Chapter 5 - Frameworks for Health Promotion

An immigrant from Guatemala, age 47, is admitted to the coronary care unit with congestive heart failure. This is the fourth admission for this client, and the physician believes that the client's inability to adhere to his diet and medication regimen is the reason for his frequent admissions. The physician refers the client to the local community health nurse, on discharge from the hospital. Which would be most appropriate for the nurse to include in this client's plan of care? A) Insisting that the client adhere to his diet B) Developing culturally relevant and gender-sensitive interventions C) Teaching the family to adapt their cultural dietary plans to the client's diagnosis D) Assessing the client's financial needs and obtaining financial assistance as needed

B) Developing culturally relevant and gender-sensitive interventions

The nurse conducts a class on the basics of nutrition to a group of obese adults. The nurse counsels the audience, telling them that they need to change their behaviors. By the end of the class, the nurse has lost the audience. To enhance audience participation and learning in the next class, the nurse should: A) Use consistent methods of persuasion B) Offer advice while the participants are passive C) Encourage the group to participate in the decision making D) Encourage the group to continue ambivalent behaviors

C) Encourage the group to participate in the decision making

A 47-year-old client and three members of his neighborhood have had their homes robbed and belongings scattered. The client contacts the police and, with their assistance, develops a neighborhood watch. The watch is organized and 24 families have been recruited to participate. The watch will be active throughout vacation months and as needed. This organization is representative of: A) Transtheoretical model B) Theory of reasoned action C) Social learning D) Relapse prevention model

D) Relapse prevention model

Learning Model (Skinner):

A behavior change model emphasizing reinforcement of social competence, problem solving, autonomy, and sense of purpose - A goal is established and reinforced by the nurse with rewards given for partial accomplishment if necessary. - Incremental increases are then made until the specific goal is reached.

Theory of Reasoned Action:

A behavior model that emphasizes that individual performance of a given behavior is primarily determined by a person's intention to perform that behavior

Immunity:

A host's ability to resist a particular infectious disease-causing agent.

A 34-year-old client is recovering from a below-the-knee amputation secondary to a motor vehicle accident. The nurse meets with the client to update his care plan, and client states that he knows that he will walk again. He asks for physical therapy schedules and timelines for prosthetics on the basis of his healing process. On the basis of knowledge of the theory of reasoned action, the client's behavior reflects: A) An enhanced ability to meet his goals on the basis of his intention and behaviors B) Goal setting that is unrealistic and irrational based on the client's diagnosis and behaviors C) A depression that will complicate the healing process D) Denial of the injury and part of the healing process

A) An enhanced ability to meet his goals on the basis of his intention and behaviors

The local clinic is dedicated to the well adult and child. It has evening hours and offers varied programs for the community. The programs include immunizations and classes on fire safety, health education, and car safety, to name a few. How would the nurse explain the level of prevention used in this setting to your colleagues? A) Primary B) Secondary C) Tertiary D) Quaternary

A) Primary

Herd Immunity

immunity level present in a population group

Cross-Immunity:

immunity to one agent providing immunity to another related agent

Active Immunity:

long-term, sometimes lifelong; acquired naturally or artificially

Secondary Prevention:

maximizing health and wellness through strategies that are set in place at the early and active chronic stages of pathogenesis of illness and injury

Tertiary Prevention:

maximizing health and wellness through strategies that are set in place at the palliation and end-stage of disease and injury trajectories

Primary Prevention:

maximizing health and wellness through strategies that are set in place before illness or injury is present

Behavior change models:

models that assist clients, groups, and communities to redirect activities toward health and wellness

Theory of Reasoned Action is linked to other models such as

the theory of planned behavior, and the concept of self-efficacy

Motivational interviewing:

client-centered communication style for eliciting behavior change by helping clients and groups explore and resolve ambivalence to change

Social Learning:

- A behavior change model that considers environmental influences, personal factors, and behavior as key components of change - A person must believe they are capable of performing the behavior (self-efficacy) and must have a personal incentive to do so. - Family members, friends, neighbors can influence change by offering social support- direct assistance, information, or emotional support

Transtheoretical Model's 5 Categories:

Precontemplation Contemplation Preparation Action Maintenance Relapse

Passive Immunity:

short-term; acquired naturally or artificially

The Relapse Prevention Model:

The idea that relapse often occurs because of: - Negative emotional states - Lack of or limited coping skills - Decreased motivation Stress - High-risk experiences