HEALTH

is a state of complete physical, mental, social well-being and not merely the absence of disease or infirmity. World Health Organization is the ability to maintain internal milieu. Claude Bernard is the ability to maintain homeostasis or dynamic equilibrium. Walter Canon is being well and using ones power to the fullest extent. Health is maintained through prevention of disease via environmental health factors. Nightingale is viewed in terms of the individuals ability to perform 14 components of nursing care unaided. Henderson Positive health symbolizes wellness. It is a value term defined by the culture or individual. Rogers

is a state and a process of being and becoming an integrated and whole person. Roy is a state that is characterized by soundness and wholeness of developed human structures and of bodily and mental functioning. Orem is a dynamic state in the life cycle. King is an elusive, dynamic state influenced by biologic, psychologic, and social factors. Health is reflected by the organization, interaction, interdependence and integration of the subsystems of the behavioral system. Johnson a dynamic state of being in which the developmental and behavioral potential of an individual is realized to the fullest extent possible. American Nurses Association the ability to maintain normal roles. Talcott Parsons is not a condition; it is an adjustment. It is not a state but a process. The process adapts

the individual not only to our physical but also our social environments. United States Presidents Commission on Health Needs

WELLNESS
is the maximizing of personal potential and a state of well-being. It involves attitudes and behaviors that enhance quality of life. A subjective perception of balance, harmony and vitality. Leddy & Pepper Has been described by Anspaugh et al as: as a choice. as a way of life. as the integration of body, mind and spirit. as the loving acceptance of ones self.

WELL-BEING
is a subjective perception of vitality and feeling well. Basic concepts include: Self responsibility

An ultimate goal Dynamic Growing process Daily decision making nutrition Stress Management Physical Fitness Preventive Health Care Emotional Health

in

areas

of

DIMENSIONS OF WELLNESS:
Physical Ability to carry out daily tasks, maintain adequate nutrition, achieve fitness, avoid drugs and alcohol and practice positive lifestyle. Emotional Managing stress and expressing emotions appropriately; accepting ones limitations.

Social Interacting successfully with people. Intellectual Ability to learn and use information effectively; striving for continued growth; dealing with new challenges. Spiritual Believing in a higher power that provides meaning and purpose to life. Occupational The ability to achieve a balance between work and leisure time. Environmental The ability to promote health measures that improve the standard of living and quality of life in the community.

ILLNESS
is a personal state in which the personal feels unhealthy. is a state in which a persons physical, emotional, intellectual, social, developmental or spiritual functioning is diminished or impaired compared with the previous experience. is not synonymous with disease.

Stages of Illness:
1. Symptom Experience transition stage the person believes something is wrong experiences some symptoms 3 aspects: Physical Cognitive Emotional 2. Assumption of Sick Role Acceptance of the illness

Seeks advice, support for decision to give up some activities 3. Medical Care Contact Seeks advice of health professionals for the following reasons: Validation of real illness Explanation of symptoms Reassurance or prediction outcome 4. Dependent Patient Role The person becomes a client dependent on the health professional for help. Accepts/rejects health professionals suggestions. Becomes more passive and accepting. May regress to an earlier behavioral stage. 5. Recovery/Rehabilitation Gives up the sick role and returns to former roles and functions.

ASPECTS OF SICK ROLE:

One is not held responsible for his condition. One is excused from social roles. One is obliged to get well as soon as possible. One is obliged to seek for competent help.

DISEASE
is an alteration in body functions which causes reduced capacities or shortened life span.

Common Cause of Disease:

Biologic agents Inherited genetic defects Developmental defects Physical agents Chemical agents Tissue response to irritation/injury Faulty chemical/metabolic process Emotional/physical reaction to stress

RISK FACTORS
is any situation, habit, social or environmental condition, physiological or psychological condition, developmental or intellectual condition, or spiritual or other variable that increases the vulnerability of an individual or group to an illness or accident.

Risk Factors of a Disease:

Genetic and Physiological Factor is a major physical risk factor Age Age increases or decreases susceptibility to certain illnesses. Environment The physical environment in which a person works or lives can increase the likelihood that certain illnesses will occur.

 Lifestyle Many activities, habits and practices involve risk factor. Lifestyle practices and behaviors can also have positive and negative effects on health.

Classifications of Diseases:
1. ACCORDING TO ETIOLOGIC FACTORS:
Heredity Due to defect in the genes of one or other parent which is transmitted to the offspring. Congenital Due to a defect in the development, hereditary factors, or prenatal infection; present at birth. Metabolic Due to disturbances or abnormality in the intricate processes of metabolism.

Deficiency Results from inadequate intake absorption of essential dietary factors. Traumatic Due to injury. Allergic Due to abnormal response of the body to chemical or protein substances or to physical stimuli. Neoplastic Due to abnormal or uncontrolled growth of cells Idiopathic Cause is unknown; spontaneous origin. self-originated; of or

Degenerative Results from the degenerative changes that occur in tissue and organs

Iatrogenic Results from treatment of a disease.

2. ACCORDING TO DURATION OR ONSET:

Acute Illness is characterized by severe symptoms and relatively short durations. Chronic Illness Lasts for an extended period (6 months or longer). It usually has a slow onset and periods of remission and exacerbation.

3. OTHERS MAY ALSO BE DESCRIBED AS:

Organic Results from changes in the normal structure, from recognizable anatomical changes in an organ or tissue of the body.

Functional No anatomical changes are observed to account for the symptoms present, may result from abnormal responses to stimuli. Occupational Results from factors associated with the occupation engaged by patient. Familial Occurs in several individuals of the same family. Venereal Usually acquired through sexual relation. Epidemic Attacks a large number of individuals in a community at the same time. Endemic Present more or less continuously or recurs in a community.

Pandemic An epidemic disease which extremely widespread involving an entire country or continent. Sporadic A disease in which only occasional cases occur.

LEVELS OF PREVENTION:
Primary Prevention To encourage optimal health and to increase the persons resistance to illness. Seeks to prevent a disease or condition at a prepathologic state; to stop something from ever happening. Health promotion Specific protection

Secondary Prevention It is also known as health maintenance. Seeks to identify specific illnesses or conditions at an early stage with prompt intervention to prevent or limit disability; to prevent catastrophic effects that could occur if proper attention and treatment are not provided. Early diagnosis/Detection/Screening Prompt treatment to limit disability Tertiary Prevention To support the clients achievement of successful adaptation to known risks, optimal reconstitution, and or establishment of high level wellness. Occurs after a disease or disability has occurred and the recovery process has begun. Intent is to halt the disease or injury process and assist the person in obtaining an optimal health status. Rehabilitation

LEVELS OF CARE:
Health Promotion Means to modify a clients knowledge, attitudes, skills to adopt behaviors leading to a healthier lifestyle thus achieving a higher level of wellness from any point on a continuum from health to illness. Emphasizes the important role clients play in maintaining their own health and encourage them to maintain the highest level of wellness they can achieve. Early detection of disease; accomplished through routine screening of the population and focused screening of those at risk of developing certain conditions. Illness Prevention May be directed at the client or the community and involve such practices as providing immunization, identifying risk factors for illnesses and helping people take measures to prevent these illnesses from occurring.

Also involves environmental programs that can reduce incidence of illness or disability. Diagnosis and Treatment Major component of the health care system It is where the largest segment of the health care services has been dedicated. Technological advances have allowed physicians to diagnose illness far sooner and treat them more effectively than in the past. Restoration Is a process of restoring ill or injured people to optimum and functional level of wellness. Emphasizes the importance of assisting client to function adequately in the physical, mental, social, economic, and vocational areas of their lives. Its goal is to help people move to their previous level of health or to the highest level they are capable of given their current health status. May begin in the hospital, but will eventually lead clients back into the

community for further treatment and follow up once health has been restored. Activities are applied to a wide range of health problems such as: Stroke Joint replacement Burns Spinal cord injury

Supportive Care Includes medical, nursing, psychological and social services aimed at helping the client manage a chronic illness, disability or, or terminal illness when rehabilitation or restoration is not a realistic goal. This care can be provided in a hospital, a nursing home, a hospice, or in the clients home settings and aims to meet the physical, emotional, and spiritual needs of the client and the family. Objective is to help clients achieve or maintain the highest level of functioning possible, thus permitting the greatest degree of independence and participation in their community.

MODELS OF HEALTH AND WELLNESS:

SMITHS MODELS OF HEALTH: Adaptive Model
Health is a creative process; disease is a failure in adaptation or maladaptation. Aim is to restore the ability of the person to adapt, which is to cope. Extreme good health is flexible adaptation to the environment and interaction with the environment to maximum advantage.

Clinical Model
Has the narrowest interpretation of health. Opposite of health is disease or injury. Used in relief of signs and symptoms of disease and elimination of malfunction and pain.

Role Performance Model

health is defined in terms of the individuals ability to fulfill societal roles, that is, to perform his or her work. People who can fulfill their roles are healthy even if they have clinical illnesses.

Eudemonistic Model
Incorporates a comprehensive view of health. Health is seen as a condition of actualization or realization of a persons potential. The highest aspiration of people is fulfillment and complete development, which is actualization. Illness is a condition that prevents selfactualization.

AGENT-HOST-ENVIRONMENT MODEL
Also called ecologic model. Originated in the community work of Leavell and Clark. Used primarily in predicting illness rather than in promoting wellness.

Has 3 Dynamic Interactive Elements: Agent any environmental factor or stressor that by its presence or absence can lead to an illness or disease. Host persons who may or may not be at risk of acquiring a disease. Environment all factors external to the host that may or may not predispose the person to the development of disease.

HEALTH BELIEF MODEL

Proposed by Rosenstock which intended to predict which individuals would or would not use such preventive measures as screening for early detection of cancer. Based on motivational theory. Described the relationship between a persons belief and behavior. Becker modified HBM to include these components: Individual perceptions Perceived susceptibility to an illness Perceived seriousness of an illness

Perceived threat of an illness Modifying factors Demographic variables Sociopsychological variables Structural variables Cues to action Variables likely to affect initiating action Perceived benefits of preventive action Perceived barriers to preventive action

THE HEALTH-ILLNESS CONTINUUM Dunns High Level Wellness Grid ENVIRONMENT

Protected poor health in favorable environment

HLW in favorable environment

ILLNESS

HEALTH

Good Health

High Level Wellness

Precursor of Illness

Poor Health in unfavorable environment

Emergent HLW in unfavorable environment

High Level Wellness (HLW)

An integrated method of functioning that is oriented towards maximizing ones potentialities within the limitations of his environment.

Precursors of Illness:
Heredity Behavioral factors Environmental factors

DUNNS HIGH LEVEL WELLNESS GRID

Described a health grid in which a health axis and an environmental axis intersect. Has 4 Quadrants of Health and Wellness: High-level wellness in a favorable environment Emergent high level wellness in an unfavorable environment Protected poor health in a favorable environment Poor health in an unfavorable environment

ILLNESS-WELLNESS CONTINUUM

Wellness Model
Education Growth

Premature Death Disability Symptoms Signs Awareness

High Level Wellness

Treatment Model

Neutral Point (no discernible illness or wellness)

First developed by Travis in 1972. Illustrates 2 arrows pointing in opposite directions and joined at a neutral point.

TYPES OF HEALTH PROMOTION PROGRAMS

Information Dissemination Use of variety of media to offer information to the public about the particular lifestyle choices

and personal behavior, the benefits of changing that behavior and improving the quality of life. Health Appraisal and Wellness Assessment Programs Appraise individuals of their risk factors that are inherent in their lives in order to motivate them to reduce specific risk and develop positive health habits. Wellness assessment programs are focused on more positive methods of enhancement. Lifestyle and Behavior Change Programs Basis for changing health behavior Geared toward enhancing the quality of life and extending lifespan. Worksite Wellness Programs Include programs that serve the needs of persons in their workplace. Environmental Control Programs Developed to address the growing problem of environment pollution- air, land, water, etc..

ACTIVITIES TO PROMOTE AND PREVENT ILLNESS

HEALTH

Have a regular Physical Examination Women: Regular Pap test Monthly BSE Men: Regular Testicular self examination Annual dental examination and prophylaxis Regular eye exam Exercise regulary Do not smoke Avoid alcohol and recreational drugs Increase fiber in diet Sleep regularly Eat breakfast Eat regular meals with few snacks