Title of Exhibit: Provides Health Promotion in Patients with Arthritis nonpf core competency #1

DSGNE Program Outcome #3: Background for practice from sciences and humanities design nursing care for a clinical or community-focused population based on biopsychosocial, public health, nursing, and organizational sciences.

This competency is relevant to a primary – care wellness and prevention program for a community aquatic center. The American population is aging and the need for more preventive and wellness programs for arthritis sufferers is more relevant than it has ever been (Arthritis Foundation, 2013). There are individuals with cerebral palsy that benefit from the services of an aquatic therapy program for increased gross motor skills (Lai et al., 2015). In patients with chronic heart failure (CHF) thermal vasodilation for about 15 minutes will increase left ventricular ejection fraction in association with an increase in CD34 (+) cells, and reduces brain natriuretic peptide (Mooventhan & Nivethitha, 2014).

Aqua therapy is for the reduction of pain by the use of warm water, approximately 86 – 90 degrees Fahrenheit to reduce pain and spasm (Aquatic exercise association, 2010-2013; Alteneder & Hornbeck, 2003). The physical traumas and past injuries are reduced by movement, buoyancy and resistance to decrease the stress on joints and ligaments. The heat increasing the circulation creates increased flexibility with decreased guarding and potential for injury. The air quality, water quality, and intensity of exercise are also safety features noted by the Aquatic exercise association (2010 – 2013).

Pain is a problem that requires multiple approaches including lifestyle modification. One approach is moderate, low impact exercise daily. For a special population of clients, use of a slower tempo cadence of music and the approximate heart rate of 120 -145 for therapy is recommended (Aquatic exercise association, 2010 -2013). In a study by Olsen (1995) with multiple pain issues, a group of fifty participants exercised with over half requiring no medication 2 months after therapy(Alteneder & Hornbeck, 2003).

In the beginning of the exercise class it is important to do a screening of all of the participants. Have essential paperwork completed such as medical information, doctor release, or doctor order if recent surgery. Medications, limitations and concerns are safety issues that are important. Address, phone number and related information for follow up are things to consider if participants receive credit from insurance plans for exercise participation. After initial assessment, then you may find if this is the first class for some individuals and work more closely with this group. The location needs to be a big community pool area, such as the YMCA.

Follow up with the participants the next day and the next three days to see how medication use and activity compare no exercise. Evaluation of the enjoyment of the class and if they plan to return are to be completed by phone or mail survey.

Reflection:

Osteoarthritis benefits from activity and the decreased amount of strain placed on joints in warm water is a useful form of therapy for healing (Alteneder & Hornbeck, 2003). Superior results in hip and total knee replacement are seen with late use of aquatherapy in the healing stages of the replacement or after two weeks of healing instead of earlier (Liebs, Herzberg, Rüther, Haasters, Russlies, & Hassenpflug, 2012).

Aquatic Exercise Association. (2000-2013). Standards and Guidelines. Retrieved June 26, 2013 from http://www.aeawave.com/PublicPages/Education/StandardsGuideslines.aspx

Arthritis Foundation. (2013). Arthritis foundation program: Aquatic. Store. Retrieved June 25, 2013 from http://www/afstore.org/For-Health-Professonals/AF-Programs_2

Lai, C., Liu, W., Yang, T., Chen, C., Wu, C. & Chan, R. (2015). Pediatric aquatic therapy on motor function and enjoyment in children diagnosed with cerebral palsy of various motor severities. Journal of Child Neurology, 30(2), 200-208. doi: 10.1177/0883073814535491

Liebs, T. R., Herzberg, W., Rüther, W., Haasters, J., Russlies, M., & Hassenpflug, J. (2012). Multicenter randomized controlled trial comparing early versus late aquatic therapy after total hip or knee arthroplasty. Archives Of Physical Medicine And Rehabilitation, 93(2), 192-199. doi:10.1016/j.apmr.2011.09.011

Mooventhan, A., & Nivethitha, L. (2014). Scientific evidence-based effects of hydrotherapy on various systems of the body. North American Journal Of Medical Sciences, 6(5), 199-209. doi:10.4103/1947-2714.132935

I have read and understand the plagiarism policy as outlined in the syllabus and the sections in the Catalog relating to the IWU Honesty/Cheating Policy. By affixing this statement to the title page of my paper, I certify that I have not cheated or plagiarized in the process of completing this assignment. If it is found that cheating and/or plagiarism did take place in the writing of this paper, I understand the possible consequences of the act/s, which could include expulsion from Indiana Wesleyan University.

I primarily provided the teaching plan as my power point presentation and listed the activities of low impact aqua therapy to provide optimal pain relief. Concerns for the safety and the reduced impact of the exercises are to be expressed throughout the program. The comfort level of dress and attire is as important as safety. Aquatic footwear, shorts, shirts or various garments for comfort is very acceptable and encouraged.

Your input is necessary to assist in improving or modifying this offering and in planning

future programs. Please complete this form at the completion of the program in order to receive your Contact Hours.

Extent to which stated objectives were achieved: At the end of the session, the participants will be able to:	Excellent	Above Average	Average	Below Average	No Response	Total
Will be able to discuss the mechanisms to decrease pain by aqua therapy
Will demonstrate safe exercises that will help to strengthen joints and not provide too much resistance
Will keep the exercises low impact
Appropriateness of content to TARGET audience.
Relevance of content stated objectives
Instructor’s overall performance. Roberta Boon BSN, RN OCN
Opportunity for learner participation.
Design/format of program for learning
Handout
Audiovisuals
Physical Facilities
6. Overall evaluation of this learning experience

PLEASE GIVE YOUR SPECIFIC RESPONSE TO THE FOLLOWING:

1. 
   Which aspect of this offering was most effective in helping you to learn?
   
2. 
   Which aspect of this offering was least effective in helping you to learn?
   
3. 
   How would you improve this offering?
   
4. 
   If you gave any below average ratings, please explain.
   

Aqua therapy is therapeutic for many painful conditions such as orthopedic injuries, arthritis, fibromyalgia, and other chronic pain conditions (Alteneder & Hornbeck, 2003; Arthritis Foundation, 2013). Many different styles of aqua therapy exercises are available with a broad variety of equipment. The use of the equipment is dependent upon the training and the injury of the participant (Winters, 2013).

References

Alteneder, R.R., & Hornbeck, C. (2003). Focus on you: Advocating for aqua therapy; here’s. what women need to know about exercising in water. AWHONN Lifelines, 7(5), 445-449.

Aquatic Exercise Association. (2000-2013). Standards and Guidelines. Retrieved June 26, 2013 from http://www.aeawave.com/PublicPages/Education/StandardsGuideslines.aspx

Arthritis aquatic classes – Knee Guru (n.d.) Retrieved June 26, 2013 from http://www.kneeguru.co.uk/KNEEtalk/index.php

Arthritis Foundation. (2013). Resources Community programs for better living. Aquatics. Retrieved June 25, 2013 from http://www.arthritis.org/resources/community-programs/aquatics/

Arthritis Foundation. (2013). Arthritis foundation program: Aquatic. Store. Retrieved June 25, 2013 from http://www/afstore.org/For-Health-Professonals/AF-Programs_2