NCHP wellness & sleep & spiritual health

health

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

health belief model

person’s beliefs guide nursing plan of care

• individal perception of disease risk

• individual perception of severity of illness

• likelihood that person will take preventative action

health promotion model

health as a positive, dynamic process

• individual characteristics/experiences

• behavior and knowledge

• behavioral outcomes

maslow’s hierarchy of needs

certain human needs are more basic than others, and some needs must be met before other needs

• physiological

• safety and security

• love and belonging needs

• self-esteem

• self-actualization

holistic health

relationship between mind, body and spirit affect a person’s health.

• holistic nursing promotes a patient’s optimal level of health by considering the dynamic interactions among the emotional, spiritual, social, cultural, and physical aspects of an individual wellness

influences on health beliefs and practices: developmental stage

perceptions and ability to participate in self-care, childhood to older adult

influences on health beliefs and practices: intellectual background

cognitive ability influences level of thought and understanding, consider health literacy

influences on health beliefs and practices: perception of functioning

gather subjective data and objective data

influences on health beliefs and practices: emotional factors

coping mechanisms, stress, depression, and fear

influences on health beliefs and practices: spiritual factors

religious practices influencing treatment choices, levels of hope and comfort

influences on health beliefs and practices: external variables

family role and practices: individual is influences by family’s beliefs/practices

influences on health beliefs and practices: external variables

social determinants of health: povery, food insecurity, no primary health care in a community, culture, exposure to violence, and access to green spaces

influences on health beliefs and practices: culture

values, beliefs, customs will influence health beliefs and practices

primary prevention

• true prevention

• health EDUCATIONN

• HEALTH PROMOTION

secondary prevention

• screening techniques and treating early stages of disease

tertiary prevention

• occurs when a defect or disability is permanent and irreversible

• minimizing the effects of long-term disease or disability by interventions directed at preventing complications and deterioration

risk factors

a situation, habit, social or enviornmental, physiological or psychological, development or intellectual, spirtual condition, or other variable that increases the vulnerability or an individual or group to an illness or accident

• DOES NOT CAUSE disease or accident

• INCREASES THE CHANCE of disease or dysfunction

nonmodifiable risk

genetic and physiological: hereditary and genetic predisposition to illness

nonmodifiable risk

age: premature, infants, and elderly patients

modifiable risk

lifestyle: smoking, drinking alcohol, stress, physical inactivity, insufficient rest and sleep

modifiable risk

enviornmental exposure: air pollution, water supply, soil, allgergens, toxic chemicals, excessive sun exposure

risk factor indications

nurses are responsible for identifying and modifying risk factors in all settings —> risk factors indicate the need for ACTION and EDUCATION

stages of change “Transtheoretical Model:” pre-contemplation

person not interested, defensive, no change within 6 months

stages of change “Transtheoretical Model:” contemplation

person ambivalent but will accept information, considering a change within the next six months

stages of change “Transtheoretical Model:” preparation

person believes that change in necessary —nurse assists in developing developing a plan of action, making small changes in preperation for a change in next month

stages of change “Transtheoretical Model:” action

person actively involved in plan for change —barriers may be present (approx. 6mo)

stages of change “Transtheoretical Model:” maintenance

ideally changed are intergrated into the person’s lifestyle; sustained change over time

most effective behavior modification

matches the stage of change

illness

the state in which a person’s physical, emotional, intellectual, social, developmental, or spiritual functioning is diminised or impaired

• in the presence OR absence of disease

acute illness

severe— abrupt onset of intense symptoms

reversible— relatively short duration

chronic illness

• persistent (beyond 6mo)

• irreversible

• affects functioning in one or more body systems

illness behavior

how a patient

• behaves or acts to monitor their bodies

• defines and interprets symptoms

• take action

• uses healthcare resources in the event of an illness

illness behavior: internal variables

person’s beliefs and values related to health and illness

illness behavior: external variables

the visibility of symptoms, social groups, cultural background, economic variables, accessability of the health care system, and social support

spirituality

an awareness of one’s inner self and sense of connection to a higher being, nature, or some purpose greater than oneself

• includes personal beliefs

• different meanings for different peoples

• nurses need to be aware of their own ____

factors influencing spirituality

• acute illness

• chronic illness

• terminal illness

• near-death experience

nursing diagnosis related to spirituality

• risk for spiritual distress

• spiritual distress

• readiness for enhanced spiritual well-being

• decreased spiritual distress

• hopelessness

circadian rhythm

24-hour, day-night

biological time clocks

sleep regulation: homeostatic process (Process S)

regulates the length and depth of sleep

sleep regulation: circaian rhythms (Process C)

influences the internal organization of sleep and the timing and duration of sleep-wake cycles

time of wake-up is defined by…

intersection of process S and process C

Nonrapid eye movement (NREM)

75% of night

rapid eye movement (REM)

25% of night

pre-sleep period

first 10-30 min of sleep

three stages of NREM

• N1, N2, N3 (75%)

• combines with REM (25%) for a total of 90-110 min

N1 and N2

light sleep

N3

deep sleep

REM

vivid dreaming, but dreams can also occur in NREM

functions of sleep

• a time of restoration, memory consolidation, and preparation for the next period of wakefulness

• restores biological process

• dreams are important for learning, memory, and adaption to stress

physical illness

can cause pain, physical discomfort, anxiety, depression, and sleep disturbances

insomnia

a symptom that patients experience when they have chronic difficulty in falling alseep, frequent awakenings from sleep, and/or a short sleep or nonrestorative sleep

• associated with poor sleep hygiene

sleep apnea

a disorder in which an individual is unable to breathe and sleep at the same time

• OSA: obstructive sleep apnea

• centeral sleep apnea

• mixed apnea

• obesity and hypertension major factors in OSA

symptoms of sleep deprovation

daytime sleepless, fatigue, irritability, trouble thinking/focusing/remembering, headaches, slowed reaction times

sleep amt newborns

about 16 hours

infants amt sleeping

15 hours

preschoolers amt sleeping

12 hours

school-aged children amt sleep

9-12 hours

adolescents amt sleep

8 to 10 hrs

young adults amt sleep

6 to 8.5 hrs

middle adults amt sleep

7 to 9 hrs

older adults amt sleep

< 7 hrs

factors influencing sleep

• drugs and substances

• lifestyle

• usual sleep patterns

• emotional stress

• environment

• excersise and fatigue

• food and caloric intake

best source for sleep assesment

• the patient is the best resource

• bed partners

• children —> ask parents or guardians

health risks associated with inadequate sleep

• obesity

• diabetes

• heart disease

• cancer

• dementia

nursing diagnosis r/t sleep

• disturbed sleep pattern

• insomnia

• sleep deprivation

• readiness for enhanced sleep