Ppt Ch 1 8th Edition

Chapter 1Chapter 1

Health Defined: Objectives Health Defined: Objectives for Promotion and Preventionfor Promotion and Prevention

Copyright © 2014 by Mosby, an imprint of Elsevier Inc.

Exploring Concepts of HealthExploring Concepts of Health

Wellness-illness continuumWellness-illness continuum Health as dichotomy: High-level wellness vs. Health as dichotomy: High-level wellness vs.

depletion of healthdepletion of health High-level wellnessHigh-level wellness

Sense of well-being, life satisfaction, quality of lifeSense of well-being, life satisfaction, quality of life Negative endNegative end

Adaptation to disease/disabilityAdaptation to disease/disability

Copyright © 2014 by Mosby, an imprint of Elsevier Inc. 2

3Copyright © 2014 by Mosby, an imprint of Elsevier Inc.


Unitary patterning of person-environment Unitary patterning of person-environment (1970s and 1980s)(1970s and 1980s) UnidirectionalUnidirectional DevelopmentalDevelopmental Expanding consciousness, pattern/meaning Expanding consciousness, pattern/meaning

recognitionrecognition Health outcome of ongoing patterns Health outcome of ongoing patterns

person/environmental interactionperson/environmental interaction Person is a complex, interconnected systemPerson is a complex, interconnected system

Exploring Concepts of Health Exploring Concepts of Health (Cont.)(Cont.)


Comprehensive and multidimensionalComprehensive and multidimensional Interconnection between people and Interconnection between people and

physical/social environmentsphysical/social environments Promotes health on multiple levelsPromotes health on multiple levels

IndividualIndividual FamilyFamily Community Community SocietySociety

Ecological Model of HealthEcological Model of Health


Before 1940: Health = absence of diseaseBefore 1940: Health = absence of disease Infectious diseases prominentInfectious diseases prominent Physician: independent primary practitionerPhysician: independent primary practitioner Government: start public health/welfareGovernment: start public health/welfare

1940s-1950s: Health = ability to fulfill roles1940s-1950s: Health = ability to fulfill roles Physicals for fitnessPhysicals for fitness Physicians linked to hospital servicesPhysicians linked to hospital services Increased federal role: hospital expansion, federal Increased federal role: hospital expansion, federal

programsprograms

Historical Perspective of HealthHistorical Perspective of Health


Historical Perspective of HealthHistorical Perspective of Health(Cont.)(Cont.)

1960s-present: Health = adaptation and reaction 1960s-present: Health = adaptation and reaction to environmentto environment Disease prevention/health promotionDisease prevention/health promotion Emphasis on individual responsibility/lifestyle choicesEmphasis on individual responsibility/lifestyle choices Growing number/diversity of primary providersGrowing number/diversity of primary providers Government: control costsGovernment: control costs Quality of life seen as component of healthQuality of life seen as component of health

• Patient/family perception importantPatient/family perception important


Models of HealthModels of Health

ClinicalClinical Absence s/s disease; prevention not emphasizedAbsence s/s disease; prevention not emphasized

Role performanceRole performance Health based on whether person can perform Health based on whether person can perform

societal rolessocietal roles AdaptiveAdaptive

Ability to adapt positively to changeAbility to adapt positively to change Eudaimonistic modelEudaimonistic model

Exuberant well-being: interaction and Exuberant well-being: interaction and interrelationships in multiple aspects of lifeinterrelationships in multiple aspects of life



Key Health ConceptsKey Health Concepts

FunctioningFunctioning Levels reflected in terms of performance/social expectations; loss Levels reflected in terms of performance/social expectations; loss

indicator of need for nursing interventionindicator of need for nursing intervention HealthHealth

State of physical, mental, spiritual, and social functioning within State of physical, mental, spiritual, and social functioning within developmental contextdevelopmental context

Both individual and societal responsibilityBoth individual and societal responsibility DiseaseDisease

Failure of adaptive mechanismsFailure of adaptive mechanisms Results in functional or structural disturbancesResults in functional or structural disturbances

Illness Illness Subjective experience of individual and physical manifestation of Subjective experience of individual and physical manifestation of

diseasedisease


Healthy People 2020Healthy People 2020

National Guidelines to Promote HealthNational Guidelines to Promote Health Define national emphasis for health promotion and Define national emphasis for health promotion and

disease prevention effortsdisease prevention efforts Four overarching goalsFour overarching goals

Attain high quality, longer lives free of preventable disease, disability, injury, and premature death.

Achieve health equity, eliminate disparities, and improve the health of all groups

Create social and physical environments that promote good health for all

Promote quality of life, healthy development, and healthy behaviors across all life stages


Healthy People 2020 Healthy People 2020 (Cont.)(Cont.)

Forty-two focus areasForty-two focus areas Guide for health care research, practice, education, Guide for health care research, practice, education,

policy, and communicationspolicy, and communications Twelve leading health indicators (e.g., access Twelve leading health indicators (e.g., access

to health services, environmental quality, to health services, environmental quality, physical activity, obesity, tobacco use)physical activity, obesity, tobacco use)


Planning for Health: Planning for Health: Healthy Healthy People 2020 People 2020 (Cont.)(Cont.)

Research of current health incorporatedResearch of current health incorporated Responsibility for interventionResponsibility for intervention

Individual–lifestyle/behaviorsIndividual–lifestyle/behaviors Health care providers–offer preventative Health care providers–offer preventative

services/monitoring behaviorsservices/monitoring behaviors Community partnerships to promote health (e.g., Community partnerships to promote health (e.g.,

work sites, faith communities)work sites, faith communities)


Levels of PreventionLevels of Prevention

Levels of PreventionLevels of Prevention Steps of PreventionSteps of Prevention

PrimaryPrimary 1. Health promotion and 1. Health promotion and specific protectionspecific protection

SecondarySecondary 2. Early diagnosis2. Early diagnosis

3. Prompt treatment3. Prompt treatment

4. Disability limitation4. Disability limitation

TertiaryTertiary 5. Restoration and 5. Restoration and rehabilitationrehabilitation


Primary PreventionPrimary Prevention

Precedes disease/dysfunctionPrecedes disease/dysfunction InterventionsInterventions

Health promotion (e.g., education)Health promotion (e.g., education) Specific protection (e.g., immunization, reducing Specific protection (e.g., immunization, reducing

exposure to carcinogens, occupational hazards)exposure to carcinogens, occupational hazards) Focus: Maintain/improve general Focus: Maintain/improve general

individual/family/community healthindividual/family/community health Passive–not personally involvedPassive–not personally involved

Public health efforts–clean water/sewerPublic health efforts–clean water/sewer Active–personally involved Active–personally involved

Lifestyle changesLifestyle changes


Transtheoretical Model of Health Transtheoretical Model of Health PromotionPromotion

Example of health promotion modelExample of health promotion model Incorporates: Incorporates:

Stages of changeStages of change Decisional balanceDecisional balance Self-efficacySelf-efficacy Processes of changeProcesses of change Six stages–each provides nursing opportunity for Six stages–each provides nursing opportunity for

information and supportinformation and support



Secondary PreventionSecondary Prevention

ScreeningScreening Goal: Identify individuals in early, detectable stage of Goal: Identify individuals in early, detectable stage of

diseasedisease Treating early stages of diseaseTreating early stages of disease Limiting disabilityLimiting disability Interventions similar to primary prevention but Interventions similar to primary prevention but

applied to individuals/ populations with diseaseapplied to individuals/ populations with disease


Tertiary PreventionTertiary Prevention

Defect/disability permanent or irreversible (e.g., Defect/disability permanent or irreversible (e.g., stroke)stroke)

Minimizing effect to prevent Minimizing effect to prevent complications/deteriorationcomplications/deterioration

Objective: Return to useful place in society, Objective: Return to useful place in society, maximize remaining capacitymaximize remaining capacity SurveillanceSurveillance Maintenance Maintenance Rehabilitation Rehabilitation


The Nurse’s RoleThe Nurse’s Role

Emphasis shifting from acute, hospital-based Emphasis shifting from acute, hospital-based care to preventative community-based carecare to preventative community-based care

Nurses must assume blended roles with a Nurses must assume blended roles with a knowledge base using evidence-based knowledge base using evidence-based practice practice


Nursing Roles in Health Nursing Roles in Health Promotion and ProtectionPromotion and Protection

AdvocateAdvocate Care managerCare manager ConsultantConsultant Deliverer of servicesDeliverer of services EducatorEducator HealerHealer ResearcherResearcher


Evidence-Based PracticeEvidence-Based Practice

Conscientious, explicit, and judicious use of Conscientious, explicit, and judicious use of current best evidence in making decisions current best evidence in making decisions about the care of individual patientsabout the care of individual patients

Integrating individual clinical expertise with the Integrating individual clinical expertise with the best available external clinical evidence from best available external clinical evidence from systematic research (ANA, 2004)systematic research (ANA, 2004)


Improving Prospects for HealthImproving Prospects for Health

Population effectsPopulation effects Increased diversityIncreased diversity Changes in age distribution (older population)Changes in age distribution (older population) Health promotion approaches may need to adaptHealth promotion approaches may need to adapt

Shifting problemsShifting problems Environmental pollution Environmental pollution StressStress Lifestyle (obesity, substance abuse)Lifestyle (obesity, substance abuse) Increase in chronic conditionsIncrease in chronic conditions

Moving toward solutionsMoving toward solutions Individual involvement (lifestyle changes, motivation)Individual involvement (lifestyle changes, motivation) Governmental involvement (legislation and financing)Governmental involvement (legislation and financing)




Ppt Ch 1 8th Edition

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