Chapter 17 Health, Wellness, and Illness Dr. Wajed Hatamleh

Learning Outcomes Identify influences on clients’ definitions of health, wellness, and well-being. Describe five components of wellness. Compare the various models of health outlined in this chapter. Identify variables affecting health status, beliefs, and practices.

Learning Outcomes (cont'd) Describe factors affecting health care adherence. Differentiate illness from disease and acute illness from chronic illness. Identify Parsons’ four aspects of the sick role. Explain Suchman’s stages of illness.

Learning Outcomes Describe the effects of illness on individuals’ and family members’ roles and functions.

Health, Wellness, Wellbeing Many definitions and interpretations Be familiar with most common aspects of the concepts Consider how they may be individualized with specific clients

Health Presence or absence of disease Complete physical, mental, social well-being Ability to maintain normal roles Developmental and behavioral potential is realized to the fullest extent possible Striving toward optimal functioning Individual perception

Wellness State of well-being Basic aspects include 5 components: Self-responsibility An ultimate goal A dynamic, growing process Daily decision-making in areas of nutrition, stress management, physical fitness, preventive health care, and emotional health Whole being of the individual

Figure 17-2 The seven components of wellness Figure 17-2 The seven components of wellness. From Wellness: Concepts and Applications, 7th ed. (p. 4), by D. J. Anspaugh, M. H. Hamrick, and F. D. Rosato, 2009, New York, NY: McGraw-Hill. Reprinted with permission. 8

Physical Ability to carry out daily tasks Achieve fitness Maintain nutrition Avoid abusing drugs and alcohol or smoking Practice positive lifestyle habits

Divide the students into groups and assign each a component of wellness. Ask the students to provide examples of wellness behavior in each component.

Social Interact successfully Develop and maintain intimacy Develop respect and tolerance for those with different opinions and beliefs

Emotional Ability to manage stress Ability to express emotion

Intellectual Ability to learn Ability to use information effectively Striving for continued growth Learning to deal with new challenges

Spiritual Belief in some force that serves to unite Provide meaning and purpose to life Person’s own morals, values and ethics

Occupational Ability to achieve balance between work and leisure

Environmental Ability to promote health measure that improves Standard of living Quality of life Influences such as food, water, and air

Well-being Subjective perception of vitality and feeling well Described objectively, experienced, measured Can be plotted on a continuum

Health-Illness Continuum Measure person’s perceived level of wellness Health and illness/disease opposite ends of a health continuum

Health-Illness Continuum (cont'd) Move back and forth within this continuum day by day How people perceive themselves and how others see them will affect where their placement on the continuum

Variables Influencing Health Status, Beliefs, and Practices Internal variables External variables

Variables Influencing Health Status, Beliefs, and Practices These factors may or may not be under conscious control. People can usually control their health behaviors and can choose healthy or unhealthy activities. In contrast, people have little or no choices over their genetic makeup, age, gender, culture, and sometimes their geographical environments

Internal Variables Biologic dimension Psychologic dimension genetic makeup, gender, age, and developmental level Psychologic dimension mind-body interactions and self-concept Cognitive dimension lifestyle choices and spiritual and religious beliefs

External Variables Physical environment Standards of living Family and cultural beliefs Social support networks

Health Belief Models Developed to help determine whether an individual is likely to participate in disease prevention and health promotion activities

Health Belief Models (cont'd) Rosenstock’s and Becker’s Health Belief Models Individual’s perception Modifying factors Likelihood of action

Health Care Adherence Client motivation Degree of lifestyle change Perceived severity of health care problem Value placed on reducing the threat of illness Ability to understand and perform specific behaviors

Health Care Adherence (cont'd) Degree of inconvenience of the illness itself or of the regimens Beliefs that the prescribed therapy or regimen will or will not help

Health Care Adherence Complexity, side effects, and duration of the proposed therapy Cultural heritage, beliefs, or practices that support or conflict with the regimen Degree of satisfaction and quality and type of relationship with the health care providers Overall cost of therapy

Illness A highly personal state Person’s physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished Not synonymous with disease May or may not be related to disease Only person can say he or she is ill

Disease Alteration in body function A reduction of capacities or a shortening of the normal life span Causation of disease is called etiology

Acute Illness Characterized by symptoms of relatively short duration Symptoms often appear abruptly, subside quickly May or may not require intervention by health care professionals Most people return to normal level of wellness

Chronic Illness Lasts for an extended period, usually 6 months or longer Usually has a slow onset Often have periods of remissions, when the symptoms disappear and exacerbations, when the symptoms reappear

Chronic Illness (cont'd) Care includes promoting independence, sense of control, and wellness Learn how to live with physical limitations and discomfort

Parson’s Four Aspects of the Sick Role Rights Clients are not held responsible for their condition Clients are excused from certain social roles and tasks

Parson’s Four Aspects of the Sick Role (cont'd) Obligations Clients are obligated to try to get well as quickly as possible Clients or their families are obligated to seek competent help

Suchman’s Stages of Illness Stage 1: Symptom experience Believe something is wrong Stage 2: Assumption of the sick role Accepts the sick role and seeks confirmation Stage 3: Medical care contact Seeks advice of a health professional

Suchman’s Stages of Illness (cont'd) Stage 4: Dependent client role Becomes dependent on the professional for help Stage 5: Recovery or rehabilitation Relinquish the dependent role Resume former roles and responsibilities

Effects of Illness Impact on the Client Behavioral and emotional changes Self-concept and body image changes Lifestyle changes

Effects of Illness (cont'd) On the Family Depends on: Member of the family who is ill Seriousness and length of the illness Cultural and social customs the family follows

Impact on the Family Role changes Task reassignments Increased demands on time Increased stress due to anxiety about outcomes Conflict about unaccustomed responsibilities Financial problems

Impact on the Family (cont'd) Loneliness as a result of separation and pending loss Change in social customs