WELLNESS

 an active process by which an individual progress towards maximum potential possible, regardless of
current state of health
 is the interactive process of becoming aware of and practicing healthy choices to create a more
successful & balanced life.

Behaviors that promote wellness

✦ Being a smart consumer
✦ Exercising at least 3 times per week for 60 minutes
✦ Eating a variety of foods from all the food groups
✦ Eating a diet low in fat, cholesterol & sodium
✦ Learning to control anger & aggression
✦Having fun – taking time for yourself to play/relax
✦Avoiding alcohol, drugs & tobacco
✦Being in a positive environment – surrounded by good role models, good people, good social life

Benefits of wellness
✦ Stronger heart, body and mind
✦ Less stress
✦ Better able to deal with stressful situations
✦ Increased life expectancy & better quality of life
✦ Lower cholesterol
✦ Better/more positive self-esteem
✦ Easier to meet new people and socialize

Components of Wellness

1. PHYSICAL, e.g.:
a. ability to carry out daily tasks
b. achieve fitness
c. maintain nutrition and proper body fat
d. avoid abusing drugs, alcohol, or using tobacco products
e. generally, to practice positive life-style habits
2. SOCIAL, e.g.:
a. ability to interact successfully with people and within the environment of which each person is a
part
b. develop and maintain intimacy with significant others
c. develop respect and tolerance for those with different opinions and beliefs
3. EMOTIONAL, e.g.:
a. ability to manage stress and express emotions appropriately
b. ability to recognize, accept, and express feelings
c. ability to accept one’s limitations
4. intellectual, e.g.:
a. ability to learn and use information effectively for personal, family, and career development
b. striving for continued growth and learning to deal with new challenges effectively
5. SPIRITUAL, e.g.:
a. belief in some force (nature, science, religion, or a "higher power") that serves to unite human
beings and provide meaning and purpose to life
b. includes a person’s morals, values, and ethics
6. OCCUPATIONAL
a. ability to achieve a balance between work and leisure time
b. beliefs about education, employment and home influence personal satisfaction and relationships
with others
7. ENVIRONMENTAL
a. ability to promote health measures that promote the standard of living and quality of life in the
community
i. influences include:
1. food
2. water
3. air

Various health models to provide effective health care.

1. MASLOW’S HIERARCHY OF NEEDS

• Proposed by
• Basic human needs are elements that are necessary for human survival and health (e.g., food, water,
safety, and love

1. Physiological needs

2. Safety needs
3. Love and belongingness needs - after physiological and safety needs have been fulfilled, the third level of
human needs is social and involves feelings of belongingness

4. Esteem needs - which Maslow classified into two categories:

5. Self-actualization needs - realizing personal potential, self-fulfillment, seeking personal growth and peak
experiences. A desire “to become everything one is capable of becoming”

2. HEALTH BELIEF MODEL

- is a framework that helps indicate whether a person will adopt or not a recommended health
behaviour.
A person takes a health care decision based on the following six factors

1.  Perceived Susceptibility:  refers to how vulnerable a person feels about getting afflicted by a disease.
2. Perceived Severity: refers to the serious repercussions that could follow as a result of not adopting a
recommended health behaviour.
3. Perceived Benefits
4. Perceived Barriers: This includes the cost of the treatment, complexity of adopting a new dietary/health
regimen, lack of belief that one has the ability to change, side effects and length of treatment.
5.  Health Value: refers to the physical and emotional costs of undergoing treatment.

ILLNESS

- is a broad term that defines the poor state of mind, body, and, to a certain extent, spirit. It is the general
feeling of being sick or unwell (outside the person’s belief of good health).

Risk Factors
1. Genetic and Physiological Factors Heredity
2. Age increases or decreases susceptibility to certain illnesses
3. Environment. The physical environment in which a person works or lives can increase the likelihood that
certain illnesses will occur
4. Lifestyle

According to Etiologic Factors

1. Hereditary. Due to defect in the genes of one or other parent which is transmitted to the offspring.
2. Congenital. Due to a defect in the development, hereditary factors, or prenatal infection; present at birth.
3. Metabolic. Due to disturbances or abnormality in the intricate processes of metabolism.
4. Deficiency. Results from inadequate intake of absorption of essential dietary factors.
5. Traumatic. Due to injury.
6. Allergic. Due to abnormal response of the body to chemical or protein substances or to physical stimuli.
7. Neoplastic. Due to abnormal or uncontrolled growth of cells.
8. Idiopathic. Cause is unknown; Self-originated; of spontaneous origin.
9. Degenerative. Results from the degenerative changes that occur in tissue and organs.

According to Duration or Onset

1. Acute Illness
Usually has a short duration and severe.
•The signs and symptoms appear abruptly, are intense and often subside after a relatively short period.
 • has a rapid onset of symptoms that lasts for a limited and relatively short period of time e.g., typically
less than six months

2. Chronic Illness
Slow onset. Persists, usually longer than 6 months and can also affect functioning in any dimension.
•Chronically ill person has long term disease process
 has a gradual onset of symptoms that lasts for an extended and relatively long period of time e.g.,
typically six months or longer
 characterized by periods of remission and exacerbation
o remission
o exacerbation

Characterized by:

a) Remission - Period during which the disease is controlled symptoms are not obvious
b) Exacerbation - The disease becomes more active again at a future time, recurrence of pronounced
symptoms.
c) Organic - results from changes in the normal structure, from recognizable anatomical changes in an
organ or tissue of the body
d) Functional - no anatomical changes are observed to account for the symptoms, present may result from
abnormal response to stimuli
e) Familial -occurs in several individuals of the same family (e.g. )
f) Venereal - Usually acquired through sexual relation
g) Epidemic. Attacks a large number of individuals in a community at the same time
h) Endemic. Present more or less continuously or recurs in the community.
i) Pandemic. Epidemic diseases which is extremely widespread involving an entire country or continent.
j) Sporadic. A disease in which only occasional cases occur.

HEALTH SERVICES

1. PROMOTIVE HEALTH SERVICE
- is an activity and / or a series of health service activities that prioritize health promotion activity.
- The process of enabling people to increase control over, and to improve, their health.
The example:
 Promoting breastfeeding.
 Promoting child and family nutrition.
 Promoting physical activity.
 Smoking cessation programs such as 'quit' activities and 'brief interventions'

2. PREVENTIVE HEALTH SERVICE
- is a preventive activity against a health problem / illness.
The example : healthcare services that include _________, __________, and _________ to prevent
illness, disease and other health-related problems

3. CURATIVE HEALTH SERVICE
- is an activity and / or a series of treatment activities aimed at healing of disease, the reduction of
suffering from the disease, disease control, or disability control in order to control the quality of the patient
that can be maintained as optimal as possible.
The example:
The issue of curative care comes up when a patient has a terminal illness and is considering hospice care.

4. REHABILITATIVE HEALTH SERVICE/SPECIAL HEALTHCARE SERVICES

- that help a person regain physical, mental, and/or cognitive (thinking and learning) abilities that have
been lost or impaired as a result of disease, injury, or treatment.
- The example: Services: _______________________________________________________

5. TRADITIONAL HEALTH SERVICES

- refers to the knowledge, skills and practices based on the theories, beliefs and experiences indigenous to
different cultures, used in the maintenance of health and in the prevention, diagnosis, improvement or
treatment of physical and mental illness
The examples:

a. Traditional alternative medicine. These therapies have been practiced for centuries worldwide.
o Acupuncture is a technique that involves inserting very thin metal needles into the skin at precise
points on the body to clear energy channels, with the aim of restoring and maintaining health
o Ayurveda/Ayurvedic medicine is one of the world's oldest holistic (“whole-body”) healing systems.
o Homeopathy is a medical system based on the belief that the body can cure itself. Those who
practice it use tiny amounts of natural substances, like plants and minerals.
o Naturopathy a system of treatment of disease that avoids drugs and surgery and emphasizes the
use of natural agents (such as ___, ___, and ____) and physical.
o Chinese or Oriental medicine

b. Body. Touch has been used in medicine since the early days of medical care.
o
o
o
o
c. Diet and herbs. 
o
o
o
d. Mind.
o
o

Levels of Health Prevention (Leavell and Clark)

1. Primary Prevention - aims to prevent disease or injury before it ever occurs. This is done by preventing
exposures to hazards that cause disease or injury, altering unhealthy or unsafe behaviours that can lead
to disease or injury, and increasing resistance to disease or injury should exposure occur.

o development of good health habits and hygiene

o proper nutrition
o proper and prompt utilization of available health and medical facilities
o proper attitude towards sickness
o education about healthy and safe habits (e.g. eating well, exercising regularly, not smoking)

may include:
 Control of means of spread of vector such as:
 Increasing resistance of the individual by specific immunization.
 Hand washing observed strictly.
 Immunizations for children 0-6 years of age include:

 Hepatitis B
 Rotavirus
 Diphtheria, tetanus, pertussis (DTP vaccines)
 Haemophilus influenzae type B
 Pneumococcal
 Poliovirus
 Influenza
 Measles, mumps, rubella (MMR vaccins)
 Varicella (chickenpox)
 Hepatitis A
 Meningococcal (for certain high-risk groups)

Vaccinations before becoming pregnant

Vaccines teach your immune system how to recognize and destroy germs if you are ever exposed to them. They
protect you and your baby from certain infections, some of which can cause:____________________________
Before becoming pregnant, you should be up to date on routine vaccinations, including:
 hepatitis B
 measles
 mumps
 pertussis (whooping cough)
 tetanus
 varicella (chickenpox)
 influenza (the flu)

Vaccinations during pregnancy

There are 2 types of vaccines:
1. Inactivated vaccines
- contain whole or parts of killed germs that cannot infect you
o examples include influenza and TdaP
2. Live attenuated vaccines
- contain bacteria or viruses that are weakened so that they cannot infect you
o examples include varicella and MMR

As we get older, the protection we had from previous vaccination can decrease for some diseases. Getting
another dose (called a BOOSTER) can increase our immunity to provide the best protection. Some adults may
have missed one or more of their vaccines when they were a child. They may need to catch up and get these
vaccines now.

4 main types of vaccines:

 Live-attenuated vaccines
 Inactivated vaccines
 Toxoid vaccines

a. Live-attenuated vaccines
Live vaccines use a weakened (or attenuated) form of the germ that causes a disease.

Because these vaccines are so similar to the natural infection that they help prevent, they create a strong and
long-lasting immune response. Just 1 or 2 doses of most live vaccines can give you a lifetime of protection
against a germ and the disease it causes.

But live vaccines also have some limitations. For example:

 Because they contain a small amount of the weakened live virus, some people should talk to their health
care provider before receiving them, such as people with weakened immune systems, long-term health
problems, or people who’ve had an organ transplant.
 They need to be kept cool, so they don’t travel well. That means they can’t be used in countries with
limited access to refrigerators.
Live vaccines are used to protect against:

 Measles, mumps, rubella (MMR combined vaccine)

  Rotavirus
 Smallpox
 Chickenpox
 Yellow fever

b. Inactivated vaccines

Inactivated vaccines use the killed version of the germ that causes a disease.

Inactivated vaccines usually don’t provide immunity (protection) that’s as strong as live vaccines. So you may
need several doses over time (booster shots) in order to get ongoing immunity against diseases.

Inactivated vaccines are used to protect against:

 Hepatitis A
 Flu (shot only)
 Polio (shot only)
 Rabies

c. Toxoid vaccines

A vaccine made from a toxin (poison) that has been made harmless but that elicits an immune response
against the toxin. are based on the toxin produced by certain bacteria (e.g. tetanus or diphtheria).
2. Secondary Prevention

- aims to reduce the impact of a disease or injury that has already occurred.
This is done by detecting and treating disease or injury as soon as possible to halt or slow its progress,

Examples include:
 regular exams and screening tests to detect disease in its earliest stages (e.g. mammograms to detect
breast cancer)

 daily, low-dose aspirins and/or diet and exercise programs to prevent further heart attacks or strokes
 suitably modified work so injured or ill workers can return safely to their jobs.
 Early identification of health problems

SCREENING TEST is done to detect potential health disorders or diseases in people who do not have any
symptoms of disease.

3. Tertiary Prevention

- aims to soften the impact of an ongoing illness or injury that has lasting effects.
This is done by helping people manage long-term, often-complex health problems and injuries (e.g.
chronic diseases, permanent impairments) in order to improve as much as possible their ability to
function, their quality of life and their life expectancy.
Examples include:
 cardiac or stroke rehabilitation programs, chronic disease management programs (e.g. for diabetes,
arthritis, depression, etc.
 support groups that allow members to share strategies for living well
 vocational rehabilitation programs to retrain workers for new jobs when they have recovered as much as
possible.
 PROPAEDEUTIC

1. Auscultation
- diagnostic procedure in which the physician listens to sounds within the body to detect certain defects or
conditions, such as heart-valve malfunctions or pregnancy
2. Inspection
- Inspect each body system using vision, smell, and hearing to assess normal conditions and deviations.
Assess for color, size, location, movement, texture, symmetry, odors, and sounds as you assess each body
system.
- A medical practitioner examines a patient for any possible medical signs or symptoms of a medical condition.
It generally consists of a series of questions about the patient's medical history followed by an examination
based on the reported symptoms
3. Palpation
-  is one of the assessment techniques health providers use during a physical exam to detect certain
characteristics of the body. It's the technique of using the sense of touch to assess parts of the body. By
using different parts of their hands, different characteristics about the patient's body - such as swelling, size
and movement - can be identified. The information collected can help determine the patient's health status..

Part of hand Type of palpation

a. fingertips are used in fine tactile discriminations, such as skin texture, swelling and pulsations. You can
collect information about whether a person's skin is smooth or rough, if there is fluid in the tissues, and
characteristics of pulses.
b. finger and thumb used in a grasping action can help determine the position, size and consistency of a
body part. This is used to help thoroughly examine any masses a person may have in the body.
c. back of the fingers and hands are used to check the body temperature. Since the skin is thinner at this
location, it can easily determine whether a body part is cool, cold, warm or hot.
d. palm of your hands on the same side of your pinky finger is used to check for vibrations in the body.
You can feel this when you place your hands on a person's chest while they are talking.

Types of Palpation:

a. Light Palpation
Apply tactile pressure slowly, gently and deliberately.
The clinician’s hand is placed on the part to be examined and depressed about 1-2cm.
b. Deep Palpation
It is done after light palpation.
It is used to detect abdominal masses.
Technique is similar to light palpation except that the finger is held at a greater angle to the body surface
and the skin is depressed about 4-5 cm.
c. Bimanual Palpation
It involves using both hands to trap a structure between them. This technique can be used to evaluate
spleen, kidney, breast, uterus and ovary
d. Bidigital palpation
It is done by pressing the structure to be examined between examiner’s thumb & index finger.
Done for evaluation of nodules, lip etc

4. Percussion  involves tapping your fingers or hands quickly and sharply against parts of the
patient's body to help you locate organ borders, identify organ shape and position, and determine if an organ
is solid or filled with fluid or gas.
Methods of Percussion:

a. Mediate or Indirect Percussion

 It can be performed by using the finger on one hand as a plexor (Striking finger) and the middle
finger of the other hand as a pleximeter (the finger being struck).
 Used mainly to evaluate the abdomen or thorax.
b. Immediate Percussion
 Used mainly to evaluate the sinus or an infant thorax.
 It can be performed by striking the surface directly with the fingers of the hand.
c. Fist Percussion
  Used to evaluate the back and kidney for tenderness.
 It involves placing one hand flat against the body surface and striking the back of the hand with a
clenched fist of the other hand.

Diagnostic

1. Laboratory tests

a. Biopsy test is a medical test commonly performed by a surgeon, interventional radiologist, or

an interventional cardiologist involving extraction of sample cells or tissues for examination to determine
the presence or extent of a disease. 
 Skin biopsy.
 Fine-needle aspiration.
 Core needle biopsy.
 Open biopsy.

b. Blood test, laboratory examination of a sample of blood used to obtain information about its physical and
chemical properties. Blood analysis is commonly carried out on a sample of blood drawn from the vein of
the arm, the finger, or the earlobe

i. Blood count, laboratory test that determines the number of red blood cells (erythrocytes) and
white blood cells (leukocytes) in a given volume of blood. The readings vary with sex, age,
physiological state, and general health, but the blood of a normal individual contains on average
5,000,000 red cells and 7,000 white cells per cubic millimetre. 
ii. Blood typing is a method to tell what type of blood you have. Blood typing is done so you can
safely donate your blood or receive a blood transfusion.

c. Stool test is a series of tests done on a stool (feces) sample to help diagnose certain conditions

affecting the digestive tract. These conditions can include infection (such as from parasites, viruses, or
bacteria), poor nutrient absorption, or cancer.
d. Urinalysis/ urine test- The tests detect and/or measure several substances in the urine, such as
byproducts of normal and abnormal metabolism, cells, cellular fragments, and bacteria.

Urine test can include three parts:

 Visual exam.  for color and clearness.
Example:
 Blood may make urine look red or the color of tea or cola.
 An infection may make urine look cloudy.
 Foamy urine can be a sign of kidney problems.
 Microscopic exam.  A small amount of urine will be looked at under a microscope to check for things
that do not belong in normal urine that cannot be seen with the naked eye, including red blood cells, white
blood cells (or pus cells), bacteria (germs), or crystals (which are formed from chemicals in the urine and
may eventually get bigger and become kidney stones).

 Dipstick test.  A dipstick is a thin, plastic stick with strips of chemicals on it.  It is dipped into the urine. 
The strips change color if a substance is present at a level that is above normal. 

o Acidity (pH) is a measure of the amount of acid in the urine.

o Protein is an important building block in the body. Everyone has protein in their blood.  But it
should only be in your blood, not your urine. 
o Glucose (sugar) is usually a sign of diabetes.
o White blood cells (pus cells) are signs of infection.
o Bilirubin is a waste product from the breakdown of old red blood cells.  It is normally removed
from the blood by the liver.  Its presence in the urine may be a sign of liver disease. 
o Blood it can be a sign of an infection, a kidney problem, certain medicines, or even heavy
exercise.  Finding blood in the urine requires further testing.  It does not mean you have a serious
medical problem.

Others:
 i. Glucose tolerance test, procedure to assess the ability of the body to metabolize glucose, the principal type
of sugar found in the blood.

The most common glucose tolerance test is the oral glucose tolerance test (OGTT). Before the test begins, a
sample of blood will be taken.

ii. Anoscopy- tube called an anoscope is used to look at the inside of your anus and rectum. Doctors use
anoscopy to diagnose hemorrhoids, anal fissures (tears in the lining of the anus), and some cancers.

iii. Schilling test is not readily available in most countries as a means of diagnosis for vitamin B12 deficiency.
The level of serum vitamin B12 is now a test of choice in many hospitals.

iv. Mantoux tuberculin skin test (TST) or the TB blood test can be used to test for M.
tuberculosis infection.The test is read within 48 to 72 hours by a trained health care worker, who looks for a
reaction (induration) on the arm.
TB is a disease caused by Mycobacterium tuberculosis.
 Blood tests
 Imaging tests
 Sputum tests
 Acid Fast Staining Acid fast stains are used to differentiate acid fast organisms such mycobacteria. are
the easiest, quickest, and least expensive diagnostic procedures. By the use Acid Fast Stain, a stain
used to diagnose the causative agent of Tuberculosis.

v. Rapid Antigen Test (RAT) is a rapid diagnostic test suitable for point-of-care testing that directly detects the

presence or absence of an antigen. This distinguishes it from other medical tests that detect antibodies
(antibody tests) or nucleic acid (nucleic acid tests), of either laboratory or point of care types.
Antigen- is a harmful substance which enters the body which causes the body to make antibodies as a
response to fight off disease. An example of an antigen is a common cold virus which causes the body to
make antibodies which help prevent the person from getting sick.

vi. Skin prick test, also known as a puncture or scratch test, is a way for your doctor to determine your
sensitivity to inhaled allergens such as pollen, pet dander, or mold. The test can look for allergic reactions of
up to 40 different substances at the same time. The skin prick test can also be used to identify food allergies.
vii. Skin patch test/ Patch testing is a type of allergy test used to identify substances that cause contact
dermatitis (i.e., skin irritation or inflammation due to contact).

viii. Venereal Disease Research Laboratory (VDRL) Test is used to detect if a person has been infected with
the bacteria causing syphilis, which is a sexually transmitted disease. The test detects the presence of
antibodies against the bacteria Treponema pallidum.

ix. Inoculum is a substance introduced into the body to create or increase the body's resistance or immunity to
a disease.

 Minimum Inhibitory Concentration (MIC) is defined as the lowest concentration of an antimicrobial

ingredient or agent that is bacteriostatic (prevents the visible growth of bacteria).

 Minimum Bactericidal Concentration (MBC) or Minimal Fungicidal Concentration (MFC) is the

lowest concentration of an antibacterial drug that results in a 99.9% reduction in the initial microbial
density.

x. Coagulation Tests- measure your blood’s ability to clot, and how long it takes to clot. Testing can help your
doctor assess your risk of excessive bleeding or developing clots (thrombosis) somewhere in your blood
vessels.
 Complete blood count (CBC)
 Prothrombin time(PT or PT-INR). This test gives information about fibrinogen and other blood parts
that help form clots. It's also used to measure the effects of warfarin.
 Activated partial thromboplastin time. This test also gives information about factors in blood
clotting. And it is used to measure the effects of heparin.

xi. Types of Scans and Medical Imaging:

i. Magnetic resonance imaging (MRI) scan. An MRI can detect nerve injuries, tumors, brain injuries,
stroke, or even the cause of a headache. There is no radiation involved in an MRI since it uses radio
waves and magnetic fields to scan the body.
ii. X-ray is a quick, painless test that produces images of the structures inside your body — particularly
your bones.
- mammogram 
 - barium enema 
iii. Computerized tomography (CT) and computerized axial tomography (CAT) Scan
- detailed images of internal organs are obtained by this type of sophisticated X-ray device. It is used in
the emergency room to evaluate headaches or trauma, such as a broken rib. 
iv.  Ultrasound uses high-frequency sound waves to take images of the inside of the body. The scan is
performed by applying a water-based gel and then gliding a transducer over the area to be scanned. 

xii. Biopsy is a procedure that removes a small amount of tissue for examination in a laboratory. Biopsies are
done to diagnose many diseases, especially cancer. 

 different biopsy techniques, depending on which tissue or organ is being sampled.

i. Skin biopsy — A sample of skin tissue is removed with a scalpel or punch tool.
ii. Fine-needle aspiration — A very thin needle is inserted into an organ.
iii. Core needle biopsy — A larger needle with a cutting edge is used to take a full tissue sample, rather
than just sucking out cells.
iv. Open biopsy — Requires an incision in the skin. Depending on the depth of the body part to be biopsied,
the complexity of the procedure varies

xiii. Chemotherapy literally refers to the treatment of certain diseases using specific chemicals that are
destructive to malignant cells or to the causative agent of a disease such as a bacteria or virus.

Chemotherapy drugs kill cancer cells or prevent them from growing and dividing. Chemotherapy drugs are also
called anti-cancer drugs.

a. Chemotherapy drugs kill cancer cells or prevent them from growing and dividing. Chemotherapy drugs are
also called anti-cancer drugs.

Plant alkaloids—prevent cells from dividing normally.

Steroid hormones—slow the growth of some cancers that depend on hormones.
Antitumor antibiotics—made from natural substances such as fungi in the soil.
Alkylating drugs—kill cancer cells by directly attacking DNA, the genetic material of the genes.