Health Promotion on Copd free essay sample

This essay will be discussing the health promotion role of a nurse looking after a patient that has Chronic Obstuctive Pulmonary Disease(COPD) . The essay will focus on a 65 year old gentleman Mr Abraham who has been admitted into a general medical ward,with an acute exacerbation of COPD. Mr Abraham is well known to the ward as he is admitted regularly, the ward staff are aware of the fact that he continues to smoke and uses his inhalers incorrectly. World Health Organisation (WHO 2010) state Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by chronic obstruction of lung airflow that interferes with normal breathing and is not fully reversible. Patient UK(2008) state an exacerbation of COPD can be defined as a sustained worsening of a patients symptoms from his/her usual stable state that is beyond normal day-to-day variations, and is acute in onset. Commonly reported symptoms are worsening breathlessness cough, increased sputum production and change in sputum colour. We will write a custom essay sample on Health Promotion on Copd or any similar topic specifically for you Do Not WasteYour Time HIRE WRITER Only 13.90 / page The risk factors which can predispose a person to be more prone to acquiring COPD are cigarette and cigar smoking,exposure to inhaled pollutants ,recurrent respiratory tract infections ,Age Process ,Male Sex, Family history of COPD, Air pollution,  (ONeill ,2002). COPD can be brought on by many of these   factors but the majority of cases are brought on by smoking. Mr Abraham has continued smoking which has made his   COPD progress in its pace and he has recurrent exacerbations placing him in hospital . The nurse and Mr Abraham will need to explore ways which which will give Mr Abraham the health education to aid him in a bid to reduce /stop smoking . Mr Abraham is also not using his inhalers correctly and the nurse can show Mr Abraham   how   to use his inhalers correctly by teaching him how to use them this will help Mr Abrahams health and reduce the onset and severity of his exacerbations. The National Service framework (NSF) is a government policy used in the United Kingdom (UK). The NSF for long-term conditions was made to set national standards and identify key things that can be done for people with a particular long term condition and put in place strategies that support the implementation of these standards to ensure people have access to the care they are entitled too. NSFs try to cut down the amount of hospital stays people with long-term illnesses stay and for them to be able to manage their condition in the community. The NSF for long-term conditions is mainly written for people affected with neurological conditions but it has been used as a guideline for other long-term conditions such as COPD. (DOH 2009). The Department of Health (DOH) and The British Lung Foundation (BLF) are working together to create a NSF specifically for COPD this will be implemented as a national policy for the whole of England it will ensure everyone affected by COPD will have the same high standards of care regardless of were they live in the UK, this will also outline the minimum standards of treatment that people with COPD can expect to receive in their local area. BLF 2009) According to the Nursing and Midwifery Council (NMC) Code of Professional Conduct (2008), nurses and midwives must protect and promote the health and well-being of patients in their care and also their families. They must work in an open and co-operative way with other members of the multi disciplinary team by encouraging the independence of patients and showing respect with regards with their involvement in the planning and delivery of care. The health professional will promote and respect the dignity of Mr Abraham and cater to his needs and concerns without discriminating against him because of his condition. The health professional will help Mr Abraham by gaining access to information from the internet and hospital leaflets   regarding COPD management so he can learn about how to decrease his COPD exacerbations. It is very important to play a key role in empowering Mr Abraham to cut down on how much he smokes in order for him to be able to manage his condition well, which will help him understand the value of health and understand some of the known complications of   COPD (NMC 2009). Prochaska and DiClemente(1984)   deals with intentional behavioural change and views change as a process rather than an event. The change process is characterised by six stages of change. These include the precontemplation,contemplation,preparation,action,maintenance and relapse which can occur at any stage in any part of the cycle. Relating to Mr Abraham scenario he is presumed to be in the precontemplation stage of the Procheska and Di-Clemente model (1984)The scenario set is he is well known to the ward he has been admitted   numerous times due to having exacerbations of COPD . Furthermore Mr Abraham is fully aware that smoking contributes and makes an impact on his health condition however there are no clear indications in him willing to take steps to quit smoking and he is also hesitant to consider the possibility of change. Before the model of change can begin, the nurse should develop a non-judgemental supportive therapeutic relationship with Mr Abraham which will enable   the nurse to know him better and see what his triggers are and what challenges he faces in his everyday life . The health professional should inform and empower him about health issues to improve his health. Before action the nurse should discuss with Mr Abraham his understanding of his condition, what support he would like and what his goals are and how much time he wants to get there . Mr Abraham needs to be given choices and empowered when given information regarding his health to enable him to become knowledgeable about his condition. The nurse should empower Mr Abraham to make decisions on his illness and discuss what actions Mr Abraham is willing to take to improve his quality of life. The Nursing and Midwifery Council (2009) code of conduct states that consent should be obtained from the patient as to whether they require your help and support. To help Mr Abraham progress through the stages of change model the health professional should encourage re-evaluation of Mr Abrahams current behaviour pattern and provide Mr Abraham with relevant information that would help him stop smoking. The contemplation phase The nurse will discuss the smoking cessation process and inform him of Nicotine Replacement Therapy products such as patches chewing gum ,nasal sprays . The nurse will explore with Mr Abraham the benefits of him quitting smoking would have on his health and his finances. Preparation Stage is were the the nurse can engage Mr Abraham in exercise which can allow Mr Abraham to set goals using the SMART objectives which are goals that are specific,measurable,achievable,reliable, and time framed. Mr Abraham and the nurse will discuss the triggers which lead him to smoke and discuss other things he enjoys which could replace a cigarette, Procheska and DiClemente model encourages change at a small amount at a time. For example Mr Abraham may be going through 8 cigarette a day the nurse and him could look at ways in which he could look to cutting back   by having one every 3hours . In time if Mr Abraham   could consider having one cigarette 4 hourly . The nurse could also address the question Mr Abraham had initially asked as to why he is repeatedly readmitted and explain to him that by him preparing to change his lifestyle reduce his smoking habit how that makes a huge impact to his health helping to reduce his number of re-admissions. The nurse will be able to assess Mr Abrahams inhaler technique and with his consent the nurse will refer him to a specialist respiratory nurse who would be able to teach him inhaler techniques . Written information such as leaflets will also be provided for Mr Abraham as a reminder of the key issues and techniques they would have discussed to help him change his behaviour. The next stage is the Action stage this is the stage in which Mr Abraham is expected to put words into action and beginning to practice the smart goals that would have been set in the preparation stage. This stage is in which the nurse will re-evaluate current behaviour , restructure cues. The health care professional will give Mr Abraham support, encouragement to reach his goals. Mr Abraham should attempt to start activities which he enjoys by doing so Mr Abraham will be reducing his stress levels and will be distracted from the urge to smoke. The following stage is maintenance stage this is when an individual is trying to maintain their new behavioural change and it can take up to several months to get to this stage. The nurse will discuss with Mr Abraham of what benefits he is feeling in himself and if he feels his health ,finances and social life have improved. Mr Abraham may experience some ethical dilemmas and influences at this stage this will determine if Mr Abraham will maintain his new attitude to changing and be able to maintain his situation until he gets complete control over his lifestyle. The relapse stage can occur at any part of the stages of change model and its when the patient can revert to old behaviour The nurse should explain relapse does not mean failure Mr Abraham can acknowledge this stage it would give him an opportunity to explore the challenges he is going through and analyse the goals he would have set himself as to whether the goals set were too big or he had not given himself enough time. According to Procheska et al (1992) a professional worker involved in the care of people affected by COPD will need to evaluate triggers for the patient relapsing,reassess motivation techniques,barriers affecting change and devise stronger coping strategies. Mr Abraham may encounter some barriers as he attempts to change his behaviour. These could be in his support network as in peers may not be very supportive of him trying to quit smoking . Mr Abraham may also have lack of education on his medication and may not see the importance of taking his inhalers to relieve his symptoms so the nurse will need to educate Mr Abraham about his medication and give him written information to go home with. The nurse should encourage and   empower Mr Abraham to take control of his health and make informed decisions on how he is going to change his lifestyle. In conclusion the essay topic has highlighted the importance of identifying people affected with COPD and the different needs of individuals affected . The NSF for long-term conditions is helpful by having set standards for all patients affected with a long-term condition in the UK. The essay has also highlighted the benefit a separate NSF would be required to aid patients suffering COPD and there to be governmental standards set in the care they would receive . The Procheska and Diclemente model of change was discussed and explored the way in which a patient can go from thinking about change to implementing change and then relapsing and going back a step change is a slow process and it requires   the patient to want to change. This essay was service user based as the patient was involved in their plan of care and it was a process of change.