Chapter 02

Chapter 2
Concepts of Health, Illness, Stress,

and Health Promotion
Copyright © 2018, 2014, 2009 by Saunders, an imprint of Elsevier Inc. All rights reserved.
Lesson 2.1
Health and Illness and
Contributing Factors
Theory
1)Compare traditional and current views of the meanings
of health and illness.
2)Describe what the word “health” means to you.
3)Define what “sickness” means to you.
4)Discuss why nurses need to be aware of any cultural,
educational, and social differences that might exist

between themselves and their patients.
5)Compare cultural/racial differences in disease
predisposition and communication between the main

cultures and different races.
Lesson 2.1
Health and Illness and
Contributing Factors
Clinical Practice
1)Observe patients during the data-gathering
process and interview process and determine
their views on health and illness.
2)Recognize cultural differences in health care
concepts and behaviors in the clinical setting
and be able to share those observations with
fellow students.
Health and Illness
 Health means different things to people
 Absence of disease
 Optimum functioning on every level
 Miller-Keane dictionary defines health as:
 “A relative state in which one is able to function
well physically, mentally, socially, and spiritually in
order to express the full range of one’s unique
potentialities within the environment in which one
is living”
Traditional Views of Health
and Illness
 Chronic illness
 Develops slowly over a long period and lasts
throughout life
 Acute illness
 Develops suddenly and resolves in a short time
 Terminal illness
 No cure available; ends in death
Traditional Views of Health
and Illness (cont’d)
 Primary illness
 Develops without being caused by another health
problem
 Secondary illness
 Results from or is caused by a primary illness
Stages of Illness
 Transition stage
 May deny feeling ill, but recognize symptoms of
illness are present
 Acceptance stage
 Acknowledge illness and take measures to
become well
 Convalescence stage
 Recovering after the illness and regaining health
Current Views of Health
and Illness
 Health evaluated on a graduated scale or
continuous spectrum
 Ranges from obvious disease through absence of
disease to a state of optimum functioning in every
aspect of life
Implications of Current Views
 Value of nursing as caring profession

reinforced
 Although nurse is involved in curing the ill or
injured, goal is primarily under the control of
physician
 Nurses seek to help patients use coping skills
Health and Illness Behavior
 Health behavior
 Any action taken to promote health, prevent
disease, or detect disease in early, asymptomatic
(without symptoms) stage
 Illness behavior
 Any activity a person takes to determine her actual
state of health and seek a suitable remedy for a
health problem
Cultural Influences on Concepts
of Health and Illness
 Racial and ethnic differences apparent in
attitudes and practices related to:
 Birth, death, and general health care
 Susceptibility to specific diseases
 Responses to pain and suffering
 Personal hygiene and sense of privacy
 Adjustment to life changes
 Low health literacy can adversely affect
patient outcomes
Question 1
Illness occurs in three stages. All of the
following are stages of illness except the:
1)transition stage.
2)acceptance stage.
3)convalescence stage.
4)terminal stage.
Question 2
Jane has hypertension and has recently
suffered a mild stroke. This diagnosis is an
example of a/an:
1)primary illness.
2)secondary illness.
3)idiopathic illness.
4)terminal illness.
Lesson 2.2
Holistic Care, Human Needs, and
Homeostasis
Theory
6)List the components of holistic health care.
7)Identify the four areas of human needs and give an
example within each level of need.
8)Identify ways in which the body adapts to maintain
homeostasis.
Clinical Practice
3)Determine a patient’s status on Maslow’s hierarchy during a
clinical experience.
4)Describe alterations in homeostasis as observed in the
clinical setting.
The Holistic Approach
 Nurses take holistic approach to caring for
the sick and promoting wellness
 Considers biologic, psychological, sociologic,
and spiritual needs
 Acupuncture, acupressure, biofeedback,
meditation, and various relaxation techniques
Maslow’s Theory of Basic Needs
 Hierarchy of human needs as an explanation
for the things that motivate human behavior
 Basic physical needs—food, air, water, rest—
must be satisfied before emotional needs
 Used to determine priorities of nursing care
Maslow’s Theory of Basic Needs (cont’d)
 Physiologic needs
 Fundamental physical needs essential to
maintain life
 Security and belonging
 Security for patients depends on reassurance
that their physiologic and safety needs will be
met
 Each person needs to feel that she belongs
or is attached to others
Maslow’s Theory of Basic Needs (cont’d)
 Self-esteem and love and belonging

 Interrelated, because one cannot truly love others
until one first loves or accepts oneself
 Self-actualization
 Occurs when individuals are comfortable with
themselves and are certain of their beliefs and
values
Homeostasis
 Biologic systems maintain stability of internal
environment by continually adjusting to
changes necessary for survival
 Wellness maintained or regained when one is
able to keep a sense of balance while
adapting to factors that can upset that
balance
 Stress disturbs homeostasis and causes the
body to attempt to adapt
Adaptation
 A response to change
 Body’s systems have self-regulatory
mechanisms to maintain homeostasis
 Requires pathway of communication between
the brain and various body systems
Central nervous system
structures
The General Adaptation
Syndrome
 Occurs in response to long-term exposure to
stress
 Stages
 Alarm stage
 Stage of resistance
 Stage of exhaustion
Question 3
A teenage drug addict who has lost numerous jobs
states, “I do not have a problem with drugs.
Everyone uses them as much as I do. I can quit
anytime.” This is an example of which coping
mechanism?
1)Denial
2)Repression
3)Rationalization
4)Displacement
Lesson 2.3
Stress
Theory
9)Explain why a particular stressor may be experienced
differently by two people.

10)List the common signs and symptoms of stress.
11)Identify four ways in which a nurse can help decrease
stress and anxiety for patients.
Clinical Practice
Document observations about stress-reduction
5)
techniques used by staff or patients during a clinical

experience.
The Effects of Stress
 A stressor can be helpful or harmful
depending on the person’s:
 Perception of the stressor
 Degree of health and fitness
 Previous life experiences and personality
 Available social support system
 Personal coping mechanisms
Coping with Stress
 Coping—adjusting to or solving challenges
 Three types of coping responses:
 Actions or thoughts that change the situation so it
is no longer stressful
 Alteration of thoughts to control the meaning of the
situation before it triggers a stress response
 Control of thoughts and actions to stop a stress
reaction
Defense Mechanisms
 Strategies that protect us from increasing
anxiety
 Reduce anxiety and the secretion of stress
hormones
 Used to maintain and improve our self-
esteem
 Can be overused in a maladaptive way
Stress Reduction Techniques
 Progressive relaxation
 Imagery
 Massage
 Biofeedback
 Yoga
 Meditation
 Regular physical exercise
Health Promotion and
Illness Prevention
 Healthy People 2020: Society in Which All
People Live Long Healthy Lives
 Created by scientists: a comprehensive set of
objectives for disease prevention and health
promotion for the nation
 Goals
• Increase the quality and years of healthy life
• Eliminate health disparities
• Create social and physical environments promoting good
health for all
• Promote quality of life, healthy development, and healthy
behavior across all life stages
Health Promotion and
Illness Prevention (cont’d)
 Primary prevention
 Avoid or delay occurrence of a disease or disorder
 Secondary prevention
 Follow screening guidelines for easily treated
diseases if found early or detecting disease return
 Tertiary prevention
 Rehabilitation measures after disease/disorder
has stabilized
Question 4
A nurse should minimize stress for a patient
whenever possible. A common measure to
reduce stress is:
1)explaining all procedures.

2)listening carefully and answering all questions.
3)providing privacy.
4)All of the above
Question 5
A charge nurse is reviewing a student’s
charting. Which descriptive term might be
considered inappropriate when charting an
assessment?
1)Agitated
2)Nauseated
3)Fatigued
4)Noncompliant

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Chapter 2

Concepts of Health, Illness, Stress,

3)Define what “sickness” means to you.

4)Discuss why nurses need to be aware of any cultural,

educational, and social differences that might exist

predisposition and communication between the main

 Value of nursing as caring profession

 Self-esteem and love and belonging

differently by two people.

11)Identify four ways in which a nurse can help decrease

stress and anxiety for patients.

techniques used by staff or patients during a clinical

1)explaining all procedures.

4)All of the above

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