NURS 320: Treas Health Promotion Reading

Wellness, Health, and Illness Continuum

• Full-spectrum nursing promotes wellness regardless of client circumstances, emphasizing a holistic understanding of health as multidimensional.

Dimensions of Health along the Continuum

• Understanding these dimensions broadens the concept of health.

1. Biological Factors

• Biological factors play a significant role in how individuals perceive their health status.

  • Genetic Makeup

  • Family history can dramatically affect health risks, such as the genetic predisposition to breast cancer.

  • Sex

  • Certain diseases are more prevalent in one sex versus another:

    • Female: rheumatoid arthritis, osteoporosis, breast cancer.

    • Male: ulcers, color blindness, bladder cancer.

  • Age & Developmental Stage

  • The likelihood of illness correlates with age and developmental stage.

    • Example: 75% of new breast cancer cases are in women over 50.

    • Adolescent boys have higher rates of head and spinal cord injuries due to risk-taking behaviors.

  • Developmental Influences

    • Coping abilities are influenced by developmental stages.

    • Young children have limited experiences and communication skills regarding illness.

    • Perceptions of loss or disease change based on age.

    • Example: The death of a child vs. that of an older adult has different impacts on coping skills and perceptions.

    • Important to recognize that losses are subjective.

2. Nutrition

• Nutrition is essential for health; deficiency diseases like scurvy are rare in those with nutritious diets.

• Poor diet correlates with chronic diseases such as Type 2 diabetes and heart disease.

• Foods rich in antioxidants have protective properties, prompting the adage "You are what you eat".

• Detailed nutritional discussions in Chapter 24.

3. Physical Activity

• Active lifestyles correspond with better health outcomes.

  • Moderate physical activity can reduce chronic disease risks and promote longevity.

  • Example: 30 minutes of gardening or 15 minutes of jogging can yield health benefits.

• Specific exercises can target disease prevention:

  • Weight training increases bone density in women over 40 and aerobic exercise reduces heart disease risk.

• Further discussion on physical activity in Chapter 29.

4. Sleep and Rest

• Sleep contributes to overall health; it is essential for tissue regeneration and mental health.

• Sleep deprivation leads to difficulties in concentration, sensory deficits, and mood disturbances.

• Chronic sleep deprivation is common among students and caregivers, affecting their well-being.

• The impact of sleep and rest is further elaborated in Chapter 31.

5. Meaningful Work

• Engaging in meaningful work can help people cope with stress and promote health.

  • Erik Frankl’s insights on meaningful work during extreme stress highlight its importance.

  • Meaningful work is subjective, encompassing volunteering and personal hobbies.

  • Enjoyable activities (e.g., music, arts, sports) contribute to health and well-being.

6. Lifestyle Choices

• Healthy self-perception often correlates with healthy lifestyle choices.

• Awareness of health threats from:

  • Smoking: Causes addiction and health risks; links to heart attack and cancer.

  • Alcohol: Moderate consumption may offer benefits, but excessive use damages health and increases injury risks.

  • Substance Abuse: Increases risks for numerous diseases, including HIV and hepatitis.

7. Personal Relationships

• Healthy familial relationships are vital for wellness and influence self-perception regarding health.

• Disruptions in support systems (e.g., incarceration, bullying) can negatively impact health perceptions.

• Support networks are crucial during times of disruption.

8. Culture

• Cultural background impacts health decisions, behaviors, and interpretations of illness or wellness.

• Culture influences health-promoting values, coping strategies, and responses to illness.

9. Religion and Spirituality

• Religious beliefs can dictate healthcare choices, contributing to wellness through spirituality.

• The mind-body connection can facilitate healing and maintain a positive self-view in illness.

10. Environmental Factors

• Environmental aspects can promote wellness (e.g., personalized spaces) or cause illness (e.g., pollutants).

11. Finances

• Economic status influences a person's access to healthcare and ability to afford basic needs.

• Poverty impacts health choices and can limit access to healthy food and medical care.

• Health insurance plays a critical role in healthcare accessibility.

Disruptions to Health

• Health can be disrupted by various factors that drive individuals towards the illness end of the continuum.

1. Physical Disease

• Chronic or life-threatening diseases impact life quality and identity, evoking anxiety and existential questions.

  • Example: Treya Killam Wilber reflects on her breast cancer diagnosis and its mental implications.

2. Injury

• Injuries bring sudden disruptions to health and can lead to feelings of loss and regret.

  • Example: Christopher Reeve discusses the devastation of his spinal injury.

3. Mental Illness

• Mental health conditions generate persistent suffering, stigma, and socioeconomic impacts on families.

4. Chronic Illness

• Changes in health status necessitate patient self-management, often facilitated by telehealth technologies.

  • Telehealth helps empower chronic illness patients by enabling remote monitoring and timely healthcare interactions.

5. Pain

• Pain disrupts daily functioning and alters personal identity, challenging coping mechanisms.

6. Loss

• Major losses can impact identity and function, requiring significant coping mechanisms to reinterpret experiences.

7. Impending Death

• Facing death brings existential concerns, challenges in acceptance, and requires sensitive nursing care.

8. Competing Demands

• Everyday responsibilities can overwhelm individuals and distract them from managing their health needs.

9. The Unknown

• Unforeseen health changes can create significant challenges, disrupting preparation or coping strategies.

10. Imbalance

• Perceived injustices in life events (e.g., loss of a child, treatment failures) can disrupt wellness and provoke distress.

11. Isolation

• Illness often leads to feelings of loneliness, compounding the pain of the experience.

Levels of Prevention

• Identified by Leavell and Clark (1965), there are three levels of prevention:

  • Primary Prevention: Actions to prevent disease onset (e.g., healthy diet, exercise).

  • Secondary Prevention: Early detection through screenings (e.g., physical exams).

  • Tertiary Prevention: Rehabilitation and management of existing diseases to prevent complications.

Health Promotion Models

Pender's Health Promotion Model

• Framework identifying variables influencing health promotion:

  • Individual characteristics and experiences.

  • Behavior-specific cognitions and affect.

  • Behavioral outcome.

• Incorporates interpersonal influences and self-regulation, guiding health-promoting behavior.