Identify as many opportunities for health promotion as you can from the on-site childcare available for L.J. after she delivers her baby.

The aim of this work was to investigate how managed care organizations (MCOs) currently approach asthma treatment and management and to determine factors affecting asthma outcomes. A Web-based survey was administered to a national sample of 351 medical directors of MCOs to investigate the asthma management program components in their organizations as well as gaps and barriers in the management of patients with asthma. All 134 (38.2%) responding medical directors reported that their organizations monitor asthma patients. Plans use a variety of asthma management activities, including general member education (90%), member education by mail (87%), self-management education (85%), and provider education (82%). Educational resources (89%) and telephone advice nurse (77%) were the most common self-management strategies offered. Among factors impeding the provision of effective asthma care, virtually all respondents cited noncompliance with asthma treatment, the inappropriate use of medications, and the need for multiple medications. Health plans rely on an array of strategies to manage asthma patients. Education encouraging patient self-management is a key component of asthma management programs. However, a considerable number of treatment approach barriers are impeding the achievement of proper asthma care. Without innovative approaches to care, it appears that current MCOs’ asthma management efforts may not result in substantial improvements in asthma outcomes.

 

1. What factors do you think prevent individual health care providers from engaging in health promotion activities even when these activities are supported by the managed care system in which they practice?

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1. Do you think the study results would have been different if the primary care providers had answered the survey questions instead of the medical directors? If the patients had answered the survey questions?

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1. Does this survey address the quality or effectiveness of care provided?

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WEEK  2 ASSIGNMENT   Due 2/1

 

 

 Developmental Stages of the Learner

 

The Laurence G. Paquin School in North Baltimore, established in 1966, is reserved for childbearing adolescents. (See Boyer-Patrick article in “Links” below).   Pregnant female students from the city high schools are referred to Paquin School for the duration of their pregnancy. Pacquin School is always full.  Pregnant teens from surrounding counties will move into a relatives home within the city limits in order to attend school there. 95% of the student population is black, as is the principal, who fights vigorously to keep her students in school.

 

Besides a comprehensive academic program, other services include a Family Health Center on-site which offers prenatal care and counseling.  If a teen delivers during the school year, she may finish that year at Paquin, bringing her baby with her to classes.  This enables the new mothers to participate in child care while attending classes herself.  The father of the baby is also encouraged to attend pregnancy and child care classes.

 

1. J. is a typical student at Paquin School. She is unmarried and 15 years old.  She moved to her grandmother’s house in Northwest Baltimore from a nearby suburban community.  This is her second pregnancy, the first ended in an abortion.  The father of her baby is a first year city college student, and is staying involved with L.J.  She hopes to return to her old high school where she was on the track team, and eventually to attend college herself.

 

After reading this case study, answer the following questions:

 

1. What different developmental tasks is this pregnant adolescent facing at the same time?

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1. What adaptations to the prepared childbirth classes offered by the school nurse Might have to be made to accommodate the different developmental levels in the student population?

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1. Identify as many opportunities for health promotion as you can from the on-site childcare available for L.J. after she delivers her baby. _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

WEEK 3  – ASSIGNMENT Due 2/9

 

 

Gender, Socioeconomic and Cultural Attributes of the Learner

 

After reading this case study, answer the questions following:

 

A student nurse has been a member of a volunteer fire and rescue company for seven years. The student has chosen this group as a focus for a patient education class. The ages of the 17 members range from 18-68; they are primarily male with four females. Since the US Fire Administration lists heart attack as the number one cause (45%) of line-of-duty deaths in 2003, the student chose to assess this group for cardiovascular disease risk factors. He identified stress, smoking, diet, overweight, and lack of exercise as risk factors. The working environment for the firefighters, as described by the student, is physically demanding. When on a call, they normally wear bulky gear, which can weigh 50 pounds. The fire-fighting situation is normally hot, humid, and stressful.  In these conditions firefighters may need to run, crawl, chop with an axe, or drag heavy objects. The student chose to focus the health promotion class on the general risks of cardiovascular disease with an emphasis on the importance of exercise and physical fitness. His methods included PowerPoint lecture and role modeling using available exercise equipment.

1. Given the work environment and the gender mix of the learners, did the student choose an appropriate risk factor to emphasize?

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1. What additional learning activities might have been productive for this audience and topic?

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WEEK 4  – ASSIGNMENT  Due 2/16

 

Behavioral Objectives

 

After reading this case study, answer the questions following:

 

A nurse who works in the Neonatal Intensive Care Unit has been assigned to develop a teaching plan for the parents of premature babies who are nearly ready for discharge. The parents are predominantly white and Hispanic, with ages ranging from 15 to 47.  The infants may have any number of physical needs upon discharge including special feeding instructions, apnea monitors, temperature instability, colostomy care, and oxygen supplementation, among others. The parents will be anxious, tired, disoriented, and possibly in pain (post-caesarean section mothers). The NICU can be an intimidating and distracting place for learning, with monitor noise, dim or bright lighting, multiple staff performing multiple procedures, and the potential for life-threatening crises with their child or another nearby.

 

Before writing learning objectives, the nurse establishes three priority educational needs (diagnoses): (a) risk for abnormal body temperature fluctuations, (b) risk for ineffective breathing patterns, and (c) altered nutrition: less than body requirements. She has difficulty formulating learning objectives at this point.

 

1. A) What is the problem with the focus of this needs list? Rewrite the needs list to better reflect the purpose of the teaching plan.

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After reframing her prioritized educational needs (diagnoses), the nurse writes the following learning objective, “Parents will verbalize correct feeding procedures for breast and bottle feedings and demonstrate competency in feeding infant in one or both ways that are chosen to feed infant.”

 

 

 

 

 

 

WEEK 5  – ASSIGNMENT  Due 2/23

 

 

Technology in Education

 

After reading this case study, answer the questions and complete the exercise following:

 

Mrs. A. F. is a 78 year-old widow with a high-school education. Her medical problems include hypertension, hypercholesterolemia, and a history of transient ischemic attacks. She has had lens implants for bilateral cataracts. Her children have just purchased a computer for Mrs. F. and helped her learn how to access the Internet. She enjoys e-mailing distant family and friends, and shopping online. At her next outpatient visit, she asks about the benefits of eating organic foods to prevent cancer and the use of herbal supplements to stimulate her immune system for fighting influenza.

 

1. What questions would you ask Mrs. F. about her sources of health information? ______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

 

You refer Mrs. F. to the URL  www.health.gov/scipich/ . “SciPICH: Science Panel on Interactive Communication and Health” is a Website designed to help inform consumers navigate through the new technologies and health resources on the web in order to locate the best information resources. Consumers can take the exercises on this site and learn how to recognize quality information. (Sponsored by the Office of Disease Prevention and Health Promotion, U.S. Dept. of Health and Human Services.)

 

1. Access “SciPICH”. Locate and list below several specific tips and exercises that would be appropriate for Mrs. F.’s age and health history.
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1. The authors conclude that certain program changes might improve the situation. Is this justified based on the results as reported in the abstract?