Health and illness.pdf

C
HEALTH AND ILLNESS
B.KAVITHA M.SC(N)
ASSOCIATE PROFESSOR
ASWINI COLLEGE OF NURSING
THRISSUR
Prof.Kavitha.B, Aswini college of nursing
15-03-2022

Syllabus – 10 hrs
• Concept of health illness continuum
• Factor influencing health
• Cause and risk factor for developing illness
• Illness and illness behavior
• Impact of illness on patient and family
• Health care services- health promotion & prevention
• Health care teams
• Types of health care agencies
• Hospitals – types, organization & functions
• Health promotion- levels of disease prevention
15-03-2022

C
TERMINOLOGIES
15-03-2022

❑Disease:
• Disturbance of structure or of function of the body or its
constituent parts.
• Lack of or inadequate adaptation of
the organism to his environment.
• Failure of the adaptive mechanism to
adequately counteract the stimuli or
stresses to which it is subject resulting
in disturbances in function and
structure of any part, organ or system
of the body
15-03-2022

❑ Morbidity: Condition of being diseased.
❑ Morbidity Rate: The proportion of disease to
health in a
community.
❑ Mortality: Condition or quality of being subject to
death
❑ Epidemiology: Study of the patterns of health and
disease, its occurrence and distribution in man, for
the purpose of control and prevention of disease.
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❑ Susceptibility: The degree of resistance the potential host
has against the pathogen.
❑ Etiologic Agent: One that possesses the potential for
producing injury or disease. (e.g. Streptococcus,
Staphylococcus)
❑ Virulence: Relative power or the degree of pathogenicity of
the invading microorganism, the ability to produce poisons
that repel or destroy phagocytes.
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❑ Symptomatology: Study of symptoms.
❑ Symptom: Subjective evidence of disease. Any disorder of appearance,
sensation or function experienced by the patient indicative of a certain
phase of a disease. Manifestation of perceptible changes in the body
which indicate the presence of a disease or disorder.
❑ Sign: An objective symptom or objective evidence or physical
manifestation made apparent by special methods of examination or use
of sense. Prof.Kavitha.B, Aswini college of nursing
15-03-2022

❑ Syndrome. A set of symptom, the sum of which constituents a
disease.
▪ A group of symptoms which commonly occurs together
▪ A group of signs & symptoms which when considered together
characterize a disease.
❑ Pathology. The branch of medicine which deals with the cause,
nature, treatment and resultant structural and functional changes of
disease.
15-03-2022

❑ Diagnosis. Art or act of determining the nature of a disease, recognition of a
diseased state.
❑ Complication. A condition that occurs during or after the course of an illness.
❑ Recovery. Implies that the person has no observable or known after effects from
his illness; there is apparent restoration to the pre-illness state.
❑ Prognosis. Prediction of the course and of a disease, medical opinion as to the
outcome of a disease process. Good prognosis means that there is great possibility
to recover from the disease and poor prognosis means that there is great risk for
morbidity or mortality.
15-03-2022

C
CONCEPT OF
HEALTH AND ILLNESS
15-03-2022

Most people define and describe health
as the following:
• Being free from symptoms of disease and pain as much as
possible.
• Being able to be active and to do what they want or must.
• Being in good spirits most of the time.
15-03-2022

DEFINITIONS OF HEALTH
❑Health: a state of complete physical, mental, and
social well being, not merely the absence of disease
(WHO)
❑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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Wellness & Well-Being
Wellness further describes health status. It allows health to be
placed on a continuum from one’s optimal level (“wellness”) to
a maladaptive state (“illness”)
15-03-2022

❑Wellness is a dynamic process that is ever changing. The well person usually
has some degree of illness and the ill person usually has some degree of
wellness.
❑This concept of a health continuum negates the idea that wellness and illness
are opposite because they may occur simultaneously in the same person in
varying degrees
❑The classic description of wellness was developed by Dunn in the early 1960s.
According to Dunn (1961), high-level wellness means functioning to one’s
maximum health potential while remaining in balance with the environment.
15-03-2022

Dimensio
ns of
Wellness
Physical
Social
Environmental
Occupational
Emotional
Spiritual
Intellectual
15-03-2022

❑Physical: The ability to carry out daily tasks, achieve fitness (e.g.
pulmonary, cardiovascular, gastrointestinal), maintain adequate nutrition
and proper body fat, avoid abusing drugs and alcohol or using tobacco
products, and generally to practice positive lifestyle habits.
❑Social: The ability to interact successfully with people and within the
environment
❑Emotional: The ability to manage stress and to express emotions
appropriately, Emotional wellness involves the ability to recognize,
accept, and express feelings.
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❑Intellectual: The ability to learn and use information effectively for personal,
family, and career development
❑Environmental: The ability to promote health measures that improve the
standard of living and quality of life in the community
❑Spiritual: The belief in some force (nature, science, religion, or a higher power)
that serves to unite human beings and provide meaning and purpose of life
❑Occupational: The ability to achieve a balance between work and leisure time,
A person's beliefs about education, employment, and home influence personal
satisfaction and relationships with others.
15-03-2022

C
MODELS OF
HEALTH AND
ILLNESS
15-03-2022

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
15-03-2022

Copyright 2008 by Pearson Education, Inc.
Agent-Host-Environment Model
• The Agent, Host, And
Environment Interact In Ways
That Create Risk Factors.
• Each factor constantly
interacts with the others
• When in balance, health is
maintained
• When not in balance, disease
occurs
15-03-2022

Copyright 2008 by Pearson Education, Inc.
Health-Illness Continuum
•Views Health As A Constantly Changing State With
High-level Wellness And Death On Opposite Sides Of
A Continuum
•Measure person’s perceived level of wellness
•Health and illness/disease opposite ends of a health
continuum
•Move back and forth within this continuum day by
day
•Wide ranges of health or illness
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15-03-2022

Basic Human Needs (Maslow)
15-03-2022

The Health Belief Model
The HBM is based on the understanding that a person will take a
health-related action (i.e., use condoms) if that person:
1. Feels that a negative health condition (i.e., HIV) can be
avoided,
2. Has a positive expectation that by taking a recommended
action, he/she will avoid a negative health condition (i.e., Using
condoms will be effective at preventing HIV), and
3. Believes that he/she can successfully take a recommended
health action (i.e. He/she can use condoms comfortably and
with confidence).
15-03-2022

C
15-03-2022

Health Promotion Model
• The health promotion model (HPM) proposed by
Nola J Pender (1982; revised, 1996) was designed
to be a “complementary counterpart to models
of health protection.”
• It defines health as "a positive dynamic state not
merely the absence of disease".
• Health promotion is directed at increasing a
client’s level of well being.
• The health promotion model describes the multi
dimensional nature of persons as they interact
within their environment to pursue health.
15-03-2022

Top Ten Causes of Death
Number of deaths for leading causes of death
1. Heart disease: 652,091
2. Cancer: 559,312
3. Stroke (cerebrovascular diseases): 143,579
4. Chronic lower respiratory diseases: 130,933
5. Accidents (unintentional injuries): 117,809
6. Diabetes: 75,119
7. Alzheimer's disease: 71,599
8. Influenza/Pneumonia: 63,001
9. Nephritis, nephrotic syndrome, and nephrosis:
43,901
10. Septicemia: 34,136
15-03-2022

Factors Influencing Health
Status, Beliefs, And Practices
Internal
variables
External
variables
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Internal variables
Developmental
stage
Intellect
background
Perception
of
functioning
Emotional
factors
Spiritual
factors
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External factors
Cultural
Backgro
und
Socio
Economi
c
Factors
Family
Practice
s
15-03-2022

Internal factors
• Biologic dimension genetic
makeup, sex, age, and
developmental level all
significantly influence a
person's health.
• Psychological dimension
emotional factors influencing
health include mind-body
interactions and self-
concept.
• Cognitive dimension include
lifestyle choices and spiritual
and religious beliefs.
External factors
◼ Environment.
◼ Standards of living. Reflecting
occupation, income, and
education.
◼ Family and cultural beliefs.
Patterns of daily living and
lifestyle to offspring( children).
◼ Social support networks.
Family, friends, or confidant
(best friend) and job
satisfaction helps people
avoid illness.
15-03-2022

C
CONCEPT OF ILLNESS
Rey Vincent H. Labadan, RN
15-03-2022

People may view illness and disease as the same entity,
health professionals view them as completely separate.
Illness is a personal state in which the person feels
unhealthy or ill.
• Illness may or may not be related to disease
• Illness is a state in which a person’s physical,
emotional, intellectual, social, developmental or
spiritual functioning is diminished or impairment
compared with previous experience.
• Although nurses must be familiar with different
kinds of diseases and their treatments, they are
concerned more with illness, which may include
disease.
15-03-2022

Disease is used to describe as an alteration in
body functions resulting in a reduction of capacities
or a shortening of the normal life span.
• Etiology – causation of the disease. Etiologic
description includes identification of all
factors that act together to bring a disease
condition.
15-03-2022

Risk Factors of a Disease
1. Genetic and Physiological Factors
• Heredity, or genetic predisposition to
specific illness, is a major physical risk
factor. - for example
2. Age
• Age increases or decreases
susceptibility to certain illnesses (the
risk of heart diseases increases with
age for both sexes)
• The risk of birth defects and complications of
pregnancy increase in women bearing
children after age 35.
15-03-2022

3. Environment
• The physical environment in which a person works
or lives can increase the likelihood that certain
illnesses will occur. - for example
4. Lifestyle
• Many activities, habits and practices involve risk
factors. Lifestyle practices and behaviors have
positive or negative effects on health.
• Stress can be a lifestyle risk factor if it is severe or
prolonged, or if the person is unable to cope.
• Stress can threaten mental health & physical well-
being
15-03-2022

Common Causes of Disease
Biologic Agents
Inherited Generic
Defects
Physical Agents
Chemical Agents
Tissue response to
irritation/injury
(fever,
inflammation)
Faulty chemical or
metabolic process
Emotional or
physical reaction
to stress
15-03-2022

Classification
Of
Disease
According
To
Etiologic
Factors
According
To
Duration Or
Onset
Other
Classification
15-03-2022

According to Etiologic Factors
1. Hereditary. Due to defect in the genes of one or other parent
which is transmitted to the offspring.
2. Congenital. Due to a defect in the development, hereditary
factors, or prenatal infection; present at birth. (e.g. cleft lip,
cleft palate)
3. Metabolic. Due to disturbances or abnormality in the intricate
processes of metabolism.
4. Deficiency. Results from inadequate intake of absorption of
essential dietary factors.
15-03-2022

5. Traumatic. Due to injury.
6. Allergic. Due to abnormal response of the body to
chemical or protein substances or to physical stimuli.
7. Neoplastic. Due to abnormal or uncontrolled growth of
cells.
8. Idiopathic. Cause is unknown; Self-originated; of
spontaneous origin.
9. Degenerative. Results from the degenerative changes that
occur in tissue and organs.
10. Iatrogenic. Results from the treatment of a disease.
15-03-2022

According to Duration or
Onset
Acute Illness:
• Typically characterized by severe symptoms of
relatively short duration.
• The signs and symptoms appear abruptly, are
intense and often subside after a relatively
short period.
• Following an acute illness a person may return
to normal level of wellness
15-03-2022

Chronic Illness :
• Slow onset. Persists, usually longer than 6 months & often
for person's life and can also affect functioning in any
dimension.
• Chronically ill person have long term disease process
• The client fluctuate between maximal functioning and
serious relapses that may be life threatening. Characterized
by:
✓ Remission - Period during which the disease is
controlled symptoms are not obvious
✓ Exacerbation - The disease becomes more active again at
a future time, recurrence of pronounced symptoms
15-03-2022

OTHER CLASSIFICATION OF DISEASE MAY 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 response to stimuli.
• Occupational – results from factors associated with the
occupation engaged in by the patient (e.g. cancer among
chemical factory workers.
• Familial – occurs in several individuals of the same family
(e.g. hypertension, cancer)
15-03-2022

• Venereal – Usually acquired through sexual
relation (AIDS, gonorrhea)
• Epidemic. Attacks a large number of individuals in
a community at the same time (SARS)
• Endemic. Present more or less continuously or
recurs in the community.
• Pandemic. Epidemic diseases which is extremely
widespread involving an entire country or
continent.
• Sporadic. A disease in which only occasional cases
occur.
15-03-2022

PRECURSOR OF ILLNESS
These are the factors which impose on the
individuals to lead towards illness spectrum.
Heredity. e.g.
family history for
diabetes mellitus,
hypertension,
cancer.
Behavioral
factors. e.g.
cigarette smoking,
alcohol abuse,
high animal fat
intake.
Environmental
factors. e.g.
overcrowding,
poor sanitation,
poor supply of
potable water.
15-03-2022

STAGES OF ILLNESS –
SUCHMAN FIVE STAGES
Stage 1:
symptoms
experiences.
Stage 2:
assumption of
the sick role
confirmation
from family and
friends.
Stage 3:
medical care
contact.
Stage 4:
dependent
client role.
Stage 5:
recovery or
rehabilitation
.
15-03-2022

1. Symptom experience :
• the person experience believes something is
wrong but couldn't able to diagnose the
problem
• Transition stage.
• Experience some symptoms include
awareness of physical changes like pain,
rashes & lumps
• 3 aspects:
• - Physical (fever, muscles aches, malaise,
headaches)
• - Cognitive (perception of “having flu”)
• - Emotional (worry on consequences of
illness) Prof.Kavitha.B, Aswini college of nursing
15-03-2022

2. Assumption of sick role
1. If symptom persists then the client will assume sick
role & seek confirmation from the family
members
2. Gets excuse from the normal duty
3. Results in emotional changes such as withdrawal,
depression, & physical changes
4. Acceptance of the illness.
5. Seeks advice, support for decision to give up
some activities.
15-03-2022

3. Medical care contact :
• seeks advice to health professionals for the
following reasons:
- Validation of real illness
- Explanation of symptoms
-Reassurance or prediction of outcome
• Health professional may determine whether the
client is ill or not
15-03-2022

4. Dependent patient role :
• Accepts the diagnosis & The person becomes a
client dependently on the health professional
for help.
• Accepts/rejects health professional’s
suggestions.
• Becomes more passive and accepting.
• May regress to an earlier behavioral stage.
15-03-2022

Four aspects of sick role:
• Clients are not 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
Three distinct criteria to determine if a person is ill
• The presence of symptoms
• The perception of how they feel
• Their ability to carry out daily activities
15-03-2022

Recovery and Rehabilitation:
• In this stage the symptoms gets subsiding
• The persons regains the original health status
• In case of chronic illness, final stage involves an
adjustment to a prolonged reduction in health
and functioning
15-03-2022

Fear
Overdependence &
feeling of helplessness
Anxiety
Hope
Anger & hostility
15-03-2022

Impact
on illness
on client
• Rest
• Sleep
Impact
of illness
on family
• Behavioral & emotional
changes
• Impact on family roles
• Impact on body image
• Impact on self concept
• Impact on family
dynamics
IMPACT
OF
ILLNESS
• Privacy
• Autonomy
• Financial
burden
• Life-style
15-03-2022

IMPACT OF ILLNESS
Family and significant others
❖Factors that determine the extent of effect of illness:
• The member of the family who is ill
• The seriousness and length of the illness
• Cultural and social customs the family follows
❖ The changes that can occur in the family:
• Role changes
• Tasks reassignments and increase demands on time
• Increase stress due to anxiety about the outcome of the illness
• Financial problems
• Loneliness resulting from separation and pending loss
• Change in social customs
15-03-2022

PREVENTION AND PROTECTION FROM
ILLNESS
• The health team is mainly responsible for prevention of
illness, protection and promotion of health by making
public aware of illness, injury of illness, injury and disease.
• Nurses play an important role in preventing the
transmission of disease by maintaining medical and
surgical asepsis
• Nurse can protect the public from illness by teaching
them the self care strategies to enhance the fitness,
improve nutrition, and manage stress
15-03-2022

• Encourage the public to avail maximum benefit from
health care system
• Encourage the individual, family, and communities to
promote their level of health by taking well balanced
diet
• Nurses play an important role in prevention of illness by
encouraging and guiding the public to adopt a healthy
life style
• A healthy life style includes good habits , regular
exercise, control the stress by problem solving avoid
smoking, drug abuse and alcohol drinking
15-03-2022

Health Care Services- Health
Promotion & Prevention
Health Promotion – an activity
undertaken for the purpose of achieving
higher level of health and wellness.
15-03-2022

TYPES OF HEALTH CARE SERVICES:
Health promotion:
•Prenatal classes
•Nutritional counselling
•Exercise classes
•Stress management
•Smoking cessation classes
Illness Prevention:
•Screening Programmes
•Routine check ups or
physical examination
•Immunization
•Occupational health and
safety hazards
•Public education
Diagnosis:
• Radiological
procedures
• Physical examination
• Blood testing
Treatment
• Client education
• Surgical intervention
• Laser therapy
• Pharmacological
therapies
Rehabilitation
•Cardiovascular programme
•Pulmonary programmes
•Sports medicine
•Alcohol and drug dependent
•Stroke and spinal cord injury
programmes
15-03-2022

Types of Health Promotion Program
1. Information Dissemination
• Use of variety of media to offer information to the
public about the particular lifestyles choices and
personal behavior, the benefits of changing that
behavior and improving the quality of life.
2. Health Appraisal and Wellness Assessment Programs
• Appraise individuals of their own 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.
15-03-2022

3. Lifestyle and Behavior Change Programs
• Basis for changing health behavior.
• Geared toward enhancing the quality of life and
extending the life span.
4. Worksite Wellness Programs
• Include programs that serve the needs of persons
in their workplace.
5. Environmental Control Programs
• Developed to address the growing problem of
environment pollution-air, land, water, etc.
15-03-2022

Body Defense, Immunity and
Immunization
Active immunity
Humoral immunity
Cellular immunity
Combination of both
Passive immunity:
Normal immune Ig
Specific immune Ig
Animal antigen
15-03-2022

Also known as Wellness activities. To encourage optimal
health and to increase the person’s resistance to illness.
Seeks to prevent a disease or condition at a
prepathologic state; to stop something from ever
happening.
• It precedes disease
• Applied generally for health individuals
• Health promotion
Quit smoking
Avoid or limit alcohol
intake
Exercise regularly
Eat well-balanced diet
Reduce fat &increase
fiber in diet
Take adequate fluids
Avoid over exposure to
sunlight
Maintain ideal body
weight
Wear hazard devices in
work site
Complete Immunization
program
also known as health maintenance (for individuals
experiencing health problem). Seeks to identify
specific illnesses or conditions at an early stage with
prompt intervention to prevent or limit disability.
• Early diagnosis/detention/screening
• Prompt treatment to limit disability
• Prevention of complication
Begins after an illness. To support the client's
achievement of successful adaptation to known
risks, and or establishment of high-level wellness. It
focus to rehabilitate individual s and restore them to
an optimum level of functioning within the constraint
of their disability.
• Rehabilitation
Have annual physical examination.
Regular Pap’s test for women.
Monthly BSE for women who are 20 years –
above.
Sputum examination for Tuberculosis.
Annual stool guaiac test and rectal examination
for clients over age 50 years.
Self-monitoring of blood glucose among
diabetics.
Attending self-management education for
diabetes.
Physical therapy after CVA; participation in
cardiac rehabilitation after MI
Undergoing speech therapy after
laryngectomy
Primary
prevention
Secondary
prevention
Tertiary
prevention
Promoting Health and Wellness
15-03-2022

HEALTH CARE TEAM
15-03-2022

Communi
ty
Health
Team
Physician
s
Nurses
Social
Workers
Health
Assistanc
e
Trained
Dias
Village
Health
Guide
Auxiliary
Personnel
15-03-2022

• Long term
hospital
• Short term
hospital
• Day care
hospital
•Teaching
hospital
•Non teaching
hospital
•General
hospital
•Specialized
hospital
• Public hospital
• Charitable
hospital
• Private hospital
• Corporate
hospital
Based on
ownership
of hospital
Based on
clinical
specialties
Based on
LOS
Based on
diversity in
aim of
hospital
Classification Of Hospital
15-03-2022

Hospital Board
Management
Hospital
Administration
Informative
Services
Admission
Billing &
collection
Health
education
Medical record
Information
system
Human
resources
Therapeutic
services
Medical care
Surgical care
Maternity care
Pediatric care
Other
Superspeciality
care
Physiotherapy
Clinical
psychology
nursing
Diagnostic
services
Medical lab
Imaging &
radiology
Cardiology
Lab
Neurology Lab
Supportive
services
Central supply
Dietary
Pharmacy
Biomedical
technology
House
keeping
Maintenance
Transportation
15-03-2022

THANK YOU!
15-03-2022

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