Concept of Heath Flashcards
Nursing Metaparadigm
Terms- Health
A balanced state of physical, mental, emotional, social, and spiritual well-being, influenced by personal and external factors.
Terms- Disease
A objective, measurable dysfunction in the body’s structure or function; can be acute, chronic, or communicable.
Terms- Illness
A person’s subjective experience of feeling unwell, with or without a diagnosable disease.
Chronic Illness
Duration: Lasts for extended periods (6 months to lifetime).
Onset: Slow with remission (symptoms disappear) and exacerbation (symptoms reappear).
Care Focus: Promote independence and control for the patient.
Management: Requires multiple resources for effective self-management.
Acute Illness
Duration: Short with severe symptoms.
Onset: Symptoms appear + subside quickly.
Interventions: May / may not need
medical/nursing care
Recovery: Most people return to regular activities afterward.
Terms- Wellness
An active approach to improving health through lifestyle choices + personal responsibility. (subjective experience)
Terms- Well-being
Overall state of happiness, satisfaction, and positive functioning, broader concept combining health and wellness.
Health Conceptualizations
Stability: Maintaining homeostasis, adapting to changes.
Actualization: Fulfillment of human potential; health and wellness viewed interchangeably.
Actualization & Stability:
Combines self-care, relationships, adapting to life demands, and harmony with environment.
Resource: Capacity for roles, meeting daily demands (WHO, Ottawa Charter, 1986).
Unity: Whole-person approach; self-transcendence and actualization.
Historical Approaches- Medical
- Focuses on restoring health through medical intervention.
- Dominated 20th-century Western thinking.
- Targets physiological risk factors (e.g., hypertension, obesity).
- Prioritizes disease treatment over prevention and promotion.
- Relies on a strong healthcare system for population health.
Historical Approaches- Behavioral
- Origin: Emerged in 1970s due to limited health improvement despite higher healthcare spending.
- Lalonde Report (1974)
- Focus: Shifted responsibility to individuals to address behavioral risks (e.g., smoking, poor diet).
- Strategies: Promoted health through education and social marketing.
- Criticism:
+ Favored privileged groups capable of lifestyle changes.
+ Accused of “victim blaming” for ignoring structural issues.
Historical Approaches- Socio-environmental
- Focuses on political, social, and cultural factors influencing health.
- Links personal behaviors to social and physical environments.
- Addresses socio-environmental barriers like poverty and pollution.
- Advocates for:
+ Downstream: Supporting individuals.
+ Upstream: Driving systemic change with policymakers.
Canada Health Documents - Ottawa Charter for Health Promotion (1986)
- Focuses on supportive environments, community action, personal skill development, and reorienting health services.
- Shifts from a medical to a socio-environmental approach.
Canada Health Documents- Population Health Promotion (Public Health Agency of Canada, 2013)
- Recognizes broader determinants of health.
- Emphasizes addressing social, economic, and environmental factors.
- Promotes cross-sector collaboration and evidence-based policies to improve health outcomes.
Canada Health Documents- Toronto Charter for a Healthy Canada (2002)
- Addresses social and economic inequalities.
- Focus on social health determinants, policy development, and equity
Canada Health Documents- Truth and Reconciliation Commission of Canada: Call to Action
Purpose:
- Reveal legacy of Residential Schools.
Promote reconciliation and inclusivity.
Calls to Action #18–24 (Health):
- Close health outcome gaps between Aboriginal and non-Aboriginal communities.
- Recognize distinct health needs (Métis, Inuit, off-reserve populations).
- Fund healing centers + collaborate on Aboriginal healing practices.
- Increase Aboriginal healthcare professionals, cultural competency training.
- Include Aboriginal health issues in medical, nursing curricula.
Indigenous Health - Illness
Imbalance in emotional, physical, spiritual, and mental health.
Traditional practices include ceremonies, herbal medicine, and storytelling.
Prescribers: Traditional healers, medicine persons, elders.
Elder Status: Bestowed by community, experts in specific areas.
Values: Kindness, non-interference, non-competitiveness, accepting responsibility.
Indigenous Health - Healing
Medicine Wheel: Focus on balance/harmony of four components (Physical, Mental, Emotional, Spiritual).
Sacred connection to person, nature, and seasons.
Storytelling: Passing down values and teachings
Indigenous vs. Eurocentric Health Beliefs
Indigenous:
- Holistic approach: Balance = healing.
- Well-being tied to land, food, water.
- Relationships built on respect and trust.
Eurocentric:
- Health beyond absence of disease.
- Social/environmental determinants matter.
- Regulated professional healthcare.
How to Integrate Eurocentric and Indigenous Health Perspectives
Value Traditional Practices: Include Elders, healers, and Indigenous knowledge in care.
Holistic Care: Address physical, emotional, social, and spiritual needs; involve family and community.
Cultural Safety: Train providers on Indigenous history and ensure respectful, responsive care.
Collaborative Approach: Partner with Indigenous communities to design and deliver healthcare.
Key determinants of health
Factors influence health status of individuals or populations both negative and positive
Include:
- Personal
- Social, economic
- Environmental
Social Determinants of Health
- a specific subset of the broader determinants of health
- Root causes of health inequities.-> Lead to poorer outcomes for specific groups.
- Income and Social Status (Income and its distribution)
- Social Support Network
- Education and Literacy
- Employment and Working Conditions (Unemployment and Employment Securities)
- Physical Environments (Geography, Housing,
Food Security) - Biology and Genetic Endowment
- Individual Health Practices and Coping Skills
- Healthy Child Development
- Health Services
- Gender
- Culture (Immigrant Status, Race, Indigenous Ancestry)
- Social Environments (Social Safety Net, Social Exclusion, Disability)
Upstream Thinkers vs Downstream Thinkers
Upstream Thinkers:
- Focus on root causes and contributing factors.
- Advocate for long-term solutions.
- Address all factors influencing health (biological, psychological, socioeconomic, etc.).
Downstream Thinkers:
- Focus on the immediate problem.
- Provide care to address current health issues without tackling underlying causes.
=> Key Point: Balancing both approaches ensures comprehensive care.
Health Promotion - Prerequisites for Health
Peace
shelter
education
food
income
ecosystem
resources,
social justice
equity.
Health Promotion
Focus on broad social changes to improve health.
Empowers individuals and communities for better health.
Aims to reduce overall risk of disease through long-term, multisectoral strategies.
Involves policy and political action.
5 Health Promotion Strategies (Ottawa Charter)
- Build healthy Public Policy
- Create supportive environments
- Strengthen community action
- Develop personal skills
- Reorient health services
Disease Prevention
Targets specific efforts -> avoid or delay disease onset.
Aligned with natural history of disease (before, during, and after onset)
Addresses immediate + long-term needs based on individual circumstances.
3 level of Disease Prevention
- Primary: Prevents disease before it starts (e.g., vaccines).
- Secondary: Early detection and treatment (e.g., screenings).
- Tertiary: Restore health and rehabilitate (e.g., therapy).
Canadian Healthcare Settings
- Institutional Sector: Provides care for inpatients (hospital stays) and outpatients (non-stay services).
+ Ex: Hospitals, long-term care, psychiatric facilities, rehabilitation centers. - Community Sector: Focuses on health promotion, disease prevention, and community-based care.
+ ex: primary care clinics, community health agencies, public health programs, and home care services. - Private-Sector: Supplement Services typically paid out-of-pocket or by insurance.
+ ex: private clinics, pharmacies, and other for-profit
5 Levels of Care
- Health Promotion:
- Focus: Enabling people to control and improve their health determinants.
- Methods: Policies, education, collaboration, supportive environments. - Disease and Injury Prevention:
- Focus: Prevent illness/injury and reduce risks.
- Strategies:
+ Clinical: Immunizations.
+Behavioral: Support groups.
+ Environmental: Climate activism. - Diagnosis and Treatment:
- Focus: Identify and treat health issues.
- Activities: Diagnosis (e.g., X-rays), treatment (e.g., medications).
- Settings: Hospitals, clinics.
4.Rehabilitation:
- Focus: Restore function and improve quality of life post-illness/injury.
- Services: Physiotherapy, mental health rehab.
Ex: Stroke rehab, post-surgery recovery.
- Supportive Care:
- Focus: Long-term care for disabilities, dependency, or terminal illness.
Ex: Palliative care, respite care.
Canada Health Act (1984)
- Purpose: Ensure universal health care for all Canadians.
- Key Provisions:
+ Prohibits extra billing and user fees.
+ Provinces/territories manage health plans under the Act.
+ Federal government shares costs.
5 principles of Canada Health Act (1984)
- Public Administration:
Health plans managed by public, non-profit entities. - Comprehensiveness:
Covers all medically necessary services. - Universality:
Equal access for all residents. - Portability:
Coverage maintained across provinces/territories. - Accessibility:
No financial or other barriers to care.
Four Pillars of Primary Health Care
- Access: Timely, equitable care by removing barriers (e.g., mobile clinics, telemedicine).
- Coordination: Seamless care through communication and collaboration across providers.
3.Continuity: Long-term patient-provider relationships for consistent, personalized care.
- Teams: Interdisciplinary collaboration for comprehensive, patient-centered care.
Concerns and barriers to Primary Health Care
- Access:
Geographical, financial, cultural, and language barriers limit care, especially in rural and marginalized communities. - Coordination:
Poor communication, fragmented systems, and lack of electronic records disrupt care continuity. - Workforce:
Provider shortages, burnout, and high workloads reduce care quality. - Funding:
Unequal funding and misaligned resource allocation hinder services. - Traditional Practices:
Limited integration of cultural healing practices reduces responsiveness. - Social Determinants:
Siloed & weak systems fail to address social, economic, and environmental health factors
