Health Maintenance,Health Promotion, andWellness
Health, Illness, and Wellness Health is the process through which a person seeks to maintain an equilibrium that promotes stability and comfort. Health is a dynamic process that varies according to a person’s perception of well-being.
Health, Illness, and Wellness Health refers to all aspects of a person’s life. • Physical status • Emotional well-being • Social relationships • Intellectual functioning • Spiritual condition
Health, Illness, and Wellness Illness is the inability of an individual’s adaptive responses to maintain physical and emotional balance, which results in an impairment of functional abilities. Wellness is the condition in which an individual functions at optimal levels.
Models of Health Health is the maintenance of harmony and balance among body, mind, and spirit. • Balance or homeostasis is an equilibrium among psychological, physiological, sociocultural, intellectual, and spiritual needs.
Models of Health Clinical model Health-belief model High-level wellness model Social learning theory Host-agent-environment model Health promotion model
MODELS OF HEALTHCLINICAL MODEL • Traditional Perspective • Health is absence of illness • Individuals who are not sick are healthyHEALTH BELIEF MODEL • Rosenstock • Expectations direct behavior that leads to the fulfillment of the expectations • Group values exert influence on beliefs about health • Belief may change as the person grows and develops
MODELS OF HEALTHHIGH LEVEL WELLNESS MODEL Dunn Health is influenced by the interaction among the individual, family and community Health is viewed toward achieving one’s fullest potential Health is viewed as an attempt toward achieving one’s fullest potential
MODELS OF HEALTHSOCIAL LEARNING THEORY Bandura • Beliefs strongly influence action Rosenstock • Behavior is influenced by expectations and reinforcements
MODELS OF HEALTHHOST AGENT ENVIRONMENT MODEL Leavell and Clark Health depends on the interaction of host agent and environment Balance among these elements results in health Illness occurs when there is an imbalance in one of the three elements Model is used most often in predicting risk of illnes
MODELS OF HEALTHHEALTH PROMOTION MODEL People engage in health promoting behavior when they: • Value health • Perceive health as being within their control • Can identify benefits in self-care behaviors • Have a positive perception of their health status Health promoting behavior is influence by: • An individual’s inherited and acquired characteristics • Significant others, who model the behavior, expect the behavior to occur, and facilitate the behavior • Families, peers, and health care providers
Cultural Influence on Health Culture affects how an individual views health and illness. One’s cultural background influences health-related behaviors and expectations of treatment when illness occurs.
Family Influences on Health Care Families help determine the following: • Whether or not to seek treatment. • What type of treatment is appropriate. • Who should provide the treatment or care. • Where the treatment or care should be provided.
Family Influences on Health Care Families are often the major caregivers for their relatives. Extended families and communities have traditionally acted as a buffer against excessive stress and illness.
Family Influences on Health Care Lack of social support from family or significant others results in psychological and spiritual isolation, which may negatively impact a person’s physiological state.
Illness Perspectives Illness is the result of a disease or injury that affects functioning and occurs when there is an inability to meet one’s needs. An acute illness is usually characterized by a rapid onset, intense manifestations, and a relatively short duration. A chronic illness is usually characterized by a gradual, insidious onset with lifelong changes, usually irreversible.
Parson’s 4 Aspects of the Sick Role Clients are not held responsible for their condition Clients are excused from certain social roles and tasks Clients are obliged to try to get well as quickly as possible. Clients or their families are obliged to seek competent help
Suchman’s Stages of Illness Stage 1 – Symptom Experience • Person comes to believe something is wrong. • May experience some symptoms such as pain, rash, cough, fever, or bleeding. • Unwell person usually consults others about the symptoms or feelings • May try home remedies • If self management is ineffective, person enters next stage • 3 Aspects: • Physical experience of symptoms • Cognitive aspect (the interpretation of the symptoms in terms that have some meaning to the person) • The emotional response
Suchman’s Stages of Illness Stage 2 – Assumption of the Sick Role • Person accepts the sick role and seeks confirmation from family and friends • Often continues with self-medication and delay contact with health care professionals as long as possible • People may be excused from normal duties and role expectations • When symptoms persist, person is motivated to seek professional help • Emotional Responses during this stage – withdrawal, anxiety, fear, and depression
Suchman’s Stages of Illness Stage 3 –Medical Care Contact Sick person seeks the advice of a health professional either on their own initiative or at the urging of significant others Information Obtained from health Care Professionals: - Validation of real illness - Explanation of symptoms in understandable terms - Reassurance that they will be all right or prediction of what the outcome will be Client may accept or deny the diagnosis. If the diagnosis is accepted, the client usually follows the prescribed treatment plan. If diagnosis is not accepted, client may seek the advice of other health care professionals or quasi-practitioners who will provide a diagnosis that fits the client’s perceptions.
Suchman’s Stages of Illness Stage 4 – Dependent Client Role • Dependent on health care professional for help • People vary greatly in the degree of ease with which they can give op their independence. Role obligations such as those of wage earners, father, mother, student etc. complicate the decision to give up independence. • Dependent on family and friends for support
Suchman’s Stages of Illness Stage 5 – Recovery and Rehabilitation • Client is expected to relinquish the dependent role and resume formers roles and responsibilities • For people with acute illness, the time is generally short and recovery is usually rapid • For people with long term illnesses and must adjust their lifestyle may find recovery difficult • For clients with permanent disability, this stage may require therapy to learn how to make major adjustment in functioning.
Wellness Perspectives Wellness places health on a continuum, from one’s optimal level (wellness), to a maladaptive state (illness). High-level wellness means functioning to one’s maximum health potential while remaining in balance with the environment.
Health Behaviors and Variables Influencing Health Behavior is defined as the observable response of an individual to external stimuli. All behavior has meaning.
FACTORS CAUSING ILLNESS Predisposing Factor – a condition that is characterized by a previous tendency and susceptibility to a disease E.g. Family history of heart disease Contributing Factor – a condition that helps bring about an illness E.g. Smoking Obesity Precipitating Factor – a condition that brings on an illness with undue rapidity, suddenly hastens the onset of illness, or activates it under certain conditions. E.g. stressful event
Health Behaviors and Variables Influencing Health Variables Influencing Health • Lifestyle • Locus of Control • Self-Efficacy • Health Care Attitudes • Self-Concept • Cognition
Health Behaviors and Variables Influencing Health Variables Influencing Health • Age and Developmental Levels • Gender • Previous Experiences with the Health Care System • Environment • Economic Resources
Health Maintenance Behavior directed toward maintaining a current level of health Health maintenance activities are the activities/behaviors an individual performs to maintain or improve a current level of health.
Health Maintenance Characteristics of Health Maintenance • Perception • Motivation • Maintenance
Health Promotion and Disease Prevention (Health Protection) Health Promotion • Behavior motivated by the desire to shape a healthy lifestyle. • Process of enabling people to increase control over their health and to improve their health. • Includes avoidance of unhealthy behaviors. • Health promotion efforts intervene with healthy, rather than ill populations.
Health Promotion and Disease Prevention (Health Protection) Disease Prevention • Activities/behaviors that protect people from the ill effects of actual or potential health threats - Primary prevention - Secondary prevention - Tertiary prevention
LEVELS OF PREVENTION (Leavell and Clark)Primary Prevention – precedes disease or dysfunction and is applied to generally healthy individuals or groupsPurpose: to decrease the risk or exposure of the individual or community to disease.Focus: • health promotion • protection against specific health problems.Examples: Health education on healthy lifestyle Immunizations Risks assessment for specific diseases Family planning services and marriage counseling Environmental sanitation and provision of adequate housing, recreation, and work conditions
Quit smoking Avoid/limit alcohol intake Exercise regularly Eat well-balanced diet Reduce fat and increase fiber in diet Take adequate fluids Maintain ideal body weight
LEVELS OF PREVENTION (Leavell and Clark)Secondary Prevention –includes prevention of complication and disabilitiesPurpose: to identify individuals in an early stage of a disease process and to limit future disability.Focus: early identification of health problems prompt intervention to alleviate health problemsExamples: Screening surveys and procedures of any type Encouraging regular medical and dental check-ups teaching self examination for breast and testicular cancer Assessing the growth and development of children Nursing assessments and care provided in home, hospitals and other agencies to prevent complications (e.g. turning bedridden clients to prevent pressure ulcers etc.)
Annual physical examination Regular Pap smear for women Monthly BSE for women who are 20 years old and above Sputum for TB Annual guiac stool test and rectal examination for clients over 50 years
LEVELS OF PREVENTION (Leavell and Clark)Tertiary Prevention – begins after an illness, when a defect or disability is fixed, stabilized, or determined to be irreversible.Purpose: Help rehabilitate individuals and restore them to an optimum level of functioning within the constraints of disability.Focus: restoration rehabilitationExamples: Referring a client who has had a colostomy to a support group Teaching a client who has diabetes to identify and prevent complications Teaching a client to use crutches
Undergo speech therapy after laryngectomy. Attend self-management education for diabetes. Participate in cardiac rehabilitation of MI. Physical therapy after CVA.