Chapter 6: Health and Wellness (Intro Wk)

Question 1

What is Healthy People

Answer 1

Healthy people sets 10 year national objectives to help the United States increase its focus on health promotion and disease prevention (instead of illness care) and encourages cooperation among individuals, communities, and other public, private, and nonprofit organizations to improve health from an interprofessional approach.

Question 2

What did Healthy People 2020 focus on

Answer 2

It identified leading health indicators (LHIs) which are high priority health issues

Question 3

What did Healthy People 2030 focus on

Answer 3

It promoted a holistic approach to health promotion and disease prevention. Examples of the health topics and objectives as defined by Healthy People 2030 include physical activity; adolescent health; tobacco use; substance abuse; sexually transmitted diseases; mental health and mental disorders; injury and violence prevention; environmental health, immunization and infectious disease; access to health services; and LGBTQ+ health

Question 4

Define Health

Answer 4

state of complete physical, mental and social well-being not merely the absence of disease or infirmity. It is a state of being that people define in relation to their own values, personality and lifestyle. Culture influences health.
Life conditions also have a positive and negative effect. Life conditions include environment, diet, lifestyle

Question 5

What is the purpose of health models

Answer 5

Models help explain complex concepts or ideas such as health and illness
Models help you understand the relationships between complex concepts or ideas and a patient’s attitude toward health and health behaviors

Question 6

Health Beliefs

Answer 6

Health beliefs are a person’s ideas, convictions, and attitudes about health and illness. They can be based on reality or false expectations, facts or misinformation, common sense or myths, or good or bad experiences.

Question 7

What are the 2 type of health behaviors people usually have

Answer 7

1. Positive Health Behaviors - maintains, attain, or regain health and prevent illness. Common positive health behaviors include immunizations, scheduled screenings (e.g., colonoscopy, mammogram), proper sleep patterns, adequate exercise, stress management, and nutrition.
2. Negative Health behaviors - practices that are harmful to health, such as smoking, drug or alcohol abuse, risky sexual behaviors, poor diet, and refusing to take necessary medications.

Question 8

What is the Health Belief model

Answer 8

The Health Belief Model addresses the relationship between a person’s beliefs and behaviors

Question 9

What are the 3 components of the health belief model

Answer 9

1. individual’s perception of susceptibility to an illness.
2. individual’s perception of the seriousness of the illness.
3. likelihood that a person will take preventive action.

Question 10

What is the Health Promotion model

Answer 10

The Health Promotion Model (HPM) defines health as a positive, dynamic state, not merely the absence of disease. Health promotion increases a patient’s level of well-being. The HPM describes the multidimensional nature of people as they interact within their environment to pursue health.

Question 11

What are the three areas the Health Promotion model focuses on

Answer 11

The model focuses on the following three areas: (1) individual characteristics and experiences; (2) behavior-specific cognitions and affect; and (3) behavioral outcome, in which the patient commits to or changes a behavior.

Question 12

What are the three steps of the health promotion model

Answer 12

1. Individual characteristics and experiences including prior related behavior and personal factors (biological, psychological, and sociocultural) lead to behavior specific cognitions and affect.
2. 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.
3. 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.

Question 13

What is Maslows Hierarchy of needs

Answer 13

Nurses use Maslow’s hierarchy of needs to understand the interrelationships of basic human needs. Although each person has unique needs, all people share basic human needs, and the extent to which people meet their basic needs is a major factor in determining their level of health.

Question 14

How do nurses apply Maslow’s hierarchy of needs while practicing

Answer 14

Maslow’s hierarchy provides a basis for nurses to care for patients of all ages in all health settings. It is important to apply Maslow’s hierarchy to each patient individually. To provide the most effective care, you need to understand the relationships among different needs and the factors that determine the priorities for each patient.

Question 15

What are the five levels of Maslows Hierarchy

Answer 15

From Top to Bottom:

Self-actualization;

Self-esteem;

Love and belonging needs;

Safety and security including physical and psychological safety; and

Physiological: Oxygen, fluids, nutrition, body temperature, elimination, shelter, and sex.

Question 16

What is the holistic health model

Answer 16

The relationships among body, mind, and spirit affect a person’s overall health. The Holistic Health Model of nursing promotes a patient’s optimal level of health by considering the dynamic interactions among the emotional, spiritual, social, cultural, and physical aspects of an individual’s wellness. You put your patients at the center of their care and recognize your patients as the ultimate experts concerning their own health. A patient’s subjective experience is relevant in maintaining health or assisting in healing. The Holistic Health Model empowers patients to engage in their own recovery and assume some responsibility for health maintenance

Question 17

What are some of the most widely used holistic interventions used in the holistic health model

Answer 17

meditation, music therapy, reminiscence, relaxation therapy, therapeutic touch, and guided imagery. These holistic strategies, which can be used in all stages of health and illness, are integral in the expanding role of nursing.

Question 18

What are some internal variables that influence health

Answer 18

Internal variables include a person’s developmental stage, intellectual background, perception of functioning, and emotional and spiritual factors.

Question 19

Describe the developmental stage of the internal variable

Answer 19

A person’s perceptions of health, illness, and health behaviors change over time. Considering a patient’s growth and developmental stage helps you predict a patient’s response to an actual illness or the threat of a future illness. Adapt your nursing care based on a patient’s developmental stage and the ability to participate in self-care.

Question 20

Describe the intellectual background of the internal variables

Answer 20

A person’s beliefs about health are shaped in part by educational background, traditions, and past experiences, all of which influence knowledge or misinformation about health and illness.

Question 21

Perception of functioning

Answer 21

When you assess a patient’s level of health, gather subjective data about the way a patient perceives physical functioning, such as level of fatigue, shortness of breath, or pain. Then obtain objective data about actual functioning such as blood pressure, height measurements, and lung sounds. Analyzing this information allows you to plan and implement individualized approaches to improve a person’s ability to function (e.g., self-care, mobility) more successfully.

Question 22

Emotional factors

Answer 22

A patient’s degree of stress, fear, anxiety, depression, or fear influences health beliefs and practices. How people handle stress influences their reaction to illness.

Question 23

Spiritual factors

Answer 23

Spirituality serves as an integrating theme in people’s lives and often provides motivation to participate in health promoting activities. Religious practices are one way that people exercise spirituality. Some religions restrict the use of certain forms of medical treatment. You need to understand patients’ spiritual beliefs to incorporate them effectively in nursing care.

Question 24

What are external variables

Answer 24

External variables influencing a person’s health beliefs and practices include family practices, psychosocial and socioeconomic factors, and cultural background.

Question 25

Family role and practices

Answer 25

The roles and organization of a family influence how each family member defines health and illness and values health practices. Families’ perceptions of the seriousness of diseases and their history of preventive care behaviors (or lack of them) influence how patients think about health.

Question 26

Social determinants of health

Answer 26

Health is determined by a person’s circumstances and environment. Factors such as where a person lives, the quality of the environment, income, educational level, and relationships with others have a considerable impact on a patient’s health. Social determinants of health (SDOH) include a variety of social, commercial, cultural, economic, environmental, and political factors that affect health disparities. They refer to the conditions in which people are born, grow, live, work, and age. There are five categories of SDOH: economic stability, education access and quality, health care access and quality, social and community context, and neighborhood and built environment.

Question 27

How does culture influence health

Answer 27

Culture influences a patient’s beliefs, values, and customs. It influences the approach to the health care systems, personal health practices, and the nurse-patient relationship. Cultural background also influences an individual’s beliefs about causes of illness and remedies or practices to restore health. If you are not aware of your own cultural patterns of behavior and language, you will have difficulty interacting with your patients and recognizing and understanding your patient’s behaviors and beliefs. Effective nursing interventions incorporate cultural factors into a patient’s, family’s, or community’s plan of care.

Question 28

What is the purpose of health promotion

Answer 28

Helps individuals maintain or enhance their present health

Question 29

What is the purpose of health education

Answer 29

Helps people develop a greater understanding of their health and how to better manage their health risks

Question 30

What is the purpose of illness prevention activities

Answer 30

protects people from actual or potential threats to health

Question 31

What are the 3 levels of prevention

Answer 31

1. Primary prevention
2. Secondary prevention
3. Tertiary prevention

Question 32

Primary Prevention

Answer 32

Primary prevention is true prevention. Its goal is to reduce the incidence of disease. Many primary prevention programs are supported by the government (e.g., federally funded immunization programs). Primary prevention includes health education programs, nutritional programs, and physical fitness activities. It includes all health promotion efforts and wellness education activities that focus on maintaining or improving the general health of individuals, families, and communities.

Question 33

Secondary prevention

Answer 33

Secondary prevention focuses on preventing the spread of disease, illness, or infection once it occurs. Activities are directed at diagnosis and prompt intervention, hopefully reducing severity and enabling the patient to return to a normal level of health as early as possible. Examples include 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. It includes screening techniques and treating early stages of disease to limit disability by averting or delaying the consequences of advanced disease. Screening activities may lead to primary prevention intervention. For example, a nurse screens a patient who is obese for diabetes mellitus. After gathering more information from the patient, the nurse provides health education about physical activity and preventing hypertension.

Question 34

Tertiary prevention

Answer 34

Tertiary prevention occurs when a defect or disability is permanent and irreversible. It involves minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration. Activities are directed at rehabilitation rather than diagnosis and treatment. For example, a patient with a spinal cord injury undergoes rehabilitation to learn how to use a wheelchair and perform activities of daily living independently. Care at this level helps patients achieve as high a level of functioning as possible, despite the limitations caused by illness or impairment.

Question 35

Examples of primary prevention

Answer 35

Health education

Good nutrition based on developmental stage

Provision of adequate housing, recreation, and working conditions

Marriage counseling, sex education, and genetic screening

Providing immunizations

Attention to personal hygiene

Use of environmental sanitation

Protection from occupational hazards

Protection from accidents and carcinogens

Question 36

Examples of secondary prevention

Answer 36

Individual and mass screening surveys

Focused examinations to cure and prevent diseases, prevent spread of communicable diseases, prevent complications, limit disability, and prevent death

Adequate treatment to stop disease process and prevent further complications

Provision of facilities to limit disability and prevent death

Question 37

Examples of tertiary prevention

Answer 37

Providing retraining and education to return to highest level of functioning

Helping people with disabilities find work and accommodating them in the workplace

Question 38

Risk Factor

Answer 38

A risk factor is any attribute, quality, environmental situation, or trait that increases the vulnerability of an individual or group to an illness or accident. Nurses in all areas of practice have opportunities to reduce patients’ risk factors to promote health and decrease risks of illness or injury. It is very important to identify patient’s risk factors to keep them safe and prevent further injury or illness.Impaired gait, reduced vision, and lower extremity weakness are examples of risk factors for falls.

Question 39

What are the 3 types of risk factors

Answer 39

1. Nonmodifiable risk factors
2. Modifiable risk factors
3. Environment

Question 40

Nonmodifiable risk factors

Answer 40

Nonmodifiable risk factors cannot be changed like age, gender, genetics, and family history.

Question 41

Modifiable risk factors

Answer 41

Some risk factors such as lifestyle practices and behaviors can be modified. Modifiable behavioral risk factors include smoking, drinking alcohol, unhealthy diet, physical inactivity, stressors, and insufficient rest and sleep. These risk factors put people at risk for certain chronic illnesses, such as diabetes and heart disease and risk for developing specific diseases. For example, excessive sunbathing increases the risk of skin cancer, and smoking also increases the risk of lung cancer.

Question 42

Environment as a risk factor

Answer 42

Where we live and the condition of that area (its air, water, and soil) determine how we live, what we eat, the disease agents to which we are exposed, our risk factors, our state of health, and our ability to adapt. The physical environment in which a person works or lives can increase the likelihood that certain illnesses will occur. For example, some kinds of cancer and other diseases are more likely to develop when people are exposed to certain chemicals at work or when people live near toxic waste disposal sites.

Question 43

Wellness strategy

Answer 43

Once you identify a patient’s risk factors, you can implement appropriate and relevant health education and counseling to help a person change or implement behaviors to maintain or improve health status. This is called a wellness strategy. It includes risk-factor modification, health promotion, and illness prevention activities.

Question 44

Transtheoretical Model of Change

Answer 44

Series of five stages people go through when they make a change

1. Precontemplation- No intent to make changes within the next 6 months
   Patient is unaware of, not interested in, or underestimates the problem. May be defensive.

“There is nothing I really need to change.”

2. Contemplation- Considering a change within the next 6 months
   May be ambivalent about the change or is thinking about making a change.

“I have a problem that I think I need to work on.”

3. Preparation- Making small changes in preparation for a change in the next month
   May have tried to make changes in the past but was unsuccessful. Patient believes that advantages outweigh disadvantages of behavior change.

“I started running once, but I didn’t keep it up. I think I might try again in a few weeks.”

4. Action- Actively engaged in strategies to change behavior; lasts up to 6 months
   Committed to change. Previous habits may become barriers to change.

“I am really working hard to stop smoking.”

5. Maintenance stage- Sustained change over time; begins 6 months after action has started and continues indefinitely
   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.”

Question 45

What is disease

Answer 45

A medical condition that causes distress for a person in the form of its symptoms is referred to as a disease. It is a generic term that includes all disorders, infections, disabilities, and deformities that can afflict human beings.

Question 46

What is illness

Answer 46

Illness is a state in which a person’s physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired. It is a feeling of poor health.A person can feel ill in the presence or absence of a disease. A person can feel ill even when there is no underlying medical condition.

Question 47

What are the 2 types of illnesses

Answer 47

Both acute and chronic diseases have the potential to affect many dimensions of functioning. An acute disease is usually reversible and has a short duration. The symptoms appear abruptly, are intense, and subside after a relatively short period. A chronic disease on the other hand usually lasts more than 6 months, is irreversible, and affects functioning in one or more systems. Patients often fluctuate between maximal functioning and serious health relapses that may be life threatening.

Question 48

Name the external and internal variables that influence illness and illness behavior

Answer 48

1. Internal variables - patient’s perceptions of symptoms and the nature of a disease. An example are patient’s coping skills. If patients believe that the symptoms of their diseases disrupt their normal routine is serious or life threatening, they are more likely to seek health care assistance than if they do not perceive the symptoms to be disruptive.
2. External variables - External variables influencing a patient’s illness behavior include the visibility of symptoms, social group, cultural background, economic variables, accessibility of the health care system, and social support. The visibility of an individual’s symptoms affects body image and illness behavior. A patient with a visible symptom (e.g., a high fever) is often more likely to seek assistance than a patient with no visible symptoms (e.g., symptoms associated with ovarian cancer such as fatigue and bloating).

Question 49

How does the illness have an impact on the patient and family

Answer 49

• behavioral and emotional changes
• impact on body image
• impact on self-concept - mental self image of all aspects of your personality
• impact on family roles
• impact on family dynamics

Question 50

According to Maslow’s hierarchy of needs, which need would the patient seek to meet first?
A. Self actualization
B. Self Esteem
C. Shelter
D. Love and belonging

Answer 50

Self Actualization