NHM 531 Case Study 2
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School
University of Mississippi *
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Course
531
Subject
Health Science
Date
Apr 3, 2024
Type
docx
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4
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NHM 531: Case Study 2
Mary Claire Dale
Based on Andrew’s nutrition assessment, his sedentary behaviors due to his commute to the office and being seated behind a desk significantly contribute to his fatigue. Along with this, his decisions to eat mainly convenience foods and watch television while having chips and beer also contribute to his low energy levels. His testimony of simply having no time for exercise can simply be replaced with his time spent on the couch after work with his friends. A proper nutrition screen can be administered, but most of the questions present on it have been answered by Andrew already. Thus, a more in depth assessment can be done by the RDN that includes: anthropometrics, biochemical, dietary, energy/exercise, and functional status. With a BMI of 31, Andrew is within the range of obesity, so acquiring information about his food preferences, allergies, diet history, body fat/muscle mass %, fluid accumulation, educational status, and kitchen usage, will help formulate a plan to initiate weight loss. Andrew has stated he desires dietary and lifestyle changes to help positively alter his way of life, so he is apparently aware of the position his health is in at this time. Furthermore, as Andrew has admitted that he does not want to be following the footsteps of his mother being that she died from diabetes, he has a positive perceived susceptibility to his health circumstance. In educating him on the perceived severity of metabolic syndrome, being pre-diabetic with genetic predispositions, and an inflated BMI, it is important for him to understand the consequences of these diagnoses via scientific evidence.
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Once those points have been covered, it is imperative for Andrew to understand there is a
light at the end of the tunnel. Allowing him to see testimonials of previous clients that have been successful in their journey of weight loss as risks for diabetes or heart disease, would allow him to understand this journey is entirely possible. Also, allowing him to share with you what he has learned so far and that he can turn his health around affirms the dietary plan and its effectiveness.
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His next step will be implementation of the plan designed and how to accurately follow this program via methods of how-to education and virtual check-ins with the RD. Finally, assessing his level of confidence to perform the necessary behaviors to successfully complete the program can be done through means of understanding how to make better decisions, teaching him how to verbally support himself, and how to set and achieve small goals to keep a steady progression. Through self-regulation practice, Andrew will be provided with the means to understand how to make decisions, self-monitor, set goals, problem solve, and self-reward. The lack of self-
regulation affects Andrew's drive to make the time to exercise, choose nutritious foods, and say no to bad habits when he’s with his friends.
In order to create a progressive motivational interview with Andrew, an affirmation and reflective listening format would work best with Andrew. By doing this the counseling session moves toward a supportive environment that recognizes the change within the client, and boosts motivation to stay on the track of change. Together we established the goal of conversing with his social circle to combat any sort of enabling practices that will allow him to decrease his waist
circumference by two inches in one month. In order to decrease his alcohol intake the following behavioral methods will be used: self-monitoring in accordance with strategies to review and identify eating patterns, goal setting as a byproduct of self-monitoring to encourage confidence to be successful, and stimulus control through understanding and modifying environments that encourage triggers. Another approach from The Lifestyle Change Group involved participants joining a Diabetes Prevention Program (DPP) Lifestyle Change Program. The program aimed for participants to lose 7% of their body weight and sustain that loss through reduced fat and calorie intake, along with 150 minutes of weekly exercise. Individual meetings occurred at least 16
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times in the initial 24 weeks, followed by bi-monthly sessions with at least one phone call between visits. Andrew would greatly benefit from this outline being that it targets all of his problem areas, and would create the concise scheduling to stay on track.