Stages of Illness

Health
As defined by the World Health Organization (WHO): state of complete physical, mental and
social well-being, not merely the absence of disease or infirmity.
Characteristics:
A concern for the individual as a total system
A view of health that identifies internal and external environment
An acknowledgment of the importance of an individual’s role in life
*A dynamic state in which the individual adapts to changes in internal and external
environment to maintain a state of well being
Presence or absence of disease
Complete physical, mental, social well-being
Ability to maintain normal roles
Process of adaptation to physical and social environment
Striving toward optimal wellness
Individual definitions
Wellness
State of well-being
Basic aspects include:
 Self-responsibility
 An ultimate goal
 A dynamic, growing process
 Daily decision-making in areas related to health
 Whole being of the individual
Well-being
 Subjective perception of vitality and feeling well
 Described objectively, experienced, measured
 Can be plotted on a continuum
Illness
A highly personal state
Person’s physical, emotional, intellectual, social, developmental, or spiritual functioning is
diminished
Not synonymous with disease
May or may not be related to disease
Only person can say he or she is ill
Disease
Alteration in body function
A reduction of capacities or a shortening of the normal life span
Acute Illness
 Characterized by severe symptoms of relatively short duration
 Symptoms often appear abruptly, subside quickly
 May or may not require intervention by health care professionals
 Most people return to normal level of wellness
Chronic Illness
 Lasts for an extended period
 Usually has a slow onset
 Often have periods of remissions and exacerbations
 Care includes promoting independence, sense of control, and wellness
 Learn how to live with physical limitations and discomfort

Parson’s Four Aspects of the Sick Role

 Clients are not held responsible for their condition
 Clients are not excused from certain social roles and tasks
 Clients are obligated to try to get well as quickly as possible
 Clients or their families are obligated to seek competent help
Schuman’s Stages of Illness
Stage 1: Symptom experience
- Believe something is wrong
Stage 2: Assumption of the sick role
- Accepts the sick role and seeks confirmation
Stage 3: Medical care contact
- Seeks advice of a health professional
Stage 4: Dependent client role
- Becomes dependent on the professional for help
Stage 5: Recovery or rehabilitation
- Relinquish the dependent role – Resume former roles and responsibilities
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
Impact of Illness: Family Changes
 Role changes
 Task reassignments
 Increased demands on time
 Anxiety about outcomes
 Conflict about unaccustomed responsibilities
 Financial problems
 Loneliness as a result of separation and pending loss
 Change in social customs
In Summary:
3 Stages of Illness
Stage of Denial – Refusal to acknowledge illness; anxiety, fear, irritability and aggressiveness.
Stage of Acceptance – Turns to professional help for assistance
Stage of Recovery (Rehabilitation or Convalescence) – The patient goes through of resolving loss
or impairment of function
Rehabilitation
A dynamic, health-oriented process that assists individual who is ill or disabled to achieve his
greatest possible level of physical, mental, spiritual, social and economic functioning.
Abilities not disabilities are emphasized.
Begins during initial contact with the patient
Emphasis is on restoring the patient to independence or regain his pre-illness/pre-disability
level of function as short a time as possible
Patient must be an active participant in the rehabilitation goal setting an din rehabilitation
process.
Focuses of Rehabilitation
Coping pattern
Functional ability – focuses on self-care: activities of daily living (ADL); feeding,
bathing/hygiene, dressing/grooming, toileting and mobility
Mobility
Integrity of skin
Control of bowel and bladder function
 LEVELS OF PREVENTION
Leavell and Clark’s Three Levels of Prevention
I. Primary Prevention –
 Purpose: to decrease the risk of exposure of the individual or
community to disease consists of activities which are
undertaken before diseases strike
 applied to generally healthy people in order to keep them well
 seeks to prevent a disease or condition at a pre pathologic
state ; to stop something from ever happening.

 Health Promotion
 Objective: to enable individuals, families, groups and
the community to maintain health and realize their full
potential for development
 consists of activities aimed at maintaining or
enhancing people’s physical, mental or social well-
being
o health education
o marriage counseling
o genetic screening
o good standard of nutrition adjusted to
o developmental phase of life
 Disease Prevention
 Involves activities designed to protect patients or other members of the
public from actual or potential health threats and their harmful
consequences.
o use of specific immunization.
o attention to personal hygiene.
o use of environmental sanitation.
o protection against occupational hazards
o protection from accidents
o use of specific nutrients.
o protections from carcinogens
o avoidance to allergens
II. Secondary Prevention –
 also known as “Health Maintenance”. Seeks to identify specific illnesses or
conditions at an early stage with prompt intervention to prevent or limit
disability; to prevent catastrophic effects that could occur if proper attention
and treatment are not provided
 Objectives:
 o halting disease progress
o minimizing severity of disease
o shortening disease duration
o prevent or reduce complications
o bring about cure
 Focus: early identification of health problems and prompt interventions to
alleviate health problems
 includes activities for early diagnosis and prompt treatment of disease or health
problem which has not been prevented

 Early Diagnosis and Prompt Treatment

o case finding measures
o individual and mass screening survey
o prevent spread of communicable disease
o prevent complication and sequelae
o shorten period of disability
- Disability Limitations
o adequate treatment to arrest disease process and prevent
further
o complication and sequelae.
o -provision of facilities to limit disability and prevent death.

III. Tertiary Prevention –

Occurs after a disease or disability has occurred and the
recovery process has begun; Intent is to halt the disease or
injury process and assist the person in obtaining an optimal
health status. To establish a high-level wellness.
“To maximize use of remaining capacities’
Objective: to restore the patient to an optimum level of
functioning consists of activities which are done when the
disease process, an injury or a calamity has already exacted its
damage and ill effects, with consequent disability or loss of function in varying degrees
• begins early in the period of recovery from illness
• minimizes residual disability and helps clients to learn to live productively with
limitations
• continuing health supervision during rehabilitation
 Restoration and Rehabilitation
o work therapy in hospital
o use of shelter colony