Wk 1- PNUR104 On-Line Learning Guide - Concept of Health, Health Documents ,100% CORRECT

Wk 1- PNUR104 On-Line Learning Guide - Concept of Health, Health Documents Please read text Potter & Perry 6th edition; Kozier et al., 4th edition and complete the following questions as you complete your readings prior to coming to class. This will allow you to be an active participant in class activities and discussions. Metaparadigm: a set of theories or ideas that provide structure for how a discipline should function. 4 sets of theories consist of 4 basic concepts that address the patient as whole. Nursing Metaparadigm Identify and describe the 4 components (parts) of the Nursing Metaparadigm using key words from readings. 1. Client and person: - focuses on the receiver of the care - Theorists understood a person as a system of interacting parts, a system of competing human needs, and refers to individual’s as entities with biological, physical, social, and spiritual dimensions - Recipients of nursing actions may be well or ill and include individuals, families, and communities - Nurse needs to consider how the patient defines family when planning care (can affect the type of support a client is receiving) 2. Environment: - The person is part of and interacts with a complex environmental system - Environment could involve the person’s family or social ties, the community, the health care system, as well as geopolitical issues that affect health - Environment also includes societal beliefs, values, mores, customs, and expectations - The environment is an energy field in mutual process with the human energy field and is conceptualized as the arena in which the nursing client encounters aesthetic beauty, caring relationships, threats to wellness and the lived experiences of health. - Dimensions that may affect health include physical, psychosocial, cultural, historical and developmental processes, as well as the political and economic aspects of the social world. - Environment can also include internal, external, and social factors that impact a patient’s health including genetics, immune function, culture, mental state, education level, social status and etc. 3. Healthcare: - Health is defined as an ideal state of optimal health or total well-beings toward which all individuals could strive. - Health, a dynamic process, is the mixture of wellness and illness and is defined by the perception of the client across the life span. - This view focuses on the entire nature of the client in physical, social, aesthetic, and moral realms - Health is contextual and relational - Includes the ability to access healthcare and resources to support health and wellness 4. Nursing care: - Nursing is an academic discipline and a practice profession - It is the art and science of holistic health care guided by the values of human freedom, choice, and responsibility - Nursing science is a body of knowledge arrived at through theory development, research, and logical analysis. - The art of nursing practice, actualized through therapeutic nursing interventions, is the creative use of this knowledge in human care. - Nurses use critical thinking and clinical judgment to provide evidence-based care to individuals, families, aggregates, and communities to achieve an optimal level of client wellness in diverse nursing settings/contexts - Clinical judgment skills are therefore essential for professional nursing practice. - Human caring as the moral ideal of nursing is the central focus of professional practice. - It involves concern and empathy, and a commitment to the client’s lived experience of human health and the relationships among wellness, illness, and disease. - The nurse, as a person, is engaged as an active partner in the human care transactions with clients across the life span. - Nurses function autonomously and use power to shape the profession and empower clients through caring partnerships and other transactions. - Within this framework, power is defined as the capacity to participate knowingly in the nature of change and is characterized by awareness, advocacy, choice, freedom to act intentionally, healing and involvement in creating changes. What is the definition of Health according to the World Health Organization (WHO)? a) Explain in your own words what it means that “health is a state of complete physical, mental and social well-being” (WHO, 1948). - Health is a resource to support an individual’s function in wider society, rather than an end in itself - A healthful lifestyle provides the means to lead a full life with meaning purpose - The tendency of seeing health as a state dependent on the absence of illnesses/diseases - An individual could be declared as healthy if no diseases are found - Health is a state of balance, an equilibrium that an individual has established within himself and his social and physical environment - Health is a state that allows the individual to adequately cope with all demands of daily life b) Give an example of mental and social well-being. - Mental Wellbeing is how we respond to life’s ups and downs: Self-acceptance, sense of self as something greater, Accurate perception of reality, desire for continued growth, optimism, having and pursuing interests (MENTAL WELL-BEING IS NOT THE ABSENCE OF MENTAL ILLNESSES NOR LACK OF CHALLENEGS/PROBLEMS/ADVERSITY) - Examples include: the woman who once experienced a period of homelessness and now gives back by volunteering in the organizations that helped her in the past OR the human being with anxiety and depression who gets out of bed every single day, creates a goal for the day, and takes small steps toward it and acknowledging the bravery and progress at the end of the day - Social Well-being is defined as the ability to effectively interact with people around us and to create a support system that includes family and friends: joining clubs and organizations, reflecting on one’s self and social needs, making an effort to keep in touch with supportive friends and family, practicing self-disclosure, participating in group discussions and active listening - Examples include: An introvert individual who encompasses a low level of self- confidence decides to join the soccer team to improve his confidence and build communication, leadership, and teamwork skills. c) Give an example of spiritual well-being. - Spiritual well-being is an indication of a person’s experience of personal integration, meaning, purpose and peace. It encompasses a person’s life-giving relationship with others, their own culture, the arts, the environment, god, and the significant of the sacred: practicing mediation, praying or taking part in organized religion, spending quiet time alone pondering the meaning of life, serving the community, spending time in nature - Examples: include: Volunteering, social contributions, belonging to a group, a fellowship optimism, forgiveness and expressions of compassion d) What does it mean that health includes socio-cultural influences? (ON TEST, REFER TO THE INDIGINEOUS COMMUNITY’S VALUES) - Socio-cultural environments shape our psychology regarding health & illness - Also, an individual’s way of living conditions and work condition may affect one’s overall health such as poor living conditions, poverty, not having access to food and water resources, - Cultural differences in delay in healthcare seeking are attributed to a diverse set of factors, ranging from knowledge and beliefs regarding causes of the disease, associated symptoms, curability, and consequences to trust in physicians - For example, a cultural group’s expectations and acceptance of pain as a ‘normal part’ of life will determine whether it is seen as a clinical problem which requires a clinical solution (ex. In Poland, labor pains are both expected and accepted by women giving birth, while in north America they are not accepted and anesthesia is frequently demanded) - Those from different socio-cultural backgrounds tend to differ in the extent to which they delay seeking medical help What is your own **personal** definition of health? Health is not only related to having a disease/illness but is also related to various holistic concepts an individual can achieve (Mental, Physical, Emotional, Spiritual, Social) Define the following terms and discuss what each term could mean for a client? (Application Exercise) 1. Health: Being healthy could be defined variously depending on the patient’s socio- cultural background and beliefs. Ex. pain 2. Wellness: A general state of well being 3. Well-being: refers to the quality of life based on the client’s overall well-being. 4. Illness: 5. Disease Describe the concept of health according to the following Nurse Theorists: Nightingale  Practise observations, epidemiology  she described conditions necessary to promote health and healing  her observations during the Crimean war led to the first principles for nursing practice  acknowledging the particular importance of the environment, including clean living areas, fresh air, fresh air, and the presence of light  demonstrated how to think about the patients and their environment  shifted the focus of nursing practice from medicinal to practical and proper care of patients as well as understanding their behaviours Roy  Helson’s adaptation theory  Facilitating manas an adaptive system  considered the client as not as a behavioural system but rather as an adaptive one  viewed a person as a biopsychosocial being in constant interaction with a changing environment  her model depicted four modes of adaptation: psychosocial needs, self-concept, role function, and interdependence  conceptualized the person as an adaptive system with two major internal processes by which to adapt: the congenator and the regulator subsystems  explains the interconnectedness of all aspects of human adaptation Leininger  Transcultural care theory  the theory attempts to provide culturally congruent nursing care through “cognitively based assistive, supportive, facilitative, or enabling acts or decisions that are mostly tailor-made to fit with individual, group’s, or institutions cultural values, beliefs, and lifeways.”  main focus is to provide beneficial health outcomes for people of different or similar cultural backgrounds  flows knowledge into about families, groups, communities and institutions in diverse health care systems  created the Sunrise model  in a logical order to demonstrate the interrelationships of the concepts in her theory of culture care diversity and universality Watson  phenomenal field/ unitary consciousness  Nursing as caring; clinical caritas processes  considered the individual to be a totality who can be viewed as a transpersonal self. □ states it is more vital to understand individual’s as “ an embodied spirit; a body spirit; person- nature-universe as oneness, connected”  states the primary function of a nurse is caring  embodies an aesthetic that facilitates both healing and growth **Application - Case Study Discussion Give an example of a Cultural influence on health . Brief Historical Overview of Canadian Documents Info provided below is to give a brief overview of changes that contributed to in the definition of Health, along with a change in focus **Students do not need to know dates, only need to know focus of the reports. Describe the focus of the following approaches to health care: (Bio) Medical (Curative) Approach to Health (prior to 1970’s) – - Believes that medical intervention Behavioral Approach to Health or Model (1970’s) - Socio-Environmental Approach to Health (1980’s) - Canadian Documents Overview – What does each approach/document 1974 - Lalonde Report -> Behavior (Lifestyle) PAGE 23 ON POTTER TEXTBOOK (Memory Trick: Think of L for Lalonde and L for Lifestyle) 1986 - Ottawa Charter -> Socio-Environmental Aspects to Health - Importance of _Socio-cultural_ approach. - Stressed that individuals & government and non-government agencies need to work together in _partnership_ for health. - Responsibility for health - includes both ? & ? now we had government involvement in health 1986 - Epp Report  Challenges to Health & Inequities "Achieving Health for All: A Framework for Health Promotion” Canada hosted the first international conference on: Health Promotion - emphasized importance of Public participation /role of the community - focused on implementing ? programs 1994 - Strategies for Population Health -> Determinants of Health - discussed Wk 1 Day 2 - Health Determinants x15 - health determinant are factors that can affect or change a person’s health. - Social & economic - Individual coping skills - Health services - Physical environment - Personal health practices Population Health Model: What does this mean? - Emphasizes the overall health of the public - Uses a three-prong approach to prevention and innervation - 1. A susceptible host (a person), 2. An infectious agent (ex. Drugs), 3. A supportive environment (an environment that makes the spread of infection possible such as unsanitary or unsafe living conditions) - Harm Reduction is an example of a public health strategy - Focuses on reducing harm not eliminating (ex. Addiction) - Goal is an overall improvement in public health - In the public health model, recovery consists of intervening at any level (host, agent, environment) in varying degrees, as needed Public Health Agency: What is the main goal for Canada? - Public health agency of Canada is the main government of Canada agency responsible for public health in Canada - The agency’s primary goal is to strengthen Canada’s capacity to protect and improve health of Canadians and to help reduce pressures on the health-care system - To do this, the agency is working to build an effective public health system that enables Canadians to achieve better health and well-being in their daily lives by promoting good health, helping and control chronic diseases and injury, and protecting Canadians from infectious diseases and other threats to their health - The agency is also committed to reducing health disparities between the most advantaged and disadvantaged Canadians. Jakarta Declaration: What is the main underpinning? - is the name of an international agreement that was signed at the world health organization in 1997 - the declaration reiterated the importance of the agreements made in the Ottawa charter for health promotion and added emphasis to certain aspects of health promotion - the Jakarta declaration included the following five “priorities for health promotion in the 21st century” 1. Promote social responsibility for health 2. Increase investments for health development 3. Consolidate and expand partnerships for health 4. Increase community capacity and empower the individual 5. Secure an infrastructure for health promotion - The declaration recognizes that: 1. Participation is necessary for change 2. health literacy is essential for participation - emphasizes the need for access to education and information and hence, the empowerment of individuals and communities. 3. Combinations of five strategies for health promotion -- "build healthy public policy", "create supportive environments", "strengthen community action", "develop personal skills", and "reorient health services"—are more effective than "single-track approaches". Toronto Charter: What is the main underpinning? - The Toronto Charter is a call to action directed at people who. influence and make decisions about the provision of HIV/AIDS. services for Indigenous Peoples around the world. The Toronto Charter was developed and formulated by Indigenous Peoples throughout the world. - Key principles of the charter include: - Acknowledge that Indigenous Peoples have shared experiences relating to the AIDS epidemic and its impacts on our communities. - Health and social programmes for Indigenous Peoples must provide culturally appropriate service delivery. Programmes need to incorporate and integrate traditional healers and systems where appropriate. - Affirm that the AIDS epidemic continues to have a devastating effect on our communities. - Indigenous Peoples must be able to have access to their own languages in the provision of health and social services. - Acknowledge that Indigenous Peoples have inherent rights which guarantee them good health and well-being. - Health and social programmes must be disseminated and communicate information about the prevention and treatment of HIV/AIDS that is relative to the reality in which Indigenous Peoples live. - Acknowledge that the changing patterns of the HIV/AIDS epidemic are placing Indigenous Peoples at increased risk of HIV infection. - RECOMMENDATIONS - Recognise that Indigenous Peoples have the right to determine their own health priorities. - Ensure the central participation of Indigenous Peoples in all programmes related to the prevention of HIV and programmes for the care and support of Indigenous Peoples living with HIV/ AIDS. - Reaffirm that Indigenous Peoples have the right to control all aspects of their lives, including their health. - Provide adequate resources to Indigenous Peoples to design, develop and implement HIV/AIDS programmes. - HIV/AIDS AND INDIGENOUS PEOPLES - Three decades into the HIV/AIDS epidemic Indigenous Peoples are adversely affected by this epidemic. - Increase current resources so that Indigenous communities can respond in a timely and effective way to the demands placed on communities by the AIDS epidemic. - The epidemic is having a profound effect on families and communities from which we come. - Ensure the process of participation of Indigenous Peoples in United Nations forums is strengthened so their views are fairly represented. - In some countries, Indigenous Peoples have disproportionately higher rates of HIV infection than non-Indigenous people. - Incorporate this Charter in its entirety in all policy pertaining to Indigenous Peoples and HIV/AIDS. - The impact of HIV/AIDS on Indigenous Peoples is compounded by a range of socio- cultural factors that place Indigenous Peoples at increased risk of HIV/AIDS. - Monitor and take action against any States whose persistent policies and activities fail to acknowledge and support the integration of this Charter into State policies relating to HIV/ AIDS. - It is essential that HIV/AIDS data on Indigenous Peoples be collected, analysed and reported in a manner that is respectful of the needs of Indigenous Peoples as identified by Indigenous Peoples themselves. Indigenous Health Care Model Aboriginal Views - see the interconnectedness with all creation i.e. family, community, nation, plants, animals and the spirit people - also the interconnectedness between the physical and spiritual worlds and among the mind, body and spirit - health and & wellness described by use of the Medicine Wheel Medicine Wheel - Emphasizes balance and harmony between the 4 components to achieve health. Physical, Mental/Intellectual, Emotional, Spiritual. Components are viewed as sacred and connected to person, nature and the season Circle 4 components represents interconnectedness Describe the meanings and significance of the following healing practices used by the indigenous people: Circles - - the Ojibwe believes that everything in the universe is contained within a circle and everything has its place within that circle - the circle is used to express the holistic nature of everything around them - the circle is used to represent ideas such as the circle of life- strength, unity, and balance. The circle has no beginning and no ending- its timeless - the circle is used to describe different aspects of the physical world as well as the spiritual world - in relation to the spirit world, the circle is used to describe how people are composed of a physical body, a spirit and a soul - The circle shape represents the interconnectivity of all aspects of one’s being, including the connection with the natural world. - Medicine wheels are frequently believed to be the circle of awareness of the individual self; the circle of knowledge that provides the power we each have over our own lives. Seven Grandfathers Teachings – The Seven Sacred Teachings, also known as the Teachings of the Seven Grandfathers, is a set of teachings on human conduct towards others. They are what was traditionally and still is to this day needed in order for communities to survive. 1. The first Sacred Teaching, wisdom, is the practice of balance in all things; the exercise of inner vision; and the ability to see how all things fit together. Wisdom is also being able to understand and look at situations with an open-minded lens and understand that there are many ways of knowing and doing, which allows us to reach goals differently but effectively 2. Love, the second Sacred Teaching, means treating people with special care and kindness. Love also is a teaching for Aboriginal communities, as all of us have a responsibility to include, embrace, and care for all children and families, whether we are biologically related to them or not 3. The Sacred Teaching of respect is the third teaching our elder described. This teaching means showing honour to someone or something; considering the well-being of everything; and treating everything with deference or courtesy. Respect means to honour all parts of creation 4. This Sacred Teaching states that courage is personal bravery in the face of fear. It is doing what needs to be done even when it is difficult or frightening. Courage is needed to try new things and face new situations, and to pick up oneself after a mistake and try again. Sometimes courage means recognizing a danger and standing firm. There is also courage at the community level, when we take responsibility for our community members, such as Aboriginal when child welfare agencies take on a child protection mandate 5. The fifth Sacred Teaching, honesty, is about being sincere, open, and trustworthy 6. Humility, the sixth Sacred Teaching, asks us to place the needs of others first, and to avoid criticizing others. It directs us to serve and help others. To be humble is to admit and learn from mistakes. Humility is a process of learning and improving the self 7. The seventh Sacred Teaching, truth, is about coming to know, and trying to understand, the previous six teachings. Truth focuses on how we practice—or put into action—wisdom, love, respect, bravery, honesty, and humility. Truth also encompasses the overarching picture as we try to understand both the past and the present. Smudging – - Smudging is a tradition, common to many First Nations and Métis, which involves the. burning of one or more medicines gathered from the earth. The four sacred medicines. used in First Nations' ceremonies are tobacco, sage, cedar and sweetgrass. - Smudging is often used when someone is born, or someone dies, or during a crisis. It might also be part of a patient’s everyday spiritual practices. - During a smudging ceremony, people generally burn traditional, medicinal plants and waft the smoke over parts of the body as a spiritually cleansing ritual. - Patients can smudge in three different types of spaces at the hospital: outside the hospital building, in a designated indoor smudging area, or if the patient can’t be moved to a designated indoor smudging area, a smudge can be arranged for inpatient rooms. - The standard operating procedure for smudging includes safety requirements so that smoke and scent from the smudge doesn’t travel through the hospital and affect other patients, families, or staff members. Provide a brief history and timeline of the following key factors that relate to Indigenous Health: ( PAGES 137-149) The Indian act: - Ever since the Indian Act (1985) gives the federal government the authority to make regulations related to medical treatment and public health of Indigenous health, but Lavoie's points out that it “does not outline an obligation to provide services, and does not provide sufficient authority for a comprehensive public health - since the Indian Act was assented to in 1876, the health of Indigenous People in Canada has been tragically impacted. - They were dispossessed of their lands, traditional economies, and the traditional foods that had sustained them since time immemorial, which compromised their immune systems. - Their self-sufficiency was destroyed and replaced by dependency on government agencies. - Their culture and traditions were ruled illegal. - They were moved into poorly constructed housing that was often not appropriate for the environment and did not accommodate the tradition of extended family groups. - Their children (150,000) were taken and placed in buildings with insufficient heat that proved to be breeding grounds for tuberculosis; the children were malnourished, cold, ill, lonely, homesick, and frequently subjected to medical experimentation. - The gender bias of the Indian Act devalued women (and continues to do so today) and denied them their legal rights and access to services for themselves and their children. ” Canada is one of the only nations in the world that continues to use legislation to limit access to services and benefits for Aboriginal peoples on the basis of a descent criterion.” Initiation and end of Residential school: - Residential schools were established by Christian churches and the federal government to assimilate Indigenous children into Euro-Canadian society. - The government of did not want to give first nations what they were supposed to get through treaties. By sending children to residential schools they could assimilate them to our culture and make them no longer considered Indians under the law. Their other goals were to get rid of the first nations languages, religions, and lifestyle. - The effects of colonization are apparent in all aspects of Indigenous peoples’ health and well-being, affecting not only their physical health, but the mental, emotional, and spiritual wellness. - In large part, these health disparities have been a result of government policies to assimilate Indigenous peoples into the Euro-Canadian ways of life, leading to physical and emotional harms to children, lower educational attainment, loss of culture and language, and the disconnect of family structures. - Many of the illnesses and conditions that are disproportionately experienced by Indigenous peoples, including obesity, diabetes, and cardiovascular disease, have therefore been attributed to the lasting effects of colonialism, including the Indian Act, the reserve system, and residential schooling - A significant factor to consider is how the attachment relationship between children, their parents, their natural community and cultural supports were violated. The experience of being taken away from their care givers would have been traumatic and had a significant impact on the children’s development. Attachment to a responsive, nurturing, consistent caregiver is essential for healthy growth and development. Prime Minister of Canada apology: (JUNE 11, 2008) - On June 11, 2008 prime minster harper offers full apology on behalf of Canadians for the Indian residential schools - The government now recognizes that the consequences of the Indian Residential Schools policy were profoundly negative and that this policy has had a lasting and damaging impact on Aboriginal culture, heritage and language - The government recognizes that the absence of an apology has been an impediment to healing and reconciliation. Date and meaning of The Truth and Reconciliation: (IMPLEMENTED IN 2007): - The Truth and Reconciliation Commission (TRC) provided those directly or indirectly affected by the legacy of the Schools system with an opportunity to share their stories and experiences. - The goals of the Commission were to: (a) Acknowledge Residential School experiences, impacts and consequences; (b) Provide a holistic, culturally appropriate and safe setting for former students, their families and communities as they come forward to the Commission; (c) Witness1, support, promote and facilitate truth and reconciliation events at both the national and community levels; (d) Promote awareness and public education of Canadians about the IRS system and its impacts; (e) Identify sources and create as complete an historical record as possible of the IRS system and legacy. The record shall be preserved and made accessible to the public for future study and use; (f) Produce and submit to the Parties of the Agreement2 a report including recommendations3 to the Government of Canada concerning the IRS system and experience including: the history, purpose, operation and supervision of the IRS system, the effect and consequences of IRS (including systemic harms, intergenerational consequences and the impact on human dignity) and the ongoing legacy of the residential schools; (g) Support commemoration of former Indian Residential School students and their families in accordance with the Commemoration Policy Directive (Schedule “X” of the Agreement). -