Chapter_009(,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,,1).pptx

Introduction to Functional Health
Patterns and Health Promotion
Chapter 9
Copyright © 2017 Elsevier Inc. All Rights Reserved.

Functional Health Patterns and
Health Promotion
 WHO definition of health
 “A state of complete physical, mental and social well-
being and not merely the absence of disease or
infirmity.”
 Health as a universal human right
 Healthy People 2020 goals
 New areas of focus specifically related to:
• Early/middle childhood, adolescence
• Social determinants of health
• Global health
2

Functional Health Patterns and
Health Promotion
3

Functional Health Patterns –
The Behaviors of Health
 Gordon’s functional health patterns
 Emphasize health promotion
 Focus on lifestyle behaviors affecting health
• Health perception/health management
• Nutrition/metabolic
• Elimination
• Activity/exercise
• Sleep/rest
• Cognitive/perceptual
• Self-perception/self-concept
• Role/relationship
• Sexuality/reproductive
• Coping/stress tolerance
• Values/beliefs
4

Health Perception and
Health Management
 Health Perception
 Components of health perception
• Beliefs/feelings about state of health
 Shaped by severity of, experience with, knowledge of condition
 Cultural cues about condition/health in general
• Relationship between health status/practices
 “Internal locus of control” vs seeing problems as beyond control
5

Health Management
 Health Perception (Cont.)
 Components of health perception (Cont.)
• Children’s conceptualizations of health and illness
 Must consider within developmental framework
 Piaget’s theory of cognitive development and emerging
understanding of causality vs magical thinking
 Providers can educate children about bodies, health, illness
 Assessment foundations: health behavior prediction
models
6

Health Management
models
• Health belief and self-efficacy model
 Belief in susceptibility to disease
 Belief in negative consequences of disease
 Belief that taking action will reduce risk
 Belief that benefits of action outweigh costs
7

Health Management
models (Cont.)
• Stages of change model
 Stages of change – precontemplation, contemplation,
preparation, action, maintenance
 Patterns of change – change affected by barriers, relapses,
recycling of change
 Decisional balance – weighing pros and cons of change
8

Health Management
models (Cont.)
• Health promotion model
 Cognitive-perceptual factors – locus of control, individual
definitions of health
 Modifying factors – demographic, biologic, behavioral,
situational, interpersonal, social support, education and
knowledge, values, cultural perspectives
9

Health Management
 Health management – process of making decisions/taking action
• Assessment of health management patterns
 See Table 9-1
 Use functional health patterns
 Clinical findings indicating health perception/health management
problems
• No regular provider/care
• Use of ED for non-emergent conditions/lack of
follow-up care
• Failure to adhere to treatment/lack of immunizations
• Knowledge deficit about children/illness
10

Health Management
 Management strategies for functional health patterns
• Provider-child-family triad
 Developing relationship of trust/respect
 Provide opportunities to discuss concerns
 Acknowledge ambivalence, stress
 Solicit parent/child thoughts/beliefs
 Acknowledge strengths, expertise
 Develop strategies appropriate to parents’ skills, needs, desires
11

Health Management
(Cont.)
• Health promotion care
 Regular clinic visits
 Assess strengths/weaknesses in health and intervene early
 Assess home, family, culture, social life
 Encourage children to make healthy lifestyle decisions
 Bright Futures/AAP Recommendations for Preventive Pediatric
Health Care
12

Health Management
(Cont.)
• Behavioral counseling interventions
 Usually directed at complex behaviors
 Client attributes predisposing to successful change include:
desire to change, few obstacles to change, skills/self-
confidence, feelings of benefits to change, social support for
change
 Five A’s to help with behavioral change: assess, advise, agree,
assist, arrange
13

Health Management
 Health education
• Required participation of provider and family
• Mutual understanding and shared planning
 Assessing and fostering health literacy – ability to
read/communicate, evaluate/interpret health information
 Low health literacy affects health status – increased ED use,
fewer preventive measures, poor treatment management
 Screening tools include Fog Index, SMOG, Flesch-Kincaid
Readability Tests, Rapid Estimate of Adolescent Literacy in
Medicine
 Be clear in communication – avoid jargon, speak clearly, use a
variety of educational materials, written materials at 5th grade
level
14

Health Management
 Health education (Cont.)
• Patient education process
 Set climate for learning – comfortable, free from distractions
 Identify mutual goals of learner/provider
 Assess the learner – readiness, attitudes/feelings, style of
learning, level of knowledge, physical/developmental
capabilities
 Plan – state learning objectives/long-term and short-term
 Advise – manage the intervention/actively engage client
 Evaluate outcomes – reformulate if needed
15

Health Management
 Health education (Cont.)
• Patient education strategies
 Provide data and verbal advice – normal outcomes and areas
of concern
 Role model
 Bibliotherapy – books, pamphlets
 Multimedia instruction – DVDs, smartphone applications,
internet-accessed programs
16

Health Management
 Health system interventions
• Skills to access resources: referrals, e-mail and telephone
communication
 Referrals when specialty care, support groups, classes,
practice opportunities needed
 Help families identify, locate, and use resources
 Encourage independent action/decision-making
• Remove barriers to care
 Financial/insurance issues
 Ways to reduce other costs
17

Health Management
 Management strategies for children with special
needs
• Receive care from many specialists – still need primary care
• Primary care providers coordinate care
• Communication/collaboration essential
• Adaptation of usual interventions to meet special needs
• ADL, activities, exercise adaptations
18

Health Management
 Evaluating Health Promotion Interventions
 Identify goals, objectives, indicators of success
 Quantitative and/or qualitative evaluations
 Evaluation of both outcomes and process
19

Discussion Questions
1. You are asked to administer a health literacy screening tool (e.g.,
Newest Vital Signs [NVS], Home Literacy Environment single-item
tool, S-TOFHLA) to a parent who has limited English skills.
Discuss what criteria you will use to decide which tool to use and
how to best administer the test.
2. Using a family-centered collaborative negotiation process, discuss
how you will manage the care of an overweight teenage girl.
3. Identify at least two resources in your community to which you
could refer families with a child who has asthma, leukemia, cystic
fibrosis, or cerebral palsy.
4. What strategies can a busy practice use to help parents manage
their child’s growth and development needs until the next well-
child visit?
20

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