Health Defined - Chapter 1

Passive Nature of Health Promotion

Involve the individual as an inactive participant or recipient, i.e. public health efforts to maintain clean water and sanitary sewage systems to decrease infectious diseases and improve health, efforts to introduce vitamin D in all milk to ensure that children will not be at high risk for rickets when living in areas where sunlight is scare. These strategies are used to promote the health of the public when individual participation might be low but the benefit to society is high.

Determine Health Outcomes

Larger societal and environmental concerns

Paradigm

Like a model, used to examine patterns

Consultant

Offer advice about what types of health promotion activities should be considered; all nurses need to develop this skill that can be integrated into practive

Primary Prevention

* Precedes disease or dysfunction * Interventions: Health Promotion (educating client on heart healthy diet), and Specific Protection (immunications; reducing occupational hazards, accidents, allergens, carcinogens) * Purpose: to decrease the vulnerability of the individual or population to disease or dysfunction. * Focus: maintain/improve general individual/family/community health * Passive: not personally involved (clean water, sewer) * It is therapeutic in that it includes health as beneficial to well-being, uses therapeutic treatments and as a process or behavior towards enhancing health; involves symptom identification when teaching stress reduction techniques

Nursing Roles in Health Promotion and Protection

- Advocate - Care Manager - Consultant - Deliverer of Services - Educator - Healer - Researcher

Fall Risk Factors

- Age (include visual: loss of night vision/depth perception, hearing, functional limitations: loss of upper /lower body strength) - Medication (disequilibrium) - Environmental Hazards (clutter, too much furniture, placement of items in walkways, lighting problems, needed repairs to flooring/walls, need for supports like grab bars and railings) - Adequate Hydration

Modifiable Behaviors

- Eating - Resting - Exercising - Handling anxieties - Stress Management

Nurse's Role

- Emphasis shifting from acute, hospital-based care to preventative community-based care - Nurses must assume blended roles with a knowledge base using evidence-based practice

Social Determinants of Health

Refers to factors in society that have an influence on health and the options available to people to improve or maintain their health.

Health Disparities

Refers to the wide variations in health services and health status among certain population groups. Examples are the growing problems of access to medical care; differences in treatment based on race, gender, and ability to pay; and related issues such as urban versus rural health, insurance coverage, Medicare and Medicaid reimbursement for care, and satisfaction with service delivery.

Care Manager

- Facilitating communication among parties is one of the most important functions - Prevents duplication of services, maintains quality and safety; reduce costs - Gathers information from reliable data sources to help individuals avoid care that is unproven, ineffective or unsafe - Use sources of information on best practices, evidence-based practices and standard protocols, specialty organizations - Depend on a collaborative relationship among them, other nurses and hysicians, the individual and his/her family, insurance provider

Historical Perspective of Health 1940s-1950s

- Health = ability to fulfill roles - Physicals for fitness - Physicians linked to hospital services - Increased federalrole: hospital expansion, federal programs

Historical Perspective of Health Before 1940

- Health = absence of disease - Infectious disease prominent - Physician: independent primary practitioner - Government: start public health/welfare

Historical Perspective of health 1960s - Present

- Health = adaptation adn reaction to environment - Disease prevention/health promotion - Emphasis on individual responsibility/lifestyle choices - Growing number/diversity of primary providers - Government: control costs - Quality of life seen as component of health and patient/family perception important

Advocate

- Help individuals obtain what they are entitled to received through the health care system - Try to make the system more responsibe to individual and community needs - Help persons develop the skills to advocate for themselves - Strives to ensure that all persons receive high-quality, appropriate, safe and cost-effective care - May spend a great deal fo time identifying and coordinating resources for complex cases

Healthy People 2010

- Increase quality and years of healthy life - Eliminate health disparities

Healthy People 2000 Goals

- Increase the span of healthy life - Reduce health disparities - Create access to preventive services for all

Tertiary Prervention

- Occurs when a defect or disability is permanent and irreversible. - The process involves minimizing the effects of disease and disability by surveillance and maintenance activities aimed at preventing complications and deterioration. - Focuses on rehabilitation to help people attain and retain an optimal level of functioning regardless of their diabling condition. - The objective is to return the affected individual to a useful place in society, maximize remaining capacities or both.

Secondary Prevention

- Ranges from providing screening activities and treating early stages of disease to limiting disabilty by averting or delaying the consequences of advanced disease. - The principal goal is to identify individuals in an early, detectable stage of the desiease process. - Offers an excellent opportunity to offer health teaching as in primary preventive, but applied to individuals/populations with disease

Deliverer of Services

- The core role of the nurse in health education, flue shorts and counseling - It is the foundation for the public image of nursing

Healer

- This role requires the nurst to help individuals integrate and balance the various parts of their lives - Resides in the ability to glimpse or intuit the interior of an individual, to sense and identify what is important to that other person and to imcproorate the specific insight into a care plan that helps that person develop his or her own capacity to heal

Health-related Quality of life

A broad multidimensional concept that usually includes self-reported measures of physical and mental health.

Active and Passive Nature of Health Care

A combination of the two is best for making an individual or society healthier.

Racism

A devaluing of the beliefs, values, and customs of others.

Ecological Model of Health

A more recent and comprehensive developmental approach useful for promoting health at individual, family, community, and societal levels.

Ecological Model of health

A more recent and comprehensive developmental approach useful for promoting health at individual, family, community, and societal levels.

Wellness-Illness Continuum

A paradigm that is a bipolar, interactive portrayal of health and illness in myriad configurations, ranging from high-level wellness to depletion of health (death).

Adaptive Model of Health

A person's measure of health is his or her ability to adjust positively to social, mental, and physiological change. Illness occurs when the person fails to adapt or becomes maladaptive to these changes.

Asset Planning

A planning approach that focuses the family and the providers on the building blocks for their future, given the realities of the present.

High-level Wellness

A sense of well-being, life satisfaction, and quality of life.

Wellness

A state involving progression toward a higher level of functioning, an open-ended and ever-expanding future, with its challenge of fuller potential and the integration of the whole being. A positive state in which incremental increases in health can be made beyond the midpoint. These increases involve improved physical and mental health states.

Health - Book Definition

A state of physical, mental, spiritual and social functioning withing developmental context; a core concept in society; both individual and societal responsibility; a concept modified with qualifiers; modified based on a variety of factors

Eudaimonistic

A theory that the highest ethical goal is happiness and personal well-being.

Health Modification Factors

Age, Gender, Race, Ethnic Heritage, Comparison Group, Current Health or Physical Condition, Past Conditions, Social or Economic Situation, Geographic Location, Demand of Various Societal Roles

The Transtheoretical Model

An application of the health promotion model. It incorporates Stages of Change (readiness to take action), Decisional Balance (benefits to and detractors from changing a behavior), Self-Efficacy (personal confidence in making a change) and Processes of Change (cognitive, affective, and behavioral activities facilitating change). The basis are the stages of change.

Role Performance Model of Health

Defines health in terms of individuals' ability to perform social roles. Illness would be the failure to perform roles at the level of others in society.

Active Strategies of Health Promotion

Depend on the individual becoming personally involved in adopting a proposed program of health promotion, i.e. performing daily exercise aas part of a physical fitness plan, and adopting a stress-management program as part of daily living.

Person-centered Care

Describes the inclusion of patients and their families in the decision-making process for medical treatment and respect for each patient's cultural traditions, personal preferences and values, family situations, and lifestyle.

Qualitative Studies

Research studies that describe phenomena or define the historical nature, cultural relevance, or philosophical basis of aspects of nursing care.

Quantitative Studies

Research studies that describe situations, correlate different variables related to care, and test causal relationships between variables related to nursing care.

Applied Research

Research that is done to directly affect clinical practice.

Evidence-based Practice

The conscientious, explicit, and judicious use of current best evidence in making decisions about the care of individuals.

Disease

The failure of a person's adaptive mechanisms to adequately counteract stimuli and stresses, resulting in functional or structural disturbances.

Health Promotion

The science and art of helping people change their lifestyle to move toward a state of optimal health. The process of advocating health to enhance the probability that person (individual, family, and community), private (professional and business), and public (federal, state, and local government) support of positive health practices will become a societal norm; theoretical underpinnings are behavior based (Health Belief Model); hold the best promise of lower cost methods of limiting the constant increase in healthcare costs and empowering people to be responsible for their lives and wellbeing

Theoretical Basis of Health Promotion

The theoretical underpinnings for health promotion have evolved since the early 1980s. Most of these theories are behaviorally based, derived from the social science and extensively researched. They include the Theory of Reasoned Action, Theories of Behavior, The Health Belief Model, Pender's Health Promotion Model, and Stages of Change Theories

Eudaimonistic Model of Health

Emphasizes the interactions between physical, social, psychological, and spiritual aspects of life and the environment that contribute to goal attainment and create meaning. Illness is reflected by a denervation or languishing, a lack of involvement with life.

Health Modifiers/Qualifiers

Excellent, Good, Fair, Poor

Specific Protection

Focuses on primary prevention methods designed to protect people from injury and disease, for example, by providing immunizations and reducing exposure to occupational hazards, carcinogens, and other environmental health risks.

Health - CSU Definition

Health is - a dynamic state of being, determined by the abilityto adapt - a human response to stressors in an effort to maintain equilibrium - adaptation is the process by which one attempts to maintain equilibrium - varying levels of heath exist which fluctuate in response to interaction with the internal and external stressors in the environment - failure to maintain equilibrium results in physicl, psychosocial or spiritual disequilibrium

Social Nature of Health Promotion

Health promotion goes behond providing information. It is also proactive decision-making at all levels of society as reflected in the healthy People 2020 objectives. Based on the need for health promotion activities within the health care system, efforts must be made to identify the multiple determinants of health, determine relevant health promotion strategies and delineate issues relevant to social justice and acces to care.

HRQoL

Health-related Quality of Life

Community-based Care

Care that is provided in health care settings in the community.

Quality of Life

Characteristics, conditions, and situations of life that compose the whole of a person's living. People strive for a positive quality of life. Illness or disease can diminish one's quality of life.

Well-being

State of being well. The status of one's condition of living. The definition of health is related to one's state of complete physical, mental, and social well-being

Levels of Prevention

Steps to Prevention; Primary, secondary, and tertiary means to avert the development of disease in the future.

Illness

Subjective experience of individual and physical manifestatoin of disease; a social construct in which people are in an imbalanced, unsustainable relationship with their environment and are failing in the ability to survive and to create a higher quality of life

Healthy People 2020

The Federal Government's Health Objectives For The Nation

Epidemiology

The Study of Health and Disease in Society

Healthy People

The Sturgeon General's Report on Health Promotion and Disease Prevention; first published in 1979

Functional Health

The ability to function cognitively and physically; levels reflected in terms of performance/social expectations; loss is an indicator of need for nursing intervention

Cultural Competence

The ability to give care to an individual that demonstrates awareness of and sensitivity to the underlying personal and cultural reality of the individual by identifying and using cultural norms, values, and communication and time patterns in collecting and interpreting assessment information.

Empathy

The ability to understand another's feelings without losing personal identity and perspective.

Clinical Model of Health

The absence, and illness by the conspicuous presence, of signs and symptoms of disease. It is the conventional model of the discipline of medicine.

Ethnocentrism

The assumption that an individual's own perspective is correct and shared by others.

Health Related Concept Theories

Theories of Health Behavior or Health Planning

Stages of Change

There are six stages that people spiral through on a path toward making and sustaining a behavioral change to promote health 1. Precontemplative: not considering change 2. Contemplative: aware of but not considering change soon 3. Preparation Action: planning to act soon 4. Action: has begun to make behavior change (recent) 5. Maintenance: continued commitment to behavior (long-term) 6. Relapse: reverted to old behavior

Interprofessional Practice

Two or more professions working together as a team with a common purpose.

Health Related Concepts

Wellness, Illness, Disease, Disability, Functioning; are frequently embedded in theories