Friday, September 26, 2014

Major Concepts: Person, Environment and Health

PERSON

In Roper-Logan-Tierney Model of Nursing, a person is viewed as an integrated individual with physiological, psychological, socio-cultural, politico-economical and spiritual components.

It is having the ability to perform the activities of daily living, which are essential that enhances the quality of life. The person is valued at all stages of the lifespan that is infancy, childhood, adolescence, adulthood, and old age.

Throughout the lifespan until adulthood, the person tends to become increasingly independent in the activities of daily living. While independence in the ADL's is valued, dependence should not diminish the dignity of the person.

A person’s knowledge, attitudes and behavior related to ADL's are influenced by a variety of factors which can be categorized broadly as biological, psychological, sociocultural, environmental and politico-economic factors.

The way in which a person carries out the ADL's can fluctuate within a range of normal for that individual. When the individual is sick or unwell there maybe problems which may be, actual or potential, arises with ADL's.

During the lifespan, most individuals experience significant life events which can affect the way they carry out ADL's and may lead to problems, actual or potential.

Living is a complex process which we undertake using a number of activities that ensure survival. The current model seeks to define 'what living means, and categorizes these discoveries into Activities of Daily Living (ADL), in order to promote maximum independence, through complete assessment leading to interventions that further support independence in areas that may prove difficult or impossible for the individual on their own.

There are 12 activities of daily living that were listed in the Roper-Logan-Tierney Model of Nursing. A person needs to maintain a safe environment in order to stay alive and carry out any of the other ADL. These actions may include activities such as prevention of accidents in home or driving carefully.

Human beings are essentially social beings and a major part of living involves communicating with other people in one way or another. Communicating not only involves the use of verbal language as in talking and writing, but also the non-verbal transmission of information by facial expression and body gesture. Breathing is an essential activity that a person performs.

It is indispensable for life itself and all other activities are therefore dependent on being able to breathe. Moreover, the person must need to eat the right food and drink the right fluids that ensure the correct balance. Many cultures have rituals and behaviors that govern activities of elimination.

A person considers it as a private activity. Personal cleansing rather than washing is also a vital activity. These activities include care of hair, nails, teeth and mouth as well as hand washing and bathing.
Human beings are able to maintain their internal body temperature at a constant level due to a heat regulation system, but extremes in external temperatures can cause this to endanger normal living.

Playing and working is an activity which depends on what lifespan the person is presently situated. A child may play while adulthood works.

Sleeping is an ADL that enables the body to relax from the stresses of everyday living and it is also during that when growth and repair of cells takes place. The list also includes death and sexuality as activities of daily living, but these are often disregarded depending on the setting and situation for the individual person.

Author: 
Maria Eleanor Santos Reyna, RN
ENVIRONMENT

According to the Roper-Logan-Tierney Model for Nursing, environmental factor is one of the five factors that influence the activities of living. The incorporation of these factors into the theory of nursing makes it a holistic model. The environmental factor in Roper's theory of nursing makes it a "green" model. The theory takes into consideration the impact of the environment on the activities of daily living, but also examines the impact of the activities of daily living on the environment.

A client’s environment includes all of the many physical and psychosocial factors that influence or affect the life and survival of the client. This broad definition of environment crosses the continuum of care for settings in which the nurse and client interact (e.g. the home, community center, school, clinic, hospital, and long-term care facility). Safety in health care settings reduces the incidence of illness and injury, prevents extended length of treatment and/or hospitalization, improves or maintains a client’s functional status, and increases the client’s sense of well-being.

A safe environment gives protection to the staff as well, allowing them to function at an optimal level. A safe environment includes meeting basic needs, reducing physical hazards, reducing the transmission of pathogens, maintaining sanitation, and controlling pollution. In addition, a safe environment is one where the threat of attack from biological, chemical, or nuclear weapons is prevented or minimized.

Basic needs: Physiological needs, including the need for sufficient oxygen, nutrition, and optimum temperature and humidity, influence a person’s safety.  Oxygen - Be aware of factors in a client’s environment that decrease amount of available oxygen. A common environmental hazard in the home is an improperly functioning heating system. A furnace that is not properly vented or a car left running inside a closed garage introduces carbon monoxide into the environment.  Nutrition – Meeting nutritional needs adequately and safely requires environmental controls and knowledge. In the home the clients need refrigerator with a freezer compartment to keep perishable foods fresh. An adequate, clean water supply is necessary for drinking and washing fresh produce and dishes. Provision for garbage collection is necessary to maintain sanitary conditions.



Physical Hazards in the environment place client at risk for accidental injury and death; we can minimize many physical hazards, especially those contributing to falls, through adequate lighting, reduction of obstacles (doormats, small rugs, wet spot, clutters), control of bathroom hazards (fall & medicine poisoning), and security measures (smoke and carbon monoxide detector instillation, No flushing of outdated medicine to toilet to prevent soil and water contamination).

Transmission of pathogen: One of the most effective methods for limiting the transmission is the medical aseptic practice of hand hygiene. Immunization can also reduce, and in some cases prevent, the transmission of disease from person to person. At community level, adequate disposal of human waste through proper construction and repair of sewers and drains controls the transmission of disease. Insect and rodent control (e.g. spraying mosquitoes) is also necessary to reduce the disease transmission.
Pollution: A healthy environment is free of pollution. It is a harmful chemical or waste material discharged into the water, soil, or air; it can also be excessive noise that presents health risk.

Terrorism: A potential environmental health threat is the possibility of bio-terrorism attack using biological, chemical, or nuclear. Although terrorist could use any agent, health official are most concerned with biological agents such as anthrax, smallpox, pneumonic plaque, and botulism.

Author:  
Renato Regalado, RN

HEALTH 

It is the degree of wellness or illness experienced by the person.  The health status of the person is dependent on ones ability to adapt to, and cope with the challenges affecting life. Roper et al identified factors that affects a person’s adaptation to illness.  These are Social factors, cultural factors, Environmental factors, and Psychological Factors.

Social Factors include the person’s economic status like poverty and problems with overcrowding


Cultural Factors are the person’s beliefs, traits, and faith which determine ones lifestyle such as food preferences

Environmental Factors are the living conditions such as water and air pollution, poor sanitation and community hazards

Psychological Factors are the person’s manifestation of past experiences in present behavior.

Author:  
Sandra Lou Razon, RN

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