Health Promotion for a Hypertensive Patient - Term Paper Example

University> By НЕАLTH РRОMОTIОN FОR А HYРЕRTЕNSIVЕ РАTIЕNT INTRODUCTION According to World Health Organization, Health promotion is the process of enabling the members of the society to enhance control over and to improve their health (Bolton, 2005). It is imperative to note that the health of an individual plays a crucial role in the daily life. For instance, to cope with the environment, realize goals and objectives, and even satisfy needs calls for mental and physical health. Typically, Health promotion is “the process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behavior towards a wide range of social and environmental interventions”(Guedes, Moreira & Cavalcante, 2012 pp4). Thus, this is a clear indication that health promotion engages individual and the members of the society to make changes and behave in a manner that reduces their exposure to various diseases. Centers for Disease Control (CDC) and Prevention indicate that approximately 70 million American adults have high blood pressure. This shows that 29% of the American population have are hypertensive and that in every three adults one has high blood pressure (CDC, 2015). In addition to the above, only approximately 52% of the people affected have their conditions under control. As such, the remaining 48% of the high blood pressure patients have their conditions, not under control. High blood pressure costs the United States of America approximately 46million dollars annually. These are inclusive of the health care services costs, days when work is missed, and the cost of medication. World Health Organization Rankings indicated that Hypertension Deaths in Oman reached 223, which translates to 2.6% of the total deaths. The age-adjusted death rate is 17.8 per 100, 000 of population ranks Oman 79 in the world (WHO, 2014). According to Woodson, “Hypertension (HTN) or Blood pressure is the force of blood against the walls of arteries. Blood pressure will rise and fall throughout the day. When the pressure stays elevated over time, it’s called high blood pressure” (Woodson, 2012 pp.6). Thus, hypertension (HTN) is a medical term that is used by professionals such as nurses and doctors to refer to high blood pressure. It is imperative to note that that hypertension is hazardous since it can lead to the hardening of the blood arteries resulting in the blockage of the flow of oxygen-rich blood. As such, this increases the risks of an individual being attacked by heart diseases and stroke that eventually may lead to death. Other conditions that may result include congestive heart failure, blindness, and kidney infections. World Health Organization 2014, Oman HTN information indicates that “High blood pressure Deaths in Oman reached two hundred and twenty-three or 2.57% of total deaths. The age adjusted Death Rate is 17.83 per 100,000 of population ranks Oman #79 in the world”. On the contrary, Riyami and Afifi assert that “the crude prevalence of HTN was 33.1%, while the age-adjusted prevalence was 38.3%. Older age groups, male gender, lower level of education, not- working, hypercholesteremic, being married, obese, smoker, or having abnormal Waist Hip Ratio (WHR), or Total Impaired fasting glucose (TIFG) were found to be associated with hypertension in bivariate analysis” (Riyami & Afifi, 2002 pp.1). Thus, this is a clear suggestion that the rate of hypertension in Oman has substantially increased over the previous years. Several factors have led to this increase in hypertension. One of the most significant factors is the change of diet whereby people eat food that contributes a lot to obesity or overweight. The other factors that have been elemental in the increase in hypertension include increased use of Tobacco, lack of physical activity, and drinking too much of alcohol. Therefore, there is a substantial need to enhance health promotion to ensure that several people at risk are saved from succumbing to HTN. Researchers and scholars across the globe have come up with various ways in which prevalence of HTN can be reduced. One of the most significant methods of reducing HTN is to encourage people to always eat a balanced diet. It has been noted that eating healthy food play a crucial role in maintaining a good control of blood flow. The other way is to maintain a healthy body weight. These two strategies work well when the client and the community are empowered. For instance, a patient can be encouraged to ensure that he or she eats vegetables and fruits for a balanced diet. As well, the members of the community are empowered to reduce weight and ensure that they are always physically active to avoid obesity. Empowerment in health promotion can also be achieved through encouraging people to limit drinking of alcohol and use of Tobacco (National Heart, Lung, and Blood Institute, 2006). On the other hand, health promotion should also focus on inspiring the members of the society to exercise regularly and monitor their blood pressure. One of the most important health vision 2050 of Ministry of Health in Oman states that “various departments of the government make policies and decisions that inevitably have an impact on the main risk factors and, ultimately, on the health of the nation. However, collaboration and joint planning among government sections are still rudimentary and need to be strengthened. Preventive health initiatives would have better results if public policies on taxation, trade, food, urban strategies, and the like are based on evidence and set with due consideration for public health" (Al-Riyami, 2012 pp.2). This is a clear suggestion that the government is committed to ensuring that all departments work together in health promotion of the nation. In addition to the above, Oman Nursing and Midwifery Council guidelines states that “The delivery of healthcare process is a complicated process that requires a multi-disciplinary approach to meet the health needs of the society.” This is the main reason departments should work as a team in ensuring that that health promotion in Oman is effective and efficient. Thus, the aim of this is to ensure that the health of the nation is enhanced. EPIDEMIOLOGY According to the Centers for Disease Control and Prevention (CDC), “Epidemiology is the study of the distribution and determinants of health-related states or activities in given populations, and the application of this research to the control of health issues” (CDC, 2015). There are several reasons Epidemiology is important in the promotion of health. One of the most significant importance is that epidemiology is useful is assessing the community’s health. Descriptive epidemiology ensures that information such as actual and potential health issues in society, places of occurrence, populations at increased risk, and identification of problems with high potential for growth. Epidemiology as well is crucial in individual decision making. When people make individualistic decisions such as quit drinking alcohol or smoking tobacco, such decisions are mainly arrived at after having access to epidemiologist information. In health promotion, it is also worth noting that epidemiology plays a vital role in searching for the causes. CDC reports indicate that “Much epidemiologic study is committed to searching for causal factors that impact one's risk of disease. Ideally, the objective is to identify a cause so that recommended public health action might be taken” (CDC, 2015). Thus, this is a clear indication that the Epidemiologic research plays a vital role in searching for solutions to health problems such as HTN. According to World Health Organization (WHO) Global Health Observatory (GHO) Data, HTN is estimated to cause up to 75 million deaths. This means that hypertension causes approximately 12.8% of the overall global deaths. In essence, this is translated to account for up to 57million disability-adjusted life years (DALYS). The report further indicates that “Globally, the overall prevalence of raised blood pressure in adults aged 25 and over was around 40% in 2008” (World Health Organization, 2015). However, it is profound to note that there has been a substantial increase in the number of people with uncontrolled hypertension over the last ten years. It is indicated that the number of individuals with uncontrolled HTN rose from 600 million in 1980 to approximately 1billion in 2008. The main factors that have been core in such dramatic increase include aging and rapid population growth (Ichihara at al., 2006). In Gulf Countries, 45% of the early deaths are mainly caused by Hypertension and other cardiovascular diseases. The statistics indicated that “The estimated overall prevalence of hypertension was 29.5%, which shows a higher prevalence of high blood pressure among Arabs compared to people from the sub-Saharan African” (Aljefree & Ahmed, 2015pp.2). As such, HTN remains one of the most threatening risk factors that has a national prevalence rate ranging from 15% to 30% in adults. In addition to the above, the statistics indicate that “Awareness of high blood pressure was reported for 46% of the studies and varied from 18% (Jordan) to 79.8% (Syria)” (Aljefree & Ahmed, 2015pp.2). In Oman, WHO 2014 indicated that “High blood pressure Deaths in Oman reached 223 or 2.57% of total mortality. The age adjusted Death Rate is 17.83 per one hundred thousand of population ranks Oman 79 in the world”. Other statistics indicate that “The researcher mentions that the general prevalence of disease in OFS up to 2008 were Hypertension 23 per cent, High Cholesterol 37 per cent, Diabetes Mellitus 5.5 per cent, Obesity 3 per cent. Apart from high cholesterol, these results were considered to be moderate or subtle at that time” (El-Deeb at al., 2015). The above statistics shows the comparison of HTN prevalence globally, in Gulf Countries, and in Oman. HEALTH PROMOTION (HP) MODEL Andrew Tannahill created one of the most widely used health promotion models in the 1980’s. The model is based on three overlapping spheres of activity namely: health education, prevention, and health protection. According to Tannahill “health education is designed to change the knowledge, beliefs, attitude, and behavior in a way that facilitates health” (Tannahill, 2009 pp.63). On the other hand, prevention of diseases is supported by the objective of reducing and minimizing various risk factors resulting in the reduction of the outcomes or impacts of the diseases. Thus, prevention of hypertension is categorized into three main parts namely; primary, secondary, and tertiary prevention. The most commonly used techniques in the protection of hypertension in Oman include legal controls and policies with the primary objective of enhancing the health of the members of the society. Some of the most common policies currently applicable ensure that there is equal access to employment, healthcare facilities, and education. Finally, health protection is mainly concerned with safeguarding the population primarily through legislative, financial, or social measures. On the contrary, it is imperative to note that several critics have been developed against Tannahill Model of health promotion. One of the main critic points notes that the model pays no consideration to the community-based factors. However, Tannahill responded to this claim by developing a new definition of health promotion which states that “health promotion is the sustainable fostering of positive health and prevention of ill-health through policies, strategies in various overlapping areas of action” (Tannahill, 2009). HEALTH EDUCATION Health education plays a vital role when dealing with hypertensive patients in the society. One of the most common things that such education should focus on is the diet. It is imperative to note that diet is one of the most leading causes of hypertension in Oman and other places across the globe. As such, there is a crucial need to educate people on the importance of eating a balanced diet. For instance, the members of the society should be encouraged to eat vegetables and fruits that make their diet complete. In addition to the above, it is profound to note that this health education should not be limited to the patient only. The members of the family should also be included in such education to ensure that all of them benefit from such education (Narula, Shor, Young & Hong, 2008). Furthermore, the members of the society should be educated on the significance of physical activity in their health. Exercising regularly enhance the flow and circulation of blood in one’s body thus reducing the chances of hypertension. Thus, it is vital that people be encouraged to ensure frequently that they engage in any physical exercise to reducing the risks of being affected by high blood pressure (Galiè at al., 2009). PREVENTION Health prevention is mainly concerned with various ways that are aimed at reducing the risk of diseases such as hypertension. Mostly, prevention in health care is divided into three central section’s namely; primary prevention, secondary prevention, and tertiary prevention. Health professionals such as doctors and nurses can accomplish this in practice, by making every contact count and educating adolescents of the importance of healthy eating which involves limiting the intake of foods high in fat and sugar, and increasing their consumption of fruit and vegetables and taking part in the recommended levels of physical activity, during all patients contacts (WHO, 2015). The main reason for the emphasis on a balanced diet is because hypertension is mainly caused by eating an unbalanced diet. Primary prevention involves all the activities that play a significant role in the reduction of the risk of developing hypertension. Primary prevention may also involve the use of social media platforms in creating awareness about high blood pressure. For instance, Facebook and Twitter can be a useful tool in ensuring that people eat balanced diet and exercise regularly. The primary objective of such strategies is to ensure that the flow of blood in one’s body is active leading to minimal or no risks of HTN. One of the most significant roles played by the nurses and other health professionals in this prevention stage is to ensure that people are educated on the importance of exercising regularly, monitoring their blood pressure, and eating a balanced diet (Whelton at al., 2002). This is especially to the adults that are primarily affected by HTN in Oman and other places across the globe. It is profound to note that there are there are various primary prevention of HTN strategies that have been implemented in Oman. One of the most common strategies involves setting up of full check-up done for everyone above 40 years old to detect noncommunicable diseases and Hypertension is one of them. The second stage is the secondary prevention which involves HP activities that aim to reduce the ongoing severity of a disease and reduce or minimize further complications (Agodoa at al., 2009). It is imperative to note that secondary prevention is concerned with the systematic form of detecting the earlier stages of the disease and taking action before the development of full symptoms of hypertension. One way in which nurses and other professionals conduct secondary prevention in adults is to prescribe statins with the main objective of reducing cholesterol and taking necessary measures to reduce hypertension. As a result, there is the various significance of conducting secondary prevention. Firstly, secondary prevention is based on a different range of interventions that are considered as cost effective. As such, the implementation of such strategies ensures that the life expectancy is rapidly impacted. The other significance of secondary prevention is that this is the primary area whereby the ‘inverse law case’ broadly applies. As well, those at high risk of hypertension can easily be identified and saved reducing the risks of the associated consequences. In that connection, it is imperative to note that successful secondary prevention plays a vital role in reducing complications and enhancing life expectancy (Hong, 2010). Finally, there are several ways of conducting secondary prevention of hypertension. One of the most common ways is through managing disease registers, identifying practices where improvement is required, and systematic screening, enhancing systematic control of hypertension, working closely with local authorities, and working with the members of the society and voluntary groups to promote health. The last stage is the tertiary prevention which covers all HP activities which aim to reduce the ongoing complications or disabilities associated with a condition. This preventative approach focuses on palliative and rehabilitative interventions, which is not the focus of this assignment. HEALTH PROTECTION It is imperative to note that various legal controls and policies have been formulated with the primary objective of reducing the risks associated with hypertension. The most commonly used techniques in the protection of hypertension in Oman include legal controls and policies with the primary purpose of enhancing the health of the members of the society. Some of the most common procedures currently applicable ensure that there is equal access to employment, healthcare facilities, and education (Al-Riyami & Afifi, 2002). Finally, health protection is mainly concerned with safeguarding the population primarily through legislative, financial, or social measures. Similarly, it is crucial to note that there are MACRO, MESO, and MICRO perspectives of legal controls and policies currently in use in the fight against hypertension (Chobanian at al., 2003). The World Health Organization (WHO) ‘Global strategy on diet, physical activity, and health’, was developed to help guide HP practice globally in an attempt to reduce the prevalence of Hypertension across the global. The primary objective of this policy is to ensure that all people across the globe ensure that they eat a balanced diet, exercise regularly, thus enhancing the minimal risk to hypertension (Funder at al., 2008). In connection to that, Gulf countries as well have legal controls and policies that are aimed at minimizing risks to Hypertension. These systems are mainly centered on encouraging people on the importance of eating a balanced diet, exercising regularly, and monitoring their blood pressure. On the contrary, one of the policies used in Oman states that “Omani guide to healthy eating and physical activity,' to help reinforce the healthy lifestyle habits required to promote health and wellbeing amongst the Omani population.” The above policy is similar to the global strategy used by World Health Organization in enhancing and improving health. In conclusion, there is a substantial need for people in Oman and other regions of the globe to practice all the three strategies explained by Tannahill model. These include health education, health prevention, and health protection. One of the most significant of this is health education whereby people are educated on the need to eat a balanced diet, exercise regularly, and monitor their blood pressure to ensure that they avoid hypertension. REFERENCES Al-Riyami, A., 2012. Health vision 2050 Oman: a committed step towards reforms. Oman medical journal, 27(3), p.190. Aljefree, N. and Ahmed, F., 2015. Prevalence of cardiovascular disease and associated risk factors among adult population in the Gulf region: a systematic review. Advances in Public Health, 2015. Al Riyami, A.A. and Afifi, M.M., 2002. Hypertension in Oman: distribution and correlates. The Journal of the Egyptian Public Health Association, 77(3-4), pp.383-407. Agodoa, L.Y., Appel, L., Bakris, G.L., Beck, G., Bourgoignie, J., Briggs, J.P., Charleston, J., Cheek, D., Cleveland, W., Douglas, J.G. and Douglas, M., 2001. Effect of ramipril vs amlodipine on renal outcomes in hypertensive nephrosclerosis: a randomized controlled trial. Jama, 285(21), pp.2719-2728. Bolton, C., 2005. Nursing management of hypertension. Nursing best practice guideline: Shaping the future of nursing, pp.45-46. Centers for Disease Control and Prevention (CDC). 2015. Introduction to Epidemiology. Retrieved from http://www.cdc.gov/ophss/csels/dsepd/ss1978/lesson1/section3.html Chobanian, A.V., Bakris, G.L., Black, H.R., Cushman, W.C., Green, L.A., Izzo Jr, J.L., Jones, D.W., Materson, B.J., Oparil, S., Wright Jr, J.T. and Roccella, E.J., 2003. The seventh report of the joint national committee on prevention, detection, evaluation, and treatment of high blood pressure: the JNC 7 report. Jama, 289(19), pp.2560-2571. El-Deeb, M.H., Sulaiman, K.J., Al-Riyami, A.A., Mohsin, N., Al-Mukhaini, M., Al-Lamki, M., Al-Busaidi, N., Al-Salmi, I., Al-Lawati, J., Al-Rawahi, N. and Al-Riyami, M.B., 2015. 2015 Oman Heart Association Guidelines for the Management of Hypertension. High Blood Pressure & Cardiovascular Prevention, 22(1), pp.83-97. Funder, J.W., Carey, R.M., Fardella, C., Gomez-Sanchez, C.E., Mantero, F., Stowasser, M., Young Jr, W.F. and Montori, V.M., 2008. Case detection, diagnosis, and treatment of patients with primary aldosteronism: an endocrine society clinical practice guideline. The Journal of Clinical Endocrinology & Metabolism, 93(9), pp.3266-3281. Guedes, N.G., Moreira, R.P., Cavalcante, T.F., Araujo, T.L.D., Lopes, M.V.D.O., Ximenes, L.B. and Vieira, N.F.C., 2012. Nursing interventions related to health promotion in hypertensive patients. Acta Paulista de Enfermagem, 25(1), pp.151-156. Galiè, N., Hoeper, M.M., Humbert, M., Torbicki, A., Vachiery, J.L., Barbera, J.A., Beghetti, M., Corris, P., Gaine, S., Gibbs, J.S. and Gomez-Sanchez, M.A., 2009. Guidelines for the diagnosis and treatment of pulmonary hypertension. European heart journal, 30(20), pp.2493-2537. Hong, W.H.S., 2010. Evidence-based nursing practice for health promotion in adults with hypertension: A literature review. Asian nursing research, 4(4), pp.227-245. Ichihara, A., Kaneshiro, Y., Takemitsu, T., Sakoda, M., Suzuki, F., Nakagawa, T., Nishiyama, A., Inagami, T. and Hayashi, M., 2006. Nonproteolytic activation of prorenin contributes to development of cardiac fibrosis in genetic hypertension. Hypertension, 47(5), pp.894-900. Tannahill, A., 2009. Health promotion: the Tannahill model revisited. Public health, 122(12), pp.1387-1391. National Heart, Lung, and Blood Institute. 2006. Lowering Your Blood Pressure with DASH. Schocken, D.D., Benjamin, E.J., Fonarow, G.C., Krumholz, H.M., Levy, D., Mensah, G.A., Narula, J., Shor, E.S., Young, J.B. and Hong, Y., 2008. Prevention of heart failure A scientific statement from the American Heart Association councils on epidemiology and prevention, clinical cardiology, cardiovascular nursing, and high blood pressure research; Quality of care and outcomes research interdisciplinary working group; and functional genomics and translational biology interdisciplinary working group. Circulation, 117(19), pp.2544-2565. World Health Organization (WHO). 2014. World Health Rankings: Live Longer Live Better. Retrieved from http://www.worldlifeexpectancy.com/oman-hypertension World Health Organization, 2013. High blood pressure-country experiences and effective interventions utilized across the European Region. Woodson, J. 2012. Hypertension Stop It! Control It! Teaching Guide. Millicent Braxton-Calhoun, M.S. Whelton, P.K., He, J., Appel, L.J., Cutler, J.A., Havas, S., Kotchen, T.A., Roccella, E.J., Stout, R., Vallbona, C., Winston, M.C. and Karimbakas, J., 2002. Primary prevention of hypertension: clinical and public health advisory from The National High Blood Pressure Education Program. Jama, 288(15), pp.1882-1888. Read More