Week 12 Community Health Care Plan 2 Danisse Gonzalez Florid

Week 12 community health Care Plan 2 Danisse Gonzalez Florida National University Nursing Program NUR-4636 Community Nursing Prof. Eddie Cruz, RN, MSN November 18th , 2018

Develop a comprehensive community health care plan focusing on three health issues: Attention Deficit Hyperactivity Disorder (ADHD), Melanoma, and Diabetes Mellitus (DM). Your plan should include three primary components for each condition: assessment, diagnosis, planning, implementation, and evaluation. Use credible sources to support your interventions and ensure your plan demonstrates evidence-based practice principles. The plan should be structured, concise, and demonstrate an understanding of community health nursing concepts, including assessment methods, culturally appropriate interventions, and evaluation strategies.

Paper For Above instruction

The development of a comprehensive community health care plan requires a systematic approach that integrates assessment, diagnosis, planning, implementation, and evaluation strategies tailored to specific health issues within community settings. This paper focuses on three prevalent health conditions—Attention Deficit Hyperactivity Disorder (ADHD), melanoma, and diabetes mellitus (DM)—to illustrate how community health nursing can effectively address diverse health challenges through evidence-based interventions and culturally competent care.

Attention Deficit Hyperactivity Disorder (ADHD)

ADHD is a neurodevelopmental disorder characterized by persistent patterns of inattention, impulsivity, and hyperactivity, affecting children's academic, social, and emotional functioning (American Psychiatric Association, 2013). In community settings, early identification and multidisciplinary management are essential for optimizing outcomes. The assessment process involves observation of behaviors across multiple environments—home, school, and social settings—and gathering reports from family members, teachers, and the individual when appropriate. Screening tools such as Conners’ Rating Scales and clinical interviews are vital for accurate identification (Barkley, 2015).

The diagnosis centers on behavioral symptoms and their impact on functioning, while ruling out comorbid conditions such as anxiety or learning disabilities. Community nurses should also evaluate for neurodevelopmental immaturity and related motor or vocal tics, which may complicate management (Thomas & Penz, 2016). Cultural considerations include recognizing diverse perceptions of behavioral norms, which influence help-seeking behaviors and intervention acceptance.

Planning involves educational and behavioral strategies to assist children with ADHD and their families. Implementing memory retraining techniques, such as writing checklists, using visual cues, and mnemonic devices, can help improve organizational skills (Fabiano et al., 2018). Counseling should aim to address feelings of frustration, helplessness, and anxiety commonly experienced by children and parents. Pacing learning activities, incorporating regular rest periods, and fostering positive reinforcement are crucial components of creating a supportive environment (McCarthy et al., 2017).

Implementation requires community nurses to establish therapeutic communication, avoiding infantilization and promoting autonomy. Use of visual aids, simple instructions, and structured routines helps children with short attention spans stay engaged. Creating predictable daily routines and limiting overstimulating environments minimize distractions and hyperactivity. Recognizing the importance of physical activity in managing ADHD symptoms, nurses should encourage age-appropriate exercise, balancing activity with adequate rest (Carmody & Waddell, 2019). Positive reinforcement, such as praise and tangible rewards, enhances compliance and self-esteem.

Evaluation assesses the child's ability to utilize memory techniques, cope with emotional challenges, and adhere to structured routines. Feedback from caregivers and teachers provides insight into behavioral changes across settings (Sullivan et al., 2020). Success is reflected in improved social interactions, academic performance, and decreased disruptive behaviors.

Melanoma

Melanoma, a malignant tumor arising from melanocytes, is one of the most aggressive forms of skin cancer, with the potential for metastasis if not detected early (American Cancer Society, 2022). Community-based assessments focus on skin examinations to identify suspicious moles or pigmented lesions. The ABCDE criteria—Asymmetry, Border irregularity, Color variation, Diameter over 6mm, and Evolution—serve as a guide for screening (Garbe et al., 2019). Clients presenting with irregular, asymmetric, and evolving lesions require prompt referral for dermatological evaluation.

Diagnosis involves histopathological examination following biopsy procedures. It is essential to consider psychosocial impacts, as a melanoma diagnosis can evoke fear and anxiety. Culturally competent care includes respecting diverse beliefs about health, appearance, and disease, which influence treatment adherence and psychological adjustment (Lebo et al., 2021). Community nurses should provide education about self-skin examinations, sun safety, and early detection strategies.

Planning interventions include public health campaigns on skin cancer awareness, especially in high-risk populations. Strategies involve distributing educational materials, organizing screening events, and collaborating with local organizations and schools. Emphasizing sun protection behaviors—use of sunscreen, protective clothing, and avoidance of peak UV hours—can reduce melanoma incidence (Gupta et al., 2020). Support services like counseling help patients cope with diagnosis and treatment distress.

Implementation encompasses patient education on lesion monitoring, encouraging regular skin self-examinations, and facilitating access to dermatology services. Mental health support should address feelings of vulnerability and stigma associated with skin cancer. Personalized care plans that acknowledge cultural attitudes toward skin health improve participation in prevention activities (D'Souza et al., 2019). Nurses can also advocate for policy initiatives to increase community awareness and screening initiatives.

Evaluation measures include tracking the increase in early detection rates, client knowledge about skin self-examination, and adherence to sun safety behaviors. Patient feedback provides insight into barriers to engagement, enabling refinement of community programs (Miller et al., 2018). Long-term, evaluating the impact on melanoma mortality rates affirms the effectiveness of prevention and early detection strategies.

Diabetes Mellitus (DM)

Diabetes Mellitus, particularly type 2 diabetes, is a chronic metabolic disorder characterized by insulin resistance and relative insulin deficiency, leading to hyperglycemia (American Diabetes Association, 2023). It poses significant community health challenges, including cardiovascular disease, neuropathy, and renal impairment. Community assessment involves monitoring blood glucose levels, HbA1c, foot examinations, and evaluating lifestyle factors such as diet, physical activity, and health literacy (Funnell & Anderson, 2019).

Diagnosis relies on blood tests, including fasting glucose, oral glucose tolerance test, and HbA1c. Community nurses must evaluate the individual's understanding of the disease, their adherence to medication, and the presence of complications. Cultural competence is vital, as dietary habits and beliefs influence management. For example, understanding traditional foods and incorporating them into dietary plans enhance adherence (Chung et al., 2020).

Planning involves comprehensive lifestyle modifications—nutritional counseling emphasizing a low-sugar, high-fiber diet; promotion of regular physical activity; and medication adherence. Education on self-monitoring blood glucose, recognizing hypoglycemia symptoms, and foot care is incorporated. The use of community resources like support groups and health promotion programs can empower individuals to manage their health effectively (Cavanaugh et al., 2020). Safe medication practices and regular screening for complications form core components of community-based care.

Implementation requires community nurses to conduct culturally sensitive education sessions tailored to individual needs. Group classes promoting peer support and shared experiences foster motivation. Providing practical training on insulin injections and blood glucose testing enhances self-efficacy. Nurses should collaborate with local organizations to ensure access to affordable medications and supplies, and advocate for policies facilitating healthy environments—such as increasing access to nutritious foods and safe exercise spaces (Balasubramanian et al., 2020).

Evaluation involves tracking glycemic control via HbA1c levels, monitoring lifestyle modifications, and assessing participants’ confidence in self-management skills. Patient feedback identifies barriers like financial constraints or cultural beliefs. Outcome measures include reduced incidence of diabetic complications, improved quality of life, and increased participation in preventive health behaviors (Egan et al., 2021). Such data guide ongoing community health interventions and resource allocation.

Conclusion

A successful community health care plan integrates comprehensive assessment, culturally appropriate diagnosis, strategic planning, hands-on implementation, and ongoing evaluation. Addressing ADHD, melanoma, and DM exemplifies the importance of tailored interventions that consider individual, familial, and community factors. By applying evidence-based strategies and fostering community engagement, nurses can significantly improve health outcomes and promote sustainable wellness within diverse populations. Future efforts should focus on enhancing health literacy, reducing health disparities, and advocating for policies that support preventive care and early detection across all health conditions.

References

• American Cancer Society. (2022). Melanoma skin cancer. https://www.cancer.org/cancer/melanoma-skin-cancer.html
• American Diabetes Association. (2023). Standards of medical care in diabetes—2023. Diabetes Care, 46(Suppl 1), S1–S2.
• American Psychiatric Association. (2013). Diagnostic and statistical manual of mental disorders (5th ed.).
• Barkley, R. A. (2015). Attention-deficit hyperactivity disorder: A handbook for diagnosis and treatment. Guilford Publications.
• Balasubramanian, A., et al. (2020). Social determinants and management of type 2 diabetes in underserved communities. Journal of Community Health, 45(3), 547-555.
• Carmody, T., Waddell, K. (2019). Exercise recommendations for children with ADHD. Journal of Pediatric Psychology, 44(2), 239-246.
• Cavanaugh, K., et al. (2020). Community-based interventions to improve diabetes management: A systematic review. Diabetes Care, 43(4), 754-764.
• D'Souza, K., et al. (2019). Cultural attitudes and barriers to skin cancer screening. Journal of Oncology Practice, 15(2), e187-e192.
• Fabiano, G. A., et al. (2018). Behavioral management strategies for children with ADHD. Journal of Clinical Child & Adolescent Psychology, 47(3), 324-336.
• Garbe, C., et al. (2019). Guidelines for the management of melanoma. European Journal of Cancer, 124, 193-205.
• Funnell, M. M., & Anderson, R. M. (2019). Patient empowerment strategies. Diabetes Management, 46(6), 654-660.
• Glinianaia, S. V., et al. (2020). Early detection and community awareness in melanoma prevention. Community Oncology Journal, 12(3), 243-252.
• Lebo, M., et al. (2021). Cultural competence and psychosocial support in skin cancer care. Journal of Cultural Diversity, 28(2), 55-61.
• Miller, R., et al. (2018). Impact of community outreach programs on melanoma detection. Journal of Cancer Education, 33(2), 350-357.
• McCarthy, K., et al. (2017). Behavioral interventions in children with ADHD. Clinical Child Psychology and Psychiatry, 22(4), 776-788.
• Sullivan, P., et al. (2020). Community-based behavioral management: Outcomes and strategies. Journal of School Psychology, 81, 23-29.
• Thomas, R., & Penz, K. (2016). Neurodevelopmental immaturity in ADHD. Journal of Child Neurology, 31(4), 427-433.
• Townsend, M. C. (2017). Nursing diagnoses in psychiatric nursing. FA Davis.