1. 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.
  2. 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.
    • –Promote Health
    • –Prevent illness
    • –Prevent disabilities
    • –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
  3. 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:

    • –Health Department
    • –Primary care clinics
    • –School based clinics
    • –Prenatal and well-baby clinics
    • –Community
    • –Hospital
  4. 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,
    • 2002, p.3).”

    •Is an approach behavior

    • •It is not disease orientated (Pender, Murdaugh, & Parsons
    • 2002, p.7)

    •Stachtchenko and Jenicek (1990)

    –Involves not only lifestyle changes but allowing individuals and
  5. 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

    Secondary Prevention

    –Presence of disease and illness

    –Early identification of of health problems

    –Prompt intervention to alleviate health problems

    • Tertiary Prevention
    • –Disability is present
    • –Focuses on restoring and rehabilitation
  6. 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
  7. Describe five concepts of health promotion as described by Schultz.
  8. 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
  9. 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
    • whites.

    • · 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
    • whites.

    • · 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.
  10. What are the leading health indicators that reflect major public health
    concerns in the United States?
    · Physical activity

    · Overweight and obesity

    ·Tobacco use

    ·Substance abuse

    ·Responsible sexual behavior

    ·Mental health

    ·Injury and violence

    ·Environmental quality


    ·Access to health care
  11. Describe four types of health promotion programs.
    · Information dissemination

    ·Health appraisal and wellness assessment

    ·Lifestyle and behavior change, and

    ·Environmental control programs
  12. Identify ten sites for health promotion activities
    • ·in the home with a counselor or
    • nurse.


    ·Local health department

    ·Fire department




    ·Web md.
  13. 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
    • over time.

    • ·Health professionals constitute a part of the interpersonal environment
    • that exerts influence on the persons throughout their life span.
  14. 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
    • practice.

    • ·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
    • activities.

    • ·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.
  15. 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.
  16. 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.

  17. 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
    • months.

    • · 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.
  18. 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
    • relationships.

    · 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.
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