Instructor manual for physical examination and health assessment canadian 2nd edition by jarvis

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Jarvis: Physical Examination & Health Assessment, 2nd Canadian
Edition
Chapter 02: Health Promotion in the Context of Health Assessment
Instructor’s Manual
ANNOTATED LEARNING OUTCOMES
After completing this chapter, the student will do the following:
Discuss the concept of health promotion.
In the Ottawa Charter for Health Promotion, health promotion is defined as “the process
of enabling people to increase control over, and improve their health” (WHO, 1986, p.1).
This illustrates a shift in power from health care providers to consumers of health care
and their communities.
Discuss the concept of disease prevention.
Disease prevention is characterized by three levels; primary, secondary, and tertiary
prevention.
Primary prevention focuses on preventing people from getting ill, sick, or injured
in the first place (e.g., teaching about smoking in schools). Secondary prevention focuses
on the early detection of disease before symptoms emerge (e.g., mammography, testicular
self-examination, Pap test). Tertiary prevention is the implementation of complicationreducing activities after the disease has been diagnosed (e.g., cardiac rehabilitation,
limiting second-hand smoke exposure for person with chronic obstructive pulmonary
disease).
Identify the social determinants of health.
The social determinants of health are factors that have been identified as being influential
to an individual’s health. The determinants of health include: the socioeconomic
environment (includes income, social status, social support networks, education,
employment, and social environments), the physical environment, healthy childhood
development, personal health practices, individual capacity and coping skills, biology and
genetics, health services, gender, and culture. Inquiry into the determinants of health
occurs during the health assessment.

Identify the five principles underpinning health promotion activities.
Five principles underpin the development and implementation of health promotion
activities. Health promotion activities (1) involve the population as a whole in the context
of their everyday lives, (2) are directed toward action on the social determinants of
Instructor Manual for Physical Examination and Health Assessment Canadian 2nd
Edition by Jarvis


Instructor’s Manual
health, (3) combine diverse but complementary methods, (4) aim at effective and
concrete public participation, and (5) are nurtured and enabled by health care providers,
particularly in primary health care.
Identify important topics to be discussed during counselling activities.
Injury prevention, diet, exercise, sexual health, substance use, dental health, anticipatory
guidance, and primary prevention of specific cancers are important to discuss during
health encounters.
Discuss the importance of screening.
Screening fosters early detection of conditions and diseases, and is possible when
sensitive and effective tools are available. The decision to screen is based on the
prevalence of the disease in the population, and is only reasonable when the prevalence is
relatively high in a specific age group, gender, or ethnic population.
Identify tools used to assess developmental tasks.
Several provinces use the Nipissing District Developmental Screen (NDDS) to assess
children’s development. Other tools to assess development in children are presented in
the chapter.
KEY TERMS
Health promotion
“Moving upstream”
Pender’s Health Promotion Model (HPM)
Primary prevention

Screening
Secondary prevention
Social determinants of health
Tertiary prevention
TEACHING STRATEGIES
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Have students develop a primary prevention activity.
In groups, have students develop and present a secondary prevention activity.
Have students identify tertiary prevention services in your community.
Use an available or new scenario or case study to help students identify
determinants of health and their impact on health.
Using available or new scenarios or case studies, ask students to identify
appropriate nursing diagnoses.
Have students discuss their perspectives on immunization, and identify arguments
for and against it.
Invite a public health nurse to class to discuss the assessment of developmental
tasks in children and the use of specific tools.
Have pairs of students create and role-play health encounters. Ask the other
students in the class to identify counselling activities.

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Edition by Jarvis

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Instructor’s Manual
CRITICAL THINKING EXERCISES
Application to Clinical Practice
For each situation described below, have students identify the need for health promotion
and disease prevention. They should identify appropriate health promotion activities and
the level of disease prevention the problem represents.
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G.S. recently emigrated from Nigeria. He works two jobs in order to save money
to bring his family to Canada. He has untreated hypertension.
B.W. is the mother of an 18-month-old girl. She visits the public health clinic for
a developmental assessment of her child.
E.B. is a 32-year-old man who has recently diagnosed with asthma, and who has
been smoking for the past 10 years. During a health visit, he expresses a desire to
quit smoking.
J.B., a 69-year-old farmer, is admitted to the hospital for chest pain. He is
overweight and has been financially strapped since his last crop was destroyed by
a flood.
K.L, 53 years old, has gained 22 pounds in the last year. Her older sister and
brother both have type 2 diabetes.
J.T. is a 16-year-old homeless girl who comes to the prenatal clinic for follow-up

care.

WEB SITES OF INTEREST
Canadian Best Practices Portal—
Canadian Consortium for Health Promotion Research—
/>Health Canada—
Public Health Agency of Canada— hp-ps

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OPEN-BOOK QUIZ
Chapter 2: Health Promotion in the Context of Health Assessment
Complete the following crossword puzzle.

CLUES
Across

2. “Not merely the absence of disease”
4. Socioeconomic environment determinant of health
5. Secondary-prevention activity for women
6. Primary-prevention activity
7. Preventing people becoming ill in the first place

8. “The process of enabling people to increase control
over and to improve their health”
9. Childhood developmental screening tool

Down

1. Tertiary prevention following myocardial
infarction
3. Health promotion model developer

Instructor Manual for Physical Examination and Health Assessment Canadian 2nd
Edition by Jarvis