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Introduction介绍
这项assignment作业主要将讨论全球医疗保健改变患者教育以减少高血压。然后，找出如何在个人专业实践中运用领导和管理技能，并对其进行批判性分析。首先，这项任务将讨论当前教育患者减少高血压的动力。然后，讨论了什么样的领导方式和领导风格，并将领导理论运用到个人的专业实践中，以提高工作效率。此外，本文还将批判性地运用领导和人事管理技巧来反映个人职业实践中的分析。接下来，将讨论如何在患者教育中降低高血压的风险。最后，它将总结我之前提到的重要要点。
This assignment will talk about a global healthcare change of patient education to reduce hypertension. Then, find out how to use leadership and management skills in individual professional practice and critically analyze it. First, this assignment will discuss current drives for changes in educating patient to reduce hypertension. Then, it will discuss about what leadership and leadership styles are and use leadership theories in individual professional practice to improve work efficiency. Besides, this essay will critically use leadership and people management skill to reflect analysis in individual professional practice. Next, it will discuss how to reduce the risk of hypertension in patient education. Finally, it will summarise significant points for what I have mentioned before.
根据Go等人（2014年），高血压是一种常见的慢性疾病，称为高血压。他们还指出，高血压是一种长期的医疗状况，指持续高的全身动脉血压和心脏、大脑、肾脏或其他器官的损害，是世界上中风、心脏病、冠状动脉疾病和慢性肾脏疾病的主要危险因素之一（Go等人，2014年）。
According to Go et al (2014), hypertension is a common chronic disease, which known as high blood pressure. They also state hypertension is a long term medical condition refers to persistently high systemic arterial blood pressure and the heart, brain, kidney or other organs damage, and it is one of the main risk factors for stroke, heart disease, coronary artery disease and chronic kidney diseases in the world (Go et al, 2014).
Lochner等人（2006）指出，血压测量由收缩压和舒张压组成，其值在一定范围内变化。他们也将高血压分为两类：原发性和继发性高血压。大约90%的高血压是原发性高血压，由于生活方式和遗传因素，任何人都可能患上高血压（Lochner等人，2006年）。增加高血压风险的生活方式因素包括年龄、性别、种族、盐摄入过量、超重、吸烟和饮酒。继发性高血压是由一些可识别的疾病引起的，如慢性肾病（Lochner等人，2006年）。
Lochner et al (2006) state the blood pressure measurements are consist of the systolic and diastolic pressures, and its value changes within a certain range. They also state hypertension is classified into two categories: primary and secondary hypertension. About 90 percent of hypertension is the primary hypertension, and anyone can develop high blood pressure due to lifestyle and genetic factors (Lochner et al, 2006). Lifestyle factors that increase the risk of high blood pressure are including age, genders, race, excessive salt intake, overweight, smoking and drinking. The secondary hypertension is caused by some identifiable medical condition, such as chronic kidney disease (Lochner et al, 2006).
Based on the diagnosis, the healthcare providers should develop effective treatments for primary hypertension, which comprise lifestyle modifications and medication to decrease the blood pressure (Hackam et al, 2013). Therefore, for the patients with secondary hypertension, the treatment would work on the condition which suspected of causing the high blood pressure. It is widely known the healthcare of hypertension has been facing dramatic changes and undergoing a worldwide trend of development by the growth in several drivers recently (Hackam et al, 2013).
According to Macphee et al (2013), hypertension is a global epidemic, and it is also a kind of age-related pathophysiology. Generally, the risk of high blood pressure increases in stages as ageing. The blood vessels also lose its flexibility and permeability through aging, which can cause high blood pressure. Now the ageing population is likely to influence patterns of healthcare industry in both developed and developing countries. Macphee et al (2013) state the ageing population means a shift in the distribution of the countries population towards older age and decline in the number of youth. This has happened initially in the developed countries, but now becomes a global problem. Till year 2018, 10 percent of the total world population would be older than 50 (Macphee et al, 2013). The ageing population would put a lot of pressure on the healthcare system and arise two dramatic effects: the increasing demand of services delivery and the decreasing financial support from the government (Denton and Spencer, 2010).
Therefore, Poulter et al (2015) state hypertension (high blood pressure) is a biggest problem in global burden of disease. They also state it has a high improvement risk of hypertension at present. Therefore, if carers want to reduce the risk of hypertension, it should do many measurements on educating patients. National Center for Chronic Disease Prevention and Health Promotion Division for Heart Disease and Stroke Prevention (2015) state there are several steps to maintain normal blood pressure levels: 1. Get patient’s blood pressure checked regularly. For example, check the blood pressure in free time each day or every other day. 2. Eating a healthy diet, eat some food without fatty. 3. Maintain a healthy weight, do some exercise regularly. For my individual nursing practice, I can provide some approaches to reduce the risk of hypertension for educating patients. If the patient is in hospital, I can remind patient of eating anti hypertension medication each time and based on different blood pressure to check once or twice each day. However, if the patient at home, I can suggest them to do some exercise and keep a balanced diet. To be sepicific, there will be a checklist to record names and brief personal information to remind the patient of eating and exercising in time.
According to Bass (2008), leadership is a complex topic, which is one of science’s most examined phenomena in society. Leadership in healthcare is vital to enable practitioners to delivery safe, high quality, evidence based and compassionate care in innovative ways (The Faculty of Medical Leadership and Management 2015). The Faculty of Medical Leadership and Management (2015) states a good individual leader in health services should offer a high quality and safe care. Also they state leader should provide supportive, available, fair, respectful, compassionate and empowering in nursing practice. Therefore, to reduce the risk of hypertension, I have to develop and evaluate individual healthcare leadership development and management skills.
Moreover, both leadership and management are overlapping concepts, and both of them are essential in the individual healthcare (Ricketts, 2009). Therefore, I have to design to reflect each individual patient’s needs in healthcare as a leader, which can develop the necessary management skills to reduce the risk of hypertension.
When I was a leader, I have to set a vision of other workmates, inspire them and design organizational value and strategic development objectives. And the management skills involves in directing people and resources to achieve organizational values and strategic direction established.
According to Gilmartin and D’Aunno (2007), a great deal of research is focused on nurses and nurse managers. There were strong links between nurse management skill and leadership style in nursing practice. Nurses preferred managers should be participative and emotionally intelligent and can use a great leadership style to organize other followers. Therefore, as a good nurse leader, I should have many excellent qualities, such as strong operational and cooperation ability. Gilmartin and D’Aunno (2007) also found that a good nurse leader should be flexible and can share power, to promote high quality nursing care. Karilnli et al (2008) state the quality of nurse managers’ relationships with their staff can use Leader Member Exchange theory to improvement work efficiency. When I was a leader, I would offer nurses opportunities for participation in decision making to develop their independent operational capacity. When I finished educating patient to reduce hypertension, I should review it again to check nothing has been missed. And if I missed some thing, I can tell patient immediately.
According to Zaccaro et al (2003), the leadership style theory emerged in the 1940s and 1950s, and it tends to be distinct by the motivation models performance by leaders. They state the leadership styles may influence the subordinates’ level of patients’ satisfaction and effectiveness of healthcare. In addition, the major types of the leadership styles based on the relationship between the leaders and the followers are transactional leadership and transformational leadership (McCleskey, 2014). Transactional leadership focuses on the exchanges and always occurs among leaders and followers (Bass, 2008). The leadership style is based on the notion that leadership could be constructed as a set of behaviors. In the transactional leadership, the relationship between leaders and followers is kind of transaction (Lai, 2011). Leaders will guide their followers in the direction to complete the mission by clarify their roles and tasks in practice. For the followers’ behaviour, the leader emphasizes only contingent reward or discipline. Therefore, if I used transactional leadership in my practice, I would discuss what is good for patient and convey some important things with workmates.#p#分页标题#e#
The transformational leadership was defined by Downton (1973). In the transformation leadership, the leaders motivate their followers to efforts at self-concepts and encourage them to offer higher ideas, set moral values and create beyond their duties (Givens 2008). Unlike the transactional leadership, the transformational leadership is based on the motivated followers’ emotion (Givens 2008). Also the transformational leadership is considered as the most effective model. Because, in the transactional leadership, the effective leaders have to think about the entire situation might happen in the healthcare and motivated the needs of their followers in a narrow range of strategies (McCleskey, 2014). Moreover, in the transformational leadership, the leaders arouse deep emotions of the followers and encourage them to behaviors more than expected. Therefore, in my professional healthcare practice, I should have to learn how to reduce the risk of hypertension on patient’s education through motivating and inspiring my followers as a transformational leader. In addition, if I used transformational leadership in my practice, I would considerate all possible problems that might occur and then if these problem happens, I can do treatment at once in my practice. Bishop (2009) states in my hypertension healthcare programme, the leader should motivate the patients to efforts at self-concepts and encourage them to offer higher ideas, set moral values and create beyond their duties. Also the leader will lead the team members to develop a new and effective ways to transfer the knowledge of professional healthcare to the patients with hypertension (Bishop, 2009). Therefore, in my hypertension healthcare programme, I followed a transformational leadership style, which is based on the motivated followers’ emotion. I would form and lead a team to provide hypertension education to the patients. And I would arouse deep emotions of the followers and encourage them to behaviors more than expected.
Loomis (2000) states there are some difference in Baby Boomers and Xers styles. The concept of Baby Boomer and Xer are social concepts, the former means the generation of 4664 period (1946-1964) and the latter means the generation from 1965to 1979. Comparing with the generation of Baby Boomer, the generation of Xers tend to be more independent, self-motivated and self-sufficient. However, Baby Boomers tend to be more diligent and prefer a more stable working environment (Loomis, 2000). Therefore, each style has own benefits in nursing practice. For example, Baby Boomers can use to take advantage of training opportunities, the Xers can use for carers to improve working skills in nursing practice. Both of them have a high need for autonomy and flexibility in nursing practice, and then can as a great leader to organize. Moreover, if I use Baby Boomers and Xers leadership style in my practice, I would check patient’s blood pressure and take care of patient by myself to help me become more independent.
Lewin (1948) and Lewin et al (1939) state there are three types of groups: leadership styles, social climates, and interpersonal dynamics and then find out three types of styles: autocratic, democratic, and laissez-faire. When I use Lewins in my practice, I would offer many ways to help patient reduce hypertension, such as do some exercise or keep a healthy eating habits or eat some medicine.
To improve the hypertension healthcare, it requires the evidence-based practice of innovative approaches of the leadership. According to Kumer (2015), there are multiple effective approaches to deliver the necessary knowledge to the patients in the professional education programme: First, the healthcare leaders must ensure the latest knowledge of hypertension for the patients and other followers. It can be done by searching the latest literatures or medication information through the internet. And the leaders also should make the knowledge and information available to get immediately at any time the team members want(Kumar, 2015).
The healthcare leaders should engage patients to understand the reason for the behaviour change and the consequence they may meet (Mcmanus et al, 2010). Therefore, the healthcare leaders should provide an opportunity for the patients to accept education from the professionals, such as a face-to-face instruction or online communication between the patients and teachers. The healthcare providers have to ensure patients understanding of the whole hypertension knowledge by continuously asking questions (Mcmanus et al, 2010).
Furthermore, Mcmanus et al (2010) state the healthcare provides also help the patients to set their self-management goals based on their diagnosis, and forms an feasible plan. The plan contains the objectives, the stages, the requirements of diet, exercising and the personal healthcare details. Therefore, patients with hypertension are encouraged to monitor their own blood pressure at home and report the unhealthy condition to the hospital. And they are also encouraged to adopt healthy lifestyle changes. The healthy lifestyles includes: eat healthy foods, decrease the salt in diets, maintain a normal weight, get exercise, limit alcohol intake, quit smoking, reduce stress and relax (Mcmanus et al, 2010). They also state the healthcare leaders should find out whether the patients with hypertension understand and accept the medication plan, and carry it through in time.
Ontario Healthy Communities Coalition (2003) states the healthcare leadership is commonly associated and limited by the policies of the local government and elected officials. And for some leaders in healthcare, it is necessary to participate in implement policy, and influence strategically in the respective organizations. The political leadership also involves in submitting evidence and healthcare experience to the public interest and promotes the improvement of healthcare policy (Ontario Healthy Communities Coalition 2003). Nowadays, the nurses have great chances to be involved in the international healthcare organization to assume a global leadership. And the leaders need to develop the political leadership skills to bring about action on issues of healthcare concern, and communication to the public of different countries.
Leadership and management are overlapping concepts, and both of them are essential in the individual healthcare (Day, 2001). Therefore, use leadership and management skill can reflect each individual patient’s needs in healthcare as a leader, and develop the necessary skills to enhance high quality service delivery with the followers. However, the management is different from the leadership in many aspects. The leadership is more likely getting right people to do things, while the management is getting things done right through people. According to Ricketts (2009), the leadership is defined as a process whereby an individual influences a group of individuals to achieve a common goal. However, he also states management is defined to exercise executive, administrative, and supervisory direction of a group or organization. Leadership and management also have some similar ways. Both leadership and management involve influence, working with people, and working with effective goal management (Ricketts, 2009). In my practice, I set tasks’ direction for the followers, while the management plans the tasks for details. And I would enable the followers to accomplish the tasks by inspiration, while the management enables patient to do this task by offering incentives. As a great leader, I should deal with important, complex, conflicting trends and other changes in nursing healthcare. To be a successful leader, I have to figure out the implication of the changes, develop effective strategies that account for changes, and manage the respective healthcare organization as well as the leading activity.
In order to put the effective leadership into the individual professional development, I have to explore the appropriate leadership management skills for the reflective practice. Leadership skills are the skills that healthcare leaders would use in the interaction and communication with their followers (Davidson et al, 2011). The common skills would include writing letters and notes, preparing oral and written presentation of the healthcare goals, conducting group meetings or interviews, giving direction and suggestion to the followers and providing for the budgets. Reflecting on my practice, when I educated patient to reduce hypertension, I can take a paper which include some key points to patient. Therefore, if I forgot something, I can look at this paper. These skills are formed in the traditional nursing education system and practiced in each clinical healthcare task. In the past few years, many patients can not afford hospitalization costs, they might not cure the disease. Therefore, if patient can not afford expense, government can do some discount by different medical card at present. Nowadays, when I educate patient how to reduce hypertension, I can do more communication with patient to know their condition. And patient can eat healthy food such as some fruit or vegetable to reduce hypertension.
Further to meet the needs of improved healthcare service delivery in educating patient to reduce hypertension, the leadership skills should be apt to increase the effectiveness of the interpersonal processes through which leaders motivate their followers. Therefore, I can use leadership and people management skills in my individual professional practice to improve work efficiency to achieve the goal of reduce hypertension. The first demand for the leaders is to enhance self awareness. The good leaders should be able to figure out the situation and environment they are facing, and determine the proper activities to deal with various situations. For example, when I found a patient who has difficulty in breathing, I would put patient to lie down on their side right away, and observed their clinical manifestation. In addition, I have to make realistic assessments of their own abilities and accept my responsibility for healthcare tasks in individual professional practice. And I also should have the confidence to use professional knowledge to make decisions and guide the followers. In this process, I would use the professional skill and awareness to solve the possible problems and this would be a process of self-management and professional reaction. The second demand for the leaders is self-regulation. It is necessary for them to handle their emotions in any situations, so they facilitate rather than interfere with the task at hand. Therefore, facing the challenge from the education patient on hypertension, I have to conscientious and delay ratification to pursue the goals. If there is a failure in the work, I should recover quickly from the emotional distress. If I am a good leader, I can know a lot about my patients and strive to exceed their expectations. #p#分页标题#e#
The most important skill for the leaders is to build and develop a good team work. In my individual practice, I should make clear awareness of the goals of health care, and avoid any potential conflict between team members from different cultures and professional levels to reduce the risk of hypertension. And I also need to collect, aggregate and analyze the outcome data of the healthcare. I should know how to design the healthcare practices and collaborative exchange with followers and the patients. I should sense what the team members are feeling, take their perspective, and cultivate rapport and attunement with them. These leadership skills are required for individual professional development needs.
Conclusion
Hypertension is a common chronic disease. And it is one of the main risk factors for stroke, heart disease, coronary artery disease and chronic kidney diseases in the world, and has no syndrome on patients to notice. There are two types of hypertension: primary and secondary hypertension. The treatments for the primary hypertension include lifestyle modification and medication. Evidence suggested there was a huge lack of understanding of hypertension background and professional healthcare knowledge among patients with hypertension. Only a few patients would improve lifestyles and take medication in time. That suggests that inefficient hypertension treatments on the patients are associated with lacking of necessary knowledge on hypertension healthcare. In order to improve the hypertension healthcare, the clinical healthcare leaders form an education programme to teach patients the necessary knowledge of hypertension and build self-management. The leaders also provide decision support for patients in daily practice. This assignment also suggests the leadership and management skills are important for the education. To enable to be a good leader and deliver high quality healthcare, I have explore the appropriate leadership management skills with a reflective analysis of individual professional development needs. Then I can appoint to the management positions from which they are expected to lead. The global healthcare changes can promote the leaders in management position to change management strategies to reflect governance, evidence based practice and professionalism.
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