NCM 103 Unit 2

* diagnosis


* interventions
* evaluation of outcomes from an established plan of care

knowledge base for nursing practice

* promote health
* prevent illness
* restore health
* facilitate coping with disability or death

Four broad aims of nursing practice

* cognitive
* technical
* interpersonal
* ethical/legal

Nurses uses 4 essential competencies

cognitively skilled

nurses think about the nature of things sufficiently to make sense of their world and to grasp conceptually what is necessary to achieve valued goals

technically skilled

nurses manipulate equipment skillfully to produce a desired outcome of result.

interpersonally skiled

nurses establish and maintain caring relationships that facilitate the achievement of valued goals while simultaneously affirming the worth of those on the relationship

ethically and legally skilled

nurses conduct themselves in a manner consistent with their personal moral code and professional roles and responsibilities

RA 9173: The Philippine Nursing Act of 1991

* an act providing for a more responsive nursing professions
* for the protection and improvement of the nursing profession by instituting measures that will result in relevant nursing education, human working conditions, better career prospects, and a dignified existence for our nurses

Code of Ethics for Nurses

established the ethical standard for the profession and provides a guide for nurses to use in ethical analysis and decision-making

Health

state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity

Wellness

* integrated method of functioning which is oriented toward maximizing the potential of which the individual is capable
* requires that the individual maintain a continuum of balance and purposeful direction within the environment where he is functioning (Halbert Dunn)

Disease

alteration in body functions resulting in reduction of capacities or a shortening of the normal life span

Illness

state in which one’s needs are not sufficiently met to allow the individual to have a sense of physical and psychosocial well-being

* Physical
* Emotional
* Intellectual
* Environmental
* Sociocultural
* Spiritual

Factors affecting Health and Illness

Physical Dimension

genetic make-up, age, developmental level, race, sex, are all part of an individual’s physical dimension and strongly influences health status and health practices

Emotional Dimension

* how the mind and body interact to affect body function and to respond to body conditions also influences health
* long-term stress affects the body systems and anxiety affects health habits; conversely, calm acceptance and relaxation can actually change body responses to illness

Intellectual Dimension

* encompasses cognitive abilities, educ background, and past experiences
* influences a client’s response to teaching about health and reactions to health care during illness
* also play a major role in health behaviors

Environmental Dimension

* environment has many influences on health and illness
* housing, sanitation, climate, pollution of air, food, and water are of environmental dimension

Sociocultural Dimension

* health practices and beliefs are strongly influenced by a person’s economic level, lifestyle, family, and culture
* the family and the culture to which the person belongs determine patterns of living and values about health and illness that are often unalterable

low-income groups

less likely to seek health care to prevent or treat illness

high-income groups

more prone to stress-related habits and illness

Spiritual Dimension

spiritual and religious beliefs and values are important components of the way the person behaves in health and illness

Models of Health

developed to help describe the concept and relationships involved in health and illness because definitions of health and wellness are not specific

Health-Illness Continuum Model

* health is a constantly changing state, with high level wellness and death being on opposite ends of a graduated scale or continuum

High Level Wellness Model - Halbert Dunn (1961)

* functioning to one’s maximum potential while maintaining balance and purposeful direction in the environment
* can be applied to the individual, family, community, environment, and society

* Being
* Belonging
* Becoming
* Befitting

5 Aspects Processes that help the person know who and what he is

Being

recognizing self as separate and individual

Belonging

being part of a whole

Becoming

growing and developing

Befitting

making personal choices to befit the self for the future

Precursor of Illness

* these are the factors which impinge on the individuals to lead towards the illness spectrum

* heredity
* behavioral factors
* environmental factors

Precursor of Illness

Agent-Host-Environment Model

initially concentrated on community health but it is also appropriate when examining the cause in an individual (multiple causation of disease)

* Agent
* Host
* Environment

Agent-Host-Environment Model 3 Variables

Agent

must be present/absent for an illness to occur

Host

living being capable of being infected/affected

Environment

everything external to the host

Agent-Host-Environment Model

more useful in predicting illness than in promoting wellness, although recognition of risk factors resulting from interaction of agent-host-environment is important in the promotion and maintenance of health

Health Belief Model

* based on what people perceive/believe to be true about themselves
* useful in teaching individuals health and illness
* nurse can identify the client’s health and structure goals to realistically meet the clients needs

* perceived susceptibility to a disease
* perceived seriousness of the disease
* perceived value of action

Health Belief Model components

perceived susceptibility to a disease

belief that he either will or will not contract a disease

perceived seriousness of the disease

seriousness of the disease, effect on lifestyle

perceived value of action

how effective the person believes preventive measures will be in preventing illness

HBM 2 Influencing Factors

* conviction that carrying out a recommended action will prevent/modify the disease
* the person’s perception of the cost and the unpleasant effects of performing a health behavior

Smith’s Model of Health Clinical Model

views people as physiologic system with related functions and identifies health as the absence of signs and symptoms of disease or injury

Role Performance Model

defines health in terms of individual’s ability to fulfill societal roles such as performing work

Adaptive Model

* focuses on adaptation
* views health as creative process; and disease as a failure in adaptation or mal-adaptation
* model believe that the aim of treatment is to restore the ability of the person, that is to cope

Eudaemonistic Model

* conceptualizes that health is a condition of actualization or realization of a person’s potential
* model avers that the highest aspiration of people is fulfillment and complete development - actualization

Health Promotion Model

* describes the multidimensional nature of persons as they interact within the environment to pursue health
* health promotion is directed at increasing a client’s level of wellbeing
* the health promotion model notes that each person has unique personal characteristics and experiences that affect subsequent actions

* status, beliefs, practices
* basic human needs
* self-concept (a person’s mental image)

Factors affecting health and wellness