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.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 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 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 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

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.

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.

Dun’s Concept of Wellbeing

Death

Very Vaforable Environment

Pealk Illness

Very Unvafotable Environment

Emergent Level of Wellness

High Level of Wellness

Protected Poor Health

Poor Health

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

Factors influencing health status, beliefs, and practices:

Internal factorsExternal factors

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.

Public Policy & Intervention

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.

Impact of Illness

On the ClientBehavioral and

emotional changesLoss of autonomySelf-concept and

body image changes

Lifestyle changes

On the FamilyDepends on:

◦ Member of the family who is ill

◦ Seriousness and length of the illness

◦ Cultural and social customs the family follows

Impact of Illness: Family Changes

Role changesTask reassignmentsIncreased demands on timeAnxiety about outcomesConflict about unaccustomed

responsibilities Financial problemsLoneliness as a result of separation and

pending lossChange in social customs

AsessmentIndividuFamilyCommunity

Intervention

• Health promotion• Disease prevention :

◦Primary Prevention◦Secondary Prevention

Primary Health CareEssential ServiceEquitable ServiceIndividual & Community

Involvement in the lanningEmphasis on Promotion &

PreventionTechnology should be

AppropriatelyHealth Development should be

integrated with social economic development