Concepts of Health,

Wellness & Well-Being, Illness &

Disease
 After the end of this session the student
will be able to:

Differentiate health, wellness, and well-being, illness &

disease.
Describe five dimensions of wellness.
Compare various models of health.
Identify factors affecting health status, beliefs, and
practices.
Identify health care adherence.
Differentiate illness from disease and acute illness from
chronic illness.
Explain Suchman's stages of illness.
 Introduction

• Health, wellness & well-being ,illness, &

disease 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.
 Health
• There is no consensus (agreement) about any
definition of health. There is knowledge of
how to attain(reach) a certain level of health,
but health itself cannot be measured.
• 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
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 defined
health
• a dynamic state of being in which
the developmental and
behavioral potential (possible) of
an individual is realized to the
fullest extent possible
Most 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.
LAY FILIPINO DEFINITIONS OF HEALTH
DEFINITION OF ILLNESS
 Illness and Disease
Illness
Is a highly personal state in which the
person's physical, emotional, intellectual,
social, developmental, or spiritual
functioning is thought to be diminished.
Illness is usually associated with disease but
may occur independently of it. Illness is a
highly personal state in which the person
feels unhealthy or ill.
• Illness is defined as a product of disharmonious
interaction (disease) between mind, body,
emotions and spirit.
• Illness is a product of complimentary interaction
between mind and body
• Illness can be a signal that important needs are
not being met.
• Illness is not merely the presence of disease
process. An abnormal state in which a person’s
physical, emotional, intellectual, social
development or spiritual functioning is diminished
nor impaired compared with the person’s previous
experience
• Illness includes disease and also its effect on functioning and
well-being in dimension
• Illness is a manifestation of human state; physical, mental,
emotional and spiritual discomforts
• Illness is a representation of the negative relationship between
a man and his natural and supernatural environment
• An unhealthy condition of body and mind(Merriam)
• Is the response of the person to a disease; it is an abnormal
process in which the person’s level of functioning is changed
when compared with a previous level (Taylor et al)
DEFINITION OF…………
 Wellness & Well-Being

• Wellness further describes health status. It

allows health to be placed on a continuum
from one’s optimal level (“wellness”) to a
maladaptive state (“illness”)
• Wellness is a dynamic process that is ever
changing. The well person usually has some
degree of illness and the ill person usually has
some degree of wellness.
• This concept of a health continuum negates
the idea that wellness and illness are opposite
because they may occur simultaneously in the
same person in varying degrees
Dimensions of Wellness

Copyright 2008 by Pearson Education, Inc.

 1. Physical.
• The ability to carry out daily tasks, achieve
fitness (e.g. pulmonary, cardiovascular,
gastrointestinal), maintain adequate nutrition
and proper body fat, avoid abusing drugs and
alcohol or using tobacco products, and
generally to practice positive lifestyle habits.
 2. Social.
• The ability to interact successfully with people
and within the environment
 3. Emotional.
• The ability to manage stress and to express
emotions appropriately, Emotional wellness
involves the ability to recognize, accept, and
express feelings.
 4. Intellectual.
• The ability to learn and use information
effectively for personal, family, and career
development
 OCCUPATIONAL
• - Involves the suitability of our work of
interest, skills and values and the
fulfillment we gain from our professions
 ENVIRONMENTAL
• -is the ability to recognize our own
responsibility for the quality of the air, the
water and the land that surrounds us.. the
ability to make a positive impact on the
quality of environment, be it our homes, our
communities or our planet contributes to our
environmental wellness
 5. Spiritual.
• The belief in some force (nature, science,
religion, or a higher power) that serves to
unite human beings and provide meaning and
purpose of life
 6. Occupational.
• The ability to achieve a balance between work
and leisure time, A person's beliefs about
education, employment, and home influence
personal satisfaction and relationships with
others.
 7. Environmental.
• The ability to promote health measures that
improve the standard of living and quality of
life in the community
DIFFERENT MODELS OF HEALTH
1.SMITH’S 4 MODELS OF HEALTH
2.AGENT HOST ENVIRONMENT MODEL
3.HEALTH BELIEF MODEL
4.HEALTH ILLNESS CONTINUUM
5.NEEDS FULFILLMENT MODEL
6.HEALTH PROMOTION MODEL
 Clinical Model
 Provides the narrowest interpretation of
health
 People viewed as physiologic systems
 Health identified by the absence of signs and
symptoms of disease or injury
 State of not being “sick”
 Opposite of health is disease or injury

Copyright 2008 by Pearson Education, Inc.

 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 maladaption
 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 self-
actualization
 Actualization is the apex of the fully
developed personality

Copyright 2008 by Pearson Education, Inc.

 Agent-Host-Environment Model
 Each factor constantly
interacts with the
others
 When in balance,
health is maintained
 When not in balance,
disease occurs

Copyright 2008 by Pearson Education, Inc.

 AGENT
 -also called as the ecologic model. This model
is used primarily in predicting illness rather
than in promoting wellness.
 -when in balance, health is maintained
 When not in balance, disease occurs
 HOST
• - person who may not/may be in risks of acquiring a
disease: family history, age, and lifestyle or habits
influence the host’s reaction
 ENVIRONMENT
• - all factors external to the host that may
create or may predispose the person to
the development of diseases
 HEALTH BELIEF MODEL
• this model assumes that there is a relation
between a person’s belief and actions
• The classic description of wellness was
developed by Dunn in the early 1960s.
According to Dunn (1961), high-level wellness
means functioning to one’s maximum health
potential while remaining in balance with the
environment.
 Health-Illness Continuum
Measure person’s perceived level of wellness
Health and illness/disease opposite ends of a health
continuum
Move back and forth within this continuum day by day
Wide ranges of health or illness

Copyright 2008 by Pearson Education, Inc.

DUNN’S HIGH LEVEL WELLNESS
GRID
TRAVIS ILLNESS WELLNESS
CONTINUUM
NEEDS FULFILLMENT MODEL BY ABRAM
HAM MASLOWS
 Factors influencing health status,
beliefs, and practices:
• Internal factors
• External factors
 FACTORS AFFECTING
1. INTERNAL FACTORS
HEALTH
• GENETICS
• GENDER
• AGE AND DEVELOPMENTAL AGE
• MIND BODY INTERACTIONS
• LIFESTYLE
• SPIRITUAL AND RELIGIOUS BELIEF
• SERIOUS ILLNESS
• EDUCATION
• 2. EXTERNAL FACTORS
• GEOGRAPHY
• PHYSICAL ENVIRONMENT
• HEALTH SERVICES
• INCOME AND SOCIAL STATUS
• SOCIAL SUPPORT NETWORK
 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 ( design) on a
continuum". It is a component of health.
 1. Internal factors
– Biologic dimension genetic makeup, sex,
age, and developmental level all
significantly influence a person's health.
– Psychological dimension emotional factors
influencing health include mind-body
interactions and self-concept.
– Cognitive dimension include lifestyle
choices and spiritual and religious beliefs.
 2. External factors

Environment.
Standards of living. Reflecting occupation, income, and
education.
Family and cultural beliefs. Patterns of daily living and
lifestyle to offspring( children).
Social support networks. Family, friends, or confidant
(best friend) and job satisfaction helps people avoid
illness.
 Health Care Adherence

• Adherence (obedience) : is the extent to which

an individual's behavior for example, taking
medications, following diets or making
lifestyle changes. Degree of adherence may
range from disregarding (ignoring) every
aspect of the recommendations to following
the total therapeutic plan.
• Disease
• Disease can be described as an alteration
in body functions resulting in a reduction of
capacities or shortening of the normal life
span.
• The causation of a disease is called its
etiology.
 There are many ways to classify
illness and disease:

• Acute illness is typically characterized by

severe symptoms of relatively short duration.
• A chronic illness is one that lasts for an
extended period, usually 6 months or longer,
and often causes a long term change for
person's life.
 Suchman describes five stages of
illness:
• Stage 1 symptoms experiences.
• Stage 2 assumption of the sick role confirmation
from family and friends.
• Stage 3 medical care contact.
• Stage 4 dependent client role.
• Stage 5 recovery or rehabilitation.
 There are several approaches to
health maintenance:
• • Health promotion
• • Health protection
• • Disease prevention
 Impact of Illness
On the Client On the Family
•Behavioral and emotional •Depends on:
changes – Member of the family
•Loss of autonomy who is ill
– Seriousness and length
•Self-concept and body
of the illness
image changes – Cultural and social
•Lifestyle changes customs the family
follows
 Impact of Illness: Family Changes
• Role changes
• Task reassignments
• Increased demands on time
• Anxiety about outcomes
• Conflict about unaccustomed responsibilities
• Financial problems
• Loneliness as a result of separation and pending loss
• Change in social customs
 ILLNESS
• A state in which a person’s physical, emotional,
intellectual and social development or spiritual
functioning is diminished compared to previous
experience.
 Stage I – Symptom Experience
Believes something is wrong
Experienced symptoms
Fear and anxiety
 Stage II Assumption of a Sick Role
Seek Help
Excused from normal duties and roles
Not held responsible
for their condition
 Stage III Medical Care Contact
•Seeking Medical advise
• - to validate
illness
• - explanation of
symptoms
• - relief of the
illness
• - may accept or
deny diagnosis
 Stage IV Dependent Client Role
• Give out dependence
• Accepts treatment plan
 Stage V – Recovery or
Rehabilitation
• Back to normal function
COMMON RESPONSE TO STRESS
AND ILLNESS
 3 Levels of Prevention
•Primary – Health promotion and protection

•Secondary – Early detection, diagnosis and treatment

•Tertiary - Rehabilitation
 Primary Prevention
 EMPHASIS ON:
1. Generalized health promotion and specific protection
2. Encourage optimal health & increase person’s resistance to illness
3. Seeks to prevent disease or condition at a pre-pathologic state
4. Recipients are GENERALLY HEALTHY PEOPLE
 WHEN GIVEN:
Before onset of illness or before onset of disease
 Secondary Prevention
- known as health maintenance
seeks to identify specific illness/condition at an early stage
with prompt intervention to prevent or limit disability
Emphasis placed on:
1. Early Diagnosis, Detection, Screening
2. Prompt treatment
3. Health maintenance of persons already having health
problems
4. Prevention of complications
 TERTIARY PREVENTION

Support client’s achievement of successful

adaptation to known risks, optimal
reconstitution or establishment of high-level
wellness
occurs after a disease or disability has occurred
& recovery process has begun
seeks to halt the disease or injury process &
obtain optimal health status
 TERTIARY PREVENTION
Emphasis on:
Support of the client to achieve the following:
1. Successful re-adaptation
2. Optimal reconstitution
3. Regain high-level wellness
4. Therefore, the purpose is more of
REHABILITATION
IDENTIFY WHICH OF THE FOLLOWING HEALTH LEVELS OF
PREVENTION IS PRIMARY, SECONDARY OR TERTIARY

1. Have regular (yearly) PE/Papsmear and BSE

2. Men: regular testicular examination
3. Annual dental examination
4. Exercise regularly at least 3x per week for 30 mins.
5. Do not smoke.
6. Avoid alcohol
7. Reduce fat and increase fiber in the diet.
8. Sleep regularly 7 to 8 hours/ night
9. Eat breakfast
10. Maintain an ideal body weight
Quit Smoking
Wear hazard devices
Physical Therapy after CVA
Attending Self-Management education for DM
patients
Have annual physical examination
Sputum Exam for TB
Weighing the children
Taking adequate fluids
Complete immunization
Speech therapy after laryngectomy
Phil.Health Care Delivery System
• 1.PRIMARY LEVEL FACILITIES

• 2. SECONDARY LEVEL FACILITIES

• 3. TERTIARY LEVEL FACILITIES

 Classify as to what level the ff. belong
1. Teaching and Training Hospitals
2. City Health Services
3. Emergency and District Hospitals
4. Private Practitioners
5. Heart Institutes
6. Puericulture Centers
7. RHU