Health Promotion Dr. Wajed Hatamleh NUR 211 Chapter16

Learning Outcomes 1.Explain the relationship of individuality and holism to nursing practice. 2.List four main characteristics of homeostatic mechanisms. 3.Identify theoretical frameworks used in individual health promotion. 4.Identify Maslow’s characteristics of the self-actualized person.

Learning Outcomes (cont'd) 5.Describe the vision, mission, and goals of Healthy People 2020 and the development process for specific objectives to help improve the health of a community. 6.Differentiate health promotion from health protection or illness prevention. 7.Identify various types and sites of health promotion programs.

Learning Outcomes 8.Discuss the Health Promotion Model. 9.Explain the stages of health behavior change. 10.Discuss the nurse’s role in health promotion. 11.Describe components of health assessment that pertain to health promotion.

Learning Outcomes (cont'd) 12.Discuss nursing diagnosing, planning, implementing, and evaluating as they relate to health promotion.

Assessing and Planning Health Care Enhanced when nurses understand: –Individuality –Holism –Homeostasis –Human needs

Concept of Individuality Each individual is a unique being Focus on total care and individualized care context Total care context considers all the principles that apply when taking care of any client

Concept of Individuality (cont'd) Individualized care context means using the total care principles that apply to the person at this time

Holism Concerned with the individual as a whole, not as an assembly of parts Strive to understand how one area of concern relates to the whole person Consider the relationship of individuals to the environment and to others Interventions are directed toward restoring overall harmony

Physiological Homeostasis Homeostasis is the tendency of the body to maintain a state of balance or equilibrium while constantly changing. Homeostatic mechanisms have four main characteristics: Self-regulatory Compensatory

Psychological Homeostasis Emotional or psychological balance or a state of mental well-being A stable physical environment in which the person feels safe and secure A stable psychological environment where feelings of trust and love are developed

Psychological Homeostasis (cont'd) A social environment includes adults who are healthy role models A life experiences the provides satisfactions

Applying Theoretical Frameworks A variety of theoretical frameworks provide the nurse with a holistic overview of health promotion. –Needs Theories : Maslow –Developmental Stage Theories

Figure 16-3 Maslow’s needs. From Psychology of Human Behavior, 5th ed., by R. A. Kalish, © Wadsworth, a part of Cengage Learning, Inc. Reproduced by permission,

Needs Theories Maslow’s five levels of human needs –Physiological needs –Safety and security needs –Love and belonging needs –Self-esteem needs –Self-actualization

Needs Theories Developmental stage theories –Describe typical behaviors within a certain age group –Explain the significance of those behaviors –Predict behaviors that might occur in a given situation –Provide rationale to control behavioral manifestations –Can be used in parental and client education, counseling, and anticipatory guidance

Healthy People 2020 Belief that individual health is closely linked to community health and the reverse Partnerships are important to improve individual and community health –Business, local government, and civic, professional, and religious organizations can all participate

Box 16-2 Healthy People 2020 Framework

Defining Health Promotion Three levels of prevention –Primary focuses on health promotion, protection against specific health problems –Secondary focuses on early identification of health problems, prompt intervention to alleviate health problems –Tertiary focuses on restoration and rehabilitation with the goal of returning the individual to an optimal level of functioning

Defining Health Promotion Health promotion is behavior motivated by the desire to increase well-being and actualize human health potential Disease prevention or health protection is behavior motivated by a desire to actively avoid illness, detect it early or maintain functioning with the constraints of illness

Sites for Health Promotion Activities Various settings for programs: –In home –Community setting –Schools –Hospitals –Worksites

Identify one health promotion behavior that you have attempted to change or would like to change. For example, has the student attempted to change this behavior before? If so, what happened and how might this prior attempt at behavior change influence this attempt to change the behavior?

Health Promotion Model (HPM) Competence or approach-oriented model Motivational source for behavior changes based on individual’s subjective value of the change

Variables of HPM Individual characteristics and experiences –Personal factors –Prior related behaviors

Variables of HPM (cont'd) Behavior-specific cognitions and affect –Perceived benefits of action –Perceived barriers to action –Perceived self-efficacy –Activity-related affect –Interpersonal influences –Situational influences

Variables of HPM (cont'd) Commitment to a plan of action Immediate competing demands and preferences Behavioral outcome

Figure 16-4 The Health Promotion Model (Revised). From Health Promotion in Nursing Practice, 6th ed. (p. 45), by N. J. Pender, C. L. Murdaugh, and M. A. Parsons, 2011, Upper Saddle River, NJ: Prentice Hall. Reprinted with permission.

Figure 16-5 The stages of change are rarely linear. It is more common for people to recycle several times through the stages. The person who takes action and has a relapse (recycles through some or all of the stages again) is more apt to be successful the next time than the individual who never takes action. Diagram based on content from Changing for Good, by J. O. Prochaska, J. C. Norcross, and C. C. DiClemente, Copyright by J. O. Prochaska, J. C. Norcross, and C. C. DiClemente. Reprinted by permission of HarperCollins Publishers Inc.; and “The Transtheoretical Model and Stages of Change” by J. O. Prochaska, C. A. Redding, and K. E. Evers, in Health Behaviors and Health Education: Theory, Research, and Practice, 3rd ed., 2009, by K. Glanz, B. K. Rimer, and F. M. Lewis (Eds.). Copyright © 2009 by Jossey-Bass. Reproduced with permission from John Wiley & Sons, Inc.

Nurse’s Role in Health Promotion Model healthy lifestyle Facilitate client involvement Teach self-care strategies Assist individuals, families, and communities to increase levels of health Educate clients to be effective health care consumers

Nurse’s Role in Health Promotion Assist clients, families, and communities to develop and choose health-promoting options Guide development in effective problem solving and decision making Reinforce clients’ personal and family health-promoting behaviors Advocate in the community for changes that promote a healthy environment

Assessment of Health Health history Physical examination Physical fitness assessment Lifestyle assessment Spiritual health assessment

Assessment of Health (cont'd) Social support system review Health risk assessment Health beliefs review Life-stress review

Diagnosing Wellness diagnoses can be applied at all levels of prevention Useful for healthy clients who require teaching for health promotion, disease prevention, and personal growth Provides a clear focus for planning interventions without indicating a problem exists

Planning Based on needs, desires, and priorities of the client Client decides on: –Goals –Activities or interventions to achieve these goals –Frequency and duration of activities –Method of evaluation

Implementing Health Promotion Plans Involve both the nurse and the client Nursing interventions include: –Review and summarize data from assessment –Reinforce strengths and competencies –Identify health goals –Identify behavioral outcomes –Develop a behavior-change plan –Reiterate benefits of change

Implementing Health Promotion Plans (cont'd) Nursing interventions include: –Address environmental and interpersonal facilitators and barriers –Determine a time frame –Formalize commitment –Implementing Health Promotion Plans –Exploring available resources –Implementing

Implementing Health Promotion Plans (cont'd) Nursing interventions include: –Providing and facilitating support –Individual counseling sessions –Telephone or computer counseling –Group support –Facilitating social support –Providing health education –Enhancing behavior changes –Modeling

Evaluating Ongoing Client actions may include: –Continue the plan –Reorder priorities –Change strategies –Revise the contract Collaborative effort