Discussion 1: Psychosocial Factors in Health

 Psychosocial factors include all social resources such as emotional support and social integration as well as psychological resources such as sense of coherence, perceived control, and self-esteem, including psychological risk factors such as depression, vital exhaustion, and hopelessness that may potentially affect health (Thomas et al., 2020). Psychosocial factors play a significant role in the development of many diseases and overall health status. Psychosocial behaviors have been linked with a direct relationship with health behaviors (Thomas et al., 2020). For example, social factors such as increased tobacco use compared to non-smoking are reported with a higher possibility for poor health care outcomes. According to studies, smokers are more likely to develop metabolic issues such as diabetes and other non-communicable diseases following poor lifestyles associated with psychosocial factors (Thomas et al., 2020). Risk alcohol consumption, inactivity, and poor diet are among many psychological factors that significantly lead to poor health care outcomes.

Despite various efforts by the United States government, it has been shown that engaging in multiple health risk behaviors such as increased tobacco use increases the risk of disease development, thus the poor health status in the community (Thomas et al., 2020). Strategies that can be used in addressing these psychosocial factors in the promotion of health include mass community health education. For example, people need to be educated on the role of their negative social life, such as increased use of tobacco on metabolic syndrome and risk of many non-communicable diseases. Poor psychosocial factors result in poor quality of life, including poor disease management outcomes (Thomas et al., 2020). Population and community education provides a chance to promote health awareness in ensuring that people choose healthy lifestyle habits. Because psychological factors potentially influence both acute and chronic diseases, nurses, especially community nurses, have a significant role in health promotion. One of the primary roles in carrying out holistic health needs assessment among patients is in providing patient-centered care. Holistic assessment includes identifying potential psychosocial, spiritual, cultural, and physical health-related needs that need addressing in health promotion (Santos et al., 2018). Nurses have a significant role as well in health promotion through patient and community education. For example, nurses can be involved in programs that aim to reduce the health burden associated with smoking through health education (Nutbeam, 2019).

References

Nutbeam, D. (2019). Health education and health promotion revisited. Health Education Journal, 78(6), 705–709. https://doi.org/10.1177/0017896918770215

Santos, J. C., Bashaw, M., Mattcham, W., Cutcliffe, J. R., & Giacchero Vedana, K. G. (2018). The Biopsychosocial Approach: Towards Holistic, Person-Centred Psychiatric/Mental Health Nursing Practice. In J. C. Santos & J. R. Cutcliffe (Eds.), European Psychiatric/Mental Health Nursing in the 21st Century: A Person-Centred Evidence-Based Approach (pp. 89–101). Springer International Publishing. https://doi.org/10.1007/978-3-319-31772-4_8

Thomas, K., Nilsson, E., Festin, K., Henriksson, P., Lowén, M., Löf, M., & Kristenson, M. (2020). Associations of Psychosocial Factors with Multiple Health Behaviors: A Population-Based Study of Middle-Aged Men and Women. International Journal of Environmental Research and Public Health, 17(4), 1239. https://doi.org/10.3390/ijerph17041239

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Psychosocial factors influence health and wellbeing on a daily basis, especially chronic disease (Friis & Sellers, 2021).  Healthy People

2020 highlighted social and physical environment and how it promoted health (Healthy People, 2020).  Understanding how psychosocial factors influence health and wellbeing is valuable to improve and understand patient outcomes.

Psychosocial Example 1

Asthma is a common chronic disease in children with approximately 5.5 million children affected in the United States (Schiliro et al., 2021).  A psychosocial factor that influences asthma in children is exposure to second-hand smoke (SHS), especially by household members (Schiliro et al., 2021).  Children with asthma are especially vulnerable to SHS due to it being an airway irritant (Schiliro et al., 2021).  Exposure to SHS causes exacerbations of asthma symptoms, such as wheezing, recurrent pulmonary and ear infections and is completely preventable (Schiliro et al., 2021).  In addition to asthma exacerbations, SHS has been found to increase heavy metal concentrations in children (Li et al., 2018).

Though the number of adult smokers has decreased, the exposure to the vulnerable population of children still exists (Shiliro et al., 2021).  Additional education is needed to adult smokers to help them understand the risks presented to others, especially children, to SHS (Shiliro et al., 2021).  Quit smoking lines are available in most states free of charge to smokers.  Advertisements that accentuate the child exposed to SHS may help with more adult smokers seeking help to quit smoking.

The role of the nurse could be to inquire at well child visits if the parents are smokers.  If so, information and education could be provided to the parent on the effects to the child from SHS.  Awareness and continual efforts to alleviate the exposure to SHS in children is necessary (Li et al., 2018).

Psychosocial Example 2

The second example of a psychosocial factor influencing health is depression in the obese patient.  My hospital has a Bariatric Center of Excellence.  Candidates for bariatric surgery are screened prior to their surgery approval for psychosocial factors, which includes depression.  Obesity and depression are separate health issues, but can affect or be a contributor to the other (Borgland, 2021).  Depression often causes a patient to reduce their activity levels, emotionally eat, and increase alcohol consumption, which contributes to obesity (Borgland, 2021).  Understanding if the patient is at risk for depression or has depression influences the ability to carry through with the intense regimen after bariatric surgery.

Appropriate treatment for depression in the obese patient is paramount for success.  Behavioral therapy can often be a way to help the patient manage their obesity as part of their multimodal regimen (Borgland, 2021).  Educating the obese patient on ways to manage their depression and behaviors will help them have successful weight loss.

Nursing’s role for the bariatric surgery patient is to continually monitor them during their hospital admission for depression.  Just because the patient has entered the hospital to have their bariatric surgery, does not mean the patient cannot have intensification of their depressive symptoms.  The link between obesity and depression needs additional research so that nursing may have a better understanding of how to help this special population of patients.

References

Borgland, S. L. (2021). Can treatment of obesity reduce depression or vice versa? Journal of Psychiatry & Neuroscience, 46(2), E313–E318. https://doi.org/10.1503/jpn.210036

Friis, R. H., & Sellers, T. (2021). Epidemiology for public health practice (6th ed.). Jones & Bartlett Learning, LLC.

Healthy People. (2020). Social determinants of health. Healthy People 2020. http://healthypeople.gov/2020/topicsobjectives2020/overview.aspx?topicid=39

Li, L., Guo, L., Chen, X., Xiang, M., Yang, F., Ren, J., & Zhang, G. (2017). Secondhand smoke is associated with heavy metal concentrations in children. European Journal of Pediatrics, 177(2), 257–264. https://doi.org/10.1007/s00431-017-3053-2

Schiliro, M., Vogel, E. R., Paolini, L., & Pabelick, C. M. (2021). Cigarette smoke exposure, pediatric lung disease, and COVID-19. Frontiers in Physiology, 12, 1–12. https://doi.org/10.3389/fphys.2021.652198