Promoting Health and Patient Education

What is health?

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

Health Promotion

the process of enabling individuals and communities to increase control over, and to improve their health. It emphasizes changes in individuals behavior and addresses the social and environmental factors that impact health

Health Protection

safeguarding individuals and communities from factors that negatively impact health and ensuring access to quality healthcare services. It includes disease prevention.

Factors that influence personal health

• Genetics/family health history

• age

• sex/gender

• ethnicity

• lifestyle

Positive Health Behaviors

• Regular/consistent exercise

• healthy food choices

• adequate sleep

• up-to-date immunization/vaccination

• regular medical check-ups

• effective stress management

• avoid tobacco, alcohol, illicit drug use

Negative Health Behaviors

• sedentary lifestyle

• poor diet/unhealthy food choices

• poor sleep

• skipping medical check-ups

• risky secual activites

• smoking

• excessive alcohol consumption

• illicit drug use

Modifiable Risk Factors

• Lifestyle: sedentary life, poor diet, smoking, illicit drug use, excessive alcohol consumption

• Medical conditions: diabetes mellitus, high blood pressure, high cholesterol

• Environmental factors: air pollution, water pollution

• Others: poor sleep, excessive stress

Non-modifiable risk factors

• Demographic: Age, sex/gender, and race/ethincity

• Genetics: Family history, genetic mutation such as in cystic fibrosis and sickle cell disease

Primary Prevention

Activities designed to prevent or slow the onset of disease. Examples include eating healthy, exercising, wearing sunscreen, seat belts, and keeping up with immunization

• health promotion, illness prevention

Secondary Prevention

Involves screening activities and education for detecting illnesses in the eary stages. Examples are regular physical examinations, blood pressure and diabetes screenings, tuberculosis skin tests

• health restoration

Tertiary Prevention

Focuses on stopping the disease from progressing and returning the individual to the pre-illness phase, or assisting the individual to maximize the existing potential and live a meaningful life

• Rehabilitation is the main intervention during this level, end of life care

Health Promotion: Assessment

• Health history/ physical examination

• Physical Fitness

  • Cardiorespiratory fitness, muscular fitness, flexibility

• Lifestyle and risk appraisal

  • Personal responsibility for health, physical activity, nutrition, interpersonal relations, spiritual growth, stress management, health risk appraisal (HRA) tool

• Life-stress Review

  • daily stresses, stress-inducing life changes, hardiness vs. vulnerability

• Health Beliefs

  • cultural beliefs and personal experiences

• Nutritional Assessment

  • Dietary patterns, body mass

• Health Screening

  • blood pressure screening, cancer screening tests, breast exams, vision screenings, lab studies

Health Promotion: Analysis

 The nurse describes the patient’s motivation and desire to maintain or pursue well-being and to actualize health potentials

Health Promotion: Planning

 Planning depends on the focus area

 

 This is influenza (Flu) season. The school nurse is planning a health promotion program. What activities will the nurse include in the planning?

Health promotion: Implementation

• Role modeling

• Counseling

• Health education/ teaching

• Supporting Lifestyle changes

Pender’s Health Promotion Model

Description:

• This framwork explains why indivudals engages in activies that promote health

• it focuses on the interaction between individuals characteristics, experiences and the environment

• it emphasizes that individuals seek to creat environments that promote health and well-being

Core Concepts of Pender’s Health Promotion Model

• Individual Characteristics and Experiences:

•Includes self-esteem, personal attitudes, and values

•Past experiences with health behaviors.

• Behavior-Specific Cognitions and Affect:

•An Individual's beliefs about the benefits and barriers of a health behavior

•Emotions associated with that behavior.

• Behavioral Outcome:

•This includes the individual's health behaviors and their impact on health status.

Pender’s health promotion model: Factors Influencing Health Behaviors

•Perceived Benefits: Individuals are likely to engage in a health behavior if they perceive (think) that the benefits outweigh the potential barriers.

•Perceived Barriers: Are obstacles individuals may experience when trying to adopt a healthy behavior. Barriers include a lack of time, cost, or convenience.

•Self-Efficacy: Individuals’ belief in their ability to succeed in a specific health behavior strongly predicts engagement. Example: someone who is strongly motivated to quit smoking, though their friends smoke.

•Interpersonal Influences: Family, friends, and healthcare providers have an influence on an individual's health behaviors.

•Situational Influences: Environmental factors can facilitate or hinder health behaviors. Examples include access to healthy food, safe exercise environments, or supportive social networks.

Wellness Wheel

• portrays dimensions of a balanced lifestyle

• outlines dimensions of wellness as markers to help individuals accomplish a well-rounded, health lifestyle ad live a life of value and meaning

Transtheoretical model of change (stages of change model)

• this framework helps to understand howpeople change their health behavior

• It consists of 6 Stages:

• Precontemplation

  • Not aware, uninformed, no intention to change

• Contemplation

  • Aware problem exists, are thinking about changing

• Preparation

  • Intention to take action to change

• Action

  • Make modifications in their behavior

• Maintenance

  • Have made modifications, prevent relapse

• Termination

  • 100% self efficacy, no temptation to relapse

Health Promotion Strategies 

Immunization Across Lifespan

Infancy and Childhood:

•A comprehensive schedule of vaccinations, including DTaP, polio, MMR, varicella, and flu vaccine

Adolescence:

•Booster shots and vaccinations such as HPV, meningococcal, and annual flu shots. 

Adulthood:

•Annual flu shots, Tdap or Td boosters every 10 years, and consider other vaccinations based on age, risk factors, and health conditions. 

Older Adults:

•Pneumococcal and shingles vaccines, plus others, depending on their health status. 

Health Screening Across Lifespan

Early Childhood:

•Screenings for developmental milestones, hearing, and vision

Adolescence:

•Cholesterol checks, blood sugar tests, STI tests, and discussions about mental health. 

Adulthood:

•Screening is age and sex dependent: cholesterol checks, diabetes tests, blood pressure checks, and cancer screenings (mammograms for females starting at 40 years;  colonoscopies at 45years or earlier for high risk). 

Older Adults:

•Continued screenings for various conditions

•Discuss screening needs with the healthcare provider. 

Health education and health promotion Program

Method-Disseminating information: Information may be disseminated at the individual, group, or community level.

• Individual-level: teaching a patient how to modify his or her personal dietary intake. 

•Group-level: programs include classes offered at the local hospital, prenatal education programs, and worksite programs. 

•Community-level: health promotion programs are directed at the entire community.

Purpose-Changing lifestyle and behavior (all levels)

•Offer group-level programs such as activities on weight loss, smoking cessation, exercise, nutrition, and stress management. 

•Provide information and offer support.

Wellness assessment

•A wellness assessment tends to focus on healthy behaviors. 

•It supports positive change to improve health. 

Health risk appraisal

•A health risk appraisal identifies risky behaviors that promote disease.

Nurses role in health promotion

Educators

Advocates

Health care providers

•Direct caregiver

•Care coordinator

•Screening and health assessment

What is Patient Education?

-Patient education is the process of equipping patients with relevant knowledge and skills to understand, manage, and improve their health conditions.

-It is a vital aspect of nursing

-It can be done anywhere- at home, schools, worksites, hospitals, providers’ offices, clinics, and community settings such as shopping malls, places of worship

Three domains of Learning

• Cognitive (Thinking)

• Psychomotor (doing)

• Affective (feeling)

Cognitive learning

• Includes storing and recalling information.

•Six levels- knowledge, comprehension, application, analysis, synthesis, and evaluation

Psychomotor

•Hands-on skills; requires thinking and doing

•Psychomotor learning involves learning a skill that requires both mental and physical activity. 

Affective

• Includes beliefs, attitude, value, appreciation, preference

Five Rights of Teaching

• Right time

• right context

• right goal

• right content

• right method

Right time

•Patient readiness (physical and mental readiness)

• Nurse-patient trusting relationship

• Sufficient time for the teaching session

Right context

• environment- quiet, free of distractions, and private 

Right Goal

•Patient is involved in setting the learning objectives

•Goals or learning objectives should be realistic and valued by the patient

•Nurse-patient commitment to achieving the set goals (the desired behavioral changes)

• Family or friends’ involvement

Right Content

•Age or level appropriate

•Relevant and meets patients’ needs

• New information or reinforcement of information

Right Method

•Appropriate teaching strategies to fit the learning style and ability of the patient

• Use of a variety of teaching strategies

A Teaching Plan

A teaching plan is an outline that guides the nurse on what and how to provide educational information to a patient, including how to measure the patient’s learning.

•A roadmap for a specific class

•An organizer 

Components of a teaching plan

•Content includes the information the patient needs to understand to reach the desired goal.

•Examples: Side effects of anti-hypertensive medications, handwashing technique, healthy eating

•Teaching strategies are the methods used to present the content.

•Examples include demonstration and return demonstration, one-to-one instruction, lecture, simulation, and online learning.

•Scheduling and sequencing consist of when teaching will happen and how information should be presented

•Example: Schedule a teaching at a time that works for both nurse and patient

•Examples: Present simple before complex topics and nonthreatening topics before more controversial ones.

•Instructional material is tools that are used to introduce information and reinforce learning.

•Examples: Textbooks, videos, worksheets, flashcards, articles

Factors that Affect Patient Learning

§Repetition

§Learning environment

§Scheduling of the session

§Amount and complexity of content

§Nurse/client communication

§Special populations

§Developmental stage

§Culture

§Health literacy

§Motivation

§Readiness to learn

•Physical condition

•Emotions

•Stress

§Timing

§Active involvement

§Feedback given

KNOW

BARRIERS TO LEARNING AND MITIGATING BARRIERS TO LEARNING

How to evaluate learning

-Oral questions/interviews/questionnaires/ checklists

-Direct observation/return demonstration

-Patient reports and patient records

-Tests and written exercises