unit 1.1

BASIC B.Sc. NURSING YEAR-INURSING FOUNDATION

Mr.Sunil Rupjee

Unit IIntroduction

1. Concept of Health: Health – illness continuum.�2. Factors influencing health.�3. Causes and risk factors for developing illness.�4. Body defenses: Immunity and immunization.�5. Illness and illness Behavior:�6. Impact of illness on patient and family.�7. Health Care Service: Health Promotion and Prevention Primary Care, Diagnosis, �

Treatment,8. Rehabilitation and Continuing Care.9. Health care teams.�10. Type of health care agencies.�11. Hospitals: Types, Organization and Functions.�12. Health Promotion and Levels of Disease Prevention.�13. Primary health care and its delivery: Role of nurse.�

Concepts of Health, Wellness, & Well-Being

After the end of this chapter the student will be able to:

• Differentiate health, wellness, and well-being.• Describe five dimensions of wellness.• Compare various models of health.• Identify factors affecting health status, beliefs, and

practices.• Identify health care adherence.• Differentiate illness from disease and acute illness

from chronic illness.• Explain Suchman's stages of illness.

Introduction

• 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 (agreement) about any definition of health. There is knowledge of how to attain (reach) 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

• 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

• a dynamic state of being in which the developmental and behavioral potential (possible) of an individual is realized to the fullest extent possible

Most people define and describe health as the following:

• Being free from symptoms of disease and pain as much as possible.

• Being able to be active and to do what they want or must.

• Being in good spirits most of the time.

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”)

• 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

• The classic description of wellness was developed by Dunn in the early 1960s. According to Dunn (1961), high-level wellness means functioning to one’s maximum health potential while remaining in balance with the environment.

Copyright 2008 by Pearson Education, Inc.

Health-Illness Continuum• 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

Copyright 2008 by Pearson Education, Inc.

Dimensions of Wellness

1. Physical.

• 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.

2. Social.

• The ability to interact successfully with people and within the environment

3. Emotional.

• The ability to manage stress and to express emotions appropriately, Emotional wellness involves the ability to recognize, accept, and express feelings.

4. Intellectual.

• The ability to learn and use information effectively for personal, family, and career development

5. Spiritual.

• 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

6. Occupational.

• 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.

7. Environmental.

• The ability to promote health measures that improve the standard of living and quality of life in the community

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Models of Health• Clinical Model• Role Performance Model• Adaptive Model• Eudemonistic Model• Agent-Host-Environment Model• Health-Illness Continuum

Copyright 2008 by Pearson Education, Inc.

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

Role Performance Model

• Ability to fulfill societal roles• Healthy even if clinically ill if roles fulfilled• Sickness is the inability to perform one’s role

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.

Copyright 2008 by Pearson Education, Inc.

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 Dictionary: • eudemonism: morality evaluated according to

happiness : التماس تجعل نظرية السعادة فلسفةله ومحكا االخالقي للسلوك اساسا السعادة

Copyright 2008 by Pearson Education, Inc.

Agent-Host-Environment Model

• Each factor constantly interacts with the others

• When in balance, health is maintained

• When not in balance, disease occurs

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.

Factors influencing health status, beliefs, and practices:

• Internal factors• External factors

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.

Illness and Disease Illness

• Is 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.

• DiseaseDisease 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:

• Acute illness is typically characterized by severe symptoms of relatively short duration.

• A 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:

• Stage 1 symptoms experiences.• Stage 2 assumption of the sick role

confirmation from family and friends.• Stage 3 medical care contact.• Stage 4 dependent client role.• Stage 5 recovery or rehabilitation.

There are several approaches to health maintenance:

• Health promotion• Health protection• Disease prevention

Impact of Illness

On the Client• Behavioral and

emotional changes• Loss of autonomy• Self-concept and body

image changes• Lifestyle changes

On the Family• Depends on:– Member of the family

who is ill– Seriousness and length

of the illness– Cultural and social

customs the family follows

Impact of Illness: Family Changes

• Role changes• Task reassignments• Increased demands on time• Anxiety about outcomes• Conflict about unaccustomed responsibilities • Financial problems• Loneliness as a result of separation and pending loss• Change in social customs

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