Chapter 4 Health and Illness

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Copyright 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Chapter 4Health and Illness


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Definitions of Health States

Health: a state of complete physical, mental, and socialwell being, not merely the absence of disease

Illness: the unique response of a person to a disease

Wellness: an active state, oriented toward maximizingthe potential of the individual


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Human Dimensions of Health

Physical

Intellectual

Emotional

Sociocultural

Spiritual

Environmental aspects


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The Human Dimensions Composing theWhole Person


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Acute Illness

Generally has a rapid onset of symptoms and lasts only arelatively short time

Examples: appendicitis, pneumonia, diarrhea, commoncold


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Chronic Illness

A broad term that encompasses many different physicaland mental alterations

Examples: diabetes mellitus, lung disease, arthritis, lupus


7/31Copyright 2008 Wolters Kluwer Health | Lippincott Williams & Wilkins

Characteristics of a Chronic Illness

It is a permanent change

It causes, or is caused by, irreversible alterations innormal anatomy and physiology

It requires special patient education for rehabilitation

It requires a long period of care or support



Stages of Illness Behavior

Experiencing symptoms

Assuming the sick role

Assuming a dependent role

Achieving recovery and rehabilitation



Models of Health and Illness

The agent-host-environment model

The healthillness continuum

The high-level wellness model

The health belief model

The health promotion model



Agent-Host-Environment Model (Leavelland Clark)

Examines the causes of disease in an individual

Agent, host, and environment interact in ways that

create risk factors Understanding the risk factors is important for the

promotion and maintenance of health

The host reaction is influenced by family history, age,

and health habits The environment includes physical, social, biologic, and

cultural factors

Each of the agent-host-environment factors affects and is

affected by the others



The Agent-Host-Environment Triangle



The HealthIllness Continuum

Measures a persons level of health

Views health as a constantly changing state with high-level wellness and death on opposite sides of acontinuum

Illustrates the dynamic (ever-changing) state of health



The HealthIllness Continuum



The High-Level Wellness Model (Dunn)

Encourages the nurse to care for the total person

Involves functioning to ones maximum potential whilemaintaining balance and a purposeful direction

Regards wellness as an active state, oriented towardmaximizing the potential of the individual, regardless ofhis or her state of health

Incorporates the processes of being, belonging,becoming, and befitting



The Health Belief Model (Rosenstock)

Concerned with what people perceive to be true aboutthemselves in relation to their health

Modifying factors for health include demographic,sociopsychological, and structural variables

Based on three components of individual perceptions ofthreat of a disease

Perceived susceptibility to a disease

Perceived seriousness of a disease

Perceived benefits of action



The Health Promotion Model (Pender)

Illustrates the multidimensional nature of personsinteracting with their environment as they pursue health

Incorporates individual characteristics and experiencesand behavior-specific knowledge and beliefs, to motivatehealth-promoting behavior

Personal, biologic, psychological, and sociocultural

factors are predicative of a certain health-related habit Health-related behavior is the outcome of the model and

is directed toward attaining positive health outcomes andexperiences throughout the lifespan



Factors Affecting Health Status, Beliefs,and Practices

Risk factors for illness

Factors in the human dimensions that influence healthillness status

Beliefs and practice

Basic human needs

Self-concept



The Human Dimensions Physical dimensiongenetic inheritance, age,

developmental level, race, and gender

Emotional dimensionhow the mind affects body

function and responds to body conditions Intellectual dimensioncognitive abilities, educational

background, and past experiences

Environmental dimensionhousing, sanitation, climate,pollution of air, food, and water

Sociocultural dimensioneconomic level, lifestyle, family,and culture

Spiritual dimensionspiritual beliefs and values



Basic Human Needs

Physiological needs

Safety and security needs

Love and belonging needs

Self-esteem needs

Self-actualization needs


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Factors That Influence aPersons Self-Concept

Past experiences

Interpersonal interactions

Physical and cultural influences

Education


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Levels of Preventive Care

Primary preventione.g., diet, exercise, immunizations

Secondary preventione.g., screenings, mammograms,family counseling

Tertiary preventione.g., medications, surgicaltreatment, rehabilitation


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Question

Which of the following is an example of an acute illness?

A. Diabetes

B. Rheumatoid arthritis

C. Pneumonia

D. Osteoporosis


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Answer

Answer: C. Pneumonia

Rationale:

Pneumonia is an acute illness that has a rapid onset ofsymptoms and lasts only a relatively short time.Diabetes, rheumatoid arthritis, and osteoporosis arechronic illnesses that cause a permanent change, require

special patient education for rehabilitation, and require along period of care or support.


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Question

Tell whether the following statement is true or false.

A person who is experiencing a productive cough andfever takes a sick day to recuperate and decide whetherto make an appointment with the doctor. This person issaid to be in stage 3 of illness behavior: assuming adependent role.

A. TrueB. False


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Answer

Answer: B. False

A person who defines himself as sick and self-medicatesor visits a doctor is said to be in stage 2 of illnessbehavior: assuming the sick role.


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Question

Which of the following models of health and illness viewshealth as a constantly changing state, with high-level

wellness and death being on opposite ends of agraduated scale?

A. Agent-host-environment model

B. Health-illness continuum

C. High-level wellness model

D. Health belief model


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Answer

Answer: B. Health-illness continuum

Rationale:

The health-illness continuum measures a persons levelof health on a graduated scale.

The agent-host-environment model refers to theinteraction of the agent, host, and environment creatingrisk factors that must be examined.

The high-level wellness model involves functioning tomaximum potential with balance and direction.

The health belief model is concerned with what peoplebelieve to be true about their health.


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Question

Tell whether the following statement is true or false.

A person who keeps in touch with neighbors in anattempt to foster a community feeling is promoting hisor her emotional human dimension.

A. True

B. False


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Question

Which of the following is an example of a nursing activitythat promotes secondary prevention as a level of

preventive care?A. Conducting a smoking cessation class

B. Performing a blood pressure screening at a local mall

C. Performing range-of-motion exercises on a bedriddenpatient

D. Promoting safe sex practices in school settings


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Answer

Answer: B. Performing a blood pressure screening at alocal mall

Rationale:

Secondary preventive care focuses on early detection ofdisease, such as the heart disease in this example.

Primary preventive care is directed toward promotinghealth and preventing diseases.

Tertiary care begins after an illness is diagnosed toreduce disability and rehabilitate patients.


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Answer

Answer: B. False

A person who keeps in touch with neighbors in an

attempt to foster a community feeling is promoting hisor her sociocultural human dimension.

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Chapter 4 Health and Illness

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