NRSG 111 Midterm

WHO definition of health

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

Illness

A subjective experience of loss of health. The etiology can often NOT be identified.

Disease

Is an objective state of ill health, the pathology of which can be detected by medical science. Can be diagnosed and measured. The etiology can often NOT be identified

Etiology

cause of disease

Wellness

Seen as subjective- determined by the person experiencing health.

Society

The systems that incorporate the social, political, economic, and cultural infrastructure to address issues of concern.

Population

A large group of people who have at least 1 characteristic in common and reside in a community.

Community

People and relationships that emerge among them as they develop and commonly share agencies, institutions, or physical space. Define by geography etc..

Group or Aggregate

Groups within a population. Ex. youth with diabetes.

Family

2 or more individuals who depends on eachother

Socio-Environmental Definition of Health

Indicated that lifestyle was a choice and did not take one's environment into consideration.

What is the #1 determinant of health?

Poverty

Health promotion & disease prevention

Strategy to influence Health Determinants- Different although interrelated

Pender

Health promotion is directed towards increasing the level of well-being and self-actualization and disease prevention is action to avoid or forestall illness/ disease

Ottawa Charter for Health Promotion

the process of enabling people to increase control over, and to improve, their health

Primary disease prevention

Prevent disease occurrence (e.g. vaccination), also considered upstream work, stopping before it happens.

Secondary disease prevention

early detection of disease, screening, self exams

Tertiary disease prevention

minimizing residual disability

Health promotion emphasizes

Participation
Empowerment
Equity

What does health promotion address?

Structural and systemic inequities. When government gets involved with policies it works to change things

What are the 5 broad strategies in the Ottawa Charter for Health Promotion?

1. Build healthy public policy (make things law i.e. have to wear a seatbelt)
2. Create supportive environments
3. Strengthen community action (only as strong as weakest member)
4. Develop personal skills
5. Reorient health services (people being healthy outside the hospital, ageing in place)

What does the health promotion model have a foundation of?

Evidence informed decision making

Evidence is informed by?

Research
Experiential learning
Evaluations of program, policies & projects

Canada Health Act

Federal legislation that puts in place conditions by which individual provinces and territories in Canada may receive funding for health care services

How many principles in the Canada Health Act?

5

Public Administration

all administration of provincial health insurance must be carried out by a public authority on a non-profit basis. must also be accountable for the province or territory, and their records and accounts are subject to audits.

Comprehensiveness

all necessary health services, including hospitals, physicians and surgical dentists, must be insured.

Universality

All insured residents are entitled to the same level of health care

Portability

a resident that moves to a different province territory is still entitled to coverage from their home province during a minimum waiting period, also applies to residents that leave the country

Accessibility

All insured persons have reasonable access to health care facilities. In addition, all physicians, hospitals, etc, must be provided reasonable compensation for the services they provide.

Patient Medical home

Medical office assistant, patient, doctor/NP

Primary Care Network

Therapist, Pharmacist, dietitian, nurse, social worker

Primary Care

The first point of contact with the health care system

Primary Health Care

Foundation of Canada's health system. Entry into the system and your continuity of care. It is meant achieve better care for all. Strong emphasis on health promotion and disease prevention. A more integrated approach that hits on the ideology of "health for all". AN interrsectoral approach.

Nursing Process

assessment, planning, intervention, evaluation

What the WHO does

Looks after communicable diseases, preparedness, response.
Everyone has the right to be healthy.

WHO definition of health risk

the probability of an adverse outcome, or a factor that raises this probability

risk-benefit analysis

deciding whether an action is going to cause more harm than good. surgical procedures might be viewed this way, or medication.

Internal health risks

Genetics, gender, age, psychological, how you think

External health risks

physical environment, the risk that your going to choose to smoke, living conditions, family & culture, social supports

Beliefs

a firm opinion or conviction

Values

Principles that influence your thoughts and emotions and guide the choices you make in life. Things you care about but also cause you to behave as you do.

Attitudes

A settled opinion or way of thinking. Stable set of beleifs, feelings, and behavioral tendencies in relation to something or someone. Mental position: I think something is good or bad.

social determinants of health

Factors put upon us that seem strategically/ systemically unfair, something that happened that doesn't set you up to be on a level playing field.

Pender's Health Promotion Model

If client sees benefits to changing a given behavior, they will be motivated to change. Health promoting behavior outcomes are based on:
Individual characteristics and experiences
Behavior specific cognition's and affect
Commitment to a plan of action
Immediate competing demands
FEAR NOT A MOTIVATION

Health Belief Model

A theory of health behaviors; the model predicts that whether a person practices a particular health habit can be understood by knowing the degree to which the person perceives a personal health threat and the perception that a particular health practice will be effective in reducing that threat.

Theory of Reasoned Action and Planned Behaviour

benefit + I can + I want = I will

Prochaska and DiClemente's Stages of Change

precontemplation, contemplation, preparation, action, maintenance, termination.
no one is forcing you

cyclic

people move through stages of prochaska and declementes change however relapse to earlier stage is possible

Broken Window Theory

When a neighborhood looks shitty its more likely to get worse because it already looks bad and people have the attitude that "no one cares about this place anyways"

Maslow's Hierarchy of Needs

physiological, safety, love/belonging, esteem, self-actualization

Dynamics of healthy community

Communication, Leadership, Decision making

evidence

clinical knowledge, expert opinion, information resulting from research.

Evidence-informed practice

the use of evidence in practice

QI (Quality Improvement studies)

not considered research

Evidence informed decision making

a continuous interactive process involving the explicit, conscientious and judicious consideration of the best available evidence to provide care

self-concept

Who am I?

self-esteem

Am I worthy?

Puberty

hypothalamus sends a message to pituitary gland which then sends hormones to sexual organs.

Gender Dysphoria

discomfort or distress caused by a discrepancy between a person's gender identity and that person's sex assigned at birth

Tubal Ligation

a permanent method of contraception involving tying, cutting, clipping, or otherwise blocking the fallopian tubes to prevent passage of an ovum

vasectomy

removal of a segment of the vas deferens to produce sterility in the male

3 reasons over 65 is the biggest age group

extension of life span, baby boomers ageing, health care (we know how to take better care of diseases).

Two indicators of health besides age

Functional capacity and multi-morbidity

ADLs (activities of daily living)

Walking, bathing, toileting, eating, dressing

IADLs (instrumental activities of daily living)

Shopping, housekeeping, food preparation, gardening, banking etc.

Multi-morbidity

multiple chronic illnesses

End stage of kidney function

less than 15% of normal, dialysis or kidney transplant needed

top 2 reasons kidney damage

type 2 diabetes, high blood pressure

Anemia and kidney disease

develops from decreased renal synthesis of erythropoietin- hormone responsible for bone marrow stimulation for RBC production

Emphysema

Narrowing and destruction of alveoli = severe airflow obstruction and barrel chest

Non Invasive Positive Pressure Ventilation

good option for people to be at home who have advanced COPD.

CPAP

machine that provides continuous positive airway pressure. machine delivers a positive pressure to the airway to keep it open so the airway won't collapse and become obstructed.

BiPAP

bi level positive airway pressure, inspiratory positive airway (ipap) expiratory positive airway pressure (epap)

Osteoporosis

Women after menopause have decrease in calcium, stop producing bone protecting hormone estrogen

What accounts for greater use of health care

# of chronic conditions, not age

Primary health care involves:

treatment of illnesses, as well as health promotion and prevention activities

Polypharmacy

The use of multiple medications on a regular basis.

Dementia

an umbrella term for cognitive decline marked by memory disorders, personality changes, and impaired reasoning.

Alzheimer's disease

microscopic plaques and tangles within and between neurons, loss of brain tissue (brain shrinkage), progressive decline

Dementia with Lewy Bodies

neurodegenerative condition linked to abnormal structures in the brain

Parkinson's disease

also marked by the presence of Lewy bodies, often considered a disorder of movement, ppl can also get dementia

Huntington's disease

characterized by specific types of uncontrolled movements but also includes dementia

6 key mechanisms help older people age healthy

social connectedness, self care, physical activity, healthy eating, falls prevention, smoking cessation