Date post: | 16-Aug-2015 |
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Health & Medicine |
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Dr. Naglaa F. A. Youssef
Lecturer
Medical Surgical Nursing Dep.
Faculty of Nursing
Cairo University
Content outlines
Definitions of terms: health, disease, illness and wellness or well-being
Concept of health
Models of health & illness
Factors affecting health belief, health status and practice
Levels of prevention
Illness classifications
Impact of illness on patients & family
Role of the nurse in promotion & maintenance of health Identify risk factors
Follow levels of prevention
Health: is a broad term, individualized to each person, and is
affected by so many factors, thus it has various definitions.
Disease: is a pathological change in structure &/or function……signs.
Illness: is the response of person to disease, which is based on the person’s perception……symptom.
Wellness (health): is a status in which individual is capable of meeting the minimum physical, psychological and social requirements of appropriate functioning.
Glossary
Self-concept (also called self-construction, self-identity, self-perspective or self-structure). It is a collection of beliefs about oneself that includes elements such as academic performance, gender roles and sexuality, and racial identity.
Glossary
Dimensions of wellness
Health and illness:
are not static conditions,
They are vital concepts,
They are subject to continuous evaluation and
change.
First definition:
In 1948, the World Health Organization
(WHO) defines health as “a state of complete
physical, mental and social well-being and
not merely the absence of infirmity and
disease”.
Definitions of Health
1. Health is a multidimensional concept that includes different interdependent and interrelated aspects, i.e.
Feeling of health can be with or without disease.
Based on the WHO definition
Mental health
Social health Well-being
Physical health
Bio-psychosocial dimensions of health
Characteristics of the WHO definition of health
1. Considers the individual as a holistic system.
2. Looks at the internal and external factors.
3. Acknowledges the individual’s role in life and his
value.
However, there is no general agreement about this
definition of health.
Second definition of Health
Potter & Perry (2014) define health as a “ dynamic state, in which the individual adapts to changes in internal and external environments to maintain a state of well-being”.
Characteristics of the second definition of health
Considers health as a dynamic status, which can be changed from time to time.
Acknowledges the relationship between internal and external environment and health status.
Recognizes the importance of adaptation to maintain state of health and well-being.
Models of health and illness
1. Health-illness continuum
2. Agent-host environment model
3. High-Level Wellness Model
4. Health belief model
5. Health promotion model
1. Health-illness continuum model (adapted)
Disability symptoms Signs Awareness Education Growth
Premature death
High level
wellness Treatment model
Psychosocial model Medical model
Nursing/care providers interventions
Main idea of health-illness continuum model
Health and illness are seen as relative concepts and
not as separate absolutes.
Health and illness as a graduated scale has two ends.
Health is a dynamic state that fluctuates as a person
adapts to changes in the internal and external
environments to maintain a state of well- being.
2. Agent–Host Environment Model
This model is used primarily in describing causes of illness rather than in promoting wellness.
It helps in identifying risk factors that
result from interaction of agent-host-environment.
Agent
Host
Environment
Any internal or external factor or stressor
(biological, chemical, mechanical, physical, or psychological) that by its
presence or absence (e.g. lack of essential nutrients → illness or
disease).
Person's who may be at risk of acquiring a disease.
External factors that make illness more or less likely.
Physical environment → climate, living conditions, sound (noise) levels, and economic level.
Social environment → interaction with others and life events, such as death of spouse, stress, or conflicts.
Components of this model
• When each of the agent-host-environment factors are in
balance, health is maintained and when not in balance
disease occurs (fluid, electrolytes, vitamins,…etc.
Factors affecting health belief, health status and practice
Factors
Internal factors
External factors
A. Internal Factors affecting health belief, health status and practice
A-Biological dimension
Developmental stage e.g. age,
Heredity, genetics, race, and gender
B-Psychological dimension:
Mind-body interaction
Self-concept
Emotional factors
C-Cognitive / intellectual dimension:
Life-style choices Patterns of eating and exercise, use of tobacco, abuse of drugs and alcohol.
Spiritual and religious beliefs
B. External Factors affecting health belief, health status and practice
Family practices
Socioeconomic status
Cultural background
Social support networks
Levels of Preventive Care
Tertiary prevention
Secondary prevention
Primary prevention Health promotion and protection
Early diagnosis, treatment and disability limitation
Restoration and rehabilitation
? Give example
The Illness Classifications
I. Acute illness: – Short term < three
months. – Severe symptoms
appear suddenly.
Result in:
– Complete recovery, – Death, or – Develop into a
chronic disease.
II. Chronic illness: – long term > 3 months, – Less severe symptoms,
and – Slow onset.
Result in:
– A state of optimizing patient’s levels of functioning.
– A state of optimizing patient’s ability to live with the illness (coping).
Care for patient and his family as one unit
Impact of Illness on patient and family
Illness is never an isolated life event.
Behavioral and emotional changes
Impact on body image
Impact on self concept
Impact on family roles
Impact on family dynamics
1. Behavioral and emotional changes
People react differently to illness.
Reaction to illness depends on:
Nature of illness e.g. duration, severity.
Client’s attitude toward the illness.
The others’ reaction (e.g. family) to the client’s illness.
E.g. life threatening illness can lead to more extensive emotional and behavioral changes, such as anxiety, depression, shock, denial, anger and withdrawal. Example of leg amputation…..
3. Impact on Body Image
Body image has been defined as “the subjective concepts of
physical appearance’’ (Potter and Perry 2014).
Reaction to changes differently according to:
Type and rate of changes,
Individual's capacity of adaption, and
Availability of supportive health service.
2. Impact on family roles
People have various social role in and out their families,
such as work, decision maker and parent.
When illness occurs, the client’s and family’s role may
change.
The change may be slight or huge based on the disease
duration and severity, and people ability to cope.
Nurses should involve the patient’s family in the
care plan.
5. Impact on Family Dynamics
It means the process of family coping,
making decision and giving support.
Activities & decision making delay action,
new pattern of functioning stress &
reversal of roles → stress & conflicting
responsibilities.
Each client responds uniquely to illness →
nursing assessment, diagnosis, and
interventions must be individualized.
Role of the Nurses in the Promotion & Maintenance of Health
Maintaining or improving the person’s perception about his/her health status is a central goal of nursing practice.
A nurse can determine a client’s level of health using the health-illness continuum.
Then, a nurse can help the patient/client to identify his/her position on the health-illness continuum. This can guide to set a goal for achieving optimal health.