Dr.

Amani Mahmoud Fadul

Level 3__ 1441 H

 Fundamentals of Nursing
Learning outcomes:
•Discuss the definition of health.
•Discuss the health belief, health
promotion.
•Describe variables influencing health
beliefs and practices.
•Describe health promotion, wellness,
and illness prevention activities.
Learning outcomes:
• Discuss the three levels of preventive care.
• Describe four types of risk factors.
• Discuss risk factor modification and
changing health behaviors.
• Describe variables influencing illness
behavior.
• Describe the impact of illness on the
patient and family.
• Discuss the nurse’s role in health and illness
Introduction
•Health, wellness, and well-being have
many definitions and interpretations.
•The nurse should be familiar with the
most common aspects of the concepts
and consider how they may be
individualized with specific clients.
Definitions of health :
•Traditionally health has been defined
in terms of the presence or absence of
disease.
•Nightingale defined health as a state
of being well and using every power
the individual possesses to the fullest
extent.
Definitions of health :
• The World Health Organization (WHO)
defined health as a state of complete
 physical, mental, and social well-being,
and not merely the absence of disease or
infirmity.
• The American Nurses Association, in its
social policy statement (2010), states,
“Health and illness are human
experiences. The presence of illness does
not preclude health, nor does optimal
health preclude illness
Health:
• Health, as defined by each person,
integrates all the human dimensions- the
physical, intellectual, emotional,
sociocultural, spiritual, and environmental
aspects of the whole person.
• The nurse giving holistic nursing care
must equally consider all these
interrelated and interdependent
dimensions of the whole person.
Concepts of health
• Pender, Murdaugh, and Parsons (2011)
suggest that for many people conditions of
life rather than pathological states define
health.
• Life conditions canhave positive or negative
effects on health long before an illness is
evident.
• Life conditions include socioeconomic
variables such as environment, diet, and
lifestyle practices or choices and many other
physiological and psychological variables.
Example:
A 15-year-old with diabetes takes injectable insulin
each morning. He plays on the school soccer team
and is editor of the high school newspaper. Many
people define and describe health as the following:
• Being free from symptoms of disease and pain as
much as possible
• • Being able to be active and to do what they want
or must
• • Being in good spirits most of the time.

Wellness and Well-Being:

• Wellness is a state of well-being(optimal
health).
• Basic aspects of wellness include
selfresponsibility; self- awareness, an
ultimate goal; a dynamic, growing process;
stress management, physical fitness,
preventive health care, and emotional
health; and, most importantly, the whole
being of the individual.
The seven components of
wellness
Concept of Well-being:
“Well-being is a subjective perception
of vitality/ energy and feeling well . . .
can be described objectively,
experienced, and measured . . . and
can be plotted/planned on a
continuum”. It is a component of
health
Model of
Clinical model:
Role Performance Model:
•Ability to fulfill societal roles
•Healthy even if clinically ill if roles
fulfilled
•Sickness is the inability to perform
one’s role
Adaptive Model:
• Creative process
• Disease is a failure in adaptation or
maladaptation
• Extreme good health is flexible
adaptation to the environment
• Focus is stability
• The aim of treatment is to restore the
ability of the person to adapt.
Eudemonistic Model:
• Comprehensive view of health
• Condition of actualization (make real)
or realization of a person’s potential
• Illness is a condition that prevents
selfactualization
• Actualization is the apex of the fully
developed personality
Agent-Host-Environment
Model:
The Health- illness continuum:
• Measure person’s level of health
• Movement to the right of the neutral point
indicates increasing levels of health and
wellness for an individual. This is achieved
through health knowledge, disease prevention,
health promotion, and positive attitude. In
contrast, movement to the left of the neutral
point indicates progressively decreasing levels of
health.
Variables influencing health
status, beliefs, and practices
PSYCHOLOGICAL
DIMENSION
▪Mind–body interactions
▪Self-concept.
▪Mind–body interactions can affect health
status positively or negatively. Emotional
responses to stress affect body function
▪Self-concept is how a person feels about
self (self-esteem) and perceives the
physical self (body image).
COGNITIVE
DIMENSION
▪ Lifestyle choices
▪ Spiritual and religious beliefs.
▪ Examples of healthy lifestyle choices.
• Regular exercise
• Weight control
• Avoidance of saturated fats
• Avoidance of excessive alcohol
• Abstaining from use of tobacco products
• Seat belt use

Variables that influence

beliefs and practices
• Internal • External
• Developmental • Family practices stage
• Socioeconomic
• Intellectual factors background
• Cultural background • Perception of functioning
• Emotional factors
• Spiritual factors
Health promotion

“…the science and art of helping

people change their lifestyle to move
toward a state of optimal health.”
Such as routine exercise and good
nutrition help patients maintain or
enhance their present levels of
health
Wellness
•A state of optimal health where in an
individual:
•Moves toward integration of human
function.
•Maximizes human potential.
•Takes responsibility for health.
•Has greater self-awareness and
selfsatisfaction.
Illness prevention:

• Illness prevention activities such as

immunization programs protect patients
from actual or potential threats to health.
They motivate people to avoid declines in
health or functional levels
• OBJECTIVE OF THIS TOPIC:
• Encourage all to participate in the
improvement of health.
Prevention Health Care
Team
◼ Individual - ultimate responsibility

◼ Nurses - teaching & screening

◼ Primary Physicians - family practitioners,

internists, pediatricians
Nurse’s Role in Health
Promotion:
•Role Model
•Counselor
•Health Education
•Motivation
•Provide Support for lifestyle
changes
Health Protection Activities:
•Prevent accidents
•Occupational Safety & Health
•Ensuring the Safety of Food & Drugs
•Environmental Strategies
Levels of Preventive Care:
Risk factors influences
health:
• Age: school aged children are at high risk for
communicable disease.
• Genetic factors: familyhistory of cancer or
diabetes.
• Physiological factors: obesity increases the
possibility of heart disease.
• Environment: Hazards materials and poor
sanitation may contribute to disease.
• Lifestyle: events that increase stress( divorce,
work related to pressure) may precipitate
accident and illness.

Risk Factor Modification and

Changing Health Behaviors:
• Modifiable (changeable or controllable) risk
factors. These are things that individuals
can change and control such as their
sedentary lifestyle, smoking, drinking
alcohol or poor dietary habits.
• Non-modifiable (non-changeable or
noncontrollable) risk factors. These are
factors such as age, sex and inherited genes
and are things that individuals cannot
change or do not have control over.
Illness:
•A state in which a person’s
physical, emotional, intellectual,
social, developmental, or spiritual
functioning is diminished or
 impaired
Illness Behavior:
• When a person becomes acutely ill, certain
illness behaviors may occur in identifiable
stages. These behaviors are the way people
cope with alterations in function caused by
the disease.
• Illness behaviors are unique to the
individual and are influenced by age,
 gender, family values, economic status,
culture, educational level, mental status.
Personal Behavior
This area has many factors influencing
health and wellness:
• Level of Stress.
Diet.
• • Tobacco and Drug • Exercise. Use.

• Personal Care. • Alcohol Use.

• Sexual Relationships. • Safety.

A- Acute Illness
• Characterized by severe symptoms of
relatively short duration
• Symptoms often appear abruptly, subside
quickly
• May or may not require intervention by
health care professionals
• Most people return to normal level of
wellness
Chronic Illness
• Lasts for an extended period (6 months or longer)
• Usually has a slow onset
• Often have periods of remissions (symptoms
disappear) and exacerbations (symptoms reappear)
• Care includes promoting independence, sense of
control, and wellness
• Learn how to live with physical limitations and
discomfort
Variables Influencing Illness and
Illness Behavior
Internal variables:
• Patient perceptions of symptoms • Nature
of the illness External variables :
• visibility of symptoms,
• social group & social support,
• cultural background,
• economic variables,
•
Impact of Illness:
1-On the Client
▪Behavioral and emotional changes
▪Loss of autonomy
▪Self-concept and body image changes
▪Lifestyle changes
▪Privacy is usually affected
Impact On the Family
Impact on Family Roles:
• People have many roles in life such as wage earner,
decision maker, professional, child, sibling, or parent.
When an illness occurs, parents and children try to
adapt to the major changes that result..
Impact on Family Dynamics:
• As a result of the effects of illness on the patient and
family, family dynamics often change.
• Family dynamics are the processes by which the family
functions, makes decisions, gives support to individual
members, and copes with everyday changes and
challenges.