Week 1 Enhanced

KOZIER & ERB’S
Fundamentals of NURSING
NINTH EDITION Concepts, Process, and Practice
CHAPTER 2
Health, Wellness,
and Illness
Kozier & Erb’s Fundamentals of Nursing: Concepts, Process, and Practice, Ninth Edition Copyright ©2012 by Pearson Education, Inc.
Audrey Berman • Shirlee Snyder All rights reserved.
Topics
 Man (characteristics, environment, needs)
 Concepts of health, wellness, and illness
 Models of health and illness
 Factors affecting health
 Stages of wellness and illness
 Effects of illness to client and family
Concepts of Man
• A biopsychosocial and spiritual being who
is in constant contact with the
environment.
• An open system in constant interaction
with changing environment.
• A unified whole composed of parts which
are interdependent and interrelated with
each other.
Figure 16-3 Maslow’s needs.From Psychology of Human Behavior, 5th ed., by R. A. Kalish, © 1983. Wadsworth, a
part of Cengage Learning, Inc. Reproduced by permission, www.cengage.com/permissions.
Stages of Life
1.) Infancy and early childhood, which lasts from birth to age 5.

These are babies who are just learning to walk and talk and
figuring out the world around them.
2.) Middle childhood lasts from age 6 to age 12. During this time,
children become more self-sufficient as they go to school and
make friends.
3.) Adolescence, which lasts from age 13 to age 18, comes with
hormonal changes and learning about who you are as an
individual.
4.) Early adulthood lasts from age 19 to age 30 and involves
finding an occupation and often finding a life partner as well.
5.) Middle Age lasts from age 30 to age 60 and is the time when
most people start a family and settle into their adult lives.
6.) Later Maturity is the time of life after age 60. During this time,
people adjust to life after work and begin to prepare themselves
for death.
Health
• Complete physical, mental, social well-
being
• Presence or absence of disease
• Ability to maintain normal roles
• Striving toward optimal functioning
Wellness
• Wellness - state of well-being
• 7 components:
Physical Components of Wellness
• Carry out daily tasks
• Achieve fitness
• Maintain nutrition
• Avoid abusing substances
• Practice positive lifestyle habits
Social Components of Wellness
• Interact successfully
• Develop and maintain intimacy
• Develop respect and tolerance for others
Emotional Components of Wellness
• Ability to manage stress
• Ability to express emotion
Intellectual Components of
Wellness
• Ability to learn
• Ability to use information effectively
• Striving for continued growth
• Learning to deal with new challenges
Spiritual Components of Wellness
• Belief in some force that gives life
meaning and purpose
• Person’s own morals, values, and ethics
Occupational Component of
Wellness
• Ability to achieve balance between work
and leisure
Environmental Components of
Wellness
• Ability to promote health measure that
improves
– Standard of living
– Quality of life
• Influences such as food, water, and air
Models of Health
• Clinical model
• Role performance model
• Adaptive model
• Eudemonistic model
• Agent-host-environment model
• Health-illness continuum
Clinical Model
• Provides narrowest interpretation of health
• People viewed as physiologic systems
• Health identified by absence of disease or
injury
• State of not being “sick”
• Opposite of health = disease or injury
Role Performance Model
• Able to fulfill societal roles
• Viewed as healthy even if clinically ill, if
still able to fulfill roles
• Sickness = inability to perform one’s role
Adaptive Model
• Creative process
• Disease = a failure in adaptation or
maladaptation
• Extreme good health = flexible adaptation
to the environment
• Focus is stability, with ability to grow and
change
Eudemonistic Model
• Comprehensive view of health
• Actualization or realization of a person’s
potential
• Illness = condition that prevents self-
actualization
• Human potential through goal-directed
behavior, competent self-care
Eudemonistic Model (cont'd)
• Satisfying relationship with others
• Maintaining structural integrity and
harmony with social and physical
environments
• Health = expansion of consciousness
Agent-Host-Environment Model
• Each factor constantly interacts with the
others
• When in balance, health is maintained
• When not in balance, disease occurs
Figure 17-3 The agent–host–environment triangle.
Health Belief Models
• Help determine whether individual is likely
to participate in disease prevention and
health promotion activities
• Health Locus of Control Model
– Internals - health status is under their own or
others’ control
– Externals - health is largely controlled by
outside sources
Health Belief Models (cont'd)
• Rosenstock’s and Becker’s Health Belief
Models
– Individual’s perception
– Modifying factors
– Likelihood of action
Figure 17-6 The health belief model. From “Selected Psychosocial Models and Correlates of Individual Health-
Related Behaviors,” by M. H. Becker et al., 1977, Medical Care, 15(5 Suppl), pp. 27–46. Reprinted with
permission.
Health-Illness Continuum
• Measures 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
• How people perceive themselves and how
others see them affects placement on the
continuum
Figure 17-5 A, Illness-Wellness Continuum. From Wellness Workbook: How to Achieve Enduring Health and
Vitality, 3rd ed., by J. W. Travis and R. S. Ryan, 2004, Berkeley, CA: Celestial Arts. Retrieved from
http://www.thewellspring.com/wellspring/introduction-to-wellness/357/key-concept-1-the-illnesswellness-
continuum.cfm
Variables Influencing Health Status,
Beliefs, and Practices
• Internal variables
• External variables
Internal Variables
• Biologic dimension
– genetic makeup, gender, age, and
developmental level
• Psychologic dimension
– mind-body interactions and self-concept
• Cognitive dimension
– lifestyle choices and spiritual and religious
beliefs
External Variables
• Physical environment
• Standards of living
• Family and cultural beliefs
• Social support networks
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
• Reduction of capacities or shortening of
normal life span
• Causation of disease is called etiology
Suchman’s Stages of Illness
• Stage 1: Symptom experience
– Believes 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
Suchman’s Stages of Illness
(cont'd)
• Stage 4: Dependent client role
– Becomes dependent on professional for help
• Stage 5: Recovery or rehabilitation
– Resumes former roles and responsibilities
Effects of Illness
• Impact on the client
– Behavioral and emotional changes
– Self-concept and body image changes
– Lifestyle changes
• Impact on family depends on:
– Which family member is ill
– Seriousness and length of illness
– Cultural and social customs of family
Impact on the Family: Changes
• Role changes
• Task reassignments
• Increased demands on time
• Stress due to anxiety about outcomes
• Conflict about unaccustomed
responsibilities
Impact on the Family: Changes
(cont’d)
• Financial problems
• Loneliness as result of separation or loss
• Change in social customs

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KOZIER & ERB’S

1.) Infancy and early childhood, which lasts from birth to age 5.

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