Health Promotion in Adult Nursing: Adult Asthma Case Study

wellness Promotion in braggart(a) breast feeding Adult Asthma Case StudyThis essay leave alone address how to succor a 20 year old asthma sharpshoot fall fag ender fill to an end his recurrent admissions to hospital beca employment of discriminating exacerbations in his asthma. Asthma is a common and continuing inflammatory disorder of the airways, associated with marked wellness and economical consequences. It is estimated that approximately 5.2 one thousand thousand sight in the United Kingdom (UK) suffer from asthma, making the condition the most common long verge un healthiness in this country. Asthma levels for 1,400 deaths per annum, with a third of these being among individualists under 65 years of age. Similarly, asthma also accounts for about 69,000 hospital admissions a year. It is estimated that to a greater extent than half of the 5.2 million people with asthma in the UK do not have adequate symptom control. While 500,000 of these have asthma that is d ifficult to control with in stock(predicate) medication, and are thought to be resistant to corticosteroids, asthma is not well controlled in approximately 2.1 million people for reasons much(prenominal) as non-concordance with medication (Asthma UK, 2004, pp3-7).As already mentioned asthma is a long-run chronic condition (LTC) and although chronic illness is not a newly-recognised phenomenon, the incidence and prevalence has signifi back toothtly increased oer the second half of the twentieth century and continues to rise in the 21st century (Howie, 2005, p318). This is not least because of the aging population and advances in medical science diminishing the partake of infectious diseases. In addition, the emergence of unhealthy lifestyles is arguably the trigger for some(prenominal) non-communicable diseases such as chronic heart disease, type 2 diabetes mellitus, and chronic obstructive pulmonary disease to which asthma has similar pathophysiology. (Nissinen et al, 2001, p96 3). It is estimated that in the UK over 17.5 million people are affected by a LTC and 8.8 million have long term illness that severely limits their day to day ability to cope. It is proposed that those aged over 65 affected by a LTC are more likely to have multiple long term conditions, which makes assistance particularly complex. Debatably, unhealthy lifestyles and an aging population are the reasons for the soaring prevalence of LTCs contributing towards the large financial costs in affectionateness for these patients who occupy up to 42 percent of all acute hospital bed days (Department of Health (DH), 2005b, p10). Arguably, these issues indicate that these patients are not receiving the care in ways that meet their unavoidably or the necessitys of the health system. It is proposed that this is why oversight of LTCs is of specific importance to current Government health strategies. To this effect, numerous policy documents have been published that define the present philoso phies for the management of LTCs.One particular policy The National gain Framework (NSF) for grand Term Conditions was published by the DH in March 2005 (DH, 2005b, p24). The NSF predominantly concentrates on individuals with long-term neurological conditions. However, it is anticipated that to a great extent the focusing presented could be relevant to all long-term conditions. The document has outlined 11 quality requirements and among others there are various ones that are particularly relevant to Steven Williamss case. These include the provision of person-centred care and choice, the offer of information and jump for the safe and effective use of medicines, the jumping of self care and the condition of health promotion needs.It is suggested that in order to meet Stevens needs he will require support and education so that he whoremonger make informed choices. Metcalf (2005, p60) suggests that informed choice for those with LTCs is the key fruit to victor and a means o f examining issues pertaining to non-concordance, risk taking behaviours and patient choice. As already mentioned, Steven began to smoke when he started attending university. Cigarette pot is implicated as a health-risk behaviour and there is evidence to suggest that active ingest in adults with asthma increases asthma severity. A study by Siroux et al, (2000, p470) on the relationships of active take to asthma and asthma severity, found that current smokers with asthma had more asthma symptoms, more frequent asthma attacks ( 1 attack per day) and scored higher on the asthma severity scores, compared to those asthma sufferers who had never ingest and ex-smokers. Other trigger factors that can exacerbate asthma symptoms include house dust mites, pet allergens, pollen, moulds and fungal spores, certain drugs such as asprin and genus Beta blockers, occupational triggers and viral respiratory tract infections (Roberts, 2002, p46).Arguably, in Stevens case, on board his lack of conc ordance with his asthma medication, it is suggested that his smoking habit is a key factor in his acute asthma exacerbations. Therefore, it is proposed that Steven needs serve well with smoking cessation and education on the side effects and concordance of his medication. legion(predicate) approaches are presently being utilised for smoking cessation. These approaches incorporate pharmacological methods, such as nicotine replacement therapy or antidepressants, hypnotherapy, and exercise supported interventions. behavioral approaches include stage found interventions, which mainly use the transtheoretical simulation (Prochaska, DiClemente Norcross, 1992, p1102-14) and this model divides people into five different stages. These are the precontemplation, contemplation, preparation, action, and maintenance stages. The justification behind staging people, as such, is to fit the therapy to a persons need at his or her particular point in the change process. sequence through the stag es is in order, although relapses to previous stages can happen. The model also recognises 10 processes of change, the theory being that the effectiveness of the different processes of change will take off according to the patients stage. Arguably, however, this has not repeatedly been defended in confirmable research (Sutton, 2000, p31).It is proposed that it would be necessary for health professionals to recognise precisely an individuals stage of change, or readiness to change. This is so that an intervention ground on stage specific processes of change can be employed. It is heavy that the stage of change is re-evaluated regularly, and that the intervention should reflect changes in the individuals willingness to change. These elements of the intervention can be continual until the person accomplishes and sustains the change in behaviour. In this way, stage based interventions develop and adjust in manage to the individuals progression through the stages of change. Therefo re it is debated that stage based models recommend that interventions that take into account the existing stage of the individual will be much more successful and efficient than one size fits all interventions (Prochaska, DiClemente Norcross, 1992, p1103). Having said this however, the stages of change theory does not take into account any outside influences that might have an impact on a persons ability to change.It is proposed that Steven recognises that he has a problem and has asked for help. Therefore, it is suggested that this places him in the contemplation stage. It is suggested therefore, that Steven needs to be given help and advice that will bleed him to the preparation for action stage. In doing this, debatably, it will be necessary for Steven to esteem his feelings regarding his smoking behaviour. It is all important(predicate) therefore that health professionals who are using behavioral change models for smoking cessation are thoroughly trained in the procedure o r at least are aware of the handiness of a smoking cessation nurse. Ethically, it is argued that health professionals have a trading of care to help patients like Steven live healthier lifestyles. However, ethically Steven has the even off to autonomy in his lifestyle choices (Tschudin, 2003, p151).It is proposed that inhaled corticosteroids are still the most effective preventer drug for attaining treatment objectives (British thoracic Society, Scottish Intercollegiate Guidelines Network (BTS, SIGN, 2004, Chapter 4, p2). Steven has verbalise concerns about the effects of steroids and this has stopped him taking his preventative inhaler. Similarly, he tho uses his reliever inhaler when he becomes extremely wheezy. This is in accordance with breaking balls (2002, p554) suggestion that one of the reasons people do not take their medication is because they are worried about side effects. It is argued that this could be because their initial concerns might have not been fully addr essed by health professionals (Carter et al, 2003, p27). It is proposed that nurses are ideally placed to educate patients on the benefits of medication concordance. It is important that a nurse thoroughly explains the necessity of the treatment and any resultant side effects. Inhaled corticosteroids are the main preventative treatment for asthma sufferers. When taken twice daily at a moo dose, corticosteroids are super effective in reducing asthmatic symptoms, improving lung function, and reducing cellular inflammation. Systemic effects are rare on a low dose and most asthma patients are extremely well controlled on a low dose inhaler. Adverse local effects can include dysphonia and oral candidiasis. These symptoms can be relieved by either gargling or rinsing the mouth with water after inhalation (Roberts, 2002, p48). It is proposed that if Steven regularly takes his preventative inhaler then his asthma will be give way controlled and he is much less likely to need systemic corticosteroids that can have adverse side effects such as weight down gain and thinning of the skin when taken long-term.The NSF quality requirements of person-centred care and choice, and the offering of advice on the use of medication are relevant to the case mentioned, as is the consideration of health promotion needs. The patient will require help in giving up smoking as this is a major(ip) factor contributing to his repeat admissions to hospital. Help in the correct use of his medication is also required if he is to remain free from episodes of acute asthma. Nurses caring for patients like Steven will need to know what help is available with smoking cessation and the various options that can be offered to individuals who want to foreswear smoking. The Prochaska and DiClemente model of behaviour change is commonly used in smoking cessation however, its effectiveness is questionable.ReferencesAsthma UK (2004) Where do we stand, http//www.asthma.org.uk/how_we_help/publishing_re ports/index.html (last accessed June 25th 2007)Bender BG (2002) Overcoming barriers to nonadherence in asthma treatment, Journal of Allergy and Clinical Immunology, 109 Supplement 6, S554-559British Thoracic Society, Scottish Intercollegiate Guidelines Network (BTS, SIGN) (2004) British Guideline on the centering of Asthma A National Clinical Guideline, revised edition, Edinburgh, http//www.sign.ac.uk/guidelines/published/support/guideline63/download.html, chapter4, (last accessed June 26th 2007)Carter S, Taylor D Levenson R (2003) A Question of Choice conformation in Medicine Taking, Medicines Partnership, capital of the United KingdomDepartment of Health (2005b) The National Service Framework for Long-term Conditions, http//www.dh.gov.uk/en/Policyandguidance/Healthandsocialcaretopics/Longtermconditions/index.htm (last accessed June 25th 2007)Howie K (2005) Long-term conditions, recital Nursing, 16, 7, 318Metcalf J (2005) The management of patients with long-term conditions, Nu rsing Standard, 19, 45, 53-60Nissinen A, Berrios X Puska P (2001) Community-based noncontagious disease intervention lessons from developed countries for developing ones, Bulletin of the World Health Organisation, 79, 963-970, http//www.who.int/bulletin/archives/79(10)963.pdf (last accessed June 25th 2007)Prochaska JO, DiClemente CC Norcross JC (1992) In search of how people change Applications to addictive behaviors, American Psychologist, 47, 1102-14Roberts J (2002) The management of poorly controlled asthma, Nursing Standard, 16, 21, 45-51Tschudin V (2003) Ethics in Nursing The Caring Relationship, Third edition, Butterworth Heinemann, LondonSiroux V, Pin I, Oryszczyn MP, Le Moual N, Kauffmann F (2000) Relationships of active smoking to asthma and asthma severity in the EGEA study, European Respiratory Journal, 15, 3, 470477Sutton S (2000) A circumstantial review of the transtheoretical model applied to smoking cessation. In Norman P, Abraham C, Conner M, eds. understand and changing health behaviour from health beliefs to self-regulation. Amsterdam Harwood Academic put right