1
Q
what is health
A
The balance of the person, both within one’s being (physical, mental and spiritual) and in the outside world (natural, communal and metaphysical).
Health: presence/ absence of disease, state of complete physical, mental and social wellbeing and not merely absence of disease of infirmity (WHO)
- no single definition, not a static entity, is complex and dynamic, it is affected by culture and the determinants of health)
2
Q
what is wellness
A
A state of wellbeing; engaging in attitudes and behaviours that
enhance quality of life and maximise personal potential. Including physical, environmental, social, emotional, intellectual, spiritual and occupational
3
Q
what is illness
A
Illness: highly personal state in which persons physical, emotional, intellectual, social, developmental or spiritual functioning is thought to be diminished.
A highly personal state in which the person feels unhealthy or ill; may
or may not be related to disease
4
Q
what is diesease
A
Disease: alteration in body functions resulting in a reduction of capacities or a shortening of the normal lifespan
5
Q
what is wellbeing
A
Wellbeing: A subjective perception of balance, harmony and vitality, described objectively, experienced and measured and plotted on a continuum
6
Q
- what are some of the models of health and wellness
A
- clinical model
- role peformance model
- adaptive model eudemonistic model
- agent host environmental model
- health illness continua
- 4+ models of wellness
7
Q
Explain the health belief model
A
- More to do with how individuals perceptions affect their health behaviours
constructs are
Perceived severity-
Perceived susceptibility
Modifying variables
Perceived benefits
Perceived barriers
Cues to action
Self-efficacy
8
Q
the factors influencing health beliefs and practices
A
- Internal
(biological- genetic makeup, psychological + emotional, cognitive-intellectual factors including lifestyle choices and spiritual and religious beliefs - External variables- environment, standards of living, family and cultural beliefs and social support networks
9
Q
how does culture affect health, wellness and illness
A
influence people’s ways of knowing about:
- Health and illness
- Beliefs about the determinants of health
- Expectations of health services and practitioners
10
Q
describe clinical model of health and wellness?
A
Clinical model: ppl viewed as physiological systems with related functions and health is identified by absence of signs and symptoms of disease or injury
11
Q
describe role peformance model of health and wellness
A
Role performance model: ability to fulfil societal roles; that is to perform their work or role in society e.g. Mother, daughter, friend, work
12
Q
describe adaptive model of health and wellness
A
Adaptive model: aim of treatment is to restore ability of a person to adapt; that is, to cope
13
Q
describe the Eudemonistic model of health and wellnes
A
Eudemonistic model: health is seen as condition of actualisation or realisation of a persons potential. Actualisation is apex of the fully developed personality
14
Q
describe the ecological/ agent-host-environment model of health and wellness
A
Agent/ host/ environment model: also called ecological model.
Used in predicting illnesses rather them promoting wellness, although identifying risk factor that results in interactions between A, H and E is helpful in promoting and maintaining health
15
Q
describe the health illness continua of health and wellness
A
Health illness continua- used to measure perceived level of wellness applying to ecological model
16
Q
7 components of wellness?
A
( 7 components of wellness are: physical, social, emotional, intellectual, spiritual, occupational, environmental)
17
Q
explain the and socioEcological perspective of health
A
“health depends on our ability to understand and manage the interaction between human activities and the physical biological environment” WHO
- The social world provides the context within which people interact with the environment
- Ecology refers to the study of the interaction between living things and their environment
- Health is the product of interactions between people in their many environments in ways that conserve and sustain health and wellbeing
18
Q
health belief model constructs
A
Perceived severity- an individual’s belief of the seriousness of the health issue
Perceived susceptibility- an individual’s belief of their chances of having the health issue
Modifying variables- an individual’s personal factors that influence their health beliefs and behaviours
Perceived benefits- an individual’s belief to whether or not the new behaviour is better than their current behaviour
Perceived barriers- an individual’s beliefs of what will stop the, from adopting the new behaviour
Cues to action- factors that will influence an individual to change their behaviour
Self-efficacy- personal belief in ones own ability to do something
19
Q
barriers and facilitators of health, wellness, well being, disease and illness examples
A
- Employment
- Povety
- Education
- Housing
- Sporting clubs
- Recreation facilities
- Community grouos
- Population
- Crime
- Nutrition
- Water
- Pollution
- Sanitation
- Transport
- Health care services
- Access to services
- Environmental health
- Conflict/ terrorism
20
Q
explain the 4+ models of wellness
A
), consists of the four domains of the inner self—physical,
spiritual, emotional and intellectual—plus the elements of the outer systems (environment, culture, nutrition, safety and many other elements). The nurse assesses the inner self for strengths and excesses, sources of nurturing and depletion, and the interactions between the inner self and the outer systems.
21
Q
agent vs host vs environment
A
Agent: environmental factor or stressor presence or absence can lead to illness or disease
Host: Person @ risk of acquiring a disease
Environmental: All factors external to the host that may or may not predispose the person to the development of disease
-> E ->
-> A ->
-> H ->
When variables are in balance, health is maintained; when not= disease illness occurs
22
Q
what are the levels of the multilevel ecological model perspective
A
public policy community organisational interpersonal individual
23
Q
how do traditional models of health often work
A
- often draw on cultural knowledge closely linked with ’how to live’ within a specific group
- may be linked with rituals that have moral or religious value but may also draw on experiential and scientific knowledge
- In western cultures.. dominant biomedical model, traditional health models are often viewed as unscientific and of lesser value
- it is important to recognise the significance of these models of health and healing to provide appropriate, optimum care and cultural safety
24
Q
what determines cultural safety in nursing
A
- effective nursing practice of a person or family from another culture, is determined by that person or family
- culture includes age, generation, gender, sexuality, occupation, socioeconomic status, ethnicity, migrant experience, religious or spiritual belief and disability
- unsafe cultural practice is any action which diminishes, demeans or dis empowers the cultural identity and well being of an individual
- and environment which is safe for old people is one where there is no so, challenge or denial of the identity who they are and what they need
- truly listening shared respect shared, meaning, shared knowledge and experience of learning together with dignity
25
what shouyld a health professional do with their own cultural idnetity
- the health professional would needs to reflect on their own cultural identity and recognise its impact on their professional practice
26
what is the UDHR?
‘the Universal Declaration of human rights (UDHR) is a milestone document in history of human rights. Drafted by representatives with different legal and cultural background from all religions of the world, the declaration was proclaimed by the United Nations General Assembly on in Paris on the 10th of December 1948 General Assembly resolution 2178A as a common standard of all achievements for old people and all nations it's set out for the first time, fundamental human rights to be universally protected. ‘
27
social justice and advocacy in nursing
- social factors limit distribution of goods and services throughout the population
- equitable or fair distribution of the burdens and benefits of society among its members
- health is one of the results of access to societal benefits
- help professionals are responsible to see that members of the community have equitable access to all the societal benefits that promote health
28
what is epidemiology
is the study of the distribution of health and illness within a population comma and factors that determine the population help status
- information used to direct population or public health interventions
- public health is aimed at preventing disease and promoting the health of populations
- examples: vaccination and screening programme (mammogram, pap smears, bowel cancer ),skin cancer prevention programs ,drug awareness and mental health programs
29
what is health psychology
sub theory of psychology that applies psychological principles to the scientific study of health, illness and health related behaviours. It specialises in how biological, psychological and sociocultural factors contribute to health and illness and injury through health promotion and health policy development
30
Explain the Determinants of Health .
- circumstances and environment ( Social and economic, physical environment or individual characteristics and behaviour)
- context of peoples lives determine their health
- Blaming individuals for having poor health is inappropriate
- individuals may not be able to directly control many of the determinants of health
31
Define health literacy
- skills, knowledge, motivation and capacity to access, understand, appraise and apply info learnt to make effective decisions about health and health care to take appropriate action.
- More than being able to read pamphlets and make appointments
- Critical to empowerment
- Targets environmental, political and social determinants of health
- Should aim to not only influence individual life choices but raise awareness of determinants of health and encourage both individual and collective actions = modification of determinants
- Interaction, participation and critical analysis
32
health risk behaviours examples
E.g. Poor nutrition and hydration, physical inactivity, alcohol use, other substance use, tobacco smoking, other smoking, lack of socialisation, unsafe sex
33
Explore their own circumstances to identify their determinants of health, and analyse their health promoting and health risk behaviours in relation to Self-efficacy Theory.
...
34
Be able to consider lifespan and cultural factors when learning to understand health behaviour
...
35
what is health behaviour
Health behaviour- action taken to attain, maintain or regain good health and to prevent illness. Health behaviour reflects a person’s health beliefs.
*ANY BEHAVIOUR INFLUENCING HEALTH*
Internal (biological- genetic makeup, psychological
E.g. Alcohol and other drug use, physical activity, nutrition, sun protection, health screening, vaccination, STI protection
36
Why use theories and models in healthcare?
- To understand how people think and behave
- To explain, predict and understand health behaviour
- Make people engage
- Provide framework of research and evidence-based practice
* research *theory and models *evidence-based practice
37
what are some of the health behaviour models
Health belief model, self-efficacy theory, transtheoretical model, protection motivation theory, diffusion of innovation and ecological models
38
what is the self efficacy theory
‘’people will only try to do what they think they can do and wont try what they cant do”
mastery experience + vicarious experience + verbal persuasion + physiological state = self efficacy = behaviour peformance
39
constructs of self efficacy theory
mastery experience: previous results andexperience
vicarious experience: observation of self and others
verbal persuasion: feedback and coaching
```
physiological state phyical and emotional state peformance
=
self efficacy
=
behaviour and peformance
```
40
what is health numeracy
the capacity to access, process, interpret, communicate and act on numerical, quantitative, graphical, biostatical, and probabilistic health information needed to make effective health decisions
41
health promoting behaviours examples
E.g. Eating fruits and vegetables, fibre, whole grains, physical activity, sun protection, safe sex, socialisation
42
what is harm minimisation
```
strategies to address alcohol and other drug problems by reducing harmful effects on individuals and society
1) Reduce harm from drugs
2) Supply reduction
3) Demand reduction
Facing that inevitable part of society
```
43
Describe the relationship between individual health and holism
- Individuals are unique + require person centred holistic care
- Holistic theoretical frameworks help to provide a holistic overview of individuals and families across the lifespan e.g. Maslow’s hierarchy of needs, Kalish’s hierarchy of needs
44
Explain at least one holistic theoretical framework
maslows hierchy of needs
- Arranged with highest priority the lowest
- Explains why health promotion that targets behaviours that are higher in hierarchy (lowest priority) can be ineffective. Should work from bottom up
1. self actualisation (desire to become the most that one can be)
2. esteem (respect, self esteem, status, recognition)
3. love and belonging ( friends, intimacy, family)
4. safety needs (personal security, employment)
5. physiological needs ( air, water, food, shelter, sleep)
45
Define health promotion
WHO: process involving a combination of actions and strategies to bring about health related changes A combination of educational, organisational, economic and political actions designed with consumer participation ,enable individuals, groups and whole communities to increase control, and to improve their health through knowledge, attitudinal , behavioral, social and environmental changes
- In nursing often used to describe any activity that promotes health but interdisciplinary definition describes it as really another model to explain behavioural change
46
explain the Transtheoretical Model of Behaviour Change
- People move through stages forming a cycle where individual can get on or off at any stage
Precontemplation- not aware
Contemplation- getting ready/ recoginising pros and cons
Preperation- ready to make change/ small steps
action- people making specific and deliberate changes to behaviour and started to aquire new healthy behaviours
Maintainence- maintain behaviour at leats 6 months and preventing relapses
- Important not to assume people are ready or want to make an immediate change
47
explain Protection Motivation Theory
perceived severity, liklihood of occurance = threat apprasial
perceived efficacy of proposed behaviour, ability to perform behaviour
= coping appraisal
treat appraisal and coping appraisal = protection motivation= behaviour
48
Consider lifespan and cultural factors when learning about health promotion and behaviour change.
..
49
5 KEY AREAS OF HEALTH PROMOTION ACCORDING TO OTTOWA CHARTER
5 key areas of action for health promotion
1. Building healthy public policy
2. Creating supportive environments
3. Strengthening community action
4. Developing personal skills
5. Reorienting health services
50
basic steps in health promotion
..
51
basic steps in health promotion
cycle
assess needs of population- assess causes, set priorities and objectives- design and implement program- evaluate program - restart or reassess and design/ implement again
52
health promotion framework
```
illness or health risk
=
individuals, groups, populations (focus)
=
educational, motivational, operational, economic, regulatory, technological ( strategies)
=
behavioural adaption or environmental adaptions (impact)
=
better health and wellbeing (outcome)
=
quality of life (outcome)
```
53
explain the cognitive dissonance theory
- People try avoid dissonant experiences
- Change their beliefs or behaviours so less conflict and more agreement between them
- People avoid messages that conflict with their beliefs and continue with unheqalthy behaviours
- Likelihood of change in belief/ behaviour influenced by balance of perceived cost and benefit of change
54
describe the components of a health promotion program with examples of strategies.
1.Strategies-
capacity building, health education, social marketing
- Incorporate elements of Ottawa charter
1. Building healthy public policy e.g. Seatbelts
2. Supportive environment e.g. Work, school
also. .NHMRC/ AIHW recommendations and WA health strategic framework
3. Strengthen community action
- Capacity building
4. Developing personal skills
- Health education, social marketing
5. Reorientating health services
- Prevention, primary healthcare
55
what is health education, disease prevention and primary health care.
Health education: Historically providing information based on assumption that just having information would motivate people to act on it -..Based on authority model where health professional was the authority
-Contemporary-change environment to be more conducive to healthy behaviour and use participatory learning to enable increased informed decisions about their health
- Health professionals use health education on a daily basis
- Often used as a health promotion strategy within a program
56
Explain the WA Health Department Health Promotion Strategic Framework.
main focus is
* curbing the rise in overweight and obesity
* healthy eating
* a more active WA
* making smoking history
* reducing harmful levels of alcohol use
* preventing injury and promoting safer communities
57
Identify and apply Australian Government evidence based health recommendation and guidelines to promote health and prevent disease.
...
58
what is the Social Cognitive / Social Learning Theory to explain health behaviour.
- Learning occurs within social context
- Emphasizes self-efficacy
- People learn through own experiences as well as by observing the actions of others and the rest of those actions
- Relevant use with groups using modelling by individuals and communities
- An observable change is not necessary for learning to occur
- People can learn through observation
- Learning will not necessarily be reflected in a change in their behaviour
cognition, environment, expectations, behaviour, self efficacy, modelling and reinforcement = learning
59
Be able to consider lifespan and cultural factors when learning about promoting health and preventing illness across the lifespan
...
60
what is the preceed proceed model
- Precede refers to predisposition, reinforcing and enabling constructs in educational and environmental diagnosis and evaluation
- Proceed refers to policy regulatory and organisation of constructs in educational and environmental development
- Predisposing e.g. Genetic, exposure
- Reinforcing e.g. Reward a person for an unhealthy behaviour e.g. Drug user getting acceptance, sedentary job
- Enabling factor e.g. Parent giving child money to buy alcohol or cigarettes
61
what is capacity building
- Empowering individuals, communities, organisations and systems to adopt change
- Build ability for problem solving
Achieved through…
- Provision of resources, infrastructure, expertise, training
- Improving health literacy
- Participation, knowledge exchange, ownership, equity and sustainability
62
what is social marketing
- Adaption of established commercial marketing techniques for the achievement of social change
Differences between commercial marketing
- Commercial products tend to offer instant gratification where as the benefits of ealthy behaviour are often delayed
- Social marketing attempts to repace undesirable behaviour that is often more costly in our time or effort, less pleasurable and unpleasant
Eg. Advertising, publicity, civic journalism, mass media, limited reach media, internet
63
explain the Diffusion of Innovation Theory an
- Behaviour change theory
- Categories of when a behaviour is proposed to be changed
small proportion of innovators, Early adopters
Early majority
Late majority
Laggards/ late adopters
64
5 key elements of primary health care
1. Reducing exclusion of social disparities in health
2. Organising health services around peopled needs and expectations
3. Integrating health into all sectors (public policy reforms)
4. Pursuing collaborative models of policy dialogue
5. Increasing stakeholder participation
65
what is primary health care
- Socially appropriate, usually accessibly scientifically sound 1st level of care provided by health services and systems
- In Australia, PHC
Incorporates personal care with health promotion and prevention of illness and community development.
- Includes interconnecting principles of equity, access, empowerment, community self determination and intersectoral collaboration
66
what is disease prevention
Disease prevention activities designed to protect patients or other members of the public from actual or potential health threats and their harmful consequences
67
levels of disease prevention
Levels
Primary prevention- prevention of occurrence of a condition or problem. in this level action is taken prior to the occurrence of the health problem. Action encompasses aspects of health education, promotion and protection, illness and prevention e.g. Immunisation
Secondary- screening, diagnosis and treatments. Focus of early identification. E.g. Health screening.
Tertiary- prevention of consequences and of recurrence of a condition or problem. Return client to higher level of function, prevent deterioration and recurrence e.g. Health surveillance and follow up treatment
68
how wHO thinks PHC can lead to better health (5 elements)
1. Reducing exclusion of social disparities in health
2. Organising health services around peopled needs and expectations
3. Integrating health into all sectors (public policy reforms)
4. Pursuing collaborative models of policy dialogue
5. Increasing stakeholder participation
69
Explain self-concept
- One mental image of themselves
- Positive self concept required for mental and physical health
- Complex and influences:
How one thinks, talks and acts
How one sees and treats others
Ones choices
Ability to give and receive love
Ability to take action and make change
70
explain the formation of self-concept.
Develops through social interactions with others
- Theorist: Ericksons eight stages of psychosocial development (table 40.1)
- People face developmental tasks through out life- success or failure determines the development of self concept
3 stages in development of self concept
- Infant learns physical self is separate from environment
- Child internalises others attitude towards self
- Child and adult internalise standards of society
71
Describe the components of self-concept
```
dimensions...
Self knowledge
Self expectation
Social self
Social evaluation
```
components. ..
- Personal identity
- Body image
- Role performance
- Self esteem
72
factors that affect self-concept across the lifespan.
Self concept influenced by how one perceives and evaluates themselves in
- Vocational performance
- Intellectual functioning
- Personal appearance and attractiveness
- Sexual attractiveness and performance
- Being liked by others
- Ability to cope with and resolve problemns
- Independence
- Talents
more factors affecting...
- Stages of development
- Family and culture
- Resources
- History of success and failure
- Illness
73
Explain the development of human sexuality across the lifespan and the factors influencing sexuality.
- Begins with conception and continues over the lifespan
* characteristics of sexual development across the lifespan in the readings (infancy, toddler, pre-schooler, schoolage, adolescence, young adulthood, middle adulthood, late adulthood)
74
Describe sexual health.
state of physical, emotional, mental and social wellbeing in relation to sexuality.
The integration of the somatic, emotional, intellectual and
social aspects of sexuality, in ways that are positively enriching and that
enhance personality, communication and love.
75
Explain sexual health
- Individual and contantly changing
- Often not considered till it is impaired or lost
- Best determined by the individual
5 crtical components
- Self concept
- Body image gender identity
- Gender role behaviour
- Freedom and responsibilities
The integration of the somatic, emotional, intellectual and
social aspects of sexuality, in ways that are positively enriching and that
enhance personality, communication and love
76
what is sexuality
central aspect of being human throughout life encompasses sex, gender, identity and roles, sexual orientation, eroticism, pleasure, intimacy and reproduction
- Difficult to define
- Expressed in various ways across the lifespan
- Lindvidually expressed
- Highly personal phenomenon
- Meaning evolves from life experiences
- Influenced by physiological, psychosociual and cultural factors
- No normal universalsexual behaviours
- Normal varies among cultures and religions
77
what are the different areas of sexual health education, promotion and national screening programs.
- Cervical cancer
- Breast cancer
- Testicular cancer
- Sexially transmitted infections
- Contraception
78
cervical cancer sexual health edu/ promo
- New national cervical screening program for women 25-74, both HPV vaccinated and unvaccinated to undertake HPV test every 5 years
- Available on medicare benefits schedule form 2017
- Expected to reduce no. of cervical abnormalities among women younger than 25 years of age and will continue to do so
79
breast cancer sexual health edu/ promo
Australian government recommendations
1) Breast awareness- women of all ages attend mammographic screening should be aware of how their breasts normally look and feel and report any new or unusual changes promptly to their GP
2) Clinical breast examination (physical examination) of an asymptomatic women’s breasts by a medical or allied health professional
3) Screening mammography in asymptomatic women to detect breast cancer at an early stage
- No one method for women to use when checking their breasts is recommended over another
- To reduce risk of death due to breast cancer is recommended that women aged 50-74 years attend the breast screen Australia program for free 2 yearly screening mammograms
- Mammographic screening is not recommended for women younger than 40 years of age
- Women 40-49 and 75 years and over are eligible to receive free screening mamnograms through the breastscreen Australia program but do not receive an invitation to attend
80
testicular cancer sexual health edu/ promo
- Cancer council recommends
Testicular awareness: men become familiar with the usual shape, size and feeling of their testicles and to see their gp if the surface of the testicles heaviness, aching and other changes
- Population based screening for testicular cancer not recommended given rareness of disease, lack of test accuracy and favourable treatment outcomes (even when diagnosed at late stage)
81
some sexually transmitted diseases examples
- Chlamidya
- Gonorreha
- Non specific urethritis
- Trichomoniasis
- Syphilis
- Human immunodeficiency virus (HIV)
- Hepatitis a, b, c
- Human papilloma virus (HPV)
- Herpes simplex virus (HSV)
- Molluscum contagiosum
- Donovanosis
- Pubic lice
- Candida (thrush)
- Bacterial vaginosis
- Balanotitis / Balanoposthitis
82
long acting reversable contraceptives
- Long acting reversable
IUD (progesterone, copper)
Progesterone implant
-
83
Short acting hormonal contraception
Progesterone injection
Combined esterogen and progesterone pill
Progesterone only pill
Vaginal ring (osterogen and progesterone)
84
barrier method contraceptives
- Male and female condom
| - Diaphragm
85
other methods of contraception
- Abstinence
- Withdrawal
- Fertility awareness
- Sterilisation
- Emergency contraception (pill, copper, IUD)
86
Explain the concept of stress.
- Part of human life
- Can be positive and useful
- Can be negative and harmful
- Physiological and psychological effects
’’a condition in which the person experiences changes in the normal equilibrium or balance’’
An event or set of circumstances causing a disrupted response; the
disruption caused by a noxious stimulus or stressor.
87
Explain the models of stress
- Stimulus based models
- Response based models
…alarm reaction
…stage of resistance
…stage of exhaustion
- Transduction based models... ppl and groups being different in sensitivity and vunerablility to events, reading 18
88
Explain the categories indicators of stress.
physiological
- Pupils dialate
- Diaphoresis (sweating) , increased metabolism and body temperature
- Increased heart rate and cardiac output
- Peripheral vasoconstriction, pale skin
- Increased respiratory rate and depth\reduced urinary output
- Dry mouth
- Reduced peristalsis (contraction of GI intestional walls)
- Improved mental alertness
- Increased muscle tension
- Increased blood sugar levels
psychological
- Anxiety
- Fear
- Anger
- Depression
- Ego defence mechanisms
- cognitive responses
- can be helpful or harmful
89
Explain the concept of coping
- dealing with change
- coping strategy/ coping mechanism is a way of responding to change, a problem, a situation
- innate or learned response
- problem focused strategies improve a situation by taking action
- emotion focused strategies relieve emotional distress using thoughts and actions
- can be long or short term
- can be helpful or harmful/ adaptive or maladaptive
- adaptive coping helps us deal with the stressful event and minimise distress
- maladaptive coping can result in unnecessary distress for the person and others
- coping varies among individuals
- three common approaches
…alter the stressor
… adapt to the stressor
…avoid the stressor
- effectiveness of an individual’s coping is influenced by:
…number, duration and intensity of stressors
…past experiences
…support systems
…personal qualities
90
differentiate between adaptive and maladaptive coping mechanisms.
adaptive- good
| maladaptive- bad/ harmful
91
Discuss stress and coping across the lifespan.
...
92
what is a psychoactive substance
a drug that affects a persons central nervous system. Psychoactive substances alter brain activity, and can change the way a person thinks, feels or behaves
93
Discuss the DSM-5
DSM- diagnostic statistical manual of mental disorders
- standard classification of mental disorders
- -used by mental health professionals
- Diagnostic criteria for every psychiatric disorder recognised
- Used for accurate diagnosis and targeted treatment
- DSM-4 (1994) previously divided into categories of substance abuse and substance dependence
- DSM-5 now combines these into single disorder measured on a continuum from mild to severe
- Each specific substance is addressed as a separate disorder
94
Explain risk factors for substance use disorders
- Ecological perspectives of health
- Determinants of health
- Genetic- alcohol
- Biological- effect on neurotransmitters in brain
- Psychological- depression..
- Sociocultural- peer pressure, cultural norms
95
identify common psychoactive substances
- Caffeine (cns stimulant)
- Nicotine [cns strumlant]
- Cannibas [cns stimulant]
- Alcohol [ cns stimulant]
- Benzodiazepines [cns depressant]
- Psychostimulants [amphetamines, ecstasy/mdma, cocaine]
- Opioids [cns depressant, heroin, morphine, oxycodone, fentanyl, mathandone]
- Hallucinogens [ lysergic acid/ lsd, psilocybin/ magic mushrooms, phencyclidine/pcp]
- Solvents
- Dissociative anaesthetic agents [ketamine, gamma hydroxybutyrate/ ghb]
96
Discuss the role of interdisciplinary care in assisting people with substance use disorders
- Successful treatment requires an interdisciplinary team
- Diagnostic tests
- Pharmacotherapy and emergency care
- Psychosocial interventions:
…opportunistic/ berif interventions
…motivational interviewing, problem solving, goal setting
…cognitive behavioural therapy
…psychodynamic therapy- increase pt understanding,
…self help and support groups
… continuing care
97
Describe health promotion in relation to alcohol and other drugs
national drug strategy 2016-2025
- aim:’to contribute to ensuring safe, healthy and resilient Australian communities through minimising alcohol, tobacco and other drug related health, social and economic harms among individuals, families and communities’’
- harm minimisation approach
Strategic principles ...
Partnership..
Coordination and collaboration…
National direction…
98
what is a stressor
‘’any event or stimulus that causes an individual to experience stress’’
A persons response of stressors are referred to as:
- Coping strategies
- Coping responses
- Coping mechanisms
99
sources of stress
- Internal
- External eg. Peer pressure, work pressure
- Developmental- table 43.1
- Situational- unpredictable, anytime, birth, death marriage, divorce
100
effects of stress
- Physical
- Emotional
- Intellectual
- Social
- Spiritual
101
what is anxiety
“a state of mental uneasiness, apprehension, dread or feeling of helplessness related to an impending or anticipated threat to self or significant relationship’’
- ranges from mild, moderate, severe to panic
- mild anxiety can be constructive
- severe anxiety can be harmful
..reading- table 43.2 shows indicators of levels of anxiety
102
what is anger
‘’an emotional state consisting of subjective feeling of animosity or strong displeasure’’
- verbal expression is signal to others
- hostility involves harmful or destructive behaviour, aggression and violence
- verbal expression may be constructive
-
103
what is depression
‘’an extreme feeling of sadness, despair, dejection, lack of worth or emptiness’’
- Common reaction to events that seem overwhelming or negative
- signs, symptoms, severity vary
…emotional: tiredness, sadness, emptiness, numbness
…behavioural: irritability, concentration difficulty, indecisiveness, loss of libido, crying, sleep disturbance, social withdrawal
…physical: loss of appetite, weight loss, constipation, headache, dizziness
104
what is an ego defence mechanism
‘’uncocisous psychological adaptive mechanisms’’
- originated from Freud (1946)
- mental mechanisms developed to protect us from anxiety
- precursors to unconscious cognitive coping mechanisms
- can release tension
…table 43.3 examples of adaptive (positive )and maladaptive (negative ) defence mechanisms
105
cognitive responses to stress
- thinking responses
…problem solving
…structuring situations to prevent stress
…Self-control or discipline to convey a sense of being in control
…supressing a thought from the mind
…fantasy or daydreaming to change an undesirable reality
- can be helpful if lead to problem solving
- can be unhelpful if used to avoid dealing with reality
106
what is substance use
using of consuming psychoactive substance
107
what is dependence
: the drug is central to a persons life, they have trouble reducing their use and experience symptoms of withdrawal. Can be physical or psychological, or both.
108
physically vs psychologically dependence
.. when a persons body has adapted to a drug and is used t functioning with the drug present a person is said to be physically dependent upon that drug
… when a person feels compelled to use a drug in order to function effectively or to achieve emotional satisfaction, the person is said to be psychologically dependent upon that drug
109
what is tolerance
- tolerance: where a persons body becomes used to a drug being present and more of the drug is needed to cause the same effect felt previously with smaller amounts
110
what is withdrawal
stopping or reducing heavy or lengthy drug use. Usually accompanied by a set of symptoms ranging from mild to severe, which depend on the person and the drug they are withdrawing from
111
what is substance use disorder
a group of cognitive, behavioural and psychological symptoms that indicate continued use of a drug despite significant problems
112
what is a neurotransmitter
- A chemical that is released from a nerve cell
- Transmits an impulse from one nerve to another nerve cell, muscle, organ, or tissue
- A chemical messenger of neurologic information from one cell to another
- Problem is substances can mimic or block the brains important neurotransmitters and their respective neurotransmitters
- Dopamine (movement, posture, mood, positive reinforcement and dependency) , serotonin(reg temp, sleep, mood, temperature, pain) , noradrenaline (involved with attentiveness, sleeping, dreaming, learning) are some important neurotransmitters
113
what is brief interventions
- Quick, informal opportunistic intervention
- people benefit from appropriate information at the right time
- works well for young people
…who are less likely to engage in ongoing counselling
…can be impulsive and erratic in decision making
…aims for harm reduction and safer substance use
- an opportunity to raise awareness, share knowledge and get a young person thinking about changing/ improving their health and behaviours
- informal counselling and information on harms and risks associated with drug use and/or risky behaviours
- the aims are to:
…engage with those young people who are not yet ready for change
…increase the young persons perception of real and potential risks and problems associated with AOD use
… encourage change by helping the young person to consider the reasons for change and the risks of not changing
- utilise skills such as motivational interviewing, problem solving, decision balancing and goal setting
- requires and understanding of the process change
- can be brief lasting as little as 30 seconds
114
what is motivational interviewing
- a purposeful conversation around chanhe
- does not attempt to convince the person of need to change or instruct them how to change
- utilises person centered counselling to encourage the person to move througj stages of change
- client resistance is viewed as evidence of conflict or ambivalence and met with reflection rather than confrontation
- examples of stages:
1. pros and cons for making change or staying the same (decision balancing)
2. looking forward/ future directions
3. worst case scenario/ best case scenario
115
principles of brief intervention and motivational interviewing
- require good communication skills
- listen to what a young person has to say
- notice what they haven’t said or don’t wish to talk about
- observe how they react
- empathise with them and their situation
- consider what you may already know about them
- talk in non-threatening manner
- don’t lecture
- at least young person should go away with some information, advice and point for referral for ongoing support and/ or information
116
three pillars of harm reduction
- demand reduction: strategies and actions that prevent the uptake of drug use, delay the first use of drugs and reduce their harmful use in the community.
- Supply reduction: prevent, stop, disrupt or otherwise reduce the production andsupply of illicit drugs and alcohol
- Harmful reduction: aim to reduce the negative outcomes from alcohol, tobacco and other drug use
117
Describe holism
Combined mental,
emotional, spiritual, relationship and environmental
components, referred to as holism, are considered to play crucial
and equal roles in a person’s state of health.
118
descibe humanism
The humanist perspective includes propositions such as the
following: the mind and body are indivisible, people have the
power to solve their own problems, people are responsible for
the patterns of their lives, and wellbeing is a combination of
personal satisfaction and contributions to the larger community.
119
Describe balances.
he concept of balance consists
of mental, physical, emotional, spiritual and environmental
components
120
descibe spirituality
Spirituality (see Chapter
42) includes the drive to become all that one can be and is bound to intuition, creativity and motivation.
Belief in or relationship with some higher power, creative force,
driving being or infinite source of energy.
121
describe energy
Energy is viewed as the force that integrates
the body, mind and spirit; it is that which connects
everything.
122
describe healing environement
We create healing environments when we use our hands,
heart and mind to provide holistic nursing care. We create
healing environments through the facilitation of others by
providing the knowledge, skills and support that allow them
to tap into their inner wisdom and make healthy decisions
for themselves.
healing environments for ourselves too to avoid burnout
123
Explain holistic health care practices
- Ayurveda
- Traditional Chinese medicine
- Traditional healing beliefs of indigenous Australians
124
explain botanical healing
- Herbal medicine
- Aromatherapy
- Homeopathy
- naturopathy
125
explain nutritional therapy
.
126
explain manual healing
- chiropractic
- osteopathy
- massage
- acupuncture
- acupressure and reflexology
- kinesiology
- alexander technique
- Bowen therapy
- hand mediated biofield therapies
127
explain mind body therapies
- yoga
- meditation
- hypnotherapy
- guided imagery
- biofeedback
- qigong and tai chi
- Pilates
128
what are some other miscellaneous therapies
- Music therapy
- Humour and laughter
- Bioelectromagnetic
- Infrared photoenergy therapy
- Detoxifying therapies
- Animal assisted therapy
- Horticultural therapy
also spiritual therapy which includes faith and prayer
129
discussing complememtary and alternative therapies with patients
- Estimated that more than 2/3 of Australian population use CAM
- Patients do not always disclose use of CAM
Clinician doesn’t ask
Believe that CAM products and therapies are natural and safer
Dissatisfied with conventional medicine
Lack of awareness of the clinician’s attitude to or knowledge of CAM
Discomfort in raising topic
Fear of practitioner’s response
- Without a full understanding of a patients health practices, it is difficult for clinicians to provide safe patient centred care
130
what is traditional medicine
: The sum of total knowledge, skills and practices based on theories, beliefs, and experiences indigenous to different cultures, whether explicable or not, used in the maintenance of health as well as in the prevention, diagnosis, improvement or treatment of physical and mental illness.
131
what is complementary and alternative medicine
used interchangeably with traditional medicine in some countries. they refer to a broad set of healthcare practices that are not part of that countries own tradition and are not integrated into dominant care system
- Known by many different terms, including alternative medicine, holistic therapy and traditional medicine
- A wide range of treatments exist within complementary therapy
- Each treatment has its own unique theory and practice, which makes it difficult to identify a blanket definition
- Share similarities:
…many complementary therapies are as based on anatomy and physiology as contemporary western medicine is
…contemporary western medicine has widened its scope to include a ore holistic approach to healthcare and has adopted therapies that originated in contemporary medicine
- Patients don’t always have to choose between western medicine and their preferred complementary medicine
- These can often work well together alongside each other
- It is important for patients to discuss all drugs, treatments and remedies they take with both their health professionals and complementary therapists
- Herbs and homeopathic remedies can sometimes interact with prescription drugs and cause side effects
132
how are CAMs regulated
- AHPRA partners with the national boards of some CAM practitioners… national registration and accreditation scheme and body for registered health practitioners
- CAM practitioners covered by AHPRA must be registered by law with the national board of their profession to practice under a protected title
- Health practitioners registered with AHPRA are therefore required to meet quality and standards of care
- Most CAM practitioners are not covered by AHPRA and are largely self regulated
Regulation often differs between each state and territory
- Most CAM therapists are affiliated with a professional association
Membership is usually voluntary
Any agreed standards of care do not carry legal obligations
133
what is spirituality
- A board concept with room for many perspectives
- Generally, includes a sense of connection to something bigger than ourselves
- Typically involves search for meaning in life
- A universal human experience—something that touches us all
- People may describe a spiritual experience as sacred or transcendent or simply a deep sense of aliveness and interconnectedness
- Like one’s sense of purpose, one’s personal definition of spirituality may change throughout life, adapting to experiences and relationships
Belief in or relationship with some higher power, creative force,
driving being or infinite source of energy.
134
describe the concepts of spiritual need
Nurses cannot hear, never mind respond to, a person’s spiritual
need unless they hear and respond to their own need (Taylor
2007). Indeed, the notion that effective healers are ‘wounded
healers’ has long existed. A nurse’s spiritual needs, pains or
‘woundedness’ can affect how they care for people. Nurses
who are unaware of, afraid of, or misunderstand their spiritual
needs will be very limited in their ability to accurately identify
and explore a person’s spiritual needs.
135
describe spiritual wellbeing
A feeling of inner peace and of being generally alive,
purposeful and fulfilled; the feeling is rooted in spiritual values and/or specific
religious beliefs.
136
describe spiritual distress,
A disturbance in or a challenge to a person’s belief or value
system that provides strength, hope and meaning to life.
137
describe faith
Faith is to believe in or be committed to something or someone.
138
describe hope
Hope is a concept that incorporates spirituality. Stephenson
(1991) suggested this definition: ‘a process of anticipation that
involves the interaction of thinking, acting, feeling and relating
and is directed toward a future fulfilment that is personally
meaningful’
139
describe transcendence
A person’s recognition that there is something other or
greater than the self and a seeking and valuing of that greater other, whether it
is an ultimate being, force or value
The term transcendence is often used interchangeably with
self-transcendence, which Coward (1990) defined as ‘the
capacity to reach out beyond oneself, to extend oneself beyond
personal concerns and to take on broader life perspectives,
activities and purposes’
140
describe forgiveness
The concept of forgiveness is receiving increased attention
among health care professionals. For many people illness or
disability brings a sense of shame or guilt. The health problem
is interpreted as a punishment for past sins; for example,
141
Explain the importance of spiritual self-awareness for health professionals and common practices affecting health care.
- Health professionals must be aware of own spiritual needs in order to care for the spiritual needs of others
- Don’t need to have shared the same experience
- Do need to recognise how they have shared similar emotions
- Required to be compassionate
- May need to employ strategies to improve spiritual awareness (readings) e.g. To write a self epitar- ask questions such as what is significant about your life/ how you’d like to be remembered, e.g. List significant values e.g. Conducting a spiritual assessment- what is your sense of purpose/ mission in life
142
what is loss
- Actual or potential situation in which something that Is valued is changed or is no longer present
- Death is a fundamental loss for the dying person and others
143
what is greif
total response of the emotion of the experience of loss
144
what is bereavement
-subjective response of the surviving people after a loved one has died
145
what is mourning
- behavioural process through which grief is eventually resolved
146
Describe the stages of grief the factors influencing loss and grief.
5 stages
1. denial
2. anger
3. bargaining
4. depression
5. acceptance
147
Explain the concepts of and responses to dying and death.
- Depend on the same factors regarding loss
- Depend on development of the concept of death
- Responses tend to cluster in the phases described by the theorists regardless of the individual differences
- Both the person dying, and significant others experience loss and grief
Examples: denial, guilt, anger, despair, feeling worthless, crying, inability to concentrate/ make decisions, fear, immobility, increased pulse/ respirations, dry mouth, anorexia, difficulty sleeping, nightmares, hopelessness, apathy, pessimism, powerlessness, violence, depression, passive behaviour
148
how to Use the Kessler Psychological Distress Scale (K10).
- Measure of nonspecific psychological distress in the anxiety depression spectrum
- Quantifies frequency and severity of symptoms experienced four weeks prior to screening
- Used in clinical settings
- Used in research eg. ABS health surveys national health survey and Australian national survey of mental health and wellbeing also state based catty surveys
- 10 questions from 1 which is the least to 5 the most
- Starting point
- Screening to identify ppl in need for further assessment
149
what is religion
- Belief in a god or a group of gods
- An organised system of beliefs, ceremonies and rules used to worship a god or group of gods
- Commitment or devotion to religious faith or observance
- Personal or institutionalised system of religious attitudes, beliefs and practices
150
types of loss
- Actual or perceived (e.g. perceived - Psychological loss- losing independence)
- Situational (situational loss e.g. Losing a job, developing an illness of loss of a loved one)
or developmental (developmental e.g. Process of normal human development- transitioning from childhood to adolescence
151
sources of loss
- Aspect of self (body image, self-image)
- External objects ( car, house, pets)
- Familiar environment ( leaving home, work)
152
factors influencing loss of grief
- Age
- Significance of loss
- Culture
- Spiritual beliefs
- Gender
- Socioeconomic status
- Support systems
- Cause of loss or death
153
understanding of death/dying over the lifespan
- Concept of death is developed over time
- Changes as we age
- - <5 years does not understand concept of death
- 5-9 years understands death is final
- 9-12 years understands that death is inevitable
- 12-18 years may reach adult perception of death, but may be emotionally unable to accept it
- 18-45 years concept of death is influenced by religious and cultural beliefs
- 45-65 years accepts own mortality
- 65 + death has multiple meanings, fears prolonged illness
154
Define mental health
- More than just the absence of mental illness or disorder
- Influenced by determinants of health
- Determined by multiple interacting social, psychological and biological factors
- Linked to behaviours
‘mental health is a state of wellbeing in which an individual realises his or her own potential, can cope with the normal stresses of life, can work productively and fruitfully, and is able to make a contribution to her or his community’
155
Describe mental health in Australia
- ~7.3 million Australians aged 16-85 will experience a high prevalence mental disorder in their lifetime (eg. Depression, anxiety, substance use disorders)
- The age distribution of high mental disorders in 2007 was similar to result in 1997
- ~64 000 people with psychotic illness are in contact with public specialised mental health services each year (private not measured)
- ~560 000 children and adolescents aged 4-17 (almost 14%) experienced mental disorders in 2012-13
156
Discuss mental health services in Australia
where
- specialised hospital services; public and private
- residential mental health care services
- community mental health care services
- private clinical practices
- non govt organisation services
who
- gp
- psychiatrist and other med staff
- psychologist
- nurses; rn and en
- social workers
- allied health professionals
- peer workers
- other personal care staff
157
common mental disorders examples
- Psychotic disorders
- Bipolar disorders
- Depressive disorders
- Anxiety disorders
- Obsessive compulsive disorders
- Trauma/ stressor disorders
- Substance use disorders
- Personality disorders
158
Provide a basic description of Australian Government mental health strategic plans
Australias fifth national mental health plan (DOH, 2016)
Priorities
1. Intergrated regional and service delivery
2. Coordinated treatment and supports for people with severe and complex mental illness
3. Suicide prevention
4. Aboriginal and torres strairt islander mental health and suicide prevention
5. Phbysical health ofpeople living with mentakl health issues
6. Stigma and discrimination reduction
7. Safety and quality in mental health care
```
Western Australias mental health sgtrategic plan (readings
Action areas:
1. Good planning
2. Services working togetherf
3. A good home
4. Getting help earlir
5. Specific populations
6. Justice
7. Preventing suicide
8. A sustainable workforce
9. A high quality system
```
159
Discuss mental health promotion and identify strategies to promote one’s own mental health
- Mental health can be enhanced by effective public health interventions/ health promotion
- Collective action depends on shaed values as much as the quality of scientific evidence
- A climate that respects and protects basiccivil, political, economic, social, and cultural rights is fundamental to promotion of mental health
- Intersectoral linkage is the key for mental health promotion
- Work along side prevention, diagnostic and treatmnet services
- Mental health is everyones buisiness
160
what are depressive disorders
- What differers between dissorders is duration, timing and presumed etiology (cause)
- Disruptive mood dysregulation disorder- chronic severe and persistent irritability and can include temper outbursts, anger that’s inconsistent to developmental stages
- Major depressive disorder - includes discreet episodes of at least 2 weeks and are recurring in most cases. Same symptoms as for major depressive episodes in bipolar disorders.
- Persistemt depressive disorder (Dysthymia) more chronic form of depression- 2 year in childreen, one in adults. Meet at least 2 symptoms eg. Depressed mood, poor appetite or over eating,insominia or hypersomnia
- Substance/ medication- induced depressive disorder
- Other depressive disorder
- Chaaracterised by
Presence of sad, empty or irritable mood, accompanied by somatic and cognitive changes that significamntly affect the individuals capacity to function
161
what are anxiety disoders
- Characterised by excessive fear, anxiety and related behavioural disturbances
Fear: emotional response to real or percieved imminent threat
Anxiety: anticipation of future threat
- Differ from normal fear and anxiety by being excessive, disproportionate, or occuring without identifiable cause
- Differ from developmentally normal fear and anxiety by being exceeive or percisting beyond developmenbtally appropriate ;eriods
- Differ from transient fear and anxiety by being persistent (>6 months), often stress induced
- Eg. Seperation anxiety, social anxiety, agrophobia, generalised anxiety disorders, medication and substance induced anxiety disorders
162
what are obsessive compulsive disoders
- Obsessive compulsive disorder
- Body dysmorphic disorder- persistent and intrusinvepreocupation with an imagined or minor part of bodily appearance
- Hoarding disorder
- Trichotillomania disorder- hair pulling
- Excoriation disorder- skin picking
- Substance/ medication- induced obsessive compulsive and related disorders
- Other obsessive compulsive and related disorders
- Characterised by the presence of obsessions- recurrent or consistent thought and/r compulsions- repetitive behavioir or mental act
- Differ from developmentally normal preoccupations and rituals by being excessive or persisting beyond developmentally appropriate periods
- Result in significant distress and impairment in functioning
163
what are trauma or stressor disorders
- Disorders resulting from exposure to a traumatic event
Reactive attachment disorder- pattern of inhibited imotionally or socizlly withdrawn behavior.
Disinhibited social engagement disorder- pattern of behaviour in which child apprroaches and interactes with unfamiliar adults.
Acute stress disorder- occurs after exposure to actual or threatened death, sexual violation.
Posttraumatic stress disorder- results from exposure to actual or threatenned death, sexual violence.
Adjustment disorders- development of emotional or behavioural symptoms in response to an identifiable stressor that occurs within 3 months of the onset of that stressor.
164
what are personality disorders
- An eduring pattern of inner experience and behaviour that deviates makedly from the expectations of the individuals culture
- Manifest in at least twi of the following ways:
Cognition ( ways of percieveing and interpreting self, others and vents)
Affectivity (range, intensity, lability and spprop[riateness of emotional responses)
Interpersonal functioning
Impulse control
3 clusters
cluster A (may appear odd or essentric.
cluster B. can appear dramatic, emotional and erratic.
cluster C. can appear appear anxious or fearful
165
strategies to promote personal mental health
- value and respect yourself
- get enough sleep
- be physically active
- include good nutrition and hydration
- incorporate relaxation
- engage in creativity or a hobby
- include time in a quiet, safe, space
- talk about concerns and problems
- practice reflection and mindfulness
- value and respect others
- be engaged in the community, volunteer, help others
- make time to engage with positive friends and family
- socialise and develop frienships that are mutually supportive
- practice your religion or spirituality
- hearn healthy ways to deal with stress
- prioritise important relationships
- limit or avoid alcohol and other drugs
- develop conflict management skills
- set realistic goals
- ask for help when you need it
- develop resilience and optimism
resilience
- ability to set realistic but rewarding goals
- ability to acively work towards goals
- forming good relationships with others
- ability to learn and grow from experiences
- ability to recognise and manage emotions in self
- ability to recognise emotions in others and be empathetic towards others
166
what are the aihw dietatry guidelines
1. To achieve and maintain a healthy weight, be physically active and choose amounts of
nutritious food and drinks to meet your energy needs.
• Children and adolescents should eat sufficient nutritious foods to grow and develop
normally. They should be physically active every day and their growth should be
checked regularly.
• Older people should eat nutritious foods and keep physically active to help maintain
muscle strength and a healthy weight
2.Enjoy a wide variety of nutritious foods from these five groups every day:
• Plenty of vegetables, including different types and colours, and legumes/beans
• Fruit
• Grain (cereal) foods, mostly wholegrain and/or high cereal fibre varieties, such as
breads, cereals, rice, pasta, noodles, polenta, couscous, oats, quinoa and barley
• Lean meats and poultry, fish, eggs, tofu, nuts and seeds, and legumes/beans
• Milk, yoghurt, cheese and/or their alternatives, mostly reduced fat (reduced fat
milks are not suitable for children under the age of 2 years)
And drink plenty of water.
3.Limit intake of foods containing saturated fat, added salt, added sugars and alcohol.
a. Limit intake of foods high in saturated fat such as many biscuits, cakes, pastries,
pies, processed meats, commercial burgers, pizza, fried foods, potato chips,
crisps and other savoury snacks.
• Replace high fat foods which contain predominantly saturated fats such as
butter, cream, cooking margarine, coconut and palm oil with foods which
contain predominantly polyunsaturated and monounsaturated fats such as oils,
spreads, nut butters/pastes and avocado.
• Low fat diets are not suitable for children under the age of 2 years.
b. Limit intake of foods and drinks containing added salt.
• Read labels to choose lower sodium options among similar foods.
• Do not add salt to foods in cooking or at the table.
c. Limit intake of foods and drinks containing added sugars such as confectionary,
sugar-sweetened soft drinks and cordials, fruit drinks, vitamin waters, energy and
sports drinks.
d. If you choose to drink alcohol, limit intake. For women who are pregnant, planning
a pregnancy or breastfeeding, not drinking alcohol is the safest option.
4. Encourage, support and promote breastfeeding
5. Care for your food; prepare and store it safely.
167
australias physical activity sedentry behavior guidelines
Physical Activity Guidelines
Doing any physical activity is better than doing none. If you currently do no physical activity, start by doing some, and gradually build up to the recommended amount.
Be active on most, preferably all, days every week.
Accumulate 150 to 300 minutes (2 ½ to 5 hours) of moderate intensity physical activity or 75 to 150 minutes (1 ¼ to 2 ½ hours) of vigorous intensity physical activity, or an equivalent combination of both moderate and vigorous activities, each week.
Do muscle strengthening activities on at least 2 days each week.
Sedentary Behaviour Guidelines
Minimise the amount of time spent in prolonged sitting.
Break up long periods of sitting as often as possible.
168
what are the elements involved in the determinants of health model
```
-social and economic environment:
Social status
Politics, Power
Education
Culture , Religion
Social support
Social stability
```
Income
Employment
Poverty
Prosperity
```
- individual characteristics and behaviours:
Health promoting behaviour
Health risk behaviour
Stress
Coping skills
Mental health
Mental disorders
Intrinsic factors
Genetics
Physical health
Development
Functional status
Nutritional status
Immunity
Gender
```
- physical environment:
Built environment
Natural environment
Sustainability
Health System (Acceptability, Accessibility
,Affordability,Use, Appropriateness, Competence, Continuity, Effectiveness, Efficiency, Safety)
169
what is a good bmi
For most adults, an ideal BMI is in the 18.5 to 24.9 range.
170
how to calculate bmi?
dividing your weight in kilograms (kg) by your height in meters (m) twice (use a calculator).
171
how many mg equal 1 ml
100 mg= 1ml
172
what is EAR / Estimated Average Requirement
A daily nutrient level estimated to meet the requirements of half the healthy individuals in a particular life stage and gender group.
173
what is RDI / Recommended Dietary Intake
The average daily dietary intake level that is sufficient to meet the nutrient requirements of nearly all (97–98 per cent) healthy individuals in a particular life stage and gender group.
174
what is AI / Adequate Intake (used when an RDI cannot be determined)
The average daily nutrient intake level based on observed or experimentally-determined approximations or estimates of nutrient intake by a group (or groups) of apparently healthy people that are assumed to be adequate.
175
AI for sodium
The AI of sodium for adults is 460-920mg/day
176
RDI for fibre
The RDI of fibre is 30g for adult men and 25g for adult
177
Retinol, Retinal, Retinoic Acid
vitamin a
178
Thiamine
vitamin b1
179
Riboflavin
vitamin b2
180
Pyridoxine
vitamin b6
181
Cyanocobalamin
vitamin b12
semester 2 nursing
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