Health-Perception-Health-Management Pattern
Risk-Prone Health Behavior (2006, 2008)
DEFINITION
Failure to modify lifestyle/behaviors in a manner that improves health status
DEFINING CHARACTERISTICS
Diagnostic Cues
Failure to take action that prevents health problems
Minimizes health status change and/or
Demonstrates nonacceptance of health status change
Supporting Cues
Failure to achieve optimal sense of control over health risks
Smoking; excessive alcohol ingestion
OUTCOME
Acceptance: Health Status
Adjusts lifestyle/behaviors to attain optimal health and well-being
ETIOLOGICAL OR RELATED FACTORS
Inadequate comprehension
Inadequate social support
Low self-efficacy
Low socioeconomic status
Multiple stressors
Negative attitude toward health care
Ineffective Health Maintenance (Specify)* (1982)
DEFINITION
Inability to identify basic health practices, manage own health, or seek help to maintain health
DEFINING CHARACTERISTICS
Diagnostic Cues
Demonstrated lack of knowledge regarding basic health practices (inability to state this knowledge)
and/or
Reported or observed inability to take responsibility for meeting basic health practices
Supporting Cues
History of lack of health-seeking behavior
Lack of expressed interest in improving health behaviors
Demonstrated lack of adaptive behaviors to environmental changes
OUTCOME
Personal Health Status
Overall physical, psychological, social, and spiritual functioning meets expected norms
ETIOLOGICAL OR RELATED FACTORS
Unachieved developmental tasks
Complete or partial lack of gross/fine motor skills
Uncompensated perceptual-cognitive impairment (perception and judgment)
Ineffective coping (individual or family)
Disabling spiritual distress
Dysfunctional grieving
Reported or observed lack of material resources (equipment, finances, or other resources for health maintenance)
Reported or observed impairment of personal support system
HIGH-RISK POPULATIONS
Mental retardation
Cognitive impairment (e.g., severe head injury, Alzheimer’s disease, dementia, and other mental disorders)
Sensory-motor impairment (e.g., hemiplegia, paraplegia)
Ineffective Health Self-Management* (2008)
DEFINITION
Pattern of regulating and integrating into daily living a therapeutic regime for treatment of illness and its sequelae that is unsatisfactory for meeting specific health goals
DEFINING CHARACTERISTICS
Failure to include treatment regimens in daily living
Verbalizes difficulty with prescribed regimens
Verbalizes desire to manage illness (as a goal)
Failure to take action to reduce risk factors
Choices in daily living are ineffective for meeting health goals
OUTCOME
Health-Promoting Behavior
Consistently demonstrates personal actions that promote wellness and/or manage therapeutic regimen to meet health goals
States plan for integrating therapeutic regimen or rehabilitative recommendations into daily activities (prior to assuming responsibility for self-management)
ETIOLOGICAL OR RELATED FACTORS
Complexity of healthcare system
Complexity of therapeutic regimen
Decisional conflicts
Economic difficulties
Excessive demands made (e.g., individual, family)
Family conflict
Family patterns of health care
Inadequate number of cues to action
Knowledge deficit
Perceived barriers (culture, etc.)
Powerlessness
Perceived seriousness
Perceived low susceptibility; lack of benefit
Social support deficit
New treatment regimen
HIGH-RISK POPULATIONS
New and/or complex treatment regime
Mental retardation
Readiness for Enhanced Health Self-Management* (2008)
DEFINITION
A pattern of regulating and integrating into daily living a therapeutic regime for treatment of illness and its sequelae that is sufficient for meeting health-related goals and can be strengthened
DEFINING CHARACTERISTICS
Expresses desire to manage the illness (e.g., treatment, prevention of sequelae)
Choices of daily living are appropriate for meeting goals (e.g., treatment, prevention)
Describes reduction of risk factors
Expresses little difficulty with prescribed regimens
No unexpected acceleration of illness symptoms
OUTCOME
Health-Promoting Behavior
Consistently demonstrates personal actions that promote wellness and/or manage therapeutic regimen to meet health goals
States plan for integrating therapeutic regimen or rehabilitative recommendations into daily activities
Ineffective Family Therapeutic Regimen Management (Specify Area) (1994)
DEFINITION
Pattern of regulating and integrating into family processes a program for treatment of illness and the sequelae of illness that is unsatisfactory for meeting specific health goals
DEFINING CHARACTERISTICS
Inappropriate family activities for meeting the goals of a treatment or prevention program
Acceleration of illness symptoms of a family member
Lack of attention to illness and its sequelae
Verbalized desire to manage the treatment of illness and prevention of the sequelae
Verbalized difficulty with regulation/integration of one or more effects or prevention of complication
Verbalizes that family did not take action to reduce risk factors for progression of illness and sequelae
OUTCOME
Family Stabilization
Capacity of the family to maintain routines and develop strategies for optimal functioning when a member has a chronic illness or disability
ETIOLOGICAL OR RELATED FACTORS
Complexity of healthcare system
Complexity of therapeutic regimen
Decisional conflicts
Economic difficulties
Excessive demands made on individual or family
Family conflict
Deficient Community Health (2010)
DEFINITION
Presence of one or more health problems or risk factors for a health problem experienced by an aggregate that deters wellness
DEFINING CHARACTERISTICS
Diagnostic Cues
Health problems or risk factors experienced by aggregates/populations (specify problems/risk factors)
And one or more of the following:
No program available to enhance wellness
No program available to prevent/reduce/eliminate one or more health problems
Risks related to hospitalization
Risks related to physiological or psychological states
OUTCOME
Aggregate experiences decreased incidence of health problems and risk factors for health problems
ETIOLOGICAL OR RELATED FACTORS
Lack of access to public healthcare providers
Lack of community experts
Limited resources
Existing program partly addresses health problem
Existing program has inadequate:
Budget
Community support
Consumer satisfaction
Evaluation
Outcome data
HIGH-RISK POPULATIONS
High unemployment
High immigrant population with minimal resources
High substance abuse
Political unrest
Risk for Health-Management Deficit (Specify Area)
DEFINITION
Presence of risk factors for inability to manage activities related to health promotion and/or disease or disability prevention (specify drug or treatment regimen, dietary prescription, observation and reporting of symptoms, follow-up care of disease, health promotion, disease prevention).
RISK FACTORS
Priority setting, knowledge, comprehension, and/or motor skills needed for continuing treatment of disease exceed actual or potential competencies
Priority setting, knowledge, comprehension, and/or motor skills required for specific health promotion and disease prevention activities exceed actual or potential competencies
Activity intolerance (level IV)
Uncompensated perceptual or cognitive impairment
Uncompensated impaired coordination
Impaired mobility (levels II through IV)
Uncompensated short-term memory deficit
Uncompensated visual or hearing loss
Impaired reality testing
Severe depression
OUTCOME
Compliance Behavior
Takes personal actions to promote wellness, recovery, and rehabilitation based on professional advice
Noncompliance (Specify Area) (1973, 1996, 1998)
DEFINITION
Nonadherence to a therapeutic recommendation following informed decision and expressed intention to attain therapeutic goals (specify drug or treatment regimen, dietary prescription, observation and reporting of symptoms, follow-up care, health-promoting behaviors)
DEFINING CHARACTERISTICS
Diagnostic Cues
One or more of the following:
Direct observation of noncompliance or statements by client or significant others describing behaviors indicating failure to adhere
Objective tests revealing nonadherence (physiological measures, detection of markers)
Supporting Cues
Evidence of development of complications
Evidence of exacerbation of symptoms
Failure to keep appointments
Failure to progress (resolve problem)
OUTCOME
Adherence Behavior
Takes self-initiated actions to promote wellness, recovery, and rehabilitation
ETIOLOGICAL OR RELATED FACTORS
Value, health beliefs, cultural, or spiritual conflict
Knowledge or skill deficit (developmental abilities)
Perceived therapeutic ineffectiveness
Perceived nonsusceptibility or invulnerability
Denial of illness
Family pattern disruption
Low motivation
Satisfaction with care/credibility and continuity of provider/access and convenience of care/client-provider relationship
HIGH-RISK POPULATIONS
New and/or complex treatment regimen (duration, cost, or complexity)
Risk for Noncompliance (Specify Area)
DEFINITION
Presence of risk factors for nonadherence to the therapeutic recommendations following informed decision and expressed intention to adhere to or to attain therapeutic goals
RISK FACTORS
Denial of illness
Perceived ineffectiveness of recommended practices
Perceived lack of seriousness of problem or risk factors
Perceived lack of susceptibility
Insufficient knowledge or skills (therapeutic recommendations)
Absence of a plan for integrating therapeutic recommendations into daily routines
New and/or complex treatment regimen
Lack of support systems (supportive others)
History of noncompliance with aspects of therapeutic regimen
OUTCOME
Compliance Behavior
Demonstrates personal actions to promote wellness, recovery, and/or rehabilitation based on professional advice
Contamination (2007)
DEFINITION
Exposure to environmental contaminants in doses sufficient to cause adverse health effects
DEFINING CHARACTERISTICS
(Defining characteristics are dependent on the causative agent. Agents cause a variety of individual organ responses as well as systemic responses.)
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