Motivational Interviewing Theory

Jones has set, he is having trouble with his own health management as he recovers post-surgery. The Occupational Therapy Practice Framework defines health management as “developing, managing, and maintaining routines for health and wellness promotion” (AOTA, 2014, p. S19). Maintaining proper health management is a crucial occupation as Mr. Jones recovers from his surgery. To improve his health post-surgery, the surgeon has required Mr. Jones to abide by his hip precautions and avoid putting any weight on his right leg. Mr. Jones seems to have trouble understanding the importance of the hip precautions because he is so eager to return to full function. The use of a health-related quality of life assessment tool, the SF-36, will evaluate his quality of life despite his operation (Smith, Johnson, Ballantyne, Dunstan, & Brenkel, 2012). SF-36 will provide insight to how Mr. Jones feels regarding his health and further explore how I can help him understand and apply his hip precautions. Per Smith, et al., (2012), The SF-36 is a “36-item questionnaire that produces scores in eight domains relating to health-related quality of life” (p. 2). The eight domains include physical function, physical role, body pain, general health, emotional vitality, social functioning, emotional role, and mental health. (Smith, et al., 2012). By interpreting Mr. Jones health-related quality of life based on these eight domains, I can better understand how he rates his current condition and how his total hip replacement has affected his health and health management qualities. I can then develop strategies prioritizing health management. Including methods to secure compliance with his hip precautions to assure he has a full recovery and can quickly return to his

The Self-Care Deficit Theory of Nursing impacts modern health as well as nursing more so than expected during its creation and evolution. The Institute of Medicine (IOM, 2001) demanded the need for health care to shift from acute care setting to management of disease. Consequently, today’s health care is in the midst of a paradigm shift, as it redirects its attention towards patient centered care, disease prevention and wellness promotion. The Affordable Care Act implemented regulations, enforced by financial reimbursement to ensure that hospitals have shorter lengths of stay, lower readmission rates and strategies to enhance health promotion, disease prevention and improved quality of life (Taylor, 2012). The government has placed incredible demands on the health care system as baby boomers are aging and chronic diseases are becoming more complex requiring increased use of technology and nursing support. In order to meet the legislative requirements, administrators and educators must transition to the structure and concepts provided by the Self-Care Deficit Nursing Theory, for it is in this theory, nurses are empowered to better care for the patients as they present with complex self-care needs requiring specialized assistance from highly advanced, educated nurses who prepare these patients to return home better equipped for self-care despite their chronic conditions.

This experiment was used to determine the impact of reminder systems on appointment nonadherence rates in a clinic population. Clinician time lost due to no-shows is unrecoverable. Because of the unpredictable nature of appointment nonadherence, providers’ schedule gaps cannot be filled with other patients. Since the no-shows then to occur at spotty intervals, creating short periods of downtime, it is even difficult for providers to fill the time with administrative tasks. The loss of revenue from fees that would have been charged for services had patients kept their appointments affects clinic budgets significantly (Maxwell 2001).

Half of those ages over 75 years who fracture their hip as a result of a fall die within one year (Rawskey, 1998), and those who survive rarely regain complete mobility (Marotolli et al 1992). Falls are associated with major morbidity, functional decline and increased health

Mrs. Pink, aged 75 was admitted to the orthopaedic ward after suffering a fall at home, resulting in an intracapsular fracture of the hip at the femoral neck. Mrs. Pink has a history of cancer and cardiac diseases and has severe rheumatoid arthritis. Due to ageing patients putting a great deal of strain on the health care system, the incidences of hip fractures in the elderly are a major concern and requires careful consideration regarding treatment. Known as a major cause of disability in the elderly, hip fractures and their subsequent need for surgery result in chronic pain and an altered quality of life (Strike, Sieber, Gottschalk & Mears, 2013). Although important to improve a patient’s quality of life and physical independence, pain related to a total hip replacement (THR), also known as hip arthroplasty (HA) can lead to delays in ambulation, longer hospital stays, poor functional outcomes and quality of life. The purpose of this essay is to identify the rationale behind nursing interventions provided to post-operative THR patients as well as the pathology of a femoral neck hip fracture and their procedure for assessment and diagnosis.

All participants must undergo an evaluation by a physical therapist to assess baseline ROM, muscle strength, flexibility, and measurement of their flexed posture by means of kyphometer placed on specific landmarks on the spine (University of California, San Francisco, Department of Physical Therapy & Rehabilitation Science, n.d.). This evidence-based exercise program is designed to modify the postural changes that often happen in the older adult. Not only it will improve compliance with tasks, but also promotes a social atmosphere for the participants since most of the clients have a common goal of improving wellness and overall health. The fitness- wellness program consists of postural awareness training and bone wellness activity such as weight bearing exercises. Upper body and lower body exercises are accomplished by utilizing a resistive Therabands, foam rollers, dumbbells, and ankle weights. Equally important, core back muscles strengthening task are implemented with the help of core trunk stabilization drills. Al Dajah & Muthusamy (2015, p. 237) recommends that back strengthening exercise should be a part of a wellness treatment program to help improve the respiratory condition of elderly clients with flexed posture due to osteoporosis. Finally, balance and steadiness awareness tasks

The goal for nurses as a profession is not only to be “patient advocates” but also assist the patient to learn and gain the necessary skills to achieve the best level of functioning for the patient based on their current illness. In order to help a patient achieve their optimal level of functioning the nurse must work with the patient and the interdisciplinary team to create a collaborative plan that is logical for the patient. Through examining a musculoskeletal disorder case study #35 from Preusser (2008), one can create a critical pathway for the patient, S.P. a 75 year old female, with severe rheumatoid arthritis (RA) and admitted to the orthopedic ward for a hip fracture status post fall (p. 183). Since the patient’s needs is unique

Motivational interviewing is a counseling approach that was studied and understood as an applicable theory of practice that would be beneficial in the environment where I currently work which is an alcohol treatment facility. Whereas, it is understood that clinical and applied aspects of Motivational Interviewing (MI) have shown effective as a relatively brief intervention (Levensky, Cavasos, & Brooks, 2008), especially those dealing with an alcohol dependency. According to Miller and Roderick, MI, has been defined mostly as a directive, client centered counseling approach for eliciting behavior change by helping clients to explore and resolve ambivalence. In addition, with its goal-orientated approach it can help break down resistance to change (Corey, 2013, pp. 191-194). This theoretical approach is the most favored for the environment in my profession of choice, in addition, integrating it with the practice of Cognitive Behavioral Therapy (CBT) which is already in use.

Dorothea Orem’s self-care theory of nursing is one of the major nursing theories. It pays particular attention to the role of the patient in their own rehabilitation, as it expounds the benefits of self-care. Orem’s theory is well documented and has been used by several researchers as a basis for their research. This particular theory of nursing is broad and can be applied to the primary, secondary and tertiary levels of prevention. Many nursing schools have used this theory as a benchmark or guide in their curriculum development.

Deficit Nursing Theory or SCDNT has three systems that can be used to meet patient’s self-care requirements.

Feo (2017) reported that addressing this factors promotes successful health outcomes. it helps the patient to develop skills to handle stress in everyday living. For instance, learning to cope with changes and significant loss. Similarly, Feo, Conroy, Marshall, Rasmussen, Wiechula, and Kitson (2017) sates that nurses’s role is communicating with the health care team all information gathered from a comprehensive assessment to provide the patient with specialised care to ensure appropriate nursing care are delivered. In addition, Karnatovskaia, Gajic, Bienvenu, Stevenson, and Needham (2015) highlight addressing psychosocial concerns increases compliance with the treatment and empowers the patient to manage health

Hip replacements are viable surgical options when damage occurs within the joint or bones affecting the ability to function. The most common causes of requiring a hip replacement include osteoarthritis, rheumatoid arthritis, post-traumatic arthritis, avascular necrosis and childhood hip diseases (Foran & Fischer, 2015). Rooks et al. (2006) reported that “osteoarthritis is an increasingly prevalent chronic illness of aging Americans and the leading cause of disability in the US” (p. 700). Progression of symptoms relating to arthritis lead to a decrease in mobility, reduced functional status and deconditioning (Rooks et al., 2006). Arthritis or other conditions damaging the hip joint severely impact individual’s quality of life and independence in occupational performances. Overall, studies report a rise every year in hip replacements due to the aging population. Due to the increased need for this population, “long waits for surgery prolong the experience of pain and low functioning level, therefore possibly leading to an increase in disability" (Gill, McBurney, & Schulz, 2009, p. 388). Clients may face many physical and emotional changes about their arthritis while awaiting the opportunity to undergo a hip replacement.

In the case of Anne Morrell there are several normal physiologically changes that impact her quality of life. Anne is experiencing normal aging related changes to her musculoskeletal system. Changes in musculoskeletal tissue occur through the loss of muscle mass and strength which replace lean body mass which fat and fibrous tissue. These changes in tissue cause a decrease in contractile muscle force with increased weakness and fatigue (Boltz, Capezuti, Fulmer, & Zwicker, 2012). As discussed in her case study she reports back pain when standing or walking for longer than 15 minutes, needs assistance with steps, ambulates with a cane since she fell last year which affects her mobility and ability to perform her activities of daily living. This loss in Anne’s muscle function greatly increases her chance of falls and she also has an increased risk for disability.

According to the University of Tennessee at Chattanooga School of Nursing & Students (2016), Dorothea Orem self-care deficit theory was created due to Dorothea E. Orem objective of enhancing the quality of nursing in hospitals where she resided. In the year 1949, Dorothea visited the Indiana State Board of Hospital where she participated in upgrading the hospitals in the area. In the year 1958 to the year 1959, she worked with a project aimed at enhancing the practical training of nurses. As a result, she decided to determine the conditions under which decisions for nursing care are made. She developed the “another self” idea which became “self-care” and later Self Care Deficit Nursing Theory where self-care implies that people are able to take care of themselves when they

Three connecting theories developed by Dorothea Orem are the theory of self- care, the theory of self-care deficit and the theory of the nurse system (George, 2011). Self-care theory is offering an