Describe the concept of health promotion.
How does this relate to consumer changes in personal responsibility
for health care in recent decades?
Any endeavor directed at enhancing the quality of health and well-being of individuals,
families, groups, communities, and or nations through strategies involving
supportive environments, coordination of resources, and respect for personal
coice and values.
The document Healthy People 2000 was presented in 1990. Since then, it has been updated to
Healthy People 2010. Go to the
and identify the goals of Healthy People 2010.
–Prevent premature death
1.Increase quality and years of healthylife
–Improved quality of life
–Well-being or satisfaction with one’s life
–Embraces all aspects of life
2.Eliminate health Disparities
What opportunities are provided to the nurse in the role of health
promoter? What other nursing roles
are included in the role of health promoter?
Model healthy lifestyle behaviors and attitudes.
Facilitate client involvement in the assesment implemmentation and evaluation of health goals. Teach
clients self-care strategies to enhance fitness improve nutrition manage stress
and enhance relationships. Pg.130
•Education about prevention
and maintaining health:
–Primary care clinics
–School based clinics
–Prenatal and well-baby clinics
How does your text define health promotion?
•“Any endeavor directed at enhancing the quality of health and
well-being of individuals, families, groups, communities, and/or nations
through strategies involving supportive environments, coordination of
resources, and respect for personal choice and values (Manville & Hurta,
•Is an approach behavior
•It is not disease orientated (Pender, Murdaugh, & Parsons
•Stachtchenko and Jenicek (1990)
–Involves not only lifestyle changes but allowing individuals and
In previous discussions, we talked about Leavell and Clark’s
levels of prevention. Describe primary, secondary, and tertiary prevention according to Leavell and
Clark. Give an example of each.
–Precedes any disease symptoms
–Encourage optimal health
–Increase a person’s resistance to illness
–Presence of disease and illness
–Early identification of of health problems
–Prompt intervention to alleviate health problems
–Disability is present
–Focuses on restoring and rehabilitation
Pender, Murdaugh, and Parsons describe three levels of prevention as health
protection. How do they define health protection?
–“Is behavior motivated by a desire to actively avoid illness,
detect it early, or maintain functioning within the constraints of illness
Describe five concepts of health promotion as described by Schultz.
The United States spends more money on health care
than any of the other industrialized nations. Where does the United
States stand in rankings of life expectancy among the industrialized nations. What factors in the United
States do you think influence this ranking?
U.S. falls at 78.9 for women 19th
rank and 25th rank for men at 72.5
Identify seven health disparities among people in the United
States. What are the focus areas that will be monitored in achieving goals
to eliminate health disparities?
· Infant death rate among African Americans is more than double that of
· African Americans have higher death rates than whites related to heart
disease. (40% higher), cancer (30%higher), HIV/AIDS (700%), and homicide (600%)
·Hispanics living in the U.S. are more likely to die from diabetes than
non hispanic whites. They have higher rates of hypertension and obesity than non-hispanic
· Native Americans and Alaska natives have hiigher infant mortality
rates, higher rates of diabetes, and higher death rates associates with
unintentional injuries and suicide.
·People with higher levels of education and income have lower incidence
of heart disease, diabetes, obesity, hypertension, and low birth weight.
·People with disabilities report more anxiety, pain, sleeplessness, and
days of depression than do those who do not have disabilities.
·People in rural areas are more likely to have heart disease, cancer,
and diabetes than those who live in urban areas.
What are the leading health indicators that reflect major public health
concerns in the United States?
· Physical activity
· Overweight and obesity
·Responsible sexual behavior
·Injury and violence
·Access to health care
Describe four types of health promotion programs.
· Information dissemination
·Health appraisal and wellness assessment
·Lifestyle and behavior change, and
·Environmental control programs
Identify ten sites for health promotion activities
·in the home with a counselor or
·Local health department
On what assumptions is Pender’s Health Promotion Model based?
·Persons seek to create conditions of living through which they can
express their unique human health potential.
·Persons have the capacity for reflective self-awareness, including
assessment of their own competencies.
·Persons value growth in directions viewed as positive and attempt to
achieve a personally acceptable balance between change and stability.
·Individuals in all their biopsychosocial complexity interact with the
environment, progressively transforming the environment and being transformed
·Health professionals constitute a part of the interpersonal environment
that exerts influence on the persons throughout their life span.
How do individual characteristics and experiences influence a person’s health
promotion activities? Pender’s component of Behavior Specific Cognitions and Affect are considered the
“critical core for intervention because they are subject to modification through nursing actions.” Describe
the behavior specific cognitions and affect and discuss how they may be modified. What barriers may affect
the anticipated health promotion outcomes?
If a person has had positive prior experience with health promotion and other
health related activites, they are more likely to maintain those activities than
someone who has had negative prior experiences.
·Perceived benefits of action- Affect the person’s level of
participation in health-promoting behaviors and may facilitate continued
·Perceived barriers to action- Person’s perceptions about available
time, expense, inconvenience, access to facilities, difficulty performing the
activity, or other perceived negative consequences related to health-promotion
·Perceived self-efficacy- Refers to the conviction that a person
can successfully carry out the behavior necessary to achieve a desired outcome,
such as maintaining an excercise program to lose weight.
·Activity-related affect- includes the subjective feelings that
occur before, during, and following an activity.
Discuss how Kulbok’s Resource Model of Preventive Health Behavior maximizes and individual’s health behaviors.
It hypothesizes that the greater a person’s social and health resources, the more
frequently the person will perform preventitive behaviors.
Describe how Betty Neuman’s Systems Model describes levels of prevention and
factors that strengthen a person’s lines or barriers of defense.
·Primary prevention- Identifies risk fctors, attempts to
eliminate the stressor, and focuses on protecting the normal line of defense and
strengthening the flexible line of defense.
A reaction has not yet ocurred, but the degree of risk is known.
·Secondary prevention- Relates to interventions or active
treatment initiated after symptoms have occured. The focus is to strengthen internal lines of
resistance, reduce the rection, and increase resistance factors.
·Tertiary prevention- refers to intervention following that in
the secondary stage. It focuses on
readaptation and stability and protects reconstitution or return to wellness
following treatment. The nurse
emphasizes educating the client in strenghtining resistance to stressors and
ways to help prevent recurrence of reaction or regression.
Discuss the five stages of health behavior change described by Prochaska and
DiClemente. Give an example of a nursing strategy for each stage.
· Precontemplation stage- the person does not think about changing
behavior, nor is the person interesed in information about the behavior. The
negative aspects of making the change outweigh the benefits.
· Contemplative stage- the person seriously considers changing a
specific behavior, actively gathers information, and verbalizes plans to change
the behavior in the near future. Belief in the value of the change and self-confidence in the ability to change both
increase in this phase.
·Preparation stage- occurs when the person undertakes cognitive
and behavorial activities that prepare the person for change. At this stage, the person believes that the
disadvantages and makes specific plans to accomplish the change. i.e. cuttingout sugar from coffee..
·Action stage- occurs when the person actively implements
behavioral and cognitive strategies to interrupt previous behavior patterns and
adopt new ones. To prevent recurrences
of previous behavior, the action stage needs to continue for several weeks or
·Maintenance stage- the person integrates newly adopted behavior
patterns into his or her lifestyle. This
stage lasts until the person no longer experiences temptation to return to
previous unhealthy behaviors.
Describe nine ways that the nurse functions as a health promoter.
· Model healthy lifestyle behaviors and attitudes.
· Facilitate client involvement in the assessment, implementation, and evaluation of the health goals.
· Teach clients selfcare strategies to enhance fitness, improve nutrition, manage stress, and enhance
· Assist individuals, families, and communities to increase their level of health.
· Educate clients to be effective health care consumers.
·Assist clients, families, and communities to develop and choose health-promoting options.
·Guide clients’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.