Determinants of Health

Determinants of Health

• Includes financial and social status makes up 40%

Financial and social status

• Food insecurity, homelessness, interpersonal violence, substance use, chronic and communicable diseases, and ill health affects this status
• Poverty causes a lack of health resources
• Poverty also causes high levels of psychosocial stress
• Poverty causes adoption of health threatening behaviors to cope with limited resources and stress
• Includes education, job status, family/social supports, income, and community safety

Social support networks

• Includes isolation, exclusion and a lack of supportive relationships

Social environments

• Includes contaminants leading to disease and isolation
• Includes house and indoor air quality
• Includes urban development, lighting, and transportation services

Physical environments

• Physical environments make up 10% and include housing

Personal health practices and coping skills

• Personal health practices and coping skills are also known as health behaviors, makes up 30%

Health services

• Health services make up up 20% of your exam

Health Promotion

Ottawa Charter for HP 1984 consists of 5 Health Promotion Strategies

• Build health public policy
• Create supportive environments
• Strengthen community action
• Develop personal skills
• Reorient health services

Health Promotion vs. Disease Prevention

• Health promotion informs, influences, and assists individuals and communities to accept responsibility to maintain their mental and physical health
• Health promotion is enabling or empowering people to increase control over and improve their health by maximizing positive changes to their physical, economic, social, and political environments
• The goal with Health promotion is an increase in the level of well-being including self-actualization

Disease prevention has three levels

• Avoids the disease
• Primary prevention is health promotion and protection, precedes disease example is vaccination, family planning, stress management
• Secondary prevention is early detection, start treatment early example is TB skin test, cancer screenings, infant heel prick
• Tertiary prevention is restoration and rehabilitation post illness example is cardiac rehab, pain management, clinics, foot care for diabetes
• The goal is to avoid or delay illness and disease and increase resistance to harm

Behaviour Change Theories

• Transtheoretical Model of Change and Systemic Theory

Transtheoretical Model of Change includes 7 Stages

• Pre-contemplation, consider harm reduction strategies
• Contemplation, what do you need to know and what resources do you need
• Preparation, what kind of support do you need
• Action, assess the person for success
• Maintenance, ensure the person has supports in place
• Termination
• Relapse or recycle

Nursing Role and Nursing Process

Four Categories of Health Care

• Health Promotion and Illness Prevention- public health
• Diagnosis and Treatment- Acute care
• Rehab and Health Restoration
• Hospice-palliative, or end of life care

Definition of acute illness

• Characterized by severe symptoms of relatively short duration
• Symptoms often appear abruptly, subside quickly
• May or may not require intervention by health care professionals
• Most people return to normal level of wellness

Nursing Process

• A method by which the theoretical framework is applied to practice nursing
• A deliberate, problem-solving approach that requires cognitive, technical and interpersonal skills
• Directed towards meeting the needs of the client
• Maintains the client's optimal wellness
• Involves a relationship between client and nurse
• Consists of 5 phases ADPIE

ADPIE provides an organized approach to nursing care

Assessing

• Collect, organize, validate & document data; to identify problems, concerns, or human responses
• Interview to obtain health history, physical assessment, lab and test results, interview family members, and review the literature
• Health history including physical exam, lifestyle management, spiritual health assessment, social support systems review, health-risk appraisal, health behaviors review, life stress review, validate the assessment data

Diagnosing

• Analyze data to identify needs and draw Nursing diagnosis

Planning

• Develop strategies to minimize/correct the problems identified in the diagnosis.
• Steps: Establish priorities, set outcomes in client collaboration, consult health personnel, write nursing orders, and record on client care plan.

Implementation

• Includes necessary actions to achieve outcomes.
• Communicate the plan to participants like the health team, the client, or the client's family
• Use Plan of Care as a guide

Evaluation

• Ongoing to measure goal achievement, through data collection on client response compared to outcome criteria; modify care plan if needed
• In health promotion: collaboration with client to make decisions about the plan

Integrative Health Care

• Includes Holism and Holistic Nursing
• Includes Spiritual, Physical, Mental, Emotional

Indigenous Health

• Use the Aboriginal Medicine Wheel
• Understand Language Ties, Disconnects, Connects Us To Our Land
• Intergenerational Trauma: Shared collective experiences of sustained and numerous attacks on a group that may accumulate over generations.

Nutrition

Glycemic Index

• A scale ranking carb-rich foods by blood glucose level when compared to a standard food (glucose or white bread).
• Low GI controls blood glucose and cholesterol levels, appetite, and lowers risk of heart disease or type 2 diabetes.
  • Low GI: grains, pumpernickel
  • Med GI: whole wheat, rye, pita
  • High GI: white breads, Kaiser, bagel

Macros

• The main source of energy: carbs, proteins, fats/lipids

Nutrients

• Water, carbs, proteins, lipids (macro), vitamins, minerals (micro)
  • Providing energy for body processes and movement
  • Providing structural material for body tissues
  • Regulating body processes
  • Homeostasis