disease and its causation

8/11/2019 Disease and Its Causation

1/36


2/36

Healthisastateofcompletephysical,mental

andsocialwell-beingandnotmerelythe

absenceofdiseaseorinfirmity.(WHO)

Healthistheabilitytomaintaininternalmilieu,

homeostasisordynamicequilibrium.


3/36

Healthisbeingwellandusingonespowertothe

fullestextent.Healthismaintainedthrough

preventionofdiseaseviaenvironmentalhealthfactors.(Nightingale)Healthisviewedinterms

oftheindividualsabilitytoperform14

componentsofnursingcareunaided.

(Henderson)


4/36

Healthisastateandaprocessofbeingand

becominganintegratedandwholeperson.

(Roy)Healthisastatethatischaracterizedbysoundnessorwholenessofdeveloped

humanstructuresandofbodilyandmental

functioning.(Orem)Healthisadynamicstateinthelifecycle.(King)


5/36

Healthisanelusive,dynamicstateinfluenced

bybiologic,psychologic,andsocialfactors.

Healthisreflectedbytheorganization,interaction,interdependenceandintegration

ofthesubsystemsofthebehavioral

systems.(Johnson)Illnessistheresultoffailuretomaintaintheinternalenvironment.

Wellnesssymbolizespositivehealth.Itisa

valuetermdefinedbythecultureorindividual.


6/36

DIMENSIONS OF HEALTHPHYSICAL SPIRITUAL

MENTAL EMOTIONAL

SOCIAL VOCATIONAL


7/36

Body size, shape, sensory acuity&responsiveness, fitness, andsusceptibility to disease and

disordersAbility to perform activities of daily

living (ADLs)

The techniques of physical health

assessment are general andspecific observations, questioning,physical and chemicalexaminations and investigations,

nutrition and dietary assessment.


8/36

There are 3 major characteristics:

He is free from internal conflicts andtensions. He knows himself andneither underestimates nor

overestimates, accepts hisshortcomings. He is self confidentand has self identity and selfesteem. He does not have unduespells of depression or elatedmood.

He is able to feel a part of others andhas harmonious relation with others

He is well adjusted and able to meetthe demands of life and able to

solve the problems intelligently


9/36

SOCIAL HEALTH

Man is a social well being.

Social health is rooted in-

-- Positive material

environment focusing on

financial and residential

matters and

-- Positive human

environment which is

concerned with the social

network of the individual.


10/36

SPIRITUAL HEALTH

Belief in supreme being

Feeling of oneness with

others and nature

Guiding sense of

meaning or value

Purpose in life


11/36

EMOTIONAL HEALTH

Ability to express emotions

appropriately, controlling

emotions

Self esteem and self

confidence

Ability to trust, love, etc.

Mental health can be seen

as knowing or cognition

while emotional health

relates to feeling .


12/36

VOCATIONAL

The vocational dimension is part of humanexistence.

When work is fully adapted to humangoals, capacities and limitations, workoften plays a role in promoting bothphysical and mental health.

Physical work is usually associated withan improvement in physical capacity,while goal achievement and selfrealization in work are a source ofsatisfaction and enhanced self esteem


13/36

Intellectual Dimension -encompassescognitive

abilities,educationalbackgroundandpast

experiences.Theseinfluenceresponsestoteachingabouthealthandreactionstonursing

careduringillness.Theyalsoplayamajorrole

inhealthbehaviors.Environmental Dimension housing,sanitation,

climateandpollutionofair,foodandwaterare

elements in the environmental dimension.


14/36


15/36

Illnessisahighlypersonalstateinwhichthe

personsphysical,emotional,intellectual,social,

developmentalorspiritualfunctioningisthoughttobediminished.Illnessishighlysubjective

anditisnotsynonymouswithdiseaseandmay

ormaynotberelatedtodisease.


16/36


17/36


18/36

DiseasecanbesimplyexplainedAs

dis=No,ease=comfortable=dis-comfortable

orillhealthDeviationfromnormalfunctionAdisturbanceinequilibriumbetweenmanandhis

totalenvironment.Diseaseisadisorderor

malfunctionofthemindorbody,whichleadstoadeparturefromgoodhealth.Canbea

disorderofaspecifictissueororganduetoa

single cause.


19/36

Webster:Aconditioninwhichbodyhealthis

impaired,adeparturefromstateofhealth,an

alterationofhumanbodyinterruptingtheperformanceofvitalfunctions

Oxford:Aconditionofthebodyorsomepartor

organofthebodyinwhichitsfunctionsaredisruptedorderanged


20/36

EcologicalDef.:amaladjustmentofthehuman

organismtotheenvironmentSociological:diseaseisasocialphenomena,

occurringinallsocietiesdefinedandfoughtin

termsofparticularculturalforcesprevalentinthesociety


21/36

SUPERNATURALTHEORYOFDISEASE

GERMTHEORY-LouisPasteur,RobertKoch

EPIDEMIOLOGICALTRIAD

MULTIFACTORIALTHEORY

Webofdiseasecausation,

Wheelofcausation


22/36

SUPERNATURALTHEORYOF

DISEASE: Intheearlypast,thediseasewasthought

mainlyduetoeitherthecurseofGodordueto

theevilforceofthedemons.Accordingly,

peopleusedtopleasetheGodsbyprayersand

offeringsorusedtoresorttowitchcrafttotame

thedevils.


23/36

Germtheorybecamepopularinthe19 thandearly

partof20thcentury.Thistheoryattributes

microorganismsareearlycauseofdisease.Accordingtothistheorythereissinglespecific

microorganism(Causativeagentstoevery

disease.Thisreferstoonetoonerelationshipbetweencausativeagentanddiseasesoitis

calledassinglecausetheory.

E g Cholera due to Vibrio cholere


24/36

Causativeagent Man Disease

Cause Effect

Thistheoryislimitedtoinfectiousdiseasesonly.

Thistheorywasfurthersupportedby

identificationofotherspecificagentsas

causativeagentsforcertainhealthproblems.

e.g.lackofVit.Cwasfoundtocausescurvy.


25/36

Thegermtheoryorsinglecausetheoryhasmany

limitations

e.g.T.B.AllthosewhowereexposedtotheT.B.didnot

sufferfromtuberculosis.Onlythosewhowere

undernourished,liveindarkanddirtyplacesandwhodidnothaveimmunityagainst

Tuberculosisgotthedisease.


26/36


27/36

-Agent:Itisconsideredtobeprimaryfactor

E.g.bacteria,amoeba,viruswithoutwhich

diseasecantoccur

-Host: Humanbeingswhocarriesintocontact

withtheagents.Thehostrelatedfactorswhich

playimportantrolei.e.genetic,age,sex,race,

immunity,healthbehavioretc.

-Environment: Itincludesexternaltohostand

agentbutmayinfluenceinteractionbetween

them


28/36


29/36

EpidemiologicalTriadmodelisapplicableto

infectiousdiseaseonly.Ithelpstounderstand

differentfactorsrelatedtocommunicable

diseasebutitisnotapplicabletononinfectiousandchronicdiseaseslikeheartdisease,arthritis

Itisbecausethesediseasesarenotlinkedwith

specificcausationagentandcantbepreventedandcontrolbyisolation,immunization

techniquesandimprovementofsanitationlike

infectious disease


30/36

Thesediseasescausedbymultiple

factorsfore.g.coronaryheart

diseaseisassociatedwithlifestyleactivitieslike

smoking

ingestionoffood(cholesterol)lackofexercise

Increasedmentalandemotionalstress.

Environmental pollution


31/36


32/36

TheWebofcausationDevelopedtode-

emphasizeagentChainofcausationMultiple

factorspromoteorinhibitEmphasizesmultipleinteractionsbetweenhost

andenvironmentIllustratestheinter-

connectednessofpossiblecausesSuitedforchronicdiseasesUsefulindeveloping

possibleinterventions


33/36


34/36

Thetermnaturalhistoryofdiseaseisakey

conceptinepidemiologyitssignifiestheway

inwhichadiseaseevolvesovertimefromearlieststageofitspre-pathogenesisphaseto

itsterminationasrecovery,disabilityordeath,

inabsenceoftreatmentorprevention.Eachdiseasehasitsownuniquenaturalhistory

whichisnotnecessarilythesameinall

individuals.


35/36

Accordingtothisconceptdiseasemaybe

comparedwithiceberg-thefloatingtip

oftheicebergrepresentstheclinicalcases[s/s]

Thevastsubmergedportionoficeberg

representsthehiddenmassofdiseasethatislatent.inapparent,pre-symptomic

andundiagnosedcases


36/36

disease and its causation

Documents