Running head: PERSONAL HEALTH PLAN

Personal Health Assessment and Health Promotion Plan Tamara Putney Ferris State University

PERSONAL HEALTH PLAN Abstract Understanding health promotion and knowing how to develop a plan for change is of the utmost

importance when practicing as a professional nurse. The purpose of this paper is to illustrate the path taken in assessing and creating a health promotion plan for the author. Many tools will be utilized, and results analyzed to explore current health practices and identify deficits to develop a plan to promote optimal health. Readiness for change will be assessed and applied to the Transtheoretical Model, and a nursing diagnosis will be selected based on the resultant criteria. Interventions will be defined and measurable personal goals and outcomes will be established, as well as an evaluation plan to track progress. Keywords: health promotion plan, optimal health, Transtheoretical Model

PERSONAL HEALTH PLAN Personal Health Assessment and Health Promotion Plan The purpose of this paper is to explore the authors health practices and beliefs, identify areas of improvement, set goals and establish a solid health promotion plan. Several weeks ago in preparation for this paper, the author began to write down health habits and kept a rough log of physical activity. About three weeks ago however, the author began to rapidly motivate

toward a changing health behavior due to the result of a body mass index (BMI) calculation done for a nursing class discussion board (Putney, 2011). The BMI calculation was done using the BMI calculator on the National Heart, Lung and Blood Institute [NHLBI] website (http://www.nhlbisupport.com/bmi/). The NHLBI indicates being overweight as a dangerous risk factor for disease. An immediate consequence of realizing the overweight BMI was a more regular exercise regime, and an increase in physical activity. The change was positive, but more exploration of current health habits was needed to clearly devise a long term health promotion plan that would lower the authors BMI and decrease the risk for disease. A variety of assessment tools were utilized to isolate the reason why regular exercise and weight loss was such an obstacle to overcome. Once deficits and barriers are identified a plan can be tailored to produce a specific outcome (Pender, Murdaugh & Parsons, 2011). The first major instrument utilized by the author to assess attitudes toward health and illness was the Health Beliefs Survey (Appendix A). The results of the survey were clear and indicated the author believes she controls her own health. The scores of this survey indicate the author believes little is ever left to chance for consideration of what determines the state of health or illness (Ursuy, 2011, p. 22). As a critical care nurse the author believes health can definitely be affected by surroundings, attitude, adaptability and availability of resources. Each person is in control of their own health, finding the motivating factor and leveraging that power to produce

PERSONAL HEALTH PLAN change is the key. The change that is needed is a more strict exercise regime, which will result in decreased BMI (Pender et al., 2011 p. 102). Figuring out where to start with the development

of a health promotion plan lead the author to complete a self-esteem questionnaire (Appendix B). Also, at the beginning of September an exercise log was started (Appendix C), and a brief 4-day evaluation was done on muscular strength and endurance of the upper and lower body (Appendix D). The author took another step and completed two other surveys to define feelings about weight loss (Appendix E) and to assess the current stage of change. By utilizing the Transtheoretical Model of Behavior Change Measures (Appendix F) the author identified which stage of the Transtheoretical Model she was in; this was a valuable piece of information to assist in developing the overall plan. Instrument Selection and Evaluation The results of the Health Beliefs Survey (Appendix A) indicate the author feels in total control over a healthy condition, yet consistent exercise seemed difficult. To explore the lack of motivation and identify if any barriers existed other instruments were utilized. Self esteem is the value attributed to self or how one feels about oneself (Pender et al., p. 204). The results of the Self Esteem Questionnaire (Appendix B), as provided by Professor Ursuy, in the Ferris State University Nursing 310 Syllabus, indicated that the author has high self-esteem, is confident, believes in herself, and values herself (2011, p. 30). This is a very important characteristic needed to produce change. The next logical step seemed to be for the author to officially write down every kind of physical activity that was done. Utilizing a log or journal as a tool allowed the author to visually establish a baseline of exercise habits. Initial assessment is imperative to establish interventions and goals for any desired outcome (Pender et al., 2011). This information is reflected in the authors exercise log (Appendix C), modeled after the log design in Ursuys

PERSONAL HEALTH PLAN syllabus (2011, p. 26). An overview of the information gathered over the course of about one month showed a clear trend. This is where identification of the problem started to take shape.

Examination of the authors log, demonstrated that exercise was not routine, not aerobic, and not long enough in duration. Aerobic exercise, for the appropriate amount of time, is essential to burn fat and promote weight loss (Cardio Exercises to Burn Fat, 2011). The author was then prompted to assess the existing strength and endurance of her middle and lower body musculature. (Due to a recent shoulder injury, the author was unable to complete the upper body strength test due to the risk of further ligament damage.) The Assessment of Muscular Strength and Endurance Test (Appendix D), was used to compare the authors level of endurance to that of individuals in the same age group (Ursuy, 2011, p. 23). The author logged the first evaluation at the end of September and tested four times in two weeks. Results indicated muscular endurance was average, and although strength appeared to increase, there was definitely room for improvement. To investigate the perceived value of weight loss by the author, a decisional balance scale was used. According to the researchers at the Habits Lab at the University of Maryland, Baltimore County (n.d.), by knowing how the pros and cons balance out on the opinion of weight loss the success of it actually happening can be measured. The results from completing the scale, called the Transtheoretical Model of Behavior Change Measure: Weight (Appendix E), resulted in an indication that the author endorsed more pros than cons for weight loss. Knowing and understanding that weight loss and decreased BMI was imperative for better health, the author was now ready to develop a routine exercise regime to promote the health changes needed. Transtheoretical Model Assessing readiness for change is important in understanding what is needed to support

PERSONAL HEALTH PLAN and actually make the change. Researched based models are great tools to use for this assessment. The author has chosen to use the nursing Transtheoretical Model of change. This model is derived from psychotherapy and theories of behavior change, and is an integrative framework to describe how individuals progress toward adopting and maintaining behavioral change (Pender et al., 2011 p. 51). Change is not just a simple event. Change is a process. Change does not happen overnight and understanding this model and the stages is imperative. The Transtheoretical Model has five stages of behavior change; in order to adopt the

desired healthy behavior individuals must progress through each stage (Pender et al., 2011, p.51). The stages are: pre-contemplative, contemplation, planning or preparation, action and maintenance (Pender et al., 2011, p.51). Understanding the definition of each stage is important for the author to assess which stage of change she is in. Definitions are as follows: stage one, pre-contemplative, is described as the earliest stage in which the individual is not intending or even thinking about making a change (Pender et al., 2011, p.51). The author cannot remember a time in this stage. It has always been a desire to produce behavior change in regards to exercise for weight loss. Contemplative is the second stage of the model. In this stage individuals are just starting to think about changing their behavior (Pender et al., 2011, p. 51). About two years ago the author was in this stage, basically wishing for a miracle that weight loss would occur, but she knew only physical activity would resolve the problem of slow weight gain; yet motivation was not present. The third stage is the planning or preparation stage. This is where individuals have actually decided to make a change and are starting to develop a plan (Pender et al., 2011, p.51). The author is currently in this stage. As evidenced by the results of the questionnaire assessing the Stages of Change for Exercise: Continuous Measure (Appendix F). This tool was retrieved from

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the Cancer Prevention Research Center, University of Rhode Island website (n.d.) and is used to place an individual into one of the stages of the Transtheoretical Model of change. Although health promotion activity is not yet consistent and uniform, it is a positive start in the right direction. Next is the fourth or action stage. In this stage the person is actively making a behavior change, they are engaged in the behavior, but it has lasted for less than six months (Pender et al., 2011, p.51). It will not be long before the author enters this stage. Progression of positive health practice is evident; a plan just needs to be solidified. The last stage of the Transtheoretical Model of behavior change is the maintenance stage. Individuals in this stage have been there six months or more and are working hard to keep it up (Pender et al., 2011, p.51). It will take hard work for the author to reach and maintain this stage. A very realistic and clear health promotion plan will make this stage very possible in the next year. Nursing Wellness Diagnosis Health seeking behaviors related to inadequate aerobic activity as a risk factor for disease is the most appropriate wellness nursing diagnosis for this author (Sparks & Taylor, 2010, p. 842). This diagnosis is evidenced by lack of consistent, effective aerobic physical activity resulting in an overweight BMI, and only average muscular endurance. Sparks and Taylor define this nursing diagnosis appropriate for a person in stable health seeking ways to alter personal habits or the environment in order to move toward a higher level of health (2010, p.842). Through assessment and self-actualization, the author realized change was needed to improve health. She was concerned about the risk of disease due to an increased BMI, and has illustrated readiness to achieve the goal of increased activity to promote weight loss. Interventions for this goal include an increase in aerobic exercise with adequate nutrition to decrease BMI and increase muscular endurance.

PERSONAL HEALTH PLAN Personal Goals and Outcomes The author has set very measurable goals to continue a consistent aerobic and nonaerobic workout schedule, to record weight weekly, and continue to record daily activity on the exercise log. The continuing practice of writing in the exercise log will allow for evaluation of progression through the Transtheoretical Model of change. The long-term goal (over the next four months) is to lose a total of 16 pounds to achieve and maintain a BMI of less than 25. This

will be accomplished by alternating days of 30 minutes of very brisk walking with 30 minutes of light jogging. In addition, daily wall sits and abdominal holds will be performed daily with results recorded. The authors short-term goal (over the next two months) is to perform the daily routine as described above, enjoy the satisfaction of participating in healthy behavior and to read one book on motivation of healthy behaviors to promote wellness. The author will need to work very hard every day to maintain a consistent motivating effort for health improvement. The author has changed work schedules to accommodate these goals and is thus far successful. The plan has been implemented for three weeks and a loss of 5 pounds has been noted, as well as a decrease in BMI (27.3 to 26.6). The author has also increased the amount of water consumed, is sleeping better and has an increased level of energy. Conclusion In conclusion, exercise is imperative for maintenance of good health. The author has definitely benefited from the tools used in this paper and the self-assessment that was done. Interestingly, prior to this class the author did not realize the value of proper self-exploration and assessment to develop a structured health promotion plan. As a nurse the author frequently makes health and wellness plans for patients, it never occurred to her to take the time to evaluate and structure her own health lifestyle and habits! The author takes immense pride in the fact that

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she has finally found the motivation and understands the importance of adhering to an organized, consistent health promotion plan. Caring for others is the best job in the world, but the author understands now, the only way to continue the great career of nursing for as long as possible is to take care of her own health! Wellness and optimal health is truly a gift to cherish, it makes sense to do anything possible to achieve and maintain it.

PERSONAL HEALTH PLAN References Cardio exercises to burn fat. (2011). Retrieved October 11, 2011, from http://www.livestrong.com/cardio-exercises-to-burn-fat/

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Pender, N. J., Murdaugh, C. L., & Parsons, M. A., (2011). Health promotion in nursing practice (6th ed.). Upper Saddle River, NJ: Pearson Prentice Hall. Putney, T. (2011, September 26). Week 5/Unit 5- Team 1 [Online forum comment]. Retrieved from https://fsuvista.ferris.edu/webct/urw/lc3183618720011.tp3309403854011/newMessageT hread.dowebct?discussionaction=viewMessage&messageid=3481710887051&topicid=3 447926359011&refreshPage=false&sourcePage= Sparks, S., & Taylor, C. (2010). Nursing diagnosis reference manual (8th ed.). Philadelphia, PA: Lippincott Williams & Wilkins. University of Maryland Baltimore County. (n.d.). [Online questionnaire]. Decisional balance scale: Weight. Retrieved from http://www.umbc.edu/psyc/habits/content/ttm_measures/decisional/index.html University of Rhode Island Cancer Prevention Research Center. (n.d.). [Online questionnaire]. Exercises: Stages of change. Retrieved from http://www.uri.edu/research/cprc/Measures/Exercise01.htm Ursuy, P. (2011). NURS 310 Class Syllabus.

PERSONAL HEALTH PLAN 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. 2 3 4 5 6

PERSONAL HEALTH PLAN 10. Health professionals control my health. 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.

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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.

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

Table 1: Tamis Personal Scores

Total Score Total Score

Internal Chance Powerful

4 2 5

5 2 2

3 2 2

5 2 2

5 1 2

5 2 1

27 11 14

54 22 28

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.

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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 Table 2: Tamis Results NORMATIVE INTERNAL CHANCE POWERFUL 50.4 TAMI 54 RESULTS GREATER PERSONAL CONTROL MODERATE CHANCE LESS POWERFULOTHERS

31 40.9

22 28

PERSONAL HEALTH PLAN Appendix B

Self-Esteem Questionnaire

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The way you feel about yourself, your self-esteem, or self-assurance affects your life more than you know. It is a simple psychological fact that you cannot love anyone unless you first love yourself. Self-esteem leads to a better life for you and everyone with whom you come in contact. Do you have a healthy regard for yourself? To find out, just answer the 30 questions below. Remember, there are no right or wrong answers, only answers that will help you learn more about yourself. Each question can be answered with the word never, rarely, seldom, occasionally, or always. Select your answer, and then write down the number that corresponds to the word you have chosen. 1 = Never 2 = Rarely 3 = Seldom 4 = Occasionally 5 = Always ___4__ 1.If someone hurts my feelings I tell them so. ___4__ 2. People value my opinions. ___5__ 3. I feel intelligent. ___4__ 4. Nothing is too good for me. ___5__ 5. With few exceptions, I am satisfied with myself the way I am. ___5__ 6. I consider comparing myself with other people to see if I rate higher than they, or if they rate higher than me a waste of time. ___5__ 7. I enjoy meeting and talking with new people. ___5__ 8. I feel at ease at parties. ___5__ 9. I am happy being me and, with few exceptions, wouldn't want to change places with others. ___5_ 10. I don't want to be somewhere else, doing something else. __5_ 11. I am content with the way I live my life. __5__ 12. I like the place where I live. __4__ 13. I enjoy my work. __5__ 14. People generally admire me. __5__ 15. I am a kind person. __4__ 16. I enjoy getting up in the morning. __5__ 17. I can take care of myself. __5__ 18. Other people need me. __5__ 19. I enjoy watching what I eat, getting proper exercise, and taking good care of myself.

PERSONAL HEALTH PLAN __5__ 20. I try to make sure I lead a balanced life, enough sleep, enough work, enough play. __5__ 21. I don't mind being alone. __5__ 22. I enjoy my time alone. __5__ 23. I like myself. __5__ 24. I respect myself. __5__ 25. I value myself. __4__ 26. I see myself as a good-looking person. __4__ 27. I see myself as a sexual person. __5__ 28. I see myself as a loving person.. __5__ 29. I see myself as a sharing person. __5__ 30. I see myself as a confident person. Score 143 How to Evaluate Your Score

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150 Points If your score adds up to 150, it means you have answered every question "always and given yourself 5 points for each answer. This indicates that you have very high selfesteem. All your relationships would be very rewarding. Keep up the good work. 149 - 120 Points Your self-esteem is in the high-normal range. You can take people and situations in stride. You also have enough confidence to improve if you need to. You are in the low-normal range. Try to raise your self-esteem; you have the confidence to do it yourself. Your self-esteem is low. You can build it up yourself if you are willing to work hard. You may need help to raise your self-confidence level.

119 - 90 Points

89 - 60 Points

59 - 30 Points

PERSONAL HEALTH PLAN Appendix C

EXERCISE JOURNAL

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Date

Exercise

Amount of Time 30 minutes 45 minutes 20 minutes 20 minutes 30 minutes 20 minutes 20 minutes 20 minutes 20 minutes 30 minutes 60 minutes 45 minutes 30 minutes 30 minutes 20 minutes 90 minutes 60 minutes 45 minutes

Aerobic / Non-Aerobic Aerobic Non-Aerobic Non-Aerobic Non-Aerobic Aerobic Non-Aerobic Aerobic Non-Aerobic Non-Aerobic Non-Aerobic Non-Aerobic Non-Aerobic Non-Aerobic Non-Aerobic Non-Aerobic Non-Aerobic Non-Aerobic Aerobic

Alone/With Someone With partner With partner and Dog With partner and Dog With partner and Dog With partner With partner and Dog Alone With Dog With partner and Dog With partner and Dog With partner and Dog With partner With partner and Dog With partner and Dog With Dog With partner and Dog With partner and Dog Alone

9/01/11 9/03/11 9/04/11 9/06/11 9/09/11 9/10/11 9/11/11 9/12/11 9/13/11 9/16/11 9/17/11 9/18/11 9/20/11 9/22/11 9/23/11 9/24/11 9/25/11 9/26/11

Bike Walk Walk Walk Bike Walk Jog Walk Walk Walk Walk Bike Walk Walk Walk Walk Walk Walk Briskly Realized BMI was HIGH 27.3 Walk Briskly

9/27/11

45 minutes

Aerobic

With Dog

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9/28/11

9/29/11

9/30/11

10/01/11

10/02/11

10/03/11

10/04/11

10/05/11

10/06/11

10/07/11

10/08/11

10/09/11

10/10/11

Jog Started Physical Therapy for Shoulder Endurance Walk Briskly Physical Therapy for Shoulder and endurance Light Jog Physical Therapy for Shoulder and endurance Walk Briskly Physical Therapy for Shoulder and endurance Walk Briskly Physical Therapy for Shoulder and endurance Light Jog Physical Therapy for Shoulder and endurance Walk Briskly Physical Therapy for Shoulder and endurance Light Jog Physical Therapy for Shoulder and endurance Walk Briskly Physical Therapy for Shoulder and endurance Light Jog Physical Therapy for Shoulder and endurance Walk Briskly Physical Therapy for Shoulder and endurance Light Jog Physical Therapy for Shoulder and endurance Walk

20 minutes 15 min stretches 5 minutes 35 minutes 15 min stretches 30 minutes 15 min stretches 30 minutes 15 min stretches 30 minutes 15 min stretches 30 minutes 15 min stretches 30 minutes 15 min stretches 30 minutes 15 min stretches 30 minutes 15 min stretches 30 minutes 15 min stretches 30 minutes 15 min stretches 30 minutes 15 min stretches 3 hours in intervals at conference and downtown Kansas City 15 min stretches

Aerobic

With partner and Dog Alone With Dog Alone With partner and Dog Alone With partner and Dog Alone With partner and Dog Alone With Dog Alone With Dog Alone With Dog Alone With partner and Dog Alone With Dog Alone With partner and Dog Alone Alone Alone With others

Aerobic

Aerobic

Aerobic

Aerobic

Aerobic

Aerobic

Aerobic

Aerobic

Aerobic

Aerobic

Aerobic

Non-Aerobic

Physical Therapy for Shoulder and endurance

Alone

PERSONAL HEALTH PLAN Date Exercise Amount of Time 3 hours in intervals at conference Aerobic / Non-Aerobic Non-Aerobic Alone/With Someone With others

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10/11/11

Walk

10/12/11

Physical Therapy for Shoulder and endurance Walk

15 min stretches 2 hours in intervals at conference and airport 15 min stretches 30 minutes 15 min stretches 30 minutes 15 min stretches 30 minutes 15 min stretches

Non-Aerobic

Alone With others

10/13/11

10/14/11

10/15/11

Physical Therapy for Shoulder and endurance Light Jog Physical Therapy for Shoulder and endurance BMI 26.6 Light Jog Physical Therapy for Shoulder and endurance Very Brisk Walk Physical Therapy for Shoulder and endurance

Aerobic

Alone With Dog Alone

Aerobic

With Dog Alone With partner and Dog Alone

Aerobic

PERSONAL HEALTH PLAN Appendix D

Assessment of Muscular Strength and Endurance

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Table 1: The Wall Sit [Lower Body]: Test your lower body strength by bending your legs at the angle demonstrated leaning your back against the wall 20 years 30 years 40 years 50 years
Men High Women Men Women Men Women Men Women

90 sec 60 sec 30 sec

68 sec 45 sec 23 sec

77 sec 51 sec 26 sec

57 sec 38 sec 19 sec

66 sec 43 sec 22 sec <22 sec

49 sec 33 sec 17 sec

56 sec 37 sec 19 sec

42 sec 27 sec 14 sec <14 sec

Average Below Average Low

<30 sec <23 sec <26 sec <19 sec Tamis wall-sit test results: Date 9/29/11 10/04/11 10/08/11 10/13/11

<17 sec < 19 sec

Time/seconds 39.5 seconds 42.41 seconds 34 seconds 40 seconds

Endurance Average Average Average Average

Table 2: The Abdominal Hold [middle body]: Test your middle body strength with this isometric pose. With your hands behind your head, maintain this 45-degree angle as long as you can 20 years
Men High Women Men

30 years
Women Men

40 years
Women Men

50 years
Women

25 sec 15 sec 5 sec <5 sec

19 sec 11 sec 4.3 sec <4.3 sec

21 sec 13 sec 4.3 sec <4.3 sec

16 sec 10 sec 3.2 sec <3.2 sec

18 sec 11 sec 3.6 sec <3.6 sec

13 sec 8 sec 2.7 sec <2.7 sec

15 sec 9 sec 3.1 sec < 3.1 sec

12 sec 7 sec 2.3 sec <2.3 sec

Average Below Average Low

Tamis wall-sit test results: Date 9/29/11 10/04/11 10/08/11 10/13/11

Time/seconds 11.6 seconds 12.3 seconds 11.4 seconds 12.1 seconds

Endurance Average Average Average Average

PERSONAL HEALTH PLAN Appendix E Transtheoretical Model of Behavior Change Measures

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Weight: Decisional Balance Each statement represents a thought that might occur to a person who is deciding whether or not to lose weight. Please indicate how IMPORTANT each of these statements might be to you if you were considering a decision to lose weight. There are FIVE possible responses to each of the items that reflect your answer to the question How important would this be to you? Please circle the number that best describes how important each statement would be to you if you were deciding whether or not to lose weight.
1=Not important at all 2=Slightly important 3=Moderately important 4=Very important 5=Extremely important PLEASE READ EACH STATEMENT AND ASSIGN A NUMBER TO INDICATE HOW YOU RATE ITS LEVEL OF IMPORTANCE AS IT RELATES TO YOUR MAKING A DECISION ABOUT WHETHER TO LOSE WEIGHT.

How important is this to me? Importance in making a decision about losing weight: 1) The exercises needed for me to lose weight would be drudgery. 2 2) I would feel more optimistic if I lose weight. 4 3) I would be less productive. 1 4) I would feel sexier if I lose weight. 5 5) In order to lose weight I would be forced to eat less appetizing foods. 2 6) My self-respect would be greater if I lose weight. 5 7) My dieting could make meal planning more difficult for my family or housemates. 2 8) My family would be proud of me if I lose weight. 3 9) I would not be able to eat some of my favorite foods if I trying to lose weight. 3 10) I would be less self-conscious if I lost weight. 5 11) Dieting would take the pleasure out of meals. 3

PERSONAL HEALTH PLAN 12) Others would have more respect for me if I lose weight. 5 13) I would have to cut down on some of my favorite activities if I try to lose weight. 1 14) I could wear more attractive clothing if I lost weight. 5 15) I would have to avoid some of my favorite places if I were trying to lose weight. 1 16) My health would improve if I lost weight. 3 17) Trying to lose weight could end up being expensive when everything is taken into account. 2 18) I would feel more energetic if I lost weight. 5 19) I would have to cut down on my favorite snacks if I were dieting. 3 20) I would be able to accomplish more if I carried fewer pounds. 5

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WEIGHT LOSS SCORING 20 Item Version

Pros of Losing Weight 2, 4, 6, 8, 10, 12, 14, 16, 18, 20 Cons of Losing Weight 1, 3, 5, 7, 9, 11, 13, 15, 17, 19

To get the average number of Pros endorsed, add up the total number of points from the items and divide by 10. Pros of Weight Loss = Sum of items / 10 To get the average number of Cons endorsed, add up the total number of points from the items and divide by 10. Cons of Weight Loss = Sum of items / 10 To calculate the difference score, subtract the Cons from the Pros. If the number is positive, the individual is endorsing more Pros than Cons for weight loss. If the number is negative, the individual is endorsing more Cons then Pros for weight loss. Tamis Results-Pros 45/10=4.5 Cons 20/10=2.0 Pros minus Cons= 2.5

PERSONAL HEALTH PLAN Result is more pros than cons to losing weight.

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PERSONAL HEALTH PLAN Appendix F Cancer Prevention Research Center

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Measures
Exercise: Stages of Change - Continuous Measure
Please use the following definition of exercise when answering these questions: Regular Exercise is any planned physical activity (e.g., brisk walking, aerobics, jogging, bicycling, swimming, rowing, etc.) performed to increase physical fitness. Such activity should be performed 3 to 5 times per week for 20-60 minutes per session. Exercise does not have to be painful to be effective but should be done at a level that increases your breathing rate and causes you to break a sweat. Please enter the number in the box that indicates how strongly you agree or disagree with the following statements. 1 = Strongly Disagree 2 = Disagree 3 = Undecided 4 = Agree 5 = Strongly Agree 1. 2. 3. 4. 5. 6. 7. 8. 9. As far as I'm concerned, I don't need to exercise regularly. 1 2

I have been exercising regularly for a long time and I plan to continue. I don't exercise and right now I don't care. I am finally exercising regularly. 2 3 1

I have been successful at exercising regularly and I plan to continue. I am satisfied with being a sedentary person. 1 5

I have been thinking that I might want to start exercising regularly. I have started exercising regularly within the last 6 months. I could exercise regularly, but I don't plan to. 1 5 1 5

10. Recently, I have started to exercise regularly.

11. I don't have the time or energy to exercise regularly right now. 12. I have started to exercise regularly, and I plan to continue. 4

13. I have been thinking about whether I will be able to exercise regularly.

5 5

14. I have set up a day and a time to start exercising regularly within the next few weeks. 15. I have managed to keep exercising regularly through the last 6 months. 16. I have been thinking that I may want to begin exercising regularly. 5 5 2

17. I have lined up with a friend to start exercising regularly within the next few weeks.

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18. I have completed 6 months of regular exercise. 2 2 5

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19. I know that regular exercise is worthwhile, but I don't have time for it in the near future. 20. I have been calling friends to find someone to start exercising with in the next few weeks. 21. I think regular exercise is good, but I can't figure it into my schedule right now. 3

22. I really think I should work on getting started with a regular exercise program in the next 6 months. 23. I am preparing to start a regular exercise group in the next few weeks. 5 4

24. I am aware of the importance of regular exercise but I can't do it right now.

Scoring Precontemplation (non-believers in exercise) items: 1, 3, 6, 9=4 Precontemplation (believers in exercise) items: 11, 19, 21, 24=10 Contemplation items: 7, 13, 16, 22=19 Preparation items: 14, 17, 20, 23=20 Action items: 4, 8, 10, 12=16 Maintenance items: 2, 5, 15, 18=9

Tamis Results: Preparation Stage

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Personal Health Assessment and Health Promotion Plan

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Purpose: The purpose of this assignment is for each student to internalize the health promotion concepts in a way that is personally meaningful for his/her own health promotion. Paper should not exceed 10 pages, including the title page, abstract, and references. Assignment Directions: In order to meet the objectives of the course and this assignment each student will select one of the following options: A. Self Assessment Plan 1. 2. Begin your health assessment with the Health Beliefs Survey listed first in the Assessment Tools To Consider section of this document. With the knowledge you have gain from your self-assessment, assess one component of his/her own health using at least two additional instruments to fully assess that component of health promotion (a few examples are stress management, smoking cessation, healthy eating habits, starting a fitness regimen, or weight loss). Students may use instruments included in this course pack or those found in professional journals. Rationale must be provided for the choice of each instrument. Why did you choose to use the particular instrument? Does it have good reliability, validity etc? Students also must assess their readiness for change based on the Transtheoretical Model discussed in the Pender book. After all of the results are available the results must be analyzed. What is the significance of the findings of the assessment? A wellness-oriented nursing diagnosis congruent with the findings must be developed or selected. A personal health promotion plan that is congruent with the assessment and diagnosis will be developed and implemented. Outcomes of the self-interventions will be measured and reported. This is to be a formal scholarly paper. It requires APA format with professional references. Any journals, food logs, copies of instruments or other documentation should be included as appendices.

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COURSE OBJECTIVES: 1. Examines the role of the nurse as a collaborative partner in community health promotion. 2. Analyzes theories and evidence relevant to population focused health promotion. 3. Uses concepts of culturally competent care in health promotion. 4. Critically examines the evidence of population strategies to create healthy communities. 5. Uses the nursing process and community health concepts for addressing population base health promotion. 6. Examines health promotion strategies within an ethical framework.

Personal Health Assessment and Health Promotion Plan Grading

ASSESSMENT CRITERIA POINTS POSSIBLE Assessment tools appropriate for the area to be assessed Rationale provided and sourced for tools in first area to be assessed Rationale provided and sourced for Readiness for Change instrument Analysis is appropriate, reflects critical thinking. Wellness diagnosis/diagnoses congruent with assessment findings. Health plan follows principles of health promotion. Includes all stages of change Implementation is appropriate for time period. Is documented with reliable evidence. Outcome measures are recorded and appropriate. Long-term outcomes are included. APA: Title page, Running Head, Margins, Headers with page numbers, Use of headings Grammatical: Spelling, Typing, Grammar, Neatness, Sentence Structure & Paragraphing. Critical Thinking using elements of reasoning and Intellectual 10 10 5 10 10 10 10 5 5 10 5 10 10 10 5 10 10 10 10 5 5 10 5 10 POINTS EARNED

PERSONAL HEALTH PLAN

Standards. (Not to be used as outline points) TOTAL POINTS 100

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100

COMMENTS:
Great work on your paper! Strong writing capability and skill! You have created a very strong plan that is well supported through your assessment tools. You provided great detail, examples, and rationale. Excellent job on entire paper overall. Appropriate NANDA chosen, and well evidenced and supported. Your plan follows the Transtheoretical Model. You have provided appropriate and reliable resources. The outcomes you have identified are well done. You have also displayed good APA formatting. Your paper reflects professional and scholarly writing skills. All assignment criteria met and exceeded. On target with course objectives with the completion of this assignment. See paper for minor APA formatting comments. If you want to clean up the paper and eliminate the bubble in the right hand column and the vertical lines in the left column, right click on a red underline and select accept changes. This will accept the tracked changes I added to your paper. Then you can use it as a template for future papers.