Health and Illness ➢ Wellness is the condition in which all
▪ HEALTH- is a fundamental right of every
human being. It is a state of integration of
the body and mind. It is much sought after
state; a highly desirable state for most
people and yet at times, it remains elusive
for some people.
▪ Heath and illness are highly individualized
perceptions. Meanings and descriptions of
health and illness vary among people, in
relation to geography and to culture.
▪ CONCEPTS OF HEATH AND ILLNESS
➢ Health is a state of complete, mental and
social well-being, and not merely the
absence of the disease or infirmity. (WHO)
➢Health is the ability to maintain the internal
milieu. Illness is the result of failure to
maintain the internal environment.(Claud
Bernard)
➢Health is the ability to maintain
homeostasis or dynamic equilibrium.
➢ Homeostasis is regulated by the negative
feedback mechanism. (Walter Cannon)
➢Health is being well and using one’s power
to the fullest extent. Heath 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)
➢Positive health symbolizes wellness. It is a
value term defined by the culture or
individual. (Rogers)
➢ Health is a state and a process of being
and becoming an integrated and whole
person. (Roy)
➢Heath is 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 life cycle.
(King)
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 system. (Johnson)
Wellness and 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 subjective perception of balance,
harmony and vitality
▪ Wellness is a choice
▪ Wellness is a way of life
▪ Wellness is the integration of body, mind and
spirit
▪ Wellness is the loving acceptance of one’s self
MODELS OF HEALTH AND ILLNESS
I. The health-Illness Continuum (Dunn)
Dunn’s theory on “health-illness continuum”
describes the interaction of the
environment with well-being and illness.
ENVIROMENT
Protected poor health HLW in favorable
In favorable environment environment
ILLNESS HEALTH
Death Poor Health Good health High
precursor Level
of illness Wellness
Poor health in Emergent HLW in
Unfavorable environment
unfavorable environment
▪ High level wellness (HLW). An integrated
method of functioning that is oriented
towards maximizing one’s potentialities
within the limitations of his environment.
This concept connotes ability to perform
ADL or to perform independently.
▪ Precursor of Illness
These are the factors which impinge on the
individuals to lead towards the illness
spectrum:
1. Heredity (ex. Family history for diabetes
mellitus, hypertension, cancer.
2. Behavioral factors (ex. Cigarette
smoking, alcohol abuse, high minimal fat
intake)
3. Environmental factors (ex overcrowding
poor sanitation, poor supply of potable
water.
MODELS OF HEALTH AND ILLNESS
II. Health Belief Model (HBM) Becker, 1975
▪ Describes the relationship between a
person’s belief and behavior
▪ Individual perceptions and modifying
factors may influence health beliefs and
preventive health behavior.
MODELS OF HEALTH AND ILLNESS
▪ Individual perceptions include the
following:
1. Perceived susceptibility to an illness. Ex.
Family history to diabetes mellitus
increases risk to develop the disease.
2. Perceived seriousness of an illness. Ex.
Diabetes mellitus is a lifelong disease.
3. Perceived threat of an illness. Ex.
Diabetes mellitus causes damage to the
brain, heart, eyes, kidneys, blood
vessels.
MODELS OF HEALTH AND ILLNESS
▪ Modifying factors include the following:
1. Demographic variables (age, sex, race,
etc)
2. Sociopsychologic variables (social
pressure or influence from peers, etc.)
3. Structural variables (knowledge about
the disease, and prior contact with it)
4. Cues to action (internal: fatigue,
uncomfortable symptoms; external; mass
media, advice from others)
MODELS OF HEALTH AND ILLNESS
▪ Likelihood of taking recommended preventive
health action depends on:
1. Perceived benefits of preventive action.
2. Perceived barriers to preventive action.
a. Preventive health behavior may include
lifestyle changes, increased adherence to
medical therapies, search for medical advice
or treatment.
b. Perceived barriers to preventive action may
be due to difficulty in adhering to lifestyle
changes; social pressures; physical symptoms
such as fatigue, joint pains, etc; economic
factors; accessibility of heath care facilities
MODELS OF HEALTH AND ILLNESS
III. Smith’s Model of Health
1. Clinical model: Views people as
physiologic system with related functions
and identifies health as the absence of
signs and symptoms of disease or injury.
2. Role Performance Model. Defines health
in terms of individual’s ability to fulfill
societal roles such as performing work.
MODELS OF HEALTH AND ILLNESS
3. Adaptive model: Focuses on adaptation.
Views health as creative process; and
disease as a failure in adaptation or mal-
adaptation. This model believes that the
aim of treatment is to restore the ability of
the person to adapt, that is to cope.
4. Eudaemonistic Model: Conceptualizes
that health is a condition of actualization or
realization of a person’s potential. This
model avers that the highest aspiration of
people is fulfillment and complete
development-actualization.
MODELS OF HEALTH AND ILLNESS
IV. Leavell and Clark’s Agent-Host Environment
Model (Ecologic Model)
▪ Avers that there are three interactive factors
affect health and illness. The three factors are
as follows:
1. Agent- any factor or stressor that can lead to
illness or disease.
2. Host- persons who may or may not be affected
by a disease.
3. Environment-any factor external to the host
that may or may not predispose the person to
a certain disease.
MODELS OF HEALTH AND ILLNESS
V. Health Promotion Model (Pender 1982 1993,
1996)
▪ The health Promotion Model (Pender)
describes the multi-dimensional nature of
persons as they interact within the
environment to pursue health. The model
focuses on the following areas:
1. Individual Perceptions (client’s cognitive
perceptual factors).
2. Modifying Factors (demographic and social
factors)
3. Participation in Health- promoting behaviors
(likelihood of Action)
MODELS OF HEALTH AND ILLNESS
▪ This model attempts to explain the
reasons why individuals engage in health
activities.
▪ Pender advocates the heath promotion
involves activities that are directed
toward increasing the level of well-being
and self-actualization.
1. Includes efforts to assist individuals in
taking control of and responsibility for
their health risks and ultimately improve
quality of life.
2. Encompasses activities to improve the
health of those who are not initially
healthy as well as the healthy individuals.
3. Includes individual and community
activities to promote healthful lifestyles.
4. Includes the principles of self
responsibility, nutritional awareness,
stress reduction and management and
physical fitness..
5. Health promotion activities such as
routine exercise and good nutrition, help
clients maintain or enhance their present
level of health.
6. Illness prevention activities such as
immunization programs protect clients
from actual or potential threats to health.
ILLNESS and DISEASE
❖ILLNESS
▪ Is a personal state in which the person feels
unhealthy.
▪ Is a state in which a person’s physical,
emotional, intellectual, social, developmental or
spiritual functioning is diminished or impaired
compared with previous experience.
▪ Is not synonymous with disease; although
nurses must be familiar with different kinds of
diseases and their treatments, they are
concerned more with illness, which may include
disease but also the effects on functioning and
well-being in all dimensions.
❖ 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 (e.g. microorganism)
2. Inherited genetic defects (e.g. cleft palate)
3. Developmental defects (e.g. imperforate anus)
4. Physical agents (e.g. hot and cold substances,
radiation, ultraviolet rays)
5. Chemical agents (e.g. lead, emissions from
smoke-belching cars)
6. Tissue response to irritation/injury (e.g. fever,
inflammation)
7. Faulty chemical/metabolic process (e.g.
inadequate insulin in diabetes mellitus,
inadequate iodine causing goiter)
8. Emotional/physical reaction to stress (e.g.
anxiety, fear)
❖ Stages of Illness
1. Symptom experience
▪ Transition stage
▪ The person believes something is wrong
▪ Experiences some symptoms
▪ 3 aspects
a. Physical (fever, muscle aches, malaise,
headache)
b. Cognitive (perception of “having flu”)
c. Emotional (worry on consequence of
Illness)
2. Assumption of Sick Role
▪ Acceptance of the illness
▪ Seeks advice, support for decision to give
up some activities.
3. Medical Care Contact
▪ Seeks advice of health professionals for
the following reasons:
a. Validation of real illness
b. Explanation of symptoms
c. Reassurance or production of outcome
4. Dependent Patient Role
▪ The person becomes a client dependent
on the health professional for help.
▪ Accepts/rejects health professional’s
suggestions.
▪ Becomes more passive and accepting
▪ May regress to an earlier behavioral stage.
5. Recovery/Rehabilitation
▪ Gives up the sick role and returns to
former roles and functions.
❖ Aspects of Sick Role
1. One is not held responsible for his condition.
The person did not cause his illness
2. One is excused from social roles. This person
is allowed to rest by seeking sick leave or
leave of absence.
3. One is obliged to get well as soon as possible.
The person is expected to cooperate and
comply with recommended therapies.
4. One is obliged to seek for competent help. The
person is expected to seek help from health
professionals.
❖Risk Factors
▪ A risk factor is any situation, habit, social,
or environmental condition, physiological
or psychological condition, developmental
or intellectual condition, or spiritual or
other variable that increases the
vulnerability of an individual or group to an
illness or accident.
▪ The presence of risk factors does not
mean that a disease will develop, but risk
factors increase the chances that the
individual will experience a particular
dysfunction.
▪ Risk Factors of a Disease
1. Genetic and Physiological Factors
▪ Heredity, or genetic predisposition to
specific illness, is a major physical risk
factor. For example, a person with a
family history of diabetes mellitus is a
risk for developing the disease later in
life.
2. Age
▪ Age increases or decreases susceptibility
to certain illnesses (e.g. the risk of heart
diseases increases with age for both
sexes)
▪ The risk of birth defects and complications
of pregnancy increase in women bearing
children after age 35.
3. Environment
▪ The physical environment in which a
person works or lives can increase the
likelihood that certain illnesses will occur.
For example, some kinds of cancer and
other diseases are more likely to develop
when industrial workers are exposed to
certain chemicals or when people live near
toxic waste disposal sites.
4. Lifestyle
▪ Many activities, habits and practices
involve risk factors. Lifestyle practices and
behaviors can also have positive or
negative effects on health.
▪ Other habits that put a person at risk for
illness include tobacco use, alcohol or
drug abuse and activities involving a threat
or injury, such as skydiving or mountain
climbing.
▪ Stress can be a lifestyle risk factor if it is
severe or prolonged, or if the person is
unable to cope with life events adequately.
▪ Stress can threaten mental health
(emotional stress), as well as physical well
being (physiologic stress).
▪ The goal of risk factor identification is to
merely assist clients in visualizing those
areas in their life that can be modified or
even eliminated to promote wellness and
prevent illness.
TERMINOLOGIES
▪ Disease. Disturbance of structure or of
function of the body or its constituent
parts.
▪ Lack of or faulty or inadequate adaptation of
the organism to his environment.
▪ Failure of the adaptive mechanism to
adequately counteract the stimuli or stresses
to which it is subject resulting in disturbances
in function and structure of any part, organ or
system of the body
▪ Morbidity- condition of being diseased.
▪ Morbidity rate- the proportion of disease to
health in a community.
▪ Mortality- condition or quality of being
subject to death.
▪ Ecology- the science of organisms as
affected by factors in their environment;
deals with the relationship between the
disease and geographical environment.
▪ Epidemiology- study of the patterns of
health and disease, its occurrence and
distribution in man, for the purpose of
control and prevention of disease.
▪ Susceptibility- the degree of resistance the
potential host has against the pathogen.
▪ Etiologic agent- one that possesses the
potential for producing, injury or disease
(e.g. streptococcus, staphylococcus)
▪ Virulence- relative power or the degree of
pathogenicity of the invading
microorganism, the ability to produce
poisons that repel or destroy phagocytes.
▪ Symptomatology- study of symptoms
▪ Sign- an objective symptom or objective
evidence or physical manifestation made
apparent by special methods of
examination or use of senses
▪ Symptom- any disorder of appearance,
sensation or function experienced by the
patient indicative of a certain phase of a
disease.
▪ Syndrome- a set of symptoms, the sum of
which constitutes a disease.
▪ A group of symptoms which commonly occur
together.
▪ A group of signs and symptoms which when
considered together characterize a disease.
E.g. fever, rashes , Koplik’s spot in measles.
▪ Pathology- the branch of medicine which deals
with the cause, nature, treatment and resultant
structural and functional changes of disease.
▪ Pathogenesis- method of origin and
development of a disease, including sequence
of processes or events from inception to the
development of characteristic lesion or disease.
▪ Diagnosis- art or act of determining the nature of
a disease, recognition of a diseased state.
▪ Sequela- the consequence that follows the
normal course of an illness.
▪ Complication- a condition that occurs during or
after the course of an illness.
▪ Prognosis- prediction of the course and end of a
disease, medical opinion as to the outcome of a
disease process. Good prognosis means that
there is great possibility to recover from the
disease and poor prognosis means that there is
great risk for morbidity or mortality.
▪ Recovery-implies that the person has no
observable or known after effects from his
illness; there is apparent restoration to the pre-
illness state
Classification of Diseases
A. According to Etiologic Factors
1. Hereditary- due to defect in the genes of
one or other parent which is transmitted
to the offspring. (e.g. diabetes mellitus,
hypertension)
2. Congenital- due to a defect in the
development, hereditary factors, or
prenatal infection; present at birth. (e.g.
cleft palate, cleft lip)
3. Metabolic- due to disturbances or
abnormality in the intricate processes of
metabolism (e.g. diabetes mellitus,
hyperthyroidism)
4. Deficiency- results from inadequate intake
or absorption of essential dietary factors
(e.g. osteomalacia, which is vitamin D
deficiency in adults)
5. Traumatic- due to injury. (e.g. fractures)
6. Allergic- due to abnormal response of he
body to chemical or protein substances or
to physical stimuli (e.g. asthma, skin
allergy)
7. Neoplastic- due to abnormal or
uncontrolled growth of cells. (e.g. cancer
8. Idiopathic- cause is unknown; self-
oriented; of spontaneous origin. (e.g.
cancer)
9. Degenerative- results from the
degenerative changes that occur in tissue
and organs. (e.g. osteoporosis,
osteoarthrtis)
10. Iatrogenic- results from the treatment of
a disease. (hypothyroidism after thyroid
surgery; alopecia after chemotherapy)
B. According to Duration or Onset
1. Acute illness- an acute illness usually
has a short duration and is severe. The
signs and symptoms appear abruptly, are
intense and often subside after relatively
short period. An acute illness may affect
functioning in any dimension. (e.g. acute
appendicitis)
2. Chronic Illness- a chronic illness persists,
usually longer than 6 months, and can
also affect functioning in any dimension.
The client may fluctuate between maximal
functioning and serious relapses that may
be life threatening. (e.g. hypertension). It is
characterized by remission and
exacerbation.
▪ Remission- period during which the
disease is controlled and symptoms are
not obvious.
▪ Exacerbation- the disease more active
again at a future time, with recurrence of
pronounced symptoms.
3. Sub-acute- symptoms are pronounced but
more prolonged than in acute disease.
(e.g. sub-acute endocarditis)
C. Others. Diseases may also be described
as:
1. Organic- results from changes in the
normal structure, from recognizable
anatomical changes in an organ or tissue
of the body
2. Functional- no anatomical changes are
observed to account for the symptoms
present, may result from abnormal
responses to stimuli (e.g. psychiatric
illness)
3. Occupational- results from factors
associated with the occupation engaged in
by the patient (e.g. cancer among
chemical factory workers)
4. Familial- occurs in several individuals of
the some family. (e.g. Hypertension,
cancer)
5. Venereal- usually acquired through sexual
relation. (e.g. AIDS)
6. Epidemic- attacks a large number of
individuals in a community at the same
time (e.g. SARS)
7. Endemic- present more or less
continuously or recurs in a community.
(e.g. malaria, in Palawan, Goiter in
Mountain Province)
8. Pandemic- an epidemic disease which is
extremely widespread involving an entire
country or continent.
9. Sporadic- a disease in which only
occasional cases occur. (e.g. Dengue
during rainy season, leptospirosis during
floods)
Leavell and Clark’s Three Levels of
Prevention
1. Primary Prevention: to encourage
optimal heath and to increase the
person’s resistance to illness. Seeks to
prevent a disease or condition at a
prepathologic state; to stop smoking from
ever happening.
▪ Health promotion
▪ Specific protection
2. Secondary Prevention: It is also known as
health maintenance. Seeks to identify
specific illness or conditions at an early
stage with prompt intervention to prevent
disability; to prevent catastrophic effects
that could occur if proper attention and
treatment are not provided.
▪ Early detection/diagnosis/screening
▪ Prompt treatment to limit disability
3. Tertiary Prevention: To support the client’s
achievement of successful adaptation to
known risks, optimal reconstitution, and/ or
establishment of high-level wellness.
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.
▪ Rehabilitation
Behaviors Associated with the
Levels of Prevention
❖ Primary Prevention
▪ Quit smoking
▪ Avoid/limit alcohol
▪ Exercise regularly
▪ Eat well-balanced diet
▪ Reduce fat and increases fiber in diet
▪ Take adequate fluids
▪ Avoid exposure to sunlight
▪ Maintain ideal body weight
▪ Complete immunization program
▪ Wear hazard devices in work site.
❖Secondary Prevention
▪ Have annual physical examination
▪ Regular Pap’s test for women
▪ Monthly BSE for women who are 20 years
old and above
▪ Sputum examination for Tuberculosis
▪ Annual stool guaiac test and rectal
examinaton for clients over age 50 years
❖Tertiary Prevention
▪ Self-monitoring of blood glucose among
diabetics
▪ Physical therapy after CVA (stroke);
participation In Cardiac Rehabilitation after
MI (myocardial infarction or heart attack)
▪ Attending self-management education for
diabetes.
▪ Undergoing speech therapy after
laryngectomy.
Types of Health Promotion
Programs
1. Information Dissemination
▪ Use of variety of media to offer
information to the public about the
particular lifestyle choices and personal
behavior, the benefits of changing that
behavior and improving the quality of life.
2. Health Appraisal and Wellness
Assessment Programs
▪ Appraise individuals of their risk factors
that are inherent in their lives in order to
motivate them to reduce specific risk and
develop positive health habits.
▪ Wellness assessment programs are
focused on more positive methods of
enhancement.
3. Lifestyle and Behavior Change Programs
▪ Basis for Changing health behavior
▪ Geared toward enhancing the quality of
life and extending the life span.
4. Worksite Wellness Programs
▪ Include programs that serve the needs of
persons in their workplace.
5. Environment Control Programs
▪ Developed to address the growing
problem of environment pollution-air, land,
water, etc.
▪ Activities to Promote Health and Prevent
Illness
1. Have regular (yearly) physical
examination

2. Women
▪ Regular Par test
▪ Monthly BSE (breast self –examination)

3. Men: regular testicular self-examination

4. Annual dental examination and

prophylaxis.

5. Regular eye exam (every 1-2 years)

6. Exercise regularly at least 3x per week for

30 minutes

7. Do not smoke: avoid second hand smoke

8. Avoid alcohol and “recreational drugs”

9. Reduce fat and increase fiber in diet.

10. Sleep regularly 7-8 hours/night

11. Eat breakfast

12. Eat regular meals with few snacks

13. Maintain Ideal Body Weight

▪END