Directions: Submit Sections 1 - 4 and (REFERENCE-13 )

Obesity has become a significant concern in the healthcare system, and diet is the key contributing factor to obesity. Therefore, a healthy diet should be the primary requirement in reducing weight and improving overall health. The health life knowledge gap among patients and limited nursing education programs contribute to this condition. Nurses should work closely with patients to provide healthcare education that will help patients improve their nutrition habits and identify the challenges the patients face in maintaining a healthy diet. An education training program for nurses in outpatient settings regarding obesity and diet will allow nurses to advance their knowledge on the risk factors of obesity, the health conditions associated with obesity, and how to manage obesity (Mitchell et al. 2018).

Acknowledgment

[Inclusion of an acknowledgment page is optional. The student should seek guidance from the project director on whether to include the page in the final project manuscript. If it is included, it is numbered as page Roman numeral v, each paragraph is indented five spaces (1/2”), and the text is double-spaced. This page is placed just after the Abstract and just before the Table of Contents.]

Table of Contents

Chapter

I. PROJECT INTRODUCTION ..................................................................... 1

Statement of Purpose ................................................................................... 2

Theoretical Framework ............................................................................... 2

Initial Review of the Literature ................................................................... 9

Significance and Justification ...................................................................... 9

Project Objectives ..................................................................................... 11

Definition of Terms ................................................................................... 11

Project Limitations .................................................................................... 14

Project Development Plan ......................................................................... 15

Plan for Protection of Human Subjects ..................................................... 16

Plan for Project Evaluation........................................................................ 17

Summary ................................................................................................... 17

II. REVIEW OF LITERATURE .................................................................... 19

Summary ................................................................................................... 30

III. PROJECT DEVELOPMENT PLAN. ....................................................... 39

Project Setting and Population… .............................................................. 39

Content Expert Participants ....................................................................... 39 Data Collection Methods ........................................................................... 39

Project Tools ............................................................................................. 40

The Protection of Human Subjects ............................................................... 41

Summary ................................................................................................... 42

IV. PROJECT EVALUATION, IMPLICATIONS, AND FUTURE RECOMMENDATIONS

…………………………………………..... 44

Project Evaluation ..................................................................................... 44

Implications for Future Practice ................................................................ 46

Future Recommendations .......................................................................... 48

Summary ................................................................................................... 50

References ................................................................................................. 51

Appendices ................................................................................................ 60

7

List of Appendices

Appendix

A D’Youville Patricia H. Garman School of Nursing Full Approval Letter

…………………….…. 60

B Letter of Intent ................................................................................................. 62

C Evaluation Tool ............................................................................................... 64

D Product ............................................................................................................ 66

E Survey tool results in graph……………………………………………….

Chapter I

The age of fast food and instant gratification brought about by the growth of technology has affected the general population in many ways In America, obesity is becoming problematic with a prevalence estimate of 41% leading to risk in severity of diseases (Kalligeros et al., 2020). As a result, there is a need for nursing practice to take accountability in developing a relationship with collaborative patient care. Obesity can be a lifestyle disease. Therefore, all stakeholder participation must be considered a need to look at the four-metaparadigm perspectives in caregiving using a foundational basis in a theoretical framework. For this study, interpersonal relations in nursing theory will be discussed.

ADD MORE STUFF HERE……..

Statement of Purpose

Should start like this ----Dorothea E. Orem's (1991) self-care deficit nursing theory is utilized as the theoretical framework for the development of this project. A brief overview of the theory is presented as well as a discussion regarding how the theory was utilized to guide the development of the project. In addition, Orem's (1991) theoretical definitions for nursing’s four metaparadigm concepts (nursing, health, person, and environment) as well as the Project Author’s operational definitions for nursing’s four metaparadigm concepts will be presented.

( source, year, page). The theoretical framework section should be a minimum of 3 pages in length. This section should be presented as follows:

Not like this- please change the format- Many theories support the understanding of nursing concepts and thus form the basis and foundational elements of patient care. Interpersonal Relations in Nursing Theory is a theory formulated by a female nurse, Hildegard Peplau. Within the theory, Peplau describes the metaparadigm concept of nursing within the four sequential interpersonal relationships. They are foundational elements as orientation, identification, exploitation, and resolution defined within nurse, health, patient, and environments aspects of nursing healthcare provision. "As such, the theory emphasizes the importance of crosscutting issues and their effect on nursing care and patient wellness (Peplau, 2004)." (“The purpose of this project is to develop an educational training ...”)

It thus facilitates better planning to understand the complexities of issues underlying the patient's conditions, which would hinder getting well. In recognition of this, this paper aims to bring to attention the definition of the metaparadigm concept of patient care within this theory by looking at its significance and interpersonal relationship as contextualization in patient care. At the same time, the paper will look at its actual application as employed in modern nursing care as a mainstream cultural competency component. The deliberate look of this theory within this aspect will facilitate a conclusion on the modern-day emphasis and necessitated patient-centered model of care.

As a mother of nursing psychiatry, Peplau (2004) describes interpersonal relations as a conditional aspect that includes first the interaction of the nurse and patient. She points out that this is attained when understanding each patient's condition is an experience that allows for improving nursing care (Peplau, 2004, p. x). Therefore, the focus in the definition of the theory begins with grasping the nurse and patient metaparadigm concepts as the interaction between patient and nurse makes the relationship personal. Similarly, considerable insights thus point out that the patient care process is personalized in a way that responsibility is both technical and emotional. Peplau (2004) explains that effective patient outcome delivery comes from trust in diagnostics and thus acceptance of health as an essential metaparadigm aspect. The theory focuses on the development of the relationship between a nurse and a patient in a way that emphasizes trust and collaboration. It is therefore a good fit for my topic as the relationship between outpatient and the nurse must be founded on trust so that information can be shared in comfort and with trusted support to be present. Based on the fact that obesity and issues surrounding obesity could often bleed into self-esteem and mental health, it is essential that a support system is developed well, a foundation that this theoretical framework supports.

Thus, nursing can be defined based on culture and concrete work (Peplau, 2004, p. 5). Thus, it promotes health through appropriate methods and illness prevention by recognizing triggers for all patients (A second theory from a discipline outside of nursing such as sociology, education, or management non-nursing theorist may also be used. you cannot use this; must be Peplua only-Riekert, 2021). Therefore, the nurse can only facilitate treatment and not make a diagnosis; hence, the critical aspect is ensuring that the environment is conducive and that communication in the relationship with patients is constant. This means the nurse favors patients' understanding of their issues by explaining the problem and the treatment plan. This includes a preventive measure to ensure informed decision-making is enhanced and thus a partnership that, in essence, is therapeutic.

According to Okdie et al., (2018), communicative action between in the digital age between nurse and patient is a bold navigation of interpersonal relationships. The increase ins tendency of maintenance takes a newer approach as infromation overload can be present due to media. This could be advantageous for outpatient care but also the opposite is true. As such, following Peplau’s underpinning of patient care, nursing is the implementation of need-based healthcare delivery through the respectable promotion of perception and prevention of escalation of illness (Peplau, 2004, p. 9). Therefore, it can be said that the operational definition of nursing is ensuring that patient needs are met adequately and suitably hence unique to the patient. With that, a different relationship develops between nurse and patient.

In recognition, a person is operationally defined as an entity with individual preconceptions and mutual understanding of the nature of a medical issue and collaborates towards a productive solution. Therefore, this contextualizes the environment as conditions that allow for human processes that facilitate tendencies supportive of positive development to attain health (Peplau, 2004, p. 12). By this definition, health can operationally be defined as a symbolic future positive goal that is attained after effective healthcare hence instrumental for the person moving in the forward direction of wellbeing (Peplau, 2004, p. 13).

Initial Review of the Literature

Use this format- even though I did over my self- A review of nursing and health related literature was (the initial review of literature has been conducted so in this section, you can write in past tense) conducted to explore (project area of interest) using the following keywords both singularly and in multiple combinations: , , . Databases searched, limited to the years to , included AMED, Alt Health Watch, CINAHL Plus with Full Text, and EBSCO. The search was limited to the years to to ensure that current evidence-based literature was reviewed and summarized for the purpose of this project. A summary of the review of the literature is presented.

Dynamics of Outpatient Care

Critical to the discussion on nursing care for outpatient with obesity is the fact that it is a lifestyle disease. As such, the focus of care is strongly on management and fostering better and healthy weight maintenance (Kalligeros et al., 2020). It thus does not necessarily focus on age but understands that eagerness is also a risk factor in getting comorbidities associated with being overweight. Kalligeros et al. (2020) study point out that the exploration of the association between obesity and chronic diseases is something that should be understood. This is because there is a direct relation between the severity of the outcomes that are seen in intensive care units and admission rates. Using analysis of a retrospective cohort with 103 patients, the research found out that of the patients that are admitted to the hospital history of heart disease is a direct result of obesity. Therefore, there is a recommendation that vigilance should be given to the treatment of patients with obesity alluding to necessitated prevention of escalation when faced with other conditions (Kalligeros et al., 2020).

Role of Nursing

This is supported by Rezaei, et al. (2022) study that points out the fact that high morbidity rates are caused by poor health maintenance. The fact that the high number of obesities creates a risk factor in the population that carries it points to a need to emphasize the training for this. As such, recognition of physician effort in collaboration with outpatient by sensitization on environmental awareness is essential (Walia et al., 2022). This includes considering that proper evaluation starts by recognizing the appropriateness of the environment for supporting weight management. Achieving and maintaining weight loss or gain requires that there is physician-patient collaboration in a way that can be facilitated by nurses providing proper information. Support and motivation also are determined by letting a carefully defined plan be identified together with the patient to understand the health outcomes expected. This is the work of the nurse as it allows for the recognition of strategy of control for each different patient.

According to Rezaei et al. (2022), the combination of aspects such as cost of health, care expenditures, and hospitalization risks are some of the reasons that can be used in motivating outpatients to adhere to their plan of losing weight. Advanced heart diseases are often caused by obesity and lack of maintenance and within that determinant of failure lies in early handling of the issue. Health literacy is an important part of the nursing fraternity to impart to the patients as it allows for the opportunity to understand the implication of obesity in the long run. This is especially true because by the time medication is involved, the progression will be higher risk associated and thus significant mortality risk. Health literacy as part of outpatient training will not only provide the necessary support for proper weight loss but also in maintaining it while allowing room for recognition of mental health too. This caters to the grasping of the incorporation of strategies that align outcomes centered on the totality of patient care within the six sigma of quality improvement in healthcare delivery (Alexander et al., 2021).

Alexander et al., (2021) research look into the focus of promotion of healthcare delivery as a focal point in preventive care. The research looks at transitioning patients from outpatient to inpatient and within this provides insight on what to avoid and what is necessary to promote better care. Right from the start the research allows room for relativity in practices that promotes and optimizes safety, and within those points to the relevance of patient individual circumstance. While the paper stick to giving valuable information on the standard procedure, it contributes to the discussion on the improvement of health by nurses in general. It thus applies that, for all patients, recognition of the value in situation background assessment facilitates the improvement of health outcomes. The improvement starts with a reduction in risks hence understanding beneficial outcomes accurately first (Alexander et al., 2021).

Recognition of Potential Barriers

Categorically, there is also a need to recognize the degree of the impact of cultural competency within nursing care (Chae & Park, 2019). With outpatients, there is a risk of exposure to external biases and pressure that may result in declining health whenever they leave a session. Therefore, the value must be provided in educating the patient on the potential risks that they face within their environment. This can only be achieved through collaboration. It is important for the perspective of the community and support system that is there for the patient to be observed by the patient (Ogbolu et al., 2018). Therefore, sharing with the nurse is a natural step of goal setting that allows an informed understanding of the underlying implication of the stereotypes and norms of expectation (Halvorson et al., 2019). This will help in focusing on reducing the risk of “temptation” of hindrances to the improvement of patient health in a way that respects both them and their communities. Planning is an essential tool that both the nurse and the patient should recognize early on.

It is especially important when it comes to the management of unvoiced expectations of a patient in a way that recognized their efforts and their input towards change. Being a lifestyle disease, obesity management requires self-discipline at a higher level than normal and within that recognition of a result that is gradual (Ma et al. 2019). The fact that it cannot be cured by medication and results are not immediate is a cause of concern that should be understood by both nurse and patient. This requires patience and a lens where competent management can only be weighed by the small milestones.

Similarly, when optimization of management is a need in the treatment strategy for a patient with obesity, especially outpatients, there is a need for longitudinal consideration of the comprehensiveness of management aspects. According to Seger (2019), a complication of obesity as a chronic illness is as sophisticated as any other issue. As such, there is an intensity level that should be employed with preventive controls active in line with the responsibility set. This allows for desired treatment to be the main goal rather than the desired end product such as specific weight. It removes eth tension without negating the implication of the process and thus optimizes input by the small measures that can be seen regularly. A pathophysiological approach is necessary for an all-hands-on methodology hence simplicity that is specific to the patient in question rather than a generalization (Block et al., 2020). And this is too short,, please add more; you have to compare and contrast the studies, you have to use all the 20 reference here, and must use transitional phrases.

Find one study from the literature review that support the subject and Start like this Findings from the initial literature review reveal that a lack of knowledge exists in nursing and patient care practice regarding…

Then you talk about the article you chosen; you have included the sentence based on how the literature support the project purpose.

WriteWhy do you feel this article is a good choice for supporting your proposed project?

WE STOP HERE FOR NOW….

6. Instructions for the Project Objectives section -SINGLE SPACE AND INDENTED

The Project Objectives section follows the Significance and Justification section and is written in the present tense. Project objectives identify at least 3 specific outcomes (aims/goals) describing what the student hopes to accomplish by carrying out the project. All educational projects require students to 1) conduct a review of the literature exploring the background of the project topic/problem/issue; 2) develop and/or create a product such as an educational program, workshop, PowerPoint, or video, an interview schedule, questionnaire or survey, a professional brochure or pamphlet, or a handbook or resource guide; and 3) have the project product evaluated/reviewed by a panel of content experts who have extensive knowledge and expertise in the project area of focus.

Project Objectives

The objectives of this project are to:

1. Conduct an extensive review of the literature exploring (project area of interest) using the following keywords both singularly and in multiple combinations: , , . Databases searched, limited to the years to , will include AMED, Alt Health Watch, CINAHL Plus with Full Text, and EBSCO Host;

SINGLE SPACE FOR THIS SECTION

The objectives of this project are to:

1. Conduct an extensive review of the literature exploring discharge planning using the following keywords both singularly and in multiple combinations: discharge planning, nursing, research, study, elderly, discharge preparedness, community nursing, and selfcare. Databases searched, limited to the years 2017 and 2022, will include, CINAHL Plus with Full Text, EBSCO, Google Scholar and the D'Youville library to loan articles through interlibrary loan;

2. Develop a resource guide; and

3. Have a panel of five content experts with extensive knowledge and expertise in discharge planning evaluate and critique the project for clarity, readability, applicability, quality, organization, and evidence-based clinical relevance.

References

Kalligeros, M., Shehadeh, F., Mylona, E. K., Benitez, G., Beckwith, C. G., Chan, P. A., & Mylonakis, E. (2020). Association of obesity with disease severity among patients with coronavirus disease 2019.  Obesity,  28(7), 1200-1204.

Peplau, H. (2004). Interpersonal Relations in Nursing: A Conceptual Frame of Reference for Psychodynamic Nursing. Springer Publishing.

Riekert, S. A. (2021). The Home Healthcare Nurse: A Concept Analysis.  Home Healthcare Now,  39(4), 194-202.

Ogbolu, Y., Scrandis, D. A., & Fitzpatrick, G. (2018). Barriers and facilitators of care for diverse patients: Nurse leader perspectives and nurse manager implications.  Journal of nursing management,  26(1), 3-10.

Okdie, B. M., & Ewoldsen, D. R. (2018). To boldly go where no relationship has gone before: Commentary on interpersonal relationships in the digital age.  The Journal of social psychology,  158(4), 508-513.

Ma, J., Rosas, L. G., Lv, N., Xiao, L., Snowden, M. B., Venditti, E. M., ... & Lavori, P. W. (2019). Effect of integrated behavioral weight loss treatment and problem-solving therapy on body mass index and depressive symptoms among patients with obesity and depression: the RAINBOW randomized clinical trial.  Jama,  321(9), 869-879.

Seger, J. C. (2019). Optimizing Outcomes in Outpatient Obesity Management. In  Quality in Obesity Treatment (pp. 221-234). Springer, Cham.

Halvorson, E. E., Curley, T., Wright, M., & Skelton, J. A. (2019). Weight bias in pediatric inpatient care.  Academic pediatrics,  19(7), 780-786.

Chae, D., & Park, Y. (2019). Organisational cultural competence needed to care for foreign patients: A focus on nursing management.  Journal of Nursing Management,  27(1), 197-206.

Wood, D. A., Mahmud, E., Thourani, V. H., Sathananthan, J., Virani, A., Poppas, A., ... & Krahn, A. D. (2020). Safe reintroduction of cardiovascular services during the COVID-19 pandemic: from the North American Society Leadership.  Journal of the American College of Cardiology,  75(25), 3177-3183.