Module: HN 0106

FOUNDATION OF NURSING 2

Title:
THE CONCEPT
OF
HEALTH & ILLNESS
 Concept of health and illness
Learning Objectives:
1.Definition of health and illness
2.Identify Illness and illness behaviour
3.Identify factors influencing health
4.Describe the impact of illness on patient
and family
5.Health care services: health promotion and
prevention of illness
 Definition of health and illness
“Health is a state of complete physical, mental and social
well-being and not merely the absence of disease or
infirmity (sickness)” (WHO, 1974).

“ Health is not a condition; it is an adjustment. It is not a

state but a process. The process adapts the individual not
only to our physical, but also our social environments”
(President Commission, 1953).

Health is being well and using one’s power to the fullest

extent. Health is maintained through prevention of disease
via environmental health factors (Nightingale).

HEALTH is the ability to maintain the internal milieu. Illness

is the result of failure to maintain the internal
environment (Claude Bernard).
 Definition cont’...
• Illness is a personal (physical, emotional,
intellectual, social, developmental or spiritual)
state in which the person feels unhealthy.

• Most people define and describe health as:

– Being free from symptoms of disease and pain
as much as possible
– Being able to be active and able to do what
they want or must
– Being in good spirits most of the time

• Health and illness are highly individualized

perceptions
 Definition of illness
• Illness is a personal (physical, emotional,
intellectual, social, developmental or spiritual) state
in which the person feels unhealthy.
• Disease is an alteration in body functions resulting
in reduction of capacities or shortening of normal
life span.
• May or may not be related to disease

• An individual could have a disease Eg. Growth in

the stomach and not feel ill. However, some token,
a person can feel ill – uncomfortable
• Illness is highly subjective

• Only he or she can say he or she is ill.

Model: Health and Illness
Model of health
The Iceberg Model of Health and
Disease
 Factors influencing health
PRECURSORS (underpinning) OF ILLNESS

1. Heredity- family history for diabetes

mellitus; hypertension; cancer

2. Behavioral factors- cigarette smoking;

alcohol abuse; high animal fat intake

3. Environmental factors- overcrowding;

poor sanitation; poor supply of potable
water
 FACTORS AFFECTING HEALTH AND ILLNESS

1.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 practices.
 FACTORS AFFECTING HEALTH AND ILLNESS
Cont’…

2. EMOTIONAL DIMENSIONS
• How the mind and body interact to affect
body function and to respond to body
conditions also influences health. Long-
term stress affects the body systems and
anxiety affects health habits; conversely,
calm acceptance and relaxation can
actually change body responses to illness.
 Factors affecting health and illness Cont’…

3. INTELLECTUAL DIMENSION
• The intellectual dimension
encompasses cognitive abilities,
educational background and past
experiences. These influence a client’s
responses to teaching about health
and reactions to health care during
illness. They also play a major role in
health behaviors.
 Factors affecting health and illness Cont’…

4. ENVIRONMENTAL DIMENSION
• The environment has many
influences on health and illness.
Housing, sanitation, climate, and
pollution of air, food and water are
aspects of environmental dimension.
 Factors affecting health and illness Cont’…

5. SOCIOCULTURAL DIMENSION
• Health practices and beliefs are strongly
influenced by a person’s economic level, life
style, family and culture. Low-income
groups are less likely to seek health care to
prevent or treat illness; high-income groups
are more prone to stress-related habits and
illness. The family and the culture to which
the person belongs determine patterns of
living and values about health and illness
that are often unalterable.
 Factors affecting health and illness Cont’…

6. SPIRITUAL DIMENSION
• Spiritual and religious beliefs and
values are important components of
the way the person behaves in health
and illness.
 Levels of prevention
• PRIMARY PREVENTION
– Providing specific protection against disease to
prevent its occurrence is the most desirable
form of prevention.
– Primary preventive efforts spare the client the
cost, discomfort and the threat to the quality
of life that illness poses or at least delay the
onset of illness.
– Preventive measures consist of counseling,
education and adoption of specific health
practices or changes in life style.
 Levels of prevention Cont’…
• SECONDARY PREVENTION
– It consists of organized, direct screening
efforts or education of the public to
promote early case finding of an
individual with disease so that prompt
intervention can be instituted to halt
pathologic processes and limit disability.
– Early diagnosis of a health problem can
decrease the catastrophic effects that
might otherwise result for the individual
and the family from advanced illness
and its many complications.
 Levels of prevention Cont’…
• TERTIARY PREVENTION
– It begins early in the period of recovery from illness
and consists of such activities as consistent and
appropriate administration of medications to
optimize therapeutic effects, moving and
positioning to prevent complications of immobility
and passive and active exercises to prevent
disability.
– Continuing health supervision during rehabilitation
to restore an individual to an optimal level of
functioning. Minimizing residual disability and
helping the client learn to live productively with
limitations are the goals of tertiary prevention
(Pender, 1987).
 STAGES OF ILLNESS BEHAVIOR

STAGE 1: SYMPTOM EXPERIENCE

• The person is aware that "something is
wrong". A person usually recognizes a
physical sensation or a limitation in
functioning but does not suspect a specific
diagnosis. The person's perception of a
symptom includes awareness of a physical
change such as pain, a rash or a lump;
evaluation of this change and a decision
that it is a symptom of an illness, and an
emotional response.
 Stages of illness behavior Cont’…

STAGE 2 : ASSUMPTION OF THE SICK ROLE

• If symptoms persist and become
severe, clients assume the sick role. At
this point the illness becomes a social
phenomenon, and sick people seek
confirmation from their families and
social groups that they are indeed ill
and that they be excused from
normal duties and role expectations.
 Stages of illness behavior Cont’…

STAGE 3: MEDICAL CARE CONTACT

• If symptoms persist despite the
home remedies, become severe, or
require emergency care, the person
is motivated to seek professional
health services. In this stage the
client seeks expert acknowledgement
of the illness as well as the
treatment.
 Stages of illness behavior Cont’…
STAGE 4 : DEPENDENT CLIENT ROLE
• The client depends on health care
professionals for the relief of symptoms.
The client accepts care, sympathy and
protection from the demands and
stresses of life. A client can adopt the
dependent role in a health care
institution, at home, or in a community
setting. The client must also adjust to
the disruption of a daily schedule.
 Stages of illness behavior Cont’…
STAGE 5 : RECOVERY AND REHABILITATION

• This stage can arrive suddenly, such

as when the symptoms appeared. In
the case of chronic illness, the final
stage may involve in an adjustment
to a prolonged reduction in health
and functioning
 Health promotion
• The process of enabling people to in areas
to control over and to improve health

• Health education

• Environmental modifications

• Nutritional interventions

• Lifestyle and behavioral changes

 Specific protection
• Immunization
• Specific nutrients
• Chemoprophylaxis
• Protection against occupational
hazards
• Protection from carcinogens
• Avoidance of allergens
Rehabilitation
• The combined and coordinated use of
 medical, social, educational and
vocational  measures for training and
retraining the  individual to the highest
possible level of  functional ability.
Examples-schools for blind, reconstructive
surgery in leprosy, provision of aids for
the crippled
 Intervention approaches:
• Individual-focused (personal health)

• Community-focused (population or
subgroup)

• System-focused (procedures, rules,

regulations, policy and law)
Thank You