Module: HN 0106 FOUNDATION OF NURSING
2
Title: THE CONCEPT
OF HEALTH & ILLNESS
Concept of health and illness
Learning Objectives:1.Definition of health and illness2.Identify Illness and illness behaviour3.Identify factors influencing health4.Describe the impact of illness on
patient and family 5.Health care services: health
promotion and prevention of illness
Definition of health and illness“Health is a state of complete physical, mental and social
well-being and not merely the absence of disease or infirmity (sickness)” (WHO, 1974).
“ Health 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 Commission, 1953).
Health is being well and using one’s power to the fullest extent. Health is maintained through prevention of disease via environmental health factors (Nightingale).
HEALTH is the ability to maintain the internal milieu. Illness is the result of failure to maintain the internal environment (Claude Bernard).
Definition cont’...
• Illness is a personal (physical, emotional, intellectual, social, developmental or spiritual) state in which the person feels unhealthy.
• Most people define and describe health as:– Being free from 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 of the time
• Health and illness are highly individualized perceptions
Definition of illness
• Illness is a personal (physical, emotional, intellectual, social, developmental or spiritual) state in which the person feels unhealthy.
• Disease is an alteration in body functions resulting in reduction of capacities or shortening of normal life span.
• May or may not be related to disease
• An individual could have a disease Eg. Growth in the stomach and not feel ill. However, some token, a person can feel ill – uncomfortable
• Illness is highly subjective
• Only he or she can say he or she is ill.
Model: Health and Illness
Model of health
The Iceberg Model of Health and Disease
Factors influencing healthPRECURSORS (underpinning) OF ILLNESS
1. Heredity- family history for diabetes mellitus; hypertension; cancer
2. Behavioral factors- cigarette smoking; alcohol abuse; high animal fat intake
3. Environmental factors- overcrowding; poor sanitation; poor supply of potable water
1.PHYSICAL DIMENSION
• Genetic make-up, age, developmental level, race and sex are all part of an individual’s physical dimension and strongly influence health status and health practices.
FACTORS AFFECTING HEALTH AND ILLNESS
FACTORS AFFECTING HEALTH AND ILLNESS Cont’…
2. EMOTIONAL DIMENSIONS • How the mind and body interact to affect
body function and to respond to body conditions also influences health. Long-term stress affects the body systems and anxiety affects health habits; conversely, calm acceptance and relaxation can actually change body responses to illness.
Factors affecting health and illness Cont’…
3. INTELLECTUAL DIMENSION • The intellectual dimension
encompasses cognitive abilities, educational background and past experiences. These influence a client’s responses to teaching about health and reactions to health care during illness. They also play a major role in health behaviors.
Factors affecting health and illness Cont’…
4. ENVIRONMENTAL DIMENSION
• The environment has many influences on health and illness. Housing, sanitation, climate, and pollution of air, food and water are aspects of environmental dimension.
Factors affecting health and illness Cont’…
5. SOCIOCULTURAL DIMENSION • Health practices and beliefs are strongly
influenced by a person’s economic level, life style, family and culture. Low-income groups are less likely to seek health care to prevent or treat illness; high-income groups are more prone to stress-related habits and illness. The family and the culture to which the person belongs determine patterns of living and values about health and illness that are often unalterable.
Factors affecting health and illness Cont’…
6. SPIRITUAL DIMENSION
• Spiritual and religious beliefs and values are important components of the way the person behaves in health and illness.
Levels of prevention
• PRIMARY PREVENTION – Providing specific protection against disease to
prevent its occurrence is the most desirable form of prevention.
– Primary preventive efforts spare the client the cost, discomfort and the threat to the quality of life that illness poses or at least delay the onset of illness.
– Preventive measures consist of counseling, education and adoption of specific health practices or changes in life style.
Levels of prevention Cont’…
• SECONDARY PREVENTION – It consists of organized, direct
screening efforts or education of the public to promote early case finding of an individual with disease so that prompt intervention can be instituted to halt pathologic processes and limit disability.
– Early diagnosis of a health problem can decrease the catastrophic effects that might otherwise result for the individual and the family from advanced illness and its many complications.
Levels of prevention Cont’…• TERTIARY PREVENTION
– It begins early in the period of recovery from illness and consists of such activities as consistent and appropriate administration of medications to optimize therapeutic effects, moving and positioning to prevent complications of immobility and passive and active exercises to prevent disability.
– Continuing health supervision during rehabilitation to restore an individual to an optimal level of functioning. Minimizing residual disability and helping the client learn to live productively with limitations are the goals of tertiary prevention (Pender, 1987).
STAGES OF ILLNESS BEHAVIOR
STAGE 1: SYMPTOM EXPERIENCE • The person is aware that "something is
wrong". A person usually recognizes a physical sensation or a limitation in functioning but does not suspect a specific diagnosis. The person's perception of a symptom includes awareness of a physical change such as pain, a rash or a lump; evaluation of this change and a decision that it is a symptom of an illness, and an emotional response.
Stages of illness behavior Cont’…
STAGE 2 : ASSUMPTION OF THE SICK ROLE
• If symptoms persist and become severe, clients assume the sick role. At this point the illness becomes a social phenomenon, and sick people seek confirmation from their families and social groups that they are indeed ill and that they be excused from normal duties and role expectations.
Stages of illness behavior Cont’…
STAGE 3: MEDICAL CARE CONTACT
• If symptoms persist despite the home remedies, become severe, or require emergency care, the person is motivated to seek professional health services. In this stage the client seeks expert acknowledgement of the illness as well as the treatment.
Stages of illness behavior Cont’…
STAGE 4 : DEPENDENT CLIENT ROLE
• The client depends on health care professionals for the relief of symptoms. The client accepts care, sympathy and protection from the demands and stresses of life. A client can adopt the dependent role in a health care institution, at home, or in a community setting. The client must also adjust to the disruption of a daily schedule.
Stages of illness behavior Cont’…
STAGE 5 : RECOVERY AND REHABILITATION
• This stage can arrive suddenly, such as when the symptoms appeared. In the case of chronic illness, the final stage may involve in an adjustment to a prolonged reduction in health and functioning
Health promotion• The process of enabling people to in areas
to control over and to improve health
• Health education
• Environmental modifications
• Nutritional interventions
• Lifestyle and behavioral changes
Specific protection• Immunization
• Specific nutrients
• Chemoprophylaxis
• Protection against occupational hazards
• Protection from carcinogens
• Avoidance of allergens
Rehabilitation• The combined and coordinated use of
medical, social, educational and vocational measures for training and retraining the individual to the highest possible level of functional ability. Examples-schools for blind, reconstructive surgery in leprosy, provision of aids for the crippled
Intervention approaches:• Individual-focused (personal health)
• Community-focused (population or subgroup)
• System-focused (procedures, rules, regulations, policy and law)
Thank You