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