Practical Nursing Program Attendance and Resources

Health, Disease, and Illness

• Health: a state of complete physical, mental, and social well-being, not just the absence of disease or infirmity (WHO, 2021)
• Disease: a condition viewed from a pathophysiological model, whereas illness refers to the human experience of symptoms and suffering

Acute Illness and Chronic Illness

• Acute illness: characterized by a sudden onset, with signs and symptoms that are directly related to the disease process itself, such as fever, pain, or inflammation. These illnesses typically resolve quickly, often with treatment, and may have a clear cause-and-effect relationship between the disease and its symptoms.
• Chronic illness: marked by an uncertain etiology, multiple risk factors, long latency, and prolonged duration, with a noninfectious origin. Chronic illnesses often involve a complex interplay of genetic, environmental, and lifestyle factors, and may have a gradual onset, subtle symptoms, and unpredictable progression.
• Comorbidity: the simultaneous presence of two or more disorders that are not directly related to each other in a person at the same time. This can lead to complex clinical presentations, treatment challenges, and increased healthcare utilization. Comorbidities can involve physical and mental health conditions, such as diabetes and depression, or substance abuse and hypertension.
• Multimorbidity: the simultaneous occurrence of several chronic medical conditions in the same person, which may or may not be related to each other. Multimorbidity is increasingly common, particularly among older adults, and can have significant implications for healthcare delivery, resource allocation, and patient-centered care. Examples of multimorbidities include hypertension, diabetes, and osteoarthritis in an individual.

Determinants of Health

• Lifestyle factors: choices made by individuals, influenced by social, economic, and environmental factors
• Social environment: affects an individual's ability to eat well, stay active, obtain immunizations, and access education and healthcare
• Income and education: impact the ability to obtain and provide nutritious food, good housing, and access to healthcare
• Poverty and socioeconomic disadvantage have a major impact on the development of chronic illness

Factors Contributing to Chronic Illness

• Individual risk factors: classified as background (e.g., age, sex, genetics, education), behavioural (e.g., smoking, poor diet, physical inactivity), or intermediate (e.g., hypertension, obesity, diabetes)
• Community-level factors: poverty, employment, air pollution, housing, cultural practices, urbanization, etc.

Prevention of Chronic Illness

• Prevention is the best approach, and elimination of four behavioural risk factors can be effective disease prevention interventions: tobacco use, unhealthy diet, insufficient physical activity, and harmful use of alcohol
• "Best buys" are actions that produce accelerated results in terms of lives saved, diseases prevented, and heavy costs avoided

Role of Genetics and Aging

• Genetics play an important role in the development of some chronic illnesses
• Advances in genome sequencing will increase the importance of genetics in prevention, detection, and treatment of chronic illnesses
• Chronic illnesses increase as populations age and individuals live with one or more chronic conditions

Advocacy in Nursing

• Nurses are in an excellent position to be effective advocates, with a unique and knowledgeable perspective on patient experience, work environments, and healthcare delivery
• Advocacy leads to better outcomes for patients, improved quality care, reduced inequities, and better work environments for nurses
• Steps to becoming an advocate include identifying a problem, gaining a greater understanding of the issue, involving others, and working hard for change