Hypertension and Healthy Lifestyle Management

Question: Discuss about the Hypertension and Healthy Lifestyle Management. Answer: Introduction: Assessing a patients learning needs is crucial for focusing on patients priorities, during care plan development. According to the metaparadigm of nursing, there are four domains in nursing, client, health, environment and nursing (Goh, Chan Kuziemsky, 2013). On the other hand, an environmental assessment is needed for understanding the learning environment and the factors needed to be considered in the teaching plan. For instance, the learning needs of an overweight patient are: To understand why people become overweight To understand the key to achieve a healthy weight To be aware of the factors contributing in weight gain The importance of exercise for overweight patient Complications and consequences of being over weight The assessment would include analysis of patients physical needs like age, past health history and current health status. In the next step, the readiness of the client to learn would be identified with the help of PEEK model. The physical readiness would be measured by measuring gross motor movement, strength, flexibility, complexity of task, behavioural change, comfort level and environmental effects, such as presence of environmental hazards, interruption of noise or light. In the next level, the emotional readiness would be assessed, where level of patients anxiety, fear, risky behaviour, frame of mind, emotional developmental stage and supporting systems would be analyzed. The present knowledge base of the patient, his cognitive ability and learning style would be assessed, for understanding the learning style. According to the cognitive approach by Anthony Grasha and Sheryl Riechmann, learning styles include avoidant, participative, competitive, collaborative, dependent and inde pendent (Casement, 2013). In patient education session, participative and collaborative learner is most suitable. There are several barriers, which may hinder patient learning. These are: Linguistic barrier Financial constrain Religious belief Family dynamics Emotional concern Lack of motivation Inadequate time of teaching Poor communication Nursing Diagnosis Addressing Learning Need With the help of existing literature, the learning participative learning style has been identified for the selected client, according to the cognitive learning approach (Bastable, 2016). The patient is overweight, for which her diagnosis involved the measurement of height, weight, BMI, blood glucose, BP and blood cholesterol level. The other vital signs will also be assessed. From the diagnosis, it has been revealed that the patient has a knowledge deficit regarding the role of proper diet and exercise in weight management. In addition, the patient also has a poor knowledge base regarding the negative health complications that might be raised due to overweight. In addition, the patient is anxious for her health status due to very low self-esteem. As the patient is consisting participative learning style, she would be able to participate in developing her own learning plan. Develop a Client-Centred Goal Prior to develop the learning plan for the client, a goal is set for ensuring that the learning plan will meet patients learning needs. The client-centred goal is: To make the client aware of complications of being overweight as well as to make her aware of the importance of exercise and healthy diet Prior implementing the intervention, identifying the expected outcome helps both the learner as well as care provider to follow a systematic approach, thereby enhancing the chance of meeting learning outcomes (Boet et al., 2014). Two learning outcomes are established in two different domains, i.e. cognitive and psychomotor domain. Learning Objectives in the Cognitive Domain: The client will be able to differentiate her normal diet and a healthy low fat diet that she should maintain to combat with her health status S- Specific The outcome is specific, as it is focused on patients health condition, over weight M- Measurable It is measurable, as the outcome will be evaluated at the end of specified intervention period A- Attainable The outcome is attainable by implementing proper learning intervention based on clients learning needs (Bray et al., 2011) R- Relevant It is relevant, as clients knowledge base is poor, which is hindering her to manage her weight, causing health hazard T- Time-specific It is time specific, as the outcome will be achieved within a specified time, i.e 3 months Learning Objectives in the Psychomotor Domain: The client will be able to demonstrate the health complications, which may be raised due to her overweight health status S- Specific It is specific, as the outcome is focused on clients learning need, i.e. her poor knowledge about the complications of a overweight client M- Measurable The outcome can be measured by interviewing the client at the end of intervention period A- Attainable It is attainable by keeping the client adhered to the learning intervention and reducing learning barriers R- Relevant It is relevant because, the client is not aware of the severe health complications promoted by overweight, which could be avoided by managing weight with a proper knowledge base (Hacihasano?lu Gzm, 2011) T- Time-specific It is time specific as the learning outcome will be achieved within 3 months, at the end of the learning intervention period Planning Implementations/Interventions Based on the learning goals and expected outcomes, teaching strategies are selected. The patient is participative, thus, a discussion session is planned with the patient, after establishing a good rapport with the patient. It would help to engage the client with the teaching or educational program. Initially, the rapport would be built by using online video conference tool. It would help the professional to know the client and to understand her feelings about the learning process. The next sessions will be face-to-face discussion with the professional (Bradshaw Lowenstein, 2013). It would help to reduce patients anxiety or fear related to the educational session. The professional would gain access to know the patient in more in-depth manner. The sessions in the next month would include lecture as teaching tool, which would include power point presentation as teaching tool. It would promote the patient to respond in a wider context. Finally, printed materials would be provided for fu rther information and knowledge gain. The teaching resources would include, patients understanding regarding healthy weight and a healthy diet. The patient would be educated about the risk of obesity, high blood pressure, diabetes and cardiovascular disorders related to overweight. For evaluating cognitive domain of learning outcome, evaluation would include interviewing client, where she would be asked about her future diet plan and exercise schedules. She would be asked, whether she is able to state complications related to overweight (Bornais et al., 2012). On the other hand, for evaluating psycholotor domain learning outcome, she would be evaluated by asking her to demonstrate a practical physical exercise session. The teaching plan is effective for an overweight client, who has a risk of developing obesity. The client is overweight, the teaching plan has been set on the basis of clients learning needs, after diagnosing her. This is a key strength of the teaching plan, that all the clients priorities has been met. In addition, aligning the learning style of the client with the learning goal also strengthens the teaching outcomes. However, there are some weaknesses. All the barriers of learning has not been identified. Moreover, no family members were involved in the teaching plan for extended learning at home environment. From this teaching plan communication and interaction skills has been developed, which will help in establishing positive therapeutic alliance with other clients in future. Reference List Bastable, S. B. (2016). Essentials of patient education. Jones Bartlett Publishers. Boet, S., Bould, M. D., Fung, L., Qosa, H., Perrier, L., Tavares, W., ... Tricco, A. C. (2014). Transfer of learning and patient outcome in simulated crisis resource management: a systematic review. Canadian Journal of Anesthesia/Journal canadien d'anesthsie, 61(6), 571-582. Bornais, J. A., Raiger, J. E., Krahn, R. E., El-Masri, M. M. (2012). Evaluating undergraduate nursing students' learning using standardized patients. Journal of Professional Nursing, 28(5), 291-296. Bradshaw, M., Lowenstein, A. (2013). Innovative teaching strategies in nursing and related health professions. Jones Bartlett Publishers. Bray, B. S., Schwartz, C. R., Odegard, P. S., Hammer, D. P., Seybert, A. L. (2011). Assessment of human patient simulation-based learning. American journal of pharmaceutical education, 75(10), 208. Casement, P. (2013). Further learning from the patient: The analytic space and process. Routledge. Goh, S. C., Chan, C., Kuziemsky, C. (2013). Teamwork, organizational learning, patient safety and job outcomes. International journal of health care quality assurance, 26(5), 420-432. Hacihasano?lu, R., Gzm, S. (2011). The effect of patient education and home monitoring on medication compliance, hypertension management, healthy lifestyle behaviours and BMI in a primary health care setting. 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