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.
 Health, Illness, and Wellness
 Health refers to all aspects of a person’s life.
• Physical status
• Emotional well-being
• Social relationships
• Intellectual functioning
• Spiritual condition

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.

Models of Health
 Health is the maintenance of harmony and balance among body, mind, and spirit.
• Balance or homeostasis is equilibrium among psychological, physiological, sociocultural,
intellectual, and spiritual needs.

Models of Health
 Clinical model
 Health-belief model
 High-level wellness model
 Social learning theory
 Host-agent-environment model
 Health promotion model

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.

Family Influences on Health Care

 Families help determine the following:
• 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.
 Families are often the major caregivers for their relatives.
 Extended families and communities have traditionally acted as a buffer against excessive stress and
illness.
 Lack of social support from family or significant others results in psychological and spiritual
isolation, which may negatively impact a person’s physiological state.

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.

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.

Health Behaviors and Variables Influencing Health

 Behavior is defined as the observable response of an individual to external stimuli.
 All behavior has meaning.
 Variables Influencing Health
• Lifestyle
• Locus of Control
• Self-Efficacy
• Health Care Attitudes
• Self-Concept
• Cognition
 Variables Influencing Health
• Age and Developmental Levels
• Gender
• Previous Experiences with the Health Care System
• Environment
• Economic Resources

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.
 Characteristics of Health Maintenance
• Perception
• Motivation
• Maintenance

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.
 Disease Prevention
• Activities/behaviors that protect people from the ill effects of actual or potential health
threats
- Primary prevention
- Secondary prevention
- Tertiary prevention
Health Promotion on a Global Level
 World Health Organization
• Organizes international conferences and meetings and disseminates successful health
promotion strategies, programs, and policies.
 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

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.

Assessment
 Risk Factor Identification in Health Maintenance
• Physical, environmental, psychological behaviors that increase the vulnerability of an
individual to disease or injury
 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.

Nursing Diagnosis
 Ineffective Health Maintenance
 Health-Seeking Behavior
 Noncompliance
 Deficient Knowledge
 Ineffective Therapeutic Regimen Management

Planning and Outcome Identification

 In many ineffective health maintenance situations, desired outcomes of care are best accomplished
in small increments.

Implementation
 Health Promotion and Vulnerable Populations
• Children
• The Elderly
• Economically Disadvantaged
• Homeless
 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.
 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.
 • Maslow’s Hierarchy of Needs

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.
• Physical Self-Examination Techniques
• Health Maintenance in Nutrition- Management Behaviors
• Health Maintenance and Alterations in Sleep Patterns

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.

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.

Intellectual Dimension of Needs and Health

 Cognitive function and development can be impaired by multiple factors.
• Infection
• Exposure to toxins
• Substance abuse
• Trauma
• Psychological problems
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

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.

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.