1. Chapter 15 Health, the Individual, and Holism Fundamentals of Nursing: Standards & Practices, 2E

2.  Copyright 2002 by Delmar, a division of Thomson Learning 15-2  Health is the process through which a person seeks to maintain an equilibrium that promotes stability and comfort.  Illness is the inability of an individual’s adaptive responses to maintain physical and emotional balance which results in an impairment of functional abilities.  Wellness is the condition in which an individual functions at optimal levels.

3.  Copyright 2002 by Delmar, a division of Thomson Learning 15-3 Models of Health  Clinical model  Health-belief model  High-level wellness model  Social learning theory  Host-agent-environment model  Health promotion model

4.  Copyright 2002 by Delmar, a division of Thomson Learning 15-4  Homeostasis an equilibrium among psychological, physiological, sociocultural, intellectual, and spiritual needs.  The process by which a person adjusts to achieve homeostasis is called adaptation.

5.  Copyright 2002 by Delmar, a division of Thomson Learning 15-5  Health refers to every aspect of a person’s life, including Physical status Emotional well-being Social relationships Intellectual functioning Spiritual condition

6.  Copyright 2002 by Delmar, a division of Thomson Learning 15-6  Health status is influenced by Beliefs and attitudes Cultural factors Lifestyle behaviors

7.  Copyright 2002 by Delmar, a division of Thomson Learning 15-7 Cultural Influence on Health  Culture affects how an individual views health and illness.  One’s cultural background influences health-related behaviors and expectations of treatment when illness occurs.

8.  Copyright 2002 by Delmar, a division of Thomson Learning 15-8 Family Influences on Health Care  Families help determine the following Whether or not to seek treatment What type of treatment is appropriate Who should provide the treatment or care Where the treatment or care should be provided

9.  Copyright 2002 by Delmar, a division of Thomson Learning 15-9  Extended families and communities have traditionally acted as a buffer against excessive stress and illness.  Lack of social support from family or significant others results in psychological and spiritual isolation, which may negatively impact a person’s physiological state.

10.  Copyright 2002 by Delmar, a division of Thomson Learning 15-10 Illness Perspectives  Illness is the result of a disease or injury that affects functioning, and occurs when there is an inability to meet one’s needs.  An acute illness is usually characterized by a rapid onset, intense manifestations, and a relatively short duration.  A chronic illness is usually characterized by a gradual, insidious onset with lifelong changes.

11.  Copyright 2002 by Delmar, a division of Thomson Learning 15-11 Wellness Perspectives  Wellness is on a health continuum, from one’s optimal level (wellness), to a maladaptive state (illness).  High-level wellness means functioning to one’s maximum health potential while remaining in balance with the environment.

12.  Copyright 2002 by Delmar, a division of Thomson Learning 15-12 Health Behaviors  Variables influencing health include Lifestyle Perceived locus of control Ease or difficulty in accomplishing a task (self-efficacy) Health care attitudes Self-concept

13.  Copyright 2002 by Delmar, a division of Thomson Learning 15-13 Health Promotion  This is a process undertaken to increase the levels of wellness in individuals, families, and communities.  Nurses must motivate clients to want to change in order to encourage the development of healthy behaviors.

14.  Copyright 2002 by Delmar, a division of Thomson Learning 15-14  Health promotion goals Respect and support Identify and use client strengths and assets Empower clients to promote own health or healing

15.  Copyright 2002 by Delmar, a division of Thomson Learning 15-15 Health Protection Activities  Prevention of accidental injury in the home, at school, and the workplace  Programs that focus on occupational safety and health, designed to protect employees’ health  Governmental efforts to ensure the safety of food and drugs  Environmental strategies

16.  Copyright 2002 by Delmar, a division of Thomson Learning 15-16 Disease Prevention Activities  Occur on a continuum from averting the development of disease, to limiting its course once developed  Primary prevention  Secondary prevention  Tertiary prevention

17.  Copyright 2002 by Delmar, a division of Thomson Learning 15-17 Nurse’s Role in Health Promotion/Disease Prevention  Client teaching is a major intervention for promoting health.  Nurses can better help clients engage in healthy behaviors by considering the client’s beliefs and experiences when planning care.

18.  Copyright 2002 by Delmar, a division of Thomson Learning 15-18 Health Promotion and Vulnerable Populations  Children  The elderly  Those who are economically disadvantaged  The homeless

19.  Copyright 2002 by Delmar, a division of Thomson Learning 15-19 The Individual as a Holistic Being  The holistic viewpoint guides the total care of the individual as a complete being, rather than fragmented care focused on parts of the person.  The practice of body-mind medicine is rooted in the origins of healing and the works of Hippocrates, Socrates, and Florence Nightingale.

20.  Copyright 2002 by Delmar, a division of Thomson Learning 15-20 Needs and Health  The entire person (mind, body, and spirit) is influenced by satisfaction of needs.  Basic human needs are those that are necessary for every person’s survival.  Physiological, psychological, sociological, intellectual, spiritual

21.  Copyright 2002 by Delmar, a division of Thomson Learning 15-21  Maslow’s Hierarchy of Needs Physiological needs Safety and security needs Love and belonging needs Self-esteem needs Self-actualization needs

22.  Copyright 2002 by Delmar, a division of Thomson Learning 15-22 Physiological Dimension  Focuses on achievement of the basic needs such as: oxygenation, circulation, sleep and comfort, nutrition, and elimination

23.  Copyright 2002 by Delmar, a division of Thomson Learning 15-23 Psychological Dimension  Individuals have psychological needs for security, a sense of belonging, and self-esteem.  Client goals focus on improving self- esteem, establishing trusting relationships, developing social skills.

24.  Copyright 2002 by Delmar, a division of Thomson Learning 15-24  Nursing actions include Treating the client as a unique individual Protecting confidentiality and privacy Using touch and personal space in a therapeutic manner

25.  Copyright 2002 by Delmar, a division of Thomson Learning 15-25 Recognizing and respecting cultural differences Decreasing anxiety through stress management techniques

26.  Copyright 2002 by Delmar, a division of Thomson Learning 15-26 Sociocultural Dimension  As social creatures, all people rely on others to some extent.  It is important for the nurse to assess the client’s degree of dependence.  Empowerment is the process of enabling others to do for themselves and consists of encouraging the client to be an active participant in care.

27.  Copyright 2002 by Delmar, a division of Thomson Learning 15-27 Intellectual Dimension  Consists of cognitive functions such as judgment, orientation, memory, and the ability to take in and process information  Can be impaired by infection, exposure to toxins, substance abuse, trauma and psychological problems

28.  Copyright 2002 by Delmar, a division of Thomson Learning 15-28 Spiritual Dimension  Spirituality refers to one’s relationship with one’s self, a sense of connection with others, and a relationship with a higher power or divine source.  Spirituality assists a person in determining the sense of meaning or purpose in one’s life.

29.  Copyright 2002 by Delmar, a division of Thomson Learning 15-29  Religion refers to a set of beliefs associated with a particular church, synagogue, mosque, or other formal organized group. Spirituality is not the same as religion.  Factors that affect spirituality include cultural context, family, developmental stage, and health status.

30.  Copyright 2002 by Delmar, a division of Thomson Learning 15-30  Spirituality evolves throughout one’s life.  Spiritual beliefs can enhance self-esteem and help protect individuals from stress.  Health status can have an impact on spiritual beliefs. Spiritual beliefs can have an impact on health status.

31.  Copyright 2002 by Delmar, a division of Thomson Learning 15-31  Nursing process and spirituality Spiritual assessment tools are useful to the nurse. Nursing diagnoses: Spiritual distress, Readiness for enhanced spiritual well-being Meeting the spiritual needs of clients often evokes anxiety in nurses.

32.  Copyright 2002 by Delmar, a division of Thomson Learning 15-32  Providing spiritual care Listen actively Demonstrate an interested, empathetic response to client’s comments Respect the client’s beliefs Provide privacy to perform religious rituals Make referrals to the clergy when appropriate

33.  Copyright 2002 by Delmar, a division of Thomson Learning 15-33  Indications that spiritual distress has lessened Acceptance of spiritual support Decrease in restlessness, insomnia, crying Decrease in statements of worthlessness and hopelessness Verbalization of satisfaction with beliefs

34.  Copyright 2002 by Delmar, a division of Thomson Learning 15-34 Sexual Dimension  Sexuality refers to all aspects of being male or female including feelings, attitudes, beliefs, and behavior.  Sex roles are culturally determined patterns associated with being male or female.

35.  Copyright 2002 by Delmar, a division of Thomson Learning 15-35  Gender identity How one views one’s self as male or female in relationship to others Sexual orientation  Heterosexuality  Homosexuality  Bisexuality  Transsexuality

36.  Copyright 2002 by Delmar, a division of Thomson Learning 15-36  Human sexual response Excitement Plateau Orgasm Resolution

37.  Copyright 2002 by Delmar, a division of Thomson Learning 15-37  Sexuality and health Illness, disability, surgery, medications, and hospitalization may impair a person’s sexual integrity

38.  Copyright 2002 by Delmar, a division of Thomson Learning 15-38  Nursing process and sexuality Assure privacy and maintain confidentiality Use simple, direct language Provide explanations Allow time for client’s questions Have nonjudgmental attitude Use open-ended questions

39.  Copyright 2002 by Delmar, a division of Thomson Learning 15-39 Nursing diagnoses: Sexual dysfunction, Ineffective sexuality patterns Planning takes into consideration age- specific variations. Communication skills are necessary to assure optimal exchange of information regarding sexual concerns.

40.  Copyright 2002 by Delmar, a division of Thomson Learning 15-40 Education is an integral part of treating clients with sexual problems.  Prevention of sexually transmitted diseases  Effects of aging on the sexual response  Disease prevention: breast self- examination, testicular self-examination

41.  Copyright 2002 by Delmar, a division of Thomson Learning 15-41 During the evaluation process, the nurse observes the client and partner for expressions of intimacy. It is important for the nurse to remain open-minded and nonjudgmental when evaluating sexuality of clients.