HH/NURS2543 A - Health of Families and Social Groups

Health as a distinct but interrelated concept

a patient can have a chronic disease and healthy characteristics

disease

objective state of ill health

illness

subjective experience of loss of health

health

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

wellness

positive subjective experience of whole body

health as stability

Maintenance of physiological, functional and social norms (homeostasis)

health as actualization

actualization of human potential (health and wellness)

Health as actualization and stability

the realization of human potential through goal-directed behaviour, competent self-care, and satisfying relationships with others, while adapting to meet the demands of everyday life and maintain harmony with the social and physical environments

health as resource

capacities to fulfill roles, meet demands and engage in the activities of everyday living

health as unity

reflecting the whole person as process and is synonymous with self-transcendence

qualities of health

feeling vitalized and full of energy
good social relations
feeling of control over life
enjoy things
sense of purpose
connected to community

medical approach to health

Stability-oriented
20th century
medical intervention restores health

medical approach to health and physiological risk factors

precursors to disease. ex: hypertension, obesity, genetic predisposition

behavioral approach to health

1970s
called for better knowledge of biology, improvement in environment and reduction in self-imposed risk

behavioral risk factors (4)

smoking, substance, lack of exercise, unhealthy diet

Socioenvironmental Approach to health and 2 examples

1980s
health is tied to social structures (poverty, air pollution)

prerequisites for health (9)

peace, shelter, education, food, income, stable ecosystem, sustainable resources, social justice and equity

Ottawa Charter 5 major strategies to promote health

healthy public policy
supportive environment
community action
personal skills
health services

Epp's 3 major health challenges

reducing inequities
increasing prevention
enhancing coping mechanisms

Labonte psychosocial risk factors to health (3 ex)

isolation, lack of support, low self esteem

Labonte socioenvironmental risk factors to health (3 ex)

poverty, low education, discrimination

population health approach

entire range of known individual and collective factors and conditions that determine population health status, and the interactions among them, are taken into account in planning action to improve health

12 key health determinate for population health approach

income and social status
social support
education
employment
physical environment
biology and genetic
personal health
healthy child develop.
health services
gender
culture
social environments

Jakarta Declaration added 4 prefers to Ottawa Charter

empowerment of women
social security
respect for human rights
social relations

what is greatest determinant of health and why

income and social status
has the greatest influence

social support affects health behaviors and health care through what? (4 supports)

practical, emotional, informational, affirmational

physical environments affect health both...

directly and indirectly

3 levels of disease prevention

primary, secondary, tertiary

primary prevention and (example)

protect before signs and symptoms occur (immunization)

secondary prevention and (example)

early detection and treatment (Pap test)

tertiary prevention and (example)

minimizing residual disability (cardiac rehab)

health promotion is guided by 4 principles

addresses health issues in context
supports a holistic approach
requires a long term perspective
multisectoral

how can a nurse promote the health of lower income patients?

access resources and supports that enhance personal skills

how is health promotion and evidence information decision making related

foundation that ensures policies and programs focus on right issues with effective action

critical thinking

phenomenon of process and a set of skills. ability to make accurate judgement and decisions

what is the ethos of patient centered care

care is tailored to specific needs of individual patient

evidence informed knowledge

based on research or clinical expertise

health is a positive or negative concept?

positive

theory of indigenous health

medicine wheel teachings

family nursing

ability to simultaneously attend to needs of individual and family members

family

set of relationships that influence a life, regardless of biological or legal ties

Crisis proof family

integrate stability with need for growth and change

crisis prone family

lacks control over environment

family hardiness

internal strengths and durability of a family, sense of control, change as growth and active approach to stress

family resiliency

ability to cope with expected and unexpected stress and change

where is focus put when considering the family as context?

individual patient within the context of the family, or the family with the individual as context

example of individual patient within the context of the family

a man with heart disease, nurse asks the wife about family diet and possible stress

example of family with the individual as context

nurse interviews the daughter about how she is doing in regards to her mother's MS

relational inquiry approach

Consider how families and nurses are embedded within life contexts.

relational inquiry approach: practice/implementation (4)

entering into relation
inquiring into family health and experience
following lead of family
learning to let be

Calgary Family Assessment Model (CFAM)

Relational, strengths-focused practice model that guides nurses in the completion of comprehensive family assessment

CFAM focuses on what 3 categories

structural
developmental
functional

structural assessment of family (3 dimensions)

internal
external
context

Internal dimension of structural assessment of family

people who are included in the family and how they are connected to one another

external dimension of structural assessment of family

extended family
larger systems

context dimension of structural assessment of family

situation or background relevant to family

structural assessment tools: genogram

sketch of family structure and relevant info about family members

structural assessment tools: ecomap

sketch of family's relationships with persons and groups outside the family

functional assessment of family

how family members interact and behave towards one another

functional assessment of family: instrumental

normal activities of daily living

functional assessment of family: expressive

ways families communicate

Calgary Family Intervention Model (CFIM)

promoting and improving family function in cognitive, affective and behavioral domains

Linear Questions

elicit information about a patient or family and their perceptions

circular questions

helps determine possible changes for a patient or family.

Linear or Circular Question: When did you first notice her changed eating habits?

Linear

Linear or Circular Question: How does your Mother show she is worrying?

Circular

commendation

conversational statement emphasizing with strengths and abilities of family

illness narrative

person's story of how illness affects whole being

what 3 skills are required of nurses when interviewing families?

perceptual
conceptual
executive

Family Systems Theory

family is viewed as a unit and studied that way

Family Life Cycle Theory

Families move through stages and the identity of the individual is studied with that in mind

McGill Model of Nursing

situation-responsive nursing has a strength based focus

Multiculturalism in Canada (3 affirmations adopted in 1971)

value of all Canadians
rights of Indigenous peoples
French and English - 2 official languages

Acculturation

The adoption of cultural traits, such as language, by one group under the influence of another.

social determinants of health (definition)

social determinants that shape health experiences and nursing practice

*social determinants of health (specific terms)

income and social protection
education
unemployment/job security
working life conditions
food insecurity
housing, basic amens, environment
early childhood development
social inclusion
structural conflict
access to affordable health care

learning about a cultural background
impact of cultural influence on care
understanding family environment
be aware of hospital surrounding and potential impacts of care

cultural context of the family, what nurses can do

two purposes of infection control (IPAC)

protecting patients from infection and protecting health care workers

chain of infection (6)

pathogen, reservoir, portal of exit, mode of transmission, portal of entry, susceptible host

what do pathogens require to thrive in a reservoir? (6)

food, oxygen, water, temperature, pH 5-8, minimal light

direct contact transmission

skin to skin contact

indirect contact transmission

host and contaminated intermediate object

droplet contact transmission

particles from respiratory system go through air and deposit onto a host

airborne contact transmission

particles remain in air for long periods of time and are inhaled by host

vehicle contact transmission

single contaminated source transmits infection to multiple hosts

vectorborne contact transmission

insects transmit to humans

normal flora

assist in fighting infection and inflammation, maintain homeostasis

defense mechanisms: skin

first line of defense, provides barrier

defense mechanisms: mouth

Intact multilayered mucosa
Saliva

defense mechanisms: eye

tearing and blinking

defense mechanisms: respiratory tract

cilia lining airway with mucus, macrophages

defense mechanisms: urinary tract

flushing action of urine, intact layer or epithelium

defense mechanisms: gastro tract

acidity of gastric secretions

defense mechanisms: vagina

normal flora causing vaginal secretions to achieve low pH

asepsis

Absence of pathogens

4 types of disinfection/sterilization

moist heat, chemicals, ethylene oxide gas, boiling water

lower center of gravity means a greater or lower stability?

greater

when friction is reduced, less or more force is required to move?

less

Client ID bands (3 types)

ID, Allergies, Risks

communicable disease

transmitted from person to person