FNP Health

●​ Health Belief Model - addresses the relationship

between a person’s beliefs and behaviors. ●​ As defined by the World Health
Organization (WHO): state of
●​ Health Promotion Model - defines health as a complete physical, mental and social
positive, dynamic state, not merely the absence of well-being, not merely the absence of
disease. Health promotion increases a patient's disease or infirmity.
level of well-being.
three areas: Characteristics
(1) individual characteristics and
experiences 1.​ A concern for the individual as a total
(2) behavior- specific knowledge and affect system
(3) behavioral outcomes, in which the 2.​ A view of health that identifies internal
patient commits to or changes a behavior. and external environment
3.​ An acknowledgment of the importance
●​ Holistic Health Model of an individual’s role in life
The relationship between body, mind, and spirit affects a
person’s health. *A dynamic state in which the individual adapts to changes
The Holistic Health Model of nursing promotes a patient’s in internal and external environment to maintain a state of
optimal level of health by considering the dynamic well being
interactions among the emotional, spiritual, social, cultural,
and physical aspects of an individual’s wellness.
Models of Health and Illness
VARIABLES INFLUENCING HEALTH AND HEALTH
BELIEFS AND PRACTICES 1.​ Health-Illness Continuum (Neuman)– Degree of
client wellness that exists at any point in time,
❖​ Internal variables - include a person’s ranging from an optimal wellness condition, with
developmental stage, intellectual background, available energy at its maximum, to death which
perception of functioning, and emotional and represents total energy depletion.
spiritual factors. 2.​ High – Level Wellness Model (Halbert Dunn)– It is
1.​ Developmental Stage oriented toward maximizing the health potential of
2.​ Intellectual Background an individual. This model requires the individual to
3.​ Perception of Functioning maintain a continuum of balance and purposeful
4.​ Emotional Factors direction within the environment.
5.​ Spiritual Factors 3.​ Agent – Host – environment Model (Leavell)– The
❖​ External Variables - External variables influencing level of health of an individual or group depends on
a person’s health beliefs and practices include the dynamic relationship of the agent, host and
family practices, psychosocial and socioeconomic environment
factors, and cultural background. ●​ Agent– any internal or external factor
1.​ Family Role and Practices that disease or illness.
2.​ Social Determinants of Health ●​ Host– the person or persons who may
be susceptible to a particular illness or
●​ Health promotion helps individuals maintain or disease
enhance their present health. It motivates people to ●​ Environment– consists of all factors
engage in healthy activities such as routine outside of the host
exercise and good nutrition to reach more stable 4.​ Health – Belief Model– Addresses the relationship
levels of health. Health education includes topics between a person’s belief and behaviors. It
such as physical awareness, stress management, provides a way of understanding and predicting
and self-responsibility. how clients will behave in relation to their health
●​ Health education helps people develop a greater and how they will comply with health care
understanding of their health and how to manage therapies.
their health risks.
●​ Illness prevention activities such as immunization Four Components
programs and blood pressure screenings protect
people from actual or potential threats to health. ●​ The individual is perception of
They also help people avoid declines in their health susceptibility to an illness
or ability to function. ●​ The individual’s perception of the
seriousness of the illness
●​ The perceived threat of a disease
●​ The perceived benefits of taking the
necessary preventive measures
5.​ Evolutionary – Based Model– Illness and death
serves as an evolutionary function. Evolutionary
viability reflects the extent to which an individual's
 function promotes survival and well-being. The 5.​ Patient must be an active participant
model interrelates the following elements: in the rehabilitation goal setting and in
●​ Life events rehabilitation process.
●​ Lifestyle determinants
●​ Evolutionary viability within the social Focuses of Rehabilitation
context
●​ Control perceptions 1.​ Coping pattern
●​ Viability emotions 2.​ Functional ability – focuses on
●​ Health outcomes self-care: activities of daily living
6.​ Health Promotion Model– A “complimentary (ADL); feeding, bathing/hygiene,
counterpart models of health protection”. Directed dressing/grooming, toileting and
at increasing a client’s level of well-being. Explain mobility
the reason for client’s participation in 3.​ Mobility
health-promotion behaviors. The model focuses on 4.​ Integrity of skin
three functions: 5.​ Control of bowel and bladder function
●​ It identifies factors (demographic and
socially) enhance or decrease the Definition
participation in health promotion
●​ It organizes cues into pattern to Health
explain likelihood of a client’s
participation health-promotion ●​ Presence or absence of disease
behaviors ●​ Complete physical, mental, social
●​ It explains the reasons that individuals well-being
engage in health activities ●​ Ability to maintain normal roles
●​ Process of adaptation to physical and
Illness social environment
●​ Striving toward optimal wellness
●​ State in which a person’s physical, ●​ Individual definitions
emotional, intellectual, social
developmental or spiritual functioning Wellness
is diminished or impaired. It is a
condition characterized by a deviation ●​ State of well-being
from a normal, healthy state.
Basic aspects include:
3 Stages of Illness
●​ Self-responsibility
1.​ Stage of Denial– Refusal to ●​ An ultimate goal
acknowledge illness; anxiety, fear, ●​ A dynamic, growing process
irritability and aggressiveness. ●​ Daily decision-making in areas related
2.​ Stage of Acceptance– Turns to to health
professional help for assistance ●​ Whole being of the individual
3.​ Stage of Recovery (Rehabilitation or
Convalescence)– The patient goes Well-being
through of resolving loss or
impairment of function ●​ Subjective perception of vitality and
feeling well
Rehabilitation ●​ Described objectively, experienced,
measured
1.​ A dynamic, health-oriented process ●​ Can be plotted on a continuum
that assists individual who is ill or
disabled to achieve his greatest Dimensions of Wellness
possible level of physical, mental,
spiritual, social and economical Physical Dimension
functioning.
2.​ Abilities not disabilities are ●​ Ability to carry out daily tasks
emphasized. ●​ Achieve fitness
3.​ Begins during initial contact with the ●​ Maintain nutrition
patient ●​ Avoid abuses
4.​ Emphasis is on restoring the patient to
independence or regain his Social Dimension
pre-illness/pre-disability level of
function as short a time as possible ●​ Interact successfully
●​ Develop and maintain intimacy
 ●​ Develop respect and tolerance for Ardell’s Wellness Model
others
5 Dimensions of Wellness
Emotional Dimension
Nutritional Awareness
●​ Ability to manage stress
●​ Making healthy food choices on a
●​ Ability to express emotion
regular basis.
Intellectual Dimension
Physical Fitness
●​ Ability to learn
●​ Regular exercise program.
●​ Ability to use information effectively
Stress Management
Spiritual Dimension
Determining the stress factors in one’s life is one thing, but
●​ Belief in some force that serves to doing something about it is another thing you could do to
unite manage their stress levels

Occupational Dimension
●​ Meditation
●​ positive visualization
●​ Ability to achieve balance between ●​ taking time out
work and leisure ●​ listening to music
●​ journal writing
Environmental Dimension ●​ regular physical activity are all
●​ Ability to promote health measure that Environmental Sensitivity
improves
●​ Living lightly on the earth, helping in
Standard of living anyway you can to keep the planet
Quality of life healthy is important as personal
Models of Health wellness depends on planetary
wellness.
●​ Medical Model
●​ Agent-Host-Environment Model Self- Responsibility
●​ Health-Illness Continuum
●​ Ardell says, all dimensions of wellness
Medical Model are important, but self-responsibility
seems more equal than all the rest.
●​ Provides the narrowest interpretation Personal accountability for our own
of health lifestyle is of utmost importance
●​ People viewed as physiologic systems
●​ Health identified by the absence of Bellin’s Model for Competency Improvement
signs and symptoms of disease or
injury ●​ Bellin’s Health System, focus is health
●​ State of not being “sick” care delivery system
●​ Opposite of health is disease or injury ●​ is based upon the belief that
outcomes are the results of processes
Agent-Host-Environment Model that can be improved through:

●​ Each factor constantly interacts with Identification of success metrics,

the others
●​ When in balance, health is maintained Setting of goals and the Plan Do Study Act
●​ When not in balance, disease occurs (PDSA) change process.

Travi’s Health-Illness Continuum ●​ Statistical process control charts are

used to track identified processes for
●​ Measure person’s perceived level of stability and response to improvement
wellness efforts. Measurement is focused on:
●​ Health and illness/disease opposite
ends of a health continuum Growth
●​ Move back and forth within this
continuum day by day Effectiveness
●​ Wide ranges of health or illness
 Efficiency ●​ Degree of satisfaction and quality and
type of relationship with the health
Engagement care providers
●​ Overall cost of prescribed therapy
Innovation
Illness
Iceberg Model
●​ A highly personal state
●​ The Iceberg Model shows us that our ●​ Person’s physical, emotional,
state of physical health or illness is intellectual, social, developmental, or
only the visible “tip” of the iceberg. spiritual functioning is diminished
●​ In order to completely understand our ●​ Not synonymous with disease
physical condition, we need to look ●​ May or may not be related to disease
beneath the surface to our ●​ Only person can say he or she is ill

Choices of lifestyle (our eating habits, Disease

exercise level, addictions to alcohol, food,
adrenaline, shopping, drugs, etc), ●​ Alteration in body function
●​ A reduction of capacities or a
Psychological beliefs (the thoughts, shortening of the normal life span
feelings, attitudes and beliefs we hold)
Acute Illness
Spirituality (our inner life, our belief in a
higher power and our degree of acceptance ●​ Characterized by severe symptoms of
and love of self and others). relatively short duration
●​ Symptoms often appear abruptly,
Factors Affecting Health Status, Beliefs, and Practices subside quickly
●​ May or may not require intervention
Internal Variables by health care professionals
●​ Most people return to normal level of
●​ Biologic dimension (genetic makeup, wellness
gender, age, and developmental level)
●​ Psychologic dimension (mind-body Chronic Illness
interactions and self-concept)
●​ Cognitive dimension (intellectual ●​ Lasts for an extended period
factors include lifestyle choices and ●​ Usually has a slow onset
spiritual and religious beliefs) ●​ Often have periods of remissions and
exacerbations
External Variables ●​ Care includes promoting
independence, sense of control, and
●​ Physical environment wellness
●​ Standards of living ●​ Learn how to live with physical
●​ Family and cultural beliefs limitations and discomfort
●​ Social support networks
Parson’s Four Aspects of the Sick Role

●​ Clients are not held responsible for

Factors Affecting Health Care Adherence their condition
●​ Clients are not excused from certain
●​ Client motivation social roles and tasks
●​ Degree of lifestyle change necessary ●​ Clients are obligated to try to get well
●​ Perceived severity of problem as quickly as possible
●​ Value placed on reducing the threat of ●​ Clients or their families are obligated
illness to seek competent help
●​ Difficulty in understanding and
performing specific behaviors Schuman’s Stages of Illness
●​ Degree of inconvenience of the illness
itself or of the regimens Stage 1: Symptom experience
●​ Complexity, side effects, and duration
of the proposed therapy ●​ Believe something is wrong
●​ Specific cultural heritage that may
make adherence difficult Stage 2: Assumption of the sick role
 ●​ Accepts the sick role and seeks ●​ use of specific immunization
confirmation ●​ attention to personal hygiene
●​ use of environmental sanitation
Stage 3: Medical care contact ●​ protection against occupational
hazards
●​ Seeks advice of a health professional ●​ protection from accidents
●​ use of specific nutrients
Stage 4: Dependent client role ●​ protections from carcinogens
●​ avoidance to allergens
●​ Becomes dependent on the
professional for help Secondary Prevention

Stage 5: Recovery or rehabilitation ●​ Also known as “Health Maintenance”.

Seeks to identify specific illnesses or
●​ Relinquish the dependent role – conditions at an early stage with
Resume former roles and prompt intervention to prevent or limit
responsibilities disability; to prevent catastrophic
effects that could occur if proper
Impact of Illness on the Client attention and treatment are not
provided
●​ Behavioral and emotional changes
●​ Loss of autonomy Early Diagnosis and Prompt Treatment
●​ Self-concept and body image changes
●​ Lifestyle changes On the Family ●​ case finding measures
●​ Depends on: ●​ individual and mass screening survey
●​ prevent spread of communicable
Member of the family who is ill disease
●​ prevent complication and sequelae
Seriousness and length of the illness ●​ shorten period of disability

Cultural and social customs the family Disability Limitations

follows
●​ Adequate treatment to arrest disease
Impact of Illness: Family Changes process and prevent further
complication and sequelae.
●​ Role changes ●​ Provision of facilities to limit disability
●​ Task reassignments and prevent death.
●​ Increased demands on time
●​ Anxiety about outcomes Tertiary Prevention
●​ Conflict about unaccustomed
responsibilities ●​ Occurs after a disease or disability
●​ Financial problems has occurred and the recovery
●​ Loneliness as a result of separation process has begun; Intent is to halt
and pending loss the disease or injury process and
●​ Change in social customs assist the person in obtaining an
optimal health status. To establish a
Leavell and Clark’s Three Levels of Prevention high-level wellness. “To maximize use
of remaining capacities’
Primary Prevention
Restoration and Rehabilitation
●​ Seeks to prevent a disease or
condition at a prepathologic state; to ●​ Work therapy in hospital
stop something from ever happening. ●​ Use of shelter colony
Health Promotion Profession​
●​ health education
●​ marriage counseling ●​ Is a calling that requires special
●​ genetic screening knowledge, skill and preparation.
●​ good standard of nutrition adjusted to ●​ An occupation that requires advanced
developmental phase of life knowledge and skills and that it grows
out of society’s needs for special
Specific Protection services.
Professional Nursing 4.​ Nursing is committed to promoting
individual, family, community, and
●​ Is an art and a science, dominated by national health goals in its best
an ideal of service in which certain manner possible.
principles are applied in the skillful 5.​ Nursing is committed to personalized
care of the well and the ill, and services for all persons without regard
through relationship with the client/ to color, creed, social or economic
patient, significant others, and other status.
members of the health team. 6.​ Nursing is committed to involvement
in ethical, legal, and political issues in
Criteria of Profession the delivery of healthcare.

1.​ To provide a needed service to the Personal Qualities of a Nurse​

society.
2.​ To advance knowledge in its field.
3.​ To protect its members and make it 1.​ Must have a Bachelor of Science
possible to practice effectively. degree in nursing.
2.​ Must be physically and mentally fit.
Characteristics of a Profession​ 3.​ Must have a license to practice
nursing in the country.

1.​ A profession requires an extended A professional nurse therefore, is a person who has
education of its members, as well as completed a basic nursing education program and is
basic liberal foundation. licensed in his country to practice professional nursing.
2.​ A profession has a theoretical body of
knowledge leading to defined skills, Roles of a Professional
abilities and norms.
3.​ A profession provides basic service. 1.​ Caregiver/ Care provider
4.​ Autonomy. Members of a profession ●​ the traditional and most essential role
have autonomy in decision making ●​ functions as nurturer, comforter,
and in practice. provider
5.​ Code of [Link] profession as a ●​ “mothering actions” of the nurse
whole has a code of ethics for ●​ provides direct care and promotes
practice. A profession has sufficient comfort of client
self-impelling power o retain its ●​ activities involves knowledge and
members throughout life. It must not sensitivity to what matters and what is
be a mere steppingstone to other important to clients
occupations. ●​ show concern for client welfare and
6.​ The most unique characteristic of acceptance of the client as a person
nursing as a profession is that, it is a 2.​ Teacher
CARING profession. ●​ provides information and helps the
client to learn or acquire new
Nursing knowledge and technical skills
●​ Encourages compliance with
●​ Is a disciplined involved in the delivery prescribed therapy.
of health care to the society. ●​ promotes healthy lifestyles
●​ Is a helping profession ●​ interprets information to the client
●​ Is service-oriented to maintain health 3.​ Counselor
and well-being of people. ●​ helps client to recognize and cope
●​ Is an art and a science. with stressful psychologic or social
●​ Nurse – originated from a Latin word problems; to develop an improve
NUTRIX, to nourish. interpersonal relationships and to
promote personal growth
Characteristics of Nursing​ ●​ provides emotional, intellectual to and
psychologic support
●​ Focuses on helping a client to develop
1.​ Nursing is caring. new attitudes, feelings and behaviors
2.​ Nursing involves close personal rather than promoting intellectual
contact with the recipient of care. growth.
3.​ Nursing is concerned with services ●​ Encourages the client to look at
that take humans into account as alternative behaviors recognize the
physiological, psychological, and choices and develop a sense of
sociological organisms. control.
4.​ Change agent
 ●​ Initiate changes or assist clients to perioperative, and postoperative
make modifications in themselves or phases of a patient’s
in the system of care. operative/interventional procedure(s).
5.​ Client advocate (Visit ANAAfor more details.)
●​ Involves concern for and actions in 5.​ Nurse Educator
behalf of the client to bring about a ●​ A nurse usually with an advanced
change. degree, who beaches in clinical or
●​ Promotes what is best for the client, educational settings, teaches
ensuring that the client’s needs are theoretical knowledge, clinical skills
met and protecting the client’s right. and conducts research.
●​ Provides explanation in client’s 6.​ Nurse Entrepreneur
language and support clients ●​ A nurse who has an advanced
decisions. degree, and manages health-related
6.​ Manager business.
●​ makes decisions, coordinates 7.​ Nurse administrator
activities of others, allocate resource ●​ A nurse who functions at various
●​ evaluate care and personnel levels of management in health
●​ Plans, give direction, develop staff, settings; responsible for the
monitor operations, give the rewards management and administration of
fairly and represent both staff and resources and personnel involved in
administrations as needed. giving patient care.
7.​ Researcher
●​ participates in identifying significant Fields and Opportunities in Nursing
researchable problems
●​ participates in scientific investigation 1.​ Hospital/Institutional Nursing
and must be a consumer of research ●​ A nurse working in an institution with
findings patients
●​ Must be aware of the research ●​ Example: rehabilitation, lying-in, etc.
process, language of research, a 2.​ Public Health Nursing/Community Health Nursing
sensitive to issues related to ●​ Usually deals with families and
protecting the rights of human communities. (no confinement, OPD
subjects. only)
●​ Example: Barangay, Health Center
Expanded role as of the nurse 3.​ Private Duty/special Duty Nurse
●​ Privately hired
1.​ Clinical Specialists 4.​ Industrial/Occupational Nursing
●​ Is a nurse who has completed a ●​ A nurse working in factories, office,
master’s degree in specialty and has companies
considerable clinical expertise in that 5.​ Nursing Education
specialty. She provides expert care to ●​ Nurses working in school, review
individuals, participates in educating center and in hospital as a CI.
health care professionals and 6.​ Military Nurse
ancillary, acts as a clinical consultant ●​ Nurses working in a military base.
and participates in research. 7.​ Clinic Nurse
2.​ Nurse Practitioner ●​ Nurses working in a private and public
●​ Is a nurse who has completed either clinic.
as certificate program or a master’s 8.​ Independent Nursing Practice
degree in a specialty and is also ●​ Private practice, BP monitoring, home
certified by the appropriate specialty service.
organization. She is skilled at making ●​ Independent Nurse Practitioner.
nursing assessments, performing P.
E., counseling, teaching and treating Nursing History in the Phils.
minor and self- limiting illness.
3.​ Nurse-midwife Early Beliefs, Practices and Care of the sick
●​ A nurse who has completed a
program in midwifery; provides ●​ Early Filipinos subscribed to
prenatal and postnatal care and superstitious belief and practices in
delivers babies to woman with relation to health and sickness
uncomplicated pregnancies. ●​ Diseases, their causes and treatment
4.​ Nurse anesthetist were associated with mysticism and
●​ A nurse who completed the course of superstitions
study in an anesthesia school and ●​ Cause of disease was caused by
assess, prescribe, deliver, and another person (an enemy of witch) or
manage care during the preoperative, evil spirits
 ●​ Persons suffering from diseases April 1946 – a board exam was held
without any identified cause were outside of Manila. It was held in the Iloilo
believed bewitched by “mangkukulam” Mission Hospital thru the request of Ms.
●​ Difficult childbirth were attributed to Loreto Tupas, principal of the school.
“nonos”
●​ Evil spirits could be driven away by 3.​ Luke’s Hospital School of Nursing –
persons with powers to expel demons 1907; opened after four years as a
●​ Belief in special Gods of healing: dispensary clinic.
priest-physician, word doctors, 4.​ Mary Johnston Hospital School of
herbolarios/herb doctors Nursing – 1907
5.​ Philippines General Hospital school of
Early Hospitals during the Spanish Regime Nursing – 1910

●​ Religious orders exerted efforts to College of Nursing

care for the sick by building hospitals
in different parts of the Philippines: 1.​ UST College of Nursing – 1st College
1.​ Hospital Real de Manila San Juan of Nursing in the Phils: 1877
de Dios Hospital 2.​ MCU College of Nursing – June 1947
2.​ San Lazaro Hospital Hospital de (1st College who offered BSN – 4
Aguas Santas year program)
3.​ Hospital de Indios 3.​ UP College of Nursing – June 1948
4.​ FEU Institute of Nursing – June 1955
Prominent personages involved during the Philippine 5.​ UE College of Nursing – Oct 1958
Revolution
1909
1.​ Josephine Bracken– wife of Jose
Rizal installed a field hospital in an ●​ 3 female graduated as “qualified
estate in Tejeros that provided nursing medical-surgical nurses”
care to the wounded night and day.
2.​ Rose Sevilla de Alvaro– converted 1919
their house into quarters for Filipino
soldiers during the Phil-American War ●​ The 1st Nurses Law (Act#2808) was
in 1899. enacted regulating the practice of the
3.​ Hilaria de Aguinaldo–wife of Emlio nursing profession in the Philippines
Aginaldo organized the Filipino Red Islands. It also provided the holding of
Cross. exams for the practice of nursing on
4.​ Melchora Aquino– (Tandang Sora) the 2nd Monday of June and
nursed the wounded Filipino soldiers, December of each year.
gave them shelter and food.
5.​ Captain Salomen– a revolutionary 1920
leader in Nueva Ecija provided
nursing care to the wounded when not ●​ 1st board examination for nurses was
in combat. conducted by the Board of Examiners,
6.​ Agueda Kahabagan– revolutionary 93 candidates took the exam, 68
leader in Laguna also provided passed with the highest rating of
nursing services to her troops. 93.5%-Anna Dahlgren
7.​ Trinidad Tecson (Ina ng Biak na ●​ Theoretical exam was held at the UP
Bato)– stayed in the hospital at Biac Amphitheater of the College of
na Bato to care for the wounded Medicine and Surgery. Practical exam
soldiers. at the PGH Library.

School Of Nursing 1921

1.​ Paul’s Hospital School of Nursing, ●​ Filipino Nurses Association was

Intramuros Manila – 1900 established (now PNA) as the
2.​ Iloilo Mission Hospital Training School National Organization Of Filipino
of Nursing – 1906 Nurses
●​ PNA: 1st President – Rosario Delgado
1909 – Distinction of graduating the 1st ●​ Founder – Anastacia Giron-Tupas
trained nurses in the Phils. With no
standard requirements for admission of 1953
applicants except their “willingness to work”
●​ Republic Act 877, known as the
“Nursing Practice Law” was approved.