B233, health and wellness

Health is a core concept that describes the state of physical, social, mental and spiritual wellbeing of a person and not just the absence of disease or infirmity. Health is a measure of functioning that realizes a person's potential and is viewed in a developmental context.

Health can be described as poor, excellent and these descriptions are based on a variety of factors.

These factors could include age, race, ethnicity, physical condition, social or economic situation, etc.

Health is an objective term.

Wellness is a subjective term.

It is used to describe how someone is feeling .

Someone can be decribed as feeling well even when they have been diagnosed with cancer or diabetes.

One can say that they are feeling poor, or ill, etc.

It is an objective term.

It is the pathophysiology of something going on in the body.

Disease literally means - without ease.

If one has a disease, the body's mechanisms are unable to counteract stimuli and stresses adequately.

Illness is a subjective term.

Subjective experience coupled with the physical manifestation of the disease.

A person does not have an illness, they have a disease that is causing them to feel ill.

Illness is a response to the body's ability to sustain a balanced relationship with thier environment.

A concept by Newman.

Health (objective) and illness (subjective)

This model depicts health and illness as opposites (left to right respectively).

From top to bottom, you have a high level of wellness (favorable environment) and a low level of wellness (unfavorable environment)

This says that a person can have good health, but a low level of wellness. Meaning that it is taking into account a holistic view.

This view is combining health and social and environmental factors.

This is a model by Smith.

It is more of a classic model of convention medicine.

• It defines health by absence and
• defines illness by the presence of disease or symptoms thereof.

The data in this model are objective.

A model of health by Smith.

Defines health as the ability to perform a social role as determined by society.

The role can be work, family, and social roles and these are determined by societal expectations.

For example, I work at UPS and I drop a package on my foot. Therrefore, I can't return to work immediately because I am not capable of performing my role as a bagger. Therefore, I am not in good health as determined by this model.

This model is used by occupational health agencies, physcian - excused absenses and school physical examination.

A model by Smith.

Health is defined as the ability to emotionally adapt to changes that occur physically, mentally and physiologically.

For example, I hurt my leg and I am not able to workout. I really want to get this weight off. If my thought process is, "I'm doomed to be fat forever" then I would describe myself as not being in good health. If my thought process is more adaptive to my situation, such as, "I have got to come up with a way to modify my workout and change my diet until my leg starts to feel better" then I would say that I am in good health.

This is a model by Smith.

Health is defined by an optimal state of wellbeing.

The model is holistic (physical, social, psychological, and spiritual aspects of life) and the environment contributes to goal attainement.

Illness is defined by a lack of involvement with life.

• An example is:
• Still finding meaning in life when you have come down with a disease.

1) Increase the quality and years of healthy life.

2) Eliminate health disparities

These models of health explain the different ways in which one view health.

This determines when and if we see a healthcare provider, and what type of provider we see.

• For the clinical model:
• This person does see a doctor regularly, infact only when there are symptoms and signs of something not right. My purpose for seeing the doctor is to go and let him fix me and I'll be back the next time I feel ill.

For this model, there is not much if any preventative care and education only when the patient comes in to the office. This person will view the nurse as inconsequential because she is not the healer.

Think Melvin when you think of this model.

• For the Role Performance model:
• Under this model you will see a medical professional when you are unable to perform a task related to your role.

Under this role, you an be excused from your task in your role.

This person will see a doctor because they want to be excused, because they have to see the medical professional in order to return to their work role, etc.

You would not go to this doctor for education or for preventative care. The purpose of this profession is to get you well so that you can return to your role.


The Adaptive model:

These goals, broken down into objectives, are going to tell us which helath promotion and disease prevention efforts take place.

• 1) HP 2020 places an emphasis on personal responsibility.
• As a nurse, we have to educate our clients on healthy ways on living. For ex., we should ask each client if they smoke or exercise and provide ways to quit smoking if they do or work an exercise program into their lifestyle.

2) As providers, we can serve in the communities that need help and may be able to serve those people better.

3) As providers, we can serve on advisory boards and community boards as active participants, which will help providers learn what needs are present and the available resources to meet those needs.

Averting development of disease in the future.

Primary prevention is what you do to avoid or avert any disease of dysfunction.

• For example,
• 1) you vaccinate (specific protection) to prevent a disease like the varicella virus (chicken pox)

2) you educate (health promotion) about the harmful effects of smoking

Secondary prevention - the disease is already present and you want to keep the disease from advancing and you also want to limit any adverse affects of the disease.

1) early screening and early stage treatment and

2) limiting the disability of a disease caught in the later stages

Risk is the liklihood of development of something. This is done through lots of research.

Betsy spoke about the study about oral contraceptives.

Absolute risk - the bare bones (genetic)

Relative risk - shows the effect of risk factors (diet and exercise)

This is important because you need to know what to do to change the risk around.

Advocate - you can advocate for your patient (medications, etc) and you can advocate for insurance coverage with the health insurance agency.