Foundations

• Presence or absense of a disease.  A state of complete physical, mental and social. 
• Someone striving tword optimal functioning. 
• Sense of WELLNESS
• Persons perception.

• Medical term used by medicine
• Nursing for a disorder in the body. 
• It is physical
• Somethin that can be diagnoised
• Perhapsed cured but not always

• Individualized perseption: "I have a st or ha"; "I just dont feel well today".
• Highly subjective
• Can have a illness without a disease or can have a disease without illness.
• A state of a perons physical, emotional, interlectual, socaial or spiritual is deminished or impaired.

• Subjective
• Individualized perseption "I want to dance"
• Felling of wholeness and functioning at ones potential at all aspects.
• Experence is measured

• Decisions made everyday about health.
• Ex did you choose to eat a breakfast knowing that it is the important meal of the day or excersise or set on the couch.
• State of well being
• Self Responsibility an ultimate goal, dynamic, growing process.
• The whole being of the individual.

With in a person, spiritual factor, intellegance delevemental stage, emotions that can influence on how healthy that person is.

• Outside, what is the the enviroment-Is it healthy?
• Are you far from a medical resource.  Finances? and social class?
• Family dynamics-do they get routine exams? 
• Culture?
• Do they wait and go to the ER when sx's are bad?
• How does their peer group deal with the illness.
• Individual lifestyles-do they sit out in the sun??

• Lower level is the most important; it is the physiological state.
• ************always remember ABC***************

Always be open to what the client is feeling as well.

deals w/ concept of health as it truely exsists from high level wellness to death.

• One big arrow
• Left-premature dealth (disability, symptoms, and signs) Right-up to high level of wellness.
• Top of arrow all the way across-wellness
• Middle is the neutral point
• Bottom half way is the treatment arrow.

• No discernible illness or well ness
• (think of the Army girl that got hurt)

• The patient could be ill and at the same time orient tword wellness
• Physically healthy and at the sametime function from the illness mentality.

Clients perceptions of the health and illness-nurses can provide more meaningfull assistance to help them maintain regain or attane a state of health

• What you believe about life usually influences health
• Internal" Do you control your health"?
• Enternal: "Do you believe that something else of a higher power controls your life"  Such as genes or "A God".

Ex:  Im going to die at 40 because all my uncles died at 40 or I can't stop drinking because my mom did not stop drinking.

Why some people maintain health and treat illness while others fail to protect themselves mostly preventing a disease and illness.

• Individual perception
• Ex:  15 year old girl-sexual active does not believe that she can get a std.  You friend laughes at it.  She does not see the reason to use a condom or protection.
• Modifing factors: peer pressure and age-will greatly influence how she feels about the illness and the seriousness.
• Cues to action: Wake her up to the serious of things: mass media campaigns, advise from others, postcard from physicians, illness of friend, family, newspapers.
• Likelihood of action: Percieved benifits prevenative action-barriors hard to get to office or embarressed.

• Well she get the help or not????

• Assumptions of people, their behaviors, nature of health, the goal of health promotion:
• Health promotion al directing a clients well being
• ************Promoting Wellness*************
• * Individual characteristics and experiences
• *Behavior specific congnitions and affect
• *Behavioral outcomes
• Ex:  50yr hyperlipid needs to start exerc.  Must concider
• 1)Prior related behavior before, is this a pattern?
• 2) personal factors: culture, family routine, psych, What will help him undertake this?
• 3) Whole relm of influences will he do it or not?
• Health promoting behavior
• Nurse can collect data from the chart and intervene w/the client and help him change his life.

• Clients are the ULTIMATE experts able to guide their own health: if they have the info from the nurse.
• Nurses strive for this.

• Dont ignor emotional factor with the physical
• Dont ignor the spiritual in favor of the interletual
• Conplementary: use nursing care with medical care to improve patients health

• Therapy: herbal, music, relaxation, touch
• Its broad can be used in all stages of health and illness.

• 49th health practices
• #1 health practices
• 38% smoke but has come down
• 31% obese
• 40% ex. reg.

• Nurses must be involved not only preventing disease but promoting health. 
• Educate people.
• Encourage people to be responsible for taking control of their health
• Inc. concepts of wholeness, wellness, well-being, and lifestyle changes.
• Program that modify enviroment and individual behaviors.
• EX:  45yr old feels healthy but has high cholestrol and does not ex. needs health promotion.

• Healthy people
• 1970's vision for nations health.
• Goals are created on the fed level every decade and public health agencies at all levels of gov work to meet them.
• State, city, and local to meet these goals.

Eat better move more don't smoke

• Increase quality and yrs of healthy life in indivi.
• Eliminate health disparities
• Ex:  Certain pop. lets give them equal access to medical care.
• Increase vacciness, reduce obesity, low cancer death rates, and low htn.

• interventions aimed at decreasing probability of specific illness or dysfunction.
• Aimed at healthy people!!!!!!
• Ex:  prenatal pills, adult starts ex program, vacciness, exams.

• Secondary
• Early dx and prompt treatment of illness
• Persons who are experiencing or at risk of experencing health problems and are at risk of developing complication.
• EX: per exp thrist and freq urination: pcp does a bs: dx w/dm.  EARLY TX:  Recognizing the disease and starting tx such as nutrition and demostrating bs test.
• EX: family breast cancer: get a mammo. 
• May have the disease but tx before it gets worse.

• Tertiary
• Focused on minimizing the effects of permanent and irreversible disease or disability.
• Ex: emphazyma-avoid worsening the disease.  No going out in the cold.  Stay away from crowds-worried about infecitons.
• Ex: CHF- weight everyday and call nurse if any descripincies with weight.

• Help client identify that there could be risk factors in their lifestyle even if they are not feeling unhealthy.
• Were is the client at??

Client is not thinking of changing their lifestyle in the next 6mo.

• Knowledge to the problem. 
• Thinking about changing the in the next 6 mo
• May not be ready to commit.

• Immediate action w/in a month
• Usually making small behavior changes
• Buying self help books

• Actively implements behavior and conginitive strategies of the action plan.  Adapt new behavior
• Great Commitment

• Strives to prevent relapse.
• Adopting new behavior.
• Stage last until no tempations usually 6mo to 5yrs.

• Longer than 6mo
• Disabilities
• leading health problem for older adults and children
• Physicial changed that affects functioning (maybe in more than one dimintion)
• Btw mulitfunctioning or life threatening relapse.
• Can not be cured.

• Short term problem
• Can affect the patient life-emotional, spiritual, physical.
• Sx's may be adrupt but then subside
• Might be cured.

• How a person thinks about illness and how that influences them or weather internally.
• Is the sx's disrupting their routine? 
• Sx's life threatening?
• Do I believe I'm in control of my health

• How do my peer group deal with my illness?
• Do I accept this "sick role" or do I accept health care?
• Sx's visible to others?
• Culture recognize my sx's as a illness
• Should I delay treatment b/c I can't afford it?
• HC confusing?