use of health promotion diagnoses at every stage of health and illness
DESCRIPTION
Use of Health Promotion Diagnoses at Every Stage of Health and Illness. Margaret Lunney, RN, PhD Professor & Graduate Programs Coordinator College of Staten Island City University of New York. Paper Outline. What, why, when & how of using health promotion diagnoses - PowerPoint PPT PresentationTRANSCRIPT
![Page 1: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/1.jpg)
Use of Health Promotion Diagnoses at Every Stage of Health and Illness
Margaret Lunney, RN, PhDProfessor & Graduate Programs Coordinator
College of Staten IslandCity University of New York
![Page 2: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/2.jpg)
Paper Outline• What, why, when & how of using
health promotion diagnoses• Health promotion: Individuals
– Diagnoses + Outcomes & Interventions• Health promotion: Families
– Diagnoses + Outcomes & Interventions
![Page 3: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/3.jpg)
What? Context for health promotion is community-based (CB) care:• Philosophy, primary health care (WHO)• Characteristics of CB care:
– Collaboration/partnership with community– Comprehensive– Coordinated– Continuous
• Health Promotion• Health Protection (disease prevention)• Health Restoration
![Page 4: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/4.jpg)
What? Assumptions• Health promotion (HP) diagnoses are
relevant at all stages of health & illness
• Clinical judgment: is client (Individual, family, community) ready for HP?
• With insufficient evidence of a problem, HP Dxs may apply
• Ex: Communication, coping, decision making
![Page 5: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/5.jpg)
What? • Process of facilitating optimum health• Positive process, not negative • Every individual, family and community served by nurses deserves health promotion servicesPrimary Source:Pender, N.J., Murdaugh, C.A., & Parsons, M.A.
(2006). Health promotion in nursing practice (5th ed.). Upper Saddle River, NJ: Pearson Prentice Hall.
![Page 6: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/6.jpg)
Health Promotion Model
![Page 7: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/7.jpg)
Why focus on health promotion?• Reinforces strengths• Helps to optimize health status• Provides a foundation for the future• Non-threatening• Non-blaming• Helps people to live healthfully
![Page 8: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/8.jpg)
When should you use health promotion diagnoses?• Cues that person needs help with
health behaviors• Person agrees to accept help• Person states there is no clear
problem or risk state• To avoid blaming, e.g., Ineffective
Coping, Chronic Low Self Esteem
![Page 9: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/9.jpg)
Health Promotion DiagnosesReadiness for Enhanced:CommunicationComfortCopingDecision makingFluid BalanceHopeImmunization StatusKnowledgeNutrition
Organized Infant BehaviorPowerReligiositySelf CareSelf ConceptSelf Health ManagementSleepSpiritual Well Being
![Page 10: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/10.jpg)
NOC Outcomes for Health Promotion Diagnoses: e.g., • Communication• Comfort Level• Coping • Hope• Knowledge: Disease Process• Nutrition• Self Esteem• Social Support• Spiritual Well Being
![Page 11: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/11.jpg)
NIC Interventions for Health Promotion Diagnoses• Coping Enhancement• Exercise promotion• Health Care Information Exchange • Health Education• Mutual Goal Setting• Nutrition Management• Patient Contracting• Power Enhancement• Program Development• Sleep Enhancement• Spiritual Support
![Page 12: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/12.jpg)
Using the diagnosis:RfE Self Health Management (SHM)
• High % of people with chronic illnesses• Chronic Illnesses = self management of
therapeutic regimens (nutrition, exercise, medication)
• Integration with daily living = difficult, complex• People with chronic illnesses need nurses to help them with SHM
![Page 13: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/13.jpg)
How? Support SHM
• Work in partnership• Ask if they want
help with integration• If yes, review knowledge: “Knowledge is necessary
but not sufficient”• Use Active Listening, Presence, & Decision
Making Support• Identify factors that support & interfere
![Page 14: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/14.jpg)
Supporting SHM• Consider assessment factors:
– Use the health promotion model– Past habits and behaviors– Likes and dislikes– Support of family, friends, others– Community resources– Perceived barriers– Perceived benefits
• Identify outcomes, e.g.,Treatment Behavior: Illness
![Page 15: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/15.jpg)
SHM: Nursing Interventions
• Behavior Modification• Emotional Support• Family Support• Financial Resource Assistance• Health System Guidance• Decision making Support• Exercise promotion• Self Modification Assistance
![Page 16: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/16.jpg)
Case Study: Readiness for Enhanced SHM• John D., 40 years• Hx of Asthma• Uses Inhaler as needed• Had removed all possible allergens
from home environment• Does not smoke• Respiratory distress while at a party• Went to Emergency Department (ED)
![Page 17: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/17.jpg)
ED Nurse Assessment, Diagnosis & Interventions• Diagnosis-SHM = good• Question: Was John exposed to any
environmental chemicals?• John’s suit was just at dry cleaners,
they may have used a new chemical • NDX: Readiness for Enhanced SHM• Interventions:
– Asthma Management (review)– Emotional Support
![Page 18: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/18.jpg)
Health Promotion: Family
• NANDA-I– Readiness for Enhanced
(RfE) Parenting– RfE Family Processes– RfE Family Coping
![Page 19: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/19.jpg)
Family Outcomes
• NOC Family Outcomes, e.g.:1=Never demonstrated-5=Consistently demonstrated– Family Coping– Family Functioning– Family Health Status– Family Integrity– Family Normalization
![Page 20: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/20.jpg)
Family focused NIC Interventions, e.g.,• Caregiver Support• Family Integrity Promotion• Family Mobilization• Family Process Maintenance• Family Support• Parenting Promotion• Respite Care• Role Enhancement
![Page 21: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/21.jpg)
Case Study: Stella C• 49 y.o. single, Italian-American woman• Type 2 DM with adequate control• Overweight• Head of household; 80 y.o. mother• Works full time, cares for self & mother • Accepts care of mother, but overworked• Attempts to reduce her workload have failed• Mother thinks Stella “can do it all”• Mother discourages son’s involvement• Stella expresses stress & lack of control
![Page 22: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/22.jpg)
Family Nursing Diagnoses• RfE Family Coping• Checking for accuracy:
– Are there a sufficient number of confirming cues?
– Are there any disconfirming cues?– Did the family validate the diagnosis?– Should other providers be consulted?
![Page 23: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/23.jpg)
NOC Outcome• Family Coping:
Family actions to manage stressors• Moderately compromised (3); Goal = 4 • Indicators:
– Demonstrates role flexibility (3)– Family enables member role flexibility (3)– Expresses feelings & emotions freely (2)– Arranges for respite care (2)– Seeks assistance when appropriate (3)– Uses social support (3)
![Page 24: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/24.jpg)
Nursing Interventions• Assertiveness Training• Self Esteem Enhancement• Emotional Support• Caregiver Support• Role Enhancement• Family Involvement Promotion• Respite Care
![Page 25: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/25.jpg)
Evaluation of Outcomes• Family Coping = 4
After 4 wks, • Family goals are planned • Family enabled member role flexibility• Family arranged for respite care• Family exhibited improved coping
![Page 26: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/26.jpg)
NursingDiagnoses
• Language tools to communicate & collaborate
• Partners in Care: Individuals, families• Health promotion diagnoses are very
useful
![Page 27: Use of Health Promotion Diagnoses at Every Stage of Health and Illness](https://reader035.vdocument.in/reader035/viewer/2022062521/56816836550346895dddf06a/html5/thumbnails/27.jpg)
Thank You! Comments?