Koizer D.

Paleng 08-05-2008

Health Care lecture 3:00-4:30 TThS A908

Health-illness continua
a. Dunn’s High-Level Wellness Grid
i. composed of two axis’s
a. a health axes which ranges from peak wellness to
death
b. a environmental axes which ranges from very favorable
to very unfavorable
ii. the two axis’s form four quadrants
a. high-level wellness in a favorable environment
1. e.g., a person who implements healthy life-style
behaviors and has the biopsychosocialspiritual
resources to support this life-style
b. emergent high-level wellness in an unfavorable
environment
1. e.g., a woman who has the knowledge to
implement healthy life-style practices but does
not implement adequate self-care practices
because of family responsibilities, job demands,
or other factors
c. protected poor health in a favorable environment
1. e.g., an ill person whose needs are met by the
health care system and who has access to
appropriate medications, diet, and health care
instruction
d. poor health in an unfavorable environment
1. e.g., a young child who is starving in a drought
ridden country
b. Travis’ Illness-Wellness Continuum
i. composed of two arrows pointing in opposite
directions and joined at a neutral point
a. movement to the right on the arrows (towards high-
level wellness) equals an increasing level of health and
well-being
1. achieved in three steps:
a. awareness
b. education
c. growth
b. movement to the left on the arrows (towards premature
death) equates a progressively decreasing state of
health
 1. achieved in three steps:
a. signs
b. symptoms
c. disability

ii. most important is the direction the individual is facing

on the pathway
a. if towards high-level health, a person has a genuinely
optimistic or positive outlook despite his/her health
status
b. if towards premature death, a person has a genuinely
pessimistic or negative outlook about his/her health
status

iii. compares a treatment model with a wellness model

a. if a treatment model is used, an individual can move
right only to the neutral point
1. e.g., a hypertensive client who only takes his
medications without making any other life-style
changes
b. if a wellness model is used, an individual can move
right past the neutral point
1. e.g., a hypertensive client who not only takes his
medications, but stops smoking, looses weight,
starts an exercise program, etc.