MODULE 1 CONCEPT OF MAN,HEALTH, &ILLNESS

WHAT IS MAN?
 a person a patient person. The mind and body of a person as inseparable Viewed as an holistic being (PEPLAU,
HENDERSON, TRAVELBEE.)
 Defined as a human being. (PEPLAU, HENDERSON, TRAVELBEE.)
 A person is an Open System that works together with other parts of its body as it interacts with the environment.

NURSING CONCEPT OF MAN

 Man is an integrated BIO-PSYCHOSOCIO-CULTURAL & SPIRITUAL BEING:

CONCEPT OF MAN ….
1. Biological being, man is  like all other men . Because all men have the same basic human needs.
2. Psychological being, man is  like no other man. Because man is a unique, irreplaceable, one being. No two persons are exactly
alike. time  Capable of rational, logical thinking but become irrational and illogical when provoked.

3.  Social being Capable , man is like some other men  Has of relating with others the capacity to cope with stressful  . stimuli. A
group of people have common attributes that make them different from other groups.  Some factors that characterized a particular
groups of people are culture, age groups, social status, educational status, etc…

4. Spiritual being , man is  like all other men. All men are spiritual in nature, because they have intellect & will; endowed with
virtues of faith, hope & charity.  All men believe in the existence of a Supreme Power who guides our fate & destiny; the source of
meaning & purpose of life; to whom we seek console in case of difficulties in life.

 Man is an  OPEN SYSTEM ….

It allows input & output to and from its boundaries; one that allows exchange of, or is constantly affected by matter,
energy & information
a) Matter . foods, medicines, microorganisms
b) Energy pain, fever, inflammation
c) Information diagnosis of an illness, pregnancy, undergoing surgery or other treatments, death of a loved one

 Man is a UNIFIED WHOLE composed of parts which are interdependent and interrelated with each other.
The different organs and organ systems function together to achieve a particular purpose.

 Man is composed of parts which are greater that and different from the sum of all his parts.
“Greater than the sum of all his parts”…. b ecause he is not simply a composite of physiologic body parts but also
endowed with intellect, will, judgment, decisionmaking abilities, talents, strengths & other numerous enabling
powers. 
“ Different from the sum of all his parts” … because at times his responses are predictable, but at times
unpredictable. He is a creature with contradictions.

 Man is composed of Subsystems and Suprasystems

Subsystems- cells, tissues, organs, organ system
Suprasystem-.family, community and the society.

 Man is an individual with vital reparative processes to deal with disease & desirous of health but passive in terms of
influencing the environment or nurse.
 Man is a whole, complete and independent being who has 14 fundamental needs to: breath, eat & drink, eliminate,
move & maintain body posture, sleep & rest, dress & undress, maintain body temperature, keep clean, avoid
danger, communicate, worship, work, play, and learn.
 Man is a unity who can be viewed as functioning biologically, symbolically & socially & who initiates & performs
selfcare activities on own behalf in maintaining life, health & wellbeing.
CONCEPT OF HEALTH
 (WHO) “A state of complete physical, mental, and social well being, not merely the absence of disease or infirmity”.
 (Claude Bernard) Health is the ability to maintain internal milieu, homeostasis or dynamic equilibrium
 Health is being well and using one’s power to the fullest extent. Health is maintained through prevention of disease via
environmental health factors.. (nightingale)
 Health is viewed in terms of the individual’s ability to perform 14 components of nursing care unaided.(Henderson)
 Health is a state and a process of being and becoming an integrated and whole person.(Roy)
 A state that is characterized by soundness or wholeness of developed human structures and of bodily and mental functioning.
(Orem)
 Health is a dynamic state in the life cycle; illness is an interference in the life cycle.(King)
 Wellness are in harmony in which all parts and subparts of an individual are in harmony with the whole system. (Neuman)
 Health is an elusive, dynamic state influenced by biologic, psychologic  , and social factors. Health is reflected by the
organization, interaction, interdependence and integration of the subsystems of the behavioral systems.(Johnson)
 Positive health symbolizes wellness. It is a value term defined by the culture or individual.(Rogers)

HEALTH PROMOTION PROGRAMS

 Information dissemination
 Health Appraisal & Wellness Assessment Programs
 Lifestyle & Behavior Change Programs
 Worksite Wellness Programs
 Environmental Control Programs

MULTIPLE FACTORS AFFECTING HEALTH & Illness

 Several models have been designed to define health. One of these define health as a multifactorial phenomenon. According to
this model, there are several factors within and outside the person that influence health. These factors may or may not be
under the conscious control by the person or others in the environment. However, one thing is certain it is the interaction of
these factors that constitutes health. ( Leddy & Pepper 1993)
 Biological Factors-Include genetic inheritance, sex, age, developmental level, nutrition, cognitive structures intelligence, & race.
 Behavioral Factors-Behaviors are learned from parents, members of extended family, church, school, mass media & others in
the environment.
 Socio-economic Factors-Economic status, standard of living, occupational roles & memberships in social groups influence health
beliefs & practices.
 Political Factors-Political structure, leadership, people’s empowerment & will, policies & laws. The form of government, the
style of leadership, the extent & consistency in implementing laws, policies & ordinances
 Environmental Factors-Rapidly accelerating changes in the ecosystem. Increasing mobility of people creates megacities.
Psychosocial environment information technology which has increased people’s access to information.

WELLNESS & WELL BEING

 Wellness is well being. It involves engaging in attitudes and behaviors that enhance quality of life and maximize
personal potential.
 Well-being is a subjective perception of balance, harmony and vitality.
 Wellness is a choice; way of life; the integration of body, mind and spirit and the loving acceptance of one’s self

DIMENSIONS OF WELLNESS

1. Physical Dimension
 Genetic makeup, age, developmental level, race and sex that strongly influence health status and health practices.
 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.
 Examples • The toddler just learning to walk is prone to tall and injure himself. • The young woman who has a family
history of breast cancer and diabetes is at a higher risk to develop these conditions.

2. Emotional Dimension
  Ability to express feelings & develop/sustain relationship; long term stress affects body condition →  health habits
 The ability to manage stress and to express emotions appropriately, Emotional wellness involves the ability to
recognize, accept, and express feelings.

3. Mental Dimension
 Positive sense of purpose & underlying belief in one s own worth .Feeling Good
4. Sociocultural Dimension
 Health practices & beliefs are strongly influenced by a person ’ s economic level, life style, family and culture.
 Family & culture to which the person belongs determine patterns of living & values about health & illness are often
unalterable.
5. Intellectual Dimension
 Cognitive abilities, educational background and past experiences.
 influence a client ’ s responses to teaching about health and reactions to health care during illness & play a major
role in health behaviors. 
 The ability to learn and use information effectively for personal, family, and career development.
6. Environmental Dimension
 Housing, sanitation, climate and pollution of air, food and water.
 The ability to promote health measures that improve the standard of living and quality of life in the community
7. Spiritual Dimension
 Spiritual and religious beliefs and values are important components of the way the person behaves in health and
illness.
 Recognition & ability to put into practice moral & religious principles & beliefs
8. Occupational Dimension
 Ability to achieve a balance between work & leisure time.

HEALTH ILLNESS CONTINUUM

 The health illness continuum is a graphic illustration of a well being ,concept first proposed by John.W.Travis in 1972 .
 It describes how wellbeing is more than simply an absence of illness , but also incorporates the individuals mental and
emotional health.
 Travis believed that the standard approach to medicines , which assumes a person is well when there are no signs or
symptoms of disease ,was insufficient.
 Composed of two arrows pointing in opposite direction and joined at a neutral point.
 Movement to the right to the arrows (toward the high level of wellness) equals an increase in level of health and wellbeing
Achieved in three steps: awareness, education & growth.
 Movement to the left to the arrows (towards premature death) equates a progressively decreasing state of health.
Achieved in three steps: signs, symptoms & disability.

Other Models of Health & Illness

 The Health & Illness Continuum (Dunn)
 Health Belief Model (HBM)
 Smith ’ s Models of Health
 Leavell & Clark Model ’ s AgentHost
 Health Promotion Model

Illness
 Is a personal state in which the person feels unhealthy. A state in which a person s physical, emotional, social, intellectual,
developmental or spiritual functioning is diminished or impaired compared with previous experience.
 Classification of Illness:
a) Acute severe symptoms, short duration
b) Chronic lasts for 6 months or longer
 Stages of Illness: 1) Symptom experience
2 ) Assumption of sick role
3 ) Medical care contact
4 ) Dependent patient role
5 ) Recovery / rehabilitation

DISEASE
 An alteration in body functions resulting in reduction of capacities or a shortening of the normal life span.
 Common Causes of Disease: 1) Biologic agents 2) Inherited genetic defects 3) Development defects 4) Physical agents 5)
Chemical agents 6) Tissue response to irritation / injury 7) Faulty chemical / metabolic process 8) Emotional/ physical reaction to
stress

Health Care System

 Totality of services offered by all health disciplines.  It is changing with increasing awareness in health promotion, illness of
prevention & level of wellness, so with the roles of nurses

TYPES OF HEALTH CARE SERVICES

1) Health Promotion and Illness Prevention (Primary prevention)
2) Diagnosis and Treatment (Secondary prevention)
3) Rehabilitation, Health Restoration & Palliative Care (Tertiary prevention)

Health Promotion & Illness Prevention (Primary Prevention)

 Primary prevention programs: adequate & proper nutrition, weight control & exercise & stress reduction.
 Health promotion activities emphasize the important role clients play in maintaining their own health & encourage them to
maintain the highest level of wellness they can achieve.
 Illness prevention: immunizations, identifying risk e.g factors for illness, help in taking measures to prevent illness ( stop smoking
campaign); environmental protective measures.

Diagnosis & Treatment (Secondary Prevention)

 Offered by hospitals & physicians offices.
 Hospitals provides emergency, intensive & around the clock acute care.
 Evolving freestanding diagnostic & treatment facilities.
 Walkin clinics

Rehabilitation, Health Restoration & Palliative Care (Tertiary Prevention)

 Goal of tertiary prevention: To help people move to their previous level of health or to the highest they are capable of.
 Rehabilitative Care assisting clients to function adequately in the physical, mental, social, economic, & vocational areas of their
lives.
 Palliative Care –- ofpeople cannot return to health, hence we provide comfort & treatment of symptoms. End life care

TYPES OF HEALTH CARE AGENCIES & SERVICES

1)Public Health 2)Physician’s office 3)Ambulatory Care Centers –diagnostics & treatments facilities 4)Occupational Health Clinics
5)Hospitals 6)Sub-acute care facilities 7)Extended (Long Term) Care facilities 8)Retirement & Assisted Living Centers 9)Rehabilitation
Centers 10)Home Health Care Agencies

Factors Affecting Health Care Delivery

1) Increasing number of older adults
 Long term illness will be prevalent
 Home management & nursing support services are required to assist those living in homes & communities
 Need to feel that they are still part of the community the feeling of being useful, wanted & productive.

2) Advances in Technology
 Improved diagnostic procedures
 Sophisticated equipment
 New medications being manufactured
 Surgical procedures are more common today
 Laser & microscopic procedures
 Computers, internet access
3) Economics
 Health care cost is becoming a greater problem.
 Major reasons for cost increases: New equipment costs more, inflation increase, growing population especially the older adults,
hospital costs were billed to medicare or healtcare aids, more people seek medical assistance, relative number of people who
provide health care services increased, number of uninsured individuals are changing, cost of drugs is increasing.

4)Women’s Health
  Birthing centers, concerns for reproductive aspects of health
5)Uneven distribution of Services
 Insufficient number of healthcare professionals & services available to meet the healthcare needs in remote & rural areas.
6)Access to Health Insurance
 Problems of individuals to access to health insurance: low income; receive less preventive care, delay & avoid care & meds;
eligibility for government insurance programs

7) The Homeless & the Poor

 The conditions where homeless people live their health problems increases & becomes chronic.

8) Health Insurance & Portability & Accountability Act

 This is instituted to protect the privacy of individuals by safeguarding individually identifiable healthcare records 
9) Demographic Changes
 Singleparent families & alternative family structures.
 Culture & ethnic diversity

Nursing as an profession and history of nursing

CONCEPT OF NURSING
Common themes in the definition of NURSING:
• Nursing is caring. • Nursing is an art. • Nursing is a science. Nursing is client centered. • • Nursing is holistic. • Nursing is adaptive.
Nursing is concerned with health promotion, health maintenance and health restoration. • Nursing is a helping profession.

Recipients of Nursing
1.consumer –individual group of people.
2. patient –latin word- to suffer /to bear) person waiting for or undergoing medical treatment & care.
3. Client - person or who engages the advice ormservices of another who qualified to provide this service. ’ s They are collaborators
in their care.

ROLES & FUNCTIONS OF THE NURSE

1. Caregiver 2. Communicator 3. Teacher 4. Client Advocate 5. Counselor 6. Change Agent 7. Leader 8. Manager 9. Case
Manager Research Consumer

Module 2 NURSING AS A PROFESSION

PROFESSION –
 An occupation that requires extensive / advanced knowledge & skills & is an outgrowth of society needs for special services.
 An occupation that requires extensive education or calling that requires special knowledge, skills & preparation. 
 Professionala person who is conscientious in actions, knowledgeable about the subject, & responsible to self & others.

CRITERIA OF A PROFESSION
1. Specialized Education 3. Body of Knowledge 4. Service Orientation 4.Ongoing Research 6. Code Ethics 7. Autonomy
7.Professional Organization

Personal Qualities of a Nurse

Philosophy of Life
 It is concerned with those basic truths that contribute to personal growth in a systematic fashion & with those principles that
relate to the moral values that shape the facets of the character.
 Theories of nursing can be taught, but not a philosophy of life or a philosophy of service.

Good personality
 It consists of the distinctive differentiates individual qualities one person from the another.
 It refers to the that impression one makes on others which will include more than that which meets the eye.
 It consists of deeper traits which come from the heart & which infiltrate the real person if one wishes to exert a magnetic
influence on others.
 It is a result of integrating one ’ s abilities, desires, impulses, habits, & physical character into a harmonious whole.
Components of Good Personality
1) Personal appearance includes posture, grooming, dress and uniform.
 2) Characterthe moral values and beliefs that are used as guide to personal behavior and actions.
3) Attitude a manner of acting, thinking or feeling that is indicated by one ’ s response toward another person, situation or
experience.
4) Charm influence the senses or the mind by some quality or attraction.

Qualities of a Professional Nurse

 Has faith in the fundamental values: Respect for human dignity Self-sacrifice for common good Strong sense of responsibility
for sharing in the solution of the problems of society
 Has sense of responsibility for understanding those with whom he/she works with.
 Has faith in the reality of spiritual and aesthetic values and awareness of the value and the pleasure of self development
through the pursuit of some aesthetic interests.
 Has the basic knowledge, skills and attitudes necessary to address the present problem through the use of critical thinking
 Has skill in using written and spoken language, both to develop own thoughts and to communicate them to others
 Appreciates and understands the importance of good health
 Has emotional balance

Caring
 People, relationship and things matter
 It is central to all & enables people to create meaning in their lives
 Sharing deep & genuine concern about the welfare of another person.
 Caring Practice
 involves connection, mutual recognition and involvement between the nurse & client.

Nursing Theories on Caring

Leininger- Caring as throughout a nurturing history factors health  . in Caring is helping the dominant and  Nurses order actions
must to function which preservation, behavior and is one has of been the most people essence of unifying maintain nursing focus of
and nursing present critical or the regain . distinct, understand different effectively . They cultures utilize in nursing are culturally
accommodation & congruent repatterning.

Theory of Bureaucratic Caring (Ray)  Caring in organizations as cultures. Caring in nursing is contextual and is influenced by the
organizational structure.

Caring, the Human Mode of Being (Roach)  Caring as proposes a that philosophical caring is the concept human and mode being,
of the “ most common, of authentic criterion of humanness . ”  All persons caring are abilities caring, by being being real and being
and develop their true to self, who they truly are .

Nursing as Caring ( Boykin and Schoenhofer )  The purpose of the discipline and profession of nursing is to know persons and
nurture them as persons living and caring and growing in caring.  Respect for persons as caring individuals and respect for what
matters to  them. Caring is a lifetime process, lived moment to moment by the nurse and constantly unfolding.

Watson  Caring as the essence and moral ideal of nursing.  Human care is the basis nursing  ’ s role in society.There is
transpersonal human caring, a human connection wherein the nurse enters into the experience of the client and vice versa. It gains
self knowledge & keeps alive his or her common humanity & avoids reducing the other to an object.

Theory of Caring (Swanson)  Caring valued as nurturing other, way toward of whom relating one to feels a personal sense
responsibility .  of commitment Described the caring processes which provided guidance for nurses when caring for pregnant &
postpartum women. These are knowing, being with, doing for, enabling & maintaining belief .

Process of Caring
1. Knowing -striving to understand an event as it has meaning in the life of others.
Subdimensions : Avoiding assumptions , Caring on the one cared for, Assessing thoroughly, Seeing cues, Engaging the self of
both

2.being with- being emotionally present to the other.

Subdivisions: Being there ,Conveying ability, Sharing feelings, Not burdening

3. Doing for- doing for the other as she or he would do for the self if it were at all possible.
Sub dimensions : Comforting ,Anticipating, Performing competently / skillfully , Protecting, Preserving dignity

4. Enabling-facilitating the other’s passage through life transitions (e.g. birth, death) & unfamiliar events.
Subdimension : Informing / explaining ,Supporting / allowing , Focusing , Generating alternatives / thinking it through, Validating /
giving feedback.

5. Maintaining beliefs- sustaining faith in the other’s capacity to get through an event or transition & face a future with meaning.
Subdimensions: Believing in / holding in esteem, Maintaining a hope filled attitude, Offering realistic optimism, Going the distance.

The primacy of caring (Benner and Wrubel)

 Caring nursing is . the essence of excellence in
 Caring practice requires attending to the particular client over time, determining what matter to the person and using this
knowledge I clinical jugdement.

IN NURSING PRACTICE CARING INVOLVES: PROVIDING PRESENCE, COMFORTING, LISTENING, KNOWING THE CLIENT, SPIRITUAL
CARING, FAMILY CARE.

THE 6C’S of CARING:

 COMPASSION- Awareness of one’s relationship to others, sharing their joys, sorrows, pain and accomplishments.
Participation in the experience of another
 COMPETENCE- Having the knowledge, judgment, skills, energy, experience and motivation to respond adequately to others
within the demands of professional responsibilities
 CONFIDENCE- The quality that fosters trusting relationships. Comfort with self, client and family
 CONSCIENCE- Morals and , ethics, wrong . and an Awareness informed of sense personal of right responsibility .
 COMMITMENT- Convergence obligations and between the one ’ s deliberate desires choice to and accordance with them
act in .
 COMPORTMENT- Appropriate bearing, demeanor, dress and language, that are in harmony with a caring presence.
Presenting one self as some one who respects others and demands respect.

Caring for Self and Others

 Caring for Self -helping oneself grow and actualize one’s possibilities.
 Self-Care -responding to one’s own needs to grow, is the opposite of self-complacency that often accompanies egocentricity.

Self Care Activities

1. A balanced diet 2. Regular exercise 3. Adequate rest and sleep 4. Recreational activities 5. Meditation and prayer

REFLECTIVE PRACTICE

 Critical thinking, self-analysis and reflection are required in order to learn from one’s experience.
 A student develops as a practitioner by thinking about how values and standards guide practical experience.
 Reflection -is thinking from a critical point of view, analyzing why one acted in a certain way, and assessing the results of one’s
actions. To develop oneself as a caring practitioner, reflection on practice must be personal and meaningful.
 It is a method of self ’examination that involves thinking back over what happened in a nursing situation. It involves the whole
person, including one s emotions.
 It includes becoming aware of how one feels about oneself and recognizing how one thinks and acts.
 It requires discipline, action, openness, and trust.
 A form of self-evaluation.

ROLES & FUNCTIONS OF A PROFESSIONAL NURSE:

1. Caregiver – it includes all the activities that assist the client physically & psychologically while preserving the client’s dignity. Nurse
is concerned with the client’s needs. E.g. routine work of the nurse when they take care of the patient – giving meds, taking vital
signs, doing bedside care, assisting them in their needs – bathing, toileting, feeding, etc..

2. Communicator - nurses identify client’s problems & communicate these verbally or in writing to other members of the healthcare
team. E.g. referring abnormal lab results to the physician, giving of updates regarding the condition of the patient during rounds,
endorsing with colleagues on the new shift.
3. Teacher – nurse helps clients learn about their health & the health care procedures they need to perform to restore or maintain
their health. Also teach nursing aides, unlicensed personnel or new nurse (novice) in the care of the patient.

4. Client Advocate – acts to protect the client. Nurse may represent the client’s needs & wishes to the other members of the health
team. Nurses speaks in behalf of the patient. Nurse promotes what is best for the client, ensures that the client’s needs are met, &
protects their rights.

5. Counselor – helping the client recognize & cope with stressful psychologic & social problems, to develop improved interpersonal
relationships, & to promote personal growth. Giving support to the patient (emotional, intellectual, & psychologic support)

6. Change Agent – assisting others (clients) to make modification or changes in their own behavior or lifestyle to promote health.

7. Leader – the nurse through the process of interpersonal influence helps the client make decisions in establishing & achieving goals
to improve his well-being.

8. Manager – the nurse plans, gives directions, delegates tasks to subordinates, develops staff, monitors operations, gives rewards
fairly, and represents both staff members & administration as needed. The nurse manages the nursing care of individuals, groups,
families & communities.

9. Case Manager – nurse coordinates all activities of other members of the health care team, such as nutritionists and PTs, when
managing a group of client’s care. They work with the multidisciplinary health care team to measure the effectiveness of the case
management plan and to monitor outcomes.

10. Research Consumer – nurses often use research to improve client care. E.g. applying what they have learned from trainings,
conferences, etc.. in their practice; engaging in evidence based practice to improve care given to patients

TEACHING

NURSING AS AN ART

TEACHING

 A system of activities in tended to produce learning. The teaching-learning process involves dynamic interaction between
teacher and learner.
 Nurses teach a variety of learners in various settings–clients & their families, community, health personnel

AREAS OF CLIENT EDUCATION

1)Promotion of Health

2)Prevention of Illness / Injury

3)Restoration of Health

4)Adapting to altered health & function

LEARNING

 A change in human disposition or capability that persists and that cannot be solely accounted for by growth.
 It is represented by a change in behavior.
 LEARNING NEED –is a desire or a requirement to know something that is presently unknown to the learner . It could include a
new knowledge or information or a new or different skill or physical ability or a new behavior or a need to change an old
behavior.
 Compliance
 Adherence

LEARNING DOMAINS

 Bloom (1956) identified three (3) domains or areas of learning:

1)COGNITIVE DOMAIN (“thinking”) –includes 6 intellectual abilities & thinking processes -knowing, comprehending, applying,
analysis, synthesis & evaluation.

2)PSYCHOMOTOR DOMAIN (“skill) –includes fine & gross motor abilities such giving an injection.

3)AFFECTIVE DOMAIN (“feeling”) –deals with personal issues such as “attitudes, beliefs, behaviors & emotions”

 Factor affecting Learning

SETTING LEARNING OUTCOMES (OBJECTIVES)

1)State the client behavior or performance, not nurse behavior.

2)Reflect an observable, measurable activity. Avoid using words such as knows, understands, believes and appreciates because they
are neither observable nor measurable.

3)May add conditions or modifiers as required to clarify what, where, when or how the behavior will be performed.

4)Include criteria specifying the time by which learning should have occurred.

SMART–specific, measurable, attainable or achievable, realistic, time-bound.

 Gen. Objective: After 1 day of RLE, the Level I Nursing students will be able to learn the proper giving of hygiene to their
respective clients.
 Specific Objectives: Within 5 hours of RLE, the Level I nursing students will be able to:

COGNITIVE: 1. Explain the importance of proper hygiene in taking care of the client.

PSYCHOMOTOR: 1. Demonstrate the different procedures in providing proper hygiene to a client such as hair care, bed shampoo,
oral hygiene, complete bed bath and back rub/ massage.

AFFECTIVE: 1. Participate willingly in the demonstration of the different procedures in providing proper hygiene to a client.