Concepts of Health, Wellness, & Well-Being

After the end of this chapter the student will be able to:

Differentiate health, wellness, and well-being.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, and well-being 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 healthas a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.

the American Nurses Association defined healtha 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.

Wellness & Well-Being

Wellness further describes health status. It allows health to be placed on a continuum from ones 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

The classic description of wellness was developed by Dunn in the early 1960s. According to Dunn (1961), high-level wellness means functioning to ones maximum health potential while remaining in balance with the environment.

Copyright 2008 by Pearson Education, Inc.Health-Illness ContinuumMeasure persons perceived level of wellnessHealth and illness/disease opposite ends of a health continuumMove back and forth (forward) within this continuum day by dayWide ranges of health or illness

Copyright 2008 by Pearson Education, Inc.Dimensions of Wellness

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

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

.Models of HealthClinical ModelRole Performance ModelAdaptive ModelEudemonistic ModelAgent-Host-Environment ModelHealth-Illness Continuum

Copyright 2008 by Pearson Education, Inc.Clinical ModelProvides the narrowest interpretation of healthPeople viewed as physiologic systems Health identified by the absence of signs and symptoms of disease or injuryState of not being sickOpposite of health is disease or injury

Role Performance ModelAbility to fulfill societal rolesHealthy even if clinically ill if roles fulfilledSickness is the inability to perform ones role

Adaptive ModelCreative processDisease is a failure in adaptation or maladaptationExtreme good health is flexible adaptation to the environmentFocus is stabilityThe aim of treatment is to restore the ability of the person to adapt.

Copyright 2008 by Pearson Education, Inc.Eudemonistic ModelComprehensive view of healthCondition of actualization (make real) or realization of a persons potentialIllness is a condition that prevents self-actualizationActualization is the apex of the fully developed personality Dictionary: eudemonism: morality evaluated according to happiness :

Copyright 2008 by Pearson Education, Inc.Agent-Host-Environment ModelEach factor constantly interacts with the othersWhen in balance, health is maintainedWhen not in balance, disease occurs

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.

Factors influencing health status, beliefs, and practices:

Internal factorsExternal factors

1. Internal factorsBiologic 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.

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.

DiseaseDisease 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 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 IllnessOn the ClientBehavioral and emotional changesLoss of autonomySelf-concept and body image changesLifestyle changesOn the FamilyDepends on:Member of the family who is illSeriousness and length of the illnessCultural and social customs the family follows

Impact of Illness: Family ChangesRole changesTask reassignmentsIncreased demands on timeAnxiety about outcomesConflict about unaccustomed responsibilities Financial problemsLoneliness as a result of separation and pending lossChange in social customs

****Figure 17-2 The seven components of wellness. (From Wellness: Concepts and Applications, 6th ed. (p. 4) by D.J. Anspaugh, M.H. Hamrick, and F.D. Rosato, 2006. Reproduced with permission of the McGraw-Hill Companies.)****************