Health and Illness Continuum
Wellness
a state of well being and a component of health
WHO Definition of Health
"A state of complete physical, mental, and social wellbeing, not merely the absence of disease or infirmity (1947)." → more holistic view of health because the WHO's definition reflects concern on how a person functions as a whole (psychologically, physically and socially) → Describes people's lives (and therefore their health) to be affected everything they interact with like environment (climate, food availability, clean water), family, lovers, and etc.
Smith Model of Health
1. Clinical Model 2. Role Performance Model 3. Adaptive Model 4. Actualization Model (also known as Eudaemonistic Model)
Health Protection/Illness Prevention
A behavior that is geared towards preventing illness with early detection (to avoid disease development in the future).
Agent Host Environment Model
Also known as ecologic model or epidemiologic model. It is an illness model. 3 Dynamic Elements: 1.Agent (environmental factor/stressor that must be present ie: bacteria, chemical, radiation, virus) 2.Host (living organism capable of being infected or affected by an agent ie: human being, animal) 3.Environment (all the factors external to the host that make illness more or less likely) Transmission occurs when the infectious agent leaves the reservoir or host through a portal of exit, is conveyed/entered by a mode of transmission through a portal of entry to infect the susceptible host. This model is used to predict illness rather than promote wellness. Each factor are to constantly interact with each other. When in balance=health is maintained; When not in balance= disease occurs.
Smith Model of Health: Adaptive Model
Health= a creative process where one is able to adapt to the environment and interact with external stimuli Sickness/Disease= the failure to adapt (maladaptation) Treatment= restore the ability to adapt or cope → stability
Dunn's High Level Wellness Grid
Demonstrates the interaction of the environment with illness-wellness continuum 1. High level Wellness: functioning to one's maximum health potential while remaining in balance with the environment. Educated, knows about health and has abundance of resources 2. Emergent high-level wellness: is educated about health but poor environment affects living healthy (me) 3. Protected poor health/guarded: someone in poor health, but enough resources to be well taken care of 4. Poor health: starving child in poor country or homeless person with health chronic health condition
Types of Health Promotion Programs
Health Promotion (clinics) Specific Protection (immunization, nutrition programs..) Screening for early detection of disease
Smith Model of Health: Role Performance
Health is one's ability to fulfill/perform his or her's societal role (mother, daughter, friend) even if he/she has clinical illness.
Smith Model of Health: Clinical Model
Health is the absence of s/sx of a disease or injury (state of being "not sick"). Practitioners use the clinical model by trying to eliminate the s/sx, and when the s/sx is no longer present, the health is restored. The most narrow interpretation of health.
Smith Model of Health: Actualization (eudaemosnistic) model
Health is when one is able to reach self-actualization or realization of his/her own potential. To achieve self actualization is to achieve clinical, role, and adaptation model. Illness is when a condition prevents self-actualization. (ie: not meeting physiological needs)
Health Promotion
Helping an individual develop well being and actualizing health potential → IS: personal Motivation for behavior, expanding positive potential for health → IS NOT: disease oriented
Illness vs. Disease
Illness A personal subjective state which the person feels ill (but does not mean the person has a discernable disease). It can be discomfort with the person's physical, emotional, intellectual, social, development, or spiritual functioning. It is not synonymous with disease, because a person can feel ill but not have a disease (or vice versa). Disease An alteration in body f(x) that causes a person's normal lifespan to shorten. The causation of a disease is called its etiology.
Healthy People Leading Health Indicators (LHI)
Leading Health Indicators are the objectives chosen to improve american health.It includes a subset of high-priority health issues that represent significant threats to the public's health. There are 26 Leading Health Indicators (LHIs), are organized into 12 topic areas promote quality of life, healthy behaviors, and healthy development across all life stages) Some noteworthy progress indicators: Fewer adults smoking cigarettes Fewer children exposed to 2nd hand smoke More adults meeting physical activity targets Fewer adolescents using alcohol or illicit drugs
Wellness-Illness Continuum (Travis)
Movement to the right of neutral point: increasing levels of health and wellness → achieved through awareness, education and growth (ie: health promotion, disease prevention, positive attitude) Movement to the left of neutral point: decreasing level of health towards premature death → achieved with the progression of signs,symptoms and disability
Levels of Preventions to Promote Health
Primary Prevention: 1st level prevention to promote health by education, immunization & risk assessment Secondary Prevention: Emphasizes early detection of disease & prompt intervention (diagnostic test, surgery to remove cause of disease (ie: tumor)). Tertiary Prevention: Focuses on rehabilitation of patient or client whose disability has been fixed. → Goal: to return the p/c to optimal level of function. Ex: Physical Therapy
Healthy People 2020
provides science based agenda for improving the nation's health • Attain high-quality, longer lives free of disease, disability, and premature death. • Achieve health equity, eliminate disparities, and improve the health of all groups. • Create better environments that promote good health for all. • Promote quality of life across all life stages.
Health Care Practice: ADHERENCE
the extent to which an individual's behavior coincides with medical or health advice (ie: taking meds, following diets, making lifestyle changes) Locus of control and adherence: 1.Internal Locus of control: a social nursing theory used to determine if patient can control their own health. Patients w/ internal locus control are self determined and adherent to healthcare regimen. 2.External Locus of control: patient does not take control of own health. Patients w/ ext. locus of control are dependent on others.
Suchman's Stages of Illnesses
• Stage1. Symptoms experienced. Patient believes something is wrong. With treatment an illness can stop at this stage. • Stage 2. Assumption of the sick role; Accepts the sick role and seeks confirmation. When symptoms of illness persist or increase, the person is motivated to seek professional help. • Stage 3. Medical care contact; Seeks advice of health professional; validates illness. • Stage 4. Dependent client role; Accepts Dx & Rx give up independence • Stage 5. Recovery or rehabilitation. Person is expected to stop dependent role and expected to assume previous role and responsibility