1. ILLNESS, WELLNESS AND
HEALTH

2. DEFINITIONS OF HEALTH
• World Health
Object 5
Organization
– Health is the state of
complete physical,
mental, social (totality)
well-being and not
merely the absence of
disease or infirmity

3. DEFINITIONS OF HEALTH
• Health is individually defined by each person
• On a personal level, individuals define health
according to
– how they feel
– absence or presence of symptoms of illness
– and ability to carry out activities

4. Wellness
• An integrated method of functioning which
is oriented toward maximizing the potential
of which the individual is capable.
• It requires that the individual maintain a
continuum of balance and purposeful
direction within the environment where he
is functioning. (Halbert Dunn)

5. DISEASE
• Objective pathologic process
• Pathologic change in the structure or function of
the mind and body

6. DISEASE
• Acute
– Rapid onset of symptoms
– Some are life threatening
– Many do not require medical treatment

7. DISEASE
• Chronic
– Broad term that encompasses many different
physical and mental alterations in health
• It is a permanent change
• Requires special patient education for
rehabilitation
• Requires long term of care and support

8. Illness
• A highly personal state in which the
person feels unhealthy, may or may not
related to disease.

9. ILLNESS
• Highly subjective
feeling of being sick
or ill
• How the person
feels towards
sickness
• Concerns the Nurse

10. ELEVEN STAGES OF ILLNESS
AND HEALTH-SEEKING
BEHAVIOR BY SUCHMAN
• 1. Symptom Experience
– Client realizes there is a problem
– Client responds emotionally
• 2. Sick Role Assumption
– Self-medication / Self-treatment
– Communication to others

11. ELEVEN STAGES OF ILLNESS AND
HEALTH-SEEKING BEHAVIOR BY
SUCHMAN
• 3. Assuming a Dependent Role
– Accepts the diagnosis
– Follows prescribed treatment
• 4. Achieving recovery and rehabilitation
– Gives up the dependent role and assumes
normal activities and responsibilities

12. Well-being
• A subjective perception of balance,
harmony and vitality

13. Dimensions of Wellness

14. 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 practice.
– Examples
• The toddler just learning to walk is prone to tall and injure
himself.
• The young woman who has a family history of breast cancer
and diabetes is at a higher risk to develop these conditions.

15. Emotional Dimensions
• Refers to feelings, affect and person’s ability to
express these;
• includes belief in one’s worth.
• long-term stress affects the body systems and
anxiety affects health habits; conversely, calm
acceptance and relaxation can actually change
body responses to illness.

16. Intellectual Dimension
• encompasses cognitive abilities,
educational background and past
experiences; positive sense of purpose.
• These influence a client’s response to
teaching about health and reactions to
health care during illness.

17. Environmental Dimension
• The ability to promote health measures
that improve the standard of living and
quality of life in the community.
• includes influences such as food, water,
and air.

18. Socio-cultural Dimensions
• Concerns the sense of having support
available from family and friends;
practices, values and beliefs that
determine health.

19. Spiritual Dimensions
• Refers to the recognition and ability to
practice moral or religious principles or
beliefs; recognition and maintenance of
a harmonious relationship with a Supreme
Being.

20. Health-Illness Continuum

21. Health-Illness Continuum
• Health and illness can be viewed as the opposite ends of
a health continuum
• From high level of health a person’s condition can move
through good health -- normal health -- poor health --
extremely poor health -- to death.
• People move back and forth within this continuum day by
day.
• How people perceive themselves and how others see
them in terms of health and illness will also affect their
placement on the continuum.

22. Characteristics of Health-Illness
Continuum Model
• At any time any person’s health status
holds a place on certain point between
two ends of health-illness continuum.
• Any point on the health-illness continuum
is a synthetically representation of various
aspects of individual in physiology,
psychology and society.

23. • Nurses Responsibilities
– To help the client to identify their place
on the health-continuum.
– To assist the clients to adopt some measures
in order to reach a well state of health.

24. MODELS OF HEALTH AND
ILLNESS

25. DUNN’S HIGH-LEVEL WELLNESS
AND GRID MODEL
• X-axis is HEALTH
– ranges from peak wellness to death
• Y-axis is ENVIRONMENT
– ranges from very favorable to very
unfavorable

26. DUNN’S HIGH-LEVEL WELLNESS
AND GRID MODEL
Quadrant 1 Quadrant 2
- High Level Wellness - Protected Poor Health
in a favorable in a favorable
environment environment
Quadrant 3 Quadrant 4
- Poor health in an - Emergent High Level
unfavorable Wellness in an
environment unfavorable environment

27. Travis’ Illness-Wellness
Continuum
• Composed of two arrows pointing in
opposite directions and joined at a neutral
point

28. 1.Movement to the right on the arrows
(towards high-level wellness) equals an
increasing level of health and well-being
– Achieved in Three Steps:
a. Awareness
b. Education
c. Growth

29. 2. Movement to the left on the arrows (towards
premature death) equates a progressively
decreasing state of health
– Achieved in Three Steps:
a. Signs
b. Symptoms
c. Disability

30. 3. Most important is the direction the individual is facing on
the pathway
a. If towards high-level health, a person has a genuinely optimistic
or positive outlook despite his/her health status
b. If towards premature death, a person has a genuinely
pessimistic or negative outlook about his/her health status

31. 4. Compares a treatment model with a wellness model
a. If a treatment model is used, an individual can move right only to the
neutral point
Example: a hypertensive client who only takes his medications
without making any other life-style changes
a. If a wellness model is used, an individual can move right past the
neutral point
Example: a hypertensive client who not only takes his medications, but
stops smoking, looses weight, starts an exercise program, etc.

32. HEALTH BELIEF MODEL BY
ROSENTOCK
• Concerned with what people perceive about
themselves in relation to their health
• Consider perceptions (influences individuals
motivation toward results)
– Perceived susceptibility
– Perceived seriousness
– Perceived benefit out of the action

33. Scope of
Nursing Practice

34. Scope of Nursing Practice
Nurses provide care for 3 types of clients:
• a. Individuals
• b. Families
• c. Communities
4 Areas of Nursing Practice
1. PROMOTING HEALTH & WELLNESS
(HEALTH PROMOTION)
-Wellness is a state of well-being. It means
engaging in attitudes and behavior that
enhance the quality of life and maximize
personal potential.
-Health promotion is a behavior motivated by
the desire to increase well-being and
actualize human health potential.

35. Scope of Nursing Practice
The Nurse’s Role in Health Promotion:
– 1. Model healthy lifestyle behaviors and attitudes.
– 2. Facilitate client involvement in the assessment,
implementation and evaluation of health goals.
– 3. Teach clients self-care strategies to enhance fitness, improve
nutrition, manage stress and enhance relationships.
– 4. Assist individuals, families and communities to increase their
level of health.
– 5. Educate clients to be effective health care consumers.
– 6. Assist clients, families and communities to develop and
choose heal h promotion options.
– 7. Guide client’s development in effective problem solving and
decision-making.
– 8. Reinforce client’s personal and family health promoting
behaviors.
– 9. Advocate in the community for changes that promote a
healthy environment.

36. Scope of Nursing Practice
client… no matter how acutely or chronically ill,
has Strength. The Nurse must identify the use
of these strengths to help client reach maximum
function & quality of life or meet death with
dignity.
Programs or Health Promotion
• 1. Information dissemination
• 2. Health risk appraisal and wellness assessment
• 3. Lifestyle and behavior change
• 4. Environmental control programs.

37. Scope of Nursing Practice
H E A L T H P R O M O T IO N T O P IC S
INFANTS
• -Infant- parent attachment/ bonding
• - Breastfeeding
• - Sleep patterns
• - Playful activity to stimulate development
• - Immunizations
• - Safety promotion and injury control.
CHILDREN
• Nutrition
• Dental check-ups
• Rest and exercise
• Immunizations
• Safety promotion and injury control

38. Scope of Nursing Practice
ADOLESCENTS
• Communicating with the teen.
• Hormonal changes
• Nutrition
• Exercise and rest
• Peer group influences
• Self concept and body image
• Sexuality
• Safety promotion and accident prevention
ELDERS
• Adequate sleep - Drug Management
• Exercise - Appropriate use of alcohol
• -Dental/ oral health - Foot health

39. Health Maintenance
• goes hand in hand with health promotion and disease
promotion.
• The active process of achieving health and remaining
healthy.

40. Elements Included in the Strategies
Used for Health Maintenance:
• Nutrition
– The science that studies how the kind of food people eat affects their health and
performance
– foods or food components that cause disease or deteriorate health.
– studies foods and dietary supplements that improve performance, promote
health, and cure or prevent disease.
• Exercise
– The performance of movements in order to develop or maintain physical
fitness and overall health.
– Frequent and regular physical exercise is to prevention of some diseases such
as cancer, cardiovascular disease, Type 2 diabetes, obesity and back pain.

41. • Hygiene
– The practice of keeping the body clean to prevent
infection and illness, and avoidance of contact with
infectious agents.
– include bathing
• brushing and flossing teeth
• washing hands especially before eating
• washing food before it is eaten
• cleaning food preparation utensils and surfaces
before and after preparing meals
• help prevent infection and illness.

42. • Stress Management
– The application of methods either to reduce stress
or increase tolerance to stress since prolonged
psychological stress may negatively impact health,
such as by weakening the immune system.
– Relaxation techniques are physical methods used to
relieve stress,
– While psychological methods (cognitive therapy,
meditation, positive thinking) work by reducing
response to stress.

43. • Health Care
– The prevention, treatment, and management of illness and the
preservation of mental and physical well being through the
services offered by the medical, nursing and allied health
professionals.
• Workplace Wellness Programs
– Recognized by an increasingly large number of companies for
their value in improving the health and well-being of their
employees, and for increasing morale, loyalty and productivity.
– Workplace wellness programs may include:
• onsite fitness centers
• health presentations
• wellness newsletters
• access to health coaching
• tobacco cessation programs and
• training related to nutrition,
• weight and stress management.

44. Scope of Nursing Practice
• Health screening recommendations
• Hearing aid use - Safety precautions
• Immunizations - Smoking cessation
• Medication instruction - Weight control
• Mental health - Nutrition
• Preventive health services - Physical fitness
2. PREVENTING ILLNESS
(DISEASE PREVENTION)
> The GOAL of illness prevention programs
is to maintain optimal health by preventing
disease.

45. Scope of Nursing Practice
• Nursing activities that prevent illness includes:
> Immunizations
> Pre-natal and Infant care
> Prevention of STDs.
The objective of illness prevention activities are:
- to reduce the risk of illness
- to promote health habits
- to maintain the individual’s optimal
functioning

46. Scope of Nursing Practice
Activities for Illness Prevention
– 1. Hospital educational programs in areas such as prenatal care
for pregnant women, smoking-cessation programs and &
reduction seminars.
– 2. Community programs & resources that encourage healthy
lifestyles including aerobic exercise classes, swimnastics &
physical fitness programs.
– 3. Literature & TV information on diet, exercise & the importance
of good health habits.
– 4. Health assessments in institutions, clinics & community
settings that identify areas of strength & potential for illness.
Levels of Prevention:
1. Primary Prevention
2. Secondary Prevention
3. Tertiary Prevention

47. 1. Primary- is true prevention
- it precedes disease or dysfunction and its applied to clients
considered to be physically & emotionally healthy.
- includes all health promotion efforts as well as wellness
activities that focus on maintaining & improving the general
health of individuals, families & communities.
Health Promotion includes:
• Health education programs
• Immunization
• Physical & Nutritional fitness activities

48. Primary Prevention
• By measures designed to promote
positive general health:
– development of good health habits and
hygiene;
– proper nutrition,
– proper attitude towards sickness,
– proper and prompt utilization of available
health and medical facilities.

49. • Specific protection
– By the use of measures against specific disease agents like
protection of the individual, or
– The establishment of barriers against agents in the environment.
may include:
– Control of means of spread of vector such as control,
sanitation of food, milk, water, and air, proper sewerage
disposal, proper disposal and or disinfect ion of soiled articles or
clothing, eradication or animal reservoir.
– Increasing resistance of the individual by specific
immunization.
– Hand washing observed strictly.

50. Scope of Nursing Practice
2. Secondary
- Focuses on individuals who are experiencing
health problems or illness & who are @
risk for developing complications or
worsening condition.
- Activities are directed at diagnosis and
prompt intervention thereby reducing the
severity & enabling the client to return to
a normal level of health as early as
possible.
- Includes screening techniques & treating
early stages of disease to limit disability.

51. Secondary Prevention
• Consists of early diagnosis and prompt
treatment of the disease in order to arrest
the disease / problem and to prevent its
spread to other people.

52. • Examples of secondary prevention include:
– Public education to promote breast self-examination
– use of home kits for detection of occult blood in the stool
specimens
– Screening programs for hypertension, diabetes, uterine cancer
(Pap Smear), breast cancer, glaucoma and sexually
transmitted diseases

53. Scope of Nursing Practice
3. Tertiary
- occurs when the defect or disability is
permanent & irreversible. It involves
minimizing the effects of long term disease or
disability by interventions directed at
preventing complications & deterioration.
- activities are directed at rehabilitation rather
than diagnosis and treatment.
- care @ this level aims to help clients achieve
as high a level of functioning as possible,
despite the limitations caused by illness or
impairment. It I Involves preventing further
disability or reduced functioning.

54. Tertiary Prevention
• Begins early in the period of recovery from illness
• consists of such activities as
– consistent and appropriate administration of medications to
optimize therapeutic effects
– moving and positioning to prevent complications of immobility
and active and passive exercises to prevent disability.
– minimizing residual disability and helping the client learn to live
productively with limitations

55. Scope of Nursing Practice
3. Restoring Health
(Curative/ Rehabilitative Care)
> Focuses on the ill client and extends from early
detection of disease through helping the client
during the recovery period.
Nursing activities include the following:
1. providing direct care to the ill person, such as
administering medications, baths, and specific procedures
and treatments.
2. performing diagnostic and assessment procedures such
as measuring BP and examining feces for occult blood.
3. consulting with other health care professionals about client
problems.
4. teaching clients about recovery activities such as
exercise that will accelerate recovery after a stroke.
5.rehabilitating clients to their optimal functional level
following physical or mental illness, injury or chemical
addiction.

56. Scope of Nursing Practice
4. Care of the Dying
• Involves comforting and caring for people
of all ages who are dying.
• It includes helping as comfortably as
possible until death and supporting persons
to cope with death.
• Nurses’ carrying out these activities work in
homes, hospitals and extended care
facilities.
• Some agencies called hospices are
specifically designed for this purpose.

57. Scope of Nursing Practice
On Facilitating coping
– Nurses facilitate client & family coping with altered
functions, life, crisis, & death.
– Nurses provide care to both clients & SO during the
terminal illness
– Nurses are becoming, more active in hospice
programs which are developed to assist individuals &
their families in preparing for death & living as
comfortably as possible until death occurs.
Institutions:
Hospice
Long term nursing facilities
Nursing Homes

58. BASIC INTERVENTIONS USING
NURSING PROCESS TO MAINTAIN
HEALTHY LIFESTYLE
Lifestyle
the values and behaviors adopted by a
person in daily life

59. • Assessment
– Health History and Physical Examination
– Utilize Gordon’s 11 functional health patterns to elicit health history.
– For the physical assessment, start at the head and proceed in a
systematic manner downward (head-to-toe).

60. • Lifestyle Assessment
• Focus on the personal lifestyle and habits
of the client as how
• they affect his/her health. Categories of
lifestyle generally
• assessed are physical activity, nutritional
practices, stress
• management, and such habits as
smoking, alcohol
• consumption and drug use