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Introduced goals for improving health of Americans.
Focus on prevention not care
Cooperation by government
Healthy people documents
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Identified health improvement goals
Infant mortality declined
Death from CHD and stroke declines
Healthy people documents
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2010 road map for improving health of people in US
- Promote healthy behaviors
- Promote healthy and safe communities
- Improve systems for personal and public health
- Prevent & reduce diseases and disorders
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Dynamic state in which the individual adapts to change
Not just absence of illness
Not thing, part of body or function
Very individual
Health
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State when a person's physical, emotional, intellectual, social, developmental or spiritual functioning is diminished or impaired.
Sick role behaviors
Not synonymous with disease.
Illness
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Health-Illness Continuum
- Health and illness neither good or bad- relative qualities
- Continually alters as person adapts to change
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Relationship between what a person believes and actions taken.
Health Belief Model-Rosenstoch
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Individual's perception of
1. Susceptibility to illness
2. Seriousness of illness
3. Benefits of present action
Health Belief Model - Rosenstoch
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Create condition that promotes optimal health.
Client seen as expert regarding own health.
Holistic Health Model
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Client involved in healing process
Uses holistic interventions - music, relaxation, therapuetic touch, naturual remedies
Holistic Health Model
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Oriented to maximizing potential
Represents dynamic process, not passive, static.
High level Wellness
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Striving to higher level of wellness
Illness considered in regard to prevention not treatment
High level Wellness
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Level of health or illness depends on dynamic relationship between and agent and host.
Agent-Host environment model
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Any factor that leads to disease or illness.
Strep Virus
Agent
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Individual or group
Patient
Host
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All factors outside host
Cold weather, neighborhood
Environment
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Relationship between health - disease, wellness - illness
Human experience of actual or perceived function - dysfunction influenced by perception.
Wellness-Illness model
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Variables influencing health beliefs and practices:
- Developemental stage
- Intellectual background
- Emotional factors
- Spiritual factors
- Socioeconomic factors
- Family practices
- Cultural background
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Focus on individual with no health problems, with activities to decrease probability of a specific disease.
Primary
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Smoking cessation, immunizations, prevent cancers.
Primary
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Individual experiencing health problem, prevent it from getting worse
Secondary
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In the hospital, prevention of worsening pneumonia.
Secondary
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Individual with short or long term disability - rehab not diagnosis or treatment.
Tertiary
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Usually short duration and severe
Symptoms appear abruptly, are intense and leave quickly.
Acute
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Longer than 6 months, affect functioning in any dimension
Often periods of remission and exacerbation.
Chronic
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Provide $ for hospital construction and to improve.
Hill Burton Act
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Health care delivery systems:
Medicare and Medicaid passed
Rural Health Clinics Act
*Prospectus pricing plan based on Diagnosis Related Groups
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Alternative delivery system:
- Health Maintenance Organizatiosn HMO's
- Preferred provider organization PPO's
- Managed care management
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Stresses health promotion as the key to quality care
Health Department
Prventive and Primary
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Focuses on diagnosis and treatment of disease hospitals
Surgery center
Secondary and tertiary
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Serves client recovering from an acute or chornic illness.
Helps regain functioning
Extended care, Trust point
Restorative
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Coordination of services and equipment
Focuses on independence
Home care
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Restores clients to fullest potential
Rehabilitation
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Provides intermediate care for recovery from acute illness
Extended Care Facility
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Those disabled, dependent
Continuing Care
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24 hour custodial care
Regulated by standards
Nursing Centers
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Home environment-autonomy
Assisted Care
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Short term relief for care provider
Respite Care
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Services for interaction
Adult Day Care
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Support during terminal phase and time of death
Hospice
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Factors influencing health care delivery:
- Health care delivery system
- Societal and consumer influences
- New knowledge and technology
- Economic influences
- - needs of uninsured and underserved
- Political influences
- Socioeconomic influences
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Competency Pew Report
- 21 competencies
- Know most current standards
- Nurse's responsibility
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Evidence based practice
- New information
- Provide evidence based data to provide effective client care
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Knowing clients
- Client satisfaction
- Role in patient outcomes
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Assistive personnel
Who to do what
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Quality health care
- Use only medically needed services
- Regulated ina nd out of facility
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