Choose one case study from below:
Case 1
Ms B is an 40year old woman living in rented accommodation in a rural town with her partner and three children aged 12, 9 and 7 years. Ms B works shifts at the local factory and although the work is regular it is not that well paid. Ms B is overweight, smokes and has always liked her food. Recently she has been feeling tired and listless, so her partner has told her to visit the GP for a check-up. At the appointment the doctor asks her about her symptoms and gathers other information to help him make a diagnosis. Following his physical examination, the doctor finds that a) Ms B is clinically obese, b) Her blood pressure is higher than the healthy range c) Her blood sugar is higher than normal, and she appeared to be short of breath when walking into the office. The doctor also found that:
She smokes 20 cigarettes a day
Does not do any organised exercise but does walk around shopping centres. Although she admits she does get a bit out of breath if she walks around too ‘much’
Drinks alcohol occasionally and usually – beer,but also consumes 2-4 cans of coke a day
Eats take away food frequently – especially when working shifts
She does cook at home, but there is a high content of fat and sugar. She isn’t keen on fruit and vegetables so doesn’t always eat them. The family also eat a lot of dessert items
She snacks frequently when at work – Kit Kats,chocolate bars, lollies
The doctor considers Ms B as a prime candidate for type 2 diabetes. The doctor talks to her about what this means and organises blood and urine tests to confirm his diagnosis. He prescribes medication to address her diabetes and high blood pressure. Ms B is shocked as she feels that she may be overweight, but she considers herself healthy. Ms B’s family members are on the ‘big’ side, even her children take after her side of the family as they are a bit chubby. She is not keen on the idea of changing her diet, having to take any exercise (she’s never been keen on it) and giving up smoking.
Case 2
Mr T is a 35year old Indigenous man who lives with his partner and two children in rented accommodation in an urban area. He is currently unemployed but has previously worked as a labourer in the building industry. Mr T has a history of cardiac disease, high blood pressure, smoking and other drug use. Mr T does go hunting with his family throughout the year when the opportunity is available to travel back to country. He also likes to watch the footy, however, he does not actively engage with any other exercise. As the family are dependent on a low income, personal choices regarding diet, exercise and other activities are limited. The family does not have the income to sustain a regular nutritious diet and often have take away meals that are high in fat and sugar. Mr T continues to smoke and use other drugs occasionally. Mr T has a large family support network but does not always take advice regarding his health. He has seen a Dr and other allied health professionals but does not regularly attend appointments so is not following the advice he has been given. This has impacted on the management of his health condition and his health in general. His family are concerned that he is sick as he is tired, short of breath, and his ankles are slightly swollen. They convince him to go to the local Aboriginal medical service to see a doctor. Following his physical examination, the doctor finds that Mr T’s blood pressure is higher than the healthy range and he is short of breath. His records show that Mr T has put on a lot of weight since his last appointment which was a long time ago and was now overweight. He is also concerned that Mr T’s ankles were slightly swollen which may indicate that his cardiac disease had worsened. The doctor also found that:
He smokes 30 cigarettes a day – roll ups
Does not do any organised exercise and has cut down walking any great distance. When hunting with his family he usually stays near the campsite but can fish from the river bank.
Drinks alcohol frequently – beer, usually a 6pack 4-5 times a week
He eats take away food regularly which has a high content of fat and sugar
His diet appears to lack any healthy choices such as fruit and vegetables
He has not been taking his heart medication regularly
He has not been following the dietary advice given to him
The doctor feels that Mr T needs to get back on track and explains to him the importance of healthy lifestyle choices and taking his medication. He also explains that making these changes his health will improve and it will reduce the risk of developing any complications. To help support Mr T to make the changes he suggests that he comes to see a male Aboriginal Health Practitioner regularly. Mr T recognises that what the doctor is saying makes sense however he has been a smoker for a long time and doesn’t really want to give up and he likes his take away food because it’s easy to get and the family like it. Plus, they don’t have much money so buying ‘good’ food may be expensive.
Assessment Instructions
Using one of the following models discuss how you can help the individual make the lifestyle changes that are required and become involved in the self-management of their condition:
Health Belief Model
Trans-theoretical Model
Relapse Prevention model
You will also need to:
Identify the factors that have impacted on the individuals condition.
Identify Issues that need to be addressed.
Identify strategies that you think could be implemented to help the individual make lifestyle changes.
