Health & Illness

Concepts of Man , Health & Nursing

• Definition of Health according to WHO :

• Is globally committed to health for all , the
World Health Organization defines health “As
a state of complete physical , mental and
social well-being , not merely the absence of
disease or infirmity .”
• Each person perceived and defines health
differently , and the role of the nurse is :
• To recognize the importance of respecting
such differences rather than imposing
standards that may be unrealistic for the
person
• There are some concepts related to health
that is defined by the perception of the
person which are :
• 1-Health : A limited Resources ; here health is
considered quite precious , people often say :
“As long as you have health , you have
everything and health is wealth”.
• Health : A Right ; regardless the age , gender ,
level of education , religion , ethnic origin ,
social position or wealth..everyone is equal
and entitled to life , liberty and to feel happy .
• If everyone is equally deserving of health it
follows that the nation in general and nurses
in particular have a duty to protect and
preserve the health
• 3-Health: A Personal Responsibility ; health
requires continuous personal effort , there is
such potential for illness as there is for health.
Pilch in 1981 said : “No one can do wellness to or for
another you alone do it , but you do not do it alone”.
 Wellness
• Wellness means a full and balanced
integration of all aspects of health , it involves
physical , emotional , social and spiritual
health
• Physical exists when the body organs function
normally
• Emotional health results when one feels safe
and copes effectively with the stressors of life
• Socially is feeling accepted and useful
• Spiritual health characterized as believing that
one’s life has purpose : so all components
referred as HOLISM
• Holism : Is the sum of physical , emotional ,
social and spiritual health , holism or in
another word WHOLE , whole or well person
feel .
• Change positive or negative in one of these
components effect the other , nurses profess to
be “Holistic Practitioners” , because they are
committed to restoring balance in each of the
four components that affect health
• Hierarchy of Human Needs , in 1988 Abraham
Maslow a psychologist identified five levels of
human needs (Explain ) and nurses adopted
Maslow hierarchy as a tool for setting priorities
for client care
 Illness
• Illness is a state of discomfort results when
disease , deterioration or injury impairs a
person’s health , the terms refer to illness are:
• 1-Morbidity & Mortality ; morbidity is an
incidence of a specific disease , disorder or injury
refers to the rate or numbers of people affected
• Mortality , is an incidence of death denotes the
number of people who died from a particular
disease or condition
• 2-Acute , Chronic & Terminal illness ;
• Acute one that comes on suddenly and lasts a
short time may be self treated or requires
medical treatment
• Chronic ; one that comes on a slowly and lasts
a long time requires long term medical
treatment
• Terminal illness ; is one in which there is no
potential for cure .
• 3-Primary & Secondary illness :
• Primary ; one that develops independently of
any other disease
• Secondary ; disorder that develops from a
preexisting condition , for example pulmonary
disease acquired from smoking is primary but
pneumonia or heart disease occurs as a
consequences of smoke-damaged issues it is
consider secondary
• 4-Remission & Exacerbation :
• Remission ; means disappearance of signs and
symptoms associated with a particular disease
the duration of remission is unpredictable
• Exacerbation ; is a reactivation of a disorder
• Remission and exacerbation depend on the
immune system function
• 5-Hereditary , Congenital & Idiopathic Illness :
• Hereditary ; disorder acquired from the genetic
codes of one or both parents may or may not
produce symptoms immediately after birth ,
example lung disease after birth can be diagnose
but MS manifest by the age
• Congenital , these present at birth but which are
the result of faulty embryonic development such
as if the mother during pregnancy had Germany
measles , or took drug in the first 3 months
• Idiopathic illness is an illness who cause is
unexplained , treatment focuses on relieving
the signs and symptoms because the etiology
is unknown example Fever from unknown
cause .
 Disease
• Disease is a medical term meaning that there are
pathologic changes in the structure or function of
the body or mind , the causes of the diseases can
be :
• Genetics such as Thalasemia
• Biological agent or toxins
• Taking drugs during pregnancy
• Expose to chemical or radiation
• Injury - Stress - Hormonal changes
 Risk Factors
• Is something that increases a person’s chance
for illness or injury there are six types of risk
factors :
• Age , school age are at risk for communicable
disease
• Genetics a family history of diabetes
• Physiologic such as obesity can lead to heart
disease
• Health habit such as smoking
• Lifestyle multiple sexual relationship risk of
transmitted sexual disease
• Environment poor sanitation contributes to a
disease
 Models of Health & Illness
• 1-Agent-Host-Environment model , developed
in 1965 for the use in community health is
useful for examine the causes of disease in an
individual
• Agent can be bacteria , or virus or fungus that
caused illness
• Host the living being capable of being infected
• Environment the external and internal factors
makes the occurrence of illness
• 2-Health-Ilnness Continuum , this continuum
is a model of the dynamic state of health as a
person’s adapts to changes in the internal and
external environment to maintain a state of
well-being
• 3-High-Level wellness model , described by
Dunn in1961 to differentiate between
wellness from good , good health is a passive
answer but wellness is an active answer
• 4-Health Belief model , is concerned about
what people perceived or believe to be true
about themselves in relation to health , such
as :
• A-Perceived susceptibility to a disease , one
person who smoke cigarette may believe he is
at danger for lung cancer but he continue
smoking
• B-Perceived serious of a disease believe that
cigarette smoking causes lung disease is more
likely to stop smoking
• C-Perceived benefits of action , stop smoking
can prevent future of illness
• (NOTE : ACESS to Care in the book is related
to American issues)
 Health Care Agencies in Palestine
• Health care in our region divided into :
• 1-Jerusalem area
• 2-West Bank
• In Jerusalem we have several hospitals in
which Palestine population can receive
primary , secondary , tertiary and extended
care
 Hospitals in Jerusalem
• 1- Makassed Hospitals : can receive medical
case and medical critical cases such as heart
attack , ..surgical cases and even cases that are
critical such as open heart surgery , brain
surgery , orthopedics surgery.. Pediatric and
neonatal ward , maternity ward , close critical
units ,
• Massked hospitals so advance in specialty and
technology and well as ER
• 2-August Victoria Hospital : near Makassed ,
nowadays this hospital become specialize in
oncology treatment , surgery to remove
tumors , chemotherapy , radiation and in this
hospital there is an advance unit for Geriatric
skills nursing care , newly a unit was opened
for bone marrow transplant
• 3-Hilal Hospital : so near to August Victoria
and Makassed hospital and it is specialize for
maternity
• 4-St. Joseph Hospital : contains
surgical/medical units ER , ICU ,and this
hospital they hope that next year 2013 a
maternity and Neonatal units will be open
 Hospitals in West-Bank
• Several hospitals are refers to Governmental
branch such as Ramallah , Rafidah , Al-Watani
Jenin , Beit-Jala..
• In west-Bank also there are several private
hospitals
 Team-Work in Nursing Practice
• In health-care system team-work is so
essential
• Teamwork: when nurses function as part of a
unit and when they act as part of a team the
job itself is easier and more efficient and
overall pt care is enhance
• In nursing teamwork is emphasized and
valued every member works together to meet
the pt’s needs and to improve pt outcome
which is the common goal for all the team:
Nurses , Doctors , Nutrition , Social workers..
 Nursing Team
• The goal of the nursing team ( Personnel who
care for clients directly) is to help clients
maintain or regain health
• Teams may include several types of
professionals such as physiotherapist ,
technicians..
 Functional Nursing
• Which means each nurse in the unit is
assigned for a specific tasks for example one
assigned for dressing , other carry out
physicians orders
• But this is being used less often because its
focus tends to be more on completing the task
rather than caring for individual clients as a
holistic
 Team Nursing
• Is the division of the nursing staff such as
Team Leader which may assist but usually
she/he makes assignment and supervision
• Team members report then outcomes of
their care to the team leader
• Team leader is evaluating whether the goals
of client care are met
 Primary Nursing
• Which is the admitting nurse assumes
responsibility for planning client care and
evaluating the client’s progress
• Primary nurse remains responsible and
accountable for specific clients until they are
discharged
 Some Definitions for TW
• Interdisciplinary Practice : refers to people
working together for a common purpose or
goal for the patient
• Multidiscipline team : a team of professionals
including representatives of different
disciplines who coordinated the contributions
of each profession in order to improve quality
of patient care
Effective Communication Between
Health Team
• Between nurses , physician , hospitalists ,
should communicate effectively the diagnosis
and treatment this will lead to beneficial
treatment and plan of care
• Effective communication demonstrate
improve in efficiency and quality of care
• Achieving desire pt’s goal outcome rest on TW
and efficient communication
• So teamwork strength the ability of nurse and
other health care providers to provide higher
quality more efficient care
• Teamwork and communication are equally
important when changing shift , the nurse
should be aware of what duties can be
delegated , she/he should communicates
her/his needs with co-assigned nurse
Competency & defining Behaviors
• Factors are :
• 1-Diversity of Cultures , talents and
personalities can promote creativity and
innovation and raise awareness and respect
for differences among team-members
• 2-Communication: again communication is a
work of relationship consist of trust and
appreciation
• Communication effective teamwork is
facilitate by clear and open communication
• 3-Leadership teamwork is supported by
effective leadership , the leadership
inspiration , direction , collaboration and
encouragement , so the role of leader
promote and maintain high level of morale
and motivation
 The Nurse-Client Relationship (Pg92)
• Relationship means association between two
or more people , established between the
nurse and the client when nursing services are
provided or skills that assist individuals , client
or patient in order to promote health ,
prevent illness , restore health and facilitate
coping
• The nurse-client relationship requires the
nurse to respond to the client’s needs
according to National Council of States Boards
of Nursing which are:
• Safe , effective care environment
• Health promotion and maintenance
• Psychological integrity
• Physical integrity
• And in order to meet these the nurse perform
four basic roles :
• The nurse as caregiver
• The nurse as educator
• The nurse as collaborator ( see photo pg 93)
• The nurse as delegator
 The Therapeutic Nurse-Client
Relationship
• Therapeutic relationship is a client centered with
a focus goal achievement , before the patient
was passive but today the pt. and the family
become involved , communicate , question and
assist in planning in their care
• Therapeutic relation ship is more likely to
develop when the nurse treats each client as a
unique person and respects their feeling , so the
nurse promotes the health of the client according
to WHO
 Phases of the Nurse-Client
Relationship
• 1-Introductory phase , introducing each other
the nurse demonstrate active listening ,
empathy , competent and appropriate
communication , in order to ensure positive
Relationship
• 2-Working Phase , task performed both the
nurse and the client participate
• 3-Terminating phase
• (Barriers to Therapeutic RS Page 95)
 Communication
• Communication means exchange of
information involves both sending and
receiving messages between two or more
people followed by feedback indicating that
information was understood
• Therapeutic communication involve verbal &
Non verbal and the nurse develops skills of
communication that can enhance therapy
interactions
 Verbal Communication
• Communication that uses words includes
speaking , reading and writing , also we use
instructions , clarify and exchange ideas
• May factors affect the ability to communicate
by speech or in writing examples include
• 1-Attention & Concentration
• 2-Understand the language
• 3-Skills in conversations
• 4-hearing and visual acuity
• 5-Motor function involving the throat , tongue
and teeth
• 6-personal attitude and culture
* So the nurse promotes the factors that
enhance communication
 Therapeutic Verbal
Communication
• Can be through:
• 1-Listening : is important more than speaking
do not show the pt that you feel boredom ,
impatient , or looking on the window or watch
encourage clients to continue and shows full
involvement in what is being said
• 2-Silence : plays an important role in
communication , keep silence and listening
help the client to reduce his/her anxiety
• When the nurse talks a lot and ignore silence
this is a kind of obstacle for therapeutic
communication
 Non-Verbal Communication
• Exchange of information without using words
a person has less control over nonverbal than
verbal communication , because words should
be chosen with care but facial expression
,body gesture is harden to control
• As result people often communicate messages
more accurate through nonverbal
communication
• Non-verbal communication such as TOUCH
• Effective touch is therapeutic when the client:
• 1-Lonely 2-Uncomfortable
• 3-Near death 4-Disoriented
• 5-Anxious , insecure 6-Disfigured
• 7-Semiconscious or Comatose
• 8-Visual imapried