Module 2

Concept of Health and Illness

NCM 103 Instructors

 II. Learning Objectives:
At the end of the discussion, you should be able to:
• Discuss the basic concepts of Health and Illness
• Determine the different aspects of health , well
ness and well being
• Understand the different components of
wellness
• List the different models of health
• Identify concepts of Illness /disease and illness
behavior
• Enumerate the dimensions health
• Familiarize Risk Factors of health
 Concept Health
• Health as a state of
being well and using
power the individual
possesses to the fullest
extent .
( Nightingale, 1860/1969)
 Other definitions
• “Health” was defined as
a state of complete
physical, mental, and
social well-being, and
not merely the absence
of a disease or infirmity.

• Eg. a physically healthy

person (WHO, 1948)
 Definitions…
• Health is defined in • Health is not a
terms of role and condition , it is an
performance. adjustment. It is not
( Talcott,P. , 1951) a state but a process.
( US Pres.
Commission, 1953)
 Definitions…
• Health and illness are human experience. The
presence of illness does not preclude health,
nor does optimal health preclude illness.(ANA)
 Individual activity
• ONE MINUTE PAPER
• Write your own personal definition of what is
HEALTH
• In your notes
• Cite at least 2 concrete examples
 Wellness and well-being
• Wellness- state of well-
being

• Aspects
• Self-responsibility
• An ultimate goal
• dynamic
• Growing process
• requires daily decision
making
 Wellness and well-being
• 7 Components
• Environmental
• Social
• Emotional
• Physical
• Spiritual
• Intellectual
• Occupational
• importantly, the whole being of
the individual.
• Anspaugh, Hamrick, and Rosato
(2011) propose seven
components of wellness
 Components of wellness
• Environmental • Social
• Promote health • Interact successfully
measures to improve with people
standard of living and
quality of life • Eg. Maintaining
intimacy
• Eg. water
Components of Wellness
• Emotional • Physical
• Ability to manage stress • Ability to carry out daily
and to express task, achieve fitness
emotions appropriately
• Eg. Adequate nutrition
• Eg. Expression of feeling
 Components of wellness..
• Spiritual • Intellectual
• Belief in some force, • Ability to learn and use
serves to unite human information effectively
beings and provide for personal, family and
meaning and purpose in career development
life.
• Eg. studying
• Eg. religion
Components of wellness
• Occupational •
• Ability to achieve a
balance between work
and leisure time.
• Beliefs about education,
employment and home
 MODELS OF HEALTH AND
WELLNESS
• Health as a complex
concept

• Researchers –
developed models or
paradigm
 clinical model
• physiological systems
related functions

• Health- absence of signs

and symptoms of
disease or injury.
• The opposite of health
is disease or injury.
• Relief and elimination
of malfunction
 Role performance model
• Ability to fulfil societal
roles

• Able to perform his or her

work

• Eg. Mother, daughter, son

• Considered healthy even

with clinical illness
 Adaptive model
• Health is a creative
process

• Disease- failure in
adaptation or
maladaptation
• Eg. environment
• Aim: to restore ability to
adapt, to cope

• Roy Adaptation Model

Eudaimonistic model
• Health – actualization or
realization of person’s
potential

• Abraham Maslow-
actualization- apex
• Highest aspiration-fullfilment
and complete development
• Illness-prevents actualization
• Margaret Newman
Eudaimonistic model…Maslow’s
• Video..
 Agent-host-environment model
• Also called Ecologic
Model
• Leavell and Clark (1965)
community health work
• Theory multiple cause of
disease
• Predicts illness than
promoting wellness
• Risks factors- interaction :
Agent-Host- Environment
 Health – illness continua
• Grids or graduated
scales
• Measure person’s level
of wellness

• Health and disease –

opposite ends

• People move back and

forth in the continuum
 Dunn’s high level wellness grid
• Dunn(1959) health grid
• Intersection: health axis- peak wellness to
death and environment- favorable and
unfavorable
Dunn’s high level wellness grid
 Illness-wellness continuum
• By Anspaugh, Hamrick,
and Rosato(2011)
• Optimal health to
premature death
• Arrows in opposite
direction and neutral point
• Right- increase levels of
health and wellness
• Left- decrease levels of
health
 Activity: Wellness Plan
1. Place the following items on a table or desk in
the front of the room: towel, soap, comb,
toothbrush, book, and pillow.
2. Select one of the objects and describe how
the object contributes to wellness, then places
the object in a large, decorated box labeled
“Good Health” or “Wellness.”
 Activity: Wellness Plan
3. After all the items have been described and placed in
the box, brainstorm a definition of wellness with a
family member.
4. Write the ideas on the board or paper. Then, create a
written plan focusing on an important health skill. You
may share plans to someone at home.
5. After a designated time period, write a short note to
their parents announcing their accomplishments
related to the plan.
6. In a week you may track progress towards your goals.
7. Write a pledge to reach a health goal. You can also
ask the whole family to do this.
 CONCEPT OF ILLNESS and disease
• ILLNESS – also called
disease or sickness
• This refers to the
condition of being in
poor health all aspects
of health.
• Highly personal state
• Affects components of
wellness
• an individual may
have the disease and
not feel ill

• Disease- alteration in
body functions

• Etiology refers to
cause eg. bacteria
 Classification
• ACUTE
• symptoms with
relatively short duration
• Abrupt and subsides
quickly
• May or may not require
interventions
• Eg. colds
 classification
• CHRONIC
• Lasts for extended
period, 6 months or
longer
• With slow onset
• With period of
remissions and
exacerbations
• Eg. diabetes
 Illness behaviors
• A coping mechanism,
involves ways
individuals describe,
monitor, and interpret
their symptoms, take
remedial actions and
use health care system.

• Rights and obligations

 Activity: HEALTH PUZZLE
• Instructions : • Instructions :
• 4. After completing the picture, glue the
• 1. Prepare a paper then cut in illustration on oak tag or construction
shapes, such as a heart, paper, or hard paper and then cut the
triangle, or rectangle. puzzle on the sectioned lines.
• 5. You exchange puzzles and try to guess
• 2. Divide each shape into the health behavior. After having a chance
several irregular sections to to solve the puzzles, place own puzzle
form a puzzle. You may ask also pieces in an envelope.
• 6. On the front of the envelope, write a
a family member or companion brief clue about the puzzle for his/her
to make one also. parent or guardian (e.g., if the puzzle
• 3. illustrate a positive health illustrates eating vegetables the clue might
be “you’ll be green with envy when you
behavior in the shape (e.g., solve my puzzle”).
brushing teeth, eating fruit, • You can do solving the puzzle at home and
wearing safety equipment). share with family members.
 5 stages of illness
• described by Suchman •
(1979)
• Not all client progress
through each stage
• Stage 1 – Symptoms
Experiences
 5 stages of illness
• Stage 2- •
Assumption
of the Sick
Role
 5 stages of illness
• Stage 3– •
 5 stages of illness
• Stage 4- Dependent •
Client Role
 5 stages of illness
• Stage 5– Recovery or •
Rehabilitation
 Factors and Issues Affecting Health Illness

• FACTORS- influence health

status , beliefs and practices

• Health status-state of health

• Health Beliefs- concepts of
health than an individual
believes are true.
• Health Behaviors- actions
people take to maintain their
good health.
 Internal variables
• Biologic, psychological
and cognitive

• Non-modifiable

• Cannot be changed
 dimensions
• Biologic

• Examples
• Genetic make-up-
susceptibility to disease
eg. Cancer
• sex – acquired and
genetic diseases sex-
linked
 dimensions
• Biologic

• Examples
• age – disease varies

• development level-
impact to health status
 dimensions
• Psychological

• Emotional –mind body

interactions and self-concept
( feels about self- self
esteem ) ,physical self ( body
image), needs, roles, and
abilities.
Eg. Anorexia
• affects health status -/+
• Emotional distress
• Emotional reactions; fear
 dimensions
• Cognitive- intellectual • Healthy Lifestyle
factors.
Choices
• Eg. Lifestyle choices

• Lifestyle- general way of

living. Behaviors and
activities
• +/- effect to health
• Risk factors

• Spiritual and religious beliefs

 External variables
• Environment- affects
health and wellness

• Eg. Climate, pollution

• Environmental hazards-
eg.
Radiation,Greenhouse
effect, pesticides
External variables
• Standards of living
• -occupation, income, and
education
• Related to health
morbidity and mortality
• Hygiene, food habits, and
ability seek health care
• Low income families
• Environmental conditions
• Occupational roles
External variables
• Family and Cultural Beliefs
• - assess patterns of daily living and lifestyle to
offspring

- Each culture has ideas about health

- Eg. Use of home remedies
- Cultural rules, values, and beliefs
External variables
 External variables
• Social support networks
• - family, friends
• Job satisfaction

• Lack of support network –

increasingly ill

• Support people- provide

motivation for ill person
to become well.
 Healthcare adherence
• Adherence- extent to
which an individual’s
behavior coincide with
medical or health
advice.
• Eg. Diet

• Factors influencing
adherence
 Healthcare adherence
• Non-Adherence- identification
• Steps:
• 1. Establish why the client not
following the regimen.
• 2. Demonstrate caring.
• 3. Encourage healthy
behaviors
• 4. Use aids to reinforce
teaching
• 5. Establish therapeutic
relationship.
 PartAtIIthe…end of the lesson ,
• Learning Objectives:
the students will be able to:
• Define terms related to health care delivery
system.
• Identify the purposes of HDS
• Enumerate the types of healthcare services
• Differentiate health promotion and disease
prevention
• List the different health agencies
• Identify the providers of healthcare
• Understand the frameworks of care
 Health Care Delivery System
• Definition of terms:

• System – a set of interrelated and independent parts that form as

complex whole.

• Health system – is the interrelated ways in which country organizes

available resources.

• Health care system- is the totality of services offered by all health

disciplines.

• Health Sector – groups of services or institutions in the

community/country.

• Health Care Delivery System - The network of health facilities and

personnel.
 Purpose of HCS
• To provide care to people who were ill or
injured.
• HCS is changing and also the nurses roles due to
the ff:
• Awareness of health promotion
• Illness prevention
• Level of wellness
 TYPES OF HEALTHCARE SERVICES
• Described according to
levels of disease
prevention

• 1. Primary Prevention
• 2. Secondary Prevention
• 3. Tertiary Prevention
 Primary prevention
• Refers to Health
promotion and illness
prevention

• To maintain an
optimum level of
wellness

• WHO Project : Health

People by 2020
 Project goals
• 1. Increase quality and years of
healthy life
• 2. achieve health equity and
eliminate health disparities
• 3. Create a healthy
environment for everyone
• 4. Promote health and quality
life across life span.
YOUR

• HEALTH IS IN YOUR HANDS

 Health promotion vs Disease
prevention
• is a social and political action • Disease or illness prevention
enhancing public awareness in are activities used to make a
health, fostering healthy lifestyle person who feels well
and creating conditions
conducive to health. –WHO
prevent future illness.
• Directed at the client or
• is a process of enabling people community
to take action to improve their • Involves programs
health.

• Eg. identify risk factors,

• Emphasize the important role of
clients to maintain their own
taking measures to prevent
health illness,
 Case Scenario..which is HP or DP
• May jog because her • Maria jogs every
physician has told her to morning before work.
do so. She is overweight She enjoys jogging, and
and has a family history she likes to start her day
of heart problems. Her that way. She finds it
physician tells her she stimulates her for the
needs exercise to help day’s activities. She
prevent future feels tired when she has
cardiovascular problems not been able to jog.
• Answer: DP Maria jogs to promote
wellness.
• Answer: HP
activities
•
 Activities
• Physical assessments, • Teaching and counseling
disease screening regarding lifestyle changes
• developmental screening • stress reduction, home
management after diagnosis of
• newborn screening
chronic illness
• breast and testicular self- • physical therapy
examinations • mental health counseling
• hearing and vision screening • support groups,
• mammography • teaching on clean technique of
• use of home kits asepsis and hygiene,
• familiarization of the danger • motivation and proper
signal of cancer movement and positioning
 Activities
-Immunization
- family planning
- smoking cessation
- well-child care
- hygiene teaching
- fitness classes
- alcohol and drug prevention
- use of seatbelts
- child car restraints
- environmental protection
 Secondary prevention
• Refers to diagnosis and
treatment
• Freestanding diagnostic
and treatment facilities

• Health promotion
service – early
detection of disease
• Eg. Routine screening
Activities
• Regular dental exam
• Bone density studies
• Mammograms
• Health education early detection of CA
• Voluntary HIV testing and counseling
• Walk in clinics for dxtic test -testing
high blood pressure, and cholesterol
 Tertiary prevention
• Refers to Rehabilitation,
Health Restoration, and
Palliative Care

• Goal: To help people move

to their previous level of
health

• Emphasize the importance

to assist client to function
adequately
Activities
• Outreach programs
• Rehabilitation
• Support groups
• Palliative care-provide
comfort and treat
symptoms, alleviate
pain, provide end of life
care
 Self-check Exercise
• Let us review..
• To the ff. activities identify whether P-Primary, S-
Secondary, T- Tertiary
• Please answer in your notes:
• 1. Annual Dental Check-up
• 2. Post stroke therapy
• 3. Health teaching
• 4. Breast self-examination
• 5. Hospice care
• Check you answer:
• STPPT
 Types of health care agencies and
services
• Provides services in different settings
• Public Health
• Physicians offices
• Ambulatory care centers
• Occupational health clinics
• Hospitals
• Subacute care facilities
• Extended(Long Term) Care Facilities
• Retirement and Assisted Living Centers
 Types of health care agencies and
services
• Health facilities that are
able to provide and
attend to the needs of
patients will provide
them better means to
increase awareness
about their health and
adhere to medical
recommendations
 Types of health care agencies and
services
• Provides services in
different settings
• Rehabilitation Centers
• Home Healthcare Agencies
• Day Care Centers
• Rural Care
• Hospice Services
• Crisis Centers
• Mutual Support and Self-
help groups
 Providers of healthcare
• Healthcare team or •
health professionals

• Mutual goal: to help

restore a client’s health
and promote wellness

• Click the video…

 Providers of healthcare
• Nurse
• Alternative Care provider
• Case Manger
• Dentist
• Dietitian or Nutritionist
• Emergency Medical Care
• Occupational Therapist
• Paramedical Technologist
• Pharmacists
 Providers of healthcare
• Physical Therapist
• Phyician
• Physician Assistant
• Podiatrist
• Respiratory Therapist
• Social worker
• Spiritual support
Personnel
• Unlicensed Assistive
Personnel
 PHILIPPINE HEALTH CARE
DELIVERY SYSTEM
Access to quality • Composed of 2 sectors :
health care is given in
• 1. Public
various settings such
• - national and local
as, hospital and clinics. government agencies
• 2. Private
• - for profit and non-
profit providers
• According to Hagger (2015)
primary health is the
frontline of the health care
system in a variety of
settings and by multiple
types of providers.
• It provides community-
based, multidisciplinary,
patient- centered with the
focus on both the treatment
and prevention of various
conditions
 Factor affecting health care
delivery
• Increasing number of older adults
• Advances in technology
• Women’s health
• Uneven distribution of services
• Access to health insurance
• Homeless and poor
 Factor affecting health care
delivery
• Health insurance
portability and
accountability act
• Demographic changes
• Delivery of nursing care
support ,continuity of
care and cost
effectiveness
 Frameworks for care
• Managed Care- HCS
goals – to provide cost
effective, quality care,
and improved outcomes
• Collaboration of HC
providers and agencies
Frameworks for care
• Case Management-
integrate HCS for
individuals and groups
• Involves multi-
disciplinary teams
• Cost containment
strategy

• Case manager
• Use of critical pathways
Frameworks for care
 Frameworks for care
• Differentiated Practice-
system, best possible
use of nursing personnel
• Educational preparation
and skills

• Specific job descriptions

for nurses
• Delineation of roles
 Frameworks for care
• Case Method
• -total care
• Cleint centered method
• Comprehensive care of
client
• Client consistent
contact with one nurse
 Frameworks for care
• Functional Method
• - focuses on jobs to be
completed
• Task oriented approach
• Based-production and
efficiency model
• With defined job
descriptions, procedures,
policies, and line of
communication
 Frameworks for care
• Team Nursing
• -delivery of care to
individual clients by a
group of providers
• Led by nurses

• Nursing Team
 Frameworks for care
• Primary Nursing
• One nurse – oversee care
of a number of clients , 24
hrs, days a week
• Uses technical knowledge
and management skills
• Primary nurse- first line
manager
• Associates- does some care
 Reference
• Kozier et al ( 2016). Fundamentals of Nursing
Practice. 10th Edition. Pearson. USA
 Thank You
Continue to Study Hard
Keep Safe 