Chapter 1 pender_4593d4ab157e5b28b8525318112c354d.pptx

TOWARD A DEFINITION OF HEALTH CHAPTER 1  OBJECTIVES 1. Compare traditional and holistic definitions of health. 2. Contrast conceptions of individual health. 3. Describe conceptions of health by nurse theorists. 4. Discuss family and community definitions of...

TOWARD A DEFINITION OF HEALTH CHAPTER 1  OBJECTIVES 1. Compare traditional and holistic definitions of health. 2. Contrast conceptions of individual health. 3. Describe conceptions of health by nurse theorists. 4. Discuss family and community definitions of health. 5. Describe the social determinants of health. 6. Discuss the significance of global health. 7. Describe the changing conceptions of health promotion.  TOWARDS A DEFINITION OF HEALTH -EXAMPLES  Age: Definition of health changes across life span (young adults 16- 24 years report lower priority on health and less engagement than do adolescents and adults 25 years or older. Older adults hold a more holistic approach (physical, mental, spiritual and social aspects) to health.  Gender: Gender differences in health are due to genetic and biologic factors, as well as social and behavioral factors such as risk-taking behaviors, health-seeking behaviors, and coping styles. Gender is a crucial sociocultural determinants of health throughout the life course. The promotion of gender equality and empowerment interventions is crucial in improving women’s Health. HEALTH AS AN EVOLVING CONCEPT  In a positive model of health, emphasis is placed on strengths, resiliencies, resources, potentials, and capabilities rather than on existing pathology.  Health literacy: Health Literacy has been defined as the cognitive and social skills which determine the motivation and ability of individuals to gain access to, understand and use information in ways which promote and maintain good health.  Health Literacy means more than being able to read pamphlets and successfully make appointments. By improving people's access to health information and their capacity to use it effectively, health literacy is critical to empowerment.   Do you think that being healthy means being free of disease? HEALTH AS  Have you encountered a AN cancer patient who spreads hope to you? EVOLVING  Have you heard of an athlete who challenged his disability? CONCEPT  Have you seen a disease- free individual who spreads negativity to your life?  HEALTH AS AN EVOLVING CONCEPT  Health is a state of complete physical, mental, social and spiritual well being and not merely the absence of disease or infirmity, (World health organization, 1946-reaffirmed in 2005.  Individual health cannot be separated from health of the society  Health is not a fixed state , as it varies depending on an individual’s life state (1943-Huber et.al., 2011)  HEALTH AS AN EVOLVING CONCEPT  It is now accepted that individual health cannot be separated from the health of society and that individuals are interdependent with the totality of the world.  One can not be healthy in an unhealthy society or world. Individual health is almost inseparable from the health of the larger community, and the health of every community influences the overall status of the nation. DEFINITIONS OF HEALTH THAT FOCUS ON INDIVIDUALS Health as Realization of human potential through goal directed behavior, Actualization competent self care and satisfying & Stability relationships with others Health is a resource for daily Health as an living. It is the capacity to engage Asset in various activities, fulfill roles, and meet demands of daily life  IDEAS OF HEALTH Health: State Disease: “ Illness: Well-being: or condition of dysfunction of the subjective subjective integrity of body” and a feeling of perception of functioning deviation from being vitality and (functional clearly unhealthy that feeling well capacity and established may or may (can be plotted ability)and norms. A variety not be related on a perceived well of factors related to disease. continuum) being (feeling to the host, well). agent, environment- interrelated in the  DEFINITIONS OF HEALTH THAT FOCUS ON THE FAMILY  Contextual Definition of family varies by culture and social norms.  Role of family is significant in HP because behaviors are learned, shared, shaped, and reinforced in daily routine.  Social, environmental, and religious factors determine how families view their health.  A biopsychosocial definition of family health as a dynamic , changing state of well being, including biologic, psychologic, sociologic, spiritual, and cultural factors of the family system.  In this definition an individual’s health affects family functioning, and in turn, family functioning affects individual health. Thus, both the family system and the individual members must be part of the health assessment and planning for health promotion.  DEFINITIONS OF HEALTH THAT FOCUS ON THE COMMUNITY  Communities are defined as a social group determined by both geographical area and common values, with members who know each other and interact within a social structure ( who, 1974).  Fundamentals to community health promotion are: shelter, peace, education, food, income, stable ecosystem, sustainable resources, social justice and equity.  HEALTH PROMOTION THAT FOCUS ON COMMUNITY Dimensions to develop understanding of community health:  Status dimension: Biological, emotional, social components - measured by morbidity, mortality, life expectancy, consumer satisfaction, mental health, crime rates, functional levels, workers absenteeism, infant mortality.  Structural dimensions: CHS and resources measured by - utilization patterns, provider/population ratios, socioeconomic and racial distributions, median educational level.  Process dimension: Effective community functioning results in self-other awareness, commitment, effective communication, conflict containment, management of relations with larger society  COMMUNITY HEALTH  Meeting the collective needs of members of the community through identifying problems, managing interactions within the community and between community and larger society.  SOCIAL DETERMINANTS OF HEALTH  Social determinants of health are: the social conditions that people are born, live, work and age including the health care system.  The social conditions under which people live—including poverty with its accompanying inadequate housing, poor sanitation, suboptimal food, lack of education, and social discrimination—have a dramatic impact on health  Individual factors (beliefs, knowledge, attitudes) are down stream factors which are shaped by upstream determinants (living and working conditions, economic and social opportunities and resources  Important for nurses to effectively intervene in neighborhoods, organizations and communities to improve individual health.  SOCIETAL WELLNESS  Depends on social action and policies that protect the health and welfare of all age groups  A well society provides all members with quality standard of living and way of life that allows them to meet basic human needs and engage in activities that express their human potential  It needs involvement of education, food production, housing, employment and health sectors  How does Oman provide societal wellness ? Discuss  PREREQUISITES FOR A WELL SOCIETY  A belief that disease and illness are not inevitable consequences of human existence.  A vision for the population beyond that of immediate survival.  Awareness of close relationship between individual, family and community health assets and the well being and productivity of a society.  Acceptance of high-level wellness as the goal of society.  CONCEPTIONS OF HEALTH PROMOTIONS  Health promotions as a process to enable people to overcome challenges and increase control over their environments to improve their health (WHO, Ottawa, 1986)  Health promotion- a core responsibility of all governments (WHO, Bangkok chapter updated in 2005)  HEALTH PROMOTION CONCEPTS  Health promotion is an umbrella Health term for range of activities Education  It is the science & art of preventing disease, protecting health and educating individuals Health promotion and society through organized efforts Disease Prevention Health Protection  HEALTH EDUCATION (HE)  Health education- “comprises consciously constructed opportunities for learning involving some form of communication designed to improve health literacy, including improving knowledge, and developing life skills which are conducive to individual and community health” (WHO, Health Promotion Glossary, 1998, p.4)  Health education (HE) is a tool or mechanism for health related learning resulting in increased knowledge, skill development, and change in behavior of individuals or groups.  DISEASE PREVENTION & HEALTH PROTECTION Health protection Disease prevention  Health protection the legal and  Refers to actions that fiscal controls and other modify the environment, regulations to enhance health behaviors, or body defenses and prevent illness in eliminating, slowing or changing disease process  Example: the standardized (Maville & Huerta 2008) response and reporting procedures, occupational  The underlying motivation safety rules, and certain guidelines or rules for why the behavior was optimizing worker carried out (Pender,2005) rehabilitation following injury Activities for health promotion and disease prevention programs  Health promotion and disease prevention programs often address social determinants of health, which influence modifiable risk behaviors.  Modifiable risk behaviors include, for example, tobacco use, poor eating habits, and lack of physical activity, which contribute to the development of chronic disease. Typical activities for health promotion and disease prevention programs include:  ACTIVITIES FOR HEALTH PROMOTION AND DISEASE PREVENTION PROGRAMS  Communication: Raising awareness about healthy behaviors for the general public. Examples of communication strategies include public service announcements, health fairs, mass media campaigns, and newsletters.  Education: Empowering behavior change and actions through increased knowledge. Examples of health education strategies include courses, trainings, and support groups.  Environment: Changing structures or environments to make healthy decisions more readily available to large populations. Like walkable cities, bicycles infrastructure , safe playground  Policy: Regulating or mandating activities by organizations or public agencies that encourage healthy decision-making. QUESTION The Director-General of Health engages with public health professionals and monitor the procedures for achieving safe drinking water supply at Oman. This is an example of: A. health promotion B. health protection C. illness prevention D. public policy CORE PRINCIPLES OF HEALTH PROMOTION Participation – involve the stakeholders at all stages of the project Empowerment – enable individuals and communities to take control over the personal, socioeconomic, and environmental factors that affect their health Holism – consider all health components Intersectoral – ensure collaboration from all the disciplines and areas concerned Equity – seek fairness in health and justice Sustainability – implement changes that can be maintained Multiple strategies- several approaches in combination  MEASUREMENT OF HEALTH  Many measures of health focus on mortality, morbidity related indices as dysfunction, disability-Measures of illness  Measures of health by WHO definition(1987)-5 dimensions which are physical health, mental health, social functioning, role functioning and general perceptions of well being  Community assessment indexes measure policies, programs and practices that affect healthy behaviors  CONSIDERATIONS FOR HEALTH PRACTICE IN THE CONTEXT OF HOLISTIC HEALTH  Nurses and health professionals must remember to assess all dimensions of health  Use information in assessment to determine health needs  In holistic view of health assessment is not complete unless it considers (individual, family, community in which person live and function) 5 LEVELS OF PREVENTION IN PUBLIC HEALTH Primordial Prevention: consists of risk factor Primary Prevention: reduction targeted towards an consists of measures aimed at entire population through a a susceptible population or focus on social and individual. The purpose of environmental conditions. primary prevention is to Such measures typically get prevent a disease from ever promoted through laws and occurring. Vaccination national policy. Banning program, oral health program, Trans Fats, floraidation of mental health awareness water  5 LEVELS OF PREVENTION IN PUBLIC HEALTH  Secondary prevention: emphasizes early disease detection, and its target is healthy-appearing individuals with subclinical forms of the disease. Cancer screening, BP, cholesterol testing , routine eye checkup  Tertiary prevention targets both the clinical and outcome stages of a disease. It is implemented in symptomatic patients and aims to reduce the severity of the disease as well as of any associated sequelae. Rehabilitation and treatment  Quaternary prevention: action taken to identify patients at risk of overmedicalization, to protect him from new medical invasion, and to suggest to him interventions, which are ethically acceptable (an action taken to protect individuals (persons/patients) from medical interventions that are likely to cause more harm than good) OPPORTUNITIES FOR RESEARCH IN HEALTH What interactive conditions between Gender, cultural and How does health individuals and racial differences in differ at various environment will expression of health points of lifespan ? deplete or improve their health Which health How does determinants are globalization affect critical to assess the health of individuals health of families? and communities?  QUESTIONS? ~THANK YOU~