Concepts of Health and

Illness
Introduction
Health is a fundamental right of every human being. It is a state of
integration of the body and mind. It is a much sought after state; a highly
desirable state for most people and yet at times, it remains elusive for some
people.
Across the lifespan, man moves from the health spectrum to the illness
spectrum. Some people think of themselves as healthy and well if they are not ill
and ill if they are not well. However, there is no exact point at which health ends
and illness begins as both are a relative in nature.
Health and illness are highly individualized perceptions. Meanings and
descriptions of health and illness vary among people in relation to geography
and to culture.
This section will help you, to have a better notion and perpective of health
and illness.
Concept of Health and Illness
Health is a state of complete, physical, mental nd social well-being, and
not merely the absence of disease or infirmity. (WHO)
Health is the ability to maintain the internal milieu. Illness is the result of
failure to maintain the internal environment. (Bernard)
Health is the ability to maintain homeostasis or dynamic equilibrium.
Homeostasis is regulated by the negative feedback mechanism. (Walter
Cannon)
Health is viewed in terms of the individuals ability to perform 14
components of nursing care unaided. (Henderson)
Health is being well and using ones power to the fullest extent. Health is
maintained through prevention of disease via environmental health
factors. (Nightingale)
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Positive health symbolizes wellness. It is a value term defined by the

culture or individual. (Roger)
Health is a state and process of being and becoming an integrated and
whole person.
Health is a state that is characterized by soundness or wholeness of
developed human structures and of bodily and mental functioning.
(Orem)
Health is a dyanmic state in the life cycle; illness is an interference in the
life cycle. (King)
Wellness is the condition in which all parts and subparts of an individual
are in harmony with the whole system. (Neuman)
Health is an elusive , dynamic state influenced by biologic, psychologic,
and social factors. Health is reflected by the organization, interaction,
interdependence and integration of the subsystems of the behavioral
system. (Johnson)

Wellness and Well-being

Wellness is well-being. It involves engaging in attitudes and behaviors
that enhance quality of life and maximize personal potential.
Well-being is a subjective perception of balance, harmony and vitality.
Wellness is a choice.
Wellness is a way of life.
Wellness is the integration of body, mind & spirit.
Wellness is the loving acceptance of ones self.
Models of Health and Illness
The Health-Illness Continuum
Health Belief Model
Smiths Model of Health
Levell and Clarks Agent-Host-Environment Model (Ecologic Model)
Health Promotion Model
Seven Components of Wellness

The Health-Illness Continuum (Dunn)

Dunns theory on Health-Illness Continuum describes the interaction
of the environment with well-being and illness.
High level wellness (HLW)
An integrated method of functioning that is oriented towards maximizing
ones potentialities within the limitations of his environment.
This concept connotes ability to perform ADL or to function
independently.
Precursor of Illness
These are the factors which impinge on the individuals to lead towards illness
spectrum.
1. Heredity. E.g. family history of diabetes mellitus, hypertension, cancer.
2. Behavioral factors. E.g. cigarette smoking, alcohol abuse, high animal fat
intake.
3. Environmental factors. E.g. overcrowding, poor sanitation, poor supply
of potable water.

Traviss Illness-Wellness Continuum

Health Belief Model (HBM)

Becker, 1975

Individual Perceptions
1. Perceived susceptibility to an illness. E.g. family history to
diabetes mellitus increase risk to develop the disease.
2. Perceived seriousness of an illness. E.g. Diabetes mellitus is a
lifelong disease.
3. Perceived threat of an illness. E.g. Diabetes mellitus causes
damage to the brain, heart, eyes, kidneys, blood vessels.
4. Modifying factors
1. Demographic variables (age, sex, race, etc.)
2. Sociopsychologic variables (social pressure or influence
from peers, etc.
5. Structural variables (knowledge about the disease, and prior
contact with it)
6. Cues to action. (internal: fatigue, uncomfortable symptoms;
external: mass media, advice from others)
7. Likelihood of taking recommended preventive health action
depends on:
1. Perceived benefits of preventive action
2. Perceived barriers to preventive action
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Smiths Model of Health

1. Clinical Model
Views people as physiologic system with related functions and identifies
health as the absence of signs and symptoms of disease or injury.
2. Role Performance Model
Defines health in terms of individuals ability to fulfill societal roles
such as performing work.
3. Adaptive Model
Focuses on adaptation. Views health as creative process; and disease as a
failure in adaptation or mal-adaptation. This model believes that the aim of
treatment is to restore the ability of that person to adapt that is to cope.
4.

Eudemonistic Model
Conceptualizes that health is a condition of actualization or realization of
a persons potential. This model avers that the highest aspiration of people is
fulfillment and complete development----actualization.

Leavell and Clarks Agent-Host-Environment Model (Ecologic Model)

Three Interactive factors that affect health and illness;
1. Agent. Any factor or stressor that can lead to illness or disease.
2. Host. Persons who may or may not be affected by a disease.
3. Environment. Any factor external to the host that may or may not
predispose the person to a certain disease.
The Agent-host-environment Triangle

Health Promotion Model (Pender)

The Health Promotion Model (Pender) describes the multidimensional
nature of persons as they interact within the environment to pursue health.
1. Individual Perceptions (clients cognitive perceptual factors)
2. Modifying Factors (demographic and social factors)
3. Participation in health promoting behaviors (likelihood of action)

Pender advocates that health promotion involves activities that are

directed toward increasing the level of well-being and self-actualization.
1. Includes efforts to assist individuals in taking control of and
responsibility for their health risks and ultimately improve quality of
life.
2. Encompasses activities to improve the health of those who are not
initially healthy as well as the healthy individuals.
3. Includes individual and community activities to promote healthful
lifestyles.
4. Includes the principles of self-responsibility, nutritional awareness,
stress reduction and management and physical fitness.
5. Health promotion activities such as routine exercise and good nutrition,
help clients maintain or enhance their present level of health.
6. Illness prevention activities such as immunization programs protect
clients from actual or potential threats to health.

ILLNESS AND DISEASE

Illness
Illness is a personal state in which the person feels unhealthy.
Illness is a state in which persons physical, emotional, intellectual,
social, developmental or spiritual functioning is diminished or impaired
compared with previous experience.
Illness is not synonymous with disease; although nurses must be
familiar with different kind of diseases and their treatments, they are
concerned more with illness, which may include disease but also the
effects on functioning and well being in all dimensions.
Disease
Alteration in body functions resulting in reduction of capacities or a shortening
of the normal life span.
Causes of Disease
1. Biologic agents (e.g. microorganisms)
2. Inherited genetic defects (e.g. cleft palate)
3. Developmental defects (e.g. imperforate anus)
4. Physical agents (e.g. hot and cold substances, radiation, ultraviolet rays)
5. Chemical agents (e.g. lead, emissions from smoke belching cars)
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6. Tissue response to irritation/injury (e.g. fever, inflammation)

7. Faulty chemical/metabolic process (e.g. inadequate insulin in diabetes
mellitus, inadequate iodine causing goiter)
8. Emotional/physical reaction to stress (e.g. anxiety, fear)
Illness behavior
A coping mechanism, involves ways individuals describe, monitor, and
interpret their symptoms, take remedial actions, and use the health care system.
Aspects of Sick Role (Parson)
One is not held responsible for his condition. The person did not cause
his illness.
One is excused from social roles. The person is allowed to rest by
seeking sick leave or leave of absence.
One is obliged to get well as soon as possible. The person is expected
to cooperate and comply with the recommended therapies.
One is obliged to seek for competent help. The person is expected to
seek help from health professionals.

Stages of Illness (Suchman)

1. Symptom of Experience
Transition stage
The person believes something is wrong.
Experiences some symptoms.
3 aspects:
Physical (fever, muscle aches, malaise, headache)
Cognitive (perception of having flu)
Emotional (worry on consequence of illness)
2. Assumption of Sick Role
Acceptance of the illness.
Seeks advice, support for decision to give up some activities.
3. Medical Care Contact
Seeks advice of health professionals for the following reasons:
Validation of real illness.
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 Explanation of symptoms.
Reassurance or prediction of outcome
4. Dependent Patient Role
The person becomes a client dependent on the health
professional for help.
Accepts/rejects health professionals suggestions.
Becomes more passive and accepting.
May regress to an earlier behavioral stage.
5.

Recovery/Rehabilitation

Gives up the sick role and returns to former roles and functions.
Risk Factors
A risk factor is any situation, habit, social or environmental
condition, physiological or psychological condition, developmental
or intellectual condition, or spiritual or other variable that increases
the vulnerability of an individual or group to an illness or accident.
The presence of risk factors does not mean that a disease will
develop, but risk factors increase the chances that the individual
will experience a particular dysfunction.

Risk Factor of a Disease

1. Genetic and Physiological Factors
2. Age
3. Environment
4. Lifestyle
Terminologies
Disease. Disturbance of structure or of function of the body or its
constituent parts.
Lack of or faulty or inadequate adaptation of the organism to its
environment.
Failure of the adaptive mechanism. to adequately counteract the stimuli or
stresses to w/c it is subject resulting in disturbances in function and
structure of any part, organ or system of the body
Morbidity. Condition of being diseased.
Morbidity rate. The proportion of disease to health in a community.
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Mortality. Condition or quality of being subject to death.

Ecology. The science of organisms as affected by factors in their
environment; deals w/ the relationship b/w disease and geographical
environment.
Epidemiology. Study of the patterns of health and disease, its occurrence
and distribution in man, for the purpose of control and prevention of
disease.
Susceptibility. The degree of resistance the potential host has the
pathogen.
Etiologic agent. One that possesses the potential for producing injury or
disease. (e.g. Streptococcus, Staphylococcus)
Virulence. Relative power or the degree of pathogenicity of the invading
microorganism, the ability to produce poisons that repels or destroys
phagocytes.
Symptomatology. Study of symptoms.
Symptom. Any disorder of appearance, sensation or function experienced
by the patient indicative of a certain phase of a disease.
Sign. An objective symptom of evidence or physical manifestation ade
apparent by special methods of examination or use of senses.
Syndrome. A set of symptoms, the sum of which constitutes a disease.
Pathology. The branch of medicine which deals with the cause, nature,
treatment and resultant structural and functional changes of disease.
Pathogenesis. Method of origin and development of a disease, including
sequence of processes or events from inception to the development of the
lesion or disease.
Diagnosis. Art or act of determining the nature of the disease, recognition
of a diseased state.
Sequela. The consequence that follows the normal course of an illness.
Complication. A condition that occurs during or after the course of an
illness.
Recovery. Implies that the person has no observable or known after effects
from his illness; there is apparent restoration to the pre-illness state.
Prognosis. Prediction of the course and end of the disease, medical
opinion as to the outcome of a disease process. Good prognosis means
that there are great possibility to recover from the disease and poor
prognosis means that there are greater risk for morbidity or mortality.

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Classification of Diseases
A. According to Etiologic Factors
Hereditary. Due to the defect in genes of one or another parent which is
transmitted to the offspring
Congenital. Due to a defect I the development, hereditary factors or
prenatal infection; present at birth.
Metabolic. Due to disturbances or abnormality in the intricate processes
of metabolism.
Deficiency. Results from inaduquate intake or absorption of essential
dietary factors.
Allergic. Due to abnormal response of the body to chemical or protein
substances or to physical stimuli.
Traumatic. Due to injury.
Neoplastic. Due to abnormal or uncontrolled growth of cells.
Idiopathic. Cause is unknown; self-originated; of spontaneous origin.
Degenerative. Results from the degenerative changes that occur in tissues
and organs.
Iatrogenic. Results from the treatment of a disease
B. According to the Duration or Onset
Acute illness. An acute illness usually has a short duration and is severe.
The signs.
Chronic illness. A chronic illness persists usually longer than 6 months
and can also affect functioning in any dimension. It is characterized by
remission and exacerbation.
Sub-acute. Symptoms are not pronounced but more prolonged than in
acute disease.
C. Other. Disease may also described as:
Organic. Results from the changes in the normal structure, from
recognizable anatomical changes in an organ or tissue of the body.
Functional. No anatomical changes are observed to account for the
symptoms present, may result from abnormal responses to stimuli.
Occupational. Results from the factors associated to the occupation
engaged in by the patient.
Familial. Occurs in several individuals of the same family.
Venereal. Usually acquired through sexual relation.
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Epidemic. Attacks a large number of individuals in a community at the

same time.
Endemic. Present more or less continuously or recurs in a community.
Pandemic. An epidemic disease which is extremely widespread involving
an entire country or continent.
Sporadic. A disease in which only occasional cases occur.

Leavell and Clarks Three Levels of Prevention

1. Primary Prevention
Health Promotion
Specific Protection
2. Secondary Prevention
Early Diagnosis/Detection/Screening
Prompt Treatment to Limit Disability
3. Tertiary Prevention
Rehabilitation

Behaviors Associated with the Levels of Prevetion

Primary Prevention
Quit smoking
Avoid/limit alcohol
Exercise regularly
Eat well-balanced diet
Reduce fat and increase fiber in diet
Take adequate fluids
Avoid over exposure to sunlight
Maintain ideal body weight
Complete immunization program
Wear hazard devices in work site
Secondary Prevention
Have annual physical examination
Regular paps test for women
Monthly BSE for women who are 20 yars old and above
Sputum exam for tuberculosis
Annual stool guaiac test and rectal exam for clients over 50 years
Tertiary Prevention
Self-monitoring of blood glucose among diabetics
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Physical therapy after CVS; participation in Cardiac Rehabilitation after

MI
Attending self-management education for diabetics
Undergoing speech therapy after laryngectomy

Types of Health Promotion Programs

Information dissemination
Health appraisal and Wellness Assessment Programs
Lifestyle and Behavior Change programs
Worksite Wellness Programs
Environmental Control Programs
Activities to Promote Health and Prevent Illness
1. Have yearly physical examination
Women: Regular Pap test
Monthly BSE
3. Men: Regular testicular self examination
4. Annual dental exam and prophylaxis
5. Regular eye exam (every 1-2 years)
6. Exercise regularly at least 3x per week for 30 minutes
7. Do not smoke: avoid second hand smoke
8. Avoid alcohol and recreational drugs
9. Reduce fat and increase fiber in diet
10. Sleep regularly 7-8 hours/night
11. Eat breakfast
12. Eat regular meals with few snacks
13. Maintain Ideal Body Weight

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