The document outlines objectives and concepts related to health, wellness, and disease. It discusses various definitions and models of health, including the World Health Organization's definition of health as complete physical, mental and social well-being. It describes dimensions of wellness, factors influencing health, and differences between illness and disease. Stages of illness and approaches to health maintenance are also summarized. Key health indicators in Pakistan like infant mortality rate and life expectancy are listed.

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2. Group member's
• Abdur rauf
• Tariq aziz
• Izaz ali
• Naveed ali
• Zeeshan khan
2

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Epidemiology
Concept of Health & Disease

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Objective
• After the end of this session the student will be
able to:
• Differentiate health, wellness, and well-being.
• Describe five dimensions of wellness.
• Compare various models of health.
• Identify factors affecting health status, beliefs,
and practices.
• Identify health care adherence.
• Differentiate illness from disease and acute
illness from chronic illness.
• Explain Suchman's stages of illness.
• Enlist the health indicator in pakistan

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Introduction
• Health, wellness, and well-being have
many definitions and interpretations. The
nurse should be familiar with the most
common aspects of the concepts and
consider how they may be individualized
with specific clients.

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Health
• There is no consensus (agreement) about any
definition of health. There is knowledge of how
to attain (reach) a certain level of health, but
health itself cannot be measured.
• Traditionally health has been defined in terms
of the presence or absence of disease.
• Nightingale defined health as a state of being
well and using every power the individual
possesses to the fullest extent

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The World Health Organization
(WHO) defined health
• as a state of complete physical,
mental, and social well-being,
and not merely the absence of
disease or infirmity.

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the American Nurses Association
defined health
• a dynamic state of being in which the
developmental and behavioral potential
(possible) of an individual is realized to the
fullest extent possible

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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.

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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”)

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Conti…
• 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.

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Conti….
• 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

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Conti….
• 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.

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Copyright 2008 by Pearson Education, Inc.
Health-Illness Continuum
• Measure person’s perceived level of wellness
• Health and illness/disease opposite ends of a health
continuum
• Move back and forth (forward) within this continuum day
by day
• Wide ranges of health or illness

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Copyright 2008 by Pearson Education, Inc.
Dimensions of Wellness

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1. 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.

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2. Social.
• The ability to interact successfully with
people and within the environment

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3. 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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4. Intellectual.
• The ability to learn and use information
effectively for personal, family, and career
development

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5. 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

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6. 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.

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7. Environmental.
• The ability to promote health measures
that improve the standard of living and
quality of life in the community

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Models of Health
• Clinical Model
• Role Performance Model
• Adaptive Model
• Eudemonistic Model
• Agent-Host-Environment Model
• Health-Illness Continuum

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Copyright 2008 by Pearson Education, Inc.
Clinical Model
• Provides the narrowest interpretation of
health
• People viewed as physiologic systems
• Health identified by the absence of signs
and symptoms of disease or injury
• State of not being “sick”
• Opposite of health is disease or injury

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Role Performance Model
• Ability to fulfill societal roles
• Healthy even if clinically ill if roles fulfilled
• Sickness is the inability to perform one’s
role

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Adaptive Model
• Creative process
• Disease is a failure in adaptation or
maladaptation
• Extreme good health is flexible adaptation
to the environment
• Focus is stability
• The aim of treatment is to restore the
ability of the person to adapt.

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Copyright 2008 by Pearson Education, Inc.
Agent-Host-Environment Model
• Each factor constantly
interacts with the
others
• When in balance,
health is maintained
• When not in balance,
disease occurs

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Well-being
• "Well-being is a subjective
perception of vitality (energy) and
feeling well.....can be described
objectively, experienced, and
measured......and can be plotted
( design) on a continuum". It is a
component of health.

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Factors influencing health status,
beliefs, and practices:
• Internal factors
• External factors

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1. 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.

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2. 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.

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Illness and Disease Illness
• Is a highly personal state in which the
person's physical, emotional, intellectual,
social, developmental, or spiritual
functioning is thought to be diminished.
Illness is usually associated with disease
but may occur independently of it. Illness
is a highly personal state in which the
person feels unhealthy or ill.

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• Disease
Disease can be described as an alteration
in body functions resulting in a reduction
of capacities or shortening of the normal
life span.
The causation of a disease is called its
etiology.

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There are many ways to classify
illness and disease:
• Acute illness is typically characterized by
severe symptoms of relatively short
duration.
• A chronic illness is one that lasts for an
extended period, usually 6 months or
longer, and often for person's life.

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Suchman describes five stages of
illness:
• 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.

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There are several approaches to
health maintenance:
• Health promotion
• Health protection
• Disease prevention

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Impact of Illness
On the Client
• Behavioral and
emotional changes
• Loss of autonomy
• Self-concept and
body image changes
• Lifestyle changes
On the Family
• Depends on:
– Member of the family
who is ill
– Seriousness and
length of the illness
– Cultural and social
customs the family
follows

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Impact of Illness: Family Changes
• Role changes
• Task reassignments
• Increased demands on time
• Anxiety about outcomes
• Conflict about unfamiliar responsibilities
• Financial problems
• Loneliness as a result of separation and pending
loss
• Change in social customs

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Health Indicators
• 1-Infant Mortality Rate IMR
• 2-Life Expectancy at age
• 3-Literacy rate
• 4-Life Expectancy at age Birth-
• 5-Poverty
• Literacy rate

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