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Health Promotion Plan: Mr. Smith

Kristina Fernette, OTS

Diagnosis and Reason for Service:

  • Mr. Smith recently underwent a THA after breaking his hip while getting into his shower
  • Mr. Smith's main worries are navigating through his home and the community with his walker and continuing his Sunday night routine of cooking for his grandchildren

Mr. Smith's Occupational Profile

Occupational Profile

Occupational Profile

Occupational Profile

  • Mr. Smith is a 74-year-old widower who enjoys spending time with his family and friends. All of his children and grandchildren live within an hour of his home. The client values his Sunday night routine of cooking dinner for his four grandchildren. In his free time, he enjoys playing cards with his friends at the community center or spending time at the library. He does not drive, so he relies on public transit to get to these places.
  • After being discharged after his surgery, Mr. Smith has been feeling easily fatigued and finds leaving his house tiring. His priorities are to maintain his independence and learn to navigate his home and community with his walker. He has expressed interest on reducing his reliance on his walker because remaining active is important to him.

Health Behavior Change Theories

  • The Transtheoretical Model of Change (TTM) "describes health behavior as a process and at any given time individuals are at varying levels of readiness for change (Snelling, 2014, p 31)"
  • Under the TTM, intervention would require tailoring the desired outcome based on which stage of readiness the patient is at
  • The Social Cognitive Theory (SCT) "frames individual behavior as a response to observational learning from the surrounding environment (Snelling, 2014, p 27)"
  • Intervention using the SCT would include educating the client, improving self-efficacy, setting goals, addressing setbacks, and utilizing personal contributing skills

Health Behavior Change Theories

TTM

Transtheoretical Model of Change

  • In order to push Mr. Smith from the precontemplation to the contemplation stage, I would educate him on ways he could improve his overall health which would in turn improve his fatigue
  • Going from the contemplation stage to the preparation stage would involve setting goals and creating a plan as to how to accomplish those goals
  • The action stage would be accomplished by following through on the plans that were made during the preparation stage
  • The maintenance and termination stages would be complete after Mr. Smith follows through on his plans and goals for an extended period of time

Figure 1. Transtheoretical Model of Change: Stages of Change. Reprinted from Introduction to Health Promotion (pg. 32), by M. Snelling, (2014), San Francisco, CA: Jossey-Bass

Intervention Plan

Intervention Plan

  • Interventions will include a home assessment and a plan to improve Mr. Smith's endurance so that he can continue to move about the community and participate in his desired occupations
  • The goal of the home assessment is to adapt his home to be more walker friendly
  • Making his home more walker friendly will allow Mr. Smith to continue to cook his Sunday night dinners for his grandchildren
  • The goal of improving Mr. Smith's cardiovascular endurance is so that he can be more confident leaving the house in order to utilize the public transit system, go play cards with his friends, or spend time at the library

Therapeutic Use of Self

  • My therapeutic mode is encouraging - I am most comfortable when I am pushing and supporting someone to accomplish their goals
  • I would use my therapeutic use of self to connect with Mr. Smith and draw him out of his comfort zone so that he can make progress toward accomplishing his goals
  • My communication with Mr. Smith would be respectful and collaborative, rather than a young therapist instructing her older patient without taking into consideration his opinions or how he is feeling

Therapeutic Use of Self

References

References

Snelling, A. (2014). Introduction to Health Promotion. San Francisco, CA: Jossey-Boss.

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