Care Of Selected Community Health Problems PDF

CARE OF SELECTED COMMUNITY HEALTH PROBLEMS  Disability Definition:- The world health organization defines disability as a loss in the ability to perform an activity. 0  Concept of Disability Disability as a physical or men...

CARE OF SELECTED COMMUNITY HEALTH PROBLEMS  Disability Definition:- The world health organization defines disability as a loss in the ability to perform an activity. 0  Concept of Disability Disability as a physical or mental impairment that substantially limits one or more of the major life activities of an individual 0  Chronic Physical Health Problems § Health problems present for extended periods and that are characterized by nonreversible pathological changes Need for lifestyle adjustment Prolonged period of supervision and care by health professionals  Personal Effects of Chronic Health Problems § Impairment: Loss of psychological, physiological, or anatomical structure or function § Disability: Limitation in functional ability § Handicap: Disadvantage resulting from impairment or disability that impedes role fulfillment § Financial burden  Population Effects of Chronic Health Problems § Societal costs § Morbidity § Mortality Classification of Disability Major Life Activities limitations (Play, School, Work, Self-Care) Non-Major Life Activities limitations (Climbing Stairs, Driving Automobile) 0  Role of Community Health Nursing in Disability 1. Community health nursing efforts to prevent disability must address prevention and adequate treatment of chronic conditions. 2. Both spinal cord and traumatic brain injuries require intensive, long-term health care resources. 0  Role of Community Health Nursing in Disability 1. Conduct programs that identify children with congenital and traumatic illness/injury to prevent farther disability, promote development, learning and integration into the community 2. Assist people with disabilities in community settings, collaborate with the client to establish realistic goals that will foster the maintenance of independent functioning. 0  Primary Prevention of Physical Health Problems § Health promotion/illness prevention § Risk factor modification Health Promotion/ Illness Prevention § Education for prevention and promotion § Political activity § Immunization  Risk Factor Modification § Smoking cessation § Weight control § Hypertension control § Use of safety precautions § Elimination of environmental pollutants  Secondary Prevention of Physical Health Problems § Screening § Early diagnosis § Prompt treatment  Tertiary Prevention of Physical Health Problems § Preventing loss of function in affected systems § Preventing loss of function in unaffected systems § Restoring function § Monitoring health status § Promoting adjustment § End-of-life care Mental Health The ability to successfully perform mental functions, to engage in productive activities and meaningful interpersonal relationships, and to adapt to change and cope with adversity  Mental Illness/Problems § Mental illness: A wide variety of diagnosable mental disorders characterized by changes in thinking, mood, or behavior associated with stress or impaired function § Mental health problems: Status characterized by signs and symptoms of mental distress of insufficient duration or intensity to qualify as mental disorders diagnosed based on accepted criteria  Effects of Mental Health Problems § Personal effects § Family effects § Societal effects  Personal Effects of Mental Health Problems § Suffering § Disability: Interference with l Cognitive function l Occupational function l Family role function l Social function l Physical function  Family Effects of Mental Health Problems § Emotional effects § Economic effects § Caregiver burden § Increased family stress § Unemployment and poverty  Societal Effects of Mental Health Problems § Global disease burden and disability § Decreased productivity § Societal costs for care  Prevention of Mental Health Problems § Promoting protective factors l Coping l Resilience § Risk factor reduction  Treatment of Mental Health Problems § Pharmacotherapy § Individual or group psychotherapy § Family intervention § Support groups SUBSTANCE ABUSE  Substance Use and Abuse § Drug use: The taking of a drug in the correct amount, frequency, and strength for its medically intended purpose § Drug abuse: Deliberate use of a drug for other than medicinal purposes in a manner that can adversely affect one’s health or ability to function  Psychoactive Substances § Drugs or chemicals that alter ordinary states of consciousness, including mood, cognition, or behavior Psychoactive Substance Dependence Syndrome A cluster of cognitive, behavioral, and physiological symptoms that indicate impaired control over the use of a psychoactive substance and continued use despite adverse consequences  Psychoactive Substance Dependence Characteristics - 1 § Increasing use § Persistent desire for the substance or one or more unsuccessful attempts to control use § Increased time spent obtaining, using, or recovering from the effects of the substance § Frequent symptoms of intoxication or withdrawal interfering with obligations § Elimination/reduction of important activities as a result of use  Psychoactive Substance Dependence Characteristics - 2 § Continued use of the substance despite recurrent problems § Increased tolerance to the substance § Experience of characteristic withdrawal symptoms § Increased substance use to decrease withdrawal symptoms Psychoactive Substance Abuse Maladaptive patterns of substance use that meet the diagnostic criteria for dependence  Abused Substances -1 § Alcohol § Sedatives, hypnotics, anxiolytics § Opioids § Cocaine § Amphetamine  Abused Substances - 2 § Hallucinogens § Cannabis § Inhalants § Steroids § Nicotine  Effects of Substance Abuse § Personal effects § Family effects § Societal effects l Mortality l Cost l Crime  Assessment § Assessing for risk factors § Assessing for signs of abuse § Assessing for intoxication § Assessing for withdrawal § Assessing for long-term effects Assessment Considerations Biophysical Considerations §Age §Family history of substance abuse §Physiologic status §Physical effects of abuse §Pregnancy  Psychological Considerations § Self-image § Life goals § Impulse control/frustration tolerance § Stress § Coping ability § Psychopathology  Sociocultural Considerations § Social mores § Legislation § Peer support for use and abuse § Family interactions/violence § Religion/culture § Socioeconomic status § Occupational factors § Substance accessibility  Behavioral Considerations § Substances abused/multi-substance abuse § Recreational/leisure use and abuse § Other high-risk behaviors  Health System Considerations § Provider attitudes § Extent of client education for prevention § Recognition of abuse § Prescription of psychoactive drugs § Availability and access to treatment facilities  Primary Prevention Goals § Preventing initiation of use § Preventing progression from occasional to chronic use § Preventing expansion to use/abuse of other drugs  Approaches to Primary Prevention § Client/public education § Risk factor modification  Secondary Prevention § Screening § Intervention § Treatment Intervention The act of confronting the substance abuser with the intent of making a referral for assistance in dealing with the abuse  Principles of Substance Abuse Treatment -1 § A combination of modalities is more effective than a single treatment modality. § Treatment should be tailored to the problems, responses, and resources of the individual abuser. § Both professionals and laypersons should provide treatment. § Client, family members, and significant others should be involved in treatment.  Principles of Substance Abuse Treatment -2 § Detoxification is the first step in treatment. § Associated psychopathology requires psychiatric treatment. § Guilt will need to be addressed to prevent relapse. § Social and vocational rehabilitation may be required. § Treatment may also be required for the consequences of substance abuse.  Tertiary Prevention § Support and encouragement § Lifestyle changes to prevent relapse § Modification of stressors