Health Promotion and Disease Prevention

Roxanne Riedy, MSN

Marilee Elias, MSN

Health and Wellness Promotion

• Health

• Illness

• Wellness

Health Promotion

• What’s the motivation?

• R/T Individual lifestyle

• What are the choices?

Vs. Health Protection

• How does the motivation differ?

• R/T Individual lifestyle

• Why make the choice to change?

Health Promotion Models

• The Health-illness Continuum

• Dunn’s Health Grid

• Neuman’s Continuum

• Pender’s Health Promotion

• Wheel of Wellness

• Transtheoretical Model of Change

Dimensions of Health Along Health and Illness Continuum

• Biological factors

• Nutrition

• Physical activity

• Sleep and rest

• Meaningful work

Dimensions of Health Along Health and Illness Continuum

(continued)• Lifestyle choices

• Family relationships

• Culture

• Religion and spirituality

• Environmental factors

• Finances

The term “Health” refers to?

• Physical Status

• Emotional Well-being

• Interpersonal Relationships

• Intellectual function

• Spiritual condition

• Sexuality

“Health” is influenced by?

• Patient’s Belief System

• Attitudes toward control of health– We’ll revisit locus of control

• Cultural Influences

• Lifestyle behaviors

• And of course the influence of Family

Illness Perspectives

• Illness results from injury and/or disease

• Inability to meet one’s needs

• Acute Illness vs.

• Chronic Illness vs.

• Acute/Chronic Combo?

Wellness Perspectives

• Continuum of Health

• Optimal Health to

• Maladaptive Health

• What’s High-level Wellness?

Health Behaviors

• Variables of Influence–Lifestyle

–Locus of Control

–Self-efficacy

–Beliefs & attitudes about Healthcare

–Self-concept

Variables Influencing Health Beliefs and Practices

• Internal Factors–Developmental stage

–Intellect

–Emotion

–Spiritual

–Physical

More Variables

• External Factors–Family

–Socioeconomic

–Culture & Ethnicity

–Environmental

Biological Risk Factors

• Genetics

• Gender

• Age

• Developmental Stage

Other Risk Factors

• Environmental

• Lifestyle

Other Dimensions of Health Factors

• Nutrition

• Physical Activity

• Sleep and Rest

• Meaningful Work

• Vulnerable Populations

Health Promotion

• Activities to improve health & well-being

• What are we aiming for?–Patient Empowerment

–Good Decision Making• Lifestyles & Activities

Health Promotion Programs

• Disseminating Information

• Changing Lifestyles & Behaviors

• Environmental Control

• Wellness Assessments

• Health Risk Appraisals

• Remember nurses are A.T.A.T.T.(All Teaching All the Time)

Health Promotion and Vulnerable Populations

• Age

• Chronic disease

• History of abuse/trauma

• Limited economic resources

• Limited social resources

Health Protection Activities

• Prevent accidents

• Occupational Safety & Health

• Ensuring the Safety of Food & Drugs

• Environmental Strategies

Disease Prevention Activities

• Continuum of Disease–Prevent the Disease–Limit the Course of the Disease

• Levels of Prevention–Primary–Secondary–Tertiary

Health Promotion

• Motivated by the desire to increase well-being

• Related to individual lifestyle choices

• Healthy People 2020• National initiative• Addresses the effect of lifestyle on health• Created health improvement goals • Eliminate health disparities

Healthy People Initiatives

• We’re in the 4th decade of this national health framework for public health preventions priorities and actions.

• The overarching goals and focus topic areas are refocused every 10 years using the input from public health and prevention experts, government officials and the public.

Healthy People 2020• “The launch of Healthy People comes at a

critical time. Our challenge and opportunity is to avoid preventable diseases from occurring in the first place.” HHS Secretary Katherine Sebelius

• Use of IT to make Healthy People come alive through a “challenge” to develop ‘myHealthyPeople’ apps. (www.healthypeople.gov ) 

• Revision of Healthy People 2010

Healthy People 2020• Updated with New Topic Areas

• Main (or broad) goals of this plan:– increase healthy life expectancy– reduce health care disparities– create social and physical environments that

promote good health for all – Promote quality of life, healthy development,

and healthy behaviors across all life stages

New Topic Areas 2020

• Adolescent Health Genomics• Blood Disorders & Blood Safety Global Health• Early and Middle Childhood Preparedness• Dementias, including Alzheimer’s Disease• Healthcare-Associated Infections• Health-Related Quality of Life and Well-Being• Lesbian, Gay, Bisexual, and Transgender Health• Sleep Health• Social Determinants of Health

What’s in Healthy People 2020?(www.healthypeople.gov)

Next Class…

• Teaching Project Presentations

• Holistic View of Health

Holistic View of Health

• Holism focus is relationships between all living things

• The individual as a holistic being– Each person is unique– Basic human needs are integrated – Mind, body and spirit– Health is balance, integration and harmony in

life

Holistic View of Health

• Basic human needs:–Physiological

–Psychological

–Sociocultural

–Intellectual

–Spiritual

Physiological Dimension

• Focus is achievement of basic needs:– Oxygenation

– Circulation

– Sleep & comfort

– Nutrition

– ELimination

Psychological Dimension

• Focus is achievement of:– Positive self-esteem and security

– Trusting relationships

– Appropriate social skills

– Coping skills

Sociocultural Dimension

• Focus is achievement of:

– Client needs• Both dependence and independence

– Client Empowerment• Enabling the client to do for themselves

Intellectual Dimension

• Focus is achievement of Cognitive Functions:– Judgment

– Orientation

– Memory

– Ability to process information

– Factors that impair cognitive functions

Spiritual Dimension

• Spirituality is each individual’s relationship with:– Self

– Others

– Higher Power

– Assists each person in determining their sense of meaning or purpose in life

Health Screening Activities

• Secondary Level of Prevention

• Lifespan considerations– Screenings throughout the Lifespan

• Cultural Considerations

Nursing Assessments for Health Promotion

• Health History/physical exam

• Physical Fitness

• Lifestyle and risk appraisal

• Life-stress review

• Nutritional Assessment

• Other health screenings

Nurse’s Role in Health Promotion

• Role Model

• Counselor

• Health Education

• Motivation

• Provide Support for lifestyle changes