Based on the case study, Alice and Travis might be suffering from several health issues highlighted below;
Obesity
Obesity is the state of having a Body Mass Index of 30 or greater. It is the same as being overweight. This comes along with many health issues especially to pregnant mothers that include:
Gestational diabetes-this is diabetes that is first diagnosed during pregnancy and puts the pregnant mother or the baby to be born at a higher risk of suffering from diabetes in future. The condition also increases the chances of having a cesarean delivery during childbirth (Bhadoria, 2015).
Preeclampsia-this is a blood pressure that occurs during pregnancy or after pregnancy affecting the woman’s entire body. This can further lead to kidney or liver failure or even stroke.
Sleep apnea-this is a condition associated with obesity where a person stops breathing for a short period of sleep. This lead to fatigue, high blood pressure, preeclampsia, eclampsia, and heart and lung disorder (Bhadoria, 2015).
Both Alice and Travis are suffering from this condition that may lead to the above problems.
Neural Tube Defects
This is a birth defect that occurs in the brain or spinal cord in the first month of pregnancy even before the woman knows that she is pregnant. Due to her overweight, Alice might suffer from this condition.
Macrosomia
This is a condition where the baby is larger than normal thus increasing its chances of being injured during childbirth. It also increases the chances of cesarean delivery. The baby has a higher risk of being obese in future. This health issue is evident as several doctors have told Alice that her baby is overweight.
Miscarriage
This is an unexpected loss of a woman’s pregnancy before the 20th week. The chances of miscarriage are higher in obese women than in assistance women. Since Alice is obese, then her chances of suffering from obesity are high.
Medical Care Denial
This is the refusal of medical assistance by a patient or failure to provide medical assistance to a patient who requires it. In this case, Alice is refusing to get medical assistance. This can be due to low self-esteem. She thinks that the four doctors she has gone to are rude to her despite them telling her the truth (Bhadoria, 2015).
Strategies to Prevent Healthcare Concerns
Macrosomia is a condition that the baby becomes large than the normal size. This condition is as a result of several factors i.e. the parents could be large thus having passed the genes to the unborn child (Schuster, 2016). In addition, the mother increased insulin resistance results to baby getting large volumes of glucose which in turn is stored as body fats thus causing macrosomia. However obesity like in the case of Alice could lead to macrosomia which is very risky for her and her baby.
Conditions such as obesity and diabetes are common during pregnancy; Alice has to admit to having exercises often, this would reduce glucose and fat pileup in the body thus reducing the amounts of glucose and insulin that reach the baby. Alice should, therefore, agree to review her diet and also most importantly reduce her weight to avoid cases of Macrosomia (Ogden et al., 2014)
Alice is at the risk of delivering a child with the brain, and spinal code defects due to her obesity conditions she should also include folic acids in her diet which is also known as folate or vitamin B9.folic acid will highly reduce chances of neural tube defects for her newborn child.
Alice has a problem in accepting medical attention this has all other problems aligned on her case she has constantly refused to heed what her four doctors have reflected on .this issue is so serious that she cannot treat other problems if she doesn’t like the manner of treatment administered by the doctor. I think she3 can only be first be included in therapy sessions that will help her gain self-esteem and accept to heed the doctors advise(Ogden et al.,2014).
Primary, Secondary and Tertiary Prevention Strategies to Assist the family
Primary strategies
These are activities that help the patient understand the risks factors that result in problems in health. This is achieved by making changes to the environment and also in nutrition and in lifestyle. For Alice case study she likes eating fries and purchasing treatment for her son to make him happy .also she likes staying indoors and playing video games with her son. The very primary strategy for her obesity issue is to change her lifestyle and again change her nutrition program. She has to change her diet and avoid fries and in place use vegetables and fruits. Again instead of sitting in the house and playing video games, she should go for walk with Travis this will help them burn extra calories thus reducing the extra weight.
Secondary Strategies
These are strategies that are put in place to reduce or to slow the disease progress .these include the patient taking medical tests and screening to diagnose the health issue. Alice is at risk of getting macrosomia disease and again she risks getting her baby infected by neural tube infection (Schuster,2016).she has to visit the medical facility for testing and diagnosis. Whether she is at risk of neural tube or not she has to take folic acid during her pregnancy to reduce the risks. She has to take diabetes test check on her insulin transmission of glucose to the fetus to reduce cases of excessive baby growth. Also, she has to go through tests to check if she has any genetically related issue that may affect her unborn child.
Tertiary Strategy
This involves rehabilitating and managing patients with the diagnosed health issues to reduce any possible complications and as well improve their lives. Alice and her son are victims of obesity and having gone through diagnoses it’s time to manage their condition and as well improving their quality of life and increasing productivity (Choudhury, 2018).
By changing diet for the two and having them use only healthy food and putting them on exercise will gradually manage and rehabilitate their lifestyle.
Health Promotion Model
Alice has a huge problem both psychologically and physically she lacks inspiration and hides in the fact that Kenny loves them as they are. Moreover, she forgets there are Travis and the unborn child who are at much risk of the obesity and related issues .according to Albert Bandura‘s self-efficacy book Alice has a lot to learn and apply in her lifestyle (Maddux,2016). Bandura reasoned out that if you have the belief that you can achieve a certain goal you are set to do then that is all you need and it is healthier very effective and very successful .so based on this health model she has to believe she can reduce her weight and psychologically prepare for it be ready to face the challenges and she will finally secure her life and that of her both children.
Health People 2020 Goals to Assist the Family
According to health people 2020, Alice and Travis should limit the intake of caloric to meet the caloric need. They should also limit the intake of saturated and trans-fats, sodium, alcohol, added sugars, and cholesterol. They should consume whole grains, fruits, vegetables, foods with proteins, and fat free milk (Lloyd-Jones et al., 2012). This will help reduce obesity. Alice should also consume the recommended amount of folic acid before and after pregnancy to prevent neural tube defects. She should also feed her child with breast milk as it is more nutritious.