DEFINITION OF MODEL A model is a theoretical way of understanding a concept or idea. Represent different ways of approaching complex issues. Health beliefs are a person’s ideas, convictions, and attitudes about health and illness. Because health beliefs usually influence health behaviour, they can positively or negatively affect a client’s health. ‘Prevention of illness’ is a positive health behaviour. Common positive health behaviours include immunizations, proper sleep patterns, adequate exercise, and nutrition. Preventing illness is one aspect of wellness care that focuses on detection or prevention of disease.
CONTD…… Primary prevention focuses on the health of a person or population. Secondary prevention includes screening for those at risk to develop an illness or those who could have disease diagnosed early in the process for prompt treatment. Tertiary prevention occurs when diagnosis of a long term disease/disability has already been made.
Definition of health Traditional medicine - "absence of disease”. "Health is a state of complete physical, social and mental well-being, and not merely the absence of disease or infirmity"- WHO(1948) Murray & & Zentner –"state of well-being (where)…person uses purposeful, adaptive responses…to maintain relative stability and comfort strive for personal objectives & cultural goals".
New philosophy of health Health is: fundamental right Essence of productive life Intersectoral Integral part of development Central to the concept of quality of life Involves individual, state and international responsibilities World wide social goal Major social investment
Millennium development goal
In the millennium declaration of September 2000, member states of the United Nations made a most passionate commitment to address the crippling poverty and multiplying misery that grip many areas of the world. Government sets a date of 2015 by which they would meet the millennium development goals.
Goals Eradicate extreme poverty and hunger Achieve universal primary education Promote gender equality and empower women Reduce child mortality Improve maternal health Combat HIV/AIDS, malaria and other disease Ensure environmental sustainability Develop a global partnership for development
Concept of prevention "...prevention is any activity which reduces the burden of mortality or morbidity from disease."
Clinical model the absence of signs and symptoms of disease indicates health. Illness would be the presence of conspicuous signs and symptoms of disease. People who use this model of health to guide their use of healthcare services may not seek preventive health services, or they may wait until they are very ill to seek care.
Role performance model health is indicated by the ability to perform social roles. Role performance includes work, family and social roles, with performance based on societal expectations. Illness would be the future to perform a person’s roles at the level of others in society. This model is basis for work and school physical examination and physician –excused absences. The sick role, in which people can be excused from performing their social roles while they are ill, is a vital component of the role performance model.
Adaptive model the ability to adapt positively to social, mental, and physiological change is indicative of health. Illness occurs when the person fails to adapt or becomes inadaptive toward these changes.
Agent-Host-Environmental model by Leavell and Clark(1965) useful for examining causes of disease in an individual. The agent, host and environment interact in ways that create risk factors, and understanding these is important for the promotion and maintenance of health. An agent is an environmental factor or stressor that must be present or absent for an illness to occur. A host is a living organism capable of being infected or affected by an agent. The host reaction is influenced by family history, age, and health habits.
High Level Wellness Model by Dunn(1961) recognizes health as an ongoing process toward a person’s highest potential of functioning. This process involves the person, family and the community. describes high-level wellness as “the experience of a person alive with the glow of good health, alive to the tips of their fingers with energy to burn, tingling with vitality – at times like this the world is a glorious place”.
Holistic Health Model by Edelman and Mandle, 2002 Holism acknowledges and respects the interaction of a person’s mind, body and spirit within the environment. Holism is an antidote to the atomistic approach of contemporary science. An atomistic approach takes things apart , examining the person piece by piece in an attempt to understand the larger picture. Holism is based on the belief that people (or their parts) can not be fully understood if examined solely in pieces apart from their environment.
Nightingale’s Theory of Environment Florence Nightingale This model views health as a constantly changing state, with high level wellness and death being on opposite ends of a graduated scale, or continuum. This continuum illustrates the dynamic state of health, as a person adapts to changes in the internal and external environments to maintain a state of well-being. A patient with chronic illness may view himself/herself at different points of the continuum at any given time, depending on how well the patient believes he/she is functioning with .
Milio’s Framework for Prevention Nancy Milio includes concepts of community – oriented, population- focused care. basic treatise was that behavioural patterns of the populations-and individuals who make up populations – are a result of habitual selection from limited choices. challenged the common notion that a main determinant for unhealthful behavioural choice is lack of knowledge. Milio’s framework described a sometimes neglected role of community health nursing to examine the determinants of a community’s health and attempt to influence those determinants through public policy.
Levels of Prevention Model advocated by Leavell and Clark in 1975 This model suggests that the natural history of any disease exists on a continuum, with health at one end and advanced disease at the other. LEVELS OF PREVENTION Primordial prevention- prevention of the emergence or development of risk factors in population or countries in which they have not yet appeared. efforts are directed towards discouraging children from adopting harmful lifestyles. Primary prevention-An action taken prior to the onset of disease, which removes the possibility that the disease will ever occur. Secondary prevention- Action which halts the progress of a disease at its incipient stage and prevents complications.
Tertiary prevention-All measures available to reduce or limit impairment and disabilities, minimize suffering caused by existing departures from good health and to promote the patient's adjustment to irremediable conditions. Modes of intervention Health promotion Specific protection Early diagnosis and treatment Disability limitation rehabilitation