Chapter 3 pg 54-71

Key Terms

  • acute illness: Short-term illnesses that arise rapidly and typically resolve in a relatively short time.

  • antiracism: The practice of actively challenging and opposing racism in various forms.

  • chronic illness: Long-term health conditions that persist over time and may affect daily functioning.

  • disease: Refers to specific pathologic changes in the body's structure or function.

  • diversity: The inclusion of individuals from various backgrounds and perspectives.

  • equity: Fairness and justice in healthcare distribution, ensuring all individuals access necessary resources for health.

  • exacerbation: The worsening of symptoms associated with a chronic illness.

  • health: A dynamic state of well-being that encompasses physical, mental, and social aspects.

  • health disparity: Differences in health outcomes and access to care among different populations.

  • health equity: The pursuit of eliminating health disparities, ensuring all individuals can achieve optimal health.

  • health promotion: Activities aimed at enhancing health and preventing disease.

  • holistic health care: Care that addresses the complete individual, including physical, emotional, social, environmental, and spiritual health.

  • illness: The subjective experience of a person related to disease, affected by individual perceptions and responses.

  • inclusion: Efforts to ensure that diverse groups feel welcome, valued, and respected.

  • institutional or structural racism: Systemic discrimination embedded within policies and practices of institutions.

  • morbidity: The frequency of disease occurrence within a population.

  • mortality: The measure of death rates associated with a disease.

  • racism: Prejudice and discrimination towards individuals based on their race or ethnicity.

  • remission: A period during which symptoms of a chronic illness lessen or disappear.

  • risk factor: Attributes or exposures that increase the likelihood of a disease or injury.

  • social determinants of health: Conditions in which individuals are born, live, and work that affect health outcomes.

  • unconscious or implicit bias: Automatic attitudes or stereotypes influencing judgment on an unconscious level.

  • vulnerable population: Groups that are at increased risk for health problems due to social, economic, or environmental disadvantages.

  • wellness: An active pursuit of activities, choices, and lifestyles leading to a state of holistic health.

Objectives of Nurses as Caregivers

  • Promote health, prevent illness, restore health, and facilitate coping with illness, disability, or death.

  • Aim to maximize health for people across all ages and settings, emphasizing comprehensive care.

  • Recognize that health transcends simply not being ill; it also involves an active pursuit of well-being and individual potential.

Understanding Health and Illness

  • Health is defined as the state of complete physical, mental, and social well-being, not merely the absence of disease (WHO, 1974).

  • Individuals define health based on personal feelings and societal expectations; these definitions vary from person to person.

  • Nurses must respect and understand individual definitions of health to provide person-centered holistic care.

  • Understanding models of health and individual responses to illness is crucial in developing effective care plans.

Health Disadvantage in the United States

  • The 2013 Institute of Medicine report highlighted significant health disadvantages in the U.S. compared to other affluent countries despite higher healthcare spending.

  • Key areas where the U.S. fares poorly include:

    • Infant mortality

    • Low birth weight

    • Injuries and homicides

    • Teenage pregnancies

    • Sexually transmitted infections

    • Chronic diseases such as obesity and diabetes

    • Heart disease and chronic lung disease

  • Importance of investigating underlying causes and strengthening health and social service systems to enhance health outcomes is emphasized (Woolf & Aron, 2013).

Concepts of Health and Wellness

  • Health is contextualized through the intersection of physical, intellectual, emotional, sociocultural, spiritual, and environmental dimensions.

  • Wellness is an active pursuit of health and balanced living, informed by Dunn’s model of high-level wellness emphasizing personal growth and direction.

  • Holistic Care entails addressing all dimensions of health, integrating physical and psychological aspects.

Concepts of Illness and Disease

  • Disease: Pathologic changes diagnosed by healthcare providers; traditionally linked to specific medical conditions.

  • Illness: Refers to the individual's personal experience and response to disease, often affected by psychological, cultural, and social factors.

  • Illness can be classified as acute (rapid onset, short duration) or chronic (long-lasting, requiring ongoing management).

Common Causes of Disease

  • Inherited genetic defects

  • Developmental defects

  • Biologic agents such as pathogens

  • Physical agents like toxins

  • Stress and emotional reactions

  • Hormonal imbalances

Chronic Illness and Healthcare Burden

  • Chronic illnesses are prevalent and associated with major risk factors: tobacco use, poor diet, inactivity, excessive alcohol consumption, and uncontrolled hypertension.

  • The CDC's approach to mitigating the burden of chronic diseases involves:

    • Epidemiology and surveillance

    • Environmental support for health

    • Health system improvements

    • Community resources linked to clinical services.

Impact of Illness on Individuals and Families

  • People with chronic illness often experience psychological and social impacts, influencing their daily functioning.

  • Involvement of families in care routines, where family dynamics can alter based on health challenges, creating stress and changing roles.

  • Recognizing the impact of caregiving stress, nurses should advocate for caregivers’ health and provide them with resources for self-care.

Health Disparities and Social Determinants of Health

  • Health disparities highlight the inequities based on race, ethnicity, socioeconomic status, and other factors affecting health access and outcomes.

  • Social determinants of health include conditions such as economic stability, education, social context, healthcare system access, and community resources.

  • The effect of structural racism and unconscious bias leads to persistent health disparities, emphasizing the need for antiracism and diversity in healthcare practices.

Wellness Promotion and Nursing Implications

  • Health promotion encompasses a commitment to improving well-being and preventing disease through personalized care.

  • Examples of primary health promotion include immunization programs, dietary education, and lifestyle intervention strategies.

  • Tertiary prevention involves rehabilitation activities aimed at restoring functionality post-illness.

Ethical and Legal Considerations

  • Nurses must navigate the complexities of ethical dilemmas in healthcare, especially when issues of cultural diversity and inclusion arise.

  • Ongoing education and reflection on personal beliefs and biases are essential for providing inclusive and equitable care.

  • The ANA Code of Ethics provides a framework for nurses to advocate for health equity and address discrimination and bias in healthcare environments.

Conclusion

  • Nurses play a fundamental role in addressing health disparities and promoting health equity.

  • It's crucial to recognize and integrate diverse individual experiences into nursing practice, focusing on the overall well-being of each patient.