Patho - physiologic &

Psychodynamics of

disease causation

CONCEPTS OF HEALTH

• Health

• Health status

• Health belief

• Health behavior

Health - Belief Model

Individual perceptions•Perceived susceptibility•Perceived seriousness•Perceived threat

Modifying factors

•Demographic variables•Structural variables•Cues to action

Likelihood of action

•Perceived benefits to action – Perceived barriers to action

Concepts ( contd…)

• Patho-physiologic

• Psychodynamics

Body

The Dynamic Balance

A Steady State

Body- A balanced

state

Constancy

Homeostasis Stress

Adaptation

Homeostasis

Physiologic homeostasis

Psycho logic homeostasis

Physiologic homeostasis

Self-regulation Compensatory

Feedback mechanism

s

Physical environment

Psychological environment

Social environment

Life experiences

Psycho logic homeostasis

Stress

Types of stressors

• Physical• Physiologic• Psycho-social

Physiologic Manifestations of Stress

•`Interpretation of stressful stimuli by brain

•Sympathetic nervous system Response

•Sympathetic Adrenal Medullary response

•Hypothalamic Pituitary response

Physiologic Manifestations of Stress (Contd.)

• Dilation of pupils• Diaphoresis• Increases heart rate• Paleness of the skin• Increased blood pressure• Increased cardiac output• Increased rate & depth of respiration• Decreased urine output

Physiologic Manifestations of Stress (Contd.)

• Dry mouth• Increased peristalsis of the intestines• Increased muscle tension• Increased blood sugar• Lethargy, Mental lassitude, inactivity

Psycho logic Manifestations of Stress

• Anxiety- mild, moderate, sever anxiety

• Fear

• Anger- Hostility, Aggression, Violence

• Depression

Cognitive Manifestations of Stress

• Problem-solving• Structuring• Self-control• Suppression• Fantasy or day-dreaming• Prayer

Verbal & Motor Manifestations of Stress

•Crying•Verbal abuse•Laughing•Screaming•Hitting or Kicking•Holding & touching

Unconscious ego defense mechanisms

Stress at cellular levelCellular injury

Causes-• Hypoxia• Physical Agents – Extremes of temperature, Radiation & electrical shock, Mechanical trauma• Chemical agents• Disordered immune response• Genetic disorders

Adaptation

Modes of Adaptation

•Physiologic Mode/ Biologic adaptation

•Psycho logic adaptation

•Socio-cultural Adaptation

Characteristics of Adaptive responses

•All adaptive responses are attempts to maintain homeostasis.•Adaptation is a whole body or total body responses.•Adaptive responses have limits.•Adaptation requires time.•Adaptability varies from person to person.•Adaptive responses may be inadequate or excessive.•Adaptive responses are ego-centric and tiring.

Dimensions of Adaptation

Physical Developmental Emotional Intellectual Social Spiritual

Stages of Adaptation to response

1. An Alarm reactionShock PhaseCounter shock phase

2. Stage of resistance

3. Stage of exhaustion

General Adaptation response

ALARM REACTION

1. Hypothalamus

2. Posterior pituitaryIncreased ADH – increased water absorptionDecreased urine output

General Adaptation response

3. Anterior pituitaryIncreased ADH- Adrenal cortex-Increased Aldosterone

4. SNS & Adrenal medullaIncreased epinephrineIncreased nor epinephrine

5. Fight or Flight

General Adaptation response

RESISTANCE

Sterilization

Hormonal levels return to normal

Parasympathetic Nervous System

Adaptation to stress

General Adaptation response

EXHAUSTION

Increased physiological response as in alarm reaction

Decreased energy levels

Decreasing physiological adaptation

Death

Local Adaptation Syndrome

•Reflex pain response

•Inflammatory response

Inflammatory response

Vascular & cellular response

Exudative response

Reparative stage

Illness

Stages-

1. Transition from health to illness2. Period of accepted illness3. Convalescent stage

Illness behavior

IGUN’s 11 stages of illness behavior

1.Symptom experience2.Self-treatment or medication3.Communication to others4.Assessment of symptoms5.Sick-role assumption6.Concern

Illness behavior ( Contd.)

7. Efficacy of treatment8. Selection of treatment9. Treatment10. Assessment of effectiveness of

treatment11. Recovery & Rehabilitation

Nursing Implications

•Promoting healthy Life-style•Enhancing Coping strategies•Teaching relaxation exercises•Educating•Enhancing social support•Recommending support & therapy Group•Crises intervention

Stages of health behavior change

•Pre-contemplation

•Contemplation

•Preparation

•Action

•Maintenance

THANKS