Man, Health, and Illness Concepts

Concept of Man, Health, and Illness

• Man is a unique, dynamic biopsychosocial and spiritual being with inherent dignity and worth.
• Health is a dynamic state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity (WHO, 1948).
• Illness is a state where there's a deviation from the individual's baseline health, affecting their ability to function optimally.

Factors Affecting Health and Illness

• Environmental factors: External conditions such as climate, pollution, noise, and living conditions.
• Sociocultural factors: Social structures, cultural beliefs, traditions, and societal norms. Include family, education, peer influence, and economic status.
• Intellectual factors: Cognitive abilities, education, critical thinking, problem-solving skills, and knowledge acquisition.
• Physical factors: Biological and physiological aspects like genetics, diet, exercise, sleep, and overall health.
• Emotional factors: An individual's ability to manage and express emotions, cope with stress, and maintain mental and psychological stability.
• Spiritual factors: Beliefs, values, purpose in life, and connection to a higher power or personal sense of meaning.

Health Care Delivery System

• The comprehensive network of individuals, institutions, and resources that collaborate to deliver health care services to meet the health needs of specific populations.
• Components include health care settings, health care providers, regulatory agencies, financing, and technological advancement.
• Societal changes: Shifts in cultural values, norms, demographics, and social behaviors, for example, changes in family structures, gender roles.
• Economic pressure: Financial challenges such as inflation, unemployment, rising costs of living, and income inequality.
• Political climate: The overall mood, stability, and policies of a government or political system.
• Technological innovations: Advancements in technology like AI, automation, and digital transformation.
• The Philippine Health Care Delivery System (PHCDS) is the organized framework through which health services are provided to the population.
• PHCDS includes both public and private sectors and is responsible for delivering preventive, curative, promotive, and rehabilitative health services.

Levels of Health Care Delivery

• Primary or first contact care/preventive care: Focus on basic health services such as prevention, health promotion, and treatment of common illnesses.
• Secondary or specialist care/intermediate care: Specialized medical care provided by specialists upon referral.
• Tertiary or specialized care/advanced care: Highly specialized medical care provided by advanced hospitals and specialists, including surgeries, intensive care, and treatments for severe or rare diseases.

Health Care Sectors

• Public: Government-funded healthcare services that provide accessible and affordable medical care.
• Private: Health services provided by privately owned hospitals, clinics, and healthcare professionals, usually requiring out-of-pocket payments or private insurance.

Health Financing and Insurance

• PhilHealth is a government-run health insurance program in the Philippines that provides financial assistance for medical expenses.
• Universal Health Care is a system where all individuals have access to necessary health services without suffering financial hardship.

Challenges in PHCDS

• High Out-of-Pocket Expenses: Many Filipinos pay directly for medical services due to inadequate insurance coverage.
• Overcrowding in Public Hospitals: Government hospitals often face a high patient load and strained healthcare services.
• Unequal Access to Health Services: Healthcare facilities and services are not evenly distributed.
• Shortage of Health Professionals: A lack of doctors, nurses, and other medical staff due to migration, low salaries, and poor working conditions.

Nursing as a Profession

• Nursing: A highly respected and dynamic profession that blends scientific knowledge, technical skills, and compassionate care.
• Evidence-Based Practice: Nursing interventions are guided by scientific research and clinical expertise.
• Specialized Education: Formal training through diploma, associate, bachelor's, or advanced degrees is required.
• Code of Ethics: Nurses follow ethical principles such as autonomy, beneficence, and nonmaleficence.
• Autonomy and Accountability: Nurses make independent decisions while adhering to professional standards.
• Commitment to Lifelong Learning: Continuing education and certification is essential.

Historical Perspective of Nursing

• Florence Nightingale (1820-1910) emphasized hygiene, sanitation, and systematic training.
• The Development of Nursing Education: Evolution of nursing schools, integrating scientific principles and clinical training.
• Professional Organizations: Bodies like the American Nurses Association (ANA) and International Council of Nurses (ICN) advocate for nursing rights, policies, and education.

Levels of Nursing Practice

• Licensed Practical Nurse (LPN)/Licensed Vocational Nurse (LVN) Provides basic bedside care under RN supervision.
• Registered Nurse (RN): Provides direct care, patient education, and coordination of care.
• Advanced Practice Registered Nurse (APRN): Includes Nurse Practitioners (NPs), Clinical Nurse Specialists (CNSs), Nurse Anesthetists (CRNAs), and Nurse Midwives (CNMs).

Role Basic to Nursing Care

• Caregiver: Provides direct patient care and promotes physical, emotional, and psychological well-being.
• Advocate: Ensures patients' rights and preferences are respected and works to prevent medical errors.
• Educator: Teaches patients and families about diseases, medications, and healthy lifestyles.
• Communicator: Uses therapeutic communication to build trust with patients.
• Manager/Leader: Coordinates care, plans patient-centered care, and participates in policy-making.
• Researcher: Engages in nursing research to improve patient outcomes.
• Counselor: Provides emotional and psychological support to patients and families.
• Collaborator: Works with multidisciplinary teams to ensure integrated patient care.

Criteria of Nursing as a Profession

• Specialized Education & Training: Requires formal education, advanced practice nurses require master's or doctoral degrees.
• Theoretical Body of Knowledge: Practice based on scientific principles, nursing theories, and evidence-based research.
• Autonomy and Accountability: Nurses make independent clinical decisions within their scope of practice.
• Code of ethics: Ethical guidelines ensure professional integrity.
• Service orientation: A profession dedicated to public service, prioritizing patient well-being over financial gain.
• Professional organization and standard: Nurses adhere to standards set by regulatory bodies like the ANA, ICN, and the National League for Nursing (NLN).
• Ongoing research & evidence-based practice constantly evolves practice.

Personal and Professional Qualities of a Nurse

• Compassion & Empathy: Understanding and caring for patients' feelings and needs.
• Adaptability & Flexibility: Adjusting to different situations and challenges.
• Problem-Solving & Critical Thinking: Making quick and effective decisions.
• Physical & Mental Endurance: Maintaining strength and resilience.
• Compassionate Leadership & Teamwork: Leading with care and working well with others.
• Patience & Emotional Stability: Staying calm and composed under pressure.
• Communication & Active Listening Skills: Effectively conveying and understanding information.
• Integrity & Ethical Awareness: Upholding honesty and ethical standards.
• Clinical Competence & Technical Skills: Mastery of medical knowledge and procedures.
• Time Management & Multitasking: Efficiently handling multiple tasks and responsibilities.
• Commitment to Lifelong Learning: Continuously updating skills and knowledge.
• Leadership & Team Collaboration: Guiding others and working effectively within a healthcare team.
• Cultural Competence & Respect for Diversity: Providing inclusive care to diverse patient populations.
• Attention to Detail & Accuracy: Ensuring precision in treatments and documentation.
• Professionalism & Accountability: Maintaining ethical behavior and responsibility in practice.
• Advocacy & Patient-Centered Care: Prioritizing patients' needs, rights, and well-being.

History of Nursing

• Early Civilizations (Before 1000 AD): Often performed by religious groups, caregivers, and healers; Ancient Egyptians, Greeks, and Romans documented healing practices; the rise of Christianity saw nuns and monks providing hospital care.
• The Middle Ages (500-1500 AD): Hospitals expanded, and religious organizations played a central role.
• The Renaissance and Early Modern Period (1500-1800 AD): Nursing became more structured, though still informal.
• Florence Nightingale & the Birth of Modern Nursing (1820-1910): Improved sanitation and hygiene during the Crimean War, and established the first formal nursing school at St. Thomas' Hospital in London (1860).
• The 20th Century: Nurses played a critical role in treating wounded soldiers during World Wars I & II, Universities introduced degree programs, and ANA, ICN, and NLN were established.
• The 21st Century has technological advancements with Electronic health records and telemedicine however there are ongoing nursing shortages and global challenges.

Field of Nursing

• General Nursing Fields: Medical-Surgical, Pediatric, Geriatric, Psychiatric & Mental Health, Community Health, Occupational Health, Critical Care (ICU), Emergency, Perioperative (Surgical), Neonatal.
• Specialized Nursing Fields: Oncology, Cardiovascular, Pulmonary, Endocrinology, Neuroscience, Gastroenterology, Hematology, Transplant, Nephrology (Renal), Dermatology.
• Maternal & Child Health Nursing: Obstetric (Maternity), Midwifery, Lactation, Perinatal, Reproductive Health.
• Advanced & High-Risk Nursing Fields: Anesthesia (CRNA), Flight, Burn Unit, Trauma, Pain Management, Toxicology, Forensic, Disaster & Humanitarian.
• Alternative & Emerging Nursing Fields: Holistic, Genetics, Telenursing (Telehealth), Aesthetic/Cosmetic, Weight Management, Space, Sleep.
• Legal & Administrative Nursing: Nurse Case Management, Legal Nurse Consultant, Health Policy, Nursing Informatics, Nursing Education, Nursing Research, Public Health.
• Unique & Niche Nursing Fields: Military, Correctional (Prison), Home Health, Travel, School, Parish (Faith-Based), Veterinary, Refugee.

Clinical Nursing Specialties

• Medical-Surgical Nursing: Provides care for adult patients with acute and chronic conditions.
• Pediatric Nursing: Focuses on the care of infants, children, and adolescents.
• Geriatric Nursing: Specializes in elderly care, including dementia and palliative care.
• Obstetric and Gynecologic Nursing: Supports women's health, pregnancy, and childbirth.
• Psychiatric/Mental Health Nursing: Treats patients with mental health disorders.

Advanced Practice Nursing (APN)

• Nurse Practitioner (NP): Diagnoses and treats illnesses, often independently.
• Clinical Nurse Specialist (CNS): Provides expert care in a specialized area.
• Nurse Anesthetist (CRNA): Administers anesthesia during surgeries.
• Nurse Midwife (CNM): Provides prenatal, delivery, and postpartum care.

Community and Public Health Nursing

• Community Health Nurse: Promotes wellness and disease prevention.
• School Nurse: Provides healthcare services in educational institutions.
• Occupational Health Nurse: Ensures workplace safety and employee health.

Non-Clinical Nursing Roles

• Nurse Educator: Trains future nurses in academic and clinical settings.
• Nurse Researcher: Conducts studies to improve healthcare practices.
• Healthcare Administrator: Manages nursing teams and hospital operations.

Caring Practice Models

• Jean Watson's Theory of Human Caring emphasizes transpersonal caring.
• Swanson's Caring Theory describes five caring processes: Knowing, Being With, Doing For, Enabling, and Maintaining Belief.
• Leininger's Transcultural Nursing Theory focuses on cultural competence.
• Mayeroff's Caring Ingredients include honesty, humility, trust, courage, etc.
• (Anne Boykin & Savina Schoenhofer): Caring is the essence of nursing.
• Health Promotion Model (Nola Pender): Integrates caring with health promotion; Encourages nurses to empower patients.

5 Cs OF CARING (SISTER SIMONE ROACH)

• Compassion: Deep awareness of the suffering of others.
• Competence: Using knowledge and skills effectively.
• Confidence: Trusting oneself and others.
• Conscience: Ethical awareness and responsibility.
• Commitment: Dedication to patient well-being.

6C's OF CARING IN NURSING

• Compassion: Kindness towards patients.
• Competence: Providing quality care.
• Communication: Interacting with patients and healthcare teams
• Courage: Advocating for patients and making difficult decisions
• Commitment: Providing best patient care.
• Care: Ensuring patients feel safe and supported

Process and Modes of Communication

• Process of communication has a sender, message, receiver, feedback, and context.
• Barriers to effective communication include language differences, emotional distress, noise, lack of clarity, and cultural difference.
• Modes of communication are Verbal, Nonverbal, and Electronic.

Importance of effective Communication

• Improves patient outcomes and safety
• Supports patient education and empowerment

Therapeutic communication

• Focuses on active listening, empathy, and interactions to support the patients emotional and psychological well-being.
• Includes Active Listening, Using open-ended question, Empathy, Providing silence, Offering general leads, Reflecting and paraphrasing, Giving information, Clarification, and Validation.

Helping relationship

• A nurse-patient relationship that is professional, goal-directed which include phases such as, 1)pre-interaction 2)orientation 3)working 4)termination.
• A helping relationship should focus on patient-centered outcomes while maintaining boundaries.

Nursing process

• A systematic and scientific approach to patient care and requires the following steps: assessment, diagnosis, planning, implementation, & evaluation.

Teaching

• A critical nursing role that empowers patients
• Includes; Health promotion, disease prevention and health restoration

Asepsis and Infection Control

• Asepsis refers to the absence of disease-causing microorganisms of which include;
• Medical Asepsis (Clean Technique) and Surgical Asepsis (Sterile Technique).

Chain of infection

• The sequence on how infection would spread in our body.
• i. infectious agent
• ii. reservoir
• iii. portal of exit
• iv. means of transmission
• v. portal of entry
• vi. susceptible host

The Different Modes of Transmission

• Direct Contact; takes place through skin-to-skin contact, as well as kissing and sexual intercourse.
• Indirect transmission; refers to the transfer of an infectious agent from a reservoir to a host using methods such as airborne, or vehicles.

Safety, Security, and Emergency Preparedness

• Ensuring patient safety encompasses various aspects such as physical hazards and environmental safety.
• Nurses must be aware of emergency preparedness protocols to deal with disasters and calamities.

Complementary and Alternative Therapies

• Complementary and alternative therapies encompass a variety of practices not traditionally part of conventional medical care for example: herbal remedies.
• 10 herbal therapeutic medicine approve by DOH:
  • 1. Lagundi (Vitex negundo), 2. Sambong (Blumea balsamifera), 3. Tsaang Gubat (Ehretia microphylla) 4. Akapulko (Senna alata) , 5. Yerba Buena (Clinopodium douglasii) 6. Niyog-niyogan (Quisqualis indica), 7. Ulasimang Bato / Pansit-pansitan (Peperomia pellucida) 8. Guava (Psidium guajava) 9. Garlic (Allium sativum) 10. Ampalaya (Momordica charantia)

Medications

• Medication administration is a critical nursing responsibility that involves understanding a drugs pharmacokinetics.
• Routes of administration include Enteral, Parenteral, Topical, Inhalation, Transdermal, Ophthalmic & Otic.
• Must provide Monitoring and Documentation to esure safety, effectiveness, and early detection of side effects.

Nursing Interventions to Promote Healthy Physiological Responses

• Hygiene: Evaluate and assist with personal hygiene to maintain comfort.
• Skin Integrity: Regular inspections and relief pressure to prevent pressure sores
• Mobility/Activity: Encourage mobility to enhance physical health and prevent complications
• Rest and Sleep: Optimize the environment to ensure a regular seep schedule.
• Comfort and Pain Management: Assess and Administer pain, and collaborate with non-pharmacologic methods.
• Nutrition: Assess nutritional status, plan for Dietary needs, and educate dietrary needs.
• Urinary Elimination: Monitor urine output.
• Bowel Elimination: Assess bowel, stool and diet with food rich foods.

Nursing Responsibilities to promote mental and physical wellness

• Support Self-Concept.
• Promote Stress and Aid Adaptation.
• Promote Grieif (Grief & Loss).
• Ensure Sensory Function.
• Discuss Sexuality with patients.
• Ensure Spirituality.