HEALTH AND WELLNESS
- Is a state & a process of being &
Health
- is a state of complete physical, mental,
and social well-being, and not merely the
absence of disease or infirmity.
- It encompasses well-being, illness,
disease and non-disease in an evolving
potential that cannot be quantified.
Three characteristics health:
a. It reflects concern for the individual as a total
person rather than as merely the sum of various
parts.
b. it places health in the context of the
environment.
c. it equates health with productive and creative
living.
Concepts of Health
- Is a state of complete physical, mental &
social well-being & not merely the
absence of disease or infirmity (WHO)
- is a state of integration of the body &
mind.
- Health is the ability to maintain the
internal milieu. Illness is the result of
failure to maintain the internal
environment. (Claude Bernard)
- Is the ability to maintain homeostasis or
dynamic equilibrium. Homeostasis is
regulated by the negative feedback
mechanism. (Walter Cannon)
- Is being well & using one’s power to the
fullest extent. Health is maintained
through prevention of disease via
environmental health factors.
(nightingale)
- Is viewed in terms of individual’s ability to
perform components of nursing care
unaided. (Henderson)
- Positive health symbolizes wellness. It is
a value term defined by the culture or by
the individual. (Rogers)
FUNDAMENTALS OF NURSING REVIWER 2ND SEM/TG
becoming an integrated & whole
person. (Roy)
- Is a state that is characterized by
soundness or wholeness of
developed human structures and of
bodily & mental functioning. ( Orem)
Health
- Is an elusive, dynamic state influenced
by biologic, psychologic, & social factors.
It is reflected by the organization,
interaction & interdependence &
integration of the Subsystems of the
behavioral system. (johnson)
Johnson’s Behavioral Subsystem
Attachment or affiliative subsystem:
“social inclusion intimacy and the formation and
attachment of a strong social bond.”
Dependency subsystem:
“approval, attention or recognition and physical
assistance”
Ingestive subsystem:
“social events surrounding the occasion when
the food is eaten”
Eliminative subsystem:
“human cultures have defined different socially
acceptable behaviors for excretion of waste.”
Sexual subsystem:
" both biological and social factor affect the
behavior in the sexual subsystem”
Aggressive subsystem:
" It relates to the behaviors concerned with
protection and self-preservation it also
generates defensive response from the
individual when life or territory is being
threatened”
Achievement subsystem:
”provokes behavior that attempt to control the
environment intellectual, physical, creative,
mechanical and social skills achievement are
some of the areas that Johnson recognizes
Concepts of health
•Is a dynamic state in the life cycle; illness is
an interference in the life cycle. (King)
WELLNESS
 HEALTH AND WELLNESS
- is an integrated method of functioning
which is oriented towards maximizing the
potential of which the individual is
capable, within the environment wherein
the individual is functioning..
- active process of becoming aware of and
making choices towards a higher level of
well-being
- Is a condition in which all parts and
subparts of an individual are in harmony
with the whole system. (Newman)
HEALTH STATUS
- is a state of health of an individual at a
given time.
HEALTH BELIEFS
- concepts about health that an individual
believes to be true. Such beliefs may or
may not found on facts.
WELL-BEING
- Is a subjective perception of balance
harmony and vitality, however it is also a
state that can be described objectively
and therefore can be measured.
HEALTH BEHAVIORS
- are the actions people take to understand
their health state, maintain an optimal
state of health, prevent illness and injury,
and reach their maximum physical and
mental potential.
MODELS TO EXPLAIN HEALTH
Clinical (smith)/Medical Model (M.B. Bellock
& L. Breslow, 1972)
- People are viewed as physiologic
systems with related functions, and
health is identified by the absence of
signs and symptoms of disease or injury.
Ecologic Model
- it is based on the relationship of human
to their environment. (Leavell & clark)
Three Interactive Elements of Ecologic
Model
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1. The Host- a person or group who may or may
not be at risk of acquiring an illness or disease.
2. The Agent- any factor in the environment that
by its presence or absence can lead to illness or
disease.
3. The Environment- including the intrinsic or
extrinsic environment, which may or may not
predispose the person to the development of the
disease.
Health Illness Continuum (Mc Cann, Flynn &
Heffson 1984)
- Health is constantly changing state, with
high level wellness and death being on
opposite ends of a graduated scale or
continuum.
High Level wellness (Dunn,1961)
- High level wellness refers to functioning
to one’s maximum potential while
maintaining balance of purposeful
direction in the environment.
Needs Fulfillment Model Abraham Maslow in
his 1943
- Health is a state in which needs are being
sufficiently met to allow an individual to
function successfully in life with the ability
to achieve the highest possible potential
Role Performance Model (Parsons 1958)
- Health is defined in terms of the
individual’s ability to fulfill societal roles.
Adaptive Model (adaptation)
- Health is a creative process
(Dubos,1978) Individuals are actively
and continually adapting to their
environments. Disease is failure in the
adaptation.
Eudaemonistic Model
- Health is seen as a condition of
actualization or realization of person’s
potential.
Actualization is the apex of the fully developed
personality. Health is the actualization of
inherent & acquired human potential through
satisfying relationships with others while
adjustments are made as needed to maintain
 HEALTH AND WELLNESS
structural integrity & harmony with the
environment. (smith)
WHO (1947)
- Health is the state of complete physical,
mental, social, and mental well-being and moral or religious principles or beliefs;
not merely the absence of disease or
infirmity.
Dimensions of Wellness:
(1) Physical Dimension
Genetic make up
age
developmental level
race
gender
(2) Emotional Dimension
- Focuses to which a person feels positive
about the self & enthusiastic about life. It
emphasizes awareness & acceptance of
one’s feelings, the capacity to manage
one’s feelings, the ability to cope
effectively with stress, the ability to
maintain satisfying relationships with
others, and the assessment and
acceptance of one’s limitations.
(3) Intellectual Dimensions
- Encompasses the cognitive abilities,
educational background and past
experiences.
- encourages stimulating & creative mental
activities & the use of available
community resources to expand one’s
knowledge and increase the potential for
sharing with others.
(4) Occupational Dimension
- focuses on preparation for work that will
produce personal \ satisfaction &
enrichment of life.
(5) Socio Cultural Dimension
- Concerns the sense of having support
available from family and friends;
practices , values and beliefs that
determine health.
(6) Sexual Dimension
FUNDAMENTALS OF NURSING REVIWER 2ND SEM/TG
- refers to the acceptance and ability to
achieve satisfactory expression of one’s
sexuality.
(7) Spiritual Dimension
- Refers to the recognition and ability to practice
recognition and maintenance of a harmonious
relationship with the supreme being.
- involves seeking meaning & purpose in human
life.
Variables Affecting Health Status:
Heredity/Genetic Endowment
- influences biologic characteristics, innate
temperament, activity level & intellectual
potential
Race
- Disease distribution is associated with
race.
Sex
- Certain acquired & genetic diseases are
more common in one sex than in the
other.
Age & Developmental Level
- Capabilities for responding to disease
are less during the first few years of life &
again near the end of life.
Mind-Body Relationship
- Emotional responses to stress affect
body function & what emotional reactions
occur in response to body conditions also
influence health.
Life Style
- patterns of eating, exercise, use of
tobacco, drugs & alcohol; & methods of
coping with stress.
Physical Environment
- This refers to the sum or total of all the
conditions and elements that make up
the
surroundings and influence the health and
health practices of the client. The environment
with which the client lives and works either
promote and maintain health or increase the
likelihood of illness or even death.
 HEALTH AND WELLNESS
• Standards of Living/Socio economic
factors
- An individual’s standard of living
(reflecting occupation, income
education) is related to health, morbidity,
& mortality. Hygiene, food habits, & the
propensity to seek health care advice &
follow health regimens vary among high
& low income groups.
Socio Cultural beliefs
- Cultural rules, values & beliefs give
people a sense of being stable & able to
predict outcomes.
- The challenging of old beliefs & values by
second-generation ethnic groups may
give rise to conflict, instability & insecurity b. Needs
in turn contributing to illness.
Family
- In addition to transmitting genetic
predispositions, the family passes on
patterns of daily living & lifestyles to
offspring.
•Emotional health
- A climate of open communication
sharing, & love posters the fulfillment of
the person’s optimum potential.
Support Network & Job Satisfaction
- Support people also provide the stimulus
for an ill person to become well again.
Job satisfaction positively influences both
the individual’s self-concept & mind-body
relationship.
Developmental Status
- The ability to conceptualize a state of
health & the ability to respond to changes
in health are directly related to age.
(Pender)
Geography
- Geography determines climate and
climate affects health.
•Previous Experiences
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- Knowledge gained from past
experiences helps determine people’s
definitions of health. (Pender)
&
•Expectations of Self
- Some people expect to be functioning at
a high level physically & psychosocially
all the time when they are healthy. Others
expect variations in their level of
functioning, & their definitions of health
accommodate those variations. (Pender)
Perception of Self
- General perception about self. These
perceptions relate to such aspects of self as:
a. Esteem
c. Body Image
d. Role
e. Ability
- When there is any threat or perceived threat to
these views of self , the individual usually feels
some anxiety & may need to reassess health &
to redefine health itself. (Pender)
Political factor
- This factor refers to one’s leadership,
how he rules, manages and how other
people concerned are followed to actively
participate in the decision making
process.
Related Concepts:
1. Political Will- the determination to pursue
something that is in the interest of the majority.
2. Empowerment- The ability of the person to
do something; It involves creating the
circumstances where people can use their
facilities and abilities at a the maximum level in
the pursuit of common goals.
Levels of Prevention:
u Primary Level
- Measures are designed to promote
positive general health; Development of
good health habits and hygiene; proper
nutrition; proper attitude towards
 HEALTH AND WELLNESS
sickness; proper and prompt utilization of 5.Rehabilitative
available health and medical facilities.
- Specific protection; Use of specific Levels of Clientele
measures against disease agents like -Individual
protection of the individual, or the -Group
establishment of barriers against agents -Family and
in the environment -Community

a. Control of means of spread of vector such ILLNESS, SICKNESS & DISEASE

as: ILLNESS
-Vector Control - highly personal state in which the person
-Sanitation feels unhealthy or ill.
- Proper sewerage disposal - A state of disturbance in the normal
b. Increasing resistance of an individual by functioning of the total human individual,
specific immunization. including both the state of the organism
c. Hand Washing as a biological system, and of his
personal and social adjustments.
u Secondary Prevention
- Consists of early diagnosis and prompt Sickness
treatment of the disease in order to arrest - Is a status of social entity that is usually
the disease/problem and to prevent its associated with disease or illness but can
spread to other people. occur independently (Twaddle 1977)
Ex: - 3 distinct Criteria to determine if illness is
a. Public education to promote breast self- present
examination; use of home kits for detection of »Presence of Symptoms
occult blood in the stool specimens; and »Perception of how one feels
familiarity with the seven cancer danger signals. »Activity to carryout daily activities
b. Screening programs for hypertension,
diabetes, uterine cancer, breast cancer, DISEASE
glaucoma, and STD. - Alteration in body functions resulting in
reduction of capacities or a shortening of
u Tertiary Prevention the normal lifespan (Twaddle, 1977)
- It begins early in the period of recovery
from illness and consists of such •ETIOLOGY > Causation of the disease
activities as: - The identification of all causal factors that
-consistent and appropriate administration of act together to bring about the particular
medications to optimize therapeutic effects disease
-moving and positioning to prevent •RISK FACTORS:
complications of immobility and active Genetic make up
-passive exercises to prevent disability. Life style or health habits
-It also includes minimizing residual disability Age
and helping the client learn to live productively Environment
with limitations. Physiologic Factors
-Intensive, periodic follow up and treatment.
ILLNESS BEHAVIORS
Levels of Care: - Any activity undertaken by a person who
1.Health Promotion feels ill, to define the state of his health
2.Disease Prevention and to discover a suitable remedy.
3.Health Maintenance Variables affecting the Illness Behavior:
4.Curative •Personality
FUNDAMENTALS OF NURSING REVIWER 2ND SEM/TG
 HEALTH AND WELLNESS
•Modes of coping 3. Reassurance that they will be alright
•Education /prediction of what the outcome will be.
•Socioeconomic Status
•Religion 4. Dependent Patient Role Stage
•Psychological stability - During this stage sick people may or may not
•Ethnic Origin be reluctant to accept a processional's
•Age recommendations.
•Sex - Open communication is needed, nurse should
•Occupation provide information that would allay some fears
& provide data that would support the person.
Five Stages of Illness (Suchman,1972) 5. Recovery or Rehabilitation Stage
1. Symptom Experience Stage - The client learns to give up the sick role and
- Transition stage during which people come to return to former roles & functions.
believe something is wrong. - People who have long term illnesses & who
3 aspects must make adjustments in lifestyle may find
1.Physical experience of symptoms recovery more difficult.
2.Cognitive aspect - During this stage, readiness for social
3.Emotional response functioning may not coincide
with physical readiness.
2. Assumptions of the sick role
- Acceptance of the illness. At this time Effect of Hospitalization
individuals decide that their symptoms •Loss of privacy–When a client enters a
or concerns are sufficiently severe to suggest hospital or nursing facility, the loss of privacy is
that they are sick. instantly obvious.
Activities: Privacy- has been described as a comfortable
1.Seek professional help quickly feeling reflecting a deserved degree of social
2.Self treatment retreat.
3.Follow suggestions of family and friends
•Altered Autonomy
–Accepts that they are ill but may not accept the - Is the state of being independent and
reason for being ill. self-directed without outside control.
–Sick people in this stage are usually afraid. - Loss of individuality is often difficult to
–Seek advice and support for decisions to give accept, and the client may feel
up some activities dehumanized into “just a piece of
machinery”. Nurses have a major
2 possible outcomes responsibility to humanize care by
1.Symptoms have change & Feel better learning about the client as a person and
2.Symptoms persist by individualizing nursing care plans.
- No improvement
- Seek further treatments Altered Life-Style
Ways to Adapt to Changes in life-style
3. Medical Care Contact Stage 1.Providing explanations about hospital
–Seek advice of a health Professional either on routines.
their own initiative or at the urging of significant 2.Making arrangements wherever to
others. accommodate the client’s life style.
3.Health professionals should be aware and
3 Types of information support healthy aspects of that lifestyle.
1. Validation of real illness 4.Reinforcing desirable changes in practices.
2.Explanation of symptoms in
understandable terms. Economic Burden
FUNDAMENTALS OF NURSING REVIWER 2ND SEM/TG
 HEALTH AND WELLNESS
- Nurses can be aware of these costs and Period which the disease is controlled.
provide care that is as economical as is Symptoms are not obvious.
safely possible. –Exacerbation
- Nurses may initiate referrals to the social Disease becomes more active again at a future,
service department to assist clients in with recurrence or a pronounced symptoms.
making arrangements to address the –Sub-acute
financial burdens imposed by Symptoms are pronounced but more prolonged
hospitalization. than in acute disease.

Classification of diseases: Types of Health Promotion Programs:

A. ACCORDING TO ETIOLOGIC FACTORS •Information Dissemination
1. Hereditary •Health Appraisal & wellness assessment
defect in the genes of the parent which Programs
transmitted to the offspring. •Lifestyle & Behavior Change Programs
2. Congenital •Worksites Wellness Programs
defect in the development •Environmental Control Programs
3. Metabolic
disturbance in the intricate process of
metabolism.
Deficiency- inadequate intake / absorption of
essential dietary factors.
4.Traumatic
due injury
5.Allergic
abnormal response of the body to stimuli.
6.Neoplastic
Abnormal growth of cells
7. Idiopathic
Self-originated, unknown, spontaneous origin
8.Degenerative
degenerative change in tissue or organ.
9.Iatrogenic
results from the treatment.

B. ACCORDING TO DURATION OR ONSET

•Acute Illness
- Short duration & is severe. The signs &
symptoms appear abruptly, are intense &
often subside after are relatively short
period.
•Chronic Illness
- Usually longer than six months, Client
may fluctuate bet. Maximal functioning &
serious relapse that may be life
threatening.

Chronic is characterized by:

–Remission

FUNDAMENTALS OF NURSING REVIWER 2ND SEM/TG