Final Re-Arranging And Adding Capstone essay paper
Final Re-Arranging And Adding Capstone
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Final Capstone Project Manuscript
Kathyrina Pham
The United States University
MSN 600
April 19, 2022
Abstract
Obesity was approximately 43 percent in the U. S. in 2017–2018. In the United States, obesity prevalence increased from 30 percent in 1999 to 42 percent in 2018. Over the same time span, the prevalence of extreme obesity climbed from 4.7 percent to 9.2 percent. Obesity has been linked to strokes, heart attacks, DM2, and a variety of malignancies. Those are among the most common causes of death that can be avoided. In 2008, obesity was predicted to cost the US $147 billion in healthcare costs. Obesity-related medical costs were $1,429 more than those linked with such a healthy body weight (CDC, 2021). It is the second most preventable cause of death after smoking (Panuganti et al., 2021). Obesity therapy, whether by diet and exercise or gastric sleeve surgery, is graded on its capacity to effectively reduce weight in individuals with certain high-impact disorders over a 6-month period.Final Re-Arranging And Adding Capstone
The proteome analysis of the patients was used in this experiment, and they were categorized into two groups based on highest score of the BMI or its severity. A low-calorie diet has linked with weight loss with minimum side effects or rebound. Researchers employed a randomized controlled trial to provide guidance for a specific plan with recommend a 6- to 12-month full lifestyle changes that includes reduced caloric intake, exercising regularly, and behavioral modification tactics (Semlitsch et al., 2019). On the other hand, the other participant groups are recommended shrinking the stomach’s size through laparoscopic surgery and limiting the number of calories consumed at one time (Puzziferri & Almandoz, 2018).Final Re-Arranging And Adding Capstone
After six months period, a report will generate the amount of weight loss through these groups including and side effects and rebound weight gained. The action plan’s goal is for obese individuals to lose weight and achieve a BMI about less than 25.
Obesity management might be challenging owing to a lack of commitment to the diet plan and a desire to complete the program. Clinicians can better target resources to individuals who are often at threat in this project concert by examining patients’ issues or rebound weight gain. The Medical Outcomes Study is a study that looks at how medical interventions affect people’s quality of life. Physical functioning, role limitations owing to physical health concerns, physiological discomfort, iv) overall health perspectives, v) energy, vi) social functioning, vii) position restrictions caused by emotional issues, and viii) psychological health are the eight categories assessed by the SF-36 (Panuganti et al., 2021).Final Re-Arranging And Adding Capstone
Keywords: obesity, overweight, diet, exercise, low-calorie diet, gastric sleeve surgery
Table of Contents
Final Capstone Project Manuscript…………………………………………………………………………………… 5
Background & Significance……………………………………………………………………………………………… 5
Literature Review……………………………………………………………………………………………………………. 6
Supporting Evidence……………………………………………………………………………………………………….. 6
Purpose or Aims of the Study…………………………………………………………………………………………… 7
Theoretical Model or Framework……………………………………………………………………………………… 8
Methods/Design/Sampling……………………………………………………………………………………………… 11
Proposed Interventions…………………………………………………………………………………………………… 13
Expected Results/Outcomes……………………………………………………………………………………………. 16
Anticipated Conclusion………………………………………………………………………………………………….. 16
Possible Limitations………………………………………………………………………………………………………. 17
Potential Implications to Practice…………………………………………………………………………………….. 18
References……………………………………………………………………………………………………………………. 20
Appendix A………………………………………………………………………………………………………………….. 23
Appendix B………………………………………………………………………………………………………………….. 24
Final Capstone Project Manuscript
In the United States, obesity was 42.4 percent in 2017–2018. Obesity prevalence in the United States climbed from 30.5 percent in 1999 to 42.4 percent in 2018. Extreme obesity prevalence increased from 4.7 percent to 9.2 percent within the same time period. Obesity is connected to stroke, heart disease, type 2 diabetes, and several cancers. These are some of the most common preventable causes of death. Obesity was expected to cost $147 billion in medical costs in the United States in 2008. Medical costs associated with obesity were $1,429 more than those associated with a healthy weight (Centers for Disease Control and Prevention [CDC], 2021). As a result, the theoretical framework will be focused on better-individualized patient education tactics to forecast eating habits and effectively lose weight. Rather than engaging solely when a crisis has developed, this approach promotes long-term obesity prevention as the ideal model.
My capstone research investigates the efficacy of weight-loss programs. My PICOT issue statement is: Does the implementation of bariatric surgery (I) compared to lifestyle adjustments (C) deliver weight-loss effectiveness outcome (O) in at least six months periods (T) among individuals aged 18 and up with obesity (P)? One of the most often used models for avoiding and altering bad behaviors while Pender’s philosophy of health promotion is focused on excellent health. The fundamental components of Pender’s health promotion model are individual attributes and experiences, cognition and affect specific to behavior, and behavioral results. (Khodaveisi et al., 2017). Pender’s health promotion model is a nursing-based framework for predicting health behaviors. Pender’s health promotion model was created to identify the factors that contribute to better health through personal and behaviorally specific cognitions and affect. When constructing interventions, behavior-specific cognitions and outcomes are crucial motivating factors to consider (Hwang & Kim, 2020). Obese individuals who are participants in the study should commit to lifestyle modifications such as maintaining adequate and routine exercise regimens in order to prevent and change bad behaviors. Patients who do not maintain a healthy lifestyle following bariatric surgery will relapse to obesity.
The proposed solutions must be based on a predetermined strategy that has already proven to be beneficial. Semlitsch et al. (2019) and Puzziferri & Almandoz (2018) make recommendations based on their research, which yielded positive results. Semlitsch et al. (2019), for example, advise for a 6- to 12-month complete lifestyle plan that requires decreased calorie consumption, increased physical activity, and strategies to facilitate behavioural change. Puzziferri & Almandoz (2018) suggested using laparoscopic surgery to remove a portion of the stomachs through small incisions, resulting in a narrow “sleeve” out of the stomach. The surgery reduces the size of the stomach, restricting the amount of foods that may be consumed at one time. It aids patients in feeling satisfied with less meals. The procedure also alters the synthesis of hunger-suppressing hormones that stomach and intestines produce.
All but three of the 19 suggestions contained suggested lifestyle adjustments, which included food, physical activity, and behavioral treatments. People with a BMI of more than or equal to 30 kg/m2 or a BMI of more than or equal to 25 kg/m2 and weight-related problems should lose weight (eg, diabetes mellitus type 2, hypertension). Bariatric surgery is a therapy option for persons with a BMI >= larger 40 kg/m2 or a BMI >= 35 kg/m2 with weight-related problems, according to eleven guidelines. (Semlitsch et al., 2019).
Patients, clinicians (who will be directly involved), and the government (who will be indirectly stakeholders) will be the project’s key stakeholders. The intervention (education) is anticipated to be a healthcare reform that would necessitate the participation of all stakeholders in their various roles. Patients are expected to engage in the study willingly and obediently as primary suppliers of weight loss information. Patients who have lost weight successfully will be included in the experiment. Clinicians are the first to respond, and they are expected to provide their patients with useful health education. The government will have an influence on policy reforms requiring all overweight and obese patients to get mandatory education.The project’s primary stakeholders, patients, providers, and the government, will improve the outcome if they collaborate closely.
All the project’s stakeholders are enthusiastic about it and are prepared to help where they can, whether through direct influence or resource supply. The findings of the study will be of relevance to health services as a whole, as well as medical facilities and patients’ family and friends. It could also benefit pharmaceutical and insurance corporations in terms of profit margins and their moral obligation to patients. Given the burden created by complication of obesity and the cost impact on health care as a whole, encouraging stakeholder participation should not be a challenging task. Mandatory public meetings will be held to establish these ties, allowing each participant to participate by submitting evidence pertinent to the research. Stakeholders will also be asked to collaborative the research when it is completed, based on specific field of expertise. This will boost the research’s validity and acceptability. To guarantee that all of their ideas are included in the findings, all stakeholders must work together to decide the nature of the analysis.
Because different stakeholders place varying values on different areas of healthcare, there will almost certainly be conflict over which project goal should be prioritized. Stakeholders are likely to have biases that could jeopardize the project’s success, depending on the specific value provided by the research findings. Most patients are concerned with their health while functioning, whereas physicians are concentrated on compliance (de Gooyert et al., 2017). If each stakeholder assigns a distinct value to a given variable, the outcome may be influenced. The goal of the study is to focus stakeholders’ minds on the issues and make it a key part for each participant. Evidence-based research is generally expensive, which is another problem that can delay the research’s conclusion.
Complete stakeholder engagement is required for any quality research to be effective. I propose to open and build clear communication channels, taking into account the different viewpoints and perspective among stakeholders. To prevent confusion and promote equity, all involvement should be public and standard (de Gooyert et al., 2017). Stakeholder education is also necessary to ensure that all parties adopted in this research are aware of their roles and responsibilities. Every participant will also be required to pursue research with whichever capacity they desire, based on their experience. Similarly, education must have constraints in order to allow sufficient study to take place without external interference. As a result, all stakeholders will be asked to participate in the development of guidelines via deliberation. To sustain health-care standards, all guidelines must be ethically and morally enforceable (de Gooyert et al., 2017).
Theoretical Model or Framework
Pender’s health promotion theory is mostly social cognitive, focusing on variables such as an individual’s experiences and attributes, behavior-specific cognition, and outcomes (Chen & Hsieh, 2021). Its features examine the perceived advantages of patient education while also considering potential impediments. It also emphasizes the importance of each stakeholder’s involvement in maximizing engagement. The study will look into why people have certain worldviews about health, how these attitudes affect their response to treatment, external influences such as friends and family, and their linkages to weight-loss programs using an experimental research technique. The study’s methodology focuses on establishing causal linkages between patients and their eating habits, which helps to answer issues about how to properly manage weight-loss situations.
Because it is beneficial in gathering and analyzing various types of numerical weight-loss data, the model effectively presupposes both qualitative and quantitative methods. There is a growing understanding that combining quantitative and qualitative findings in a mixed-method synthesis can aid in understanding how complexity affects treatments in specific circumstances (Noyes et al., 2019). Data, which are measures of counts and values, are commonly characterized using statistical approaches in quantitative research, which helps the researcher draw judgments. In order to discover the underlying meanings of human experiences and behaviors, qualitative research includes the recording, interpretation, and analysis of non-numerical data. The third methodological technique, mixed methods research, entails gathering and analyzing both qualitative and quantitative data with the goal of answering separate but related questions, or even the same questions (Renjith et al., 2021). Quantitative research examines patient connections in order to identify trends and create predictions that may be applied to a larger population. Assuming this type of study ensures that a patient’s sociocultural ideas are taken into account when establishing the best treatment plans after the study is over. The efficacy of the intervention is dependent on the patient’s willingness to accept it; as a result, certain attitude concerns must be included in the research. Structured observation will be the primary method of data gathering in qualitative research. The method will allow for the classification of behaviors as well as their attribution to specific outcomes. The study will use document review, such as retrospective electronic chart review, as the major data collecting strategy to acquire medical evidence of eating habits and treatment plans in order to identify patterns that will help researchers answer the research question. The study will look at personal records that have been authorized and populated by healthcare facilities, as well as physical evidence that has been uncovered. Comparisons will be performed between the time of the first diagnosis of obesity and six months later, with an emphasis on eating habits trends in gaining or decreasing weight (Nebeker et al., 2020).
Education, as a theoretical framework, will be used to assess the development of the research from start to finish. The study’s assertions will be supported by a comparison of patients’ behavior before and after an intervention. The model instinctively confirms the research’s theory and offers a tailored outlook on weight-loss interventions. Pender’s health promotion model focuses on behavioral counseling to assist lifestyle changes, which allows for successful change to any problem (Khodaveisi et al., 2017).
The approach effectively asserts that inherited beliefs have an impact on how a person is treated. As a result, people only commit to interventions that appear to be beneficial. Patient compliance, and hence their commitment to participate in health-promoting activities, is also influenced by family, peers, and clinicians. Patients can make a commitment to the desired habit and stick to it over time. Patients are enticed to join in the study through health incentives. The model presents a long-term weight-loss regimen that is appealing to many patients. Unfortunately, the model fails to accurately define the fundamental elements of any nursing philosophy including environment, health, and man (Hwang & Kim, 2020). Education is identified as the key health-promoting intervention in the study, which supports the hypothesis.
An uncontrolled randomized experimental research design will be employed in this investigation. The practical study design is the term used to describe the impact of changes between dependent variables or independent groups (Miller et al., 2020). Variables are frequently referred to as independent and dependent variables. The group variables are the independent variables in the study design, whereas the study variables or results are the dependent variables. As a result, the research will look at the two distinct groups in the study and analyze the changes that occurred as a result of their program.
The study’s measurement tools will be a low-calorie diet combined with 30 minutes of exercise for obese patients without any surgery compared to a regular diet for post-gastric sleeve surgery patients. Obesity is generally caused by a discrepancy between calories consumed and calories expended, while genetics and illnesses such as hypothyroidism, despair, Cushing’s disease, through the use of antiepileptic drugs and antidepressants can all contribute to fat accumulation in the body. Obesity is treated mostly through diet, augmented by workouts and supported by cognitive behavior therapy. Calorie restriction is one of the most used dietary plans. A low-calorie meal is defined as one which eats around 800 to 1500 calories a day, though a very low-calorie meal is defined as one that consumes less than 800 calories each day. In regards to macronutrients, mineral deposits, and vitamins, most diets must be well-balanced. Carbohydrates should make up 55 percent of the total calories, proteins ten percent, and fats thirty percent, with saturated fatty acids accounting for ten percent of total fat. After you’ve reached your target body mass, gradually increase your dietary calorie intake to maintain a balance between caloric intake and calorie expenditure. Regular physical activity boosts diet efficiency by enhancing the satiating power of a fixed meal, and it’s crucial for maintaining diet-induced weight loss (Perreault & Apovian, 2021). Thus, the study will investigate how effectively the low-calorie diet with exercise comparing to the gastric sleeve surgery in weight loss management. These patients will be weight daily and monitor their lab works weekly to monitor their body reaction.
To kick off the effort, flyers will be prepared and distributed throughout the College Hospital in Costa Mesa and primary doctor offices throughout Orange County. All the qualifications and attributes that a volunteer must possess in order to participation in the study will be listed on the flyers. Participants will be asked to provide their full name, contact information, e-mail address, and diagnoses on a website that will serve as a sign-up page. The log sheet will be open for a short time before automatically closing. Once the deadline passes, the team will prepare a questionnaire that includes all the credentials they’ll need. What type of exercise do you do, for example: cardio, weight-bearing, yoga, or Zumba? How much time do you spend exercising each day? How many times a week do you exercise? What kind of food do you eat? Do you keep a food journal? Do you follow a special diet or a conventional one? Participants will be picked at random based on their answers to these questions. At the first day of our conference, all participants will be given an informed consent form following the sequence of the patients. On the first day of the meeting, you will receive a series of instructions. Before the session, the recommendations will describe the kind of foods which can be fed and the amount of exercise that can be undertaken.
I’ll go over the various types of exercises that will be done during the first day of the program. In the same way, I’ll schedule everyone on different times and days; schedules will be provided. I’ll conduct the assessments and discuss what they comprise on the same day. I’ll keep track of weight as well as any changes in the body on a weekly basis.
To manage obesity using the low-calorie diet and exercise, I will provide a specific menu for each week in combination with the exercise scheduling. The meal menu will specify the amount, portion, the ingredient, and the time for consumption. The exercise schedule will entail the type of exercise, duration and the frequency of exercise set. It will provide the specific exercise lesson to burn a specific amount of calorie each day. Participants also keep a daily weight diary. Moreover, the patient will keep a dairy of any changes in their body such as energy level, nausea, vomiting, diarrhea, constipation, dizziness, fatigue and so forth.
On the other hand, to manage obesity using regular diet for post gastric sleeves surgery patients, I will ask for the daily diet diary from the participants with the daily weight diary. In addition, I will call weekly talking over the phone or telehealth with the patient to assess for any changes in the body including nausea, vomiting, constipation, diarrhea, dizziness, fatigue, and so on.
Obesity has evolved into an epidemic that has gotten worse over the previous 50 years. The cost is projected to be around $100 billion every year in the United States. Obesity is a complicated disease with numerous causes. After smoking, it is the 2nd major cause of death that can be avoided (Panuganti et al., 2021). Obese people have a higher risk of dying and are more likely to suffer from a variety of health problems. They die at a higher rate as they get older, owing to intrinsically poorer defense systems versus their younger generation. Lower income is linked to a higher risk of obesity. However, the possibility of a reverse causality, in which obesity is regarded a cause of reduced income when obese persons drift into lower-paying employment due to labor–market discrimination and public stigmatization, is frequently overlooked (Kim & von dem Knesebeck, 2018). Obesity patients bear a significant social and financial burden, not just on themselves but also on the society.
Obesity is challenging, making it tough to lose weight successfully. Patients with obesity who have yet to lose weight typically have a number of comorbidities (Hall & Kahan, 2018). Interdisciplinary and patient-centered weight loss techniques are the most effective. They must enlist the assistance of many other team members to help the patient. Weight loss must be coordinated at all levels, including chronic management to medical clinics and acute care institutions (Panuganti et al., 2021).
Providers must use an evidence-based change model to establish an effective weight loss treatment system. In this case, the ACE STAR Model of Transformation is the preferred framework for change, as it combines data gathered in the clinical setting and applies it into practice (Dolezel et al., 2021). The paradigm is an interactive learning cycle that provides a clear structure for an evidence-based practice method to function inside. To improve patient outcomes, nursing practitioners want to employ the technique to combine cumulative knowledge using individual skill. As a result, it is likely that its adoption will have a positive impact on the communities who are now being targeted.
Only a few important stakeholders will be participating in this proposal, but their collaborative power will be crucial to the development’s success: a project coordinator, a physician, a nurse, a state official, and a representative from the institution. The physician and nurse are important because they bring experience and skill to the process, as well as crucial input on how the procedures should be conducted and practical ideas for professionally addressing the issue. Stakeholder proposals will be organized by institutional representatives, who will examine if they are appropriate for the organization’s setting, possibly contributing in the integration of knowledge and experience.In this situation, an official delegate will assess the quality of patient care and evaluate if it meets national standards. A project manager’s major responsibility is to structure the project and ensure that individual tasks and responsibilities are accomplished properly.
The hospital will create a welfare community initiative, through which patients will be able to get financial and social help, especially if they have chronic illnesses. Investors, healthcare professionals, and participants will all be participating in the wellness, and they will be brought in via education workshops and seminars to assist protect themselves against weight loss. The welfare group’s booklets will be sent to suitable patients for evaluation.
The goal of the action plan is for obese patients to reduce weight to a BMI of less than 25. As a consequence, the body composition such as height and weight of the patient are evaluated throughout the therapy as essential indicators. The committee will make a report after six months to see if there has been any improvement.
If the hospital’s results are satisfactory, the initiative could be broadened all across the area to cover a variety of institutions with a wider patient population. Other states’ hospitals may be permitted to take similar action to make sure that these changes are made in their facilities.
The team will need a website to communicate with various stakeholders. Internally, monthly reports detailing the job completed will be generated. They can also hold a Zoom conference meeting every two months to tweak or analyze the project’s progress.
A reform strategy of this sort is expected to lead in future medical gains for chronically ill people as well as cost savings. Professionals expertise and experiences, as well as data from academic evaluations, were used to turn the concepts garnered into proof. The evidence was then put into effect, and once in place, it will undoubtedly benefit patients and healthcare organizations.
Obesity, as previously mentioned, has a variety of overall health consequences. As a result, individuals must take appropriate steps to ensure that they achieve and maintain a healthy weight for a quality life. A few of the expected outcomes of adult obesity treatment are listed below.
The first goal of the approach is to help obese people lose weight. Obese patients benefit from weight loss for a variety of reasons. They include decreased blood pressure, lower cholesterol levels in the blood, and increased mobility due to less stress on the bones and joints of the feet and hands.
Another planned outcome of the treatment is that the reduced body weight would be maintained. Furthermore, the patients are urged to avoid regaining their previous excess body weight. Despite their weight decrease, healed obese individuals must follow a healthy meal plan. This method will not only keep people from gaining weight, but it will also feed the body with important nutrients and vitamins (Kim & von dem Knesebeck, 2018).
The longer a person is overweight, the more serious the obesity-related risk factors become. Obesity also raises the likelihood of developing additional chronic illnesses and symptoms. As a result, preventing obesity in the general public is crucial for health care professionals and other health related stakeholders. Increased public awareness of weight gain, its risk factors, and management techniques is one way to manage the disease.
In addition, for a healthy nation, the authorities and other medical players can engage in prevention and treatment. Subsidizing nutritious foods like fruits and vegetables is one example of an intervention strategy that the government may use. In addition, the government can organize community events and rallies to promote physical activity in the community. In furthermore, the government might allow public playgrounds encouraging obese patients to participate in physical activities.
Finally, adult obesity therapy may lead to a reduction in obesity-related morbidity and death. The anticipated outcome for the program is reduced mortality rate of the population in the country. Furthermore, symptoms and diseases associated with obesity, including such hypertension and cardiovascular disease, will be less prevalent (Kim & von dem Knesebeck, 2018).
Evidence-based patient care is an important method for nurses to include patients in their treatment strategies. Some of the important aspects that contribute to the efficacy of EBP and the use of telemedicine care in the health context are as follows: Professionals with a high level of knowledge in the field of health care. More quality patient care has emerged from the rapid advancement and usage of information and telecommunications technology. There are online peer-to-peer discussion forums that can be helpful. Screening consultant. Telemedicine enhances patient satisfaction and habits by providing appropriate health care counseling and treatments. EBP, on the other hand, is formed by a plethora of defects that have an impact on its outcomes. Among these faults are the risks of a lower screening incentive, a lack of health awareness of medical services offered through telemedicine infrastructure and systems, and high expenses of getting medical services (Zolfaghari et al., 2018).
Insufficient health care facilities, the greater cost of health care appliances, teaching, and preservation of telehealth remedies, limited network internet access in rural areas, inadequate training, knowledge, and assets, social construction barriers in developing and industrialized economies, and client confidentiality potential dangers are just a few of the major threats to nurses’ EBP implementation. Nonetheless, EBP adoption has significant potential for improving healthcare services. Such possibilities include access to the technology that has assisted robust development in healthcare, WHO sustainability, the growth of telehealth connections to communicate effectively between rural areas and medical providers, reducing the healthcare cost, and patients in trying to raise recommendations for service delivery (Ladd et al., 2020).
Potential Implications to Practice
The increased number of obese individuals, and the severity of their disease, has an impact on healthcare profession, particularly nurses who provide direct patient care. According to new research, client overweight may enhance nurse tasks and time spent delivering clinical care. The increased number of obese individuals, or the complexity of their disease, puts more pressure on nurses by cutting the level of time they have to care for them. To meet these growing demands, more nurses are needed, especially those who have advanced clinical abilities.
Obese persons often necessitate specialized and costly medical and paramedic equipment for medical treatment and transfer. Health care workers may be at a greater risk of moving and handling accidents when treating obese patients. Adult obesity management that is effective minimizes the burden involved in caring for these patients. As a result, nurses’ workloads are less burdened. Nurses also report greater job satisfaction while their clients are at a lower risk of negative medical consequences (Hall & Kahan, 2018).
In conclusion, overweight amongst adults in the United States became a major source of worry in the medical community. Obese adults are on the rise in substantial numbers. The numbers are anticipated to climb again in the following five years, according to reports. Obesity is caused by a combination of factors including inadequate nutrition, physical inactivity, and underlying medical issues. A number of obese individuals in the country has also increased as a result of technological improvement. Individuals spend a lot of their leisure time on their phones, television screens, and computers instead of participating in physical activities, which is bad for their health.
Obesity puts the life of these individuals and their children in jeopardy. When compared with children nurtured by healthy parents, kids who grow up by obese adults become double as likely to become obese in the future. As a result, it is critical for individuals to assume responsibility for their own health in the interests of future generations. Obesity management efforts must also be supported by healthcare stakeholders for a healthy and productive population (Hall & Kahan, 2018).
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Poster
