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Health Education Plan

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tracie owens

on 5 February 2014

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Transcript of Health Education Plan

Health Education Plan
Participating Family
Health Education Development
Family Description
The Family chosen to participate in the family assessment is a family in transition. The father recently passed away from cancer in September 2013 from cancer. His passing was sudden as he was diagnosed in August 2013 with Stage 4 colon cancer and died six weeks later. This is now a single parent home consisting of the widowed mother and their 10 year old son with Asperger's Syndrome.
The family's history was complicated. There was a twenty year age difference between the mother and father and he was estranged from his family at the time of their meeting. The mother stated she had never met them and he did not want her to contact them even when he was dying. He had been very controlling in their twenty year marriage and kept the family socially isolated, even to the point of not allowing her to drive anywhere and drove her back and forth to her job every day. He also did not allow his son to ride the bus to and from school. The mother stated he even still gave their 10 year old son a bath every day, stating he had said he did not trust him (their son) to wash properly. He made all the decisions for the family. Their roles were reversed, however, from the traditional family model, in the fact that she was the primary money-earner and he stayed at home and did not work. While he did not cook and they ate out practically every meal he did the yard work, housekeeping, and the laundry.
The mother states that her and the father did not have a close relationship after the birth of their son and that they had not shared a bed since then, stating they had stayed together for the sake of their son. Their son had been developmentally delayed and diagnosed with Asperger's Syndrome. He had received some therapies but the father dismissed the diagnosis and would not allow any further therapies after the son started school. However, he allowed the mother to meet with the school after the school notified them of his special needs and an Individualized Educational Plan with the school was developed. However, the father was not participatory, even refusing to help their son with his homework.
The mother and son have a very close relationship, a relationship that she obviously values, and she encourages the son to remember his father in a positive light. She does not talk in a negative manner about him around their son, instead confiding me the previous details in private. She allows the son to have input but she is the decision-maker now and he obeys her without question or power struggles. She is now provider of all roles in the family. She seems like a butterfly coming out of a cocoon and excitedly talks about driving again, learning to cook, and developing new friends. She is clinically obese and newly diagnosed with diabetes this past year. She stated her latest A1C level was over 10. Her son is slightly overweight and socially awkward. During time spent with the family he displayed no concept of personal boundaries, coming up to the writer of this paper multiple times and petting her head and running his fingers through her hair. The mother is quick to correct his behavior, seemingly always on guard, and he listens to her without question. She is attempting to socialize him more and has enrolled him in the YMCA afterschool program and allows him to ride the bus. (Owens, 2014).
Values & Culture
The family values are reflective of the mother's concern for her child's well-being, their health, and safety. These values are identified as ones that are also of importance to the writer. We also share similar sociocultural backgrounds which assisted in establishing a patient-based approach to assess core issues, effective communication, and a trusting relationship (Betancourt, Green, & Carrillo, 2014). Both the writer and the mother agreed that this experience was a very positive one and would not have done anything differently.
Chosen Diagnosis:
Knowledge deficient of healthy food choices and preparation
Health Education Tool & Assessments
The Health Education Tool was developed through research of educational tools and learning theories in coordination with review of the Windshield Survey, Community and Family Assessments. "Information personalized to the patient encourages greater compliance with intended behavior changes" was the starting point ( Stonecypher, 2009, p. 464). The mother voiced numerous concerns regarding her diabetes, weight, eating habits, and ability to prepare healthy food at home. This information, combined with the numerous fast food restaurants observed in the community during the Windshield Survey and perceived lack of immediate community resources for these concerns by the family helped to drive the tool development. "Health education research and practice have found individuals' health decisions and behaviors to be related to their perceptions of need" solidified the decision for the tool development (Eng & Blanchard, 2007, p. 141).
Community Resources & the Health Education Tool
The Health Education Tool focuses on helping the family to "identify resources" and "develop and call forth strengths, mobilize and use resources" from within the community (Feeley & Gottlieb, 200, p. 9). The mother truly desires to develop healthy behaviors but is unsure how. Her motivation is driven by her own health issues and to be a healthy role model for her son. "Internal motivations of the patient are more effective for lifestyle chage than external motivation" (Bagnasco, Di Giacomo, Da Rin Dellamora, Catinia, Turci, Rocco, & Sasso, 2014, p.188). This motivation is a strength and "developing and using strengths and resources is a critical feature of health and healthy behavior" (Feeley & Gottlieb, 2000, p. 11). The Health Education Tool was designed to use this strength and to complement community resources.
Educational Session Development
"Understanding how to design and implement patient information so that education is effective is paramount" (Stonecypher, 2009, p. 462). Extensive research was conducted on multiple internet sites and community resources were utilized to assist with development of the Educational Session. "Simply handing your patient a pamphlet is not enough to promote understanding or behavior change" (NC Program on Health Literacy, 2013). To encourage the family to become partners in their own care the session needed to "allow the learners to become actively engaged with the construction of their learning and not be a passive tool of teaching" (Clapper, 2010, p. e8). Armed with that perspective the Educational Session took shape, falling into place like pieces of a puzzle. This individualized Educational Session based on the combination of all the assessments done not only "encourages greater compliance with intended behavior change" but also arms them with "the knowledge, skills, and the ability" to implement that change (Stonecypher, 2009, p. 464; Bagnasco et al, 2014, p. 188).
Multiple theories were used to create the Health Education Tool and Educational Session. Knowles' Adult learning Theory, the Health Belief Model, the Self-Efficacy Theory, and Kolb's Experimental Learning Theory were all incorporated to guide the process. First Knowles' six principles were used as the basis of directing the process for the Health Education Tool because it was aimed at educating the mother.The principles are that adults are self-directed, they have life experiences, learning must be immediately relevant, they are internally motivated to learn, and they need to know why they are learning something (Sandlin, 2010). All of which ere taken into account with the content direction of the Tool. The Health Belief Model was used to support "the perception of change" that the benefits of the lifestyle alteration to the healthy eating and cooking behaviors "outweigh(s) the barriers, resulting in success" (Stonecypher, 2009, p. 463). The Self-Efficacy Theory and Kolb's Experimental Learning Theory assisted in guiding the Educational Session. The Self-Efficacy Theory that empowerment or the belief that they will succeed will motivate the necessary change to achieve their goal was used to direct the session (Stonecypher, 2009). Kolb's Experimental Learning Theory was also instrumental with the Educational Session by forming a hands-on approach that actively involved the family "in the experience and reflecting on the experience during as well as after" because then knowledge through active participation is achieved (Clapper, 2010, p. e10).
The Tool
The Tool is a pocket folder containing colorful, easy-to-read handouts with a Flesch-Kincaid score of 5.7. The folder begins with an overview of diabetes, how the foods you eat affect the body's glucose, and long term complications. Next we covered the benefits of making healthy food choices, how food affects blood glucose, and then an overview of A1C and how it corresponds to blood glucose levels. Then we went over what are healthy food choices for diabetics, how to use the plate method when preparing meals, practical tips for portion control, and how to chose carbohydrates. Next we discussed how to read a food label and then using it to make healthy food choices. Then we went over how to use a food diary to better track food choices and corresponding blood glucose levels. Also included was a booklet containing nutritional information on most fast food restaurants and how to make healthier choices when eating at them and keep within the diabetic guidelines. Also included were community resources which included the local chapter of the American Diabetes Association in Richmond and a flyer for a Diabetes Control program at the local YMCA that includes cooking classes. After that educational session with the tool we then went to American Diabetes Association website and chose recipes for dinner. We all then went to the grocery store, using the information we just went over, and bought the ingredients for the recipes. With an informal cooking lesson we all made a healthy dinner with the recipes.
The Response
The family's response was very positive. The son asked many questions and was very participatory. The mother was very enthusiastic about all the information presented and also asked many questions. They both were very excited to be involved in regards to picking out the recipes, the trip to the grocery store, picking out healthy food for the recipes, and then preparing the meal using all the information that we had discussed. Both mother and son did an awesome job preparing the healthy meal, with the son hardly able to eat he was so excited and proud. We all agreed it was a great experience for all of us and that they would continue to use the information provided and lessons learned from the experience.
The Experience
The experience was a very positive and enlightening one. Not only did the writer help this family on their journey to achieving a goal but the writer also gained helpful information in regards to her own life journey. As we all went through this process together, the writer could really empathize with this family during this transition in their lives.The writer of this presentation would not do anything different based on the extensive research done and in light of the positive response of all involved. We achieved the balance of " 'knowing what' (knowledge gained from health professionals) and 'knowing how' (knowledge gained from each other)" that evidence shows "improves outcomes and quality of life" by "improving people's ability to self care" (Cooper, 2013, p. 22-23).
Community & Available Resources
Educational Session
Tracie Owens
NUR 405
February 10, 2014
Bonnie Schoettle

This diagnosis was chosen for the educational tool for the following reasons:
The mother is obese, does not know how to prepare healthy meals, and frequently eats at fast food restaurants.
The son is also slightly overweight and children learn their eating habits from their parents (Parlakian & Lerner, 2007).
The mother voices concerns regarding her weight, diabetes, and how this will affect her son's life.
The family's community is culturally diverse. Their neighborhood is bordered on one side by a neglected industrial/retail area and then a large thriving retail area on the other. As it is considered an under served area for the city, reflected in the higher that average rates of crime, poverty, and transients, the community has a number of organizations that offer financial assistance, job training, and youth programs that put forward community involvement through social, recreational, and educational activities (Owens, 2014). Those identified for the family's needs were the YMCA, the Neighborhood Resource Center, the Salvation Army Boys Club, the Autism Society of Central Virginia, and the local chapter of the American Diabetes Association.
Bagnasco, A., Di Giacomo, P., Da Rin Dellamora, R., Catania, G., Turci, C., & Sasso, L. (2014, January). Factors influencing self-management in patients with type 2 diabetes: a quantitative systematic
review protocol. Journal of Advanced Nursing , 70(1),187-200. doi: 10.1111/jan.12178
Betancourt, J.R., Green, & A.R, Carrillo, J.E., (2014). Cross-cultural care and communication. Retrieved from
http://www.uptodate.com.ezproxy.apollolibrary.com/contents/cross-cultural-care-and- communication?source=search_result&search=community+and+public+health+care&selectedTitle=24~150#H1
Clapper, T.C. (2010, January). Beyond Knowles: what those conducting simulation need to know about adult learning theory. Clinical Simulation in Nursing, 6(1), e7-e14. Retrieved from University of
Phoenix Library.
Cooper, A. (2013, March). Using social networks to help patients self-care. Nursing Times, 109(10), 22- 24. Retrieved from University of Phoenix Library.
Eng, E., & Blanchard, L. (2007). Action-oriented community diagnosis: A health education tool. International Quarterly of Community Health Education, 26(2), 141-158. Retrieved from University of
Phoenix Library.
Feeley, N., & Gottlieb, L.N. (2000, February). Nursing approaches for working with family strengths and resources. Journal of Family Nursing, 6(1), 9-24. Retrieved from University of Phoenix Library.
NC Program on Health Literacy. (2013). Retrieved from http://nchealthliteracy.org/toolkit/
Owens, T.M. (2014). Family nursing diagnosis; Community Assessment. Unpublished papers, NUR 405- Health Communities: Theory and Practice, University of Phoenix.
Sandlin, J. (2010). Andragogy. In C. Kridel (Ed.), Encyclopedia of curriculum studies. (pp. 36-37). Thousand Oaks, CA: SAGE Publications, Inc.
doi: http://dx.doi.org.ezproxy.apollolibrary.com/10.4135/9781412958806.n20
Parlakian, R., & Lerner, C. (2007). Promoting healthy eating habits right from the start. YC Young Children, 62(3), 60-62. Retrieved from Retrieved from University of Phoenix Library.
Stonecypher, K. (2009, October). Creating a patient education tool. The Journal of Continuing Education in Nursing, 40(10), 462-467. Retrieved from University of Phoenix Library.

Diabetes Patient Handouts Used for Educational Session:
The Benefits Of Making Healthy Food Choices
How Food Affects Blood Glucose
Monitoring A1C
The Plate Method
Making Healthy Food Choices
Practical Tips for Portion Control
Reading the Nutrition Facts Label
Using a Nutrition Facts Label
Choosing Carbohydrate Wisely
Keeping and Using a Food Diary
The library of diabetes patient handouts [Multimedia]. Milner-Fenwick. (2011). Retrieved from VCU Community Health Education Center.
Diabetes and the Food You Eat: Getting Started
Diabetes or High Blood Sugar: Hyperglycemia and Hypoglycemia
Long-Term Complications of Diabetes
Diabetes Handouts (2010). Retrieved from VCU Community Health Education Center.
Fast Food Guide
BD Getting Started Fast Food Guide. (2007).BD Diabetes Patient Education. Retrieved from VCU Community Health Education Center.
Recipes used during Educational Session:
Parmesan Crusted Chicken
Rustic Red Potatoes and Green Beans
No-Bake Peanut Butter & Chocolate Bites
Recipes - American Diabetes Association. (2013). Retrieved from http://www.diabetes.org/mfa-recipes/recipes/
Local Address and phone number of the American Diabetes Association
Flyer form the Richmond YMCA for Diabetes Control program that includes cooking classes
Health Education Tool
Full transcript