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