Concept of Wellness and Illness

Health: -
The World Health Organization (WHO): defines health as "a state of
complete physical, mental, and social well-being, and not merely the
absence of disease or infirmity".
Wellness: -
Wellness is a state of well-being. Basic concepts include self-
responsibility; an ultimate goal; a dynamic process; daily decision
making in the areas of nutrition, stress management, physical fitness,
health prevention, emotional health, and other aspects of health the
whole being of an individual.
According to Hamrick and Rosato 2003, there are seven components
of wellness which people must deal for optimum health and
wellness. They are as follows: -
 Physical
 Social
 Emotional
 Intellectual
 Spiritual
 Occupational
 Environmental
Determinants of Health
Physical environment: - Safe water and clean air, healthy workplace
and safe houses, communities and roads all contribute to good
health.
 Economic environment
 Social environment
 Culture
 Education
  Genetics
 Personal behaviour and coping skills
 Health services and gender
 Person’s individual characteristics and behaviours.

Illness: -
Illness is an emotional state connected to loss of health. Illness is a
state in which a person’s physical, emotional, intellectual, social and
spiritual functioning is diminished or impaired. It refers to a person’s
subjective understanding of it such as discomfort, tiredness or
general malaise.
Disease: -
Disease is an abnormal pathological state of a human being that
affects the structure and/or function of a part or whole of a
organism. It can be acute or chronic.
Health and illness can be viewed as opposite ends of a health
continuum. From high level of health a person’s health can move
through good health, normal health, poor health, extremely poor
health and ultimately death. People move back and forth this
continuum day by day.

Dr. John W. Travis developed the illness-wellness

continuum in 1972. He observed that doctors and nurses
usually treat illness, disabilities, and symptoms, which bring
a patient to the neutral zone. However, Dr. Travis did not
believe the neutral zone should be the end goal. Instead, he
thought wellness is a process and that nurses and doctors
should educate and help their patients move further down
the continuum towards high-level wellness. According to Dr.
Travis, this could be done through awareness, education,
and growth.
The left part of the continuum is the traditional treatment
paradigm which is the traditional way of treating illness
through prescriptions, doctor visits, surgery etc. Here the
treatment responsibility rests with the medical professional
to treat the problem and it stops at a neutral point.
For e.g if a person is overweight and has diabetes as a result
of being overweight this person is in the treatment
paradigm. The person’s choices have put him on the side of
the paradigm that results in premature death. If the person
makes positive changes in their lifestyle they will begin
moving to the right and reach the neutral point. But of
course, if the goal is to reach the wellness paradigm, one
can achieve it through awareness, education and growth.
Most important is the direction of the individual facing on
the pathway. If towards high level of health, a person has
genuinely high optimistic and positive outlook despite
his/her health status. If towards premature death, a person
definitely has a pessimistic or negative outlook about
his/her health status.
If a treatment model is used, an individual can move right
only to the neutral point. For e.g an individual takes only
medications for hypertension without making any changes
in the lifestyles.
Whereas if the wellness model is used, an individual can
move right past the neutral point. For e.g a hypertensive
person will not only take medication but also stop smoking,
loses weight and joins a fitness program.

Health Maintenance
Goes hand in hand with health promotion and disease prevention.
Elements included are as follows
Nutrition: - The science that studies what kind of food people eat and
how it affects them.
Exercise: - Frequent and regular exercise to prevent some diseases
like cancer, cardiovascular diseases, back pain, type 2 diabetes.
Hygiene: - Keeping the body clean and avoiding infectious agents.
Frequent brushing, washing hands before and after food, keeping the
food preparation premise clean, preventing infections and diseases.
Stress management: - The application of methods to reduce stress
or increase the tolerance to stress since prolonged stress may
negatively impact health and weaken the immune system.
Relaxation techniques are physical methods used to relieve stress.
Psychological methods like cognitive therapy, meditation and
positive thinking helps in reducing stress.
Workplace wellness program: - This may include onsite fitness
centres, health presentations, access to health coaching, tobacco
cessation program, training related to nutrition, weight and stress
related management.
Illness prevention: -

 Primary Prevention – Action taken prior to the onset of

the disease/disability, which will remove the possibility
that a disease/disability will occur.
 Secondary Prevention – Action, which halts the progress
of the disease/disability at its incipient stage and prevents
complications. The specific interventions are early
diagnosis and adequate treatment.
 Tertiary Prevention – All measures available to reduce or
limit impairments and disabilities, and minimize suffering
caused by existing disability. This phase is also called
rehabilitation, which includes physical, psychosocial and
vocational measures taken to restore the patient back to
normal or near normal condition

Integrating prevention into health care

 Support paradigm shift towards integrated, preventive

health care.
 Promoting financing systems and policies
 Equip patients with needed information, motivation, skill in
prevention and self-management.
 Prevention an element of every health care interaction

Establishing preventive health care services in low resource

communities
Low resource communities -- - trained nurse supervision --
 once in a month home visit ----- child health status,
vaccination, prenatal care, cancer screening

Incorporating prevention into health care

Multi-disciplinary team consisting of therapist, physician, nurses

and health education who can be linked with pharmacy and
telephonic advice can help in chronic condition and
management program.