HEALTH, WELLNESS, ILLNESS, INJURY & SLEEP

HEALTH, WELLNESS, ILLNESS, INJURY & SLEEP

Instructor: Susan Dellos, MSN, RN

Objectives

  • Define the concept of Health, Wellness, Illness, and Injury.

  • Discuss the three levels of prevention and give examples of each.

  • Describe the impact that client needs, values, and choices have on the optimization of health outcomes.

  • Discuss the role of the nurse in promoting health.

  • Define the nurse’s role in health promotion and injury prevention.

  • Discuss how hygiene practices play a role in wellness, health, and illness.

  • Discuss principles of complementary and alternative medicine.

  • Apply the nursing process to promote sleep-rest health.

Health

  • Definition by World Health Organization:

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

  • Health & Wellness Concept:

    • Health and Wellness are characterized as optimal physical, emotional, and social well-being.

  • Personal Definition of Health:

    • Inquiry for personal definition from students.

Wellness

  • Describing Wellness to a Patient:

    • Importance of explaining wellness to patients.

  • 7 Components of Wellness:

    1. Physical

    2. Financial

    3. Intellectual

    4. Environmental

    5. Emotional

    6. Spiritual

    7. Social

Illness and Disease

  • Illness Defined:

    • A highly personal state where an individual's physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished.

    • General state causing discomfort or not feeling well.

  • Disease Defined:

    • A detectable alteration in body function resulting from infections (by microorganisms) that reduce bodily capacities or shorten lifespan.

    • Pathologically caused, also known as pathogenesis.

  • Chronic Illness:

    • Definition to be provided.

  • Acute Illness:

    • Definition to be provided.

  • Importance of Safety in Illness:

    • Discussion of safety concerns across all illnesses needed.

  • Interventions Examples:

    • Suggest examples for intervention beneficial to acute or chronic illness.

  • Teaching Verification:

    • Enquire on nurse methods to verify patient understanding of their diagnosis.

Injury

  • Injury Defined:

    • An act or event causing damage, harm, or loss to the functioning of the body.

  • Impact of Illness or Injury, Factors Include:

    1. Nature of the injury

    2. Severity

    3. Duration of the event

    4. Precipitating factors (by patient or others)

    5. Financial costs associated

    6. Required lifestyle changes

    7. Significant adjustments in usual roles

  • Autonomy and Injury:

    • Discussion on the importance of patient autonomy regarding injuries.

The Health Continuum

  • Illness-Wellness Continuum Importance:

    • Visual representation of health ranging from premature death to optimal health.

  • Health Stages on the Continuum:

    • 1-10 scale ranging from poor health to optimal health.

    • Inclusion of symptoms, medications, lifestyle changes, and health priorities across the spectrum.

Prevention

3 Levels of Prevention

  1. Primary Prevention:

    • Implemented before disease/injury evidence.

    • Aims to reduce or eliminate causative risk factors (risk reduction).

    • Examples include:

    • Good health habits

    • Diet and Exercise

    • Smoking cessation

    • Vaccinations

  2. Secondary Prevention:

    • Implemented after disease has begun, but before symptoms appear.

    • Focuses on early identification and treatment (through screening).

    • Examples include:

    • Testing (e.g., Mammogram, Colonoscopy)

    • Screening for diabetes and cardiovascular diseases

  3. Tertiary Prevention:

    • Implemented after a disease is established.

    • Aim to prevent sequelae and stop disease progression.

    • Examples include:

    • Managing chronic diseases (diabetes, hypertension)

    • Keeping glucose and blood pressure under control to reduce comorbidities

Social Determinants of Health

  • Key influences include:

    1. Neighborhood and Built Environment

    2. Economic Stability

    3. Health and Health Care

    4. Education

    5. Social and Community Context

Internal and External Variables Affecting Health Choices

Internal Variables

  • Definition and examples required from nursing interventions.

External Variables

  • Definition and examples required from nursing interventions.

Health Promotion Across the Lifespan

  • Importance of understanding health promotion activities tailored to different age groups.

  • Discussion on patient resistance to health promotion recommendations.

Behavioral Changes in Health Promotion

  • Integrative Behavioral Health Models:

    • Multiple theoretical frameworks that include the following:

    • Cognitive Dissonance Theory

    • Diffusion of Innovation

    • Social Cognitive Theory

    • Stages of Change Theory

    • Theory of Reasoned Action

    • Theory of Planned Behavior

    • Value-Belief-Norm Theory

    • Adult Learning Theory

    • Community/Group Organization & Development

    • Transformational Education

    • Social Marketing

Stages of Change

  1. Precontemplation:

    • Unaware of the problem

  2. Contemplation:

    • Aware of the problem and the need for behavior change.

  3. Preparation:

    • Intends to take action

  4. Action:

    • Actively practicing the desired behavior

  5. Maintenance:

    • Sustaining behavior change

  6. Termination:

    • The ultimate goal where change is solidified.

Complementary Health Approaches

  • Various practices including:

    • Acupuncture

    • Biofeedback

    • Chiropractic Medicine

    • Deep Breathing

    • Dietary & Herbal Supplements

    • Homeopathy

    • Massage Therapy

    • Medication

    • Naturopathy

    • Osteopathic Medicine

    • Traditional Chinese Medicine

    • Yoga

Nursing Process

Assessment

  • What data is collected regarding health?

  • Focus on sleep patterns including open-ended questions for patients (e.g., "Do you feel rested when you wake up?").

Diagnosis

  • Defining the problem encountered by the patient.

Planning

  • Strategy for managing identified problems.

Implementation

  • Executing the planned actions.

Evaluation

  • Assessing whether the interventions were effective.

Sleep

Sleep Stages

  1. Stage 1:

    • Light sleep where awakening is easy.

  2. Stage 2:

    • Eye movement and brain waves slow.

  3. Stage 3:

    • Delta waves begin to appear.

  4. Stage 4:

    • Deep sleep, challenging to wake.

  5. REM Stage:

    • Breathing becomes more rapid and irregular, associated with dream activity.

Sleep Cycle

  • A complete sleep cycle (NREM & REM) lasts 90-110 minutes, averaging 6 cycles per night.

  • NREM Sleep Contribution:

    • NREM accounts for approximately 80% of sleep.

    • Stages 1 to 4 with distinct brain activity variations observed.

Circadian Rhythms

  • Melatonin Secretion:

    • Starts at 9:00 PM, stops at 7:30 AM.

  • Physiological Indicators Throughout the Day:

    • 12:00 PM: Peak alertness

    • 2:00 AM: Deepest sleep

    • 6:30 PM: Highest body temperature

    • 3:30 PM: Highest cardiovascular efficiency

    • 4:30 AM: Lowest body temperature

Factors Affecting Sleep

  • Factors include:

    • Physiologic disorders

    • Emotional stress

    • Stimulants such as caffeine

    • Alcohol consumption

    • Smoking

    • Diet

    • Medications

    • Motivation or boredom

    • Environmental conditions

    • Pain

    • Illness or injury

    • Life events

The Importance of Sleep

  • Key Functions of Sleep:

    • Repair body

    • Improve learning and memory

    • Lower stress levels

    • Enhance creativity

    • Support growth and development

    • Maintain immune function

  • Enhancing Sleep Quality:

    • Adhere to same sleep schedule daily

    • Refrain from large meals before bedtime

    • Engage in regular exercise

    • Minimize screen time before bed

    • Optimize bedroom environment for sleep (cool, dark, quiet)

  • Consequences of Insufficient Sleep:

    • Increased anxiety, depression, and other mental health concerns

    • Mood swings and irritability

    • Physical issues such as headaches, weight gain, and fatigue

Sleep Needs by Age

  • Recommended Sleep Duration:

    • Newborn (0-3 months): 14-17 hours

    • Infant (4-12 months): 12-16 hours

    • Toddler (1-2 years): 11-14 hours

    • Preschooler (3-5 years): 10-13 hours

    • Schoolchild (6-12 years): 9-12 hours

    • Teenager (13-18 years): 8-10 hours

    • Adult (19 years and older): 7-9 hours

Effects of Sleep Deprivation

  • Consequences include:

    • Daytime sleepiness

    • Impaired immune function

    • Increased irritability and potential for obesity

    • Decreased reaction time

    • Elevated risk for diabetes

    • Reduction in working memory and attentiveness

    • Potential for depression

    • Increased risk of physical injury

Sleep Disorders

  1. Insomnia:

    • Difficulty in falling asleep or maintaining sleep, waking too early; categorized into acute, chronic, or intermittent types.

  2. Sleep Apnea:

    • Types include central, obstructive, and mixed.

  3. Narcolepsy:

    • Characterized by uncontrollable sleep attacks.

  4. Hypersomnolence Disorder:

    • Marked by excessive daytime sleepiness lasting at least 3 months.

Sleep Promotion Strategies

  • Recommendations for better sleep:

    • Exposure to sunlight during the day

    • Limiting screen time 2-3 hours prior to sleep

    • Establishing caffeine cut-off time

    • Maintaining a cooler sleep environment

    • Utilizing magnesium (like Epsom salt baths)

    • Implementing blackout curtains and reducing light around bedtime

    • Downloading calming practices such as meditation

    • Grounding techniques to enhance relaxation

    • Weighing the use of medications for sleep as a last resort

Dietary Considerations for Sleep Health

  • Foods that support sleep include:

    • Poultry (contains tryptophan)

    • Fish (sources of melatonin)

    • Yogurt (rich in calcium)

    • Kale (another calcium source)

    • Bananas (rich in potassium, tryptophan, and magnesium)

    • Whole grains (insulin activates tryptophan)

    • Honey (reduces orexin levels)

    • Nuts (boost serotonin via magnesium and tryptophan)

    • Eggs (rich in tryptophan)

    • White Rice (high glucose content helps tryptophan absorption)

Nursing Process Related to Sleep

Focused Assessment

  • Identifying sleep patterns with specific queries.

  • Key Characteristics to Assess:

    • Sleep duration

    • Sleep quality

    • Sleep timing

    • Daytime alertness

    • Presence of potential sleep disorders

  • Assess associated behavioral factors such as:

    • Alcohol or substance abuse

    • Disruption of normal routine (e.g., travel, shift work)

    • Poor sleep hygiene (e.g., electronics, caffeine)

    • Environmental factors (room temperature, lighting)

    • Chronic conditions (e.g., heart failure, hyperthyroid issues)

Patient Goals

  • Ensure patient identifies factors contributing to poor sleep patterns.

  • Aim for the patient to report averaging 7-9 hours of sufficient, restful sleep.

  • Strive for patients to feel rested and energized upon waking.

  • Education on basic sleep hygiene behaviors, including maintaining a consistent sleep schedule, and restricting daytime napping.

  • Recommendations for enhancing sleep environment.

  • Referrals as necessary to sleep specialists for comprehensive assessments.

  • Suggestions of relaxing activities as preventative measures.

Conclusion

  • A holistic understanding of health encompasses a multi-faceted approach involving prevention, behavioral theories, and sleep optimization in promoting well-being.