1. Chapter 4 Health and Illness

2. Definitions of Health States
Health: a state of complete physical, mental, and social well being, not merely the absence of disease
Illness: the unique response of a person to a disease
Wellness: an active state, oriented toward maximizing the potential of the individual
Review “through the eyes of a student” discuss is Carrie healthy. Disease a pathological change in structure and function of the body. Where does mind vs body come into play. Can you be ill with out a disease? (mental illness)
Students to define Health.
Reflective practice. What would you do? Why?

3. Human Dimensions of Health
Physical
Intellectual
Emotional
Sociocultural
Spiritual
Environmental aspects
See picture next page. How do these interrelate? Ask students for examples of each.

4. The Human Dimensions Composing the Whole Person

5. Acute Illness
Generally has a rapid onset of symptoms and lasts only a relatively short time
Examples: appendicitis, pneumonia, diarrhea, common cold
Stages of acute illness:
Experienceing symptoms
Assuming sick role: ask students what do they want when sick. Mom, ginger ale, crushed ice curl up in bed with TV and tea.
Assume dependent role: agree to be cared for by others, nurses in hospital, mom, spouse,
Achieve recovery and rehabilitation : give up dependence and reassume normal activities and responsibilities.

6. Chronic Illness
A broad term that encompasses many different physical and mental alterations
Examples: diabetes mellitus, lung disease, arthritis, lupus
Permanent change
Irreversible alteration to anatomy or function
Education for rehab and to learn to live with condition
Long term care and support
Slow onset, remission and exacerbation more common as population ages.

7. Characteristics of a Chronic Illness
It is a permanent change
It causes, or is caused by, irreversible alterations in normal anatomy and physiology
It requires special patient education for rehabilitation
It requires a long period of care or support

8. Stages of Illness Behavior
Experiencing symptoms
Assuming the sick role
Assuming a dependent role
Achieving recovery and rehabilitation

9. 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

10. Agent-Host-Environment Model (Leavell and Clark)
Examines the causes of disease in an individual
Agent, host, and environment interact in ways that create risk factors
Understanding the risk factors is important for the promotion and maintenance of health
The host reaction is influenced by family history, age, and health habits
The environment includes physical, social, biologic, and cultural factors
Each of the agent-host-environment factors affects and is affected by the others
Agent is environmental factor or stressor, bacteria, virus, chemical substance
Host is living organism cable of being affected by the agent
Environment is factors that are external to host that make illness more likely ie: lack of sleep. Cold temperature,

11. The Agent-Host-Environment Triangle

12. The Health–Illness Continuum
Measures a person’s level of health
Views health as a constantly changing state with high- level wellness and death on opposite sides of a continuum
Illustrates the dynamic (ever-changing) state of health

13. The Health–Illness Continuum
Individual can view themselves at varying places along the continuum depending on how they feel at any given moment.

14. The High-Level Wellness Model (Dunn)
Encourages the nurse to care for the total person
Involves functioning to one’s maximum potential while maintaining balance and a purposeful 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, becoming, and befitting
Active state. More than good health (passive) maximizes the person’s potential. More total person focus incompasses all of the dimensions
Being: recognizing self as separate and individual
Belonging” being part of a whole:
becoming: growing and developing
Befitting: making personal choices to befit the self of the future

15. The Health Belief Model (Rosenstock)
Concerned with what people perceive to be true about themselves in relation to their health
Modifying factors for health include demographic, sociopsychological, and structural variables
Based on three components of individual perceptions of threat of a disease
Perceived susceptibility to a disease
Perceived seriousness of a disease
Perceived benefits of action
Example: smoking cessation classes and programs. Does smoker percieve it to be a health problem? Do they believe it will lead to cancer? Are the lifestyle changes worth the effort. Social network?

16. The Health Promotion Model (Pender)
Illustrates the “multidimensional nature of persons interacting with their environment as they pursue health”
Incorporates individual characteristics and experiences and behavior-specific knowledge and beliefs, to motivate health-promoting behavior
Personal, biologic, psychological, and sociocultural factors are predicative of a certain health-related habit
Health-related behavior is the outcome of the model and is directed toward attaining positive health outcomes and experiences throughout the lifespan
Used to design and provide nursing interventions
Used to predict how a person is likely to incorporate health promotion behaviors into their lifestyle. Smoking. If parents smoke children more likely to smoke.

17. Factors Affecting Health Status, Beliefs, and Practices
Risk factors for illness
Factors in the human dimensions that influence health– illness status
Beliefs and practice
Basic human needs
Self-concept
Internal or external behaviors;
Alcoholics, social activity. All friends drink. If give up may need to give up friends. Smokers, light up after a meal. How to change and incorporate.
Table 4-1 pg 71
age
Genetics
Physiolgic ( obesity, chronic disease),
Habits
Lifestyle
Environment

18. The Human Dimensions
Physical dimension—genetic inheritance, age, developmental level, race, and gender
Emotional dimension—how the mind affects body function and responds to body conditions
Intellectual dimension—cognitive abilities, educational background, and past experiences
Environmental dimension—housing, sanitation, climate, pollution of air, food, and water
Sociocultural dimension—economic level, lifestyle, family, and culture
Spiritual dimension—spiritual beliefs and values

19. Basic Human Needs Physiological needs Safety and security needs
Love and belonging needs
Self-esteem needs
Self-actualization needs
Need essential to emotional and physical health and survival. Part of all dimensions. Relate to Maslow.
WWMD vs WWJD?
Refer to table 4-2 page 73

20. Factors That Influence a Person’s Self-Concept
Past experiences
Interpersonal interactions
Physical and cultural influences
Education
How a person perceives themselves, believes is perceived by others. Impacts response to stress and illness. Example: diffences in perception of how to survive is boat capsized in puget sound.

21. Levels of Preventive Care
Primary prevention—e.g., diet, exercise, immunizations
Secondary prevention—e.g., screenings, mammograms, family counseling
Tertiary prevention—e.g., medications, surgical treatment, rehabilitation
Table 4-3 pg 73
Promote health and prevent development of disease process. Assess risk, health promotion activities, exercise, diet, attitude.
Secondary; mamograms, identify and detect disease, health maintenance plans for patients. Allergy testing. Dental care
Tertiary: used to achieve maximum functioning for chronic illness, support groups, PT,

22. Question Which of the following is an example of an acute illness?
A. Diabetes
B. Rheumatoid arthritis
C. Pneumonia
D. Osteoporosis

23. Answer Answer: C. Pneumonia Rationale:
Pneumonia is an acute illness that has a rapid onset of symptoms and lasts only a relatively short time. Diabetes, rheumatoid arthritis, and osteoporosis are chronic illnesses that cause a permanent change, require special patient education for rehabilitation, and require a long period of care or support.

24. Question Tell whether the following statement is true or false.
A person who is experiencing a productive cough and fever takes a sick day to recuperate and decide whether to make an appointment with the doctor. This person is said to be in stage 3 of illness behavior: assuming a dependent role.
A. True
B. False

25. 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 behavior: assuming the sick role.

26. Question
Which of the following models of health and illness views health as a constantly changing state, with high-level wellness 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

27. Answer Answer: B. Health-illness continuum Rationale:
The health-illness continuum measures a person’s level of health on a graduated scale.
The agent-host-environment model refers to the interaction of the agent, host, and environment creating risk factors that must be examined.
The high-level wellness model involves functioning to maximum potential with balance and direction.
The health belief model is concerned with what people believe to be true about their health.

28. 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

29. Question
Which of the following is an example of a nursing activity that promotes secondary prevention 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

30. Answer
Answer: B. Performing a blood pressure screening at a local mall
Rationale:
Secondary preventive care focuses on early detection of disease, such as the heart disease in this example.
Primary preventive care is directed toward promoting health and preventing diseases.
Tertiary care begins after an illness is diagnosed to reduce disability and rehabilitate patients.

31. 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 dimension.