Chapter 4 Health and Illness

1. Chapter 4Health 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

3. Human Dimensions of Health • Physical • Intellectual • Emotional • Sociocultural • Spiritual • Environmental aspects

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

6. Chronic Illness • A broad term that encompasses many different physical and mental alterations • Examples: diabetes mellitus, lung disease, arthritis, lupus

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

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

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

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

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

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

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

20. Factors That Influence a Person’s Self-Concept • Past experiences • Interpersonal interactions • Physical and cultural influences • Education

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

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.