Multilevel Model of Health
Social ecological models (SEM) were developed to further enhance the understanding of the relationship between various personal and environmental factors. The model bridges the gap between behavioral theories that focus on small settings. The SEM examines human development by studying how human beings develop according to their environment. This can include society as a whole and the period in which they live, which will impact behavior and development. in order to understand human development, the entire ecological system in which growth occurs needs to be taken into account.
This system is composed of five socially organized subsystems that support and guide human development. Each system depends on the contextual nature of a person's life and offers the diversity of options and sources of growth. Within each system are bi-directional influences. The bi-directional influences imply that relationships have impact in two directions, both away from and towards the individual.
This can be easily applied to an area of nursing that is near and dear to my heart - long term care. The residents we care for are at the centre of everything we do - the interpersonal level. The interpersonal level describes how the residents interact within their environment - both with staff, family and other residents. At the institutional level, we view how the nursing home provides for the residents through food, lodging, cleanliness, basic care needs, and positive and safe interactions. How does the community interact with the senior population living within a long term care setting?
This can be viewed as either a positive, caring environment or a negative place where we only send people we do not care about. Lastly, SEM sets out how the long term care system interacts at the federal/provincial level regarding policy development and implementation. At this level, financial security plays a vital role in the ability to access care in a long term care home. Thankfully, in Ontario, all residents have access to long term care services with extra funds to help pay for the monthly fee if the persons income is low.