Running head: PERSONAL HEALTH ASSESSMENT AND HEALTH PROMOTION

Personal Health Assessment and Health Promotion Plan Tori Gwilt Ferris State University

PERSONAL HEALTH ASSESSMENT AND HEALTH PROMOTION Abstract

Personal health is vitally important to each individuals well-being. It also greatly contributes to the quality and quantity of life. In this personal health assessment and promotion paper, I will examine my own personal health belief system using an assessment tool called the Health Beliefs Survey. I will utilize the results of this survey and create a detailed and personalized program designed to properly manage my stress level. This paper documents my attempt to distinguish and creatively generate techniques in which to combat the signs and symptoms of stress. The hope is that it will reduce the negative health consequences in my personal life. Furthermore, I will utilize the provided Transtheoretical Model (TM) with the goal of adapting, incorporating, and permanently applying these new healthy behaviors into my daily routine. I will also detail three tools in which to gauge my progress of stress management. These tools are instrumental in assisting me to achieve my pursuit of living a life with a tolerable amount of stress.

PERSONAL HEALTH ASSESSMENT AND HEALTH PROMOTION Personal Health Assessment and Health Promotion Plan

Personal health is a significant and essential aspect in the life of a healthcare provider. In the role of a registered nurse, it is imperative to manage personal stress in order to thoroughly and effectively care for the physical and emotional needs of patients and their families. Personal stress is an everyday occurrence; it is often compounded and has the potential to lead to a variety of other, potentially more series health issues. In light of this, it is a necessity to develop tools to properly cope with stress. Unfortunately, stress management is often an issue that is disregarded due to other, seemingly more imperative concerns in central focus. The purpose of this paper is to detail my personal health plan in concurrence with stress management. Another intention of this paper is for me to formulate avenues in which I can relieve stress in an effort to regulate extremely stressful moments in life. In an effort to comprehensively create an ongoing plan to decrease and manage my stress level, I first appraised my personal views on health by using the Health Beliefs Survey (Appendix A). This questionnaire allowed me to weigh my opinions in order to determine to what extent I believe I am in control of my own health and what other influences I believe to be the root of illness. The Health Beliefs Survey scores revealed that I do not believe others have control over my health; I scored very low in the powerful-others category. I was also able to ascertain that I believe both chance as well as internal factors play a role in the development of illness and the restoration of health. In response to the Health Beliefs Survey, I was able to produce a plan of action that I believe will best contribute to the continuation and improvement of my overall health and wellness. The goal of my plan is to strive to decrease and manage my stress level. According to The Oxford Dictionary, stress is defined as a state of mental or emotional strain or tension

PERSONAL HEALTH ASSESSMENT AND HEALTH PROMOTION

resulting from adverse or demanding circumstances (2013). The National Institute of Mental Health published an article and fact sheet regarding stress along with the bodys response to such triggers. According to the article, intermittent stress is a natural response and can even be beneficial and life-saving in some situations, such as in a fight or flight circumstance (The National Institute of Mental Health, 2013). However, issues ensue when stress becomes a relentless entity. In a situation such as this, stress has the ability to cause both corporeal and emotional turmoil that can wreak havoc on the body. According to the same article, symptoms of stress are manifested differently depending on the person gastrointestinal problems, headaches, inability to sleep, mood changes, hypertension, immune system changes, depression, and anxiety are often seen in response to constant stress (The National Institute of Mental Health, 2013). In an effort to prevent these negative ramifications, I developed a health plan specifically designed to reduce my stress level based upon my primary stress sources. I also tailored interventions that I believe will best combat my stress. Instrument Selection I have chosen to concentrate my efforts on three instruments that I believe will greatly aid in decreasing my stress level. The target is to focus on sleep habits, exercise regimen, and activities that are known to alleviate stress. The first area in which I would like to address is sleep. According to an article published by Medline Plus in association with the National Institute of Health, it is important to achieve an average of 7 to 8 hours of sleep per night in order to effectively cope with everyday stressors (2012). I have chosen to use an instrument that comes in the form of an application on my iPhone called Sleep Cycle (Appendix B). This application is an alarm clock that uses an accelerometer (standard on all iPhones) that has the ability to track movements during sleep.

PERSONAL HEALTH ASSESSMENT AND HEALTH PROMOTION

This aids in determining the amount of time in which a person is in each stage of the sleep cycle. Using this information, the application is able to graph the total amount of time I slept and how much time I spent in each stage of sleep. This product is marketed as a bio-alarm clock that analyzes your sleep patterns and wakes you when you are in the lightest sleep phase (Maciek Drejak Labs, 2013). This ensures that the user has a better chance of waking up feeling refreshed and rejuvenated instead of exhausted. Through analysis of this information, I was able to determine that I need to devote more time to rest and sleep. The first graph (Appendix B) shows a typical nights sleep as of June 2012. At that time in my life, my average sleeping time was between four to five hours of sleep per night. As apparent on the graph, my quality of sleep was measured at 48 percent. I woke up feeling exhausted, irritable, and unmotivated. The second graph (Appendix B) shows an average night of sleep as of January 2013. I spent seven hours and forty minutes in bed and my quality of sleep was estimated at 73 percent. My sleeping habits in 2013 have vastly improved from 2012. Although there is still room for improvement, I feel as if I am on the correct path to increasing my health and decreasing my stress. The second tool that I would like to discuss in my stress management endeavor is that of adequate exercise. The National Institute of Mental Health states that daily exercise of just 30 minutes per daycan help boost mood and reduce stress (2013). As of a year ago, I walked my dogs on the days that I did not work. After realizing that this endeavor helped to alleviate stress, I chose to increase the number of days that I walk and the amount of time per walk. As of now, I have decided to walk five to six days per week for approximately an hour per walk. I have employed the use of a pedometer iPhone application in order to track the amount of time, distance, speed, and calories burned per walk (Appendix C). This new walking regimen has truly helped to increase my energy level and decrease my stress level.

PERSONAL HEALTH ASSESSMENT AND HEALTH PROMOTION Another tool that I believe will greatly aid in my management of stress is volunteering at the local Humane Society. I have chosen to volunteer once a week to walk dogs, clean kennels, and socialize both dogs and cats. According to the American Institute of Stress (2013), nurturing and caring seem to induce or be associated with significant psychologic and physiologic responses that have beneficial health repercussions. I believe that this will be a great stress relieving activity, as animals have the natural ability to help calm and relax humans. I believe I will greatly benefit from walking my own dogs frequently as well as walking dogs at

the local animal shelter not only from an exercise point of view but also from a stress relieving perspective. Transtheoretical Model The transtheoretical model is a frame of reference used to define how a person develops, advances, and sustains behavior modification. This theory states that there are five steps in which a person must pass through in order to successfully implement the change. The first step is known as precontemplation. This occurs when a person is not yet ready to make any changes within the next six months and may not see any issues with the current way of living (Pender, Murdaugh, & Parsons, 2011, p. 51). Although everyday life has its stressors, I now noticed that I began to operate under a higher level of stress when I chose to return to school to finish my bachelors of science in nursing (BSN) degree in the spring of 2012. Looking back, I believe this was the start of the precontemplation stage. Between work, school, and other responsibilities, I found myself sleeping and exercising less and becoming more irritable as I had more to accomplish in a small window of time. This realization guided me toward phase two, contemplation. This stage is characterized by a person identifying a certain behavior as problematic and recognizing the need to change in the next six months (Pender, Murdaugh, &

PERSONAL HEALTH ASSESSMENT AND HEALTH PROMOTION Parsons, 2011, p. 51). It was in this timeframe that I knew something eventually would need to change in order for my physical and mental health to remain strong, but I was not overly

concerned with making any changes as of yet. This realization led me to the next natural step in the process. The third step, planning or preparation, occurs when a person intends to make changes in behavior within the next month, and shows a readiness to change by making some small modifications in behavior (Pender, Murdaugh, & Parsons, 2011, p. 51). At this point in time, I had the opportunity to change shifts at work from working the day shift (0645-1715 four days a week) to working the afternoon shift (1045-2315 three days a week). I gladly took this change in shift, as I am not a morning person and it was becoming increasingly difficult for me to function in the mornings. After this change, I recognized that my energy level was heightened and I actively sought to move to the next chapter action. This fourth phase involves a person who successfully modified his behavior, although it has persisted for less than six months (Pender, Murdaugh, & Parsons, 2011, p. 51). It was in this phase that I began to increase my exercise regimen. This was accomplished by walking my dogs five to six days a week. I noticed that my stress seemed to seep away as I was out in the fresh air. This activity also allowed me time to process my thoughts whilst bonding with my dogs. It was in this phase that I chose to consciously improve my sleeping habits by allowing myself more hours to sleep. I also began to engage in activities that I found to be stress relieving and relaxing. This involves not only spending time with my two dogs, but also volunteering at the local humane society. The fifth stage in the transtheoretical model is maintenance. It is marked by a person who has successfully maintained the behavior change for a period of at least six months (Pender, Murdaugh, & Parsons, 2011, p. 51). As I look into the future to the maintenance step (I have been practicing this regimen for approximately two months), I see how managing stress impacts

PERSONAL HEALTH ASSESSMENT AND HEALTH PROMOTION the sustenance of health. I look forward to maintaining this stress managing lifestyle, as I am sure I will need to with my future plans to pursue a graduate degree. Nursing Wellness Diagnosis After much thought and research, I believe that the most appropriate and fitting nursing diagnosis is that of health-seeking behaviors related to stress management (Ackley & Ladwig, 2006). I believe this nursing diagnosis incorporates my recognition and understanding of the need to change my behavior in order to regulate the amount of stress in my life to a healthy

intermittent level. I also believe that this nursing diagnosis shows that I am taking control of my health to prevent issues in the future. Personal Goals My overall goal revolves around the attempt to live a healthy, happy and semi tranquil life during the hectic and stressful time that I am involved in school. My personal short-term goal involves attempting to sleep between seven and eight hours a night in order for my body to fully rest and recover from its daily routine. In addition, I plan to continue to walk on a regular basis (at least five days a week) for approximately an hour. In my spare time, my goal is to immerse myself in calming and stress relieving activities, such as volunteering. My long term goal is to transition this new lifestyle into the future and adapt it to other stressful life situations. Conclusion Although a small amount of stress is a natural occurrence, it can easily escalate and spiral out of control, which can result in chaos. As I compare my current lifestyle to where I was one year ago, I notice that I am a much healthier and happier person. I directly contribute this change to enhanced sleep, consistent exercise, and the positively mood altering effects of relaxing activities. I am grateful that I was able to recognize the need for change and was able to act upon

PERSONAL HEALTH ASSESSMENT AND HEALTH PROMOTION that information and make the needed adjustments in my life. The transtheoretical model was vital in helping me to visually note the steps that I must take in order to successfully make this change permanent. The model worked to progressively guide me through the phases of change. I can clearly see that this new way of living has had a positive effect on my life physically, mentally, and emotionally.

PERSONAL HEALTH ASSESSMENT AND HEALTH PROMOTION Reference Ackley, B., & Ladwig, G. (2006). Nursing diagnosis handbook (7th ed.) St. Louis, MO: Mosby Elsevier. The American Institute of Stress. (2013). Pets. Retrieved from http://www.stress.org/pets/ Maciek Drejak Labs. (2013). Sleep Cycle. Retrieved from http://www.sleepcycle.com/

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Medline Plus (2012). Stress management. National Institute of Health and U.S. National Library of Medicine. Retrieved from http://www.nlm.nih.gov/medlineplus/ency/article /001942.htm. National Institute of Mental Health (2013). Stress. Retrieved from http://www.nimh.nih.gov /health/publications/stress/fact-sheet-on-stress.shtml Pender, N. J., Murdaugh, C. L., & Parsons, M. A. (2011). Health promotion in nursing practice (6th ed.). Upper Saddle River, NJ: Pearson. Stress. (n.d.). Oxford Dictionaries online. Retrieved from http://oxforddictionaries. com/definition/English/stress?q=stress

PERSONAL HEALTH ASSESSMENT AND HEALTH PROMOTION Appendix A Health Beliefs Survey

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The questionnaire is designed to determine the way in which different people view certain important health-related issues. Each item is a belief statement, with which you may agree or disagree. Beside each statement is a scale that ranges from strongly disagree (1) to strongly agree (6). For each item, choose the number that represents the extent to which you disagree or agree. This is a measure of your personal beliefs; obviously, there are no right or wrong answers. Please answer these items carefully, but do not spend too much time on any one item. As much as you can, try to respond to each item independently. When making your choice, do not be influenced by your previous choices. It is important that you respond according to your actual beliefs and not according to how you feel you should believe or how you think we want you to believe. 1 - Strongly Disagree; 2 - Moderately Disagree; 3 - Slightly Disagree; 4 - Slightly Agree; 5 Moderately Agree; 6 - Strongly Agree 1 1. If I get sick, it is my own behavior that determines how soon I will get well again. 2. No matter what I do, if I am going to get sick, I'll get sick. 3. Having regular contact with my physician is the best way for me avoid illness. 4. Most things that affect my health happen to me by accident. 5. Whenever I don't feel well, I should consult a medically trained professional. 6. I am in control of my health. 7. My family has a lot to do with my becoming sick or staying healthy. 8. When I get sick, I am to blame. 9. Luck plays a big part in determining how soon I will recover from an illness. 10. Health professionals control my health. X X X X 2 3 4 X 5 6

PERSONAL HEALTH ASSESSMENT AND HEALTH PROMOTION 11. My good health is largely a matter of good fortune. 12. The main thing that affects my health is what I myself do. 13. If I take care of myself, I can avoid illness. 14. When I recover from illness, it's usually because other people have been taking good care of me. (doctor, nurses, family) 15. No matter what I do, I'm likely to get sick. 16. If it's meant to be, I will stay healthy. 17. If I take the right actions, I can stay healthy. 18. Regarding my health, I can only do what my doctor tells me to do. X X X X X X

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These three subscales, and the items included in each, are as follows:

Internal Items: 1, 6, 8, 12, 13, 17 Chance Items: 2, 4, 9, 11, 15, 16 Powerful-others items: 3, 5, 7, 10, 14, 18

The score on each subscale is the sum of the values for each item in that subscale multiplied by 2. Scores within each subscale can range from 12 to 72. The higher the score on the internal subscale, the more personal control clients believe that they exercise over their own health. The higher the scores on the chance subscale and power-others subscale, the higher the beliefs in the importance of chance and others respectively in controlling personal health. Normative means for adults on each subscale are as follows:

Internal, 50.4 Chance, 31.0 Powerful-others, 40.9

PERSONAL HEALTH ASSESSMENT AND HEALTH PROMOTION Appendix B Sleep Cycle

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The first graph depicts a typical night of sleep as of June 2012 when I was working the day shift (0645-1715).

The second graph depicts a typical night of sleep now that I am working the afternoon shift (1045-2315).

PERSONAL HEALTH ASSESSMENT AND HEALTH PROMOTION Appendix C Pedometer log This log depicts my walking activity for the week of February 17- 23, 2013.
Days: Sunday Monday Tuesday Wednesday Thursday Friday Saturday Steps: 6480 5525 4894 5637 Did 6845 8245 Distance: 3.4 miles 2.8 miles 2.4 miles 3.7 miles Not 3.5 miles 4.1 miles Time: 71 minutes 66 minutes 48 minutes 50 minutes Walk 74 minutes 89 minutes 305 344 Calories: 284 237 191 328

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