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MID 50

FUNDAMENTALS OF MIDWIFERY PRACTICE

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Physiological Oxygen, water, food,

temperature(shelter and
clothing),elimination sleep ,activity ,
and sex
Psychological Self-esteem, feeling of security,
happiness, sadness
Socio-cultural Feeling of belonging, relationship
Intellectual Thinking, learning
Spiritual Being connected with others

A need is something that is essential to the emotional and

psychological health and survival of humans. All people strive to meet basic
needs at any given time and individual¶s need may be met, partially met, or
unmet. A person whose needs may be considered to be healthy and a
person with one or more unmet needs is at increased risk of illness or health
alterations in one or more of the human dimensions.

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‡ Its absence results in illness
‡ Its presence prevents or signals health
‡ meeting an unmet need restores health

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!", in which certain
needs are more basic than others. Although all the needs are present, the
individual strives to meet certain of the needs at least to a minimal level
before attending to the others.

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{c Jistorically, Western culture defines health as the absence of illness.

{c World Jealth Organization (WJO) defines health as a state of complete
physical, mental and social well being and not merely the absence of
disease or infirmity.
{c The process, through which a person seeks to maintain an equilibrium
that promotes stability and comfort, is a dynamic process that varies
according to a person¶s perception of well being.

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{c Is the inability of an individual¶s adaptive responses to maintain

physical and emotional balance that subsequently results in an
impairment of functional abilities.

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{c Is the condition in which an individual function at optimum levels.

{c Wellness is a multidimensional state of being describing the existence
of positive health in an individual as exemplified by quality of life and a
sense of well-being.

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Genetic make up, developmental level, age, race, life

style and gender are all part of an individuals
physical dimensions strongly influences health status and
health practice.

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Jow the mind and the body interact to affect body
function and to respond to body conditions also influences
health. Locus control refers to individual sense of
control over events and situation affecting their lives.

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Encompass cognitive abilities educational
background and past experiences. These influence a
client¶s response to teaching about health and reaction to
health care during stress. They also play a major role in
health behavior.
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Jousing, sanitation, climate, pollution, food and
water are aspect of environmental dimension that
affect health.
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Jealth practice and beliefs are influenced by
economic status, life style, family and culture.
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Religious belief and values are important component
of the person¶s behavior in health and illness.


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A healthy body is maintained by good nutrition, regular exercise,
avoiding harmful habits, making informed decisions about health and
seeking medical assistance when necessary.
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The ability to understand your own feelings, accept your limitations,
achieve emotional stability and become comfortable with your
emotions.
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The sense that life is meaningful and has a purpose; the ethics, values
and morals that guide us and give meaning and direction to life.
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A state in which your mind is engaged in lively interaction with the
world around you. It involves continued learning, problem solving and
creativity.
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It has to do with the attitude at work and how you are while you are
working. The occupational component mostly talks about your skills
while working and how you use them in your working area. Your
attitude is one of them and how you get along in your work.
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The ability to relate well to others, both within and outside the family
unit. It encourages contributing to a healthy community by supporting
a healthy living environment and initiating better communication with
others.

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ñc I get enough sleep
ñc I minimize and/or avoid the use of all types of drugs (nicotine, alcohol,
caffeine, illegal drugs, over-the-counter)
ñc I eat a balanced diet consisting of food high in complex carbohydrates
and low in fat
ñc When I am ill, I seek medical care
 ñc If I am heterosexual, I use an effective birth-control method
consistently when I am intimate
ñc If I am sexually active, I minimize my risk of Sexually Transmitted
Diseases (STDs)
ñc I take daily relaxation breaks
ñc I do not restrict calories, fad diet, or purge to get rid of excess calories
ñc I exercise aerobically three to five times a week (walking, jogging,
biking, stairmaster, rowing, swimming, etc.)
ñc I exercise because it is enjoyable and beneficial to my heart and
health, not only because it burns calories or fat.
ñc I do not over-exercise (for non-competitive athletes, 3-5 times a week
is plenty)


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ñc I am emotionally comfortable with my sexuality and current sexual
practices
ñc I take responsibility for creating my feelings
ñc I express my feelings directly and often
ñc I have a high self-esteem
ñc I am free of self-destructive behaviors
ñc I take time out for introspection
ñc I am satisfied with the size and shape of my body
ñc I don't feel guilty when I fail to exercise
ñc I don't feel guilty when I eat high calorie foods
ñc I do not rely on drugs and alcohol as a way to manage stress
ñc I do not blame others for what I am feeling
ñc I treat myself as well as I would treat my best friend

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ñc I enjoy my schooling
ñc I enjoy my job
ñc I work in a health place
ñc I stay current in my profession
ñc I earn a fair salary
ñc I am compatible with my co-workers
ñc I choose a job/major with the opportunity for growth
ñc My job is not in conflict with my personal values


ñc I stay current with local, national and world events
ñc I read materials which make me think
ñc I listen to and consider ideas different from my own
ñc I re-evaluate my judgment and opinions
ñc I appreciate the arts
 ñc I am politically active
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ñc I recognize my impact on the environment and its impact on me
ñc I minimize the use of disposable products
ñc I recycle (newspaper, glass, aluminum, plastic)
ñc I walk or bike to work or class
ñc I realize that my consumption today affects future generations
ñc I don't litter
ñc I enhance or clean up the environment
ñc I buy products and/or support companies which support the
environment
ñc I support political leaders who are environmentally aware

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ñc I care about others
ñc I recognize and appreciate interdependence
ñc I have several healthy, intimate relationships
ñc I'm involved in at least 1 university or community group
ñc I refrain from abusive relationships with members of same gender as
well as opposite gender
ñc I contribute to the well-being of my family
ñc I have a positive effect on others
ñc I do not exploit, verbally abuse, physically abuse, or deceive others
ñc I value sharing time with others
ñc I appreciate cultural diversity and have friends from all walks of life
ñc I am satisfied with social life

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ñc I have a sense of meaning and purpose in my life
ñc I mediate or pray regularly
ñc My actions reflect my spiritual beliefs
ñc I have thought about, and accepted, my death
ñc I have a feeling of peace
ñc I am comfortable with my spirituality at this time in my life
ñc I go to church, synagogue, spiritual meetings, or inspirational
gatherings
ñc I take time out for introspection and reflection of a "bigger" picture

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MODEL TJEORIST ASSUMPTIONS
Clinical Model Traditional perspective {c Jealth is absence of
illness
{c Individuals who are not
sick are healthy
Jealth belief model Rosenstock {c Expectations direct
behaviors that lead to
fulfillment of the
expectations
{c Group values exert
influence on beliefs about
health
{c Beliefs may change as a
person grows and
develops
Jigh-level wellness dunn {c Jealth is influenced by the
model interaction among the
individual, family, and
community
{c Jealth is viewed as an
attempt toward achieving
one¶s fullest potential
Social learning theory Bandura {c Beliefs strongly influence
actions
rosenstock {c Behavior is influence by
expectations and
reinforcement( or
incentives)
Jost-agent ± Leavell and clark {c Jealth depends on the
environment model interaction of host, agent,
(³Ecologic´ model) and environment
{c Balance among the these
elements results in health
{c Illness occurs where there
is an imbalance in one of
the three elements
{c Model is used most often
in predicting risk of illness
Jealth promotion pender {c People engage in health-
model promoting behavior when
they:
1.c Value health
2.c Perceive health as
being within their
control
 3.c Can identify
benefits in self-care
behaviors
4.c Jave a positive
perception of their
health status

{c Jealth-promoting
behavior is influenced by:
1.c An individual¶s
inherited and
acquired
characteristics
2.c Significant others,
who model the
behavior, expect
the behavior to
occur, and facilitate
the behavior
3.c Families, peers, and
health care
providers.

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{c Developmental Stage - A person thought and behavior pattern

change throughout life. The nurse must consider the client level of
growth and development when using his or her belief and practices as
a basic for planning care.
{c Intellectual Background - A persons belief about health are shaped
in part by the persons knowledge about body function and illness,
educational background and past experiences. Cognitive abilities shape
the way a person thinks including the ability to understand factors
involved in illness and to apply knowledge of health and illness to
personal health practices.
{c Perception of Functioning - The way people perceive their
physical functioning affects health belief and practices.
{c Emotional Factors - The client¶s degree of calm or stress can
influence health belief and practices. The manner in which a person
handles stress throughout each stage of life will influence the way the
person reaction to illness.( under pressure by emotion )
 {c Spiritual factor - Spirituality is reflected in how a person live his
or her life including the value and belief exercise the relationship
established with family and friends and the ability to find hope and
meaning in life.

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{c Family Practices - The way that clients families use health care
services generally affect their health practices.
{c Socio-economic status - Social and psychosocial factors can
increase the risk for illness and influence the way that a person defines
and react to illness. Psychosocial variables include the stability of the
person¶s marital or intimate relationship lifestyle, habits and
occupational environment.
{c Cultural background - influences belief values and custom. It
may also influence an individual belief about the cause of illness as
well as remedies or practices to restore health.


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{c Behavioral and Emotional Changes - People react differently to

illness or the treatment of illness individual behavioral and emotional
reactions depends on the nature of the illness the client¶s attitude
toward it the reaction of others to it and the variables of illness
behavior.
{c Impact on Body Image - Body image is the subjective concept of
physical appearances when a change in body image occurs such as
result from a leg amputation the client generally adjusts in the
following phases Shock, withdrawal, acknowledgement, acceptance
and rehabilitation.
{c Impact on Self Concept - Self concept is a mental self image of
strengths and weakness in all aspects of personality. Self concept
depends in part on body image and roles but also includes other
aspect of psychology and spiritually.
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If a person is aware of something is wrong it recognized

physical sensation, there is limitation in functioning level. Ex. Fever=
symptoms=rashes.

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If symptoms occur and severe clients assumed becomes

social phenomena and sick people seek for their family, group excuse from
the normal activities.

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On this stage the client seeks expert knowledge.

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The patient is dependent on professional health for the

relief of symptoms. The client accepts care, sympathy protection in demand
and stress adjust to destruction of daily schedule.

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Period of recovery from the illness restoration of life

function to optimum level. Some cases in this stage can arrive suddenly
such as when a symptom appears in the call of chronic illness may involve
adjustment to prolong in health and functioning.

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Jealth promotion is the process of enabling people to increased control

over their health and to improve their health through development of
human resources and behaviors that maintain or enhance well being.
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{c Primary prevention -primary prevention aimed at health promotion

includes health education programs, immunization and physical
fitness activities and proper nutrition.

{c Secondary Prevention -Focuses on individuals who are experiencing

health problems or illnesses and who are at risk for developing
complication or worsening condition.

{c Tertiary prevention -Occurs when a defect or disability is

permanent and irreversible. It involves minimizing the effect of long
term disease or disability by interventions directed at preventing
complications and deterioration.

Prepared By:

Kriegel Paman Bihasa RM, RN, USRN