Promotion of Health within Adult Nursing - Essay Example

Promotion of Health within Adult Nursing Introduction: All nurses have key roles to play in the health promotion movement applying health promotion theory and practice in the post-qualification period. This essay is the summation of learning outcome of a training module on health promotion related to a health promotion activity. This essay is designed to reflect this my understanding of the concepts the role of a nurse in health promotion in the practice setting, where individual behavioural change strategy was applied in practice to influence the binge drinking behaviour of the adults. Health promotion is a synergistic, multisectorial activity, hence it calls for shared learning. As a part of the curriculum, I also was part of health promotional forum to accomplish this shared learning. This essay also demonstrates the effects of multi-professional learning through the group health promotional activity in the forum. Adult care nurse practitioner is needed to identify and implement appropriate health promotion and disease prevention strategies across the life span of her clients with application of her education and experience in creating a plan for prevention to promote health in the community, and in doing so, the nurse would be involved in action of health promotion (Whitehead, D., Taket, A., and Smith, P., 2003). Binge drinking is defined as consuming half of the recommended weekly consumption of alcohol in a single session. This involves behavioural health issues, yet it has received meager attention as a component of health promotion programmes. Binge drinking of alcohol lacks empirical evidence (Turner, J.C., 2007), and the ideal health promotional activity should take an approach of health risk appraisals in combination with health risk campaign, identifying and targeting higher-risk individuals, and integrating alcohol prevention messages within the broader contexts of general overall health (South, J. and Tilford, S., 2000). High alcohol consumption is a well- known aetilogy for high blood pressure, cardiovascular disease, neuropathy, and cirrhosis of liver (Chenet, L. and Britton, A., 2001). An array of psychosocial aberrations leading to mishaps, such as, accidents, injuries, suicides, crimes, domestic violence, rape, murder, and unsafe sex may all result from high levels of alcohol consumption (Measham, F. and Brain, K., 2005). These problems arise specifically out of excessive alcohol consumption in a single drinking session. The effects of binge drinking would be apparent from the following epidemiologic and demographic details (McCarty, C.A., et al., 2004). The incidence of traumatic injuries out of car accidents is twice when the blood alcohol level of the driver is 80 mg/100mL, and it shoots up to ten times more with 150 mg/mL. A similar pattern emerges with non-traffic accidents. The range of adverse medical, personal, and social effects with alcohol consumption, hence, is dependent on the amount of overall consumption and the pattern of drinking (Gill, J.S., 2002). Evidence suggests that drinkers, particularly binge drinkers, have impaired reasoning and memory functions attributed to regression of hippocampus. Binge drinking can, therefore, be termed as a dangerous pattern of consumption, the severity of which is determined by how frequently it occurs and over how long a period it is maintained. Apart from these, binge drinking causes higher level of psychological morbidity, specially anxiety and neurosis that might predispose to acute unsafe sex incidences and chronic alcohol dependence later in life (Wight, D. et al., 2000). The magnitude of problems with alcohol drinking will be evident from the following data. Among college students, the annual and 30-day prevalence rates are 83.6% and 69.6% respectively. More alarming is the pattern of drinking; binge drinking is in the range of 44.1%, and the prevalence of frequent binge drinking defined by three or more episodes of binge drinking in the previous 2-week period is in the range of 22.7% (Wechsler, H., Lee, J.E., Kuo, M., and Lee, H., 2000). Our target group, hence, are the adults in the college student group where a health promotion activity against binge drinking would have a higher chance of motivational results. Our forum activity can at least create an awareness of the problem, and application of theories of health promotional policy have higher chances of being effective here, and this training exercise in the university setting can act as the building block of future health promotions. The UK National Health Policy accepts that fact that every citizen is affected by alcohol whether they drink or not, and much of alcohol-related problems are preventable. The Alcohol Harm Reduction Strategy for England focuses on improving screening and delivery of brief interventions to hazardous and harmful drinkers and improved treatment for dependent drinkers. Harmful and hazardous drinkers who have received brief interventions often moderate their drinking habits, and it is accepted that interventions and health promotions beginning at the rudimentary and primary level would reduce the hazardous and harmful habits to a low-risk level (Lapham, S.C., Gregory, C., and McMillan, G., 2003). Effective public health and health promotion activities help people maintain and improve health, reduce disease risks, and can successfully improve wellbeing of the individual and community. Usually such successes require behaviour change at many levels. The behaviour change approach of health promotion aims to encourage individual behaviour conducive to freedom from disease and uses behaviour change to encourage adoption of a healthier life style (Yanovitzky, I. and Stryker, J., 2001). This health promotion strategy emphasizes the values of healthy life style as defined by the experts. The most successful promotional strategies and initiatives achieve the desired outcomes because those are guided by expert knowledge giving rise to a clear understanding of targeted health behaviour in a specific environmental context (Morawska, A. and Oei, T.P., 2005). Health behaviour theory impregnated with ideas of creating awareness about binge drinking and thereby, implementing the goal of controlling the behaviour of the clients on the problems of binge drinking is a psychosocial manipulation targeting consumer behaviour and strategies to modify it (Major, A., 2004). This approach has the hidden goal of imposing alien values on the client in order to modify it since it is acknowledged that individual behaviour is the primary cause of ill health in the specific issue of alcohol abuse (Marlatt, G.A. and Witkiewitz, K., 2002). The promoter must allow practical considerations of the client’s negative feelings, and approach must be unimposing. The practitioners usually use theory to investigate answers to the questions, why, what, and how health problems would be addressed (Anonymous, 2005). This group has clarified the nature of the targeted behaviour related to alcoholic abuse. The information collected from this particular behaviour helps the planners and promoters to develop a promotional programme, and this also helps devising strategies to have an impact. Theory also aids to recognize the indicators to be monitored and measured during evaluation of the programme, and then programme planning, implementation, and monitoring is more likely to succeed (Glanz, K., Rimer, B.K., Lewis, F.M., 2002). Effective practice uses theories and strategies appropriate to situation. The promotional activity was to raise awareness of binge drinking in university students in the age range of 18 to 25 years. Additionally, the objective of the project was to increase awareness in the students of what a unit amount is and how many units does it need to drink for binge drinking and how dangerous could it be for own health and society if one goes above the limit. In recent years, health promotion campaigns have emphasised the negative effects of continued heavy drinking on health and have strongly advocated drinking within sensible weekly limits, 2-3 units per day for women and 3-4 units for men (Gill, J. and OMay, F., 2007). One unit is equivalent to 10 mL of pure alcohol, one- half a pint of beer, or a small wine glass. Binge drinking, on the other hand, is defined as drinking half the amount of recommended weekly consumption in a single session, making it 7 units for women and 10 units for men (Webster-Harrison, P.J., Barton, A.G., Sanders, H.P., Anderson, S.D., and Dobbs, F., 2002). Using this definition, it was found that the prevalence of binge drinking was highest in the younger age group with 31.1% of drinkers in the range of 18 to 24, and they engage in binge drinking at least once a week. Male drinkers were predisposed to more binge drinking, and 25.4% of the drinkers were engaged in full-time education (Park, C.L. and Levenson, M.R., 2002). By choosing to have a promotional activity in the University Campus forum, this group can reach the most prospective target group who do not even know how much of drinking constitutes a hazardous drinking behaviour. This approach, as is evident from the responses in the forum, would increase awareness of the need for a change and through personal participation would ensure personalized information about the risks of binge drinking and would motivate the participants and encourage them to make specific plans. This would assist the individuals with developing and implementing concrete action plans with help in setting gradual goals and also to assist with feedback, problem solving, social support, and reinforcement. In other words, if people are aware about how their lifestyle may affect their health, they would change their habits (Fitzpatrick, J.J., 2006). Evaluation: The theory of planned behaviour was employed to identify the key motivational factors in binge drinking among young university students. This is a widely used psychosocial model to explore the relationship between attitude and behaviour and to predict a range of health behaviours (Wetherill, R.R. and Fromme, K., 2007). The group consisted of 6 members, and the mutual understanding and relationship within the group was demonstrable in the forum and also in other group meetings. When they spoke, they always agreed to each other, as though they are family. This group acquired vast knowledge on promotional activity against binge drinking. This group demonstrated very organized team effort in all spheres, in group meetings, in the class room, and in preparation for the forum. However, like any group, all the members were not identical in terms of input, one would always skip the meetings, would always miss the study tasks, but that is not the responsibility of the other group members since they are not empowered to ensure participation of all the members. The forum promotional activity, however, had all the group members present and actively participating. It was a demonstration of very efficient group activity. The forum happened in the University campus, The booth was well organized with sweets and refreshments brought from the University stand and displayed on the stands. This attracted the public and the students to our booth. All who attended spent more than 3 minutes of time, and they were particularly interested in the displayed poster, “How Much is Too Much” followed by the game this group created for the visitors. The game was a very simple demonstrative game to determine the amount an individual takes and how much they are over the limit. Depending on the answers from the students, a group member would pour water on a large wine glass to demonstrate the amounts. It was very evident that most of the visitors did not know how much over the limit they were drinking. After seeing the amount they were over the limit, they appeared surprised and shocked. Few would not play the game for fear of disclosure of their heavy drinking to their friends. While doing these tests and after that, they received information about the prescribed limit of alcoholic drinks with highlight that alcohol is a poison. The next activity after the test was the bulletin board and display stand, where leaflets from the Department of Health were displayed. It included helpline number 08009178282 and website www.drinkaware.co.uk for help in case of addiction. It also contained precise information about the effects of binge drinking from Alcohol Is Poison, and how to deal with it; written by David Moore, Published by Portman Group, printed by Belmont Press, 2005 and alcohol concern leaflets. The most interesting prop was the unit calculator that was used to calculate how much one has and how much he is over the limit. One of our members discussed the effects of drinking alcohol and its adverse effects on many organ systems. All this were directed to create awareness among students about their drinking behaviour, and this, the group believes, would manipulate the attitude, behavioural beliefs, and control beliefs. This was a very successful project as evidenced by people’s response, and it went up to the extent of a queue in front of our booth, while some people were inside some waited outside. The last part was the questionnaire that questioned about the individual daily limit, knowledge about three adverse physical effects of binge dinking, and assessment of level of information after visit to our booth. Eighty-one questionnaires were filled out with 100% response rate in question 1, question 2 demonstrated a failure arte of 1.23%, and on question 2, 1 out of 81 knew already about binge drinking, he did not know from the stand. There was very strong impact on the public, specially the university students with this group’s promotional effort on binge drinking. The slogan poster, “How Much is Too Much”, the snacks and the food, and the experiment and information all should have impact on the emotions of the students, embarrassment, insecurity, new knowledge, and enriched awareness about binge drinking. This project highlighted the fact that this kind of drinking is addiction, even if this is social outing to them as of now, in no time, this would transform into addiction, and they were aware of this possibility after coming into our booth. Our objectives were to let the visitors be aware about pros and cons of binge drinking, and since every one knew what his unit amount was, how many units make one a binge drinker and how that can affect the body in the long run, it can be considered that the objective of this promotional activity were met, although this is a trial setting and learning exercise, and predictive accuracy depends on the evaluation of the outcome after followup at 6-month or 1-year interval in the actual practice setting, and that is not possible in this setting because this is population in transition, many will be leaving the university in a short while, short enough to baffle any long-term promotional plans in the near future. Our experiment with the glass of wine measured the university students’ daily alcohol intake. We applied the group’s research data of daily over the limit allowance, and the group was well prepared to demonstrate and explain that in terms of the adverse effects that it might produce. The leaflets would support that, and this would serve the purpose of creating awareness as a promotional activity. The booth we used should have been larger to accommodate more people. The time per visitor of three minutes was less. The group was so busy handling the people, the group failed to notice that many students did not have a chance to enter. Aside from these pitfalls, the programme was success since our lecturer and health promoter commented that this group is very knowledgeable. In practice this kind of activity can happen in the primary care clinic. Overall, this was a very enriching experience for the group, and it is always a wonder to experience the classroom teaching happening outside moderated by us, and we all felt thrilled how it would be like when we would do these same things in our practice. Reference List Anonymous, (2005). Asking Nicely Who, What, Where, and When Reduces Risk for Binge Drinking in Middle-School Kids. Journal Watch Pediatrics and Adolescent Medicine, Jul 2005; 2005: 3 Chenet, L. and Britton, A., (2001).Weekend Binge Drinking May Be Linked To Monday Peaks In Cardiovascular Deaths. British Medical Journal; 322: 998. Fitzpatrick, J.J., (2006). Alcohol awareness. Archives of Psychiatric Nursing; 20(5): 203-4. Gill, J.S., (2002). Reported Levels Of Alcohol Consumption And Binge Drinking Within The UK Undergraduate Student Population Over The Last 25 Years. Alcohol Alcohol; 37: 109 - 120. Gill, J. and OMay, F., (2007). Practical demonstration of personal daily consumption limits: a useful intervention tool to promote responsible drinking among UK adults? Alcohol Alcohol; 10.1093/alcalc/agm049. Glanz, K., Rimer, B.K., Lewis, F.M., (2002). Health Behavior and Health Education: Theory, Research, and Practice (3rd Edition). San Francisco, California.: Jossey-Bass. Lapham, S.C., Gregory, C., and McMillan, G., (2003). Impact Of An Alcohol Misuse Intervention For Health Care Workers — 1: Frequency Of Binge Drinking And Desire To Reduce Alcohol Use. Alcohol Alcohol; 38: 176 - 182. Major, A., (2004). Life Styles And Health Promotion Behavior Among Adolescents. Alcohol Consumption. Servir; 52(6): 276-83. Marlatt, G.A. and Witkiewitz, K., (2002). Harm Reduction Approaches To Alcohol Use: Health Promotion, Prevention, And Treatment. Addictive Behaviours; 27(6): 867-86. McCarty, C.A., et al., (2004). Continuity of Binge and Harmful Drinking From Late Adolescence to Early Adulthood. Pediatrics; 114: 714 - 719. Measham, F. and Brain, K., (2005). ‘Binge’ drinking, British alcohol policy and the new culture of intoxication. Crime Media Culture; 1: 262 - 283. Morawska, A. and Oei, T.P., (2005). Binge Drinking In University Students: A Test Of The Cognitive Model. Addictive Behaviours; 30(2): 203-18. Park, C.L. and Levenson, M.R., (2002). Drinking To Cope Among College Students: Prevalence, Problems And Coping Processes. Journal of Studies in Alcohol; 63(4): 486-97. South, J. and Tilford, S., (2000). Perceptions Of Research And Evaluation In Health Promotion Practice And Influences On Activity. Health Education Research; 15: 729 - 741. Turner, J.C., (2007). Is the Binge-Drinking Glass Half Full or Half Empty? Pediatrics; 119: 1035. Yanovitzky, I. and Stryker, J., (2001). Mass Media, Social Norms, and Health Promotion Efforts: A Longitudinal Study of Media Effects on Youth Binge Drinking. Communication Research; 28: 208 - 239 Webster-Harrison, P.J., Barton, A.G., Sanders, H.P., Anderson, S.D., and Dobbs, F., (2002). Alcohol awareness and unit labelling. Journal of Public Health Medicine; 24: 332 - 333. Wechsler, H., Lee, J.E., Kuo, M., and Lee, H., (2000). College binge drinking in the 1990s: A continuing problem. Journal of American College Health 48, pp. 199–210. Wetherill, R.R. and Fromme, K., (2007). Perceived Awareness And Caring Influences Alcohol Use By High School And College Students. Psychological Addictive Behaviour; 21(2): 147-54. Whitehead, D., Taket, A., and Smith, P., (2003). Action Research In Health Promotion. Health Education Journal; 62: 5 – 22. Wight, D. et al., (2000). Extent Of Regretted Sexual Intercourse Among Young Teenagers In Scotland: A Cross Sectional Survey, British Medical Journal, no. 7244. Read More