Patho - physiologic & Psychodynamics of disease causation

CONCEPTS OF HEALTH
Health

Health status
Health belief Health behavior

Health - Belief Model

Individual perceptions Modifying factors Likelihood of action

Perceived susceptibility Perceived seriousness Perceived threat

Demographic variables Structural variables Cues to action

Perceived benefits to action Perceived barriers to action

Concepts ( contd)
Patho-physiologic Psychodynamics

Homeostasis

Stress

Constancy

Adaptation

Body- A balanced state

Homeostasis
Physiologic homeostasis

Psycho logic homeostasis

Physical environment

Psychological environment

Psycho logic homeostasis

Social environment

Life experiences

Stress
Types of stressors

Physical Physiologic Psycho-social

Physiologic Manifestations of Stress

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Interpretation of stressful stimuli by brain

Sympathetic nervous system Response

Sympathetic Adrenal Medullary response Hypothalamic Pituitary response

Physiologic Manifestations of Stress (Contd.)

Dilation of pupils Diaphoresis Increases heart rate Paleness of the skin Increased blood pressure Increased cardiac output Increased rate & depth of respiration Decreased urine output

Physiologic Manifestations of Stress (Contd.)

Dry mouth Increased peristalsis of the intestines Increased muscle tension Increased blood sugar Lethargy, Mental lassitude, inactivity

Psycho logic Manifestations of Stress

Anxiety- mild, moderate, sever anxiety

Fear
Anger- Hostility, Aggression, Violence Depression

Cognitive Manifestations of Stress

Problem-solving Structuring Self-control Suppression Fantasy or day-dreaming Prayer

Verbal & Motor Manifestations of Stress

Crying Verbal abuse Laughing Screaming Hitting or Kicking Holding & touching

Unconscious ego defense mechanisms

Stress at cellular level

Cellular injury
Causes Hypoxia Physical Agents Extremes of temperature, Radiation & electrical shock, Mechanical trauma Chemical agents Disordered immune response Genetic disorders

Adaptation
Modes of Adaptation Physiologic Mode/ Biologic adaptation Psycho logic adaptation

Socio-cultural Adaptation

Characteristics of Adaptive responses

All adaptive responses are attempts to maintain homeostasis. Adaptation is a whole body or total body responses. Adaptive responses have limits. Adaptation requires time. Adaptability varies from person to person. Adaptive responses may be inadequate or excessive. Adaptive responses are ego-centric and tiring.

Dimensions of Adaptation
Physical Developmental Emotional Intellectual Social Spiritual

Stages of Adaptation to response

1. An Alarm reaction Shock Phase Counter shock phase 2. Stage of resistance 3. Stage of exhaustion

General Adaptation response

ALARM REACTION
1. Hypothalamus 2. Posterior pituitary Increased ADH increased water absorption Decreased urine output

General Adaptation response

3. Anterior pituitary Increased ADH- Adrenal cortexIncreased Aldosterone
4. SNS & Adrenal medulla Increased epinephrine Increased nor epinephrine 5. Fight or Flight

General Adaptation response

RESISTANCE Sterilization Hormonal levels return to normal

Parasympathetic Nervous System

Adaptation to stress

General Adaptation response

EXHAUSTION
Increased physiological response as in alarm reaction Decreased energy levels Decreasing physiological adaptation Death

Local Adaptation Syndrome

Reflex pain response
Inflammatory response

Inflammatory response
Vascular & Exudative Reparative cellular response stage response

Illness
Stages1. Transition from health to illness 2. Period of accepted illness 3. Convalescent stage

Illness behavior
IGUNs 11 stages of illness behavior
1. Symptom experience 2. Self-treatment or medication 3. Communication to others 4. Assessment of symptoms 5. Sick-role assumption 6. Concern

Illness behavior ( Contd.)

7. Efficacy of treatment 8. Selection of treatment 9. Treatment 10. Assessment of effectiveness of treatment 11. Recovery & Rehabilitation

Nursing Implications
Promoting healthy Life-style Enhancing Coping strategies Teaching relaxation exercises Educating Enhancing social support Recommending support & therapy Group Crises intervention

Stages of health behavior change

Pre-contemplation

Contemplation
Preparation Action Maintenance