1.

INTRODUCTION:

Health promotion is an important component of
nursing practice.
It is a way of thinking that revolves around a
philosophy of wholeness, wellness and well-
being.
In the past two decades, the public has become
increasingly aware of and interested in health
promotion.
Many people are aware of the relationship
between lifestyle and illness and are
developing health- promoting habits, such as
exercises,
rest and relaxation;
good nutrition; and
controlling the use of tobacco, alcohol and
other drugs.



Health:

(1)Traditionally health has been defined in terms of
the presence or absence of disease.

(2)Health as a state of being well and using every
power the individual possesses to the fullest
extent.
-Nightingale, 1969.
(3)Health is state of complete physical, mental
and social well-being and not merely the
absence of disease or infirmity
-World Health Organization, 1947



HEALTH PROMOTION
Definition:
One method of primary prevention is to make
people strong in body and mind and
provide them with an environment at home, at
site of work and at place of recreation
free of harmful substances & influences.
This kind of primary prevention is called
Health Promotion.

It is defined as, behavior motivated by the
desire to increase well-being and actualize
human health potential.
-Pender, Murdaugh and parsons, 2002.

PURPOSES OF HEALTH
PROMOTION:

To focus on the persons potential for wellness
It is an active process.
It is up to the individual to decide whether or not
to make the changes.
Choices must be made and only the individual
can make these choices.


PRINCIPLES OF HEALTH
PROMOTION
Self-Responsibility
Nutrition
Stress management
Exercise
Self-Responsibility:

Taking responsibility for oneself is the key to
successful health promotion.
It recognizes that the individual and only the
individual, has control over his or her life,
Each of us, alone can make those choices that
determine whether our individual lifestyle is
one that promotes health.

Nutrition:

Nutritional awareness involves an understanding
of the importance of a properly balanced diet
that supplies all of the essential nutrients and

an awareness of the relationship between diet
and disease.

Stress management:

Stress management and stress reduction have
become important aspects of health promotion.
Studies have shown the negative effects of
stress on health and
a cause and effect relationship between
stress and traumatic injuries including motor
vehicle crashes and some chronic illnesses.

Exercise:

Physical fitness is another important component
of health promotion.
An exercise programme should be designed
specially for the individual, with consideration
given to age, physical condition and any known
cardio vascular risk factors.
An appropriate exercise programme can give a
significant positive effect on the individuals
performance capacity and general state of
health.


Factors Impacting Health Promotion
And Illness Prevention:
An increase in physical limitations
Presence of one or more chronic illnesses
Change in cognitive status
Difficulty in accessing health care services due to
transportation problem.
Poor support system

Need for environmental modifications for
safety and to maintain independence.

Attitude of hopeless and depression


FACTORS AFFECTING
HEALTH MAINTENANCE:

Cognition and perception:
Cognitive and perceptual factors include what
health means to a person,
how important it is, and
how the person perceives control of health, self-
efficacy, health status, benefits and barriers.
Age and developmental level:
Age can have a significant impact on a persons
ability to manage their health status.
80 year old women with arthritis or diabetes
mellitus may perceive her health status as low
and may not engage in proper health-
maintenance practices, where as 17 years old
women may see such conditions, as acceptable
and may carry practices to promote optimum
health.

Previous experiences:
A persons past experiences with health and
health care system affect health maintenance.
If a person had a negative experience with an
agency or program, they may refuse to
participate again, even if no alternatives are
available.
Lifestyle and habits:
A persons lifestyle habits strongly affect health
maintenance.
People with an unhealthy lifestyle and habits like
lack of exercise,
poor diet,
use of tobacco,
use of alcohol,
use of illegal drugs or abuse of prescription
drugs,
multiple sexual partners,
lack of sleep,
lack of contraception,
poor dental hygiene


Environment:
Pollution,
nearby highways,
lack of safe play areas,
inadequate housing and
unsanitary conditions
lead to poor health maintenance and set the stage
for illness.


Economic resources:

People who live in poverty may be unable to
afford nutritious food and adequate housing.

Culture, values and beliefs:
The culture in which a person was raised
influences
his or her health beliefs and practices,
diet,
childbearing and child rearing customs,
self medication and
alternative therapies.
Roles and relationships:
People who are comfortable in their roles and
relationships with others often form strong
support systems and use available resources to
promote health.
Coping and stress tolerance:
Coping mechanisms - people use to handle
every day events - may help or harm their
health.


HEALTH PROMOTION MODEL:
Selected Areas of Health
Promotion:

Nutrition and diet
Smoking prevention and cessation
Exercise and fitness
Relaxation and stress management
Sexual health

NUTRITION AND DIET:

It is projected that 35% of all cancer could be
prevented with an improved diet.
A low-fat, high-fibre diet is recommended



additional restriction of substance such as
sodium and saturated fat- are also necessary to
treat and prevent chronic disease, such as
hyper tension, type 2 Diabetes mellitus, and
coronary artery disease (CAD).




Educate patients about
the five basic food groups and their placements
on food pyramid,
optimum weight,
caloric requirements and
ways to increase fibre and decrease fat in the
diet.



Encourage patients to keep food diaries and
review them periodically to determine it other
adjustments should be made.
If weight loss is desired, have the patient weight
in monthly, and review the diet

SMOKING PREVENTION OR CESSATION:
If has been estimated that 30% of all cancer is
linked to smoking and is preventable.
Studies show that 60% of all current smokers
began smoking by age 14 and that more than
3,000 children each day begin to use to tobacco
in the united states.

Smoking is the risk factor for
peripheral vascular disease (PVD),
myocardial infarction,
chronic obstructive pulmonary disease (COPD),
cancer of the lung, colon, larynx, oral cavity,
esophagus, bladder and kidney.



Smoking prevention education should begin
during childhood and stressed during
adolescence
Smoking cessation can be accomplished
through an individualized, multidimensional
programmer that includes.
Information on the short and long term health
effects of smoking.
Practical behavior modification techniques to
help break the habit - gum chewing, munch on
carrot, sucking on mints and hard candy to
provide oral stimulation

EXERCISE AND FITNESS:
Regular exercise as part of a fitness programs
helps
achieve optimal weight,
control blood pressure,
increased high density lipoprotein,
lower risk of CAD and
improve the sense of wellbeing.
Long term goals of regular exercise includes
decreased absenteeism from work,
improved balance and
reduced disability among elderly,
decreased osteoporosis and fracture risk.


Studies have shown that both high intensity
exercise and low to moderate intensity
exercise performed at least three times per week
have positive effects.

Individual tolerance, time allotment, interest
and physical impairment must be figured into
exercise planning.

Suggest walking, jogging, bicycling,
swimming, water aerobics, performed three to
five times per week for 45 minutes. Use of
weight is important for muscle strengthening
throughout the life span.
RELAXATION AND STRESS MANAGEMENT
Stress management - help patients control
illnesses, improve self-esteem, gain control and
enjoy life.
Stress management involves the identification
of physiologic and psychologic stressors
through assessment of the patients education,
job, family, habits, activities personal and
family health history.

Positive and negative coping methods should
also be identified.
Relaxation therapy is the first step in stress
management; it can be used to reduce anxiety
brought on by stress. Relaxation techniques
include.



Relaxation breathing : The simplest technique that
can be performed at any time. The patient breaths
slowly and deeply until relaxation is achieved.
Progressive muscle relaxation :It relieves
muscle tension related to stress.
Autogenic training: It can help to relieve pain
and induce sleep.
Imagery: Uses imagination and concentration
to take mental vacation. The patient imagines
a peaceful pleasant scene involving multiple
senses.
Distraction:
Uses the patients own interests and activities to
divert attention from pain or anxiety and
includes
listening to music,
watching television,
reading a book,
singing and
physical activities.







SEXUAL HEALTH
Education about sexuality should begin with
school-age children, increase during adolescence,
and continue through adulthood.
Topics to educate include:
Relationships, responsibilities, communication.
Normal reproduction- the menstrual cycle
ovulation and fertilization.
Unwanted pregnancy
Contraception
Sexually transmitted diseases
Safer sex or abstinence


HEALTH PROMOTION
PROGRAMMES:

The concepts of health, wellness, health
promotion and disease prevention have been
extensively addressed in the
lay literature and
news media
as well as in professional journals.
Health promotion programs that were once
limited to hospital settings have now moved
into the community, in settings such as clinics,
schools, churches, businesses, and industry.

The work place is quickly becoming an
important site for health promotion programs


HEALTH PROMOTION THROUGH
OUT THE LIFE SPAN

Health assessment and promotion:
Developmental screening tests:
Ongoing Nursing Assessments:
Health promotion guidelines for
Health examinations:
Protective measures:
I mmunizations:
Safety:
Elimination:
Sleep/Rest :
Sensory stimulation: Touch: Vision: Hearing:
Play:
Nutrition and exercise:
Social interactions:
Health tests and screenings:


THE INTERVENTIONS OF HEALTH
PROMOTION:


Health education
Environmental modification
Nutritional interventions
Life style and behavioral changes.


(1) Health education:
This is one of the most cost-effective
interventions.
A large number of diseases could be prevented
with little or no medical intervention
if people were adequately informed about them
and if they were encouraged to take necessary
precautions in time.
(2)Environmental modifications:

A comprehensive approach to health promotion
requires environmental modifications; such as
provision of safe water,
installation of sanitary latrines,
improvement of housing etc.
(3)Nutritional interventions:

These comprise food distribution and
nutrition development of vulnerable groups;
child feeding programs;
nutrition education etc.

(4)Life style and behavioral changes:

Health education is basic element of all health
activity.
If is of paramount importance in changing the
views, behavior and habits of people.


THE NURSES ROLE IN HEALTH
PROMOTION:

Healthy life style behaviors and attitudes.

Facilitate client involvement in the assessment,
implementation, and evaluation of health goals.

Teach clients self-care strategies to enhance
fitness, improve nutrition, manage stress, and
enhance relationships.

Assist individuals, families and communities to
increase their level of health.


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.



NURSING IMPLICATIONS:

Nurses, by virtue of their expertise in health and
health care and their long-established credibility
with consumers, play a vital role in health
promotion.

As health care professionals, nurses have a
responsibility
to promote activities that foster well-being,
self-actualization, and
personal fulfillment.

Every interaction of consumers of health care
must be viewed as an opportunity to promote
positive health attitudes and behaviors.