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Situation:

Mr. Smith, a 65-year-old man with a history of diabetes and hypertension, is admitted to the hospital with chest pain and shortness of breath. He is anxious and concerned about his health.

Background:

Mr. Smith has had multiple hospitalisations in the past for heart-related issues. He is currently taking medication for his diabetes and hypertension but has difficulty managing his diet and exercise regimen. He also has a history of smoking and has struggled to quit.

Assessment:

Mr. Smith is experiencing symptoms of a possible heart attack and is at high risk for complications due to his medical history. His anxiety and lack of adherence to his treatment plan are contributing factors to his current health status.

Recommendation:

To provide patient-centred care for Mr. Smith, it is important to address his physical symptoms as well as his emotional and psychological needs. The care team should work together to develop a comprehensive treatment plan that includes close monitoring of his cardiac status, medication management, nutritional counselling, and support for smoking cessation.

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Be ready to present what you have discussed to the wider group.

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Be ready to present what you have discussed to the wider group.

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Do not log off just switch off camera and mute yourself. Enjoy!

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Enjoy your lunch. Please do not log off, mute your mikes and switch off your cameras.

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Lesson Aim
To gain knowledge and understanding of Patient assessment by discussing the principles and techniques for patient assessment.

Outcomes

1. Students will develop a working knowledge and
understanding of what constitutes effective
communication.

2. Understand the importance of patient assessment.

3. Students will know how to perform a patient assessment
in a systematic way.
4.  Document findings from the case scenario.

5.  Students will hand over the care they have delivered
using an SBAR tool.

6. Participate in peer discussions and self-reflection.

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In your group discuss what your have seen in practice. Decided on a patient you can collectively plan a care for. Work as a team and be ready to feedback.

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Situation: A 16-year-old patient has been brought into the emergency department after a car accident.

Background: The patient is a 16-year-old female who was the passenger in a car collision. She is conscious but complaining of severe abdominal pain and difficulty breathing.

Assessment: The patient has visible bruising and swelling on her abdomen and chest. She is experiencing shortness of breath and has a rapid heart rate.

Recommendation: Notify the trauma team for immediate assessment and possible imaging studies to evaluate for internal injuries. Consider pain management and emotional support for the patient during the assessment and treatment process.

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nihms712389.pdf

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The Health Belief Model helps predict public attitudes and actions around health issues. It is used implicitly or explicitly in many areas of medicine. The Health Belief Model assumes that people are largely rational in their thoughts and actions, and will take the best health-supporting action if they:

Feel that it is possible to address a negative health issue.

Have a positive expectation that taking the proposed action will be effective in addressing the issue.

Believe they are able to take the proposed action.

There are a number of sub-variables in the belief that a health-related action is valuable. These provide both factors to enable measurement of attitudes and also routes to persuading people to act in healthy ways.

Perceived susceptibility: This is the person's assessment of the likelihood of them getting the given condition. If, for example, they are younger and believe that the condition afflicts mainly older people, then they will be less likely to act to protect themselves. Education may correct misunderstandings about susceptibility, which is often grossly incorrect, typically due either to social folklore or individual denial.

Perceived severity: This is the person's view of how severely they would be impacted if they were affected by the condition. The most severe health impact is death, followed by disablement and pain. Duration is also important: a short, sharp pain may be preferable to a long ache. As with susceptibility, education can be specific about severity, including probabilities of survival and disablement.

Perceived benefits: This is the belief in how effective the advised medicine or action will be in mitigating the problems of the condition considered in severity. You can give a positive message about the benefits of taking specific actions, including accurate information about how effective medicines are at reducing susceptibility and severity. The message may also subtly include instructions in taking the recommended actions and indicate the timescales involved before benefits appear.

Perceived barriers: This is the person's perceptions of the difficulties they would encounter in taking the proposed actions, including both physical and psychological barriers. These may be addressed through various means of support, from financial through reassurance and assistance.

Cues to action: These are the prompts that are needed to move the person into the state where they are ready to take the prescribed action. These can include practical ways of nudging them, such as marked calendars, email reminders, how-to charts and so on.

Self-efficacy: This is the person's confidence and belief in their own ability to take the given action. If they think 'I cannot do this' or even 'I would find it difficult' then they may well shy away from action, even if they believe the action is essential or otherwise worthwhile. This self-belief can be bolstered with encouragement, hand-holding, training and other support.
THE MODEL
The model assumes the following causal linkages between constructs and other factors.

Likelihood of behaviour change is affected solely by the perceived threat from the disease.

Perceived threat is impacted by:

Perceived susceptibility and seriousness

Cues to action, including information and symptoms

General factors such as age, sex, race, personality and intelligence affect all of:

Perceived threat

Perceived susceptibility and seriousness

Perception of benefits vs. barriers

This model simply describes a combination of a personal risk analysis, followed by an evaluation of the proposed solution and its use. As a general method of addressing beliefs it offers a useful structure for a wider range of belief-change situations.

When seeking to change a person's belief, we first need to understand the model beneath the belief and then address the sub-elements. The Health Belief Model provides a useful framework that may either provide direct help or may inspire similar thinking.

Want to know more how this model can be used effectively in your daily dealings with patients and colleagues?

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The Health Belief Model & Understanding Patient Behaviour

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The Health Belief Model helps predict patient behaviour and actions around health issues. It is used implicitly or explicitly in many areas of medicine.

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In your group discuss what your have seen in practice. Decided on a patient you can collectively plan a care for. Work as a team and be ready to feedback.

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Situation: A 30-year-old female mental health patient in the psychiatric unit is exhibiting signs of distress and agitation.

Background: The patient was admitted two days ago with a diagnosis of bipolar disorder and a history of attempted suicide.

Assessment: The patient is pacing back and forth, talking rapidly, and refusing to engage in any activities or conversations with staff or fellow patients.

Recommendation: Notify the mental health team for immediate assessment and intervention to address the patient's escalating agitation and potential risk of harm to herself or others. Offer a calm and supportive presence while waiting for assistance from the mental health team.

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Using the health belief model to assess racial/ethnic disparities in cancer-related behaviors in an NCI-designated comprehensive cancer center catchment area | Cancer Causes & Control (springer.com)

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In your group discuss what your have seen in practice. Decided on a patient you can collectively plan a care for. Work as a team and be ready to feedback.

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Please prepare a 10 minute feedback presentation.

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Color awareness: A must for patient assessment (myamericannurse.com)

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Consider the components of the health belief models in regard to smoking. Please use use your group feedback.

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In your group discuss what your have seen in practice. Decided on a patient you can collectively plan a care for. Work as a team and be ready to feedback.

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Let's talk about person-centred care | Caring with Confidence: The Code in Action | NMC

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Please prepare a 10 minute feedback presentation.

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Identifying AEFI in diverse skin colour - The Melbourne Vaccine Education Centre (MVEC) (mcri.edu.au)

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Emotional Portrait of a Woman 45 Years Old, Empty Beer Bottles, Sad Look. Concept: Female Alcoholism, 

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Sarah Age: 45

Occupation: Office manager

Marital status: Married with two children (ages 10 and 12)

Education: Bachelor's degree in business administration

Health status: Hypertension, high cholesterol, and mild depression

Drinking habits: Heavy drinking (4-5 drinks per day, 5-6 days a week) for the past 10 years. She started drinking as a way to cope with the stress of her job and the challenges of her personal life. Over time, her drinking has become more frequent and excessive, and she has started to experience negative consequences as a result. She has had several blackouts, has been in trouble at work, and has lost touch with her friends and family.

Apply the components of the Health Belief Model to Sarah's situation:

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Blood Pressure: Korotkoff Sounds | Ausmed Explains...

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Teen adjusts to life with Type 1 diabetes

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Emma, a 13-year-old, has just been diagnosed with type 1 diabetes. She's been feeling tired and thirsty lately, and her parents have been taking her to the doctor for regular check-ups. Today, Emma's doctor told her that she has diabetes and will need to take insulin injections every day.

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Understanding the audio-visual skill of blood pressure reading

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Understanding the audio-visual skill of blood pressure reading

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LearningTools: Blood Pressure Basics - Audio-Visual Coordination Skills

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Blood Pressure: Korotkoff Sounds | Ausmed Explains...

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This is a comprehensive A to E assessment

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Nursing students ABCDE assessment framework

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Feedback From Verona Applying the components of the Health Belief Model to Mary's situation:

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Feedback From Verona Applying the components of the Health Belief Model to Mary's situation:

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Mary is a 45-year-old woman who has been smoking for the past 20 years. She has recently been experiencing frequent coughing, shortness of breath, and chest discomfort. Concerned about her health, Mary schedules an appointment with her primary care physician to discuss her symptoms.

During the appointment, Mary's doctor explained to her the potential health risks associated with smoking, including an increased risk of lung cancer, heart disease, and respiratory problems. The doctor mentions that quitting smoking can significantly reduce these risks and improve Mary's overall health.

- Perceived susceptibility: Mary acknowledges that she is at risk of developing serious health conditions due to her smoking habit and the symptoms she is experiencing, such as coughing and chest discomfort.

- Perceived severity: Mary understands the serious consequences of continuing to smoke, including the potential development of lung cancer or heart disease.

- Perceived benefits: Mary believes that quitting smoking will reduce her risk of developing smoking-related illnesses and improve her respiratory health. She sees the benefits of quitting in terms of feeling better, having more energy, and improving her overall quality of life.

- Perceived barriers: Mary is aware of the challenges of quitting smoking, such as nicotine dependence, withdrawal symptoms, and potential social triggers when around friends who smoke.

- Cues to action: Mary's recent symptoms serve as a cue for her to take action and address her smoking habit. Also, the advice and recommendations from her physician to quit smoking provide further motivation.

- Self-efficacy: Mary expresses confidence in her ability to quit smoking, especially with the support of her healthcare provider, friends, and family members. She believes that she can successfully overcome the challenges of quitting.

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Feedback From Verona

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Feedback from Verona Using Roper, Tierney and Logan Health Behaviours

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Feedback from Verona Using Roper, Tierney and Logan Health Behaviours

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Scenario:

Mrs. Johnson, a 55-year-old woman with type 2 diabetes, has been prescribed metformin by her primary care physician to manage her blood sugar levels. However, she has been having trouble adhering to the medication regimen, which involves taking the medication twice daily.

Biological Component:

Mrs. Johnson's body chemistry is affected by her lack of medication adherence. Her blood sugar levels are consistently higher than target range, which increases her risk of developing complications such as kidney disease and vision loss.

Psychological Component:

Mrs. Johnson experiences some anxiety and fear about taking medication, which makes her hesitant to take it regularly. She worries about potential side effects and feels overwhelmed by the complexity of managing her diabetes.

Sociocultural Component:

Mrs. Johnson is a single mother who works part-time and has limited financial resources. She struggles to afford the cost to pay for her medication and often has to choose between paying for medication or other essential expenses. Her cultural background also influences her beliefs about health and illness, as she was raised to prioritise self-reliance and avoid relying on medical professionals.

Environmental Component:

Mrs. Johnson's environment contributes to her lack of adherence by making it difficult for her to remember to take her medication. She lives alone and often forgets to take her medication because she doesn't have reminders or support from others.

Political-economic Component:

Mrs. Johnson's lack of health insurance coverage and limited financial resources make it difficult for her to afford the medication she needs. She has had to adjust her budget to accommodate the cost, which has led to feelings of financial stress and anxiety.

Using the Health Belief Model, we can analyse how these components influence Mrs. Johnson's decision-making process regarding medication adherence:

Perceived Susceptibility:

Mrs. Johnson is aware of the risks associated with poor blood sugar control, but she may not perceive herself as susceptible to these risks due to her fear of medication side effects.

Perceived Severity:

Mrs. Johnson recognises the severity of the potential consequences of poor blood sugar control, but her fear of side effects may lead her to underestimate the severity.

Perceived Benefits:

Mrs. Johnson understands that taking her medication will help manage her blood sugar levels, but she may not perceive the benefits as significant enough to overcome her fears and challenges.

Perceived Barriers:

Mrs. Johnson faces multiple barriers to adherence, including financial constraints, environmental factors (e.g., forgetting), and psychological factors (e.g., fear of side effects).

Cues to Action:

The health care provider's reminder calls and patient education can serve as cues to action, encouraging Mrs. Johnson to take her medication regularly.

By analysing these components using the Health Belief Model, healthcare providers can develop targeted interventions to address Mrs. Johnson's concerns and improve her medication adherence. This may include providing education on medication safety, helping with costs or directing to financial support, and implementing environmental reminders or support systems.

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Roper, Tierney and Logan Health behaviour.PNG