00:01
I’m Jessica Spellman, and this is health
promotion, disease prevention, and health
screening. After taking this course, you will be
able to differentiate between health promotion
and disease prevention. Recognize the nursing
role in health promotion and disease prevention.
00:18
Identify health screening priorities across
the lifespan. The old definition of health
was the absence of disease. The more modern
definition of health focuses on a state of
physical, mental, and social well-being, and
not merely the absence of disease.
00:38
Wellness is a proactive and holistic approach
to health. It extends to emotional, social,
spiritual health, not just physical health.
Health promotion is the process of enabling
people to increase control over and to improve
their health. Focuses on bringing the concept
of wellness to communities and encouraging
individual behavior that maximizes health,
not just prevent illness. Again, it focuses
on emotional wellness, physical wellness,
social wellness, and spiritual wellness. It
includes efforts not only to prevent disease
but to minimize its effects after diagnosis.
Primary disease prevention prevents ailments
or disease. Example is vaccinations and
wellness behaviors. Secondary disease prevention
focuses on identifying risk factors before
disease is diagnosed. An example is health
screenings. Tertiary disease prevention focuses
on treating a medical condition in order to
prevent disease progression. An example is
taking medication to treat hypertension to
prevent complications. Medical models have
focused more on the tertiary care of disease
than on primary prevention. The nurses’
role in health promotion and
disease prevention is to assess patient’s
perception of health and willingness to learn,
perform appropriate health screenings, educate
patients at all levels of health promotion
and disease prevention, mentor patients
efforts to improve their health, and evaluate
patient’s understanding of education and provide
feedback. So it is important for nurses
to understand the leading cause of death throughout
the lifespan. They need to tailor education
to each individual patient. And the Center
for Disease Control and Prevention regularly
publishes this data. The top ten causes
of death in the United
States, as reported by the CDC in 2012. First, under
age one- birth defects, premature complications,
and Sudden Infant Death Syndrome. For ages
1 through 4: accidents, birth defects, and
homicide. Age 5 to 9: accidents, cancer, and
homicide. Age 10 to 14: accidents, cancer,
and suicide. Age 15 to 24, and age 25 to 34,
accidents, suicide, and homicide. Age 35 to
44: accidents, cancer, and heart disease.
Age 45 to 54, and 55 to 64: cancer, heart
disease, and accidents. And greater than age
65: heart disease, cancer, and respiratory
illnesses. It is easier to remember
this information
if you look at the common themes. Accidents
are the number one cause of death ages 1 through
44. Heart disease and cancer are among the
leading cause of death for everyone over age 35.
04:01
And violence is among the leading cause of
death in children and adolescents. I want
to take a look at accidents throughout the
lifespan. In infants, they have a high risk
for falls, asphyxia, and burns. So their nursing
education should focus on sleeping on the
back, water safety, specifically never leaving
children alone in the water, and checking
the temperature of the water, as well as car
safety and using car seats.
04:33
For toddlers, they are curious and more mobile,
so they have high risks in those areas, as
well as poisoning, choking, and drowning.
So the nursing education needs to focus on
home safety, specifically baby gates, outlet covers,
and baby proofing the home. Keep medication,
cleaners out of reach, car safety, and the
use of car seats. In school-age children,
they have much more safety risks, including
traffic, water, fire, strangers, accidents
during play. So for the school-age children,
their nursing education is to focus on fire
safety, water safety, traffic safety, stranger
danger, using car seats and boosters until
the child is 4’9” and 80 lbs. In the adolescent
group, their risks for accidents
are caused from an increase of independence
and an invincible attitude. They don’t believe
anything bad will ever happen to them. So,
nursing education needs to focus on driver
education, sexual health information, alcohol
and substance abuse. For adults, motor vehicle
accidents and sport and leisure-related accidents.
So promoting motor vehicle’s safety and
fire safety, as well as wellness promotion
and injury prevention. In older adults, falls,
medication side effects, and increase in
physical and cognitive impairments are their
highest risks. For our older adults, we
want to review medication
in side effects, assess for elder abuse, neglect
and fall risk, as well as evaluate for confusion
and ability to complete self-care activities.
Promoting health is one aspect of primary
disease prevention. The role of the nurse is to
educate about healthy behaviors, specifically,
diet, exercise, and lifestyle, role modeling
healthy behaviors, and identifying patient’s
barriers to health and wellness and
overcoming them.
06:49
Examples of primary prevention include: stress
management, exercise, complementary and alternative
therapies, immunizations, promote regular
visits specifically to the dentist and the
primary care physician. Secondary disease
prevention includes a lot of health screening.
07:11
There are innumerable guidelines for health
screening, based upon age, sex, and family
history. It is impossible to review all of
the guidelines for every disease.
07:22
Instead, it is the nurses’ role to identify opportunities
for health screenings across the lifespan,
focus health screenings on the leading causes
of death for specific age groups, educate
individuals on the results of their health
screening, and recommend interventions to
decrease the risk of specific disease developing.
Some recommendations for health screening
specifically for blood sugar include the
World Health Organization and American Diabetes
Association suggest the fasting glucose level
of less than 125. And the National Institutes
of Health report that one-third of patients
with diabetes are unaware that they have it.
08:08
Recommendations for blood pressure: BP less
than 140/90, and is named the silent killer
because many people do not know that they
have hypertension. Fasting lipid profile,
adults should have lipid profiles at least
every four to six years. More if they’re
at high risk. Total cholesterol should be
less than 200. Triglycerides should be less
than 150. HDL should be greater than 40 in
men, and greater than 50 in women, and LDL
less than 100. Colorectal screening. Men
and women should
begin this at age 50. Prostate screening.
A digital rectal exam is recommended at an
annual physical. Previous recommendation
was an annual prostate-specific antigen or
PSA test every year for men over 50. New guidelines
caution against testing anyone less than 40
or greater than 70 with the PSA. Men age 41
through 69 should discuss the test with their
physician. Mammograms. The U.S. Preventative
Services Task Force mammogram guidelines recommend
that women begin screening at age 50 and repeat
the test every two years.
09:28
The American Cancer Society and other organizations
recommend screening begin at age 40 and continue
annually. Tertiary disease prevention was
the focus of the healthcare industry for the
past decade. It is an approach to healthcare
that teaches patients how to manage a chronic
disease. Patients receive education and learn
about guidelines and resources to assist them
with the care of their chronic disease. As nurses,
we need to have an interdisciplinary
approach to caring for patients with chronic
disease, and we need to base our care on national
guidelines and evidence-based practice. The
aim is to avoid potential problems or exacerbation
of a health problem. The benefits of disease
management are that it empowers patients and
families with information to care for themselves
or their loved ones. It should reduce complications
and decrease hospitalizations, as well as
improve the quality of life for individuals.
10:34
So the nursing role in disease management
focuses on educating patients and families
regarding the condition, assess and overcome
barriers to education and implementation of
interventions, as well as coordinate care
across disciplines, and provide support and
understanding for individuals and families.
Education also needs to take into account
other social determinants of health. These
include socioeconomic status, education level,
literacy, access to healthcare and insurance
coverage, culture and language, access to
technology, safe housing, access to healthy
food, exposure to crime and violence, as well
as transportation. So health is more
than just the absence of
disease. Its focus is shifting to holistic
wellness and promoting health. Disease prevention
is still vital, though. And nurses’ role
and disease prevention includes educating
about health and wellness prevention and promotion,
health screening to educate regarding risk
reduction, and disease management and education.
Providing education is the key role for nurses.
11:51
It is important to provide patient-centered
education, take into account all social determinants
of health, brainstorm about ways to overcome
barriers, evaluate patient understanding of
education, provide support, encourage accountability,
and coordinate services.
12:12
This is Jessica Spellman, and this has been health
promotion, disease prevention, and health screening.