Essay Sample on Weight Gain: Maintenance of a Healthy Weight

Situation and Desired Change Description

Carrie Alves has been diagnosed with hormonal imbalance, polycystic ovary syndrome (PCOS), and insulin resistance which are clinically present due to her weight gain, infertility, acne and irregular menstrual cycle. Alves has been disturbed by her condition psychologically especially because she has been trying multiple times to get pregnant with no success. Alves is not happy about her weight gain which has significantly impaired her self-image. There is a need for quick intervention to treat Alves conditions to ensure that she leads a normal life. Insulin resistance is a severe condition that can result in further healthcare implications. Therefore, Alves will require an inter-professional care plan to be able to achieve the needed health outcomes (Sharmila & Babu, 2015). The desired outcomes include; the ability of Alves to conceive, weight loss, reduction of insulin resistance, and regular menstrual cycle. Overall, Alves needs to regain good physical, emotional and psychological health.

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Change Strategies

Nurses have a significant role in patient care and achieving the desired care outcomes. The best approach to maintain change in the health of a patient is through a continuous quality improvement model which requires the nurse to identify the clinical issues first before creating any interventions.

Developing a PICOT

The initial stage towards achieving the desired patient outcomes is the creation of a PICOT which helps to identify the interventions as well as the current patient situation. In this scenario, a PICOT will be critical in planning care and choosing the best response for the patient. The PICOT helps to improve the critical appraisal of the patient clinical features and further narrowing down of the possible interventions and outcomes to be expected (Eads & Maruzzella, 2016).

Table 2: Carrie Alves Change Strategy PICOT

Communication

Upon the collection of the necessary information and the change interventions to achieve the desired patient outcomes. All the stakeholders should be notified of the diagnosis and the intervention plans with the aim of increasing the success of the intervention and the number of people involved within a healthcare organization (Gesme & Wiseman, 2010). In Alves case, interpersonal coordination and involvement will be needed to solve every problem. The following are the critical stakeholders in Villa Health who will be directly involved in the treatment of Alves polycystic ovary syndrome and insulin resistance comorbidities.

Dietician

Insulin resistance is a serious condition that should be controlled using medications as well as a lifestyle change that will be accompanied by a new meal and nutrients plan to ensure the success of the interventions. The primary issue that is overlooked in PCOS treatment is the metabolic risk factor of the condition. Since diet and lifestyle are the most important treatment for Alves, a dietician should be consulted and continuously engaged in the entire treatment plan which optimizes her health and prevents opportunistic diseases (Grassi, 2017). As a metabolic disorder, a routine program for the appropriate nutrition to overcome binge eating which is associated with high insulin levels in the body. An anti-inflammatory diet can significantly help in the case of Alves to manager her weight gain.

Psychological Counsellor

As mentioned earlier, PCOS is accompanied by anxiety and depression especially in women because gaining weight is one of the undesired healthcare outcomes. To be able to overcome the depression and anxiety a psychologist will be required to offer counselling which will significantly contribute to positive health.

Exercise Instructors

Exercising is a critical approach of treating PCOS, Alves will require to be engaged in constant mild exercises daily to be able to manage insulin resistance which studies have shown a decrease in resistance through exercising and maintaining an active life. Besides, exercising will play a significant role in achieving the required hormonal balance in the body. Reducing weight and an increased hormonal balance in the body can help women with PCOS to be able to acquire the human environment necessary to be able to regain her fertility, acne, irregular periods and cessation of excess health growth in the body (Khademi, Alleyassin, Aghahosseini, Tabatabaeefar, & Amini, 2010). Therefore, a gymnastics instructor will be actively involved in the treatment plan and course.

Pharmacology Doctor

Apart from exercising and dieting, PCOS will be treated using hormonal injections and a recommendation of certain vitamins that will be required for full recovery. Therefore, the treatment will involve a pharmacologist who will assign medication such as inositol which is considered as a first-line treatment for PCOS. Drugs help to reduce hirsutism, acne and promote androgen levels reduction which leads to a balanced hormonal environment (Ndefo, Eaton, & Green, 2013). Estrogen and progestin combinations will be required in the treatment of the condition. Besides, Clomiphene which is a drug to induce ovulation will be used and will increase the chances of conception. Other antidiabetic agents will be added to Clomiphene to improve fertility, and the reduce androgen circulation levels such as metformin (Ndefo et al., 2013). The best pharmacology therapy is the combination of metformin and Clomiphene which success rate in curing PCOS is higher compared to single therapies.

Patient Education

The last step in the change strategy after identifying all the stakeholders who will be involved in the patient education. Patient education helps to maximize the effect and approach of the interpersonal approach of the treatment which will promote good Alves reception of the care plan. Alves should be prepared for the inter-personnel treatment as well as the change in lifestyle to be able to ultimately deal with PCOS (Gesme & Wiseman, 2010). Patient education creates readiness for change in Alves which will increase her involvement in the diet and exercise treatment approaches.

References

Ndefo, U. A., Eaton, A., & Green, M. R. (2013). Polycystic ovary syndrome: a review of treatment options with a focus on pharmacological approaches. Pharmacy and Therapeutics, 38(6), 336. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3737989/

Khademi, A., Alleyassin, A., Aghahosseini, M., Tabatabaeefar, L., & Amini, M. (2010). The effect of exercise in PCOS women who exercise regularly. Asian journal of sports medicine, 1(1), 35. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3289164/

Grassi, A. (2017, May). New Data on Polycystic Ovary Syndrome - Today's Dietitian Magazine. Vol. 19, No. 5, P. 12 Retrieved January 21, 2019, from https://www.todaysdietitian.com/newarchives/0517p12.shtml

Gesme, D., & Wiseman, M. (2010). How to implement change in practice. Journal of oncology practice, 6(5), 257-259. Retrieved from https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2936472/

Eads, V. & Maruzzella, G. (2016). The Clinical Nurse as an Agent of Change. Medsurg Nursing, 25(3).

Sharmila, V., & Babu, T. A. (2015). Oral contraceptive pills induced hemichorea in an adolescent female with polycystic ovarian disease. Indian journal of pharmacology, 47(2), 232.