Chapter 4 Health and Illness

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Definitions of Health States

Health: a state of complete physical, mental, and social well being, not merely the absence of disease Illness: the unique response of a person to a disease

Wellness: an active state, oriented toward maximizing the potential of the individual

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Human Dimensions of Health

Physical Intellectual Emotional Sociocultural Spiritual Environmental aspects

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The Human Dimensions Composing the Whole Person

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Acute Illness
Generally has a rapid onset of symptoms and lasts only a relatively short time Examples: appendicitis, pneumonia, diarrhea, common cold

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Chronic Illness
A broad term that encompasses many different physical and mental alterations Examples: diabetes mellitus, lung disease, arthritis, lupus

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Characteristics of a Chronic Illness

It is a permanent change It causes, or is caused by, irreversible alterations in normal anatomy and physiology

It requires special patient education for rehabilitation

It requires a long period of care or support

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Stages of Illness Behavior

Experiencing symptoms Assuming the sick role Assuming a dependent role Achieving recovery and rehabilitation

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Models of Health and Illness

The agent-host-environment model The healthillness continuum The high-level wellness model The health belief model The health promotion model

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Agent-Host-Environment Model (Leavell and Clark)

Examines the causes of disease in an individual
Agent, host, and environment interact in ways that create risk factors Understanding the risk factors is important for the promotion and maintenance of health The host reaction is influenced by family history, age, and health habits

The environment includes physical, social, biologic, and cultural factors

Each of the agent-host-environment factors affects and is affected by the others
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The Agent-Host-Environment Triangle

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The HealthIllness Continuum

Measures a persons level of health Views health as a constantly changing state with highlevel wellness and death on opposite sides of a continuum Illustrates the dynamic (ever-changing) state of health

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The HealthIllness Continuum

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The High-Level Wellness Model (Dunn)

Encourages the nurse to care for the total person Involves functioning to ones maximum potential while maintaining balance and a purposeful direction

Regards wellness as an active state, oriented toward maximizing the potential of the individual, regardless of his or her state of health
Incorporates the processes of being, belonging, becoming, and befitting

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The Health Belief Model (Rosenstock)

Concerned with what people perceive to be true about themselves in relation to their health Modifying factors for health include demographic, sociopsychological, and structural variables Based on three components of individual perceptions of threat of a disease Perceived susceptibility to a disease Perceived seriousness of a disease Perceived benefits of action
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The Health Promotion Model (Pender)

Illustrates the multidimensional nature of persons interacting with their environment as they pursue health Incorporates individual characteristics and experiences and behavior-specific knowledge and beliefs, to motivate health-promoting behavior Personal, biologic, psychological, and sociocultural factors are predicative of a certain health-related habit

Health-related behavior is the outcome of the model and is directed toward attaining positive health outcomes and experiences throughout the lifespan
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Factors Affecting Health Status, Beliefs, and Practices

Risk factors for illness Factors in the human dimensions that influence health illness status

Beliefs and practice

Basic human needs Self-concept

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The Human Dimensions

Physical dimensiongenetic inheritance, age, developmental level, race, and gender
Emotional dimensionhow the mind affects body function and responds to body conditions Intellectual dimensioncognitive abilities, educational background, and past experiences Environmental dimensionhousing, sanitation, climate, pollution of air, food, and water

Sociocultural dimensioneconomic level, lifestyle, family, and culture

Spiritual dimensionspiritual beliefs and values
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Basic Human Needs

Physiological needs Safety and security needs Love and belonging needs Self-esteem needs Self-actualization needs

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Factors That Influence a Persons Self-Concept

Past experiences Interpersonal interactions Physical and cultural influences Education

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Levels of Preventive Care

Primary preventione.g., diet, exercise, immunizations Secondary preventione.g., screenings, mammograms, family counseling

Tertiary preventione.g., medications, surgical treatment, rehabilitation

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Question
Which of the following is an example of an acute illness? A. Diabetes B. Rheumatoid arthritis C. Pneumonia D. Osteoporosis

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Answer
Answer: C. Pneumonia Rationale: Pneumonia is an acute illness that has a rapid onset of symptoms and lasts only a relatively short time. Diabetes, rheumatoid arthritis, and osteoporosis are chronic illnesses that cause a permanent change, require special patient education for rehabilitation, and require a long period of care or support.

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Question
Tell whether the following statement is true or false. A person who is experiencing a productive cough and fever takes a sick day to recuperate and decide whether to make an appointment with the doctor. This person is said to be in stage 3 of illness behavior: assuming a dependent role. A. True

B. False

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Answer
Answer: B. False A person who defines himself as sick and self-medicates or visits a doctor is said to be in stage 2 of illness behavior: assuming the sick role.

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Question
Which of the following models of health and illness views health as a constantly changing state, with high-level wellness and death being on opposite ends of a graduated scale?

A. Agent-host-environment model
B. Health-illness continuum C. High-level wellness model D. Health belief model

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Answer
Answer: B. Health-illness continuum Rationale:

The health-illness continuum measures a persons level of health on a graduated scale.

The agent-host-environment model refers to the interaction of the agent, host, and environment creating risk factors that must be examined. The high-level wellness model involves functioning to maximum potential with balance and direction. The health belief model is concerned with what people believe to be true about their health.
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Question
Tell whether the following statement is true or false. A person who keeps in touch with neighbors in an attempt to foster a community feeling is promoting his or her emotional human dimension. A. True B. False

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Question
Which of the following is an example of a nursing activity that promotes secondary prevention as a level of preventive care? A. Conducting a smoking cessation class B. Performing a blood pressure screening at a local mall C. Performing range-of-motion exercises on a bedridden patient D. Promoting safe sex practices in school settings

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Answer
Answer: B. Performing a blood pressure screening at a local mall Rationale:

Secondary preventive care focuses on early detection of disease, such as the heart disease in this example.
Primary preventive care is directed toward promoting health and preventing diseases. Tertiary care begins after an illness is diagnosed to reduce disability and rehabilitate patients.

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Answer
Answer: B. False A person who keeps in touch with neighbors in an attempt to foster a community feeling is promoting his or her sociocultural human dimension.

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