The document discusses concepts of health, illness, disease, and rehabilitation. It defines health using biomedical, ecological, psychosocial, and holistic concepts. Health is described as a state of complete physical, mental and social well-being. Illness is the personal experience of disease and involves assuming a sick role. Rehabilitation aims to train individuals to the highest level of functional ability using medical, social, educational and vocational measures. The document outlines levels of health care from primary to tertiary and levels of fitness from beginner to elite athlete.

1.  PRESENTED BY : EUSIVIA PASI
HEALTH, ILLNESS
AND
REHABILITATION

2. CONTENTS
CONCEPT OF HEALTH AND DISEASE
 Health and well-being
 Dimensions of health
 Determinants of health
 Disease ,sickness and illness
 Levels of health care
 Levels of fitness
CONCEPTS OF REHABILITATION
 Public awareness to the various disabilities
 Communications.
 Message generation and dissipation

3. CONCEPT OF HEALTH
AND DISEASE

4. CONCEPT OF HEALTH
BIOMEDICAL CONCEPT ECOLOGICAL CONCEPT
PSYCHOSOCIAL
CONCEPT
HOLISTIC CONCEPT

5. DEFINITIONS
HEALTH is a state of complete physical , mental and social well being
and not merely an absence of disease or infirmity (WHO 1948)
More recently, WHO has stated that the „ultimate
outcome‟ of health is well-being and quality of life (WHO 2003)

6. OPERATIONAL DEFINITION
OPERATIONAL DEFINITION OF HEALTH BY WHO – A
condition or quality of human organism expressing
adequate functioning of the organism in given conditions
genetic or environmental

7. HEALTH AND WELL BEING
Positive health – it implies the notion of perfect
health in body and mind .it cannot become a reality , it
always remain a dream because everything in our life
is subject to change .
“Wellness is a multidimensional state of being
describing the existence of positive health in an
individual as exemplified by quality of life and a
sense of well –being “.

8. GOOD HEALTH TRAID
PHYSICAL
STATUSSOCIAL
STATUS
MENTAL
STATUS

9. DIMENSIONS OF HEALTH

10. DETERMINANTS OF HEALTH
Determinants are those predisposing factor which
influence the health of a particular community

11. FOUR HEALTH
DETERMINANTS
HEALTH
SOCIAL &
PSYCHOSOCIAL
ENVIRONMENTAL
ECONOMIC
BIOLOGICAL

12. INDICATORS OF HEALTH
An index is an objective measure of an existing situation
Indices are defined as relative numbers expressing the value of
certain quantity as compared with another
CHARACTERISTICS OF AN INDICATOR:
1. Valid
2. Precise
3. Sensitive
4. Specific

13. USES OF HEALTH INDICATORS
a) Reflect changes in the health profile over a specified time span
b) Enable delimitation of backward and priority areas in a country.
c) Permit international comparison
d) Allow evaluation of health services and specific interventions
e) Help to diagnose community needs and perceptions.
f) Helpful to program planners and health administrators for
charting out progress
g) Allow projections for the future.

14. CLASSIFICATION OF INDICATORS
1.Baseline indicators
Progress indicators
 Evaluation indicators
2. Evaluative indicators
3. Comparative indicators

15. TYPES OF INDICATORS
 VITAL INDICATORS
a) MORTALITY INDICATORS
b) MORBIDITY INDICATORS
c) DISABILITY INDICATORS
d) SERVICE INDICATORS
e) COMPOSITE INDICATORS
 BEHAVIOURAL INDICATOR.

16. SPECTRUM OF HEALTH
POSITIVE HEALTH
BETTER HEALTH
FREEDOM FROM DISEASE
UNRECOGNISED DISEASE
MILD DISEASE
SEVERE DISEASE
DEATH

17. CONCEPT OF DISEASE

18. CONCEPT OF DISEASE
SICKNESS
DISEASE PROCESS
DISEASE
ILLNESS

19. WHAT IS ILLNESS
Is a personal state in which the persons feels unhealthy
Physical, emotional ,intellectual ,social ,developmental or
spiritual functioning is diminished or impaired compared
with previous experience
Illness is not synonymous with disease
Disease is an alteration in body functions resulting in
reduction of capacities or a shortening of the normal life
span

20. PRECURSORS OF ILLNESS
HEREDITY
BEHAVIORAL FACTAL FACTORS
ENVIRONMENTAL FACTORS

21. STAGES OF ILLNESS

22. 1. SYMPTOMS EXPERIENCE
 Transition stage
 The person believes something is wrong
 Experiences some symptoms (physical, cognitive ,
emotional

23. 2.ASSUMPTION OF SICK ROLE
Acceptance of the illness
Seeks advice ,support for decision to
give up some activities

24. 3.MEDICAL CARE CONTACT
 Seeks advise of health professionals for the
following reason :
 validation of real illness
 Explanations of symptoms
 Reassurance or prediction of outcome

25. 4.DEPENDENT PATIENT ROLE
Become dependent to health professionals
Accepts/rejects health professional‟s suggestions
Become more passive and accepting
May regress to an earlier behavioural stage

26. 5. RECOVEY /REHABILITATION
Gives up the sick role and returns to
former roles and functions

27. DEFINITION OF DISEASE
 Ecological point of view ,disease is defined as “a
maladjustment of the human organism to the
environment “
 The simplest definition is that disease is just the
opposite of health .i.e.,. Any deviation from normal
functioning or state of complete physical or mental
well-being

28. DISTINCTION BETWEEN DISEASE, ILLNESS
AND SICKNESS
The term disease literally mean “without ease “
Illness refers to the presence of a specific disease and also to the
individuals perceptions and behaviour in response to the disease ,as
well as the impact of that disease on the psychosocial environment .
Sickness refers to a state of social dysfunction .
Disease is a physiological/psychological dysfunction
Illness is a subjective state of the person who feels aware of not being
well

29. EPIDEMIOLOGICAL TRAID
Environment
Agent Host

30. HEALTH CARE AND FITNESS

31. HEALTH CARE
Health care is a multitude services provided to
individuals ,families ,or communities by health
professions or other for achieving the objectives of
promoting ,maintaining, monitoring or restoring health

32. CHARACTERISTICS OF
HEALTH CARE
 COMPASSION : feeling of pity about suffering of others
 CONSCIENCE : sense of right and wrong ,feel of guilty
 COMMITMENT : seriously take the responsibilities
 CONFIDENCE : feeling sure about ones ability
 COMPETENCE : do the best to be done .

33. LEVELS OF HEALTH CARE
PRIMARY LEVEL
SECONDARY LEVEL
TERTIARY LEVEL

34. PRIMARY HEALTH CARE
 WHO (1978) defines PHC as essential care made
universally accessible to individuals and families in
the community by means acceptable to them through
their full participation and at a cost that the
community and country can afford at every stage of
development
 The term „primary health care‟ (PHC)gained
widespread currency following the 1978.

35. PRINCIPLES OF PRIMARY
HEALTH CARE
Equity
Acceptable
Accessible
Affordable
Community participation
Appropriate technology
Inter-sectoral co-ordination

36. COMPONENTS OF PRIMARY
HEALTH CARE
 Health education
 Food supply and nutrition
 Safe drinking water and sanitation
 Maternal and child health, family planning
 Expanded programme on immunization (EPI)
 Prevention and control of endemic diseases
 Appropriate treatment of common diseases , injuries and accidents
 Provision of essential drugs.

37. SECONDARY HEALTH CARE
 The first referral level ,deals with more complex
problems ,which provides mainly curative and
rehabilitative services
 Health facilities level includes hospitals and
rehabilitative centres

38. TERTIARY HEALTH CARE
 More specialised level such as teaching hospital and
specialized hospital
 The care is usually given by the specialist ,major
surgeries are included in this level

39. FITNESS AND ITS LEVEL

40. FITNESS
ACSM defines fitness as the ability to perform moderate to
vigorous levels of physical activity without undue fatigue
and the capability of maintaining such ability throughout the
life.

41. COMPONENTS OF FITNESS
components
of fitness
Muscular
strength
Speed or
velocity
Body
composition
Cardiovascular
endurance Flexibility
or
suppleness
Muscular
endurance

42. LEVELS OF FITNESS
Level I – Healthy beginner
Level 2 – Intermediate athlete
Level 3 – Advanced athlete
Level 4 – Elite athlete

43. LEVEL -I
HEALTHY BEGINNER.
 Basic standard for health and fitness. Lacking these basic levels of
strength, flexibility, and work capacity may limit you in life activities.
 The complete Level I should be attainable within 3 to 12 months for
those with no significant limitations.
 A proper basic movements such as hip flexion and active shoulder use
while healed injuries and structural problems are resolved.

44. LEVEL -II
INTERMEDIATE ATHLETE.
All healthy adults can aspire to this level of fitness. Basic
movements are perfected and advanced skills are
introduced.
The complete Level 2 may take from six months to several
years to reach after achieving Level I.

45. LEVEL-III
ADVANCED ATHLETE.
Few people possess this level of general fitness any healthy
person can achieve it.
The strength, work capacity, power and skill required to
meet these goals can prepare to tackle any kind of physical
performance with competence and confidence.
Expect to invest another three to five years of consistent
effort.

46. LEVEL-1V
ELITE ATHLETE.
 This level of achievement requires long-term dedication and a
passion for fitness.
 The skills required of Level 4 are very advanced and represent a
highly skilled and well-rounded athlete. While few may attain all of
the Level 4 skills,
 should continually seek improvement and get closer to achieving
each one

47. CONCEPT OF REHABILITATION

48. DEFINITION OF
REHABILITATION
ILO‟s Definition “Rehabilitation involves the
combined and coordinated use of medical,
social, educational and vocational measures for
training or retraining the individual to the
highest possible level of functional ability”

49. REHABILITATION
 Defined as “combined and coordinated use of medical , social ,
educational and vocational measures for training and retraining the
individual to the highest possible level of functional ability “
 Areas of concern in rehabilitation :
• Medical rehabilitation
• Vocational rehabilitation
• Social rehabilitation
• Psychological rehabilitation

50. THE MEDICAL MODEL
Definition of disability was composed by the World Health
Organisation (WHO) in the early 1980s.
IMPAIRMENT - loss or abnormality in structure or function;
DISABILITY - inability to perform an activity within the
normal range for a human being, because of impairment;
HANDICAP - inability to carry out normal social roles
because of an impairment/disability.

51. DEFINITION
WHO definition of CBR
“CBR involves measures taken at the community
level to use and build on the resources of the community,
including the impaired, disabled and the handicapped
persons themselves, their families and their community as a
whole”.

52. THE REHABILITATION PROCESS
Identify
problems and
needs
Relates problems to
modifiable and
limiting factors
Define target
problems and target
mediators ,select
appropriate measure
Plan ,implement
,and co ordinate
interventions
Assess effects

53. Health condition
Activities
Participation
Environmental
factors
Personal
factors
Body
structures and
functions
The WHO (2001) framework of disability (after Hurri 2003).
Functioning and disability depend on complex interactions between
all the components.

54. EVOLUTION OF REHABILITATION
SERVICES
The discipline of rehabilitation developed after the Second
World War. In 1951 the UNO established a Rehabilitation
Unit with the aim of facilitating the transfer of these new
medical and technical advances to developing countries.

55. PUBLIC AWARENESS
TO
THE VARIOUS DISABILITIES

57. PROMOTIONAL IDEAS FOR
DISABILITY HISTORY AND
AWARENESS WEEKS

58. Hang banners in schools and/or use school marquee to
recognize Disability History and Awareness Week.
 Allow students to design posters, fliers, and/or buttons
related to Disability History and Awareness. Post student-
designed posters and fliers in the school.
 Use school and district Web sites to promote disability
history and awareness.
 Ask schools to include biographical information on famous
people with disabilities in morning announcements

59. Encourage district school board to pass a resolution
recognizing Disability History and Awareness Week
Distribute a letter announcing Disability History and
Awareness Weeks, including a flier to all parents
 Ask the local PTA/PTO to include articles related to
disability history and awareness in their newsletters and
October meetings

60.  Ask teachers to incorporate into their lesson plans information about
disability history and awareness
 Post a timeline of disability history in every school. Allow students to
design timelines.
 Encourage school libraries to do a book exhibit to expand students‟
understanding and awareness of individuals with disabilities and
related history and on the disability rights movement.
 . Contact local media outlets concerning articles and stories related to
disability history or awareness during Disability History and
Awareness Week.

61.  Recognize the achievement of local and other people with disabilities
all year. Focus on their abilities and achievements through the district
Web site, newsletters, morning announcements, and working with
local media for stories and articles.
 Encourage schools to host school-wide Disability History &
Awareness event(s).
 Involve parents and other members of the community in planning and
implementing activities at the district and school level.
 Encourage student councils/student government in planning and
implementing activities at district and school level.

62. Provide training for teachers concerning disability history
and awareness -- give inservice points for participation.
 Encourage district and school personnel to participate in
Disability Mentoring Day. Additional information on
Disability Mentoring Day can be found at:
http://www.aapd.com/site/c.pvI1IkNWJqE/b.5606851/k.CD
B/Welcome_to_the_Disability_Mentoring_Program.htm
 Designate a point person to coordinate disability history
and awareness activities for the district.

63. WHAT IS COMMUNICATION?
Communication is any act by which one person gives to
or receives from another person information about that
person's needs, desires, perceptions, knowledge, or
effective states. Communication may be intentional or
unintentional, may involve conventional or
unconventional signals, may take linguistic or non-
linguistic forms, and may occur through spoken or other
modes.

64. COMMUNICATION PROCESS
Sender Message Channel Receiver
Awareness
Interest
Adoption
Evaluation

65. LEVELS OF COMMUNICATION
 Intrapersonal,
Interpersonal and
 Group communications

66. MODES OF COMMUNICATION
Communication occurs through words, actions, or a
combination of words and actions.
Verbal messages are messages communicated through
words, and language, either spoken or written.
Non-verbal messages are messages communicated without
words, i.e., through body language
Some of the non –verbal communications are facial
expressions, posture, gestures and touch.

67. COMMUNICATION SKILLS
1. Eye contact:
2.Body language:
3.Question:
4.Reinforcement:

68. Physiological
barrier
Psychologic
al barrier S
Cultural
barrier
Environmental
barrier
COMMUNICATION BARRIER
Education
Class difference
language variation
Attitude
Religion
Beliefs
Customs

69. OBJECTIVES OF HEALTH
EDUCATION
1. To ensure that health is valued as an asset to the
community
2. To equip the people with skills, knowledge and attitudes
to enable them solve their health problems by their own
actions and efforts ,and
3. To promote the development and proper use of health

70. HEALTH EDUCATION

71. DEFINITION
“Health education is a process that informs, motivates and
helps people to adopt and maintain healthy practices and
lifestyles, advocates environmental changes as needed to
facilitate this goal and conducts, professional training and
research to the same end”

72. APPROACHES TO PUBLIC
HEALTH
There are three well known approaches to public health
(1) REGULATORY APPROACH
(2) SERVICE APPROACH
(3) EDUCATIONAL APPROACH

73. CONTENT OF HEALTH
EDUCATION
Divided into 8 main divisions:
(1) HUMAN BIOLOGY
(2) NUTRITION
(3) HYGIENE
(4) ENVIRONMENTAL HYGIENE
(5) FAMILY HEALTH CARE
(6) CONTROL OF COMMUNICABLE AND NON-COMMUNICABLE DISEASES
(7) MENTAL HEALTHA
(8) PREVENTION OF ACCIDENTS

74. PRNCIPLES IN HEALTH
EDUCATION
1. Unless there is motivation people will not lean.
2. There should be an interest or a desire to learn
3. The worker or the physiotherapist should include the
people or community in health education programmes
4. One should start educating people from what they know
already and then expose them to new knowledge
5. We should know the level of understanding ,education
and background of people

75. 6. Education should be repeated
7.Imparting knowledge to people by positive
approach will give better results than the negative
approach.
8. People remember better while doing
9. The physiotherapist would be able to communicate
better if she knows thoroughly the existing practices
,religious ,belief, habits ,taboos, and customs of
people prior to the education programmes.

76. 10.Establish good interpersonal relationships
11. Adequate planning is essential ,even if it is a five-minute
talk
12. Health education should be carried out with the co-
operation of local leaders, school teachers, dais and other
prominent persons

77. CONTENTS OF HEALTH
EDUCATION
It depends upon
1. Interest of the group and their needs.
2. What the group knows already
3. Age and sex.
4. Health problem of the community

78. METHODS OF HEALTH EDUCATION
1. Lecture
2. Group discussion
3. Demonstration
4. Panel discussion
5. Symposium

79. 6. Workshop
7. Institute
8. Role playing
9. Programmed instruction
10. Stimulation exercises

80. AUDIO-VISUAL AIDS
The advantages of AV Aids are :
1. They create interest in the learners
2. They make learning permanent
3. They increase the thinking of the people
4. They give opportunity for variety of learning
5. They offer reality of experience

81. VARIOUS AUDIO-VISUAL AIDS
1. Motion pictures or movies
2. Film strip
3. Exhibits
4. Black board or white board
5. Bulletin boards
6. Flannel graph
7. Flash cards

82. 8. Posters
9. Puppets
10. Television
11. Radio
12. Health museum
13. Health magazines
14. Computer and internet

83. FLANNELBOARD
With suitable pictures a story can be very
effectively told using a flannel board.

84. MAKING POSTERS
Posters can convey a single, simple message very
strongly. They can be displayed in health centres,
clinics, schools, or in public places.

85. HEALTH MUSEUM

86. COLOUR SLIDES AND FILMSTRIPS

87. USING PUPPETS

88. FUNCTION OF HEALTH
COMMUNICATION
1. Information
2. Education
3. Motivation
4. Persuasion
5. Counselling
6. Raising morals
7. Health development
8. Organization

89. CONDUCTION OF HEALTH
EDUCATION AT THREE LEVELS
a)Individual and family health education
b)Group health education
c)Mass health education

90. REFERENCES
1. Neelamkumari ;A text book of community health nursing -1
2. Kasthuri Sunder Rao :An introduction to community health nursing
;4th edition (chapter 30)
3. K.Park : Preventive and social medicine .20th edition
4. www.wcpt.org
5. www.disabilityindia.org