health,illness and healthcare agencies - Copy (3).pptx

Health Care Team And Agencies
Prepared By
Monika Devi NR
M.Sc. Nursing

• DEFINITION:
“ The health team consist of a group of
people who coordinate their particular skills in
order to assist a patient or his family”.
HEALTH TEAM MEMBERS:
 The Physician
 The nurse
 The Dietitian or Nutritionist
 The Physiotherapist
Monika NR M.Sc.Nursing 2

 The social worker
 The occupational therapist
The Paramedical Technologist:
Laboratory technologist
Radiology technologist
The Pharmacist
The inhalation therapist

HEALTH CARE AGENCIES
1. HOSPITALS:
An institution for the care , diagnosis and
treatment of the sick and injured. Hospital can be
generalized or specialized.
2. LONG TERM CARE FACILITIES:
These agencies provide care to the patients who
are critical and continuous care for recovery.

3. RETIREMENT CENTRES:
Few old people after retirement from their job, fell
in crisis. They feel alone and their psychological needs
are not fulfilled so these centres are meant to care for
people with psychological and maturational crisis.
4. REHABILITATION CENTERS:
These are the centres which provide organized
employment within the capacity of patient.
5. HOSPITAL SERVICES:

HEALTH PROMOTION

• Building health public policy
• Creating supportive environment
• Strengthening community action
• Developing personnel skills
• Reorienting health services

HEALTH MAINTENANCE ORGANISATIONS
• WHO
• UNICEF
• INTERNATIONAL RED-CROSS
• FOOD AND AGRICULTURAL ORGANISATION
(FAO)
• FORD FOUNDATION
• WORLD BANK

ILLNESS

INTRODUCTION:
Illness is not described in
the term of disease conditions, it is the
deviation from the normal healthy state
and it results in frustration, anxiety,
denial, grief and uncertainity.

DEFINITION:
Koizer:-
“Illness is a condition characterized by
a deviation from a normal healthy state
which is manifested by physical and
psychological symptoms”.

Potter & Perry:-
“Illness is a state in which person’s
physical, intellectual, emotional, social
or spiritual functioning is deminished or
impaired in comparison with the
previous experience”.

ILLNESS BEHAVIOUR
• It is the way in which client act towards
illness. It is expression of the symptoms,
monitoring the bodies, defining illness in
their own way.
• All human beings react to illness in different
ways. Illness behaviour becomes abnormal if
it is disproportionate to the present illness.

VARIABLE
AFFECTING ILLNESS
BEHAVIOUR

1. INTERNAL VARIABLES:
a) Perception of Symptoms:-
 It is the way of perceiving symptoms of illness
behaviour.
 If a person takes symptoms not too serious and take
adequate treatment ,recovery will be quickly.
 But if he perceives symptoms very seriously whether
they are or not, it becomes life threatening for that
person.

b) Nature of Illness:-
In acute illness when person taking treatment that will
be more effective.
But in chronic illness client may become less actively
involved in their care and may get frustrated and do
not comply with the therapy.
c) Characteristic of Person:-
How the person response to the illness depends upon
the adjusting, coping abilities.

2. EXTERNAL VARIABLE :
a) Visibility of symptoms
b) Social group
c) Culture and values
d) Economic variables
e) Accessibility of the health care system

STAGES OF ILLNESS BEHAVIOUR

• STAGE 1 - SYMPTOM EXPERIENCE:
In this stage person feels that something is wrong,
but he is not able to diagnose the problem.

• STAGE 2 - ASSUMPTION OF SICK ROLE:
Assumption of sick role results in emotion
changes such as withdrawal, depression,
physical changes.

• STAGE 3 - MEDICAL CARE CONTACT:
At this stage client acknowledge the illness and
seeks explanation of causes, duration of illness and
its complications. Health professional may
determine whether the client is ill or not.

• STAGE 4 - DEPENDENT CLIENT CARE:
After accepting the diagnosis, client become
dependent upon health care professional to get
treatment. Client accepts the care, sympathy,
protection from the demands and stress of life.

• STAGE 5 - RECOVERY &
REHABILITATION:
This is the stage when the symptoms of illness get
subsiding. The person starts regaining original
health status.

EMOTIONAL RESPONSE TO ILLNESS
• The common emotional responses are:-
I. Fear
II. Overdependence & feeling of hopelessness
III.Anxiety
IV.Hope
V. Anger & Hostility

DIFFERENT IMPACT OF ILLNESS
Impact of illness on client:
• illness interfere with the ability of sleep and rest
of a person.
• People who are ill require more sleep because of
their need for increase growth hormone , to
promote tissue repair, illness disturb the normal
rhythm of sleep and wakefulness

Impact of illness on client and family:
1. Behavioral & emotional changes:-
 individual’s reaction toward illness depends on his
attitude, nature of illness.
 short term illness can cause emotional changes like
irritability, lack of interest in family, angerness etc.
 life threatening or severe illness leads to more
changes like anxiety, shock, denial, and withdrawal etc

2. Impact on family role:
During illness role of client and family members
get disturbed, may be for the short time or for the
longer period as nature of illness.
Long term changes require an adjustment process.
3. Impact on body image:
The main thing is affected by the illness is physical
appearance.

4. Impact on self concept:
Self-concept means individual mental image of
themselves, like how they view their strengths and
weakness in all aspect of their life.
If person get self concept affect he can not able to
cope up with anxiety and shows frustration and
denial.

5. Impact on family dynamic:
It is a process by which family functions, makes
decision, gives support to an individual members
and copes with everyday changes and challenges.

PREVENTION & PROTECTION FROM
ILLNESS
• The health team is responsible for prevention of
illness, promotion and protection of health by
aware of illness, injury or disease.
• Nurse play an important role in preventing the
transmission of disease by maintaining medical
and surgical asepsis.
• Nurse can teach public about self care strategies,
enhance fitness, improve nutrition, manage stress.

• Encourage the public to avail maximum use of
health care services.
• A healthy life style include good eating habits,
regular exercise, controls the stress by problem
solving, avoid smoking, drug abuse and alcohol
drinking.
• Proper Immunization
• Nurse can protect public by giving health
education about accidents and poisoning, nutrition
promotional measures, protection against
occupational hazards etc.

BODY DEFENCES, IMMUNITY
AND IMMUNIZATION

INTRODUCTION
• Every human being has its immune system to
defend it against the pathogens.
• Resistance is the ability to ward off the disease
through our defences. Defences against disease are
of two specific resistance and non-specific
resistance.
• Non-specific resistance is the general response
against invasion by a wide range of pathogens.

MECHANISM OF NON SPECIFIC
DEFENCE

1.First Line Of Defence :
Mechanical Barriers
Chemical Barriers
2.Second Line Of Defence :
Inflammation Process
Phagocytosis
3.Third Line Of Defence :
Specific Immune responses
Natural Killer Cells.

FIRST LINE OF DEFENCE
• Mechanical and chemical barriers: it
involves skin and mucous membrane. In
these membranes, there are densely packed
cells that protect the internal environment
from the invasion by foreign cells.
• Substance such as sebum, mucus, HCL in
gastric mucosa act as non specific defences.

SECOND LINE OF DEFENCE
• A} INFLAMATORY RESPONSE:
It isolates the pathogens and stimulate the speedy
arrival of large number of immune cells.
All bacteria break through the chemical and
mechanical barriers then the body has 2nd line of
defence.
The inflammatory mediators like histamine, kinins
and prostaglandin when release….

Attract WBCs
Results in
Chemotaxis
Causes
Redness, Pain, Swelling
Leads to
Increased flow & vascular permeability in effected region

Leads to
Phagocytic WBCs reach affected area
Enter the affected tissue & engulf foreign body
Histamine, prostaglandin stimulate accumulation of
phagocytes at region
Inflammation occur at affected site

B} PHAGOCYTOSIS:
It is major component of 2nd line of
defence.
It involve ingestion and distruction of
micro-organism or other small particles
with the help of two type of phagocytes.

PHAGOCYTES
Neutrophils Macrophages
- Granular leukocytes - phagocytic monocytes
- First to arrive at the - get enlarge to form giant
scene of inflammation phagocytic cells

STAGES OF PHAGOCYTOSIS

THIRD LINE OF DEFENCE
A} Natural Killer cells:-
Group of phagocytes
Can kill many type of tumor cells and cells infected by
different kind of viruses
B} Interferon:-
• a protein released by animal cells, usually in response
to the entry of a virus, which has the property of
inhibiting virus replication.
• Inhibit the spread of virus infection

Types:- Leukocytes interferon (α)
Fibroblast interferon (β)
Immune interferon (χ)
C} Complement:-
- The complement system is a part of the immune
system that enhances (complements) the ability of
antibodies and phagocytic cells to clear microbes
and damaged cells from an organism, promote
inflammation, and attack the pathogen's cell
membrane.

SPECIFIC RESISTANCE OR
IMMUNITY
• Immunity:- The ability of the body to
defend itself against invading agents such as
bacteria, toxin, viruses and foreign tissue is
called immunity.
• Antigens:- substance that are recognized by
the immune system and provoke immune
responses are called antigens.

TYPES OF IMMUNE SYSTEM
1. Cell-Mediated Immunity:-
in this type CD 8 and T cells proliferate into
killer T cells and directly attack the invader
antigen.
It is effective against intracellular pathogens,
cancer cells & foreign tissue transplant.

2. Antibody mediated(Humoral) Immune
Response:
In this β cells transform into plasma cells,
which synthesize and secrete specific
proteins called antibodies or immunoglobulin
(Ig).
It works against antigens dissolved in body
fluids & intracellular pathogen

TYPES OF SPECIFIC
IMMUNITY

IMMUNITY
INNATE
(Genetic factor)
ACQUIRED
PASSIVE
(Ready made
antibodies)
ACTIVE
(Own antibodies)
ARTIFICIAL
Antibodies
from other
sources
NATURAL
Maternal
Antibodies
ARTIFICIAL
Immunization
NATURAL
Exposure to
infectious agent

Acquired or Inherited Immunity
• It occurs when specific or non specific immune
responses are put in place by genetic mechanism
during early stage of human development in
womb.
• Acquired immunity divided in to active and
passive form and these forms may be natural or
artificial.
• Active Immunity occurs when an individual’s own
immune system responds to harmful agents.

• Passive Immunity results when immunity to a disease
that has developed in another individual is transferred
to an individual who was not previously immune.
• Formation of T cells and β cells:-
Both of T cells and β cells develop from the stem cell
in bone marrow.
Immature T cells migrate from bone marrow into
Thymus.
T cells develop immuno competence i.e. (Ability to
carry out immune response of properly stimulated)

β cells complete their development into
functional immune cell in bone marrow.
Before T cells leave the thymus or β
cells leaves bone marrow, they acquire
several distinctive surface proteins.

lymphocytes
B- cell T- cell
transferred to
Mature in bone marrow
mature T cell Active to B cell activated T cell

There are 4 main types of T cells.
• CD4+ Helper Cells:- CD4+ helper cells
help in the maturation of B cells into
plasma cells and memory B cells. ...
• CD8+ Cytotoxic Cells:- CD8+
cytotoxic cells cause lysis of virus-
infected and tumour cells....

• Memory T Cells:- Memory T
cells are antigen-specific T cells that
remain long-term after an infection
has been eliminated.
• providing a rapid response to past
infection.
• Natural Killer T Cells:

ANTIGEN
“Any chemical substance that when introduce
into body is recognized as foreign or antigen”
• Characteristics of ANTIGEN:
1. Immunogenicity: It is the ability of an antigen
to provoke an immune response in the body of a
human and other animal.
2. Reactivity: It is the ability to react specifically with
produced antibodies of an antigen.

IMMUNIZATION
“IMMUNITY IS THE RESISTANCE THAT A
PERSON HAS AGAINST DISEASE”
Active Immunization:
It is produce by natural or acquired stimulation so that
body produce its own antibodies.
Passive Immunization:
It provides temporary protection and is produced by
infection of serum that contain antibodies.

HOSPITAL
TYPES, CLASSIFICATION,
ORGANIZATION AND
FUNCTIONS

DEFINITION
According to WHO: A hospital is an integral
part of a social and medical organization, the
function of which is to provide for the
population, the complete health care, both
curative and preventive and whose out
patient service reach out to the family and its
home environment

According to Steadman’s medical
dictionary:
Hospital is an institution for the cure, care
and treatment of the sick and wounded ,
for the study of diseases and for the
training of nurses and doctors.

Classification of Hospital
• Hospitals have been classified in many ways based on
different criteria.
1. Size or bed capacity : The size of an institution is
determined by the number of beds it has.
• Small hospital : Bed capacity of 100 or less.
• Medium size hospital : Bed capacity 101 to 300 beds
• Large hospital : Bed capacity 301 to 1000 beds.

On the basis of health committee report it is
recommended to classify the hospital according to
the bed strength.
• Teaching hospital : bed strength 500 and above
• District hospital : bed strength 200 to 300
• Taluka hospital : bed strength 50 to 200
• Community health center (CHC) : bed strength 30 to
50
• Primary health center (PHC) : bed strength 6 to 10

2. Ownership or control :
On the basis of ownership or control, hospital are classified into :
• Government or public hospitals : These are run by central or
state government or local bodies on now commercial lines. They
can be general hospitals or specialized hospitals or both.
• Non – government hospitals : They are supported by client’s
fees, gifts, endowments. These hospitals are owned by
individual, partnership or corporation. For example : Voluntary
hospitals, Private nursing home, Corporate hospitals.

3. Objectives:
Based on the objectives, hospitals can be classified
into the following :
• Teaching cum research hospitals
• General hospitals
• Specialized hospitals
• Isolation hospitals
• Rural hospitals

4. Systems :
According to the system of medicine, hospitals are
classified into:
• Long-term care hospitals or chronic care hospitals : in this
client stay in the hospitals for a long time & disease may
be of chronic nature, e.g., leprosy, cancer, etc.
• Short- term care hospitals or acute care hospitals : In this
the client stay in the hospital for a short period only & the
disease is usually of acute nature , e.g., pneumonia,
gastroenteritis.

5. Management :
According to the management of the hospital they are
classified as follows :
• Hospitals run by Union Government / Government of India
e.g., hospitals run by railways, military, defence.
• Hospitals run by State Government
• Hospitals run by local bodies e.g., panchayat, municipality,
jilla parishad.
• Autonomous bodies e.g., AIIMS
• Private hospital
• Voluntary hospital

Functions Of Hospital
• Care of injured and sick
• Prevention of disease e.g. By immunization
• Promotion of health
• Diagnosis and treatment of disease
• Mental therapy
• Rehabilitation
• Vocational training : Medical education, Nursing
education, paramedical training
• research

Promotion of health
HEALTH
PROMOTION
HEALTH
EDUCATION
HEALTH
SCREENING
DISEASE
PREVENTION

HABITS THAT SHOWN HEALTH
PROMOTION
1) Three meals a day with no smoking
2) Breakfast everyday
3) Moderate exercise
4) Sleep at least 7-8 hours
5) No smoking
6) Ideal body weight
7) Alcohol only in moderation

LEVELS OF DISEASE PREVENTION
1) Primordial prevention
2) Primary prevention
3) Secondary prevention
4) Tertiary prevention

1.Primordial prevention
• It is a new concept is receiving special attention in the
prevention in its purest sense, that is prevention of
emergency or development of risk factor in
population.
• This starts from where people already used to do it
for ex. Adults have many health issue have their early
childhood origin because its time to change lifestyle
and they get bad habits like smoking , alcoholism etc.

2. Primary Prevention
• Primary prevention can be defined as “action
taken prior to the onset of disease, which
removes the possibility that a disease will ever
occur”.
• It may be accomplish by measures designed to
promote general health and well being, and
quality of life of people .
• It includes the concept of “positive health”

3.Secondary Prevention
• It can be defined as “action which halts the progress
of a disease at its incipient stage and prevents
complication”.
• The specific intervention are early diagnosis and
adequate treatment.
• Secondary prevention is largely the domain of
clinical medicine. The health programme initiated
by governments are usually at the level of
secondary prevention

4.Tertiery Prevention
• When the disease process has advanced beyond its
early stages, it is still possible to accomplish
prevention by what might be called tertiary
prevention.
• Tertiary prevention can be defined as “all measures
available to reduce or limit impairment and
disabilities , minimize suffering caused by existing
departures from good health and to promote the
patient’s adjustment to irremediable conditions”

Primary health care :
Definition :
• Primary health care is essential health care made
universally accessible to individual and acceptable
to them, through their full participation and at cost
that the community and country can afford.

Principles of primary health care:
• Accessibility
• Public participation
• Health promotion
• Use of appropriate technology
• Intersectoral cooperation
• Principle of equity
• Multisectoral approach

Elements of primary health care:
• Education about prevailing health problems and how to
prevent and control them
• Food supply and proper nutrition
• Adequate supply of safe water and basic sanitation
• Maternal and child health care , Family planning
• Immunisation against infectious diseases
• Prevention and control of endemic diseases
• Treatment of common infections
• Essential drugs

Role & responsibility of nurse in primary
health care:
• Record medical history and symptoms
• Collaborate with teams to plan for patient care
• Advocate for the health and wellbeing of patients
• Monitor patient health and record signs
• Administer medications and treatments
• Operate medical equipment
• Perform diagnostic tests
• Educate patients about management of illnesses
• Provide support and advice to patients

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