discussion w3 635

DQ-1

Chronic obstructive pulmonary disease (COPD) is a lung disease characterized by progressive pulmonary symptoms and is a serious health problem that constitutes the fourth cause of mortality worldwide. It is typified by changes in the airway caused by inflammatory reactions to inhaled irritants and pollutants (Bull, 2018, p. 671-672). The conditions are often linked with smoking, systemic inflammation, airflow limitation, and aging.

An essential feature of the primary prevention of COPD is the need to identify those at greatest risk for or in the earliest stages of COPD so that risk-mitigating interventions are possible. This includes identifying specific COPD subgroups, such as individuals with chronic bronchitis, those with α1-antitrypsin deficiency, or early radiographic changes with normal spirometry. Additionally, providing education about the health hazard of smoking and the benefits of cessation is necessary (Recio Iglesias, Díez-Manglano, López García, Almagro, & Varela Aguilar, 2020).

In secondary prevention, performing spirometry is the cornerstone of COPD diagnosis, and appropriate testing may reduce the number of undetected cases and diagnostic misclassification. A study conducted by Soumagne, Guillien, Roux, Laplante, Botebol, Laurent, Roche, Dalphin, & Degano (2020) to test the reliability of spirometry performed in primary health setting when compared to pulmonary function laboratory setting revealed that both are equally efficient and produced a reliable result.

According to Bull (2018), pulmonary rehabilitation as a part of tertiary prevention for COPD has been well established to alleviate the signs and symptoms of various pulmonary conditions and optimize functional capacity, improve exercise tolerance and quality of life.

Patients with chronic obstructive pulmonary disease (COPD) are particularly vulnerable to influenza, with evidence for increased incidence and infection severity. In this patient group, annual influenza inactivated or recombinant influenza vaccine can be given from age 19 and beyond the age of 65 years while attenuated live influenza may be given annually from age 19 up to 49 years old only. Pneumococcal conjugate vaccine (PCV 13) is recommended for all adults 65 years and older while the pneumococcal polysaccharide vaccine (PPSV23, Pneumovax) is indicated for patients age 19-64 years-old with chronic health conditions (Bull, 2018; Centers for Disease Control and Prevention [CDC], 2020)

References

Bull, A. (2018). Chronic obstructive pulmonary disease. In A. Hollier (Ed.). Clinical Guidelines in Primary Care (3rd ed., pp. 671-672). Lafayette, LA: Advanced Practice Education Associates, Inc.

CDC (2020). Recommended adult immunization schedule for ages 19 years or older, United States, 2020. Retrieved from https://www.cdc.gov/vaccines/schedules/hcp/imz/adult.html#vacc-adult

Recio Iglesias J, Díez-Manglano J, López García F, Díaz Peromingo JA, Almagro P, & Varela Aguilar JM. (2020). Management of the COPD Patient with Comorbidities: An Experts Recommendation Document. International Journal of COPD, ume 15, 1015–1037.

Soumagne, T., Guillien, A., Roux, P., Laplante, J.-J., Botebol, M., Laurent, L., Roche, N., Dalphin, J.-C., & Degano, B. (2020). Quantitative and qualitative evaluation of spirometry for COPD screening in general practice. Respiratory Medicine and Research, 77, 31–36. https://doi-org.lopes.idm.oclc.org/10.1016/j.resmer.2019.07.004

Q-2

Behavior change is the mechanism through which individual patients can make lifestyle adjustments to address factors directly impacting their health and wellness. For behavior change to be effective it has to be clearly communicated resulting to inspired as well as motivated patients through utilizing a change process. The last component provides the patients with new knowledge and ways to access additional services according to Laverack, (2017, p. 1). Behavioral change interventions must be accepted and embraced by the individual patients because a forced change will be resisted. When the patients are motivated and empowered they will actively participate in the behavioral change process to reduce the impact of chronic illness discussed by Laverack, (2017, p. 2). An example is educating a patient, newly diagnosed with hypertension on the benefits of a DASH diet for reducing the risk factors of cardiovascular disease.

Education is comprised of critical thinking, reasoning, emotional intelligence, general knowledge and communication skills comprise the patient’s educational knowledge base. Education directly affects the patient’s perception of overall health through the ability of personal control that incorporates healthy behavioral choices in maintaining overall health and wellness stated by Hahn & Truman, (2015, p. 657). The level of formal education is a key determine in the individual patient’s current and future health status researched by Hahn & Truman, (2015, p. 657).

References

Hahn, R. A., & Truman, B. (May 19, 2015). Education improves public health and promotes health equity. International Journal Health Services, 45(4), 657-678. https://doi.org/10.1177/0020731415585986

Laverack, G. (October 17, 2017). The challenge of behavior change and health promotion, 8(25), 1-4. Retrieved from https://webcache.googleusercontent.com/search?q=cache:C63reVofdsQJ:https://www.mdpi.com/2078-1547/8/2/25/pdf+&cd=17&hl=en&ct=clnk&gl=us

Q-3

The health belief model (HBM) explains health motivation and the prediction of health behaviors (Bruno, Biesecker. 2020). When an individual has perceived susceptibility, severity, benefits of behavior change, they tend to identify the health risks for them which make them cues for practice preventive and maintenance health behavior and improve their self-efficacy by seeking advice, acquire information and educating themselves and equip themselves with positive behaviors to maintain the health and prevent disease. Behavior change is a complex, timely, and cognitive process and once the patient understands the above-mentioned variables, the change takes place. The behavior role changes for prevention and disease maintenance were mainly changes in lifestyles, attitude towards the treatment and medications, health maintenance activities, and taking preventive steps towards disease exacerbation. A smoking asthma patient may decide to quit smoking once he perceived the benefits such as reducing asthma attacks, reduction of lung cell destruction and improve exercise tolerance and reducing future complications such as lung cancer and damages to the other body systems and overall cost of the patient in reducing hospital admissions, loss of workdays and suffering days and spending more quality time with family and friends will all the incentives for the patient.

The role of education through a patient-centered collaborative motivational interview approach and motivational interactions which are spoken and non-spoken communications of health professionals with patients may promote positive interactions enhance patient satisfaction with healthcare (McNeil, Addicks, & Randall, 2017), making positive changes and well-being. Education through even text messages was capable of producing positive change in preventive health behaviors and maintained once the intervention stops (Armanasco, Miller, Fjeldsoe, & Marshall, 2017). Health facilitators which focus on enjoyment, benefits of healthy aging, social support, clear messages, integration of behaviors into lifestyle with identified barriers with a tailored educational intervention can inform and promote health behavior in mid-life (Kelly, Martin, Kuhn, Cowan, Brayne, & Lafortune, 2016). Improving self-esteem and confidence through motivational interaction can be a motivator for behavior changes such as stop smoking, drinking alcohol, and taking illicit drugs and weight control will eventually help the patient to perceive the short and long-term effects on patient health and their well-being.

Reference.

Armanasco, A. A., Miller, Y. D., Fjeldsoe, B. S., & Marshall, A. L. (2017). Preventive health behavior change text message interventions: a meta-analysis. American Journal of Preventive Medicine, 52(3), 391-402. Retrieved from  https://www.sciencedirect.com/science/article/abs/pii/S0749379716305864

Bruno, C.S., Biesecker. B. (2020). Introduction to the principles of health behavior change. In Coviello (3rd Eds.), Health promotion and disease prevention in clinical practice (pp.161-163). Philadelphia: Wolters Kluwer.

McNeil, D. W., Addicks, S. H., & Randall, C. L. (2017). Motivational interviewing and motivational interactions for health behavior change and maintenance. Retrieved from  https://www.oxfordhandbooks.com/view/10.1093/oxfordhb/9780199935291.001.0001/oxfordhb-9780199935291-e-21

Kelly, S., Martin, S., Kuhn, I., Cowan, A., Brayne, C., & Lafortune, L. (2016). Barriers and facilitators to the uptake and maintenance of healthy behaviors by people at mid-life: a rapid systematic review. PloS one, 11(1), e0145074. Retrieved from  https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0145074