HEALTH, WELLNESS, AND ILLNESS WEEK 3

1. HEALTH, WELLNESS, AND ILLNESS WEEK 3

2. Concepts of Health, Wellness, and Well-Being • Health • Presence or absence of disease • Nightingale • “…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”

3. 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 health • Highly individualized • Free from symptoms, pain • Being able to be active, in good spirits • Developing personal definition of health

4. Wellness • State of well-being • Self-responsibility • Ultimate goal • Dynamic, growing process • Daily decision making • Whole being of individual

5. Components of Wellness Environmental Occupational Intellectual Spiritual Physical Emotional Social Well-being is a component of health

6. 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.

7. Illness and Disease • Illness • Highly personal state • Diminished functioning • Disease • Alteration in body functions • Results in reduction of capacities • Shortening of normal life span

8. Classifications of Illness • Acute • Severe symtpoms • Relatively short duration • Chronic • Lasts for 6 months or longer

9. Illness Behaviors • Coping mechanisms • Involves ways individuals: • Describe, monitor and interpret symptoms

10. Effects of Illness on Client and Family • Brings change • Behavioral and emotional • Self-concept and body image • Lifestyle • Loss of autonomy • Change in lifestyle

11. Nurse’s Role • Provide explanations about necessary adjustments • Make arrangements to accommodate clients’ lifestyle • Encourage other health professionals to become aware of person’s lifestyle • Support healthy aspects • Reinforce desirable changes in practices

12. 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

13. Health Promotion, Protection and Disease Prevention • Prevention • Narrow sense • Broad sense • Promotion • Motivated by desire to increase well-being • Protection • Motivated by desire to actively avoid illness • Health promotion can be offered to all

15. Nurse’s Role in Health Promotion • Way of thinking • Revolves around philosophy of wholeness • Wellness, well-being • Disseminate information

16. Programs to Promote Health • Information dissemination  most basic • Consider culture, age group • Critical to know where misinformation originates • Health risk appraisal and wellness assessment • Used to teach about risk factors • Motivate to reduce specific risks

17. Programs to Promote Health, continued • Lifestyle and behavior change • Requires participation of individual • Geared toward enhancing quality of life • Environmental control • Toxic and nuclear wastes • Nuclear power plants • Air and water pollution • Herbicide and pesticide use

18. Health Promotion Activities • Collaborative relationships • Work with not for people • Nursing process basic tool • Teach self-care responsibility • Emphasize illness prevention, health promotion • Assess, plan enhanced care

19. Variables Influencing Health • Biologic dimension • Genetic makeup • Gender • Age • Developmental level • Infants • Toddlers • Adolescents • Older adults

20. Psychologic Dimension • Mind-body interactions affect health status • Increase susceptibility to organic disease • Precipitate organic disease • Mind’s ability to direct body’s functioning • Emotional reactions occur in response • Self-concept affects how we handle situations

21. Cognitive Dimension • Intellectual factors influencing health • Lifestyle • Living conditions • Patterns of behavior • Risk factors • Healthy lifestyle choices • Spiritual and religious beliefs • Jehovah’s Witnesses and blood transfusions • Jews perform circumcision on 8th day of life

22. Nursing Process: Assessment • Health history and physical examination • Existing problems • Age • Safety assessment • Nutritional assessment • Physical fitness assessment • Muscle endurance • Flexibility and body composition • Cardiorespiratory endurance

23. Assessment, continued • Lifestyle assessment • Personal lifestyle and habits of client • Lifestyle assessment tools • Spiritual health assessment • Ability to develop inner nature to fullest

24. Assessment, continued • Social support systems review • Social context in which person lives • Creates environment for healthy behavior • Life stress review • Validating assessment data • Client and nurse together • Review, validate and summarize information • Existing health problems

25. Nursing Diagnoses • NANDA wellness diagnoses • Readiness for Enhanced Spiritual Well-being • Readiness for Enhanced Coping • Readiness for Enhanced Nutrition • Readiness for Enhanced Knowledge • Readiness for Enhanced Parenting • Readiness for Enhanced Self-Concept • Readiness for Enhanced Immunization Status • Readiness for Enhanced Self-Care

26. Plan • Health promotion plan developed • In response to needs, desires, priorities • Nurse acts as resource person • Steps in planning • Review and summarize assessment data • Reinforce strengths, competencies of client • Identify health goals, related options • Identify behavioral or health outcomes

27. Plan, continued • Steps in planning, continued • Develop a behavior-change plan • Reiterate benefits of change • Address barriers to change • Determine time frame for implementation • Formalize commitment to behavior change plan • Explore available resources

28. Implementation • Self-responsibility • Ongoing support • Focuses on desired behavior change • Individual counseling sessions • Telephone, internet counseling • Group support

29. Implementation, continued • Facilitating social support • Assist client to assess, modify and change • Providing health education • Enhancing behavioral change • Strategies at each stage of change • Precontemplation  Action • Contemplation  Maintenance • Preparation  Termination

30. Implementation, continued • Enhancing behavioral change • Establish rapport • Set agenda • Assess importance, confidence and readiness • Exchange information • Reduce resistance • Advance client to next stage of changing • Modeling

31. Evaluation Ongoing basis as short-term goals met After long-term goals completed Date determined during planning phase Collaborative effort

32. Exemplar 13.2 Physical Fitness and Exercise • Physical fitness • Enables body to perform to its potential • Helps individuals look, feel, do their best • Ability to perform daily tasks vigorously, with energy left over • Involves performance of heart, lungs, muscles • Influences mental alertness, emotional stability

33. Healthy People 2010 • Increase proportion of people who • Engage in moderate physical activity daily • Perform physical activities to enhance, maintain: • Muscle strength  Endurance  Flexibility • Increase work sites offering physical fitness programs • Reduce chronic back condition limitations • Reduce number of overweight people

34. Fitness and Exercise • Research • Exercise improves health status • Exercise can prevent, reverse chronic diseases experienced in aging • Activity-exercise pattern  routine of exercise, activity, leisure • ADLs • Type, quantity, quality of exercise

35. Physical Activity and Exercise • Physical activity • Bodily movement produced by skeletal muscle contraction • Increases energy expenditure • Exercise • Type of physical activity defined as planned • Repetitive bodily movement • Performed to improve, maintain fitness

36. Physical Activity and Exercise, continued • Activity tolerance • Type and amount of exercise, ADLs individual can perform without adverse effects • Functional strength • Body’s ability to perform work

37. Types of Exercise • Isotonic • Isometric • Isokinetic • Aerobic • Anaerobic

38. Benefits of Exercise • Musculoskeletal system • Muscles hypertrophy • Joints receive nourishment • Bone density and strength maintained • Cardiovascular system • Primary prevention of stroke, CV disease • Increase heart rate, strength of heart muscle • Mediates harmful effects of stress

39. Benefits of Exercise, continued • Respiratory system • Ventilation and oxygen intake increases • Toxins eliminated • Problem solving, emotional stability enhanced • Prevents pooling of secretions • Gastrointestinal system • Improves appetite • Increases GI tract tone

40. Benefits of Exercise, continued • Metabolic/Endocrine system • Elevates metabolism • Weight loss, exercise stabilize blood sugar • Urinary system • Promotes efficient blood blow • Body excretes wastes more efficiently • Immune system • Lymph fluid more efficiently pumped • Strenuous exercise may reduce immune function

41. Benefits of Exercise, continued • Psychoneurologic system • Mental, affective disorders may affect desire to move • Role of exercise in elevating mood Relieving stress, anxiety • Regular exercise increases levels of endorphins • Improves quality of sleep

42. Benefits of Exercise, continued • Cognitive function • Positive effect • Athletic older adults have denser brains • Brain gym • Improves mood, learning, problem solving • Contralateral movements help those with • ADD, ADHD, learning disorders, mood disorders

43. Benefits of Exercise, continued • Cognitive function • Positive effects in individuals with • Parkinson’s disease • Alzheimer’s disease • Spiritual health • Enhance experience of mind-body-spirit connection