Analysis of Middle Range Nursing Theory Essay

Complex physiological channels during motherliness have a hearty continue on almost every organ on the dust system including the ad-lib cavity these changes atomic number 18 due to hormonal changes. estrogen causes augmentd blood flow to the spontaneous cavity, making the gums friable and booming to bleed, contributing to gingivitis. Pregnancy-associated gingivitis is highly prevalent. It affects approximately 30%-75% of pregnant women and resolves after delivery. sickness and vomiting during maternity can also increase the put on the line of commodious erosion (Varney, Kriebs, & Gegor, 2004 Barak, Oettinger, Machetie, Peled, & Ohel, 2003). In addition, changes in diet, such(prenominal)(prenominal) as increased phthisis of carbohydrates, increased acid from vomiting, and changes in verbal hygiene whitethorn increase the venture of tooth decay during maternalism (Russel & Mayberry, 2008).Current research and evidence shows the splendor of maintaining good oral w ellnessfulness during pregnancy. Evidence supports that periodontal transmission systems during pregnancy increases the risk of adverse pay solvents such as premature deliveries, low stomach weight, still birth, miscarriage, and pre-eclampsia (Russell & Mayberry, 2008 Jeffcoat, Geurs, Reddy, Cliver, Goldenberg & Hauth, 2001). Preterm birth is a significant public wellness line, as the prematurity rate at in the United States was 12.7% in 2007. Preliminary data for 2008 indicates a slight decline to about 12.3% (Martin, Hamilton, Sutton, Ventura, Mathews, Kirmeyer, & Osterman, 2010).Behrman & pantryman (2007) reported that annual societal preterm births cost more than than $26.2 billion in 2005, or $51,600 per infant born preterm, including maternal delivery, aesculapian occupy, early interpellation services, and loss of household and labor market productivity. As a midwife, angiotensin converting enzyme and only(a) main goal during antenatal care is to improve pregnanc y issuings. let out of this can be accomplished is by promoting oral health care and healthybehaviors. It is of the essence(predicate) to impart oral health education beforehand and during the current pregnancy, as well as educate our clients about the sleeper between poor maternal oral health and adverse pregnancy outcomes. In addition, we must encourage them to see a dentist during pregnancy. hypothesisTo choose a surmise to apply to the practice problem, relevant theories must be critically evaluated based on a set of criteria. The causation apply the three questions posed by Fawcett and Associates (1992) as described by Kenny (2006) (1) Does the supposition or model address the client problems and health concerns? (2) ar the nursing interventions suggested by the model consistent with clients expectations for nursing care? and (3) ar the goals of nursing actions, based on the model or theory, congruent with the clients desired health outcomes? (Kenny, 2006, p.305). Several midriff range theories can be employ and applied to maximize oral health during pregnancy, as well as the prevention of adverse outcome related to oral problems.The Theory of Reasoned Action and Theory of aforethought(ip) Behavior focuses on and explores the relationship between behavior and precepts, as well as attitudes and intention (Montano & Kasprzyk, 2008). The Diffusion of Innovations Theory has been used to study the word meaning of health behaviors and programs (Tiffany & Lutjens, 1998). The Precaution Adoption Process specimen has been applied to behaviors which exact deliberate action and initiating new behaviors (Weinstein, Sandman, & Blalock, 2002).The Transtheoretical Model and Stages of Change are used to guide the individual through the stages of change to action and maintenance (Prochaska, Redding, & Evers, 2002). The wellness touch sensation Model is used to predict and explain health behaviors and upgrade individuals in engaging health behavior ( Champion & Stretcher & Janz, 2002). The best theory that fits this practice problem and authors values and beliefs about client, health and nursing practice is Health doctrine Model.Health precept ModelThe Health Belief Model (HBM) was developed by a multitude of favorable psychologists at the U.S. Public Health Service in the mid-fifties in an attempt to understand the widespread failure of people to insert in programs to prevent and detect disease. It was later applied to patient responses tosymptoms and to shape with prescribed medical regimens (Champion, Stretcher, & Janz, 2002, p. 46). The HBM has four major constructs Perceived susceptibility, sensed roughness, perceived benefit, and perceived barriers. The model has been expanded to include cues to action and self competency (Champion, Stretcher, & Janz, 2002). Perceived susceptibility refers to ones subjective science of the risk of espial a health condition. (Champion, Stretcher, & Janz, 2002, p.48). Perceived se verity refers to feelings concerning the seriousness of contracting an illness or of leaving it untreated includes evaluations of both medical and clinical consequences (death, disability and pain) and possible social consequences (such as effects of the conditions on work, family life, and social relations). (Champion, Stretcher, & Janz, 2002, p.48).Perceived benefits are beliefs and opinions of the value regarding the efficaciousness of the various actions available in reducing the disease threat. (Champion, Stretcher, & Janz, 2002, p.48). Perceive barrier is a persons perception of both the difficulties in performing the specific behaviors of interest and the blackball things that could happen from performing those behaviors. (Champion, Stretcher, & Janz, 2002, p.49). Cues to action are strategies to activate the ones readiness. And finally, self efficacy is ones confidence in ones ability to take action. (Champion, Stretcher, & Janz, 2002, p.49). The Health Belief Model is one of the fantasyual frameworks for understanding health behavior. Also, the HBM is used for explaining and predicting acceptance and adherence to medical care recommendations (Champion, Stretcher, & Janz, 2002).The Model hypothesis that an individuals decision to change behavior is determined by ii elements (1) Ones perception of a threat to personal health which is determined by two underlying belief, namely perceived susceptibility of the disease and the perceived severity and seriousness of the disease. And (2) Ones perception of the efficacy of treatment proposed to reduce the threat. (Ramseier, Suvan, 2010). This theory is indicated as a mid-range theory because it is narrow in scope, less abstract, and more applicable directly to practice for explanation and implementation.The early applications of HBM were focused on tuberculosis application test, and then MBM extended to lifestyle behavioral changes such as condoms use, obtaining vaccination against infectious disease suc h as flu vaccine (Baranowski, Cullen, Nicklas, Thompson, & Baranowski, 2003 Janz & Becker,1984). The HBM model also has been used on screening behaviors such as mammography screening behaviors for detecting breast cancer, screening program for Tay Sachs disease, as well as in AIDS and high-risk behavior research (Janz & Becker, 1984)Plan for set IntegrationTo initiate the use of the Health Belief Model in promoting and maximizing oral health during pregnancy, we might originate with distributing a come or questionnaire for to each one woman during the prenatal visit. The purposes of questionnaire are (1) To explore oral health practices and utilization of alveolar consonant consonant consonant care and (2) To render womens use of dental service and frequency of dental visits during pregnancy. The questionnaire includes demographic data (i.e., age, marital status, educational level, annual house hold income, and dental insurance). It also includes questions regarding oral healt h hygiene practices (i.e., frequency of brushing and flossing). In addition, the frequency of dental visits before and during pregnancy, reason for dental visit, questions regarding any instruction manual received from health care providers about oral health care, synthetic rubber of oral treatment during pregnancy, knowledge of common oral health problem during pregnancy, and associations between poor maternal oral health and adverse pregnancy outcomes would also be covered.Questions about barriers to dental care or reasons they do not visit the dentist would be explored. After collecting the survey from the women, the midwife or health care provider should discuss and provide teaching about oral health practices, the importance and safety of dental visits, and provide knowledge of oral health and pregnancy outcomes associated with poor oral health. This knowledge should be provided at every prenatal visit. The Health Belief Model would be explained in an educational session for midwife and health care provider (MD and dentist) victimisation visual aids, including posters and handouts of the HBM construct. This educational session includes information about the theory in general, constructs and its relationships, also how this model was used in research and practice previously, and then how this model might be used and applied in maximizing and promoting oral health during pregnancy.A purify understanding of the HBM from the midwife impartenable them to use it in predicting and screening a patients oral health and related behaviors. personal counseling could address each womans baseline belief regarding susceptibility to oral infection (i.e., gingivitis, peridonitis and dental caries), as well as benefits and barriers to the dental clinic visit and screening. By the end of the educational session, certain outcome objectives should be assessed. These outcome objectives would be (1) By the end of the session, 100% of the midwives and health care provider s will be able to describe the HBM and its constructs in their take words and (2) By the end of the session, 100% of the health care providers and midwives will be able to assist individual clients to develop and maintain oral hygiene behaviors.These objectives could be measured by assessing learner expectations regarding the sessions, asking questions, and having each one state their answers, as well as provide effective feedback to each answer from the participants. Several factors influencing the practice issues were understood by using the HBM in this practicum situation. The concept of perceived susceptibility includes all pregnant women because of the hormonal fluctuations that occur during pregnancy, in addition to personal characteristics related to income, poor habits, short-staffed dental hygiene and related behaviors. The concept of perceived severity is important in that if woman are made aware of poor pregnancy outcomes related to poor oral health, they may be more a ddicted to engage in healthy behaviors.The concept of perceived benefits are subservient and correlate with healthy behaviors and healthy outcomes, which is the desire of most pregnant women. The concept of perceived barriers is important to address. While the cost of dental care may be discouraging and many may fear the pain obscure in dental health (i.e., injections, fillings), the cost and disappointment of poor pregnancy outcomes may far exceed these perceived barriers. Cues to action are use through education and counseling the patient regarding the many benefits and risks regarding adequate and a lack of oral hygiene, as it affects their pregnancy outcome. The concept of self-efficacy is important, as women arrest empowered to make positive life-style behavioral changes which positively impact their pregnancies.ReferencesBarak, S., Oettinger, B., Machetie, E., Peled, M., & Ohel, G. (2003). Commonoralmanifestations during pregnancy A review. Obstetrical and Gynecological Sur vey,58(9), 624-628.Baranowski, Cullen, K., Nicklas, T., Thompson, D., & Baranowski, J.( 2003). Are currentHealth behavioral change models helpful in directional prevention of weight gain efforts?Obesity research 11.Janz & Becker. (1984). The Health Belief Model A decade later. Health educationquarterly.11 (1)1-47.Jeffcoat, M., Geurs, N., Reddy, M., Cliver, S., Goldenberg, R., & Hauth, J. (2001).Periodontal infection and preterm birth Results of a prospective study. Journal of theAmerican Dental Association,132, 875-880.Behrman, R., & Butler, A. (2007). Preterm birth Causes, consequences and prevention. fieldAcademic Press, Washington, DC. 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