health promotion and pt education

health

state

complete physical, mental, and social well-being

wellness

action/behavior

active process of living a healthy lifestyle

human dimension

holistic care

• physical

• intellectual

• emotional

• sociocultural

• spiritual

• environmental

treat the whole person, not just disease

concept of health and wellness

holistic healthcare

morbidity

mortality

disease

illness

acute illness

chronic illness

holistic healthcare

addresses many dimensions

treat whole person

morbidity

how often disease occurs

mortality

number of death from disease

death rate

disease

pathological change in structure or function of body or mind

pathology → objective

illness

response to disease, person’s level of functioning is changed

pt experience → subjective

acute illness

rapid onset of symptoms, short-term → sudden

chronic illness

lifelong management

permanent change, irreversible alteration, slow onset

long-term, irreversible

remission

exacerbation

remission

no symptoms

disease present

exacerbation

symptoms return

common cause of disease

Inherited genetic defects 

Dev defects resulting from exposure 

Biological agent or toxins 

Physical agent 

Generalized tissue response to injury or irritation 

Physiologic and emotional reaction to stress

Excessive or insufficient production of body secretions

social determinants of health and health disparity

health equity

SDOH

health disparity

vulnerable population

health equity

attainment of highest level of health for all

equal opportunity for health

SDOH

condition of env affect ranges of health

env affecting health

health disparity

differences due to inequality

Influenced by race, ethnicity, poverty, sex assigned at birth, age, mental health, education level, disabilities, sex orientation, health insurance, access to healthcare

vulnerable population

higher risk groups

Racial, ethnic minorities, poor, women, children, elderly, rural population, disabilities, and special health care needs

social determinants of health (SDOH)

health outcome

• mortality, morbidity, life expectancy, health care expenditures, health status, functional limitations

SDOH economic stability

• Employment 

• Income 

• Expenses

• Diet 

• Medical bill

• Support

SDOH neighborhood/physical env

• Housing 

• Transportation 

• Safety 

• Parks 

• Playgrounds 

• Walkability

SDOH education

• Literacy 

• Language 

• Early childhood education 

• Vocational training

SDOH food

hunger

access to healthy options

SDOH community/social context

• Social integration 

• Support system 

• Community engagement 

• Discrimination

SDOH health care system

• Health coverage 

• Provider availability 

• Provider 

• Linguistic and cultural competence

• Quality of care

health promotion / illness prevention

health promotion

• behavior of person who is motivated to improve well-being and health

stages

• primary

• secondary

• tertiary

health promotion primary

promoting health

prevent dev of disease

vaccine, diet, exercise

smoking cessation

health promotion secondary

screening for early detection of disease

prompt diagnosis and treatment

screenings

health promotion tertiary

manage disease, treatment

after illness is diagnosed/treated

goal:

• reduce disability and rehabilitate pt maximum level of functioning

rehab

medication

physical therapy

health belief model

what people believe or perceive as healthy

why pt choose to follow or not follow health behavior

predict health behavior

health belief model perceived susceptibility

risk

Pt's belief about risk of getting disease 

Higher belief = more likely to act

health belief model perceived seriousness

how bad is it

how serious pt thinks the condition is

• physical affects

• social affects

health belief model perceived benefit vs perceived barriers

perceived benefit

• will this help me

• belief action will reduce risk or improve health

perceived barriers

• what’s stopping me

• obstacles prevention action

  • cost, SE, convenience, fear, discomfort

  • remove barrier = improve compliance

health belief model cues to action

what made me act

what pushed the pt to act

• trigger behavior change

internal → symptoms

external → doctor, media, fam advice

health belief model self efficacy

confidence

can i actually do this

pt confidence in performing behavior → better outcome

health belief model lecture definition

three components of individual perceptions of threat of a disease:

• (1) perceived susceptibility to a disease

• (2) perceived seriousness of a disease

• 3) perceived benefits of action

health belief model pt

pt will take action when..

• They feel at risk susceptibility

• They think it's serious severity

• They believe treatment works benefits

• Barriers are low 

• They get a trigger cue

• They feel confident self-efficacy

Higher change of healthy behavior

health belief model nurse intervention

Educate → increase susceptibility + severity awareness

Explain benefit clearly 

Reduce barriers (cost, access, SE) 

Provide cues (reminder, teaching) 

build confidence (teach skills)

healthy people 2020/2030

Focus on prevention + equity 

Attain healthy, thriving lives, well-being free of preventable disease, disability, injury, premature death

eliminate health disparities

Create social, physical, economic env that promotes attaining full potential for health 

Promote healthy dev, behavior, well-being on all life stages 

eliminate health disparities

Achieve improved health for all, attain health literacy to improve health and well-being of all

nolas pender’s health promotion model

Indv characteristics 

Behavior-specific factors 

Commitment to action 

Focus = motivation + behavior change

health illness continuum

Health constantly changes 

Range:

• High wellness → illness → death 

Shows changes in a person's health as they adapt to maintain a state of well-being

• Internal (lifestyle, genetic, emotion) 

• External (env, culture) 

stages of change model

pre-contemplation

contemplation

preparation

action

maintenance

relapse

pre-contemplation

no intention in changing behavior

contemplation

aware of problem but w/o commitment to action

preparation

intent on taking action to address the problem

action

active modification

maintenance

sustained changes

new behavior replaces old

relapse

fall back to old patterns

nurse role in health promotion

focus on health

empower pt

recognize health is multidimensional

recognize external factors

patient education

help pt

• gain knowledge

• change behavior

• improve self-care

patient education goal

promote health

prevent disease

restore health

help coping

pt education health literacy

ability to understand health info

understand pt level of understanding

tips:

• simple language

• pt teach back

• visuals

low literacy - poor outcome

quality of pt education counseling

resources and support that pt need to participate actively in self-care and facilitate their coping with their situation

quality of pt education learning

pt attains or increase knowledge

changes behavior in measurable way

quality of pt education nurse intervention

listen to pt and fam

every interaction is opportunity to teach

begin teaching with first encounter

engage and motivate

goal of education

maintain and promote health and wellness

restore health

prevent illness or further injury

facilitate coping

teaching and nursing process

A-assess

• learning needs, resources, readiness, barriers, abilities, support

D-diagnose

• identify needs

P-plan

• validate with pt/fam

• dev learning outcomes

I-implement

• dev and implement teach plan

E-evaluate

• evaluate learning

communication

Be clear 

Use simple language 

Ask open-ended questions 

Avoid too much info

Listen 

Ask if pt has any questions 

Avoid lecturing 

assessment

learning needs

• what are the gaps in knowledge

• pt knows/needs/wants to know

readiness

• physical abilities

• complexity of task

• language, age

emotional status

• emotional health

• motivation, willingness

• support system

learning style

• idv preference

• ability to process content

strength

• personal preference used to facilitate in learning

learning style VARK

V-visual

A-aural

• teach back

• discussion

• interesting examples

R-read/write

K-kinesthetic

• 5 senses

M-multimodal

learning domains: Bloom’s Taxonomy

cognitive

• knowledge

• storage, ability to recall new inf

psychomotor

• skills

• demonstrate, manipulate, assemble

affective

• feeling, attitude

• change in attitude, value, feelings

nurse problem, SMART goal

Specific

• goal verify specific and grounded

Measurable

Achievable

• realistic, reasonable

Relevant

• relate to what your hoping to accomplish

Time-bound

• timeframe, reasonable

plan

choose time and setting

determining teaching method would be best for pt

teaching methods

resources and supplies

implementation

effective communication

organization

time management

interpersonal skill

teach-back method

non-judgmental approach

steps:

• teach

• ask pt to explain

• clarify

• repeat

use open-ended questions

ask me 3 framework

organize message in an easy-to-understand

1. main problem is…

2. next step in your care is for you to…

3. you need to do this because…

evaluate

did pt learn

measure how well outcomes have been achieved

• what went wrong/right

evaluate learning

• proof or feedback

time evaluation

• teaching is complete before evaluation → resolution may be skewed

evaluate methods

question

demonstration

observation

evaluate and revise

as needed to meet desired outcome

documentation

LEGAL REQUIREMENT

Outcome not met

• show plan for further teaching

includes:

• learning needs

• plan

• teaching

• evaluation

• follow-up plan