CONCEPT OF ILLNESS AND DISEASE

Objectives

By the end of the lecture, students should e able to:1. Define health2. Discuss various models of health3. Explain health promotion4. Discuss levels of Preventive care5. List the stages of illness behaviour

DEFINITION OF HEALTH

• Good health is not only the absence of disease• Health is a state of beingWHO:• Concern for the individual as a total system• View health as internal and external

environment• Acknowledgement of individual’s role in life

Models of Health and Illness

• Health beliefs – health behaviours• Positive health behavior- maintaining, attaining

or regaining good health and preventing illness E.g. immunizations, proper sleep patterns, adequate exercise, and nutrition• Negative health behaviours- smoking, drinking,

drug or alcohol abuse, poor diet and refusal to take necessary medication

Health Illness Continuum

• Newman(1990), health on a continuum is the degree of client wellness that exists at any point in time, ranging from optimal wellness condition with available energy at its maximum to death which represent total energy depletion

• Health is in a dynamic state that alters continuously as a person adapts

Illness Wellness CONT’D

• It can be viewed as points on a scale

• It is not always easy to describe a client’s level of health in terms of one point between two extremes

High Level Wellness Model

• Require individuals to maintain a continuum of balance and purposeful direction within the environment

• Progress towards a higher level of functioning• An open-ended and ever expanding challenge to

live at the fullest potential• Continued integration of health practices by the

individual at increasing highest levels throughout life

High Level CONT’D

• Nurse managed care centers for older adults

• Modify selected high risk behaviours

• Principles of adult learning

• Its dynamic and not static

Nurse-Client -Partnership

• Holistic health model• Nursing utilizing the nursing process considers

clients as the ultimate experts regarding their own health

• Respects client’s subjective experience as relevant in maintaining health or assisted in healing

• Clients are coparticipants in health promotion

Agent –Host-Environment Model

• The level of health or illness of an individual or groups depends on the dynamic relationship of the agent, host and environment

• Agent-internal or external factor that by its presence or absence can lead to disease or illness

• Host- person or persons susceptible to a particular disease or illness

Agent-Host CONT’D

-Physical or psychosocial - hx, age, sex, lifestyle• Environment- all factors outside the host- Physical env.- Economic level, climate, living conditions, elements- Social env.- stress, conflicts with others, economic hardships, life crisis• Health and illness depends on the dynamic

interactions between all three variables

Health Belief Model

• Relationship between belief and behaviour• Understanding and predicting how clients will

behave in relation to their health and how they will comply with health care therapies

• Individuals perception of susceptibility to the illness

• Individuals perception of seriousness of the disease

• Benefits of taking action

Health Promotion Model

It focuses on three functions:• Cognitive-perceptual factors

• Modifying factors

• Participating in health promoting behaviourReasons why people engage in health behaviours

Variables influencing Health Beliefs and Practices

Internal Variable• Developmental stage• Intellectual background• Perception of function• Emotional factors• Spiritual factors

Variables CONT’D

External Variables• Family practices

• Socioeconomic factors

• Cultural background

Health Promotion and Disease Prevention

• Health promotion and disease prevention are closely related

• HP-maintain or enhance their present levels of health

• DP- protect clients from actual or potential threats to health

• Both are future oriented

Health Promotion CONT’D

• HP activities can be active or passive• Passive strategies-gain from activities of

others without doing anything themselves. e.g. fluoridation of water and fortification of milk

• Active strategies-individuals are motivated to adapt specific health programs. e.g. weight reduction, smoking cessation

Determinants of Health• Smoking• Nutrition• Alcohol use• Habituating drug use• Driving• Exercise• Sexuality and contraception or barrier use• Family relationships• Risk factor modification• Coping and adaptation

Levels of Preventive Care

3 levels• Primary Prevention- precedes disease or

dysfunction and is applied to clients considered physically and emotionally healthy.

• Its not therapeutic and is not symptoms identification

• E.g. health education, immunization, physical and nutritional activities

Levels CONT’D

• Secondary Prevention-focuses on individuals who are experiencing health problems or illnesses and who are at risk for developing complications or worsening conditions

• Activities are directed at diagnosis and prompt interventions

• Delivered at the hospital, home,skilled nursing facility

• E.g. screening, and early detection of disease

Levels CONT’D

• Tertiary Prevention- occurs when a defect or disability is permanent and irreversible. Minimizing the effect of the disease or disability-complications, deterioration

• E.g. rehablitation

Risk Factors

• Any situation, habit , environmental condition, physiological or other variable that increases the vulnerability of an individual or group to illness or accident

• The presence of risk factor does not mean disease will develop but increases the chance of the individual to develop such a disease

• It can influence ones health status, health beliefs and HP and DP

Risk CONT’D

• Genetic and physiological factors

• Age

• Environment

• Lifestyle

Illness and Illness Behaviour

Variables that influence illness behaviour

• Internal-acute and chronic illnesses

• External – visibility of symptoms, social group, cultural background, economic variables, accessibility of health care system and social support

Stages of illness Behaviour (5 Stages)

Stage 1: (Symptom Experience)• Person is aware that there is something

wrong• Recognizes a physical sensation or limitation in

functioning but not specific diagnosis• It may be pain ,rash, lump• Evaluation of the symptom and decision • Emotional response

Stages CONT’D

Stage 2:( Assumption of the Sick Role)• If symptoms persist and become severe,

clients assume the sick role• Social phenomenon-seek confirmation from

family and society that they are ill and shd be excuse from their normal duties and role expectations

Stages CONT’D

• Social gp support- continued self medication

• Emotional changes such as withdrawal or depression and physical changes

Stages CONT’D

Stage 3: (Medical Care Contact)• If symptoms continue despite home remedies,

become severe or require emergency care, the person is motivated to seek professional health services

• Client seek for an explanation of the situation

• Some may deny disease and “shop”

Stages CONT’D

Stage 4: (Dependent Role)• Client depends on health professionals for

relief of symptoms• Accepts care, sympathy and protection from

demands and stress of life• It is socially accepted for client at this stage to

be relief of their roles or tasks• Adjust to the disruption of daily schedules

Stages CONT’D

Stage 5: (Recovery and Rehabilitation)• It can arrive suddenly-fever subsides

• If not long term care may be required

• May involve prolong reduction in health and functioning

Impact of Illness on Family and Client

• Behavioral and Emotional Changes

• Impact on family roles

• Impact on body image

• Impact on self concept

• Impact on family dynamics

Assignment