Nursing Diagnosis
The assessment results demonstrate that the primary nursing diagnoses and problems that can be found in the selected aggregate include the risk for development and progression of various chronic conditions such as hypertension, diabetes, and cardiovascular disease. The factors that may contribute to the deterioration of health in the family members are mainly associated with their lifestyles, namely, imbalanced nutrition (less or more than body requirements), exposure to stress, insufficient physical activity, and so on.
Intervention Strategies
The intervention that may be suggested for the family is the home-based self-care intervention delivered by a healthcare provider. According to Dickson et al. (2013), “the primary goal of self-care including self-management interventions is to improve health and quality of life outcomes in patients with chronic conditions” (p. 2). Since the strategy comprises educational practices, it can potentially help increase the family members’ understanding of their health conditions and health risks. In this way, the designed program can motivate them to take responsibility for improvement. As Dickson et al. (2013) note, the increase in patients’ self-efficacy is a common outcome of such intervention plans. The five steps suggested by the MAP-IT strategy will be followed during the intervention.
Mobilize
The strategy for the selected aggregate will consist of education, behavioral modifications, and individualized care elements. Therefore, several health care providers and distinct information resources will be mobilized throughout the process. Consistently with the Chronic Care Model, the health care practitioners who will work with the family will provide them with the information about available community resources needed to support their decisions and behavioral change (Philis-Tsimikas & Gallo, 2014).
Assess
It is possible to say that allergy and high blood pressure, which were identified in some of the family members, are among the most common non-communicable health conditions and people often tend to underestimate the risks associated with them. It is known that hypertension largely contributes to various cardiovascular events including “cerebral vascular accidents, myocardial infarctions, congestive heart failure, peripheral vascular disease, and chronic renal failure” (Katende, Groves, & Becker, 2014, p. 1). At the same time, in some cases, dust mite allergy may induce the symptoms of asthma. Thus, both of these conditions are characterized by a significant disease burden leading to the deterioration of the quality of life and decrease in affected individuals’ productivity (Katende et al., 2014).
Plan
The vision of the desired change for the family is their sustainable engagement in healthy activities and a conscious approach towards their health. Therefore, during the education sessions with the family, the nurse will aim to intervene in their health beliefs, attitudes, and perceptions about these disorders. To do so, the curriculum will comprise various multimedia information sources needed to clarify information regarding disease-specific health risks and promote healthy behaviors. The behavioral intervention will mainly address the family’s dieting and physical activities. Van Buren and Tibbs (2014) state that “an increase in the intake of foods with saturated/trans fatty acids, cholesterol, salt, and sugar” is commonly associated with overweight, obesity, and the development of chronic conditions such as cardiovascular disease (p. 557). Thus, the health practitioner will promote fruit and vegetable intake within the aggregate and stimulate the participants to control the size of portions and decrease the intake of energy-dense products.
Researchers also observe that changes in the diet can be more effective when combined with the engagement in physical activity (Van Buren & Tibbs, 2014). Even moderate activity such as walking can have a favorable impact on hypertension and insulin resistance. Additionally, Van Buren and Tibbs (2014) state that strength training often results in the reduction of cardiovascular disease risks. Therefore, the nurse needs to show all possible benefits of behavioral changes to the participants. The referral to a dietitian and a physiotherapist can also be recommended because the specialists can help them choose appropriate nutrition and physical load regimes.
Implement and Track
The intervention program will last for eight weeks and combine such contact modes as in-person, in-group, and multimedia communication. The family will meet the specialists at least two times a week. Each new education session will start with the evaluation of the participants’ achievements, discussion of their perceptions of self-efficacy, and the overall effectiveness of the intervention. To sum up the results and analyze the efficiency of the suggested intervention plan, the objective data will be collected by using clinical assessment tools. The BMI and other final physiological indexes will be compared to those collected before the beginning of the intervention course.
Disaster Management Plan
Miami-Dade County, FL, is prone to such disasters like hurricanes and tornado outbreaks. To survive them and minimize possible traumas, an emergency preparedness plan is required. According to Gowan, Sloan, and Kirk (2015), disaster planning allows developing an adapting capacity by promoting the right attitudes and stimulating appropriate behaviors in individuals. First of all, to be prepared means to be aware of risks. With an increased risk awareness, the family can prepare all the necessary resources promptly and, in this way, ensure individual resilience and survival during the disaster recovery process.
The family disaster management plan will include the development of knowledge base, acquisition of skills, and acceptance of irreversible changes and adverse consequences of disasters. The hurricane season in Florida lasts from June until November, and the tornado outbreaks may happen from June until September and from February till April (State Emergency Response Team, 2016). All family members should know what events can take place during these seasons to better handle them. Therefore, they should be educated about various categories of hurricanes/tornadoes and possible damages they may cause. It may be useful to review the history of recent and most serious incidents that took place in the region. Like in all types of prevention endeavors, training, and education with the provision of visual and graphical information (e.g., videos and photographs) can lead to positive behavioral and attitudinal shifts. Therefore, it is important to instruct the participants about the potential negative consequences of the events to encourage them to adhere to basic disaster management guidelines.
The health practitioner will educate the family about the major precaution measures, namely the planning of evacuation routes and checking on all the necessary contacts in advance of these periods. He/she will also provide the list of required tornado and hurricane kit items which may include floatation devices, rain gear, blankets, torches, water supplies, and so on. The preparation of a survival kit is especially important in case the family will decide to stay at home during the forthcoming disasters.
During the in-group session involving all aggregate members, the intervention leader will design the list of all important documents and information sources. The nurse will additionally instruct the family members on the first aid principles and train them to perform some of the first aid measures. The list of the most critical first aid supplies will be provided to them as well. It may include drugs for the common cold, peroxide, antibacterial and antiseptic hand rubs, bandages, and so on. Lastly, the instructor should educate the family about the role of the psychological coping mechanisms in the disaster recovery process. Together they will generate some ideas about what activities, practices, and items can help reduce stress and bring comfort during the post-disaster phase.
Conclusion
During the development of the intervention and disaster management plans, the principles of family-centered care and community-based disease prevention were implemented. The expected measurable outcomes of the suggested programs include the increased knowledge of disease-specific problems, prevention methods, risk factors, clinical representation, symptoms, etc. By raising the family members’ awareness and developing a right attitude in them, the nurse will aim to stimulate healthy behaviors in the aggregate. In the long run, it may help to reduce the morbidity and mortality rates within the community.
References
Dickson, V. V., Nocella, J., Yoon, H.-W., Hammer, M., Melkus, G. D., & Chyun, D. (2013). Cardiovascular disease self-care interventions. Nursing Research and Practice, 2013(407608), 1-16.
Gowan, M. E., Sloan, J. A., & Kirk, R. C. (2015). Prepared for what? Addressing the disaster readiness gap beyond preparedness for survival. BMC Public Health, 15, 1139.
Katende, G., Groves, S., & Becker, K. (2014). Hypertension education intervention with Ugandan nurses working in hospital outpatient clinic: A pilot study. Nursing Research and Practice, 2014(710702), 1-6.
Philis-Tsimikas, A., & Gallo, L. C. (2014). Implementing community-based diabetes programs: The Scripps Whittier Diabetes Institute experience. Current Diabetes Reports, 14(2), 462.
State Emergency Response Team. (2016). Florida hazard watch − Tornadoes. Web.
Van Buren, D. J., & Tibbs, T. L. (2014). Lifestyle interventions to reduce diabetes and cardiovascular disease risk among children. Current Diabetes Reports, 14(12), 557.