Chapter 32
Health Maintenance,
Health Promotion, and
Wellness
Health, Illness, and Wellness
 Health is the process through which a
person seeks to maintain an equilibrium
that promotes stability and comfort.
 Health is a dynamic process that varies
according to a person’s perception of
well-being.
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Health, Illness, and Wellness
 Health refers to all aspects of a person’s
life.
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Physical status
Emotional well-being
Social relationships
Intellectual functioning
Spiritual condition
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Health, Illness, and Wellness
 Illness is the inability of an individual’s
adaptive responses to maintain physical
and emotional balance, which results in
an impairment of functional abilities.
 Wellness is the condition in which an
individual functions at optimal levels.
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Models of Health
 Health is the maintenance of harmony
and balance among body, mind, and
spirit.
• Balance or homeostasis is an equilibrium
among psychological, physiological,
sociocultural, intellectual, and spiritual
needs.
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Models of Health
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Clinical model
Health-belief model
High-level wellness model
Social learning theory
Host-agent-environment model
Health promotion model
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Cultural Influence on Health
 Culture affects how an individual views
health and illness.
 One’s cultural background influences
health-related behaviors and
expectations of treatment when illness
occurs.
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Family Influences on
Health Care
 Families help determine the following:
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Whether or not to seek treatment.
What type of treatment is appropriate.
Who should provide the treatment or care.
Where the treatment or care should be
provided.
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Family Influences on
Health Care
 Families are often the major caregivers
for their relatives.
 Extended families and communities have
traditionally acted as a buffer against
excessive stress and illness.
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Family Influences on
Health Care
 Lack of social support from family or
significant others results in psychological
and spiritual isolation, which may
negatively impact a person’s
physiological state.
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Illness Perspectives
 Illness is the result of a disease or injury
that affects functioning and occurs when
there is an inability to meet one’s needs.
 An acute illness is usually characterized
by a rapid onset, intense manifestations,
and a relatively short duration.
 A chronic illness is usually characterized
by a gradual, insidious onset with lifelong
changes, usually irreversible.
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Wellness Perspectives
 Wellness places health on a continuum,
from one’s optimal level (wellness), to a
maladaptive state (illness).
 High-level wellness means functioning to
one’s maximum health potential while
remaining in balance with the
environment.
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Health Behaviors and Variables
Influencing Health
 Behavior is defined as the observable
response of an individual to external
stimuli.
 All behavior has meaning.
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Health Behaviors and Variables
Influencing Health
 Variables Influencing Health
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Lifestyle
Locus of Control
Self-Efficacy
Health Care Attitudes
Self-Concept
Cognition
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Health Behaviors and Variables
Influencing Health
 Variables Influencing Health
• Age and Developmental Levels
• Gender
• Previous Experiences with the Health Care
System
• Environment
• Economic Resources
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Health Maintenance
 Behavior directed toward maintaining a
current level of health
 Health maintenance activities are the
activities/behaviors an individual
performs to maintain or improve a current
level of health.
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Health Maintenance
 Characteristics of Health Maintenance
• Perception
• Motivation
• Maintenance
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Health Promotion and Disease
Prevention (Health Protection)
 Health Promotion
• Behavior motivated by the desire to shape a
health lifestyle.
• Process of enabling people to increase
control over their health and to improve their
health.
• Includes avoidance of unhealthy behaviors.
• Health promotion efforts intervene with
healthy, rather than ill populations.
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Health Promotion and Disease
Prevention (Health Protection)
 Disease Prevention
• Activities/behaviors that protect people from
the ill effects of actual or potential health
threats
- Primary prevention
- Secondary prevention
- Tertiary prevention
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Health Promotion on a Global
Level
 World Health Organization
• Organizes international conferences and
meetings and disseminates successful
health promotion strategies, programs, and
policies.
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Health Promotion on a Global
Level
 Fifth Global Conference on Health
Promotion
• Established Priorities for Health Promotion in
the 21st Century
 “Healthy Cities” Movement
• A vehicle to stimulate local-level health
promotion
• Public, private, and nonprofit responsibility
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Health Promotion in the United
States
 Healthy People Initiative
• Promote healthy behaviors.
• Promote healthy and safe communities.
• Improve systems for personal and public
health.
• Prevent and reduce diseases and disorders.
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Assessment
 Risk Factor Identification in Health
Maintenance
• Physical, environmental, psychological
behaviors that increase the vulnerability of
an individual to disease or injury
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Assessment
 Laboratory and Diagnostic Tests and
Health Maintenance
• Laboratory data includes cholesterol levels,
blood glucose, urine studies.
• Health maintenance behaviors may be
measured with varieties of diagnostic tests
and equipment.
• Client education about what to do with
results obtained from these tests is given.
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Nursing Diagnosis
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Ineffective Health Maintenance
Health-Seeking Behavior
Noncompliance
Deficient Knowledge
Ineffective Therapeutic Regimen
Management
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Planning and Outcome
Identification
 In many ineffective health maintenance
situations, desired outcomes of care are
best accomplished in small increments.
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Implementation
 Health Promotion and Vulnerable
Populations
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Children
The Elderly
Economically Disadvantaged
Homeless
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Implementation
 The Individual as a Holistic Being
• The client with health maintenance
considerations is a holistic being.
• Individuals function as complete units that
cannot be reduced to the sum of their parts.
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Implementation
 Needs and Health
• The entire person (mind, body, and spirit) is
influenced by satisfaction of needs.
• Basic human needs are those that are
necessary for every person’s survival.
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Maslow’s Hierarchy of Needs
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Needs and Health
 Physiological Dimension
• Focuses on achievement of the basic needs
of a client.
• The nurse must assess for system
alterations and then provide interventions to
meet these needs.
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Physiological Dimension of
Needs and Health
 Physical Self-Examination Techniques
 Health Maintenance in NutritionManagement Behaviors
 Health Maintenance and Alterations in
Sleep Patterns
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Psychological Dimension of
Needs and Health
 Treating the client as a unique individual.
 Protecting confidentiality.
 Using touch and personal space in a
therapeutic manner.
 Recognizing and respecting cultural
differences.
 Decreasing anxiety through stress
management techniques.
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Sociocultural Dimension of
Needs and Health
 Empowerment is a process of enabling
others to do for themselves.
 Nurses empower clients by teaching
them and their families how to develop
skills for self-care and for healthier living.
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Intellectual Dimension of Needs
and Health
 Cognitive function and development can
be impaired by multiple factors.
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Infection
Exposure to toxins
Substance abuse
Trauma
Psychological problems
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Spiritual Dimension of Needs
and Health
 Spirituality assists a person in
determining the sense of meaning or
purpose in one’s life.
 Spirituality is multidimensional.
• A sense of one’s self
• A sense of connection with others
• A relationship with a higher power or divine
source
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Sexual Dimension of Needs
and Health
 Sexuality refers to all aspects of being
male or female, including feelings,
attitudes, beliefs, and behavior.
 Sex roles are culturally determined
patterns associated with being male and
female.
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Evaluation
 The client and nurse together measure
how well the client has achieved the
goals specified in the plan of care.
 Factors that contribute to a goal
achievement are identified.
 Certain goals may need to be
reevaluated.
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