Nursing 1070A/B Lecture Notes - Lecture 2: Fetal Alcohol Spectrum Disorder, Health Promotion, World Health Organization
20 Oct 2016
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Week 2: Evolution of Health Promotion
Health Promotion:
The proess of epoerig people to irease otrol oer ad to
iproe their health World Health Organization (WHO, 2006)
• This is a broad definition and includes the spectrum of health
enhancement, health education, health protection, disease
prevention, health restorations/recovery
• Empower; being able to take action yourself.
• Disempowered; lost the power or someone took the power away to
control yourself
• Canadian healthcare focuses on health promotion, as it is cheaper to
prevent illness then to treat it.
• Canada changed from a medical model to a health promotion model.
• Nursing is changed from an individual focus to a community focus.
Where and When Did Health Promotion Begin?
• Not always called Health Promotion, but dates back
• Dating to 600 BC Babylonians and Romans had a system that flushed away waste. They
dug channels to drain marshy area, laws were in place to keep water clean, had sewage
systems. This would could people healthier for a longer periods of time.
• During the Biblical Times, in Jerusalem there was also a water system. There was stone
covered channels to control the flow of where water was coming from
• Quarantine dates back to 579 BC. It was used when people became ill from leprosy.
When a family member was infected, the family would be at risk so they would
quarantine the ill.
• Greeks and Romans drank beer, as in the fermentation process the alcohol killed
bacteria. But people who drank too much beer had problem too, they realized
itoiatio as a thig. The also prohiited alohol o the ouple’s eddig ight as it
was associated with birth defects and health challenges. (fetal alcohol spectrum
disorder)
Broad Street Pump:
There was a Cholera Outbreak in the Sohio District London,
• People’s seage i “oho area used to flo uder hoes; seage as dierted to the Thaes
River, which resulted in contaminated water.
• A Cholera outbreak resulted in many deaths of people living around a certain water pump. At
the time, people did not know much about germ theory, so did not associate the cholera
outbreak with water.
• John Snow, a physician, made the connection and decided to remove the pump handle to
stop water use. Deaths subsided.
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Florence Nightingale:
Patiets are to e put i the est oditio for ature to at o the, it is the resposiilit of
urses to redue oise, to reliee patiets’ aieties, ad to help the sleep.
In most nursing theories, environmental adaptation remains the basis of holistic nursing care.
Nurse during the war, that discovered a lot of simple things that can lead to health
Floree Nightigale’s Major Health Priiples
1. Ventilation and warming (let fresh air in, so soldier with disease ina space do not breath each
other’s air, those ho are sik ust e ar.)
2. Light, Noise (stressors contribute to disease)
3. Cleanliness of rooms/walls
4. Health of houses
5. Bed and bedding (bed bugs, flees, ticks)
6. Personal cleanliness (hygiene, the better hygiene the more well you are)
7. Variety (mental health, not being in the same place at all times, body has a hard time
recovering when your mind is sick)
8. Chattering hopes and advices (improving spirits, false sense of hope)
9. Taking food. What food? (High quality food)
10. Petty management/observation (balancing seeing patients with her work, detailed ntoed
what is in ingested)
Ottawa Charter November 1986:
Discusses the prerequisites for health, health for all by 2000, through health promotion.
Source of money is needed to be healthy
Education for health literacy, the more education the more accessibility
If your health, you can help others be healthy
Spend tons of money on health promotion strategies
Hoping to get people in control the health in their life, increases awareness in health
promotion.
Five action areas for health promotion were identified in the charter:
• Involving the population as a whole
• Action on the determinants or causes of health
• Diverse by complimentary methods or approaches
• Aims particularly at effective ND concrete public participation.
• Health care professionals have the role of nurturing and enabling health promotion.
The basic strategies for health promotion were prioritized as:
• Advocate: Health is a resource for social and developmental means, thus the dimensions
that affect these factors must be changed to encourage health.
• Enable: health equity must be reached where individuals must become empowered to
control the determinants that affect their health, such that they are able to reach the
highest attainable quality of life.
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• Mediate: Health promotion cannot be achieved by the health sector alone; rather its
success will depend on the collaboration of all sectors of government (social, economic,
etc.) as well as independent organizations (media, industry, etc.).
Specific Models of Health Promotion:
The Biomedical Approach: (treatment)
Doiat perspetie ithi the health siees for a ears, health as the asee of
disease
• Disease is an abnormality from normal
• Someone is different from normal, they are unhealthy
• People outside the normal felt disempowered.
• Elimination of disease depended on the scientific advancements, pathogens, scientific
neutrality of medicine
• In spite of all the money put into health innovation (penicillin), the overall health was
not improving, some people were even getting sicker.
• Causes: Hypertension, family history, hypercholesterolemia
• Strategies: Treatment, Drugs, Diet Regimen.
Behavioral Model/Lifestyle Approach: (health promotion)
The Behavioral model views health as the product of making healthy lifestyle choice, health
experts decided on the good and bad behaviors and tried to get people to alter their lifestyle.
• Focuses on prevention of disease and disability in people who are at risk
because of their lifestyle or behavioral risk factors (i.e. high fat diet,
exercise)
• Step forward in health care due to 1974 Lalonde Report
• Lalonde Report shifts perspective to lifestyle approach and to get people
healthier instead of medicine. Behavioral modifications, and healthier
choices.
• Better than bio medical model, but habits are hard to break and
changing a lifestyle is hard.
• Lalode odifiale ehaiors ere alas ative, beverage better,
and choose calorie-wise.
• Causes: Smoking, High fat diet, high stress, low level of physical
activity.
• Strategies: Health education/ communication, self-help, advocacy for
public, policies supporting lifestyle choices
Lalonde Report:
• 1974 Marc Lalonde is the minister of health and welfare Canada introduced the notion of
health nationally and internationally.
• This report initialed a shift from a biomedical view of health to a more global approach
to health
• Increased awareness in of human biology, environment, and lifestyle as determinants of
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