Actual Assignment:
Health Assessment Strategies to Promote Wellness
Course Objectives: #1, 2, 3, 4, 6
Course Evaluation: 100 points (35% of course grade)
Due Date: Week 6
Preparation
- Review the assignment grading rubric (at the end of this document) before beginning work on this assignment.
- Review assignment details (below) for guidelines/point allocations.
- Contact your instructor if you have any questions.
Submission Requirements:
- Use your last name in the file title
- Save your paper as a single Word document to your desktop and then upload it to the assignment link located in the week 7 folder.
- Appropriate formatting
- Elements of APA format to focus on for Major Assignments are:
12-point Times New Roman font
Double line spacing, except for instances in which you can appropriately convey the information with bullet points (single space those)
Title Page
Page numbers, upper right corner
Margins, 1 inch on all sides
Headings, use appropriate levels
In-text citations
Reference page
- If your assignment requires interviewing an individual, this is considered personal communication and is listed as an in-text citation only. You will not include the personal communication on the reference page. Document the communication, in your paper, in question/answer format using numerals or bullet points.
- Refer to Purdue Online Writing Lab for specifics on required formatting:
In this assignment you will be having a conversation in the form of a guided interview with a person about his or her health and health goals. This course has emphasized the importance of asking good questions to encourage people to share their own insights about their health patterns, needs, and goals. To best promote health, nurses must move away from a medical model in which the health professional comes with all the questions (and answers). Instead, we use our knowledge of health and wellness to ask good questions as an invitation to people to discuss health matters in the spirit of a partnership. The person (patient) is, after all, the “expert” regarding his or her health, life patterns, and goals. So think: I will conduct an interview in which I ask questions designed to invite another person to converse with me about his or her health. You are a “coach,” encouraging and inviting others to participate.
***Please choose a friend or family member to complete this assignment. Please do not use an actual patient from work.
Assignment Part 1: Assessment (50%)
Select an adult (of any age) to interview and gather information about his or her functional health patterns associated with health promotion. Your assignment will be more valuable if you select a person who is willing and able to talk about his or her overall health and wellness goals, and ways of approaching health throughout life. Since you will not be performing a physical assessmentor discussing more sensitive issues related to bodily function (unless initiated by the interviewee), you could talk with a person you know. You will not be using names or personal identifiers in your paper, so inform your interviewee that your assessments will be seen only by yourself and a faculty member.
You will be assessing 3 Functional Health Patterns most closely related to health promotion, health literacy, health behaviors, coping, and cultural/spiritual influences. The patterns you are required to discuss are: Health Perception-Health Management; Coping-Stress Tolerance; Values and Belief Patterns. If the person you are interviewing begins to talk about another pattern (Activity/exercise, for example) follow his or her lead, listen carefully, and ask follow up questions related to AT LEAST ONE MORE pattern to keep the conversation going in the direct the person takes it. The additional pattern you choose to assess should be appropriate for the patient’s health needs. You will have addressed a total of 4 patterns for this part of the assignment.
To prepare for your interview, develop open-ended interview questions for the four patterns–Health Perception-Health Management; Coping-Stress Tolerance; Values and Belief; to get started and direct the flow of the conversation. You will also be practicing the skill of asking clarifying questions as the interview moves along.
After you have completed your interview, you will analyze your interviewee’s responses, and cluster the responses so that you can develop a sense of what sort of health promotion plan would be most useful to your interviewee.
Part I should have these 3 sections (use headings to keep Part 1 organized).
- Section 1: Overall description of your interviewee, as stated above, including health literacy assessment. Begin Part I by describing the general assessments of your interviewee. Include in this paragraph age, gender, race, social circumstances, employment status, general education level. Also, provide information about allergies, medications and relevant family history at the beginning of your assessment documentation. Assess your interviewee’s health literacy, using one of the tools you used in your previous paper and discuss the results of the assessment in detail.
- Section 2: Detailed reporting of the interview/assessment. Develop open ended interview questions for Health Perception-Health Management; Coping Stress Tolerance; Values and Belief Patterns. You should ask a minimum of 3 questions for each health pattern. Include each question you ask in your paper, followed by summarized or bulleted list of your interviewee’s responses. As you converse with your interviewee, be prepared to add questions and record a summary of those conversations. Select ONE additional pattern to assess, relevant to your patient’s health needs for a total of 4 patterns. Resources for completing your interview are:
- Health Promotion throughout the Lifespan textbook, chapter 6 will give help you to determine what to ask for each pattern.
- Gordon’s Functional Health Pattern table located under “coursework”, in the “week 1” folder.
- Weekly class content – discussion boards may provide additional specific assessment data
- Section 3: Physical assessment. Identify TWO body systems (cardiovascular, gastrointestinal, etc.) to assess that you believe is pertinent to your interviewee based on your discussion with them. Explain why you chose these systems to assess. You do not need to perform the physical assessment but give an in-depth description of the physical assessments you would perform on the individual. Please provide the assessment details in a numbered list with descriptions of the steps in your own words. Refer to a physical assessment textbook you may have or use a reliable online resource(s) and cite your source using APA format.
Note – if you are not able to identify a specific physical assessment pertinent to your patient based on the interview, give a detailed description of a physical assessment, using two body systems, in an area that you believe you could use more practice.
- Section 4: Summary of what you learned about your interviewee’s health after concluding your interview. Include descriptions of the interviewee’s use of health promotion and illness prevention activities in detail in this section.
Part 2: Developing a Health Promotion Plan, using Health Literacy Principles: (25%)
Find appropriate health promotion resources, available to you at no cost, that you believe would be useful for the person you interviewed. You will discuss the materials in a paragraph description of how the materials would be useful to this person and why.
- Identify one priority area for health promotion from the health concerns identified in your interview.
- Locate at least THREE health-teaching resources (e.g. handouts, brochures, on-line web sites, referral sites, and/or other media) appropriate for your interviewee’s health promotion needs and literacy level.
- List the materials you located and provide the source and/or any linked web site address. Include a brief rationale for why you chose these resources. Rationale should be well thought out, not just one sentence. Please check links prior to submitting your assignment. Please cite these resources following APA format. Do not provide a link to a main page of a website. You should identify which information on the website is appropriate and include live links to the teaching material you would provide to the individual.
Part 3: Reflection (15%)
Reflect on your experience of being a “health coach” and communication partner in health promotion strategies. Your reflection should focus on your overall growth in the role of a nurse in health promotion. Respond to all 4 points below in your reflection using a new paragraph for each:
1) Describe how your interview/conversation about health, goals, and health behaviors seemed different from a standard medical history interview and assessment.
2) Evaluate your personal strengths in a health promotion interview, and those skills or topics that were more difficult for you.
3) Describe strategies you used to keep the interview on track and geared toward your interviewee’s interests.
4) Name one specific thing you learned in this interview process. Describe how you will use this in your current practice.
Example of the assignment:
Major Assignment #3 Health Assessment and Health Promotion Plan
Health Assessment Strategies to Promote Wellness
September 29, 2021
Major Assignment #3 Health Assessment and Health Promotion Plan
The first part of this major assignment will discuss the assessment of an individual’s health literacy, an interview with the individual, and the physical assessment of two body systems. The second part of the assignment with discuss the health promotion plan developed for the individual using health literacy principles. The last part of this assignment is my reflection on being a “health coach” and communication partner in health promotion strategies.
Part 1: Assessment
Section 1: Overall Description
This interview was conducted with an 87-year-old. Caucasian male named Don. He is a retired farmer, and his highest education level was 12th grade. He has no known allergies. His medications are as follows:
- Coumadin 8.5 mg on Mon, Wed, Fr. 8 mg on Tues, Thurs, Sat, Sun
- Flomax 0.4 mg every day
- Iron Supplement 150 mg every day
- Lexapro 20 mg every day
His family history is not significant; however, he has an artificial mitral heart valve placed 25 years ago. He also has skin cancer and gets checked every 6 months or more frequently as needed. He gets his skin lesions treated with cryotherapy. He also has benign prostatic hypertrophy (BPH). He sees his psychiatrist every 6 months for depression and monitoring of dementia. He is current on his pneumonia and shingles vaccine. He plans to receive the flu vaccine in the next few weeks. He received both COVID doses and looks forward to getting his booster. He socially distances and wears a mask when out in public. Don does very well for his age. He rides his horses at least three times a week, goes to Bible study one day a week, and goes to church on Sundays. He still drives locally.
I assessed Don’s health literacy by performing the Short Assessment of Health Literacy-English (SAHL-E) (n.d.). He did not miss any items on the test. His final score was 18. The test states a score between 0 and 14 indicated low health literacy. It is concluded that Don has adequate health literacy.
Section 2: Interview
Health Perception-Health Management Pattern. Three open-ended questions were asked to assess this pattern:
- Describe the measures you take to prevent you from falling at home and what you do to keep your home safe.
- I always wear non-skid shoes in the house. I also keep my house free of clutter, or should I say the housekeeper does.
- You seem to keep yourself busy. Tell me why this is important to you.
- I’m an old man. I can either sit and feel sorry for myself or I can choose to be social and keep my mind active, and my body. Being with others makes me happy.
- Describe your family relationships.
- My sons are usually always around as they farm my ground. My daughter works a lot, but I see her once or twice a week. My grandchildren and great-grandchildren I see here and there. My wife passed several years ago.
Coping-Stress Tolerance Pattern. Three open-ended questions were asked to assess this pattern:
- Do you have stress in your life, and if so could you please describe it?
- Well, I stay out of the farming, I leave that up to my sons and grandson. Sometimes when they experience difficulties I hear about it, but I don’t get involved.
- Tell me what you do to relax or enjoy yourself.
- I take care of and ride my horses. They are my babies. If I didn’t have them to take care of, I’m not sure what I would do.
- I see that you take an antidepressant. Please tell me how that is working for you.
- Several years ago, I wanted to kill myself. My daughter got me help and between the medication and seeing my “shrink” I think I am doing good.
Values and Belief Pattern. Three open-ended questions were asked to assess this pattern:
- You told me earlier you attend church every Sunday. Please tell me, if you will, about your beliefs.
- I believe in God. I read the Bible every morning and go to Bible study on Tuesday mornings. I try to live a good Christian life.
- Please tell me a little more, have you always gone to church and read the Bible?
- Well, in my younger days I was, well young and busy. But probably around middle age I started really studying the Bible. Yes, I have always gone to church, even as a child.
- Would you say that your spirituality has helped you with your depression? Can you talk more about that?
- Yes, I lean on God a lot. He got me the help I needed those years ago.
Activity-Exercise Pattern. Three open-ended questions were asked to assess this pattern:
- Please tell me about your typical day.
- Well, I get up around 5am, eat breakfast, read the newspaper and watch the news on TV. I then go out and feed and care for my horses. When the weather is nice and I have someone to go with, I will ride. Then I piddle around the farm. Usually go to town, to Farm & Home. I eat lunch around noon. Then I take a nap. Then I go out again and feed my horses. There is usually my son or grandson that has something for me to do also.
- It sounds like you get a lot of exercise. Tell me how you tolerate all of that.
- I do have to take a nap in the afternoon. I get mad at myself because I take longer to do things and have to stop and rest more than I used to.
- You are on Coumadin, how does that work with how active you are?
- I have learned over the years that I have to be more careful, but I have also learned to have bandaids on hand.
Section 3: Physical Assessment
The two body systems I chose to assess that are pertinent to Don were first, the genitourinary system because of his history of BPH. The second system I chose to assess was both the muscular and cognitive systems, specifically his functional ability due to his advanced age.
Genitourinary Assessment. Goolsby and Grubbs (2015) was used as a guide for this assessment.
- Obtain medical/surgical history, including pain assessment
- Obtain sexual history if applicable
- Inspection: look for suprapubic fullness and fullness at the costovertebral angle. Observe for any visible striae or truncal obesity.
- Auscultation: auscultate abdomen in all 4 quadrants. Auscultate over renal artery to rule out renal artery aneurysm. Auscultate the scrotum if a hernia is suspected, to distinguish loops of bowel from scrotal mass.
- Percussion: Percuss at the costovertebral angle and the flank to identify (possible elicit) pain associated with hydronephrosis or pyelonephritis. Percuss abdomen in the 9 regions of the abdomen for dullness indicating fluid or solid rather than air.
- Palpation: Examine for inguinal hernia, palpate kidneys, and a digital rectal exam may be done. Palpate the abdomen with both light and deep palpation to detect tenderness, tumors, or any changes in the underlying structures.
- Obtain a urinalysis. Observe for color and clarity.
Muscular and Cognitive Assessment Focusing on Functional Ability. Goolsby and Grubbs (2015) was used as a guide for this assessment. Many conditions in the elderly are not reversible (Goolsby & Grubbs, 2015). The focus of this assessment will be on maximizing Don’s function and maintaining or improving his well-being (Goolsby & Grubbs, 2015).
- Perform the Physical Activities of Daily Living
- Perform the Instrumental Activities of Daily Living
These two scales will determine the need for assistive services and classify the level of care required for institutional services. I already know Don is in pretty good shape so I would also conduct the 10-Minute Screener for Geriatric Conditions. This screening tool addresses vision, hearing, leg mobility, urinary incontinence, nutrition and weight loss, memory, depression, and physical disability. Lastly, to specifically measure Don’s cognitive function, I would perform a Mini-Cog test. It is a fast test taking about three minutes to administer. This test asks the patient to remember three unrelated words, repeat the words, draw the face of a clock, then repeat the three previously presented words. A positive result would require further evaluation (Goolsby & Grubbs, 2015).
Section 4: Summary
Don is a very active and healthy 87-year-old. I learned, from Don, that life does not end when you are elderly. Don makes the most of every day and has a healthy outlook on life. He described a dark time he went through several years ago, but his antidepressant and therapy seem to be working for him. He remains active with the care and riding of his horses, all while remaining social with friends. He was very knowledgeable about his health history and vaccine status as well as his medications. He continues to social distance and wear a mask in public.
Part 2: Health Promotion Plan
The priority area for health promotion that I identified while talking with Don would be physical safety. I would like to make him more aware of how he can possibly prevent falls and other accidents that the elderly is prone to. Below are three health-teaching resources that are appropriate for his health literacy.
The first health-teaching resource I found is a tip sheet about home safety for older adults (HealthinAging.org). This sheet is available in a PDF so I can print it for Don. It discusses how to prevent falls, safety-proof your home, protect against fire and related dangers, avoid bathroom hazards, prevent poisoning, and protect against abuse. Not only is this information relevant to Don, but it is also in an easy-to-read format that is appealing to the eye. It is very informative yet not too long.
The second health-teaching resource I found for Don is about safe medication use for older adults (National Institute on Aging, 2021). This is a website with many links to further information on the topic. Since Don does not use a computer, someone would need to review the site with him. This site discusses the importance of checking expiration dates on bottles, how to take medications safely, and how some medications may affect ones driving ability.
Lastly, the Centers for Disease Control and Prevention (2021) has a section on their website that discusses how to protect yourself and others when you’ve been fully vaccinated. Don would need assistance navigating this website but there is a lot of information he may benefit from. It talks about the booster vaccine, what you can do once you are fully vaccinated, what you should keep doing, and information about the vaccines.
Part 3: Reflection
The interview I conducted with Don used open-ended questions instead of the closed questions that are typically on an acute care setting intake form. Don did most of the talking instead of me. Also, the three of the four patterns that I assessed were areas that I do not necessarily spend very much time discussing with my acute care patients in the hospital. I probably should, but unfortunately health perception-health management, coping-stress, and values and beliefs are only touched on in my acute care intake form.
The topics of the above-mentioned health patterns were somewhat difficult, probably more awkward, for me to talk about than a physical body system. Also, forming all open-ended questions was a slower process for me as I kept wanting to start my sentences with “Do you….”. I found the entire interview very challenging but rewarding in the end.
Don did want to digress on various topics a lot during our interview. I tried to redirect him by saying, “Now lets get back to xyz”. He was very easy to redirect. I think he was just very happy I took interest in him.
I learned that I have neglected some very important areas with my patients when conducting an assessment. In acute care, the focus tends to be on the problem and how to fix that problem medically or surgically. So few times do I consider the spiritual aspect of one’s health or how they cope with the problem we are trying to fix. I also learned that asking open-ended questions tend to produce more information than closed questions.
In closing, this was a very rewarding assignment in which I learned assessment skills that I will take back to improve my practice.
References
Centers for Disease Control and Prevention. (2021). When you’ve been fully vaccinated.
When You’ve Been Fully Vaccinated | CDC
Goolsby, M. J. & Grubbs, L. (2015). Advanced assessment interpreting findings and formulating differential diagnoses. F.A. Davis Company.
HealthinAging.org. (2021). Tip sheet: Home safety tips for older adults.
Home Safety Tips for Older Adults (healthinaging.org)
National Institute on Aging. (2021, September 29). Safe use of medicines for older adults.
Safe Use of Medicines for Older Adults | National Institute on Aging (nih.gov)
Short Assessment of Health Literacy-English (SAHL-E). (n.d.) Retrieved September 12, 2021,
