EXERCISE AS A HOLISTIC APPROACH IN HEALTH PROMOTION

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EXERCISE AS A HOLISTIC APPROACH IN HEALTH PROMOTION

From Edelman & Mandle text, I find the holistic therapy entailing exercise more appealing and interesting. Exercise, even to a layman enables one to live a healthy life with reduced chances of disease attack and other associated health complications. This paper will look at several studies that have been done to prove the efficacy of the theory, patients’ experiences and how the same theory can be applied across age, culture and disability. 

Studies that prove the efficacy of exercises as a holistic approach

A study was conducted to determine how efficient exercise therapy could be of use both mentally and physically for depressed patients. In the study, Knapen et al. (2015), grouped the study subjects into four groups and generated results for each group. For those patients who were suffering from mild to moderate depression, exercise was found to have the same effect as antidepressant medication as well as psychotherapy. For the second group that was characterized with severe depression, exercise proved to be an effective complement for traditional treatments. In the third group that was categorized on the basis of having co-morbid somatic complications, more so those with type 3 diabetes, and cardiovascular diseases, exercise was found to be more effective in preventing the mentioned diseases as well as controlling them. To older adults, exercise was found to be effective in improving their body image, quality of life, independence in daily activities, and also in their stress coping mechanisms. In general, exercise as a holistic approach towards promotion of health from the study was found to be true and applicable. 

To induce exercise as a holistic therapy calls for exerted efforts to ensure that the therapy is well inculcated into the patient and there will be consistency. In this regard, a nursing professional will be required to help the patient through the therapy. One theory that has been successfully applied to solve addictive behavior and also to inculcate positive behavior such as exercise has been discussed by Shinitzky and Kub (2001). Their study discusses the Transtheoritical Model of Change that was developed by Carlo DiClemente and James Prochaska in the 1990s. The theory proposes five stages that a nursing practitioner needs to take their patient through. First there is the preconteplation stage where the patient does not accept that they have a problem and therefore no need to change. Second is the contemplation stage where the patient considers change of course out of persuasion by the nurse by helping them weigh the benefits and losses of both being active and inactive. The patient then enters the third stage that involves preparation. Here, the patient is able to commit to change and expresses a high degree of motivation and agrees that the losses of being active are less than the benefits. They are therefore likely to respond positively to a new behavior. The fourth stage involves action where the patient actually engages in the new behavior (exercise) and moves on to the last stage which is maintenance. The patient is able to maintain the new behavior to benefit from the advantages associated with it and at the same time, mitigating effects of disease.  

Patient’s experiences

Various studies have been done to assess the experiences patients have been having with regards to exercises. Danielsson et al. (2016), looked at how patients with major depression experienced exercise as part of their therapy. The study was conducted inductively using qualitative analysis and found out that though patients appreciated exercise as hard work, the patients resonated with exercise as being a worth option that made them withdraw from their depression as well as feel alive and be proud of being in a position of doing something for themselves. Exercise was found out to be in a position to improve a patient’s perspective of themselves besides improving their health wellbeing.

Andersen et al. (2014), looked at breast cancer patients and the effect that exercise has on them especially during adjuvant chemotherapy. Chemotherapy is known to be a painful procedure and there is indifference as to whether exercise worsens or improves the situation. The study found that patients were able to demonstrate high adherence rates to exercise as pain was not aggravated by exercise than it is by chemotherapy. In groups, patients showed heightened willpower to endure exercises owing to the fact that they derived camaraderie from the group.

Kolnes (2016), studied experiences of women with anorexia nervosa and their interaction with exercise. Despite the women involved being severely underweight and suffering from exhaustion, the study subjected them to a continuous exercise which was severe, rigorous and excessive. As a result, they used extensive energy and time. Patients in this study had a problem with exercises since according to them, they were cut off from the social world. The participants were also found to talk negatively about exercises. The study did not however look at the health effects of the exercises to the women. 

Applicability of the therapy across variables such as age, culture and disability

It is widely known and is in public domain that for children to develop, there is need for them to have enough exercise. Actually, children demand for their right to exercise in the name of playing. If the same is withdrawn from them, there are severe mental and physical adversities that are likely to befall them. In adults, as discussed by Kravitz (2012), lack of exercise is a precursor of cardiac complications, degeneration of joints and attached muscles and ligaments, increased cholesterol and loss of sensory sensations, for instance, thirst, eyesight, balance and hearing. It is therefore recommended that aging adults be involved in exercises to ensure that they maximize benefits to their physical and psychological status. 

Rimmer (1999), looked at how health can be promoted using exercise among the physically disabled. The study found out that exercises provide functional independence to the disabled, presents a chance for them to get involved in leisure and enjoyment, and enhances their quality of life. It therefore follows that exercise cannot be overlooked just because one is disabled. Culturally, exercises are taken in various forms across cultures and the same is attributed to the immense benefits it offers. 

In conclusion, I definitely would integrate the exercise holistic approach to my practice. Exercises have a raft of benefits as demonstrated by the literature reviewed there above. The benefits range from physical health, mental health and to some extent spiritual health. I would consider it unfair to deny my patients the same benefits which if well followed, could also benefit myself as a nurse. 

References 

Andersen, C., Rørth, M., Ejlertsen, B., & Adamsen, L. (2014). Exercise despite pain–breast cancer patient experiences of muscle and joint pain during adjuvant chemotherapy and concurrent participation in an exercise intervention. European journal of cancer care, 23(5), 653-667.

Danielsson, L., Kihlbom, B., & Rosberg, S. (2016). “Crawling Out of the Cocoon”: Patients’ Experiences of a Physical Therapy Exercise Intervention in the Treatment of Major Depression. Physical therapy.

Edelman, C. L., Mandle, C. L., & Kudzma, E. C. (2013). Health promotion throughout the life span. Elsevier Health Sciences.

Knapen, J., Vancampfort, D., Moriën, Y., & Marchal, Y. (2015). Exercise Therapy Improves both Mental and Physical Health in Patients with Major Depression. Disability and rehabilitation, 37(16), 1490-1495.

Kolnes, L. J. (2016). ‘Feelings stronger than reason’: conflicting experiences of exercise in women with anorexia nervosa. Journal of eating disorders, 4(1), 1.

Kravitz, L. (2012). The age antidote. mimeo, University of New Mexico. Retrieved https://www.unm.edu/~lkravitz/Article%20folder/age.html

Rimmer, J. H. (1999). Health promotion for people with disabilities: the emerging paradigm shift from disability prevention to prevention of secondary conditions. Physical therapy, 79(5), 495-502.

Shinitzky, H. E., & Kub, J. (2001). The Art of Motivating Behavior  hange: the use of Motivational Interviewing to Promote Health. Public Health Nursing, 18(3), 178-185.