L&E Chapter 002


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  • It is important to define what you believe health and illness to mean because your perception of these terms influences what you say and do when caring for patients. What may influence a person’s idea of what the meaning of health is to him or her?
  • Who influenced the traditional view of health in Western culture? For many years an acceptable definition of health was simply “the absence of disease.” In 1946, the World Health Organization redefined health as “the state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.”
  • Peripheral vascular disease resulting from diabetes is an example of a secondary illness. Some diseases are inherited (genetic) or congenital (present at birth). Sickle cell anemia is an inherited disease. What is an idiopathic illness?
  • When experiencing illness, people act in ways called illness behaviors. Fear of what the problem may be and of undergoing examination and diagnostic procedures often causes anxiety. During convalescence from a chronic illness, total recovery is replaced by either adaptation (adjustment in structure or habits) or maladaptation (lack of adjustment).
  • In general, being healthy means being able to function well physically and mentally and to express the full range of one's potential within one’s environment. Who is René Dubos, and who is Halbert Dunn?
  • A common theme in all of nursing theory is that nursing is concerned with helping people cope with adverse physiologic, psychosocial, and spiritual responses to illness, rather than with treating the illness itself. Since Florence Nightingale, nurses have encouraged a wholesome environment in the home, hospital, and community.
  • Health and illness behaviors are based on what a person knows and believes about health and illness. What are some examples of health behavior? Illness behavior?
  • Great cultural diversity in the United States brings many differences between the values and practices of various ethnic and minority groups. Many cultural health beliefs are based on folk medicine passed down through the generations within a culture.
  • The current focus on holism was stimulated by Jan Smuts, a noted South African who formulated a philosophical theory of holism. In the holistic approach to healing, the person is the central focus, not the illness or injury. What influences our basic beliefs about other humans and our relationships with them?
  • Maslow’s hierarchy takes into account the social needs and personal needs of the individual. In acute illness, which needs are most often compromised? (physiologic) In chronic illness, which needs are affected? (All of them may be affected.)
  • Protection from physical harm, from a nursing standpoint, is often equivalent in importance to physical needs.
  • How does self-esteem develop? Nursing actions that facilitate self-actualization are pertinent mainly during rehabilitation periods, when the nurse assists the patient to strive to achieve full potential.
  • In order to enjoy some degree of health and sense of well-being, one must adapt to factors in the external environment. What is maladaptation?
  • Coordination of the central nervous system, the autonomic nervous system, and the endocrine system is required for the body to adjust, adapt, and maintain equilibrium. What comprises the central nervous system?
  • In 1950 Hans Selye, a Canadian physician, published his research-based theories on stress. Selye concluded that stress plays a role in every disease process because of faulty adaptation (maladaptation) by the body. What did Selve believe would happen if the body overreacts in defending itself?
  • What may cause a very mild reaction in one person may cause a much stronger reaction in someone else. What are some common patient stressors?
  • Coping mechanisms help us to resist and master stressors. Ways to achieve coping responses are: Seeking information Taking direct action Stopping an unhelpful reaction Discussing the situation with someone from your social support system Using defense mechanisms to perceive the situation differently
  • Unconsciously using defense mechanisms gives us time to solve the problem and adapt in a positive manner.
  • How does exercise promote a feeling of well-being and tranquillity?
  • Every nurse has a responsibility to patients to promote better health through teaching about illness prevention, periodic diagnostic testing for cancer and diabetes, and safe health practices.
  • What are some examples of each type of prevention?
  • L&E Chapter 002

    1. 1. Chapter 2 Concepts of Health, Illness, Stress, and Health Promotion
    2. 2. <ul><li>Chapter 2 </li></ul><ul><li>Lesson 2.1 </li></ul>
    3. 3. Learning Objectives <ul><li>Theory </li></ul><ul><li>Compare traditional and current views of the meanings of health and illness </li></ul><ul><li>Describe what “health” means to you </li></ul><ul><li>Define what “sickness” means to you </li></ul><ul><li>Discuss cultural, educational, and social differences between nurses and their patients </li></ul><ul><li>Compare differences in disease predisposition and communication among cultures and races </li></ul>
    4. 4. Learning Objectives <ul><li>Clinical Practice </li></ul><ul><li>Observe patients during data-gathering and interview and determine their views on health and illness </li></ul><ul><li>Recognize cultural differences in health care concepts and behaviors in clinical setting and share those observations with fellow students </li></ul>
    5. 5. Health and Illness <ul><li>Health means different things to people </li></ul><ul><ul><li>Absence of disease </li></ul></ul><ul><ul><li>Optimum functioning on every level </li></ul></ul><ul><li>Miller-Keane dictionary defines health as: </li></ul><ul><ul><li>“ A relative state in which one is able to function well physically, mentally, socially, and spiritually in order to express the full range of one’s unique potentialities within the environment in which one is living” </li></ul></ul>
    6. 6. Traditional Views of Health and Illness <ul><li>Chronic illness </li></ul><ul><ul><li>Develops slowly over a long period and lasts throughout life </li></ul></ul><ul><li>Acute illness </li></ul><ul><ul><li>Develops suddenly and resolves in a short time </li></ul></ul><ul><li>Terminal illness </li></ul><ul><ul><li>No cure available; ends in death </li></ul></ul>
    7. 7. Traditional Views of Health and Illness <ul><li>Primary illness </li></ul><ul><ul><li>Develops without being caused by another health problem </li></ul></ul><ul><li>Secondary illness </li></ul><ul><ul><li>Results from or is caused by a primary illness </li></ul></ul>
    8. 8. Stages of Illness <ul><li>Transition stage </li></ul><ul><ul><li>May deny feeling ill, but recognize symptoms of illness are present </li></ul></ul><ul><li>Acceptance stage </li></ul><ul><ul><li>Acknowledge illness and take measures to become well </li></ul></ul><ul><li>Convalescence stage </li></ul><ul><ul><li>Recovering after the illness and regaining health </li></ul></ul>
    9. 9. Current Views of Health and Illness <ul><li>Health evaluated on a graduated scale or continuous spectrum </li></ul><ul><ul><li>Ranges from obvious disease through absence of disease to a state of optimum functioning in every aspect of life </li></ul></ul>
    10. 10. Implications of Current Views <ul><li>Value of nursing as caring profession reinforced </li></ul><ul><li>Although nurse is involved in curing the ill or injured, goal is primarily under the control of physician </li></ul><ul><li>Nurses seek to help patients use coping skills </li></ul>
    11. 11. Health and Illness Behavior <ul><li>Health behavior </li></ul><ul><ul><li>Any action taken to promote health, prevent disease, or detect disease in early, asymptomatic (without symptoms) stage </li></ul></ul><ul><li>Illness behavior </li></ul><ul><ul><li>Any activity a person takes to determine her actual state of health and seek a suitable remedy for a health problem </li></ul></ul>
    12. 12. Cultural Influences on Concepts of Health and Illness <ul><li>Racial and ethnic differences apparent in attitudes and practices related to: </li></ul><ul><ul><li>Birth, death, and general health car </li></ul></ul><ul><ul><li>Susceptibility to specific diseases </li></ul></ul><ul><ul><li>Responses to pain and suffering </li></ul></ul><ul><ul><li>Personal hygiene and sense of privacy </li></ul></ul><ul><ul><li>Adjustment to life changes </li></ul></ul>
    13. 13. <ul><li>Chapter 2 </li></ul><ul><li>Lesson 2.2 </li></ul>
    14. 14. Learning Objectives <ul><li>Theory </li></ul><ul><li>List the components of holistic health care </li></ul><ul><li>Identify and give examples of four areas of human needs </li></ul><ul><li>Identify how the body adapts to maintain homeostasis </li></ul><ul><li>Clinical Practice </li></ul><ul><li>Determine patient’s status on Maslow’s hierarchy during a clinical experience </li></ul><ul><li>Describe alterations in homeostasis in the clinical setting </li></ul>
    15. 15. The Holistic Approach <ul><li>Nurses take holistic approach to caring for the sick and promoting wellness </li></ul><ul><li>Considers biologic, psychological, sociologic, and spiritual needs </li></ul><ul><li>Acupuncture, acupressure, biofeedback, meditation, and various relaxation techniques </li></ul>
    16. 16. Maslow’s Theory of Basic Needs <ul><li>Hierarchy of human needs as an explanation for the that motivate human behavior </li></ul><ul><li>Basic physical needs—food, air, water, rest—must be satisfied before emotional needs </li></ul><ul><li>Used to determine priorities of nursing care </li></ul>
    17. 17. Maslow’s Theory of Basic Needs <ul><li>Physiologic needs </li></ul><ul><ul><li>Fundamental physical needs essential to maintain life </li></ul></ul><ul><li>Security and belonging </li></ul><ul><ul><li>Security for patients depends on reassurance that their physiologic and safety needs will be met </li></ul></ul><ul><ul><li>Each person needs to feel that she belongs or is attached to others </li></ul></ul>
    18. 18. Maslow’s Theory of Basic Needs <ul><li>Self-esteem and love and belonging </li></ul><ul><ul><li>Interrelated, because one cannot truly love others until one first loves or accepts oneself </li></ul></ul><ul><li>Self-actualization </li></ul><ul><ul><li>Occurs when individuals are comfortable with themselves and are certain of their beliefs and values </li></ul></ul>
    19. 19. Homeostasis <ul><li>Biologic systems maintain stability of internal environment by continually adjusting to changes necessary for survival </li></ul><ul><li>Wellness maintained or regained when one is able to keep a sense of balance while adapting to factors that can upset that balance </li></ul><ul><li>Stress disturbs homeostasis and causes the body to attempt to adapt </li></ul>
    20. 20. Adaptation <ul><li>A response to change </li></ul><ul><li>Body’s systems have self-regulatory mechanisms to maintain homeostasis </li></ul><ul><li>Requires pathway of communication between the brain and various body systems </li></ul>
    21. 21. Central nervous system structures
    22. 22. The General Adaptation Syndrome <ul><li>Occurs in response to long-term exposure to stress </li></ul><ul><li>Stages </li></ul><ul><ul><li>Alarm stage </li></ul></ul><ul><ul><li>Stage of resistance </li></ul></ul><ul><ul><li>Stage of exhaustion </li></ul></ul>
    23. 23. <ul><li>Chapter 2 </li></ul><ul><li>Lesson 2.3 </li></ul>
    24. 24. Learning Objectives <ul><li>Theory </li></ul><ul><li>Compare traditional and current views of health </li></ul><ul><li>Discuss why a particular stressor may be experienced differently by two people </li></ul><ul><li>List common signs and symptoms of stress </li></ul><ul><li>Discuss four ways a nurse can help decrease patient stress/anxiety </li></ul><ul><li>Clinical Practice </li></ul><ul><li>Observe stress-reduction techniques used by staff or patients during a clinical experience </li></ul>
    25. 25. The Effects of Stress <ul><li>A stressor can be helpful or harmful depending on the person’s: </li></ul><ul><ul><li>Perception of the stressor </li></ul></ul><ul><ul><li>Degree of health and fitness </li></ul></ul><ul><ul><li>Previous life experiences and personality </li></ul></ul><ul><ul><li>Available social support system </li></ul></ul><ul><ul><li>Personal coping mechanisms </li></ul></ul>
    26. 26. Coping with Stress <ul><li>Coping—adjusting to or solving challenges </li></ul><ul><li>Three types of coping responses: </li></ul><ul><ul><li>Actions or thoughts that change the situation so it is no longer stressful </li></ul></ul><ul><ul><li>Alteration of thoughts to control the meaning of the situation before it triggers a stress response </li></ul></ul><ul><ul><li>Control of thoughts and actions to stop a stress reaction </li></ul></ul>
    27. 27. Defense Mechanisms <ul><li>Strategies that protect us from increasing anxiety </li></ul><ul><li>Reduce anxiety and the secretion of stress hormones </li></ul><ul><li>Used to maintain and improve our self-esteem </li></ul><ul><li>Can be overused in a maladaptive way </li></ul>
    28. 28. Stress Reduction Techniques <ul><li>Progressive relaxation </li></ul><ul><li>Imagery </li></ul><ul><li>Massage </li></ul><ul><li>Biofeedback </li></ul><ul><li>Yoga </li></ul><ul><li>Meditation </li></ul><ul><li>Regular physical exercise </li></ul>
    29. 29. Health Promotion and Illness Prevention <ul><li>Healthy People 2010: Understanding and Improving Health </li></ul><ul><ul><li>Created by scientists: a comprehensive set of objectives for disease prevention and health promotion for the nation </li></ul></ul><ul><ul><li>Goals </li></ul></ul><ul><ul><ul><li>Increase the quality and years of healthy life </li></ul></ul></ul><ul><ul><ul><li>Eliminate health disparities </li></ul></ul></ul>
    30. 30. Health Promotion and Illness Prevention <ul><li>Primary prevention </li></ul><ul><ul><li>Avoid or delay occurrence of a disease or disorder </li></ul></ul><ul><li>Secondary prevention </li></ul><ul><ul><li>Follow screening guidelines for easily treated diseases if found early or detecting disease return </li></ul></ul><ul><li>Tertiary prevention </li></ul><ul><ul><li>Rehabilitation measures after disease/disorder has stabilized </li></ul></ul>