M8-9

• Health


  A state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity (WHO, 1947)
• Health


  A state of being that people define in relation to their own values, personality, and lifestyle
• Model


  A theoretical way of understanding a concept or idea
• Health beliefs


  Person's ideas, convictions, and attitudes about health and illness. They may be based on factual information or misinformation, common sense or myths, or reality or false expectations. Because health beliefs usually influence health behavior, they can positively or negatively affect a patient's level of health.
• Health behaviors


  Positive health behaviors are activities related to maintaining, attaining, or regaining good health and preventing illness. Negative health behaviors include practices actually or potentially harmful to health.
• Health Belief Model


  Rosenstock's (1974) and Becker and Maiman (1975) health belief model addresses the relationship between a person's beliefs and behaviors. The health belief model helps you understand factors influencing patients' perceptions, beliefs, and behavior to plan care that will most effectively help patients maintain or restore health and prevent illness. This model has three components: an individual's perception of susceptibility to an illness, an individual's perception of the seriousness of the illness, and the likelihood that a person will take preventive action.
• Health Promotion Model


  The health promotion model (HPM) defines health as a positive, dynamic state, not merely the absence of disease. Health promotion is directed at increasing a patient's level of well-being. The model focuses on the following three areas: (1) individual characteristics and experiences; (2) behavior specific knowledge and effect; and (3) behavioral outcomes, in which the patient commits to or changes a behavior. Health-promoting behavior is the desired behavioral outcome and the end point in the HPM. Health-promoting behaviors result in improved health, enhanced functional ability, and better quality of life at all stages of development.
• Maslow's Hierarchy of Needs


  Maslow's hierarchy of needs is a model that nurses use to understand the interrelationships of basic human needs. According to this model, certain human needs are more basic than others. As a result, certain needs must be met before others (such as fulfilling the physiological needs before the needs of love and belonging). The hierarchy of needs model provides a basis for nurses to care for patients of all ages in all health settings. However, when applying the model, the focus of care is on a patient's needs rather than on strict adherence to the hierarchy. To provide the most effective care, you need to understand the relationships of different needs and the factors that determine the priorities for each patient.
• Holistic Health Model


  Attempts to create conditions that promote optimal health. Health care has begun to take a more holistic view of health by considering emotional and spiritual well-being and other dimensions of an individual to be important aspects of physical wellness. In this model, nurses using the nursing process consider patients to be the ultimate experts concerning their own health and respect patients' subjective experience as relevant in maintaining health or assisting in healing. In the holistic health model, patients are involved in their healing process, thereby assuming some responsibility for health maintenance. Nurses use holistic therapies either alone or in conjunction with conventional medicine.
• Variables influencing health and health beliefs and practices


  Variables influence how a person thinks and acts. Health beliefs can negatively or positively influence health behavior or health practices. Understanding the effects of these variables allows you to plan and deliver individualized nursing care.
• Internal Variables


  • Developmental Stage
  • Intellectual Background
  • Perception of Functioning
  • Emotional Factors
  • Spiritual Factors
• Internal Variables


  The nurse considers the patient's level of growth and development when using health beliefs and practices as a basis for planning care. A person's beliefs about health are shaped in part by the person's knowledge, lack of knowledge, or incorrect information about body functions and illnesses, educational background, traditions, and past experiences. These variables influence how a patient thinks about health. When you assess a patient's level of health, gather subjective data about the way the patient perceives physical functioning such as level of fatigue, shortness of breath, or pain. Then obtain objective data about actual functioning such as blood pressure, height measurements, and lung sound assessment. The manner in which a person handles stress throughout each phase of life influences the way he or she reacts to illness. A person who generally is very calm may have little emotional response during illness, whereas another individual may be unable to cope emotionally with the threat of illness and may overreact or deny the presence of symptoms and not take therapeutic action. Spirituality is 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. Religious practices are one way that people exercise spirituality. Some religions restrict the use of certain forms of medical treatment.
• External Variables


  • Family Practices
  • Socioeconomic Factors
  • Cultural Background
• External Variables


  The way that patients' families use health care services generally affects their health practices. Their perceptions of the seriousness of diseases and their history of preventive care behaviors (or lack of them) influence how patients think about health. Social and psychosocial factors increase the risk for illness and influence the way that a person defines and reacts to illness. Social variables partly determine how the healthcare system provides medical care. Like social variables, economic variables often affect a patient's level of health by increasing the risk for disease and influencing how or at what point the patient enters the health care system. Cultural background influences beliefs, values, and customs. It influences the approach to the health care systems, personal health practices, and the nurse-patient relationship. Cultural background also influences an individual's beliefs about causes of illness and remedies or practices to restore health.
• Health Promotion, Wellness, and Illness Prevention

  • Immunization Programs
  • Routine Exercise, Good Nutrition
  • Physical Awareness, Stress Management, Self-Responsibility
• Health Promotion, Wellness, and Illness Prevention

  Nursing incorporates health promotion activities, wellness education, and illness prevention activities rather than simply treating illness. Health promotion activities help maintain or enhance health. Wellness education teaches patients how to care for themselves. Illness prevention activities protect against health threats and thus maintain an optimal level of health.
• Health Promotion, Wellness, and Illness Prevention

  These activities can be passive or active. Individuals learn passive strategies from others without their own participation. Active strategies motivate the individuals to adopt health programs. The goal of a total health program is to improve a patient's level of well-being in all dimensions, not just physical health. Total health programs are based on the belief that many factors can affect a person's level of health. Health care professionals who work in the field of health promotion use proactive attempts to prevent illness or disease. Health promotion activities are passive or active. With passive strategies of health promotion, individuals gain from the activities of others without acting themselves. The fluoridation of municipal drinking water and the fortification of homogenized milk with vitamin D are examples of passive health promotion strategies. With active strategies of health promotion, individuals adopt specific health programs.
• Levels of Preventive Care


  • Primary Prevention
  • Secondary Prevention
  • Tertiary Prevention
• Primary Prevention


  True prevention that lowers the chances that a disease will develop. Aimed at health promotion includes health education programs, immunizations, nutritional programs, and physical fitness activities.
• Secondary Prevention


  Focuses on those who have health problems or illnesses and are at risk for developing complications or worsening conditions. Delivered in homes, hospitals, or skilled nursing facilities.
• Tertiary Prevention


  Occurs when a defect or disability is permanent or irreversible. Aims to help patients achieve as high a level of functioning as possible. This level of care is called preventive care because it involves preventing further disability or reduced functioning.
• Risk Factors


  A risk factor is any situation, habit, or other variable such as social, environmental, physiological, psychological, developmental, intellectual, or spiritual that increases the vulnerability of an individual or group to an illness or accident.
• Risk Factors


  • Genetic and physiological factors
  • Age
  • Environment
  • Lifestyle
• Risk Factor Modification and Changing Health Behaviors

  These stages range from: No intention to change (precontemplation), Considering a change within the next 6 months (contemplation), Making small changes (preparation), Actively engaging in strategies to change behavior (action) to maintaining a changed behavior (maintenance stage). As individuals attempt a change in behavior, relapse followed by recycling through the stages frequently occurs. When relapse occurs, a person will return to the contemplation or precontemplation stage before attempting the change again. Relapse is a learning process, and people can apply the lessons learned from relapse to their next attempt to change.
• Patient Teaching: Lifestyle Changes

  Objective: Patients will reduce health risks related to poor lifestyle habits through behavior change. Teaching strategies: Provide active listening, ask about perceived barriers, assist the patient in establishing goals, and reinforce the process of change. Evaluation: Have the patient track adherence, and provide positive reinforcement.
• Illness


  A state in which a person's physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired
• Acute Illness


  Short duration and severe. An acute illness is usually reversible, has a short duration, and is often severe. The symptoms appear abruptly, are intense, and often subside after a relatively short period. An acute illness may affect functioning in any dimension.
• Chronic Illness


  Persists longer than 6 months. A chronic illness persists, usually longer than 6 months, is irreversible, and affects functioning in one or more systems. Patients often fluctuate between maximal functioning and serious health relapses that may be life threatening. Many chronic illnesses are related to four modifiable health behaviors: physical inactivity, poor nutrition, use of tobacco, and excessive alcohol consumption.
• Health Restoration, Maintenance and Rehabilitation


  Rehabilitative care emphasizes the importance of assisting clients to function adequately in the physical, mental, social, economic, and vocational areas of their lives. For example, someone with an injured neck or back from an automobile crash may have restrictions in the ability to perform work or daily activities. If the injury is temporary, rehabilitation can assist in return to former function. If the injury is permanent, rehabilitation assists the client in adjusting the way activities are performed in order to maximize the client's abilities. Rehabilitation may begin in the hospital, but will eventually lead clients back into the community for further treatment and follow-up once health has been restored.
• Health Restoration, Maintenance and Rehabilitation


  Restoring health focuses on the ill client, and it extends from early detection of disease through helping the client during the recovery period. Nursing activities include providing direct care to the ill person, such as administering medications, baths, and specific procedures and treatments, performing diagnostic and assessment procedures, such as measuring blood pressure and examining feces for occult blood, and consulting with other health care professionals about client problems. For people with acute illness, the time as an ill person is generally short and recovery is usually rapid. Thus most find it relatively easy to return to their former lifestyles. People who have long-term illnesses and must adjust their lifestyles may find recovery more difficult. For clients with a permanent disability, this final stage may require therapy to learn how to make major adjustments in functioning.
• NURSING IS AN ART: TEACHING (PART 2) Odielon C. Filomeno, RN, MPH
• The Nursing Process


  The nursing process is a critical thinking process that professional nurses use to apply the best available evidence to caregiving and to promoting human functions and responses to health and illness. The nursing process is continuous and dynamic, so you may move back and forth among the steps. Nursing assessment helps nurses to form a clear definition of the patient's problems, which in turn provides the foundation for planning and implementing nursing interventions and evaluating the outcomes of care. The nursing process is also a standard of practice, which, when followed correctly, protects nurses against legal problems related to nursing care. The nursing process is central to your ability to provide timely and appropriate care to your patients. It begins with the first step, assessment, the gathering and analysis of information about the patient's health status.
• Nursing process


  A critical thinking process that professional nurses use to apply the best available evidence to caregiving and to promoting human functions and responses to health and illness
• Nursing process


  • Continuous and dynamic, so you may move back and forth among the steps
  • A standard of practice, which, when followed correctly, protects nurses against legal problems related to nursing care
  • Central to your ability to provide timely and appropriate care to your patients
• Nursing process


  1. Assessment

  2. Nursing diagnosis

  3. Planning

  4. Implementation

  5. Evaluation
• Assessment


  Gathering and analysis of information about the patient's health status
• Nursing diagnosis


  A clinical judgment about an individual, family, or community's response to health problems/life processes that a nurse is licensed and competent to treat
• Collaborative problem


  An actual or potential physiological complication that nurses monitor to detect the onset of changes in a patient's health status
• Interprofessional collaboration


  A partnership between a team of health care providers and a patient in a participatory collaborative and coordinated approach for shared decision making around health issues
• Nursing diagnosis was first introduced in 1950