1. Health Maintenance,
Health Promotion, and
Wellness

2. Health, Illness, and Wellness
 Health is the process through which a
person seeks to maintain an equilibrium
that promotes stability and comfort.
 Health is a dynamic process that varies
according to a person’s perception of
well-being.

3. Health, Illness, and Wellness
 Health refers to all aspects of a person’s
life.
• Physical status
• Emotional well-being
• Social relationships
• Intellectual functioning
• Spiritual condition

4. Health, Illness, and Wellness
 Illness is the inability of an individual’s
adaptive responses to maintain physical
and emotional balance, which results in
an impairment of functional abilities.
 Wellness is the condition in which an
individual functions at optimal levels.

5. Models of Health
 Health is the maintenance of harmony
and balance among body, mind, and
spirit.
• Balance or homeostasis is an equilibrium
among psychological, physiological,
sociocultural, intellectual, and spiritual
needs.

6. Models of Health
 Clinical model
 Health-belief model
 High-level wellness model
 Social learning theory
 Host-agent-environment model
 Health promotion model

7. MODELS OF HEALTH
CLINICAL MODEL
• Traditional Perspective
• Health is absence of illness
• Individuals who are not sick are healthy
HEALTH BELIEF MODEL
• Rosenstock
• Expectations direct behavior that leads to the fulfillment of
the expectations
• Group values exert influence on beliefs about health
• Belief may change as the person grows and develops

8. MODELS OF HEALTH
HIGH LEVEL WELLNESS MODEL
 Dunn
 Health is influenced by the interaction among
the individual, family and community
 Health is viewed toward achieving one’s
fullest potential
 Health is viewed as an attempt toward
achieving one’s fullest potential

9. MODELS OF HEALTH
SOCIAL LEARNING THEORY
 Bandura
• Beliefs strongly influence action
 Rosenstock
• Behavior is influenced by expectations and
reinforcements

10. MODELS OF HEALTH
HOST AGENT ENVIRONMENT MODEL
 Leavell and Clark
 Health depends on the interaction of host
agent and environment
 Balance among these elements results in
health
 Illness occurs when there is an imbalance in
one of the three elements
 Model is used most often in predicting risk of
illnes

11. MODELS OF HEALTH
HEALTH PROMOTION MODEL
 People engage in health promoting behavior when
they:
• Value health
• Perceive health as being within their control
• Can identify benefits in self-care behaviors
• Have a positive perception of their health status
 Health promoting behavior is influence by:
• An individual’s inherited and acquired characteristics
• Significant others, who model the behavior, expect the
behavior to occur, and facilitate the behavior
• Families, peers, and health care providers

12. Cultural Influence on Health
 Culture affects how an individual views
health and illness.
 One’s cultural background influences
health-related behaviors and
expectations of treatment when illness
occurs.

13. Family Influences on
Health Care
 Families help determine the following:
• Whether or not to seek treatment.
• What type of treatment is appropriate.
• Who should provide the treatment or care.
• Where the treatment or care should be
provided.

14. Family Influences on
Health Care
 Families are often the major caregivers
for their relatives.
 Extended families and communities have
traditionally acted as a buffer against
excessive stress and illness.

15. Family Influences on
Health Care
 Lack of social support from family or
significant others results in psychological
and spiritual isolation, which may
negatively impact a person’s
physiological state.

16. Illness Perspectives
 Illness is the result of a disease or injury
that affects functioning and occurs when
there is an inability to meet one’s needs.
 An acute illness is usually characterized
by a rapid onset, intense manifestations,
and a relatively short duration.
 A chronic illness is usually characterized
by a gradual, insidious onset with lifelong
changes, usually irreversible.

17. Parson’s 4 Aspects of the Sick
Role
 Clients are not held responsible for their
condition
 Clients are excused from certain social roles
and tasks
 Clients are obliged to try to get well as quickly
as possible.
 Clients or their families are obliged to seek
competent help

18. Suchman’s Stages of Illness
 Stage 1 – Symptom Experience
• Person comes to believe something is wrong.
• May experience some symptoms such as pain, rash,
cough, fever, or bleeding.
• Unwell person usually consults others about the
symptoms or feelings
• May try home remedies
• If self management is ineffective, person enters next
stage
• 3 Aspects:
• Physical experience of symptoms
• Cognitive aspect (the interpretation of the symptoms in terms that
have some meaning to the person)
• The emotional response

19. Suchman’s Stages of Illness
 Stage 2 – Assumption of the Sick Role
• Person accepts the sick role and seeks confirmation
from family and friends
• Often continues with self-medication and delay contact
with health care professionals as long as possible
• People may be excused from normal duties and role
expectations
• When symptoms persist, person is motivated to seek
professional help
• Emotional Responses during this stage – withdrawal,
anxiety, fear, and depression

20. Suchman’s Stages of Illness
 Stage 3 –Medical Care Contact
 Sick person seeks the advice of a health professional either
on their own initiative or at the urging of significant others
 Information Obtained from health Care Professionals:
- Validation of real illness
- Explanation of symptoms in understandable terms
- Reassurance that they will be all right or prediction of what
the outcome will be
 Client may accept or deny the diagnosis. If the diagnosis is
accepted, the client usually follows the prescribed treatment
plan. If diagnosis is not accepted, client may seek the
advice of other health
 care professionals or quasi-practitioners who will provide a
diagnosis that fits the client’s perceptions.

21. Suchman’s Stages of Illness
 Stage 4 – Dependent Client Role
• Dependent on health care professional for help
• People vary greatly in the degree of ease with
which they can give op their independence.
Role obligations such as those of wage earners,
father, mother, student etc. complicate the
decision to give up independence.
• Dependent on family and friends for support

22. Suchman’s Stages of Illness
 Stage 5 – Recovery and Rehabilitation
• Client is expected to relinquish the dependent
role and resume formers roles and
responsibilities
• For people with acute illness, the time is
generally short and recovery is usually rapid
• For people with long term illnesses and must
adjust their lifestyle may find recovery difficult
• For clients with permanent disability, this stage
may require therapy to learn how to make
major adjustment in functioning.

23. Wellness Perspectives
 Wellness places health on a continuum,
from one’s optimal level (wellness), to a
maladaptive state (illness).
 High-level wellness means functioning to
one’s maximum health potential while
remaining in balance with the
environment.

24. Health Behaviors and Variables
Influencing Health
 Behavior is defined as the observable
response of an individual to external
stimuli.
 All behavior has meaning.

25. FACTORS CAUSING ILLNESS
 Predisposing Factor – a condition that is characterized by a
previous tendency and susceptibility to a disease
E.g. Family history of heart disease
 Contributing Factor – a condition that helps bring about an
illness
E.g. Smoking
Obesity
 Precipitating Factor – a condition that brings on an illness
with undue rapidity, suddenly hastens the onset of illness,
or activates it under certain conditions.
E.g. stressful event

26. Health Behaviors and Variables
Influencing Health
 Variables Influencing Health
• Lifestyle
• Locus of Control
• Self-Efficacy
• Health Care Attitudes
• Self-Concept
• Cognition

27. Health Behaviors and Variables
Influencing Health
 Variables Influencing Health
• Age and Developmental Levels
• Gender
• Previous Experiences with the Health Care
System
• Environment
• Economic Resources

28. Health Maintenance
 Behavior directed toward maintaining a
current level of health
 Health maintenance activities are the
activities/behaviors an individual
performs to maintain or improve a current
level of health.

29. Health Maintenance
 Characteristics of Health Maintenance
• Perception
• Motivation
• Maintenance

30. Health Promotion and Disease
Prevention (Health Protection)
 Health Promotion
• Behavior motivated by the desire to shape a
healthy lifestyle.
• Process of enabling people to increase
control over their health and to improve their
health.
• Includes avoidance of unhealthy behaviors.
• Health promotion efforts intervene with
healthy, rather than ill populations.

31. Health Promotion and Disease
Prevention (Health Protection)
 Disease Prevention
• Activities/behaviors that protect people from
the ill effects of actual or potential health
threats
- Primary prevention
- Secondary prevention
- Tertiary prevention

32. LEVELS OF PREVENTION
(Leavell and Clark)
Primary Prevention – precedes disease or dysfunction and is
applied to generally healthy individuals or groups
Purpose: to decrease the risk or exposure of the individual or
community to disease.
Focus:
• health promotion
• protection against specific health problems.
Examples:
 Health education on healthy lifestyle
 Immunizations
 Risks assessment for specific diseases
 Family planning services and marriage counseling
 Environmental sanitation and provision of adequate housing,
recreation, and work conditions

33.  Quit smoking
 Avoid/limit alcohol intake
 Exercise regularly
 Eat well-balanced diet
 Reduce fat and increase fiber in diet
 Take adequate fluids
 Maintain ideal body weight

34. LEVELS OF PREVENTION
(Leavell and Clark)
Secondary Prevention –includes prevention of complication and
disabilities
Purpose: to identify individuals in an early stage of a disease
process and to limit future disability.
Focus:
 early identification of health problems
 prompt intervention to alleviate health problems
Examples:
 Screening surveys and procedures of any type
 Encouraging regular medical and dental check-ups
 teaching self examination for breast and testicular cancer
 Assessing the growth and development of children
 Nursing assessments and care provided in home, hospitals
and other agencies to prevent complications (e.g. turning
bedridden clients to prevent pressure ulcers etc.)

35.  Annual physical examination
 Regular Pap smear for women
 Monthly BSE for women who are 20
years old and above
 Sputum for TB
 Annual guiac stool test and rectal
examination for clients over 50 years

36. LEVELS OF PREVENTION
(Leavell and Clark)
Tertiary Prevention – begins after an illness, when a defect or
disability is fixed, stabilized, or determined to be irreversible.
Purpose: Help rehabilitate individuals and restore them to an
optimum level of functioning within the constraints of
disability.
Focus:
 restoration
 rehabilitation
Examples:
 Referring a client who has had a colostomy to a support
group
 Teaching a client who has diabetes to identify and prevent
complications
 Teaching a client to use crutches

37.  Undergo speech therapy after
laryngectomy.
 Attend self-management education for
diabetes.
 Participate in cardiac rehabilitation of MI.
 Physical therapy after CVA.