NSG 1050 Exam 1 Study Guide

NSG 1050 Exam 1 Study Guide Models of Health and Illness: Health Belief Model, Health Promotion Model, Maslow’s Hierarch, Holistic Health Models (focus of each model, components and stages of each model) Health Belief Model- addresses the relationship between a person’s beliefs and behaviors • Use this model to help plan care that will most effectively help patients maintain or restore health and prevent illness 1. Component 1 involves an individual’s perception of susceptibility to an illness ex. A patient needs to recognize the familial link for coronary heart disease to perceive the personal risk of heart disease 2. Component 2 is an individual’s perception of the seriousness of the illness; it is influenced and modified by demographic and sociographical variables, perceived threats for the illness, and the cues to action ex. A patient may not perceive his heart disease to be serious, which may affect the way he takes care of himself 3. Component 3 is the likelihood that a person will take preventative action; it results from a person’s perception of the benefits of and barriers to taking action; preventive actions include lifestyle changes, increased adherence to medical therapies, or a search for medical advice/treatment (a patient’s perception of susceptibility and seriousness of disease can help determine the likelihood of the patient partaking or not in unhealthy behaviors) Health Promotion Model- designed to be a “complimentary counterpart to models of health protection”; it defines health as a positive, dynamic state, not merely the absence of disease • health promotion is directed at increasing a patient’s level of well-being 1. individual characteristics and experiences 2. behavior specific knowledge and affect 3. behavioral outcomes, in which the patient commits to or changes a behavior • each person is unique and has unique experiences and characteristics Maslow’s Hierarchy of Needs- Holistic Health Models- Variables Influencing Health and Health Beliefs and Practices: All Internal and External Variables • Internal o Developmental stage o Intellectual background o Perception of functioning o Emotional factors o Spiritual factors • External o Family practices o Psychosocial and socioeconomic factors o Cultural background Risk-Factor Modification and Changing Health Behaviors • teach patients to care for themselves in a healthier way 1. precontemplation- not intending to make changes w/in next 6 months 2. contemplation- considering change w/in next 6 months 3. preparation- making small changes in prep for change in next month 4. action- actively engaged in strategies to change (lasts up to 6 months) 5. maintenance stage- sustained change over time (begins 6 months after action has started and continues indefinitely) Illness Acute versus Chronic Acute- is usually reversible, has a short duration and is often severe (symptoms are often abrupt and intense and go away after a relatively short period) ex. Pneumonia Chronic- persists usually longer than 6 months is irreversible, and affects functioning in one or more systems ex. Rheumatoid arthritis Illness Behavior- involves how people monitor their bodies, define and interpret their symptoms, take remedial actions, and use the resources in the health care system Variables Influencing Illness and Illness Behavior • internal – patient perception, nature of illness • external – visibility of symptoms, social group, cultural background, economic variables, accessibility, and social support Roles of the nurse (e.g. educator, advocate, counselor, manager etc) • caregiver- recognize actual and potential health care needs and identify needed community resources; also help build a healthy community • case manager- it is the ability to establish an appropriate plan of care based on assessment of patients and families and to coordinate needed resources and services for a patient’s well-being across a continuum of care • change agent- involves identifying and implementing new and more effective approaches to problems • patient advocates- help patients walk through the system and identify where to go for services, how to reach individuals with the appropriate authority; which services to request, and how to follow through with the information they receive • collaborator- working with other health care providers to achieve common goals • counselor- helps patients identify and clarify health problems and choose appropriate courses of action to solve those problems • educator- help patients and families gain skills and knowledge to care for themselves • epidemiologist- you are involved in case findings, health teaching, and tracking incident rates of an illness Emphasis on Population Wellness Social Determinants of health- are factors that contribute to a person’s current state of health 1. biology and genetics (sex and age) 2. individual behavior (alcohol use, smoking) 3. social environment (income, gender) 4. physical environment (where a person lives) 5. health services (access to health care, insurance) Health Care Settings and Services Preventive and Primary Health Care (settings and focus) • focus- improved health outcomes • setting- school, dr. office, community health centers, nursing centers, occupational health clinics Secondary and Tertiary Care (settings and focus) • focus- diagnosis and treatment of illness • setting- ED, urgent care, critical care centers, inpatient med-surge, hospitals, psychiatric facilities Restorative (settings and focus) • focus- help individuals regain max functional status and enhance quality of life through promotion of independence and self-care • setting- rehab, home care, extended care facilities Continuing Care (settings and focus) • focus- for people who are disabled, were never functionally independent, or are terminally ill; describes a variety of health, personal, and social services provided over time • setting- nursing centers/facilities, assisted living, respite care, adult day care centers, hospice Issues and Changes in Health Care Delivery Magnet Recognition – nursing quality indicators • to recognize health care organizations that achieve excellence in nursing practice • must demonstrate quality patient care, nursing excellence and innovation in professional practice • five components: 1. transformational leadership 2. structural empowerment 3. exemplary professional practice 4. new knowledge, innovations, and improvements 5. empirical quality outcomes Medicare, Medicaid, Medicare and prescription drug coverage • Medicare- insurance for people over 65 • Medicaid- insurance for low-income people • prescription drug coverage- voluntary part of Medicare Ethics Ethical dilemma – causes distress and controversy for both patients and professional caregivers 1. Ask if it is an ethical dilemma 2. Gather info relevant to case 3. Clarify values 4. Verbalize the problem 5. Identify possible courses of action