Wellness and Caring

Definition is difficult.State of complete physical, mental, and social well-being, not merely the absence of disease or infirmity (WHO, 1947) World Health Organization

Healthy People: The Surgeon Generals Report on Health Promotion and Disease Prevention, 1979Introduced national goals for improving the health of Americans by 1990

Healthy People 2000: National Health Promotion and Disease Prevention Objectives

Healthy People 2010

Healthy People 2020 (current version)

Health is more than the absence of disease!

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

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

Attain high-quality longer lives free of preventable diseases, disability, injury, and premature death

Achieve health equity, eliminate disparities

Create social and physical environments that promote good health for all

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

Health beliefs are a persons ideas, convictions, and attitudes about health and illness.

Health beliefs can negatively or positively influence health behavior or health practices.

Health beliefs and practices are influenced by internal and external variables and should be considered when planning care.

Internal FactorsDevelopmental StageIntellectual BackgroundPerception of FunctioningEmotional FactorsSpiritual Factors

External Factors

Family PracticesSocioeconomic FactorsCultural Background

Health Belief ModelAddresses the relationship between a persons beliefs and behaviors

Health Promotion ModelDirected at increasing a patients level of well-being

Basic Human Needs ModelAttempts to meet the patients basic needs

Holistic Health ModelAttempts to create conditions that promote optimal health

Addresses relationship between a persons beliefs and behaviors.3 Components:Individuals Perception of susceptibility to an illness.Perception of seriousness of the illnessLikelihood that person will take action. Results from a persons perception of the benefits and barriers to taking action.

Defines health as a positive dynamic state not just absence of disease.Focuses on:Individual characteristics and experiencesBehavior specific knowledge and affectBehavioral outcomesEach persons unique personal characteristics affect subsequent actions. Variables can be modified through nursing actions, with health-promoting behavior the desired outcome.

Recognize the innate healing abilities of the body and incorporate complementary and alternative therapiesAyurvedaChiropracticChinese MedicineHomeopathyNaturopathyMassage Therapy

A state in which a persons physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired compared with previous experience.

Primary Prevention (True Prevention): We use primary prevention methods before the person gets the disease.

Goals of Primary Prevention:aims to prevent the disease from occurring. reduces both the incidence and prevalence of a disease

Examples:Health education programsImmunizationsphysical and nutritional fitnessSunscreen Education

Secondary Prevention:Focuses on individuals experiencing health problems or illnesses and who are at risk for developing complications or worsening conditions (person may not even know anything is wrong)

Goal:The goal of secondary prevention is to find and treat disease early

Example:Screening for cancer

Tertiary Prevention: When a defect or disability is permanent or irreversibletargets the person who already has symptoms of the disease

Goals of tertiary prevention are:prevent damage and pain from the disease slow down the disease prevent the disease from causing other problems (These are called "complications.") give better care to people with the disease Minimizes the effects of disability by preventing complications and deterioration.

Example: Rehabilitation after surgery, Development of new treatments/ medications

Variables that increase the vulnerability of an individual or a group to an illness or accidentRisk factors include:Genetic and physiological factorsAgeEnvironmentLifestyle

PrecontemplationNot intending to make changes within the next 6 monthsContemplationConsidering a change within the next 6 monthsPreparationMaking small changes in preparation for a change in the next month

ActionActively engaged in strategies to change behavior; lasts up to 6 monthsMaintenance stageSustained change over time; begins 6 months after action has started and continues indefinitely

Internal factorsPerception of cause of symptoms (serious or not)

Chronic or Acute

Coping skillsInternal Locus of controlExternal Locus of controlExternal FactorsVisibility of symptoms(cancer or chickenpox)

Social Network(trust or mistrust the system, support new lifestyle changes or no?)

Economics

Leininger Trans-Cultural Caring Theory -describes the concept of care as the essence and central, unifying and dominant domain that distinguishes nursing from other health disciplines.Stresses culturally specific caring (reflect caring the way the person understands it)

Watsons Trans-Personal Caring Theory- is a holistic model for nursing that suggests that a conscious intention to care promotes healing and wholeness. Emphasizes the nurse-patient relationship. Caring is expressed through a caring connection that the nurse expresses towards the patient. Both the nurse and the patient are transformed and healing is promoted (caring has a spiritual aspect).

Swansons Theory of caring5 Caring Categories/Processes:Knowing (understand event as it has meaning in life of another)Being with (emotionally present)Doing For (as the person would if they could)Enabling (facilitating the other persons passage through a lifes event)Maintaining Belief (hope-filled attitude/ realistic optomisim)

Consider how patients perceive caring

Caring is a moral covenant (ethic of care)

Holistic & Humanistic

Providing Presence

Touch

Listening

Knowing the PatientSpiritual Care

Relieving Pain and Suffering

Family Care