UNIT 4

CHAPTER
16: health
promotion
 INTRODUCTIO
HEALTH PROMOTION
N
is an important component of nursing practice.
It is a way of thinking that revolves around a philosophy of wholeness,
wellness, and well-being.

Health-promoting Habits:

Getting Adequate Exercise, Rest, And Relaxation

Maintaining Good Nutrition
Controlling The Use Of Tobacco, Alcohol, And Other Drugs
INDIVIDUAL HEALTH
 include the person’s total character, self-identity, and perceptions.

 The person’s total character encompasses behaviors, emotional

state, attitudes, values, motives, abilities, habits, and appearances.
The person’s self-identity encompasses perception of self as a
separate and distinct entity alone and in interactions with others.
 The person’s perceptions encompass the way the person interprets
the environment or situation.
 CONCEPTS
• Microorganisms vary in their virulence
• Microorganisms also vary in the severity of the diseases
• Infectious agent transmitted to an individual by direct or indirect
INDIVIDUALIT HOLISM
contact or as an airborne infection, resulting condition is
communicableYdisease
• Pathogenicity is the ability to produce disease
• A “true” pathogen causes disease or infection in a healthy individual.
• An opportunistic pathogen causes disease only in a susceptible
individual.
• Asepsis is the freedom from disease-causing ASSESSING
microorganisms.
• SepsisHOMEOSTASIS
is the condition in which acute organ THE
dysfunction
HEALTH occurs
secondary to infection
OF
1.Medical asepsis
2.Surgical asepsis
INDIVIDUAL
CONCEPT OF INDIVIDUALITY
CAUSE INFECTIONS
 To help clients attain, maintain, or regain
an optimal level of health, nurses need to
understand clients as individuals.
CONCEPT OF HOLISM
INFECTIONS
 Nurses are concerned with the individual as a
whole, complete, or holistic person, not as an
assembly of parts and processes.
CONCEPT OF HOMEOSTASIS
 The concept of homeostasis was first introduced by
Cannon (1939) to describe the relative constancy of the
internal processes of the body, such as blood oxygen and
carbon dioxide levels, blood pressure etc.

EQUILIBRIUM- balance through adaptation to that

environment.
HOMEOSTASIS- is the tendency of the body to maintain a
state of balance while continually changing.
 2 TYPES OF HOMEOSTASIS

1.PHYSIOLOGICAL HOMEOSTASIS
2.PSYCHOLOGICAL HOMEOSTASIS
 PHYSIOLOGICAL HOMEOSTASIS

 Means that the internal environment of

the body is relatively stable and
constant.

Four Mechanic Characteristics

1. They are self-regulating.
2. They are compensatory.
3. They tend to be regulated by negative feedback systems.
4. They may require several feedback mechanisms to correct only one
physiological imbalance FUNDAMENTAL COMPONENTS OF SYSTEM:
 Matter (body)
 Energy (chemical or thermal)
 Communication (e.g., Nervous system)
2 GENERAL TYPES OF SYSTEM:

1. Closed System
2. Open System

Under the concept of Open system:

a. INPUT
b. THROUGHPUT
c. OUTPUT
 PSYCHOLOGICAL HOMEOSTASIS
 Refers to emotional or psychological balance or a state of
mental well-being.

Some prerequisites for a person to develop psychological

homeostasis can be summarized as follows:

• A stable physical environment in which the person feels safe and

secure.
• A stable psychological environment from infancy onward, so that
feelings of trust and love develop.
• A social environment that includes adults who are healthy role
models.
• A life experience that provides satisfactions. Throughout life, people
encounter many frustrations.
ASSESSING THE HEALTH OF
INDIVIDUALS
 A thorough assessment of an individual’s health status is
basic to health promotion. Components of this
assessment are the health history and physical
examination, physical fitness assessment, lifestyle
assessment, health risk appraisal, health beliefs review,
and life-stress review..
 APPLYING THEORETICAL
FRAMEWORK

2 MAJOR THEORETICAL
FRAMEWORKS
NEEDS THEORY DEVELOPMENTAL STAGE THEORIES

 It is an ideological  Developmental stage theories allow nurses to

model that seeks to describe typical behaviors of an individual
explain human within a certain age group, explain the
motivation based on significance of those behaviors, predict
an individual’s behaviors that might occur in a given
specific needs. situation, and provide a rationale to control
behavioral manifestations.
KALISH’S HIERARCHY OF NEEDS

 Richard Kalish (1983) adapted Maslow’s

hierarchy of needs into six levels rather than
five.

STIMULATION NEEDS
 includes sex, activity, exploration, manipulation,
and novelty (see Figure 16–3).
CHARACTERISTICS OF BASIC NEED
 People meet their own needs relative to their own priorities.
 Although basic needs generally must be met, some needs can be
deferred.
 Failure to meet needs result in one or more homeostatic imbalances,
which can eventually results in illness.
 A need can make itself felt by either external or internal stimuli.
 A person who perceives a need can respond in several ways to meet it.
 Needs are interrelated. Some needs cannot be met unless related needs
are also met.
Developmental stage theories
 Developmental stage theories allow nurses to
describe typical behaviors of an individual
within a certain age group, explain the
significance of those behaviors, predict
behaviors that might occur in a given situation,
and provide a rationale to control behavioral
manifestations.
“
What are the difference between the
Health Promotion and Health
Protection?
”
Pender, Murdaugh, and They define health promotion as
“behavior motivated by the desire to
Parsons (2011)

A
increase well-being and actualize
human health potential,” and disease
prevention or health protection as
“behavior motivated by a desire to
actively avoid illness, detect it early,
or maintain functioning within the
constraints of illness”.
 Defining Health Promotion

“ Enable people to increase control over

”
and improve health.
“ 3 Levels of Prevention

”
Leavell and Clark (1965) 3 levels of
prevention:

- focuses on (a) health promotion and (b) protection against specific health problems (e.g.,
Primary
immunization against hepatitis B).
The purpose of primary prevention is to decrease the risk or exposure of the individual or
community to disease.

Secondary focuses on (a) early identification of health problems and (b) prompt intervention to
alleviate health problems.

Its goal is to identify individuals in an early stage of a disease process and to limit future
disability.

Tertiary - focuses on restoration and rehabilitation with the goal of returning the
individual to an optimal level of functioning.
 Sites for Health Promotion
Activities

•Health promotion programs exist in many settings. Programs and activities may be offered to
individuals and families in the home or in the community setting and at schools, hospitals, or worksites.
Some individuals may feel more comfortable having a nurse, diet counselor, or fitness expert come to
their home for teaching and follow-up on individual needs.
 HEALTH PROMOTION MODEL

•Individual Characteristics and Experiences

- Personal factors are categorized as biologic (e.g., age, strength, balance),

- Psychological (e.g., self-esteem, self-motivation), and

- Sociocultural (e.g., race, ethnicity, education, socioeconomic status).

•Behavior-Specific Cognitions and Affect

- Behavior-specific cognitions constitute a critical “core” for intervention because nursing interventions can modify them.
 • Perceived benefits of action
• Perceived barriers to action
• Perceived self-efficacy
They include the following:
• Activity-related affect
• Interpersonal influences
• Situational influences
 Commitment to a Plan of Action
• Commitment to a plan of action involves two processes: commitment and identifying
specific strategies for carrying out and reinforcing the behavior. Strategies are important
because commitment alone often results in “good intentions” and not actual performance
of the behavior.
 Immediate Competing Demands
Behavioral Outcome
and Preferences
- The outcome of the Health Promotion
Model, is directed toward attaining

Competing demands are those behaviors over which an positive health outcomes for the client.
individual has a low level of control. Competing preferences are Health-promoting behaviors should result
behaviors over which an individual has a high level of control; in improved health, enhanced functional
however, this control depends on the individual’s ability to be ability, and better quality of life at all
self-regulating or to not “give in.” stages of development.
For example, a person who chooses a high-fat food over a low-
fat food because it tastes better has “given in” to an urge based
on a competing preference.
STAGES OF HEALTH BEHAVIOR
Health behavior change is a cyclic phenomenon in which people progress
through several stages. In the first stage, the person does not think seriously
about changing a behavior; by the time the person reaches the final stage,
he or she is successfully maintaining the change in behavior. Several
behavior change models have been proposed. The Transtheoretical Model
(TTM), proposed by Prochaska, Redding, and Evers (2009).

(a) precontemplation (b) contemplation (c) preparation (d) action

(e) maintenance (f) termination.
CONTEMPLATION STAGE
PRECONTEMPLATION STAGE

• In this stage, people do not intend to take action in the foreseeable future
(defined as within the next 6 months).

• During the contemplation stage, the person acknowledges having a problem,

seriously considers changing a specific behavior, actively gathers information,
and verbalizes plans to change the behavior in the near future (e.g., next 6
months).
PREPARATION STAGE

• In this stage, people are ready to take action within the next 30 days. People start to
take small steps toward the behavior change, and they believe changing their behavior
can lead to a healthier life.

ACTION STAGE

• In this stage, people have recently changed their behavior (defined as within the last 6
months) and intend to keep moving forward with that behavior change. People may
exhibit this by modifying their problem behavior or acquiring new healthy behaviors.
MAINTENANCE STAGE

• People in this stage work to prevent relapse to earlier

stages.

TERMINATION STAGE

• The termination stage is the ultimate goal; it is the point at

which the individual has complete confidence that the
problem is no longer a temptation or threat.
 THE NURSES ROLE IN HEALTH
PROMOTION

The trend toward health promotion has created the opportunity for nurses to
strengthen the profession's influence on health promotion, disseminate information
that promotes an educated public, and assist individuals and communities to
change long-standing health behaviors.

A variety of programs can be used for the promotion of health, including:

(a) information dissemination

(b) health risk appraisal and wellness assessment
(c) lifestyle and behavior change
(d) environmental control programs
 THE NURSING PROCESS AND HEALTH
PROMOTION

The nursing process is a Health promotion is the

series of steps nurses take to process of enabling people
assess patients, plan for and to increase control over, and
provide patient care, and to improve, their health. It
evaluate the patient's moves beyond a focus on
response to care. It is individual behaviour
considered the framework towards a wide range of
upon which all nursing care is social and environmental
based. interventions.
ASSESSMENT

Assessing is the systematic and

continuous collection, organization,
validation and documentation of data
(information) as compared to what is
standard norm.
 NURSING MANAGEMENT

Assessing

Components of assessment

• Health history and physical examination

• Physical Fitness Assessment
• Lifestyle Assessment
• Spiritual Health Assessment
• Social Support Systems Review
• Health Risk Assessment (HRA)
• Health Beliefs Review
• Life-stress Review
• Validating Assessment Data
 Diagnosing

Nursing diagnoses accepted by NANDA

International have generally focused on
impaired or imbalanced health patterns or
problems. Health promotion diagnoses can
be applied to any health state and do not
require current levels of wellness.

NANDA definition of Health promotion domain is

“the awareness of well-being or normality of
function and the strategies used to maintain
control of and enhance that well-being or
normality of function”.
Health promotion diagnosis is preceded by the modifier “readiness
for enhanced”

Readiness for enhanced Religiosity

Readiness for enhanced coping
Readiness for enhanced nutrition
Readiness for enhanced knowledge
Readiness for enhanced Relationships
Readiness for enhanced self-concept
Readiness for enhanced self-care
Readiness for enhanced urinary elimination
 TYPES OF DIAGNOSES

Actual diagnosis
describes human responses to health conditions or life processes.
Health promotion diagnosis
a clinical judgement of motivation, desire, and readiness to enhance well-
being and actualize human health potential
Risk nursing diagnosis
describes human responses to health conditions/life processes that may
develop
Syndrome diagnosis
describes a cluster of nursing diagnosis with similar interventions
 PLANNING

Health promotion plans need to be developed according to the

needs, desires, and priorities of the client. During the planning
process the nurse acts as a resource person rather than as an
adviser or counselor.
 STEPS IN PLANNING

 Review and summarize data from assessment.

 Reinforce strengths and competencies of the client.
 Identify health goals and related behavior.
 Identify behavioral or health outcomes.
 Develop a behavior-change plan.
 Reiterate benefits of change.
 Address environmental and interpersonal facilitators and
barriers to change.
 Determine a time frame for implementation.
 Formalize commitment to behavior-change plan.
 Exploring available Resources

These may be community resources such as a fitness

program at a local gymnasium, or educational programs
such as stress management, breast self-
examination, nutrition, smoking cessation, and
health lectures.
IMPLEMENTING

 Providing and Facilitating Support

 Individual Counseling Session
 Telephone or Internet Counseling
 Group Support Facilitating Social Support
 Providing Health Education
 Enhancing Behavior Change
 Modeling
 EVALUATING

EVALUATING takes place on an ongoing basis, both during the

attainment of short-term goals and after the completion of long-term
goals. the client may decide to continue with the plan, reorder
priorities, change strategies, or revise the health promotion-
prevention contract.
 THE END

ANY QUESTIONS?
 GROUP 1

BAGUAN, ALLIAH
GAPHOR, SONAYA
RADIA, SITTIE-RASHEDA