College of Nursing, SGPIMS, Lucknow

Subject-Nursing Foundation
Unit-1st
Topic- Introduction to Health and Illness
Venue- B.Sc. Nursing 1st Semester Class Room

-Presented By-

Mr. Arun Kumar

Tutor, College of Nursing, SGPGIMS, Lucknow
CHAPTER 1
Introduction to
Health and Illness
  Describe concept of health.  Explain causes and risk
 Define health. factors for developing
 Discuss the Maslow’s illness.
hierarchy of needs.  Illustrate the types of
 Explain health illness illness and illness behavior.
continuum.  Describe the impact of
Learning Objectives  Discuss factors influencing illness on health.
health.
  Concept of Health:  Causes and Risk
Definition (WHO) Factors for
 Maslow’s Hierarchy of Developing
Needs Illness
 Health- Illness  Types of Illness
CHAPTER
Continuum and Illness
OUTLINES
 Factors influencing Behavior
Health  Impact of Illness
on Patient and
Family
 MEANING OF HEALTH

Health is more than just the absence of illness;

it is an active process in which a person moves
toward his or her maximum potential.
  World Health Organization, 1947 “State of complete physical, mental,
and social well-being, not merely the absence of disease or infirmity”.

 Dorothea Orem(self care deficit Nursing theory) “Health and healthy

are terms used to describe living things when they are structurally and
functionally whole or sound

Definition of Health  Virginia Henderson Nursing is unique function to assist the individual,
sick or well, in the performance of those activities contributing to health
or its recovery (or to peaceful death) unaided if he had the necessary
strength will or knowledge”.

• Hildegard Peplau(interpersonal relationship theory) “Nursing is

therapeutic interpersonal process which functions in coordination with
human process of individuals in community.”
 Concept of Health
Biomedical Concept:
• Based on the “germ theory of the disease”.
• Health means “absence of disease”.
• The human body is a machine and disease is an outcome of the breakdown of
the machine.
• Developments led to the conclusion that the biomedical concept of health was
inadequate.
Continue….
Ecological Concept
• Health is a dynamic equilibrium between man and his environment.
• Disease is a maladjustment of the human organism to environment.
Psychosocial Concept
• Health is also influenced by social, psychological, cultural, economic and political factors
of the people concerned.
• These factors must be taken into consideration in defining and measuring health.
Holistic Concept
• Holistic model is a synthesis of all the above concepts.
• Health is multidimensional process involving the wellbeing of the person as a whole.
• Emphasis is on the promotion and protection of health.
MASLOW’S HIERARCHY OF NEEDS
Physiological Needs

• Physiological needs are the physical requirements for human survival. If

these requirements are not met, the human body can not function properly
and will ultimately fail.

• These are biological requirements for human survival example air, water
food, shelter clothing, warmth sex and sleep.
Safety and Security

• Once a person’s physical safety needs are relatively satisfied, their safety
needs take precedence and dominate behavior. In the absence of physical
safety due to war, natural disaster, family violence, childhood abuse etc. –
people may (re)experience post-traumatic stress disorder or transgenerational
trauma.
Love and Belongingness

• After physiological and safety needs have been fulfilled the 3rd level of human
needs is social and involves feelings of belongingness.

• Belongingness refers to a human emotional need for interpersonal

relationships affiliating, connectedness, and being part of a group.
Self-esteem

• Esteem needs are the 4th label in Maslow hierarchy and includes self
worth accomplishment and respect.

• Esteem presents the typical human desire to be accepted and valued by

others. people often engage in a profession or hobby to gain recognition.
these activities give the person a sense of contribution or value.
Self-actualization

• “What a man can be, he must be”. This quotation forms the basis of the
perceived need for self-actualization. This level of need refers to what a
person’s full potential is and the realization of that potential. Maslow
describes this level as the desire to accomplish everything that one can, to
become the most that one can be. Individuals may perceive or focus on this
need very specifically.
Self-actualization

• Self actualization needs are the highest level in Maslow's hierarchy

and refer to the realization of a person’s potential self fulfillment
seeking personal growth and peak experiences.
HEALTH- ILLNESS CONTINUUM
• The health–illness continuum is one way to conceptualize a person’s level
of health. This model views health as a constantly changing state, with
high-level wellness and death at opposite ends (ranging from extremely
good health to death).

• This continuum illustrates the ever-changing state of health as a person

adapts to changes in internal and external environments to maintain a
state of well-being.
 Continue…
• Composed of two arrows pointing in opposite direction and joined at a neutral
point. Movement to the right arrow (toward the wellness) has increasing level of
health and well-being. Movement to the left arrows (towards premature death)
equates a progressively decreasing state of health.
• Achieved in three steps
Movement towards right arrow
Achieved in three steps:

• Awareness: Person should be aware towards his health status and doesn’t neglect
any warning signs of illness e.g., indulgence in physical exercise to prevent any
disease or identifying signs of obesity and then starting the physical workout.

• Education: Person should be educated about the general health issues of day to day
life.

• Growth: It includes overall aspect for growth of individual such as intellectual,

mental, physical and spiritual.
 Movements towards left arrow

Achieved in three steps:

• Signs: They are objective in nature which can ruled out only by physician or other
health care worker.

• Symptoms: They are subjective signs which means patient can see or feel them but
other person cannot measure or quantify it, for example back pain or fatigue.

• Disability: It is the condition of the body or mind impairment that makes it more
difficult for the person with the condition to do certain activities (activity limitation).
FACTORS INFLUENCING HEALTH
• Income and social status: Higher income and social status are linked to better
health. Greater the gap between the richest and poorest people, the greater
difference in health.

• Education: Lower education levels are linked with poor health, more stress
and lower self-confidence.

• Physical Environment: Safe water and clean air, healthy workplaces, safe
houses, communities and roads all contribute to good health.
Continue….
• Social Support Networks: Greater support from families, friends and communities is linked to better health.

• Culture: Customs, traditions and beliefs of the family and community all affect health.

• Genetics: The inheritance plays a part in determining lifespan, healthiness and the likelihood of developing

certain illnesses.

• Health services: The access and use of services that prevent and treat disease influences health of an

individual.

• Gender: Men and women suffer from different types of diseases at different ages of their life.
ILLNESS

• An illness is the response of a person to a disease; it is a process in which the

person’s level of functioning is changed when compared with the previous
level. Illness is not synonymous with diseases.
 Type of Illness

• Acute illness: An acute illness usually has a rapid onset of symptoms and lasts only a
relatively short time. Although some acute illnesses are life threatening, simple acute
illnesses, such as common cold or diarrhea, do not usually require medical treatment.

• Chronic Illness: Chronic illness the one which persists, usually longer than 6 months. It is a
broad term that encompasses a number of different physical and mental alterations in health,
each having one or more of the following characteristics:
Causes and Risk Factors for Developing Illness

• A risk factor is any situation or habit that affects social, environmental,

physiological or psychological conditions.

• Risk factors are the factors or reasons that increase the probability to
contract a disease or infection. Risk factors are also refereed as
predisposing factor.
Continue..

• Age: The age plays an important role in influencing the health of the person. For example, the
school-aged children are at higher risk for communicable diseases.

• Lifestyle: The lifestyle behaviors can have positive and negative impacts on health. Some habits
are risk factors for specific disease.

• Environment: The physical environment in which a person lives or works can increase a
certain illness.

• Genetic and physiological factors: Inheritance plays an important role in development of certain
diseases. Some biological and genetic factors affect specific populations more than others.
EPIDEMIOLOGICAL TRIAD

• Agent: It refers to an infectious microorganism or pathogen i.e., a virus, bacterium, parasite or

any other microbe.

• Host: It refers to the human who can get the disease. A variety of risk factors, can influence an
individual’s exposure, susceptibility or response to a causative agent.

• Environment: It refers to external factors that affect the agent. These factors include physical
factors such as climate, biologic factors such as insects that transmit the agent and socio-
economic factors such as crowding, sanitation and the availability of health services.
Continue..
Continue…..
The epidemiological triad is a concept used to describe
the interaction between three factors in the spread of
infectious diseases: the host (or susceptible individual),
the agent (the pathogen causing the disease), and the
environment. This triad helps in understanding how
diseases spread and how interventions can be targeted
to control them.
 ILLNESS BEHAVIOR
• Stage 1: Experiencing Symptoms

The first indication of an illness is recognizing one or more symptoms that are incompatible with one’s personal definition
of health.

• Stage 2: Assuming the Sick Role

The individual now self-defines as being sick, seeks validation of this experience from others, gives up normal activities,
and assumes a “sick role.”

• Stage 3: Assuming Dependent Role

• This stage is characterized by the patient’s decision to accept the diagnosis and follow the prescribed treatment plan.

• Stage 4: Achieving Recovery and Rehabilitation

• Recovery and rehabilitation might begin in the hospital and conclude at home or may be totally concluded at a
rehabilitation center or at home.
IMPACT OF ILLNESS ON PATIENT AND
FAMILY
• Impact on behavior

Individual reacts differently to illness or threat of illness. An individual’s behavioral

and emotional response is influenced by duration and nature of illness. Short term
illness leads to behavioral changes.

• Impact on body image

Illness may result in the loss of body part or change in physical appearance. Every
individual responds to the changes differently.
Continue…

• Impact on family roles

Every individual has varied roles and responsibilities to play. These roles and
responsibilities change with illness.
•
 Definition of Immunity

The term ‘Immunity’ traditionally refers to the resistance exhibited by the host
towards injury caused by microorganisms and their product. “Immunity is a
condition of being able to resist a particular disease especially through
preventing development of a pathogenic microorganism or by counteracting
the effects of its products”.

Merriam Webster
 Types and Classification of Immunity

• Innate/native immunity: Innate immunity is the inborn immunity that is

already present at the time of birth. It is genetic in origin and also depends
upon the constitutional makeup of an individual.

• Acquired immunity: The resistance that an individual acquires during life is

known as acquired immunity.
Types of Innate Immunity
• Species Immunity: It refers to the total or relative refractoriness to a
pathogen, shown by all members of a species. For instance, all human
beings are totally insusceptible to plant pathogens.
• Racial Immunity: Within a species, different races may show differences
in susceptibility to infarctions. This is known as racial immunity, the
classic example of which is the high resistance of Algerian sheep to
anthrax.
• Individual Immunity: The differences in immunity exhibited by
different individuals in a race is known as individual immunity. For
example, homozygous twins exhibit similar degree of resistance or
susceptibility to lepromatous leprosy and tuberculosis.
Mechanisms of Innate Immunity

• Epithelial surfaces: This type of innate immunity resists the incoming

intruder that is considered as non-self by the host body as well as eradicates
the infection non-specifically by acting against these all non-self antigens
both at the external level as well as the internal level of the host.

• Antibacterial substances in blood and tissues: The complement system

possesses bactericidal activity and plays an important role in the destruction
of pathogenic bacteria that invade the blood and tissues.
Continue…

• Microbial antagonisms: The skin and mucous surface have resident bacterial
flora which prevent colonization by pathogens.

• Cellular factors in innate immunity: Natural defense against the invasion of

blood and tissues by microorganisms and other foreign particles is mediated
to a large extent by phagocytic cells which ingest and destroy them.
Continue…

• Inflammation: Tissue injury or irritation, irritation by the entry of pathogens or

other irritants, leads to inflammation, which is an important, non-specific

defense mechanism.

• Fever: A rise of temperature following infection is a natural defense

mechanism. It not only helps to accelerate physiological process but may in
some cases, actually destroy the infecting pathogens.
 Factors affecting the innate immunity of an
individual
• Age: The young and the old are more susceptible to infections unlike the
adults who show less susceptibility comparatively owing to well developed
immunity.

• Hygiene: Maintaining the hand hygiene especially is one of the most

important factors affecting the immunity of a person.

• Circadian rhythm: The circadian rhythms inducing the sleep-wake cycles also
affect the immunity of a person.
Continue…

• Nutrition: The vitamins C, A, B6, B12, E and the minerals including iron,
zinc play a significant role in sufficing the immunity.

• Psychological factors: The stress hormone released during stress in an

individual influences the immunity of the individual negatively.

• Genetic factors: The immunity is also influenced by the genetic makeup of

a person. Some individuals have strong immunity while the others have
weak immunity.
Types of Acquired Immunity

Active Acquired Immunity

• It is the resistance developed by an individual as a result of an antigen

stimulus. It is also known as adaptive immunity.
Types (Classification) of Active Immunity

• Natural active acquired immunity: The natural active immunity is the acquired
immunity in which the immune system gets activated naturally by a clinical or sub-
clinical natural microbial infection.

• Artificial active acquired immunity: It is induced artificially by injecting the functionally

modified forms of the pathogen (live or killed vaccines) into an individual so as to
activate the individual’s immune system in order to generate the immunity against the
injected pathogen that protects the individual from any number of natural infections
from the same pathogen in future and thus prevents the manifestation of disease.
Passive Acquired Immunity

• It is the form of immunity in which the immune system of an individual does

not play any role in the generation of the immunity during any infection that
has manifested into the disease form or during other particular cases.
Types of Passive Acquired Immunity

• Natural passive acquired immunity: It is the type of acquired immunity

which is received by an individual in the readymade form naturally in the
womb of his/her mother during the prenatal period of one’s life.

• Artificial passive acquired immunity: It is the type of acquired immunity,

provided especially in the form of antibodies, which is administered into an
individual artificially, especially in case of emergencies like during any
disease manifestation or during visits to highly disease prone areas etc.
 IMMUNIZATION

• Immunization is the protective process by which the body produces antibodies

against the vaccine preventable disease through administration of specific
vaccine.
Importance of Immunization

• To protect children against specific preventable diseases like polio, diphtheria,

pertussis, measles, rubella, hepatitis B, tetanus etc.

• The immunization against the diseases stimulate the host body to produce
immunity against specific infection.

• Immunoglobulins: There are 5 major classes: IgM, IgA, IgG, IgE, IgD. Two
types of immunoglobulin preparations are available for passive immunization:
 Normal human immunoglobulin.
 Specific (hyper-immune) human immunoglobulin.
Continue……

• Antisera: These are materials prepared in animals or non-human

sources such as horses.

• Vaccines: A vaccine is an immuno-biological substance designed to

produce specific protection against a given disease. A vaccine is
“antigenic” but not “pathogenic”.
TYPES OF VACCINES

• Live/attenuated Vaccines: Live vaccines are made from live infectious

agents without any amendment e.g. OPV, BCG

• Inactivated (Killed vaccines): Organisms are killed or inactivated by

heat or chemicals but remain antigenic. They are usually safe but less

effective than live attenuated vaccines.

Continue..

• Toxoids: They are prepared by detoxifying the exotoxins of some bacteria

rendering them antigenic but not pathogenic. Adjuvant (e.g. alum precipitation)
is used to increase the potency of vaccine e.g., diphtheria, tetanus.

• Polysaccharide and polypeptide (cellular fraction) vaccines: These are

prepared from cellular fractions of organisms e.g. meningococcal, hepatitis b

• Combination vaccines: DPT, DT.