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NRS 101 Entry Into Professional Nursing Session 2. Health & Wellness, Caring in Nursing, Ethics & Values. HEALTH AND WELLNES. IS IT THE ABSENSE OF DISEASE? MULTIDIMENSIONAL CONCEPT CONCEPTS OF: WELLNESS ILLNESS HEALTH. HEALTH AND WELLNESS. ILLNESS BEHAVIOR—REACTION TO ILLNESS
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NRS 101 Entry Into Professional Nursing Session 2 Health & Wellness, Caring in Nursing, Ethics & Values
HEALTH AND WELLNES • IS IT THE ABSENSE OF DISEASE? • MULTIDIMENSIONAL CONCEPT • CONCEPTS OF: • WELLNESS • ILLNESS • HEALTH
HEALTH AND WELLNESS • ILLNESS BEHAVIOR—REACTION TO ILLNESS • HEALTHY PEOPLE 2000 FOCUS ON HEALTH PROMOTION AND DISEASE PREVENTION • HEALTHY PEOPLE 2010 INCREASE QUALITY AND YEARSS OF LIFE, ELIMINATE DISPARITIES IN HEALTH • HOW DO YOU DEFINE HEALTH?
HEALTH AND WELLNESS • WORLD HEALTH ORGANIZATION DEFINES HEALTH O AS A STATE “OF COMPLETE PHYSICAL, MENTAL, AND SOCIAL WELL BEING” • VARIABLES DEFINE HEALTH IN RELATION TO VALUES, LIFESTYLE, PERSONALITY, MENTAL, SOCIAL, AND SPIRITUAL WELL BEING
VIEWS OF HEALTH • VIEWS OF HEALTH DEPENDENT ON: • AGE • GENDER • RACE • CULTURE CONDITIONS OF LIFE HAVE NEGATIVE OR POSITIVE EFFECTS ON HEALTH
VIEWS OF HEALTH • PHYSIOLOGICAL • PSYCHOLOGICAL • SOCIOECONOMIC • LIFESTYLE CHOICES HEALTH DEFINED IN TERMS OF INDIVIDUAL NOT EVERY ILLNESS/DISEASE AFFECTS EVERYONE IN THE SAME WAY—WHY?
HEALTH BELIEF BEHAVIORS • HEALTH BELIEF BEHAVIORS • ATTITUDES ABOUT HEALTH • FACTS/MYTHS • FALSE EXPECTATIONS/REALITY POSITIVE/NEGATIVE HEALTH BEHAVIORS
HEALTH MODELS • HEALTH BELIEF MODEL--PREDICTS PT’S BEHAVIOR IN RELATION TO HEALTH COMPLIANCE WITH HEALTH CARE THERAPIES • HEALTH PROMOTION MODEL--DEFINES HEALTH AS NOT JUST ABSENSE OF DISEASE BUT AS A POSITIVE DYNAMIC STATE • HEALTH PROMOTING BEHAVIOR • MODIFIED THROUGH NURSING ACTIONS
HEALTH MODELS • BASIC HUMAN NEEDS MODEL (MASLOW) • HIERARCHY OF NEEDS • INTERRELATIONSHIP OF BASIC HUMAN NEEDS • PEOPLE SHARE BASIC HUMAN NEEDS • EXTENT TO WHICH NEEDS ARE MET DETERMINES PERSON’S LEVEL OF HEALTH • CAN BE USED FOR ALL PTS IN ALL HEALTH CARE SETTINGS
MASLOW BASIC NEEDS MODEL • PHYSIOLOGICAL • OXYGEN • FLUIDS • NUTRITION • BODY TEMP • ELIMINATION • SHELTER • SEX
MASLOW’S BASIC NEED MODEL • EMERGENT PHYSIOLOGICAL NEED ALWAYS TAKES PRECEDENT OVER A HIGHER LEVEL NEED • FOCUS ON PT NEEDS INSTEAD OF ADHERING TO HIERARCHY OF NEEDS • MUST PRIORITIZE—RELATIONSHIP OF DIFFERENT NEEDS AND REASONS DETERMINE PRIORITY
MASLOW’S BASIC NEED MODEL • SAFETY AND SECURITY—PHYSIOLOGICAL AND PSYCHOLOGICAL • LOVE AND BELONGING • SELF ESTEEM • SELF ACTUALIZATION
VARIABLES • INTERNAL VARIABLES AFFECTING/INFLUENCING HEALTH AND HEALTH BEHAVIOR • DEVELOPMENTAL STAGE • INTELLECT • PERCEPTION OF FUNCTIONING • EMOTIONAL FACTORS • SPIRITUAL FACTORS
VARIABLES • EXTERNAL VARIABLES AFFECTING/INFLUENCING HEALTH AND HEALTH BEHAVIORS • FAMILY PRACTICES • SOCIOECONOMIC • CULTURE
LEVELS OF PREVENTATIVE CARE • PRIMARY PREVENTION • AIMED AT PREVENTING DISEASE • PRECEDES DISEASE • HEALTH PROMOTION • IMMUNIZATIONS • PERSONAL HYGIENE • ALLERGENS • NUTRITION • STRESS
LEVELS OF PREVENTATIVE CARE • SECONDARY PREVENTION • FOCUS ON PT WHO IS EXPERIENCING DISEASE OR AT RISK OF DISEASE • DIAGNOSIS—PROMPT INTERVENTION • REDUCE SEVERITY • DELAY CONSEQUENCES OF ADVANCING DISEASE • SCREENING, TREATING EARLY DISEASE EVALUATE OUTCOMES
LEVELS OF PREVENTATIVE CARE • TERTIARY • DISEASE IS PERMANENT/IRREVERSIBLE • MINIMIZE EFFECTS OF LONG TERM DISEASE, DETERIORATION • REHABILITATION • PREVENT FURTHER DISABILITY • ACHIEVE AS HIGH A LEVEL OF FUNCTIONING AS POSSIBLE
RISK FACTORS ASSOCIATED WITH ILLNESS • RISK FACTOR—HABITS, CONDITIONS, SITUATIONS THAT PREDISPOSE A PERSON TO ILLNESS/ACCIDENT • PRESENCE OF RISK FACTORS DOES NOT MEAN PERSON WILL GET DISEASE
RISK FACTORS • GENETIC AND PHYSIOLOGICAL FACTORS • AGE • ENVIRONMENT • LIFESTYLE IDENTIFY, MODIFY, AND CHANGE RISK FACTORS DO THEY WANT TO CHANGE BEHAVIORS?
CHANGING BEHAVIORS • MANY FIND CHANGE DIFFICULT • MUST MOVE THROUGH DIFFERENT STAGES TO ACCOMPLISH CHANGE • NURSE ASSISTS PT WITH CHANGE • ASSESSEMENT • INTERVENTION • EVALUATION (OUTCOMES)
STAGES OF HEALTH BEHAVIOR CHANGE • PRECONTEMPLATION • CONTEMPLATION • PREPARATION • ACTION • MAINTENANCE STAGE
ACUTE/CHRONIC ILLNESS • ACUTE ILLNESS—SEVERE, USUALLY SHORT DURATION • CHRONIC—USUALLY LONGER THAN SIX MONTH • COPING USUALLY MORE COMPLEX • NURSES HELP PT TO MANAGE ILLNESS
ACUTE/CHRONIC ILLNESS • INTERNAL VARIABLES • PERCEPTION OF ILLNESS • SEEK HEALTH CARE IF SYMPTOMS DISRUPT/AFFECT DAILY ROUTINE • THOSE WITH CHRONIC PAIN MAY NOT SEEK TREATMENT AFTER NO SUCCESS IN PREVIOUS TREATMENTS • TYPES OF SYMPTOMS • SHARP, SUDDEN, INTENSE VS ACHE
ACUTE/CHRONIC ILLNESS • EXTERNAL VARIABLES • CULTURE • FAMILY DYNAMICS • SOCIAL GROUP • DIETARY PRACTICES • ECONOMICS
IMPACT OF ILLNESS ON PT/FAMILY • BEHAVIOR/EMOTIONAL CHANGES • BODY IMAGE/ SELF CONCEPT • FAMILY ROLE CHANGES • ROLE STRAIN • ROLE CONFUSION • ROLE REVERSAL
CARING IN NURSING • NURSING AND CARING • RECENT GALLUP POLLS • CARING (BENNER, 2000)—”MEANS THAT PERSONS, EVENTS, PROJECTS, AND THINGS MATTER TO PEOPLE” • ESSENTIAL HUMAN NEED, ESSENTIAL TO POSITIVE PT OUTCOMES • ALLOWS NURSE TO DETERMINE WHICH INTERVENTIONS SUCCESSFUL • ABILITY TO KNOW CLIENT
CARING IN NURSING • TAKES EXPERIENCE • EXPRESSION OF CARING WILL DIFFER WITH EACH PT • DOES EVERYONE WHO ENTERS A NURSING PROGRAM HAVE THE CARING COMPONENT? • MANY THEORIES ON NURSING—MUTUAL GIVE AND TAKE WILL NOT HAPPEN IF NURSE IS NOT CARING
CARING IN NURSING • DIFFICULT TO SHOW CARING IF YOU DON’T UNDERSTAND WHO THE PT IS AND THEIR PERCEPTIONS OF ILLNESS • PRESENCE • BEING THERE, EYE CONTACT, BODY LANGUAGE • TOUCH • TASK ORIENTED, CARING, PROTECTIVE • KNOWING THE CLIENT • AVOID ASSUMPTIONS • INCLUDING THE FAMILY • ILLNESS AFFECTS THE FAMILY AS WELL AS THE PT
CARING IN NURSING • LISTENING • SILENCE • DON’T INTERRUPT • DON’T FINISH SENTENCES SPIRITUALITY—VERY IMPORTANT, INTERGRAL PART OF WELLNESS TO SOME PTS
ETHICS AND VALUES • AUTONOMY • BENEFICIENCE • NONMALEFICIENCE • JUSTICE
ETHICS AND VALUES • FIDELITY • ACCOUNTABILITY, RESPONSIBILITY • CONFIDENTIALITY • VERACITY
ETHICS AND VALUES • VALUE—PERSONAL BELIEF • GIVEN ATTITUDE, IDEA • CUSTOM • OBJECT REFLECTS CULTURE, RELATIONSHIPS, PERSONAL NEEDS, SOCIAL INFLUENCES
ETHICS AND VALUES • VALUE FORMATION—HOW DID YOU FORM VALUES IN YOR LIFE? • VALUES CLARIFICATION • CULTURAL VALUES • BIOETHICS
ETHICS AND VALUES • CULTURAL VALUES EXERCISE • ETHICAL DILEMMAS • STEP 1—IS THIS AN ETHICAL DILEMMS? • STEP 2—GATHER INFO • STEP 3—EXAMINE YOUR OWN VALUES • STEP 4—VERBALIZE PROBLEM • STEP 5—CONSIDER COURSE OF ACTION • STEP 6—NEGOTIATE OUTCOME • STEP 7—EVALUATE THE ACTION