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Running head: PERSONAL HEALTH ASSESSMENT AND PROMOTION PLAN 1

Personal Health Assessment and Promotion Plan

Holley West

Ferris State University

PERSONAL HEALTH ASSESSMENT AND PROMOTION PLAN 2

Abstract

The purpose of this paper is to evaluate health beliefs and lifestyle using various assessment

tools. The author’s goal is to lose weight. Reflection on assessment findings determines plan of

action for weight loss goal achievement. Readiness for change was assessed using the

Transtheoretical Model. Author’s personal health promotion plan was created and implemented.

Outcomes of weight loss plan and the effectiveness of interventions and appropriate wellness-

oriented nursing diagnosis conclude this paper. Appendices provide evaluation tools used and

author’s individualized health promotion plan.


Personal Health Assessment and Promotion Plan

The goal of this project was to create a healthy diet, exercise, and stress management plan

author could and would adhere to in order to lose weight. Author has struggled with weight since

age eleven and has tried repeatedly to follow a healthy lifestyle in regards to weight and stress

management. Throughout this project author learned new things about self, including

unrecognized habits. This paper will take you on a journey with the author in the assessment,

diagnosis, planning, intervention, and evaluation of an attempt at wellness.

Assessment Tools

Multiple tools were chosen to assess health. The Health Beliefs Survey (see Appendix A)

was the first assessment the author performed (Ursuy, 2011, pp. 22-23). This survey was used to

determine how the author perceives actions in relationship to past, present, and future health

status. Though these scores fell around the normal values, the author feels personal choices play

the biggest role in health status, followed by the actions of others. Chance section scored lowest

due to the author’s belief that most things occur due to cause and effect. Powerful others and

chance come into play when things are unavoidable or unpredictable.

In order to assess author’s adherence to an exercise regimen and feelings toward these

activities in relation to daily stress levels and accompanying coping skills author documented

these items in the Health Promotion Plan (see Appendix B) and Exercise and Stress Management

Journal (see Appendix C). These revealed stress levels and exercise performance held a strong

relationship to each other (Ursuy, 2011, p. 27). Most days that exercises were performed anxiety

and stress were lower. The application of strategies to manage stress recommended by the Mayo

Clinic (2010) website resulted in a decrease of anxiety post stressor.


Performance of the Muscular Strength and Endurance Assessment used by the U.S.

military (see Appendix D) provided needed baseline levels to create an exercise plan (Ursuy,

2011, pp. 24-25). Data needed for evaluation of progress was recorded on the Health Promotion

Plan (see Appendix B). These two mentioned assessment tools led to the exercise goals for

current and future reference.

Completion and result assessment of the Self-Esteem Questionnaire (see Appendix E)

ensured the author had the self-esteem and confidence to follow through with health promotion

plans and underlying self-esteem issues (Ursuy, 2011, pp. 31-32). The areas lacking esteem were

related to feelings of self-worth, enjoying exercise, and monitoring food intake. These two

mentioned weaknesses are barriers to weight loss and are addressed in the Health Promotion Plan

(see Appendix B).

The last assessment performed was the readiness for change based on the

Transtheoretical Model (Pender, 2011, pp. 51-53). The first stage of precontemplation occurred

over fifteen years ago. Author has been lingering in the second stage of contemplation for weight

loss and management behaviors since adolescence (Pender, 2011, p. 51). The experiential

process of dramatic relief was identified as a barrier due to childhood abuse. These included

constant name calling related to weight before obesity had even occurred and extreme exercise

regimens creating low esteem and distaste for exercise (Pender, 2011, p. 52).

Weight has always been an issue of concern leading to many instances of the third stage

of planning and preparation being implemented (Pender, 2011, p. 51). Low endurance and

dislike of body appearance are the driving force behind plans to change unhealthy behaviors of

inadequate exercise and unhealthy eating habits. The fourth stage of action generally lasts one to


two months before cycling back to the contemplation stage of change due to barriers and lack of

support. Stress management skills and self-defeating esteem beliefs related to stress eating and

lack of energy. These barriers remain at the forefront of the author’s failure to reach the

maintenance stage of change (Pender, 2011, p. 51).

Plan Analysis

Weight loss of fifteen pounds was achieved with the follow-thru of stated plan (see

Appendix B). When assessing daily stress and adherence to exercise plan identification of the

continuing role high stress played on energy was evident. On days when stress was high and

author exercised and applied stress management techniques the stress level decreased and mind

was cleared. However, if these tasks were not performed stress levels, anxiety, and residual anger

remained high. These results reaffirm the need of exercise to manage stress and increase self-

esteem. The plan was revised to include a rule for stressful or depressed states of well-being that

included immediate exercise. This rule was placed into the plan later on and was only

implemented once with positive results.

The second noted result of the plan was that on days where author over-committed stress

was higher. These days occurred when there was not a rest day or there were high work hours.

This led to the realization that overcommitting led to a constant sense of anxiety and the need for

a rest day was definite.

Diet plan was followed on low stress days and lack of compliance occurred on high stress

days. Food choices were made with the family except for on late work day’s when cereal high in

fiber and low in sugar were eaten. Breakfast six out of seven days included a yogurt and granola

bar. Lunch varied and included at least one meat and one vegetable. Dinner was smaller than


lunch and also included a vegetable, grain, and meat. Snacks were limited to fruits and crackers.

Eliminating sweets in the home was added to the health promotion plan when author noted an

increase of sugar ingestion during times of stress.

Lastly, the exercises performed that author enjoyed were adhered to more so than the

exercises on the muscular strength and endurance assessment (see Appendix D). The plan to

increase repetition every other day was below expectations. There was only an increase of three

set-ups, two push-ups, and two seconds of wall sit in twenty days when the goal was to have an

increase of ten in twenty days.

The author finds that feelings of boredom and negativity led to the lack of commitment to

the performance of these exercises. To increase muscular endurance and strength in other ways

the plan includes multiple activities that work the same muscle groups and increase the heart

equally. Future plans may include removal of said exercises listed in Appendix D from the plan

all together if author continues to have negative feelings and lack of commitment.

Nursing Diagnosis

The nursing diagnosis selected that best represents author’s wellness in relation to health

promotion plan is as follows: health seeking behaviors related to stress as a risk factor for

coronary artery disease related to weight, stress, and low level of exercise as evident by

expressed desire to seek a higher level of wellness (Sparks, 2008, p. 853). This diagnosis

represents the author due to the presence of multiple risk factors for coronary heart disease

including family history, obesity, high stress, and low level of exercise (Sparks, 2008, p. 853).

Author wishes to change unhealthy habits and create a health promotion plan that can be

committed to for life. The risk factors of cholesterol levels, age, and blood pressure are not


currently evident, though all mentioned risk factors can be decreased with implementation of

proposed life style changes (Sparks, 2008, p. 853).


References

Mayo Clinic. (2010, July 23). Stress management: Prevent stress setbacks. Retrieved from

http://www.mayoclinic.com/health/stress-management/SR00038?NSECTIONGROUP=2

Pender, N. J., Murdaugh, C. L., & Parsons, M. A. (2006). Health Promotion in Nursing Practice

(6th ed.). Upper Saddle River, NJ: Pearson Prentice Hall.

Sparks, S., & Taylor, C. (2008). Nursing Diagnosis Reference Manual (7th ed.). USA. Lippincott

Williams & Wilkins.

Ursuy, P. (2011, May). NURS 310 Class Syllabus.


Appendix A

Health Beliefs Survey

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

Disagree Agree 1

2

3

4

5

6

1. If I get sick, it is my own behavior that determines how soonI will get well again.

5

2. No matter what I do, if I am going to get sick, I'll get sick. 3

3. Having regular contact with my physician is the best way for meavoid illness.

3

4. Most things that affect my health happen to me by accident. 2

5. Whenever I don't feel well, I should consult a medically trainedprofessional.

4

6. I am in control of my health. 5

7. My family has a lot to do with my becoming sick or staying healthy.

3

8. When I get sick, I am to blame. 4

9. Luck plays a big part in determining how soon I will recover from an illness.

1

10. Health professionals control my health. 2

11. My good health is largely a matter of good fortune. 1

12. The main thing that affects my health is what I myself do. 5

1 2 3 4 5 6


13. If I take care of myself, I can avoid illness. 5

14. When I recover from illness, it's usually because other peoplehave been taking good care of me. (doctor, nurses, family)

2

15. No matter what I do, I'm likely to get sick. 2

16. If it's meant to be, I will stay healthy. 1

17. If I take the right actions, I can stay healthy. 5

18. Regarding my health, I can only do what my doctor tellsme to do.

2

These three subscales, and the items included in each, are as follows:

Internal Items: 1, 6, 8, 12, 13, 17----------results = 29x2=58 Chance Items: 2, 4, 9, 11, 15, 16---------results = 10x2=20 Powerful-others items: 3, 5, 7, 10, 14, 18---results = 16x2=32

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.

The higher the scores on the chance subscale and powerful-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


Appendix B

Health Promotion Plan

Name: Holley WestStart Date: 6/1/11Outcome Evaluation: 6/20/11

Start Weight: 258 End Weight: 243 Target Weight: 175

Strengths: Time management, finances, no physical restrictions, motivated, dedicated

Weaknesses/Barriers: Lack esteem in self-worth and enjoyment of exercise and food monitoring, stress, dramatic relief of emotional experiences

Diet: Balanced with no added sugar. Food pyramid guidelines followed with only fruits or vegetables (no butter or sugar added) after 7 p.m., smaller portions with focus on intake vs. expenditure of calories. Do not purchase sweets.

Exercise: At least one hour a day of moderate exercise with at least 2 days of aerobic/cardio with pulse rate goal of 140-160 bpm.

Activities for Exercise: Participate in daughter’s softball practicesGardening, yard workWalkingX-Box Kinect games with sonContinuous housework (vacuuming, laundry, sweeping, mopping)Set-ups, push-ups, wall-sits daily with increase of one every other day until reach middle range of the standards according to assessment of muscular strength and endurance.Wall sit = 38 secondsSet-ups = 64Push-ups = 34Stressors: work, family, school, non-compliance of others, overcommitting, dirty house, dog’s actionsStress management:To manage stress the following techniques will be implemented according to the Mayo Clinic’s website page providing strategies for stress management (2010).

-Make time for self- 10-20 minutes of quiet reflection while concentrating on slow breathing-Exercise regularly- at least 30 minutes a day.-Eat smart- diet rich in fruits, vegetables, and whole grains-Resist overcommitting- it is ok to say “no”-Be prepared- anticipate challenges, do not procrastinate


-Banish negative thoughts- put positive spin on negative thoughts helps you manage stressful situations-Keep laughing- releases endorphins

Evaluation: Increase of set-ups, push-ups, and wall sits by two. Stress management techniques used and were effective. Diet followed and exercise plan followed 12/20 days with cardio 6/20 days with HR of 140-160 bpm. If high stress or feelings of depression or low self-esteem occur immediate exercise must be implemented to decrease stress and increase feelings of success and self-efficacy.

Proposed changes: Consistent exercise schedule with incorporation of set-ups, push-ups, and wall sits. Continue to have rest day and stress management techniques. Do not overcommit. Continue to find exercises enjoyed and increase feelings of self-worth through positive thinking and less self-criticism. Daily re-enforcement to self that past abuse does not have control now by looking in mirror and speaking to self. If failure to comply with plan occurs will identify barrier leading to failure and revise plan then start again until maintenance stage of change has been reached.

JuneSun Mon Tue Wed Thu Fri Sat

-Time-quantity-Set-ups-Push-ups-Wall sit

1930a30min26,1011 secLow

2Work 12 hours, daughter game, home lateMod

32pm2 hours26,10,10 secYard-work 10 hoursLow

4Daughter game, movies, dinnerMod-Low

-Stress

5Work 18 hours1pm30 min27,1111 secHigh-low

6Work 12 hours5 pm1.5 hoursSoftball PracticeHigh-Low0, 0, 0

7Work-14hoursGame0, 0, 0High

81130a5hoursHousework, yard work0, 0, 0Mod

9Work-12hours7pm1hourKinectLow

10Work 10 hoursErrandsNo exerciseHigh

11Daughter game5pm1hourKinectLow

12Work-16hours330pm30min27, 11, 11 secMod

13Work-16hours8pm1 hourKinect28, 12, 12secHigh-mod

1410am3 hoursYard work Game28, 11, 11secLow

155pm2 hoursSoftball practice29, 12, 12secLow

16Work-12hoursNo exerciseHIGH

17Work-9hours5pm2 hoursSoftballLow

18GameFamily timeNo exerciseLow


19Work-16hoursNo exerciseMod

20Work-16hoursNo exerciseHigh-low

21 22 23 24 25


Appendix C

EXERCISE JOURNAL

Time of Day

Type of Exercise Amount of Time Spent

Aerobic / Non-Aerobic

Alone/With SomeoneFeelings

2pm Yard work 2 hours non Alone/calm satisfied

5pm Softball 1.5 hours both Team/happy

1130a Housework->yard work 5 hours non Alone/tired/

drained7pm Kinect game 1 hour Aerobic With

son/happy

STRESS MANAGEMENT JOURNAL

Time of Day

Stressor What I Did About It Effectiveness of Action

1130pm Daughter woke me up to ask to go stay night

somewhere-> argued

Told her no and tried to go back to

sleep

Poor-could not sleep

1pm Mother giving ultimatums

Tried to resolve issue and talk it over, when no

compromise let it go for today

Moderate-lingering anxiety

5pm Spouse and daughter arguing

Family meeting Good-issues resolved

9am Accident on way to work led to late start

Called patients and explained tardiness due to first responder and would be a little late

then took 10 minutes to think in silence

Good-patients were understanding and thanked author for

calling/victims stable, mind cleared and

focused8am Dog dug up garden and

two flower bedsYelled a lot and

tried to do damage control

Poor-frustrated initially and then

exercised for 30minutes and took a 15 minute time out in

quiet room-> calm


and collected

Appendix D

Assessment of Muscular Strength and Endurance

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

High

Men

90 sec

Women

68 sec

Men

77 sec

Women

57 sec

Men

66 sec

Women

49 sec

Men

56 sec

Women

42 sec

Average 60 sec 45 sec 51 sec 38 sec 43 sec 33 sec 37 sec 27 sec

Below


Low <30 sec

<23 sec <26 sec

<19 sec (11 sec)

<22 sec

<17 sec < 19 sec

<14 sec

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 30 years 40 years 50 years

High

Men

25 sec

Women

19 sec

Men

21 sec

Women

16 sec

Men

18 sec

Women

13 sec

Men

15 sec

Women

12 sec



(12 sec)

Below

Average 5 sec 4.3 sec 4.3 sec

3.2 sec 3.6 sec 2.7 sec 3.1 sec

2.3 sec

Low <5 sec <4.3 sec <4.3 sec

<3.2 sec <3.6 sec

<2.7 sec < 3.1 sec

<2.3 sec


The Push Up [upper body]To test your upper body, do as many complete, correct push-ups as you can. Women may do a

modified version.

The U.S. Army’s standards for Push-Ups and Sit ups are as follows:

WOMEN’S PT TEST

MINIMUM/MAXIMUM STANDARDS

Age Push-Ups

Min/Max

Set-Ups

Min/Max

2 mi. Run

Min/Max

17-21 19/42 53/78 18:54/15:36

22-26 17/46 50/80 19;36/15:36

27-31 17/50 (10) 45/82 (26)

20:30/15:58 (not done)

32-36 15/45 42/76 21:42/15:54

37-41 13/49 38/76 22:42/17:00

42-46 12/37 32/72 23:42/17:24

47-51 10/34 30/66 24:00/17:36

52-56 09/31 28/66 24:24/19:00


Appendix E

Self-Esteem QuestionnaireThe 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, then write down the number that corresponds to the word you have chosen.1 = Never 2 = Rarely 3 = Seldom 4 = Occasionally 5 = Always

___5__ 1. If someone hurts my feelings I tell them so.

___5__ 2. People value my opinions.

__5___ 3. I feel intelligent.

___3__ 4. Nothing is too good for me.

___4__ 5. With few exceptions, I am satisfied with myself the way I am.

__4___ 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.

___4__ 7. I enjoy meeting and talking with new people.

___4__ 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.

__4__ 11. I am content with the way I live my life.

___4_ 12. I like the place where I live.

_4___ 13. I enjoy my work.

__3__ 14. People generally admire me.

___5_ 15. I am a kind person.

__5__ 16. I enjoy getting up in the morning.

___5_ 17. I can take care of myself.

___5_ 18. Other people need me.

__2__ 19. I enjoy watching what I eat, getting proper exercise, and taking good care of myself.

__4__ 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.

Total=133

How to Evaluate Your Score150 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 self-esteem. 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.

119 - 90 Points You are in the low-normal range. Try to raise your self-esteem; you have the confidence to do it yourself.

89 - 60 Points Your self-esteem is low. You can build it up yourself if you are willing to work hard.

59 - 30 Points You may need help to raise your self-confidence level.


Personal Health Assessment and Health Promotion Plan Grading

STUDENT NAME____Holley West________________________________

DATE___06/20/2011__________SITE______FSU – Nursing 310_______

ASSESSMENT CRITERIA POINTSPOSSIBLE

POINTS EARNED

Assessment tools appropriate for the area to be assessed 10Rationale provided and sourced for tools in first area to be

assessed10

Rationale provided and sourced for “Readiness for Change” instrument

5

Analysis is appropriate, reflects critical thinking. 10Wellness diagnosis/diagnoses congruent with assessment

findings.10

Health plan follows principles of health promotion. Includes all stages of change

10

Implementation is appropriate for time period. Is documented with reliable evidence.

10

Outcome measures are recorded and appropriate. 5Long-term outcomes are included. 5

APA: Title page, Running Head, Margins, Headers with page numbers, Use of headings

10

Grammatical: Spelling, Typing, Grammar, Neatness, Sentence Structure & Paragraphing.

5

Critical Thinking using elements of reasoning and Intellectual Standards. (Not to be used as outline points)

10

TOTAL POINTS 100COMMENTS:

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