Lecture 1 - Health and Health Promotion

7/23/2019 Lecture 1 - Health and Health Promotion

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N1101w Overview

The concepts of health, health promotion and illness will be considered fromthe perspectives of individuals and families.

Health promotion will be examined in relation to personal meaning of health,

health assessment, empowerment, self-care, and health living practices.

!tudents will learn about the nursing process and phsical assessment s"ills.

!tudents will explore transitions in the life ccle, and examine the concept of

chronic health challenges and their effect on the individual and the famil.

#as in which nursing practice can support those with long-term health

challenges, especiall the older adult, will be discussed.

$ssues related to living in a %ong Term &are facilit will also be explored.



N1101w &ourse 'valuation

Midterm exam:

October (nd, (01)

H!*, rm (+, 11+0-1++0

1 hr /) min., multiple-choice alternate format exam

$ncludes course content up to !ept +0th

(0 of course mar"

Final exam:

2ecember exam period

+ hour, multiple-choice alternate format exam

+0340 emphasis of first3second half of the course

+0 of course mar"



N1101w &ourse 'valuation

Health Promotion Group Assignment:

() of course mar" 1) paper5 10 in class presentation

6aper 2ue7 October 18th5 in class 6resentations on October ( (4th

9roups of students

Scholarly Paper: Life Revie for the !lder Adult

() of course mar"

8-10 page maximum

2ue7 November +0th, b 100 hrs paper cop as well as submitted to

Turnitin.





9oals

'xplore personal meanings beliefs about health, wellness, andillness and the relationship between culture, health and illness.

=nderstand the famil as the context in which health behaviours

are learned.

*egin to understand various factors that affect health such as the

!ocial 2eterminants of Health and the relationship between

empowerment and health.

'xplore the concept of health promotion and its appropriateness

in all health care settings.



>ppearance of 6oor Health

?



#ith all our modern da technolog

and advanced "nowledge wh do soman individuals experience poor

health, or put themselves at ris"?



>ppearance of 9ood Health?



2efinition of Health

Nurses should be aware of their own

personal definitions of health and

appreciate that other people will have

their own uni@ue definitions. $t can affect

goal setting, if we are not on the same

pageA



Health

Health: according to the #orld Health

OrganiBation is a state of complete phsical,

mental and social well being and not merel theabsence of disease or infirmit #HO, 18/C.

$t is a basic human rightA

Health is a highl individualiBed experience



The 10 $ndicators of #ell-*eing

well-being.esdc.gc.ca



>boriginal views of wellness

First "ations# $nuit % Metis:

*elief of the interconnectedness with all creation - famil,

communit, nation, plants, animals, and the spirit peoplethose who have died those not et born.

=se mutual decision ma"ing.

*elief held - ;edicine #heel.

medicine wheel by Mistgod



1 The four points of the compass, each with a guidingspirit, smboliBe stages in the life Dourne. The 'ast,

direction of the dail birth of the sun, represents a personEs birth and earl ears. The !outh relates to childhood andintellectual growth. The #est smboliBes adulthood andintrospection, while the North represents the old age,wisdom and the spiritual aspects of life. The centre of thewheel is smbolic of ;other 'arth and the &reator, andtheir role in the beginning and continuation of life.

( The four points can also represent the balance betweenspiritual 'ast, mental North, phsical #est andemotional !outh aspects of health.

+ The wheel can also represent values and decisions.Here, values drawn in the 'ast, where the sun risesinfluence decisions ta"en in the mental realm drawn in the

North, at the top. Then, decisions are implemented in the phsical realm #est, and actions produce reactions in the

emotional realm !outh. Finall, these reactions providefeedbac" into the value sstem, completing the circle ofvalue - action - evaluation.

/ The @uadrants of the wheel are often coloured red,ellow, blac", white or green.

http733www.webpanda.com3There3uotGdirections-colors.htm



$llness3#ellness &ontinuum

www.studyblue.com



Health Health 6romotion

<obert %abonte a &anadian Health Theorist 188+categoriBed how people define health into six groups7

1. Feeling vital, full of energ(. Having good social relationships

+. 'xperiencing a sense of control over oneslife living conditions

/. *eing able to do things one enDos). Having a sense of purpose in life

. 'xperiencing a connectedness toIcommunitJ to others



Health *elief ;odels

>re useful tools in developing programs for helping

people change to healthier lifestles and develop a

more positive attitude toward preventive health measures.

Health Locus of &ontrol Model 'L!&(

Health )elief Model 'Rosenstoc* % )ec*er(



Health %ocus of &ontrol ;odel

> concept from social learning theory that nurses can

use to determine whether clients are li"el to ta"e action

regarding health, that is, whether clients believe that theirhealth status is under their own or others control.

6eople who have a maDor influence on their own health

status are called internals. $nternals ta"e initiative on

their own healthcare, are more "nowledgeable about their

health and adhere to prescribed health care regimens.



Health %ocus of &ontrol ;odel

Externally controlled people on the other hand need

assistance to ta"e more control internall, if behaviour

changes are to be successful.

>ssessment tools to assess %O&

e.g., ;ultidimensional Health %ocus of &ontrol !cale;H%&



<osenstoc" *ec"ers Health )elief Model

*ased on motivational theory.

$ntended to predict which individuals would or would not use

preventive measures such as screening for earl detection of

cancer.

*ec"er 184/ modified the Health *elief ;odel to include7

$ndividual perceptions

;odifing factors

Kariables li"el to affect initiating actions

<osenstoc" - good health is an obDective common to all people.

*ec"er added Ipositive health motivationJ as a consideration.



www.slideshare.net



$llness 2isease

$llness is usuall associated with disease but ma

occur independentl.

$llness is a highly personal experience in which the Iperson

feelsJ unhealth or ill.

2isease alters bod functions and results in a reduction of

capacities or shortened lifespan.

The causation of disease is called Ietiolog.J



&lassification of $llness

Acute illness:

&haracteriBed b rapid onset, severe smptoms of

relativel short duration usuall wee"s or less and

recover is expected, and predictable e.g., the Flu.

Chronic illness:

2evelops graduall, lasts months or longer or a persons entire life. !mptom management is the goal

not cure. &an be characteriBed b periods of

remission and exacerbations e.g., >rthritis, ;!, $*2



'ffects of $llness

*rings about changes for individual and for the famil

>ttitudinal changes

Financial demands

%ifestle changes>dDustments to usual roles

$mpact on the client

*ehavioural and emotional changes&hanges in self concept bod image amputation, burns

%ifestle changes



$llness $mpact on the Famil

Affects all family mem+ers in terms of :

<ole changes

Tas" reassignments

$ncreased stress

Financial problems

%oneliness

&hange in social customs



!ocial 2eterminants of Health

1. !tress, *odies, and $llness(. $ncome and $ncome 2istribution

+. 'ducation

/. =nemploment and :ob !ecurit

). 'mploment and #or"ing &onditions

. 'arl &hildhood 2evelopment4. Food $nsecurit

C. Housing

8. !ocial 'xclusion

10. !ocial !afet Net

11. Health !ervices1(. >boriginal !tatus

1+. 9ender

1/. <ace

1). 2isabilit

:. ;i""onen 2. <aphael (010



Health 6romotion

Health promotion: the process of enabling

people to increase control, and improve their

health.

=nderstanding health promotion - > short introduction, +7/C

http733www.outube.com3watch?vL8THMT'@;a=

http://www.youtube.com/watch?v=y9THQTEqMaU

http://www.youtube.com/watch?v=y9THQTEqMaU



Health 6romotion

pamodules.mc.du"e.edu



Health 6romotion

,he Lalonde Report '-./0(: !uggested that medical care was not the most important

determinant of health and that changes in lifestle and

environment plaed the greatest role in improving the

health of populations. !uggested loo"ing at health in terms of a health fields

approach, comprising / main elements7

Human biolog'nvironment

%ifestle

Healthcare organiBation

&hapter C



Health 6romotion

$n the18C0s a new focus or vision emerged of health promotion

,he !ttaa &harter for Health Promotion 18C based on

#HO, 18C recommendations was adopted.

&anada was seen as the forerunner in Health 6romotion with the publication in 184/ of the Lalonde Report one of the

founding documents in health promotion in &anada.

EPP Report 18C was released and adopted b &anada as thevision for I Achieving Health for All J b the ear (000.



Health 6romotion1PP Report '-.23(:

<ecommended decreasing ine@uities, increase prevention, enhancingcoping Kia Fostering public participation, strengthening communit

services, coordinating health public polic.

$dentified + maDor health challenges facing &anadians.

2isadvantaged groups have significantl lower life expectanc, poorer

health, and a higher prevalence of disabilit than the average &anadian.

Karious forms of preventable diseases and inDuries continue to undermine

the health and @ualit of life of man &anadians.

Thousands of &anadians suffer from chronic disease, disabilit , and

emotional stress, and lac" of ade@uate communit support to help them cope

and live meaningful, productive and dignified lives.



To address these challenges, 'pp proposed I A Framework for

Health Promotion.J



6rograms for Health 6romotion

$nformation dissemination

Health appraisal and wellness assessment Finding the people in the communit and determining how health the

are

%ifestle and behaviour change $n the past everone used to smo"e all the time.

'nvironmental control programs- Having a clean water suppl, no pesticides, etc.



2efinitions of Health 6romotion

Ronald La+onte 188+7

2efined health promotion as Ian activit or program

designed to improve social and environmental living

conditions such that peoples experience of well-being

is increased.J



Health 6romotion<onald %abonte 188+7 identified ) essential principles of

communit development that support health promotion7

1. 'mpowering services getting people involved. 9etting Ottawa

to throw mone at this process. 'mpower the people with power to

ma"e decision(. &onnective processes

+. OrganiBational actions

/. &ollaborative strategies

). >dvocac that challenges control



2efinitions of Health 6romotion

"ola Pender 1887 nursing theorist.

2efines health promotion as Iactivities directedtoward increasing the level of well-beingPand

defines primary prevention as Iactivities directed

toward decreasing the probabilit of specific

illnesses.J



6enders Health 6romotion ;odel H6;

Nola 6enders health promotion model 188 is similar to

*ec"ers Health *elief ;odel - focuses on health

promoting behaviours.

This model, which had the aim of helping nurses educate

clients with entrenched behaviours such as smo"ing and

drug abuse, has been described as one of the predominant

models of health promotion within nursing Qing, 188/.



www.slideshare.net

Health 6romotion

;odel

Nola 6ender, 6h2, <N, 188 revised model



Nurses <ole in Health 6romotion

;odel7 health lifestle behaviours and attitudes.

Facilitate7 client involvement in the assessment, implementation

evaluation of their health goals.

Teach7 client self-care strategies to enhance fitness, improve nutrition,

manage stress and enhance relationships.

>ssist7 individuals, families communities to increase their level of health.

>ssist7 clients, families communities to develop and choose health

promoting options.



Nurses <ole in Health 6romotion

'ducate7 clients to be effective healthcare consumers.

9uide7 clients development in effective problem solving anddecision ma"ing.

<einforce7 clients personal famil health promotion

behaviours.

>dvocate7 in the communit for changes that promote health.



!tages of Health *ehaviour &hange

Health behaviour change is a cclic phenomenon in which

people progress through several stages.

6rochas"a and 2i&lemente 18C( propose a five-stagemodel for health behaviour changes7

1. The pre-contemplation stage

(. &ontemplation

+. 6reparation

/. >ction

). ;aintenance



!tages of Health *ehaviour &hange

$f the person is not successful in changing behaviour, relapse ma occur

during the action or maintenance stages. However, at an point in thesestages, people ma move to an previous stage, an understanding of these

stages enables the nurse to provide appropriate nursing interventions.



Test Muestion7

1. ;r. !mith is a 4(-r-old man who lives alone in an apartment

in an urban setting in &anada. He describes himself as health,self-sufficient, and financiall secure. ;r. !mith has no living

relatives and states that he often feels sad and lonel. He does

his shopping at a grocer store across the street and eats a

well-balanced diet. #hich health determinant ma have themost influence on ;r. !miths abilit to maintain his health

over the next few ears?

>. 9ender*. Housing

&4 Social exclusion

2. $ncome income distribution



Test Muestion7

(. > new mother brings her newborn daughter to our wellness

clinic for a chec"up. $n the course of the assessment, ounotice that the mother holds the bab onl when necessar and

does not communicate with or loo" at her new bab. *elieving

this new famil to be at ris", ou offer support services of

home care visits counselling. #hich determinant of health ismost at ris" in this situation?

>. 9ender *. !ocial safet net

&4 1arly child development

2. $ncome income distribution

& !t d



&ase !tud7

:ac" and <a have both suffered heart attac"s5 the live near

downtown Toronto and are members of the First Nations people.

5ac*# on advise from his traditional healer and phsician, re@uested

a healing ceremon, started exercising, reducing his salt fat

inta"e, entered stress-reduction classes, and with support of his

wife returned to wor" wee"s after his heart attac". He has a positive outloo", is doing well, and tal"s about Ifeeling wellJ.

Ray has also changed his dietar habits and has started exercising5

however, he has been unable to @uit smo"ing, even though he

wants to and has been advised to do so. <a is single, and

fre@uentl despondent, ver fearful of having another heart

attac", has not et returned to wor", and fre@uentl tal"s about

Ifeeling illJ



&ase Study: &ritical ,hin*ing 6uestions

1. *oth men have the same health issue. :ac" considershimself to be well, whereas <a considers himself to be

ill. 'xplain this phenomenon on the basis of the !2H.

(. #hat factors ma have prevented <a from developing

the same positive outloo" and ta"ing the same actions as

:ac" did to manage his illness?

+. #hat nursing interventions would be most beneficial to

<a with regard to his smo"ing problem?



%ets ;a"e Our 2a Harder7 2r. ;i"e 'vans /700

http733www.outube.com3watch?vLwh6u<%il/c0

http://www.youtube.com/watch?v=whPuRLil4c0

http://www.youtube.com/watch?v=whPuRLil4c0

Lecture 1 - Health and Health Promotion

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