September 15, 2013
Health promotion according to World Health Organization, “Is the process of enabling people to increase control over, and to improve their health. It moves beyond a focus on individual behavior towards a wide range of social and environmental interventions.” In this assignment I have chosen three articles talking about the different health promotions. I will start with my article on teen suicide and primary prevention, then stroke article and secondary prevention and then depression and tertiary prevention. Primary Prevention
My first article called, Preliminary Effectiveness of Surviving the Teens Suicide Prevention and Depression Awareness state, “Currently, suicide ranks as the third leading cause of death among youth ages 15-24 years.” This article talks about schools, since children are in school most of the day, using this time to talk about preventive ways to stop suicide. For this article health care prevention is defined as a way to teach students about increasing awareness and knowledge of suicide intervention, risk factors and warning signs of depression and suicide but to also teach problem solving and coping skills to our teenagers. (King, Strunk & Sorter, 2011) If we put all these together, school nurses and teachers can increase adolescent students to have better self-esteem, self-efficiency, and can increase their coping/problem solving skills and also, communication skills. We can teach the students about dealing with stressors and what good health behaviors are.
This program called, “The Surviving the Teens Suicide Prevention and Depression Awareness Program,” is a school based program that helps with prevention of suicides and was developed by and registered nurse named Catherine Strunk. This school based program was offered by Cincinnati Children’s Hospital Medical Center in the Psychiatry Division. This program is learned more towards kids in the high school setting. The classes are four days and 50 minutes per class. In this class a nurse can teach students and present them with factual information regarding depression, risk factors, suicide warning signs, suicide risk factors, and common myths associated with suicide. (King, Strunk & Sorter, 2011) The program covers so many areas and addresses different things. For instance, mental health, substance abuse, social and school stressors, trauma, grief and loss, just to mention a few. If states would adopt this program, I believe that students would benefit by implementing this program in high schools. It teaches children so many ways to cope in school and the outside world. This program teaches them the necessary skills to get through life and it helps them with self-esteem issues as well. School nurses and teaching staff can come together to help our children out so there will be less suicide attempts among children in this age group. To implement this once we got the program in our schools we would first have to get consent from the parents of our students. If we can teach our children about suicide and the risk factors along with reaching the skills and give them help with self-esteem we can prevent so many kids from attempting or succeeding at suicide. This program would be a major benefit in our school systems today. Secondary Prevention
The second article chosen talks about secondary prevention in people who have already suffered one stroke. Emmie Malewezi, who wrote the article titles, Stroke policy and secondary prevention: how well are we adhering to these guidelines stated, “Recurrent stroke is more likely to be fatal than the first stroke and survivors are more likely to be left with major disability.” Strokes or Transient Ischemic Attracts or TIA for short, are very serious and after a patient has a TIA or major stroke is likely a recurrence of another one will happen within 90 days of the first stroke. (Malewezi, 2011) It is so important for a secondary prevention to start immediately and continue into their long term prevention. There are a few areas that are recommended for secondary prevention in stroke patients. First one is lifestyle modifications or changes. Patients who has had a stroke need to realize the importance of changing their lifestyle with exercise, diet, smoking if they were a smoker, weight, and alcohol consumption. Nurses and family should be there to support the patient and nurses can help come up with a plan to help with modifying the patient’s lifestyle. “ By increasing physical activity, losing weight, reducing sodium and alcohol intake, people have been shown to reduce systolic blood pressure and thus reducing their risk of stroke,” as stated by Emmie Malewezi. Another standard protocol for secondary prevention is an antiplatelet therapy. It has been shown research that if you use a combination of Aspirin with Dipyridamole will lower the risk of future vascular events then just taking Aspirin by itself. With patients who have Atrial Fibrillation, for example, should be on anticoagulant medication like Warfarin. The problem with Warfarin is the side effect of bleeding. This is why some physicians don’t necessarily want to prescribe it due to the risk of falling and then bleeding out. Lastly, a lipid medication is usually prescribed at discharge because high cholesterol or also called Hyperlipidemia can cause strokes as well.
The nursing and Midwifery Council identifies health promotion as an important aspect of nursing practice. (Malewezi, 2011) Nurses are responsible for the role of secondary prevention by making sure they set aside time to sit with the patient and discuss and reinforce lifestyle modifications they are at such high risk for another stroke. In hospitals we now have stroke teams and patients are being seen quicker and discharged faster. This makes it impossible for the nurse to always go over all the secondary prevention needed for that patient. We need to get a plan established to make sure the patient can get all the information they need about their therapy and make sure the patient are aware of their medications, whether the medication is a new one or one they have already been on. Also, nurses need to make sure patients no how to take their medications. Sometimes problems like swallowing issues becomes a problem due to the stroke and we need to make sure the patient isn’t going to have a problems swallowing their medications. Secondary prevention is important for stroke patients and nurses need to understand their role they play so we can prevent another stroke in our patients. Tertiary Prevention
Tertiary prevention in the third article talks about the promotion of recovery and prevention of relapse for depression. This article is called Prevention and Management of Depression in Primary Care and it states, “Timey recognition of depression is essential to improve patient’s mental health in quality of life.” Depression can happen for so many reasons and some of those reasons are physical illness, financial issues, or even post-partum after child birth. The problem is suicide is a big risk when people become depressed if they are not given the help they need. For the patients who have developed depression and are being treated for it are now at the level of tertiary prevention.
Tertiary prevention helps the patients by reducing the effects of the mental health condition on patients function and quality of life. Nurses can do this by giving support and encouragement. It is crucial for the nurses to teach their patients to take their antidepressants daily and to not stop them so relapse of depression doesn’t occur. The other role of the nurse that is vital in tertiary prevention is to make sure they ask their patients if they are becoming hopeless or wishing to hurt themselves by suicide. This is necessary because family history or past attempts of suicide is a big risk factor. If a patient tells a nurse that they have suicidal thoughts the nurse needs to be responsible to see if they have any support like family and friends so they can be taught about watching the patient’s mood, increased negativity, hopelessness or suicidal intent. If family or friends see any of these changes they need to call and get help for the patient. If the patient is at immediate risk the nurse needs to refer them to a mental health facility. Levels of Prevention
In closing primary prevention helps healthy patients stay healthy and prevent or develop disease. Secondary prevention are for patients who have already been diagnosed and now needs to be taught how to slow down or stop the progression of a particular disease. While tertiary prevention is about management of a disease like diabetes, stroke, depression, heart disease or even cancer. Nurses play a vital role in each level of prevention to ensure good, quality health to our patients.
Hardy, S. (2013). Prevention and management of depression in primary care. Nursing Standard, 27(26), 51-56. King, K. A., Strunk, C. M., & Sorter, M. T. (2011). Preliminary Effectiveness of Surviving the Teens® Suicide Prevention and Depression Awareness Program on Adolescents' Suicidality and Self-Efficacy in Performing Help-Seeking Behaviors. Journal Of School Health, 81(9), 581-590. doi:10.1111/j.1746-1561.2011.00630.x Malewezi, E. (2011). Stroke policy and secondary prevention: how well are we adhering to these guidelines?. British Journal Of Neuroscience Nursing, 7(6), 684-690. World health organization. (2013). Retrieved from http://www.who.int/topics/health_promotion/en/