06 MPU2312 T2 (Amend)

Topic  Dimensions
2 of Health and
Wellness I
LEARNING OUTCOMES
By the end of this topic, you should be able to:
1. Identify eight dimensions of health and wellness;
2. Plan physical activities that will contribute to physical wellness;
3. Select the strategies to achieve balanced emotional wellness;
4. Employ the spiritual support to enhance wellness; and
5. Evaluate the significance of intellectual dimension in wellness.
 INTRODUCTION
Let us start this topic by reading the following quote from Benjamin Disraeli
(refer to Figure 2.1):
Figure 2.1: Benjamin Disraeli, former prime minister of Great Britain (from 1804 to 1881)
Source: www.azquotes.com
Copyright © Open University Malaysia (OUM)

TOPIC 2 DIMENSIONS OF HEALTH AND WELLNESS I  25
What can you infer from this quote? Obviously, the quote in Figure 2.1 states the
importance of health. But do you know that there are other dimensions as well
that are essential to health and wellness? These are the physical, emotional,
spiritual and intellectual dimensions which are important attributes for health
and wellness.
Therefore, this topic will focus on these four dimensions ă physical, emotional,
spiritual and intellectual. Are you ready to discover more? Let us start the
journey!
2.1 DIMENSIONS OF HEALTH AND WELLNESS

Let us start off by learning the eight dimensions of wellness. Hopefully by the
end of this lesson, you will be able to identify them.
Do you agree that health is more than a matter of individual choices, family and
other social relationships? For instance, if a spouse has a serious illness, the
chances that his/her marital partner will acquire a serious illness doubles
(Stroebe et. al, 2007). This is the reason why the philosophy of holistic health
emphasises the unity of the mind, spirit and body.
Therefore, symptoms of illness and disease may be viewed as an imbalance in a

personÊs total state of being and is not simply as the malfunction of a particular
part of the body.
For example, think of the time when you had a headache. Although headaches
can be associated with brain injury or the symptoms of another illness, more
often than not it is caused by emotional stress. This produces a tightening of the
muscles on the neck or head. These contracting muscles increase the blood
pressure in the head, thereby causing the headache. Most people relieve
headaches by taking analgesic drugs or seeking other alternative remedies such
as massage to relieve the pain as it can alter physiological mechanisms that
produce the pain.
In contrast, someone may use the holistic approach as the first step to determine
the source of stress, tension, worry, anger or frustration and then plan to reduce
the emotional stress that may cause the illness.

26  TOPIC 2 DIMENSIONS OF HEALTH AND WELLNESS I
Health can also be defined as a reflection of your ability to use the intrinsic and
extrinsic resources related to each dimension of health to participate fully in the
activities that contribute to your growth and development, with the goal of
feeling a sense of well-being as you evaluate your progress through life (Payne,
Hahn & Mauer, 2005).
Did you realise that the real problem of health lies within ourselves? Even
though most people are aware of their unhealthy lifestyles such as smoking,
inactivity, high-fat diets or excessive stress, they seem satisfied as long as they
think they are free from any symptoms of diseases or illness. Therefore, they will
not change their lifestyle until they suffer a major health problem such as
hypertension, diabetes or heart problems. That is why it is important for us to
recognise that our current lifestyle habits dictate our future health and well-
being.
There are eight dimensions to wellness, namely, physical, emotional, spiritual,

intellectual, social, occupational, environmental and financial (refer to
Figure 2.2). However, for this subtopic, we will discuss the first four dimension
which are; physical, emotional, spiritual and intellectual.
Figure 2.2: Eight dimensions of wellness

The description of the four dimensions that we will look into in the next subtopic
is as follows:
(a) Physical Dimension

There are many factors that contribute to the physical well-being of a
person or individual including physical fitness, regular exercise and well
balanced diet.
(b) Emotional Wellness

We can apply some strategies to achieve this by remaining flexible and
compromising in order to solve problems.
(c) Spiritual Wellness

Did you realise that in order to cope with stress, another significant
dimension is the spiritual aspect? It is the ability of a person to integrate
their beliefs and values into their actions.
(d) Intellectual Dimension

What can we say about this? This dimension is the ability of a person to
contribute ideas, think critically and seek out new challenges.
Take note that when all the dimensions to health and wellness are integrated and
function together, one will achieve a high level of wellness or optimal health.
Now, how do we achieve positive wellness? Well, in order to achieve positive

wellness, a person must be free from symptoms of disease such as pain, being
active, in good spirits and feeling emotionally healthy. In addition, the personÊs
environment (including work, school, family and community) and his or her
physical, emotional, intellectual, occupational, spiritual and social dimensions of
wellness must also be in tune with one another in order to produce harmony.
As stated before, these dimensions are interrelated; one frequently affects the
others. For example, a person who is emotionally down often has no desire to
exercise, study, socialise with friends, or attend mosque or church and may be
more susceptible to illness. Therefore, these eight dimensions of wellness will
show you how the concept clearly goes beyond the absence of disease.
SELF-CHECK 2.1
State the eight dimensions of wellness.

2.2 PHYSICAL DIMENSION

This subtopic introduces some physical activities that can contribute to physical
wellness. Hopefully by the end of this subtopic, you can plan your own physical
activities in order to stay fit and healthy.
Let us learn more on the first dimension of wellness which is physical. What does
it mean to be a physically well individual?
Physically well individuals are those who are

physically active, exercise regularly, eat a well-
balanced diet, maintain the recommended body
weight and minimise exposure to environmental
contaminants.
In addition, people in good physical condition also avoid harmful drugs and
smoking as well as seek medical care as needed and participate in activities that
help prevent illness.
Naturally, good/ideal physical fitness is characterised by good cardiorespiratory

endurance, enhanced adequate muscle strength, flexibility and proper body
composition. Therefore, the physically fit person will be able to carry out the
ordinary and challenging demands of daily life safely and effectively.
How does one achieve such a condition? We will look briefly at one big factor
that contributes to the physical wellness of a person, which is physical fitness.

Nowadays, most people recognise that participating in fitness programmes

would improve their quality of life. On the other hand, we must remember that
improving physical fitness alone is not sufficient to lower the risk for disease and
ensure better health. Let us study the following scenario:
Jim Fixx (refer to Figure 2.3) is the famous author of the best seller book
entitled The Complete Book of Running. He died at the age of 52 due to heart
attack, although he had been running between 60 and 80 miles a week.
Figure 2.3: Jim Fixx (from 1932 to 1984)

Source: www.allouteffort.com
He believed that his high level of fitness would prevent dying from heart
attack. At age of 36, Jim Fixx smoked two packs of cigarettes per day, and did
not participate in regular physical activity and had a family history of heart
disease.
His father had his first heart attack at the age of 35 and died when he was 43
years old. Jim Fixx began to raise his level of fitness. He started to jog and quit
smoking. On several occasions, he declined to have electrocardiogram (ECG)
test, which would likely have revealed his cardiovascular status.

Now, what can you say as a conclusion to the given scenario? It illustrates that an
exercise programme itself is unable to make high-risk people immune to heart
disease, though it may delay the onset of cardiac arrest. What kind of exercises
can you practise to achieve physical fitness? Well, let us look at Figure 2.4 for
some examples.
Figure 2.4: Examples of physical fitness exercise

Source: http://www.fitnesshealtytips.com
Therefore, it can be said that physical wellness requires implementing positive

programmes in order to change behaviours to improve health and quality of life.
2.2.1 What is Physical Fitness?

How can we define physical fitness?
„Physical fitness is defined as the ability to meet the ordinary as well as the
unusual demands of daily life safely and effectively without being overly
fatigued and still have energy left for leisure and recreational activities‰.
(Hoeger & Hoeger, 2003)

Did you realise that when you choose to commit to physical activities as a way of
life, you will regularly exercise in order to keep fit? Aside from that, when you
are pursuing your physical fitness activities, you will probably meet other
healthy and active people. Through this, you will be able to expand your circle of
friends.
2.2.2 Developing a Cardiorespiratory Fitness

Programme
Did you know that for people of all ages, cardiorespiratory conditioning can be
achieved through many activities? This is true as long as the activities you choose
place sufficient demands on the heart and lungs which will improve physical
fitness. The familiar activities such as swimming, running, cycling, aerobic, brisk
walking, skating and even some weight training will produce cardiorespiratory
fitness. Regardless of age or physical limitation, you can select from a variety of
enjoyable activities to improve your cardiorespiratory system.
Let us look at the recommendation for achieving cardiorespiratory fitness from

The American College of Sport Medicine (ACSM). ACSMÊs (2000) most recent
recommendation is to include four major areas (refer to Figure 2.5).
Figure 2.5: Four areas to achieve cardiorespiratory fitness

as recommended by the American College of Sport Medicine
These four areas are further described as follows:
(a) Mode of Activity

The ACSM recommends the mode of activity to be any continuous physical
activity that uses large muscle groups, and can be rhythmic and aerobic in
nature. Can you name some of these activities? Well, among the activities
are continuous swimming, cycling, aerobic, basketball, walking and
running. Just take note that regardless of which continuous activity you
select, it should be enjoyable. You should also vary your activity to prevent
boredom.

(b) Frequency of Training

What does frequency of training refer to? Frequency of training refers to the
number of times per week a person should go for exercise. So how many
times are appropriate? Is it a few hours per day or per week? ACSM
recommends exercising three to four times per week.
(c) Intensity of Training

How much effort should you put into an activity? Which one would you
prefer; a quick run, a slow jog or a swim at a comfortable pace? Must a
person sweat profusely to become fit? The intensity is the number of
exercise sessions per week; for aerobic fitness 50% to 85% of your heart rate
range is recommended. The level of intensity is called target heart rate
(THR).
ACSM also recommends that healthy adults exercise at an intensity level

between 65% and 90% of their maximum heart rate. You should be aware
that there should be considerable difference between your estimated
maximal heart rate and your actual maximal heart rate. For example, a
younger person, for example, a 20-year-old person with a resting heart rate
of 60 beats/min, would need to participate in a continuous activity for an
extended period while working at a THR of 158 beats/minute. Whereas an
older person, for example, a 40-year-old person with a resting heart rate of
80 beats/min, would need to function at a THR of 150 beats per minute to
achieve positive training effect.
(d) Duration of Training

ACSM recommends that the duration of training should be between 20 and
60 minutes of continuous activity. Those who choose activities with low
range of intensity of 50% to 60% of heart rate range should maintain the
activity for longer period of time. Thus, a fast jog and a moderate walk will
require different amounts of time to accomplish the training effect.
As a conclusion, we can say that a person with physical wellness is able to:
(a) Exercise regularly and select a well-balanced diet;

(b) Make informed choices about medicine used and medical care; and
(c) Maintain a positive health-promoting lifestyle.

ACTIVITY 2.1
Select an exercise programme by Leslie Sanson entitled Three Fast Miles

via YouTube at http://goo.gl/24avKi.
Appoint an instructor and start the exercise for the first 15 minutes.
Then discuss the effect of the exercise in the group.
SELF-CHECK 2.2
1. Fitness is composed of four components ă cardiorespiratory

endurance, muscular fitness, flexibility and body composition.
Discuss in depth the component of cardiorespiratory endurance in
physical fitness.
2. Discuss the health benefits that can be achieved through regular

moderate exercise.
3. Write objectives to improve your fitness and wellness and develop

a wellness programme for the future.
2.3 EMOTIONAL DIMENSION

Now let us look at another dimension of wellness which is emotional. It is hoped
by learning about this dimension, you will be able to select suitable strategies to
achieve balanced emotional wellness.
The emotional dimension of health encompasses the ability to cope with stress
such as remaining flexible and compromising to resolve problems. Please note
that our ability to cope with stress will change as we age and as we learn new
skills of managing our emotion. For example, young adults who are in the
process of growth and development will experience emotional vulnerability,
which may lead to feelings of rejection and failure. This can affect productivity
and self-satisfaction (refer to Figure 2.6).

Figure 2.6: Illustration of emotional vulnerability

Source: http://media.cagle.com
On the other hand, the emotional dimension of wellness involves developing

awareness and accepting oneÊs feelings. For instance, emotionally well people are
able to express and manage their feelings effectively, maintain close
relationships, deal with conflicts and remain grounded during stressful times.
This is part of the continuous process of change and growth for young adult.
2.3.1 Emotional Stability

How do we relate emotional wellness with emotional stability? The answer lies
within the definition of emotional wellness.
Emotional wellness is defined as the ability to understand our own feelings,

accept limitation and achieve emotional stability.
In other words, it is the ability to express emotions appropriately, accept change

and cope with stress in a healthy way, and to enjoy life despite disappointments
and frustrations.
Now, what can we say about emotional stability? What does it stand for?
Emotional stability is also the ability to look at success and failure in a

positive manner.

When success is evident, people who are emotionally well radiate with expected
joy. On the contrary, when failure seems imminent, they respond by making the
best of circumstances and move beyond failure.
Last but not least, emotional wellness also involves happiness; it is seen as a long
term state of our mind that permeates the various facets of life and influences our
outlook. In other words, it means that true happiness signals exemption from
tension and depression that many people endure.
2.3.2 Self-concept
Now we will discuss self-concept and self-esteem as part of emotional health.
Firstly, the definition of self-concept. Do you have any idea what it means?
Self-concept is how an individual pictures himself/herself internally, the

way one sees oneself.
Self-concept is also the informational side of things, where you know facts about
yourself. What about self-esteem?
Self-esteem is how you feel about your own character and abilities. For
example, whether you enjoy the fact that you are talkative (high self-esteem)
or you think that you are annoying (low self-esteem).
Therefore, how can we achieve balanced emotional wellness? Well, here are some
practices that will help to enhance your emotional wellness:
(a) Recognising conflict as potentially healthy rather than denying it;

(b) Being responsible for your actions;
(c) Reflecting on your feelings;
(d) Accepting your feelings instead of denying them;
(e) Accepting the feelings of others;
(f) Seeking support, and guidance for uncontrollable feelings and emotions;
(g) Building sturdy social support network;

(h) Practising positive financial behaviours to enhance security and emotional

stability; and
(i) Being open to continual personal and professional development.
We can summarise that a person with emotional wellness will be able to:
(a) Possess a sense of humour;

(b) Recognise own feelings and appropriately express them;
(c) Strive to meet emotional needs; and
(d) Be responsible for his or her behaviour.
SELF-CHECK 2.3
Differentiate between self-concept and self-esteem.
ACTIVITY 2.2
1. Emotional growth requires both knowing about yourself and

learning from new experiences. Consider the following scenario:
Azman is a 30-year-old learner. He feels that he is being pulled in

many different directions. Sometimes he thinks he is losing his
sense of self or wonder if he ever had one. What can he do to help
himself grow emotionally?
Select the activities that you think can be used to foster AzmanÊs
emotional growth. Discuss your plan in a group.
2. Discuss strategies that can be implemented to enhance oneÊs self-

motivation.

2.4 SPIRITUAL DIMENSION

This subtopic covers the spiritual dimension. Hopefully, you will be able to
employ the spiritual support to enhance your wellness.
The spiritual dimension of wellness is another endeavour after emotional

wellness. The spiritual dimension of wellness involves exploring meaning and
purpose in human existence. How do we recognise spiritual people? We can
recognise them by their basic characteristics which include a sense of meaning
and direction in life, and their relationship to the Creator. These characteristics
then lead to personal freedom, prayer, faith, love, closeness to others, peace and
altruism. Therefore, people with spiritual dimension of wellness possess the
ability to integrate their beliefs and values into their daily actions.
Please note that spiritual dimension of wellness is closely connected with

religious beliefs and activities. Attending religious activities or meditation will
not only result in better health by lowering the incidence of chronic disease, but
also helps us handle stress more effectively (see Figure 2.7).
Figure 2.7: Animated stages on meditation

Source: http://www.meditationcartoons.com
In fact, religious activities or meditation can also have a positive effect on our
social lifestyle as they may help us in overcoming crisis and provide us with
better coping techniques to deal with future trauma.
Furthermore, in the spiritual dimension, prayer is the core of most spiritual

experiences as a mode of communicating with our Creator. However, for
effective results, we need to accept the efficacy of prayer and pray with sincerity,
humility and love.

Another key term under the subject of spiritual dimension is altruism. What does
it stand for?
Altruism means true concern for the welfare of others which enhance oneÊs
health and longevity.
Did you know that altruism is a powerful attribute? It is so powerful that even
watching films of altruistic endeavours would enhance the formation of an
immune system which helps fight disease.
What can we practise to increase our spiritual wellness? Well, here are some
practices that can be adopted to increase your spiritual wellness:
(a) Possess a set of guiding beliefs;

(b) Respecting beliefs and values of others;
(c) Living in a way that is consistent with your principles;
(d) Taking time for prayer or meditation;
(e) Aware of the deeper meanings of everyday events; and
(f) Spending time with nature.
To conclude, a person with spiritual wellness is able to:
(a) Examine his or her own personal values and beliefs;

(b) Search for meanings that help explain the purpose of life;
(c) Have a clear interpretation of right and wrong; and
(d) Acknowledge natural forces in the universe.

ACTIVITY 2.3
1. Form a group and sit in a circle position. Prepare for a meditation

exercise by playing background music on sounds of nature for a
duration of 10 to 15 minutes. Discuss your experience with the
group. Determine your level of tension and stress. Lastly,
formulate a stress management programme for the group.
2. What is the role of religion or spirituality in our health? To what

extent should spirituality be part of the clinical encounter between
patient and healthcare providers?
2.5 INTELLECTUAL DIMENSION

Finally, we come to the final subtopic which focuses on the intellectual
dimension. It is hoped that by learning this dimension, you will be able to
evaluate the significance of the intellectual dimension in your wellness.
What is the intellectual dimension?
Intellectual dimension is the ability to process and act on information, clarify

values, beliefs and decision-making.
On other hand, intellectual wellness refers to active participation in scholastic,

cultural and community activities. Besides that, other approaches such as valuing
and nurturing creativity, curiosity and lifelong learning are part of intellectual
wellness too. Hence, intellectually well people are open to new ideas, able to
think critically, seek out new challenges and are more likely to maintain good
cognition even as they age.
In the other words, when you possess positive intellectual dimension, you are
not intimidated by facts and figures with which you are unfamiliar, but you
embrace the chance to learn something new. You are self-motivated to enhance
your life in terms of further studies or professional development while holding
your own ideas and philosophies.

Furthermore, you will gain self-confidence which guarantees that you can take
your place among others without having to give up part of yourself and without
requiring others to do the same. Let us look at Figure 2.8 which shows you an
example of self-motivation quotes.
Figure 2.8: Example of self-motivation quotes

Source: https://s-media-cache-ak0.pinimg.com
What can we do to enhance our intellectual wellness? Well, here are some
practices that will enhance your intellectual wellness:
(a) Learning to trust your ability to make good decisions;
(b) Recognising and valuing learning as a life-long learning process;
(c) Developing creativity and resourcefulness;
(d) Being discerning when taking in information from TV, the Internet and
newspaper; and
(e) Critically analysing situations and solving problems.
As a conclusion, a person with intellectual wellness is able to:
(a) Communicate effectively orally and in writing;

(b) See the bigger picture;
(c) Keep abreast of current issues; and
(d) Exhibit good time management skills.

ACTIVITY 2.4
Reflect on your life experiences when you have been seriously ill.
(a) Describe how you feel about the nature and duration of the
illness.
(b) Discuss all the factors that you think might have contributed to
your becoming sick.
(c) Summarise all the factors that contributed to your getting well.
(d) What do you think were the most important factors that led to
your sickness?
(e) What do you think were the most important factors in your
healing process?
(f) Write your reflective journal based on the above statement.
Please note that you need to include factors such as stress, emotional
problems and poor nutrition. Also, you may include medical care,
prayer, alternative medicines and other factors too.
 There are eight dimensions to wellness, namely, physical, emotional,

spiritual, intellectual, social, occupational, environmental and financial. In
this topic, we have discussed the first four dimensions ă physical, emotional,
spiritual and intellectual.
 Physical activities that contribute to physical wellness are exercising

regularly, taking a well-balanced diet, maintaining ideal body weight and
minimising exposure to the environmental contaminants.

 Some strategies to achieve balance emotional wellness are:
 Recognising conflict as potentially healthy rather than denying it;
 Being responsible for your actions;
 Reflecting on your feelings;
 Accepting your feelings instead of denying them; and
 Accepting the feelings of others.
 Spiritual support to enhance wellness are:
 Possessing a set of guiding beliefs;
 Respecting others beliefs and values;
 Living in a way that is consistent with your principles;
 Taking time for prayer or meditation;
 Awareness of the deeper meanings of everyday events; and
 Spending time with nature.
 Intellectual dimension in wellness is the ability to process and act on

information, clarify values, beliefs and decision-making.
 The significance of the intellectual dimension in wellness is that a positive

intellectual dimension makes you more open to new ideas, able to think
critically and seek out new challenges and more likely to maintain good
cognition as you age.
Altruism Physical wellness

Emotional wellness Prayer
Intellectual wellness Spiritual wellness

American College of Sports Medicine (ACSM). (2000). Guidelines for exercise

testing and prescription. Baltimore, MD: Williams & Wilkins.
Edlin, G., & Golanty, E. (2010). Health and wellness (10th ed.). Sudbury, MA:
Jones & Bartlett.
Hoeger, W. K., & Hoeger, S. S. (2003). Lifetime physical fitness and wellness:
A personalized program (7th ed.). Belmont, CA: Thomson Wadsworth.
Payne, W. A., Hahn, D. B., & Mauer, E. B. (2005). Understanding your health
(8th ed). New York, NY: McGraw-Hill.
Stroebe, M., Schut H., & Stroebe, W. (2007). Health outcomes of bereavement.
The Lancet, 370(9603), 1960ă1973.

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Topic  Dimensions

Copyright © Open University Malaysia (OUM)

2.1 DIMENSIONS OF HEALTH AND WELLNESS

Therefore, symptoms of illness and disease may be viewed as an imbalance in a

Copyright © Open University Malaysia (OUM)

There are eight dimensions to wellness, namely, physical, emotional, spiritual,

Figure 2.2: Eight dimensions of wellness

Copyright © Open University Malaysia (OUM)

(a) Physical Dimension

(b) Emotional Wellness

(c) Spiritual Wellness

(d) Intellectual Dimension

Now, how do we achieve positive wellness? Well, in order to achieve positive

State the eight dimensions of wellness.

Copyright © Open University Malaysia (OUM)

2.2 PHYSICAL DIMENSION

Physically well individuals are those who are

Naturally, good/ideal physical fitness is characterised by good cardiorespiratory

Copyright © Open University Malaysia (OUM)

Nowadays, most people recognise that participating in fitness programmes

Figure 2.3: Jim Fixx (from 1932 to 1984)

Copyright © Open University Malaysia (OUM)

Figure 2.4: Examples of physical fitness exercise

Therefore, it can be said that physical wellness requires implementing positive

2.2.1 What is Physical Fitness?

(Hoeger & Hoeger, 2003)

Copyright © Open University Malaysia (OUM)

2.2.2 Developing a Cardiorespiratory Fitness

Let us look at the recommendation for achieving cardiorespiratory fitness from

Figure 2.5: Four areas to achieve cardiorespiratory fitness

These four areas are further described as follows:

(a) Mode of Activity

Copyright © Open University Malaysia (OUM)

(b) Frequency of Training

(c) Intensity of Training

ACSM also recommends that healthy adults exercise at an intensity level

(d) Duration of Training

(a) Exercise regularly and select a well-balanced diet;

Copyright © Open University Malaysia (OUM)

Select an exercise programme by Leslie Sanson entitled Three Fast Miles

Then discuss the effect of the exercise in the group.

1. Fitness is composed of four components ă cardiorespiratory

2. Discuss the health benefits that can be achieved through regular

3. Write objectives to improve your fitness and wellness and develop

2.3 EMOTIONAL DIMENSION

Copyright © Open University Malaysia (OUM)

Figure 2.6: Illustration of emotional vulnerability

On the other hand, the emotional dimension of wellness involves developing

2.3.1 Emotional Stability

Emotional wellness is defined as the ability to understand our own feelings,

In other words, it is the ability to express emotions appropriately, accept change

Emotional stability is also the ability to look at success and failure in a

Copyright © Open University Malaysia (OUM)

Self-concept is how an individual pictures himself/herself internally, the

(a) Recognising conflict as potentially healthy rather than denying it;

Copyright © Open University Malaysia (OUM)

(h) Practising positive financial behaviours to enhance security and emotional

(a) Possess a sense of humour;

Differentiate between self-concept and self-esteem.

1. Emotional growth requires both knowing about yourself and

Azman is a 30-year-old learner. He feels that he is being pulled in

2. Discuss strategies that can be implemented to enhance oneÊs self-

Copyright © Open University Malaysia (OUM)