Nursing School Tips PDF

Tips for Nursing School … 1. Take notes in your own words! (Download PPT slides) Strive to understand and apply rather than memorize the concepts 2. ATI Textbook is your friend! 3. Engage: true understanding is in our discussions 4. Use your resources! 5. Respectful communication...

Tips for Nursing School … 1. Take notes in your own words! (Download PPT slides) Strive to understand and apply rather than memorize the concepts 2. ATI Textbook is your friend! 3. Engage: true understanding is in our discussions 4. Use your resources! 5. Respectful communication PROFESSIONALISMCCO  Assume everyone has the best of intentions and a reason  Give grace to others and yourself  Respectful communication It'SOKAItodsagn  At some point, we will disagree and that’s okay!  will alsogive OBJECTIVES FOR 1 13 USoutlines before Introduction to Wellness & Health Promotion exam Part 1: Introduction to Wellness & Health Promotion DeIne wellness, illness, health promotion, upstream thinking, and disease prevention Identify categories of aspects of health and wellness, including social, emotional, intellectual, physical, occupational, etc. Interpret the Illness-Wellness Continuum Demonstrate an understanding of levels of prevention DiNerentiate social and physical external environment factors List considerations of internal environment that impact health and illness Demonstrate an understanding of factors that impact illness resulting in an individualized patient response Explain obstacles to patient compliance and adherence to prescribed therapies. Provide nursing actions that strengthen health, wellness, and illness management for patients Part 2: Introduction to Health Promoting Behaviors & Guidelines Highlight public health organizations focused on health promotion and disease prevention Distinguish between modiIable and non-modiIable risk factors Recommended behaviors: Physical Activity, Sleep, Dietary Patterns, Stress Management, Other Part 3: Explore Healthy People 2030 Summarize the purpose of Healthy People 2030 Identify Healthy People 2030 Objectives related to Health Promotion Next week: Class Prep Readings and Activities Introduction to Wellness & Health Promotion Part 1: Introduction to Wellness & Health Promotion  DeIne wellness, illness, health promotion, upstream thinking, and disease prevention  Identify categories of aspects of health and wellness, including social, emotional, intellectual, physical, occupational, etc.  Interpret the Illness-Wellness Continuum  Demonstrate an understanding of levels of prevention  DiNerentiate social and physical external environment factors  List considerations of internal environment that impact health and illness  Demonstrate an understanding of factors that impact illness resulting in an individualized patient response  Explain obstacles to patient compliance and adherence to prescribed therapies.  Provide nursing actions that strengthen health, wellness, and illness management for patients Reference: Assessment Technologies Institute, L.L.C. (ATI). (2023). Medical-Surgical Nursing: Review module edition 12.  presphposeMin lifer What is Wellness? joyful relationships Wellness is not the absence of disease, illness, or stress, but the presence of: Optimal physical and behavioral health; Purpose in life; Active involvement in satisfying work and play; Joyful relationships; and Happiness. relationships healthy For more information, visit www.samhsa.gov/wellness-initiative (Dunn, 1961)  Key Concept: 8 Dimensions of Wellness www.samhsa.gov/wellness-initiative SOURCE: Adapted from Swarbrick, M. (2006). A wellness approach. Psychiatric Rehabilitation Journal, 29(4), 311–314.  Physical Dimension PHYSICAL—recognizing the need for physical activity, diet, sleep, and nutrition; Able to perform ADLs Tavities of Strategies/Facilitators daily living exercise dressmaking building healthy habits come healthy dietary patterns access to healthcare  Emotional Dimension EMOTIONAL—coping eNectively with life and creating satisfying relationships; Fair Adapts to stress; expresses emotions Strategies/Facilitators - self care doingthingsthat -connectedness are you happy - sleepschedule - identifying3labeling therapy feelings practicing gratitude becoming aware  Social Dimension SOCIAL—developing a sense of connection, belonging, and a well- developed support system; Interacts successfully with others Strategies/Facilitators socializing w others community groups joining recognizing 3being grateful for healthy have at least one relationships solid connection a d  Occupational Dimension OCCUPATIONAL—getting personal satisfaction and enrichment from one’s work and hobbies; Balances work and leisure responsibilities Where worklife balance fits in Strategies/Facilitators engage in your hobbies identify 3 it at forefront ofmind your why keep separating personal life from work life  Intellectual Dimension creative abilities and INTELLECTUAL—recognizing finding ways to expand knowledge and skills’; Effectively learns and disseminates information Strategies/Facilitators Finding hobbies becominglifelong learner critical thinking asking questions  Financial Dimension FINANCIAL—finding satisfaction with current and future financial situations; effectively manages finances Strategies/Facilitators spending money wisely being comfortable having a job budgeting  Environmental Dimension ENVIRONMENTAL—achieving good health by occupying pleasant, stimulating environments that support well-being; Creates measures to improve standards of living and quality of life Strategies/Facilitators having a clean space safe space having positive green space space to be in decluttering  Spiritual Dimension SPIRITUAL—expanding your sense of purpose and meaning in life Strategies/ Facilitators religious w spiritual connecting outlook largersense of purpose meditation prayer Dimensions are Interconnected doffre Wellness incorporates many dimensions of diagram health that influence an individual’s total well- literally being. CS SOURCE: Adapted from Swarbrick, M. (2006). A wellness approach. Psychiatric Rehabilitation Journal, 29(4), 311–314. Wellness is Individualized Patients who Patients who have have chronic illnesses chronic illnesses Unique to Unique to each each Includes all includes all may describe describe person person may themselves asas aspects of aspects health ofhealth themselves healthy healthy Key Concept: Illness Impairment of physical, social, emotional, spiritual, developmental, or intellectual functioning Responses to illness vary widely and can be shaped by many factors  KEY CONCEPTS: education awareness  Health promotion anything that guides towards optimal health  Disease (or health problem) prevention things that prevent us from moving in opposite direction Expand our understanding of: Health Promotion and Disease Prevention “Your perspective is always limited by how much you know. Expand your knowledge and you will transform your mind.” - Bruce H. Lipton  Key Concept: Upstream Thinking **Helps identify & address root causes and conditions **What’s a root cause? diabetes y l tohmnxit educating ondiets helping maintain National Academies of Sciences, Engineering, and Medicine 2021. The Future of Nursing 2020-2030: Charting a Path to Achieve Health Equity. plebent Mairead Washington, DC: The National Academies Press. https://doi.org/10.17226/25982. bloodsugarlevel FIGURE 2-2 Social Determinants of Health and Social Needs Model. happened encouraging healthy behaviors  What is the intention of intervention who's your audience is toprevent disease or injury in 1st fraguming Primary: Vaxhandwashing duet KEY prevent disease from occurring in the CONCEPT: first place LEVELS OF Secondary: 3FlutestsmammogramsCTS COVID PREVENTIOA quick identification of disease or injury N where how screening diagnostic tests Wh Tertiary:educatingsomeone can nurse postdiabetes diagnosis intervene to Reduce the extent and severity of a health problem to its lowest possible level to PT maintain minimize disability and restore or preserve function optimal occurred after disease or injury has health mitigating effects disease or  not isolating when sick pomebody socialsupport IF needed crime safety poverty access SOCIAL heharthcare Spouse homelessness External Environment PHYSICAL pollution unsanitary access to clean water access to healthcare community safety Internal Environment  Life experiences  Cultural and spiritual beliefs  Age, developmental stage, gender Isex  Emotional factors stress delays healing process  Perception of physical functioning genetics Health/Wellness Assessment awareness of internal external factors of illness  Includes  Physical assessment  Evaluating health perceptions  Identifying risks to health and wellness  Identifying access to care  Identify barriers and facilitators to self-management helping pt identify what their needs are  What are some reasons why people don’t do what their providers recommend? lost lack ofunderstanding fear or anxiety denial amountability stubborn religious or cultural beliefs  Obstacles to Adherence adherence of treatment Perceptions and understanding severity of illness noncompliance ConIdence in provider reflect on self Belief in prescribed treatment on why we do Availability of support systems behaviors Family role and function that we do Financial restrictions Nursing Interventions IDENTIFY COPING IDENTIFY AND IDENTIFY IDENTIFY WAYS TO PROVIDE HEALTH MECHANISMS ENCOURAGE OBSTACLES AND REDUCE HEALTH EDUCATION SUPPORT SYSTEMS CREATE PLANS TO RISKS AND RESOURCES TO OVERCOME COMPLIANCE IMPROVE Terence WELLNESS AND DECREASE RISKS Desired Outcomes Obtain and maintain optimal state of wellness and function through health promotion, wellness, and illness prevention strategies. Health and wellness can be obtained through health education and positive action. Introduction to Wellness & Health Promotion Part 2: Introduction to Health Promoting Behaviors & Guidelines  Highlight public health organizations focused on health promotion and disease prevention  Distinguish between modiIable and non-modiIable risk factors  Summarize the purpose of Healthy People 2030  Identify Healthy People 2030 Objectives related to Health Promotion  Physical Activity  Sleep  Dietary Patterns (Brief intro)  Stress Management  Other Behaviors Major Organizations Focused on Health Promotion and Disease Prevention WHO HEALTHY PEOPLE 2020 CDC ModiIable and Non-ModiIable Risk Factors for Chronic Illness  ModiIable risk factors:  Can be controlled through lifestyle and behavior changes  Examples of common modiIable risk factors for non- communicable diseases physical activity level  1. use of tobacco 2.  3. diet  4. use of Anohol   Non-modiIable risk factors:  Individuals can not change  Examples age income difficult genetics we can't change our genetics Physical Activity: Guidelines across the lifespan (p. 8-10)  Light-intensity activity is non-sedentary waking behavior (see sidebar) that requires less than 3.0 METs; examples include walking at a slow or leisurely pace (2 mph or less), cooking activities, or light household chores. Physical Activity Moderate-intensity activity requires 3.0 to less than 6.0 METs; examples include walking briskly (2.5 to 4 mph), playing doubles tennis, or raking the DeInition yard. s Vigorous-intensity activity requires 6.0 or more METs; examples include jogging, running, carrying heavy groceries or other loads upstairs, shoveling snow, or participating in a strenuous Itness class. Many adults do no vigorous-intensity physical activity. Sleep: American Academy of Sleep Medicine https://sleepeducation.org/healthy-sleep/ do children or adults need more sleep question that will be asked Nutrition: Dietary Guidelines for Americans, 2020-2025  U.S. Department of Agriculture and U.S. Department of Health and Human Services. Dietary Guidelines for Americans, 2020- 2025. 9th Edition. December 2020. Available at DietaryGuidelines.gov. Stress Management: Many diNerent agencies & strategies https://www.nimh.nih.gov/health/publications/so-stressed-out-fact-shee Healthy People 2030 baseline data that is monitored over time Provides data driven national objectives for improving the health and wellbeing of all Americans. The initiative aims to: 1. Attain healthy, thriving lives and well-being free of preventable disease, disability, injury, and premature death. 2. Eliminate health disparities, achieve health equity, and attain health literacy to improve the health and well-being of all. 3. Create social, physical, and economic environments that promote attaining the full potential for health and well-being for all. 4. Promote healthy development, healthy behaviors, and well-being across all life stages. 5. Engage leadership, key constituents, and the public across multiple sectors to take action and design policies that improve the health and well-being of all These goals relect a comprehensive approach to public health, focusing on prevention, health equity, and the social determinants of health to create a healthier future for everyone. Healthy People 2030  https://youtu.be/ACEgRgycw Ik health disparities health equity health literacy wellbeing social determinants of health Questions? Introduction to Wellness & Health Promotion Part 1: Introduction to Wellness & Health Promotion Part 2: Introduction to Health Promoting Behaviors & Guidelines Objectives that they Part 3: Explore Healthy People 2030 want to reamover nex decade Next week: Class Prep Readings and Activities Health Promotion, Health Education & Learning Theory  Part 1: Learning Theory Bloom’s Domains of Learning Knowles’ Characteris7cs of Adult Learners Teaching-learning principles (7) Recap Client Readiness Health Literacy Readiness for change Health Transtheore7cal Model & Stages of Change Education Mo7va7onal & Interviewing Learning Theory Part 2: Health Promo7on Theory Health Belief Model Pender’s Health Promo7on Model TTM & SOC (see above) Social Determinants of Health Socio-ecological Model Precede-Proceed Model  health promotion theory Role of the Educator Health educa7on is a founda7on of prac7ce Individuals, groups, communi7es In-person, via phone, web-based, campaigns (posters, billboards), print Importance of educa7onal theory and teaching methods Helps nurse frame health messages for greatest impact and chance of success Successful learning Increase chances by making it interes7ng, relevant, and clear Image credit: hQps://wychwoodschool.org/blogs/you-can-lead-a-horse-to-water-but-you-cant-make-him-drink/ LEARNINGTHEORI 3 Main Domains of Learning Cogni&ve: mind and thinking processes A*ec&ve: emo7on, feeling, and aWect Psychomotor: learn-see-do, demonstra7ng, neuromuscular coordina7on, movement (Bloom, 1956) Cognitive Domain i e creating careplans  AAective Domain valuesinterests axitude Learning that yn occurs through emotion, feeling, or aAect Evaluation of learning: - changes in interest, attitudes, and values  have pt demonstrate Psychomotor Domain they understand how to A wound dressings physically performing skill askq's about howthey affective Visible demonstration of skill requiring feel about their ability to movement do it home Conditions for psychomotor learning, ask basic steps Whatdoyou do if learners must: Be capable of the skill Have a sensory image of how to perform the skill Practice the skill Evaluation of learning: Use return demonstration CHARACTERISTICS Adult learners diWerent from children Learning process is similar but diWerent characteris7cs of an adult learner Characteris7cs of adults with implica7ons for learning LEARNERS OF ADULT Need to know Self-directed autonomy in learning Life experience connectpastcurrent experiences Readiness to learn - relevance Problem-centered mo7va7on seekingsolutionsanswers Need more 7me for stuffyouwant Intrinsic mo7va7on to immediatelysolve motivation Infergal  ask what Clients with needs learner to Special bestmerpert Learning Needs Cultural or language diWerences Midnstator Hearing impairments Developmental delays Memory losses Visual percep7on distor7ons Problems with [ne or gross motor skills Distrac7ng personality characteris7cs Demonstra7ons of stress or emo7ons Neurodiversity  7 Teaching–Learning Principles questions in includes physicalemotional have to ask man experimental directs clientsengagement funnaturuggtities ftp.tamnspeeltopenness all Client Client Educa7onal Client readiness** percep7ons environment par7cipa7on Subject Client Client relevance sa7sfac7on applica7on 4 have client develop own If Iatthesm relevant making sure theyare satisfied situations scenarios to them w thecareoutcome  romietrrins saying.si Formal or informal, planned or unplanned fathead emergent enemsecondangosegment tgdn Methods: Lecture te howtomaintain glffa Demonstra7on with explana7on self management ab Role-playing Teaching screening Discussion – used in combina7on with all other methods Methods Materials and (*free educa7on materials available from various health focused organiza7ons – ex. AHA) Materials Images Anatomical models Equipment Printed support materials – pamphlets, handouts Examples Content, complexity, reading level, culturally appropriate  Two major considera7ons: Health Literacy Client Nursing strategies Readin Readability of wriQen materials ess Readiness for change Transtheore7cal Model & Stages of Change Mo7va7onal Interviewing Health Literacy The degree to which individuals have the capacity to obtain, process, and understand basic health informa9on needed to make appropriate decisions Including insurance, medica7on labels, disease informa7on, preven7on, and naviga7on of healthcare system Can change based on context Low health literacy is more prevalent among: Older adults Lower income communi7es Medically underserved communi7es Lower income Lower general educa7on DiWerent culture (e.g., cultural barriers to health educa7on)  Research indicates that persons with low health literacy have: less knowledge about disease management, less use of preven9ve services, and higher hospitaliza9on rates (Baker et al., 2002) Health incur higher health care costs (Howard et al., 2005) literacy an increased risk of mortality (Baker et al., 2007); and report poorer health status than persons with adequate literacy skills (IOM, 2004) Reference: hQps://nam.edu/perspec7ves-2014-health-literacy-as-an-essen7al-component-to-achieving-excel lent-pa7ent-outcomes/  Loca7ng providers and services When Filling out complex health forms clients with Sharing their medical history with providers low health Seeking preven7ve health care literacy Knowing the connec7on between risky may have behaviors and health Managing chronic health condi7ons diTculty … Understanding direc7ons on medicine hQps://www.hrsa.gov/about/organiza7on/bureaus/ohe/health- literacy/index.html Nursing practices to address low health literacy in health education Identify patients with limited literacy levels Use simple language, short sentences and deVne technical terms Supplement instruction with appropriate materials (videos, models, pictures, etc.) Ask patients to explain your instructions (teach back method) or demonstrate the procedure Ask questions that begin with “how” and “what,” rather than closed-ended yes/no questions Re^ect the age, cultural, ethnic and racial diversity of patients For Limited English ProVciency (LEP) patients, provide information in their primary language Improve the physical environment by using lots of universal symbols Written materials should be at a 4th to 6th grade level 2 Limit discussion to 3-5 key points; Repeat I pictures symbols How can we check reading level? SMOG Readability hQps://www.cms.gov/outreach-and-educa7on/outreach/wriQenmaterialstoolkit?redirect=/wriQenmaterialstoolkit/ Client Readiness – Readiness for Change Pre-contempla7on Transtheoretical Model (Prochaska & Diclemente, 1983) Mo7va7onal Interviewing Contempla7on most useful at these Stages of Change stages Processes of Change Decisional Balance (Pros/Cons) Prepara7on Self-Ehcacy Ac7on Maintenance  Transtheoretical Model Concepts Stage of Change De[ni7on ng Pre-contempla7on No inten7on to take ac7on toward behavior change in next 6 months. unborn Bene[ts of change are less than consequences of change (PROS < CONS) Contempla7on Has some inten7on to take ac7on toward behavior change in next 6 months. Weighing the pros and cons of changing behavior. (PROS = CONS) maybe I do Marknit Prepara7on Intends to take ac7on within next 6 months. Has taken steps towards behavior change – has a plan of ac7on. (PROS > CONS) planning what you're gonnado When Ac7on Has changed behavior within 6 months. Pros > Cons. maintenance Maintenance Changed the behavior over 6 months ago and strive to prevent relapse. May have lapses but these are diWerent than relapses. Pros > Cons. Processes of Change Techniques and processes that aid the progression between stages Decisional Balance Balance between gains (pros) and losses (cons) of changing behavior Self-Ehcacy Individual con[dence in maintaining behavior change Q noteThf types F A whereagenstages Is  What if they just don’t seem to care or are resistant to the informa9on ???? Stuck in precontempla9on or contempla9on?  Motivational Interviewing Helping People Work Through Ambivalence * Excellent technique for pre-contempla7on and contempla7on stages of change Motivational Interviewing Principles Avoiding argumenta7on To learn more about Mo&va&onal Interviewing and see examples: Rolling with resistance Day et al. (2017) The use of mo7va7onal interviewing in community nu rsing (avoid harsh confronta7ons) Tobacco Cessa7on - Pre-contempla7ve Stage: Expressing empathy hQps://www.youtube.com/watch?v=_YOULz-MPaU Tobacco Cessa7on – Pre-contempla7ve Stage: Developing discrepancies hQps://www.youtube.com/watch?v=hB-zchaxlNc Tobacco Cessa7on - Suppor7ng self-ehcacy hQps://www.youtube.com/watch?v=URiKA7CKnc Motivational Interviewing Core Skills: OARS Essence/Spirit O - Open-ended ques7ons Compassion A - Ahrma7ons of the pa7ent’s Acceptance No R inner strength Partnership esis R - Reoec7ve statementsmirrorpt Roll tance Evoca7on with ! S - Summary statementsverbalize it! shala Batista PPT & Video: hQps://www.youtube.com/watch?v=s3MCJZ7OGRk Changing our perspective as health educators … Judgement Curiosity Why doesn’t the teenager take What makes it dihcult for them their insulin each day? I told to take their meds? Can they them how important it is! aWord the supplies? Do they have worries about how their diabetes may aWect their soccer game? How do they like to learn? How can I connect my instruc7ons to what is important NON-COMPLIANT them?  3 Domains of Learning Cogni7ve AWec7ve Recap – Part Psychomotor 1 Teaching-learning principles (7) Health Client Readiness Education & Health Literacy Learning Nursing strategies Theory Readability of wriQen materials Readiness for change Transtheore7cal Model & Stages of Change Mo7va7onal Interviewing  Operant Condi7oning Health Belief Model Part 2: Health Pender’s Health Promo7on Model Promotio TTM & SOC (already discussed) n Models Theory of Planned Behavior Social Cogni7ve Theory (Self-ehcacy)  equipment siphon I motivation What is Health Promotion ? client education environment Runnersworld.com  Why is it so hard to make a healthy choice? a majority of healthy choices don'thave an immediate result Nogilthlation a lth limited timesaccess He viors finances e ha B are EX farity perspective COM P L hQps://lupusrebel.com/behavior-change/  I don’t I enjoy watching I’m just have the TV! not money! athle7c! It hurts! I love cake! My friends won’t like I can’t me and I don’t want [nd the to be alone! 7me! What makes it so that these people can be physically ac7ve? environment social support motivation proper equipment Health Promotion Frameworks/Theory 1 2 3 Guide how to approach Help nurses understand Help nurses develop complex concepts - mo7va7ons and barriers crea7ve, cost-eWec7ve health at the individual, to behavior change interven7ons and policy family, and community changes related to level appropriate levels of preven7on Can theories be applied across cultures? Often, yes! Can be applied to diverse cultural and ethnic groups But health practitioners must understand Characteristics of target populations (e.g., ethnicity, socioeconomic status, gender, age, and geographical location) And adjust accordingly hQps://cancercontrol.cancer.gov/sites/default/[les/2020-06/theory.pdf Health Promotion Theory Learning, Social, & Behavior Change Theories (… individual/interpersonal focused) (1) Operant Condi7oning (2) Health Belief Model (3) Pender’s Health Promo7on Model (4) TTM & SOC (previous slides) (5) Theory of Planned Behavior (6) Social Cogni7ve Theory (Self-ehcacy) Masslive.com  a lot of (1) Operant What we Conditioning do based on Moad Skinner’s Operant Condi7oning Theory Sciencenews.org Reinforcements and punishments can modify behavior Ex: Child behaving well  lollipop Intrinsic and Extrinsic Rewards: Extrinsic rewards: receiving an award Ex: Weight watchers – receive public recogni7on and ribbon/star for success Intrinsic rewards: Ex: Weight watchers – lose weight and feel good (2) Health Belief Model how likely is this badthing me fog how bad it a jlt Itillerth's maarenange attackgoing to be for me Health Belief Model Concepts Concept De[ni7on Perceived suscep7bility One’s belief regarding the chance of gewng a condi7on Perceived severity One’s belief regarding the seriousness of a given condi7on Perceived bene[t One’s belief in the ability of an advised ac7on to reduce the health risk or seriousness of a given condi7on Perceived barriers One’s belief regarding the tangible and psychological costs of an advised ac7on Cues to Ac7on Cues to Ac7on: Strategies or condi7ons in one’s environment that ac7vate readiness to take ac7on Self-ehcacy One’s Con[dence in one’s ability to take ac7on to reduce health risks  What construct are these addressing ? hQps://www.smithsonianmag.com/smart-news/cigareQe-warning-labels-more-graphic-180961721/ What construct is this addressing ? self efficacy percieved benefits for child  different than last one be It focuses on positive behavior (3) Pender’s Health Promotion mmediate Model brings in acknowledges interpersonal competing influences demands Similar to Health Belief Model Does not consider health risk as a factor that provokes change Examines factors that aAect individual actions to promote and protect health Personal factors, behaviors, abilities, self‑eTcacy Feelings, beneVts, barriers, and characteristics associated with the action Attitudes of others, and competing demands and preferences hQps://deepblue.lib.umich.edu/handle/2027.42/85351  what are your attitudes around this pervened Δ Theory of Planned manliants intention Behavior (Ajzen) Exercise is Fun & Everyone is Doing it! (4) Transtheoretical Model & Stages of Change Pre-contempla7on See previous slides Contempla7on First half of lecture Prepara7on Ac7on Maintenance (5) Social Cognitive Theory (Self-ETcacy) Albert Bandura self efficacy Knowledge Expecta7ons Awtudes Social norms Skills Prac7ce Determines Access to resources Human Ability to change own Self-ehcacy environment Self-Regula7on Behavior  Self-ETcacy To increase self-ehcacy: Vicarious experiences 389 (seeing an equal do it) Believing you can too Mastery Experiences (successful experiences) constantly doing Social Persuasion commance assets (social encouragement) peers reassurring supporting Stress Reac7on/Physiological Feedback (interpreta7on) your body reacts to physiological stress response selfefficacyresponse HR could be excitement be feel confident A few key points… Health promo7on extends beyond health educa7on alone! Just because it will change behavior, doesn’t mean it is a good strategy! Remember your nursing knowledge. Common threads: Self-ehcacy, Social Support, Awtudes/AWect, Readiness Context and systems maJer! (next class … systems models!) BEHAVIOR CHANGE IS HARD!!! Struggle and lapse are a part of change – it oyen takes several aQempts for it to s7ck! Identify recommended starting ages and frequency of a variety of screening exams. hQps://nursing.maryville.edu/blog/health-screening- recommenda7ons-by-age.html Group Activity - School Nurse Scenario School Nurse Scenario Scenario: You are an elementary school nurse. Rates of childhood obesity (BMI%) in your school con7nue to rise. You decide to create a school wide campaign to address childhood obesity. Health Promo7on campaigns that are based in evidence supported theories are most eWec7ve. A) Iden7fy a health behavior that contributes to childhood obesity B) Include a recommenda7on for a speci[c health behavior based on those discussed in the previous lecture C) Iden7fy 1 health promo7on theory from lecture that could be used as a founda7on for your health promo7on strategy D) Describe how you would use the theory/model as a framework to guide for your client educa7on or school wide campaign to address childhood obesity. To do this, select 3 constructs from the model and describe an example strategy you would use in your campaign/educa7on for each construct. E) Do you think this educa7on or campaign would be eWec7ve? Why or why not? You may work with someone else. Everyone submits their answer. Include the name of everyone on the assignment. *Do not use the same exact example that I used in the lecture. Be crea7ve.  Thank you!! Ques7ons? Health Promotion Theory Dr. Kimberly Hartson, PhD, RN  ATI TEAS - Results Remediation not required Focused review resources available You are empowered in your education  Class 1: Intro to Wellness & Health Promotion Terminology (e.g., wellness illness continuum, levels of prevention, etc.) Intro to Health Promotion Behaviors & Guidelines Healthy People 2030 Class 2: Health Promotion Theory Health Introduction to Learning Theory Health Literacy Promoti Individual/Interpersonal Theories Class 3: Health Promotion Theory on Unit (Systems) Social Determinants of Health Socio Ecological Frameworks Culture, Ethnic, Religious InXuences Class 4: Exam 1 (in person) + Online Lecture (Nutrition)  Class Prep – Q1 Identify a behavior & the associated recommendations (Sleep, PA, Nutrition) Review the guideline & develop a goal to go d o 30 l tr y to m on l l e- I wil l I wi at 10 reach p I wi of cor l utes hening serv eat 5 p o min fruit ings o slee days t urs of gt es k o st re n ti m / per vegetab f wee ast 7 h. es 3 r the c i s d ay les at le sleep exer eek fo. next ov e r w per t mont h wee the k. nex  “I can create a dedicated exercise space at home with a yoga mat and minimal equipment, making it easier to do core exercises when I can’t get to Q2 – Q4 the gym. This change addresses time constraints by reducing the need to travel and makes exercising more accessible.” Turning oG all the lights and not using any electronic devices at least 30 minutes before bedtime to help limit distractions and promote sleep. Getting a good Q2: Collecting baseline data over paststart week to early sleep can help less naps during the day and more productivity. Q3: Barriers & facilitators to achieving goal Q4: Environment modi_cation to overcome a barrierand e l ights vices o G all th onic de r Tu r ning ny elect s before “One environmental change I “ s i n g a minute imit ” could make … is to keep a variety not u least 30 to help l e sleep. at ime t omo of alternative fruit options on bedt and pr hand…” a ct i ons distr  Nudge Theory (1) Automatic processes - these are fast and reflexive reactions (2) Reflective processes - these are slow and thoughtful. Modify our environments to make the healthy choice the easy and attractive choice…  Behaviors  Health outcomes Physical activity Sleep Nutrition Stress management Medication management Preventive care Risk behaviors Alcohol Smoking Risky sexual activity Runnersworld.com Preventive Health Screenings often include: Vision, hearing Oral health Blood pressure & cholesterol Stroke screening Diabetes Mental health – depression Thyroid test (TSH), Hepatitis C, STI+HIV Cancers https://nursing.maryville.edu/blog/ health-screening-recommendations-  Health Promotion Frameworks Guide how to approach complex concepts Help nurses understand motivations and barriers to behavior change Help nurses develop comprehensive interventions related to appropriate levels of prevention  Health Promotion Frameworks Learning, Social, & Behavior Change Theories (… individual/interpersonal focused) Operant Conditioning Health Belief Model Transtheoretical Model Theory of Planned Behavior Social Cognitive Theory (Self-ecicacy) Determinants of Health Models –broad, encompassing! Social Determinants of Health Ecological Model Masslive.com  Objectives Health Promotion Theories (Systems) Describe how social determinants of health a3ect an individual's overall wellness. Discuss health promotion from an ecological/determinants of health model perspective Cultural, Ethnic, and Religious In=uences De;ne ethnocentrism Provide examples of acculturation Discuss the e3ects of culture on health promotion Distinguish nutritional concerns associated with select ethnicities Identify cultural dietary practices for speci;c populations Identify nutritional considerations for speci;c religious groups Engage Fundamentals RN 2.0: Health Promotion, Wellness, and Disease Prevention Health Promotion & Determinants of Health Models (Systems Models) Social Determinants of Health Ecological Model  Social Determinants of Health... conditions in which people are born, grow, live, work, and age... https://www.cdc.gov/socialdeterminants/index.htm Health Promotion: Neighborhood & Built Environment What parts of our neighborhood & built environment acect our behaviors? [TOPHAT] - Increasing health promoting behaviors - Decreasing risk behaviors  Health Promoting Behaviors & Economic Stability The connection between the _nancial resources people have (income, cost of living, and SES) and their ability to partake in health promoting behaviors 2022: 11.5% people in U.S. in poverty (37.9 million people) Individual < $15,225; Family of 4 < $29,678 Key issues: Poverty Employment Food security Housing stability Other (e.g., medication) https://www.census.gov/library/publications/2023/demo/p  How does lack of economic stability make one vulnerable to poor health promoting behaviors? Inadequate housing Lower education Less safe neighborhoods Unstable jobs (shift work) Decreased community Increased risk of occupational resources hazards Underinsured/uninsured Decreased extra time for Access to healthy foods healthy habits Increased stress Stigma (psychological stress) Environmental injustice Cycle of poverty/poverty trap More... Education Level Education & Health Promoting Behaviors - critical thinking - problem-solving skills - broad understanding of di3erent subjects  Health Care: Access to & Quality of Care Health Promoting Behaviors & Social and Community Context Social support Social norms Connectedness Crime, violence, safety Stigma, discrimination Ecological Model Levels are interconnected  Health Promotion: Behavior Change Models Theories/Frameworks help us to … approach complex concepts understand common motivations and barriers develop comprehensive interventions related to appropriate levels of prevention & addressing multiple ecological levels Common threads: Self-ecicacy, Social Support, Attitudes, Readiness Context and systems matter! BEHAVIOR CHANGE IS HARD!!! Struggle and lapse are a part of change – it often takes several attempt for it to stick!  Cultural, Ethnic, and Religious In=uences De;ne ethnocentrism Provide examples of acculturation Distinguish nutritional concerns associated with select ethnicities Identify cultural dietary practices for speci;c populations Identify nutritional considerations for speci;c religious groups  Meaning of Culture Culture: the beliefs, values, and behaviors that are shared by members of a society and provide a template or “road map” for living  Learned from others Integrated system of customs 5 and traits Characteristi Shared cs of Culture Mostly tacit (unspoken) Dynamic  Transcultural Nursing Caring for clients across cultural groups Requires culturally sensitive care Cultural Diversity (cultural plurality) Coexistence of a variety of cultural patterns within a geographic area Ethnocentrism Bias that a person’s own culture is best and others are wrong or inferior Image credit: https://ul_re.com.au/cultural-diversity-virtual-teams/ Cultural Sensitivity Continuum more impertas purse  Cultural Self-Awareness Recognizing the values, beliefs, and practices that make up one’s own culture and becoming sensitive to the impact of one’s culturally based responses  Ethnic/racial background Cultural Language and communication patterns Assessment Cultural values and norms Biocultural factors Religious beliefs and practices Health beliefs and practices  Health Promotion & Wellness Health beliefs & interpretations Cultural & religious traditions Social support Preventive practices Stress management Acculturation: Cultural, ethnic, or religious group adopts the dominant culture’s behaviors, beliefs, and values First-generation individuals are more likely to follow traditional foodways, while subsequent generations may adopt dominant culture practices.  Generalizations Bene_ts Consequences  Cultural Humility Cultural humility involves reflecting on what one knows about a particular group and what one does not know about the unique values, experiences, meanings, and goals of the [client]…, regardless of their group membership. Culturally humble practitioners also reflect on how personal life experiences may bias their familiarity with and acceptance of their clients’ lived experiences.... Humility can allow practitioners to approach their work with a client with healthy curiosity, rather than with overly confident and potentially erroneous assumptions about the client. Striving to be culturally humble rather than competent, facilitates lifelong learning. Cultural humility is more than learning from clients. It involves intentional and honest self-reflection about what practitioners bring to the clinical encounter in terms of lived experiences and cultural influences.  Cultivating Cultural Sensitivity Culture as enabler View culture as an enabler rather than a resistant force. Dignity and worth Recognize feelings and reinforce dignity and worth as an individual or group. Build rapport Take time for a pleasant conversation and build rapport. Involve Involve signi_cant family members in care. Reassure Reassure the client regarding con_dentiality. Cultural Diversity Be aware of cultural diversity within the same ethnic group. Communicate Communicate openness, acceptance, and willingness to learn. When a cultural practice is unknown, ask the client to detail preferences, and then Ask provide respectful care. Incorporate Incorporate cultural beliefs into the plan of care. Questions! Exam 1 Blueprint (48 questions; 72 minutes for entire exam; Multiple choice & Select X that apply etc.) Class 1 [randomly selected 16 questions] Terminology: Wellness, Illness, Wellness-Illness Continuum, Health Promotion, Disease Prevention, Upstream Thinking 8 Dimensions of Wellness (definitions, interconnectedness, & identify examples) Levels of Prevention (definitions & connect example with appropriate level of prevention) Modifiable vs. Non-modifiable risk factors for non-communicable diseases Health behavior guidelines Physical activity (adults): moderate-intensity aerobic activity per week; muscle-strengthening activity per week Sleep (across the lifespan) Who needs the most sleep per 24 hours? Who needs the least sleep per 24 hours? Recommended amount for adults per night. Dietary Guidelines: Who sets the recommended dietary guidelines in the US? We will work with details of the dietary guidelines in future classes Stress management: Strategies for coping with stress and anxiety Class 2 [randomly selected 16 questions] Domains of Learning (definitions; identifying strategies & evaluations) Bloom s taxonomy (order, examples) Characteristics of adult learners Teaching-learning principles (definitions) Client readiness Health literacy (definition, populations at increased risk, nursing practices) Readiness for change Transtheoretical Model & Stages of Change (definitions; decisional balance; examples of each level; process of change) Motivational interviewing (purpose in relation to TTM/Stages of change, core skills, essence/spirit) Intra/interpersonal health promotion model Operant condition – intrinsic/extrinsic rewards (definition, identify example) Health belief model concepts (definitions, examples, severity vs. susceptibility) Common threads Self-efficacy, social support, attitudes/affect, readiness, struggle/lapse (not linear) Strategies to increase self-efficacy (definitions, examples) Class 3 [randomly 16 questions] Nudge Theory - reflective processes, role of environment) Benefits of using health promotion frameworks to guidance practice, especially systems frameworks Social determinants of health (definitions, purpose & interconnectedness, identify examples related to health promotion) Ecological frameworks in health promotion and wellness (definitions, purpose & interconnectedness, identify examples related to health promotion and wellness) Terminology: Ethnocentrism, ethnorelativism, acculturation, transcultural nursing, cultural diversity (definitions & identify examples), cultural humility Cultural assessment (purpose, topics - including self-assessment) Engage Fundamentals RN 2.0: Review: definitions (health promotion, wellness, disease prevention, illness-wellness continuum, health education, healthy people initiative, modifiable vs nonmodifiable risk factors for CV disease, SDOH/factors affecting health, Levels of Prevention – excluding Quaternary) Cultural beliefs Self-care: client & nurse (identifying examples, self-care)