HEALTH AND

ILLNESS MARIEMEL FAITH T.

ARCUINO, RN, MAN

Definition of Terms:

Health - process through which the person seeks to maintain an equilibrium that
 promotes stability and comfort; includes physiological, psychological,
sociocultural, intellectual and spiritual well-being.

Homeostasis -the tendency toward a relatively stable equilibrium between

interdependent elements, especially as maintained by
physiological processes.

Adaptation - any change in the structure or behavior of a species which helps it

to become better fitted to survive and reproduce in its environment.

Disease - is a particular abnormal condition that negatively affects the structure or

function of part or all of an organism, and that is not due to any external injury.
Diseases are often construed as medical conditions that are associated with specific
symptoms and signs. A disease may be caused by external factors such as
pathogens or by internal dysfunctions.
Definition of Terms:

Illness – is a state in which a person’s physical, emotional, intellectual,

 social, developmental, or spiritual functioning is diminished or impaired.

Wellness - condition in which an individual functions at optimal levels.

High-Level wellness - condition of change in which the individual moves

forward, climbing toward a higher potential of functioning.

Well-being – the state of being happy, healthy or prosperous.

- is a subjective perception of vitality and feeling well. Can be
described objectively, experienced and measured and can be plotted
on a continuum. It is a component of health.
Models of Health & Illness

CLINICAL MODEL
- In this model the opposite of health is disease or injury. Many medical practitioners use
the clinical model in their focus on the relief of signs and symptoms of disease and elimination
of malfunction and pain. When these signs and symptoms are no longer present, the medical
practitioner considers the individual’s health restored.

ROLE PERFORMANCE MODEL

 - A model of health, wellness, and illness that views health in functional terms; here, if a
person can function, he or she is healthy even if they have illness.

ADAPTIVE MODEL
- A model of health, wellness, and illness that views health as adaptation to the physical
and social world in which a person lives and disease as maladaptation to this world.
Models of Health & Illness

AGENT- HOST- ENVIRONMENT MODEL

- also called the ecologic model. Originated in the community health work of Leavell and
Clark (1965) and has been expanded into a general theory of the multiple cause of disease.
The model is used primarily in predicting illness rather than in promoting wellness, although
identification of risk factors that result from the interactions of agent, host, environment are
helpful in promoting and maintaining health.

1. Agent – any environmental factor or stressor (biologic, chemical, mechanical, physical, or

psychosocial) that by its presence or absence (ex. Lack of essential nutrients)
can lead to illness or disease.

2. Host. Person (s) who may or may not be at risk of acquiring a disease. Family history, age,
and lifestyle habits influence the host’s reaction.
 3. Environment- all factors external to the host that may or may not predispose the person to
the development of disease.
Models of Health & Illness

HEALTH- ILLNESS CONTINUA

- can be used to measure a perceived level of wellness. Health and illness or disease
can be viewed as the opposite ends of a health continuum. From a high a level of
health a person’s condition can move through good health, normal health, poor
health and extremely poor health, eventually to death.
- People move back and forth within this continuum day by day. There is no distinct
boundary across which people move from health to illness or from illness back to
health. How people perceive themselves and how others see them in terms of
health and illness will also affect their placement on the continuum.

DUNN’S HIGH-LEVEL WELLNESS GRID

- Dunn described a health grid in which a health axis and an environmental axis
intersect. The grid demonstrates the interaction of the environment with the illness
wellness continuum.
- The health axis extends from peak wellness to death, and the environmental
 axis extends from very favorable to very unfavorable.
Models of Health & Illness
Models of Health & Illness
1. High-level wellness in a favorable environment.
An example is a person who implements healthy lifestyle behaviors and has
the biopsychosocial, spiritual, and economic resources to support this lifestyle.

2. Emergent high-level wellness in an unfavorable environment .

An example is a woman who has the knowledge to implement adequate
self-care practices because of family responsibilities, job demands, or other
factors.

3. Protected poor health in a favorable environment

An example is an ill person( ex. One with multiple fractures or severe
hypertension) whose needs are met by the health care system and who
has access to appropriate medications, diet, and health care institution.

4. Poor health in an unfavorable environment.

An example is a young child who is starving in drought-stricken country.
Models of Health & Illness

TRAVIS’S ILLNESS- WELLNESS CONTINUUM

 - developed by Travis. This model ranges from high-level wellness to premature
death. The model illustrates two arrows pointing in opposite directions and joined at
a neutral point. Movement to the right of the neutral point indicates increasing levels
of health and well-being for an individual. This is achieved in three steps: (a)
awareness, (b) education, and (c) growth. In contrast, movement to the left of the
neutral point indicates progressively decreasing levels of health.

- Travis and Ryan believe it is possible to be physically ill and at the same time
oriented toward wellness, or be physically healthy and at the same time
function from an illness mentality.

Models of Health & Illness

THE 4+ MODEL OF WELLNESS
- Consist of four domains of the inner self – physical, spiritual, emotional, and
intellectual plus the elements of the outer systems (environment, culture,
nutrition, safety, and many other elements). The nurse assesses the inner self for
strengths and excesses, sources of nurturing and of depletion, and the
interactions between the inner self and the outer systems. This model is useful
when working with individuals, families or communities.
Variables influencing health and health beliefs and practices
INTERNAL VARIABLES

Developmental Stage/ BIOLOGIC DIMENSION

➢ a person’s thought and behavior patterns change throughout life. ➢ The
nurse must consider the client’s level of growth and development when using
 the his or her health beliefs and practices as a basis for planning care.

Intellectual Background/ COGNITIVE DIMENSION

➢ a person’s beliefs about health are shaped in part by the person’s knowledge,
lack of knowledge or incorrect information about body functions and illnesses,
educational background and past experiences.

Perception of functioning/ PSYCHOLOGIC DIMENSION

➢ the way people perceive their physical functioning affects health beliefs
and practices. When the nurse assess a client’s level of health, they gather
subjective data about the way clients perceives
physical functioning such as level of fatigues, shortness of breath, or pain.
➢ Nurses also obtain objective data about actual functioning such as blood
pressure, height measurements, lung sound assessment.
Variables influencing health and health beliefs and practices

Emotional factors
➢ client’s degree of stress, depression, or fear.
➢ the manner in which a person handles stress throughout each phase of life will
influence the way the person reacts to illness.
Spiritual factors
➢ spirituality is reflected in how a person lives his or her life, including the values
and beliefs exercised, the relationships established with family and friends,
and the ability to find hope and meaning in life. Spirituality serves as an
integrating theme in people’s lives. Religious practices are one way that people
exercise spirituality. There are some religions that restrict use of certain forms
of medical treatment.
Variables influencing health and health beliefs and practices
EXTERNAL VARIABLES

Family practices/ ENVIRONMENT

➢ The way that clients families use health care services generally affects
their health practices. Their perceptions of the seriousness of diseases
and their history of preventive care behaviors influence how clients will
think about health.

Socioeconomic Factors/ STANDARDS OF LIVING

➢ Social and psychosocial factors increase the risk for illness and influence the
way that a person defines and reacts to illness. Psychosocial variables
include the stability of the person’s marital or intimate relationship, lifestyle
 habits, and occupational environment.
➢ A person’s compliance with the treatment that is designed to maintain or improve
health is also affected by economic status.

Cultural Background/ FAMILY AND CULTURAL BELIEFS

➢ influences beliefs, values, and customs. It influences beliefs, values, and
customs. It influences the approach to the healthcare system, personal health
practices, and the nurse-client relationship.
Variables influencing health and health beliefs and practices

LEVELS OF PREVENTIVE CARE

Primary Prevention
• is also called true prevention; it precedes disease or dysfunction and is applied to
clients considered physically and emotionally healthy.
• aims at health promotion which includes health education programs,
immunization, and physical and nutritional fitness activities.

Secondary Prevention
• focuses on individuals who are at risk for developing complications or
 worsening conditions.
• activities are directed at diagnosis and prompt intervention, thereby reducing
severity and enabling the client to return to a normal level of health as early as
possible.

Tertiary Prevention
• occurs when a defect or disability is permanent and irreversible.
• it involves the effects of long-term disease or disability by interventions directed at
preventing complications and deterioration.
Concept of Illness

CLASSIFICATION OF ILLNESS

Acute Illness
❑ Usually reversible , has a short duration, and is often severe
❑ The symptoms appear abruptly, are intense, and often subside after relatively short
period.

Chronic Illness
 ❑ Chronic illness persists, usually longer than 6 months, is irreversible, and affects
functioning in one or more systems
❑ Patients often fluctuate between maximal functioning and serious health relapses
that may be life threatening
Nursing Science
❑ Knowledge about empirical world is systematically organized into laws and
theories for the purpose of describing, explaining ad predicting phenomena of
special concern to the discipline of nursing.
❑ Empirical knowing ranges from factual, observable phenomena (eg. Anatomy and
physiology, chemistry) to theoretical analysis (eg. Developmental theory,
adaptation theory).
Nursing Ethics
❑ Goals of nursing include the conservation of life, alleviation of suffering, and
promotion of health.
❑ Ethical knowing focuses on matters of obligation or what ought to be done, and
goes beyond simply following the ethical codes of the discipline.
Nursing Aesthetics
❑ Aesthetic knowing is the art of nursing and is expressed by the individual nurse
through his or her creativity and style in meeting the needs of the client. ❑ Empathy,
compassion, holism, and sensitivity are important modes in the aesthetic pattern of
knowing.
Personal Knowledge
 ❑ Personal knowledge is concerned with the knowing, encountering, and actualizing
of the concrete, individual self.
❑ Personal knowing promotes wholeness and integrity in the personal encounter,
achieves engagement rather than detachment, and denies the manipulative or
impersonal approach.
Variables Influencing Illness and Illness behavior
INTERNAL VARIABLES

➢ Internal variables such as patient perceptions of symptoms and the nature of the
illness influence patient behavior.
➢ Patients more likely seek assistance if they believe symptoms are serious or life
threatening.
➢ Patients with acute illnesses are likely to seek healthcare and comply readily with
therapy.
➢ A patient with a chronic illness in which symptoms are not cured but only partially
relieved may not be motivated to adhere to the therapy plan.

EXTERNAL VARIABLES

➢ External variables influencing a patient’s illness behavior include the visibility

of symptoms, social groups, cultural background, economic variables,
accessibility of the healthcare system and social support.
Impact of Illness on the Patient and Family
BEHAVIORAL AND EMOTIONAL CHANGES
❖ People react differently to illness or the threat of illness.
❖ Individual behavioral and emotional reactions depend on the nature of an illness,
patient’s attitude toward it, the reaction of others to it, and the variables of illness
behavior.

IMPACT ON BODY IMAGE

❖ Some illness result in changes in physical appearance.
❖ Patients’ and families’ reactions differ and usually depend on the type of changes their
adaptive capacity, the rate at which changes take place and the support services
available.

IMPACT ON SELF-CONCEPT
❖ self-concept is a mental self-image of strengths and weaknesses in all aspects
of personality.
❖ The effect of illness on the self-concepts of patients and family members is usually
more complex and less readily observed than role changes. Self-concept is
important in relationships with other family members.
Impact of Illness on the Patient and Family
IMPACT ON FAMILY ROLES
❖ When an illness occurs, parents and children try to adapt to the major changes that
result. If a parent of an adult becomes ill and cannot carry out usual activities, the
adult child often assumes many of the parent’s responsibilities and in essence
becomes a parent to the parent.

IMPACT ON FAMILY DYNAMICS

❖ Family dynamics are the processes by which the family functions, makes decisions,
gives support to individual members, and copes with everyday changes and
challenges. When a parent in family becomes ill, family activities and decision
making often come to a halt as the other family members wait for the illness to pass,
or the family members delay action because they are reluctant to assume the ill
person’s roles or responsibilities.

❖ This often creates tension or anxiety in the family. Role reversal is also common. If a
parent of an adult becomes ill and is unable to carry out usual activities, the adult
child often becomes the family caregiver and assumes many of the parent
responsibilities. Such reversal leads to conflict responsibilities for the adult child and
often direct conflict over decision making.
Thank
You!