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“State of complete physical, mental and social well-being not merely the absence of disease or
infirmity” WHO (World Health Organization)
ILLNESS
Classification of Illness
Acute Illness
• Characterized by severe symptoms of relatively short duration
• Symptoms often appear abruptly, subside quickly
• May or may not require intervention by health care professionals
• Most people return to normal level of wellness
Chronic Illness
• Lasts for an extended period (6 months or longer)
• Usually has a slow onset
• Often have periods of remissions (symptoms disappear) and
exacerbations (symptoms reappear)
• Care includes promoting independence, sense of control, and wellness
• Learn how to live with physical limitations and discomfort
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Parson’s Four Aspects of the Sick Role (Parsons, 1979)
• Clients are not held responsible for their condition
• Clients are not excused from certain social roles and tasks
• Clients are obligated to try to get well as quickly as possible
• Clients or their families are obligated to seek competent help
Impact of Illness
On the Client
• Behavioral and emotional changes
• Loss of autonomy (autonomy is the state of being independent and self-directed
without outside control)
• Self-concept and body image changes
• Lifestyle changes (lifestyle is a general way of living based on the interplay
between living condition in the wide sense and individual pattern of behaviour as
determined by socio-cultural factors and personal characteristic)
• Privacy is usually affected (privacy is described as comfortable feeling reflecting a
deserved degree of social retreat or freedom from authorized intrusion)
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On the Family
• Depends on:
– Member of the family who is ill
– Seriousness and length of the illness
– Cultural and social customs the family follows
–
Impact of Illness: Family Changes
• Role changes
• Task reassignments
• Increased demands on time
• Anxiety about outcomes
• Conflict about unaccustomed responsibilities
• Financial problems
• Loneliness as a result of separation and pending loss
• Change in social customs
Nursing interventions:
1. explanations about adjustments
2. arrangements to accommodate lifestyle
3. encourage health professionals to become aware of changes and give support
4. reinforce desirable changes in practice
DISEASE
“abnormal vital function involving any structure, part, or system of an organism”
“specific illness or disorder characterized by a recognizable set of manifestations, attributable
to heredity, infection, diet, or environment”
WELLNESS
• State of well-being
– Subjective perception of vitality and feeling well
– Described objectively, experienced, measured
– Can be plotted on a continuum
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Dimensions of Wellness (Anspaugh, Hamrick, Rosato)
Physical Dimension
• Ability to carry out daily tasks
• Achieve fitness
• Maintain nutrition
• Avoid abuses
• Positive lifestyle habits
Social Dimension
• Interact successfully
• Develop and maintain intimacy
• Develop respect and tolerance for others
Emotional Dimension
• Ability to manage stress
• Ability to express emotion
Intellectual Dimension
• Ability to learn and grow
• Ability to use information effectively
Spiritual Dimension
• Belief in some force that serves to unite
• Belief in moral, values and ethics
Occupational Dimension
• Ability to achieve balance between work and leisure
Environmental Dimension
• Ability to promote health measure that improves
– Standard of living (food, water, air)
– Quality of life
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Models of Health
o Adaptive Model
• Creative process
• Disease is a failure in adaptation or maladaption
• Extreme good health is flexible adaptation to the environment
• Focus is stability
• Element of growth and change
o Eudemonistic Model
• Comprehensive view of health
• Condition of actualization or realization of a person’s potential
• Illness is a condition that prevents self-actualization
• also called ecologic agent ,used in predicting illness rather than promoting
wellness
• has 3 dynamic interactive elements:
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Health-Illness Continuum
• Dunn’s high level wellness grid
• Travis’s illness – wellness continuum
• Health Belief model
• Health locus of control model
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HEALTH-ILLNESS CONTINUUM
• Measure person’s perceived level of wellness
• Health and illness/disease opposite ends of a health continuum
• Move back and forth within this continuum day by day
• Wide ranges of health or illness
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Travis’s Illness – wellness continuum
• compose of 2 arrows pointing in opposite direction and joined at neutral point
• movement to the left of neutral point indicate progressive decrease in state of health
• movement to the right of the neutral point indicates increasing level of health
• traditional treatment model > help only the individual move from left to the neutral
point
• Wellness model > help move individual beyond the neutral point to high level of
wellness
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Health Locus of control model
Factors Affecting Health Status, Beliefs, and Practices
• Internal variables (Internal LOC)
• External variables (External LOC)
Internal Variables
• Biologic dimension (genetic makeup, gender, age, and developmental level)
• Psychologic dimension (mind-body interactions and self-concept)
• Cognitive dimension (intellectual factors include lifestyle choices and spiritual and
religious beliefs)
External Variables
• Physical environment
• Standards of living
• Family and cultural beliefs
• Social support networks
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Factors Affecting Health Care Adherence
• Client motivation
• Degree of lifestyle change necessary
• Perceived severity of problem
• Value placed on reducing the threat of illness
• Difficulty in understanding and performing specific behaviors
• Degree of inconvenience of the illness itself or of the regimens
• Complexity, side effects, and duration of the proposed therapy
• Specific cultural heritage that may make adherence difficult
• Degree of satisfaction and quality and type of relationship with the health care
providers
• Overall cost of prescribed therapy
- Halley
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