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MAN, HEALTH, &

ILLNESS

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Objectives:
After the discussion, the learners will be able to accom-
plish the following:
1. Describe concepts and models of health, wellness,
and illness.
2. Compare and contrast acute illness and chronic
illness.
3. Explain how the human dimensions, basic human
needs, and self-concept influence health and illness.
4. Summarize the role of the nurse in promoting health
and preventing illness.
5. Explain the levels of preventive care.
HEALTH
state of complete physical, mental, and social well-
being, not merely the absence of disease or infirmity
(World Health Organization, 1974).

The actualization of inherent and acquired human

potential through goal-directed behavior, compe-
tent self-care, and satisfying relationships with
others while adjustments are made as needed to
maintain structural integrity and harmony with the
environment.
(Pender, Murdaugh, and Parsons, 2011)

Process seeking to maintain stable, comfortable

equilibrium
WELLNESS
an active state of being healthy by living a lifestyle
that promotes good physical, mental, and emotion-
nal health.

It requires that the individual maintain a continuum

of balance and purposeful direction within the
environment where he is functioning. (Halbert Dunn)

Condition when individual functions are at optimal

levels
State of well-being
 Self-responsibility
 Ultimate goal
 Dynamic, growing process
 Daily decision making
Components of Wellness

• Environmental
• Occupational
• Intellectual
• Spiritual
• Physical
• Emotional
• Social
• Well-being is a component of health
Figure 13-3 An illness-wellness continuum. Source: Reprinted with permission from Travis, J. W., &
Ryan, R. S. (1988). Wellness workbook., Berkeley, CA: Ten Speed Press.
ILLNESS
a state in which a person’s physical, emotional, intellectual,
social, developmental, or spiritual functioning is diminished
or impaired

Inability to maintain physical and emotional balance

the response of the person to a disease; it is an abnor-

mal process in which the person’s level of functioning is
changed when compared with a previous level
FACTORS AFFECTING HEALTH
AND ILLNESS

• The Human Dimension

• Self-Concept
• Basic Human Needs
• Risk Factors of Illness
• Beliefs and Practices
````````````````````````````````````````````````````
```````````
THE HUMAN DIMENSIONS OF
HEALTH
• Physical dimension — genetic inheritance,
age, developmental level, race, and gender.

• Emotional dimension — how the mind

affects body function and responds to b
ody conditions.

• Intellectual dimension — cognitive abilitie

s, educational background, and past experi
ences.
THE HUMAN DIMENSIONS OF
HEALTH

• Environmental dimension — housing,

sanitation, climate, pollution of air, food,
and water.

• Sociocultural dimension — economic

level, lifestyle, family, and culture.

• Spiritual dimension — spiritual beliefs an

d values.
SELF-CONCEPT
– Incorporates both how the person
feels about self (self-esteem) and the
way he or she perceives his or her
physical self (body image).

Factors That Influence a

Person’s Self Concept
• Past experiences
• Interpersonal interactions
• Physical and cultural influences
• Education
BASIC HUMAN NEEDS
(Maslow)
RISK FACTORS OF ILLNESS
RISK FACTORS OF ILLNESS
BELIEFS & PRACTICES

• Cultures vary in views of what is illness,

what causes illness, and what should be
done about it
• Different ideas about how to prevent
problems, what health care they should
seek, and the types of remedies that health
providers should offer
Health Beliefs and Practices

Perceptions of Illness
• Vary across groups
• One culture may view certain signs or sy
mptoms as an affliction while others con
sider them normal
Health Beliefs and Practices

Perceptions of Disease
• Disease - “malfunctioning or maladaptation
of biologic and psychophysiologic processe
s in the individual”
• Illness - “personal, interpersonal, and cultur
al reactions to disease or discomfort”
• Some cultures believe illness can be caused
by emotional stress, supernatural causes, or
bodily imbalance
Health Beliefs and Practices

Folk Illness
• Cultural interpretations of physical states
that people perceive to be illness, but th
at do not have a physiologic cause
• Efforts to improve health need to consid
er these beliefs
Table 6.1: Selected Examples of Cult
ural Explanations of Disease
Health Beliefs and Practices

The Prevention of Illness

• Many cultures have taboos that concern
avoiding illness
• Many concern foods to avoid during pre
gnancy
• Wide variety of ritual practices to avoid il
lness
Health Beliefs and Practices

The Diagnosis and Treatment of Illn

ess and the Use of Health Services
• Common to try a home remedy, then vis
it a local healer, then consult a “western
doctor”
• “Patterns of resort” affected by cost of se
rvices, manner in which the provider trea
ts them socially
Health Beliefs and Practices

Health Providers
• Depend on location
• Local practitioners of indigenous medicin
e - traditional birth attendants, herbalist
s, priests
• Practitioners of western medicine - com
munity health workers, nurses, physicians
MODELS OF HEALTH AND
ILLNESS
• The agent-host-environment model
• The health–illness continuum
• The high-level wellness model
• The health belief model
• The health promotion model
 Agent-Host-Environment
Model (Leavell and Clark)
• Examines the causes of disease in an indivi- du
al
• Agent, host, and environment interact in way
s that create risk factors
• Understanding the risk factors is important for
the promotion and maintenance of health
• The host reaction is influenced by family hist
ory, age, and health habits
• The environment includes physical, social, bio
logic, and cultural factors
• Each of the agent-host-environment factors aff
ects and is affected by the others
The Agent-Host-Environment
Triangle
The Health–Illness
Continuum
• Measures a person’s level of health
• Views health as a constantly chan-
ging state with high-level wellness
and death on opposite sides of a
continuum
• Illustrates the dynamic (ever-chan-
ging) state of health
The Health–Illness
Continuum
The High-Level Wellness
Model (Dunn)
• Encourages the nurse to care for the total perso
n
• Involves functioning to one’s maximum poten- tial w
hile maintaining balance and a purpose- ful direction
• Regards wellness as an active state, oriented toward
maximizing the potential of the individual, regardless
of his or her state of health
• Incorporates the processes of being, belonging, beco
ming, and befitting
The Health Belief Model
(Rosenstock)
• Concerned with what people perceive to be t
rue about themselves in relation to their hea
lth
• Modifying factors for health include demog
raphic, socio-psychological, and structural var
iables
• Based on three components of indivi- dual p
erceptions of threat of a disease
– Perceived susceptibility to a disease
– Perceived seriousness of a disease
– Perceived benefits of action
The Health Promotion Model
(Pender)
• Illustrates the “multidimensional nature of per- sons i
nteracting with their environment as they pursue hea
lth”
• Incorporates individual characteristics & expe- rienc
es and behavior-specific knowledge and beliefs, to
motivate health-promoting behavior
• Personal, biologic, psychological, and socio- cultur
al factors are predicative of a certain health-relat
ed habit
• Health-related behavior is the outcome of the model
and is directed toward attaining positive health outc
omes and experiences throughout the lifespan
Types of Illness
• Acute illness
– Generally has a rapid onset of symptoms and
lasts only a relatively short time
– Examples: appendicitis, diarrhea, common cold

• Chronic illness
– A broad term that encompasses many differ-
rent physical and mental alterations
– Examples: diabetes mellitus, lung disease, M.I
Stages of Illness Behavior

• Stage 1: Experiencing symptoms.

• Stage 2: Assuming the sick role.

• Stage 3: Medical Care Contact.

• Stage 4: Assuming a dependent role.

• Stage 5: Achieving recovery and rehabilitation

Five Stages of Accepting an
Illness
• Denial

• Anger

• Fear

• Grief

• Acceptance
Five Stages of Accepting an
Illness

• Not everyone goes through these stages in the

same order.

• If you believe that you are stuck in one of the

first four stages permanently, you may want to
consult with a therapist .
Five Stages of Accepting an
Illness
Anger

• Anger is normal and can take a long time to

work through.

• Sometimes a small part of anger stays with

you throughout the entire illness.
Five Stages of Accepting an
Illness
Fear

• This is the most important stage to work through

.

Grief

• Grief can cause feelings of inadequacy and lead

to withdrawal and isolation.
 LEVELS OF PREVENTIVE
CARE

• Primary prevention—e.g., diet, exercise, i

mmunizations
• Secondary prevention—e.g., screenings,
mammograms, family counseling
• Tertiary prevention—e.g., medications, su
rgical treatment, rehabilitation
 Levels of Disease Prevention

Level of disease
Description Example
Prevention
Prevent the Health Teaching
Primary prevention occurrence of diet, exercise,
disease immunizations
Early detection and Screening
Secondary prevention
intervention procedure

Prevent further Medications,

Tertiary prevention deterioration surgical treatment,
(rehabilitation) rehabilitation
Question
Which of the following is an example of an acute
illness?
A. Diabetes
B. Rheumatoid arthritis
C. Pneumonia
D. Osteoporosis
Answer

Answer: C. Pneumonia
Rationale:
Pneumonia is an acute illness that has a r
apid onset of symptoms and lasts only a rel
atively short time. Diabetes, rheumatoid arthr
itis, and osteoporosis are chronic illnesses th
at cause a permanent change, require special
patient education for rehabilitation, and requ
ire a long period of care or support.
Question

Tell whether the following statement is true or fals

e.
A person who is experiencing a productive cou
gh and fever takes a sick day to recuperate and de
cide whether to make an appointment with the do
ctor. This person is said to be in stage 3 of illne
ss behavior: assuming a depen- dent role.
A. True
B. False
Answer

Answer: B. False
A person who defines himself as sick
and self-medicates or visits a doctor
is said to be in stage 2 of illness be-
havior: assuming the sick role.
Question
Which of the following models of healt
h and illness views health as a constantl
y changing state, with high-level wellne
ss and death being on opposite ends of
a graduated scale?
A. Agent-host-environment model
B. Health-illness continuum
C. High-level wellness model
D. Health belief model
Answer
Answer: B. Health-illness continuum
Rationale:
The health-illness continuum measures a perso
n’s level of health on a graduated scale.
The agent-host-environment model refers to th
e interaction of the agent, host, and environme
nt creating risk factors that must be examined.
The high-level wellness model involves functi
oning to maximum potential with balance an
d direction.
The health belief model is concerned with what
people believe to be true about their health.
Question

Tell whether the following statement is

true or false.
A person who keeps in touch with
neighbors in an attempt to foster a
“community feeling” is promoting his
or her emotional human dimension.
A. True
B. False
Answer

Answer: B. False
A person who keeps in touch with
neighbors in an attempt to foster a
“community feeling” is promoting his
or her sociocultural human dimen-
sion.
Question
Which of the following is an example of a
nursing activity that promotes secondary p
revention as a level of preventive care?
A. Conducting a smoking cessation class
B. Performing a blood pressure screening at
a local mall
C. Performing range-of-motion exercises on
a bedridden patient
D. Promoting safe sex practices in school
settings
Answer
Answer: B. Performing a blood pressure scre
ening at a local mall
Rationale:
Secondary preventive care focuses on early dete
ction of disease, such as the heart disease i
n this example.
Primary preventive care is directed toward pro
moting health and preventing diseases.
Tertiary care begins after an illness is diag- nose
d to reduce disability and rehabilitate patients.