontemplation, contemplation, preparation, action, maintenance, and termination.” (Prochaska, J., &

Velicer, W., 1997). CT would fall under the sector of contemplation, because although he has formulated

a plan of action, he has not taken the steps towards moving away from the unhealthy habits. By creating,

a well-informed plan and providing information to CT regarding nutritional diets and stress reduction this

will encourage CT to continue with his steps towards healthy behaviors.

Evaluation

By recording daily feelings and number of cigarettes smoked per day (shown in Appendix B) it is

determined that CT has failed to meet the first goal of reducing stress through healthy measures instead of

smoking. The log reports that CT is still smoking around a half a pack of cigarettes a day and dealing with

stress from mostly school and work. CT states, “Decreasing smoking is difficult and takes time, but he

has established relationships with classmates and coworkers to help reduce stress.” This is evident in his

log about going bowling with friends from work on his night out. CT is taking steps towards stress

reduction, but is still dealing with the complications of nicotine addiction. Steps to combat this could be

providing information on nicotine patches or gum, having a role model to talk to, or providing more stress

relief activities.

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The second SMART goal to increase fruit and vegetable, and decrease junk food was unable to be

evaluated because CT never produced a food journal log due to lack of time throughout the week. He did

express that while shopping he bought more fruits and vegetables to incorporate into his dinners and heart

healthy snacks such as yogurt, granola bars, and turkey burger instead of regular burger. He also

expressed looking up healthy meals online and examples can be found in Appendix C. Although CT did

not perform the food journal, he did manage to look up healthy recipes and bought less junk food. By

increasing his healthy food intake, and recording his weekly food journal CT can take steps to moving

towards a healthier diet. It is important to keep pushing the patient to maintain these healthy buying habits

and watch his dietary intake, while allowing for some wiggle room so he does not get burned out. Overall,

CT has many healthy behaviors that keep him fit and younger, by fixing the problems of poor diet and

smoking to relieve stress CT can eliminate the health disparities that increase his overall age.

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Appendix A

Real Age Results

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Appendix B

Days Thoughts # of cigarettes smoked

Monday Tired from working, today anxious about upcoming test.

8

Tuesday Sad from test not going well. Had dinner with dad. Ran during

the evening.

10

Wednesday Clinical was good experience learned a lot, tired

6

Thursday Class, and work today, hung out with friends bowling. Feeling

relaxed and happy.

9

Friday Worked, went to the gym afterwards, overall good mood.

6

Saturday Anxious for quiz in pathology. 7

Sunday Church and relaxed with family at home.

8

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Appendix C

Healthy Recipes

Recipes found using www.alleecipes.com

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Appendix D

Dear CT,

After having a week to work towards your goal of creating healthy lifestyle behaviors, I

can see the hard work you have been putting into making changes to your overall diet and coping

mechanisms with stress. However, there are still several traits of concern that we can work

towards in order to become even healthier. For the nutritional aspect, I would like to see you keep

track of the food you eat throughout the week. This I feel, will help you keep your goals of eating

an increased number of fruits and vegetables. You have made positive steps towards a healthy

diet by looking up recipes and shopping heart healthy. By adding the food journal to your already

good habits, you increase your chances of making this change permanent. As for your goals to

reduce smoking and create healthy stress relievers there is room for some improvement. I am

encouraged that you have continued to relieve stress by forming a strong social circle and

exercising, but still think that there is room to improve upon the amount of cigarettes you smoke

a day. Many methods such as nicotine gum or patches, plus a strong support system can all help

decrease the urge for you to smoke. Overall, you are doing a great job maintaining a healthy

lifestyle.

Your Friend,

Joshua Vrona

Running head: Partner Health Plan of Care 12

References

Anderson, E. (2013). Elanor Roosevelt Quotes . In First Lady Quotes. Retrieved July 5, 2014, from http://thinkexist.com/quotation/in_the_long_run-we_shape_our_lives-and_we_shape/13255.html

Eat Healthy. (2014). In President's Council on Fitness, Sports,& Nutrition. Retrieved July 6, 2014, from http://www.fitness.gov/eat-healthy/index.html

Etolen, N. (2008). Wellness Working Diagnosis. In ehow. Retrieved July 6, 2014, from http://www.ehow.com/about_5422752_wellness-nursing-diagnosis.html

Jonathen, M. (2014). Circulation. In American Heart Association. Retrieved July 5, 2014, from http://circ.ahajournals.org/content/107/1/e2.full

Mokdad, A., & Marks, J. (2004, March 10). Actual causes of death in the United States, 2000. Journal of American Medical Association, 29(1), 1239-1245.

Nutrition for Everyone. (2013). In Center for Disease Control and Prevention . Retrieved July 6, 2014, from http://www.cdc.gov/nutrition/everyone/fruitsvegetables/index.html?s_cid=tw_ob191

Roizen, M. and Oz, M. (2013). RealAge. Retrieved from http://www.realage.com.

Timothy, M. (2013, April 20). Adult Health. In Mayo Clinic. Retrieved July 5, 2014, from http://www.mayoclinic.org

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