CONCEPTS OF HEALTH AND WELLNESS
Professional's understanding of health and wellness
determines his scope and nature of practice. Clients'
health beliefs also influence their health practices. Some
people think of health and wellness (well-being) as the
same thing or at the very least, as accompany one another.
However, health may not always accompany well being;
conversely another person may lack a sense of well being
yet be in a state of good health. For many years the
concept of disease was the yardstick by which health was
measured. In the late 19th century the "how" of disease
(pathogenesis) was the major concern of health
professionals. The 20th century focused on finding cure
for disease. Currently health care practitioner increases
their emphasis on promoting health and wellness in
individual’s family and. communities. Definitions of
Health .
1. Traditionally, health was defined in terms of presence
or absence of disease.
2. Health is a state of being well and using every power
the individual possesses to the fullest extent (Nightingale
1860/1969)
3. Health is a state of complete physical, mental, and
social wellbeing and not merely absence of disease or
infirmity (WHO 1948)
4. Health is the ability to maintain normal roles (Talcott
Parsons 1951, an eminent American sociologist and
creator of the concepts "sick role'
5. Health is not a condition, it is an adjustments. It is not a
state but a process (US President's commission on Health
needs of the Nations 1953) -health is an adaptive process,
not a state
6. Health is a dynamic state of being in which the
developmental and behavioral potential of an individual is
realized to the fullest extent possible .(ANA 1989 ).
7. Health is an experience that is often expressed in terms
of wellness and illness, and may occur in the presence or
absence of disease or injury (ANA 2004).
Other definitions of Health.
Health is being free from symptoms of diseases and pain
as much as possible.
2. Health is being able to be active and to do what
individual want or must.
3. Health is being in good spirits most of the time. Health
is deeply personal and subjective experience. It is
perceived uniquely by each individual. Consider the
following examples of individual who would probably
say they are healthy even though they have physical
impairments that some will consider as illness.
1. 15 years old with diabetes takes injectable insulin each
morning plays on the school soccer team and is editor of
the high school newspaper.
A 32-year-old paralyzed from the waist down and needs a
wheelchair for mobility. He is taking accounting at a
nearby college and uses a specially designed automobile
for transportation.
A 72 year old takes antihypertensives to treat high BP.
She is a member of the neighborhood golf club, makes
handicrafts for a local charity and travels 2 months each
year.
Many factors affect individual definitions of health.
Health definitions vary according to an individual's
previous experience, expectations of self, age, and social
cultural influences. We should be aware of our own
personal definition of health and appreciates that other
people have their own individual definition as well. A
person's definition of health influences behavior related to
health and illness. Understanding client's perception of
health and illness, we can provide more assistance to help
them regain or attain a state of health.
Wellness and well-being
Wellness is a state of well-being. Basic aspects of
wellness include self-responsibility; an ultimate goal; a
dynamic, growing process; daily decision making in the
areas of nutrition, stress management, physical fitness,
preventive health care and emotional health, and most
importantly, the whole being of the individual. seven
components of wellness by Anspaugh, Hamrick, Rosato
(2006).
1. Social 2.Emotional 3.Physical 4.Spiritual 5.
Intellectual 6. Occupational 7 Environmental.
Social - entails ability to interact successfully with people,
interact successfully within the environments of which
each is a part, develop and maintain intimacy with
significant others, develop respect and tolerance for those
with different opinions and beliefs.
Emotional components entails ability to manage stress,
express emotions appropriately, recognize, accept and
express feelings, accept one's limitation.
Intellectual components entails ability to learn and use
information effectively for personal, family, and career
development; strive for continue growth, learn to deal
with new challenges effectively.
Spiritual components entails the belief in some force
(nature, science, religion or higher power) that serves to
unite human beings and provide meaning and purpose to
life. It includes a person's own moral, values, and ethics.
Occupational component is the ability to achieve a
balance between work and leisure time .A person's belief
about education, employment, and home influence
personal satisfaction and relationship with others.
Environmental components are the ability to promote
health, measures that improve the standard of living and
quality of life in the community. This includes influences
such as food, water, and a physical components is the
ability to carry out daily task, a cheap fitness (e.g.
pulmonary, cardiovascular, gastrointestinal)maintain
adequate nutrition and proper body fat, avoid abusing
drugs and alcohol or using tobacco products, and
generally practice positive lifestyle habits. Well being is a
subjective perception of vitality and feeling well... can be
described objectively, experienced and measured... and
can be plotted on a continuum (Hoods and Leddy 2003).
It is a component of health.
What is Health?
Health is a state of complete physical, mental, and social
well-being, not merely the absence of disease or infirmity,
as defined by the World Health Organization (WHO). It is
a dynamic condition influenced by genetic,
environmental, social, and behavioral factors. Health
encompasses multiple dimensions, including:
Physical health: Proper body function and the absence of
illness or injury.
Mental health: Emotional and psychological well-being.
Social health: Quality of relationships and societal
integration.
2. Concept of Wellness
Wellness refers to the active pursuit of activities, choices,
and lifestyles that lead to a state of holistic health. Unlike
health, which may focus on the absence of disease,
wellness emphasizes proactive and preventive approaches
to achieving optimal well-being.
Dimensions of Wellness:
1. Physical Wellness: Maintaining a healthy body through
exercise, nutrition, and regular medical care.
2. Emotional Wellness: Awareness and management of
feelings.
3. Intellectual Wellness: Engaging in mentally stimulating
activities.
4. Social Wellness: Building meaningful relationships and
support networks.
5. Spiritual Wellness: Finding purpose and meaning in
life.
6. Environmental Wellness: Living harmoniously with the
environment.
7. Occupational Wellness: Satisfaction in work and career
pursuits.
3. Illnesses and Diseases
Illness: A subjective experience of feeling unwell, often
characterized by physical, emotional, or social
discomfort. It reflects how the individual perceives their
health.
Disease: An objective, pathological condition of the body
that disrupts normal functioning, identifiable through
medical examination and diagnosis.
Key Differences:
Illness focuses on the individual's experience.
Disease refers to a medical or biological abnormality.
4. Etiology of Illness and Disease
Etiology is the study of the causes or origins of diseases
and illnesses.
Categories of Etiological Factors:
1. Genetic Factors: Inherited disorders (e.g., cystic
fibrosis, sickle cell anemia).
2. Infectious Agents: Bacteria, viruses, fungi, and
parasites (e.g., tuberculosis, malaria).
3. Environmental Factors: Pollution, toxins, and climate
changes.
4. Behavioral Factors: Lifestyle choices such as smoking,
diet, and physical activity.
5. Psychosocial Factors: Stress, trauma, and social
influences.
5. Classification of Illness and Disease
1. Acute Illness/Disease: Sudden onset and short duration,
often resolving within a few days to weeks (e.g.,
influenza, appendicitis, Pneumonia, Acute
gastroenteritis).
2. Chronic Illness/Disease: Long-lasting conditions that
persist for months or years, often with slow progression,
requiring ongoing management (e.g., diabetes, arthritis,
HTN, Asthma, Rheumatoid arthritis).
3. Communicable Diseases: Transmitted from person to
person,or through vectors, contaminated food and water.
(e.g., COVID-19, HIV/AIDS, Malaria, TB).
4. Non-communicable Diseases (NCDs): Not contagious,
often lifestyle-related (e.g., heart disease, cancer i.e.
breast &lung, stroke, CKD).
5. Congenital Disorders: Present at birth (e.g., Down
syndrome, congenital heart defects, cleft lip and palate,
spina bifida).
6. Idiopathic Diseases: No identifiable cause (e.g.,
idiopathic pulmonary fibrosis, idiopathic
thrombocytopenic purpura ITP, idiopathic epilepsy,
idiopathic scoliosis).
7. Primary diseases: are the initial or underlying
conditions that occur independently and are not caused by
another disease. They are often the root cause of
subsequent health issues. (e.g. HTN, DM, TB,
Osteoporosis)
8. Secondary diseases: are conditions that develop as a
direct or indirect result of a primary disease. They are
dependent on the presence of another health issues. e.g.
HF, RF, Pneumonia, Liver Cirrhosis
6. Theoretical Perspectives of Health and Wellness
Theories provide frameworks for understanding health
and wellness. Key perspectives include:
Biomedical Model: Focuses on biological factors and
excludes psychological and social influences.
Biopsychosocial Model: Incorporates biological,
psychological, and social aspects of health.
Holistic Model: Views health as an integration of mind,
body, and spirit.
Ecological Model: Emphasizes the interaction between
individuals and their environment.
Maslow’s Hierarchy of Needs: Suggests that basic needs
(e.g., food, shelter) must be met before achieving higher
levels of health and self-actualization.
7. The Health-Illness Continuum
The Health-Illness Continuum is a model that illustrates
the dynamic nature of health. It represents health and
illness as a spectrum, with individuals constantly moving
between extremes based on their circumstances.
Optimal Health: A state of high-level wellness, where all
dimensions of health are balanced.
Illness: A deviation from wellness, which can range from
minor discomfort to chronic conditions.
Key Features of the Continuum:
1. Encourages viewing health as a process rather than a
fixed state.
2. Emphasizes the importance of proactive health
behaviors to shift toward wellness.
3. Helps in understanding how stress, lifestyle, and
environment impact an individual’s position on the
continuum.
Conclusion
Understanding health, wellness, and illness is
foundational for nursing practice. Nurses play a critical
role in promoting wellness, preventing illness, and
managing diseases by applying these concepts holistically
to patient care. Integrating theoretical perspectives and
tools like the health-illness continuum enables nurses to
support individuals in achieving optimal health outcomes.
