Factors and Dimensions of Health

This essay will describe the dimensions of health. It will also go on to discuss how determinants of health can affect an individual’s health. Furthermore the essay will explain the professional, legal and ethical principles that will apply when nursing this individual. In conclusion this assignment will identify personal concept of nursing.

Describe the Dimensions of Health

“Health is the extent to which an individual or group is able, on the one hand, to realise aspirations and satisfy needs: and on the other hand, to change or cope with the environment. Health is therefore, seen as a resource for everyday life, not an object of living: it is a positive concept emphasising social and personal resources, as well as physical capacity” (WHO 1984).

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The dimensions of health are so inter linked that one dimension often has a knock-on effect on others. Health is therefore holistic. One dimension of health is Intellectual: this is where an individual must have the ability to develop skills and knowledge to enhance one’s lifestyle, an example of this is health education, where a person has to have the intelligence to take on board life style changes.

One other dimension is Physical, this relates to the physical systems of the body, its compositions and functioning. This can be achieved by maintaining health by exercise and diet and maintaining good fitness.

Another dimension of health is Emotional health. This is important as an individual has a more fulfilled life they have the “feel good” factor, and have the ability to handle stress and seek help if required. If individuals are able to build strong relationships and communicate with friends and family, this often allows them to express worries which also contributes to good health.

One further dimension is Social. Humans enjoy a more fulfilled existence if they are able to have social interaction with others. Having activities to attend or appointments to keep, keeps an individual aware of their own self. They may take time to get ready and take a pride in their appearance to attend social activities. This also contributes to keeping the individual both physically and mentally healthy.

The further dimension of health is Spiritual which is also very important to groups of people. This is where an individual has the ability to have religious or morals principles and be able to explore them. For some this gives great contentment and a purpose to life.

The last dimension of health is environmental this could be explained as external surroundings i.e. access to travel. It is also important to have inexpensive social housing and access to it, the most vulnerable in society are homeless people.

The Individual

The name of this person has been changed to protect their confidentiality as per NMC (2009) guidelines. The person will now be known as Mr K. I have asked Mr K and his family for permission to look at him in this assignment and I have had their consent. Mr K is a man of 68 years of age. He was brought up in a working class family, of which he was the eldest son. Mr K worked in local mining industry for 20 years until he was made redundant. Mr K then gained employment in a local factory where he worked until his ill health.

Mr K has been married for 47 years and has 3 grown up children. Mr K and his wife had a wide social circle of friends and family. Mr K and his wife spend many weekends, as did their friends, drinking in the local club and in friend’s houses. Mr K was a heavy drinker at the weekends; he also smoked when he was drinking, although he never smoked during the week. Mr K had no obvious health problems until the age of 57 when he had a stroke. A stroke (cerebrovascular accident ) is the brain equivalent of a heart attack and happens when the blood supply to a part of the brain is cut off by:

• a clot/blockage in a blood vessel or
• a bleed from a blood vessel

Blood carries all the essential nutrients and oxygen needed by the brain to function. When the blood supply is interrupted as a result of either of these two types of stroke, then the brain will not get the oxygen it needs and brain cells die. When a stroke occurs, some or all of our senses and bodily functions can be affected. This occurred without any prior warning signs. Mr K was taken to the local hospital, where various tests confirmed that he had a left sided aneurism. Mr K was paralysed on the left side both arm and leg and his speech were also affected. Mr K remained in hospital for 7 months where he went through months of re-habilitation. Mr K is currently cared for at home by his wife.

Discuss what determinants affect this individual’s health

As previous stated Health is a holistic concept, which is made up of different determinants which affect the health of an individual.

Many factors combine together to affect the health of individuals and communities. Whether people are healthy or not, is determined by their circumstances and environment. To a large extent, factors such as where we live, the state of our environment, genetics, our income and education level, and our relationships with friends and family all have considerable impacts on health, whereas the more commonly considered factors such as access and use of health care services often have less of an impact.

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One determining factor in income and wealth, it can be noted that people in a higher income bracket enjoy better health than those in the lowest income levels. Education is also a determinant of health and poorer educated people in the community are linked to ill health. Environment is essential when determining health as communities with clean water and safe housing has a huge effect on health. Employment and good working conditions can also be included in this determinant as people in employment have less illness. Good family and friend support networks often produces better health as does certain traditions and cultures. Often found to be an essential determinant of health is genetics, inheritance has a huge part to play on determining lifespan. Health service and access to health plays an important role in health as does an individual’s attendance at such. The last main determinant of health is gender which of course an individual has to live with but it is known that men and woman suffer from different illness throughout their lifetimes, and also a female is more likely to seek medical help quicker, which will affect health.

When considering Mr K many of the determinants of health become apparent and some of these could certainly have had an effect on Mr K’s early ill health. For example Mr K came from a lower working class family. Access to fresh fruit and vegetables was minimal. Most of Mr K’s food would have come from the cheapest varieties. This could be linked to Income and income distribution determinant. Mr K also came from a one parent family and his mother worked this led to the family mainly fending for themselves during the day at school holidays and some nights after school. This could be linked to psychological determinant, stressful and poor living conditions can cause continuing feelings of shame, insecurity and worthlessness. Lack of parental care also has a high impact on later health.

Although Mr K did work he worked in a nororisoly high risk industry i.e. coal mining. The working conditions were very bad at times and the stress levels while working in high risk areas at times would have had an effect on Mr K’s hypertension, although Mr K was not aware of having hypertension at the time.

Mr K’s lifestyle away from work, was not good for health either. He was a drinker and smoker. Usually binge drinking at the weekends taking about 40 units of alcohol over 1 or 2 days. Mr K was also a heavy smoker at this time often smoking 40 cigarettes at one drinking session. This would have added to high colestral and blockage to arteries.

One final determinate on Mr K’s health could be the fact of his gender, Men are less likely to go to their GP. This may be due to men’s working hours and shifts and GP opening times which could make appointments difficult to keep maintain.

All these contributing factors may be part of the cause of Mr K’s sudden and early ill health.

Explain the underpinning professional, legal and ethical principles that would apply when nursing this person

Mr K’s health has deterioted and he now requires nursing care. “The NHS has to provide comprehensive and integrated health services to prevent and treat illness and to improve the health of the population. This basic duty is also complemented by specific legislation and case law which afford patients certain rights. For example, the right to confidentiality, the right to refuse treatment and the right to access medical records. More generally, the NHS must also comply with other legislation such as the Human Rights Act 1998 and UK equalities legislation, and it should act compatibly with conventions such as the Convention on the Rights of Persons with Disabilities” Patients Right Scotland Bill 2010.

When Mr K is admitted to hospital the nursing staff must plan his care plan focussing on Mr K’s holistic care and it should be patient focused. Mr K should be asked initially for consent if Mr K is not of fit mind to make decisions then Mrs K should seek rights to be made Mr K’s appointee. This should be done in accordance with the Mental Capacity Act 2 2005. Mr K should still be consulted about his care with the inclusion of his wife and family. Mr K has the right to privacy and confidentiality in accordance with the NMC code (2008). Mr K should be asked if he will allow his records to be shared with other health professionals. Mr K could possibly need assistance from physiotherapy staff and occupational health staff.