Health
Models of Health (classifications of health definitions)
• Clinical Model: health = absence of S/S of disease/disability;
medically orientated
• Role Performance Model: health viewed in terms of
performance of social roles; health = effective performance of
roles
• Adaptive Model: Health = maintaining flexible adaptation to
environment and interacting with it to maximum advantage
• Eudaimonistic model: Health seen as exuberant well-being;
healthy person is self-actualized and fulfilled.
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Definitions of Health
WHO
• Complete physical, mental, social well-being; not merely absence of
disease/infirmity
Pender
• The actualization of inherent and acquired human potential through
goal-directed behavior, competent self-care, and satisfying
relationships with others, while adjustments are made as needed to
maintain structural integrity and harmony with relevant environments
Bevis
• The ability to set goals and to mobilize the energy and resources
needed to meet these goals while feeling good and caring about self
and others and helping others feel good about themselves
U of W
• A dynamic process whereby client is able to realize aspirations, satisfy
needs, and change/cope with environment
• A resource for everyday life
• A positive concept emphasizing social and personal resources as well
as physical capacity
• The goal of all nursing behaviors
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Alterations in Health
Acute/Episodic Illness
• Rapid onset, short duration
• Self-limiting or responds to Rx
Long term/Chronic Illness
• Permanent
• Irreversible pathologic conditions
• Residual disability
Disease versus Illness
•
Disease: objective state of ill health; manifested by
pathology detectable by medicine
•
Illness: subjective experience of loss of health
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Impact of Long term Illness of the Individual and Family
Physiologic/Somatic
Psychologic
Sexual
Social
Occupational
Financial
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Alterations in Health: Role of the Nurse
(Bevis)
Nursing
•
A process
•
Purpose - promote optimal health; facilitate maturation and
adaptation in clients (individuals [intrapersonal], groups
[interpersonal] & community)
Input
• Needs, goals, problems, desires of clients
• Includes assessment data
Throughput
• Act/practice of nursing
• Theories, concepts, processes used
• Tools used:
• Problem-solving/decision-making (critical thinking)
•
Caring
•
Teaching Learning (educator)
•
Communication
•
Management/change (change agent)
Output
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•
The behaviors, services, functions, skills of nursing
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Life Task Concepts (Bevis)
Stress - forces that press in upon or noxiously stimulate the
individual. e.g. health problems, medical diagnoses, social
problems
Strain - expresses itself in symptoms, signs or behaviors
that signal response to stress. E.g., S/S of an illness; physical
assessment findings, behaviors (crying)
Maturation - process of human development
Adaptation/Maladaptation - coping patterns or ways of
behaving that can head to an interruption or maintenance of
health
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Review of Nursing Process
Assessment
•
Data collection. Sources:
- client
- family/significant others
- records
- collaboration - other health care professionals.
• Formulate nursing judgements
- data clustering: organize into meaningful clusters (e.g., physiological
systems, Gordon’s functional health patterns)
Analysis
Analyze & interpret data, draw conclusions re health risks/problems; requires
critical thinking
• Nursing Diagnosis
•
a clinical judgement about a response to actual/potential health
problems/life processes
•
Nurse is accountable/responsible
• Collaborative problems - potential health problems for which the nurse
monitors; requires collaboration with physicians.
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Planning
• Set priorities
• Establish outcomes (collaborate with client)
•
client-centered
•
realistic
•
specific and measurable
• Select nursing interventions - individualized for the client
Implementation
• Carry out the plan of care
Evaluation
• Determine the degree to which expected outcomes were met
• Essentially a re-assessment of the client in relation to the goals
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