408703814-6-MODELS-OF-PREVENTION-Copy-pptx.pptx

prevention models

1. MODELS OF PREVENTION,PRIMARY HEALTH CARE & HEALTH PROMOTION

2. 1. MODELS OF PREVENTION

3. A model is a theoretical way of understanding a concept or idea . Models represent different ways of approaching complex issues . There are different models of prevention.

4. The absence of signs and symptoms of disease indicates health. Illness would be the presence of conspicuous signs and symptoms of disease. People who use this model of health to guide their use of healthcare services may not seek preventive health services, or they may wait until they are very ill to seek care. Clinical model is the conventional model of the discipline of medicine . 1.Clinical model

5. Health is indicated by the ability to perform social roles. Illness would be the inability to perform a person’s roles at the level of others in society. This model is basis for work and school physical examination and physician –excused absences. The sick role, in which people can be excused from performing their social roles while they are ill, is a vital component of the role performance model.   2.Role performance model

6. The ability to adapt positively to social, mental, and physiological change is indicative of health. Illness occurs when the person fails to adapt or becomes inadaptive toward these changes. As the concept of adaptation has entered other aspects of health care, this model has become widely accepted. 3.Adaptive model

7. Leavell and Clark ( 1965 ) This model is useful for examining causes of disease in an individual. The agent, host and environment interact in ways that create risk factors , and understanding these is important for the promotion and maintenance of health. An agent is an environmental factor or stressor that must be present or absent for an illness to occur. A host is a living organism capable of being infected or affected by an agent. 4.Agent host environment model

8. Dunn(1961): This model recognizes health as an ongoing process toward a person’s highest potential of functioning. This process involves the person, family and the community. High level wellness is a lifestyle focused approach which is design for the purpose of pursuing the highest level of health within a person’s capability. 5. High Level Wellness Model 

9. Dr. John Travis, 1972 This is one way to measure a person’s level of health Health as a constantly changing state, with high level wellness and death being on opposite ends of a graduated scale. This illustrates the dynamic state of health , as a person adapts to changes in the internal and external environments to maintain a state of wellbeing. 6. Illness-Wellness Continuum model

10. Edelman and Mandle , 2002 Holism represents the interaction of a person’s mind, body and spirit within the environment . Holism is based on the belief that people can not be fully understood if examined solely in pieces apart from their environment. In this model, nurses consider clients the ultimate experts regarding their own health. In holistic model of health, clients are involved in their healing process , thereby assuming some responsibility for health maintenance. 7. Holistic Health Model 

11. Disease was more prevalent in poor environments and that health could be promoted by providing adequate ventilation, pure water, quiet, warmth, light and cleanliness. Poor environmental conditions are bad for health and that good environmental conditions reduce disease . This model views health as a constantly changing state . 8. Nightingale’s Theory of Environment

12. Nancy Milio developed a framework for prevention that includes concepts of community – oriented, population- focused care. Behavioral patterns of the individuals who make up the population are a result of habitual selection from limited choices. Challenged the common notion that a main determinant for unhealthful  behavioural choice is lack of knowledge. Milio’s framework described the neglected role of community health nurse to examine the determinants of a community’s health and attempt to influence those determinants through public policy. 9. Milio’s Framework for Prevention

13. Leavell and Clark in 1975 This model suggests that the natural history of any disease exists on a continuum , with health at one end and advanced disease at the other. The goal is to maintain a healthy state and to prevent disease or injury. It has been defined in terms of four levels: Primordial prevention Primary prevention Secondary prevention Tertiary  prevention 10. Levels of Prevention Model

14. Primordial prevention Prevention of the emergence or development of risk factors in population or countries in which they have not yet appeared. Efforts are directed towards discouraging children from adopting harmful lifestyles. Primary prevention An action taken prior to the onset of disease, which removes the possibility that the disease will ever occur. It includes the concept of positive health, that encourages the achievement and maintenance of an “acceptable level of health that will enable every individual to lead  a socially and economically productive life.

15. Secondary prevention Action which halts the progress of a disease at its incipient stage and prevents complications. The domain of clinical medicine. More expensive and less effective than primary prevention. Tertiary prevention All measures available to reduce or limit impairment and disabilities, minimize suffering caused by existing departures from good health and to promote the patient's adjustment to irremediable conditions.

16. This model is based on the concept that for a behavioral change to succeed, individuals must have the incentive to change , feel threatened by their current behaviour , and feel that a change will be beneficial and be at acceptable cost. They must also feel competent to implement that change . The purpose of the model is to explain and predict preventive health behavior.  11.The Health Belief Model

17. Health Education : aimed at enhancing well-being and preventing ill-health through favorably influencing the knowledge, beliefs, attitudes and behavior of the community. Health Protection:  refers to the policies and codes of practice aimed at preventing ill-health, ex: no smoking in public places. Health Protection is responsible for the development and implementation of legislation, policies and programs in the areas of Environmental Health Protection, Community Care Facilities, and Emergency Preparedness. Prevention:   refers to both the initial occurrence of disease and also to the progress and subsequently the final outcome. 12.Tannahill Model of Health Promotion

18. 2. PRIMARY HEALTH CARE

19. According to WHO, “ The essential health care made universally accessible to individuals and families in the community through their full participation and at a cost of community and country can afford.”

20. P rinciples

21. Goals Reducing exclusion and social disparities in health Organizing health services around people's needs and expectations Integrating health into all sectors Pursuing collaborative models of policy dialogue Increasing stakeholder participation.

22. Extended Elements in 21st Century Expanded options of immunizations Reproductive Health Needs Provision of essential technologies for health Health Promotion Prevention and control of non-communicable diseases Food safety and provision of selected food supplements

23. Millennium Development Goals 1.    Eradicate extreme poverty and hunger 2.    Achieve universal primary education 3.    Promote gender equity 4.    Improve maternal health 5.    Reduce child mortality 6.    Combat HIV/AIDS, malaria, and other communicable diseases 7.    Ensure environmental sustainability 8.    Develop global partnership for development

24. Primary health care approach PHC approach consists of techniques known collectively under the acronym "GOBI-FFF".   G rowth monitoring: the monitoring of how much infants grow within a period, with the goal to understand needs for better early nutrition. O ral rehydration therapy: to combat dehydration associated with diarrhea B reastfeeding I mmunization F amily planning  (birth spacing) F emale education F ood supplementation : for example, iron and folic acid fortification/supplementation to prevent deficiencies in pregnant women.

25. R ole of nurse in primary health care Health education Food supply and proper nutrition Water supply and basic sanitation Maternal and child health care including family planning Immunization Prevention and control of endemic disease Treatment of minor aliments Provision of essential drugs

26. Problems in implementing Primary health care in India Resources Population problem Absence of political support Medical care problem Rising cost of health care Inadequate supervision and follow up Failure to restore medical supplies on a regular basis Lack of cooperation on the part of health services Increased globalization Poverty

27. Climate changes Shortage of funds Lack of materials and equipment Shortage of appropriate staff Lack of commitment which can be at the individual or government level. Lack of incentive Lack of information Inadequate community participation Inadequate intersectoral collaboration Rapid turnover of policy makers Lack of manpower training and development Inadequate utilization of services In appropriate staff recruitment Ill defined responsilities that is poor job description Ill defined authority.

28. 3. HEALTH PROMOTION

29. Health promotion and disease prevention programs focus on keeping people healthy. Health promotion engages and empowers individuals and communities to engage in healthy behaviors , and make changes that reduce the risk of developing chronic diseases and other morbidities.

30. Defined by the  World Health Organization , health promotion is: “ The process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behavior towards a wide range of social and environmental interventions.”

31. Health Promotion Interventions Health education Environmental modification Nutritional interventions Lifestyle and behavioural changes.

32. The Ottawa Charter for Health Promotion Ottawa was the venue for an international conference on health promotion in 1987.  The resulting Ottawa Charter proposed action "to achieve health for all" by the year 2000.  It included the following strategies:

33. Building healthy public policy .  This puts health on the agenda for all policymakers, directing them to be aware of the health consequences of their decisions Creating supportive environments .   (e.g. encouraging a family to support their relative who is trying to lose weight) This recognized the importance of environment for health, and proposed a socio-ecological approach to health Strengthening community action .   Health promotion requires community empowerment and involvement in setting priorities, planning and implementing strategies to achieve better health

34. Developing personal skills .   Health promotion supports personal and social development through providing information and enhancing life skills Reorienting health services .   Health promotion argues for shifting health resources towards a more equal distribution between health care and preventing disease. Responsibility for health promotion services should be shared among individuals, community groups, health professionals, health services and governments.

35. Seven prerequisites for health promotion (Ottawa charter ) Peace Shelter  Education   Food  Income   Stable Eco-system  Sustainable Resources

36. Values in Health Promotion Health promotion is implicitly based on several values:  •  equity and social justice •  a holistic definition of health •  covers the full range of health determinants •  recognizes the influence of environment on health •  empowers people and builds individual and collective capacity  •  seeks to enhance people's social participation •  involves intersectorial collaboration.

37. Nursing must expand its efforts to design and implement interventions which support promotion of health and prevention of disease/illness and disability. Nurses have developed many health models to understand the client’s attitudes and values about health and illness so that effective health care can be provided. These nursing models allow nurses to understand and predict client’s health behaviour , including how they use health services and adhere to recommended therapy.

38. REFERENCES Shabeer . P basheer , a consice textbook of advanced nursing practise, emess medical publishers pg-689-693 www. Janedoc . Org/ whatt we do / prevention model Craven RF, Hirnle CJ. Fundamentals of Nursing Human Health and Function.5th  edn . Lippincott; Philadelphia:2007,  Pp-259-284. Taylor C, Lillis C, Lemone P. Fundamentals of nursing the art and science of nursing care. 5th edn . Lippincott; Newdelhi:2006, 63-65. Potter PA, Perry AG. Fundamentals of nursing.6th edn.Mosby;Newdelhi:2005 Pp-91-4. Black JM, Hawks JH. Medical Surgical nursing clinical management for positive outcomes. Vol1. 7th edition. Saunders; India : 2005, Pp 134-136. Allender JA, Spradley BW. Community health nursing concepts and practice. 5thedition.Lippincott;Philadelphia:2001, Pp  10-12. Park K. Text book of Preventive and social medicine, 18th editiion,13-29. Kulkarni . Text book of community medicine,6th edition, page no.456-460.