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Running head: PROMOTING HEALTH AND WELLNESS 1

Promoting Health and Wellness

Deanna Warnock

Nurs-310

FSU Fall 2010

PROMOTING HEALTH AND WELLNESS 2

Abstract

There are several factors that play a part in health and wellness. This paper discusses the risks

associated with being overweight and the benefits of diet and exercise. The tools used to assess

the authors risk factors for disease related to obesity are the body mass index, waist

circumference, and the health belief survey. A food journal also assisted the author to assess the

types of foods that need to be eliminated from her diet to assist in weight loss. The tools used

were found at the Centers for Disease Control, National Heart Lung and Blood Institute, United

States Department of Agriculture, and the American Heart Association website. There are

several models and theories that discuss the promotion of healthy behavior. The model used in

this paper is the transtheoretical model found in Health Promotion in Nursing Practice by Pender

et al., has five stages a person goes through in regard to changing a behavior that is threatening

their health or adopting a health promoting behavior. The Nursing Diagnosis Reference Manual

by Sparks & Taylor was used for a nursing wellness diagnosis that would promote weight loss.

A plan was formulated, executed and still in progress toward the long term goals of this nursing

diagnosis. In conclusion it was found that the author was obese, according to the tools used and

would significantly benefit from weight loss.


Health is a complex term that has different meanings to different individuals. One’s

definition of health can also change as they age. What a person thinks of as being healthy when

they are 20 years old can be very different than what they think of as healthy at age 80. The

definition of healthy can also change though out time with advancements in our scientific

knowledge and technological development. For example, the view of health was different in the

early 1900’s than it is today. Health today has taken on a holistic view. Health is not just

considered to be the absence of illness. Rather, it includes physical, emotional and social health

as well. The concept of holistic health is supported by the World Health Organization who

developed a definition in 1974 that “…emphasized wholeness and the positive qualities of

health: Health is a state of complete physical, mental, and social well-being and not merely the

absence of disease and infirmity” (Pender et al., 2006, p. 17). Each of these elements is

intertwined with one another as part of the health spectrum.

After using the assessment tools provided in the course packet, I have decided that I

would benefit the most from weight loss. Being overweight puts me at risk for several health

issues such as type 2 diabetes, hypertension, dyslipidemia, and cardiovascular problems.

According to the health belief survey, I place a lot of importance on personal control over my

own health. I do believe that the choices and decisions I make are a key factor in my wellbeing.

For weight loss I am the one who is responsible to make an exercise and diet plan. I am solely

responsible for sticking to my plan to lose weight. According to the health belief survey I also

think that others, such as health care providers, play a part in my health. I believe that it is

important that people see their primary care provider to discuss their health and illness. I also

think that it is important to consult a primary care provider before starting or stopping a

treatment. In regards to weight loss it is important for me to talk with my doctor before I start an


exercise program to make sure that I am able to participate in strenuous activity. It is necessary

for me to discuss a diet and exercise plan with my doctor.

I chose to use a food journal for five days, the BMI calculator, and waist circumference to

assess my health in terms of being overweight. A food journal will give me a clear picture of the

types of foods I am eating. I chose not to count calories because I have tried in the past and have

not followed through with it. Instead I just wrote down what I ate and at what time I ate it.

Working 12 hour midnight shifts have really thrown off my eating habits. I also kept track of

how often I exercised. To determine a healthy weight I chose to use the BMI calculator because

I feel that this is a sound tool to give me a healthy weight range. I also chose to use my waist

measurement to assess my risk for disease. According to The National Heart Lung and Blood

Institute (2010), if a woman’s waist is greater than thirty five inches in circumference it increases

her risk for type 2 diabetes, hypertension and cardiovascular disease. The National Heart Lung

and Blood Institute provide a useful chart the combines body mass index with waist

circumference to indicate how at risk a person is for developing a disease.

My height is 5’4” and my current weight is 190.2 lbs. According the calculator on the

Centers for Disease Control, my body mass index (BMI) is 32.61. This classifies me as obese.

A healthy BMI range for my weight is 18.5-24.9. To reach a healthy BMI I need to lose at least

45 lbs, which would put my weight around 145 lbs. My current body measurements are: bust

43”, waist 41”, hips 47”, right thigh 27.5”, and right upper arm 12.5”. My waist is 6 inches

larger in circumference then what is recommended. According to The National Heart Lung and

Blood Institute (2010), I am at a very high risk for developing a disease associated with being

overweight due to my BMI and my waist circumference. After reviewing my food journal I see

that there are a few changes I could make to help me lose weight. The first one is that I need to


cut back on sugar. I eat a lot of snacks and drink too much soda. My diet also consists of too

many high fat foods. I rarely ate fresh fruits or vegetables, and I did not exercise once during the

five days I was gathering information. Outside of work I live a fairly sedentary lifestyle. After

putting all of the findings together, I could greatly increase my wellbeing by losing weight.

The transtheroretical model is model used to judge a person’s readiness to stop an

unhealthy behavior or begin a healthy one (Pender et al., 2006, p. 42). This model consists of

five stages: precontemplation, contemplation, planning or preparation, action, and maintenance.

Each of these stages measures a person’s progression towards stopping a behavior that threatens

ones health or adopting a healthier behavior. If a person is in the precontemplation stage of this

model they are not even thinking about changing a behavior. During the contemplation stage the

person is thinking about making a change in the next six months. Planning or preparation takes

place when the person is seriously thinking about changing a behavior, either stopping a negative

one or adopting a positive one, in the next month. During this phase the person also has made

small changes toward their goal. When in the action phase, the person has been actively engaged

in the new behavior for more than six months. Finally, the maintenance phase takes place six

months after the person has started a new behavior or stopped an old behavior. Once in the

maintenance phase, the person is stable and continues the desired behavior continually over time.

According to the transtheroretical model, I am in the Planning or preparation phase. I

have been seriously thinking about losing weight for more than a month. I have tried a few

programs but have not had much success. I have been in the planning and preparations phase of

the transtheroretical model for about 6 years now. My daughter was born in 2003. Prior to her

birth I was in the precontemplation stage of weight loss. Losing weight never even crossed my

mind. When my daughter was about 6 months old, I entered into the precontemplation phase. I


wanted to lose weight but was not seriously thinking about it. I am not sure when I entered the

planning phase but I do know I have been stuck in it for some time now. My next step is to enter

into the action phase by implementing the plan I developed in this paper and continuing it for at

least the next six months. Once I have been committed to my plan for more than six months I

will enter into the maintenance phase. At this point I should see how well my plan has worked

and modify it if needed.

The nursing diagnosis that best suits me for weight loss is: Health Seeking Behaviors

related to absence of aerobic exercise as a risk factor for coronary artery disease (Sparks &

Taylor, 2008, p. 842). Exercise is a very important factor in a diet and weight loss plan. My

short term goals for this plan are to establish as workout routine, determine target heart rate,

discuss the benefits of exercise related to the decrease risk for coronary artery disease, and

implement diet modification related to reducing the risk for coronary artery disease. Long term

goals for this plan include maintaining 30-45 minutes of cardiovascular exercise 3 times a week,

reducing my weight by 10%, re-evaluating body measurements on a monthly basis, reducing

sugar and fat from my diet, and increasing the amount of fruits and vegetables I consume.

There are many benefits to weight loss. Reducing my weight by 10% can decrease my

chances of developing high blood pressure, elevated cholesterol and possibly a cerebrovascular

accident (National Heart Blood and Lung Institute, 2010). I have taken my current weight and

measurements so that I can see my progress as I begin to modify my lifestyle. The plan for my

workout routine is to power walk 3 times a week to start with. After establishing a

cardiovascular workout routine I will later incorporate some strength training into my workout

routine as well. According to Sparks and Taylor (2008, p.842), my target heart rate while

working out should be between 105 and 149. My plan for exercise it to start out slow and work


my way toward my target work out time. I have tried to incorporate too many things into my

exercise routine in the past and have failed to continue over a long period of time. I want to

make changes that are going to last a lifetime, not just a quick fix to lose weight. I plan to make

an appointment with my primary care provider to discuss my plan with him. I would like to have

my blood pressure and cholesterol checked at this time as well. It is important to me to see what

my base line is in order to track my progress in my wellness plan. After one month of walking

three times a week, I plan to visit my local YMCA and discuss strength exercises with a personal

trainer so that I can incorporate strength training into my workout routine. At this time I am also

going to look into exercise classes offered by my local YMCA. To keep from getting bored in

my work out routine I will ask about classes such as yoga and dance.

I have already started to implement a few of my interventions. I have discussed the

benefits of weight loss and I have written down current weight and measurements. I plan to

monitor my weight on a weekly basis to measure my progress. I will reassess my body

measurements in one month. I have also started to become more conscious about making healthy

decisions when it comes to food. Instead of eating high fat, sugary snacks, I have been trying to

eat low fat snacks. For instance, when I was craving something sweet, I have been eating fruit

instead of a cupcake or cookies. I have also attempted to modify my daily routine to incorporate

more physical activity. At work I have been taking the stairs, not the elevator.

There are many benefits to weight loss. I can significantly reduce my chances of disease,

heart problems and many other health related problems by simply losing 10% of my current

weigth. I think that all too often I get caught up in work, school, and caring for my family and I

forget to care about myself. Taking preventative measures, such as weight loss, can greatly

improve my well being in mind, body and soul.


References

Aim for a healthy weight. (2010, September 22). Retrieved September 20, 2010, from National

Heart Lung and Blood Institute website: http://www.nhlbi.nih.gov/ health/ public/ heart/

obesity/ lose_wt/

Body composition tests. (2010). Retrieved September 21, 2010, from American Heart

Association website: http://www.americanheart.org/ presenter.jhtml?identifier=4489

Mypyramid.gov steps to a healthier you. (n.d.). Retrieved September 19, 2010, from United

States Department of Agriculture website: http://www.mypyramid.gov/

Overweight and obesity. (n.d.). Retrieved September 22, 2010, from Centers for Disease Control

website: http://www.cdc.gov/ obesity/

Pender, N., Murdaugh, C., and Parsons, M. A. (2006) Health promotion in nursing practice.

Upper Saddle River, New Jersey: Pearson Education, Inc.

Sparks, S. & Taylor, C. (2008). Nursing diagnosis reference manual. Lippincott, Williams &

Wilkins.


Appendix A


Appendix B

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