NURS 1710 Lecture Notes - Lecture 2: Continuing Care Retirement Communities In The United States, Telehealth, Ontario Health Insurance Plan
Week Two (Sept. 18 - 22, 2017)
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Introduction to Nursing
Potter and Perry Chapter 1, and 2 (Pgs. 1 - 27)
Chapter One: Health and Wellness:
Conceptualizations of Health
Some suggest that disease is an objective state of ill health; pathology of disease can be
detected by medical science and that illness is a subjective experience of loss of health.
Classifications of Health Organizations:
● Health as Stability - the maintenance of psychological, functional and social
norms, and homeostasis.
● Health as Actualizations - actualization of human potential.
● Health as Actualization and Stability - the actualization of inherent and acquired
human potential through goal-directed behaviour, competent self- care.
This definition, incorporating both actualization and stability dimensions, suggests that
people in a variety of situations—even those with physical disease or nearing death—
could be considered healthy. Aspects include the following qualities:
● Feeling vitalized and full of energy.
● Having satisfying social relationships.
● Having a feeling of control over one’s life and living conditions.
● Being able to do things one enjoys.
● Having a sense of purpose.
● Feeling connected to community.
Historical Approaches to Health in Canada
The three major approaches to health have been the medical, behavioural and socioenvirometal
approaches.
Medical Approach:
- Represents a stability orientation to health.
- Emphasizes that medical intervention restores health.
Behavioural Approach:
- Places responsibility for health on the individual.
- Lifestyle behaviours contributed to chronic diseases (such as cancer and heart
disease).
- The Lalonde Report was the first modern government document in the Western
world to acknowledge the inadequacy of a strictly biomedical health care system.
It defined health determinants as lifestyle, environment, biology and the
organization of health care.
Socio-environmental Approach:
- Health is closely tied to social structures (ie. poverty and unhealthy physical and
social environments like poor water quality) influences health directly.
Ottawa Charter
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- Identified prerequisites for health (ie. peace, shelter, education, food,
income, stable ecosystem,social justice and equality).
Achieving Health for All
- This report identified three major health challenges: reducing
inequities,increasing prevention and enhancing coping mechanism.
- Acknowledged disparities in health between low- and high-income
people.
Risk Factors and Risk Conditions
- The major determinants of health were categorized in socio
environmental approach and as a psychosocial risk factors and
socioenviromental risk conditions:
-Psychological risk factors: Isolation, lack of social support,
limited social networks, self blame.
-Socio-environmental risk factors: poverty, low education level,
political powerless, pollution.
-Strategies for Population Health: emphasized through the
population approach. Which emphasizes the use of
epidemiological data to determine the etiology of health and
disease (ie. education, income and social status, physical
environments, health services etc)
-Jakarta Declaration: emerged the 4th International Conference of
Health Promotion, the first to be held in a developing country.
Added four other prerequisites for health: empowerment of
women, social security, respect for human rights and social
relations).
-Bangkok Charter: affirmed health as a human right and
emphasized mental and spiritual well being.
-Toronto charter: identified the following social determinants as
particularly important for health: Aboriginal status, early life,
education, employment and working conditions, food security,
gender, health care services, housing, income and its distribution,
social safety net, social exclusion, and unemployment and
employment security.
Determinants of Health
The following are some of the major determinants of health affecting Canadians
Income and Social Status (Income Distribution):
-Poverty exerts its effect on health through lack of material resources that support health, higher
levels of psychosocial stress, and through health-threatening behaviours to cope with limited
resources and stress.
-Countries with greater economic inequality have lower overall health and life expectancies.
Social Support Networks:
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Week Two (Sept. 18 - 22, 2017)
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-Social isolation, exclusion, and lack of supportive relationships increase stress and vulnerability to
disease directly, as well as indirectly through increased risk behaviours such as smoking,
substance abuse, and overeating
Education and Literacy:
-People with low literacy skills are more likely to be unemployed, receive income support, earn
minimum wages in unskilled jobs, have higher stress levels, and make less use of preventive
services.
Employment and Working Conditions:
-Unemployment is linked to material and social deprivation, adoption of health-threatening coping
behaviours, psychological stress, and physical and mental health problems.
-Low-wage jobs have high levels of job insecurity; leading to more stress.
Physical Environments:
-Contaminants in air, water, food, and soil also adversely affect health, sometimes contributing to
cancer, birth defects, respiratory illness, and gastrointestinal ailments.
Biological and Genetic Endowment:
-Heredity is strongly influenced by social and physical environments.
-Age is also a strong determinant of health. Many older people develop chronic diseases, although
disability can be reduced with healthy aging.
Individual Health Practices and Coping Skills:
-Effective coping skills help people face challenges without resorting to risk behaviours such as
substance abuse.
-Three risk behaviours with major detrimental health consequences are physical inactivity, poor
nutrition, and tobacco use.
Healthy Child Development:
-Children raised in adverse environments are predisposed to coronary health disease, hypertension,
type 2 diabetes, substance abuse, and mental health problems.
Health Services:
-Quality and accessible primary care, hospital care, long-term care, home care, and public health
services are important.
Gender:
-In Canada, men are more likely than women to experience extreme forms of social exclusion and
to die prematurely, largely as a result of heart disease, unintentional fatal injuries, cancer, and
suicide. Women, however, are more likely to suffer from depression, stress (often resulting from
efforts to manage paid and family work), chronic conditions such as arthritis and allergies, and
injuries and death from family violence.
Culture:
-Cultural and ethnic factors influence people’s interactions with a health care system, their
participation in prevention and health promotion programs, their access to health information, their
health-related lifestyle choices, and their understanding of health and illness.
Social Environments:
-Social exclusion limits people’s access to the resources that support health and their participation
in community life. A sense of community belonging has been linked to better self-rated general
health and mental health.
-Absence of violence, both in the home and in the community.
Strategies to Influence Health Determinants
Health Promotion and Disease Prevention:
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find more resources at oneclass.com
Document Summary
Potter and perry chapter 1, and 2 (pgs. Some suggest that disease is an objective state of ill health; pathology of disease can be detected by medical science and that illness is a subjective experience of loss of health. Health as stability - the maintenance of psychological, functional and social norms, and homeostasis. Health as actualizations - actualization of human potential. Health as actualization and stability - the actualization of inherent and acquired human potential through goal-directed behaviour, competent self- care. This definition, incorporating both actualization and stability dimensions, suggests that people in a variety of situations even those with physical disease or nearing death could be considered healthy. Having a feeling of control over one"s life and living conditions. Being able to do things one enjoys. The three major approaches to health have been the medical, behavioural and socioenvirometal approaches. Places responsibility for health on the individual. Lifestyle behaviours contributed to chronic diseases (such as cancer and heart disease).
