HEALTH AND ILLNESS

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 Definitions of Health
 "Health is a state of complete
physical, mental, and social well-
being and not merely the absence
of disease" (WHO, 1947, p. 1)
 "Health is not a condition, it is an
adjustment. It is not a state, but a
process. The process adapts the
individual not only to our physical,
but also our social, environments"
(President’s Commission, 1953, p.
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4)
 Definitions of Health
 most individuals define health as
the following:
 being able to be active and able to
do what they want or must do
 being free of symptoms of disease
and pain as much as possible
 being in good spirits most of the
time

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 The ability of living things to
maintain constancy of their
internal milieu despite changes in
the environment (Claude Bernard)
 An expression of vigor, freedom
from discomfort (Jocano)

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 Definition of Wellness
 an active process by which an
individual progresses towards
maximum potential possible,
regardless of current state of
health

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Dimensions of wellness
 physical, e.g.:
 ability to carry out daily tasks
 achieve fitness
 maintain nutrition and proper body
fat
 avoid abusing drugs, alcohol, or
using tobacco products
 generally to practice positive life-
style habits
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 sociocultural, e.g.:
 ability to interact successfully with
people and within the environment
of which each person is a part
 develop and maintain intimacy with
significant others
 develop respect and tolerance for
those with different opinions and
beliefs
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 emotional, e.g.:
 ability to manage stress and express
emotions appropriately
 ability to recognize, accept, and
express feelings
 ability to accept one’s limitations

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 intellectual, e.g.:
 ability to learn and use information
effectively for personal, family, and
career development
 striving for continued growth and
learning to deal with new challenges
effectively

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 spiritual, e.g.:
 belief in some force (nature,
science, religion, or a "higher
power") that serves to unite human
beings and provide meaning and
purpose to life
 includes a person’s morals, values,
and ethics

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DEFINITION OF DISEASE
pathologic change in the structure or
function of the body or mind

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DEFINITION OF ILLNESS
the response a person has to a
disease; it is an abnormal
process in which the person’s
level of functioning is changed
compared with a previous level

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 influenced by the following:
 self-perceptions
 others’ perceptions
 the effects of changes in body
structure and function
 the effects of those changes on
roles and relationships
 cultural and spiritual values and
beliefs
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 TYPES OF ILLNESS

 acute illness
 has a rapid onset of symptoms that
lasts for a limited and relatively
short period of time
 e.g., typically less than six months

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 chronic illness
 has a gradual onset of symptoms that
lasts for an extended and relatively long
period of time

e.g., typically six months or longer
 characterized by periods of remission and
exacerbation

remission

symptoms disappear

exacerbation
 symptoms reappear
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MODELS OF HEALTH AND
ILLNESS
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BIOPSYCHOSOCIAL MODEL
OF HEALTH AND ILLNESS

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Travis’ Illness-Wellness
Continuum
 composed of two arrows pointing
in opposite directions and joined
at a neutral point

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 movement to the right on the
arrows (towards high-level
wellness) equals an increasing
level of health and well-being
 achieved in three steps:
 awareness

education

growth

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 movement to the left on the
arrows (towards premature
death) equates a progressively
decreasing state of health
 achieved in three steps:
 signs

symptoms

disability

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 most important is the direction
the individual is facing on the
pathway
 if towards high-level health, a
person has a genuinely optimistic or
positive outlook despite his/her
health status
 if towards premature death, a
person has a genuinely pessimistic
or negative outlook
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AND ILLNESS
 compares a treatment model with a
wellness model
 if a treatment model is used, an individual
can move right only to the neutral point
 e.g., a hypertensive client who only takes his
medications without making any other life-style
changes
 if a wellness model is used, an individual
can move right past the neutral point
 e.g., a hypertensive client who not only takes his
medications, but stops smoking, looses weight,
starts an exercise program, etc.
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 JAHODA
 Conceptualizes health and illness
along separate but co-existing
continua
 Reflects the fact that people
exhibit health and illness in
varying degrees at the same time

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HALBERT DUNN’S HIGH
LEVEL WELLNESS GRID
 High-level wellness in favorable
environment –(healthy lifestyles)
 Emergent high-level wellness in an
unfavorable environment (healthy
lifestyle not implemented because of
family, job etc)
 Protected poor health in favorable
environment (ill person whose needs
met by health care sy. Has access to
medication, diet, & care)
 Poor health in unfavorable environment
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Concepts in Dunns’ Theory
 TOTALITARITY
 Biopsychosocial components

 UNIQUENESS
 Manner in which biopsychosocial
components are integrated

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 ENERGY
 Physical energy
 Psychosocial energy
 Environmental elements
 INNER AND OUTER WORLD
 Reflections of experiences with his
past and present inner self with the
outer world
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 SELF-INTEGRATION
 Reflections of the past and present
are basis of behavior
 Inability to reintegrate results to
illness and death

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 LEAVELL AND CLARK
 Agent-host-environment model
 Ecologic model
 Describes the cause and illness in
other health areas
 Used in predicting illness rather
than in promoting wellness

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 EVOLUTIONARY
BASED MODEL
 Suggest that illness and health
sometimes have an evolutionary
function
 Interrelates elements

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 LIFE EVENTS
 Developmental variables and chance
variables e.g. accidents or relocations

 LIFESTYLE DETERMINANTS
 Personal and learned strategies a
person uses to make lifestyle changes

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 EVOLUTIONARY VIABILITY
 Reflects the extent to which people
function to promote survival and well
being

 CONTROL PERCEPTIONS
 Extent to which a person can
influence life circumstances

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 VIABILITY EMOTIONS
 Affective reactions

 HEALTH OUTCOMES
 Physiological, behavioral, and
psychological states resulting from
viability emotions

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 MASLOW’S
HEIRARCHY OF NEEDS
 Basic human needs for survival
and health
 Some needs must be met before
other needs
 Understand the relationship of
different needs and the factors
that determine the priorities for
the client
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Rosenstock/Becker’s
Health-Belief Model
 based on motivational theory
 composed of three components
 INDIVIDUALS PERCEPTION
 MODIFYING FACTORS
 LIKELIHOOD OF ACTION

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 an individual’s perceptions, e.g.:
 of perceived susceptibility
 of perceived seriousness
 of perceived threat

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 modifying factors (factors that
modify an individual’s
perceptions), e.g.:
 demographic variables
 e.g., age, gender, race, ethnicity, etc.
 sociopsychologic variables

e.g., personality, social class, peer and
reference group pressure, etc.

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 structural variables
 e.g., knowledge about the disease, prior
contact with the disease, etc.
 perceived threat
 cues to action
 e.g., mass media campaigns, advice from
others, reminder postcard from a
physician or dentist, illness of family
member or friend, newspaper or
magazine article
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 likelihood of action
 perceived benefits of the action
MINUS
 perceived barriers to action EQUALS
 likelihood of taking recommended
preventive health action

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 PENDER’S HEALTH
PROMOTION MODEL
 Describes the multidimensional
nature of persons as they interact
within their environment to pursue
health
 Defines health as a positive,
dynamic state nor merely the
absence or disease
 Directed at increasing a client’s
level of well-being
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 Focuses on the following areas
 Client’s cognitive perceptual factors
(individual perceptions)
 Modifying factors (demographic and
social)
 Participation in health promoting
behaviors (likelihood of action)

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