Discuses the three domains. Cognitive, affective and psychomotor in relation to health promotion.
health promotion-nursing role in preventing hypertension through physical exercise
Paper Details
Health promotion assignment:
Topic: Nursing role in preventing hypertension through physical exercise in Adult (40 years and Above)
Health promotion: no need to define health promotion as this is not the introduction.
• In this assignment author will follow the Tannahill health promotion model.
• Define Tannahill model.
• Reason for choosing this model.
• Benefits of using this model.
Discuses the three domains. Cognitive, affective and psychomotor in relation to health promotion.
1. Health education
• What is health education and why it is important.
• Nursing role in health education.
• Focus on educating people about hypertension, Risk factors to avoid complication of HTN
• Use evidence and previous background e.g. Randomized control trial or Cohort study about prevention of hypertension.
-do not follow medical model and do not discuss the anatomy or physiology of hypertension.
2. Health prevention:
This part should be brief .
What is health prevention.
• Primary:
This part should brief
1. Raise understanding and awareness of HTN.
2. Motivate people to take action to identify and address their lifestyle risk factors
• Secondary
.this is the main part in prevention of hypertension.
40s years screening for Non communicable disease (NCD ) to prevent complication of HTN.
**Nursing role in prevention
• Tertiary:
Rehabilitation, medical intervention.
3.Health protection:
-Focuses and compare the HTN prevention policies , legislations of three levels( Macro, Meso and Micro) the WHO (world health organisation), UK polices and Oman polices .
and social measures.
This is an exemplar:
Health Promotion (HP) Model:
To facilitate effective HP activity, HP models are used to guide and structure HP practice (Watkins, 2010). They also help to measure and evaluate the impact of practice, to evidence its worth and effectiveness. Tannahill’s HP model, creates “3 overlapping spheres of activity: health education, health prevention and health protection†(Tannahill, 2009, p.396). Each sphere of activity has subdivisions, creating seven areas of HP activity. For the purpose of this assignment, the three main spheres will be discussed and implemented. Tannahill’s model was chosen, as it incorporates health education, which would focus on the learning needs of the target population, and the preventative measures required to promote more healthier dietary choices (Sylvetskey, 2013). The model also helps to focus on the wider preventative and protective measures such as the policies and regulations, to ensure individuals are empowered to make healthier choices, by addressing the wider determinants that may influence the health need (Tannahill, 2009). This would help to ensure populations disadvantaged by inequality are empowered to have equal opportunity to address their health need, irrespective of their circumstances.
Health Education:
Health education is the process of communicating information or knowledge to empower individuals to make healthier choices by raising their awareness and influencing their attitudes (Scriven, 2010; WHO, 2015). Health education raises public awareness of specific health issues, and the nurse’s role involves acting as an advocate for individuals and supporting them to develop the knowledge and skills to improve their health and wellbeing (Balsdon, 2009; Piper, 2009) and adopt healthier lifestyles.
In relation to obesity prevention, an educational group could be provided by nurses to raise awareness of the importance of a healthy weight and maintaining physically activity. Participants of the target age group could be recruited form schools. It could complement and be delivered as part of the ‘School Health program’ in Oman (MOH 2013), whereby students currently receive a medical examination and are weighed in the first, seventh and tenth grade by trained school health nurses (Unicef-Oman, 2008; MOH, 2013). This educational session could be consented and accepted as part of this established program, so individuals do not feel victimised or judged if they have an increased weight (Lowry et al. 2007). Wilson (2007) also clarifies that adolescents prefer and are more likely to participant if it is in their school setting, and completed as part of a group environment due to their desired need to socialise. This will also promote social bonding, and facilitate a supportive environment where concerns are raised and a unified problem solving approach is encouraged (Lowry et al. 2007)
Any health promotion education activity must consider and incorporate the three domains of learning, which are cognitive, affective and behavioural (Watkins, 2010). The aim of this session would be to empower participants to make healthier choices, by incorporating the three domains of learning. The cognitive domain, would involve raising the participants awareness of obesity, and its detrimental impact on health and wellbeing. Sharma & Romas (2007) suggest the use of learning materials such as posters, leaflets and cards, to support the illustration and visualisation of the information presented. This is fundamental, as Slvestsky et al (2013) identified following completing a qualitative study that adolescents are unaware of the health implications linked to obesity, and have limited awareness of how their lifestyles are a contra-indication. However, Lowry et al. (2007) believes adolescence is an influential period, and topics such as weight management, need to be introduced sensitively to support self-esteem. Therefore information delivered needs to focus on ‘Goal Achievement’ and focus on how participants can improve their healthy eating and physical activity habits to reduce their risk of obesity. This could be achieved through the affective learning domain, which would involve exploring the participant’s feelings and attitudes regarding their new knowledge (Watkins 2010; Yoost & Crawford, 2016). During the session, group discussions would be facilitated, whereby participants could explore their current dietary habits and lifestyles behaviours to motivate them to identify potential risk factors. The behavioural domain involves, developing the skills and putting the new knowledge/learning into practice (Yoost & Crawford, 2016). Following the group discussions, participants would be supported and empowered to develop a weekly planner to empower them to start thinking about their lifestyles behaviours and dietary choices, where they could plan their dietary habits and additional physical activity. Ensuring it meets the WHO (2016), recommendations of 60 minutes a day of physical activity. Completing this within a group settling, may motivate a supportive team working environment, where physical activities could be planned together, promoting peer social support.
Prevention:
Health prevention involves activities facilitated to reduce the prevalence of disease and is categorised into three different levels, these are Primary, Secondary and Tertiary (Watkins, 2010). Primary prevention involves contributing to reducing the risk factors of developing a disease. Nurses can achieve this in practice, by making every contact count and educating adolescents of the importance of healthy eating (which involves limiting the intake of foods high in fat and sugar, and increasing their consumption of fruit and vegetables) and taking part in the recommended levels of physical activity, during all patients contacts (WHO, 2016). However, to reach a wider audience irrespective of social group, awareness could be raised by arranging an obesity campaign (Beaudoin et al, 2007). Campaigns involve any organised activity that helps to raise understanding and awareness of health issues, and motivate people to take action to identify and address their lifestyle risk factors (Wilson & Mabhala, 2009; WHO, 2016b). An obesity campaign, would need to involve a multi-disciplinary approach to utilise the skills of other professionals. This would include dietitians and physiotherapists, due to the nature of the health promotion messages. This would ensure the correct professional expertise would be available for advice and support as required. This could take place in various locations with appropriate permission, and in locations that attract adolescents, such as leisure centres etc. This educational campaign could involve a range of activities, including weight and height measurements, healthy food preparation, food tasters, methods and ideas to increase physical activity. It may primarily be essential to carry out research to get to know the target audience, as this will aid the nurse in designing the campaign, to ensure interventions are effective in motivating healthy behaviours and information is provided to meet the learning needs of the target population (Craig, 2014). The use of social media due to the chosen age group, may be effective to raise awareness of the event and its important messages.
The campaign could also target parents and raise their awareness of the issues, to help to alter family attitudes, helping healthy dietary practices to be established at home (Lowry et al. 2007). Nurses are essential and valuable practitioners, and ideally placed to be involved in health prevention techniques such as campaigning to empower the population (International Council of Nurses, 2016). In Oman, nurses have this proactive role and are already supporting the ‘International Diabetes Day’, and are involved in medical screening activities in relation to promoting diabetes prevention.
Secondary prevention:
This involves HP activities that aim to reduce the ongoing severity of a disease and reduce further complications (Raingruber, 2014). This is fundamental in obesity prevention due to the increased risk of developing non-communicable diseases (Mabry, 2014). Screening is an effective medical activity, which can help to detect conditions and complications early to facilitate prompt treatment (Sargent et al, 2012). As discussed adolescents in Oman are offered screening in school, and their weight measured as part of the ‘School health program’ (MOH, 2013). Nurses could routinely screen adolescents they have contact with, within the hospital or primary care setting. This could involve taking height and weight measurements. Although BMI measurements are used to classify obesity (WHO, 2014), this is not an effective tool when classifying obesity in children or adolescents. This is because of their growth patterns as they enter puberty, and the variation of the fat adiposity between boys and girls (Schneider, 2008). The BMI-for-age chart was therefore developed to help classify obesity in the two year to nineteen year old age bracket by the Centre for Disease Control and Prevention (2009). This chart takes into consideration the age and gender of children, and obesity is classified if the measurement when plotted on the chart is above the 95th percentile (Brook-Gunn et al. 2007). From this simple method of screening, high risk individuals could be given appropriate HP advice, and empowered to make healthy dietary choices and lifestyles choices.
Tertiary Prevention:
Tertiary prevention covers all HP activities which aim to reduce the ongoing complications or disabilities associated with a condition (Naidoo & Wills, 2009). This preventative approach focuses on palliative and rehabilitative interventions, which is not the focus of this assignment.
Health Protection:
Health protection involves promoting supportive environments, through the implementation of legislation on a global, national and local level (Watkins, 2010). The WHO ‘Global strategy on diet, physical activity and health’, was developed to help guide HP practice globally in an attempt to reduce the prevalence of obesity worldwide. The fundamental aim is to ‘promote and protect health through health eating and increased physical activity’ (WHO, 2016b). In a positive response to this strategy, the MOH (2009) has developed the ‘Omani guide to healthy eating and physical activity’, to help reinforce the healthy lifestyle habits required to promote health and wellbeing amongst the Omani population. It is also an essential evidence based document that nurses can use in their daily practice to guide their HP interventions and education, in relation to obesity prevention. In Oman also, the ministry of health is proactive in promoting health and wellbeing amongst adolescence, and promoting the importance of a healthy lifestyle though the ‘School Health Program’ (WHO, 2010). School health nurses are proactive in delivering this program in collaboration with the Ministry for Education.
To help achieve the WHO (2013) ‘Global action plan for the prevention and control of non-communicable diseases 2013-2020’, it is essential that the MOH work in collaboration with other governmental agencies , and develop policies on a national and local level that promote healthy dietary habits and increased physical activity to continue to target obesity prevention effectively. For example, many countries have put a legislative tax on sugar sweetened beverages, such as Mexico which has been found to reduce overall sales and therefore restrict these items from the population’s diet (WHO 2016c). This may be a useful legislative strategy in Oman to target adolescents, as this age group are more likely to consume sugary beverages. Lowry et al. (2007) discovered in a quantitative study exploring adolescent’s attitudes about obesity and prevention, that adolescents are unwilling to restrict soda/pop from their dietary habits. Therefore a potential tax increase might empower this age group to change their attitudes, and reconsider a healthier dietary option.
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