Chapter 7 Client’s Response to Illness

Age, growth, development

-Effect on coping with illness

-Expression of illness

-Erikson's stages of psychosocial development each stage dependent on successful completion of previous one

-some people may get stuck at a stage

culture is

the socially learned behaviors, values, beliefs, customs, and ways of thinking of a population that guide its members' views of themselves and the world. This view affects all aspects of the person's being, including health, illness, and treatment. Diversity refers to the vast array of differences that exist among populations.

Individual Factors pt 1

-Genetics, biologic factors

-Physical health and health practices

-Healthier = better coping with stress or illness

-Response to drugs

-Effect of genetic and metabolism differences

-Poor, intermediate, and ultrarapid metabolizers

-Slower metabolism = need for lower doses

Individual Factors pt 2

-Self-efficacy

-Hardiness (commitment, control, challenge)

-Resilience and resourcefulness

-Spirituality

self-efficacy

a belief that personal abilities and efforts affect the events in one's life. A person who believes that their behavior makes a difference is more likely to take action. People with high self-efficacy set personal goals, are self-motivated, cope effectively with stress, and request support from others when needed.

Interpersonal Factors

-Sense of belonging

-Value

-Fit

-Social networks and social support

-Perception of support system

-Responsiveness of support system

-Family support

a sense of belonging

the feeling of connectedness with or involvement in a social system or environment of which a person feels an integral part. Abraham Maslow described a sense of belonging as a basic human psychosocial need that involves feelings of both value and fit

social networks

groups of people one knows and with whom one feels connected. Studies have found that having a social network can help reduce stress, diminish illness, and positively influence the ability to cope and adapt for both clients and their caregivers

social support

emotional sustenance that comes from friends, family members, and even health care providers who help a person when a problem arises. It is different from social contact, which does not always provide emotional support

Cultural Factors

-Cultural competency

-Cultural humility (see Box 7.1)

-Beliefs about causes of illness

family support

Family as a source of social support can be a key factor in the recovery of clients with psychiatric illnesses. Although family members are not always a positive resource in mental health, they are most often an important part of recovery

Factors in cultural assessment

-Communication

-Physical distance or space

-Social organization

-Time orientation

-Environmental control

-Biologic variations

Social Determinants of Health

-Environmental conditions that affect health risks and outcomes

-Health literacy

Health Care Access and Quality

Access to health care/primary care

Health insurance coverage

Health literacy

education Access and Quality

HS graduation

Enrollment in higher education

Language and literacy

Early childhood education and development

Social and Community Context

Community cohesion

Civic participation

Workplace conditions

Discrimination

Incarceration

Economic Stability

Poverty

Employment

Food security

Housing stability

Neighborhood and Built Environment

Quality of housing

Access to transportation

Availability of healthy foods

Air and water quality

Neighborhood crime and violence

Five key areas in Healthy People 2030

-Health care access and quality

-Education access and quality

-Social and community context

-Economic stability

-Neighborhood and built environment

Diversity

-Knowledge of diversity as starting point when relating to people from different backgrounds

-Wide variations among people from any culture or group

culturally competent:

being sensitive to issues related to culture, race, gender, sexual orientation, social class, economic situation, and other factors

culture

all the socially learned behaviors, values, beliefs, and customs, transmitted down to each generation, as well as a population's ways of thinking that guide its members' views of themselves and the world

ethnicity:

concept of people identifying with one another based on a shared heritage

hardiness

the ability to resist illness when under stress

health literacy

ability to find, understand, and use information and services to make informed health-related decisions

resilience

defined as having healthy responses to stressful circumstances or risky situations

resourcefulness

involves using problem-solving abilities and believing that one can cope with adverse or novel situations

self efficacy

a belief that personal abilities and efforts affect the events in our lives

sense of belonging

the feeling of connectedness with involvement in a social system or environment of which a person feels an integral part

spirituality

a client's beliefs about life, health, illness, death, and one's relationship to the universe; involves the essence of a person's being and their beliefs about the meaning of life and the purpose for living

To provide care, the nurse must

find out as much as possible about a client's values, beliefs, and health practices. Often, the client is the best source of that information, so the nurse must ask the client what is important to them—for instance, "How would you like to be cared for?" or "What do you expect (or want) me to do for you?

At the initial meeting, the nurse must be alert for the client's

preferences for greeting, eye contact, and physical distance. Based on the client's behavior, the nurse can decide what approach is best. For example, if a client offers the nurse their hand, the nurse should return the handshake. If the client does not offer a hand, the nurse should refrain from initiating a handshake.

Approach the client with a

genuine caring attitude.

Ask the client at the beginning of the interview

how they prefer to be addressed and ways the nurse can promote spiritual, religious, and health practices.

Recognize any

negative feelings or stereotypes and discuss them with a colleague to dispel myths and misconceptions.

Remember that a wide

variety of factors influence the client's complex response to illness.

A model for assessing clients from various ethnic backgrounds includes six cultural phenomena:

communication techniques and style, physical distance and space, social organization, time orientation, environmental control, and biologic variations.

Biologic makeup includes

the person's heredity and physical health.

Younger clients may have

difficulty expressing their thoughts and feelings, so they often have poorer outcomes when experiencing stress or illness at an early age.

eople who have difficulty negotiating the tasks of psychosocial development have

fewer effective skills to cope with illness.

Culture has a primary influence on

a person's health beliefs and behaviors.