Models and determinants

Cards (38)

  • Health Belief Model
    Rosenstock's and Beckers Health Belief Model
  • Health beliefs
    A person's ideas, convictions, and attitudes about health and illness. They are based on factual information or misinformation, common sense, or myths. They influence health behavior and can positively or negatively affect a patient's level
  • Positive health behaviors
    Activities related to maintaining, attaining, or regaining good health preventing illness (includes immunizations, proper sleep patterns, adequate exercise, and good nutrition)
  • Implementation of positive health behaviors
    Dependent on an individual's awareness of how to live a healthy life and the person's ability and willingness to carry out such behaviors in a healthy lifestyle
  • Negative health behaviors
    Activities that are actually or potentially harmful to health, such as smoking, drug or alcohol abuse, poor diet, and refusal to take necessary medications or to care for oneself
  • Health Belief Model components

    • Individual's perception of susceptibility to an illness
    2. Patient's perception of the seriousness of the illness
    3. Likelihood that the patient will take preventive action, results from the patient's perception of the benefits of and barriers to taking action
  • Health Promotion Model
    Defines health as a positive, dynamic state, not merely the absence of disease. Proposed as a framework for integrating the perspectives of nursing and behavioral science and the factors that influence health behaviors
  • Health Promotion Model
    • Describes the multidimensional nature of people as they interact within their environment to pursue health. Focuses on the three functions of a patient's cognitive-perceptual factors (individual perceptions), modifying factors (demographic and social), and participation in health-promoting behaviors (likelihood of action)
  • Holistic health
    A comprehensive view of the person as a biopsychosocial and spiritual being. Aims to empower patients to engage in their own healing process. Consists of concepts of energy, holism, the mind-body connection, and balance in order to expand the definition of health
  • Holistic interventions
    • Aromatherapy, biofeedback, breathing exercises, massage therapy, meditation, music therapy, relaxation therapy, therapeutic touch, and guided imagery
  • Travis's Illness and Wellness Continuum
    Can be used to measure a person's level of wellness. Health and illness or disease can be viewed as the opposite ends of a health continuum
  • Maslow's Hierarchy of Needs
    Premise: Unsatisfied needs motivate human beings and that individuals have to meet certain lower level needs before they are able to satisfy higher level needs
  • Maslow's Basic Needs
    • Physiological needs (water, food, sleep, sex)
    Safety needs (establishing stability and consistency, security of a home and family)
    Love and belongingness (desire to belong to groups, feel love and acceptance)
    Self-esteem (mastery of a task, recognition from others)
    Self-actualization (desire to become everything one is capable of becoming)
  • Understanding Maslow's hierarchy of needs provides a framework to meet patient needs and specifically prioritize care for patients
  • Transtheoretical Model or Stages of Change
    Assumes people do not change behaviors quickly and decisively. Change occurs continuously through a cyclical process. Posits that individuals move through six stages of change: precontemplation, contemplation, preparation, action, maintenance, and termination
  • Precontemplation stage

    The person does not think about changing their behavior in the next 6 months. May be uninformed or underinformed about the consequences of the risk behavior(s)
  • Contemplation stage
    The person acknowledges having a problem, seriously considers changing a specific behavior, actively gathers information, and verbalizes plans to change the behavior in the near future (e.g., next 6 months)
  • Preparation (Determination) stage
    People are ready to take action within the next 30 days. They start to take small steps toward the behavior change, and they believe changing their behavior can lead to a healthier life
  • Action stage

    Occurs when the person actively implements behavioral and cognitive strategies of the action plan to interrupt previous health risk behaviors and adopt new ones. Requires the greatest commitment of time and energy
  • Maintenance stage

    The person strives to prevent relapse by integrating newly adopted behaviors into their lifestyle. Lasts until the person no longer experiences temptation to return to previous unhealthy behaviors
  • Termination stage
    The ultimate goal where the individual has complete confidence that the problem is no longer a temptation or threat. It is as if they never acquired the habit in the first place
  • Determinants of Health
    • Age
    • Sex
    • Genetic Endowment
    • Health Behaviors
    • Lifestyle
    • Individual Influences
    • Interpersonal Influence
    • Community Influence
    • Environmental Influence
    • Health Care System Influence
  • Non-modifiable
    Factors that cannot be changed
  • Age
    • Age increases susceptibility to certain illnesses (e.g., the risk of heart disease increases with age for both genders)
    • Risks of birth defects and complications of pregnancy increase in women bearing children after age 35
    • Many kinds of cancer pose a greater risk for persons over age 45 than for younger persons
    • Often closely associated with other risk factors, such as family history and personal habits
  • Educate patients about the importance of regularly scheduled checkups for their age-group
  • Sex
    • Influences distribution of diseases
    • Females/Males: osteoporosis/stomach ulcers; autoimmune disorders/abdominal hernias; lupus/resp. diseases; rheum. arthritis/ASHD; anorexia/bulimia hemorrhoids; gallbladder disease/TB; thyroid disease; obesity
  • Genetic Endowment
    • Individual biology
    • Genetic makeup and physical and mental health
  • Physical Environment
    • Where a person works or lives increases the likelihood that certain illnesses will occur
    • A person's home environment often includes conditions that pose risks, such as unclean, poorly heated or cooled, or overcrowded dwellings which increases the likelihood that a person will contract and spread infections and other diseases
    • Some kinds of cancer and other diseases are more likely to develop when industrial workers are exposed to certain chemicals or when people live near toxic waste disposal sites
    • Screening for these environmentally based risk factors is directed at the short-term effects of the exposure and the potential for long-term effects
  • Modifiable

    Factors that can be changed
  • Health Behavior
    • Responses, actions, and reactions to internal stimuli and external conditions are able to influence health through their interaction with each other and with the person's social and physical environments
  • Lifestyle
    • Lifestyle practices and behaviors have positive or negative effects on health
    • Practices with potential negative effects are risk factors
    • Include overeating or poor nutrition, insufficient rest and sleep, and poor personal hygiene
    • Other habits that put a person at risk for illness include tobacco use, alcohol or drug abuse, and activities involving a threat of injury such as skydiving or mountain climbing
    • Some habits are risk factors for specific diseases (e.g. excessive sunbathing increases the risk of skin cancer, and being overweight increases the risk of cardiovascular disease)
    • Educate your patients and the public on wellness-promoting lifestyle behaviors
  • Individual Influences
    • Factors that influence an individual's health status
  • Interpersonal Influence
    • A person's perceptions concerning the behaviors, beliefs, or attitudes of others
    • Family, peers, and health professionals are sources of interpersonal influences that can influence a person's health-promoting behaviors
    • Includes expectations of significant others, social support (e.g., emotional encouragement), and learning through observing others or modeling
  • Community Influence
    • Cultural/social interactions influence how a person perceives, experiences, and copes with health and illness
    • Cultures have distinctive ideas about health, and these are transmitted from parents to children
    • Home remedies may be perceived as superior to conventional medicines
    • Social support networks (Family, friends, confidantes, co-workers)
  • Environmental Influence
    • Determines climate which effects health
    • Tropics - malaria
    • Climate - asthma
    • Pollution - air, water, soil
    • Carcinogens - asbestos
    • Radiation - machines, UV
    • Acid rain - main component is sulfur dioxide of industrial origin, thought to damage forests, lakes, rivers
  • Health Care System Influence
    • Rural environments present unique challenges for health care access, including shortages of medical personnel, transportation and distance barriers to care, and increasing economic destabilization of rural health care services
  • References: Potter PA., Stockert P.A, Perry, A.G., Hall, A.M(2018). Fundamentals of Nursing. Elsevier(Singapore) Pte.Ltd; Svalastog AL., Donev,D, Kristofferson N.J. and Gajovic S. (2017).Concepts and definitions of health and health-related values in the knowledge landscapes of the digital society. Croat Med J. 2017 Dec; 58(6): 431–435.doi: 10.3325/cmj.2017.58.431
  • Images: https://www.canstockphoto.com/illness-health-buttons-show-sickness-or-16179545.html https://www.123rf.com/photo_56814338_stock-illustration-wellness-or-illness-good-or-bad-health-road-sign-3d-illustration.html