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Health
Definition:
State of being well and using every power the individual possesses
Wellness
Components of Wellness
1. physical, e.g.:
a. ability to carry out daily tasks
b. achieve fitness
c. maintain nutrition and proper body fat
d. avoid abusing drugs, alcohol, or using tobacco products
e. generally to practice positive life-style habits
2. social, e.g.:
a. ability to interact successfully with people and within the
environment of which each person is a part
b. develop and maintain intimacy with significant others
c. develop respect and tolerance for those with different opinions
and beliefs
3. emotional, e.g.:
a. ability to manage stress and express emotions appropriately
b. ability to recognize, accept, and express feelings
c. ability to accept one’s limitations
4. intellectual, e.g.:
a. ability to learn and use information effectively for personal,
family, and career development
b. striving for continued growth and learning to deal with new
challenges effectively
5. spiritual, e.g.:
a. belief in some force (nature, science, religion, or a "higher
power") that serves to unite human beings and provide
meaning and purpose to life
b. includes a person’s morals, values, and ethics
6. occupational
a. ability to achieve a balance between work and leisure time
b. beliefs about education, employment and home influence
personal satisfaction and relationships with others
7. environmental
a. ability to promote health measures that promote the standard of
living and quality of life in the community
i. influences include:
1. food
2. water
3. air
Models of health and illness
clinical model
• narrowest interpretation; medically-oriented model
o health is seen as freedom from disease
o illness is seen as the presence of disease
role performance model
• ability to perform work, that is fulfill societal roles, essential
to the model; assumption of the model is that a person’s
most important role is their work role
o health is seen as the ability to fulfill societal roles
o illness is seen as the inability to fulfill societal roles
adaptive model
• ability to adapt to the environment and interact with it to
maximum advantage essential to the model
o health is seen as adaptation
o illness is seen as a failure of adaptation, or
maladaptation
eudaemonistic model
• most comprehensive, holistic, view of health; ability to
become self-actualized essential to the model
o health is actualization or realization of one’s potential
o illness is seen as the failure to actualize or realize
one’s potential
Enviro
nment
Agent Host
used primarily in predicting illness rather than promoting wellness
model is composed of three dynamic, interactive elements
• the agent
o a factor (biologic, chemical, physical, mechanical,
psychosocial) that must be present or absent for an
illness to occur, e.g.:
presence of the legionella bacillus
• the host
o living beings (e.g., human or animal) capable of being
infected or affected by the agent, e.g.:
a Legionnaire at the Legionnaire’s Conference at
the Bellevue-Stratford Hotel in Philadelphia
• environment
o everything external to the host that makes illness more
or less likely, e.g.:
presence of stagnant water in the air conditioning
system at the Bellevue-Stratford Hotel in
Philadelphia
view of health and illness
• health is seen when all three elements are in balance
illness is seen when one, two, or all three elements are not in balance
Health-illness continua
Environment Axis
Very Unfavorable
Environment
composed of two axis’s
1. a health axes which ranges from peak wellness to
death
2. a environmental axes which ranges from very
favorable to very unfavorable
the two axis’s form four quadrants
1. 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
2. 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
3. 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
4. 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
Wellness Model
Premature High-level
Treatment Model
Death Disability Symptoms Signs Awareness Education Growth Wellness
Neutral Point
composed of two arrows pointing in opposite directions
and joined at a neutral point
1. 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
2. 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
most important is the direction the individual is facing on
the pathway
1. if towards high-level health, a person has a
genuinely optimistic or positive outlook despite
his/her health status
2. if towards premature death, a person has a
genuinely pessimistic or negative outlook about
his/her health status
compares a treatment model with a wellness model
1. 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
2. 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.
Locus of Control Model
Internal Variables
a. Biologic
genetic makeup
age
developmental level
race
gender
b. Psychologic or Emotional
Mind-body interaction
c. Cognitive or Intellectual
Cognitive abilities
Educational background
Past experiences
d. Spiritual
e. Environmental
Housing
Sanitation
Climate
Pollution of air, food, water
f. Sociocultural
Economic levels
Lifestyle
Family
Culture
Health Care Adherence
Adherence
Illness
Etiology
Types of illness
1. acute illness
2. chronic illness
Illness Behaviors
1. Symptom experiences
a. Physical
b. Cognitive
c. Emotional
2. Assumption of the sick role
3. Medical Care Contact
a. Validation of real illness
b. Explanation of the symptoms in understandable terms
c. Reassurance that they will be alright or prediction of what the
outcome will be
4. Dependent Client Role
5. Recovery or Rehabilitation
Effects of Illness
Impact on Client
Behavioral Changes
Emotional Change
Physical Changes
Lifestyle Changes
Factors:
1. Role Changes
2. Task reassignments and increased demands on time
3. Increased stress
4. Financial problems
5. Loneliness as a result of loss and separation
6. Change in social customs
two goals
1. help individuals of all ages increase life expectancy and
improve the quality of life
particularly African-Americans
particularly African-Americans
i. currently, years of healthy life is 63 years for
European-Americans and 62 years for
Hispanics, and 56 years for African-Americans
1. Primary Prevention
Health promotion
Protection against specific health problems
2. Secondary Prevention
Early identification of health problems
Prompt intervention to alleviate health problems
3. Tertiary Prevention
Restoration and rehabilitation
1. Community Based
2. Hospital Based
3. Health-organization programs
4. School Health-promotion programs
5. Worksite programs for healthpromotion
1. Information dissemination
health promotion programs that use a variety of media to offer
information to the public about the risk or particular lifestyle
choices and personal behavior, as well as the benefits of changing
that behavior and improving the quality of life
e.g., billboards, posters, brochures, newspaper features, books,
health fairs
2. health risk appraisal/wellness assessment programs
health promotion programs that appraise individuals of the risk
factors inherent in their lifestyles in order to motivate them to
reduce specific risks factors and develop positive health habits
e.g., tools such as Health-Style: A Self-Test
3. lifestyle and behavioral change programs
health promotion programs geared toward enhancing the quality of
life and extending the lifespan through implementation of a healthy
lifestyle or behavioral change in the individual
4. environmental control programs
health promotion programs developed in response to the recent
growth in the number of contaminants of human origin that have
been introduced into our environment
The Nursing Process and Health Promotion
1. Assessment
Health History
Physical Examination
Lifestyles assessment
2. Diagnosis
Wellness diagnosis
3. Planning
4. Implementation
Supporting
Counseling
Individual
Telephone
Facilitating
Teaching
Consulting
Modeling
5. Evaluation