Health, Wellness, and Holism Concepts

Nursing Science and the Concept of Health

• Nursing is both a discipline and a profession characterized by a distinctive knowledge base, shared values, and a societal contract. This contract is fundamentally aimed at the betterment of human lives (Donaldson and Crowley, 1978).

• As a professional practice, nursing relies on the understanding that genuine development is rooted in investing in the health and healthcare of people. This investment must be made regardless of age, sex, gender, religion, and race (Sumile, 2018).

• Health is regarded as a shared reality. Community nurses must develop a deep understanding of health as both an abstract concept and a lived experience.

Perspectives on the Definition of Health

• World Health Organization (WHO) Definition: Health is a state of complete physical, mental, and social well-being and not merely the absence of disease or infirmity.

• Sister Callista Roy (2009): Health is defined as the individual’s total well-being and the regular patterns of people and their environments that result in maintaining wholeness and human integrity.

• Pender, Murdaugh, and Parsons (2011): Health is the realization of human potential through goal-directed behavior, competent self-care, and satisfying relationships with others.

• Greiner (2014): Health is the state of physical, mental, spiritual, and social functioning that realizes a person's potential and is experienced within a developmental context.

• Margaret Newman (1997): Health is viewed as the expansion of consciousness.

• Common Themes in Health Descriptions:

  • Goal-directed behavior.

  • Purposeful actions.

  • Process-oriented nature.

  • Responses to internal and external stimuli.

  • Integrity of the person.

  • Wholeness and well-being.

Wellness and the Human Right to Health

• Dunn's Classic Concept of Wellness (1961): Wellness is influenced by an interconnected web consisting of the individual, the family, the community, society, and the environment.

• Foundational Right: The WHO identity and directive assert that the enjoyment of the highest attainable standard of health is a fundamental right of every human being.

• Universal Declaration of Human Rights (UDHR, 1948): Under the United Nations, Article 25 states that everyone has the right to a standard of living adequate for the health and well-being of himself and of his family. This includes:

  • Food.

  • Clothing.

  • Housing.

  • Medical care.

  • Necessary social services.

• The Right to Health Components:

  1. Availability: Presence of health services and programs.

  2. Accessibility: Includes features often summarized by the acronym PINE.

  3. Acceptability: Healthcare must respect ethics and be culturally and gender-sensitive.

  4. Quality: Healthcare services must be of a high standard.

• Philippine Implementation of Health Rights:

  • National Health Insurance Act of 1995 (Republic Act No. $7875$).

  • Universal Health Care Act (Republic Act No. $11223$).

• World Health Organization's View of Universal Health Coverage (UHC): This ensures all individuals and communities receive the health services they need without suffering financial hardship. It encompasses the full spectrum of essential services, including health promotion, prevention, treatment, and palliative care (WHO, 2019).

Models of Health and Illness

• Clinical Model: Health is defined simply as the absence of signs and symptoms of disease; illness is the presence of such signs. It is the traditional lens of medical science. An example is a person only seeking healthcare after suspecting a cardiovascular problem.

• Role Performance Model: Health is defined by an individual's ability to perform societal roles (at work, in the family, in society). If a person fails to fulfill these roles, they are considered ill. For example, a febrile employee who reports to work might be considered healthy by society even if they are unwell.

• Adaptive Model: Health is a dynamic state where the individual adjusts positively to social, mental, and physiological changes. Illness occurs when the person fails to cope or becomes maladaptive. This model focuses on the perception of and coping with heavy circumstances.

• Eudaimonistic Model: Health is a state of wellness where quality of life, finding meaning and purpose, and self-regulation are emphasized. The patient is seen as a holistic, unitary person.

  • Derived from Aristotle’s Eudaimonia, often translated as "flourishing" or "success."

  • Metaphor: Like a plant that grows and blooms when given water, light, and food, humans can flourish by taking responsibility, living with Arete (virtue/living each moment to the fullest), and focusing on what they can control.

• Kaginhawaan Model: A Filipino aspiration for the optimal human condition. It is a state where a person can breathe with ease and is free from wants or problems. It represents a symphony of health, wellness, and relational harmony, including peace with oneself, others, community, society, environment, Cosmos, Divinity, and the "other" worlds.

Distinguishing Health from Wellness

• Being healthy is not the same as being well.

• Objective vs. Subjective Reality:

  • A person with a chronic condition (e.g., hypertension or end-stage renal disease) may not be "healthy" objectively, but can maintain a good quality of life and experience moments of wellness.

  • A chronic smoker may feel "well" because smoking is part of their identity, yet they are not objectively healthy.

  • A person lacking meaning in their work may be physically healthy but emotionally unwell.

• Community nurses must aim for health that combines both objective physiological status and subjective well-being.

Determinants of Health and Disease

• Biology: Includes genes, family history, and physical/mental conditions.

• Behavior: The individual’s response to internal stimuli.

• Social Environment: Relationships involving family, friends, coworkers, and the community.

• Physical Environment: Sensory influences that affect health positively or negatively.

• Policies and Interventions: Regulations and programs implemented at local, regional, and national levels (e.g., DOH, DOE, DILG, DOT).

• Social Determinants of Health (SDH): Defined by CSDH (2008) as the conditions in which people are born, grow, live, work, and age. These are shaped by the distribution of money, power, and resources and include:

  • Occupation and working conditions.

  • Income and economic stability.

  • Culture and religion.

  • Education access and quality.

  • Race and gender discrimination.

  • Neighborhood and built environment.

  • Social and community context.

One Health Concept

• This framework for community and Public Health Nursing (PHN) calls for collaborative efforts between human health, veterinary medicine, and environmental health professionals.

• It addresses global and environmental health issues by recognizing the interconnected relationship between humans, livestock/wildlife, and the environment.

• Key Stats on Emerging Infectious Diseases (EIDs): Between 1940 and 2004, a total of $365$ infectious diseases were identified.

Traditional Filipino Health and Healing Practices (TFHHP)

• Practices include Indigenous health traditions, folkloric healing, and those used by ethnolinguistic communities.

• Examples: Hilot, Bintosa, Suob/Tuob, potions/herbs, and rituals for the sick or spirits.

• Traditional Alternative Medicine Act of 1997 (TAMA): Covers traditional and alternative practices, including those from Traditional Chinese Medicine like acupuncture and cupping.

• The 10 DOH-Approved Medicinal Plants (S-A-N-T-A-L-U-B-B-Y):

  1. Sambong

  2. Akapulko

  3. Niyog-niyogan (Chinese Honeysuckle)

  4. Tsaang Gubat

  5. Ampalaya

  6. Lagundi

  7. Ulasimang Bato

  8. Bayabas

  9. Bawang

  10. Yerba Buena

Questions & Discussion

Q1: Scenario involving Ms. T, a $60$-year-old woman with late-stage cancer who declined aggressive treatment for palliative care. She is not in pain and says she is "ready to go anytime." Question: In which model would she be considered well? Answer: D. Eudaimonistic Model. (This model emphasizes quality of life, meaning, and the ability to self-regulate despite physical condition).

Q2: Scenario regarding a Public Health Nurse coordinating with a municipal veterinary office and local government units for the National Rabies Prevention and Control Program. Question: What approach is being utilized? Answer: A. One Health Approach. (This focuses on the collaboration between human health and animal health sectors).

Q3: Scenario involving Miss W and her $15$-year-old child with viral flu. She uses a practice of covering the head and placing mild liniment on the soles of the feet with socks to lessen coughing. Question: What is the most appropriate action of the nurse? Answer: A. Allow the practice to be done and provide appropriate health teaching. (This respects traditional practices that are not harmful while ensuring proper medical education).", "title": "Health, Wellness, and Holism Study Guide"}