Running head: PARTNER HEALTH PROMOTION

Partner Health Promotion

Stephanie Logan
Ferris State University

PARTNER HEALTH PROMOTION

Abstract
This paper explores the positive and negative factors in my
partners life that affect her real age, while focusing on her sleep
patterns. The test results show her real age to be seven years older
than her current age. Her sleep patterns had a negative impact on a
daily basis, which caused tiredness, as well as not being able to focus
in class or on her schoolwork. We set a specific, measurable,
attainable, realistic, and time-bound goal to promote a healthy change
in her life. At the same time, we used the Transtheoretical Model to
continue promoting health by walking her through all of the steps that
help create change. Once a goal was achieved, we reevaluated and
set a new goal to continue her on the journey towards a positive
change in her life.

PARTNER HEALTH PROMOTION

Partner Health Promotion

As future nurses, it is important to promote health on a daily
basis to our patients. A key role in our field of study, is to help people
not only set a specific goal, but also have it be measurable, attainable,
realistic, and time-bound as well. After we help the patient set a goal,
we can then begin the process of working towards achieving that goal
by using the Transtheoretical Model. Precontemplation, contemplation,
preparation, action, and maintenance, are all stages found within the
Transtheoretical Model (TTM Detailed Overview, 2014). This model is
a helpful tool to use when working through change.
Assessment
My partner took the real age test, provided by Dr. Oz (Live
Life to the Youngest, 2014). The results of her test show a real age of
thirty, which is seven years older than her current age. The test results
show both positive and negative factors when it comes to her health.
Some of the positives include, keeping allergies under control, avoiding
sunburns, appreciating her mate, and keeping stress to a minimum. All
of these factors benefit her real age. A few factors that play a negative
role and increase my partners real age are financial worries,
secondhand smoke, and inconsistent sleep patterns.
After thoroughly reviewing my partners test results, I took a
closer look at her sleep patterns. My partner receives six hours of

PARTNER HEALTH PROMOTION

sleep on Mondays, five hours on Tuesdays, no sleep on Wednesdays,

six hours on Thursdays, eight hours on Fridays, seven hours on
Saturdays, and eight hours on Sundays. This sleep pattern is not only
all over the place, but does not include any sleep on Wednesday
nights. After asking my partner why she does not get any sleep on
Wednesdays, she told me it is because she works the night shift at the
hospital, and it is difficult for her to juggle school and work at the same
time. Sleep is very important for our health. A stable sleep schedule
would more than likely help decrease my partners real age.
Wellness Diagnosis
I have diagnosed my partner with, readiness for enhanced sleep
related to poor nutrition (Ralph & Taylor, 2011). My partner is more
than ready to make the changes in her sleep patterns that are going to
benefit her health the most (See Appendix A for lifestyle change quiz
results). She realizes that her current sleep patterns make her tired on
a daily basis, as well as decrease her ability to focus in class and on
her schoolwork. By making the proper changes now, her health will
not only benefit on a daily basis, but in the future as well. When
looking further into the test results, my partner told me she often eats
at fast-food restaurants when she is tired and does not have the
energy to prepare her own meals. Short sleep duration has been
linked to obesity. If my partner makes modifications to her sleep

PARTNER HEALTH PROMOTION

patterns now, she may also decrease her chances of becoming obese
in the near future.
A recent study found the correlation between short sleep
duration, weight gain, and obesity. This study used cross-sectional
data from rural communities in Missouri, Tennessee, and Arkansas.
Researchers used 1,203 people that experience short sleep duration,
which is considered less than seven hours of sleep per night. After
conducting the study, research shows that 57-percent of the
individuals with short sleep duration, were found to be obese.
Interventions were then used to promote physical activity and improve
nutritional habits, as well as modify their sleeping patterns
(Stamatakis, K. A., & Brownson, R. C., 2008).
As a nursing student, it is important for me to promote health
and encourage my partner to remain ready for change, in order to
enhance her health and sleep patterns. She can make positive
changes in her schoolwork, tiredness, and her risk for becoming obese
all at the same time.
Planning
Together, my partner and I set a specific, measurable, attainable,
realistic, and time-bound goal, also known as a SMART goal (Creating
S.M.A.R.T. Goals, 2014). When creating this goal, it was very
important for us to keep the realistic portion of the goal in mind. At
this point in time, it is not realistic for her to get sleep on Wednesday

PARTNER HEALTH PROMOTION

nights. My partner works every Wednesday night and has class, both
before and after her shift. Since Wednesdays are near impossible to
get any kind of sleep due to her job, we decided to focus on the other
days of the week, in order to keep the goal both attainable and
realistic.
It is recommended that the average adult sleeps seven to eight
hours per night (How Many Hours, 2014). Because of this
recommendation, we decided to focus in on any days of the week that
she sleeps less than seven hours. On Mondays, Tuesdays, and
Thursdays she sleeps for six or less hours per night. Collectively, we
set the goal to maintain her sleep patterns on Fridays, Saturdays, and
Sundays, while increasing her sleep on Mondays, Tuesdays, and
Thursdays. The overall goal is for her to get seven to eight hours of
sleep per night. Again, we decided to leave Wednesdays out of her
goal, since it is not realistic or attainable at this time.
Together we decided to set the length of her goal for one month.
In order to keep track of the amount of sleep my partner is getting over
the next month, I have suggested keeping a sleep log. With the sleep
log, we will be able to keep track of the exact amount of sleep she is
actually getting each night. After the month is up we will evaluate the
log, and then reevaluate our goal.
I wanted to present my partner with two interventions to help her
achieve her goal. The first therapeutic intervention I suggested was,

PARTNER HEALTH PROMOTION

for her to be as consistent as possible on a daily basis when going to

bed at night and getting up in the morning. By doing this, it will not
only help her feel rested during the day, but also help her concentrate
on the tasks at hand throughout her day. The second intervention
approach I took was to educate my partner. I wanted to present
information to her that proved it is important to get the proper amount
of sleep at night in order to feel rested during the day, which will also
help her concentrate on her schoolwork.
A recent study took a look at self-reported sleepiness, fatigue,
and cognitive inefficiency of both poor sleepers and good sleepers.
Researchers used two samples, one with 194 older adults, and another
with 136 college students. This study tested the hypotheses that poor
sleepers experience more problems functioning during the day than
good sleepers. Results in both sample groups indicated that the poor
sleepers reported more daytime difficulties functioning and
concentrating than the good sleepers. The researchers concluded from
their results that it is important for adults to get an adequate amount
of rest on a daily basis in order to properly function during the day
(Alapin, Fichten, Libman, Creti, Bailes, & Wright, 2000).
Transtheoretical Model
The Transtheoretical Model is a health promotion model designed
to help people intentionally make behavioral changes. This model
focuses on the decision making process that an individual goes through

PARTNER HEALTH PROMOTION

in order to successfully make the behavioral change. The model is

made up of five stages, which include- precontemplation,
contemplation, preparation, action, and maintenance. The
precontemplation stage is when an individual is at the very beginning
and does not intend to take action in the foreseeable future.
Oftentimes, when a person is in this stage, they are unaware that their
behavior is even problematic. When a person moves to the
contemplation stage, they are getting ready to weigh the pros and
cons regarding the behavioral change they are debating. The
individual can see that their behavior is problematic and contemplating
their actions. The preparation stage is when a person is ready to take
action and start the change in the near future. During this stage they
may begin taking small steps toward behavior change. Action is when
an individual has made specific modifications to their problem and
begins acquiring new healthy behaviors. During the maintenance
stage, an individual must be able to sustain their actions for a set
amount of time and are working hard to prevent relapse (TTM
Detailed Overview, 2014).
When my partner and I initially discussed her real age test
results, she was more than willing to make a change that involved her
sleep habits. By this point, she was already past the precontemplation
stage. When assessing her, I decided she fell in the contemplation
stage. She knew her sleeping behavior was problematic to her own

PARTNER HEALTH PROMOTION

health, but was not confident that she could make the change
necessary. Schoolwork was constantly on her mind, and she felt that it
was keeping her from getting the proper amount of sleep at night. At
this point she was going back and forth, weighing out the pros and
cons to making a change.
Once I presented her with my interventions, she decided that it
would be worth a shot and felt that it could be easy to finally make the
change. My partner was more than willing to keep a sleep log over a
one months time period. She wanted to not only see the change on
paper, but in her day-to-day activities as well. This stage of the
Transtheoretical Model that I am currently describing is the preparation
stage. My partner began taking small steps towards beginning the
change, such as telling family and friends about her goals. It was
important for me to continue to encourage her to follow through with
the steps towards making the change in her sleep patterns.
Finally, she took action and began her change by going to bed
earlier on Mondays, Tuesdays, and Thursdays. Every day she would
write in her log to make sure she was keeping track of the date, time
she went to bed, and time she woke up the next morning. The first
week was hard for her to adjust; she had a hard time falling asleep,
even though she was in bed trying to change her habits. After the first
week, her journal shows a significant change in the amount of sleep
she was getting each night. By the end of our time frame, she was

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10

getting at least seven hours of sleep every night of the week, except
Wednesday (See Appendix B for sleep log).
Currently, my partner is in the maintenance stage of the
Transtheoretical Model. My partner consistently gets more sleep than
she did in the beginning of her change, and is happy with it. Although I
only asked for one month of a sleep log, my partner feels that her log
has helped her stay on the right track when it comes to sleep, so she
has continued it for her own sake. During this stage it is important for
her to stick with the behavioral change and carry out the same actions
she took to get to this stage in the process. By maintaining her goal, it
will also help prevent a relapse.
Evaluation
My partner did a great job following through with the SMART goal
we laid out for her. The first week, it was a difficult for her to adjust
going to bed at an earlier time, but by the end of the month she was
successful. Recently, she told me she was starting to revert back to
her old ways. She also stated, when she goes to bed she has a hard
time shutting off her mind. Oftentimes, she lays in bed for thirty
minutes to two hours before she actually falls asleep. Because my
partner has a hard time falling asleep, I think it is important to
reevaluate our goal. If we do not take a look and plan a new goal for
her now, chances are she will have a relapse.

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11

According to WebMD, it is very important to power everything

down in the room when going to bed, such as the television, cell
phone, radio, and computer. These devices stimulate your brain, by
creating electrical activity that triggers neurons. When this happens,
your brain begins to race (Feature, 2014). If she does not turn
everything off in the room before going to bed, she may have a harder
time powering down herself.
I would like to set the same goal for my partner over another
month, except have her shut everything down in the room before bed.
If she can find a way to not stimulate her body while going to sleep, I
believe she will be more successful when it comes to falling asleep. My
partner is more than ready to continue with the change and is willing
to try a similar goal for another month.
It is important to reevaluate and find out what worked, and what
did not when working with goals. Not every goal is perfect for every
individual. As nurses we should set a goal for our patient and then
evaluate the results when the set time is up. If the goal was not
completely successful, we should then modify the goal to the patient
and have them try again. Just because a goal was not fully successful
at first, does not mean it failed. Goals and change are a work in
progress, and it is okay to constantly modify and create new goals.

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References
Adult health. (n.d.). How many hours of sleep are enough?. Retrieved
April 6, 2014, from http://www.mayoclinic.org/healthyliving/adult-health/expert-answers/how-many-hours-of-sleep-areenough/faq-20057898
Alapin, I., Fichten, C. S., Libman, E., Creti, L., Bailes, S., & Wright, J.
(2000). How is good and poor sleep in older adults and college
students related to daytime sleepiness, fatigue, and ability to
concentrate?. Journal of Psychosomatic Research, 49(5), 381390.
Creating S.M.A.R.T. Goals. (n.d.). - UMass Dartmouth. Retrieved April 9,
2014, from
https://www.umassd.edu/fycm/goalsetting/resources/smartgoals/
Feature, H. (n.d.). How TV, Internet, and Other Electronic Devices

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13

Impact Sleep. WebMD. Retrieved April 6, 2014, from

http://www.webmd.com/sleep-disorders/features/power-downbetter-sleep
Live Life to the Youngest. (n.d.). Take the RealAge Test. Retrieved April
9, 2014, from http://www.sharecare.com/static/realage-testmarketing-landing?cbr=GGLE10037X
Ralph, S. S., & Taylor, C. M. (2011). Sparks & Taylor's nursing diagnosis
reference manual (8th ed.). Philadelphia: Wolters Kluwer
Health/Lippincott Williams & Wilkins.
Stamatakis, K. A., & Brownson, R. C. (2008). Sleep duration and
obesity-related risk factors in the rural Midwest. Preventive
Medicine, 46(5), 439-444.
TTM Detailed Overview. (n.d.). TTM Detailed Overview. Retrieved April
6, 2014, from
http://www.uri.edu/research/cprc/TTM/detailedoverview.htm

Appendix A
Lifestyle Change Quiz Results
Are You Ready to Change Your Lifestyle?
Quiz by Liza Barnes, Health Educator.
There are so many things you can do to improve your health, from simple
changes like buying whole grain bread to more complex commitments like
consistently working out. But the most crucial thing you can do is be ready to
make changes. If you haven't built up the will or created a plan B, your best
efforts might be in vain. Take this assessment to find out if you're ready to

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change in your lifestyle.

Ready, Set: You're getting ready to change your lifestyle.

There are five stages of change that people move through when losing bad
habits or creating new ones (pre-contemplation, contemplation,
preparation, action and maintenance). Youre in the third stage,
preparationgetting ready for takeoff. In many ways, this stage is the
most important, because you're setting up the course for all the work that
lies ahead. This is the time to work out ways around the inevitable
bumps, setbacks and plateaus that lie ahead. If it's a struggle for you to
eat healthy while you're on the run, get some advice before you wind up
in the fast food line. If you dont know how you'll get to the gym when your
kids are home after school, work out a plan before school's out. And don't
get discouraged if you've tried to make changes in the past and it didnt
stick. Sometimes it takes a few tries, and you'll learn more about yourself
each time.

Appendix B
Sleep Log

Sunday

Monda

Tuesday

y
Week

10:30p-

11:00p-

12:30a-

of:

6:00a

5:00a

6:00a

Wednesd

Thursda

Friday

Saturd

ay

No Sleep

11:00p-

11:00p-

11:00p-

5:00a

7:00a

6:00a

ay

PARTNER HEALTH PROMOTION

15

Februa

7.5

5.5

ry 16

Hours

Hours

Hours

Week

11:00p-

10:00p-

11:00p-

of:

8:00a

5:00a

Februa

9 Hours

ry 23

6 Hours

7 Hours

Hours
No Sleep

11:00p-

11:00p-

11:00p-

7:00a

6:30a

7:00a

6:00a

8 Hours

7.5

7 Hours

Hours

Hours

11:00p-

11:00p-

11:00p-

Hours

Week

11:00p-

10:00p-

10:30p-

No Sleep

of:

7:30a

5:00a

7:00a

5:00a

8:00a

6:00a

March

8.5

8.5

6 Hours

7 Hours

Hours

Hours

Hours

Week

11:00p-

10:00p-

10:30p-

of:

7:30a

5:00a

March

8.5

Hours

Hours
11:00p-

11:00p-

11:00p-

7:00a

6:30a

7:00a

6:00a

8.5

7.5

7 Hours

Hours

Hours

Hours

Hours

Assessment and Diagnosis

Rubric
Assessment
Real age test completed,

No Sleep

Total Possible Points =200

60

Points Earned

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results interpreted and

discussed in paper;
summarize both positive and
negative
Area of risk focus discussed in
depth
One Wellness diagnosis for
area of focus; supported by
data and research ; EBP
Planning and Intervention
Rubric
One SMART obtainable goals
should be able to measure
progress
Interventions based on EBP ~
includes one peer reviewed
journal article as a reference
for at the minimum two
interventions
Includes information re: TTM
and readiness for change

60

Points Earned

Evaluation and Reflection

Evaluate partners progress
toward SMART goals.
Reflect on any changes that
are necessary in order for
partner to reach goals; include
references/support for these
changes
APA
APA format and references
cited properly; scholarly writing;
spelling and grammar
accurate;

50

Points Earned

30

Total Points Earned: