CONCEPTS OF HEALTH, WELLNESS, & WELL-BEING

Lecturer: Mrs. Bernadette Santos Orpeza, MAN, RN

HEALTH

Traditionally defined in terms of the presence or absence of disease.

Florence Nightingale (1860/1969)

Defined health as a state of being well and using every power the individual possesses to the fullest extent.

WHO (1948)

"A state of complete physical, mental, and social well being, and not merely the absence of disease or infirmity."

WHO (1948)

This definition reflects or has a concern for the individual as a total person which has the functionality in terms of physical, psychological, and social aspects of the individual.

Talcott Parsons (1951)

Conceptualized health as the ability to maintain normal roles.

US President’s Commission on Health Needs of the Nation (1953)

"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."

ANA (2010)

"Health and illness are human experiences. The presence of illness does not preclude health, nor does optimal health preclude illness."

ANA (2010)

For others, they may view health as highly subjective or it will depend on their perception. So for as long as, for example, they can still perform their role, then they can still consider themselves healthy even though they have a disability.

POPULATION HEALTH

Populations may be determined by geography, familial relationships, or other common characteristics. These characteristics include the social, structural, physical, and behavioral determinants of health. The term population health has many definitions, but most include the concept of the health of a group of individuals linked to but different from epidemiology, public health, and community health.

-Sufficient motivation to make health issues be viewed as important
-Belief that one is vulnerable to a serious health problem or its consequences
-Belief that following a particular health recommendation would be beneficial.

ROSENSTOCK AND BECKER’S HEALTH BELIEF MODEL Is based on the assumption that health-related action depends on the simultaneous occurrence of three factors:

ADHERENCE

is the extent to which an individual’s behavior coincides with medical or health advice.

-Client motivation to become well
-Degree of lifestyle change necessary
-Perceived severity of the health care problem
-Value placed on reducing the threat of illness
-Ability to understand and perform specific behaviors
-Degree of inconvenience of the illness itself or of the regimens
-Beliefs that the prescribed therapy or regimen will or will not help
-Complexity, side effects, and duration of the proposed therapy
-Cultural heritage, beliefs, or practices that support or conflict with the regimen
-Degree of satisfaction and quality and type of relationship with the health care providers
-Overall cost of therapy

Factors Influencing Adherence:

-Establish why the client is not following the regimen.
-Demonstrate caring.
-Encourage healthy behaviors through positive reinforcement.
-Use aids to reinforce teaching.
-Establish a therapeutic relationship of freedom, mutual understanding, and mutual responsibility with the client and support persons.

When a nurse identifies nonadherence, it is important to take the following steps:

Illness

is a highly personal state in which the person’s physical, emotional, intellectual, social, developmental, or spiritual functioning is thought to be diminished.
• subjective

Disease

can be described as an alteration in body functions resulting in a reduction of capacities or a shortening of the normal life span.

Etiology

is causation of a disease.

Acute
Chronic

Classification of illness and disease:

Remission

these are when the symptoms have died down or disappeared

Exacerbation

when symptoms would reappear again

ILLNESS BEHAVIOR

A coping mechanism, involves ways individuals describe, monitor, and interpret their symptoms, take remedial actions, and use the healthcare system.

RIGHTS

- Clients are not held responsible for their condition. Even if the illness was partially caused by an individual's behavior (e.g., lung cancer from smoking), the individual is not capable of reversing the condition on his or her own.

RIGHTS

- Clients are excused from certain social, roles and tasks. For example, an ill parent would not be expected to prepare meals for the family.

OBLIGATIONS

Clients are obliged to try to get well as quickly as possible. The ill person should follow legitimate advice regarding a specialized diet or activity restrictions that could help with recovery.

OBLIGATIONS

Clients or their families are obliged to seek competent help. For example, the ill person should contact the primary care provider rather than relying solely on his or her own ideas of how to recover.

Symptom experience
Assumption of the sick role
Medical care contact
Dependent client role
Recovery or Rehabilitation

SUCHMAN 5 STAGES OF ILLNESS

Assumption of the sick role

Accept the sick role and seek confirmation from family and friends.

Stage 1 : Symptom experience

The person begins to believe that something is wrong

Stage 4 : Dependent client role

client becomes dependent on the professional help

Stage 3 : Medical care contact

Seek advice from a health professional.

Stage 5 : Recovery or Rehabilitation

During this stage the client is expected to relinquish the dependent role and resume former roles and responsibilities.

- Validation of real illness
- Explanation of the symptoms in understandable terms
- Reassurance that they will be alright or prediction of outcome

3 Types of information being asked:

- The physical exposure to the symptoms
- The cognitive aspect
- Emotional response

3 Aspects of symptom experience:

Illness

brings about changes in both the involved individual and in the family. The changes vary depending on the nature, severity, and duration of the illness, attitudes associated with the illness by the client and others, the financial demands, the lifestyle changes incurred, adjustments to usual roles, and so on.

Behavioral and emotional changes
Changes in self-concept and body image
Lifestyle changes

IMPACT ON THE CLIENT:

- Provide explanations about necessary adjustments.
- Make arrangements wherever possible to accommodate the client’s lifestyle.
- Encourage other health professionals to become aware of the client’s lifestyle practices and to support healthy aspects of that lifestyle.
- Reinforce desirable changes in practices with a view to making them a permanent part of the client’s lifestyle.

Nurses can help clients adjust their lifestyles by these means:

The member who is ill
Seriousness and length of illness
Cultural and social customs of the family

IMPACT ON THE FAMILY:
Depends on 3 factors:

-Role changes
-Task assignments
-Increased stress due to anxiety
-Financial problems
-Loneliness due to separation and pending loss
-Change in social customs

CHANGES

Clinical Model
Role Performance Model
Adaptive Model
Eudaimonistic Model
Agent-Host-Environment Model

MODELS OF HEALTH AND WELLNESS:

Dunn’s High-Level Wellness Grid
Illness-Wellness Continuum

HEALTH-ILLNESS SCALES: