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Online Companion: Fundamentals of Nursing Standards and Practice 2E
Chapter 15 explores the concepts of health, illness and wellness in the various meanings these hold for individuals. Health practices and self-care activities are influenced by a person's family and culture. Illness means different things to different people. There are two major classifications of illness: acute and chronic illness. Behaviors that influence a person's health status include lifestyle, locus of control, self-efficacy, health care attitudes and self-concept. There is a current and growing trend in healthcare to emphasize behaviors that promote health and to teach these to clients. Examples of health promotion programs include smoking cessation, nutrition and exercise. The U.S. government, through the Department of Health and Human Services, organized the Healthy People initiative that has four objectives: to promote healthy behaviors, to promote healthy and safe communities, to improve systems for personal and public health, and to prevent and reduce diseases and disorders. The nurse has a role in promoting health and wellness. Client teaching is the major intervention for promoting health. Certain populations in the U.S., children, the elderly, the economically disadvantaged and the homeless are vulnerable to developing illness and special efforts are needed to reach them. The individual as a holistic being is the focus of the second part of Chapter 15. A holistic viewpoint guides the total care of the individual as a complete being whose healing is related to caring. Human beings have needs in the emotional, sociocultural, intellectual, physical and spiritual realms. Nurses are aware of these dimensions and provide care that addresses each of these. The psychological needs for security, a sense of belonging and self-esteem are met when the nurse treats the client as a unique individual and protects the client's privacy and confidentiality. The nature of spirituality and its relationship to health is explored in Chapter 15. Some of the world's religions and the health implications of their beliefs are described. Spiritual care of clients is based on the therapeutic nurse-client relationship. Active listening, responding empathetically, respecting the client's beliefs and referring to clergy when appropriate are the basic elements of providing spiritual care. The third major topic addressed in Chapter 15 is the sexual dimension of the person. The development of sex roles and gender identity is influenced by cultural values and experiences. The need for sexual integrity is a basic universal need of individuals; it may be threatened by illness, disability, medications and hospitalization. The nurse is aware that clients may be experiencing concerns about their sexuality and is prepared to use the nursing process in a very sensitive manner to assist these clients. There are two NANDA nursing diagnoses that are pertinent here: sexual dysfunction and altered sexual patterns. Each age group across the lifespan has unique needs for information about sexuality, including older adults. The nurse is aware of the need to assess clients in each age group for evidence of sexual abuse and sexually transmitted disease.
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