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CH 7 - Fundamentals of Nursing Care: Promoting Health and Wellness
Fundamentals of Nursing (Funds101)
Jersey College Nursing School
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Promoting Health and Wellness I. Wellness A. Illness: changes a person’s functioning, whether it be physical, mental, spiritual, or emotional B. The Wellness Illness Continuum: Most people are not completely well, and not completely ill. Rather, we move up and down along a continuum (scale) - exceptional wellness at the top and illness at the bottom.
Physical health is not the only issue when discussing wellness/illness - depression or other mental conditions prevent a person from being considered healthy. a) If a mental illness is treated and managed, a person moves closer to wellness end C. Dunn’s Theory of High Level Wellness
Dunn developed a theory about achieving high level wellness - in addition to a continuum, there is also a vertical axis to describe a person’s condition based on environment.
Very unfavorable environment - very favorable environment, peak wellness - death. Four quadrants: a) Protected poor health: Occurs when environment is favorable and health is not. b) Poor health: Occurs when both health and environment are not favorable c) Emergent high level wellness: Occurs when the environment is not favorable but health is d) High level wellness: Occurs when both environment and health are favorable D. Fitzpatrick’s Rhythm Model
A person’s state of health can vary from wellness to illness, disease, or dysfunction & changes throughout a person’s lifespan
Health is a dynamic state that results from the interaction of a person and their environment. II. Healthy People 2020 A. Works toward improving the prevention of disease and promoting health in the US B. Goals:
Attain high quality, longer lives free of preventable disease, disability, injury, and premature death
Achieve health equity, eliminate disparities, improve health of all groups
Create social and physical environments that promote good health for all
Promote quality of life, healthy development, and healthy behaviors across all life stages C. Includes 12 leading health indicators (LHI) that are the highest priority health issues D. Health Literacy
Health literacy: Ability of individuals to understand basic health information and use it to make good decisions about their health.
Referred to as the newest vital sign
Health care professionals should assess patients for their ability to comprehend health care info and use it - one very popular tool to assess: ice cream a) If you ate the entire container of ice cream, how many calories? If you usually eat 2,500 calories in a day, what percentage of calories will you be eating?
Only 12% of the population has a proficient health literacy score. People who have a low health literacy are at higher risk for poor health
Extremely important for health care professionals to ensure that patients understand information III. Illness A. Types of Illness
Acute illness: strikes suddenly and lasts for a limited time. a) Hospitalization can be required - ex) appendectomy
Chronic illness: Illness that lasts for 6 months or longer, characterized by intensifying or improving symptoms. a) May require treatment and meds or limiting activities. b) Remissions: Periods where symptoms are completely absent c) Exacerbations: Periods of worsening symptoms B. Phases of illness
Prodromal phase: Before a person develops specific symptoms, simply “does not feel good” general body ache and fatigue
Symptomatic phase: Observational symptoms develop, person either waits to see if symptoms resolve, or treat with over the counter and home remedies
Seeking help phase: When a person seeks help from a medical professional (some may go to healers, herbalists, or alternative med)
Dependency phase: Person relies on another for help in diagnosis and treatment
Recovery phase: when a person is slowly able to resume independence and regain health. C. Risk Factors for Illness
Risk factors: physiological, psychological, genetic elements, environmental elements that contribute to development of illness
Nonmodifiable: heredity, age, gender.
Modifiable: decrease risk by modifying lifestyle - stress is a common modifiable risk factor as well as: a) Obesity → diabetes, heart disease, breast cancer, colon cancer b) Diet high in trans fat, cholesterol, triglycerides → diabetes, stroke, heart disease c) Hypertension → stroke, heart disease, kidney disease
Events that are anticipated but may still be viewed as stressful
Ex) wedding, job change, graduation H. Effects of Stress on Illness
When stress is continuous - sympathetic nervous system goes into overdrive
Stress can cause exacerbations in pt with chronic disorders
Symptoms: Anger, helplessness, hopelessness, headaches, back pain, insomnia, hiding feelings, hurting loved ones, worry, memory loss, trouble thinking clearly, panic attacks, isolation, inability to make decisions, overuse of drugs, alcohol, food. I. Stress Management
Coping strategies: Actions that people utilize to combat stress - both positive and negative
Positive strategies: a) Eating regular meals low fat/sugar - regular exercise b) Sleep adequate amount each night c) Deep breathing exercises d) Rest when necessary - listen to your body e) Saying “no” when necessary f) Take time to relax and have fun with friends and family g) Laughing h) Reduce all excess - ask for help when you need i) Mental vacations j) Keep a journal
Negative strategies cause harm to yourself or others, such as drinking in excess V. Defense Mechanisms A. Unconscious reactions to decrease stress - a way we manage our fears and anxieties
Avoidance: Unconsciously staying away from events/situations that open feelings of aggression or anxiety - Can become socially isolated
Compensation: Making up for something we perceive as inadequacy by developing another desirable trait - Use of drugs/alcohol to feel confident
Conversion Reaction: Anxiety channeled into physical symptoms - nausea develops - Can lead to: anxiety not dealt with can lead to ulcers and even some cancers
Denial: Unconscious refusal to see reality, first defense learned and used, not consciously lying - Can lead to: repression, dissociative disorders
Displacement (transference): Transferring anger and hostility to another person or object that is less powerful (kick the dog syndrome) Can lead to: loss of friends/relationships, confusion in communication
Dissociation: Painful events are separated/disassociated from the conscious mind (out of body experience) Can lead to: multiple personality
disorder 7. Identification: A person takes on personality traits of someone they fear or respect (children like firefighters) Can lead to: wear clothing, arrange appearance to match that of another person 8. Intellectualization: Separates self from uncomfortable emotions by focusing on facts and logic (“its better this was because they were suffering”) - Can lead to: Fact and logic taking place of feeling emotions 9. Isolation: Emotion that is separated from original feeling - Can lead to: avoidance of dealing with true feelings and increase of stress 10. Minimization: Not acknowledging or accepting significance of ones own behavior, making it seem less important - Can lead to: no motivation to change behavior, antisocial 11. Projection (scapegoating): Blaming others, mental/verbal “finger pointing” - Can lead to: finding fault in everything and everyone, failing to take responsibility, delusional tendencies 12. Rationalization: Use of logical sounding excuse to cover up true thoughts/feelings most common - Can lead to: self deception 13. Reaction Formation (overcompensation): Similar to compensation, except the person usually develops the exact opposite trait - Can lead to: failure to resolve internal conflicts. EX) the unattractive person who wants to model speaks out to eliminate beauty pageants 14. Regression: Emotionally returning to an earlier time when there was far less stress - common when pt are hospitalized - Can lead to: Interference with perception of reality and progression/development of personality 15. Repression (stuffing): Unconscious “burying” or “forgetting” to exclude or withhold from our conscious events/events that seem unbearable - Can lead to: flashbacks, PTSD, amnesia 16. Restitution (undoing): Making amends for a behavior one thinks is unacceptable, reducing guilt. - Can lead to: “double messages” relieves the doer the responsibility of being honest 17. Sublimation: Unacceptable traits are diverted into acceptable traits. EX) burglar teaches home safety classes - Can lead to: socially accepted behavior may reinforce negative tendencies, and person will still show signs of undesirable trait
CH 7 - Fundamentals of Nursing Care: Promoting Health and Wellness
Course: Fundamentals of Nursing (Funds101)
University: Jersey College Nursing School
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