week 3,2

Health Behavior Chang Client Journal: Physical Exercise

First Draft

Client Introduction

Mary is a 42 years old lady living in Kentucky. Mary was born and brought up in Bowling Green , and she lives with her family. Mary is married, and she is a mother of two daughters, both of who are schooling. Mary has diabetes, and she constantly suffers from myocardial infarction. Mary was diagnosed with diabetes at the age of thirty years and has been over the years under medication. At the age of thirty-five years, Mary started developing signs of myocardial infarction. She has suffered the disease severally over the years, with almost one incidence occurring every year. Mary does not have been taking physical exercises seriously. According to her, other than walking, she does not take any other form of physical exercise. She also confirms that since she developed diabetes, she only walks a few times a week and for a very short distance just to get her necessities. She thus does not take physical exercises. This program will introduce weekly physical exercise as a way of protecting her from regular myocardial infarction cases. The weekly exercises will help strengthen the immunity of the body and prevent the buildup of cholesterol in the arteries. Different forms of physical exercises will be undertaken. These include walking, jogging, and rope skipping. These are common forms of physical exercises that do not require heavy financial investments to be achieved. As a result, Mary will be able to maintain her health without having to spend a lot of money preparing for the physical exercises.

The goal of this program is to protect Mary from her regular clinic visits due to myocardial infarction. Myocardial infarction is a dangerous disease that easily leads to fatalities, especially among people who have other underlying conditions like diabetes. Mary is thus required physical exercises to reduce the instances of myocardial infarction and keep her safe from the dangers of sudden death. The program's objective is to reduce instances of myocardial infarction by two within a period of seven months by introducing her to weekly physical exercise, which will be undertaken three times a week for one hour per session. Achieving this objective will involve the contribution of both Mary and a training assistant. Since Mary has not been exercising, it may be hard for her to exercise on her own. She will thus need someone to ensure that she does not over-exercise or under-exercise. The training assistant will guide Mary through her exercises until she is in a position to exercise on her own comfort.

SWOT Analysis

Mary has several strengths that will be key in her exercise plan and in attaining the set goal and objective. Mary has a lot of support from her family. Mary's husband encourages her every day to take up the physical exercises. Mary is also motivated by her urge to live a healthy life. There are opportunities that will make it easy to achieve the set goal. The environment is friendly for one to take a walk in the morning, with the weather being friendly. Thus, Mary can take advantage of it. Additionally, Mary can create friends with the large number of people who take a morning walk in her area of residence. There are, however, weaknesses that Mary has. Her diabetic condition may not enable her to exercise frequently. Additionally, Mary has a hurt finger which may make it hard for her to exercise freely for some period of time. The main threats that Mary's faces include weather changes.

Week 1 Progress Report

The first week was meant to acquaint Mary to the program to be launched on her. According to Mary, she was ready to undertake physical exercises if they will help her recover from the continuous cases of myocardial infarction which seriously affect her wellbeing. Since she has not been exercising, the introduction week was not be vigorous. Mary was made to walk for between thirty minutes to one hour on Monday, Wednesday and Saturday. This was meant to ensure that the body starts getting used for more vigorous exercises. This was well achieved as per the plan. On the first day, Mary was only able to walk for thirty minutes and got tired. She could not continue the walk. However, on the third exercise day, that is, on Saturday, she was able to cover a whole hour while walking which was a show of improvement. The time was thus used to measure her progress. Comment by Brewer, Kristen: This is a wide range. I would narrow it down and aim for a set time. Like, 30 mins three times a week. Or 45 mins 3 times a week. Not a range. There is a big difference between walking for 30 mins and walking for 60 mins. Start with 30 and work your way gradually up from there.

This week, Affective-Reflective Theory of physical inactivity and exercise was applied on Mary. The Affective-Reflective Theory of physical inactivity and exercise makes an assumption that having a stimulus like a friend’s reminder that you were to exercise triggers an automatic association and results into an automatic affective valuation of exercise (Brand & Ekkekakis, 2018). This defines the importance of motivation to exercise and having an exercise partner or assistant. Affective valuation is key in exercising as it serves as the basics for a controlled reflective evaluation (Brand & Ekkekakis, 2018). This theory was effectively applied on Mary. Every evening prior to the exercise day, she was reminded of the exercise the following morning. Additionally, she was also called in the morning by the training assistant to remind her of the walk. The training assistant also took the walk with her every morning as a way of giving her motivation. Comment by Brewer, Kristen: You should be using theories we cover in class. Review the syllabus and focus on how you can integrate those theories into this activity.

The client is very happy with the exercise sessions. She says that she has been missing important experience by not taking the physical exercises and this makes her much ready to exercise in the future She has however encountered some barriers. She says that her legs muscles when she goes back to the house after the walk. However, to avoid this, the assistant helps her with gentle stretches and muscle massage after the exercise. The main goal for next week is to increase the speed of walking and walk at a faster pace thus covering a longer distance. Comment by Brewer, Kristen: This is an incomplete sentence. What about her legs? Are they sore?

Week 2 Progress Report

The main goals this week was to increase the speed of walking and use a faster pace. This was achieved by jogging Mary. She wokeup every morning to take the morning jog with the training assistant who made sure that she only did it to the limit required as a starter. The jogging was done three time a week like in the first week the jog time also increased, moving from ten minutes to thirty minutes between Monday and Saturday. She jogged on Monday, Wednesday and Saturday in the morning before undertaking any other activity. The results of her activities was measured by time. The time she managed to jog was recorded every morning to follow up on improvements or failures made. Comment by Brewer, Kristen: I like the graphs! Try and also include a way for use to see the change over time. That is a more effective way of showing progress over time.

Just as in week 1, Affective-Reflective Theory of physical inactivity and exercise was applied. Mary was woken up by an alarm every morning which she set before sleeping. To ensure that she was up, the training assistant also called her to motivate her for the run. The two acted as stimuli. According to the Affective-Reflective Theory of physical inactivity and exercise, the stimuli motivates the client to take up the exercise positively and to overcome most of the setbacks (Brand & Ekkekakis, 2018). The training assistant also jogged with Mary to motivate her further and also monitor her progress in case of any challenges. This made Mary feel very safe as she exercised. The client is very positive about the progress of the exercises this far. She says she looks forward to every morning of exercise and she takes it very positively. This far, the only challenge experienced from week one was the muscle pain after exercise which with is reducing with the help of the training assistant. The goal of the third week is to introduce rope skipping which is a more intensive form of exercise for Mary. This will be incorporated to the weekly run. Comment by Brewer, Kristen: This is such a great cardio exercise and so many people overlook it.

Mary's Week 1 Exercise Period

Series 1 Monday Wednesday Saturday 20 45 60 Column1 Monday Wednesday Saturday Column2 Monday Wednesday Saturday

Mary's Week 2 Exercise Period

Series 1 Monday Wednesday Saturday 10 15 30 Series 2 Monday Wednesday Saturday Series 3 Monday Wednesday Saturday