2 Definitions of Health States Health: a state of complete physical, mental, and social well being, not merely the absence of diseaseIllness: the unique response of a person to a diseaseWellness: an active state, oriented toward maximizing the potential of the individualReview “through the eyes of a student” discuss is Carrie healthy. Disease a pathological change in structure and function of the body. Where does mind vs body come into play. Can you be ill with out a disease? (mental illness)Students to define Health.Reflective practice. What would you do? Why?
3 Human Dimensions of Health PhysicalIntellectualEmotionalSocioculturalSpiritualEnvironmental aspectsSee picture next page. How do these interrelate? Ask students for examples of each.
5 Acute IllnessGenerally has a rapid onset of symptoms and lasts only a relatively short timeExamples: appendicitis, pneumonia, diarrhea, common coldStages of acute illness:Experienceing symptomsAssuming sick role: ask students what do they want when sick. Mom, ginger ale, crushed ice curl up in bed with TV and tea.Assume dependent role: agree to be cared for by others, nurses in hospital, mom, spouse,Achieve recovery and rehabilitation : give up dependence and reassume normal activities and responsibilities.
6 Chronic IllnessA broad term that encompasses many different physical and mental alterationsExamples: diabetes mellitus, lung disease, arthritis, lupusPermanent changeIrreversible alteration to anatomy or functionEducation for rehab and to learn to live with conditionLong term care and supportSlow onset, remission and exacerbation more common as population ages.
7 Characteristics of a Chronic Illness It is a permanent changeIt causes, or is caused by, irreversible alterations in normal anatomy and physiologyIt requires special patient education for rehabilitationIt requires a long period of care or support
8 Stages of Illness Behavior Experiencing symptomsAssuming the sick roleAssuming a dependent roleAchieving recovery and rehabilitation
9 Models of Health and Illness The agent-host-environment modelThe health–illness continuumThe high-level wellness modelThe health belief modelThe health promotion model
10 Agent-Host-Environment Model (Leavell and Clark) Examines the causes of disease in an individualAgent, host, and environment interact in ways that create risk factorsUnderstanding the risk factors is important for the promotion and maintenance of healthThe host reaction is influenced by family history, age, and health habitsThe environment includes physical, social, biologic, and cultural factorsEach of the agent-host-environment factors affects and is affected by the othersAgent is environmental factor or stressor, bacteria, virus, chemical substanceHost is living organism cable of being affected by the agentEnvironment is factors that are external to host that make illness more likely ie: lack of sleep. Cold temperature,
12 The Health–Illness Continuum Measures a person’s level of healthViews health as a constantly changing state with high- level wellness and death on opposite sides of a continuumIllustrates the dynamic (ever-changing) state of health
13 The Health–Illness Continuum Individual can view themselves at varying places along the continuum depending on how they feel at any given moment.
14 The High-Level Wellness Model (Dunn) Encourages the nurse to care for the total personInvolves functioning to one’s maximum potential while maintaining balance and a purposeful directionRegards wellness as an active state, oriented toward maximizing the potential of the individual, regardless of his or her state of healthIncorporates the processes of being, belonging, becoming, and befittingActive state. More than good health (passive) maximizes the person’s potential. More total person focus incompasses all of the dimensionsBeing: recognizing self as separate and individualBelonging” being part of a whole:becoming: growing and developingBefitting: making personal choices to befit the self of the future
15 The Health Belief Model (Rosenstock) Concerned with what people perceive to be true about themselves in relation to their healthModifying factors for health include demographic, sociopsychological, and structural variablesBased on three components of individual perceptions of threat of a diseasePerceived susceptibility to a diseasePerceived seriousness of a diseasePerceived benefits of actionExample: smoking cessation classes and programs. Does smoker percieve it to be a health problem? Do they believe it will lead to cancer? Are the lifestyle changes worth the effort. Social network?
16 The Health Promotion Model (Pender) Illustrates the “multidimensional nature of persons interacting with their environment as they pursue health”Incorporates individual characteristics and experiences and behavior-specific knowledge and beliefs, to motivate health-promoting behaviorPersonal, biologic, psychological, and sociocultural factors are predicative of a certain health-related habitHealth-related behavior is the outcome of the model and is directed toward attaining positive health outcomes and experiences throughout the lifespanUsed to design and provide nursing interventionsUsed to predict how a person is likely to incorporate health promotion behaviors into their lifestyle. Smoking. If parents smoke children more likely to smoke.
17 Factors Affecting Health Status, Beliefs, and Practices Risk factors for illnessFactors in the human dimensions that influence health– illness statusBeliefs and practiceBasic human needsSelf-conceptInternal or external behaviors;Alcoholics, social activity. All friends drink. If give up may need to give up friends. Smokers, light up after a meal. How to change and incorporate.Table 4-1 pg 71ageGeneticsPhysiolgic ( obesity, chronic disease),HabitsLifestyleEnvironment
18 The Human DimensionsPhysical dimension—genetic inheritance, age, developmental level, race, and genderEmotional dimension—how the mind affects body function and responds to body conditionsIntellectual dimension—cognitive abilities, educational background, and past experiencesEnvironmental dimension—housing, sanitation, climate, pollution of air, food, and waterSociocultural dimension—economic level, lifestyle, family, and cultureSpiritual dimension—spiritual beliefs and values
19 Basic Human Needs Physiological needs Safety and security needs Love and belonging needsSelf-esteem needsSelf-actualization needsNeed essential to emotional and physical health and survival. Part of all dimensions. Relate to Maslow.WWMD vs WWJD?Refer to table 4-2 page 73
20 Factors That Influence a Person’s Self-Concept Past experiencesInterpersonal interactionsPhysical and cultural influencesEducationHow a person perceives themselves, believes is perceived by others. Impacts response to stress and illness. Example: diffences in perception of how to survive is boat capsized in puget sound.
21 Levels of Preventive Care Primary prevention—e.g., diet, exercise, immunizationsSecondary prevention—e.g., screenings, mammograms, family counselingTertiary prevention—e.g., medications, surgical treatment, rehabilitationTable 4-3 pg 73Promote health and prevent development of disease process. Assess risk, health promotion activities, exercise, diet, attitude.Secondary; mamograms, identify and detect disease, health maintenance plans for patients. Allergy testing. Dental careTertiary: used to achieve maximum functioning for chronic illness, support groups, PT,
22 Question Which of the following is an example of an acute illness? A. DiabetesB. Rheumatoid arthritisC. PneumoniaD. Osteoporosis
23 Answer Answer: C. Pneumonia Rationale: Pneumonia is an acute illness that has a rapid onset of symptoms and lasts only a relatively short time. Diabetes, rheumatoid arthritis, and osteoporosis are chronic illnesses that cause a permanent change, require special patient education for rehabilitation, and require a long period of care or support.
24 Question Tell whether the following statement is true or false. A person who is experiencing a productive cough and fever takes a sick day to recuperate and decide whether to make an appointment with the doctor. This person is said to be in stage 3 of illness behavior: assuming a dependent role.A. TrueB. False
25 AnswerAnswer: B. FalseA person who defines himself as sick and self-medicates or visits a doctor is said to be in stage 2 of illness behavior: assuming the sick role.
26 QuestionWhich of the following models of health and illness views health as a constantly changing state, with high-level wellness and death being on opposite ends of a graduated scale?A. Agent-host-environment modelB. Health-illness continuumC. High-level wellness modelD. Health belief model
27 Answer Answer: B. Health-illness continuum Rationale: The health-illness continuum measures a person’s level of health on a graduated scale.The agent-host-environment model refers to the interaction of the agent, host, and environment creating risk factors that must be examined.The high-level wellness model involves functioning to maximum potential with balance and direction.The health belief model is concerned with what people believe to be true about their health.
28 Question Tell whether the following statement is true or false. A person who keeps in touch with neighbors in an attempt to foster a “community feeling” is promoting his or her emotional human dimension.A. TrueB. False
29 QuestionWhich of the following is an example of a nursing activity that promotes secondary prevention as a level of preventive care?A. Conducting a smoking cessation classB. Performing a blood pressure screening at a local mallC. Performing range-of-motion exercises on a bedridden patientD. Promoting safe sex practices in school settings
30 AnswerAnswer: B. Performing a blood pressure screening at a local mallRationale:Secondary preventive care focuses on early detection of disease, such as the heart disease in this example.Primary preventive care is directed toward promoting health and preventing diseases.Tertiary care begins after an illness is diagnosed to reduce disability and rehabilitate patients.
31 AnswerAnswer: B. FalseA person who keeps in touch with neighbors in an attempt to foster a “community feeling” is promoting his or her sociocultural human dimension.