Chapter 6: Health and Wellness (p. 68-76)
Developmental stage (I)
A persons perceptions of health, illness and health behavoirs change overtime. Helps predict response to an actual illness or threat of a future one Fear and anxiety are common in ill children (especially if based on a lack of information) Emotional development also influence personal beliefs about health-related matters. person's developmental stage sometimes differs from his or her chronological age.
Perception of functioning
Affects peoples health beliefs and practices. Gather subjective data abou tthe way a patient perceives physical functioning ( level of fatigue, SOB, or pain) Obtain objective data such as blood pressure, neight measurements, and lung sounds.
Describe health promotion, health education, and illness prevention activities
Health promotion helps individuals maintain or enhance their present health. It motivates people to engage in healthy activities such As routine exercise and good nutrition to reach more stable levels of health. Health education includes topics such as physical awareness, stress management, and self-responsibility. Health education helps people develop a greater understanding of their health and how to better manage their health risks. Illness prevention activities such as immunization programs and blood pressure screenings protect people from actual or potential threats to health. They also help people avoid declines in their health or ability to function. Many businesses have on-site health promotion activities for employees. Likewise, colleges and community centers offer health promotion and illness prevention programs. often include nurses who provide direct care, act as consultants, or refer patients to them. goal of these activities is to improve a patient's level of health through preventive health services, environ- mental protection, and health education. Health promotion activities are often dassified as either passive or tive.
Describe variables influencing health, health beliefs and health practices
Internal variables: include a persons developmental stage, intellectual background, perception of functioning, an demotional and spiritual factors External variables: family practices, psychosocial and socioeconomic factors, and cultural background
Holistic health model
promotes a patient's optimal level of health by considering the dynamic interactions among the emotional, spiritual, social, cultural, and physical aspects of an individual's wellness patients are at the center of their care and recognize your patients as the ultimate experts concerning their own health. Based on patient's subjective experience empowers patients to engage in their own recovery and assume some responsibility for health maintenance recognizes a person's choices powerfully affect an individual's health. Include : meditation, music therapy, reminiscence, relax- ation therapy, therapeutic touch, and guided imagery Used alone or in conjunction with conventional medicine
Healthy People
People provides evidence-based, 10-year national objectives for promoting provides a framework to help health and preventing disease. Healthy People the United States increase its focus on health promotion and disease prevention Widely cited by the media, in professional journals, and at health conferences Emohasizes how the health of communities affects the overall healhth status of a nagtion Interprofesisonal approach 2020: promotes living long healthy lives, and idenitifies leading health indicators. The US falls behind other developed countrieson meaures of helaath and well being; infant mortality and obesity
Describe variables influencing illness behavior
Physical stressors such as a poor living environment, work stress, exposure to air pollution, and living in an unsafe environment affect health. Heredity and individual practices such as poor eating habits and not exercising regularly emotional, intellectual, social, developmental, and spiritual factors often affect the likelihood of seeking health care, adherence to therapy, and health outcomes.
Discuss the three levels of prevention
Primary, secondary and tertiary levels
Discuss the basic humans needs model (Maslow) to understand the relationship between the patient's attitudes toward health, health practices, and variable that influence health beliefs and practices
Self-actualization Self-esteem Love and belonging needs; Safety and security Physical safety Psychological safety Physiological; Body Oxygen Fluids Nutrition temperature Elimination Shelter Sex
Inpact on self-concept
Self-concept is a mental self-image of all aspects of your personality. usually more complex and less readily observed than role changes. important in relationships with other family members. a patient whose self-concept changes because of illness may no longer meet family expectations, leading to tension or conflict. As a result, family members change their interactions with the patient. develop a care plan to facilitate adjustment to the changes resulting from the illness.
Behavoiral and emotional changes
Short-term, non-life-threatening illnesses usually require few changes in the functioning of a patient or family. a father who has a cold lacks the energy and patience to spend time in family activities. He becomes irritable and prefers not to interact with his family. Severe illness, particularly one that is life threatening, leads to more extensive emotional and behavioral changes such as anxiety, shock, denial, anger, and withdrawal.
Spiritual factors (i)
reflected in how a person lives his or her life, including the values and beliefs exercised, the relationships established with family and friends, and the ability to find hope and meaning in life. provides motivation to participate in health promoting activities Jehovah Witness faith do not receive blood transfusions, understand patients' spiritual beliefs to incorporate them effectively in nursing care
Dsicuss how individuals define health
The World Health Organization (WHO) defines health as a "state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity" people define in relation to their own values, personality, and lifestyle. Health is the actualization of inherent and acquired human potential through goal-directed behavior, competent self-care, and satisfying relationships with others. Individuals' views of health vary among different cultural orientations. Health is influenced by a person's values, personality, and lifestyle. often define their health by the circumstances surrounding their lives rather than by their physical condition. Life conditions include socioeconomic variables such as environment, diet, lifestyle practices or choices, and many other physiological and psy- chological variables. Individual perceptions and definitions of health are affected by a person's health beliefs and change as a person ages. Ex; health for older people is often influenced by the absence of disease and disability, the maintenance of physical and cognitive functioning, having connections with others, and health practices a person uses regularly.
Health belief model
The first component involves an individual's perception of susceptibility to an illness. patient whose family history includes one parent and two siblings who have died from a myocardial infarction artery disease and perceives a personal risk of heart disease. The second component individual's perception of the seriousness of the illness. influenced and modified by demographic and sociopsychological variables, perceived threats of the illness, and cues to action a patient may not perceive his heart disease to be serious, which may affect the way he takes care of himself. The third component likelihood that a person will take preventive action. results from a person's perception of the benefits of and barriers to taking action. Preventive actions include lifestyle changes, increased adherence to medical therapies, or a search for medical advice or treatment. This model helps you understand factors influencing patients' perceptions, beliefs, and behaviors to plan care.
Internal variables
a patient's perceptions of symptoms and the nature of an illness. patient's coping skills and his or her locus of control more likely to seek assistance if they believe the symptoms are serious or life threatening.
Nonmodifiable risk factors
age, gender, genetics, and family history cannot be changed. Age risk factors are often closely associated with other risk factors such as family history and personal habits. Educate your patients about the importance of regularly scheduled screenings based on their age. gender affects a person's risk factors. For example, the risk for asthma is higher in boys than girls. Men have a higher risk for cardiovascular disease Family history and genetics are other risk factors for some illnesses. These patients can benefit from genetic counseling. Sometimes it is difficult to determine if the family link to illness is related to genetics, lifestyle choices, environmental expo- sure, or a combination of these factors.
Health promotion model
defines health as a positive, dynamic state, not merely the absence of disease increases a patient's level of well-being. describes the multi-dimensional nature of people as they interact within their environment to pursue health. focuses on the following three areas: (1) individual characteristics and experiences; (2) behavior-specific knowledge and affect; and (3) behavioral outcomes, in which the patient commits to or changes a behavior. Health-promoting behaviors result in improved health, enhanced functional ability, and better quality of life at all stages of development
Emotional factors
degree of stress, depression, or fear How people handle stress throughout each phase of life influences their reaction to illness. generally is very calm may have little emotional response during illness, another individual may be unable to cope emotionally and may overreact or deny the presence of symptoms and not take therapeutic action
Social determinants of health (E)
determined by a person's circumstances and environment. where a person lives, the quality of the environment, income, educational level, and relationships with others have a considerable impact a patient's health. include a variety of social, commercial, cultural, economic, environmental, and political factors refer to the conditions in which people are born, grow, live, work, and age five categories of SDOH: economic stability, education, health and health care, social and community context, and neighborhood and built environment SDOH include poverty, food insecurity, access to primary health care. culture, exposure to violence, and access to green spaces Economic status often affect a patient's level of health by increasing the risk for disease, affecting the ability to find affordable and safe housing, and influencing how or at what point the patient enters the health care system adherence to a treatment designed to maintain or improve health is also affected by economic status. Culture, influences a patient's beliefs, values, and customs. influences the approach to the health care systems, personal health practices, and the nurse-patient relationship. also influences an individual's beliefs about causes of illness and remedies or practices to restore health
Secondary prevention
focuses on preventing the spread of disease, illness, or infection once it occurs. Activities directed at diagnosis and prompt intervention, reducing severity and enabling the patient to return to a normal level of health as early as possible identifying people who have a new case of a disease or following people who have been exposed to a disease but do not have it yet. screening techniques and treating early stages of disease to limit disability by averting or delaying the consequences of advanced disease.
Discuss nursing's role in risk-factor modification and changing health behaviors
identify modifiable and unmodifiable risk factors to help understand what they can modify, control, or even eliminate to promote wellness and prevent illness. Health risk appraisal forms help identify health threats based on the presence of various risk factors develop educational programs and other community resources if a patient needs to make lifestyle changes and reduce health risks implement appropriate health education and counseling to help a person change or implement behaviors to maintain or improve health status Risk-factor modification, health promotion, illness prevention activities, or any program that attempts to change unhealthy lifestyle behaviors is a wellness strategy. -Ask patients which changes they perceive they need to make or are willing to make. motivate patients and facilitate health behavior changes. -Use evidence-based guidelines and recommendations when helping patients make health behavior changes. -effectively understand the process of change. -Help your patients understand that relapse is a learning process; important understand what happens at the various stages of the change process
Impact on family roles
many roles in life, such as wage earner, decision maker, professional, child, sibling, or parent. parents and children try to adapt to the major changes that result. Role reversal is common If a parent becomes ill and cannot carry out usual activities, an adult child often assumes many of the parent's responsibilities and in essence becomes a parent to the parent. sometimes leads to stress, conflicting responsibilities for the adult child, or direct conflict over decision making. - adjust more easily to subtle, short-term changes. know that the role change is temporary and will not require a prolonged adjustment. -long-term changes require an adjustment process similar to the grief process require specific counseling and guidance to help them cope
Modifiable risks
risk factors such as lifestyle practices and behaviors can be modified. includes poor nutrition, overeating, and insufficient rest and sleep. excessive sunbathing increases the risk of skin cancer; smoking increases the risk of lung diseases, poor diet and being overweight increase the risk of cardiovascular disease. Behavioral risks that contribute to chronic illnesses include unhealthy diet, physical inactivity, tobacco use, alcohol abuse, poor control of hypertension, and elevated lipid and glucose levels behaviors that lead to uninten- tional injuries (e.g., texting while driving, driving under the influence of drugs or alcohol, bullying); carrying a weapon; use of tobacco, smokeless tobacco products, alcohol, and other drugs; sexual behav- iors leading to unintended pregnancy and sexually transmitted infections; unhealthy diet choices; and physical inactivity Lifestyle behavioral choices are also modifiable. impact on our health care system, our economy, and our communities. Stress is a lifestyle risk factor if it is severe or prolonged or if the person is unable to cope with life events adequately. threatens mental health (emotional stress) and physical well-being (physiological stress). Environment
Family role and practices (e)
roles and organization of a family influence how each family member defines health and illness and values health practices. Their perceptions of the seriousness of diseases and their history of preventive care behaviors influence how patients think about health.
Intellectual background (I)
shaped in part by knowledge or misinformation about body functions and illnesses, educational background, traditions, and past experiences. cognitive abilities shape the way a person thinks, Cognitive abilities relate to a person's developmental stage.
Impact on family dynamic
the process by which the family functions, makes decisions, gives support to individual members, and copes with everyday changes and challenges. Family changes because of the effects of illness. A single parent experiences severe injury; brother assumes some of her roles and responsibilities, getting the children to and from school.
Primary prevention
true prevention. The goal is to reduce the incidence of disease. supported by the government (e.g., federally funded immunization programs). includes health education programs, nutritional programs, and physical fitness activities. includes all health promotion efforts and wellness education activities that focus on maintaining or improving the general health of individuals, families and communities.
Maslow's hierarchy of needs
understand the interrelationships of basic human needs necessary for human survival and health (e.g., food, water, safety, and love). Although each person has unique needs, all people share basic needs human needs, certain human needs are more basic than others, and some needs must be met before other needs. Self- actualization is the highest expression of one's individual potential and allows for continual self-discovery. provides a basis for nurses to care for patients of all ages in all health settings. focus of care is on a patient's needs rather than on strict adherence to the hierarchy.
Impact on body image
usually depend on the type of changes (e.g, loss of a limb or an organ), then adaptive capacity, the rate at which changes take place, and the support services available. profound change such as amputation or mastectomy, experiencing phases of the grief process Initially the patient in shock they become anxious and often withdraw, refusing to discuss it. they then gradually accept the loss.
External variables
visibility of symptoms, social group, cultural background, economic variables, accessibility of the health care system, and social support. visibility of the symptoms affects body image and illness behavior. A patient with a visible symptom more likely to seek assistance Patients' social groups help them accept or deny the threat of illness. A person's family and cultural background teach the person how to be healthy, how to recognize illness, and how to be ill. Economic variables are SDOH influence the way a patient reacts to illness. Financial difficulties often lead to delayed treatment entry into the system is complex or confusing.
Tertiary prevention
when a defect or disability is permanent and irreversible. minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration directed at rehabilitation rather than diagnosis and treatment. Ex: learn how to use a wheelchair and perform activities of daily living independently. helps patients achieve as high a level of functioning as possible, despite the limitations
