HEALTH, WELLNESS, AND ILLNESS
WEEK 3
Concepts of Health, Wellness, and
Well-Being
 Health
 Presence or absence of disease
 Nightingale

“…state of being well and using every power the individual
possesses to the fullest extent”
 WHO

“…state of complete physical, mental and social well-being,
and not merely the absence of disease or infirmity”
Health, Wellness, and Well-Being,
continued
 ANA

“…dynamic state of being in which the developmental and
behavioral potential of an individual is realized to the fullest
extent possible”
 Personal definitions of health
 Highly individualized
 Free from symptoms, pain
 Being able to be active, in good spirits
 Developing personal definition of health
Wellness
 State of well-being
 Self-responsibility
 Ultimate goal
 Dynamic, growing process
 Daily decision making
 Whole being of individual
Components of Wellness
 Environmental
 Occupational
 Intellectual
 Spiritual
 Physical
 Emotional
 Social
 Well-being is a component of health
Figure 13-3 An illness-wellness continuum. Source: Reprinted with permission from Travis, J. W., & Ryan, R. S. (1988).
Wellness workbook., Berkeley, CA: Ten Speed Press.
Illness and Disease
 Illness
 Highly personal state
 Diminished functioning
 Disease
 Alteration in body functions
 Results in reduction of capacities
 Shortening of normal life span
Classifications of Illness
 Acute
 Severe symtpoms
 Relatively short duration
 Chronic
 Lasts for 6 months or longer
Illness Behaviors
 Coping mechanisms
 Involves ways individuals:
 Describe, monitor and interpret symptoms
Effects of Illness on
Client and Family
 Brings change
 Behavioral and emotional
 Self-concept and body image
 Lifestyle
 Loss of autonomy
 Change in lifestyle
Nurse’s Role
 Provide explanations about necessary adjustments
 Make arrangements to accommodate clients’ lifestyle
 Encourage other health professionals to become aware
of person’s lifestyle
 Support healthy aspects
 Reinforce desirable changes in practices
Health Promotion
• Healthy People 2010: Understanding and
Improving Health
–
Two major goals


–
–
–
Increase quality and years of healthy life
Eliminate health disparities
28 focus areas
10 leading health indicators
Individual health linked to community
health
Health Promotion, Protection and
Disease Prevention
 Prevention
 Narrow sense
 Broad sense
 Promotion
 Motivated by desire to increase well-being
 Protection
 Motivated by desire to actively avoid illness
 Health promotion can be offered to all
Nurse’s Role in Health Promotion
 Way of thinking
 Revolves around philosophy of wholeness
 Wellness, well-being
 Disseminate information
Programs to Promote Health
 Information dissemination  most basic
 Consider culture, age group
 Critical to know where misinformation originates
 Health risk appraisal and wellness assessment
 Used to teach about risk factors
 Motivate to reduce specific risks
Programs to Promote Health,
continued
 Lifestyle and behavior change
 Requires participation of individual
 Geared toward enhancing quality of life
 Environmental control
 Toxic and nuclear wastes
 Nuclear power plants
 Air and water pollution
 Herbicide and pesticide use
Health Promotion Activities
 Collaborative relationships
 Work with not for people
 Nursing process basic tool
 Teach self-care responsibility
 Emphasize illness prevention, health promotion
 Assess, plan enhanced care
Variables Influencing Health
 Biologic dimension
 Genetic makeup
 Gender
 Age
 Developmental level




Infants
Toddlers
Adolescents
Older adults
Psychologic Dimension
 Mind-body interactions affect health status
 Increase susceptibility to organic disease
 Precipitate organic disease
 Mind’s ability to direct body’s functioning
 Emotional reactions occur in response
 Self-concept affects how we handle situations
Cognitive Dimension
 Intellectual factors influencing health
 Lifestyle
 Living conditions
 Patterns of behavior
 Risk factors
 Healthy lifestyle choices
 Spiritual and religious beliefs
 Jehovah’s Witnesses and blood transfusions
 Jews perform circumcision on 8th day of life
Nursing Process:
Assessment
 Health history and physical examination
 Existing problems
 Age

Safety assessment
 Nutritional assessment
 Physical fitness assessment
 Muscle endurance
 Flexibility and body composition
 Cardiorespiratory endurance
Assessment, continued
 Lifestyle assessment
 Personal lifestyle and habits of client
 Lifestyle assessment tools
 Spiritual health assessment
 Ability to develop inner nature to fullest
Assessment, continued
 Social support systems review
 Social context in which person lives
 Creates environment for healthy behavior
 Life stress review
 Validating assessment data
 Client and nurse together


Review, validate and summarize information
Existing health problems
Nursing Diagnoses
 NANDA wellness diagnoses
 Readiness for Enhanced Spiritual Well-being
 Readiness for Enhanced Coping
 Readiness for Enhanced Nutrition
 Readiness for Enhanced Knowledge
 Readiness for Enhanced Parenting
 Readiness for Enhanced Self-Concept
 Readiness for Enhanced Immunization Status
 Readiness for Enhanced Self-Care
Plan
 Health promotion plan developed
 In response to needs, desires, priorities
 Nurse acts as resource person
 Steps in planning
 Review and summarize assessment data
 Reinforce strengths, competencies of client
 Identify health goals, related options
 Identify behavioral or health outcomes
Plan, continued
 Steps in planning, continued
 Develop a behavior-change plan
 Reiterate benefits of change
 Address barriers to change
 Determine time frame for implementation
 Formalize commitment to behavior change plan
 Explore available resources
Implementation
 Self-responsibility
 Ongoing support
 Focuses on desired behavior change
 Individual counseling sessions
 Telephone, internet counseling
 Group support
Implementation, continued
 Facilitating social support
 Assist client to assess, modify and change
 Providing health education
 Enhancing behavioral change
 Strategies at each stage of change



Precontemplation
Contemplation
Preparation
 Action
 Maintenance
 Termination
Implementation, continued
 Enhancing behavioral change
 Establish rapport
 Set agenda
 Assess importance, confidence and readiness
 Exchange information
 Reduce resistance
 Advance client to next stage of changing
 Modeling
Evaluation
 Ongoing basis as short-term goals met
 After long-term goals completed
 Date determined during planning phase
 Collaborative effort
Exemplar 13.2 Physical Fitness
and Exercise
 Physical fitness
 Enables body to perform to its potential
 Helps individuals look, feel, do their best
 Ability to perform daily tasks vigorously, with energy left
over
 Involves performance of heart, lungs, muscles
 Influences mental alertness, emotional stability
Healthy People 2010
 Increase proportion of people who
 Engage in moderate physical activity daily
 Perform physical activities to enhance, maintain:

Muscle strength  Endurance  Flexibility
 Increase work sites offering physical fitness programs
 Reduce chronic back condition limitations
 Reduce number of overweight people
Fitness and Exercise
 Research
 Exercise improves health status
 Exercise can prevent, reverse chronic diseases
experienced in aging

Activity-exercise pattern  routine of exercise, activity,
leisure
 ADLs
 Type, quantity, quality of exercise
Physical Activity and Exercise
 Physical activity
 Bodily movement produced by skeletal muscle
contraction
 Increases energy expenditure
 Exercise
 Type of physical activity defined as planned
 Repetitive bodily movement
 Performed to improve, maintain fitness
Physical Activity and Exercise,
continued
 Activity tolerance
 Type and amount of exercise, ADLs individual can
perform without adverse effects
 Functional strength
 Body’s ability to perform work
Types of Exercise
 Isotonic
 Isometric
 Isokinetic
 Aerobic
 Anaerobic
Benefits of Exercise
 Musculoskeletal system
 Muscles hypertrophy
 Joints receive nourishment
 Bone density and strength maintained
 Cardiovascular system
 Primary prevention of stroke, CV disease
 Increase heart rate, strength of heart muscle
 Mediates harmful effects of stress
Benefits of Exercise, continued
 Respiratory system
 Ventilation and oxygen intake increases
 Toxins eliminated
 Problem solving, emotional stability enhanced
 Prevents pooling of secretions
 Gastrointestinal system
 Improves appetite
 Increases GI tract tone
Benefits
of
Exercise,
continued
 Metabolic/Endocrine system
 Elevates metabolism
 Weight loss, exercise stabilize blood sugar
 Urinary system
 Promotes efficient blood blow
 Body excretes wastes more efficiently
 Immune system
 Lymph fluid more efficiently pumped
 Strenuous exercise may reduce immune function
Benefits of Exercise, continued
 Psychoneurologic system
 Mental, affective disorders may affect desire to move
 Role of exercise in elevating mood Relieving stress,
anxiety
 Regular exercise increases levels of endorphins
 Improves quality of sleep
Benefits of Exercise, continued
 Cognitive function
 Positive effect
 Athletic older adults have denser brains
 Brain gym

Improves mood, learning, problem solving
 Contralateral movements help those with

ADD, ADHD, learning disorders, mood disorders
Benefits of Exercise, continued
 Cognitive function
 Positive effects in individuals with


Parkinson’s disease
Alzheimer’s disease
 Spiritual health
 Enhance experience of mind-body-spirit connection