Health and Wellness


Wellness is more than being free from illness, it is a dynamic process of change and growth. “…a state of complete physical, mental, and social well-being, and not merely the absence of disease or infirmity.” – The World Health Organization.

  • Presence or absence of disease
  • Complete physical, mental, social well-being
  • Ability to maintain normal roles
  • Process of adaptation to physical and social environment
  • Striving toward optimal wellness
  • Individual definitions
  • State of well-being

Basic aspects include:

  • Self-responsibility
  • An ultimate goal
  • A dynamic, growing process
  • Daily decision-making in areas related to health
  • Whole being of the individual
  • Subjective perception of vitality and feeling well
  • Described objectively, experienced, measured
  • Can be plotted on a continuum
Dimensions of Wellness


Physical Dimension

  • Ability to carry out daily tasks
  • Achieve fitness
  • Maintain nutrition
  • Avoid abuses

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
  • Ability to use information effectively

Spiritual Dimension

  • Belief in some force that serves to unite

Occupational Dimension

  • Ability to achieve balance between work and leisure

Environmental Dimension

  • Ability to promote health measure that improves
    • Standard of living
    • Quality of life
Models of Health
  • Medical Model
  • Agent-Host-Environment Model
  • Health-Illness Continuum
Medical Model
  • Provides the narrowest interpretation of health
  • People viewed as physiologic systems
  • Health identified by the absence of signs and symptoms of disease or injury
  • State of not being “sick”
  • Opposite of health is disease or injury
Agent-Host-Environment Model
  • Each factor constantly interacts with the others
  • When in balance, health is maintained
  • When not in balance, disease occurs
Travi’s 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

Travi’s Health-Illness Continuum

Ardell’s Wellness Model
5 Dimensions of Wellness

Nutritional Awareness

  • Making healthy food choices on a regular basis.

Physical Fitness

  • Regular exercise program.

Stress Management

Determining the stress factors in one’s life is one thing, but doing something about it is another thing you could do to manage their stress levels

  • Meditation
  • positive visualization
  • taking time out
  • listening to music
  • journal writing
  • regular physical activity are all

Environmental Sensitivity

  • Living lightly on the earth, helping in anyway you can to keep the planet healthy is important as personal wellness depends on planetary wellness.

Self- Responsibility

  • Ardell says, all dimensions of wellness are important, but self-responsibility seems more equal than all the rest. Personal accountability for our own lifestyle is of utmost importance
Bellin’s Model for Competency Improvement
  • Bellin’s Health System, focus is health care delivery system
  • is based upon the belief that outcomes are the results of processes that can be improved through:
    • Identification of success metrics,
    • Setting of goals and the Plan Do Study Act (PDSA) change process.
  • Statistical process control charts are used to track identified processes for stability and response to improvement efforts. Measurement is focused on:
    • Growth
    • Effectiveness
    • Efficiency
    • Engagement
    • Innovation
Iceberg Model
  • The Iceberg Model shows us that our state of physical health or illness is only the visible “tip” of the iceberg.Iceberg Model
  • In order to completely understand our physical condition, we need to look beneath the surface to our
    • Choices of lifestyle (our eating habits, exercise level, addictions to alcohol, food, adrenaline, shopping, drugs, etc),
    • Psychological beliefs (the thoughts, feelings, attitudes and beliefs we hold)
    • Spirituality (our inner life, our belief in a higher power and our degree of acceptance and love of self and others).
Factors Affecting Health Status, Beliefs, and Practices
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
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
  • A highly personal state
  • Person’s physical, emotional, intellectual, social, developmental, or spiritual functioning is diminished
  • Not synonymous with disease
  • May or may not be related to disease
  • Only person can say he or she is ill
  • Alteration in body function
  • A reduction of capacities or a shortening of the normal life span
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
  • Usually has a slow onset
  • Often have periods of remissions and exacerbations
  • Care includes promoting independence, sense of control, and wellness
  • Learn how to live with physical limitations and discomfort
Parson’s Four Aspects of the Sick Role
  • 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
Schuman’s Stages of Illness

Stage 1: Symptom experience

  • Believe something is wrong

Stage 2: Assumption of the sick role

  • Accepts the sick role and seeks confirmation

Stage 3: Medical care contact

  • Seeks advice of a health professional

Stage 4: Dependent client role

  • Becomes dependent on the professional for help

Stage 5: Recovery or rehabilitation

  • Relinquish the dependent role – Resume former roles and responsibilities
Impact of Illness on the Client
  • Behavioral and emotional changes
  • Loss of autonomy
  • Self-concept and body image changes
  • Lifestyle changes 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


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