Essay Sample on Health Assessment and Teaching Plan in Navajo Community

The Navajo community is one of the largest tribal nations in America. For long the community has been neglected ad forgotten when it comes to crucial issues such as health. I once worked at an Indian hospital while living in Seattle, Washington. From working there, I got to understand that individuals from the community face unique challenges such as life stressors and the lack of knowledge and access to quality health services. The population has a high rate of individuals with diabetes. According to the Center for Disease Control and Prevention (n.d), Navajo, the largest tribal community in America, are twice as likely as any other nation to experience diabetes because of health inequalities such as the lack of access to care. Also, CDC (n.d) indicated that up to 200,000 people live in the Navajo Nation. Additionally, it is approximated that more than 75000 people in the Navajo nation have prediabetes, and 1 in 5 adults have diabetes (CDC, n.d). A health assessment is a plan of care that aims to identify the specific needs of a patient and how a health professional will work with the patient to ensure those needs are met. Furthermore, a teaching plan, in this case, outlines a comprehensive session that provides interventions for diabetes. I will be working with the Navajo community to determine nutrition, exercise, and stress management interventions. The paper provides a health assessment teaching plan and stress assessment for the Navajo community.

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Health Assessment

Cultural Assessment

A cultural assessment plan is needed to form the foundation of the care plan and interventions. By conducting a cultural assessment, I will manage to understand the community’s cultural beliefs, values, and practices that will provide individualized care to the community. Some of the questions to be asked in the cultural assessment will include the following,

• What cultural group do you identify with?
• What are some of the negative and positive experiences you have had when communicating with other people?
• What barriers do you experience in accessing healthcare?
• What are your feelings about living with diabetes?
• How many meals do you have per day?
• What are some of the foods do you normally consume?
• Do you have someone who you share any problems you might have?

Learning Assessment

The learning assessment provides the objectives, content, rationale, and evaluation of the older adults in the Navajo community. Some of the learning objectives include an overview of diabetes, prevention strategies, education on the skin and foot care, as well as the management of their hypo/hyperglycemic episodes. By the end of the learning, I hope that about 80% of the population will manage to understand and fulfill the objectives. The table below shows what the community will learn at the end of the intervention.

Objective Content/Documentation Teaching/Rationale Evaluation

Diabetes overview The community will describe what diabetes is and how to manage it. 1. Explain how insulin works.

2. Explain how the pancreas works. They will be able to teach others in the community what diabetes is, and get a teach-back from their other community members

Describe the prevention of type 2 diabetes.

1. Weight reduction for overweight individuals.

2. Exercise regularly

3. Eat a balanced healthy diet.

4. Control their blood pressure.

1. Teach menu planning.

Eat only the recommended amount of calories per day.

2. Exercise 3-4 times a week such as walking, joining an exercise class, and riding bikes.

3. Eating fruits, vegetables, whole grains, beans, and lean protein. If they cannot get fresh fruits and vegetables, they should buy canned in water without added sugar. Also, they should follow ADA recommendations.

Also, they should control their carbohydrates by starting with 45-60 grams, and adjust as needed.

4. Lose excess weight. Exercise regularly. Eat healthy meals. Decrease sodium intake. Limit alcohol. Quit smoking- Join a support group. Reduce stress- exercise, meditation, Prayer drums.

The patients in the community will be able to teach back what a healthy diet is and how to prevent diabetes.

Teach skin and foot care to the Native American community.

1. Wash feet daily

2. Inspect skin

3. Wear appropriate shoes and socks

1. Wash and dry feet carefully each day, especially between toes.

2. Inspect the skin for changes. Inspect calluses, swelling, bruising, breaks in the skin, report changes to the doctor.

3. Wear non-constricting shoes and a cotton sock. Do not go barefoot. Patients in the community will understand that feet problems are common in diabetics and understand the importance of taking care of their skin.

Patients in the community will be able to manage hypo/hyperglycemic episodes.

1. They will check on blood glucose.

2. They will recognize hypoglycemia.

3. They will recognize hyperglycemia.

1. Demonstrate how to use the glucometer. Explain why it is important to keep track of your blood glucose levels.

2. They will understand hypoglycemia symptoms such as feeling shaky, anxiety, sweating, chills, clamminess, irritability, confusion, racing heartbeat, dizziness, hunger.

3. Patient will understand hyperglycemia symptoms: Increased thirst, headache, trouble concentrating, blurred vision, frequent urination, weight loss, nausea and vomiting, fruity-smelling breath, abdominal pain.

The patients in the community will verbally state how to manage diabetic problems.

Motivation Assessment

A motivation assessment will be useful because it will provide insights into the suitability of the interventions for diabetes. The community will need to be motivated to ensure that they cooperate through the process and acquire as much information that is needed regarding nutrition, exercise, and stress management. The focus of the motivation assessment is to provide opportunities for the community to care for themselves and enable them to stay motivated to improve their quality of care. Some of the motivation strategies to help them will include helping them to make good food choices and allow them to vent their frustrations on their causes of stress. Furthermore, I will organize morning walks with them every weekend and, as well as remind them every morning through text messages to take their medications and test their blood sugars.

Stress Assessment

The purpose of the stress assessment will be to examine the levels and extents of stress among the Navajo community. The stress assessment will determine elements such as possible stressors, ideas for stress reduction, and social support needed for the Navajo community. The elements of the stress assessment include the following,

Possible stressors - Among the Navajo Native American community, one possible cause of stress is their quest for tribal justice. Todacheene (2015) indicated that before the introduction of the Euro-American cultural system, the Navajo nation had its traditions and values as well as land. However, after that, the imbalance of culture made the nation lose its land, as well as, traditional values, and cultures. The loss of their land, traditions and cultures made the Navajo community helpless and vulnerable, which ultimately resulted in their stress levels increasing. Furthermore, Trevisi wt al. (2019) indicated that the lack of access to treatment on conditions such as diabetes is a burden to people in the Navajo. The lack of quality treatment is also a stress factor because of their vulnerability and lack of money and insurance to cater for their hospital bills.

Ideas for stress reduction – for the Navajo community, the possible ideas for stress would be to draft policies that advocate for their rights to their land and improvement in their quality health services.

Social support - Social support has a strong correlation to improved health outcomes in Native Americans. The type of social support that is appropriate for the group is emotional. It involves expressions of sympathy, love, and care. Conte, Schure, and Goins (2015) established that social support had significant associations with positive self-reported health status. The social support would help the Navajo community alleviate their stress and improve their living conditions.

Teaching Plan

The teaching strategy for the Navajo community will include PowerPoints, lectures, demonstrations, questions and answers, audience participation. The schedule for the teaching plan will August 1st, 2020 from 2:00 - 6:00 pm at the Navajo Community Center, special events room. The contents in the teaching plan will include the following,

Introduction -15 minutes.

Treatment/prevention, and where to find help - 15 minutes.

Health issues unique to the Navajo Native American population - 40 minutes.

Break with refreshments -15 minutes.

Peer support programs on the reservation - 10 minutes.

Opportunity for participants to offer input - 10 minutes.

A presentation by a Native American traditional healer - 40 minutes.

Break with coffee provided - 15 minutes.

Benefits of physical activity film - 10 minutes.

Information about where to find resources for stress reduction, including counseling, AA, exercise groups - 10 minutes.

Meditation introduction - 10 minutes and meditation practice for 1 minute.

A conversation about what the community center offers - 30 minutes.

Opportunity for participants to ask questions - 10 minutes.

Raffle at the end of the meeting – the prize reward will be $50 gift card for groceries.

Instruction Materials in the Teaching Plan

One of the instruction materials will include a brochure that outlines the significance of physical activity in the Navajo community. Also, a lecture on the importance of nutrition physical activity, and stress management will be provided. Additionally, a guest speaker, a mental health nurse in a community hospital will appear to talk about stress reduction. The brochure for the importance of physical activity is below.

Conclusion

The health assessment and teaching plan will help the Navajo Native American community learn to incorporate a healthy nutritional plan, learn how to do exercises, and manage stress. From research about the Navajo Nation, it is apparent that the community needs support and motivation through the intervention. At the end of the intervention, I am hopeful that about 80% of the population will manage to follow a proper nutrition plan, perform physical activity, and engage in stress reduction strategies.

References

Centers for Disease Control and Prevention. (n.d). Navajo youth lead the way to healthier lives in

Arizona, Utah, and New Mexico. NCCDPHP Success Story. https://nccd.cdc.gov/nccdsuccessstories/TemplateSeven.aspx?s=13770&ds=1#:~:text=Approximately%20200%2C000%20Navajos%20live%20on,estimated%20that%2075%2C000%20have%20prediabetes.

Conte, K. P., Schure, M. B., & Goins, R. T. (2015). Correlates of social support in older

American Indians: The Native elder care study. Aging & Mental Health, 19(9), 835–843.

doi: 10.1080/13607863.2014.96717. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5338610/Todacheene, H. J. (2015). She saves us from monsters: The Navajo creation story and modern

tribal justice. Tribal Law Journal, 15. https://lawschool.unm.edu/tlj/volumes/vol15/TLJ_15-2_Todacheene.pdfTrevisi, L., Orav, J. E., Atwood, S., Brown, C., Curley, C., King, C., Muskett, O., Sehn, H.,

Nelson, K. A., Begay, M. G., & Shin, S. S. (2019). Integrating community health representatives with health care systems: clinical outcomes among individuals with diabetes in Navajo Nation. International journal for equity in health, 18(1), 183. https://doi.org/10.1186/s12939-019-1097-9