PRIMARY HEALTH CARE

MIDWIFERY COURSE AUDIT

SUMMER, 2014
A. HEALTH AND ILLNESS
DEFINITION OF HEALTH
DIMENSIONS OF HEALTH AND WELLNESS
MODELS OF HEALTH
LEVELS OF PREVENTION
FACTORS AFFECTING HEALTH
HEALTH (defined by WHO and some
theorists
- A state of complete physical, mental, and
social well-being and not merely the absence
of disease or infirmity (WHO)
- Is the ability to maintain homeostasis or
dynamic equilibrium. Homeostasis is regulated
by the negative feedback mechanism (Walter
Cannon)
HEALTH (defined by WHO and some
theorists
- Is the ability to maintain the internal milieu
(Claude Bernard)

- Is being well and using ones own power to
the fullest extent. Health is being maintained
through prevention of disease by
environmental health factors (Nightingale)
HEALTH (defined by WHO and some
theorists
- Is viewed in terms of the individuals ability to
perform the 14 components of nursing care
unaided (Henderson)

- Positive health symbolizes wellness. It is a
value termed by the culture or individual
(Rogers)
HEALTH (defined by WHO and some
theorists
- Is a state and a process of becoming and being
an integrated and whole person (Roy)

- a state characterized by soundness or
wholeness of developed human structures
and of bodily and mental functioning (Orem)
HEALTH (defined by WHO and some
theorists
- Is a dynamic state in the life cycle; illness is an
interference (King)
- Wellness is the condition in which all parts
and subparts of an individual are in harmony
with the whole system (Neuman)
- Is an elusive, dynamic state influenced by
biologic, physiologic and social factors.
(Johnson)
WELLNESS AND WELL-BEING
- Wellness is well-being. It involves engaging in
attitude and behaviors that enhance QOL and
maximize personal potential
- Subjective perception of balance, harmony
and vitality
- Is a choice
WELLNESS AND WELL-BEING
- Is a way of life

- Is the integration of boy, mind and spirit

- Is the loving acceptance of ones self
WELLNESS AND WELL-BEING
ENVIRONMENT
OCCUPATION
INTELLECTUAL
SPIRITUAL PHYSICAL
EMOTIONAL
SOCIAL
WELNESS
WELLNESS AND WELL-BEING
SEVEN COMPONENTS OF WELLNESS
1. PHYSICAL
- Ability to carry out daily tasks, achieve
fitness, maintain adequate nutrition, lifestyle
habits
2. SOCIAL
- Ability to interact successfully with people and
within the environment (intimacy, respect)
WELLNESS AND WELL-BEING
SEVEN COMPONENTS OF WELLNESS
3. EMOTIONAL
- Ability to manage stress and express emotions
appropriately

4. INTELLECTUAL
- Ability to learn and use information; continued
growth
WELLNESS AND WELL-BEING
SEVEN COMPONENTS OF WELLNESS
5. SPIRITUAL
- Belief in some force that unite beings;
meaning and purpose to life; morals and
values
6. OCCUPATION
- Ability to achieve balance between work and
leisure
WELLNESS AND WELL-BEING
SEVEN COMPONENTS OF WELLNESS
7. ENVIRONMENT
- Ability to promote health measures that
improve the quality of life and standard of
living
DISEASE
- An alteration in body functions resulting in
reduction of capacities or a shortening of the
normal life span

Common causes of disease
a. Biologic agents
b. Inherited genetic defects
c. Developmental defects
DISEASE
d. Physical agents
e. Chemical agents
f. Response to irritation/injury
g. Faulty metabolic process
h. emotional/physical reaction to stress
CLASSIFICATIONS OF DISEASE
A. ACCORDING TO BIOLOGIC FACTORS
a. Hereditary h. Idiopathic
b. Congenital i. Degenerative
c. Metabolic j. Iatrogenic
d. Deficiency
e. Traumatic
f. Neoplastic
g. Allergic
CLASSIFICATIONS OF DISEASE
B. ACCORDING TO DURATION/ONSET
a. Acute short, intense
b. Chronic longer than six months; remission and
exacerbation
c. Subacute more pronounced but longer than
acute

CLASSIFICATIONS OF DISEASE
C. Other classifications
a. Organic g. Endemic
b. Functional h. Pandemic
c. Occupational i. Sporadic
d. Familial
e. Venereal
f. Epidemic

ILLNESS
- A personal state in which the person feels
unhealthy

- A state in which a persons functioning is
diminished or impaired

- NOT synonymous with disease
ILLNESS
STAGES OF ILLNESS
1. Symptom experience
- Transition stage
- Believes something is wrong
- Experiences some s/sy
2. Assumption of the sick role
- acceptance; advice, support

ILLNESS
STAGES OF ILLNESS
3. Medical contact
- Seeks advice
- Validation, explanation
4. Dependent patient role
- Dependence
- Passive

ILLNESS
STAGES OF ILLNESS
5. Recovery
- Gives up sick role and returns to former roles
FACTORS AFFECTING HEALTH
OLOF
POLITICAL
BEHAVIOR
HEREDITY
HCDS
ENVIRONMENT
SOCIO-
ECONOMIC
FACTORS AFFECTING HEALTH
1. POLITICAL great influence
- Has the power/authority to regulate
- E.g. safety, oppression, people
empowerment, safety/crime
2. BEHAVIORAL habits, lifestyle
3. HEREDITARY genetically influenced diseases
- Understanding, increase knowledge preventive
measure
- Anticipate and counteract
FACTORS AFFECTING HEALTH
4. HCDS
- PHC, 4 As, community-based

5. ENVIRON MENTAL INFLUENCES
- Pollution and sanitation

6. SOCIO-ECONOMIC INFLUENCES
LEVELS OF PREVENTION
1. PRIMARY PREVENTION
Goal: Health promotion and specific protection
Objective: enable clienteles to maintain health and
realize full potential
- encourage optimum health and increase
persons resistance to illness
- Prevents disease; stop something to happen
- E.g. :quit smoking, avoid/limit alcohol intake,
exercise, eat well-balanced diet, avoid
overexposure to sun, maintain IBW, complete
immunization program, wear hazard devices
LEVELS OF PREVENTION
2. SECONDARY PREVENTION
Goal: Early diagnosis/detection/screening and
prompt treatment
Objective: to halt progress and prevent/reduce
complications
- health maintenance
- Identify specific illnesses or conditions at early
stage
- Prompt intervention to limit or prevent disability
- E.g.: annual PE, Paps smear, BSE, TSE, sputum
exam, stool and rectal exam
LEVELS OF PREVENTION
3. TERTIARY PREVENTION
Objective: restore OLOF
- occurs after disease or disability
- Stop the disease or injury process and assist
patient in attaining optimal health
- E.g.: self-monitoring of blood sugar, PT,
rehabilitation, therapy
THEORIES AND MODELS RELATED TO
HEALTH
1. CLINICAL MODEL
- views people as physiologic system with
related functions and identifies health as the
absence of signs and symptoms of disease or
injury
2. ROLE PERFORMANCE MODEL
- defines health in terms of ability to fulfill
societal roles
THEORIES AND MODELS RELATED TO
HEALTH
3. ADAPTIVE MODEL
- focuses on adaptation
- illness is a maladaptation

4. EUDAMONISTIC MODEL
- actualization or realization of persons
potential
THEORIES AND MODELS RELATED TO
HEALTH
5. AGENT-HOST-ENVIRONMENT MODEL

THEORIES AND MODELS RELATED TO
HEALTH
6. HEALTH ILLNESS CONTINUA
- Used to measure a persons perceived level of
wellness
- Health and illness or disease at the ends
- From good health to death
- Subjective and objective perceptions
- Environmental axis and health axis
THEORIES AND MODELS RELATED TO
HEALTH
6. HEALTH ILLNESS CONTINUA
THEORIES AND MODELS RELATED TO
HEALTH
6. HEALTH ILLNESS CONTINUA
- Two axes form four quadrants:
a. High level wellness in favorable environment
b. Emergent high level wellness in an
unfavorable environment
c. Protected poor health in a favorable
environment
d. Poor health in unfavorable environment
THEORIES AND MODELS RELATED TO
HEALTH
7. ILLNESS-WELLNESS CONTINUUM
- Believe it is possible to be physically ill and at
the same time oriented toward wellness
THEORIES AND MODELS RELATED TO
HEALTH
7. ILLNESS-WELLNESS CONTINUUM

THEORIES AND MODELS RELATED TO
HEALTH
8. HEALTH BELIEF MODEL

Perceived
susceptibility to
disease
Perceived
seriousness of
disease
Perceived threat of
disease X
Cues to action,
mass media, advice,
illness of others

Likelihood of taking
recommended
preventive health
Demographic
variables,
sociopsychologic
variables, Structural
variables
Perceived benefits
of prevention
minus perceived
barriers to
preventive action
INDIVIDUAL
PERCEPTION
MODIFYING
FACTORS
LIKELIHOOD


END OF FIRST TOPIC

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