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Sample Nursing Capstone Paper on “Prevention of Disability and Managing Chronic Illness”

Here you can check the sample nursing capstone research paper written by one of our professional writers. Feel free to check out our nursing capstone project sample here.

 The Sample of Nursing Grad School Capstone Paper on “Prevention of Disability and Managing Chronic Illness”


The aging process is biologically real and it may be associated with some dynamics beyond human control (Gorman, 1999). Old age disability constitutes a frequent problem that contributes to poor quality of life. For instance, mental and physical related disabilities predispose an individual to hospital admission, residential care, and/or premature death. This implies that quality of life among the elderly could be improved by combating disability. Any person can become disabled when physically or mentally impaired such that they are substantially limited to perform one to more major life-related activities (Americans with Disabilities Act [ADA], 2014).

World Health Organization [WHO] (2013) defines a chronic disease as the condition that slowly progresses over a long duration and eventually leads to pathological symptoms that are not related to physical injury. Existing literature shows that chronic diseases are a major cause of disability. This problem is cross-cutting in both developed and developing countries at varying intensities.

Problem statement

Disability is a major predictor of poor health. The situation is even compounded with chronic diseases since they heighten the prevalence of disability. The rising prevalence of chronic diseases is a major public health concern globally. Recent statistics show that one in four adults suffers from at least two chronic health conditions (Ward, Schiller and Goodman, 2014). There is also a body of evidence that chronic diseases such as obesity are associated with intellectual disability in adults and pose a major clinical problem (Bhaumik, Watson, Thorp, Tyrer, & McGrother, 2008; de Winter, Bastiaanse, Hilgenkamp, Evenhuis, & Echteld, 2012b; de Winter, Magilsen, van Alfen, Penning, & Evenhuis, 2009; Melville, Hamilton, Hankey, Miller, & Boyle, 2007; Morin, Merineau-Cote, Ouellette-Kuntz, Tasse, & Kerr, 2012; Reichard & Stolzle, 2011; Rimmer & Wang, 2005). The disabled adults are even more predisposed to chronic conditions than those without. As noted by Dixon (2014), this highlights the need for targeting this vulnerable population for health promotion interventions.

The impact of chronic diseases surpasses that of infectious diseases since it is the main cause of mortality and disability worldwide. Although these diseases, including heart disease, stroke, and cancer as well as diabetes, obesity plus arthritis are very common and costly, they are preventable health problems (Center for Disease Control and Prevention [CDC], 2014). Consequently, management of chronic diseases poses a major significant challenge to health systems (Buja, Damiani, Gini, Visca, Federico, Donato, Francesconi, Marini, Donatini, Brugaletta, Baldo, Donata, Bellentani, 2014). This review seeks to explore prevention of chronic diseases and the associated disabilities among senior citizens aged 60+ years.


Approximately 50% of all adults (about 117 million people) were diagnosed with at least one chronic condition in 2012 (CDC, 2014). Seven of the top 10 causes of death in 2010 were chronic diseases. Of these diseases, the report showed that the heart and cancer diseases alone caused about 48% of all the deaths. There is a body of evidence to show high burden due to chronic diseases like the heart, cancer and diabetes disease, and mental disorders in both low- and middle-income countries, with likelihood of increase as the population ages, and with risk factors urbanization and globalization (Beaglehole, Epping-Jordan, Patel, Chopra, Ebrahim, Kidd et al, 2008). This trend is pervasive to all countries and thereby the need to prepare and respond with steadfastness since the increasing prevalence of these diseases is a major challenge to the health care systems (Wu, Guo, Kowal, Jiang, Yu, Li et al., 2013).

A systematic comparative review study by Melville et al. (2007) on the prevalence of obesity among intellectually disabled adults and obesity prevalence among the general population reported significant health inequalities in the former than the later population These included shorter life expectancy and significantly high unmet health needs. The study recommended future research that focuses on the influence of dietary habits, lack of physical activity as well as socio-economic factors have on the risk of intellectually disabled cases to develop obesity. Therefore, such studies would inform policy development of evidence-based prevention interventions.

De Winter et al. (2009) focused their cross-sectional study on prevalence determination of cardiovascular risk among intellectually disability Dutch people aged 50 to 90 years at three care providing organizations. The findings showed the need to improve healthy behavior since 99% of the study participants practiced unhealthy dietary habits while 68% lacked exercise. Other prevalent health-related issues included 70% abdominal overweight, 9% diabetes, 37% hypertension, and 32% hypercholesterolemia. In their views, there is a need for health promotion campaigns with a focus on education and screening programs for prevention of cardiovascular risk factors in the target population.

Tyler et al. (2011) performed a case-control study among adults with autism spectrum disorder (ASD) attending primary care treatment at Cleveland Clinic from 2005 to 2008. The results showed high obesity, hyperlipidemia as well as hypertension rates in the study population, which predisposed them to higher vulnerability to diabetes, cancer plus cardiovascular disease compared to their adult counterparts in the general population (Tyler, Schramm, Karafa, Tang, & Jain, 2011).

Similarly, Dixon (2014).performed a comparative data-based National Health Interview Survey between 2006 and 2012 with a view to determining the extent to which disability-related risk may contribute to poor health among lifelong disabled adults and those without limitations. The study indicated higher odds of coronary heart disease and cancer to hypertension, obesity plus diabetes in lifelong disabled adults than those without. The study highlighted the need for health promotion interventions for disabled people, being high-risk population, as a measure to prevent chronic conditions.


This study used systematic review of published articles to assess the role of health promotion in the prevention of old age-related disabilities and management of chronic illnesses.

The review was guided by the following research questions:
a) What is the association of age with chronic diseases and disabilities?
b) What is the role of health promotion in prevention and management of age-related chronic diseases and disabilities?

The researcher developed the search strategy as recommended by Kable et al. (2012), and in consultation with the supervisor in order to ensure extraction of all relevant literature and data. This was followed by performing a systematic literature review from journal articles and databases such as Medline, Central, PubMed, CINAHL, EMBASE, AMED, PsychLit, and Cochrane Database between the years 2005 to 2016. Mol and Wynstra (2008) argued that “peer-reviewed journal articles provide validated knowledge, and give a good estimate of accepted topics and methodologies.” (p. 15), and the fact that they are up to date. The selection criteria were any between the years 2005 to 2016 on the association of age with chronic diseases and disabilities; and their prevention and management through health promotion. A total of 20 articles were gathered based research topic, research questions, search terms (aging, chronic diseases, and disability), and the overall selection criteria. The articles were then assessed for relevance as recommended by Bettany- Saltikov (2010) of which 8 articles were selected for systematic review.

Prevention and management of chronic diseases and associated disabilities

With this backdrop, many governments are investing in prevention and reduction of chronic conditions. However, the focus is centered on cost-effective approaches and means (e.g. cost-effective self-management and perceived self-efficacy) due to the associated economic implications. For instance, older people who have chronic conditions continuously make day-to-day decisions with regard to self-management of their illnesses. In this regard, the patients employ self-management concepts such as self-efficacy which require an individual to confidence in any behavior necessary for achieving the desired goal.

Controlled clinical trials by Bodenheimer, Lorig, Holman, & Grumbach (2002) demonstrated effectiveness in using teaching programs of self-management skills compared to information-only patient education to improve clinical outcomes. In essence, the effectiveness was an evident improvement of clinical outcomes and cost reduction for arthritis and even for an adult with asthma.

In another study, Becker (2003) focused on balance concept as central to portraying bodily awareness about signs and symptoms of chronic conditions, and their response actions in managing chronic conditions among Filipino-Americans aged 46 to 97 years. The findings revealed that the participants used various self-care practices to control chronic conditions. The study concluded that the participants combined various he ways for body attention, balance, and harmony related values, and social well-being emphasis increased bodily processes attention. Indeed, bodily awareness emphasis indicates that this cultural strength may have a role in promoting chronic illness management. Therefore, awareness about the Filipino-Americans’ cultural traditions may facilitate patient education on managing chronic conditions.

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