INTRODUCTION TO HEALTH CARE

CONCEPT OF HEALTH ,WELLNESS

& ILLNESS
BASIC TERMINOLOGIES
 WHAT IS
HEALTH?
 DEFINITION OF HEALTH

Traditionally, health was defined in

terms of the presence or absence
of disease.
 DEFINITION OF HEALTH

Florence Nightingale:
“HEALTH is a state of being well
and using every power the
individual possesses to the
fullest extent.”
 DEFINITION OF HEALTH

World Health Organization (WHO):

“HEALTH is a state of complete
physical, mental and social well-
being, and not merely the
absence of disease or infirmity.”
 DEFINITION OF HEALTH

American Nurses Association (ANA):

“HEALTH is a dynamic state of
being in which the developmental
& behavioral potential of an
individual is realized to the fullest
extent possible.”
 DEFINITION OF HEALTH
Many people define & 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
 WHAT IS
wellness?
 DEFINITION OF WELLNESS

Wellness is an active process by

which an individual progresses
towards maximum potential possible,
regardless of current state of health.
Only the person can say if he/she is well or not as
wellness is subjective while health is objective.
 7
PHYSICAL

SOCIAL

EMOTIONAL

INTELLECTUAL
COMPONENTS OF SPIRITUAL
WELLNESS
OCCUPATIONAL

ENVIRONMENTAL
 7 COMPONENTS OF WELLNESS

1. PHYSICAL
The ability to carry out daily tasks, achieve
fitness, maintain adequate nutrition and
proper body fat, avoid abusing drugs & alcohol
or using tobacco products, and generally
practice positive lifestyle habits.
 7 COMPONENTS OF WELLNESS

2. SOCIAL
The ability to interact successfully with people
& within the environment of which each
person is a part, to develop & maintain
intimacy with significant others, & to develop
respect & tolerance for those with different
opinions & beliefs.
 7 COMPONENTS OF WELLNESS

3. EMOTIONAL
The ability to manage stress and to express
emotions appropriately.
It involves ability to recognize, accept, and
express feelings & to accept one’s limitations.
 7 COMPONENTS OF WELLNESS

4. INTELLECTUAL
The ability to learn and use information
effectively for personal, family, and career
development.
Involves striving for continued growth &
learning to deal with new challenges
effectively.
 7 COMPONENTS OF WELLNESS

5. SPIRITUAL
The belief in some force (nature, religion or
higher power) that serves to unite human
beings and provide meaning and purposes to
life.
Includes a person’s own morals, values and
ethics
 7 COMPONENTS OF WELLNESS

6. OCCUPATIONAL
The ability to achieve a balance between work
and leisure time.
Includes a person’s beliefs about education,
employment,& home influence personal
satisfaction & relationship with others.
 7 COMPONENTS OF WELLNESS

7. ENVIRONMENTAL
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.
Wellness involves working on all aspects of the
model
PHYSICAL

ENVIRONMENTAL SOCIAL

OCCUPATIONAL EMOTIONAL

SPIRITUAL INTELLECTUAL
 WHAT IS
illness?
 DEFINITION OF ILLNESS

Illness is a highly personal state in

which the person’s emotional,
intellectual, social, developmental or
spiritual functioning is thought to be
diminished.
 2
MAJOR CLASSIFICATION
OF ILLNESS
Acute Illness

Chronic Illness
 ACUTE ILLNESS

 A disruption in functional ability usually

characterized by a rapid onset, intense
manifestations, and a relatively short
duration.
 Are usually reversible.
 Ex: influenza
 CHRONIC ILLNESS

 A disruption in functional ability usually

characterized by a gradual, insidious
onset with lifelong changes that are
usually irreversible.
 Chronic illnesses last a long time,
frequently throughout the individual’s
life.
 Ex: Arthritis
 CHRONIC ILLNESS

 It is characterized by:
a. Remission- period during which the
disease is controlled and symptoms are
not obvious.
b. Exacerbation-the disease becomes
more active again at a future time, with
recurrence of pronounced symptoms.
 WHAT IS A
disease?
 DEFINITION OF DISEASE

Disease can be described as an

alteration in body functions resulting
in a reduction of capacities or
shortening of the normal life span.
 DEFINITION OF DISEASE

Disease is a pathologic change in

the structure or function of the
body or mind.
RELATED TERMS:
Health Status

-state of health of a person at a given

time.
-Reflected by Blood Pressure, respiratory
rate, laboratory tests, etc.
RELATED TERMS:
Health Beliefs

-concepts about health that an individual

believes.
-Example: Sleeping with wet hair causes
blindness, eating a well-balanced diet
makes person healthy
RELATED TERMS:
Health Behavior

-the actions that people take to

understand their health state, maintain
an optimal level of health, prevent illness
and injury and reach their maximum
physical and mental health potential.
RELATED TERMS:
Health Behavior

-Example:
Exercising everyday, sleeping at least 8
hrs a day, undergoing diagnostic tests/check
ups to understand signs & symptoms being
experienced & be advised by the doctor of
proper actions to take.
RELATED TERMS:
Risk Factors

-refers to conditions or a factor that

increases the tendency or probability of
a person having a disease or being ill.
RELATED TERMS:
Risk Factors

--the presence of risk factors does not

mean that a disease will develop, but risk
factors increase the chances that the
individual will experience a particular
dysfunction.
 Risk Factors of a Disease:
GENETIC &
PHYSIOLOGICAL AGE
FACTORS

ENVIRONMENT LIFESTYLE
 DEFINITION OF TERMS:

• Condition of being
MORBIDITY diseased

MORBIDITY • The proportion of disease

RATE to health in a community

• Condition or quality of
MORTALITY being subject to death
 DEFINITION OF TERMS:
• Study of patterns of health and
disease, its occurrence and
EPIDEMIOLOGY distribution in man, for the
purpose of control and
prevention of disease

• The degree of resistance the

SUSCEPTIBILITY potential host has against the
pathogen.

• One that possesses the potential

ETIOLOGIC for producing injury or disease
AGENT (e.g. Streptococcus)
 DEFINITION OF TERMS:
• Relative power or the
degree of pathogenecity of
the invading microorganism,
VIRULENCE the ability to produce
poisons that repel or
destroy phagocytes

• The branch of medicine which

deals with the cause, nature,
PATHOLOGY treatment & resultant structural
and functional changes of
disease.
 DEFINITION OF TERMS:
• An objective symptom or
objective evidence or physical
SIGN manifestation made apparent by
special methods of examination
or use of senses.

• Any disorder of appearance,

sensation or function
SYMPTOM experienced by the patient
indicative of a certain phase of
disease. It is subjective in
nature.

• A group of signs & symptoms

SYNDROME which when considered together
characterize a disease
 DEFINITION OF TERMS:
• Method of origin and
development of disease
including sequence of
PATHOGENESIS processes or events from
inception to the development
of characteristic lesion or
disease

• Art or act of determining the

nature of a disease, recognition
DIAGNOSIS of a diseased state.
 DEFINITION OF TERMS:
• Prediction of course and
end of disease, medical
PROGNOSIS opinion to the outcome of
disease process.

• Implies that a person has

RECOVERY no observable or known
after effects from his
illness.
MODELS OF HEALTH &
WELLNESS
 MODELS OF HEALTH & WELLNESS

Role
Adaptive
Clinical Model Performance
Model
Model

Agent-Host-
Eudemonistic Health-Illness
Environment
Model Continua
Model
 MODELS OF HEALTH & WELLNESS

1. CLINICAL MODEL
 The narrowest interpretation of
health.
 People are viewed as physiologic
systems with related functions &
health is identified by the absence of
signs & symptoms of disease or injury.
 MODELS OF HEALTH & WELLNESS

1. CLINICAL MODEL
 Health is considered as the state of
not being “sick”
 In this model, the opposite of health is
disease or injury.
 MODELS OF HEALTH & WELLNESS

2. ROLE PERFORMANCE MODEL

 Health is defined in terms of the

individual’s ability to fulfill societal
roles, that is to perform his/her work.
 People who can fulfill their roles are
healthy even if they have clinical
illness.
 MODELS OF HEALTH & WELLNESS

2. ROLE PERFORMANCE MODEL

 Example:
A man who works all day at his job
as expected is healthy even though an x-
ray of his lung indicates a tumor.
It is assumed in this model that sickness is the
inability to perform one’s work role.
 MODELS OF HEALTH & WELLNESS

3. ADAPTIVE MODEL
 Health is a creative process; Disease is
a failure in adaptation, or
maladaptation.
 Aim of treatment: to restore the
ability of the person to adapt, that is
to cope.
 MODELS OF HEALTH & WELLNESS

3. ADAPTIVE MODEL

 Extreme good health is flexible

adaptation to the environment and
interaction with the environment to
maximum advantage.
 MODELS OF HEALTH & WELLNESS

4.EUDEMONISTIC MODEL
 Incorporates a comprehensive view of
health.
 Health is seen as a condition of the
actualization or realization of one’s
potential.
 MODELS OF HEALTH & WELLNESS

4.EUDEMONISTIC MODEL

 Actualization is the apex of a fully-

developed personality as described by
Abraham Maslow.
 In this model, the highest aspiration of
people is fulfillment & complete
development, which is actualization.
 MODELS OF HEALTH & WELLNESS

4.EUDEMONISTIC MODEL

 Illness is a condition that prevents self-

actualization.
 MODELS OF HEALTH & WELLNESS

5. AGENT-HOST-ENVIRONMENT
MODEL

 Also called “Ecologic Model”, originated

in the community health work of
Leavell & Clark(1965)
 It is used primarily in predicting
illnesses rather than promoting
wellness.
The model has 3 Dynamic Elements:
 3 Dynamic Elements:

1. AGENT
• Any environmental factor or stressor (biologic,
chemical, mechanical, physical or psychosocial)
that by its presence or absence can lead to
illness or disease.
 3 Dynamic Elements:

2. HOST
• Person (s) who may or may not be at risk of
acquiring a disease.
• Family history, age, and lifestyle habits
influence the host’s reaction.
 3 Dynamic Elements:

3. ENVIRONMENT
• All factors external to the host that may or
may not predispose the person to the
development of disease.
 3 Dynamic Elements:

3. ENVIRONMENT
• Physical environment includes climate, living
conditions, sound/noise levels & economic
levels.
• Social environment includes interactions with
others and life events, such as death of spouse.
 MODELS OF HEALTH & WELLNESS

Because each of the agent-host-environment

factors constantly interacts with the others,
health is an ever-changing state.
 MODELS OF HEALTH & WELLNESS

6. HEALTH-ILLNESS CONTINUA

 Grids or graduated scales that can be

used to measure a person’s perceived
level of wellness.
 Health & illness or disease can be
viewed as the opposite ends of a
health continuum.
 Dunn’s High-level
Wellness Grid

HEALTH-
ILLNESS Travis’s Illness-
Wellness Continuum
CONTINUA

The 4+ Model of
Wellness
 a. Dunn’s High Level
Wellness Grid

 Dunn (1959) described a health grid in

which a health axis and an
environmental axis intersect.
 b. Travis’s Illness-
Wellness Continuum

 Travis developed an illness-wellness

continuum that ranges from high-level
wellness to premature death.
The model illustrates 2 arrows pointing in opposite
directions and joined at a neutral point.
 Movement to the right of the neutral point
indicates increasing levels of health and
well-being for an individual.
 This is achieved in 3 steps: (a)Awareness,
(b)Education, and (c) Growth
 Movement to the left of the neutral point
indicates decreasing levels of health and
well-being for an individual.
 The model also compares the
traditional treatment model with the
wellness model.
 The traditional treatment model can
help an individual move from the left
only to the neutral point, where
symptoms of the illness are alleviated.
 c. The 4+ Model of
Wellness
 Baldwin & Conger (2001) developed this
model consisting of 4 Domains of the
Inner self- Physical, Spiritual, Emotional,
& Intellectual plus the elements of outer
systems (environment, culture, nutrition,
safety, & many other elements.
 c. The 4+ Model of
Wellness
 This model assesses the inner self for
strengths and excesses, sources of
nurturing and of depletion,& the
interactions between the inner self &
outer systems.
STAGES OF ILLNESS
STAGE 1: Symptom
Experiences

STAGE 2: Assumption
of the Sick Role STAGES OF
STAGE 3: Medical
Care Contact
ILLNESS
(Suchman, 1979)
STAGE 4: Dependent
Client Role

STAGE 5: Recovery or
Rehabilitation
STAGE 1:
Symptom Experiences

 At this stage, the person comes to

believe something is wrong.
 Either someone significant mentions
that the person looks unwell, or the
person experiences some symptoms
such as pain, cough, fever or bleeding.
 STAGE 1 has 3 Aspects:

The physical experience of symptoms

The cognitive aspect (the interpretation of

the symptoms in terms that have some
meaning to the person)

The emotional response (e.g., fear or anxiety)

STAGE 1:
Symptom Experiences

 During this stage, the unwell person

usually consults others about the
symptoms or feelings, validating that the
symptoms are real.
 At this stage the sick person may try
home remedies.
STAGE 2:
Assumption of the Sick Role

 At this stage, the individual now accepts

the sick role and seeks confirmation
from family and friends
 Often people continue with self-
treatment and delay contact with health
care professionals as long as possible.
STAGE 2:
Assumption of the Sick Role

 During this stage, people may be excused

from normal duties and role expectations.
 Emotional responses such as withdrawal,
anxiety, fear and depression are common
depending on the severity of the illness,
perceived degree of disability and
anticipated duration of the illness.
STAGE 2:
Assumption of the Sick Role

 When symptoms of illness persist or

increase, the person is motivated to seek
professional help.
STAGE 3:
Medical Care Contact

 Sick people seek the advice of a health

professional either on their own
initiative or at the urging of significant
others.
 When people seek professional advice they
are really asking for 3 Types of Information:

Validation of the real illness

Explanation of the symptoms in

understandable terms

Reassurance that they will be alright or

prediction of what the outcome will be
STAGE 4:
Dependent Client Sick Role

 After accepting the illness and seeking

treatment, the client becomes
dependent on the professional for help.
 People vary greatly in the degree of ease
with which they can give up their
independence, particularly in relation to
life and death.
STAGE 5:
Recovery or Rehabilitation

 During this stage, the client is expected to

relinquish the dependent role and resume
former roles and responsibilities.
 For clients with a permanent disability, this
final stage may require therapy to learn
how to make major adjustments in
functioning.
THEORIES OF DISEASE
CAUSATION
 Germ Biomedical Multicausal
Theory Model Theory

Psychosocial Biopsychosocio-
Theory spiritual Theoriy

THEORIES OF CAUSATION
 GERM THEORY
 One of the earliest theories of
disease causation proposed by
Pasteur.
 It describes microorganisms such as
viruses, bacteria and protozoa as the
causative agents of infectious
diseases.
 BIOMEDICAL THEORY
 This model proposes that
disease is caused by
malfunctioning of cells,
tissues and organs with
resultant signs & symptoms.
 BIOMEDICAL THEORY

 Focused only on the physical

cause and effect of disease &
failed to explain psychosocial
aspects contributing to health
and illness.
MULTICAUSAL THEORY

 This model explained the

effects of different factors
such as nutrition, lifestyle,
genetics and stress in a
person’s health and in the
development of disease.
 PSYCHOSOCIAL
THEORY
 This model integrate
physiologic, psychological, and
sociological factors that
influence disease
development.
 BIOPSYCHOSOCIO-
SPIRITUAL THEORY
 The body, mind and
environment all interact
together in the development
of disease
CONCEPT OF DISABILITY
 DEFINITION OF TERMS:

Disability
 Defined as “alteration of an individual’s
capacity to meet personal, social, or
occupational demands because of an
impairment.” (American Medical
Association, 2008)
 DEFINITION OF TERMS:

Impairment
 Defined as “alteration of an
individual’s health status; a deviation
from normal in a body part or organ
system and its functioning.”
(American Medical Association, 2008)
CONCEPT OF LOSS, DEATH &
DYING
 DEFINITION OF TERMS:
Loss
 An actual or potential situation in
which a valued object, person or the
like is inaccessible or changed so that
it is no longer perceived as valuable.
 2
Maturational
Loss

TYPES OF LOSS Situational Loss

 • Normally expected
1.MATURATIONAL during the persons’
LOSS lifetime as part of life
or development

• Loss due to sudden

2. SITUATIONAL or unpredictable
LOSS event
 DEFINITION OF TERMS:

Bereavement
 Is the subjective response to a loss
through the death of a person with
whom there has been a significant
relationship.
 DEFINITION OF TERMS:

Grief
 Is the total response to the emotional
experience of the loss and is
manifested in thoughts, feelings and
behaviors.
 DEFINITION OF TERMS:

Mourning
 Is the behavioral process through
which grief is eventually resolved or
altered; it is often influenced by
culture and custom.
 DEFINITION OF TERMS:

Death
 Is generally defined as the lack of
breathing, heartbeat and of brain
waves.
 It represents the end of the person’s
biological being.
 DEFINITION OF TERMS:

Dying
 Is the social process by which the
dying person and significant persons
in his life prepares for death and the
future.
 PHASES OF DEATH
Clinical Death- when heartbeat and respiration
cease

Brain Death- death of the entire brain caused

by insufficient oxygen reaching the brain

Cellular Death- when different cells of the

body die at different times.
PERCEPTION OF DEATH ACROSS
LIFESPAN
Infants & Toddlers
• No specific concept of death
• Reacts to pain and discomfort, experiences
separation anxiety and may become upset
when routine is changed or altered by the
absence of the significant person who
died.
PERCEPTION OF DEATH ACROSS
LIFESPAN
Preschooler
• Views death as sleep, a temporary state
wherein the dead person will awaken and
return.
• Illness & death may be viewed as a
punishment for an actual or perceived
wrongdoing.
PERCEPTION OF DEATH ACROSS
LIFESPAN

School Age Child

• Views death as permanent, wherein a
person who dies will never come back.
• Death is personified as a distinct person.
Ex: A skeleton-man or death-man who
comes to take away the living person
PERCEPTION OF DEATH ACROSS
LIFESPAN
Adolescent
• Has mature understanding about death.
• May experience strong emotions about
death such as anger, frustration and
despair
• Will worry about physical changes caused
by his/her terminal illness.
PERCEPTION OF DEATH ACROSS
LIFESPAN
Adult
• Death is viewed as disruption in lifestyles
and will be concerned about its effect on
the significant persons who will be left
behind.
• Will experience loss because of unmet
goals and plans in the future.
PERCEPTION OF DEATH ACROSS
LIFESPAN

Older Adult
• View death as inevitable
• Dying is a time of reflection, rest and
peace
 SIGNS OF DEATH:
IMPENDING IMMINENT
DEATH DEATH

CLINICAL
DEATH
a. Loss of muscle tone
 Relaxation of facial muscle, jaw may sag
 Difficulty speaking
 Difficulty swallowing
 Loss of gag reflex
 Decreased activity of GIT
 Urinary & rectal incontinence
 Diminished body movement

IMPENDING DEATH:
b. Slowing of the circulation
 Diminished sensation
 Mottling or cyanosis of extremities
 Cold skin

IMPENDING DEATH:
c. Sensory Impairment
 Blurred vision
 Impaired sense of taste and smell

IMPENDING DEATH:
 Cheyne-stokes respiration (irregular or
abnormally slow respiration, mouth
breathing
 Death rattle (noisy breathing due to
accumulation of mucus in the throat)
 Decelerated & weaker pulse
 Decreased blood pressure

IMMINENT DEATH:
 Inability to move
 Loss of reflexes
 Dilated and fixed pupils

IMMINENT DEATH:
 Total lack of response to eternal stimuli
 Absence of breathing and reflexes
 Flat encephalogram
 Traditionally, death is signaled by the
cessation of apical pulse, respiration and
blood pressure

CLINICAL DEATH: