Konsep Sehat dan Sakit

Itsna Luthfi K., S.Kep., Ns.

Setelah mengikuti kuliah ini mahasiswa akan mampu: 1. Mendefinisikan istilah-istilah kunci 2. Mengeksplorasi mengenai konsep kesehatan, kesejahteraan dan kesakitan 3. Mendapatkan overview mengenai model sehat dan sakit 4. Mengidentifikasi implikasi konsep sehat dan sakit dalam merumuskan rencana asuhan keperawatan

Kata-kata Kunci:
Homeostasis Kesehatan Kesejahteraan Determinan Kesehatan Sakit

Aspek yang Mempengaruhi Kondisi Tubuh Seseorang

F a k t o r

I n t e r n a l

Mental Fisik

F a k t o r

E k s t e r n a l

Sistem Manusia

Homeostasis

Riset-riset tentang Sehat

Calnan (1987 cit. Sidell, 1995) Konsep Sehat

pd 60 wanita di Southeast England

Health as never ill Health as being able to get through the day, to carry out

routines Health as being fit and active, taking exercise Health as being able to cope with stresses and crises in life

 Blaxter & Paterson, 1982 (cit. Sidell, 1995)

Health and Lifestyles Survey (HLS)

pada 9000 responden:
Health as not ill

Health as absence of disease

Health as reserve (strenght) Health as behaviour, health as the healthy life Health as physical fitness

Health as energy, vitality

Health as social relationships (relating well to others) Health as function Health as psycho-social well-being

Definisi sehat
Health is a state of complete physical, mental, and social

well-being and not merely the absence of disease or infirmity ( WHO, 1985 cit. Sidell, 1995)
Health is not a condition, it is an adjustment. It is not a

state but a process. The process of adaptation of an individual to not only physical, but also psychosocial environment (United States Presidents Commission on Health Needs of the Nation)
Keadaan sejahtera dari badan, jiwa dan sosial yang

memungkinkan setiap orang hidup produktif secara sosial dan ekonomi ( UU no. 23/1992 tentang Kesehatan)

Faktor-faktor yang Mempengaruhi Kesehatan

Gender Age & developmental stage Employability Parenting style Family dynamics

Health

Geographical mobility

Culture

Social resources

Family finances

Biological factors (Potter & Perry, 2005)

Definisi Kesejahteraan (Wellness)

A choice or a decision that you made to move toward optional

health A way of live a life style you design to achieve your highest potential for well-being A process a developing awareness that there is no end point, but that health and happiness are possible in each moment, here and now Efficient handling of energy energy received from the environment, transformed within you. Integration of body, mind and spirit the appreciation that everything you do, and you think, and feel and believe has an impact on your state of health Loving acceptance of self (Travis and Ryan, 1998)

Hal-hal yang Mempengaruhi Praktik Sehat

Variabel internal
Usia dan tingkat perkembangan Persepsi tentang fungsi Faktor emosi Nilai, keyakinan dan spiritual

Variabel eksternal
Latar belakang pendidikan

Kebiasaan keluarga
Faktor sosial ekonomi Latar belakang budaya

Factors that contribute to wellness

Good physical self care Prevention of illness/injury Using ones full intellectual potential Expressing emotions and managing stress appropriately Maintain good interpersonal relationships Concern about ones environment and condition throughout the world

Model Sehat-Sakit
A model or template that has been developed as a

guide to understand the various components of a complex issue

Developed by researching various factors and the link

between them and using this information as a basis for predicting possible needs and/or outcomes.

Model Sehat-Sakit
Health-Illnesses Continuum (Elwin, 2003)
Mid-point representing little awareness of health status

High level of wellness

Mental & Physical Functionality

Mental & Physical Dysfunctionality

Severe Illness

Model sehat-sakit
The health-illness continuum (Dunn, 1977)
Normal health Wellness Illness area

High Level of Wellness

Illness

Death

Model sehat-sakit
Agent-host-environment model (Leavell, 1965)

Host

Agent

Environment

Community nursing

Kesehatan tergantung pada hubungan antara agen, host dan lingkungan yang dinamis

Nurses Responsibility
To help clients to identify their place (position) on the health-illness continuum To assist clients to adopt some measures (take actions) in order to reach a well state of health

Konsep Sakit
Illness is a state of disturbance in the normal

functioning of the total human individual, including both of the state of organism as a biological system and his person and social adjustment (Parson, 1972)
Disease is an abnormal condition of an organism that

impairs bodily functions, associated with specific symptoms and signs

Views of Disease
Ancient views of disease
Ghosts and gods attach to the body Unbalance between negative and positive

Modern views of disease

A state in which there is a fall of the needs of a human Be discomfort, suffering and pain A loss and change of social behaviour

An abnormity of function, structure and shape of organism

The destroy of homeostasis of organism A reaction of the organism to harmful factors

Kategori Penyimpangan dari Normal

Organic and functional disease (including disability) Hereditary disorder Congenital disorder Infectious disease Psychological problem Metabolic disorder Neoplasmic disease Traumatic injury Occupational disease

Faktor yang Mempengaruhi Perilaku Sakit

Internal
Usia Jenis kelamin Keseimbangan

Eksternal

psikologis Kepribadian Koping yang dimiliki

Pekerjaan Sosio ekonomi Agama Budaya Pendidikan

Tahapan sakit
Symptom experience Assumption of the sick role Medical care contact Dependent patient role

Recovery and rehabilitation

Efek sakit
Perubahan tingkah laku dan emosi: cemas, shock,

denial, marah, menarik diri Perubahan gambaran diri Perubahan konsep diri Perubahan peran dalam keluarga Perubahan dinamika keluarga

Peran perawat
Membantu klien dan keluarga untuk menyesuaikan

diri dengan kondisinya sekarang Memotivasi koping yang efektif untuk menghadapi kondisi yang potensial Health promotion and illness prevention to promote a better health

Health promotion
Aktivitas untuk memotivasi seseorang untuk

bertindak secara positif agar dapat mencapai tingkat kesehatan yang lebih stabil
Kegiatan pasif: individu mendapat keuntungan dari

aktivitas orang lain tanpa ia melakukan apapun Kegiatan aktif : individu dimotivasi untuk mengadaptasi program kesehatan tertentu

Illness prevention
Memotivasi orang untuk menghindari penurunan

kesehatan atau fungsi Level pencegahan:

Primer: promosi kesehatan dan proteksi spesifik

melawan penyakti Sekunder: deteksi penyakti secara dini, intervensi bagi individu yang menderita sakit termasuk mencegah komplikasi dan kecacatan Tersier : setelah sembuh dari sakti dan terdapat kecacatan, fokus pada rehabilitasi individu dan mengembalikan fungsinya pada level optimum.

Peran perawat dalam promosi kesehatan

Advokat Konsultan

Pendidik
Koordinator pelayanan

Pilar strategis Pembangunan Kesehatan Nasional

Paradigma sehat menentukan mind set perilaku

sehat Desentralisasi memandirikan masing-masing wilayah untuk melakukan self health management Jaminan pemeliharaan kesehatan masyarakat Profesionalisme

Indonesia sehat 2010

Menggerakkan pembangunan nasional
Memelihara dan meningkatkan kegiatan individu,

keluarga dan masyarakat beserta lingkungan Memelihara dan meningkatkan pelayanan kesehatan yang bermutu, merata dan terjangkau Mendorong kemandirian masyarakat untuk sehat

Referensi
1. 2. 3. 4.

Ellis, JC; Nowlis, EA. 1994. Nursing A Human Need Approach. 5th ed. Pennsylvania: J.B. Lippincott Company Potter & Perry. 2005. Fundamentals of Nursing: Concepts, Issues and Opportunities. 4th ed. Philadelphia: Lippincott-Raven Publisher Stuart, Gail Wiscarz & Sundeen, Sandra J. 1995. Principles & Practice of Psychiatric Nursing. St. Louis: Mosby Year Book Taylor C, LilisC, Le Mone, P. 1997. Fundamentals of Nursing: The Art and Science of Nursing Care. Philadelphia: Lippincott-Raven Publishers.

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