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After the end of this chapter the student will be able to:
Differentiate health, wellness, and well-being. Describe five dimensions of wellness. Compare various models of health. Identify factors affecting health status, beliefs, and practices. Identify health care adherence. Differentiate illness from disease and acute illness from chronic illness. Explain Suchman's stages of illness.
Introduction
Health, wellness, and well-being have many definitions and interpretations. The nurse should be familiar with the most common aspects of the concepts and consider how they may be individualized with specific clients.
Health
There is no consensus (agreement) about any definition of health. There is knowledge of how to attain (reach) a certain level of health, but health itself cannot be measured. Traditionally health has been defined in terms of the presence or absence of disease. Nightingale defined health as a state of being well and using every power the individual possesses to the fullest extent
Wellness is a dynamic process that is ever changing. The well person usually has some degree of illness and the ill person usually has some degree of wellness.
This concept of a health continuum negates the idea that wellness and illness are opposite because they may occur simultaneously in the same person in varying degrees
The classic description of wellness was developed by Dunn in the early 1960s. According to Dunn (1961), high-level wellness means functioning to ones maximum health potential while remaining in balance with the environment.
Health-Illness Continuum
Measure persons perceived level of wellness Health and illness/disease opposite ends of a health continuum Move back and forth (forward) within this continuum day by day Wide ranges of health or illness
Dimensions of Wellness
1. Physical.
The ability to carry out daily tasks, achieve fitness (e.g. pulmonary, cardiovascular, gastrointestinal), maintain adequate nutrition and proper body fat, avoid abusing drugs and alcohol or using tobacco products, and generally to practice positive lifestyle habits.
2. Social.
The ability to interact successfully with people and within the environment
3. Emotional.
The ability to manage stress and to express emotions appropriately, Emotional wellness involves the ability to recognize, accept, and express feelings.
4. Intellectual.
The ability to learn and use information effectively for personal, family, and career development
5. Spiritual.
The belief in some force (nature, science, religion, or a higher power) that serves to unite human beings and provide meaning and purpose of life
6. Occupational.
The ability to achieve a balance between work and leisure time, A person's beliefs about education, employment, and home influence personal satisfaction and relationships with others.
7. Environmental.
The ability to promote health measures that improve the standard of living and quality of life in the community
Models of Health
Clinical Model Role Performance Model Adaptive Model Eudemonistic Model Agent-Host-Environment Model Health-Illness Continuum
Clinical Model
Provides the narrowest interpretation of health People viewed as physiologic systems Health identified by the absence of signs and symptoms of disease or injury State of not being sick Opposite of health is disease or injury
Copyright 2008 by Pearson Education, Inc.
Adaptive Model
Creative process Disease is a failure in adaptation or maladaptation Extreme good health is flexible adaptation to the environment Focus is stability The aim of treatment is to restore the ability of the person to adapt.
Eudemonistic Model
Comprehensive view of health Condition of actualization (make real) or realization of a persons potential Illness is a condition that prevents selfactualization Actualization is the apex of the fully developed personality Dictionary:
eudemonism: morality evaluated according to happiness :
Copyright 2008 by Pearson Education, Inc.
Agent-Host-Environment Model
Each factor constantly interacts with the others When in balance, health is maintained When not in balance, disease occurs
Well-being
"Well-being is a subjective perception of vitality (energy) and feeling well.....can be described objectively, experienced, and measured......and can be plotted ( design) on a continuum". It is a component of health.
1. Internal factors
Biologic dimension genetic makeup, sex, age, and developmental level all significantly influence a person's health. Psychological dimension emotional factors influencing health include mindbody interactions and self-concept. Cognitive dimension include lifestyle choices and spiritual and religious beliefs.
2. External factors
Environment. Standards of living. Reflecting occupation, income, and education. Family and cultural beliefs. Patterns of daily living and lifestyle to offspring( children). Social support networks. Family, friends, or confidant (best friend) and job satisfaction helps people avoid illness.
Disease Disease can be described as an alteration in body functions resulting in a reduction of capacities or shortening of the normal life span. The causation of a disease is called its etiology.
Impact of Illness
On the Client Behavioral and emotional changes Loss of autonomy Self-concept and body image changes Lifestyle changes On the Family Depends on:
Member of the family who is ill Seriousness and length of the illness Cultural and social customs the family follows