MODELS OF HEALTH AND ILLNESS

By:

Mr. M. Shivanandha Reddy

• A model is a theoretical way of understanding a concept or idea.

• Models represent different ways of approaching complex issues.

• Nurses developed various health models to provide effective health care.

• The nursing models allows the nurses to understand and predict patients’ health behaviour.

Nursing models:

• Health Illness Continuum Model

• Health Belief Model

• Health Promotion Model

• Maslow’s Hierarchy Of Needs / Basic Human

Needs Model

• Holistic Health Models

Health Illness Continuum Model

• According to this model, health is a dynamic state that fluctuates as a person adapts to changes in the internal or external environments to maintain a state of well-being.

• Illness is a process in which the functioning of a client is diminished or impaired when compared with his/ her previous condition.

• In this model, high-level wellness and severe illness are at opposite ends of the continuum

• The person moves back and forth (forward) within this continuum day by day

• Wide ranges of health or illness are present.

Health Belief Model

• Rosenstoch and Becker and Maiman proposed the Health Belief Model.

• This model addresses the relationship between a person’s beliefs and behaviours.

• The Health Belief Model helps to understand the factors influencing patients’ perceptions, beliefs, and behaviour to plan the care.

• It has got three components:

1. Individual’s perception of susceptibility to an illness

2. Individual’s perception of the seriousness of the illness

3. Likelihood of taking preventive action

1. Individual’s perception of susceptibility to an illness

• The first component of this model involves an individual’s perception of susceptibility to an illness.

• For example, a patient needs to recognize the familial link for coronary artery disease.

• After this link is recognized, particularly when one parent and two siblings have died from myocardial infarction, the patient may perceive the personal risk of heart disease.

2. Individual’s perception of the seriousness of the illness

• This perception is influenced and modified by demographic and socio psychological variables, and cues to action (e.g., mass media campaigns and advice from family, friends, and medical professionals).

• For example, if a patient may not perceive his heart disease to be serious, which may affect the way he takes care of himself.

3. Likelihood of taking preventive action

• The third component—the likelihood that a person will take preventive action—results from a person’s perception of the benefits of taking action.

• Preventive actions include lifestyle changes, increased adherence to medical therapies, or a search for medical advice or treatment.

3. Health Promotion Model

• Dr. Nola Pender developed the Health Promotion Model (HPM)

• The health promotion model focuses on helping people achieve higher levels of well-being.

• It encourages health professionals to provide positive resources to help patients achieve desired changes.

• The goal of the HPM is not just about helping patients prevent illness through their behavior, but to promote better health or optimal health.

• The model focuses on the following three areas:

(1) Individual characteristics and experiences,

(2) Behavior specific knowledge and affect

(3) Behavioral outcomes

• HPM notes that each person has unique personal characteristics and experiences that affect subsequent actions.

• These variables can be modified through nursing actions.

• Health-promoting behaviour is the desired behavioural outcome and is the end point in the HPM.

• Health-promoting behaviours result in improved health, enhanced functional ability, and better quality of life at all stages of development

4. Maslow’s Hierarchy of Needs

• Proposed by “Abraham Maslow”

• Basic human needs are elements that are necessary for human survival and health

(e.g., food, water, safety, and love).

• Although each person has other unique needs, all people share the basic human needs, and the extent to which basic needs are met is a major factor in determining a person’s level of health.

• According to this model, certain human needs are more basic than others (i.e., some needs must be met before other needs [e.g., fulfilling the physiological needs before the needs of love and belonging]).

• Self-actualization is the highest expression of one’s individual potential and allows for continual discovery of self.

• After fulfillment of the basic needs only the person aims at higher level needs.

• The hierarchy of needs model provides a basis for nurses to care for patients of all ages in all health settings.

• when applying the model, the focus of care is on the patient’s needs rather than on strict adherence to the hierarchy.

• It is unrealistic to always expect a patient’s basic needs to occur in the fixed hierarchical order

5. Holistic Health Models

• Health care has begun to take a more holistic view of health by considering emotional and spiritual well-being and other dimensions of an individual as important aspects of physical wellness.

• The holistic health model of nursing attempts to create conditions that promote optimal health.

• In this model, nurses using the nursing process consider patients to be the ultimate experts concerning their own health and respect patients’ subjective experience as relevant in maintaining health or assisting in healing.

• In the holistic health model patients are involved in their healing process, thereby assuming some responsibility for health maintenance

• Nurses using the holistic nursing model recognize the natural healing abilities of the body and incorporate complementary and alternative interventions such as music therapy, relaxation therapy, therapeutic touch, and guided imagery.

• Nurses use holistic therapies either alone or in conjunction with conventional medicine.

• For example,

• Music therapy in the operating room creates a soothing environment.

• Relaxation therapy is frequently useful to distract a patient during a painful procedure such as a dressing change.

• Breathing exercises are commonly taught to help patients deal with the pain associated with labor and delivery.