It makes the important assertion that, current health status and disease outcomes associated with disease states in individuals or populations are determined by multiple factors that are both internal and external to the individual or population. These factors include the: (1) physical environment, (2) social environment, (3) genetic endowments, (4) prosperity, (5) individual behaviors, (6) individual biology, (7) health and function, (8) disease, (9) health care systems, and (10) overall well-being.
Leading Health Indicators for Healthy People 2010: Final Report)
This theory therefore suggests a wide ranging and holistic approach and also suggests that the health issues related to family violence should be seen from an interconnected and integrated point-of-view. "The schema acknowledges the complexity of interrelationships and interactions among multiple factors that are determinants of health but not necessarily limited to traditional predictors or determinants of health. Furthermore, the field model seeks to move health policy beyond being simply health care policy" (Leading Health Indicators for Healthy People 2010: Final Report)
This holistic point-of-view also relates to modern conceptions of advanced nursing practice. The cardinal aspects of this theory can be directly related to the objectives of Healthy People 2010.
In this sense the Healthy People 2010 objective is to "...reduce the rate of physical assault by current or former intimate partners to 3.3 physical assaults per 1,000 persons ages 12 years and older... To reduce maltreatment to 10.3 per 1,000 children under age 18 years, and maltreatment fatalities of children to 1.4 per 1,000 children under the age of 18..." (Family Violence)
As stated above, the advanced nursing approach to the issue of health and family violence must take cognizance of all the relevant and related factors that are involved. This also refers to the idea of strategic intervention. There are a number of ways suggested by Healthy People 2010 to deal these issues. These include the need to assist States with tools to work with community associations, with the aim of dealing with health disparities; as well as efforts to map local neighborhood associations. (Regional Healthy People 2010 Information Page)
Another goal of Healthy People 2010 which relates to health issues emanating for family violence, is the promotion of sexual health and responsible sexual behavior. Further recommendations include screening in order to determine the relationship of the illness or health problem to the domestic situation. Other aspects include the referral to shelters and to advocacy and vocational Counseling
In the final analysis, the health issues relating to family violence are a complex and sensitive area that requires professional care and insight. The contemporary professional nurse and healthcare worker must be aware of the various aspect of this problem. There have been profound changes in the nursing profession which accords with this proposed holistic approach. The modern nurse is no longer seen merely an adjunct to the medial process, but rather as expert in a field that is unique in its wide-ranging and inclusive character.
The holistic treatment of the patient means in effect that the health and medical needs of the patient are catered for in terms of physical, social as well as psychological components. In short, holistic theory increases the range and depth of nursing responsibilities. "Nursing theorists often describe the care of the patient as attending to the whole patient. Such theories emphasize the interaction of the physical, psychological, sociocultural, and spiritual dimensions of the patient in a model of holistic care." (Engebretson, Joan) This view is in line with the objectives of the Healthy People 2010 project and is especially relevant to the treatment of health issues that can occur within the ambit of family violence.
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