Emotional Support Diagram for Client
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situations in which social support is minimal or nonexistent. Extensive review of support systems may cause anxiety and depression, and in this case, a more informal, nonthreatening approach is useful.
Social support instruments represent the broad spectrum of measures used in clinical settings as well as research. The Social Support Questionnaire is a six-item measure of per- ceived social support and satisfaction with social support. Each item presents a specific sce- nario for which respondents list the people who would be available for support in that situation. Respondents are also asked to rate their satisfaction with the support available (Sarason, Shearin, Pierce, & Sarason, 1987).
Lifestyle Assessment
In the context of health, lifestyle defines discretionary activities that are a regular part of one’s daily pattern of living and significantly influences health status. Health-promoting behavior is an expression of the human actualizing tendency that optimizes well-being, personal fulfill- ment, and productive living. The 52-item Health-Promoting Lifestyle Profile II (HPLP-II), a revision of the original instrument, consists of six subscales to measure major components of a health promoting lifestyle: health responsibility, physical activity, nutrition, interpersonal rela- tions, spiritual growth, and stress management. Scores are obtained for each subscale, or a total scale score is calculated to measure overall health-promoting lifestyle (Sechrist, Walker,
TABLE 4–4 Health-Promoting Lifestyle Profile II: Subscales and Sample Subscale Items
Subscale
Health responsibility Physical activity
Nutrition Interpersonal relations Spiritual growth Stress management
Sample Item
Read or watch TV programs about improving my health.
Question health professionals in order to understand their instructions.
Exercise vigorously for 20 or more minutes at least three times a week (brisk walking, bicycling, aerobic dancing, using a stair climber).
Get exercise during usual day activities (such as walking during lunch, using stairs instead of elevators, parking car farther away from destination and walking).
Choose a diet low in fat, saturated fat, and cholesterol. Eat 2 to 4 servings of fruit each day. Spend time with close friends. Settle conflicts with others through discussion and compromise. Feel connected with some force greater than myself.
Am aware of what is important to me in life. Take some time for relaxation each day. Pace myself to prevent fatigue.
Pender, & Frank-Stromborg, 1987). The HPLP-II provides important information about a client’s lifestyle. Sample items for each of the subscales appear in Table 4–4. A HPLP-II profile provides information to develop an individualized health promotion plan that identifies life- style strengths and resources as well as areas for further growth. A Spanish-language version of the HPLPII is available. The Adolescent Lifestyle Profile (ALP) measures seven domains of health-promoting lifestyle (Hendricks, Murdaugh, & Pender, 2006) and is useful for measuring health-promoting behaviors in adolescents.
Additional lifestyle instruments are available at educational websites, including Stanford University.
Clients may be at one of several stages in relation to any given behavior change. Table 4–5 shows the stages of change for positive health behaviors. Recognizing the different stages of change in relation to various health behaviors allows for more tailored interventions.