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HEALTH
“Is a complete physical, mental and social well-being, and not merely the absence of disease or infirmity” (WHO, 1947)
“Is not a condition; it is an adjustment. It is not a state but a process. The process adapts the individual not only to our physical, but also our social environments” (President’s Commission, 1953)
Health
• Being free of symptoms of disease and pain as much as possible
• Being able to be active and able to do what they want or must
• Being in good spirits most in time
WELLNESS & WELL-BEING
• Wellness is a state of well-being
• Wellness is the integration of body, mind and spirit—the appreciation that everything you do and think, and feel, and believe has an impact on your state of health
• Well-being is a subjective perception of balance, harmony and vitality
Smith’s models of health
1. Clinical model2. Role performance model3. Adaptive model4. Eudaemonistic model
Smith’s Clinical Model
• The narrowest interpretation of health occurs in the clinical model
• The focus of many medical practices is the relief of signs and symptoms of disease and the elimination of malfunctioning and pain. When the signs and symptoms of disease are no longer present in a person, the medical practitioner often considers that the individual’s health is restored.
Smith’s Role Performance Model
• Health is defined in terms of the individual’s ability to fulfill societal roles, that is to perform work
• According to this model : people who can fulfill their roles are healthy even if they appear clinically ill.
Smith’s Adaptive Model
The focus of the adaptive model is adaptation
Health is a creative process and disease is a failure in adaptation or maladaptation.
Smith’s Eudaemonistic
• This model is incorporates the most comprehensive view of health.
• Health is seen as a condition of actualization or realization of a person’s potential.
Leavell and Clark’s Agent-Host-Environment Model
• The model is used primarily in predicting illness rather than in promoting wellness, although identification of risk factors that result from the interaction of the agent-host-environment are helpful in promoting and maintaining health.
Health-illness Continua
• Grids or graduated scales can be used to measure a person’s perceived level of wellness.
Differentiating health status, beliefs & behaviors
• Health statusState of health of a person at a given time• Health beliefsConcept about health that an individual believes
trueSome of it are influenced by culture• Health behaviorThe actions people take to understand their health
state, maintain an optimal state of health, prevent illness and injury, and reach their maximum physical and mental potential.
Internal factors
• Biologic dimensionGenetic makeup, race, sex, age, and
developmental level• Psychologic dimensionMind-body interaction, self-concept• Cognitive dimensionLife-style choices and spiritual and
religious beliefs
External factors
• Geography• Environment• Standards of living• Family and cultural beliefs• Social support network
Health care compliance
• Is the extent to which an individual’s behavior coincides with medical or health advice
Factors influencing compliance
• Patient motivation to become well• Degree of life-style change
necessary• Perceived severity of the health
care problem• Value placed on reducing the
threat of illness• Difficulty in understanding and
performing specific behaviors• Degree of inconvenience of the
illness itself or of the regimen
Factors influencing compliance
• Belief that the prescribed therapy or regimen will or will not help
• Complexity, side-effects, and duration of proposed therapy
• Specific cultural heritage that may make compliance difficult
• Degree of satisfaction and quality and type of relationship with the health care providers
• Overall cost of prescribed therapy
How to cope??
• Establish why the patient is not following the regimen
• Demonstrate caring• Encourage healthy behaviors through
positive reinforcement• Use aids to reinforce teaching• Establish a therapeutic relationship of
freedom, mutual responsibility with the patient and support person
Illness is a highly personal state in which the person feels unhealthy or ill.
Disease is a term that can be described as an alteration in body functions resulting in a reduction of a capacities or a shortening of the normal life span.
Effects of illness
• Privacy is often affected• Give up much their autonomy• Financial burden• A change in life-style
Illness also affects the family or significant person
Promoting health and wellness
• Can be achieve through Health Promotion
• Types of health promotion programs:Information disseminationHealth appraisal/ wellness assessment
programsLife-style and behavior change programsWorksite wellness programsEnvironmental control programs
The nurse’s role in health promotion
• Model healthy life-style behaviors and attitudes• Facilitates patient involvement in the
assessment, implementation and evaluation of health goals
• Teach patients self-care strategies to enhance fitness, improve nutrition, manage stress and enhance relationships
• Assist individuals, families and communities to increase their levels of health
• Teach patient to be effective health care consumers
The nurse’s role in health promotion
• Assist patients, families and communities to develop and choose health-promoting options
• Guide the patients’ development in effective problem solving and decision making
• Reinforce the patients’ personal and family health-promoting behaviors
• Advocate in the community for changes that promote a healthy environment