Introduction

Welcome to this workbook for the Fundamentals of Behavioural Sciences module. This document provides the framework for the summative assessment of your learning for the module and allows you to demonstrate that you have met the learning outcomes, as set out below

1. Explain the importance of early years and childhood experiences and their possible impact on life choices, mental, physical and behavioural health and wellbeing
2. Demonstrate fundamental knowledge of cognitive, emotional and behavioural development and apply this knowledge to nursing practices
3. Demonstrate fundamental knowledge of the conditions that create mental health and wellbeing, and recognise signs of mental and emotional distress
4. Demonstrate fundamental knowledge of the conditions that create cognitive health and wellbeing, and recognise signs of cognitive distress and impairment
5. Demonstrate fundamental knowledge of behavioural distress, recognising how and why people’s behaviour can become agitated, aggressive or challenging
6. Recognise and assess people who show signs of abuse, neglect, self-harm and suicidal ideation, initiating interventions and escalating concerns appropriately
7. Use a range of fundamental communication strategies and evidence-based approaches to behaviour change to identify and discuss the impact of smoking, substance and alcohol use, sexual behaviours, diet and exercise on mental, physical and behavioural health and wellbeing, in the context of people’s individual circumstances

These learning outcomes are linked directly with a number of the Nursing and Midwifery Council’s standards of proficiency (NMC, 2018), Annexe A skills and Annexe B procedures, as detailed fully in Appendix 1.

You will need to write four 500-word essays based on practice scenarios and guidance for each essay is given in the four sections of this workbook.

Appendix 2 shows the marking grid that will be used to assess your work and provides details of exactly what academic skills you need to demonstrate against five criteria:

• Knowledge and critical understanding
• Application of data
• Problem solving
• Communication and references
• Personal learning and transferable skills 

Section 1

Section 1: Conditions for health and wellbeing

Before answering the scenario-based essay question for this section, you should complete the following activities:

Activity 1

First review the core lectures from 22nd October and 19th November –

• ‘Key concepts of health, wellbeing, illness and disability’, and
• ‘Social, environmental and internal factors contributing to health and illness: the determinants of health’

Activity 2

Read the articles, listed below, which provide summary overviews of the wider determinants of health, how these may impact on health and wellbeing for different people, and highlight the importance of developing awareness of them for nursing practice.

Matthews, D. (2015) Sociology in nursing 1: Can sociology help to improve nursing practice?

Nursing Times; 111(41): 18-20.

McFarland, A. and MacDonald, E. (2019) Role of the nurse in identifying and addressing health inequalities. Nursing Standard; 34(4): 37-42.

Both journal articles are available through the University’s library databases and are included on the module’s Talis reading list, but pdf copies have also been uploaded to moodle and can be found in the ‘Assessment Information’ box.

Activity 3

Access and watch this YouTube video. Even though it is only a little over 4 minutes long, it provides a lot of information, so you might benefit from watching more than once! Clicking the link should take you straight to the video:

https://www.youtube.com/watch?v=zSguDQRjZv0

Scenario 1

Lottie is 39 years old and lives with her partner Robyn and they have three children, all in their teens. She finds the children difficult to manage now that they are older and has problems getting them to school. The children aren’t allowed out on their own because the area where they live is known for having a drug gang problem. Recently, Lottie has become concerned about being very overweight after hearing on the television that this may increase the risk of severe illness if she should catch the coronavirus.

Lottie has always been ‘big’, even as a child, and her parents, who were also overweight, told her not to worry as it ‘was in their genes’. This is exactly what she tells her own children, as this family tendency has continued to the next generation. Robyn is very fussy with her food too and won’t touch a vegetable or eat fruit. Over the years it has become easier for Lottie to feed the whole family on local takeaway meals and snacks.

Recently, both Lottie and Robyn have been made redundant from work; Lottie worked part-time in a corner shop that closed down, and Robyn worked in a bar, until that was shut too by the owners. Now they do their drinking at home, which is expensive, but they find that there is plenty of time to join the children in watching television and Netflix films. The family are now surviving totally on welfare benefits and struggling to make ends meet. They have very few relatives living in the area and have lost touch with most of their old friends over the years while bringing up the children.

All of this is making Lottie very anxious and stressed, much more than usual, and she thinks that she might need to see her GP again for some help and more antidepressant tablets.

Essay Questions 1 (total 500 words)

• Identify and describe the range of potential factors (determinants of health) that may have impacted on Lottie’s current health experience and wellbeing.
• What information would it be useful for the practice nurse at the GP surgery to get from Lottie to be able to identify the family’s needs for nursing care?

Section 2

Section 2 Childhood experiences

Before answering the scenario-based essay question for this section, you should complete the following activities:

Activity 1

First review the core lectures from 5th and 26th November, and 3rd December –

• ‘Individual development across the lifespan 2: health and well-being in childhood and adolescence’
• ‘Stress, distress and self-harm: adverse experiences across the life course’
• ‘Principles of safeguarding’

Activity 2

Read the articles, listed below, which provide summary overviews of the range of adverse childhood experiences (ACEs) and their potential impact on physical, mental and behavioural development, health and wellbeing. They also highlight the importance of developing awareness of them for nursing practice, caring effectively for people across the lifespan and promoting safety.

American Academy of Pediatrics (2014) Adverse Childhood Experiences and the Lifelong Consequences of Trauma. Itasca Illinois: AAP.

Gilliver, C. (2018) Trauma-informed care in response to adverse childhood experiences. Nursing Times [online]; 114: 7, 46-49.

Both journal articles are available through the University’s library databases and are included on the module’s Talis reading list, but pdf copies have also been uploaded to moodle and can be found in the ‘Assessment Information’ box.

Activity 3

Access and watch this 6-minute YouTube video. Clicking the link should take you straight to the video:

https://www.youtube.com/watch?v=XHgLYI9KZ-A

Scenario 2

Gerry is 15 and currently living with his father and elderly grandmother. His grandmother has started to become muddled at times and Gerry feels increasingly stressed about her safety when on her own. His parents are separated following many years of a troubled relationship and his mother has returned to her family in the Philippines.

Gerry always remembers there being rows and, especially when his dad had been drinking, it was always safer to hide in his room before the physical fighting started and he learned it was best to keep out of the way. Gerry’s mum was very timid and had been kept under control herself by a very strict father, so she had taken a back seat in Gerry’s upbringing and had left him to his own devices. She would often stay in bed all day.

At school, concerns have been raised with the School Nurse about Gerry’s attendance and he is reluctant to communicate with staff or other students. There is evidence that Gerry is being bullied and taunted because of his shabby appearance, and he has begun to get involved in fighting. Gerry is also refusing to eat with others or get involved in sports at school, is wearing increasingly baggy clothes, and keeps his arms and legs covered at all times.

Essay Questions 2 (total 500 words)

• Describe the behaviours that suggest Gerry has experienced traumatic events in his life and explain what these events have been.
• Identify the principles of care in safeguarding Gerry as a vulnerable person and supporting his family.

Section 3

Section 3 Health promotion and behaviour change

Before answering the scenario-based essay question for this section, you should complete the following activities:

Activity 1

First review the core lectures from 10th and 17th December –

• ‘Health promotion and behavioural change: key health challenges and influences on behaviour’, and
• ‘Health promotion and behavioural change: health communication and health promotion frameworks’

Activity 2

Read the articles, listed below, which provide summary overviews of what health promotion and health education are and important frameworks and strategies that nurses can use in their practice to support people and encourage them to consider changing their lifestyle behaviours.

Fuller, S. (2015) Building brief intervention into your everyday work. Nursing Times; 111(5): 23- 25.

Whitehead, D. (2018) Exploring health promotion and health education in nursing. Nursing Standard. doi: 10.7748/ns.2018. e11220

Both journal articles are available through the University’s library databases and are included on the module’s Talis reading list, but pdf copies have also been uploaded to moodle and can be found in the ‘Assessment Information’ box.

Activity 3

Access and watch this YouTube video. It provides some useful examples of health promoting interactions that could be considered through the ‘Making Every Contact Count’ approach.

Clicking the link should take you straight to the video: https://www.youtube.com/watch?v=D5XeADkO5Kc

Scenario 3

Amina left university after getting a first-class honours degree in accountancy and finance. She is now working for a large finance company in town with a really good starting salary, and this has made her family very proud, but she feels that her parents, especially her farther, are too controlling.

Part of the office culture is to work hard during the week and play hard at the weekend, starting on Friday afternoon and there is an expectation that to get on, everyone must join in and be rewarded with a few drinks. They start in a local bar and move on until late in the evening. For the past couple of months, Amina has been getting home in the early hours of Saturday morning and her mother has been putting her to bed because she is so intoxicated. Most Friday evenings, Amina has blacked out, and can’t remember how she got home, or who she spent the later part of the evening with. Her parents are very worried, but Amina insists that they should mind their own business, drinking helps her to relax, and that she needs to keep socialising with her new circle of friends and to keep her job and that this is normal.

Amina’s parents receive a phone call from the local hospital telling them that she has been admitted and that they should come to the Accident and Emergency Department. When they arrive, the nurse explains to them all that Amina has acute pancreatitis because of drinking excessive alcohol and that she will need to stay in hospital for pain relief and IV fluids to treat dehydration.

Essay Questions (total 500 words)

• Identify and describe what might be motivating Amina to periods of excessive alcohol binge drinking.
• What might be the best way of discussing alcohol use with Amina, to engage with her and promote behaviour change

Section 4

Section 4 Agitation and aggression

Before answering the scenario-based essay question for this section, you should complete the following activities:

Activity 1

First review the core lectures from 12th November 2020 and 14th January 2021 –

• ‘Individual development across the lifespan 3: health and well-being in adults and old age’, and
• ‘Agitation, aggression and challenging behaviour’

Activity 2

Read the articles, listed below, which provide summary overviews of a range of challenging behaviours and why they may have arisen, and possible tactics that can be used for prevention, to manage situations and promote safety for all.

Hallett, N. (2018) Preventing and managing challenging behaviour. Nursing Standard. 32(26): 51- 62.

Harwood, R. (2017) How to deal with violent and aggressive patients in acute medical settings.

Journal of the Royal College of Physicians; 47: 176-82.

Both journal articles are available through the University’s library databases and are included on the module’s Talis reading list, but pdf copies have also been uploaded to moodle and can be found in the ‘Assessment Information’ box.

Activity 3

Access and watch this YouTube video which provides an overview of assessing risk form agitation and aggression in clinical work situations. Clicking the link should take you straight to the video:

https://www.youtube.com/watch?v=qCMJTWRnb8M

Scenario 4

Frank has been living alone with Alzheimer’s for many years, but his condition has deteriorated significantly enough over recent months, following a period in hospital after a fall, that his family decided that it would be safer and best for him to move to a nursing home for care. Before the move, Frank was visited daily by his granddaughter who used to help him get up and ready for the day and make sure he was able to get to the day centre twice a week.

Since the move, Frank has started to get out of bed as many as ten times during the night to visit the toilet and has started soiling his pyjamas on some nights. He ends up wandering, losing his way and pacing up and down the care home corridors. He spends much of his time during the day napping in his chair.

Frank’s family have noticed when they visit that he seems increasingly confused and distressed, especially in the evening and at night. He is sometimes verbally abusive to them and repeats the same phrases over and over. The care staff have reported that he has become very irritable for most of the time and has also started to lash out when approached and has refused care and help from the female staff.

Essay Questions 4 (total 500 words)

• What factors might explain Frank’s increasing agitation?
• What strategies might be useful in calming Frank and maintaining feelings of comfort and safety

Appendix 1

NMC (2018) Future Nurse: Standards of Proficiency for Registered Nurses. London: Nursing and Midwifery Council.

Standards of Proficiency

Platform 2 – Promoting health and preventing ill health 2.4

identify and use all appropriate opportunities, making reasonable adjustments when required, to discuss the impact of smoking, substance and alcohol use, sexual behaviours, diet and exercise on mental, physical and behavioural health and wellbeing, in the context of people’s individual circumstances

2.6

understand the importance of early years and childhood experiences and the possible impact on life choices, mental, physical and behavioural health and wellbeing

2.8

explain and demonstrate the use of up to date approaches to behaviour change to enable people to use their strengths and expertise and make informed choices when managing their own health and making lifestyle adjustments

Platform 3 – Assessing needs and planning care 3.1

demonstrate and apply knowledge of human development from conception to death when undertaking full and accurate person-centred nursing assessments and developing appropriate care plans

3.2

demonstrate and apply knowledge of body systems and homeostasis, human anatomy and physiology, biology, genomics, pharmacology and social and behavioural sciences when undertaking full and accurate person-centred nursing assessments and developing appropriate care plans

3.9

recognise and assess people at risk of harm and the situations that may put them at risk, ensuring prompt action is taken to safeguard those who are vulnerable

3.10

demonstrate the skills and abilities required to recognise and assess people who show signs of self-harm and/or suicidal ideation

Platform 4 – Providing and evaluating care 4.11

demonstrate the knowledge and skills required to initiate and evaluate appropriate interventions to support people who show signs of self-harm and/or suicidal ideation

Annexe A: Communication and relationship management skills

2.7

assess motivation and capacity for behaviour change and clearly explain cause and effect relationships related to common health risk behaviours including smoking, obesity, sexual practice, alcohol and substance use

Annexe B: Nursing procedures

Part 1: Procedures for assessing people’s needs for person-centred care

1. Use evidence-based, best practice approaches to take a history, observe, recognise and accurately assess people of all ages:

1.1    mental health and wellbeing status

1.1.1    signs of mental and emotional distress or vulnerability

1.1.2    cognitive health status and wellbeing

1.1.3    signs of cognitive distress and impairment

1.1.4    behavioural distress-based needs

1.1.5   signs of mental and emotional distress including agitation, aggression and challenging behaviour

1.1.6    signs of self-harm and/or suicidal ideation

1. Use evidence-based, best practice approaches to undertake the following procedures:

2.11 recognise and respond to signs of all forms of abuse

Appendix 2

LEVEL 4 MARKING GRID