Patient Education Plan for Uterine Fibroids Ramona Pullum University of Phoenix NUR/427 Barbara Deets May 13, 2010 Patient Education Plan for Uterine Fibroids Uterine fibroids are muscular tumors that grow in the wall of the uterus (womb). Another medical term for uterine fibroids is “leiomyoma” (leye-oh-meye-OH-muh) or just “myoma”. Fibroids are almost always benign or non cancerous. Fibroids can grow as a single tumor, or there can be many of them in the uterus. They can be as small as an apple seed or as big as a grapefruit. In unusual cases they can become very large.
The factors that increase a woman’s chances of developing fibroids are: age, fibroids are most common in women in their 40s and 50s, family history, women with a family history of fibroids are more likely to have them, ethnic background, African American women are more likely to develop fibroids than other ethnic groups, obesity plays a role in the development of fibroids, for heavy women the risk of having fibroids is two to three time great than average and eating habits also affect the development of uterine fibroids, eating red meat and ham is linked to fibroids (U. S.
Department of Health and Human Services, 2008). Three out of four women will have uterine fibroids. Most women with uterine fibroids are unaware of having them, because they have no symptoms. Women who do have symptoms are bothered by, pain, frequent urination, heavy menstrual bleeding, constipation, prolonged menstrual periods, trouble emptying the bladder, backache and pain in the legs and pain during sex (MayoClinic. com, 2009). The treatment for uterine fibroids depends on the size of the tumors, the number of tumors, and whether or not there are complications associated with the tumors.
Ethel C, 47 y/o African American female presented to her gynecologist with complaints of severe abdominal pain several days prior to and during menstrual period, heavy menstrual periods, break through bleeding between her menstrual cycle, nausea and occasional vomiting, the patient complained of backaches, and pain in her hips. The patient is overweight and has a large abdomen, she complains of having a full feeling sometimes. Ethel C. has a family history of uterine fibroids that includes her mother, sister and aunts.
The patient has one teenage child. She has had five abortions for various reasons, none related to the uterine fibroids. She is a non-smoker and drinks socially once in a while. Her medical history also includes three surgeries, tonsillectomy, ligament repair to the left ankle and surgery to the left shoulder to remove adhesions, shoulder injury is related to a fall. The patient has a history of chronic bronchitis. The patient complains of fatigue and being cold all the time. When questioned regarding her diet Ethel C. evealed a diet high in carbohydrates and fats. Black women who eat foods high in carbohydrates are more likely to have higher blood sugar and may have a greater risk for uterine fibroids (The U. S. National Library of Medicine and the National Institute of Health, 2010). Ethel C. , states that she has had these symptoms off and on for many years and that over the last two to three years they have become more and more severe. Several diagnostics tests are ordered for the patient. Blood work reveals Ethel C. s anemic which accounts for the fatigue and feelings of coldness and is due to the heavy blood loss. The patient has a pelvic examination and an ultrasound to confirm the presence of fibroids. The result of the patient’s pregnancy test is negative. While assessing Ethel C. for her learning needs there are, some general screening questions should be asked as a part of the general assessment; for example, what does the patient know, how does she perceive her present problems, what skills does she possess and does she have the confidence to use them (Redman, 2007)?
When asked these questions, Ethel C. shows competence in her answers. She is knowledgeable about her condition. She has been given her treatment options, which include drug treatment and several surgical treatments. She has a list of questions for her doctor, which includes questions the number, size and location of the fibroids, what treatments does the doctor recommend, are there alternative treatment she could try and are alterations to be with her lifestyle. Ethel C. elongs in the Health Belief Model. Redman (2007) states, “The health belief model affirms that individuals are not likely to take a health action unless (1) they believe that they are susceptible to the ill health condition in question, (2) they believe that the condition would seriously affect their lives if they should contract it, (3) they believe that the benefits of action outweigh the barriers to action, and (4) they are confident that they can perform the action (self-efficacy).
Cues such as an interpersonal crisis or the nature and severity of symptoms trigger action. ” From interviewing Ethel and her questions for the gynecologist, she believes she is susceptible to the illness. She knows that the condition is affecting the quality of her life, because of her condition she is very tried and irritable, and this is having a negative affect on her relationship with her family. She has had to take time off from work, usually three to four days due to the pain and heavy bleeding during her menstrual period each month.
She has expressed the desire to decide on a course of action to take to treat her condition. Ethel C. does not exhibit any age or developmental issues. She is a visual learner. As an adult the current theory of how she learns is bases on the cognitive practice; the kind of learning most characteristic of the adult phase is transformative learning. With transformative learning the adult goes through a number of changes that transform the individual (Redman, 2007).
Redman (2007) stated, “In cognitive theory, learning is the development of insights or understandings that provide a potential guide for behavior. New insights lead to a reorganization of the individual’s cognitive structure, which is stored internally in visual images and in propositional networks and schemata to organize information. Within this framework, learning makes change in behavior possible, although not necessary. Motivation to take action results from a need to make sense of the world and solve problems.
In contrast to behavioral theories that focus on the new behavior to be learned, the cognitive view emphasizes understanding of concepts and theories in the subject matter and general skills and abilities such as reasoning and problem solving. ” Teaching is accomplished using tools, both written and audiovisual. Well designed tools have been shown to be effective in creating learning. Written materials are tools used most often. They should be presented in the following manner. • Key messages are easy to find • Stories about people faced with the same issues and their outcomes Step-by-step actions to take • Present information is such a way to that presents information personally relevant to the reader • Provide material sensitive to the culture of those for which it is written, addressing their lifestyle and culture ( Redman,2007) Ethel’s education plan will include both written material and audiovisual aids that explains the different treatment options available to her. It will include diagrams of what her condition may look like. She will be given materials that explain alternative treatments.
The material created for the patient will include lifestyle changes that may be beneficial to her treatment, such as changes to her diet. Decision aids will be developed to help her make a decision between the medical options that are available to her. With the educational material designed for Ethel C. and other aids, Ethel C. will be able to make a decision regarding her treatment and lifestyle changes that will be of the most benefit to her regarding her condition and have a positive outcome, improve her relationship with her family and improve her quality of life. References MayoClinic. com. (2009). Retrieved from http://www. mayoclinic. com/health/uterine-fibroids/ds00078 Redman, B. K. (2007). The Practice of Patient Education: A Case Study Approach (10th ed. ). Philadelphia, PA: Mosby. Sue, J. (2009, October). An overview of uterine fibroids. Nurisng Standard, 24(6), 44-45. The U. S. National Library of Medicine and the National Institute of Health. (2010). Medline Plus. Retrieved from http://www. nlm. nih. gov/medlineplus U. S. Department of Health and Human Services. (2008). Womenshealth. gov The Federal Government Source for Women’s Health Information. Retrieved from http://womenshealth. gov/faq/uterine-fibroids. cfm