Chapter 4 Health and Illness

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

Human Dimensions of Health

Physical Intellectual Emotional Sociocultural Spiritual Environmental aspects

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

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

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.

Stages of Illness Behavior

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

Models of Health and Illness

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

Agent-Host-Environment Model (Leavell and Clark)

This model is useful for examining the causes of disease in an individual. The 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.

The Health-Illness 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

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 in the environment 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

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 variables, sociopsychological variables and structural variable 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

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.

Factors Affecting Health Status, Beliefs, and Practices

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

Beliefs and practice

Basic human needs Self-concept

The Human Dimensions

Physical dimension genetic inheritance, age, developmental level, race, and gender Emotional dimension how the mind affects body function and responds to body conditions Intellectual dimension cognitive abilities, educational background, and past experiences Environmental dimension housing, sanitation, climate, pollution of air, food, and water Sociocultural dimension economic level, lifestyle, family, and culture Spiritual dimension spiritual beliefs and values

Basic Human Needs

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

Factors That Influence a Persons Self Concept

Past experiences Interpersonal interactions Physical and cultural influences Education

Levels of Preventive Care

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

Tertiary prevention e.g., medications, surgical treatment, rehabilitation