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Defining Health and Health Promotion

Section 1a -  Using Dahlgren and Whitehead's (1991) model, explore the social determinants of health that are relevant to the main characters in the DVD clip. Consider ways in which these impact on the health status of the clients and the health professional. 

Central factors and Level 1 of Model 
Overview of age, sex, hereditary factors (unknown). Key issues are lifestyle factors e.g. Smoking, alcohol abuse, sedentary lifestyle, addictive behaviours, drug use etc.

Level 2 — Social and Community networks Poor/none known. Look at 'social health' as an element of holistic health e.g. physical, mental, social, emotional, spiritual, societal (see Ewies and Simnett, 2003; Scriven, 2010; Naidoo and Wills, 2009 (3'd Ed). No support from family of friends when needed. Consider Integration into the community, access to community services, issues around coping and lack of social support etc. 

Level 3 - Living and Working conditions  Consider level of education, employment / unemployment, housing (social or LA?), access to health care services. Naidoo and Ms (2009) look at 'income and health', 'housing and health' and 'education and health' that Is relevant to this layer.

Level 4— Economic, cultural and environmental conditions Might consider socio-economic status — welfare support, benefits, geographical location, standards of living ... 

Section 2a - Making reference to both linear and circular models of communication, explore the interactions between the health professional and their clients. 

See, for example, Adler and Rodman (2010) for focussed discussion of communication theory. 
You will want to explore the theory that underpins each model as part of your discussion — however, this discussion will need to be linked to appropriate interactions (communication) between the health professional and the clients. For example, when looking at linear, or 'transmission' models of cornrnunication, you might want to identify the giving of the contract' as a linear form of communication (the message flowing from the giver to the receiver in a unidirectional flow). However, as part of this you would need to explore the significance of the 'channel' through which the message is communicated (i.e. print media) and factors such as 'noise' - environmental, psychological, semantic, physiological factors that can impede the flow of messages. When you have done this you can do the same for the circular, "transaction' model — where communication is a two-way flow and people send and receive messages simultaneously. Don't forget to identify an appropriate example of this type of interaction from the DVD clip, but also include the factors that are different from the linear model — I.e. 'feedback'. 

Defining Health and Health Promotion

According to World Health Organization, the term health is defined as a complete state of physical, social and mental well being and merely absence of disease (Edelman, Mandle and Kudzma 2013). It is the level of metabolic and functional efficiency of an organism that makes them adaptive or self-manages their changing physical, mental and social status. The health promotion enables people to control their health and the social determinants of health (Pilgrim 2014). It greatly enhances the quality of life as it focuses on prevention and thereby reduces the costs on medical treatment (Sharma 2016). It focuses on healthy living and empowers the individuals to engage in healthy lifestyle and behaviors. This greatly reduces the risk of development of diseases and morbidities.

The nurses play an important role in the promotion of health among the individuals or communities (Moyse, 2009). They are considered to be the ambassadors of wellness in the health promotion. They are efficient healthcare professionals who provide appropriate information to people in the form of health teaching and training. The nursing diagnosis in the health promotion comprises of the clinical judgment that concerns the desire and motivation to live a healthy lifestyle that increases the well-being of the people (Moorhead et al. 2014). This health promotion by the nurses is possible through nurse-client relationship that explains how a nurse will communicate with the client and use their interpersonal skills to create and maintain this relationship (Larkin 2011). The interpersonal communication between the clients and the nurses helps to promote health by providing them information about healthy living (Arnold and Boggs 2015). The development of interpersonal relationships like communication and interpersonal skills is important for the nurses in the promotion of health as it involves interaction with the patients (Potter, Perry, Stockert and Hall 2016). The following essay deals with the development of interpersonal communication and skills between the clients and the nurses that helps to promote health.

The Dahlgren-Whitehead rainbow model comprises of the social determinants of the health. This model shows a relationship between the individual, environment and the disease (Modranka and Suchecka 2014). It consists of the layers that intend to influence health like the surrounding environment that greatly modifies the health status. The level of health is greatly connected to the socioeconomic level and that health issues are determined by social factors. Environmental, social and economic inequalities determine the risk of illness, ability to prevent illness and the access to healthcare services. These social factors are greatly determined by this model in which the individuals are placed in the center and surrounded by factors that influences health. These factors comprise of the lifestyle factors, living and working conditions, community influences and other related social conditions (Dzwonkowska-Godula and Garncarek 2015). Therefore, this framework helps to construct the social determinants of health, their influence on the health, the outcomes and interactions between the determinants.

The Role of Nurses in Health Promotion

The sex, age and hereditary factors are the personal characteristics that are placed at the core of the model. All these factors greatly influence the health of an individual and are considered to be beyond the influence and reach of the public health promotion programs. The lifestyle choices like poor diet, sedentary lifestyle, alcohol, smoking and drug misuse have devastating effect on the health of the individuals. An individual’s sex, behavior, genetics, lifestyle behaviors and biology comprises of the central factors that determines the health of an individual (Tolosana 2015).

In the DVD clip, the main characters are Kim and Adam who are expecting their first baby. There are various social determinants of health that has been explored in the video clip. Kim is going to give birth to Adam’s first baby. Although, Kim had three children with her former partner, however, all of them were moved by the special child care services. Kim has a serious drug problem and is also addicted to smoking. Adam has a history of mental health problems and all these social determinants greatly affect their coming baby. There are key issues related to lifestyle and genetic factors that will determine the health of the mother and her baby. According to the model, the pre-birth conditions like maternal nutrition, lifestyle factors and supplements greatly determine the health of the mother and her baby (Lawanson and Fadare 2015). In addition, the mental health problem in Adam also has an impact on the baby as the genetics and biology influences the chances of developing a disease.

This level consists of the family members, social and community care that forms protective network in terms of health. The quality of the relationships matters as the family is important for health. The family, friends and other acquaintances have a great influence on the health related behaviors in an individual. Good parenting is the basis for good health. The social grouping influence the health related behaviors like smoking, drinking and serious drug abuse that affects the health of an individual (Newman et al. 2015).

In the DVD clip, Kim is under the influence of smoking and serious drug problem. These social determinants greatly hamper the health of Kim and her coming baby. Her smoking and alcohol has subjected her previous three children to child special care service. In this video, Joe is a social worker working at Bristol’s Children’s hospital is providing social service to the couple, Kim and Adam. Their baby might be at risk due to her lifestyle related behavior and Adam’s history of mental health problem. Joe is extending social support to the family so that she is able to quit drinking as maternal nutrition determines the baby’s health and development. Because of Joe’s initiative, Kim has quit drinking during her pregnancy. Moreover, Joe is assessing the food and taking care of Kim and helping her to cope up with drinking and smoking.

Social Determinants of Health using Dahlgren-Whitehead Rainbow Model

This level comprises of the living and working conditions that comprises of the education, employment and access to health care services. It also includes the opportunities and access to services like welfare services, sanitation, running water and essential goods like clothing, housing, food and fuel (Naidoo and Wills 2016). The education, income level and housing determine the health status. The social status and income are linked to better health. The low education levels are associated with poor health. The healthy living conditions are linked to health people and strongly influence the health equity. The availability of affordable housing with provision of water, electricity and sanitation greatly affects the lives of the health. The working conditions and employment affects the health equity. The poor working conditions lead to occupational diseases that greatly hamper the well-being of the people.

The physical environment along with the cultural and social environment is the fundamentals to good health (Ewles and Simnett 2003). A good physical environment like quality of air and water helps to achieve better health gains with better outcomes. The roads, buildings and infrastructure also influence the health as poor sanitation, over crowing and pollution leads to poor health conditions (Graham and White 2016). Culture is also considered to be another social determinant of health that greatly creates a way for us to lead our lives. The feeling, thinking and believing things shape the way we lead our life. It influences the behaviors that are health related like drinking, smoking, and exercise and drug abuse. In the DVD clip, Kim is under the influence of serious drug abuse and smoking that is affecting her life and she is not able to take care of her previous children who are under social care. Another important aspect is the economic environment like the sufficient wealth to attain the reasonable health levels improves the life expectancy of an individual. The countries having fairer wealth distribution enjoy high life expectancies than the countries with uneven distribution of health. In this way, the economy, culture and the physical environment also influences the health.

The communication is the most vial factor between the health care professional and their clients. There are two models of communication like the linear and the circular model of communication. Among these, the circular transaction model is the most efficient way of interaction between the health care professional and their clients.

In the linear model of communication, the direction of message flow is one way. In this, the sender sends the message to the other end and the receiver just receives it without giving any feedback or response (West and Turner 2013). The encoding of the message takes place and the “channel” helps to transmit the message from the sender to the receiver. In the presence of “noise”, the message is send from one end to another in which the sender is the most prominent. The linear model of communication is not applicable in case of human communication as there is no feedback or response from the receiver. The linear model has many components that help to establish communication between then sender and the receiver. The sender sends the message after it is encoded. The encoding is done by converting into compatible codes that is understandable and readable by the reader through the channel by the sender. The decoding of the message is done by the recover that change the encoded message into a language that is understandable by the receiver (McQuail and Windahl 2015). The message is send by the sender to the receiver in the form of information. The medium through which the message is sent is called the channel and the receiver is the one who reads the message after decoding. Noise is the distractions that are caused during the processing of the communication through the channel or during the decoding of the information.

Lifestyle Choices and Genetics

However, this model is not applicable for the communication between the health professional and the clients. As the direction of communication is one way, there is no scope for feedback or response. The client is not able to provide feedback to the health professional that would bring about better health outcomes and better experiences for the clients (Montano and Kasprzyk 2015). This is not an effective way of communication and is applicable to mass communication like television or newspaper. The human communication is circular in nature rather than linear as the sender and the receiver involved are active participants. Moreover, more than one message cannot be send at a time and it does not happen in turns. In this mode of communication, the sender should have the ability to encode the information and the receiver should have the ability to decode the message (Cornelissen 2014). The sender and the receiver are not clear and therefore the model is not relevant in nature. In the DVD clip, Joe the social worker is interacting with the couple, Kim and Adam about their coming baby. As Kim is suffering from lifestyle related behavior problems like smoking and drinking, Joe as a social worker is helping the family to cope with her drinking problems and she can take care of her coming baby. Therefore, in this kind of communication, linear model is not applicable as feedback or response is required from Kim and Adam.

In transactional model of communication, the communication is a two way process in which there is exchange of messages between the sender and the receiver (Hargie et al. 2010). There are many turns in this way of communication where the sender and the receiver both act as communicators (Bach and Grant 2015). The role of the communicators keeps reversing each time as the process of sending as well as receiving occurs simultaneously. In this model, the humans are considered to be communicators in which there is involvement of interpersonal communication considered as the circular model of communication (Watson and Hill 2015).

In this model, there is continuous change in the process of communication and transformation takes place between the components like people, environment and between the medium (Corcoran and Bone 2007). The communicators are necessary to keep the communication alive and the communicators are interdependent on each other. The interactions and conversations take place in this model and it is very efficient form of communication. The communicators know each other very well as they share and respond to each other instantly.  The reliability and efficiency of the communicated information is dependent on the medium. The message received through phone is different from the message received face to face as the message received through telephonic conversation might lose messages or there is absence of possible gestures (Vl?du?escu 2013). This model gives an opportunity to clarify misunderstandings in the form of responses or feedbacks.

The Impact of Social Factors on Health

This model involves the feedback which is an essential component in this type of communication model (Arnold and Boggs 2002). This model greatly involves interpersonal skills like listening skills, communication skills, problem solving, verbal and non- verbal communication, stress management and decision making (Koprowska 2014). These skills help to communicate efficiently with people, customers and clients (Berkman, Kawachi and Glymour 2014).

The DVD clip is an example of transactional model of communication. In this, the social worker, Joe and the couple Kim and Adam are interacting with each other. Joe is helping the family to cope up with their lifestyle based behaviors and their coming baby as Kim is under the effect of smoking and drinking. She needs help to cope up with her addictions and is also able to take care of her coming baby as her previous babies were taken and kept under social service.

Joe is able to express her concerns and expertise to the couple through written documents to keep the information open, clear and honest. She also met the couple and conversed through verbal communication to provide them an empathetic environment where they feel comfortable to interact with her. The listening skills are also exhibited by Joe in the DVD clip as she is able to convince the couple that their concerns are being heard. It also showed that Joe is actively engaged with the couple and concerned about their crisis. The problem solving and decision making are also important factors in which the healthcare professionals are able to understand and help the clients in the middle of a crisis. Joe is also helping the couple as Kim left drinking from last six months and that helps her to take care of her baby. Joe made the appropriate decision of not registering their baby, Lee under child protection act and giving the couple are chance to take care of their baby. Therefore, this DVD clip is an example of execution of interpersonal skills that are required in a communication process between the health care professional and their clients.


The social determinants greatly influence the health like the social and economic status and its distribution among the population that greatly influences the people’s differences in terms of health status. The Dahlgren-Whitehead rainbow model greatly describes the social determinants that influences the individuals placed in the core of the model. In the DVD clip, Kim is under the influence of smoking and drinking that is greatly affecting her coming baby. Her husband, Adam is having a history of mental problems that is considered to be the genetic problems that also affects the health. This DVD clip is an example of transactional model of communication in which the social worker, Joe is helping the family to cope up with their problems and help them take care of their coming baby. This DVD also executed development of interpersonal skills that are required during the communication between a healthcare professional and their clients (Evans, Coutsaftiki and Fathers 2014). Under the Standards for Competence in Nursing and Midwifery Council (NMC), all nurses must use excellent interpersonal and communication skills that help to promote health and equal people to enjoy equal access healthcare services (Bach and Grant 2015). The skills like listening skills, verbal communication, problem solving, effective decision making and empathetic attitude towards their clients helps in solving their problems faced during a crisis (Meier, Parker and Freeth 2014).

Communication Models in Healthcare


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