BNR150 Flashcards
what is health
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)
what is wellness
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
what is illness
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
what is diesease
Disease: alteration in body functions resulting in a reduction of capacities or a shortening of the normal lifespan
what is wellbeing
Wellbeing: A subjective perception of balance, harmony and vitality, described objectively, experienced and measured and plotted on a continuum
- what are some of the models of health and wellness
- clinical model
- role peformance model
- adaptive model eudemonistic model
- agent host environmental model
- health illness continua
- 4+ models of wellness
Explain the health belief model
- 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
the factors influencing health beliefs and practices
- 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
how does culture affect health, wellness and illness
influence people’s ways of knowing about:
- Health and illness
- Beliefs about the determinants of health
- Expectations of health services and practitioners
describe clinical model of health and wellness?
Clinical model: ppl viewed as physiological systems with related functions and health is identified by absence of signs and symptoms of disease or injury
describe role peformance model of health and wellness
Role performance model: ability to fulfil societal roles; that is to perform their work or role in society e.g. Mother, daughter, friend, work
describe adaptive model of health and wellness
Adaptive model: aim of treatment is to restore ability of a person to adapt; that is, to cope
describe the Eudemonistic model of health and wellnes
Eudemonistic model: health is seen as condition of actualisation or realisation of a persons potential. Actualisation is apex of the fully developed personality
describe the ecological/ agent-host-environment model of health and wellness
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
describe the health illness continua of health and wellness
Health illness continua- used to measure perceived level of wellness applying to ecological model
7 components of wellness?
( 7 components of wellness are: physical, social, emotional, intellectual, spiritual, occupational, environmental)
explain the and socioEcological perspective of health
“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
health belief model constructs
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
barriers and facilitators of health, wellness, well being, disease and illness examples
- 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
explain the 4+ models of wellness
), 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.
agent vs host vs environment
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
what are the levels of the multilevel ecological model perspective
public policy community organisational interpersonal individual
how do traditional models of health often work
- 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
what determines cultural safety in nursing
- 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
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
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. ‘
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
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
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
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
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
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
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.
…
Be able to consider lifespan and cultural factors when learning to understand health behaviour
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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
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
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
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
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
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
health promoting behaviours examples
E.g. Eating fruits and vegetables, fibre, whole grains, physical activity, sun protection, safe sex, socialisation
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
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
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
- self actualisation (desire to become the most that one can be)
- esteem (respect, self esteem, status, recognition)
- love and belonging ( friends, intimacy, family)
- safety needs (personal security, employment)
- physiological needs ( air, water, food, shelter, sleep)
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
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
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
Consider lifespan and cultural factors when learning about health promotion and behaviour change.
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5 KEY AREAS OF HEALTH PROMOTION ACCORDING TO OTTOWA CHARTER
5 key areas of action for health promotion
- Building healthy public policy
- Creating supportive environments
- Strengthening community action
- Developing personal skills
- Reorienting health services
basic steps in health promotion
..
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
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)
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
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
- Supportive environment e.g. Work, school
also. .NHMRC/ AIHW recommendations and WA health strategic framework - Strengthen community action
- Capacity building - Developing personal skills
- Health education, social marketing - Reorientating health services
- Prevention, primary healthcare
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
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
Identify and apply Australian Government evidence based health recommendation and guidelines to promote health and prevent disease.
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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
Be able to consider lifespan and cultural factors when learning about promoting health and preventing illness across the lifespan
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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
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
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
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
5 key elements of primary health care
- Reducing exclusion of social disparities in health
- Organising health services around peopled needs and expectations
- Integrating health into all sectors (public policy reforms)
- Pursuing collaborative models of policy dialogue
- Increasing stakeholder participation
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
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
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
how wHO thinks PHC can lead to better health (5 elements)
- Reducing exclusion of social disparities in health
- Organising health services around peopled needs and expectations
- Integrating health into all sectors (public policy reforms)
- Pursuing collaborative models of policy dialogue
- Increasing stakeholder participation
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
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
Describe the components of self-concept
dimensions... Self knowledge Self expectation Social self Social evaluation
components. ..
- Personal identity
- Body image
- Role performance
- Self esteem
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
