Donna and David Ellis are 65 and 68 years old, respectively. They have been marr

Question

Donna and David Ellis are 65 and 68 years old, respectively. They have been married for 2 years. Both were single widowers for quite a while, but never gave up on the idea of finding a partner. After reading so many ads, seeing commercials on TV, and being encouraged by family, they each joined an internet singles program. Within 3 months they met, and were married a year later.

Donna has just started receiving Medicare benefits and her Social Security payment. She read through the material and discovered a program known as a “Welcome to Medicare” preventive visit and made an appointment. David has not participated in preventive health his entire life. He believes if you take good care of yourself, there is no need to see a health care provider and spend time or money. Other than smoking a ½ pack per day from age 55-65, he has been conscientious in most lifestyle choices. He has stayed physically active through being a mail carrier and playing on a men’s softball team. He eats three balanced meals per day with no snacking. He does not use alcohol or recreational drugs. Donna has had issues with maintaining ideal body weight since menopause, drinks a glass of wine daily, and takes an anti-hypertensive and a statin drug. Yet, she has the philosophy, “an ounce of prevention is worth a pound of cure.”

Donna and David have a number of conversations about his lack of preventive health care. She emphasizes repeatedly how much she loves him and wants to live many years of marriage together. David finally concedes to her request and schedules an appointment for a full physical exam with labwork and screenings—only after Donna agrees to play golf with him once a week.

Use the set of questions below to identify factors which influenced both David’s decision to pursue preventive health care and Donna’s decision to play golf with him.

What personal factors were influential (perceived self-efficacy)?

What were the perceived benefits of action?

What were the perceived barriers?

What were the interpersonal influences?

Identify a nursing diagnosis for David.

Explanation / Answer

1 David's belief about his own capabilities ,the opinions he has about himself influence on how he think ,feel and act.David percieved self-efficiency plays a central role in the self regulation of motivation through the casual attributations ,expected outcomes and taking of decisions.Though he has not taken preventive health.he knows how to maintain his health and is not an addictive to any substance abuse.But David has strong commitment towards his wife and that is the main factor which influence his decisions.

2 David is in his early ages of old age and this is the time most diseases creeps in,though however initiatives we take.So if we he agress to Donna it will be beneficial for him.A routine check-up will reveal any hidden lifestyles diseases and start an early treatment for the same.

3 David believes in his self efficiency to manage any potential health problems which may arise in the future.He also focus on self managing rather than on preventive health.

4 Though David has his own principles for effective self management of problems .From the scenario it is quite clear that he has strong interpersonal relationship with Donna.So it is easy for Donna to make him seek preventive helth care with a little bit compulsion.

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