What were the first determinants of health as identified by the Lalonde Report in 1974?
a.Biology, lifestyle, health care, environment
b.Resources, social justice, stable ecosystem, equity
c.Biology, genetics, education, social supports
d.Income, social status, education, health services
ANS: C
The perspective taken in this text is based on the Ottawa Charter definition of health: "to reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations, to satisfy needs, and to change or cope with the environment." Therefore, the World Health Organization (WHO) identified health as a resource for everyday living, i.e., taking a holistic approach that includes physical, social, and personal capabilities, with health being viewed positively. When using this definition, health is no longer viewed as an outcome (or a state to be reached); rather, health is incorporated into one's activities of daily living. Today, Health Canada continues to apply the Ottawa Charter definition of health. The view of health as a resource proposes that communities and individuals use this resource to manage and even change their environments.
ANS: C
It is important for CHNs to recognize that older adults who are depressed usually have a clinically different presentation from that of clients in other age groups. Older adults who are depressed tend to present with many bodily complaints, such as chronic pain, nausea and vomiting, and insomnia, and usually do not express feelings of sadness, guilt, or worthlessness. The depression rate among older adults is half that among younger people, but the presence of a physical or chronic illness increases rates of depression. Activities to improve the mental health status of older adults include public education programs, prevention approaches, and the provision of mental health services in primary care. Depression rates for older adults in nursing homes range from 15% to 25%, and thus this would not be a good place to recommend for social networking. Encouraging older clients to focus on their strengths rather than their weaknesses can sound insensitive if (1) the weaknesses are, indeed, profound, and (2) the necessary tools for coping are not provided along with the advice. Monitoring for signs and symptoms of depression only monitors health issues, rather than preventing them.