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HEALTH, WELLNESS, AND ILLNESSWEEK 3
HEALTH, WELLNESS, AND ILLNESSWEEK 3
Concepts of Health, Wellness, and Well-BeingHealth
Presence or absence of diseaseNightingale
“…state of being well and using every power the individual possesses to the fullest extent”
WHO “…state of complete physical, mental and social
well-being, and not merely the absence of disease or infirmity”
Health, Wellness, and Well-Being, continued
ANA “…dynamic state of being in which the
developmental and behavioral potential of an individual is realized to the fullest extent possible”
Personal definitions of healthHighly individualizedFree from symptoms, painBeing able to be active, in good spiritsDeveloping personal definition of health
WellnessState of well-being
Self-responsibilityUltimate goalDynamic, growing processDaily decision makingWhole being of individual
Components of WellnessEnvironmentalOccupationalIntellectualSpiritualPhysicalEmotionalSocialWell-being is a component of health
Figure 13-3 An illness-wellness continuum. Source: Reprinted with permission from Travis, J. W., & Ryan, R. S. (1988). Wellness workbook., Berkeley, CA: Ten Speed Press.
Illness and DiseaseIllness
Highly personal stateDiminished functioning
DiseaseAlteration in body functions Results in reduction of capacitiesShortening of normal life span
Classifications of IllnessAcute
Severe symtpomsRelatively short duration
ChronicLasts for 6 months or longer
Illness BehaviorsCoping mechanismsInvolves ways individuals:
Describe, monitor and interpret symptoms
Effects of Illness on Client and FamilyBrings change
Behavioral and emotionalSelf-concept and body imageLifestyle
Loss of autonomyChange in lifestyle
Nurse’s RoleProvide explanations about necessary
adjustmentsMake arrangements to accommodate clients’
lifestyleEncourage other health professionals to
become aware of person’s lifestyleSupport healthy aspects
Reinforce desirable changes in practices
Health Promotion• Healthy People 2010: Understanding
and Improving Health– Two major goals
Increase quality and years of healthy life Eliminate health disparities
– 28 focus areas– 10 leading health indicators– Individual health linked to community
health
Health Promotion, Protection and Disease PreventionPrevention
Narrow senseBroad sense
PromotionMotivated by desire to increase well-being
ProtectionMotivated by desire to actively avoid illness
Health promotion can be offered to all
Nurse’s Role in Health PromotionWay of thinking
Revolves around philosophy of wholeness Wellness, well-being
Disseminate information
Programs to Promote HealthInformation dissemination most basic
Consider culture, age groupCritical to know where misinformation
originatesHealth risk appraisal and wellness
assessmentUsed to teach about risk factorsMotivate to reduce specific risks
Programs to Promote Health, continued
Lifestyle and behavior changeRequires participation of individualGeared toward enhancing quality of life
Environmental controlToxic and nuclear wastesNuclear power plantsAir and water pollutionHerbicide and pesticide use
Health Promotion Activities Collaborative relationships
Work with not for peopleNursing process basic toolTeach self-care responsibilityEmphasize illness prevention, health
promotionAssess, plan enhanced care
Variables Influencing HealthBiologic dimension
Genetic makeupGenderAgeDevelopmental level
Infants Toddlers Adolescents Older adults
Psychologic DimensionMind-body interactions affect health status
Increase susceptibility to organic diseasePrecipitate organic disease
Mind’s ability to direct body’s functioningEmotional reactions occur in response
Self-concept affects how we handle situations
Cognitive DimensionIntellectual factors influencing healthLifestyle
Living conditionsPatterns of behaviorRisk factorsHealthy lifestyle choices
Spiritual and religious beliefsJehovah’s Witnesses and blood transfusionsJews perform circumcision on 8th day of life
Nursing Process: AssessmentHealth history and physical examination
Existing problemsAge
Safety assessmentNutritional assessment
Physical fitness assessmentMuscle enduranceFlexibility and body compositionCardiorespiratory endurance
Assessment, continued
Lifestyle assessmentPersonal lifestyle and habits of clientLifestyle assessment tools
Spiritual health assessmentAbility to develop inner nature to fullest
Assessment, continued
Social support systems reviewSocial context in which person livesCreates environment for healthy behavior
Life stress reviewValidating assessment data
Client and nurse together Review, validate and summarize information Existing health problems
Nursing DiagnosesNANDA wellness diagnoses
Readiness for Enhanced Spiritual Well-beingReadiness for Enhanced CopingReadiness for Enhanced NutritionReadiness for Enhanced KnowledgeReadiness for Enhanced ParentingReadiness for Enhanced Self-ConceptReadiness for Enhanced Immunization StatusReadiness for Enhanced Self-Care
PlanHealth promotion plan developed
In response to needs, desires, prioritiesNurse acts as resource personSteps in planning
Review and summarize assessment dataReinforce strengths, competencies of clientIdentify health goals, related optionsIdentify behavioral or health outcomes
Plan, continued
Steps in planning, continuedDevelop a behavior-change planReiterate benefits of changeAddress barriers to changeDetermine time frame for implementationFormalize commitment to behavior change
planExplore available resources
Implementation Self-responsibilityOngoing support
Focuses on desired behavior changeIndividual counseling sessionsTelephone, internet counselingGroup support
Implementation, continued
Facilitating social supportAssist client to assess, modify and change
Providing health educationEnhancing behavioral change
Strategies at each stage of change Precontemplation Action Contemplation Maintenance Preparation Termination
Implementation, continued
Enhancing behavioral changeEstablish rapportSet agendaAssess importance, confidence and readinessExchange informationReduce resistance
Advance client to next stage of changingModeling
Evaluation Ongoing basis as short-term goals metAfter long-term goals completedDate determined during planning phaseCollaborative effort
Exemplar 13.2 Physical Fitness and ExercisePhysical fitness
Enables body to perform to its potentialHelps individuals look, feel, do their bestAbility to perform daily tasks vigorously, with
energy left overInvolves performance of heart, lungs, musclesInfluences mental alertness, emotional stability
Healthy People 2010Increase proportion of people who
Engage in moderate physical activity dailyPerform physical activities to enhance,
maintain: Muscle strength Endurance Flexibility
Increase work sites offering physical fitness programs
Reduce chronic back condition limitationsReduce number of overweight people
Fitness and ExerciseResearch
Exercise improves health statusExercise can prevent, reverse chronic diseases
experienced in aging Activity-exercise pattern routine of exercise,
activity, leisureADLsType, quantity, quality of exercise
Physical Activity and ExercisePhysical activity
Bodily movement produced by skeletal muscle contraction
Increases energy expenditureExercise
Type of physical activity defined as plannedRepetitive bodily movementPerformed to improve, maintain fitness
Physical Activity and Exercise, continued
Activity toleranceType and amount of exercise, ADLs individual
can perform without adverse effectsFunctional strength
Body’s ability to perform work
Types of ExerciseIsotonicIsometricIsokineticAerobicAnaerobic
Benefits of ExerciseMusculoskeletal system
Muscles hypertrophyJoints receive nourishmentBone density and strength maintained
Cardiovascular systemPrimary prevention of stroke, CV diseaseIncrease heart rate, strength of heart muscleMediates harmful effects of stress
Benefits of Exercise, continued
Respiratory systemVentilation and oxygen intake increasesToxins eliminatedProblem solving, emotional stability enhancedPrevents pooling of secretions
Gastrointestinal systemImproves appetiteIncreases GI tract tone
Benefits of Exercise, continuedMetabolic/Endocrine system
Elevates metabolismWeight loss, exercise stabilize blood sugar
Urinary systemPromotes efficient blood blowBody excretes wastes more efficiently
Immune systemLymph fluid more efficiently pumpedStrenuous exercise may reduce immune
function
Benefits of Exercise, continued
Psychoneurologic systemMental, affective disorders may affect desire to
moveRole of exercise in elevating mood Relieving
stress, anxietyRegular exercise increases levels of endorphins Improves quality of sleep
Benefits of Exercise, continued
Cognitive functionPositive effectAthletic older adults have denser brainsBrain gym
Improves mood, learning, problem solvingContralateral movements help those with
ADD, ADHD, learning disorders, mood disorders
Benefits of Exercise, continued
Cognitive functionPositive effects in individuals with
Parkinson’s disease Alzheimer’s disease
Spiritual healthEnhance experience of mind-body-spirit
connection