Role of Exercise in Law, Sports Medicine, Psychology, Religion, Physical Therapy and Nursing - Dissertation Example

? Role of Exercise in Law, Sports Medicine, Psychology, Religion, Physical Therapy and Nursing of Teacher Exercise: Concept Analysis-Literature Review Introduction Exercise became necessary when human kind discovered leisure, which was enabled by the mechanization of productive work. Once, we began to skip physical exertion, the natural way of behavior for human body was restricted. The general growth of interest in mind-oriented jobs and loss of interest in jobs involving manual labor was also a related phenomenon. Without sufficient physical activities to assist the metabolism of the body, new diseases began to emerge, which were pet-named by us as life style diseases. This is the premise in which exercise became an inevitable element for sustaining a healthy life. The changes that happened in the society were also reflected in the psychological and moral realm of lives as well. Thoughts about rights and power also emerged out of leisure and the question that who are the owners of leisure, and who commands it, arose. Though Oxford Dictionaries Online has offered several definitions for the term, ‘exercise’, I will explore the following two definitions in this concept analysis, a) “activity requiring physical effort, carried out especially to sustain or improve health and fitness,” …[and b)]… “the use or application of a faculty, right, or process” (Oxford Dictionaries Online, 2010). The first definition stresses the meaning of exercise as a physical activity while, the second one views exercise as the fulfillment of a duty and as the claiming of a right. Taking these two definitions are taken as the yardsticks to understand the importance of education, this analysis envisages to find out how exercise attains a valuable place in the three areas of knowledge, namely, theology, psychology, and nursing. Exercise in theology In a democratic society, an individual has several rights and powers, the exercise of which is supposed to be the foundation of the democratic system itself. Whenever the exercise of any such right or power is denied, the foundations of democracy feel threatened. And this is why the people of many nations around the globe had to fight prolonged battles to be able to exercise these powers and rights. For example, in America, the people felt that “the right to vote was denied for so long to so many that we cannot afford to ignore any impediment to its exercise” (Grey, 2005). In the theological realm also, there are a set of such rights and powers, which follow the democratic rights but also give rise to many contentious issues as well. For example, Post (1995) has observed that “free exercise is justifiably overridden to promote public health- for example, medical treatment is required to minimize the spread of contagious disease or to benefit minors, even if religious belief is offended” (p.22). Though Post (1995) has reminded, “the free exercise clause of the First Amendment is central to American public life,” from a nurse’s point of view, situations may arise when a patient wants to exercise his/her right to refuse treatment and the nurse and the system in which he/she works are compelled to use authority and power to prevent that (p. 22). This is particularly important because, just as any other freedom, the freedom to exercise one’s religion also has limits and can be overridden if public health is at risk of being jeopardized (Post, 1995). Taking into consideration these two opposite yet justifiable positions, nurses have to be aware that a patient has the right to refuse or seek treatment based on their religion and when the right to this free exercise is dishonored, it should be examined and justified. Post (1995) has discussed a legal case in which religion, law, and medicine clash. The article is based on the true story of Baby K, a baby born with anencephaly. The mother, who believes in the sanctity-of-life principle, wants Baby K kept on a ventilator; because of her faith, she believes that a person’s life must be prolonged regardless of the quality of life for the patient. However, pediatricians argued in court against the mother, stating that ventilator support for Baby K would be medically futile (Post, 1995, p. 20). In the end, the court ruled in favor of the mother based on the Free Exercise Clause of the First Amendment (Post, 1995, p. 21). This case study calls for criticism related only to excessive treatment but in some other cases, more crucial clashes may emerge between religious beliefs, medical decisions and law. For example, traditional healers who have very strong social approval and credibility may be prevented by state from practicing their alternate medicinal practices because they are outside the realm of formal and professional training imparted by the state (Szasz and Szasz, 1988, p.103). But many a times it has been found that such traditional practitioners become “more useful to their would be clients than those officially approved” (Szasz and Szasz, 1988, p.103). This is why Szasz and Szasz (1988) have said that “the result is a complex and powerful alliance, first between the church (or mosque or whatever) and medicine and subsequently between the state and medicine- with physicians playing double role as medical healers and as agents of social control” (p.103). Exercise in psychology Research has indicated that the physical characteristic of exercise has a positive impact on psychological well-being apart from diminishing “the risk of chronic disease, premature mortality, functional limitations and disability” (Tompkins, Belza, and Brown, 2009, p.79). According to Hayes and Ross (1986), “the effect of exercise on psychological well-being appears to be internally based, possibly mediated by increased levels of endorphins and improved norepinephrine regulation which are found to be helpful to enhance a happy mood (p. 389, p.397). Another study carried out by Hayes and Ross (1986) showed that exercise and good physical health provide a beneficial effect on one’s psychological well-being but that being overweight has no significance on one’s psychological well-being (p. 397). The body-mind continuum is maintained by nature by this mutually influencing two-way process involving physical exercise and mental wellness. It is in this backdrop that nurses can recommend their patients to start exercising in order to improve their psychological well-being. This is very important because studies have shown that there is a positive connection between “healthcare providers recommending exercise and increase in the patient’s exercise activity” (Tompkins, Belza, and Brown, 2009, p.80). Though ideally this is the situation, several psychological barriers exist which prevent people from doing exercise. One such hurdle is the inability to enjoy doing exercise (Ruby et al., 2011, p.68). Ruby et al. (2011) have also found out in a survey that”people systematically underestimate their enjoyment of exercise…and that their bias is robust across a wide variety of exercise” (p.68). They (Ruby et al., 2011) have also proposed the use of “simple interventions” by counsilors “to increase people’s desire to engage in the kinds of physical activity that are critical for maintaining health” (p.72). Exercise in nursing The concept of exercise in nursing is important because nurses have the opportunity to provide exercise counseling, which will result in improved quality of life for their patients. Tompkins, Belza, and Brown (2009) have described the importance of exercise in nursing when they stated, “Exercise is a crucial component of preventative health care. Studies have shown that healthcare provider recommendations can be effective in helping patients increase their exercise and activity” (p. 79). Ruby et al. (2011) have also suggested that while advising to exercise, nursing practitioners have to emphasize how the patient will enjoy it, in order to prevent relapse (p.67). Teaching the proper way to do exercise is yet another important area where nursing practitioners can make meaningful intervention (Friedrich, Cermak, and Maderbacher, 1996, p.1083). This is crucial because “the effectiveness of exercise is most likely related to the quality of exercise performance” (Friedrich, Cermak, and Maderbacher, 1996, p.1083). The conclusion of the study carried out by (Friedrich, Cermak, and Maderbacher, 1996) was that “exercises that are based only on written instructions often are not performed properly and therefore lead to poorer outcomes compared with exercises learned under the supervision of a physical therapist” (p.1087). It has been also a matter of concern that though nursing practitioners beholds exercise counseling with high reverence, when it comes to practice, this is not reflected very strongly in reality (Tompkins, Belza and Brown, 2009, p.84). This is a matter of concern and need to be paid more attention. The word, ‘exercise’ has also one more meaning related to the practice of nursing. This meaning is bound to the question where the right of the patient to exercise his/her freedom ends and the right of the nursing practitioner to exercise his/her skills, knowledge and ethical obligations take over. This may involve simple acts of prescribing certain kind of medicine that may contain elements taboo for intake in certain religions up to serious issues like abortion and euthanasia ((Szasz and Szasz, 1988, p.96). Sports Medicine Whyte and Sharma (2010) have described the role of exercise in sports medicine in connection with each and every organ in the body. For example, it is stated that, “in response to exercise, changes in the neural control and the hormonal milieu result in alternations in the chronotropic (heart rate) and inotropic (contractile force) state of the heart” (Whyte and Sharma, 2010, p.3). In individuals who are involved with sports activity, apart from the total physical well-being, health of the heart is paramount for success. Berryman and Park (1992) have observed that even as early as in the ancient Greek civilization, “exercise, both as part of hygiene and for harmonious all-round development, was advocated for the average citizen” (p.11 of preface). History says that “a medical rationale for exercise was developed before the nineteenth century” (Berryman and Park, 1992, p.10). In accordance with the progress in sports medicine, “most contemporary practitioners, athletes, coaches, and sports officials now fully realize the value of modern “scientific” sports medicine and exercise science” ((Berryman and Park, 1992, p.14 of preface). The awareness has grown ever since that “the whole concept of the exercise…is rooted in the organic life process” (Berryman and Park, 1992, p.260). Exercise in Physical therapy It is a known fact that exercise is good for physical health. The benefits of exercise are so great that it has been observed, “involvement in exercise has the potential to reduce chronic diseases, morbidity and mortality” (Tompkins, Belza and Brown, 2009). The physical activity recommended for adults as described by Tompkins, Belza and Brown (2009) are: Adults are encouraged to meet either of the following physical activity recommendations: moderate intensity physical activities for at least 30 min for 5 or more days of the week (American College of Sports Medicine Position Stand, 1998) or vigorous intensity physical activity three or more days per week for 20 or more minutes per occasion (US Department of Health and Human Services [USDHHS], 2000). (p.79). In the study conducted by Tompkins, Belza and Brown (2009), enhanced physical wellness was observed in individuals who did regular exercise (p.84). This is the context in which exercise becomes a part of physical therapy. Is was also proven by studies that “there was a strong correlation between the quality of exercise performance and dicrease in pain” in patients who underwent physiotherapy (Friedrich, Cermak, and Maderbacher, 1996). Exercise in Law Grey (2005) has discussed the relevance of exercise in law in the context of right to vote, which is the basic right in a democratic society. The barriers “to exercise the right” to vote that existed in American society were overcome by way of social movements and corresponding legislation. Similar to this fundamental right, there are a set of rights and powers ensured by the constitution of any country, the exercise of which ensures social well being and equality. The exercise of a right being connected to the fundamental values of life and quality of life in a society, every democracy has so far tried to safeguard that process at all costs. As Grey (2005) has quoted in his article, the words of Martin Luther King Jr. reflect the core theme of the exercise of rights. His words have been, “The moral arc of the universe is long, but it bends toward justice”. This imaginary, yet very real, moral arc is the ultimate symbol of the exercise that is democracy. Summary By understanding the concept of exercise in religion, psychology, and nursing, nurses can integrate that knowledge into their practice to offer better care to patients. Enhanced nursing care can be obtained by being able to balance among patients’ freedom to exercise their religions, knowing the significance of exercise counseling, and by encouraging exercise that leads to the psychological well-being of the patients. The individual, moral and legal aspects may become mutually contradictory in many situations, which a nursing practitioner has to handle. A nursing professional has to make choices which are crucial to the well-being of the individual as well as the society. It also has to be kept in mind that decisions and consequences are context specific. An act of mediation is always welcome between the individual religious belief of the patient and what the medical books tells the practitioner. And finally, it is the physical and psychological well-being of the patient that counts more than anything else. The nursing practitioners need to be made more aware of these facts and more skilled in acting accordingly. The transformation of awareness into action is the need of the hour. References Berryman, J.W. and Park, R.J. (1992) Sport and exercise science: essays in the history of sports medicine, Illinois: University of Illinois Press. Exercise. (2010). Oxford Dictionaries Online. Retrieved February 7, 2011, from http://oxforddictionaries.com/view/entry/m_en_us1245490#m_en_us1245490 Friedrich, M., Cermak, T., and Maderbacher, P. (1996). The effect of brochure use versus therapist teaching on patient performing therapeutic exercise and on changes in impairment status. Physical Therapy Journal, 76(10), 1082-1088. Grey, R. I., Jr. (2005). A mighty right. ABA Journal, 91(3). Retrieved February 13, 2011 from http://www.abajournal.com/magazine/article/a_mighty_right/ Hayes, D., & Ross, C. E. (1986). Body and mind: The effect of exercise, overweight, and physical health on psychological well-being. Journal of Health and Social Behavior, 27, 387–400. Szasz, T and Szasz, T.S. (1988) The theology of medicine: the political-philosophical foundations of medical ethics, Syracuse: Syracuse University Press. Thurston, A. J. (2009). Art of preserving health: Studies on the medical supervision of physical exercise. ANZ Journal of Surgery, 79(12), 941-945. Post, S. G. (1995). Baby K: Medical futility and the free exercise of religion. Journal of Law, Medicine & Ethics, 23, 20–26. Ruby et.al. (2011) The invisible benefits of exercise, Health Psychology, Vol.30, No.1, pp.67-74. Tompkins, T. H., Belza, B., & Brown, M. (2009). Nurse practitioner practice patterns for exercise counseling. Journal of the American Academy of Nurse Practitioners, 21, 79– 86. Whyte, G and Sharma, S. (2010) Practical ECG for Exercise Science and Sports Medicine, Illinois: Human Kinetics. Read More