Long-Term Lifestyle Management

Self‐care in adults with asthma: how they cope

“…As is clear from earlier research evidence, social support plays an important part in self-care (Curtin & Lubkin, 1990;Lamm et al, 1991;Connelly, 1993;Woller et al, 1998). In our study three-quarters of respondents (75%) said they often resorted to social support from signi®cant others.…”

“…Social support also seems to have an impact on patients’ self‐care in different chronic diseases ( Curtin & Lubkin, 1990; Lamm et al ., 1991 ; Connelly, 1993; Woller et al ., 1998 ). For example, it has been found that social support during an asthma attack is very important to adult asthma patients ( Carrieri‐Kohlman et al ., 1991 ); this support is reported to come from family, friends, neighbours and nursing staff ( Keele‐Card et al ., 1993 ).…”

Health maintenance for the independent frail older adult: can it improve physical and mental well‐being?

“…Dungan's Model of Dynamic Integration was first published m 1991 (Lamm et al 1991) and has been used smce that time as the basis for a number of nursmg management protocols m a vanety of settings (Kumasaka & Ehmgan 1993, Mynchenberg & Dungan 1995 Figure 1 and Table 1 depict the model and are used with permission of the autbor Table 1 is an expansion of the modalities of care shown withm the mteractive wedge entitled 'therapeutic relationship' on the figure Dungan views humans as havmg three dimensions of body, mmd and spint m a relationship of dynamic mtegration and m open commimication with an ever-changing environment Life expenences demand a contmually changmg balance among the body, mmd and spmt to reflect the person's mtegration of such experiences into a perception of competence and well-hemg at each st^e of development Successful mtegration of the challenges of hfe allows for optimum functioning at any pomt m tune and IS expenenced as health…”

“…The model must be considered aloi^ three axes, shown across the bottom of the model The focus of mtervention may be directed towards either mdividual, family or larger groups at any stage of development at any pomt on the welhiess/illness scale ( Figure 1) All three axes must be considered in each health care situation Chents m the HMP were frail elderly people hvm^ at home Most of them were m Duvall's (1977) stage of declmmg family, from the time of the departure of the last offspring until one or both spouses die This is a tune of relatively sparse social networks and the population of concem represents a group at high nsk of mstitutionalization Therapeutic relationship is represented by the interactive wedge that may touch all three dimensions of the client, and facilitates mtegration or remtegration towards higher fimctionmg The model has been used to support long-term life style management usmg multi-disciplmary strategies of teachmg, counseUuig and social support to foster mdependent fimctionmg, and therefore is apphcahle to the HMP (Lamm et al 1991) Brock & O'Sulhvan (1985 found that the quality of social support was a major predictor of mstitutionalization in the aged population Supportive interventions function to mcrease the healing enei^ available to the chent for mtegration of body, mmd and spmt If self-responsibility is to be a hallmark of reformed health care, then programmes of augmented social support are needed to sustain people m their homes, especially dunng periods of transition and vulnerahility…”

Dungan Model of Dynamic Integration

“…Thus far in its development the Dungan Model of Dynamic Integration (DMDI) has been applied clinically in a series of nursing protocols over the past five years. It has been used to describe long-term lifestyle management (Lamm, Dungan, & Hiromoto, 1991), nursing strategy for initial emotional response to cancer diagnosis (Kumasaka & Dungan, 1993), relaxation protocol to reduce anxiety in cardiac patients (Mynchenberg & Dungan, 1995), protocol for management of fluid volume excess in hemodialysis patients (Sciarini & Dungan, 1996), and managing spiritual distress in patients with advanced cancer pain (Georgesen & Dungan, 1996). It also has been used as the model for a clinical research program to measure the effectiveness of a health maintenance protocol for the frail elderly (Dungan, Brown, & Ramsey, 1996).…”