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Dennis has lived in Africa since birth has a welding and body workshop in Nairobi at a place called Kibera. He is 35 years of age and has been doing his job for the last 10 years. His job is so onerous and committing requiring him to open his workshop at 6am in the morning and close it at 9pm in the evening. His job involves him in lifting, carrying, cutting and welding heavy metals and vehicle parts.
Dennis’ wife Maurine works as a second-hand clothes vendor at the local flea market. Their family consists of five children, two older sons, two daughters and a last born son. Two of his children are in the university, while the younger ones are in secondary and primary schools. The eldest son is studying law and is sponsored by the government while the other is a self-sponsored student studying actuarial science. The elder daughter is in high school while the others are in primary school. The family lives in a rental house in which both parents have to contribute to the rent each month. The youngest daughter in primary school suffers from diabetes and is under medication as authorized by the doctor.
Family Medical and Health Practices
Maurine is the only person who has ever gone for medical checkups in the family. The rest including Dennis they have never seen a physician to receive a medical check-up. After undergoing medical check-up 8 months ago, Maurine was diagnosed with low blood pressure but she opted not to share the information with her family. Dennis on this other hand has never had a chance to go for a medical check-up due to the demanding nature of his job.
He normally prefers over the counter (OTC) medication whenever he falls ill. This has prevented him from taking his children and wife to the doctor for checkups, preferring prescriptions from the local chemist whenever any of them fall ill. Besides this, Dennis is a frequent and heavy drinker, drinking a lot late in the night after work and also during the weekend.
This behaviour displeases his family because of the financial and emotional losses it has imposed on them. Lately, Dennis has been complaining of stomach pains, nausea and loss of appetite. Over the past 12 days, Dennis has also exhibited noticeable precursors to speech impairment such as stuttering and a hoarse voice. Amidst all this however, nothing has compelled him to seek medical assistance.
Physical and Dietary Requirements
A person undergoing the same experience to that of Dennis has to undertake health promotion activities and orient the solutions towards the risk factors. One of the most important requirements is to engage in physical activities or exercise. Physical activities can be performed alone or even together with other family members. The activities include running, walking, weight lifting and other physical exercises.
Physical activity is vital in reducing body cholesterol hence reducing the risk of hypercholesterolemia.1 Physical exercises also reduce the risk of developing lifestyle diseases such as diabetes, high blood pressure, heart disease and cancer.2 It also enhances body reflexes, strength, endurance and flexibility which are important especially to individuals with physically demanding jobs.3
Dennis should make sure his family always eats a balanced diet. It is essential that persons with physically demanding jobs eat meals that contain all the needed nutrients for our body, especially carbohydrates and proteins.4 If the body receives the recommended daily allowance (RDA) of nutrients, it is able to sustain health and rapidly worn out tissues. This will make Dennis stronger and more active while providing him with sufficient energy to work for longer. Through proper budgeting, the family can afford to maintain a balanced diet which is also essential for the healthy growth and development of his children.5
Excessive alcohol consumption is a risk factor that can be controlled if Dennis can learn the side effects of excessive consumption of alcohol. The over-consumption of alcohol and alcoholism in general has health, economic and social implications. The heavy and persistent drinking of alcohol can result in flaccidity of the brain cells, cardiovascular complications, and alcoholic hepatitis and can damage the central nervous system and/or death.6
Therefore it is important for heavy alcohol consumers such as Dennis to mitigate their consumption if they intend to improve their overall health. If Dennis overcomes alcohol consumption, he will increase his physical productivity since alcohol dehydrates the body and its metabolism increases lactic acid in the muscles.7
Individuals like Dennis are possibly encountering barriers to effective self-management where the first barrier is commonly composed of habit and self-belief. This barrier can be hard to uproot when it comes to behaviour change and practice. People tend to think that their existing environment and circumstances are resistant to change, making such behaviour, thoughts or attitude difficult to uproot.8 Self-belief is a stumbling block to accepting counsel from others and therefore its modification is a prerequisite to rehabilitating a behaviour or schema.9
Workload pressure may force an individual to seek unhealthy alternatives to overcome fatigue or sustain productivity.10 Dennis for instance does not get sufficient sleep nor does he receive the required nutrients to match his demanding job. To the contrary he consumes excessive alcohol which dehydrates him and lowers his physical and mental aptitude. The result is a decline in productivity both in terms of the quantity and the standard of production.
It is evident that Dennis needs to have a self-management plan. As one works towards achieving self-management, one needs to develop and implement an action plan.11 A medic or physician can be of useful assistance when developing a successful self-management plan. A self-management plan is a well-defined road map for obtaining quantifiable results relative to an individual’s health goals.12
When coming creating a self-management plan, one needs to first identify the measurable steps and strategies of achieving self-management target. The individual needs to know what they are required to do, when they should start doing it, where they will be doing it, where they will seek assistance and how they are going to implement your plans and strategies. After this they will have to select the resources and tools that will help them meet their targets and objectives.13
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The California healthcare Foundation offers a variety of tool and resources that can be used for self-management. The foundation provides articles which assist patients to manage their chronic conditions. There is a telephone based support (AHRQ) which also assists in self-management.14 Chronic Disease self-management program is another resource that is very instrumental to actualize a self-management plan.
Another tool is the Self-management support: information for Patients and families among others.15 In any given plan that the patient has decided to implement, there are several activities that the patient needs to get involved in, in order to manage their condition. These specific plans focus on the patient’s needs, preferences and readiness to complete the activity.16
Even though such plans are structured around the needs of a patient, some plans remain unsuccessful since some of the patients do not realize their goals. A lot of patients have repeated failure in following the recommended steps and changing their lifestyle. It is therefore advisable that the action plans were realistic and achievable in a manner in which the patients’ experience successes which will act as a motivation for performing other action plans.17
One of the self-management tool is by the affected opening a portal in a website that provides medical self-management information. This will keep the affected one well informed about the current ailment in his or her body and the expected ones and how to overcome this disease the earliest possible. Another tool is by getting insured. Insurance is very vital because it will come to your rescue when things get out of hand. Multi-media presentation of videos also can play a major tool of self-management. This will lead to many getting informed and taking necessary measure to ensure that they are self-management.
A multidisciplinary team is supposed to compose of medical and mental health service. Medical and mental health professions are vital when it comes to picking a team that will help in serving and implementing self-management. A medical professional is to diagnosis and prescription a patient. The physicians, toxicologists and other medics are the ones that are involved in the treatment of the injured. On the other hand psychologists and other mental health professionals assist in addressing the complex behaviour and emotional problems that their patients face. They know how to interpret and give prescription to each of their anomalies. All these leads to a perfect establishment of a self-management plan.
When it comes to the issue of self-management, the health fraternity has to organize a multidisciplinary team. The purpose of the multidisciplinary team will be to inform people in their localities the benefit of living a healthy life.18 They should inform people the goodness of living a good lifestyle and the way they can achieve it. The team should even organize seminars which will help to inform others about self-management. In addition, the team should be responsible for assisting individuals in developing self-management plans while monitoring and encouraging the patients to ensure successful accomplishment of their health goals.
American Association of Diabetes Educators, the Art and Science of Diabetes Self-management Education: A Desk Reference for Healthcare Professionals, AADE, New York, 2006.
Jordan, J, J Nankervis & C Osborne, Chronic disease self-management program; Perspective on enablers and barriers to GP and patient encouragement, Primary Health care and information service, 2006. Web.
Lalonde M, A new perspective on the health of Canadians: A working document, Government of Canada, Ottawa, 1974.
Lorig, K, S Sobel, L Ritter, D Laurent & M Hobbs, ‘Effect of self-management program on patient with chronic diseases’, Effective clinical practice, vol. 4, no. 6, 2001, pp. 256-262.
Lorig, K, D Sobel, A Stewart, B Brown, P Ritter, V Gonzalez, D Laurent & H Holman, ‘Evidence suggesting that a chronic disease self-management program can improve health status while reducing utilization cost: A randomized trial’, Medical care, vol. 37, no. 1, 1999, pp. 1086-1109.
Mensing, C, S McLaughlin, C Halstenson & American Association of Diabetes Educators. The art and science of diabetes self-management education desk reference. AADE, Chicago, 2011.
Sobel, D, J Brown & P Ritter, ‘Disease self-management program: 2 years Health status and health care utilization outcomes’, Medical care, vol. 39, no. 11, 2001, pp. 1217-1223.
Yuen, K, Social work practice with children and families: a family health approach, Haworth Social Work Practice Press, London, 2005.
- K Yuen, Social work practice with children and families: a family health approach, Haworth Social Work Practice Press, London, 2005, p.62.
- D Sobel et al, ‘Disease self-management program: 2 years Health status and health care utilization outcomes’, Medical care, vol. 39, no. 11, 2001, pp. 1221.
- M Lalonde, A new perspective on the health of Canadians: A working document, Government of Canada, Ottawa, 1974, p.115.
- K Lorig K et al, ‘Evidence suggesting that a chronic disease self-management program can improve health status while reducing utilization cost: A randomized trial’, Medical care, vol. 37, no. 1, 1999, pp. 1087.
- K Lorig et al, ‘Effect of self-management program on patient with chronic diseases’, Effective clinical practice, vol. 4, no. 6, 2001, pp.257.
- D Sobel et al, 1219.
- J Jordan et al, Chronic disease self-management program; Perspective on enablers and barriers to GP and patient encouragement, Primary Health care and information service, 2006. Web.
- Lorig et al, 2001, p.259.
- D Sobel et al, ‘Disease self-management program: 2 years Health status and health care utilization outcomes’, Medical care, vol. 39, no. 11, 2001, 1217-1223.
- Yuen, p. 44.
- Ibid, 1221.
- Jordan et al.
- American Association of Diabetes Educators, the Art and Science of Diabetes Self-management Education: A Desk Reference for Healthcare Professionals, AADE, New York, 2006, p. 68.
- Lorig et al, 2001, p.261.
- Ibid, p.261.
- Sobel et al, 1222.
- C Mensing, S McLaughlin, C Halstenson & American Association of Diabetes Educators. The art and science of diabetes self-management education desk reference. AADE, Chicago, 2011, p.56.
- Mensing et al., p.102.