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Inc.
Health, Wellness, Wellbeing
§
Many definitions and interpretations
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Pearson Education,
Inc.
Health
§
Presence or absence of disease
§
Complete physical, mental, social well-
being
§
Ability to maintain normal roles
§
Process of adaptation to physical and
social environment
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Striving toward optimal wellness
§
Individual definitions
4. Wellness
§
State of well-being
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Basic aspects include:
§
Self-responsibility
§
An ultimate goal
§
A dynamic, growing process
§
Daily decision-making in areas related to
health
§
Whole being of the individual
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Well-being
§
Subjective perception of vitality and
feeling well
§
Described objectively, experienced,
measured
§
Can be plotted on a continuum
9. Emotional Dimension
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Ability to manage stress
§
Ability to express emotion
§
how the mind and body interact to affect
the body function and to respond to body
conditions also influences health.
§
Eg. long term stress affects the body
systems, anxiety affects health habits and
conversely calm acceptance and relaxation
can actually change body responses to
illness
10. Intellectual Dimension
§
Ability to learn
§
Ability to use information effectively
§
encompasses cognitive abilities,
educational background and past
experiences.
11. Spiritual Dimension
§
Belief in some force that serves to
unite
§
spiritual and religious beliefs and
values are important components of
§
how a person behaves in health and
illness.
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Occupational Dimension
§
Ability to achieve balance between
work and leisure
13. Environmental Dimension
§
environment has many influences on health
and illness. Housing sanitation, climate,
pollution of air, food and water are aspects
of the environmental dimension.
§
Ability to promote health measure that
improves
§
Standard of living
§
Quality of life
14. Models of Health
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Clinical Model
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Role Performance Model
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Adaptive Model
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Eudemonistic Model
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Agent-Host-Environment Model
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Health-Illness Continuum
15. Clinical Model
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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
maladaption
§
Extreme good health is flexible
adaptation to the environment
§
Focus is stability
§
Element of growth and change
18. Eudemonistic Model
§
Comprehensive view of health
§
Condition of actualization or realization
of a person’s potential
§
Illness is a condition that prevents self-
actualization
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Agent-Host-Environment Model
§
Each factor
constantly interacts
with the others
§
When in balance,
health is
maintained
§
When not in
balance, disease
occurs
20. Health-Illness 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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Factors Affecting Health Status,
Beliefs, and Practices
§
Internal variables
§
External variables
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Inc.
Internal Variables
§
Biologic dimension (genetic makeup,
gender, age, and developmental level)
§
Psychologic dimension (mind-body
interactions and self-concept)
§
Cognitive dimension (intellectual factors
include lifestyle choices and spiritual
and religious beliefs)
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Inc.
External Variables
§
Physical environment
§
Standards of living
§
Family and cultural beliefs
§
Social support networks
24. Factors Affecting Health Care
Adherence
§
Client motivation
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Degree of lifestyle change necessary
§
Perceived severity of problem
§
Value placed on reducing the threat of
illness
§
Difficulty in understanding and
performing specific behaviors
§
Degree of inconvenience of the illness
itself or of the regimens
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Factors Affecting Health Care
Adherence
§
Complexity, side effects, and duration of
the proposed therapy
§
Specific cultural heritage that may make
adherence difficult
§
Degree of satisfaction and quality and
type of relationship with the health care
providers
§
Overall cost of prescribed therapy
26. Definition of disease, illness, and
sickness
§ Disease, illness, and sickness are not
synonymous. The term disease literally means
without ease, the opposite of ease-when
something is wrong with bodily function.(
Professional definition based on a
pathological process- OBJECTIVE)
§ Illness refers to the individual’s perceptions
and behavior in response to being ill ( loss of
function , not feeling well- SUBJECTIVE)
§ Sickness refers to a state of social
dysfunction.( from disease or illness)
27. Definition of disease, illness, and
sickness
§ Disease is a physiological/psychological
dysfunction defined professionally
§ Illness is a subjective state of the person
who feels aware of not being well
§ Sickness is a state of social dysfunction
based on professional and social
agreement
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Inc.
Illness
§
A highly personal state
§
Person’s physical, emotional,
intellectual, social, developmental, or
spiritual functioning is diminished
§
Not synonymous with disease
§
May or may not be related to disease
§
Only person can say he or she is ill
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Disease
§
Alteration in body function
§
A reduction of capacities or a shortening
of the normal life span
30. Acute Illness
§
Characterized by severe symptoms of
relatively short duration
§
Symptoms often appear abruptly,
subside quickly
§
May or may not require intervention by
health care professionals
§
Most people return to normal level of
wellness
31. Chronic Illness
§
Lasts for an extended period
§
Usually has a slow onset
§
Often have periods of remissions and
exacerbations
§
Care includes promoting independence,
sense of control, and wellness
§
Learn how to live with physical
limitations and discomfort
33. Sick Role
§
( If a person is diagnosed as patient by a health
professional (Disease) or considered ill by family or
community ( Illness )- is labeled as SICK such person has
TWO RIGHTS associated with
TWO DUTIES (Parson’s Four Aspects
of the Sick Role)
§
RIGHTS :
§
1- exempt from usual responsibilities.
§
2- not expected to take care or get well by himself
§
DUTIES :
§
1 -should want to get well
§
2- should seek expert advice and make effort to get
well
34. Suchman’s Stages of Illness
Behavior
S –ymptom Experience
A – ssumption of the Sick Role
M – edical care contract
D – epedent client role
R - ehabilitation
35. Stages of illness behavior
§ STAGE 1: SYMPTOM EXPERIENCE
The person is aware that "something is wrong".
A person usually recognizes change such as
pain, a rash or a limitation in functioning but
does not suspect a specific diagnosis.
§
Three aspects:
§
Physical (Fever, Muscle Aches,
Malaise,Headache) –
§
Cognitive (Perception of “having flu”) –
Emotional (Worry on consequence of illness)
36. Stages of illness behavior
§ STAGE 2 : ASSUMPTION OF THE SICK ROLE
If symptoms persist and become severe, clients
assume the sick role. At this point the illness
becomes a social phenomenon, and sick
people seek confirmation from their families
and social groups that they are indeed ill and
that they be excused from normal duties and
role expectations.
E.g. withdrawal, anxiety, fear, depression
37. Stages of illness behavior
§ STAGE 3: MEDICAL CARE CONTACT
If symptoms persist despite the home remedies,
become severe, or require emergency care,
the person is motivated to seek professional
health services.
§
In this stage the client seeks expert
acknowledgement of the illness as well as the
treatment.
§
• Validation of real illness; Explanation of
symptoms; Reassurance or prediction of
outcome
38. Stages of illness behavior
§ STAGE 4 : DEPENDENT CLIENT ROLE
The client depends on health care professionals
for the relief of symptoms. The client accepts
care, sympathy and protection. A client can
adopt the dependent role in a health care
institution, at home, or in a community
setting. The client must also adjust to the
disruption of a daily schedule.
Accepts/rejects health professional’s
suggestions; becomes more passive and
accepting; may regress to an earlier
behavioral stage
39. Stages of illness behavior
§ STAGE 5 : RECOVERY AND
REHABILITATION
This stage can be full recovery . In the
case of chronic illness, the final stage
may involve in an adjustment to a
prolonged reduction in health and
functioning.
§
Gives up the sick role and returns to
former roles and functions
40. 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
41. Impact of Illness: Family
Changes
§
Role changes
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Task reassignments
§
Increased demands on time
§
Anxiety about outcomes
§
Conflict about unaccustomed responsibilities
§
Financial problems
§
Loneliness as a result of separation and
pending loss
§
Change in social customs
42. Question 1
Which one of the following is an example of
the emotional component of wellness?
a. The client chooses health foods.
b. A new father decides to take parenting
classes.
c. A client expresses frustration with her
partner’s substance abuse.
d. A widow with no family decides to join a
bowling league.
43. Rationales 1
.1
The client who chooses healthy foods
represents the physical component.
.2
Taking parenting classes enhances the
intellectual component.
.3
Correct. Frustration is an example of
an emotion.
.4
The bowling league enhances both the
physical and social components.
44. Question 2
Which one of the following individuals appears to
have “taken on” the sick role?
a. An obese client states, “I deserve to have a heart
attack.”
b. A mother is ill and says, “I won’t be able to make your
lunch today.”
c. A man with low back pain misses several physical
therapy appointments.
d. An elder states, “My horoscope says I will be well
again.”
45. Rationales 2
.1
The sick role states that persons are not
answerable for their illness, contrary to
the obese client’s perspective.
.2
Correct. The mother has taken on the sick
role by expecting to be excused from her
usual role responsibilities.
.3
In the sick role, the client tries to get
better as opposed to the man who misses
his physical therapy appointments.
.4
The elder is not following the sick role
expectation to rely on competent help.
46. Question 3
Because a client recently diagnosed with diabetes
mellitus is confident that blood sugar control can be
improved with diet and exercise alone, and recently
went checked out a video on the management of
diabetes at the HMO education center, the client’s
actions are most representative of which one of the
following models:
a. Health belief model
b. Clinical model
c. Role performance model
d. Agent-host-environment model
47. Rationales 3
.1
Correct. The behavior is most representative
of health promotion, which is the central
focus of the health belief model.
.2
The clinical model focuses on relieving signs
and symptoms of illness.
.3
The role performance model emphasizes
social activities such as fulfilling a particular
role.
.4
The agent–host–environment model focuses
on predicting illness.
48. Question 4
Because a client with human immunodeficiency
virus (HIV) is scheduled to begin several
medications to manage the infection, the nurse will
need to provide client education. Which of the
following client characteristics is most likely to
predict adherence with the treatment program?
Select all that apply.
a. Educational level
b. A trusting relationship with the health care provider
c. An expectation that the medications will be helpful
d. Being able to take the medications twice daily instead
of four times daily
e. Gender
49. Rationales 4
.1
Education has not been shown to be a predictive
factor.
.2
Correct. Significant evidence exists that a trusting
relationship with the provider is an important
predictor of adherence.
.3
Correct. Effectiveness of the medication is an
important predictor of adherence.
.4
Correct. A less complex dosing regime is an
important predictors of adherence with the medical
regimen.
.5
Gender has not been shown to be a predictive
factor.
50. Question 5
Which one of the following might be the BEST way
to measure adherence to a prescribed medication
regime?
a. Direct observation of medication administration.
b. Evidence of illness complications or exacerbations.
c. Monitoring laboratory values of element influenced by
the medication.
d. Questioning the client about his or her medication
routine.
51. 1. This is the first stage of illness wherein,
the person starts to believe that
something is wrong. Also known as the
transition phase from wellness to
illness.
A.Symptom Experience
B.Assumption of sick role
C. Medical care contact
D. Dependent patient role
52. 2. In this stage of illness, the person accepts
or rejects a professionals suggestion. The
person also becomes passive and may
regress to an earlier stage.
A. Symptom Experience
B. Assumption of sick role
C.Medical care contact
D Dependent patient role
53. 3. In this stage of illness, The person
learns to accept the illness.
A. Symptom Experience
B. Assumption of sick role
C. Medical care contact
D. Dependent patient role
54. 4. In this stage, the person tries to find
answers for his illness. He wants his
illness to be validated, his symptoms
explained and the outcome reassured
or predicted
A. Symptom Experience
B. Assumption of sick role
C. Medical care contact
D.Dependent patient role
55. 5. The following are true with regard to
aspect of the sick role EXCEPT
A. One should be held responsible for his
condition
B. One is excused from his societal role
C. One is obliged to get well as soon as
possible
D. One is obliged to seek competent help
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Inc.
Resources
§
Audio Glossary
§
Boston College: Welcome to the Nurse Theorist Web Site
Overview of Sister Callista Roy's Adaptation Model
§
Personality Theories: Abraham Maslow
Informative Web site on Maslow's Hierarchy of Needs
§
Mental Health: A Report of the Surgeon General
The Web site relates mental health and its relationship to well-
being.
§
Center for Scientific Review: National Institutes of Health: Risk,
Prevention and Health Behavior.
This sites offers information on the biological, psychological, and
social conditions that affect mental illness.
