Concepts of Health,
Wellness, & Well-Being
Fundamentals in Nursing Practice
Jhoanna V. Tabi, RN, MAN
After the end of this chapter the
student will be able to:
Differentiate health, wellness, and well-being.
Describe five dimensions of wellness.
Compare various models of health.
Identify factors affecting health status, beliefs, and
practices.
Identify levels of preventive care.
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 health
a 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.
Physical Health
It means adequate body weight, height and
circumference as per age and sex with
acceptable level of vision, hearing,
locomotion or movements, acceptable
levels of pulse rate, blood
pressure, respiratory rate,
chest circumference, head
circumference, waist hip ratio.
Mental Health
The positive
dimension of
mental health is
stressed in WHO’s
definition of health
as contained in its
constitution.
Mental health is defined “as a state of
well being in which the individual realized
his or her own abilities, can cope with
normal stresses of life, can work
productively and fruitfully and is able to
make a contribution to his or her
community”.
Social Wellbeing
It is the third dimension of health. It
means ability of a person to adjust with
others in his social life, at home, at work
place and with people. Men interact with
men and they inter-relate and inter
depend on each other and pay their
effective role in accordance with a
situation.
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.
Health-Illness Continuum
Measure person’s perceived level of wellness
Health and illness/disease opposite ends of a health
continuum
Move back and forth (forward) within this continuum day
by day
Wide ranges of health or illness
Copyright 2008 by Pearson Education, Inc.
Dimensions of Wellness
Copyright 2008 by Pearson Education, Inc.
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
Models of Health
Clinical Model
Role Performance Model
Adaptive Model
Eudemonistic Model
Agent-Host-Environment Model
Health-Illness Continuum
.
Clinical Model
Provides the narrowest interpretation of
health
People viewed as physiologic systems
Health identified by the absence of signs
and symptoms of disease or injury
State of not being “sick”
Opposite of health is disease or injury
Copyright 2008 by Pearson Education, Inc.
Role Performance Model
Ability to fulfill societal roles
Healthy even if clinically ill if roles fulfilled
Sickness is the inability to perform one’s
role
Adaptive Model
Creative process
Disease is a failure in adaptation or
maladaption
Extreme good health is flexible adaptation
to the environment
Focus is stability
The aim of treatment is to restore the
ability of the person to adapt.
Eudemonistic Model
Comprehensive view of health
Condition of actualization (make real) or
realization of a person’s potential
Illness is a condition that prevents self-
actualization
Actualization is the apex of the fully
developed personality
Dictionary:
eudemonism: morality evaluated according to
happiness
Copyright 2008 by Pearson Education, Inc.
Agent-Host-Environment Model
Each factor constantly
interacts with the
others
When in balance,
health is maintained
When not in balance,
disease occurs
Copyright 2008 by Pearson Education, Inc.
Health-Illness Continuum
Measure person’s perceived level of wellness
Health and illness/disease opposite ends of a health
continuum
Move back and forth within this continuum day by day
Wide ranges of health or illness
Copyright 2008 by Pearson Education, Inc.
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.
Factors influencing health
status, beliefs, and practices:
Internal factors
External 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.
Health Care Adherence
Adherence (obedience) : is the extent to
which an individual's behavior for
example, taking medications, following
diets or making lifestyle changes. Degree
of adherence may range from
disregarding (ignoring) every aspect of the
recommendations to following the total
therapeutic plan.
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.
Disease
Disease 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.
There are several approaches to
health maintenance:
Health promotion
Health protection
Disease prevention
Levels of Prevention Care
Primary prevention aims to prevent
disease or injury before it ever occurs.
Examples:
legislation and enforcement to ban or
control the use of hazardous products
education about healthy and safe habits
immunization against infectious diseases.
Secondary prevention aims to reduce the
impact of a disease or injury that has already
occurred.
Examples:
regular exams and screening tests to detect
disease in its earliest stages
daily, low-dose aspirins and/or diet and
exercise programs to prevent further heart
attacks or strokes
suitably modified work so injured or ill workers
can return safely to their jobs.
Tertiary prevention aims to soften the
impact of an ongoing illness or injury that has
lasting effects.
Examples:
cardiac or stroke rehabilitation programs,
chronic disease management programs
support groups that allow members to share
strategies for living well
vocational rehabilitation programs to retrain
workers for new jobs when they have
recovered as much as possible.
Level of
disease Description Example
prevention
Primary Prevent Health teaching,
prevention occurrence of diet, exercise,
disease immunizations
Secondary Early detection Screening
prevention and intervention procedures
Tertiary prevention Prevent further Medications,
deterioration surgical treatment
and rehabilitation
Impact of Illness
On the Client On the Family
Behavioral and Depends on:
emotional changes Member of the family
Loss of autonomy who is ill
Self-concept and
Seriousness and
length of the illness
body image changes Cultural and social
Lifestyle changes customs the family
follows
Impact of Illness: Family
Changes
Role changes
Task reassignments
Increased demands on time
Anxiety about outcomes
Conflict about unaccustomed responsibilities
Financial problems
Loneliness as a result of separation and pending
loss
Change in social customs
THE END.
