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Chapter 3 - Health, Wellness, and Health Disparities

Terms in this set (65)

(1) Experiencing symptoms: The first indication of an illness usually is recognizing one or more symptoms that are incompatible with one's personal definition of health. Although pain is the most common symptom indicating illness, other common symptoms include a rash, fever, bleeding, or a cough. If the symptoms last for a short time or are relieved by self-care, the person usually takes no further action. If the symptoms continue, however, the person enters the next stage.
(2) Assuming the sick role: At this stage, most people focus on their symptoms and bodily functions. Depending on individual health beliefs and practices, the person may choose to do nothing, may research symptoms on Internet sources, may buy over-the-counter medications, may try alternative remedies to relieve symptoms, or may seek out a health care provider for diagnosis and treatment. In our society, an illness becomes "legitimate" when a health care provider diagnoses it and prescribes treatment. After seeking help from the health care provider, the person becomes a patient and enters the next stage.
(3) Assuming a dependent role: This stage is characterized by the patient's decision to accept the diagnosis and follow the prescribed treatment plan. The person may initially have difficulty conforming to the recommendations of the health care provider and may decide to seek a second opinion or deny the diagnosis. The lack of independence is more troubling for some people who, based on their diagnosis, often require assistance in carrying out activities of daily living, and need emotional support through acceptance, approval, physical closeness, and protection.
(4) Achieving recovery and rehabilitation: Might begin in the hospital and conclude at home, or may be totally concluded at a rehabilitation center or at home. Most patients complete this final stage of illness behavior at home. In this stage, the person gives up the dependent role and resumes normal activities and responsibilities. If the care plan includes health education, the person may return to health at a higher level of functioning and health than before the illness.

The role of the RN is to provide education and emotional support to the family and patient during diagnosis, prognosis, treatment, and recovery of the patient.
•Physical dimension: includes genetic inheritance, age, developmental level, race, and biological sex. There are specific racial traits for disease, including sickle cell anemia, hypertension, and stroke.
•Emotional dimension: Long-term stress affects body systems, and anxiety affects health habits; conversely, calm acceptance and relaxation can actually change the body's responses to illness.
•Intellectual dimension: Encompasses cognitive abilities, educational background, and past experiences. Whether or not someone can understand the causes of disease and the importance of healthy lifestyle behaviors can have a huge impact on health and wellness. These influence the person's responses to teaching about health and reactions to nursing care during illness. They also play a major role in health behaviors.
•Environmental dimension: Housing, sanitation, climate, and pollution of air, food, and water are elements in the environmental dimension.
•Sociocultural dimension: Health practices and beliefs are strongly influenced by a person's economic level, lifestyle, family, and culture. In general, low-income groups, racial and ethnic minorities, and other underserved populations are less likely to seek medical care to prevent illness and have fewer treatment options, while high-income groups are more prone to stress-related habits and illness. The family and the culture to which a person belongs influence the person's patterns of living and values about health and illness; such patterns are often unalterable. All of these factors are involved in personal care, patterns of eating, lifestyle habits, and emotional stability.
•Spiritual dimension: It is important that nurses respect these values and understand their importance for the individual patient.
-The model is widely used today by counselors addressing a broad range of behaviors including injury prevention, overcoming drug and alcohol addictions, and weight loss.
-Precontemplation. In this stage, people are not even thinking about trying to change their behavior. DiClemente lists as reasons the four R's: reluctance, rebellion, resignation, and rationalization. Counselors can validate the lack of readiness to change and encourage self-exploration.
-Contemplation. People ambivalently consider the need to change the problematic behavior. Counselors can help by focusing on educating about the pros and cons of the behavior and change, and clarify that the decision to change is one that only the individual can make.
-Determination: Commitment to Action. Now the decision is made to move forward and preparation ensues. Counselors are most helpful in this stage by helping people make realistic plans, with small steps that anticipate difficulties, and by identifying creative strategies to address the difficulties. It is helpful to affirm that the individual has the ability to change behaviors.
-Action: Implementing the Plan. When someone publicly begins to implement the plan and begins to achieve success, it reinforces the decision to change behavior. If family, friends, and co-workers understand that the person has decided to eat differently or stop drinking, they can become supporters. Counselors can bolster the person's ability to change by reiterating long-term benefits.
-Maintenance, Relapse, and Recycling. During this stage, people focus on sustaining the new behavior in a stage that can last from 6 months to 5 years. Counselors can be helpful by exploring strategies to support the new behaviors and by continuing support during relapse.

-Each time a person goes through the cycle, he or she learns from each relapse; referred to as the Upward Spiral
Children
Early and middle childhood provide the physical, cognitive, and social-emotional foundation for lifelong health, learning, and well-being. A history of exposure to adverse experiences in childhood, including exposure to violence and maltreatment, is associated with health-risk behaviors such as smoking, alcohol and drug use, and risky sexual behavior, as well as health problems such as obesity, diabetes, heart disease, sexually transmitted diseases, and attempted suicide.
Features of the built environment, such as exposure to lead-based paint hazards and pests, negatively affect the health and development of young children.
Adolescents
Because they are in developmental transition, adolescents and young adults are particularly sensitive to environmental influences. Environmental factors, including family, peer group, school, neighborhood, policies, and societal cues, can either support or challenge young people's health and well-being. Addressing young people's positive development facilitates their adoption of healthy behaviors and helps to ensure a healthy and productive future adult population.
Adolescents who grow up in neighborhoods characterized by poverty are more likely to be victims of violence; use tobacco, alcohol, and other substances; become obese; and engage in risky sexual behavior.
Adults
Access to and availability of healthier foods can help adults follow healthful diets. For example, better access to retail venues that sell healthier options may have a positive impact on a person's diet. These venues may be less available in low-income or rural neighborhoods.
Longer hours, compressed work weeks, shift work, reduced job security, and part-time and temporary work are realities of the modern workplace and are increasingly affecting the health and lives of U.S. adults. Research has shown that workers experiencing these stressors are at higher risk of injuries, heart disease, and digestive disorders.
Older Adults
Availability of community-based resources and transportation options for older adults can positively affect health status. Studies have shown that increased levels of social support are associated with a lower risk for physical disease, mental illness, and death.