Introduction to Health and Wellness in Nursing
Health and wellness are more than just the absence of disease—they are dynamic processes of achieving one’s full potential in physical, mental, emotional, social, and spiritual well-being. In nursing, understanding health and wellness means more than just caring for patients when they are sick; it’s about promoting lifestyles that help prevent illness, supporting recovery, and helping individuals live their best lives regardless of their health conditions.
As a future nurse, your role goes beyond clinical interventions. You are a health advocate, an educator, and sometimes a coach. You will be guiding patients not only through their recovery but also through everyday choices—what they eat, how they manage stress, how they sleep, and how they move. These lifestyle choices can significantly affect outcomes across the lifespan.
In this module, we’ll explore the dimensions of wellness, health promotion strategies, illness prevention, and how cultural and individual beliefs shape a person’s view of health. The goal is to make you feel confident in supporting others in their health journey while reflecting on your own wellness, too.
Let’s make this personal. As you read through, think of your own habits—how do you maintain balance in your life? How do stress or sleep affect your energy and performance? You’ll see that the same principles you apply to yourself will empower you to help your patients thrive.
Definitions and Dimensions of Health and Wellness
📘 What Is Health?
Health is not simply “not being sick.” The World Health Organization (WHO) defines health as “a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity.”
For nurses, this means caring for the whole person—not just their illness or injury.
Think about a patient who’s just been discharged after surgery. If their body is healing, but they’re depressed, lonely, or stressed about money, are they truly “healthy”? Not quite. Health involves more than lab results and physical exams—it’s about the person’s entire quality of life.
🧠 What Is Wellness?
Wellness is the active, lifelong process of becoming aware of and making choices toward a healthy and fulfilling life. It’s about making conscious decisions—like choosing a balanced meal, getting enough sleep, or managing your emotions—that promote optimal health.
📝 In short:
- Health is the overall condition of the body and mind.
- Wellness is the active pursuit of good health.
Both are essential and go hand-in-hand in nursing care.
🧭 The 7 Dimensions of Wellness
To give holistic care, nurses must understand that wellness is multi-dimensional. These dimensions are deeply connected—when one is affected, others may suffer too.
Here’s a breakdown using a relatable example—a nursing student named Mia preparing for her board exams:
- Physical Wellness
Maintaining a healthy body through nutrition, exercise, sleep, and avoiding harmful habits.
➤ Mia starts jogging 20 minutes a day and eats more vegetables to boost her stamina and focus. - Emotional Wellness
Understanding and managing emotions, handling stress, and seeking help when needed.
➤ Mia practices deep breathing before studying to reduce anxiety and avoids burnout. - Intellectual Wellness
Lifelong learning, curiosity, and mental stimulation.
➤ Mia joins a study group to review challenging nursing concepts and quiz each other. - Social Wellness
Building healthy, nurturing relationships and support systems.
➤ Mia checks in with friends and talks with a mentor when she feels overwhelmed. - Spiritual Wellness
Having purpose, values, and inner peace (can be religious or non-religious).
➤ Mia journals her goals and prays or meditates to stay grounded and motivated. - Occupational Wellness
Finding fulfillment in work and balancing work with life.
➤ Mia works part-time but sets boundaries to avoid burnout before the exam. - Environmental Wellness
Living in harmony with your surroundings and caring for the planet.
➤ Mia organizes her space to make it clean, quiet, and focused for studying.
💡 Memory Trick: “PIES-OSE”
Use this mnemonic to recall the 7 Dimensions of Wellness:
P – Physical
I – Intellectual
E – Emotional
S – Social
O – Occupational
S – Spiritual
E – Environmental
🧠 “A healthy PIE’S OSE (nose) sniffs out balance in life!”
📄 Mini Worksheet: “Check Your Wellness Balance”
Instruction: Put a checkmark (✓) beside each statement that describes you this week. Total your checks at the end to reflect on your wellness!
- ☐ I got at least 7 hours of sleep most nights.
- ☐ I ate balanced meals and stayed hydrated.
- ☐ I managed my stress in a healthy way.
- ☐ I made time to study or learn something new.
- ☐ I connected with at least one friend or family member.
- ☐ I did something meaningful or spiritual this week.
- ☐ I kept my environment clean and organized.
- ☐ I balanced work/school and personal time well.
Show Answer Key
- 7–8 checks: You’re maintaining strong wellness across dimensions. Keep it up!
- 4–6 checks: You’re doing well but may need to check in on 1–2 areas.
- 0–3 checks: Time to pause, reflect, and plan changes. Don’t be hard on yourself—start with one small step!
Health Promotion and Disease Prevention Models
🌱 What Is Health Promotion?
Health promotion is any activity or intervention that helps people improve their health or maintain a healthy lifestyle. This doesn’t just mean hospital care—it includes education, community outreach, screenings, vaccinations, and lifestyle coaching. It’s proactive, not reactive.
Nurses are central to health promotion. Whether it’s educating a diabetic patient about carb counting or running a community BP screening booth, your role is to empower individuals to take control of their health.
🛡️ What Is Disease Prevention?
Disease prevention refers to measures taken to prevent diseases before they occur, catch them early, or prevent them from worsening. It’s categorized into three levels:
- Primary Prevention – Prevent disease before it occurs
➤ Example: Vaccines, handwashing, smoking cessation education - Secondary Prevention – Detect disease early for timely treatment
➤ Example: Pap smears, mammograms, blood pressure screenings - Tertiary Prevention – Manage disease to reduce complications
➤ Example: Cardiac rehab, physical therapy, diabetic foot care
🧠 Major Health Promotion Models
These models help nurses understand how and why people make health choices, so they can design better interventions.
1. Pender’s Health Promotion Model
- Focuses on why people choose to improve their health
- Emphasizes individual experiences, beliefs, and the perceived benefits of action
- Nurses use this to create motivating, personalized plans
📌 Example: A nurse helps a sedentary office worker start walking daily by focusing on how exercise will boost their energy and confidence, not just prevent heart disease.
2. Health Belief Model (HBM)
- Explains why people do or don’t take health actions
- Based on perceived:
- Susceptibility (Do I think I’m at risk?)
- Severity (Is it serious?)
- Benefits (Is it worth it?)
- Barriers (What’s stopping me?)
- Cues to action (What will remind me?)
- Self-efficacy (Can I do it?)
📌 Example: A teen might skip the HPV vaccine if they don’t think they’re at risk or fear side effects—nurses can educate to shift their beliefs.
3. Transtheoretical Model (Stages of Change)
- Describes behavior change as a step-by-step process
- 5 main stages:
- Precontemplation – “I’m not ready.”
- Contemplation – “Maybe I should…”
- Preparation – “I’ll start soon.”
- Action – “I’ve started changing.”
- Maintenance – “I’m keeping it up.”
📌 Example: A smoker goes from denying the need to quit, to planning, quitting, and then avoiding relapse with support.
💡 Memory Trick: “HIP T for Models”
To recall the 3 models, use:
H – Health Belief Model
I – Individual-focused (Pender’s Model)
P – Promotion-based approach
T – Transtheoretical (Stages of Change)
🧠 “HIPT gets patients fit!”
📄 Mini Worksheet: “Apply the Models”
Instruction: Match the situation to the correct model and level of prevention.
[ Scenario | Health Model | Level of Prevention ]
- A nurse provides a flu shot to elderly patients. | ___ | ___
- A diabetic client receives foot care teaching. | ___ | ___
- A young adult begins jogging to feel better emotionally. | ___ | ___
- A nurse counsels a smoker who’s unsure about quitting. | ___ | ___
Show Answer Key
- – Not model-specific / Health Promotion in general | Primary Prevention
- – Pender’s Model (Personal motivation, chronic care) | Tertiary Prevention
- – Pender’s Model (Self-initiated improvement) | Primary Prevention
- – Transtheoretical Model (Contemplation stage) | Can span all levels (depends on context, but typically Primary)
Health Assessment and Screening Guidelines
🩺 What Is Health Assessment?
Health assessment is the systematic method of collecting patient data to determine their current and potential health status. It involves not only head-to-toe physical exams but also vital signs, health history, lifestyle questions, and screening tests.
As a nurse, you’re often the first to detect subtle signs of a brewing health problem. From measuring blood pressure to asking about sleep, nutrition, and mood, your assessments guide interventions, referrals, and education.
🔍 What Are Screening Guidelines?
Screenings are early detection tools used to catch diseases before symptoms appear. They help identify high-risk individuals and allow for early treatment. Screening isn’t the same as diagnosing—it’s a preventive approach.
🧩 Key Features of Screening:
To be useful, a screening test must be:
- Reliable: Gives consistent results
- Valid: Accurately detects the condition
- Cost-effective: Reasonable for population-wide use
- Acceptable: Safe, non-invasive, easy to perform
📋 Common Screening Guidelines by Age & Risk (USPSTF & CDC-aligned)
Below are evidence-based screening guidelines nurses should know:
| Screening | Who Should Get It? | Frequency |
|---|---|---|
| BP Check | Adults ≥18 years | Every 1–2 years |
| BMI & Obesity | All adults | Annually |
| Cholesterol (Lipid Panel) | Adults ≥20 at risk | Every 4–6 years |
| Mammogram | Women 50–74 | Every 2 years |
| Pap Smear | Women 21–65 | Every 3 years |
| Colorectal Cancer | Adults 45–75 | Every 10 years (colonoscopy) |
| Diabetes (A1C or FBS) | Adults 35–70 with BMI ≥25 | Every 3 years |
| Depression Screening | All adolescents and adults | Periodically |
| HIV | All aged 15–65 (at least once) | Once or more if at risk |
| STIs (e.g., Chlamydia, Gonorrhea) | Sexually active women ≤25 or high risk | Annually |
| Lung Cancer (Low-dose CT) | Adults 50–80 with 20+ pack-year smoking history | Annually |
💡 Memory Trick: “ABC-PSYCH-LHD” for Screening Focus Areas
A – A1C / Diabetes
B – Blood Pressure
C – Cancer (Breast, Cervical, Colorectal)
P – Pap smear
S – STIs
Y – Young women (STI)
C – Cholesterol
H – HIV
L – Lung cancer
H – Height/Weight (BMI)
D – Depression
🧠 “A Big Clean Patient Says You Can Help Lift Heavy Data.”
🧑⚕️ Nurse’s Role in Screening:
- Educate: Explain the “why” behind each test
- Perform: Collect data (BP, BMI, history) or assist with procedures
- Advocate: Encourage patients to follow age-appropriate screenings
- Refer: Flag abnormal findings for provider follow-up
📌 Example: A 52-year-old patient hasn’t had a colonoscopy yet. The nurse educates them about colorectal cancer risk and helps them schedule the screening.
📄 Mini Worksheet: “What Screening When?”
Instructions: Match each patient scenario to the most appropriate screening guideline.
[ Scenario | Most Appropriate Screening ]
- A 50-year-old man who smokes daily | _______________________
- A 23-year-old sexually active woman | _______________________
- A 55-year-old woman with no recent tests | _______________________
- A 30-year-old overweight adult | _______________________
- A 16-year-old during a school checkup | _______________________
Show Answer Key
- Lung Cancer Screening (Low-dose CT)
- STI Screening (Chlamydia, Gonorrhea)
- Mammogram, Colonoscopy, Lipid Panel
- Diabetes Screening (A1C)
- Depression Screening
Nutrition and Physical Activity Promotion
🥦 Why It Matters
Nutrition and physical activity are the foundations of health promotion. They influence nearly every body system—cardiovascular, endocrine, musculoskeletal, gastrointestinal, and even mental health. Nurses play a critical role in educating, coaching, and motivating individuals to make healthy choices that prevent disease and support recovery.
🍽️ Nutrition Promotion in Nursing
Nutrition isn’t just about calories—it’s about fueling the body with the right balance of nutrients:
- Carbohydrates for energy
- Proteins for growth and healing
- Fats for brain health and hormone balance
- Vitamins and Minerals for metabolism and immunity
- Water for hydration and cellular function
📌 Example: A nurse teaching a post-op patient to increase protein for wound healing or encouraging a hypertensive client to reduce sodium.
✅ Key Nutritional Guidelines (Based on MyPlate & Dietary Guidelines for Americans)
- Half the plate: Fruits and vegetables
- Whole grains over refined grains
- Lean proteins: fish, poultry, legumes
- Limit added sugars, sodium, and saturated fats
- Stay hydrated: 6–8 cups of water/day
- Mindful eating: Pay attention to hunger and satiety cue—
🏃♂️ Physical Activity Promotion in Nursing
Regular movement:
- Improves cardiovascular health
- Boosts mental health and mood
- Helps with weight management
- Improves sleep, digestion, and immune response
📌 Example: A nurse helping a sedentary adult start a walking routine or encouraging stretching exercises for elderly clients to maintain flexibility and reduce fall risk.
🕒 Basic Activity Guidelines (CDC & WHO-aligned)
- Adults:
- 150 minutes of moderate-intensity aerobic activity per week
- + 2 days/week of muscle-strengthening activity
- Children/Teens:
- At least 60 minutes/day of physical activity
💡 Memory Trick: “5-2-1-0 Rule” for Daily Healthy Habits
5 – servings of fruits and vegetables
2 – hours or less of screen time
1 – hour of physical activity
0 – sugary drinks
🧠 “5-2-1-0 helps h grow!” Great for teaching families and school-age children.
🧑⚕️ Nurse’s Role in Nutrition and Activity Promotion
- Assess: Ask about eating patterns, mobility, weight, and barriers
- Educate: Give patient-centered suggestions, not lectures
- Motivate: Use goal-setting and celebrate small wins
- Collaborate: Refer to dietitians or physical therapists i needed
📌 Example: A nurse helping a diabetic patient set SMART goals like walking 15 minutes after lunch or swapping soda for infused water.
📄 Mini Worksheet: “Healthy Habit Check-In”
Instructions: Reflect and check the boxes for actions you’ve done this week. Then, answer the question below.
☐ Ate at least 5 servings of fruits/vegetables today
☐ Walked or exercised for at least 30 minutes
☐ Drank water instead of sugary drinks
☐ Ate mindfully without distractions
☐ Made a healthier food choice (e.g., grilled vs. fried)
Reflection Question:
Which habit do you think is easiest to change this week? Write one small goal to try:
_______________________________________________
Stress Management and Coping Strategies
😓 What Is Stress?
Stress is the body’s natural response to any demand or challenge, whether emotional, physical, or psychological. In small doses, it can motivate you to act—like prepping for an exam. But chronic or intense stress can wear down the immune system, disrupt sleep, impair decision-making, and even lead to chronic illness.
As a nurse, you’ll not only help patients cope with stress—you’ll need to manage your own, too.
🧠 What Are Coping Strategies?
Coping strategies are the thoughts and actions used to deal with stressful situations. They can be:
- Positive (adaptive): Deep breathing, exercise, time management, talking to someone
- Negative (maladaptive): Avoidance, overeating, substance use, isolation
Nurses help patients identify, understand, and use healthy coping strategies to protect their physical and emotional health.
🛠️ Types of Coping Strategies
| Type | Description | Example |
|---|---|---|
| Problem-focused | Aims to remove or reduce the cause of stress | Creating a study schedule before finals |
| Emotion-focused | Aims to reduce the emotional distress | Practicing deep breathing or journaling |
| Avoidance-based | Temporary escape from stress (can be maladaptive) | Ignoring a diagnosis or stress-eating |
📌 Nurse Example: A nurse teaching a new cancer patient both how to manage their appointments (problem-focused) and how to process fear through counseling (emotion-focused).
🧘♀️ Common Stress Management Techniques Nurses Teach:
- Deep breathing – Activates the parasympathetic nervous system
- Progressive muscle relaxation – Helps reduce physical tension
- Mindfulness or meditation – Improves present-moment focus
- Guided imagery – Mentally visualizing calming scenes
- Time management – Reduces last-minute panic
- Social support – Talking it out with friends or family
- Physical activity – Releases endorphins and clears the mind
💡 Memory Trick: “BREATHE” for Coping & Stress Relief
B – Breathe deeply
R – Rest & recharge (sleep)
E – Exercise regularly
A – Avoid negative self-talk
T – Talk to someone
H – Hydrate & eat well
E – Engage in hobbies or nature
🧠 “When in stress, just BREATHE through it!”
🧑⚕️ Nurse’s Role in Stress Management
- Assess stress levels and signs (e.g., insomnia, irritability, headache)
- Ask about coping methods (Are they healthy or harmful?)
- Teach or model stress-relief techniques
- Refer to mental health or support services if needed
📌 Example: A nurse notices a heart failure patient is worried about being a burden. The nurse guides them in journaling and links them to a social worker for long-term support.
📄 Mini Worksheet: “What’s In Your Coping Toolbox?”
Instructions: Choose one current stressor and fill in how you might cope using the strategies below.
Stressor: ____________________________________
| Coping Strategy | What Could You Do? |
|---|---|
| Problem-Focused | ____________________________ |
| Emotion-Focused | ____________________________ |
| Physical-Based | ____________________________ |
Reflection:
Which coping tool do you already use often?
Which one would you like to try this week?
Patient Education and Health Literacy
📚 Why It Matters
Imagine giving a patient life-saving instructions—and they nod, but later take the wrong dose. This isn’t noncompliance; it may be low health literacy.
Patient education is the process of helping individuals understand their health, make informed decisions, and follow through with care plans. Health literacy is the patient’s ability to find, understand, and use health information.
As a nurse, you’re not just a caregiver—you’re a translator of complex medical terms into words patients can act on. The goal is empowerment, not information overload.
🧠 What Is Health Literacy?
Health literacy refers to a person’s ability to:
- Read and understand health materials (e.g., medication labels, discharge papers)
- Navigate the healthcare system (e.g., book appointments, follow up)
- Apply health knowledge to decisions and actions
Low health literacy can lead to:
- Medication errors
- Missed appointments
- Poor chronic disease management
- Increased ER visits and hospitalizations
👥 Levels of Patient Education
- Cognitive (Knowledge-based)
– Teaching facts, concepts, or information
➤ “What is hypertension?” - Psychomotor (Skills-based)
– Teaching tasks that require physical coordination
➤ “How to self-inject insulin” - Affective (Attitude-based)
– Influencing beliefs, values, motivation
➤ “Why quitting smoking matters”
🧑⚕️ Nurse’s Role in Patient Education
- Assess readiness to learn: Are they alert, in pain, overwhelmed?
- Assess health literacy: Can they read instructions? Understand diagrams?
- Individualize the plan: Consider education level, culture, language
- Use simple, clear language: Avoid jargon—speak in plain terms
- Teach-back method: Ask patients to explain back what they understood
- Document what was taught and how the patient responded
📌 Example: Instead of saying “You have hypertension,” say “Your blood pressure is high, which makes your heart work too hard. Let’s go over how to take your medicine every day.”
🛠️ Teaching Tips for Nurses
- Use visual aids or models
- Provide written materials in the patient’s preferred language
- Teach in short segments, using repetition
- Ask open-ended questions (“Can you show me how you’ll take this at home?”)
💡 Memory Trick: “TEACH for Effective Patient Education”
T – Tailor the teaching to the person
E – Evaluate health literacy first
A – Ask for teach-back
C – Communicate clearly and simply
H – Help them feel confident and involved
🧠 “TEACH to reach!”
📄 Mini Worksheet: “Are You Teaching to Their Level?”
Scenario-Based Questions:
Choose the best response based on patient literacy and education needs.
- Your patient reads at a 4th-grade level. What should you do?
a) Give standard hospital pamphlets
b) Use short sentences and pictures
c) Skip written materials - A patient nods during insulin teaching but later can’t recall steps. What’s your best next step?
a) Repeat the steps slowly
b) Use the teach-back method
c) Ask if they want a different medication - You need to educate an elderly client about heart failure. What strategy is best?
a) Use detailed PowerPoint slides
b) Speak quickly to cover more ground
c) Use large-print handouts and repeat key points
Show Answer Key
- b) Use short sentences and pictures
- b) Use the teach-back method
- c) Use large-print handouts and repeat key points
✅ Comprehensive & Interactive Worksheet: Health and Wellness
📝 Section 1: Match the Terms
Match the terms in Column A to their correct description in Column B.
| Column A | Column B |
|
|
📝 Section 2: Fill in the Blanks
- The three levels of prevention are: __________, __________, and __________.
- The 5 Rights of Patient Education are: Right Time, Right __________, Right __________, Right __________, and Right Feedback.
- The “5-2-1-0” rule promotes daily habits of: 5 fruits/veggies, 2 hours of __________, 1 hour of __________, and 0 __________.
- The Transtheoretical Model includes the stages: Precontemplation, __________, __________, __________, and Maintenance.
📝 Section 3: Application Scenarios
Write the best nursing response to each scenario below:
- A 52-year-old patient doesn’t think they need a colonoscopy.
Response: ___________________________________ - A client with asthma can’t explain how to use an inhaler correctly.
Response: ___________________________________ - A teenager says they don’t believe vaping is harmful.
Response: ___________________________________
Show Answer Key
Section 1:
1 → D
2 → C
3 → A
4 → E
5 → F
6 → G
7 → B
Section 2:
- Primary, Secondary, Tertiary
- Content, Method, Language
- Screen time, Physical activity, Sugary drinks
- Contemplation, Preparation, Action
Section 3: (sample answers)
- Explain colon cancer risks and benefits of early detection in age group.
- Demonstrate inhaler use and apply teach-back.
- Share risks and health statistics in a teen-friendly way; use motivational interviewing.
🧠 Memory Trick Recap
| Trick | What It Helps Remember |
|---|---|
| PIES-OSE | 7 Dimensions of Wellness (Physical, Intellectual, Emotional, Social, Occupational, Spiritual, Environmental) |
| HIPT | Health Promotion Models (Health Belief, Individual/Pender’s, Promotion, Transtheoretical) |
| ABC-PSYCH-LHD | Common Screenings (A1C, BP, Cancer, Pap, STI, Youth STI, Cholesterol, HIV, Lung, Height/weight, Depression) |
| 5-2-1-0 | Daily health habits (5 fruits/veggies, 2 hours screen, 1 hour activity, 0 sugary drinks) |
| BREATHE | Coping Strategies (Breathe, Rest, Exercise, Avoid negative thoughts, Talk, Hydrate, Engage hobbies) |
| TEACH | Patient Education Process (Tailor, Evaluate literacy, Ask for teach-back, Communicate clearly, Help confidence) |
❓ Frequently Asked Questions (FAQs)
Q1: What’s the difference between health and wellness?
A: Health is the overall state of well-being; wellness is the active process of achieving it through lifestyle choices.
Q2: How do I know if a patient has low health literacy?
A: Clues include incomplete forms, missed instructions, or saying “I forgot my glasses.” Confirm with simple tools or the teach-back method.
Q3: How do I motivate patients who aren’t ready to change?
A: Use the Transtheoretical Model. Acknowledge their stage, avoid judgment, and gently provide information and encouragement.
Q4: What if my patient speaks a different language?
A: Use certified interpreters, translated materials, and visuals. Avoid relying solely on family unless it’s an emergency.
Q5: What’s the best way to remember all these models and levels?
A: Use mnemonics like HIPT and PIES-OSE. Focus on understanding the function of each model rather than memorizing definitions.
📚 References
- Bastable, S. B. (2021). Nurse as Educator: Principles of Teaching and Learning for Nursing Practice (6th ed.). Jones & Bartlett Learning.
- Potter, P. A., Perry, A. G., Stockert, P. A., & Hall, A. M. (2022). Fundamentals of Nursing (11th ed.). Elsevier.
- Centers for Disease Control and Prevention (CDC). (2023). Physical Activity Guidelines for Americans.
- U.S. Preventive Services Task Force (USPSTF). (2023). Screening Recommendations.
- World Health Organization (WHO). (1948). Preamble to the Constitution of WHO.
- American Nurses Association (ANA). (2021). Nursing: Scope and Standards of Practice.
- Nutbeam, D. (2008). Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15(3), 259–267.