A State of complete physical, mental and social well-being, not merely the absence of disease or infirmity
the extent to which an individual or group, on the one hand, to realize aspirations and to satisfy needs; and on the other hand to change or cope with the environment. health is seen as a resource for everyday life, not just objective of living; it is a positive concept emphasizing social & personal resources, as well as physical capibilities
- objective & complex phenomena
- functional stability, balance & integrity
- positive state of being
- physical fitness, emotional/mental stability, social/spiritual ease
- impacted by social & economic conditions
-emphasis is more health than illness focus
- upstream approach
- focus on health promotion/ illness prevention
- individuals - proactive with health
individuals, groups, families, communities
Referred to as:
- patients
- clients
- residents
- consumers
- guests
- character
- self-identity
- perceptions
"Assessment of whole person"
- an individual is more than the sum of its parts
- physical
- emotional
- psycho-social
- spiritual
- State of optimal health that is defined by the individual
Ability to:
perform to potential adjust/adapt to change
- Feeling of well being
- dynamic process towards optimal functioning
- personal experience of feeling unhealthy ( subjective experience)
- state of diminished physical, social, emotional, intellectual & spiritual functioning
- not the same as disease
- an objective state of health
- ethology, signs & symptoms, remission, exacerbation
- Can be acute or chronic
Impact of health (Self)
behavioural - irritable, lethargic
emotional - anger, fear, denial, powerless
self-concept - disfigurement, dependence
lifestyle - unemployment, socialization
Autonomy - lack of control
Impact of health ( family )
Role
Financial
Loneliness
historical approaches to health care
medical approach
Behavioural approach
Socioenvironmental approach
- Focus on treatment of disease
- Focus on physiological health
- no emphasis on prevention / promotion
- noted that there was no improvement in health
- incorporate into the 1970s
- presented when large amounts of money was being spent on health care
- the health status of Canadians were not improving
- Improvement in the environment, choosing healthy behaviours, and knowledge of healthy lifestyle
- individuals are responsible for their own health
-originated from the Lalonde report
" a new perspective on health of Canadians"
- concluded that the medical approach Was not sufficient enough
- the health of Canadians lie solely in the environment and self-imposed risks
- shifted emphasis from medical to behavioural approach to health
What are the elements of the Lalonde report?
- lifestyle
- environment
- human biology
- health care organization
What were the assumptions of the behavioural approach?
if people have knowledge about risk factors of disease, they will in their own self-interest engage in health behaviours
- surfaced in the mid 1980s when the behavioural approach was falling to disfavour
- questioned " do people choose bad health or do their environment pose obstacles for attaining good health"
- increased awareness that living and working conditions can have an influence on health
what does socioenvironmental approach focus on?
- focuses on promoting healthy environments
- reducing health disparities
- health is connected to social structures
- acknowledges effect of social inequities on health
- emphasis on empowerment & community
- change in perspective from therapeutic care to health promotion/health protection
Jake Epp, the Canadian Minister of national health and welfare released " Achieving health for all: a framework for health promotion" known as the Epp report
- Reducing inequities
- Increasing prevention
-Enhancing coping mechanisms
Achieving Health for All: A framework for health promotion
- followed the Lalonde report
- health conceptualized as a function of more than just medicine advancement
- stressed the important contributions of health lifestyle, nutrition and physical environment
- broadened health promotion to include environmental and lifestyle
- introduced healthy public policy
- the government needs to assess the health status of groups that are at a disadvantage and reducing inequalities
- detecting & managing chronic disease
- identify preventable diseases and focus on prevention
- increase peoples abilities to cope
- implementing health promotion programs
- strengthening community health services
- Socioenvironmental approach to health
- identified prerequisites for health as Peace, social justice, and equity
- places responsibility for health on society rather then only individuals
- 5 strategies associated with this report has been the health promotion framework for many countries
Ottawa Charter strategies
- build public health promotion policies at all levels of government
- create and maintain supportive physical, social, cultural, spiritual, and economic environments
- strengthen community action to achieve better health, priority setting and decision making of diligent assessment, planning and implementation
strategies for population health
- 12 key health determinants at the individual level and at the population
- Stakeholders representing the various determinants must collaborate to address health determinants
- Society is responsible for its members health status
- Health status is a result of people's health practices and their social and physical environments
- Opportunities for healthy living are based on social justice, equity, and relationships of mutual trust and caring, rather than on power and status
- Health care, health protection and disease prevention complement health promotion
- Active participation in policies and programs is essential
- identified inequalities and health disparities within social and health policies
-indigenous status
- early life
- education & literacy
- employment and working conditions
- food security
- gender
- health care services
- housing, income and its distribution
- social safety net
- social exclusion
- unemployment & employment security
- culture
- biological & genetic endowment
Foundation document
- Lalonde report
- ottawa charter
- epp report
- strategies for population health
- toronto charter
- refer to a specific group of social and economic factors within the broader determinants of health
- these relate to an individual's place in society, such as income, education or employment.
- experiences of discrimination, racism and historical trauma are important social determinants of health for certain groups such as Indigenous Peoples,LGBTQ and Black Canadian
health promotion
disease prevention
- build healthy public policy
- create supportive environments
- strengthen community action
- develop personal skills
- reorient health services
population-based and individual- based interventions for primary and secondary (early detection) prevention, among to minimize the burden of diseases and associated risk factors
the optimal well being of all humans from the individual and collective perspective
- prevention, treatment, and care, while focusing on the improvement of health for all and health equity
- concerned with saving lives by improving health throughout the world
- Nurses are engaging both locally and internationally, as employees and volunteers with a diverse array of government, military, philanthropic, faith-based, academic and healthcare organization
- new opportunities for nurses to work across the borders
Environment
the environmental aspect of the metaparadigm centres on the physical, economic, emotional, ecological dimensions, social surroundings, and societal beliefs, which interact to shape and influence the health of individuals and populations
- environments are fluid and subject to have positive and negative changes
- an intact and healthy ecosystem
- disease prevented by healthy environment
planetary Heath
the health of human civilization and the state of the natural systems on which it depends
- climate change
- ultraviolet radiation
- air, water, and soil pollution
- chemical exposures
- health disparities
- health inequalities
- social determinants of health
- health equity
a metric that quantifies the health of populations at regional or national levels
- morbidity and mortality
- disability- adjusted life year
- COVID pandemic
- climate change
- non communicable diseases
- neglected tropical diseases
- health inequity
- global violence
- gender equality
a theoretical perspective regarding the influence of different social characteristics- race, ethnicity, gender, class, and socioeconomic status on a particular phenomenon
- intersectional action for health
- global citizenship
- Canada has always been a multicultural nation
- 2011 Canadian census revealed that more than 200 different ethnic origins were reported
- multiculturalism
- immigration
- refuges
- displaced persons
- shared patterns of learned values and behaviours
- language, ethnicity, spiritual, religious beliefs
- socioeconomic class
- gender
- sexual orientation
- age
- group history
- geographic origin
- education
- childhood/ life experiences
cultural conflicts
-ethnocentrism
-cultural imposition
- stereotypes
- discrimination
- racism
use own values as quite to understanding others behaviours and provision of services
- comparative study of cultures to understand similarities and differences across human groups
- culturally congruent care
- culturally competent care
cultural:
- awareness
- knowledge
- skills
- encounters
- desire
- Cultural sensitivity
- Cultural awareness
- Cultural humility
alerts nurses to the legitimacy of differences and begins a process of self-exploration as powerful bearers of their own realities which can have an impact on others
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