**6.2 Development of self-management plan**

The PLWNCDs are expected to develop a self-management plan which is inclusive of strategies which will assist in coping with psychological effects caused by the condition. They need to request for the psychological assistance with problem solving and decision-making skills related to daily life experiences and or challenges. Given the problem solving and decision-making skills they would have acquired they will be assisted in adherence to health advise and medication instructions.

The PLWNCDs must draw a self-management plan that include action plan of enhancing health advise and medication adherence because if they draw the plan themselves with short- and long-term goals, they will own that decision and make sure that they achieve what was planned.

#### **6.3 Cessation of smoking and alcohol intake**

The PLWNCDs who are smoking have to stop and those who are drinking excessively alcohol are encouraged to minimize. The reasons for the importance of the changed behavior must be clear to PLWNCDs so that they do not return back to old habits ever again. The importance of cessation of smoking that must be known to PLWNCDs is that the risk of developing acute myocardial infarction drops immediately when one stops smoking and continues to decline each year until ones' health is the same as those who are not smoking within the period of 5 years. Smoking cause the development of atherosclerotic disease, acute coronary disease and has an effect on platelets and for PLWNCDs to smoking will save them from ill health adding to already what they are experiencing [22].

The importance of not drinking alcohol for the PLWNCDs is that they will be saving themselves from liver diseases such as alcoholic hepatitis and pancreatitis [23]. Therefore, it will be valuable for PLWNCDs to quit than to continue smoking and or drinking alcohol as there are more complications that may arise.

#### **6.4 Monitoring of ones' vital signs and symptoms**

The PLWNCDs must be taught and know how to monitor vital signs and symptoms of the condition so that they could seek for medical help and or control them timeously to prevent severe complications. This will also assist them to adhere to a lifestyle that bring about improvements in their daily living. Self-monitoring of vital signs and symptoms is useful because it leads to reduction of hospitalization and re-admissions to hospitals because PLWNCDs can be able to identify problems and deal with them timeously [24]. Cardiovascular diseases, cancer, chronic respiratory diseases and diabetes are amongst the leading cause of NCDs with specific signs and symptoms [25], however, common signs and symptoms of NCDs includes pain, fever, headaches, swelling, inflammations, and stiffness of joints.

#### **6.5 Minimize salt, sugar sweetened and unhealthy food**

Salt and sugar sweetened intake need to be controlled as it influences the functioning of the cardiovascular systems resulting in worsening the condition for PLWNCDs. The regular consumption of salt intake and sugar-sweetened food is discouraged for PLWNCDs because they contribute to an increase in blood glucose and blood pressure. Many guidelines recommend that patients with NCDs should reduce both sugar-sweetened and sodium intake. PLWNCDs need to know the type of drinks that should not be taken as they could raise blood sugar levels and also high blood. The PLWNCDs need to know that they can improve their blood sugar levels when their carbohydrates intake is between 5–35% of their calories. The key to eating well when living with NCDs is to eat a variety of healthy food from each of the food groups that is Proteins, Carbohydrates, Fruits and Vegetables. PLWNCDs have to avoid food such as cakes, cookies, refined grains, muffins or anything made of white flour [26]. Therefore, changes in diet involve PLWNCDs' greater commitment and introducing changes in lifestyle that are not necessarily happily accepted but to give up consuming foods that they truly enjoy but which they are forced to exclude in their diet [24]. A healthy eating includes intake of 400 g or five portions

**293**

*Self-Management Strategies to Curb the Development of NCDs in Rural Communities*

of fruits and vegetables, 30% of total energy intake of fats [27], less than 10% of total energy intake from free sugars, which is equivalent to 50 g or about 12 teaspoons [28], less than 5 g of salt per day which is half a teaspoon [29] and consump-

The PLWNCDs has to stop to engage in unhealthy activities and modify their lifestyle in totality in order to promote quality of life [30]. The by PLWNCDs must engage in physical activity, adhere to diet, medical and health advise which is good for their condition [31]. It must also be clear to PLWNCDs that adherence to correct diet, medical and health advise is important because what one eats and do influence

The PLWNCDs must engage in physical activity so that they can keep lower blood pressure and cholesterol levels lower, improve blood flow and keep body weight under control. Furthermore, they must know that physical activity boosts energy level that will assist in getting work done without feeling exhaustion, it promotes positive attitude in an individual that resulting in relieving someone stress of not appreciating oneself and it promote sleep thus resulting in a good rest. The PLWNCDs need to know that engaging in household chores does not not replace in

Another self-management strategy that PLWNCDs must adhere to is to **manage own stress levels** to avoid falling into depression that could worsen their condition to an uncontrollable state. Stress is one of the main problems amongst PLWNCDs and this led to development of chronicity which must be avoided by the people. In other words, stress can be considered as a cause and as well as a consequence of NCDs. On the other hand, stress increase glucose and glycosylated hemoglobin which may increase stress levels amongst individuals with Type 2 diabetes, as well as causing other physical, behavioral and mental disorders [32], this must be

NCDs management must be known to by PLWNCDs as a constant process; it is an ongoing challenge that maybe complicated by the impact of stress. Excessive stress is a major barrier to effective control of the condition and a danger to PLWNCDs' general health. Whether or not you have NCDs, stress is harmful because it causes so much wear and tear on the body. The ability to think clearly and to make good decisions is impaired when the mind is burdened therefore, it is advisable to PLWNCDs to seek professional help when they feel stressed and be able to know when they are stressed [33]. Stress management and avoidance of stressors

**6.8 The importance of adherence to prescribed medication and Health advise to** 

therefore it is important that they are encouraged to collect their medications as instructed so that they do not miss the treatment. However, in rural areas sometimes medications are not always available when they arrived to collect in Primary Health Care clinics therefore, the PLWNCDs are advised to go 3 days or prior finishing the medications that they are having so that if they do not find them they will be having enough to visit the nearest hospital to get the medications. They are also encouraged

The PLWNCDs are dependent on treatment they collect from the health facilities

*DOI: http://dx.doi.org/10.5772/intechopen.96222*

tion of variety of food.

**6.6 Engage in healthy habits**

how the body reacts to a condition.

engaging in physical activity.

**6.7 Management of own stress levels**

avoided, and HCPs need to skill up by PLWNCDs.

is key when leaving with NCDs to promote quality of life.

**maintain quality of life**

of fruits and vegetables, 30% of total energy intake of fats [27], less than 10% of total energy intake from free sugars, which is equivalent to 50 g or about 12 teaspoons [28], less than 5 g of salt per day which is half a teaspoon [29] and consumption of variety of food.
