Concepts of Health, Wellness, & Well-Being

• Health, wellness, and well-being have many definitions and interpretations. The nurse
should be familiar with the most common aspects of the concepts and consider how they
may be individualized with specific clients. Health
• There is no consensus about any definition of health. There is knowledge of how to
attain a certain level of health, but health itself cannot be measured.
• Traditionally health has been defined in terms of the presence or absence of disease.
Nightingale defined health as a state of being well and using every power the individual
possesses to the fullest extent.
• The World Health Organization (WHO) defined health:
o As a state of complete physical, mental, and social well-being, and not merely the
absence of disease or infirmity.
• The American Nurses Association defined health o a dynamic state of being in which the
developmental and behavioral potential of an individual is realized to the fullest extent
possible. Wellness & Well-Being
• Wellness further describes health status. It allows health to be placed on a continuum
from one’s optimal level (“wellness”) to a maladaptive state (“illness”)

https://hayleydean1.wordpress.com/lesson-5-meanings-of-health-health-continuum/
• Wellness is a dynamic process that is ever changing. The well person usually has some
degree of illness and the ill person usually has some degree of wellness.
• This concept of a health continuum negates the idea that wellness and illness are opposite
because they may occur simultaneously in the same person in varying degrees. Health-
Illness Continuum:

https://www.slideshare.net/arifasudheer/health-illness-continuum-80612835
Measure person’s perceived level of wellness
Health and illness/disease opposite ends of a health continuum
Move back and forth (forward) within this continuum day by day
Wide ranges of health or illness
Dimensions of Wellness

The seven components of wellness. (From Wellness: Concepts and Applications, 6th ed. (p. 4) by D.J. Anspaugh,
M.H. Hamrick, and F.D. Rosato, 2006. Reproduced with permission of the McGraw-Hill Companies.)

• Physical
o 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.
• Social o The ability to interact successfully with people and within the environment
• Emotional o The ability to manage stress and to express emotions appropriately,
Emotional wellness involves the ability to recognize, accept, and express feelings.
• Intellectual o The ability to learn and use information effectively for personal, family,
and career development
• Spiritual o The belief in some force (nature, science, religion, or a higher power) that
serves to unite human beings and provide meaning and purpose of life.
• Occupational o The ability to achieve a balance between work and leisure time, A
person's beliefs about education, employment, and home influence personal
satisfaction and relationships with others.
• Environmental o The ability to promote health measures that improve the standard of
living and quality of life in the community
Models of Health
1. Clinical Model
• Provides the narrowest interpretation of health
• People viewed as physiologic systems
• Health identified by the absence of signs and symptoms of disease or
injury
• State of not being “sick”
• Opposite of health is disease or injury
2. Role Performance Model
• Ability to fulfil societal roles
• Healthy even if clinically ill if roles fulfilled
• Sickness is the inability to perform one’s role
3. Adaptive Model
• Creative process
• Disease is a failure in adaptation or maladaptation
• Extreme good health is flexible adaptation to the environment
• Focus is stability
• The aim of treatment is to restore the ability of the person to adapt.
4. Eudemonistic Model
• Comprehensive view of health
• Condition of actualization (make real) or realization of a person’s
potential
• Illness is a condition that prevents self-actualization
• Actualization is the apex of the fully developed personality 5. Agent-
Host-Environment Model

• Each factor constantly interacts with the others

• When in balance, health is maintained
• When not in balance, disease occurs
6. Health-Illness Continuum
• Measure person’s perceived level of wellness
• Health and illness/disease opposite ends of a health continuum
• Move back and forth within this continuum day by day
• Wide ranges of health or illness
Well-being
"Well-being is a subjective perception of vitality (energy) and feeling well.....can
be described objectively, experienced, and measured......and can be plotted
(design) on a continuum". It is a component of health.” ( Dr. Abdul-Monim Batiha,
Assistant Professor, Critical Care Nursing Philadelphia university)

Factors influencing health status, beliefs, and practices:

1. Internal factors
• Biologic dimension genetic makeup, sex, age, and developmental level all
significantly influence a person's health.
• Psychological dimension emotional factors influencing health include mind-body
interactions and self-concept.
• Cognitive dimension include lifestyle choices and spiritual and religious beliefs.
2. External factors
• Environment.
• Standards of living. Reflecting occupation, income, and education.
• Family and cultural beliefs. Patterns of daily living and lifestyle to offspring(
children).
• Social support networks. Family, friends, or confidant (best friend) and job
satisfaction helps people avoid illness.

Health Care Adherence

• Adherence (obedience): is the extent to which an individual's behaviour.
o for example, taking medications, following diets or making lifestyle changes.
• Degree of adherence may range from disregarding (ignoring) every aspect of the
recommendations to following the total therapeutic plan.

Illness and Disease Illness

• A highly personal state in which the person's physical, emotional, intellectual, social,
developmental, or spiritual functioning is thought to be diminished.
• Illness is usually associated with disease but may occur independently of it. Illness is a
highly personal state in which the person feels unhealthy or ill.

Disease
• Disease can be described as an alteration in body functions resulting in a reduction of
capacities or shortening of the normal life span.
• The causation of a disease is called its ETIOLOGY.
• There are many ways to classify illness and disease:
o Acute illness is typically characterized by severe symptoms of relatively short
duration.
o Chronic illness is one that lasts for an extended period, usually 6 months or
longer, and often for person's life.
• Suchman describes five stages of illness:
o Stage 1 symptoms experiences.
 o Stage 2 assumption of the sick role confirmation from family and friends. o Stage
3 medical care contact. o Stage 4 dependent client role.
o Stage 5 recovery or rehabilitation

Approaches to health maintenance:

• Health promotion
• Health protection
• Disease prevention

Impact of Illness
• On the Client o Behavioral and emotional
changes o Loss of autonomy
o Self-concept and body image changes o Lifestyle
changes
• On the Family: Depends on:
o Member of the family who is ill o Seriousness
and length of the illness
o Cultural and social customs the family follows
• Family Changes o Role changes o Task
reassignments o Increased demands on time o
Anxiety about outcomes o Conflict about
unaccustomed responsibilities
o Financial problems
o Loneliness as a result of separation and pending
loss o Change in social customs

THE PHILIPPINE HEALTH CARE DELIVERY SYSTEM

• an organized plan of health services • Health Care Delivery:
o rendering health care services to the people
• Health Care Delivery System:
o The network of health facilities and personnel which carries out the task of
rendering health care to the people.
• Philippine Health Care System o Is a complex set of organizations interacting to provide
an array of health services
• Levels of health care facilities
1. Primary Level of health care facilities
 are the rural health units, their sub-centers, chest clinics, malaria
eradication units, and schistosomiasis control units operated by the DOH;
 Puericulture centers
 tuberculosis clinics and hospitals of the Philippine
 Private clinics;
 Clinics operated by large industrial firms for their employees;
  community hospitals and health centers operated by the Philippine
Medicare Care Commission and other health facilities operated by
voluntary religious and civic groups
2. Secondary Level of health care facilities
 are the smaller, non-departmentalized hospitals including emergency and
regional hospitals.
 Services offered to patients with symptomatic stages of disease, which
require moderately specialized knowledge and technical resources for
adequate treatment.
3. Tertiary Level of health care facilities
 are the highly technological and sophisticated services offered by medical
centers and large hospitals.
 services rendered at this level are for clients afflicted with diseases which
seriously threaten their health and which require highly technical and
specialized knowledge, facilities and personnel to treat effectively.
• Three levels of primary health care workers
1. Village or grassroots health workers
 Provide simple curative and preventive health care measures promoting
healthy environment.
2. Intermediate level health workers
 Provide support to front-line health workers in terms of supervision,
training, supplies, and services.
3. First line hospital personnel
 provide back-up health services for cases that require hospitalization