1. CLIENT BY ADRIANA AVILA Health Improvement Project

2. Client overview Gender: Female Age: 25 Education: First year in college Profession: Medical assistance Family situation: Married and has a child Chief Complaints: Headaches, pain on left arm, and stress

3. Overview of Health History Weight:130 lb. Height: 5’2” ft. Adult Illnesses: Migraines Family Heath History: Hypertension, stroke, heat disease, and headaches Modes of Relaxing: taking a warm shower

4. Research “Stress-management interventions were defined as techniques that are designed to help employees modify their appraisal of stressful situations or deal more effectively with the symptoms of stress.” Stress Management in Work Settings: A Critical Review of the Health Effects “Part I describes the investigations into the characteristics of stress response syndromes.” Stress response syndromes: PTSD, grief, and adjustment disorders “Examines whether the positive association between social support and well-being is attributable more to an overall beneficial effect of support (main- or direct-effect model) or to a process of support protecting persons from potentially adverse effects of stressful events (buffering model).” Stress, social support, and the buffering hypothesis "If you want to help your patients deal with their stress, you're going to have to learn to handle your own." Stress Management for Patient and Physician

5. Target Behavior Reduce stress and learn how to manage stressful situations.

6. Theory (HBM) My client is a healthy person and understands clearly the consequences of not being as healthy as possible. The Health Belief Model (HBM) help us built a S.M.A.R.T goal. Client knew if she did not have some kind of stress management it would affect her health. If we would at least spend one day of the week just to talk about her problems and do one or two exercises she would accomplish her goal. Stress exercises 1 Jog/walk 2 Relaxation/Meditation 3 Sleep 4 Time-Outs 5 Realistic Expectations 6 Belief System Client knew she could reduce her stress and she wanted to do so as well

7. Smart Goal S- At the end of the four weeks client will slowly reduce her stress tension from work, school, home, and situations and problems that aren't predictable to at least half of her stress. M- Client will conquer her goal by charting all her exercises, reporting to me about how she has been feeling, and do any adjustments as we go. A- My client will chat all the exercises we do and activities to reduce her stress. Also talk about any worries she is stressing about R- client wants to find a way to release her stress that will help and her improve her stress management. T- Client will reach her goal by the end of the four weeks (June 9)

8. Intervention High Lights Client’s first step was to come up with a S.M.A.R.T goal together to help manage her stress. Chart from 1-5 how stressed she was at work, school, and home/unpredictable situations throughout the four weeks. Tried different exercises to helped her reduce the stress and note witch ones work best. After the four week if we saw improvement she would reward herself by going out to eat.

9. Results

10. Results Continued Client managed to reduce her stress the first two weeks by going on a run, rent couple of movies, and spend quality time with family On the third week she got really stressed and frustrated about an unexpected incident. Someone hit her car, car was not in a drivable condition and that was her only transportation. Overall her stress management has improved and she has been able to balance out her stress. Stress about one thing at a time, but not so much.

11. Analysis Personally I like making people feel better about themselves and giving them motivation to improve their lifestyle. The project was a good way for me to connect more with my client and learn more about how she felt about her stress. Overall client managed to improve her stress management throughout the four weeks.

12. Citation Stress Management in Work Settings: A Critical Review of the Health Effects Lawrence R. Murphy (1996) Stress Management in Work Settings: A Critical Review of the Health Effects. American Journal of Health Promotion: November/December 1996, Vol. 11, No. 2, pp. 112-135. Stress response syndromes: PTSD, grief, and adjustment disorders Stress response syndromes: PTSD, grief, and adjustment disorders (3rd ed.). Horowitz, Mardi Jon Lanham, MD, US: Jason Aronson. (1997). xx 358 pp. Stress, social support, and the buffering hypothesis. Stress, social support, and the buffering hypothesis. Cohen, Sheldon; Wills, Thomas A. Psychological Bulletin, Vol 98(2), Sep 1985, 310-357. doi Stress Management for Patient and Physician posen MD, D. B. (1995). The Canadian Journal of Continuing Medical Education. new york