It was bittersweet to see this summer’s service learning
project come to an end. Time spent with the consumers and staff at Piper Place
has been an enlightening and encouraging experience. The group learned
important information about disease processes and complications along with
preventative techniques. The health promotion study was a great opportunity for
the consumers to keep track of their own health factors. Although our
implementations did not yield any statistically significant results, the
targeted population, community, and I learned the importance of health
promotion. More extensive study into individual cases and specific
interventions is essential to improving health promotion. We learned that
education is a needed priority within healthcare, especially for groups with
learning disabilities or who are more prone to disease. I hope to see more effective
interventions aimed at successful health promotion in future research.
Mental Motivation: Health Promotion in the Psychiatric Community
Sunday, July 29, 2012
Saturday, July 21, 2012
Data Collection
My Last Day at Piper Place
Classes at Piper Place went very well. The consumers appreciated
each session of new information and participated in every planned activity. The
next step in the research study involved collecting post-implementation data. I
manually measured blood pressures using a stethoscope and blood pressure cuff
and weighed the consumers with an electronic scale. I collected hip and waist
measurements and also calculated BMI and heart rate. Data also included a
survey that each participant completed. A copy of it is pictured below:
Health Assessment Questionnaire
Name: ____________________________________________________
Age: ____________
Sex: _____________
1. How do you describe your health in general?
_____ Excellent
___ _ Good
_____ Fair
_____ Poor
2. During a typical day does your health limit you in moderate activities,
such as moving a table, using a vacuum cleaner, bowling, or playing golf?
_____ Yes, very limited
____ Yes, limited a little
__ No, not limited at all
3. During a typical day does your health limit you in climbing several
flights of stairs
_____ Yes, very limited
_____ Yes, limited a little
_____ No, not limited at all
4. Have you had any problems completing your regular activities during
the past month due to your physical health?
_____ Yes
_____ No
5. Were you limited in the kind of work or other activities as a
result of your physical health during the past month?
_____ Yes
_____ No
6. How often do you engage in aerobic exercise (walk or ride a bicyle
> 30 minutes, run or jog >20 minutes)?
_____ Not At All
_____ At least one time per week
_____ At least two times per week
_____ At least three times per week
_____ More than three times per week
7. During the past month have you accomplished less than you would
like due to emotional problems such as feeling anxious or depressed?
_____ Yes
_____ No
8. During the past month have you failed to complete activities as carefully
as usual due to emotional problems such as feeling anxious or depressed?
_____ Yes
_____ No
9. During the past month, how much did pain interfere with your normal
activities?
_____ Not At All
_____ Somewhat
_____ Moderately
_____ Much of the time
_____ All of the time
10. How often have you felt calm and peaceful during the past month?
_____ Not At All
_____ Somewhat
_____ Moderate amount of time
_____ Much of the time
_____ All of the time
11. How often did you have a lot of energy during the past month?
_____ Not At All
_____ Somewhat
_____ Moderate amount of time
_____ Much of the time
_____ All of the time
12. How often have you felt downhearted and blue during the past month?
_____ Not At All
_____ Somewhat
_____ Moderate amount of time
_____ Much of the time
_____ All of the time
13. During the past month, how much of the time has your physical or
emotional health interfered with your social activities (like visiting with
friends or relatives)?
_____ Not At All
_____ Somewhat
_____ Moderate amount of time
_____ Much of the time
_____ All of the time
14. How often do you feel that your life situation is putting you under
too much stress?
_____ Always
_____ Most of the time
_____ Sometimes
_____ Rarely
_____Never
15. How often do you have someone to talk to when you are feeling lonely,
depressed, angry, or in need of help?
_____ Always
_____ Most of the time
_____ Sometimes
16. Do you currently smoke cigarettes, cigars, pipes or other tobacco?
_____ Every day
_____ Most days
_____ Some days
_____ Never smoked
_____ I quit
17. Do you currently use smokeless tobacco (e.g., dip snuff)?
_____ Every day
_____ Most days
_____ Some days
_____ Rarely
_____ Used, but quit
_____ Never used
18.How often do you eat high-fat food?
_____ Every day
_____ Most days
_____ Some days
_____ Rarely
19.How often do you have fruits or leafy vegetables?
_____ Every day
_____ Most days
_____ Some days
_____ Rarely
20.Do you have your regular meals on time?
_____ Every day
___ _ Most days
_____ Some days
_____ Rarely
21. Have any of these family members been diagnosed with type II diabetes
or heart disease
(Circle all that apply)
_____ Mother
_____ Father
_____ Siblings (brother and/or sisters)
_____ Grandparents
22. How long ago did you see a physician or other healthcare provider?
_____ Within the past 6 months
_____ Within the past year
_____ Between 1 and 3 years ago
_____ Longer than 3 years
23. When was your last physical exam?
_____ Within the past 6 months
_____ Within the past year
_____ Between 1 and 3 years ago
_____ Longer than 3 years
24. When did you last see a dentist?
_____ Within the past 6 months
__ _ Within the past year
_____ Between 1 and 3 years ago
_____ Longer than 3 years
25. Did you receive a flu vaccine this past year?
_____ YES
_____ NO
It is
definitely more of a challenge to work with a group with mental disorders. Many
people would talk while getting blood pressure checked which caused me to have
to re-measure and switch arms. Excessive clothing oftentimes became a barrier.
My most difficult encounter existed with the surveys. Some consumers were illiterate while others
could not focus on the questions as a result of cognitive impairments. In most
cases, I administered the questionnaires orally. There will still others who
did not understand what I was asking, and I reframed the questions to be easier
to comprehend. Although I confronted a few problems during data collection at
Piper Place, I thoroughly enjoyed my experience. I relished in the opportunity to
reach out to this population who really needs more focused attention. I am
ecstatic to be involved in research that will add to the modest amount of
literature about health promotion interventions for people with psychiatric
disorders. After organizing all the data for Gary Milligan, he is now inputting
all the information for analysis. As a result of the six promotion courses, we
hope that the groups’ vital signs improve as well as their overall perception
of good health. Mr. Milligan plans to write about his findings at Piper Place,
and he hopes to publish in significant periodicals such as the Journal of
Psychosocial Nursing and Health Services. I will keep you updated about the results!
Thursday, July 19, 2012
Day 6- You Are What You Eat!
For the last course at Piper Place, we taught the consumers
about healthy diet and nutrition. Alabama has the highest rates of diabetes in
the South due to bad eating habits and lack of exercise. We first discussed the
benefits of eating right such as lowered blood pressure, cholesterol, and depression.
Next we broke down the components of food. Calories are the units of measurement
that indicate the energy value of food, and too many calories turn into fat. Carbohydrates
are another energy component effecting diet.
Decisions…Decisions…The
food choices we make have the greatest effect on obesity and other health
factors. However, it can be difficult for the mentally ill community to make nutritious
decisions. Many consumers do not have jobs or family assistance which contributes
to low income. Nutritious foods generally cost more than unhealthy foods, so
the quick alternative is fast food. Cognitive impairments also prohibit this
population from driving, so they may be unable to go to the grocery store and
are forced to eat what is given in their boarding home. To combat these
barriers, we taught the group how to make better decisions in their own living
environments. Simple
preventative measures include exercise, eating smaller portions, and drinking
water. We should trade bad carbohydrates like Twinkies for good carbohydrates
such as vegetables. These floods slowly enter the bloodstream, while bad carbs overload
the body and quickly convert to fat. If we have to eat fast food, the grilled
option is a healthier choice.
Finally,
the consumers participated in an activity involving the U.S. government’s new
dietary guidelines. MyPlate
illustrates the five food groups that are the building blocks for a healthy
diet using a familiar image—a place setting for a meal. Each consumer
was given a plate that we divided into the 5 food groups. Using crayons and
colored pencils, the group drew different fruits, vegetables, grains, protein,
and dairy products on their plates. This activity was an effective teaching
tool. We were sure to help the consumers choose healthy foods for each plate
section. They could also take the plate home as a constant reminder.
Follow the link below to learn more about the new MyPlate Initiative
Wednesday, July 18, 2012
Day 5- Talking To Your Doctor
It
can be hard for some of us to communicate our symptoms and needs when we visit
the doctor. We may feel nervous and forget or fear the treatment and doctor’s
advice. These emotions may even affect our health or vital signs and is called “white
coat syndrome.” If this occurrence can happen to cognitively healthy people, I
am certain that the mentally ill community has the same difficulties with their
healthcare providers. For this reason, we discussed doctor communication at the
5th study course. A good relationship with your doctor can result in
better return care. We told the
consumers to stay involved in their care and ask questions about treatments and
medications. The main point of the class involved preparation for the doctor’s
visit. Due to cognitive impairments, the group needs to take extra steps to be
sure they are effectively communicating with their doctor. Psychiatric
disorders include a variety of symptoms and methods of care, so clients should provide
the necessary information. These
important tips can even help mentally stable people come better prepared for
their healthcare visit:
1.
Write down all the questions you’d like to ask.
2.
Make and bring a list of symptoms. You might
want to research your condition at the library or on the Internet.
3.
Bring a list of all the medicines you take.
4.
Arrive early
5.
Bring your medical records/insurance details.
6.
Bring someone with you. A companion also could
help you relax, remind you of questions you forgot to ask, and help you
remember what the doctor said.
Tuesday, July 17, 2012
Day 4- Exercise
I have
been an athlete since I could walk, so this topic was my favorite to teach. I
am passionate about physical fitness and knew this kind of enthusiasm was
necessary to connect with the consumers. The daily anxieties and hardships
regarding their mental conditions oftentimes places exercise at the bottom of
the list of priorities. Research shows, however, that physical activity is even
more beneficial to the psychiatric client. Exercise stimulates cognitive
function and improves mental capacity, mood, and energy. It also maintains a
healthy weight to combat the weight gain associated with many psychiatric
medications such as antipsychotics and antidepressants. The benefits of getting
active are widespread and include reducing disease related risk factors and
increasing immunity.
We also
taught the group some useful information about the types and different
components of exercise. Stretching is an important part of a workout, and it is
also essential to vary the activity to include muscular endurance and aerobic conditioning.
Many mentally ill consumers think it’s impossible to obtain physical fitness,
so we offered some great tips to get started:
1.
30-60 minutes of moderate-vigorous exercise most
days of the week is recommended.
2.
Talk to your doctor about what you can and can’t
do based on your diagnosis.
3.
Choose activities you enjoy. I like to listen to
my favorite music while I run.
4.
Recruit a partner for support and encouragement.
You will get into conversations and 30 minutes of walking will fly by.
5.
Set realistic goals and listen to your body.
To reiterate a positive attitude
toward exercise, I finished the class with a little physical activity of my
own. I played some always-loved Michael Jackson and got the consumers up and on
their feet! Together we completed body squats, arm circles, calf raises, and
high knees. The group enjoyed the movements and were glad to find out they were
capable of physical activity.
Friday, July 13, 2012
Day 3- Diabetes
The 411 on diabetes was the topic of the third course at
Piper Place. We discussed the anatomy and physiology behind the disease,
beginning with the function of insulin. We cleared up some misunderstandings that
diabetes is not contagious like most illnesses and is not directly caused by
eating too much sugar. The power point presentation was the greatest help
because the consumers needed a visual depiction of these hard-to-grasp
concepts. Big words such as hyperglycemia were easier to understand when
assisted by brightly colored pictures. I quickly learned that these types of
aids must be considered and utilized when educating the mentally ill client.
Below is an example of a slide used to effectively teach the
warning signs of hypoglycemia:
In
addition to the signs and treatment regarding high and low blood sugar, we extensively
discussed the complications of diabetes and what the consumers should be on the
lookout for if they have this illness. When left untreated or improperly
managed, diabetes can lead to stroke, heart disease, and hypertension. The
kidneys are also affected by high blood sugar. Neuropathy can be caused by diabetes, so
patients should take special care of their eyes and feet. The consumers learned
a lot about this prevalent illness. We hoped to help those with the disease
take better care of themselves as well as prevent people from developing
diabetes.
Thursday, July 12, 2012
Day 2- Stress Management
The
next session at Piper Place focused on a topic that almost all consumers
encounter when coping with and managing their psychiatric disorders. Stress is
common to many mentally stable people, so I couldn’t imagine what challenges
the seriously mentally ill community must face. That exact point began the
stress management course—“Everyone has stress, and you’re not alone.” We then
educated the consumers about the physiological aspects of stress, informing
them that stress is not always negative. Exercise and puzzle games are some
good examples of stress. The group mentioned that bad examples of stress in
their lives include job loss, financial woes, and coping with the reactions of
other people and family.
In order
to keep the consumers thinking and engaged, we ask lots of questions. This
dialogue also allows us to see what the group already knows as well as correct
any misconceptions they may have. The participants were very aware of the
physical signs of stress such as increased heart rate, perspiration, aches, and
pains. A harder concept to grasp was the difference between external and
internal stress. An illness or relationship difficulty classify as external
stressors while personal beliefs and guilt are causes of internal stress. Coping
mechanisms ended the day’s class with great examples from us as well as the
consumers. Talking and breathing techniques were top choices for stress
management, and some people even preferred to go to a secluded place for a good
scream. The group was surprised to find out we had a great activity planned to
help relieve their tension and anxiety—DIY stress balls! We assisted the consumers
with stuffing Play-Doh into balloons. This simple hands-on experiment was a hit!
(not to mention, messy) The activity was an excellent ending to a discussion
that for this group, was quite straining.
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