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7/23/2019 Lecture 1 - Health and Health Promotion
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N1101w Overview
The concepts of health, health promotion and illness will be considered fromthe perspectives of individuals and families.
Health promotion will be examined in relation to personal meaning of health,
health assessment, empowerment, self-care, and health living practices.
!tudents will learn about the nursing process and phsical assessment s"ills.
!tudents will explore transitions in the life ccle, and examine the concept of
chronic health challenges and their effect on the individual and the famil.
#as in which nursing practice can support those with long-term health
challenges, especiall the older adult, will be discussed.
$ssues related to living in a %ong Term &are facilit will also be explored.
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N1101w &ourse 'valuation
Midterm exam:
October (nd, (01)
H!*, rm (+, 11+0-1++0
1 hr /) min., multiple-choice alternate format exam
$ncludes course content up to !ept +0th
(0 of course mar"
Final exam:
2ecember exam period
+ hour, multiple-choice alternate format exam
+0340 emphasis of first3second half of the course
+0 of course mar"
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N1101w &ourse 'valuation
Health Promotion Group Assignment:
() of course mar" 1) paper5 10 in class presentation
6aper 2ue7 October 18th5 in class 6resentations on October ( (4th
9roups of students
Scholarly Paper: Life Revie for the !lder Adult
() of course mar"
8-10 page maximum
2ue7 November +0th, b 100 hrs paper cop as well as submitted to
Turnitin.
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9oals
'xplore personal meanings beliefs about health, wellness, andillness and the relationship between culture, health and illness.
=nderstand the famil as the context in which health behaviours
are learned.
*egin to understand various factors that affect health such as the
!ocial 2eterminants of Health and the relationship between
empowerment and health.
'xplore the concept of health promotion and its appropriateness
in all health care settings.
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>ppearance of 6oor Health
?
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#ith all our modern da technolog
and advanced "nowledge wh do soman individuals experience poor
health, or put themselves at ris"?
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>ppearance of 9ood Health?
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2efinition of Health
Nurses should be aware of their own
personal definitions of health and
appreciate that other people will have
their own uni@ue definitions. $t can affect
goal setting, if we are not on the same
pageA
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Health
Health: according to the #orld Health
OrganiBation is a state of complete phsical,
mental and social well being and not merel theabsence of disease or infirmit #HO, 18/C.
$t is a basic human rightA
Health is a highl individualiBed experience
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The 10 $ndicators of #ell-*eing
well-being.esdc.gc.ca
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>boriginal views of wellness
First "ations# $nuit % Metis:
*elief of the interconnectedness with all creation - famil,
communit, nation, plants, animals, and the spirit peoplethose who have died those not et born.
=se mutual decision ma"ing.
*elief held - ;edicine #heel.
medicine wheel by Mistgod
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1 The four points of the compass, each with a guidingspirit, smboliBe stages in the life Dourne. The 'ast,
direction of the dail birth of the sun, represents a personEs birth and earl ears. The !outh relates to childhood andintellectual growth. The #est smboliBes adulthood andintrospection, while the North represents the old age,wisdom and the spiritual aspects of life. The centre of thewheel is smbolic of ;other 'arth and the &reator, andtheir role in the beginning and continuation of life.
( The four points can also represent the balance betweenspiritual 'ast, mental North, phsical #est andemotional !outh aspects of health.
+ The wheel can also represent values and decisions.Here, values drawn in the 'ast, where the sun risesinfluence decisions ta"en in the mental realm drawn in the
North, at the top. Then, decisions are implemented in the phsical realm #est, and actions produce reactions in the
emotional realm !outh. Finall, these reactions providefeedbac" into the value sstem, completing the circle ofvalue - action - evaluation.
/ The @uadrants of the wheel are often coloured red,ellow, blac", white or green.
http733www.webpanda.com3There3uotGdirections-colors.htm
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$llness3#ellness &ontinuum
www.studyblue.com
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Health Health 6romotion
<obert %abonte a &anadian Health Theorist 188+categoriBed how people define health into six groups7
1. Feeling vital, full of energ(. Having good social relationships
+. 'xperiencing a sense of control over oneslife living conditions
/. *eing able to do things one enDos). Having a sense of purpose in life
. 'xperiencing a connectedness toIcommunitJ to others
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Health *elief ;odels
>re useful tools in developing programs for helping
people change to healthier lifestles and develop a
more positive attitude toward preventive health measures.
Health Locus of &ontrol Model 'L!&(
Health )elief Model 'Rosenstoc* % )ec*er(
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Health %ocus of &ontrol ;odel
> concept from social learning theory that nurses can
use to determine whether clients are li"el to ta"e action
regarding health, that is, whether clients believe that theirhealth status is under their own or others control.
6eople who have a maDor influence on their own health
status are called internals. $nternals ta"e initiative on
their own healthcare, are more "nowledgeable about their
health and adhere to prescribed health care regimens.
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Health %ocus of &ontrol ;odel
Externally controlled people on the other hand need
assistance to ta"e more control internall, if behaviour
changes are to be successful.
>ssessment tools to assess %O&
e.g., ;ultidimensional Health %ocus of &ontrol !cale;H%&
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<osenstoc" *ec"ers Health )elief Model
*ased on motivational theory.
$ntended to predict which individuals would or would not use
preventive measures such as screening for earl detection of
cancer.
*ec"er 184/ modified the Health *elief ;odel to include7
$ndividual perceptions
;odifing factors
Kariables li"el to affect initiating actions
<osenstoc" - good health is an obDective common to all people.
*ec"er added Ipositive health motivationJ as a consideration.
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www.slideshare.net
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$llness 2isease
$llness is usuall associated with disease but ma
occur independentl.
$llness is a highly personal experience in which the Iperson
feelsJ unhealth or ill.
2isease alters bod functions and results in a reduction of
capacities or shortened lifespan.
The causation of disease is called Ietiolog.J
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&lassification of $llness
Acute illness:
&haracteriBed b rapid onset, severe smptoms of
relativel short duration usuall wee"s or less and
recover is expected, and predictable e.g., the Flu.
Chronic illness:
2evelops graduall, lasts months or longer or a persons entire life. !mptom management is the goal
not cure. &an be characteriBed b periods of
remission and exacerbations e.g., >rthritis, ;!, $*2
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'ffects of $llness
*rings about changes for individual and for the famil
>ttitudinal changes
Financial demands
%ifestle changes>dDustments to usual roles
$mpact on the client
*ehavioural and emotional changes&hanges in self concept bod image amputation, burns
%ifestle changes
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$llness $mpact on the Famil
Affects all family mem+ers in terms of :
<ole changes
Tas" reassignments
$ncreased stress
Financial problems
%oneliness
&hange in social customs
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!ocial 2eterminants of Health
1. !tress, *odies, and $llness(. $ncome and $ncome 2istribution
+. 'ducation
/. =nemploment and :ob !ecurit
). 'mploment and #or"ing &onditions
. 'arl &hildhood 2evelopment4. Food $nsecurit
C. Housing
8. !ocial 'xclusion
10. !ocial !afet Net
11. Health !ervices1(. >boriginal !tatus
1+. 9ender
1/. <ace
1). 2isabilit
:. ;i""onen 2. <aphael (010
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Health 6romotion
Health promotion: the process of enabling
people to increase control, and improve their
health.
=nderstanding health promotion - > short introduction, +7/C
http733www.outube.com3watch?vL8THMT'@;a=
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Health 6romotion
pamodules.mc.du"e.edu
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Health 6romotion
,he Lalonde Report '-./0(: !uggested that medical care was not the most important
determinant of health and that changes in lifestle and
environment plaed the greatest role in improving the
health of populations. !uggested loo"ing at health in terms of a health fields
approach, comprising / main elements7
Human biolog'nvironment
%ifestle
Healthcare organiBation
&hapter C
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Health 6romotion
$n the18C0s a new focus or vision emerged of health promotion
,he !ttaa &harter for Health Promotion 18C based on
#HO, 18C recommendations was adopted.
&anada was seen as the forerunner in Health 6romotion with the publication in 184/ of the Lalonde Report one of the
founding documents in health promotion in &anada.
EPP Report 18C was released and adopted b &anada as thevision for I Achieving Health for All J b the ear (000.
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Health 6romotion1PP Report '-.23(:
<ecommended decreasing ine@uities, increase prevention, enhancingcoping Kia Fostering public participation, strengthening communit
services, coordinating health public polic.
$dentified + maDor health challenges facing &anadians.
2isadvantaged groups have significantl lower life expectanc, poorer
health, and a higher prevalence of disabilit than the average &anadian.
Karious forms of preventable diseases and inDuries continue to undermine
the health and @ualit of life of man &anadians.
Thousands of &anadians suffer from chronic disease, disabilit , and
emotional stress, and lac" of ade@uate communit support to help them cope
and live meaningful, productive and dignified lives.
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To address these challenges, 'pp proposed I A Framework for
Health Promotion.J
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6rograms for Health 6romotion
$nformation dissemination
Health appraisal and wellness assessment Finding the people in the communit and determining how health the
are
%ifestle and behaviour change $n the past everone used to smo"e all the time.
'nvironmental control programs- Having a clean water suppl, no pesticides, etc.
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2efinitions of Health 6romotion
Ronald La+onte 188+7
2efined health promotion as Ian activit or program
designed to improve social and environmental living
conditions such that peoples experience of well-being
is increased.J
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Health 6romotion<onald %abonte 188+7 identified ) essential principles of
communit development that support health promotion7
1. 'mpowering services getting people involved. 9etting Ottawa
to throw mone at this process. 'mpower the people with power to
ma"e decision(. &onnective processes
+. OrganiBational actions
/. &ollaborative strategies
). >dvocac that challenges control
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2efinitions of Health 6romotion
"ola Pender 1887 nursing theorist.
2efines health promotion as Iactivities directedtoward increasing the level of well-beingPand
defines primary prevention as Iactivities directed
toward decreasing the probabilit of specific
illnesses.J
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6enders Health 6romotion ;odel H6;
Nola 6enders health promotion model 188 is similar to
*ec"ers Health *elief ;odel - focuses on health
promoting behaviours.
This model, which had the aim of helping nurses educate
clients with entrenched behaviours such as smo"ing and
drug abuse, has been described as one of the predominant
models of health promotion within nursing Qing, 188/.
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www.slideshare.net
Health 6romotion
;odel
Nola 6ender, 6h2, <N, 188 revised model
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Nurses <ole in Health 6romotion
;odel7 health lifestle behaviours and attitudes.
Facilitate7 client involvement in the assessment, implementation
evaluation of their health goals.
Teach7 client self-care strategies to enhance fitness, improve nutrition,
manage stress and enhance relationships.
>ssist7 individuals, families communities to increase their level of health.
>ssist7 clients, families communities to develop and choose health
promoting options.
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Nurses <ole in Health 6romotion
'ducate7 clients to be effective healthcare consumers.
9uide7 clients development in effective problem solving anddecision ma"ing.
<einforce7 clients personal famil health promotion
behaviours.
>dvocate7 in the communit for changes that promote health.
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!tages of Health *ehaviour &hange
Health behaviour change is a cclic phenomenon in which
people progress through several stages.
6rochas"a and 2i&lemente 18C( propose a five-stagemodel for health behaviour changes7
1. The pre-contemplation stage
(. &ontemplation
+. 6reparation
/. >ction
). ;aintenance
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!tages of Health *ehaviour &hange
$f the person is not successful in changing behaviour, relapse ma occur
during the action or maintenance stages. However, at an point in thesestages, people ma move to an previous stage, an understanding of these
stages enables the nurse to provide appropriate nursing interventions.
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Test Muestion7
1. ;r. !mith is a 4(-r-old man who lives alone in an apartment
in an urban setting in &anada. He describes himself as health,self-sufficient, and financiall secure. ;r. !mith has no living
relatives and states that he often feels sad and lonel. He does
his shopping at a grocer store across the street and eats a
well-balanced diet. #hich health determinant ma have themost influence on ;r. !miths abilit to maintain his health
over the next few ears?
>. 9ender*. Housing
&4 Social exclusion
2. $ncome income distribution
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Test Muestion7
(. > new mother brings her newborn daughter to our wellness
clinic for a chec"up. $n the course of the assessment, ounotice that the mother holds the bab onl when necessar and
does not communicate with or loo" at her new bab. *elieving
this new famil to be at ris", ou offer support services of
home care visits counselling. #hich determinant of health ismost at ris" in this situation?
>. 9ender *. !ocial safet net
&4 1arly child development
2. $ncome income distribution
& !t d
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&ase !tud7
:ac" and <a have both suffered heart attac"s5 the live near
downtown Toronto and are members of the First Nations people.
5ac*# on advise from his traditional healer and phsician, re@uested
a healing ceremon, started exercising, reducing his salt fat
inta"e, entered stress-reduction classes, and with support of his
wife returned to wor" wee"s after his heart attac". He has a positive outloo", is doing well, and tal"s about Ifeeling wellJ.
Ray has also changed his dietar habits and has started exercising5
however, he has been unable to @uit smo"ing, even though he
wants to and has been advised to do so. <a is single, and
fre@uentl despondent, ver fearful of having another heart
attac", has not et returned to wor", and fre@uentl tal"s about
Ifeeling illJ
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&ase Study: &ritical ,hin*ing 6uestions
1. *oth men have the same health issue. :ac" considershimself to be well, whereas <a considers himself to be
ill. 'xplain this phenomenon on the basis of the !2H.
(. #hat factors ma have prevented <a from developing
the same positive outloo" and ta"ing the same actions as
:ac" did to manage his illness?
+. #hat nursing interventions would be most beneficial to
<a with regard to his smo"ing problem?
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%ets ;a"e Our 2a Harder7 2r. ;i"e 'vans /700
http733www.outube.com3watch?vLwh6u<%il/c0
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