Health Promotion Cathy Quick, RN, BSN Primary care nurse practitioner student Auburn university

What is Health Promotion? In 2014 the World Health Organization defined health promotion as “the process of enabling people to increase control over, and to improve, their health.” Employment of primary prevention measures is one way to achieve improved health.

Primary Prevention Goal: Examples: Protect individuals from developing a disease or experiencing an injury. Examples: Education on smoking cessation and healthy eating habits Addition of fluoride to drinking water to prevent dental caries Regular physical examinations and screening tests Increasing physical exercise and activity levels Immunization against infectious diseases

Health Promotion Project Herpes Zoster Vaccine for Adults 60 and older

Herpes Zoster Herpes Zoster, or shingles, is the same virus that causes chickenpox. Any person that has had the chickenpox could develop shingles as their immunity to the chickenpox decreases, the likelihood of developing shingles increases. Of the 15 adults over 60 surveyed 4 have had the shingles, then got a shingles vaccine; 8 were interested in education and possibly receiving the vaccine; 3 had no interest/refused education. As the population ages, becomes immunocompromised, and stressed the virus can reactivate.

Clinical Complications of Herpes Zoster Herpes Zoster can result in prior to the outbreak of the rash complaints of: nausea, headache, body aches, fever, and chills. The outbreak is unilateral, usually confined to a single dermatome, but can sometimes affect two to three dermatomes with the thoracic and lumbar being the most common involved locations. Possible clinical complications once the rash has healed include: nerve pain known as post- herpetic neuralgia (PHN); hearing loss; vision loss; and loss of balance.

How to Prevent Herpes Zoster In the population of adults 60 and older the FDA approved the zoster vaccine (Zostavax), a live, attenuated strain of varicella zoster virus. One vaccine reduces the risk of contracting the shingles by 51% and PHN by 67%.

What is the shingles vaccine? A vaccine to reduce the risk of developing shingles and decrease the severity of symptoms, if shingles occurs.

Risks Associated with Shingles Vaccine There are minimal risks associated with the vaccination. It is estimated that only one in one million doses will result in a severe allergic reaction. The side effects of the shingles vaccination are usually mild to moderate and subside on their own. These effects include: headache, redness, soreness, swelling, or itching at the site of the injection. Some people might develop a chicken-pox rash at the injection site; as a precaution cover the rash until it disappears.

Implementation Regional Health Management Corporation Dr. Roland Cook It was found that many patients had misconceptions regarding immunizations. Education on the Herpes Zoster (shingles) vaccination from {Calianno & O’Shea, 2013; McGill, 2014; Shingles Vaccine What You Need to Know, 2015; Wilson, 2014}.

Design The project focused on adults 60 and older with no previous herpes zoster vaccine. The 11 individuals encountered whom have not been vaccinated were at increased risk due to age, heath risk, and stress. Many individuals encountered believed they would develop shingles, if they were vaccinated. A common misconception about vaccines. Goal: Provide education regarding the significance of the herpes zoster vaccination so the patients could make informed decisions about receiving the vaccination. Education was provided in the form of both a brochure and verbal reinforcement to increase the level of comprehension.

Delivery Project was designed using the Health Belief Model (HBM) Changes in knowledge and beliefs will result in changes in behaviors Individuals value avoiding illness and they will take action in order to prevent illness The higher the level of perceived threat of illness, the more likely that an individual will be to attempt to prevent the illness According to this model, providing adults over 60 with information about herpes zoster will result in an increased number of individuals receiving the shingles vaccination.

Evaluation Answer the questions using this scale: 1 = strongly disagree 2 = somewhat disagree 3 = neutral 4 = somewhat agree 5 = strongly agree 1. Was the information provided easy to understand? 2. Was the brochure clear and easy to read? 3. Did the information provided increase your knowledge about herpes zoster and the shingles vaccine? 4. Was the instructor knowledgeable and able to answer your questions? 5. Will you receive the shingles vaccination? I feel the education brochure and questionnaire was an effective evaluation method to evaluate the patients‘ learning. The amount of time was about 10 minutes per patient and time was allotted for questions.

Results 8 patients educated 8 patients agreed to receive shingles vaccines That is 53% of the patients receiving the vaccine after education

References AANP. (2013). Scope of practice for nurse practitioners. American Association of Nurse Practitioners. Retrieved October 13, 2015, www.aanp.org/images/documents/publications/scopeofpractice.pdf Adams, A., Hall, M., & Fulghum, J. (2014). Utilizing the Health Belief Model To Assess Vaccine Acceptance Of Patients on Hemodialysis. Nephrology Nursing Journal, 41(4), 393-407. Retrieved http://spot.lib.auburn.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=99362838&site=ehost-live Calianno, C., & O'Shea, S. (2013). Herpes zoster in older adults. Nurse Practitioner, 38(8), 10-14. doi:10.1097/01.NPR.0000431885.17739.70 McGill, N. (2014). Shingles: Painful but preventable illness. Nation's Health, 44(9), 28. Retrieved http://spot.lib.auburn.edu/login?url=http://search.ebscohost.com/login.aspx?direct=true&db=aph&AN=99056096&site=ehost-live

References (2015). Shingles Vaccine What You Need to Know. Center for Disease Control and Prevention. Retrieved October 12, 2015, from http://www.cdc.gov/vaccines/vpd-vac/shingles/vacc-need-know.htm University of Ottawa. Society, the individual, and medicine. Canada’s University. Retrieved October 13, 2015, http://www.med.uottawa.ca/sim/data/Prevention_e.htm Wilson, D. (2014). Herpes zoster: A rash demanding careful evaluation. Nurse Practitioner, 39(5), 30-37. doi:10.1097/01.NPR.0000445781.37062.16