specialty roles and model of promotion Flashcards
different factors affect our definitions
- age (young thinks no disease so i’m healthy. old thinks healthy as long as i can do x, y, and z with my dz)
- our expectations of self
- sociocultural influences (general circles of friends)
- previous experiences with health or disease
definitions of health all seem to include similar themes of:
- experiencing minimal symptoms of disease and pain
- being able to be active, do what they need to do, and enjoy it
- being in good spirits most of the time
health vs well-being
- health: more objective. a quality, an ability to adapt to change, or a resource to help cope with challenges and processes of daily living
- well-being: a subjective perception of full functional ability as a human being
healthy people initiatives
- to increase quality and years of healthy life. goal is to live longer and have less diseases
- to eliminate any barriers to accessing care, specifically thru health disparities
primary prevention
- maximizing health and wellness through strategies that are set in place before illness or injury is present
- things like immunizations, washing hands, avoiding sick people
- for things like how to prevent violence: teach resiliency, communication
secondary prevention
- maximizing health and wellness through strategies that are set in place at the early and active chronic stages of pathogenesis of illness and injury
- things like health screenings
- screen for violence = ask questions
tertiary prevention
- maximizing health and wellness thru strategies that are set in place at the palliation and end-stage of disease and injury trajectories
- meds and rehab
- trying to keep things from getting worse
screening defined
- presumptive identification of an unrecognized disease through tests, examinations or other procedures which can be applied rapidly
- screening tests sort out apparently well persons who probably have a disease from those who probably do not
- we screen people so we can find dz as early as possible
- when to start screening is v/ iffy
screening-diagnosis connection
- screening starts before diagnosis
- history questions
- physical exam findings
- lab tests
- pre-test probability
- results of screening trigger diagnostic work-up and preventive interventions
screening test
- identifies asymptomatic people who may have a disease
diagnostic test
- determines presence or absence of disease when patient shows signs or symptoms
prevention often preceded by risk appraisal
- individuals supply info about health practices, demographic characteristics, and personal and family medical history for comparison with epidemiology
- comparisons are then used to determine someone’s risk for certain disease
- USPTF provides screening/prevention guidelines based on these risks
- risk factor identification helps patients visualize areas in their life that can be modified or controlled, or even eliminated to prevent illness
characteristics of a good screening test
- simple
- rapid
- inexpensive
- safe
- available
- acceptable
screening effectiveness evaluation
- test characteristics (sensitivity & specificity) alone are never sufficient for a sound decision about whether to use a screening test
- other screening considerations
- benefits vs. risks
- prevalence of target condition
- inconvenience
- costs/resource expenditures
- patient values and cultural norms
health belief model
- developed to explain why some people who are free of disease would adopt actions to prevent illness, while others fail to do so
- model developed at time when screenings were becoming readily available, and yet people would refuse to do them
- individuals will take action if two conditions are present
- there is a perceived threat (illness susceptibility) –> they can see themself as a sick person
when will individuals take action?
- there is a perceived threat (illness susceptibility) (they see themself as a sick person)
- beliefs about personal susceptibility and seriousness of illness combine to produce the degree of threat
- the individual is convinced the benefits of taking action to protect health outweigh the barriers that will be encountered
how is the health belief model commonly used to explain behaviors?
– Breast self-examination, mammograms
– Condom use
– Contraceptive behaviors
– Physical activity in children
self-efficacy and social cognitive theory
- personal factors, the environment in which behavior is formed, and the behaviors themselves interact
- basically, self-efficacy, the belief that one has the ability to change one’s health habits greatly impact a person’s ability to adopt a behavior
- the greater the self-efficacy, the more likely a new behavior
- nurses can promote self-efficacy by creating mastery experiences for patients, imparting role models, and using verbal persuasion/reminder
health promotion model
- motivational source for change based on individuals subjective value of the change
- what they bring to the table: what’s wrong with them? what worked/didn’t work and why
- things that happen –> how do you feel now that you do the behavior
individual characteristics experiences
- prior related behaviors
- previous knowledge, experience, skill
- best predictor of behavior is the frequency of the same or similar behavior in the past
- direct and indirect effects
- outcome expectations
- hurdles
- personal factors: biological, psychological, and sociocultural
behavior specific cognitions and affect: perceived benefits of action
– Mental representation of the positive or reinforcing consequences of behavior
– Individuals invest time and resources in activities that have a high likelihood of positive outcomes
– Types of benefits
■ intrinsic: affects sustainability
■ extrinsic: more important initially
behavior specific cognitions and affect: perceived barriers to actions
– Arouse motives of avoidance
– Serve as blocks to action
– Decrease commitment to plan of action
behavior specific cognitions and affect: perceived self-efficacy
– conviction person has that they can successfully carry out actions necessary
– Four sources
■ enactive mastery experiences-doing thing in the past
■ Vicarious experiences- seeing others do it
■ Verbal persuasion-encouragement
■ Physiologic and affective states
– Influenced by activity related affect…
behavior specific cognitions and affect: actively related affect
– subjective feeling that occurs before, during and after activity
– 3 components
■ emotional arousal to the act itself
■ emotional arousal to the self acting
■ emotional arousal to the environment in which the action takes place
– Gut level response to behavior