Community Health Problems and Disability

Care of Selected Community Health Problems

• Disability is defined by the World Health Organization as a loss in the ability to perform an activity.
• Disability is a physical or mental impairment that significantly limits one or more major life activities of an individual.

Chronic Physical Health Problems

• Chronic physical health problems are present for extended periods and are characterized by irreversible pathological changes.
• Lifestyle adjustments are often needed, along with a prolonged period of supervision and care by health professionals.
• Chronic health problems can have personal effects like impairment (loss of psychological, physiological, or anatomical structure or function), disability (limitations in functional ability), handicap (disadvantages impeding role fulfillment), burden (financial).
• Chronic health problems also have population effects like societal costs, morbidity, and mortality.

Classification of Disability

• Disability can be classified based on limitations in major life activities (play, school, work, self-care) or non-major life activities (climbing stairs, driving).

Role of Community Health Nursing in Disability

• Community health nursing efforts must address disability prevention and the adequate treatment of chronic conditions.
• Conditions like spinal cord injury and traumatic brain injury require intensive long-term health care resources.
• Nursing interventions should include programs to identify and address children with congenital or traumatic illnesses/injuries to prevent further disability, promote development, learning, and integration into the community.
• Nurses should assist individuals with disabilities in community settings, collaborate with them to set realistic goals to promote and maintain independent functioning.

Primary Prevention of Physical Health Problems

• Health promotion/illness prevention: This includes education for prevention and promotion, political action, and immunization.
• Risk factor modification: This includes smoking cessation, weight control, hypertension control, safety precautions, and eliminating environmental pollutants.

Secondary Prevention of Physical Health Problems

• Screening, early diagnosis, and prompt treatment are important secondary prevention measures.

Tertiary Prevention of Physical Health Problems

• Prevention of loss of function in affected and unaffected systems.
• Restoring function, monitoring health status, promoting adjustment, and providing end-of-life care are key.

Mental Health

• Mental health is the ability to successfully perform mental functions, engage in productive activities, and maintain meaningful relationships while adapting to change and coping with adversity.
• Mental illness includes a wide variety of diagnosable mental disorders. Symptoms may include changes in thinking, mood, or behavior, associated with stress or impaired function.
• Mental health problems refer to a less severe state of signs and symptoms of mental distress that don't reach the threshold of a diagnosable mental disorder.

Effects of Mental Health Problems

• Personal effects include suffering, interference with cognitive function, occupational functioning, family role function, social function, and physical function.
• Family effects involve emotional effects, financial effects, caregiver burden, increased family stress, and unemployment/poverty.
• Societal effects include global disease burden and disability, decreased productivity, and societal costs for care.

Prevention of Mental Health Problems

• Promoting protective factors, coping, and resilience, along with risk factor reduction are helpful steps to prevent mental health problems.

Treatment of Mental Health Problems

• Treatment modalities include pharmacotherapy, individual or group psychotherapy, family intervention, and support groups.

Substance Abuse

• Drug use: Taking a drug in correct amounts, frequency, and strength, for its medically intended purpose.
• Drug abuse: Deliberate use for purposes other than medical. It may affect health or functioning negatively.
• Psychoactive substances alter ordinary states of consciousness, including mood, cognition, and behavior.
• Psychoactive substance dependence syndrome: A cluster of cognitive, behavioral, and physiological symptoms indicating impaired control, use despite negative consequences.

Psychoactive Substance Dependence Characteristics

• Characteristic 1: Increasing use, persistent desire, more unsuccessful attempts to control use, increased time obtaining/using/recovering. Frequent intoxication or withdrawal symptoms interfering with obligations, elimination/reduction of activities as a result of use.
• Characteristic 2: Continued use despite recurrent problems, increased tolerance to the substance, experience of characteristic withdrawal symptoms, or increased substance use to decrease withdrawal symptoms.

Abused Substances

• Alcohol, sedatives, hypnotics, anxiolytics, opioids, cocaine, amphetamines, hallucinogens, cannabis, inhalants, steroids, and nicotine.

Effects of Substance Abuse

• Personal effects of substance abuse
• Family effects of substance abuse
• Societal impacts of substance abuse: mortality, cost, and crime.

Assessment of Substance Abuse

• Assessment considerations include assessing risk factors, signs of abuse, intoxication, withdrawal, and long-term effects.
• Biophysical considerations include age, family history of substance abuse, physiologic status, physical effects of abuse, and pregnancy.
• Psychological considerations include self-image, life goals, impulse control/frustration tolerance, stress, coping ability, and psychopathology.
• Sociocultural considerations include social mores, legislation, peer support, family interactions/violence, religion/culture, socioeconomic status, occupational factors, and substance accessibility.
• Behavioral considerations include substance abused/multi-substance abuse, recreational/leisure use and abuse, and other high-risk behaviors.
• Health system considerations include provider attitudes, extent of client education for prevention, recognition of abuse, prescription of psychoactive drugs, and availability and access to treatment facilities.

Primary Prevention Goals for Substance Abuse

• Prevent initiation of substance use.
• Prevent progression from occasional to chronic substance use.
• Prevent expansion to use/abuse of other substances.

Approaches to Primary Prevention

• Client/public education, risk factor modification.

Secondary Prevention

• Screening, intervention, and treatment.

Intervention

• The act of confronting the substance abuser with the intention of referring the individual for assistance in dealing with the abuse.

Principles of Substance Abuse Treatment

• A combination of modalities is more effective than a single modality.
• Treatment is tailored to client needs, responses, and resources.
• Both professionals and laypersons should provide treatment.
• Client, family members, significant others should be involved.

Principles of Substance Abuse Treatment -2

• Detoxification.
• Associated psychopathology requires psychiatric treatment - guilt should be addressed to prevent relapse.
• Social and vocational rehabilitation may be required.
• Treatment may also be required for the consequences of substance abuse.

Tertiary Prevention

• Support, encouragement, lifestyle changes, and stressor modification.

This quiz explores key concepts related to community health problems, particularly focusing on disability and chronic physical health issues. It addresses definitions, impacts, and classifications that span both personal and population effects. Test your understanding of these important health topics.