N314 Exam 1
Biological health determinant examples
- age - biological sex - inherited conditions (ex. sickle cell) - genetic vulnerability (BRCA) - family history of a disease - HIV status
behavioral health determinant examples
- diet - physical activity - alcohol, tobacco, drug use
social health determinant examples
- discrimination - exposure to crime/violence - residential segregation - public safety - school quality
socioeconomic health determinant examples
- employment status - food security - housing status - wealth/poverty - social status
What affects health inequities?
- health care quality - communication - culture - health care law - social justice - health policy - health promotion
Factors contributing to vulnerability of certain people
- physical - environmental - personal (human capital) - biopsychosocial - disenfranchisement (feeling of separation from mainstream society)
psychosocial health determinant examples
- stressful living circumstances - stressful relationships - social support systems - coping skills
characteristics of a successful screening program
1. Valid (accurate): A high probability of correct classification of persons tested 2. Reliable (precise) 3. Capable of large group administration: A) Fast in both the administration of the test and the obtaining of results. B) Inexpensive in both personnel required and the materials and procedures used. 4. Innocuous: Few if any side effects, test is minimally invasive 5. High yield: Able to detect enough new cases to warrant the effort and expense 6. ethical and effective
disease characteristics required for effective screenings
1. high prevalence 2. relatively serious 3. can be detected early 4. effective treatment is available
population requirements for effective screening
1. is identifiable 2. is assessable 3. is amenable to screening 4. is willing to seek follow-up/treatment
identify characteristics of health
A state of complete physical, mental and social wellbeing, not merely the absence of disease or disability
differentiate acute illness from chronic illness
Acute illness: short term Chronic illness: long term
Describe the three learning domains that apply to patient education
Cognitive domain Psychomotor domain Affective domain
define disease
Disease is a functional or structural disturbance that results when a person's adaptive mechanisms to counteract stimuli and stresses fail
differentiate illness from disease
Disease: a functional or structural disturbance illness: physical manifestations and physically subjective to each individual
Addiction is a _________
Health problem
Dahlgren and Whitehead rainbow
Listen to slide on this
People of ____ SES are generally sicker/healthier and have _________ life expectancies than those of high SES
Low Sicker
What facilitates learning?
Motivation Readiness to learn Relevance Repetition Environment
The teaching process
Planning Implementation Evaluation Documentation
describe the nurse's role in health promotion
Reinforce health behaviors Teach self-care strategies Educate on how to be effective healthcare consumers Model healthy lifestyle behaviors Facilitate client involvement Advocate for changes promoting a healthy environment Use the nursing process to assess wellness
ATODP secondary prevention
Screening (SBIRT) urine drug screening (UDS) codependency and family involvement
what does sbirt stand for?
Screening (assess for severity, identify level of treatment), Brief Intervention (increase insight and awareness, increase motivation to change), and Referral to Treatment
Individual level of the social ecological model
Sex, age, health Individual characteristics that influence behavior
biopsychosocial model of addiction
Social: economic status, religion, relationships, culture, etc. Biological: disability, illness, genetic issues Psychological: behavior, personality, self-control, impulsivity
identify ways to accommodate for potential barriers to learning (e.g. low literacy, sensory deficits, cultural beliefs, etc.)
Teaching using multiple learning categories (demonstration, teach-back, discussion, etc.
define wellness
Wellness refers to a positive state of health of an individual, family, or community. It is multidimensional, encompassing several dimensions, including physical, mental, spiritual, social, occupational, environmental, intellectual, and financial. Wellness is seen as a continually changing state ranging from high-level to low-level wellness
describe learner assessment
When assessing social history, add questions about literacy skills in a sensitive manner "how happy are you with the way you read?" Use REALM-SF instrument to determine reading grade
The Ecological Perspective
a framework that enables us to consider the influence of individual and environmental factors
define health promotion
a process designed to help people increase control over their health with the goal of developing behaviors that maintain or enhance wellbeing. - includes the health sector, individuals, families, groups and communities
Define patient education
a process of assisting people to learn health-related behaviors so that they can incorporate these behaviors into everyday life
Define health
a state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity
Colorectal cancer control program example of SEM: individual
aims to increase the individual's knowledge and influence their attitudes towards: - the need for cancer screening - the risks/benefits of screening - access to affordable and convenient screening, diagnosis and treatment
What does ATODP stand for?
alcohol, tobacco, and other drug problems
Define prevention
anticipatory action taken to prevent the occurrence of an event
explain illness behaviors
any actions or reactions of an individual who feels unwell self-care behavior: eating soup, staying in bed healthcare utilization behavior: going to the doctor if you can't handle the symptoms
What is the teach back method?
asking a pt to explain in their own words what they need to know or do Checks for understanding
macrosystem (public policy/population) of the social ecological model
attitudes and ideologies of the culture Local state, national and global policies and laws that regulate or support healthy practices/actions
example of psychomotor learning domain
demonstration, interaction
eight dimensions of wellness
environmental emotional financial social spiritual occupational physical intellectual
What are health determinants?
factors that contribute to a person's current state of health Factors may be biological, socioeconomic, psychosocial, behavioral, or social
microsystem (interpersonal) of the social ecological model
family, school, peers, health services, religious institutions Formal and informal social networks and social support systems that can influence individual behaviors
secondary prevention
focus: early detection and prompt interventions to alleviate health problems and prevent complications examples: screening programs, daily low-dose aspirins to prevent further heart attacks
Primary prevention
focus: health promotion and prevention examples: immunization, exercise, seat belts
tertiary prevention
focus: restoring/rehabilitating the pt (management of a condition) example: support groups, cardiac rehab, chronic disease management programs
possible indicators of low health literacy
forms incomplete or inaccurate "I forgot my glasses" looking confused non-adherence with medications
the social ecological model
framework for understanding multiple levels of influence on behavior
define illness
illness is seen as the physical manifestations and the subjective experience of the individual. Illness can be present in the absence of disease, and it is possible to have no illness when a disease is present. Likewise, many individuals experience wellness in the presence of an illness...Low-level wellness is seen as an unfavorable state in which illness may result
define mortality
incidence of deaths in a population
Colorectal cancer control program example of SEM: Organizational
intended facilitate individual behavior change by influencing organizational systems and policies - promoting use of client and provider reminder systems - encouraging coverage and expansion of benefits for screening - adopting work policies that support preventive care
Colorectal cancer control program example of SEM: Interpersonal
intended to facilitate individual behavior change by affecting social and cultural norms - providers making screening recommendations to pts - patient navigators helping remove other barriers to screening
Colorectal cancer control program example of SEM: Community
intended to facilitate individual behavior change by leveraging resources and participation of community-level institutions such as - comprehensive cancer control coalitions - tribal health departments -media - community advocacy groups
mesosystem (community) of the social ecological model
interactions between the different parts of a person's microsystem Relationships among organizations and institutions which promote community norms
Colorectal cancer control program example of SEM: Policy
involve interpreting and implementing existing policy - collabing with coalitions to communicate policy decisions to the public (ex. insurance mandates for screenings) - translating local policies for community members (ex. mayor proclaims colorectal cancer awareness month)
Health care spending in the US
most money spent on those over 65yo most money spent on preventable disease
example of affective domain
motivational interviewing
Elements of effective teach back
non-shaming, open-ended questions emphasize that the responsibility to explain clearly is on you (the provider) if the pt is not able to teach back correctly, explain again and re-check
ATODP primary prevention
promotion of healthy lifestyles drug education community resources
define morbidity
proportion of illness in a population
Brofenbrenner's Ecological Systems Theory
same thing as social ecological model
The social determinants of health
social environment physical environment health services
exosystem (institutional/organizational) of the social ecological model
social services, industry, local politics, mass media, neighbors These institutions have formal or informal rules, regulation, and policies which constrain or promote behaviors
Define the social determinants of health
the complex, integrated, and overlapping social structures and economic systems that are responsible for most health inequities
define health literacy
the degree to which individuals have the capacity to obtain, process, and understand basic health information and services needed to make appropriate health decisions
Models in health care
we can't look at individual outcomes or health problems without examining the larger context that influence them
Example of cognitive learning domain
written material, lecture, discussion