What is health?
The absence of disease
A state of being well and using every power the individual possesses to the fullest extent (Florence
... [Show More] Nightingale)
A state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO)
A dynamic state of being in which the developmental and behavioral potentials of an individual is realized to the fullest extent possible...an experience that is often expressed in terms of wellness and illness, and may occur in the presence or absence of disease. (ANA, 1980 and 2004
Wellness/well-being is
Wellness is a state of well-being
Integrated, congruent function aimed at reaching one's highest potential (AHNA)
Well-being is a component of health,
A subjective perception of vitality and feeling well that can be described objectively, experienced, and measured... well-being can be plotted on a continuum
The state of being comfortable, healthy or happy
How do we quantify well-being
how the person reports feeling
The illness to wellness continuum
Premature Death -- Wellness --- High Level Wellness
Illness is
A highly personal state in which the individual's physical, emotional, intellectual, social, developmental or spiritual functioning is diminished
Disease is described as an alteration in body functions that reduces the capacities or shortens the normal life span.
Chronic vs acute illness
Acute illness - severe symptoms relatively short time
Symptoms appear abruptly and subside quickly and may or may not require intervention
Following most acute illnesses, individuals return to normal functioning
Examples: appendicitis, colds and flu
Chronic illness - lasts for an extended period of time, usually 6 months or longer, possibly for the duration of the individual's life. Often characterized by a slow onset and periods of remission (disappearance of symptoms for a time) and exacerbation (reappearance, sometimes worsening of the symptoms)
Examples: arthritis, diabetes, AIDS is now a chronic disease
Goals: promotion of the highest possible level of function/wellness, may require the modification of ADLS and other aspects of the patient's life, learning to live with physical limitations and discomfort and compliance with medication regimens
Healing vs cure
You can heal without curing and you can cure without healing. They are not the same thing.
CURING is the elimination of all evidence of disease, tends to be externally mediated
HEALING is the restoration of wholeness, occurs from within the person
Nurses participate in both
disability
Disability is not illness. However, individuals with disabilities do get ill, they suffer with the same illnesses as the typical population, sometimes they experience more illnesses comorbid with their disability
societal constraints that magnify disability and/or make disability a potent divider among people. An example of this is curbs alongside the road.
Health promotion
The concept of health promotion began with the Healthy People movement in 1979
nurse's role in health promotion
Assessment - nurses are responsible for assessment of communities, groups and individuals. Assessment helps in planning programs and screening for health risks and conditions
Intervention - lifestyle and behavior programs offer education and support. Nurses are involved in stop smoking, obesity, stress management, nutrition and other lifestyle related programs
Environmental control programs - these are a response to the continuing increase of contaminants in our environment. These may be nuclear power plants and waste disposal, herbicide and pesticide use, air quality, etc. These involve public planning and policymaking, education of the "offenders" and the public, cleaning up contaminated environments, etc.
Response - to health and environmental emergencies such as natural disasters, outbreaks, attacks, other catastrophic events (such as the massive financial fall recently experienced in the US and the world)
Important factors when working with health promotion and communities/individuals
Culture Characteristics of the target population
Literacy Access to resources
Identification of the risk
Quality of available interventions
Evaluation and planning once it's completed
Creating change
- External variables are under the individual's control and are the results of choices
Examples of these fall into the categories of health behaviors and healthy vs unhealthy activites
- Internal variables are not under the individual's control, they also may or may not be conscious
More about these on the next slide
Internal variables (Biological)
Biological (physical) dimension
Genetics, gender, age, developmental level
These can impact on susceptibility to disease, distribution of disease, health status
Internal variables (Psychological)
emotional dimension
Mind/body interactions, including emotional responses to stress, use of relaxation, "placebo effect" and self concept
Affects how individuals handle stressors which interacts with the biological responses to stress
Internal variables (Cognitive)
intellectual dimension
Lifestyle, health beliefs (does culture go here?), spiritual or religious beliefs
These affect locus of control, response to risk factors, decisions (for example on blood transfusions for Jehovah's Witnesses, or food choices for Seventh Day Adventists) also hope, and other factors
The nursing Process - Assessment
Health history and examination - detection of health problems
Physical fitness assessment - components of the body's physical functioning including muscle endurance, flexibility, body composition and cardiorespiratory endurance
Lifestyle assessment - personal lifestyle and habits and their affects on the client's health
Spiritual health assessment - ability to develop one's inner being to its fullest potential including one's purpose in life or the meaning of one's life
Social support systems review - understanding the context of one's life, support, coping, group affiliations
Life stress review - assesses the impact of stress on well-being
nursing process - planning
The nurse is a resource person in the health promotion domain. This means that the nurse provides information when asked, emphasizes the importance of small steps in behavior change, and reviews the client's goals and plans to make sure they are realistic, measurable and acceptable to the client. The nurse also explores the available resources and the client's ability to access them
Nursing process - implementation
This is the Doing
The main goal of the nurse is to support the client's efforts to create change
Nursing process - Evaluation
Ongoing, begins early, don't wait until the end [Show Less]