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
behavior specific cognitions and affect
■ Situational influences
– Perception of available options
– demand characteristics
– Aesthetic features of environment
■ Interpersonal influences
– Expectation of significant others
– Individuals likely to undertake behavior that is socially reinforced
commitment to a plan of action
■ Propels the individual into action unless a competing demand or preference interferes
■ Intention to implement and a strategy for carrying it out
immediate competing demands and preferences
- alternative behaviors that intrude into consciousness
- competing demands
- individual has little control
- competing preferences
- individual has high degree of control
behavioral outcome
■ Health promoting behavior
■ Positive health outcomes
– improved health
– enhanced functional ability
– better quality of life
cycle of change: maintenance
■ Behavior must be sustained to promote wellness
■ Assist patient in creating an environment that lends to habit forming (specific times/days, specific locations for eating, etc)
■ Continue to check in with client long after goal is met. (ex: ask about smoking every visit)
- nurse can help patient stay there
ecological model
■ Belief that all processes occurring within individual people and their environment should be viewed as
interdependent
* Emphasize the unique developmental nature of variables that influence behaviors
* Use a multilayered understanding of influence on behaviors
* Test variables from each of the identified systems in the model to guide the assessment, development,
implementation, and evaluation of targeted interventions
* Ontogenic system—personal factors
* Microsystem—relationship between women and the environment
* Exosystem—formal and informal social structures
* Macroculture—values and beliefs of culture
american association of occupational health nurses
- Professional association of nurses working in a business setting,
dedicated to the health and safety of workers, worker populations, and
community groups
national institute of occupational safety and health (NIOSH)
- The federal agency established to help ensure safe and healthy working
conditions by conducting scientific research, gathering information, and
providing education and training in occupational safety and health
occupational safety and health administration (OSHA)
- The federal agency that sets exposure standards and is responsible for enforcement of safety and health legislation
primary responsibility of OHN
- Injury prevention and health promotion, including recognition of conditions that may harm the individual worker or the community
■ The occupational health nursing process begins with an assessment of both the worker and the workplace.
■ Conduct Workplace Walk Throughs
■ Hazards- Biological - Hazards resulting from living organisms that cause adverse effects on people
- Chemical - Generated from liquids, solids, dusts, fumes, vapors, and gases
- Physical - Hazards that result from the transfer of physical energy to workers
- Psychosocial - All organizational factors and interpersonal relationships in the workplace that may affect the health of the workers
school health nurse
■ Specialized practice of professional nursing that advances the well-being, academic success, and lifelong achievement of students
■ Roles of the School Health Nurse
* Health assessment
* Individual
* Population based
* Health promotion
* School health needs
* Health educator
* Emergency preparedness
focus of palliative care
■ Helps people with serious illnesses feel better. It prevents or treats symptoms and side effects of
disease and treatment including emotional, social, practical, and spiritual problems associated with
disease
■ Can begin at diagnosis and at the same time as treatment
■ Coordinating care
■ Reducing unnecessary tests and futile interventions
■ Ongoing conversations with the client and family
focus of hospice care
■ Begins after treatment of the disease is stopped or when it is clear that the person is not going to
survive the illness
■ Support and care for persons in the last phase of an incurable disease so that they may live as fully and
comfortably as possible
hospice care
- Physician services
- Nursing care
- Physical therapy, occupational therapy, and speech-language pathology services
- Medical social services
- Hospice aide services
- Homemaker services
- Medical supplies, including drugs and biological and medical appliances
- Counseling, including dietary counseling, counseling about care of the terminally ill client, and bereavement counseling
- Short-term inpatient care for respite care, pain control, and symptom management
parish/faith nursing
- A specialty practice of nursing having registered nurses contribute to the health and wholeness of people in the context of a faith community
- The parish nurse is part of the ministry staff of the congregation and
serves the illness needs of individual people, families, and the entire faith community
roles of faith-based nurse
- Integrator of faith and health
- Personal health counselor
- Health educator
- Health advocate
- Referral agent
- Coordinator of volunteers
- Accessing and developing support
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