FUNDAMENTALS OF NURSING SISTER CALISTA ROY

PRACTICE
- State and a process of being and becoming
an integrated and whole person

CHAPTER 3: CONCEPT OF HEALTH

AND ILLNESS DOROTHEA OREM
- State that is characterized by soundness or
HEALTH
wholeness of developed human structures and of
- The fundamental right of every human bodily and mental functioning.
being. Health and illness are highly individualized
perceptions. Meaning and descriptions of health
and illness vary among people, in relation to IMOGENE KING
geography and to culture.
- Dynamic state in the life cycle; illness is an
interference in the life cycle.
DEFINITIONS OF HEALTH AND ILLNESS
DOROTHY JOHNSON
CLAUDE BERNARD - An elusive, dynamic state influenced by
biologic psychological and social factors.
- Ability to maintain the internal milieu while
illness is the result of failure to maintain the - Reflected by the organization, interaction,
internal environment. interdependence and integration of the subsystems
of the behavioral system.

WALTER CANNON
WELLNESS
- Ability to maintain homeostasis or dynamic
equilibrium. Homeostasis id regulated by the - Integrated method of functioning which is
negative feedback mechanism oriented toward maximizing the potential of which
the individual is capable
- Wellness is well being. It involves
FLORENCE NIGHTINGALE
engaging in attitudes and behaviors that enhance
- Being well and using one’s power to the quality of life and maximize personal potential.
fullest extent. Health is maintained through (Aspaugh)
prevention of disease via environmental factors.
- Wellness is a choice
- Wellness is a way of life
MARTHA ROGERS
- Wellness is the integration of body, mind
- Viewed in terms of the individual’s ability and spirit
to perform 14 components of nursing care unaided
- Wellness is the loving acceptance of one’s
- Positive health symbolizes wellness. It is a self.
value term defined by the culture or individual

NOTES BY ZYVERELLE AGBUYA POQUIZ FROM BS NURSING 1 ST YEAR – A

WELL-BEING Ex. Toddler just learning to walk is prone to fall
and injure himself
- Subjective perception of balance, harmony
and vitality (Leddy and Pepper)
B. EMOTIONAL DIMENSION
ILLNESS How the mind and body interact to affect body
function and to respond to body conditions also
- State in which someone’s needs are not
influences health
sufficiently met to allow the individual to have
sense of physical and psychosocial well being Ex. Prior to test, a student always has diarrhea
- Personal state in which the person is Extremely nervous about a surgery, a man
unhealthy. experiences severe pain following his operation
- State in which a person’s physical,
emotional, intellectual, social developmental or
C. INTELLECTUAL DIMENSION
spiritual functioning is diminished or impaired
compared with previous experience  Encompasses cognitive abilities,
educational background and past
experiences.
DISEASE
Ex. An elderly woman who has only a third grade
- An alteration in body functions resulting in education who needs teaching about a complicated
reduction of capacities or a shortening of the diagnostics test.
normal life span

D. ENVIRONMENTAL DIMENSION
PRECURSOR OF ILLNESS
 The environment has many influences on
1. HEREDITY health and illness. Housing, sanitation,
Family history for diabetes mellitus, hypertension, climate and pollution of air, food and water
cancer are aspects of environmental dimension

2. BEHAVIORAL FACTORS Ex. Increased incidence of asthma and respiratory

problems in large cities with smog
Cigarette smoking, alcohol abuse, high animal fat
intake
3. ENVIRONMENTAL FACTORS E. SOCIOCULTURAL DIMENSION

Overcrowding, poor sanitation, poor supply of  Health practices and beliefs are strongly
potable water influenced by a person’s economic level,
life-styles, family and culture

FACTORS AFFECTING HEALTH AND

ILLNESS F. SPIRITUAL DIMENSION

A. PHYSICAL DIMENSION  Spiritual and religious beliefs and values

are important components of the way the
 Genetic make-up, age, developmental person behaves in health and illness.
level, race, sex are all part of an individual’s
dimension and strongly influence health
status and health practices.

NOTES BY ZYVERELLE AGBUYA POQUIZ FROM BS NURSING 1 ST YEAR – A

 MODELS OF HEALTH 2. ASSUMPTION OF THE SICK
1. MEDICAL MODEL a. Acceptance of the illness
- Health is the state of being free of signs and b. Seeks advice, support from decision to give
symptoms of disease. Illness is the presence of the up some activities
signs and symptoms of disease.
3. MEDICAL CARE CONTACT
Seeks advice of health professionals for the
2. HEALTH-ILLNESS CONTINUUM following reasons
- Health is constantly changing state, with a) Validation of real illness
high level wellness and death being on opposite
b) Explanation of symptoms
ends of a graduated scale, or continuum
c) Reassurance or prediction of outcome

3. ROLE PERFORMANCE MODEL

4. DEPENDENT PATIENT ROLE
- Health is the ability to perform all those
roles for which one has been socialize - The person becomes a client dependent on
the health professional for help
- accepts/rejects health professional’s
4. HIGH-LEVEL WELLNESS MODEL
suggestion
- Refers to functioning to one’s maximum
- becomes more passive and accepting
potential while maintaining balance and purposeful
direction in the environment. - may regress to an earlier behavioral stage.

5. NEEDS FULFILLMENT MODEL 5. RECOVERY/REHABILITATION

- Health is a state in which needs are being - Gives up the sick role and returns to former
sufficiently met to allow an individual to function roles and functions.
successfully in life with the ability to achieve the
highest possible potential.
ASPECTS OF SICK ROLE
1. One is not held responsible for his
STAGES OF ILLNESS
condition. The person did not cause his illness
1. SYMPTOM EXPERIENCE
2. One is excused from social roles. The
a. Transition stage person is allowed to rest by seeking sick leave or
leave of absence
b. The person believes something is wrong
3. One is obliged to get well soon as possible.
c. Experiences some symptoms.
The person is expected to cooperate and comply
3 aspects: with recommended therapies
Physical (fever, muscle aches, malaise, headache) 4. One is obliged to seek for competent help.
The person is expected to seek help from health
Cognitive (perception of having “flu”)
professionals.
Emotional (worry on consequences of illness)

NOTES BY ZYVERELLE AGBUYA POQUIZ FROM BS NURSING 1 ST YEAR – A

 LEVELS OF PREVENTION
1. PRIMARY PREVENTION
- Providing specific protection against
disease to prevent its occurrence is the most
desirable form of prevention. Preventive measures
consists of counseling, education and adoption of
specific health practices or changes in life style.
Ex: mandatory immunization of children belonging
to the age range 0-59 months old to control acute
infectious disease.

2. SECONDARY PREVENTION
- It consist of organized, direct screening
efforts or education of the public to promote early
case finding of an individual with disease so that
prompt intervention can be instituted to halt
pathologic processes and limit disability.
Ex: public education to promote breast self-
examination, use home kits for detection of occult
blood in stool specimens and familiarity with seven
cancer danger signals.

3. TERTIARY PREVENTION
- Begins early in the period of recovery from
illness and consists of such activities as consistent
and appropriate administration of medication to
optimize therapeutic effects, moving and
positioning to prevent complications of immobility
and passive and active exercises to prevent
disability

NOTES BY ZYVERELLE AGBUYA POQUIZ FROM BS NURSING 1 ST YEAR – A

 FUNDAMENTALS OF NURSING MEANING OF CARING
PRACTICE
1. Caring as a moral imperative
2. Caring as an affect
CHAPTER 4: CARING 3. Caring as a human trait
4. Caring as an interpersonal relationship
CARING
5. Caring as a therapeutic intervention
 People, relationships, and things matter
 To satisfy one’s needs
 Wishing well, liking, comforting, and
THEORIES OF CARING
maintaining, or simply having an interest in
what happens to another 1. CULTURE CARE DIVERSITY AND
 To give care for the sick UNIVERSALITY (LEININGER)
 Helping another grow and actualize himself
(Mayerhoff) a. Understanding culture essential for nursing
 Growth and actualization care
 A process of relating to someone that
involves development, mutual trust and
deepening and qualitative transformation of 2. THEORY OF BUREAUCRATIC CARING
relationship (RAY)
a. Caring in nursing is contextual, influenced by
organizational structure
PROFESSIONALISM OF CARING
CARING PRACTICE
3. CARING, THE HUMAN MODE OF BEING
 Involves connection, mutual recognition (ROACH)
and involvement
a. Center of all attributes used to describe nursing
Example of caring, emerging from nursing
situations: SIX “Cs” OF CARING

 A client experiencing pos-operative pain is 1. Compassion

given medication to control her symptoms, 2. Competence
and then the nurse talks quietly and holds
her hand for a few minutes as the pain 3. Confidence
resolves. The nurse’s presence, in itself, 4. Conscience
provides comfort for the client.
5. Commitment
6. Comportment
MAJOR INGREDIENT OF CARING
 Knowing
 Alternating rhythms 4. NURSING AS CARING (BOYKIN AND
 Patience SCHOENHOFER)
 Honesty
a. Purpose of the discipline and profession of
 Trust
nursing
 Humility
 Hope
 Courage
NOTES BY ZYVERELLE AGBUYA POQUIZ FROM BS NURSING 1 ST YEAR – A
5. THEORY OF HUMAN CARING o Knowing the client
(WATSON)
o Nursing presence
a. Basis of nursing’s role in society
o Empowering the client
b. Essence and moral ideal of nursing
o Compassion
o Competence
6. THEORY OF CARING (SWANSON)
a. Caring processes in nursing intervention
SELF CARE FOR THE PROFESSIONAL
FIVE CARING PROCESSES NURSE
 Knowing  Helping oneself grow and actualize
 Being with  Self-care builds self-esteem
 Doing for  Creating a healthy lifestyle
 Enabling
o Proper nutrition
 Maintaining belief
 o Activity and exercise
7. PRIMACY OF CARING (BENNER o Recreation
AND WRUBEL)
o Avoiding unhealthy patterns
a. Nursing as a relationship
 Using mind-body therapies
b. Caring is primary
o Guided imagery
c. Possibility of giving and receiving help
o Meditation
o Storytelling
TYPES OF KNOWLEDGE IN NURSING
o Music therapy
EMPIRICAL KNOWING
o Yoga
The science of nursing

THE VALUE OF REFLECTIVE PRACTICE

AESTHETIC KNOWING IN NURSING
The art of nursing REFLECTIVE PRACTICE
- Method of self-examination
PERSONAL KNOWING - Involves thinking over what happened in a
nursing situation
The therapeutic use of self
- Includes becoming aware of how one feels
about oneself
ETHICAL KNOWING
- Recognizing how one thinks and acts
The moral component
- Lead to new understandings and
appreciations
CARING IN PRACTICE - Requires discipline, action, openness, and
trust.
 Caring encounters are demonstrated by

NOTES BY ZYVERELLE AGBUYA POQUIZ FROM BS NURSING 1 ST YEAR – A

REFLECTIVE JOURNALING
- Guidance from a mentor

NOTES BY ZYVERELLE AGBUYA POQUIZ FROM BS NURSING 1 ST YEAR – A