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