Altered Health Maintenance

 

Instructions: Fill out this form, print it, and hand it in with your assessment to your instructor. When you click on Next at the bottom of the page, you see the data you submitted. Please follow the instructions on how to save the data on the next page.

AOL users: Read this instruction.

Definition: state in which an individual or group experiences or is at risk of experiencing a disruption of health due to an unhealthy life style or lack of knowledge to manage a condition. Used for clients who wish to change an unhealthy lifestyle or who lack knowledge of their disease or condition. 

1. Your initials (required): 

2. Defining Characteristics- check those that apply to your client:

states interest in improving health behaviors shows lack of knowledge regarding basic health practices history of lack of health seeking behaviors reports or demonstrates unhealthy practice or lifestyle 
3. Related Factors- check those that apply to your client:

lack of exposure to information misinterpretation of information lack of education of age related factors (for example- safety practices, changes associated with aging, growth and development religious or cultural beliefs lack of access to health care services lack of material resources 

4. Goal (ultimate, long term) 

5. Outcome Criteria (short term) 

6. Evaluation: Was the outcome criteria met? 

Yes- Give Evidence: 

No- Explain how you would change the plan: 

7. Interventions and Rationale

A. Interventions 

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B. Rationale for each intervention
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