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Treating depression through the nurse- ing movement of chronic psychiatric patients from the orien- client relationship bimat 3ml with visa medicine 7 years nigeria. Nursing Clinics of North America 3ml bimat with mastercard medicine of the wolf, 33 buy cheap bimat 3 ml line treatment uti, tation to the working phase of the nurse-client relationship 153–172. Professional Nurse, 10(4), versal for women in a primary care setting: A pilot study. Personal, impersonal, and interpersonal rela- Psychiatric Nurses Association, 6, 119–125. Peplau’s Process of Practice-based Theory Development and Its Applications 67 practice... A therapeutic behavior Thoughts on completion of translation of basic principles of scale. Journal of the American Psychiatric Nurses Association, for developing self-awareness. Research in Nursing and Health, 2(1), Perspectives in Psychiatric Care, 18(2), 67–89. A personal responsibility: A discussion of framework for application in nursing practice. Professional closeness as a special kind of involvement with a patient, client or family group. Peplau’s Process of Practice-based Theory Development and Its Applications 69 Peplau,H. Ernestine Wiedenbach, Virginia Henderson, and Ernestine Wiedenbach died in April 1998 at the age Ida Jean Orlando are three of the most important of 98 (Gesse & Dombro, 1992, p. The work of each of these nurse scholars was based on Ida Jean Orlando was born in 1926 in New York. Concepts College School of Nursing where she received a and terms they first used are heard today around diploma in nursing. John’s University in Brooklyn, New York, and these three important twentieth-century nursing in 1954 she completed a master’s degree in nurs- theorists. Orlando’s early work from scholars who have studied or worked nursing practice experience included obstetrics, with these theorists and who wrote chapters about medicine, and emergency room nursing. Her first each for Nursing Theories and Nursing Practice 1st book, The Dynamic Nurse-Patient Relationship: edition. To the extent possible, content written by Function, Process and Principles (1961), was based each of the identified authors is used. For a wealth on her research and blended nursing practice, of additional information on these nurses, scholars, psychiatric–mental health nursing, and nursing ed- researchers, thinkers, writers, practitioners, and ed- ucation. It was published when she was director ucators, please consult the reference and bibliogra- of the graduate program in mental health and phy sections at the end of this chapter. She received a bachelor of arts degree from tative and inductive, using naturalistic inquiry Wellesley College in 1922. As a consultant at McLean Hospital in Johns Hopkins School of Nursing in 1925 (Nickel, Belmont, Massachusetts, Orlando continued to Gesse, & MacLaren, 1992. After completing a study nursing practice and developed a training master of arts at Columbia Univeristy in 1934, she program and nursing service department based on became a professional writer for the American her theory. With two opment of prescriptive theory (Dickoff, James & of her brothers serving in the armed forces during Wiedenbach, 1968). Even after her retirement in World War I and in anticipation of a critical short- 1966, she and her lifelong friend Caroline Falls of- age of nurses, Virginia Henderson entered the Army fered informal seminars in Miami, always remind- School of Nursing at Walter Reed Army Hospital. It ing students and faculty of the need for clarity of was there that she began to question the regimen- purpose, based on reality. She even continued to talization of patient care and the concept of nurs- use her gift for writing to transcribe books for the ing as ancillary to medicine (Henderson, 1991). Her pioneer work in the area of “series of almost unrelated procedures, beginning identifying and structuring nursing knowledge has with an unoccupied bed and progressing to aspira- provided the foundation for nursing scholarship tion of body cavities” (Henderson, 1991, p. Henderson admired Goodrich’s intel- Introducing the Theories lectual abilities and stated: “Whenever she visited our unit, she lifted our sights above techniques Virginia Henderson, sometimes known as the and routine” (Henderson, 1991, p. Henderson modern day Florence Nightingale, developed the credited Goodrich with inspiring her with the definition of nursing that is most well known inter- “ethical significance of nursing” (Henderson, 1991, nationally. Ida Jean Orlando was perhaps the ence forever influenced her ethical understanding first nurse to use qualitative research methods and of nursing and her appreciation of the importance was the first to articulate nursing concepts based on and complexity of the nurse-patient relationship. Each of these She continued to explore the nature of nursing nurses helped us focus on the patient, instead of on as her student experiences exposed her to different the tasks to be done, and to plan care to meet needs ways of being in relationship with patients and of the person. For instance, a pediatric experience caring based on the perspective of the individual as a student at Boston Floating Hospital introduced being cared for—through observing, communicat- Henderson to patient-centered care in which ing, designing, and reporting. Each was concerned nurses were assigned to patients instead of tasks, with the unique aspects of nursing practice and and warm nurse-patient relationships were encour- scholoarship and with the essential question of, aged (Henderson, 1991). She enjoyed the less formal vis- Initial work on Wiedenbach’s prescriptive theory is iting nurse approach to patient care and became presented in her article in the American Journal skeptical of the ability of hospital regimes to alter of Nursing (1963) and her book, Meeting the patients’ unhealthy ways of living upon returning Realities in Clinical Teaching (1969). She entered Teachers tion of prescriptive theory is that:“Account must be College at Columbia University, earning her bac- calaureate degree in 1932 and her master’s degree “Account must be taken of the motivating in 1934. She continued at Teachers College as an in- factors that influence the nurse not only in structor and associate professor of nursing for the doing what she does but also in doing it next 20 years. Henderson wrote about nursing the way she lived it: focusing on what taken of the motivating factors that influence the nurses do, how nurses function, and on nursing’s nurse not only in doing what she does but also in unique role in health care. Her works are beauti- doing it the way she does it with the realities that fully written in jargon-free, everyday language. The nurse’s central purpose in nursing is the • The Recipient, or the patient receiving this nurse’s professional commitment. For Wiedenbach, action or on whose behalf the action is the central purpose in nursing is to motivate the taken; individual and/or facilitate his efforts to over- • The Framework, comprised of situational fac- come the obstacles that may interfere with his tors that affect the nurse’s ability to achieve ability to respond capably to the demands made nursing results; of him by the realities in his situation • The Goal, or the end to be attained through (Wiedenbach, 1970, p. She emphasized that nursing activity on behalf of the patient; the nurse’s goals are grounded in the nurse’s • The Means, the actions and devices through philosophy, that “those beliefs and values that which the nurse is enabled to reach the shape her attitude toward life, toward fellow goal. She rec- in whatever setting they are found for the purpose of ognized that nurses have different values and avoiding, relieving, diminishing or curing the indi- various commitments to nursing and that to vidual’s sense of helplessness. Following is an overview of the major nurse to undergo this experience and be “willing components of Orlando’s work. The nursing process includes identifying needs nursing for examination and discussion when of patients, responses of the nurse, and nursing appropriate” (Wiedenbach, 1970, p.

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Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care buy discount bimat 3 ml online symptoms 3 weeks into pregnancy, 7th Edition order bimat 3ml otc conventional medicine. Develop a list of preferred foods to ensure healthy bowel elimination for the following patients cheap bimat 3ml without prescription medicine urinary tract infection. Describe the following exercises designed for his job complains of frequent diarrhea. Abdominal settings: What other factors are likely to promote healthy bowel elimination in these patients? Perform a physical assessment and write a nursing diagnosis for a patient who has just had a colostomy performed. List four reasons for prescribing cleansing will this patient face in his life, and what can enemas. Ileostomy: Use the following expanded scenario from Chapter 38 in your textbook to answer the questions below. Colostomy: Scenario: Leroy Cobbs, age 56, was recently diagnosed with prostate cancer. Describe how the following factors help pro- acetaminophen (Tylenol) with codeine for mote healthy bowel habits in patients. Cobbs reports that he had regular, pain-free bowel movements, once daily, before taking the pain c. He appears frustrated and says, “I’ll take my chances with the cancer pain in the future rather than take more pain d. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Reluctant to suggest substituting another medication too quickly, she asks more questions and Ms. What would be a successful outcome for in the morning and maybe a glass of wine at Mr. What intellectual, technical, interpersonal, is a workaholic computer programmer and and/or ethical/legal competencies are most spends what little spare time she has watching likely to bring about the desired outcome? She reports tiring after walking one flight of stairs and says she avoids all forms of vigor- ous exercise. Identify pertinent patient data by placing a single underline beneath the objective data in the case study and a double underline beneath 4. Complete the Nursing Process Worksheet on page 261 to develop a three-part diagnostic statement and related plan of care for this patient. Read the following patient care study and use your nursing process skills to answer the Patient strengths: questions below. Elgaresta, age 54, a single Hispanic woman, is being followed by a cardi- ologist who monitors her arrhythmia. At this visit, she says to the nurse practi- tioner who works with the cardiologist: “Right after I started taking that medication, I got 4. Pretend that you are performing a nursing terribly constipated, and nothing seems to assessment of this patient after the plan of help. The nurse practitioner realizes that Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. For the purposes of this exercise, develop the one patient goal that demonstrates a direct resolution of the patient problem identified in the nursing diagnosis. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Dullness bronchioles that are the sites of gas exchange are known as which of the following? A patient who has difficulty breathing, increased respiratory and pulse rates, and d. A nurse suctioning a patient through a is generally preferred, despite its addictive tracheostomy tube should be careful not to quality? Cough syrup with codeine catheter because it would cause which of the following to occur? Suctioning of carbon dioxide ing should be placed in which of the follow- ing positions? The patient has no impairment of speaking lobes of the lungs, the nurse should place the function. Suctioning of the tracheostomy tube must and half on the side be done using sterile technique. Trendelenburg position emphysema, the nurse would probably hear which of the following sounds? The brain is sensitive to hypoxia and will sustain irreversible brain damage after how a. His nurse has taught him pursed-lip Circle the letters that correspond to the best breathing, which helps him in which of the answers for each question. Bronchioles Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Infants have a rounded chest wall in which the physiology of the lungs are accurate? Each lobe in the lung is further divided into would a nurse expect to find when performing lobules. When palpating the trachea, the nurse describe how respirations are controlled in the should note a slightly higher skin tempera- body? The medulla is stimulated by a decrease in tions from the patient’s repeated word the concentration of carbon dioxide and should be equal bilaterally in different areas hydrogen ions and by the decreased on the chest wall. Chemoreceptors in the aortic arch and pitched sound, should be heard over carotid bodies can shut down the medulla. Which of the following actions should a nurse rate and depth of ventilation to blow off perform when inserting an oropharyngeal air- carbon dioxide and hydrogen and increase way? The medulla sends an impulse down the 60 mm is appropriate for the average spinal cord to the respiratory muscles adult).

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Kali Ray TriYoga: Founded by Kali Ray (Kaliji) is that the coiled and dormant form of this in 1980 generic 3ml bimat with amex medicine nobel prize 2016, the TriYoga Center in Santa Cruz buy generic bimat 3ml on-line symptoms job disease skin infections, Cal- power is harbored by everyone and symbolizes ifornia generic bimat 3 ml free shipping symptoms 7dpiui, was established to offer a system of the potential of consciousness. Yogi Bhajan yoga based on a series of flowing, dancelike introduced Kundalini to the West in 1969; he movements accompanied by music in a medita- believed that it is everyone’s birthright to be tive environment. PowerBreathing: PowerBreathing is a deep, yoga is a popular variation of Kundalini that slow breathing technique developed by the relies on a guru to awaken the Kundalini yoga teacher Yonah Offner. The goal is to allow through mantra, meditation, chanting, and the diaphragm to work properly by unblocking seva, or selfless service. Laya yoga: Laya yoga is a form of meditation PowerBreathing is available on Offner’s web- focusing on the energy centers located in the site, www. Laya yoga is geared Ashtanga yoga developed by Beryl Bender toward overcoming selfishness and self-cen- Birch, author of Power Yoga and Beyond Power teredness and developing the ability to cope with Yoga (New York: Simon & Schuster, 2000). Mantra yoga: Mantra, from the Sanskrit word ate of Syracuse University, Birch addresses the manas, or mind, focuses on the meditative word positive mind-body therapeutic effects of yoga, or prayer repeated for a length of time. The repetition of the word tal and physical toxins and to stretch and Japa, meaning “in the name of God,” may be strengthen muscles. Other common mantras are systems, the ultimate spiritual goal is the real- Om Namo Sivaya (to call upon the energy of ization of the Self or the recognition of the true Siva) and Om Nama Narayanaya (which calls Self as divine consciousness. Sivananda yoga: Sivananda yoga is a method address the seven charkas, or energy zones of geared toward balancing the intellect, heart, the body. The major ones are Lam, Vam, Ram, body, and mind that includes proper exercise Yam, Ham, Ksam, Bam (or Om). Office yoga: Office yoga practice is also called relaxation (savasana), proper diet (vegetarian), Desktop yoga because the stretches do not positive thinking (vedanta), and meditation require moving away from a chair or desk. Introduced to the United States of Incorporating ergonomics and working condi- America in 1957 by Swami Vishnu-devananda, tions that promote the well-being of office founder of the International Sivananda Yoga workers, office yoga offers stress relief from the Vedanta Centers, Sivananda yoga is based on daily business world routine and confinement the teachings of Swami Sivananda of Rishikesh, to the office. Svaroopa yoga: Svaroopa yoga is a method that Phoenix Rising yoga blends classical techniques includes gentle poses directed toward “core with contemporary mind-body psychology in opening,” or unraveling tensions all along the order to allow the release of physical and emo- spine, developed by Rama Berch, who founded tional tension. A Phoenix Rising session is a and directs the Master Yoga Foundation in La one-on-one, one-and-a-half-hour experience Jolla, California, and who has also directed the of assisted yoga postures, nondirective dia- yoga program for Dr. Berch discovered that many of yoga 171 her students “impose the pose upon their body resists aging. Few classes are available on this rather than unfolding it from within,” and method. Viniyoga: Viniyoga is a method incorporating dents experience the deeper effects she realized asana, pranayama, meditation, ritual, and prayer from Kundalini yoga. With the goal of opening for the higher purpose of enhancing an individ- the body and experiencing the transcendent ual’s ability to adapt. Desikachar, “Yoga Sutras,” Svaroopa focuses on alignment advocated treating each yoga student as an indi- and support and makes frequent use of chair vidual who wishes to reach particular goals in a poses to help release deep-muscle tension. Gary Each pose is based on integrated principles of Kraftsow, a yoga teacher since 1976, wrote Yoga asana, anatomy, and yoga philosophy. Tantra yoga: Tantra means expansion in San- Viniyoga (New York: Viking Penguin, 1999) and skrit; a Tantra yogi teaches ways to expand all Yoga for Transformation: Ancient Practices and levels of consciousness to realize the Supreme Teachings for Healing the Body, Mind, and Heart Reality (samadhi). Krishnamacharya and cre- awaken and balance male-female energy for ated a link with the Viniyoga tradition through the sake of inner peace and overcoming of per- his American Viniyoga Institute, which offers sonal limitations and subconscious blockages. White Lotus yoga: A nondogmatic approach Often considered a secret doctrine, the Tantra is developed by the husband-and-wife team also known as Gupta Vidya. Srinivasan said one Ganga White and Tracey Rich, White Lotus must acquire this knowledge not from books, yoga is dedicated to the development of the but from the practical Tantrikas, the Tantric whole human being. The tantric student must five yoga videos that highlight the practice of be “endowed with purity, faith, devotion, ded- partner yoga in 1978, and White is also the ication to Guru, dispassion, humility, courage, author of Double Yoga (New York: Penguin, cosmic love, truthfulness, non-covetousness, 1981). Tibetan yoga: A method of yoga little known in vigorous and consists of alignment, breath, and the West, Tibetan yoga is the name used by the basic yoga principles. White Lotus includes Buddhists to describe tantric meditation and the Flow Series, or Flow Yoga, which uses breathwork. In 1939 Peter Kelder published proper body alignment, attunement with Ancient Secret of the Fountain of Youth (New York: breath, focused attention, and the development Doubleday, 1998), which contains a series of of a balance of strength, flexibility, and postures called “The Five Rites of Rejuvena- endurance. Kilham’s book acre retreat in the Santa Ynez Mountains in explains five flowing movements that start Santa Barbara, California, offers weekend and with 10 to 12 repetitions and progress to 21, week-long yoga-immersion experiences as well with the purpose of restoring the spin of the as 16-day teacher-training programs. YogaDance: A combination of standing move- if the chakras are perfectly balanced, the body ments and yogic stretches developed by Jeff 172 yoga Hoffman, a native New Jersey yogi for 27 years, ardha matsayana (half-fish). Yoga therapy is the practice focuses on relaxation, breath, known to be beneficial as a preventive health self-observation, and individual awareness, and exercise regimen and as complementary according to Hoffman, whose website is www. Simple and common yoga asanas tism, anxiety, migraines, insomnia, nerve or (postures) include balasana (the child’s posture), muscle disease, menstrual problems and pre- paschimottanasana (posterior stretch), bhujan- menstrual syndrome, menopause symptoms, gasana (cobra), shalabhasana (locust), ardha mat- high blood pressure, heart disease, asthma, syendrasana (half-spinal twist), shavasana bronchitis, duodenal ulcer, hemorrhoids, dia- (corpse), sarvangasana (shoulder stand), and betes, obesity, and substance addictions. Z zanfu zhi qi The energy, or qi, of the body’s energetic zones for the treatment of a variety of organs, according to traditional Chinese medicine. After the laryngologist William Fitzger- ald, of Saint Francis Hospital in Connecticut, found zang fu The term for the internal organ systems that zone therapy with finger pressure applied to in traditional Chinese medicine. It aims to bodily reflexes (reflex points) and regions on the help relieve physical and mental symptoms, soles of the feet, which contain approximately improve the ability to deal with stress, and organize 7,200 nerve endings. When finger pressure is vibratory fields in order to promote a sense of applied to certain areas—the ball of the foot, rep- wholeness and well-being. Founded in 1991, the resenting the lungs and breast, for example—stim- Zero Balancing Association represents the integra- ulation and a healing effect are directed to the tion of Eastern views of energy with Western views lungs or breast. Ingham’s techniques brought forth of science and teaches how to use energy as a work- reflexology, as it is known today, as a form of ing tool in relation to body structure. More information is zong qi In Chinese traditional medicine energy, available by contacting www. Zukav, of California, became one Zikr The Sufi practice of remembrance that of the New Age movement’s intellectual explor- includes chanting, drumming, meditating, releas- ers with his vision that goes beyond physics and ing false impressions and delusions, and embracing science to the new mind-expanding theory of new dimensions of inner reality. Zukav is also the author zone therapy Originally, European technique of The Seat of the Soul (New York: Simon & Schus- that involves the stimulation of the body’s regional ter, 1989). As a result, many schools that taught prac- appear not to conform to standard medical prac- tices such as homeopathy were closed, homeopaths tice, or are not generally taught at accredited med- were shunned and stigmatized, and their therapies ical schools.

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A rear-facing safety seat is recommended for infants who are younger than 1 year old and weigh less than 20 pounds cheap bimat 3ml fast delivery medicine mountain scout ranch. Limitation in mobility: parental responsibility is on childproofing the environment buy generic bimat 3 ml on line medications with aspirin. As the primary reason for applying restraints generic bimat 3ml mastercard treatment tracker, nurses consistently cite the risk for injury to e. Limitation in knowledge: patients and healthcare workers from irrational behavior. Using a restraint on an older person who tends to wander is justified to ensure his/her safety. The number of deaths from accidental is necessary when assessing the patient for poisoning has decreased over the years. School-aged child: Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. The windows and doors do not operate bed to use the bathroom in her nursing properly in the home of an older couple, home. List four characteristics that should be but they cannot afford repairs: assessed to determine whether this patient is at a greater risk for falls. List five risks associated with the use of staying with her daughter, who also has a restraints. Bender is a patient who has been placed in restraints to protect her from falling after other methods have failed. List three questions you could ask a patient falling and repeatedly attempted to go to the to assess for hazards that may cause a child to bathroom on her own. List the information that should be included on a safety event report, when it should be filled out, and who is responsible for record- b. A mother leaves her child unattended in the bathtub while she answers the phone: d. A patient tells you she is “clumsy” and has fallen several times in the past few years: Copyright © 2011 Wolters Kluwer Health | Lippincott Williams & Wilkins. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Describe how you would assess a patient Scenario: Bessie Washington, age 77, was for risk for falling by using the Get Up and recently discharged to her home after suffering Go test (Hendrich, 2007). She parameters for full mobility, almost complete lives alone in a small one-bedroom apartment independence, and impaired mobility. A visiting nurse performing a safety assessment notes that she has hardwood floors with throw rugs covering the traffic areas, and old newspapers and mag- azines are stacked in piles close to heating vents. Washington tells you, “I have so much stuff crammed into this apartment, I almost fell this morning going from my bed- room to the kitchen. Visit the homes of friends or relatives who have children of different ages living with them. Ask for permission to inspect their home for safety features that are appropriate to the 2. Share your results with the family, and explain to them what they need to do (if anything) to improve safety in their home. Reflect on the importance that dif- ferent families attach to safety and its implica- 3. Many people tend to take safety measures for likely to bring about the desired outcome? Draw on your experiences in conver- sations with nurses to identify safety risks for both nurses and patients in different practice settings. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Which of the following is the smallest of all microorganisms and can be seen only through d. Teal is to have an indwelling urinary as contaminated blood, the route of transmis- catheter inserted. Artificial nails do not increase the risk for developing a fungal infection in the nail Multiple Response Questions bed. Specific signs and symptoms of the infection describe the processes of disinfection and ster- are present. The organisms are growing and multiplying, linens, and equipment in a healthcare set- but symptoms are not present yet. Which of the following statements regarding means of sterilization and disinfection is asepsis are accurate? Surgical asepsis involves only the rinsed first with hot running water to procedures and practices that reduce the remove organic material. Which of the following actions would a nurse perform when opening a sterile pack- d. Sterile packages should never be opened should place soiled bed linens on the floor. A sterile item should be covered if it is not should hold sterile objects below waist level used immediately. Even if a healthcare worker’s hands are not ile field from a 12-inch height or added to visibly soiled with blood or body fluids, the field from the side. Effective handwashing requires at least a with the label side uppermost and prepare 15-second scrub with plain soap or disinfec- to pour from a height of 4 to 6 inches. Study Guide for Fundamentals of Nursing: The Art and Science of Nursing Care, 7th Edition. Place the following steps of the infection cycle describes the proper use of personal protective in the order in which an infection would equipment in a healthcare agency? To remove gown: unfasten ties, if at the neck and back, and allow the gown to fall away from shoulders. Wear a mask when working within 3 feet of ous body sites and are part of the body’s a patient who is on droplet precautions.

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However order bimat 3ml with mastercard xerostomia medications that cause, McDonald and Hodgdon (1991) carried out a meta-analysis of both the correlational and experimental research into the association between depression and exercise generic bimat 3 ml without a prescription treatment using drugs. They concluded that aerobic exercise was related to a decrease in depression and that this effect was greatest in those with higher levels of initial depressive symptoms purchase bimat 3ml online medicine x pop up. In an attempt to clarify the problem of causality, McCann and Holmes (1984) carried out an experimental study to evaluate the effect of manipulating exercise levels on depression. After five weeks, the results showed a significant reduction in depressive symptomatology in the exercise group compared with the other two subject groups supporting the relationship between exercise and depression and suggesting a causal link between these two variables; that is, increased exercise resulted in a reduction in depression. The results showed improvements in affect from baseline to follow up which supports previous research suggesting that exercise is beneficial. The authors suggest that although prolonged exercise may improve mood this dip in mood may explain why people fail to adhere to exercise programmes. Anxiety Research has also indicated that exercise may be linked to a reduction in anxiety. Again, there are problems with determining the direction of causality in this relationship, but it has been suggested that exercise may decrease anxiety by diverting the individual’s attention away from the source of anxiety. Response to stress Exercise has been presented as a mediating factor for the stress response (see Chapters 10 and 11). Exercise may influence stress either by changing an individual’s appraisal of a potentially stressful event by distraction or diversion (e. Self-esteem and self-confidence It has also been suggested that exercise may enhance an individual’s psychological well- being by improving self-esteem and self-confidence. In addition, exercise may result in an improved sense of achievement and self-efficacy. Many theories have been developed to explain the factors that mediate the link between exercise and psychological state. These reflect both the physiological and psychological approaches to the study of exercise. For example, it has been argued that exercise results in the release of endorphins, the brain’s natural opioids (Steinberg and Sykes 1985), and increases in the levels of brain norepinephrine, which have been hypothesized to be a cause of depression. It has also been suggested that improved psychological state is related to the social activity often associated with exercise and the resulting increased confidence and self-esteem. Any reduction in levels of depression may be related to greater social contact, improved social support and increased self- efficacy. Because of the experimental design, the results allow some conclusions to be made about the direction of causality. However, as with many health- related behaviours, adherence to health promotion recommendations may be more motivated by short-term immediate effects (e. Therefore, understanding the immediate effects of exercise on mood has obvious implications for encouraging individuals to take regular exercise. Methodology Subjects The subjects were 36 male amateur athletes who were regularly involved in a variety of sports and exercised for more than 30 minutes at least three times per week, and 36 inactive men who exercised for less than 30 minutes per week. Design All subjects took part in two exercise sessions and completed measures of mood before and after each exercise session. Procedure At session one, all subjects completed a set of profile questionnaires (back- ground physical and psychological measures) and took part in a maximal exercise session on a cycle ergonometer. At session two, subjects were randomly allocated to 20 minutes of either maximal, moderate or minimal exercise. All subjects completed ratings of mood before exercise, 2 minutes after exercise and after 30 minutes of recovery. Measures The subjects rated items relating to tension/anxiety, mental vigour, depression/dejection, exhilaration and perceived exertion before and after each exercise session. In addition, all subjects completed measures of (1) personality and (2) trait anxiety once only at the beginning of the first session. Results The results were analysed to examine the effect of the differing degrees of exercise on changes in mood in the sportsmen and the inactive men. However, all subjects reported increased exhilaration and increased mental vigour two minutes after both the maximal and moderate exercise compared with the minimal condition, and in addition, the increase in exhilaration was maintained after the 30 minutes of recovery. Conclusion The authors conclude that both maximal and moderate exercise results in beneficial changes in both mental vigour and exhilaration in both sportsmen and inactive men and suggest that ‘exercise leads to positive mood changes even among people who are unaccustomed to physical exertion’. They also suggest that greater attention to the immediate effects of exercise may improve adherence to exercise programmes. Because of the potential benefits of exercise, research has evaluated which factors are related to exercise behaviour. The determinants of exercise can be categorized as either social/political or individual. Social/political predictors of exercise An increased reliance on technology and reduced daily activity in paid and domestic work may have resulted in an increase in the number of people having relatively seden- tary lifestyles. In addition, a shift towards a belief that exercise is good for an individual’s well-being and is relevant for everyone has set the scene for social and political changes in terms of emphasizing exercise. Therefore, since the late 1960s many government initiatives have aimed to promote sport and exercise. Factors such as the availability of facilities and cultural attitudes towards exercise may be related to individual participa- tion. Consequently, the Sports Council launched an official campaign in 1972 in an attempt to create a suitable climate for increasing exercise behaviour. Initiatives such as ‘Sport for All’, ‘Fun Runs’ and targets for council facilities, such as swimming pools and sports centres, were part of this initiative. In collaboration with the Sports Council, McIntosh and Charlton (1985) reported that the provision of council services had exceeded the Sports Council’s targets by 100 per cent. This evaluation concluded that: s Central government funding for sport and specific local authority allocations have helped participation in sport. This could take the form of vouchers for free access to the local leisure centre, an exercise routine with a health and fitness advisor at the leisure centre, or recommendations from the health and fitness advisor to follow a home-based exercise programme, such as walking. An alternative and more simple approach involves the promotion of stair rather than escalator or lift use. In addition, they can target the most sedentary members of the population who are least likely to adopt more structured forms of exercise.

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