WHO - a state of complete physical, mental, and social wellbeing and not merely the absence of disease.

- able to relize aspirations and satisfy needs and change or cope w the environment

Illness is a subjective experience of loss of health

Disease - objective, ill health.

- Use of medical interventions to restore health

- Health probs primarily as physiological risk factors

-Within the healthcare system - ensuring populations stay heatlhy 

Deflecting attention from environment

"self-imposed" 

victim blaming

knowledge

Social Context of health

Health- closely tied to social structures

Social and Environmental Conditions

Produced a Watershed Document

-The Ottawa Charter For Health Promotions

- societys reponsibility  for providing supports for people experiencing chronic medical conditions, stress, mental illness and problems associated with aging & needs for support givers.

- identified self care, mutual aid and healthy environment as ways that these challenges can be addressed 

" the entire range of known individual and collective factors and conditions that determine population health startus and the interactions among them are taken into account in planning action to improve health. 

- income/social status, social support networks, education, employment/work conditions,physical environments, biology and genetic endowment, personal health practices and coping skills, healthy child development and health services.

'96 - gender, culture and social environments added

- affirmed the Ottawa Charter prereqs and added 4 more.

- identified - promoting social responsibilities for health in public and private sectors, increasing investments for health in all sectors, consolidating and expanding partnerships for health to all levels of government and the pricae sector, increasing capacity and empowering the individual.

empowerment of women, social security, respect for human rights and social relations.

- greatest threat- poverty.

-declared health as a human right and emphasized mental and spiritual well-being as important elements.

-emphasized strong political action and sustained advocacy, empowering communities with adequate resources and coporate sector commitment to healthy workplaces and ethical business practices.

Health promotion: directed towards increasing the level of well-being and self actualization 

Disease Prevention: action to avoid illness/disease

1. on WHAT can we take action

2. How can we take action

3. with whom can we act

4. why take action

1. Primary: activity/intervention that seeks to prevent before  people have disease (PREVENT)

2. Secondary. aims to detect disease early in progression before S/S are apparent (PROMOTE)

3.Tertiary: intervention that begins once disease is apparent. Aim to reduce (MANAGE)

Organized and Logical Set of statements about a subjec, frameworks to clarify and to make sense of.

Human: inteded to account for why people become who they are - behaviour.

quantitative or measureable aspect of an individuals increase in phyiscal measurements.

ex: height, weight, teeth,

1-genetic or natural forces within the person

2- the environment in which person lives

3. interaction that takes place between those 2 factors

1. herdity and temperament

2. family, peer group, health environment, nutrition, rest/sleep/exercise, living environment, political/policy environment.

3. life experiences, prenatal health, state of health.

Describe/explain how the physical body grows and changes - changes can be quantified and compared against the establishmed norms.

- how we grow, change as we age

pattern of growth/development is directed by the activity of the genes

- fixed developmental sequence in all humans

- not all kids aquire skills at same age

- cant be pushed to develop faster

-biologically derived temperament characteristics drives childrens interactions with the environment.

"goodness of fit"

The easy child - easygoing/even tempered, regular, predictable. positive, open minded to change

The Difficult child: highly active, irritable, irregular in habits, adapts slow to new routines, intense mood expressions

The slow to warm up child: negatively reacts, mild intensity to stimuli, slowly adapts - repetitive, passive resistance.

focus on reasoning/thinking processes - changes in how people perform intellectual operations,

learn to understand their world

greatly influenced by interactions between the person and the environment

addresses the development of childrens intellectual organization and how they think, reason, perceive and make meaning of the physical world.

identifies 4 periods with subset stages - development is a spontaneous process in which individuals play an active role in their own development.

Sensorimotor: birth to 2 yrs - action pattern with environment, mouthing, looking, grasping.

Preoperational:2-7 - use of symbols, thinking with mental images

Concrete Operations:7-11 - mental operations, think about action before performing

Formal Operations:11-adulthood. - abstract thinking

theorized that a childs moral development does not advance if the cognitive development does not mature.

Preconventional, conventional and postconventional levels each with 2 stages..

people attain deifferent levels of moral development

stage 1: punishement and obedience orientation

stage 2: intrumental realtivist orientation.

reflects based on personal gain, doing something because told, one or more views may be correct.

Stage 3: good boy-nice firl orientation

stage 4: society maintaining orientation

personal internalization of sociatal and other explanations, win approval by being nice, correct behaviour, respect for authority.

Stage 5: Social contract orientation

Stage 6: universal ethical principle orientation

balance between basic human rights andobligations and rules/regs. improve society with following law or changing the golden rule, what is right...

Thought Kohlburgs theory was biased of men

men and women develop in parallel ways with one not being superior to the other.

developmental difference btwn women and men is in relationships and issues of dependency.

Seperation and Individuation

Seperation  from mother is essential for boy in development 

Psychoanalytic Model of Personality Development.

5 stages: pleasureable zones that serve as a foci for gratification and boidly pleasure

stage 1- oral, 2-anal,3-phallic 4.latency 5. genital

- each person goes through eight stages of development

-person needs to accomplish a particular task before moving onto the next stage. 

-task is framed with opposing conflicts that the person must balance

- BALANCE

1. Trust vs Mistrust(birth to 1yr) - learns to trust others, let cargiver out of sight

2.Autonomy vs sense of shae and doubt (1-3) learns to be independent and develop self confidence.

3. Initiative vs Guilt (3-6) initiate own activities, fantasy/imagination.

4. Industry vs Inferiority. (6-11) - sense of competence in physical, cognitive and social areas,

5. Identity vs Role Confusion (12-18yrs) form a unique identity, trying different roles, dramatic changes, who am i

6. intimacy vs isolation: (18-35)  young adulthood, fully active in community.

7. Generativity vs self absorption: 3-565. Mid life crisis, what can I offer to succeding generations, expand personal and social.

8. Integrity Vs Despair (65+, old age) Has my life been worthwile. Reflect on life.

1. biological and physiological - food, air, drink, shelter, warmth, sex, sleep.

2. safety needs - protection from elements, secuirty, order, law, stability, etc.

3. love and belogingness - friendshp, intimacy, affection and love, social,

4. esteem needs - self esteem, acheivement, mastery, independence, status, dominance, presitge, etc.

5. (new) cognitive need - knowledge, meaning

6. (new) aesthetic needs - appreciation, search for beauty balance and form

7. self actualization - reazlizing personal potential, self fullfilment, seeking growth, 

8. (new) transcendence needs - helping others to acheive self actualization.

- ill, diabled and unattractive

-forgetful, confused, rigid and boring,

- unable to learn, understand info,

-not interested in sex/actiivites

1. Stochastic Theory: view aging as a result of random cellular damage over time. Accumulated damage results in physical changes over the years

2. Nonstochastic: genetically programmed physiological mechanisms within the body control of the process of aging.

1. Disengagement Theory - withdrawing. 'wish i did that'

2. Activity Theory - staying engaged in social, successful transitioning

3. Continuity Theory - stability of personaility, predictable.

- adjusting to decreasing health and strength

- adjusting to retirement and reduced/fixed income

- adjusting to the death of a spouse

- accepting ones self as an aging person

-maintaining satisfactory living arrangements

-redefining relationships with adult children

-finding ways to maintain a quality of life.

- skin becomes thinnger

-loses resilience and moisture

-spots on skin

- wrinkles bc of diminished elasticity

- decreased cough reflex

- inefficient gas exchange (shortness of breath, difficult breathing)

- increased chest wall rigidity

- Decreased CO due to decreased muscle strength

- diminshed peripheral pulses

-thickening of blood vessels

- increase in fatty tissue around trunk

-delayed gastric emptying

-decrease in saliva and gastric secretions.

- female- decreased estrogen production, menopause, degeneration of ovaries

-atrophy of uterus, vagina and breasts

-male- diminished sperm count, smaller testes, erectile changes

- muscle fibers reduce in size

- strength diminishes

-bone mass declines

- supportive environements (promotes social connectedness) 

-mutual aid - promotes it as well

- self care, to meet those needs.

- potentially reveresible

-can be temporary

-sudden onset with symptoms and severity rapidly fluctuating.

-fluctuations in cognition, mood, attention, arousal and self awareness

-also, hallucinations, periodic incoherent speech, distrubed sleep.

- loss of memory, judgement, reasoning, changes in mood, behaviour, communication

-steady decline in ADL ability

-gradual onset

-not reversible because damage that occurs in brain.

-amnesia(memory loss)

-agnosia(loss of ability to recognize objects)

-apraxia(loss of ability to perform tasks)

-aphasia(loss of language skills)

- ability to do what is important

- emphazise strengths, resilience and resources and capabilities 

-social, biological, psychological, spiritual, cultural and environmental health

-exhibits a strong commitment to work

-contributing member of society.

- aimed at promoting independence and supporting self care abilities

-preventative measures includes: regular exercise, balanced nutrition, management of HTN, smoking cessation, immunizations

- inter-relation between physical and pyschosocial aspects of aging

- effects of disease and disability on functional status

-decreased efficiency of homeostatic mechanisms

-the lack of standards for health and illness norms (everyone ages differently)

-altered S/S of response to different processes.

To prevent/control the spread of infections

preventing transmissions of common diseases

to protect the vulnerable

Clean technique

procedures used to reduce and prevent the spread of microorganisms.

Hand hygience, clean gloves, clean environment

Sterile Technique

Different precautions from medical

procedures used to eliminate all microorganisms including pathogens/spores.

if touched by nonsterile object - contaminated

suctioning, foley dressings

infectious agent (pathogen)

reservior - source to grow/survive

portal of exit -  path to leave  reservoir to enter

mode of transmission - contact, droplet, direct/indirect

portal of entry - enter body

host - aquires infection - susceptibility

-visibly soiled hands

- before direct contact

-after direct contact

-contact with body fluids

-contact with equipment

-moving from contaminated to clean

- before initial contact with pt environment

- before aseptic procedure

-after body fluid exposure

-after pt environment contact

HOB raised 45 degrees or more, semisitting position

preferred with eating, NG insertion, suctioning.

HOB raised 30 degrees, less than fowlers

- wider the base of support, greater the stability

-lower the centre of gravity, greater the stability

-equilibrium of object is maintained as long as line of gravity is through the base of support

-facing direction of movement preve ts abnormal twisting.

- leverage, rolling, turning, pivoting requires less work than lifting

-when friction is reduced- less force required

-reduce muscle fatigue with good body mechanics. 

- cultural considerations

- ability to perform self care

-balance, coordination, strength, range of motion, activity tolerance,

- skin assessment

-any pain

-if dry

-infection.irritations

- difficulty to reac areas

-look for pressure ulcers

-vital signs before and after

-bathing preferences

methicillin resistant staphlyococcus aureous

nose, skin/wounds, peri area