Health and Wellness Nursing, Healing, and Caring PDF

H E A LT H A N D W E L L N E S S NURSING, HEALING, AND CARING D R. S E R P İ L TO P Ç U 1  DEFINITION OF HEALTH The World Health Organization (WHO) defines health as a “state of complete physical, mental, and social well- being, no...

H E A LT H A N D W E L L N E S S NURSING, HEALING, AND CARING D R. S E R P İ L TO P Ç U 1  DEFINITION OF HEALTH The World Health Organization (WHO) defines health as a “state of complete physical, mental, and social well- being, not merely the absence of disease or infirmity” (WHO, 1947) Health is a state of being that people define in relation to their own values, personality, and lifestyle. Each person has a personal concept of health. 2  DEFINITION OF HEALTH Individuals’ views of health vary among different cultural orientations Life conditions can have positive or negative effects on health long before an illness is evident Life conditions include socioeconomic variables such as environment, diet, lifestyle practices or choices, and many other physiological and psychological variables 3 DEFINITION OF HEALTH Individual perceptions and definitions of health are affected by a person’s health beliefs??? For example, a person with epilepsy who has learned to control seizures with medication and who functions at home and work or a person fully recovered from a stroke with limited paralysis and living independently may no longer consider himself or herself ill. 4  DEFINITION OF HEALTH Health behavior can positively or negatively affect a patient’s level of health Positive health behaviors; maintain, attain, or regain health and prevent illness immunizations, proper sleep patterns, adequate exercise, stress management, and nutrition Negative health behaviors include practices that are harmful to health smoking, drug or alcohol abuse, poor diet, and refusing to take necessary medications. 5  MODELS OF HEALTH AND ILLNESS Nurses developed the following health models to understand patients' attitudes and values about health and illness and to provide effective health care Nursing models allow to understand and predict patients' health behavior, including how they use health services and adhere to recommended therapy Nurses can use these models to individualize plans of care that will be effective in restoring or promoting a patient’s health 6 MODELS OF HEALTH AND ILLNESS - HEALTH BELIEF MODEL Health belief model addresses the relationship between a person's beliefs and behaviors. For example, a patient needs to recognize the familial link for coronary artery disease For example, a patient may not perceive his heart disease to be serious, which may affect the way he takes care of himself 7 MODELS OF HEALTH AND ILLNESS- HEALTH PROMOTION MODEL HPM notes that each person has unique personal characteristics and experiences that affect subsequent actions Behavioral variables can be modified through nursing actions Health-promoting behavior is the desired behavioral outcome and is the end point in the HPM. Health-promoting behaviors result in improved health, enhanced functional ability, and better quality of life at all stages of development 8 MODELS OF HEALTH AND ILLNESS- MASLOW'S HIERARCHY OF NEEDS Nurses use Maslow’s hierarchy of needs to understand the interrelationships of basic human needs Basic human needs are necessary for human survival and health (e.g., food, water, safety, and love) Although each person has unique needs, all people share basic human needs 9  MASLOW'S HIERARCHY OF NEEDS 10 Physiological Needs: These are the essential survival needs, like food, water, shelter, oxygen and sleep. They form the foundation of the hierarchy because they’re the most immediate requirements for human survival. Safety Needs: Once physiological needs are met, people seek safety and stability. This level includes personal security, health, financial stability, and a safe living environment. Love and Belongingness Needs: At this level, social relationships become important. Humans naturally seek to form connections with family, friends, and romantic partners. Esteem Needs: This tier involves self-respect and recognition from others. People need to feel valued and respected, which can come from achievements, personal growth, or contributions to society. Self-Actualization Needs: At the top of the hierarchy, self-actualization refers to realizing one’s full potential and pursuing personal growth and peak experiences. This might involve creative pursuits, problem-solving, or achieving one’s unique goals. 11  MODELS OF HEALTH AND ILLNESS- MASLOW'S HIERARCHY OF NEEDS According to this model, certain human needs are more basic than others (i.e., some needs must be met before other needs- e.g., fulfilling the physiological needs before the needs of love and belonging) Self-actualization is the highest expression of one’s individual potential and allows for continual discovery of self The hierarchy of needs model provides a basis for nurses to care for patients of all ages in all health settings In all cases an emergent physiological need takes precedence over a higher-level need 12 MODELS OF HEALTH AND ILLNESS-HOLISTIC HEALTH MODEL The relationship between body, mind and spirit affects a person’s health. The Holistic Health Model of nursing promotes a patient’s optimal level of health by considering the dynamic interactions among the emotional, spiritual, social, cultural, and physical aspects of an individual’s wellness Some of the most widely used holistic interventions include meditation, music therapy, reminiscence, relaxation therapy, therapeutic touch, and guided imagery The Holistic Health Model empowers patients to engage in their own recovery and assume some responsibility for health maintenance 13  VARIABLES INFLUENCING HEALTH AND HEALTH BELIEFS AND PRACTICES Internal Variables 1- Developmental Stage A person's thought and behavior patterns change throughout life The concept of illness for a child, adolescent, or adult depends on the individual's developmental stage Fear and anxiety are common among ill children Teaching about different contraception techniques for adolescent 14  VARIABLES INFLUENCING HEALTH AND HEALTH BELIEFS AND PRACTICES Internal Variables 2- Intellectual Background A person’s beliefs about health are shaped in part by knowledge or misinformation about body functions and illnesses, educational background, traditions and past experiences These variables influence how a patient thinks about health Nurse should consider patient’s intellectual background while providing patient teaching 15  VARIABLES INFLUENCING HEALTH AND HEALTH BELIEFS AND PRACTICES Internal Variables 3- Emotional Factors The patient’s degree of stress, depression or fear can influence health beliefs and practices A person who generally is very calm may have little emotional response during illness, may overreact or assume her/his life threatening of symptoms and not take therapeutic action 16  VARIABLES INFLUENCING HEALTH AND HEALTH BELIEFS AND PRACTICES Internal Variables 4- Spiritual Factors Spirituality is reflected in how a person lives his or her life, including the values and beliefs exercised, the relationships established with family and friends, and the ability to find hope and meaning in life. Religious practices are one way that people exercise spirituality Some religions restrict the use of certain forms of medical treatment. 17  VARIABLES INFLUENCING HEALTH AND HEALTH BELIEFS AND PRACTICES External Variables 1- Family Practices Family perceptions of the seriousness of diseases and their history of preventive care behaviors (or lack of them) influence how patients think about health For example, if a young woman’s mother never had annual gynecological examinations or Pap smears, it is unlikely that the daughter will have annual Pap smears. 18  VARIABLES INFLUENCING HEALTH AND HEALTH BELIEFS AND PRACTICES External Variables 2- Socioeconomic Factors Social and psychosocial factors increase the risk for illness and influence the way that a person defines and reacts to illness The organization of the health care system determines how patients can obtain care, the treatment method and the economic cost A person who has high utility bills, a large family, and a low income tends to give a higher priority to food and shelter than to costly drugs or treatment or expensive foods for special diets. 19  VARIABLES INFLUENCING HEALTH AND HEALTH BELIEFS AND PRACTICES External Variables 3- Cultural Background Cultural background influences beliefs, values, and customs Cultural background influences the approach to the health care system, personal health practices, and the nurse-patient relationship, an individual’s beliefs about causes of illness and remedies or practices to restore health You will probably have difficulty interacting with patients??? 20  “Wants and Needs Game” 21  WELLNESS Wellness further describes health status Wellness is a dynamic process that is ever changing High-level wellness means functioning to one’s maximum health potential while remaining in balance with the environment 22 23 VARIABLES INFLUENCING HEALTH BEHAVIORS Lifestyle Lifestyle consists of a person’s usual daily activities and routines that are acceptable practices in the person’s life Such routines and habits influence health status For example, consumption of large amounts of caffeine, cigarette smoking, consistent intake of high-fat foods, and a sedentary routine can adversely affect health status 24  VARIABLES INFLUENCING HEALTH BEHAVIORS Self-Efficacy Describe an individual’s perception of one’s own ability to perform a certain task When clients are able to make informed decisions about their health behaviors and feel that they are successful in these areas, they are more likely to attempt behavior change Thus, an essential component of nursing care is to provide opportunities for clients to achieve this level of self-motivation For example, when teaching a client how to self-administer injections, the nurse breaks the task down into small manageable objectives and has the client do a return demonstration. The client receives immediate feedback, which encourages further success 25  VARIABLES INFLUENCING HEALTH BEHAVIORS Health Care Attitudes Health behaviors are based on beliefs Socialization (which occurs within the family) influences the development of beliefs about health care For example, if the person believes in the use of herbs or folk healers, such nontraditional health care practices could either enhance or interfere with traditional treatment approaches There are some gender differences in beliefs regarding health care 26 HEALTH PROMOTION, WELLNESS AND ILLNESS PREVENTION 27  HEALTH PROMOTION, WELLNESS, AND ILLNESS PREVENTION Health care has become increasingly focused on health promotion, wellness, and illness prevention The rapid rise of health care costs has motivated people to seek ways of decreasing the incidence and minimizing the results of illness or disability The concepts of health promotion, wellness, and illness prevention are focused on the future; the difference among them involves motivations and goals. 28  HEALTH PROMOTION, WELLNESS, AND ILLNESS PREVENTION Health promotion activities such as routine exercise and good nutrition help patients maintain or enhance their present levels of health. They motivate people to act positively to reach more stable levels of health Wellness education teaches people how to care for themselves in a healthy way and includes topics such as physical awareness, stress management, and self responsibility. Wellness strategies help people achieve new understanding and control of their lives Illness prevention activities such as immunization programs protect patients from actual or potential threats to health. They motivate people to avoid declines in health or functional levels. 29  HEALTH PROMOTION, WELLNESS, AND ILLNESS PREVENTION Health topics and objectives as defined by Healthy People 2030 (WHO) include; 30 31 HEALTHY PEOPLE OBJECTIVES 32  LEVELS OF PREVENTIVE CARE 1- Primary prevention; It is applied to patients considered physically and emotionally healthy Aimed at health promotion includes; health education programs, immunizations and physical and nutritional fitness activities Includes all health promotion efforts and wellness education activities that focus on maintaining or improving the general health of individuals, families, and communities 33  HEALTH PROMOTION, WELLNESS, AND ILLNESS PREVENTION 2- Secondary Prevention; Focuses on individuals who are experiencing health problems or illnesses and are at risk for developing complications or worsening conditions Activities are directed at diagnosis and prompt intervention, thereby reducing severity and enabling the patient to return to a normal level of health as early as possible A large portion of nursing care related to secondary prevention is delivered in homes, hospitals, or skilled nursing facilities 34  HEALTH PROMOTION, WELLNESS, AND ILLNESS PREVENTION 3- Tertiary Prevention; Occurs when a defect or disability is permanent and irreversible. It involves minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration Activities are directed at rehabilitation rather than diagnosis and treatment. Care at this level helps patients achieve as high a level of functioning as possible, despite the limitations caused by illness or impairment This level of care is called preventive care because it involves preventing further disability or reduced functioning 35 36  RISK FACTORS A risk factor is any situation, habit, social or environmental condition, physiological or psychological condition, developmental or intellectual condition, spiritual condition or other variable that increases the vulnerability of an individual or group to an illness or accident Nurses in all areas of practice often have opportunities to help patients adopt activities to promote health and decrease risks of illness 37  RISK FACTORS 1- Genetic and Physiological Factors Physiological risk factors involve the physical functioning of the body Certain physical conditions such as being pregnant or overweight place increased stress on physiological systems (e.g., the circulatory system), increasing susceptibility to illness Heredity or genetic predisposition to specific illness, is a major physical risk factor For example, a person with a family history of diabetes mellitus, cancer, heart disease, kidney disease, or mental illness are at risk for developing the disease later in life 38  RISK FACTORS 2- Age Age affects a person’s susceptibility to certain illnesses For example, premature infants and neonates are more susceptible to infections. As a person ages, the risk of heart disease and many types of cancers increases Age risk factors are often closely associated with other risk factors such as family history and personal habits Nurses need to educate their patients about the importance of regularly scheduled checkups for their age-group Various professional organizations and federal agencies develop and update recommendations for health screenings, immunizations, and counseling 39  RISK FACTORS 3- Environment Where we live and the condition of that area (air, water, and soil) determine how we live, what we eat, the disease agents to which we are exposed, our state of health, and our ability to adapt The physical environment in which a person works or lives can increase the likelihood that certain illnesses will occur For example, some kinds of cancer and other diseases are more likely to develop when industrial workers are exposed to certain chemicals or when people live near toxic waste disposal sites Nursing assessments extend from the individual to the family and the community in which they live 40  RISK FACTORS 4- Lifestyle Many activities, habits, and practices involve risk factors Lifestyle practices and behaviors often have positive or negative effects on health Lifestyle choices contribute to seven of the ten leading causes of death Some habits are risk factors for specific diseases For example, excessive sunbathing increases the risk of skin cancer; smoking increases the risk of lung diseases, including cancer; a poor diet and being overweight increase the risk of cardiovascular disease. 41 42 43  ILLNESS Illness means different things to different people It is more than just the existence of physical signs and symptoms Illness is a state in which a person’s physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished or impaired There are two major classifications of illness: acute and chronic 44  ILLNESS 1- Acute Illness; An acute illness is a disruption in functional ability usually characterized by a rapid onset, intense manifestations, and a relatively short duration. Acute illnesses are usually reversible 45  ILLNESS 2- Chronic Illness A chronic illness is a disruption in functional ability usually characterized by a gradual, insidious onset with lifelong changes that are usually irreversible Chronic illnesses last a long time, frequently throughout the individual’s life. 46  VARIABLES INFLUENCING ILLNESS AND ILLNESS BEHAVIOR - Internal Variables Internal variables influence the way patient behave when they are ill The nature of the illness, either acute or chronic, also affects a patient’s illness behavior Patients with acute illnesses are likely to seek health care and comply readily with therapy Patient with a chronic illness in which symptoms are not cured but only partially relieved may not be motivated to comply with the therapy planning 47  VARIABLES INFLUENCING ILLNESS AND ILLNESS BEHAVIOR - External Variables External variables influencing a patient’s illness behavior include the visibility of symptoms, social group, cultural background, economic variables, accessibility of the health care system, and social support. The visibility of the symptoms of an illness affects body image and illness behavior. 48  IMPACT OF ILLNESS ON THE PATIENT AND FAMILY Behavioral and Emotional Changes Individual behavioral and emotional reactions depend on; - the nature of the illness - the patient’s attitude toward it - the reaction of others to it - the variables of illness behavior Short-term, nonlife-threatening illnesses evoke few behavioral changes in the functioning of the patient or family. 49 IMPACT OF ILLNESS ON THE PATIENT AND FAMILY Body Image Body image is the subjective concept of physical appearance Some illnesses result in changes in physical appearance Patients’ and families’ reactions differ and usually depend on the type of changes (e.g., loss of a limb or an organ) When a change in body image such as results from a leg amputation occurs, the patient generally adjusts in the following phases: shock, withdrawal, acknowledgment, acceptance, and rehabilitation 50  IMPACT OF ILLNESS ON THE PATIENT AND FAMILY Impact on Self-Concept Self concept is a mental self-image of strengths and weaknesses in all aspects of personality. Self concept depends in part on body image and roles but also includes other aspects of psychology and spirituality Self-concept is important in relationships with other family members. 51  IMPACT OF ILLNESS ON THE PATIENT AND FAMILY Impact on Family Roles People have many roles in life such as wage earner, decision maker, professional, child, sibling, or parent When an illness occurs, parents and children try to adapt to the major changes that result Role reversal is common An individual and family generally adjust more easily to subtle, short-term changes The patient and family often require specific counseling and guidance to help them cope with long-term role changes 52 IMPACT OF ILLNESS ON THE PATIENT AND FAMILY Impact on Family Dynamics As a result of the effects of illness on the patient and family, family dynamics often change. Family dynamics are the processes by which the family functions, makes decisions, gives support to individual members, and copes with everyday changes and challenges The nurse views the whole family as a patient under stress, planning care to help the family regain the maximal level of functioning and well-being 53 NURSE’S ROLE IN HEALTH PROMOTION, HEALTH PROTECTION, AND DISEASE PREVENTION Nurses play a key role in promoting health and wellness Nurses role to find ways to motivate clients and families to develop health- promoting behaviors An essential component of teaching is encouraging clients to make necessary lifestyle changes to promote health 54  NURSE’S ROLE IN HEALTH PROMOTION, HEALTH PROTECTION, AND DISEASE PREVENTION  Motivation is a key component of achieving and maintaining health  Many factors help clients feel motivated to change health behaviors: Perception of self as able to succeed (self-efficacy) Belief that health status will improve Response to their attempts to change in the form of feeling healthier and receiving confirmation of these changes from others 55  NURSE’S ROLE IN HEALTH PROMOTION, HEALTH PROTECTION, AND DISEASE PREVENTION Nurses spend the most time with the patients and provide anticipatory guidance about immunizations, nutrition, dietary, medications, and safety Nurses are consistently working to prevent illnesses such as heart disease, stroke, diabetes, and obstructive pulmonary disease Nurses do this through a variation of tactics that include education, risk factor prevention, and the monitoring of safety hazards either in the workplace, community or home. 56 NURSING ROLE FOR HEALTH 57 NURSING ROLE FOR HEALTH Maintaining and Promoting Health Nurses can help patients to value health and develop specific health practices that promote wellness Health teaching is varied and ranges from teaching passive exercises to a patient with left-sided paralysis to designing a safe exercise program for a young athlete. 58  NURSING ROLE FOR HEALTH Preventing Illness Illness prevention, a major theme in health teaching and counseling, takes many forms Nurses can counsel women of childbearing age about health practices that promote optimal fetal development, teach parents how to make their home safe for a toddler, or counsel individuals at high risk for heart disease, cancer, or communicable diseases. 59 NURSING ROLE FOR HEALTH Restoring Health Once a patient is ill, teaching and counseling focus on developing self-care practices that promote recovery Preoperative and postoperative teaching, sexual counseling for a patient recovering from a myocardial infarction, and lifestyle counseling for a patient with an ostomy are all examples of teaching and counseling directed at restoring health. 60  NURSING ROLE FOR HEALTH Facilitating Coping Developmental lifestyle changes and acute, chronic, and terminal illness all place demands on patients and families that may become overwhelming As a nurse, you will work with patients, their families and friends to help them to come to terms with illness and whatever lifestyle modifications it entails Not all patients fully recover from their illness or injury; many patients will need to learn to cope with permanent health alterations 61 THE NURSE AS TEACHER- HEALTH PROMOTION, AND DISEASE PREVENTION Nurses assume the role of teacher and your patient assumes the role of learner when there are identifiable learning needs Nurses build on this trust by sharing information that you and your patient have mutually identified as important 62  THE NURSE AS COUNSELOR- HEALTH PROMOTION, AND DISEASE PREVENTION Counseling is the interpersonal process of helping patients to make decisions that promote their overall well-being The interpersonal skills of warmth, friendliness, openness and empathy are necessary for successful counseling Caring is based on a humanistic philosophy which is the core of nursing practice 63  THE NURSE AS COUNSELOR- HEALTH PROMOTION, AND DISEASE PREVENTION Caring is important in all nursing roles but is fundamental in the counseling role Counseling involves listening carefully to the patient’s or family’s questions, concerns, demands, and complaints and then responding in an effective manner Counseling may be situational, developmental, or motivational, and short-term or long-term. 64