Nursing Diagnoses and Chocolate…A Match Made In Bliss

September 2nd, 2011

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By , BSN, RN

There was big news this past week as medical researchers in England announced that chocolate has been linked to reducing the risk of developing heart disease. Soon to be published in the British Medical Journal (BMJ), Dr. Oscar H. Franco, from the department of health and primary care at the University of Cambridge in the United Kingdom, said, "We found a potential link between chocolate consumption and prevention of heart disease. At this point we are in the early stages of research." He then added, "There have not been any clinical trials to see if this association is real."

Where do I sign up?

This major medical announcement got me thinking—work like this falls in the realm of nursing. I mean, really, you don't need a prescription to administer chocolate; you just need a reason, one supported by a nursing diagnosis. After all, a nursing diagnosis is a clinical judgment about a client's response to actual and potential health problems. Nursing diagnoses provide the basis for selecting interventions to achieve the best possible outcomes for the patient while staying within the nurse's scope of practice.

For example :

High risk for cardiac disease related to inadequate intake of chocolate.

The answer seems obvious, eat more chocolate. And, science backs this up. A professor of cardiology at the University of California, Los Angeles, commented that "despite chocolate's indulgent reputation; there is growing evidence that cocoa products which contain high levels of flavonoids may have a variety of actions which are potentially beneficial for cardiovascular and metabolic health."

Several recent studies have suggested the flavonoids found in cocoa products have antioxidant, anti-inflammatory, anti-clotting effects and may also relax blood vessels. They may also improve insulin sensitivity, reducing the risk for diabetes.

And this is not the only place where chocolate is being used therapeutically. In an article in the New York Times last year, an Arizona nursing home was described as disregarding standard nursing home procedures and allowing clients to have practically anything that gives them comfort. These measures included the right to bathe and dine whenever they want, baby dolls to comfort and care for and, unlimited chocolate, if they so choose. Research suggests that creating positive emotional experiences for Alzheimer’s patients diminishes distress and behavior problems. I see a nursing diagnosis :

Ineffective individual coping related to inadequate intake of chocolate.

I know more than a few people for who chocolate is the ultimate improvement to their state of mind. Chocolate can mean happiness, contentedness, even comfort. The director of research at the nursing home in the Times article has proof found in the latest science to back up their treatment plans. There is better evidence and more significant results in caregiver interventions than in disease treatment since no effective medical treatment for Alzheimer's or dementia has been found to date. The research director added, "The state tried to cite us for having chocolate on the nursing chart. They were like, ‘It’s not a medication.’ Yes, it is. It’s better than Xanax.”

And, let's talk about chocolate as a mood stabilizer. Again, there is scientific proof. Author Cal Orey writes in her book, The Healing Powers of Chocolate about not just the flavonoids, and polyphenols that are antioxidants but also another ingredient in chocolate, anadamide, which is known as the "bliss" chemical. Orey explains how chocolate enhances the release of endomorphins and serotonin, the body's naturally occurring "feel good" chemicals. Therein lies another nursing diagnosis :

Anxiety as related to inadequate intake of chocolate.

Seems like an easy fix. And, again, no prescription required. Now, I may be stretching the use of the North American Nursing Diagnosis Association (NANDA) definitions but, aren't science, and medicine, and nursing all about stretching beyond what we know and looking for the potential to make what we know even better? I'm just sayin'…

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