Health Promotion Pre-Work

Health Promotion and Illness

Health Continuum

• Represents the range of health states a person may experience in life.

• Ends of the continuum:

  • Illness

  • Wellness

• Nurses predominantly work with patients toward the illness end of the continuum.

• Illness uniquely affects individuals and leads to unpredictable responses.

• Comprehensive knowledge of illness concepts and stages is essential for proper nursing practices.

Distinction Between Disease and Illness

• Integral to nursing practice is understanding the difference between disease and illness.

• Disease:

  • Considered a pathological condition that requires cure.

• Illness:

  • A state that requires management and encompasses an individual's experience with an impaired condition.

• Nurses focus on managing care for individuals experiencing illness, not curing disease.

Definition of Illness

• Craven and colleagues (2017) define illness as:

  • “The product of disharmonious interaction among mind, body, emotions, and spirit.”

  • Indicates the body signaling an exceeded capacity to mediate between internal and external environments.

• Illness is an opportunity for individuals to discover meaning in life and motivate healthy behavior changes.

Categories of Illness

• Illness can be perceived from various perspectives.

• Rovesti and colleagues (2018) state it is a system the body uses to restore balance.

• Distinction between acute and chronic illness is commonly utilized:

  • Acute Illness:

  • Duration: Short-term.

  • Appearance: Sudden.

  • Impact: Reversible; severe effects possible.

  • Examples: Upper respiratory infections, panic attacks.

  • Chronic Illness:

  • Duration: Longer than six months and potentially lifelong.

  • Impact: Irreversible; often leads to permanent residual effects.

  • Examples: Diabetes, heart failure, chronic obstructive pulmonary disease (COPD).

Nursing Roles in Illness Management

• Nurses play a crucial role in health care provision, health education, and illness management.

• Actions vary between chronic and acute conditions, including:

  • Facilitating healthy lifestyle choices.

  • Reducing the occurrence of illness and managing symptoms effectively.

• Significant health education is essential for chronic illness management, as patients will need to manage symptoms long-term.

• A holistic approach to nursing addresses mental, emotional, spiritual, and physical health issues.

Suchman’s Stages of Illness (1965)

• Understanding how individuals react to illness is key for effective nursing interventions.

Five Stages of Illness:

1. Symptom Experience:

   • Awareness of abnormality.

   • Symptoms are characterized physically (e.g., fever), cognitively (e.g., perception of illness), and emotionally (e.g., worry about consequences).

2. Assumption of Sick Role:

   • Symptoms persist, leading to acknowledgment of illness.

   • Responsibilities and social obligations cease; confirmation is sought from others.

3. Medical Care Contact:

   • Professional advice is sought for diagnosis and treatment credibility.

   • Acceptance of medical diagnosis.

4. Dependent Patient Role:

   • Patient relies on healthcare expertise for treatment.

   • Signs of dependence, ambivalence, and need for support are prevalent.

5. Recovery/Rehabilitation:

   • Resuming normal life roles; adaptation to potential chronic conditions.

Impacts of the Illness Experience

• The illness experience affects both the patient and their family:

  • Change for Patients:

  • Behavioral, emotional, and self-concept alterations.

  • Loss of autonomy.

  • Lifestyle Changes for Family:

  • Role reassignment and increased conflict.

  • Financial strain and increased anxiety.

Nursing Considerations in Illness Management

• Interventions should help patients manage symptoms and enhance quality of life:

  • Establish daily routines.

  • Provide education about managing illness conditions, especially in emergencies.

Factors Influencing Health

Overview of Determinants of Health

• Health outcomes are influenced by:

  • Biologic, genetic, and environmental determinants.

• Significant examples of biologic determinants include:

  • Age:

  • Notable statistics: High infant morbidity rates of 5.8 deaths/1000 births (CDC, 2017).

  • Aging population effect on health risks.

  • Body Structure and Function:

  • Physiological characteristics assessed by anthropometric measures (e.g., height, weight, BMI).

  • Organic bodily processes affecting health (e.g., blood pressure, nutritional status).

Biologic Determinants: Sex

• Gender distinctions affect health risk factors and promotion behaviors:

  • Conditions more prevalent in men: Autism, kidney stones, and heart diseases.

  • Conditions more prevalent in women: Alzheimer's, urinary tract infections, and migraines.

Genetic Determinants

• Genetics plays a crucial role in lifespan and predisposition to diseases.

• Inheritance dictates risks and pathologic conditions:

  • Common genetic disorders include cystic fibrosis, sickle cell anemia.

Single-Gene Disorders & Chromosomal Disorders

• Single-Gene Disorders:

  • Caused by a defect in a specific gene, with over 18,000 identified.

  • Examples include cystic fibrosis and hemophilia.

• Chromosomal Disorders:

  • Stem from excess or lack of genes in chromosomes (e.g., Down syndrome).

Multifactorial Disorders

• Involves interactions between multiple genes and environmental factors:

  • Examples include cancer, coronary heart disease.

Additional Concepts: Genetic Vulnerability, Susceptibility, and Epigenetics

• Genetic Vulnerability: Risk for disease expression inherited from parents.

• Genetic Susceptibility: Predisposition to diseases even without birth conditions.

• Epigenetics: Studies gene expression alterations without changing the DNA sequence and how environment influences it.

Social Versus Physical Environment

• Social environments shape interactions; physical environments consist of tangible aspects influencing health outcomes:

  • Social Environment Factors: Norms, education level, and socioeconomic conditions.

  • Physical Environment Factors: Living conditions, exposure to hazards, and access to resources.

Key Areas of Social Determinants of Health

• Five critical determinants include:

  1. Economic stability

  2. Education

  3. Social/community context

  4. Health care access

  5. Neighborhood/built environment

Economic Stability

• Economic factors such as poverty, employment, food security, and housing significantly impact health outcomes:

  • Nearly 3 billion people live on less than $2.50/day (
    The World Counts).

Education

• Education levels correlate with health:

  • Higher education leads to improved health and life expectancy.

Social and Community Context

• Community cohesion impacts health:

  • Engaged communities promote health through civic participation and information dissemination.

Health and Health Care

• Effective health care is reliant on accessible services:

  • Access to healthcare is necessary for promoting overall health and reducing health disparities.

Health Literacy

• Defined as the ability to comprehend and utilize basic health information.

• Low health literacy correlates with poor health outcomes.

Neighborhood and Built Environment

• Influence on individuals includes access to food, environmental risks, and housing quality.

  • "Food deserts" lack access to healthy foods, affecting nutritional intake.

Crime and Violence

• Associated with increased stress and adverse health outcomes.

Housing Quality

• Poor housing conditions can lead to chronic physical and mental health issues.

Environmental Conditions

• Poor environmental quality exacerbates health conditions and can limit healthy lifestyle practices.

Conclusion

• Understanding health, illness, and the determinants of both is critical for providing effective nursing care and education.Individual factors along with broader social determinants work together to influence health outcomes and wellness strategies.