1
Q
Healthy People
A
- Provides evidence based, 10-year national objectives for promoting health and preventing disease
2
Q
Health
A
- WHO defines as “state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity”
3
Q
Health beliefs
A
a person’s ideas, convictions, and attitudes about health and illness
- can be based on reality or false expectations, facts or misinformation, common sense or myths, or good or bad experiences
4
Q
Positive health behaviors
A
- immunizations
- scheduled screenings (colonoscopy, mammogram)
- proper sleep patterns
- adequate exercise
- stress management
- nutrition
5
Q
Negative health behaviors
A
- smoking
- drug or alcohol abuse
- risky sexual behaviors
- poor diet
- refusing to take necessary medications
6
Q
Disease
A
medical condition that causes distress for a person in the form of its symptoms
- generic term
7
Q
Illness
A
a state in which a person’s physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired
8
Q
Acute illness
A
short duration and severe
9
Q
Chronic illness
A
persists longer than 6 months
10
Q
Illness behavior
A
the manner in which people who are ill from a disease act
11
Q
Internal variables that influence illness and illness behavior
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perception of illness and nature of illness
12
Q
External variables that influence illness and illness behavior
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visibility of symptoms, social group, cultural background, economics, and accessibility to health care
13
Q
Health Belief Model
A
addresses the relationship between a person’s beliefs and behaviors
14
Q
First component of Health Belief Model - Individual Perception
A
perceived susceptibility and perceived seriousness of disease
15
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Second component of Health Belief Model - Likelihood of Action
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perceived benefits of preventive action minus perceived barriers to preventive action
16
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Third component of Health Belief Model - Likelihood that a person will take preventive action
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perception, factors, and likelihood leads to likelihood of taking recommended preventive health action
17
Q
Cues to Action - Health Belief Model
A
- mass media campaigns
- advice from others
- illness of family member or friend
- newspaper or magazine article
18
Q
Health Promotion Model
A
- defines health as a positive, dynamic state, not merely the absence of disease
- describes the multidimensional nature of people as they interact within their environment to pursue health
19
Q
Step One of Health Promotion Model
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individual characteristics and experiences including prior related behavior and personal factors (biological, psychological, and sociocultural) lead to behavior specific cognitions and affect
20
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Step Two of the Health Promotion Model
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prior related behavior include activity-related affect, perceived self-efficacy, perceived benefits of action, and perceived barriers to action while personal factors include interpersonal influences and situational influences and options, demand characteristics, esthetics
21
Q
Step Three of the Health Promotion Model
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the factors along with immediate competing demands and preferences lead to commitment to a plan of action, which further leads to a health-promoting behavioral outcome
22
Q
Maslow’s hierarchy of needs
A
- used to understand the interrelationships of basic human needs
- certain human needs are more basic than others and must be met before other needs
23
Q
Holistic health model
A
- looks at the relationships among body, mind, spirit, and how these affect health
- attempts to create conditions that promote optimal health
24
Q
Internal variables that influence health
A
- developmental stage
- educational background
- perception of functioning
- emotional factors
- spiritual factors
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External variables that influence health
- family role and practices
- social determinants of health
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Developmental Stage
- a person's developmental stage sometimes differs from the chronological age
- adapt your nursing care based on a patient's developmental stage and the ability to participate in self care
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Intellectual Background
- beliefs about health are shaped in part by educational background, traditions, and past experiences
- cognitive abilities shape the way a person thinks, including the ability to understand factors involved in illness
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Perception of functioning
- collect subjective data about a way a patient perceives physical functioning such as: level of fatigue. shortness of breath or pain
- collect objective data about actual functioning such as: blood pressure, height measurements, and lung sounds
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Emotional factors
- a patient's degree of stress, depression, or fear influences health beliefs and practices
30
Spiritual factors
- some religions restrict the use of certain forms of medical treatment
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Family role and practices
- influence how each family member defines heath and illness and values health practices
- families' perceptions of the seriousness of diseases and their history of preventative care behaviors (or lack) influence how patients think about health
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Social determinants of health
- economic stability, education access and quality, health care access and quality, social and community context, and neighborhood and built environment
- examples: poverty, food insecurity, no primary health care, culture, exposure to violence, and access to green spaces
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Health disparity
a particular type of health difference that is closely linked with social, economic, and/or environmental disadvantage
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Health inequities
health differences that are avoidable, unnecessary, unfair, and unjust
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Health promotion
helps individuals maintain or enhance their present health
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Health education
helps people develop a greater understanding of their health and how to better manage their health risks
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Illness prevention
protect people from actual or potential risks to health
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Primary prevention
- goal is to reduce the incidence of disease
- includes: health education programs, nutritional programs, and physical fitness activities
- examples: promoting hearing protection in occupational settings and providing education to reduce cardiac disease risk factors
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Secondary prevention
- goal is to prevent the spread of disease, illness, or infection once it occurs
- includes: screening techniques and treating early stages of disease to limit disability by averting or delaying the consequences of advanced disease
- examples: identifying people who have a new case of a disease or following people who have been exposed to a disease but do not have it yet
40
Tertiary prevention
- goal is to minimize the effects of long-term disease or disability
- activities are directed at rehabilitation rather than diagnosis and treatment
- example: a patient with a spinal cord injury undergoes rehabilitation to learn how to use a wheelchair and perform activities of daily living independently
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Example: Type 2 Diabetes
- primary: counseling client about nutrition, counseling client about exercise
- secondary: screening for type 2 diabetes
- tertiary: treatment of type 2 diabetes with medication to control diabetes and prevent complications
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Example: Tuberculosis
- primary: vaccination, environmental control/education healthy living environments
- secondary: screening for TB
- tertiary: treating TB with medications, follow up care
43
Risk factors
any attribute, quality, environmental situation, or trait that increases the vulnerability of an individual or group to an illness or accident
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Nonmodifiable risk factors
- risk factors such as: age, gender, genetics, and family history cannot be changed
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Modifiable risk factors
- lifestyle practices and behaviors that can be changed
- smoking, drinking alcohol, unhealthy diet, obesity, physical inactivity, and insufficient rest and sleep
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Environment risk factors
- where we live and the condition of that area determine how we live, what we eat, the disease agents to which we are exposed
- air, water, soil quality
47
Ineffective behavioral change strategies
- fear
- confrontation
- coercion
- paternalism
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Precontemplation
- definition: no intent to make changes within the next 6 months
- assessment: patient is unaware of, not interested in, or underestimates the problem. May be defensive
"There is nothing I really need to change"
- tasks: awareness of need for change, increase concern about current behavior, envision change as possibility
49
Contemplation
- definition: considering a change within the next 6 months
- assessment: may be ambivalent about the change or is thinking about making a change
"I have a problem that I need to work on"
- tasks: analyze pros/cons of current behavior, weigh costs/benefits, struggle with ambivalence
50
Preparation
- definition: making small changes in preparation for a change in the next month
- assessment: may have tried to make changes in the past but was unsuccessful. Patient believes that advantages outweigh disadvantages of behavior change
"I can quit smoking by going to the Health Department classes"
- tasks: increase commitment to change (self liberation), design a plan for change
51
Action
- definition: actively engaged in strategies to change behavior; lasts up to 6 months
- assessment: committed to change. Previous habits may become barriers to change (attends classes)
"I am really working hard to stop smoking"
- tasks: actively engage in strategies for change to occur, sustain commitment in face of difficulties
52
Maintenance
- definition: sustained change over time; begins 6 months after action has started and continues indefinitely
- assessment: changes integrated into the patient's lifestyle and behaviors adopted to prevent relapse
"I need to avoid people who smoke so I won't be tempted to start smoking again"
- tasks: anticipate relapse, prepare coping strategies in advance
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Stage 1 - Oral (birth to 18 months)
- sucking and oral satisfaction are not only vital to life but also extremely pleasurable in their own rights
- begins to realize that mother Is something separate from self
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Stage 2 - Anal (18 months to 3 years)
- pleasure changes to the anal zone
- through the toilet-training process the child delays gratification to meet parental and societal expectation
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Stage 3 - Phallic or Oedipal (3 to 6 years)
- genital organs are the focus of pleasure
- child fantasizes about the parent of the opposite sex as the first love interest
- reduce conflict by identifying with the parent of the same sex to win recognition and acceptance
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Stage 4 - Latency (6 to 12 years)
- children repress and channel sexual urges
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Stage 5 - Genital (puberty through adulthood)
- sexual urges reawaken and are directed to an individual outside the family circle
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Trust vs mistrust (birth to 18 months)
- establishing a basic sense of trust is essential for the development of a healthy personality
- successful resolution of this stage requires a consistent caregiver who is available to meet their needs
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Autonomy vs sense of shame and doubt (18 months to 3 years)
- develops autonomy by making choices
- successful resolution of this stage is achieving self-control and willpower
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Initiative vs guilt (3 to 6 years)
- learn to maintain sense of initiative without imposing on the freedoms of others
- successful resolution results in direction and purpose
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Industry vs inferiority (6 to 12 years)
- eager to apply themselves to learning socially productive skills and tools
- need to be able to experience real achievement to develop a sense of competency
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Identify vs role confusion (puberty)
- identity development begins with the goal of achieving some perspective or direction
- mastery of this stage resulted in devotion and fidelity to others and their own ideals
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Intimacy vs isolation (young adult)
- deepen their capacity to love and care for others
- tasks is making attachment to others
- seek meaningful friendships and and intimate relationships
- isolation occurs when the young adult avoids making commitment to others
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Generativity vs self-absorption and stagnation (middle age)
- adult focuses on supporting future generations
- achieve success in this stage by contributing to future generations through parenthood, teaching, mentoring, and community involvement
- inability to care results in stagnation
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Integrity vs despair (old age)
- interpret their lives as a meaningful whole or experience regret because of goals not achieved
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Young Adults
18 - 35 years old
- younger adults: 18-24 years old
- older young adults: 25-35 years old
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Key milestones in young adults
- economic independence
- committed long-term relationship
- independent decision making
POTENTIALLY DIFFICULT PERIOD
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Young adult biology
- physical and emotional changes
- physical growth completed
- increase in critical thinking habits
- increased decision-making capabilities
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Life-change adjustment (young adult)
- adjusting to career change or career move
- adjusting to relocation
- balancing multiple roles
- developing long-term goals for family security
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Identity (young adult)
- increasing separation from family authority
- beginning adult identity
- work provides self esteem and socialization
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Work and personal responsibilities (young adult)
- beginning balance of personal and work responsibilities
- developing relationships within the workforce
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Young adulthood characteristics
- healthiest time of life
- peak abilities
- abstract, analytical thinking (Piaget)
- principled moral reasoning (Kohlberg)
- less experience with death of significant others
- risk takers
- lack of fear
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Young adulthood challenges
- more life changes needing adaptation leading to stress
- normative stressors: marriage, having children, starting a career
- other stressors: miscarriage, serious illness, divorce
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Achievement-oriented success (young adults)
- internal pressure to succeed defined goals
- workaholic
- can be serious both physically and emotionally leading to nutrition problems and burnout
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Health risks in young adults
- originate in the community, lifestyle patterns, and family history
- unintentional injuries
- substance abuse
- violence
- suicide
- risky sexual behavior
- workplace hazards
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Focus on disease prevention/health promotion (young adults)
- check up every 1 to 2 years
- less likely to have well visits leading to less preventative services
- developing behaviors that promote a healthy lifestyle
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Behavioral health history (young adults)
- important to obtain for young adults
- focuses on health risk behaviors
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STDs (young adults)
- half of all new STDs occur in people 24 years of age or younger
- immediate physical effects and long term health impacts
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Barriers to change in young adults
- lack of motivation
- lack of knowledge
- insufficient skills to change health status
- undefined short and long term goals
- lack of social support
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Middle Adulthood
- 36 to 64 years old
- physiologic decline begins
- early lifestyle choices begin to yield cost or benefit
81
Sandwich Generation (middle adults)
- responsibility for growing children and aging parents
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Middle adult physiologic changes
- start at 45
- hair and skin
- weight
- presbyopia (near vision)
- menopause and climacteric
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Midlife crisis
- recognize
- result is acceptance
- non acceptance results in a true midlife crisis
- make choices that affect others
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Middle adult challenges
- divorce of offspring
- young adults moving back home
- raising grandchildren
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Leading causes of death in middle adults
- malignant neoplasms (cancer)
- unintentional injuries
- heart disease
86
Chronic conditions in middle adults
- heart disease
- arthritis
- back and spine impairments
- chronic obstructive pulmonary disease (COPD)
- diabetes mellitus
- mental health conditions
- dental disease
87
Barriers to change for middle adults
- lack of materials
- lack of social supports
- lack of motivation
- lack of knowledge
- insufficient skills to change habits
- undefined goals (short and long term)
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Older adulthood
- 65 years and older
- fastest growing population
- active and contributing to society
- help them live longer but fulfilled lives with dignity and independence
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Misconceptions about older adulthood
- disease is normal and unavoidable
- health promotion is not important for older adults since their lives are almost over
- damage to health resulting from inactivity or poor nutrition is irreversible
- ageist beliefs about older adults
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