Health, Wellness, and Illness

Wellness

Involves the ability to adapt emotionally and physically to a changing state of health and environment

Illness

Is an altered level of functioning in response to a disease process

Disease

Is a condition that results in the physiological alteration in the composition of the body

Modifiable variables

Can be changed, such as smoking, nutrition, access to health education, sexual practices, and exercise

Non-modifiable variables

Cannot be changed, such as sex, age, developmental level, and genetic traits

Physical aspect of health and wellness

Able to perform activities of daily living

Emotional aspect of health and wellness

Adapts to stress; expresses and identifies emotions

Social aspect of health and wellness

Interacts successfully with others

Intellectual aspect of health and wellness

Effectively learns and disseminates information

Spiritual aspect of health and wellness

Adopts a belief that provides meaning to life

Occupational aspect of health and wellness

Balances occupational activities with leisure time

Environmental aspect of health and wellness

Creates measures to improve standards of living and quality of life

The patient's external environment

Social: crime vs. safety, poverty vs. prosperity, peace vs. social unrest, and presence vs. absence of support from social networks

Physical: access to health care, sanitation, availability of clean water, and geographic location

The patient's internal environment

Cumulative life experiences, cultural and spiritual beliefs, age, developmental stage, gender, emotional factors, and perception of physical functioning

Desired outcomes

To obtain and maintain optimal state of wellness and function through access to and use of health promotion, wellness, and illness prevention strategies

Health and wellness and be achieve through ….

Health education and positive action (stress management, proper nutrition, smoking cessation, exercise and weight loss, immunizations, seeking health care).

The Illness-Wellness Continuum is …..

an assessment took used to measure the level of wellness to premature death.

How is the Illness-Wellness Continuum useful?

As an assessment guide or tool to set goals and find ways to improve a client's state of health or to have the client return to a previous state of health, which can include an illness within optimal wellness. The health care professional can assist the client to see where they are at on the Continuum and seek ways to move toward optimal wellness.

How do the ranges on the Illness-Wellness Continuum work?

At the center of the Continuum is the client’s normal state of health.

The range of wellness to illness runs from optimal wellness to severe illness.

The degree of wellness is relative to the usual state of wellness for a client and is achieved through awareness, education, and personal growth.

Illness

The impairment of a client's physical, social, emotional, spiritual, developmental, or intellectual functioning.

Encompasses the effects of a disease on a client, but is not synonymous with disease.

What factors can influence responses to illness?

• Degree of physical changes as a result of a disease process

• Perceptions by self and others of the illness, which can be influenced by various reliable and unreliable sources of information (friends, magazines, TV, internet)

• Cultural values and beliefs

• Denial or fear of illness

• Social demands, time constraints, economic resources, and health care access

What does a health/wellness assessment include?

• Physical assessment

• Evaluating health perceptions

• Identifying risks to health/wellness

• Identifying access to health care

Neighborhood and built environment SDOH

• Air pollutants from factories exacerbate manifestations of asthma.

• Lack of sidewalks causes lack of safe spaces to walk for exercise.

• Limited public transportation affects ability to commute and less options for employment.

Social and community context SDOH

• Sole caregiver for family member neglects primary care for self.

• Health education materials about diet and exercise not in primary language of client.

• Cultural or religious beliefs may impact decision about health care.

Economic stability SDOH

• Prescription medication costs prohibit use of medications for chronic conditions.

• Lack of health insurance may cause delay in seeking care for manifestations of illness.

• Financial difficulties prohibit client from completing prescribed treatments.

Health and health care SDOH

• Lack of primary care resources in community affects preventative care.

• Lack of providers in community may lead to lack of follow-up for chronic conditions.

• Lack of access to telehealth resources.

Education SDOH

• Lack of education leads to lower paying jobs.

• Lack of health literacy affects understanding of education materials.

• Lower levels of education are associated with chronic medical conditions.

Food and nutrition SDOH

• Lack of affordable, nutritious foods contributes to undernutrition or overnutrition.

• Food insecurity increases risk for chronic illnesses.

• Contaminated food causes foodborne illnesses.

Nursing interventions to promote health and wellness

• Provide resources to strengthen coping abilities.

• Identify and encourage use of support systems during times or illness or stress.

• Identify social determinants of health and create strategies to address health disparities.

• Identify ways to reduce health risks and improve adherence.

• Develop health education methods to improve health awareness and reduce health risks.

A nurse is developing a plan of care with a client. The client is 50 years old. Their height is 63 inches (160 cm), and their BMI is 28. The client smokes 4 to 5 cigarettes daily. They exercise once every week. They have a family history of hypertension and diabetes. Describe the characteristics of the client that are modifiable variables versus non-modifiable variables.

Non-modifiable: age, height, and family history of hypertension and diabetes

Modifiable: smoking, BMI, and exercise

A nurse is performing an assessment with a client during their first appointment in a clinic. Match each characteristic to the aspect of health and wellness the nurse is assessing.

Characteristics:

Balancing work time with leisure time

Able to perform activities of daily living

Able to effectively learn information

Expresses emotions

Creates measures to improve quality of life

Adopts a belief that provides meaning to life

Interacts successfully with others

Aspects of health and wellness:

Physical

Emotional

Social

Intellectual

Spiritual

Occupational

Environmental

Balancing work time with leisure time = Occupational

Able to perform activities of daily living = Physical

Able to effectively learn information = Intellectual

Expresses emotions = Emotional

Creates measures to improve quality of life = Environmental

Adopts a belief that provides meaning to life = Spiritual

Interacts successfully with others = Social

A nurse in a health care clinic is evaluating the level of wellness for clients using the Illness-Wellness Continuum tool. Sort the following clients by whether the nurse should measure them in the center of the continuum or measure them in the range of wellness to illness.

A school-age client who is up-to-date on their immunizations

An adolescent client who has a urinary tract infection

An adult client who has influenza

An adult client who has a long history of well-controlled rheumatoid arthritis.

An adult client who has a new diagnosis of type 2 diabetes mellitus

Range of optimal wellness to severe illness:ban adolescent client who has a urinary tract infection, an adult client who has influenza, an adult client who has a new diagnosis of type 2 diabetes mellitus

Middle of the continuum: a school-age client who is up-to-date on their immunizations, an adult client who has a long history of well-controlled rheumatoid arthritis

A nurse is caring for a client who was just informed of a new diagnosis of breast cancer. The nurse evaluates the client's response. Which of the following statements by the client represents the SDOH oh health and health care?

“I do not have a history of breast cancer.”

“I need a second opinion. There is no lump.”

“I wish we lived closer to the big medical centers in the city.”

“I hope I have enough sick leave to get paid for the time I will be off work.”

“I wish we lived closer to the big medical centers in the city.”

A nurse is caring for a client who has a new diagnosis of type 2 diabetes mellitus and reports difficulty following the diet and remembering to take prescribed medicatoon. Which of the following actions should the nurse take to promote client adherence? Select all that apply.

Ask the dietitian to assist with meal planning.

Contact the client's support system.

Assess for age-related cognitive awareness.

Encourage the use of a daily medication dispenser.

Provide educational materials for home use.

Ask the dietitian to assist with meal planning.

Contact the client's support system.

Encourage the use of a daily medication dispenser.

Provide educational materials for home use.