Identify how one relevant theory of health behaviour change may help the nurse to understand Tom’s current heath related lifestyle

Case study 2

Tom has been referred by his General Practitioner (GP) to a community mental health nurse. The referral states that Tom was anxious, experiencing poor sleep and drinking alcohol excessively. Tom had requested hypnotic medication however the GP was reluctant to prescribe this and referred Tom for assessment and possible intervention.

Tom is a 43-year-old man who is employed as a senior manager at a builder’s merchants. He is married to Nicole. They have twin daughters aged 12 years. Nicole’s mother, Diane, also lives with them in an annexe to their house. Diane helps with cooking, cleaning and childcare as both Tom and Nicole have busy and stressful work lives.

Tom started cycling to help him loose weight a few years ago and since he got the “cycling bug” he stopped smoking, rarely drank alcohol, changed his diet, and lost around 10 Kilogrammes of weight. Nicole found some of these changes difficult to adjust to and worries about him after Tom was involved in a road traffic collision with a motor vehicle whilst on a training ride. Tom suffered a broken clavicle, and abrasions to his skin.

Despite making a good physical recovery, Tom has not resumed cycling. He explains that the thought of getting back on a bike terrifies him and he fears history repeating itself. He reports that he often feels “on edge.”. He experiences some nightmares and flashbacks to his accident. He says it made him realise just how dangerous cycling is and that he was lucky to survive the collision. Tom no longer sees his friends from the cycling club. Initially they encouraged him to resume cycling but he “made excuses” and now they have stopped contacting him. Tom is considering selling his bicycles to finance a family visit to Disneyworld.

Tom has not done any form of exercise since the accident. He has resumed eating his mother-in law’s meals. Consequently, he has gained weight and now has a BMI of 28. Tom is also drinking every evening and resumed smoking. The nurse has estimated that Tom is consuming around 60 units a week. Tom says that the alcohol “settles my nerves” and helps him to get to sleep, “at least for a couple or three hours.”

Tom indicates that he is unconcerned about his drinking. However, he is uncomfortable with his weight gain and he misses “having the physique of an athlete.” He regrets starting to smoke again but believes that if he stopped smoking, he would gain even more weight.

Assessment questions:

1. Identify how one relevant theory of health behaviour change may help the nurse to understand Tom’s current heath related lifestyle (LO5)

 

1. Evaluate two interactive strategies that a nurse could use to promote Tom’s health. Please provide a rationale for your suggested strategies. (LO2)