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34 Cards in this Set
- Front
- Back
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World Health Organization (WHO)'s definition of Health
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“State of complete physical, mental & social well-being, not merely the absence of disease or infirmity.” World Health Organization
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Describe the difference in the roles of a Health performance.
Clinical Model vs. Specific Role Function |
Clinical Model = Absence of illness or injury
Role Performance Model = Health is the ability to fulfill societal roles Ex: Student = Ability to come to school, perform work, turn in assignments, etc. |
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Describe the Host-Agent-Environment Wellness Model.
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Host-Agent-Environment / Ecologic Model
Relates to the cause of the disease Host = Person at risk for illness Agent = Factor that causes disease Environment = Factors create likelihood of disease (physical, social, economic, emotional, spiritual) Important for prediction of health. How present is agent? How much pressure from Environment? |
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Health Belief Model. Explain.
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Health Belief Model
Personal expectations Earlier experiences Sociocultural context Age and developmental state Rosenstock Health Belief Model Individual perception includes : Perceived susceptibility + Perceived seriousness = Perceived threat Other (modifying) factors that impact the perceived threat Cues to action (Example: advertisement against tobacco, people asking you to change) Demographics (Example: Old people more likely to smoke) Sociopsychological Structural (Example: Did someone in your family have lung cancer?) Perceived Benefits & Perceived Barriers overall influence of Likelihood to Action |
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Dunn's High Level Wellness Model
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Purpose: Attempt to achieve fullest potential
Influenced by: Individuals, families and communities Never ending. Dynamic. Always changing. -High level wellness = in favorable environment -Emergent high level wellness = in an unfavorable environment (Example: have the knowledge, but can't implement because of job demands) -Protected poor health in a favorable environment (Example: Chronic disease, diabetic and have medical treatments for it) -Poor health in an unfavorable environment (Example: Diabetic who are homeless) |
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Pender's Health Promotion Model
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Health Promotion Model, Pender:
Individual Characteristics & Experiences Behavior Specific Cognition and Affect Benefits Barriers Self-efficacy (perceive can control health) Activity related affect (value health) Interpersonal influences Situational influences Behavioral Outcomes Commitment Health Promoting Activities |
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Mazlow's Hierarchy of Needs
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1. Physiological
2. Safety & Security 3. Love and Belonging 4. Self-Esteem 5. Self-Actualization |
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Adaptive Model of Health Definition
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Health is flexible adaptation to the environment and Interaction with the environment to maximum advantage.
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Hollistic Health Model
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Views the entire person as greater than the sum of its parts.
Interaction of parts within environment |
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Stimuli that influence Health beliefs and practices
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Developmental Stage & age
Knowledge Perception of function (ex Pain level) Emotional factors Spiritual |
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Describe three levels of preventative care.
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Primary—Precedes disease Decrease possibility of illness (Health Promotion, protection and screening, Example: Seat belts)
Secondary--Focuses on individuals with health problems who are at risk. (Emergency Room Care, Acute & Critical Care, Diagnosis and Treatment) Tertiary—Rehabilitation of chronic disease or disability & preventing complications (Rehabilitation, Long Term Care, Support Services for Elderly, Respite Care) |
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Health
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The individual
s total well-being; refers to the regular patterns of people and their environments that result in maintaining wholeness and human integrity |
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Culture
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Beliefs and practices that are shared by people and passed down from generation to generation.
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Erikson?
Sullivan? |
Erikson = Stages of Psychosocial Development
Sullivan = Interpersonal Model of Personality Development |
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Humanism
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Philosophy and psychology that recognizes the person and subjective dimensions of the human experience as central to knowing and valuing.
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Main purpose of Roy
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Striving for Unity and Meaninfulness
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Veritivity
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Principle of human nature that affirms a common purposefulness of human existence, activity and reactivity for the common good and value and meaning of life.
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Adaptive/Adaptation
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Human system has the capacity to adjust effectively to changes in the environment and affects the environment. Promote survival, growth, reproduction & mastery.
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System/Systems Theory
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Set of parts connected to function as a whole for some purpose and through the interdependence of the parts. Input--Through put--Output--Feedback
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System/Systems Theory
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Set of parts connected to function as a whole for some purpose and through the interdependence of the parts.
Input--Through put--Output--Feedback |
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System/Systems Theory
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Set of parts connected to function as a whole for some purpose and through the interdependence of the parts.
Input--Through put--Output--Feedback |
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Adaptive Level
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Changing Point (Response)
- influenced by the demands of the situation and the person’s internal resources, including capabilities hopes, dreams, aspirations, motivations. Represents the persons ability to respond. (Example: One day someone can say something rude and you may laugh. The nest day, they may say the same rude thing and you get upset) 3 TYPES of Responses: Integrative/Adaptive = It's working, Don’t need much. This is if that person is adapting. Structures and functions meet human needs Compensatory/Adaptive to be Supported = This is the assistance. They are getting to the point where they are fine but they need help. Continue to meet needs. Cognator and regulator activated by a challenge Compromised/Ineffective = Integrated and compensatory processes are inadequate → adaptation problem, Needs HELP |
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Environment (Stimuli)
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3 types of Stimuli make up environment
Focal = obvious, What caused this? Internal or external stimulus most immediately confronting the person Contextual = Other, All other stimuli present that contribute to the focal stimuli. - Influence how the person can deal with the focal stimulus. Residual = May have an impact, no clear data Factors whose effect in the current situation is unclear. No clear data. Based on theory or experience of the nurse. |
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Coping Processes
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2 Processes:
Innate = Genetically determined Acquired = Learned Subsets: - Regulator = Automatic responses through neural, chemical and endocrine coping processes - Cognator = Perceptual/information (Selective attention = deciding what I’ll recognize Coding = deciding how to remember something Memory = influences future action) Learning = (Imitation = copying Reinforcement = cause and effect, practice Insight = the ah hah experience) Judgment = (Problem Solving, Decision Making) Emotion = (Defenses are used to seek relief from anxiety) |
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Group Control Processes
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Stabilizer Subsystem = System maintenance
- Structure (TUSNA, Officers) - Values (Professionalism, Self Supported) - Activities (Runs) Innovator Subsystem = Change and growth - Structures - Processes |
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Modes of Roy Model
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Adaptive Modes--Behaviors =
Physiologic-Physical (Senses, Fluid, electrolyte, and Acid-Base Balance, Neurologic Function, Endocrine Function) Self-concept-Group Identity = Both Physical and Personal Self Image (Composite of beliefs and feelings that a person holds about him or herself at a given time. & Formed from internal perceptions and perceptions of other’s reactions. & Directs one’s behavior.) Role function [Role is a set of expectations about another Need for social integrity Role classification: Primary, Secondary, Tertiary Behaviors are Instrumental (Tasks) or Expressive (Emotional) ] Interdependence [Interactions related to the giving and receiving of love, respect, and value. Need is for relational integrity (support systems, significant other) Behaviors are Receptive or Contributive (Get or Give)] |
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Level 1 Assessment
& Level 2 Assessment |
Nurse uses skills observation, measurement, and interviewing.
Gather info in each mode Behaviors: Internal, External, Verbal, Nonverbal Objective vs. Subjective Assess = compare to criteria (Strengths, strains, and coping stress) and make judgement Adaptation = Comparison to norms, Regulator (Activity) & Cognator (Mind, Perception, Emotion) A, ATS, I Stimuli = Provokes Response, Internal, external and environmental (Focal, Contextual, Residual) NSG Diagnosis = Statement of behaviors within one mode with their most relevant stimuli or Ineffective behavior related to focal stimulus Goals = Goals of nursing to maintain and enhance adaptive behavior and to change ineffective behavior to adaptive Behavioral outcomes (Identifies patient behavior, Change expected, Time frame, Realistic & Measurable) Interventions = Nurse manipulates focal and contextual stimuli--altering, increasing, decreasing, removing, or maintaining. Supporting or enhancing coping processes Validate residual stimuli Evaluation = Judging the effectiveness of the intervention in relation to the person’s behavior. Use observation, measurement and interview methods. WAS CLIENT GOAL MET??? |
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Nursing Diagnosis Classification
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North American Nursing Association (NANDA) Diagnostic Classification System
= used to identify NSG diagnoses, copyrighted, Roy was involved Others: Nursing Interventions Classification (NIC) Nursing Outcomes Classification (NOC) |
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Nutrition
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Part of Physiologic Mode =
Need is for Physiological Integrity - Oxygenation - Nutrition - Elimination - Activity & Rest - Protection 4 Complex Processes related to Physiological Adaptation - Senses - Fluids and electrolytes - Neurological function - Endocrine Function Nutrition Process Digestion = Series of mechanical and chemical processes—food to body cells - Ingestion - Propulsion - Mechanical digestion - Chemical digestion - Absorption Metabolism = Breaking down, Building simpler substances, Uses the nutrients at the cellular level |
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Possible compromised Nutrition due to...
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Obesity
- Greater than 25 BMI Diabetes II - Cardiac Disease - high cholesterol, High blood pressure Anorexia Nervosa (relatively new) Growth and development - infections - organ failure and death |
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Nutrition Assessment
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Behavior =
Eating patterns – food logs Nutrient profile – analysis of eating patterns Sense of taste and smell – can they taste sweet, sour, bitter, and salty/ can they identify odors: coffee, tobacco, vanilla (if its rotted in nasal cavity – might snort coke) Condition of Oral Cavity – Appetite and thirst – 8 glasses is the rule of thumb, thirst can be confused with appetite Height and weight Food allergies – nuts, eggs, shellfish, gluten, milk, food dye, strawberries, mustard seed, peanuts, Pain – not wanting to eat cuz in pain, meds may alter Altered ingestion – take food through other means Lab results – how much hemoglobin, low hemoglobin may be caused by not enough iron, gi bleeds Stimuli = Integrity of structure and function Disease & anomalies, lips, oral cavity, abdomen, rectum Nutrient Requirements Affected by Age, gender, size, activity, climate, activity, (person’s) temperature, pregnancy, endocrine function Illness—protein for healing, calcium and vit d for bone healing. Availability of food Poverty. Cheapest foods—pasta, carbs. Expensive food—proteins (meats not beans) Lack of transportation – (energy, may not be able to carry much, not be able to go very often) Conditions of eating Reward, punishment, alone or with family and friends, Home, fast food, restaurant Time—few minutes, standing Slow with plenty of time Fun or angry time Cues for eating Stress, smell (theater & popcorn) Internal & external Cognator Effectiveness Knowledge and perception of healthy diet or nutrition. Plan for food. Person’s perception and desired weight Person’s desire to gain, lose or maintain weight Culture Thanksgiving meal Medication Include Vitamins, assess when taken Goals = Measurable & Attainable & Observable Weight gain or loss Change in foods eaten to meet nutritional needs Interventions = Select stimuli to change based on highest probability and value to meet goal. Consequence, Probability, & Value - Exercise - Stress Reduction - Accountability Evaluation = Measurable Based on goals (One for each goal) |
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Self-Concept Mode
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- Composite of beliefs and feelings about oneself
- Need is for psychic and spiritual integrity - Self-Fulfilling Prophecy PHYSICAL SELF Body Sensation = How you feel Body Image = How you see your body PERSONAL SELF Self-consistency = Self belief + action on belief Self-Ideal = what we want to be when we grow up Moral-Ethical-Spiritual = What we think is right or good or best ASSESSMENT OF Self-Concept STIMULI Physical Development = How are they feeling? Cognitive and Moral Development = what do they think about that? What is right or wrong? Maturation Crisis = what are the challenges and crisis at this particular age Interactions and Transactions between Person and Environment = How do they interact with their primary care-giver? How will they be cared for outside the hospital? Reactions of others? How does others perceptions influence us? Self-Schema = Cognitive generalizations we have about ourselves? Picking up on what others are saying that is similar to own thoughts, thus reinforcing original belief. Value of Self, Self Esteem = Over compensation?? Normal?? Perceptual Self-Awareness = Accuracy of self knowledge. Has to do with caring for own … Coping strategies and Capacities = What do you do when you are stressed?? Coping? What was your previous response to the situation? Striving for Unity or Integrity = Self organization Consciousness of Person and Environmental Meanings = culture and societal norms, meaning of words or how you interpret words Compensatory Adaptive Process (ATS) Grieving – Anniversary Grieving Cognitive Dissonance – we strive to be self consistent, so when we are not we are becoming aware of that Compromised Adaptive Process (I) Ineffective Sexual Function Anxiety NSG Diagnosis Common problems relate to physical self - Body image disturbance - Sexual Dysfunction - Rape trauma Syndrome - Loss Common problems related to Personal Self - Anxiety - Powerlessness - Guilt - Low Self-Esteem |
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Role Function Mode
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Need for Social Integrity
Primary Role = Determines majority of behaviors - Determined by age, sex, & developmental stage Secondary Role = Assumed because they relate to developmental stage and primary role. - Achieved positions - Stable but may change over time. Tertiary Role = Related to secondary roles - Represent ways to meet role-associated requirements - Temporary - Freely chosen BEHAVIORS Instrumental = tasks - Goal oriented - Performed as part of role - Goal of Role Mastery - Usually physical action - Long-term orientation Expressive = Feelings and Attitudes about role & performance - Goal is direct or immediate feedback - Emotional - Result from interactions Role Taking = Acting as another would in the circumstance ASSESSMENT of BEHAVIOR Identify age and primary role. Identify secondary and tertiary roles & their relative importance. Determine instrumental and expressive behaviors for each role along with the “Requirements of the Role Behavior”. - Consumer = Who - Reward = What - Access to facilities/Set of circumstances - Cooperation/collaboration STIMULI influence Physical attributes and age Self-concept and emotional well-being Knowledge of Expected Behaviors Other Role Role Models Social Norms Social Setting COMPENSATORY (ATS) Role Transition = Graduating School as an example Role Distance = not owning that role Stereotyping COMPROMISED (I) Role Conflict = more than one role Role Failure = Not being successful in performing a role Diagnosis Inter-Role Conflict: Career and parenting due to first newborn Diversional Activity Deficit: |
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Interdependence Mode
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- Close relationship with others
- Need for Affection & relationships Affectional Adequacy = “feeling of security in nurturing relationships” Significant Other = Most important person in our lives. - Gives and receives respect, love, value Support Systems = Persons that also provide love, respect, and value and the same is given in return. - Less important than significant others BEHAVIORS - Receiving or Receptive behaviors: “Person’s receiving, taking in, or assimilating nurturing behaviors” - Giving or Contributive Behavior: “giving or supplying nurturing” Some ASSESSMENT STIMULI Expectations of the relationship and awareness of needs Nurturing ability of both persons Level of Self-Esteem Communication Skills Presence of the other in the physical environment (Access to each other) Developmental Stage Significant Changes COMPROMISED INTERDEPENDENCE Separation Anxiety Loneliness Substance Abuse Aggression--Individual NSG DIAGNOSIS Ineffective relationships Family coping, (compromised, disabling, or altered) |
