MODELS OF HEALTH AND WELLNES: 1.

Agent = any factor or stressor that can

lead to illness or disease
A. SMITH’S MODEL OF HEALTH Ex: lack of nutrient leads to illness or
1. Clinical Model disease
2. Host = person’s who may not be at risk
 Views people as a physiologic system of acquiring a disease
with related functions Ex: family history, age, lifestyle habits
 Identifies health as the absence of signs 3. Environment = all factors external to
and symptoms of disease or injury the host that may or may not
 The state of not being sick predispose the person to the
 The opposite of health is disease or development of disease
injury Ex: living conditions, climate, economic
 When these signs and symptoms are no level etc.
longer present the physician considers
the individuals health restored C. HEALTH PROMOTION MODEL
(PENDER)
2. Role Performance Model  Defines health as a positive, dynamic
state
 Defines health in terms of individual’s
 Describes multidimensional nature of
ability to fulfil societal roles such as
persons as they interact within their
performing work
environment
 People who can fulfil their roles are
 This model explains why individuals
healthy even if they have clinical illness
engage in health activities
 Sickness is the ability to perform one’s
 Result: improved health, enhanced
work role
functional ability, better quality of life,
Ex: A man who works all day in his job is
healthy lifestyle
healthy even though he is deaf

3. Adaptive Model
VARIABLES THAT INFLUENCE BELIEFS AND
 Focuses on adaptation PRACTICIES
 Views health as creative process and
INTERNAL
disease as a failure in adaptation or
mal-adaptation  Developmental stage
 Aim of treatment is to restore the  Intellectual background
ability of the person to adapt or to cope  Perception of functioning
with the environment  Emotional factors
4. Eudaimonistic Model  Spiritual factors

 Health is seen as a condition of EXTERNAL

actualization or realization of a person’s  Family practices
potential
 Socioeconomic factors
 Actualization is the apex of the fully
 Cultural background
developed personality (Maslows)
 Highest aspiration of people is NURSES PROVIDE CARE FOR 3 TYPES OF
fulfilment and complete development CLIENTS:

B. LEAVELL AND CLARK’S AGENT-HOST-  Individual

ENVIRONMENT MODEL  Family
(ECOLOGIC MODEL)  Community
 Used primarily in predicting illness 4 AREAS OF NURSING PRACTICE
 Identification of risk factors that results
from the interaction of agent, host and  Health Promotion
environment are important in  Disease Prevention
promoting and maintaining health  Health Maintenance
 Curative/ Rehabilitative
  Appraise individuals of their risk factors
I. HEALTH PROMOTION that are inherent in their lives in order
 Enabling people to increase control to motivate them to reduce risk and
over and to improve their health (WHO) develop healthy habits
 Helping people change their lifestyle c. Lifestyle and behaviour change
 Nurse must identify clients strength to program
help them reach maximum functioning  Basis for changing health behaviors
and quality of life  Geared towards extending the life span
DETERMINANTS OF HEALTH d. Worksite wellness programs
Income and social status  Includes programs that serve the needs
 Higher income and social status are of persons in their workplace
linked to better health e. Environmental control programs
Education  Developed to address the growing
 Low education levels are linked with problem of environment pollution = air,
poor health, more stress and lower self- land, water etc.
confidence
Physical environment NURSES ROLE IN HEALTH PROMOTION
 Safe water and clean air, healthy  Model healthy lifestyle
workplaces, safe houses, communities  Facilitate client involvement
and roads all contribute to good health  Teach clients self-care strategies to
Employment and working conditions enhance fitness, improve nutrition,
 People in employment are healthier, manage stress and enhance
particularly those who have more relationships (build rapport)
control over their working conditions  Educate clients to be effective health
Social support networks care consumers
 Greater support from families, friends  Assist clients, families and communities
and communities is linked to better in choosing health promotion options
health  Be an advocate in the community for
Culture changes that promote a healthy
 Customs and traditions, and the beliefs environment
of the family and community all affect
health II. HEALTH MAINTENANCE
Genetics  The active process of achieving health
 Inheritance plays a part in determining and remaining healthy
lifespan, healthiness and the likelihood Elements used for health maintenance
of developing certain illnesses A. NUTRITION
Personal behaviour and coping skills  Studies food and dietary supplements
 Balanced eating, keeping active, that improve health, and cure or
smoking, drinking and how we deal with prevent disease
life’s stresses all affect health  Food or food components that cause
Health services disease or deteriorate health
 Access and use of services that prevent B. EXERCISE
and treat disease influences health  The performance of movements in
Gender order to develop or maintain physical
 Men and women suffer from different fitness
types of diseases at different ages  Frequent and regular physical exercise
prevents some disease such as cancer,
TYPES OF PROGRAMS OF HEALTH cardiovascular disease, type 2 diabetes,
PROMOTION obesity and back pain
a. Information dissemination C. HYGIENE
 Uses a variety of media to offer  The practice of keeping the body clean
information to the public to prevent infection and illness, and
b. Health risk appraisal and wellness avoidance of contact with infectious
assessment agents
 D. STRESS MANAGEMENT  NUTRITIONAL INTERVENTION
 Prolonged stress may negatively impact  LIFESTYLE AND BEHAVIORAL CHANGES
health, such as by weakening of the B. SECONDARY PREVENTION
immune system  The action that halts the progress of a
 Relaxation techniques are physical disease
methods used to relieve stress  Also known as health maintenance
E. HEALTH CARE  Early detection/screening
 The prevention, treatment and  Prompt treatment to limit disability
management of illness through the EXAMPLES:
services offered by the medical, nursing  Having annual physical examination
and allied health professionals  Regular pap smear test for women who
F. WORKPLACE WELLNESS are 20 yrs old and above
PROGRAMS  Sputum examination for TB
 Recognized by companies for their  Annual stool guiac test and rectal
value in improving the health and well- examination for clients over age 50 yrs
being of their employees, and for C. TERTIARY PREVENTION
increasing morale, loyalty and  Occurs after a disease or disability has
productivity occurred and the recovery process has
begun
III. DISEASE PREVENTION  Minimizing disability and helping the
 The goal of illness prevention program client learn to live productively with
is to maintain optimal health by limitations
preventing disease  Rehabilitation
 Actions aimed at minimizing or EXAMPLES:
eliminating the impact of disease or  Self-monitoring of blood glucose among
disability diabetics and attending self-
 Hippocrates – “prevention is better management education
than cure”  Physical therapy after CVA (Stroke),
 Nursing activities that prevent illness participation in Cardiac Rehabilitation
includes: immunization, pre-natal and after MI or Heart Attack
infant care, prevention of STD’s  Undergoing speech therapy after
laryngectomy
3 LEVELS OF PREVENTION
A. PRIMARY PREVENTION IV. RESTORING HEALTH
 Defined as action taken prior to the (CURATIVE/REHABILITATIVE
onset of disease, which removes the CARE)
possibility that a disease will ever occur  Focuses on the ill client and extends
 Encourage optimal health from early detection of disease through
 Increase the person’s resistance to helping the client during the recovery
illness period
 Health promotion
EXAMPLES: Nursing activities:
 Quit smoking
 Baths
 Avoid/limit alcohol intake
 Assessment procedures
 Exercise regularly
 Collaborating with other health care
 Eat well-balanced diet
professionals about clients problem
 Take adequate fluids
 Reduce fat and increase fiber in the diet COMMUNICATION IN NURSING
 Maintain ideal body weight
Communication
 Avoid exposure to sunlight
 Complete immunization  An exchange of information, ideas, and
 Wear hazard devices in work site feelings
 Handwashing program  Nurses communicate clients
 HEALTH EDUCATION information effectively
 ENVIRONMENTAL MODIFICATION
 Through discussion, reports, and Pacing
records  Nurses should speak slowly and to
MODES OF COMMUNICATION pronounce clearly
Verbal communication Intonation
 Uses spoken or written words  Tone of voice often provides the
Nonverbal communication emotional state or energy level
 Uses gestures, facial expression, Clarity and Brevity
posture, body movement, eye contact,  Clarity – speaking slowly, pronounce
tone of voice clearly, and using examples to be easily
understood
CHARACTERISTICS OF  Brevity – direct to the point
COMMUNICATION Timing and Relevance
Simplicity  Even though a message is clear, poor
 Use of commonly understood words, timing can make it ineffective
direct and complete
Clarity GUIDELINES FOR ACTIVE AND
 Saying exactly what is meant, speak EFFECTIVE LISTENING
slowly and pronounce well  Be attentive to what the client is saying
Timing and Relevance verbally and nonverbally
 Right time, consider client’s interest and  Trust communicates acceptance and
concerns respect for the client
Adaptability S – stand/sit facing the client
 Nurse adjust on what to say depending O – observe an open posture
on mood of client L – lean towards client
Credibility E – establish and maintain eye contact
 Provide accurate information R – relax

COMPONENTS OF COMMUNICATION GUIDELINES FOR USE OF TOUCH

Sender (encoder)  Touch is one form of communication
 The person who encodes and delivers  Many messages (e.g. affection,
the message empathy) are conveyed through touch
Message  Be sensitive to other’s reactions to
 The content of the communication touch
Channel  Consider cultural factors
 Means of conveying and receiving  Touch should be as gentle or as form as
messages, visual, auditory and tactile needed and delivered in a comforting,
Receiver (decoder) non-threatening manner
 The person who receives and decodes  There are times when touch should be
the message withheld (mentally unstable)
Response (feedback)
 The message returned by the receiver ZONES OF PERSONAL SPACE
 INTIMATE ZONE (0-18 INCHES)
CRITERIA FOR EFFECTIVE VERBAL  SOCIAL ZONE (4-12 FEET)
COMMUNICATION  PERSONAL ZONE (18 INCH TO 4 FEET)
Vocabulary  PUBLIC ZONE (12 FEET AND GREATER)
 Sender and receiver should be able to
translate each other’s words (medical ZONES OF TOUCH
jargons)
 SOCIAL ZONE (permission not needed)
Denovative and connovative meaning
 VULNERABLE ZONE (special care
 Denovative – real meaning of a
needed)
particular word
 CONSENT FORM (permission needed)
 Connotative – interpretation of a
 INTIMATE ZONE (great sensitivity
word’s meaning by feelings/ ideas
needed)
people have about the word
DEVELOPMENTAL CONSIDERATIONS IN c. Be courteous, calm and open-
COMMUNICATIONS minded
d. Respect their privacy and views
1. OLDER ADULTS WITH e. Avoid judging or criticizing
COMMUNICATION NEEDS f. Praise good points and tolerate
a. Check hearing aid differences
b. Amplify voice if necessary g. Encourage expressions of ideas
c. Minimize visual and auditory and feelings
distractions
d. Provide visual aids COMMUNICATION TECHNIQUES
e. Summarize important points of  Therapeutic – the face to face process
the conversation of interaction that focuses on advancing
f. Give clients plenty of time to the physical and emotional well-being
ask/answer of a patient
g. Stick to one topic at a time
 Non-therapeutic – asking personal
questions that are not relevant to the
2. INFANTS
situation is not professional or
a. Use firm and gentle physical
appropriate
contact such as cuddling,
patting, or rocking BASIC HUMAN NEEDS
b. Hold infant so he or she can see
the parents  Oxygen
c. Talk softly to the infant  Water and fluids
 Food and nutrients
3. TOODLERS AND PRESCHOOLERS  Elimination of waste products
a. Interact with parents before  Sleep and rest
talking to child  Activity and exercise
b. Position at child’s eye level  Sexual gratification
c. Allow children to touch objects  Temperature regulation
that will come in contact with  Security and safety needs
them  Freedom from harm
d. Use simple words and short  hygiene
sentences
e. Communicate through
transition objects (e.g. dolls,
stuffed animals)

4. SCHOOL AGE CHILDREN

a. Avoid sudden advances, broad
smiles, staring, or other
threatening gestures
b. Talk to parent if child is initially
shy
c. Give opportunity to discuss
concerns without parents
present (allow to express
concerns/fears)
d. Be honest and let child know
what to expect (ex: how
equipment work)
e. Use variety of techniques such
as drawing or play

5. ADOLESCENTS
a. Give undivided attention
b. Listen