Transcript Health

NU268

Health Assessment and Promotion




Foundation class
HA – 1st step to caregiving
Health Care into the community
Preventative Health Care & Health Promotion
extremely important
Health -- early definitions


Being safe and whole of body—natural or in
harmony with nature.
Unhealthy meant unnatural or contrary to
nature. The unhealthy person was “Unclean”
therefore no attempt to cure.
Scientific Era


Increased Medical discoveries. Illness was
regarded with less disgust. Society was
concerned with avoiding effects of disease.
Health was defined as “freedom from disease”
This definition is still in use today.
World Health Organization




“Health is a state of complete physical, mental
and social well being and not merely the
absence of disease and infirmity”
Ideal goal
Supports a holistic view of health
Add spiritual
WHO Definition good because:



Looks at total person
Looks at environment (community)
Equates health with productive/creative living

We all usually agree with the WHO definition
but it is difficult to understand what it really
means since “health” means different things
to differnet people
“Classic” Definition of Health


Murray and Zettner (1975)
“A purposeful, adaptive response, physically,
mentally, emotionally and sociallly, to internal
and external stimuli, in order to maintain
stability and comfort.”


Meaning of “Health” becomes clear throughout
the educational process and maturity
Health sometimes viewed not only as the
absence of disease but also a reward for “good
behavior.”



We know a lot about illness and a lot less
about health
Each of us enters the health care community
with our own culturally based concept of
health.
Sometimes we as HCP’s view those who do
not accept the prevailing institutional
connotation of the word “health” as “deviant.”
MODELS OF HEALTH

--Western traditional/Medical model

--Holistic model

--CON conceptualization of Health
Western/Traditional Model of
health





Health and disease are opposites
Disease is due to specific agents
Look at signs and symptoms of disease
Interventions initiated after illness already
exists
If s/s are eliminated then person is said to be
healthy
Holistic Model of Health





Whole person
Mind,, body, spirit working in harmony with the
environment
Wellness is a dynamic process
Assessment data looks at lifestyle, culture, values,
family, society, developmental tasks—each of these
contributing to the whole person
Person is responsible for their health—active
participant in health care
CON conceptualization of Health

Health is a dynamic, multidimensional process
of becoming or developing which is
influenced by individual perceptions, cultural
norms,and environmental forces. It is an
important part of the human experience and
quality of life. Health affects and is affected
by human need, potential and chioice.




The persons concept of health determines which
assessment data to collect.
Nurse—focus on all dimensions of development and
the total health of the person and family.
Physical, mental, emotional, socio cultural and
spiritual needs are interrelated.
Comprehensive assessment of the whole person.
Samples of Health Meanings






Being able to do what I want to do
Physical and psychological well being
Being able to use all your body parts in the way you
want to use them-to have energy and enthusiasm
Being able to perform your normal activities, such as
working, without discomfort and at an optimal level
The state of wellness with no physical or mental illness
I would define health as an undefined term; it depends
on the situations, individuals, and other things.


Health is a lifespan process
Different meaning of health & illness based on
values, beliefs and stage of life
Factors that affect meaning of health

Socioeconomic class
–
–
–

Upper
Middle
Lower
Religion & Spirituality

Concepts of Health are Culturally Based
Culture




Learned way of doing, feeling, thinking (past and
present) of a social group within a given period of time.
No single definition of culture.
Picture culture as luggage that each of us carries
around for our lifetime. It is the sum of beliefs,
practices, habits, likes, dislikes, norms, customs,
rituals, etc. that we learned from our families during
years of socialization.
Transmitted generation to generation
Need to be “Culturally Competent”
–

A set of knowledge, skills and attitudes that allows
individuals, organizations and systems to work
effectively with diverse racial, ethnic, religious and
social groups.
Ethnic/Ethnicity
–
A social group within a cultural and social system
that claims status on the basis of complex traits
including religious, linguistics, ancestral or physical
characteristics (e.g. Germans, Italians, Asians etc.)

Causes of illnesses are “culturally influenced”
Examples of Illness beliefs

--Biomedical or Scientific

--Naturalistic

--Magico religious




Biomedical/Scientific—cause and effect.
Reality can be observed and measured.
E.g. : germ theory
Naturalistic/Holistic—life is only one aspect of
nature. E.g. Yin/yang ==balance, hot/cold
Magico/Religious—supernatural forces
dominate. e.g.: faith healing, voodoo,
witchcraft


Health Promotion
Illness Prevention (prevention of disease)

PART OF A HOLISTIC HEALTH
ASSESSMENT IS THE ASSESSMENT OF
WELL BEHAVIORS
Health Promotion (WHO)





Encourage healthy lifestyles
Create supportive environments for health
Strengthen community action
Reorient health services (tx vs. prevent
acute vs. chronic)
Build healthy public policy
Health Promotion





Families
Schools
Worksite
Nursing centers
Communities

Great Gains in:
–
–
–
–
–

BP control
Injury prevention
Smoking cessation
Immunizations
Dental Health
Need to improve:
–
–
–
Physical fitness
Teenage pregnancy
STD’s
Potential targets for health promotion













Smoking
Alcohol/drugs
Nutrition
Exercise
Stress control
Violent behavior control
Weight reduction
Prenatal classes
Parenting classes
Seat belts
Helmets
Speed limit
Child/elder abuse
HEALTH PROTECTION

Protective measures by the government
Examples:
-toxic agent control
-occupational safety
-accident prevention
-fluoridation and dental health
-control and surveillance of infectious diseases
-immunizations
Prevention
–

A continuum of activities essential for preventing
disease, prolonging life, and promoting health.
3 Levels of Prevention
Primary Prevention

Consists of activities directed toward
decreasing the probability of specific illnesses
or dysfunctions in individuals, families,
communities including active prevention
against unnecessary stressors – e.g.,
immunizations, prenatal care, parenting
classes, health promotion behaviors (exercise,
nutrition….)
Secondary Prevention

Emphasizes early diagnosis and prompt
intervention to halt the pathological process,
thereby shortening its duration and severtiy
and enabling the individual to regain normal
function at the earliest possible point – e.g.,
BP, blood sugar screenings, pap smears, other
cancer screenings.
Tertiary Prevention

Comes into play when a defect or disability is
fixed, stabilized, or irreversible. Rehabilitation,
the goal of tertiary prevention, is more than
halting the disease process itself; it is restoring
the individual to an optimum level of
functioning within the constraints of the
disability – e.g., rehabilitation from stoke, heart
disease, depression….
Agent
Environment
Host
AGENT





Physical
Chemical
Nutritive
Infectious
psychological
HOST

SUSCEPTIBLE host
Factors
-intrinsic
-physical
-psychological
-immunity
ENVIRONMENT

-physical

-biological

--social
Remember “Rural” community as a culture








Access to care
Distance
Economics
Knowledge/education
Priorities
Home remedies
Don’t seek preventative health care
Elderly=rural