Chapter 006

Chapter 6
Health and Wellness
Copyright 2017, Elsevier Inc. All Rights Reserved.
Healthy People: The Surgeon Generals Report

on Health Promotion and Disease Prevention,
1979
Healthy People 2000: National Health Promotion

and Disease Prevention Objectives
Healthy People 2010
Healthy People 2020
2
Healthy People
Documents
Healthy People 2020 Goals
Attain high-quality, longer lives free of

preventable disease, disability, injury, and
premature death
Achieve health equity, eliminate disparities, and

improve the health of all groups
Create social and physical environments that

promote good health for all
Promote quality of life, healthy development, and

healthy behaviors across all life stages
3
Healthy People
Documents (Cont.)
Case Study
Jack is a 59-year-old man with a history of type
2 diabetes, hypertension, and obesity. He is
married and works 50 to 60 hours per week in a
computer technology position.
His wife works the same number of hours,

although she tends to travel more with her job
and sometimes works the night shift.
As a result, both Jack and his wife have a hard

time fitting exercise into their daily routine, and
they often eat in restaurants.
Definition of Health
A state of complete physical, mental, and social
well-being, not merely the absence of disease
or infirmity (WHO, 1947)
A state of being that people define in relation to

their own values, personality, and lifestyle
A model is a theoretical way of understanding a

concept or idea
Health beliefs
Health behaviors
Positive
Negative
6
Models of Health and

Illness
Health Belief Model
Health Promotion Model
Maslows
Hierarchy
of Needs
Used
to understand
the interrelationships
of basic human needs
Holistic
Health Model
Attempts
to create
conditions that
promote optimal
health
Models of Health and Illness9

(Cont.)
Quick Quiz!
1. According to Maslows hierarchy of needs, which of
these needs would the patient seek to meet first?
A. Self-actualization
B. Psychological security
C. Shelter
D. Love and belonging
Case Study (Cont.)

Jack comes to the clinic today for routine followup for his diabetes. Jacks laboratory data reveal
that his blood glucose level is consistently
running high. His blood pressure is on the high
side of normal.
Sally, the diabetes nurse educator, is working

with Jack for the second time. Sally knows she
wants to find a way to get Jacks blood glucose
levels down to avoid the long-term
complications of diabetes.
11
influence health behavior or health practices.
12
Variables Influencing
Health
and
Health
andand
Variables
influenceBeliefs
how a person thinks
acts.
Practices
Health beliefs can negatively or positively
Internal Variables
Developmental Stage
Intellectual Background
Perception of Functioning
Emotional Factors
Spiritual Factors
13
External Variables
Family Practices
Socioeconomic Factors
Cultural Background
14
Case Study (Cont.)

Because Jack occasionally exercises, Sally
decides to focus her teaching on the
importance of routine exercise to improve Jacks
health and help with the management of
diabetes.
Sally finds out that 6 months ago, Jack was

using his treadmill for 20 minutes on most
mornings. Since then, he has gotten out of the
habit because he now tries to arrive at work 30
minutes earlier.
15
Quick Quiz!
16
2. After evaluating a patients external variables, the nurse

concludes that health beliefs and practices can be
influenced by
A. emotional factors.
B. intellectual background.
C. developmental stage.
D. socioeconomic factors.
Health Promotion, Wellness,

and Illness Prevention
1. Immunization Programs
2. Routine Exercise, Good Nutrition
3. Physical Awareness, Stress Management,

Self-Responsibility
17
Levels of Preventive Care

Primary Prevention
Secondary Prevention
True prevention that lowers the chances that a

disease will develop
Focuses on those who have health problems or
illnesses and are at risk for developing
complications or worsening conditions
Tertiary Prevention
Occurs when a defect or disability is permanent

or irreversible
18
Quick Quiz!
19
A. get a flu shot every year.

B. take a blood pressure reading every day.
C. explore hiring a patient with a known disability.
D. undergo physical therapy following a cerebrovascular
accident.
3. You will use the concept of primary prevention when

instructing a patient to:
Risk Factors
Variables that increase the vulnerability of an
individual or a group to an illness or accident
Risk factors include:
Genetic and physiological factors
Age
Environment
Lifestyle
20
Precontemplation
Contemplation
Preparation
Action
Maintenance stage
21
Risk Factor Modification and

Changing Health Behaviors
Case Study (Cont.)

Sally wants to apply the stages of behavior
change with Jack. By using this model, she will
work with Jack regarding what he is ready to do
rather than simply telling Jack to be more
active.
To do this, she first asks Jack how he feels about

exercise and what his plans are. Jack states, I
know that exercise would be good for me and I
should probably work on it.
This tells Sally that Jack is at the contemplation

stage.
22
Quick Quiz!
23
4. Sally has decided to set aside 30 minutes a day to walk

after work next week. Sally is in what stage of risk
factor modification?
A. Precontemplation
B. Contemplation
C. Preparation
D. Action
E. Maintenance
Objective
Teaching strategies
Patient will reduce health risks related to poor

lifestyle habits through behavior change.
Provide active listening, ask about perceived

barriers, assist the patient in establishing goals, and
reinforce the process of change.
Evaluation
Have the patient track adherence, and provide

positive reinforcement.
24
Risk Factor Modification

and Changing Health
Behaviors
Patient Teaching:(Cont.)
Lifestyle Changes
Definition of Illness
A state in which a persons physical, emotional,
intellectual, social, developmental, or spiritual
functioning is diminished or impaired
Acute Illness
Short duration and severe
Chronic Illness
Persists longer than 6 months
25
Illness Behavior
Involves how people monitor their bodies and
define and interpret their symptoms
Variables influencing illness and illness behavior
Internal variables: Perception of illness and nature

of illness
External variables: Visibility of symptoms, social

group, cultural background, economics, and
accessibility to health care
26
Behavioral and emotional changes
Impact on body image
Impact on self-concept
Impact on family roles
Impact on family dynamics
27
Impact of Illness on the

Patient and Family
Case Study (Cont.)

Teaching strategies:
Practice active listening and determine what Jack

understands regarding health risks related to poor
lifestyle.
Ask Jack what barriers and benefits he perceives

with the planned lifestyle change of consistently
exercising.
Help Jack set achievable goals for change.
Work with Jack to establish realistic time lines for

modification of exercise habits.
28
Case Study (Cont.)

At the next
appointment, Jack says,
I saw there was a sale
on walking shoes. If Im
going to start walking,
do you think I need to
get new shoes? Next
week, I am taking a
week of vacation, just
doing things around the
house, and I thought
this would be a good
time to start.
29
Case Study (Cont.)

Evaluation strategies
Have Jack maintain an exercise log to track

adherence, and provide positive reinforcement.
Ask Jack to discuss his success with lifestyle

changes, such as minutes spent in activity.
Have Jack identify community resources used in

making a change.
30
Caring for Yourself

Eat a nutritious diet
Get adequate sleep
Engage in exercise and relaxation activities
Establish a good work-family balance
Engage in regular nonwork activities.
Develop coping skills
Allowing personal time for grieving
Focus on spiritual health
Find a mentor
31

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Chapter 6

Health and Wellness

Copyright 2017, Elsevier Inc. All Rights Reserved.

Healthy People: The Surgeon Generals Report

Healthy People 2000: National Health Promotion

Healthy People 2010

Healthy People 2020

Healthy People 2020 Goals

Attain high-quality, longer lives free of

Achieve health equity, eliminate disparities, and

Create social and physical environments that

Promote quality of life, healthy development, and

His wife works the same number of hours,

As a result, both Jack and his wife have a hard

Copyright 2017, Elsevier Inc. All Rights Reserved.

A state of being that people define in relation to

Copyright 2017, Elsevier Inc. All Rights Reserved.

A model is a theoretical way of understanding a

Models of Health and

Health Belief Model

Copyright 2017, Elsevier Inc. All Rights Reserved.

Health Promotion Model

Copyright 2017, Elsevier Inc. All Rights Reserved.

Copyright 2017, Elsevier Inc. All Rights Reserved.

Models of Health and Illness9

Case Study (Cont.)

Sally, the diabetes nurse educator, is working

Copyright 2017, Elsevier Inc. All Rights Reserved.

influence health behavior or health practices.

Copyright 2017, Elsevier Inc. All Rights Reserved.

Case Study (Cont.)

Sally finds out that 6 months ago, Jack was

Copyright 2017, Elsevier Inc. All Rights Reserved.

2. After evaluating a patients external variables, the nurse

Health Promotion, Wellness,

2. Routine Exercise, Good Nutrition

3. Physical Awareness, Stress Management,

Levels of Preventive Care

True prevention that lowers the chances that a

Occurs when a defect or disability is permanent

Copyright 2017, Elsevier Inc. All Rights Reserved.

A. get a flu shot every year.

Copyright 2017, Elsevier Inc. All Rights Reserved.

3. You will use the concept of primary prevention when

Risk factors include:

Genetic and physiological factors

Copyright 2017, Elsevier Inc. All Rights Reserved.

Risk Factor Modification and

Case Study (Cont.)

To do this, she first asks Jack how he feels about

This tells Sally that Jack is at the contemplation

Copyright 2017, Elsevier Inc. All Rights Reserved.

4. Sally has decided to set aside 30 minutes a day to walk

Patient will reduce health risks related to poor

Provide active listening, ask about perceived

Have the patient track adherence, and provide

Risk Factor Modification

Short duration and severe

Persists longer than 6 months

Copyright 2017, Elsevier Inc. All Rights Reserved.

Variables influencing illness and illness behavior

Internal variables: Perception of illness and nature

External variables: Visibility of symptoms, social