PED 13

Health

• As defined by the World Health Organization (WHO): state of complete physical, mental and
social well-being, not merely the absence of disease or infirmity

Characteristics

• A concern for the individual as a total system

• A view of health that identifies internal and external environment

• An acknowledgment of the importance of an individual’s role in life

*A dynamic state in which the individual adapts to changes in internal and external
environment to maintain a state of well being

Models of Health and Illness

• Health-Illness Continuum (Neuman) – Degree of client wellness that exists at any point in time,
ranging from an optimal wellness condition, with available energy at its maximum, to death
which represents total energy depletion.

• High – Level Wellness Model (Halbert Dunn) – It is oriented toward maximizing the health
potential of an individual. This model requires the individual to maintain a continuum of balance
and purposeful direction within the environment

Models of Health and Illness2

• Agent – Host – environment Model (Leavell) – The level of health of an individual or group
depends on the dynamic relationship of the agent, host and environment

– Agent – any internal or external factor that disease or illness.

– Host – the person or persons who may be susceptible to a particular illness or disease

– Environment – consists of all factors outside of the host

Models of Health and Illness3

• Health – Belief Model – Addresses the relationship between a person’s belief and behaviors. It
provides a way of understanding and predicting how clients will behave in relation to their
health and how they will comply with health care therapies.

Four Components

– The individual is perception of susceptibility to an illness

– The individual’s perception of the seriousness of the illness

– The perceived threat of a disease

– The perceived benefits of taking the necessary preventive measures

Models of Health and Illness4

• Health Promotion Model – A “complimentary counterpart models of health protection”.

Directed at increasing a client’s level of well being. Explain the reason for client’s participation
health-promotion behaviors. The model focuses on three functions:

– It identifies factors (demographic and socially) enhance or decrease the participation in

health promotion

– It organizes cues into pattern to explain likelihood of a client’s participation health-

promotion behaviors

– It explains the reasons that individuals engage in health activities

Illness

• State in which a person’s physical, emotional, intellectual, social developmental or spiritual

functioning is diminished or impaired. It is a condition characterized by a deviation from a
normal, healthy state

Stages of Illness

1. Stage of Denial – Refusal to acknowledge illness; anxiety, fear, irritability and aggressiveness.

2. Stage of Acceptance – Turns to professional help for assistance

3. Stage of Recovery (Rehabilitation or Convalescence) – The patient goes through of resolving loss
or impairment of function

Rehabilitation

1. A dynamic, health oriented process that assists individual who is ill or disabled to achieve his
greatest possible level of physical, mental, spiritual, social and economical functioning.

2. Abilities not disabilities are emphasized.

3. Begins during initial contact with the patient

4. Emphasis is on restoring the patient to independence or regain his pre-illness/predisability level

of function as short a time as possible

5. Patient must be an active participant in the rehabilitation goal setting an din rehabilitation
process.
Focuses of Rehabilitation

1. Coping pattern

2. Functional ability – focuses on self-care: activities of daily living (ADL); feeding, bathing/hygiene,
dressing/grooming, toileting and mobility

3. Mobility

4. Integrity of skin

5. Control of bowel and bladder function

Illness

• Is a personal state in which the person feels unhealthy.

• Illness is a state in which a person’s physical, emotional, intellectual, social, developmental, or

spiritual functioning is diminished or impaired compared with previous experience.

• Illness is not synonymous with disease

Disease

• An alteration in body function resulting in reduction of capacities or a shortening of the normal

life span

Common Causes of Disease

• Biologic agent – e.g. microorganism

• Inherited genetic defects – e.g. cleft palate

• Developmental defects – e.g. imperforate anus

• Physical agents – e.g. radiation, hot and cold substances, ultraviolet rays

• Chemical agents – e.g. lead, asbestos, carbon monoxide

• Tissue response to irritations/injury – e.g. inflammation, fever

• Faulty chemical/metabolic process – e.g. inadequate insulin in diabetes

• Emotional/physical reaction to stress – e.g. fear, anxiety

Stages of Illness

• Symptoms Experience– experience some symptoms, person believes something is wrong 3

aspects –physical, cognitive, emotional

• Assumption of Sick Role – acceptance of illness, seeks advice

 • Medical Care Contact– Seeks advice to professionals for validation of real illness, explanation of
symptoms, reassurance or predict of outcome

• Dependent Patient Role

– The person becomes a client dependent on the health professional for help.

– Accepts/rejects health professional’s suggestions.

– Becomes more passive and accepting.

• Recovery/Rehabilitation – Gives up the sick role and returns to former roles and functions.

Risk Factors of a Disease

• Genetic and Physiological Factors

– For example, a person with a family history of diabetes mellitus, is at risk in developing
the disease later in life.

• Age

– Age increases and decreases susceptibility ( risk of heart diseases increases with age for
both sexes

• Environment

– The physical environment in which a person works or lives can increase the likelihood
that certain illnesses will occur.

• Lifestyle

– Lifestyle practices and behaviors can also have positive or negative effects on health.

Classification of Diseases

1. According to Etiologic Factors

2. According to Duration or Onset

3. Others

According to Etiologic Factors

Hereditary – due to defect in the genes of one or other parent which is transmitted to the offspring

Congenital – due to a defect in the development, hereditary factors, or prenatal infection

Metabolic – due to disturbances or abnormality in the intricate processes of metabolism.

Deficiency – results from inadequate intake or absorption of essential dietary factor.

Traumatic– due to injuryAllergic – due to abnormal response of the body to chemical and protein
substances or to physical stimuli.
Neoplastic – due to abnormal or uncontrolled growth of cell.

Idiopathic –Cause is unknown; self-originated; of spontaneous origin

Degenerative –Results from the degenerative changes that occur in the tissue and organs.

Latrogenic – result from the treatment of the disease

According to Duration or Onset

• Acute Illness – An acute illness usually has a short duration and is severe. Signs and symptoms
appear abruptly, intense and often subside after a relatively short period.

• Chronic Illness – chronic illness usually longer than 6 months, and can also affects functioning in
any dimension. The client may fluctuate between maximal functioning and serious relapses and
may be life threatening. Is characterized by remission and exacerbation.

– Remission– periods during which the disease is controlled and symptoms are not
obvious.

– Exacerbations – The disease becomes more active given again at a future time, with
recurrence of pronounced symptoms.

• Sub-Acute – Symptoms are pronounced but more prolonged than the acute disease

Disease may also be Described as:

• Organic – results from 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 from the symptoms present, may
result from abnormal response to stimuli.

• Occupational – Results from factors associated with the occupation engage in by the patient.

• Venereal – usually acquired through sexual relation

• Familial – occurs in several individuals of the same family

• Epidemic – attacks a large number of individuals in the community at the same time. (E.g. SARS)

• Endemic – Presents more or less continuously or recurs in a community. (E.g. malaria, goiter)

• Pandemic –An epidemic which is extremely widespread involving an entire country or continent.

• Sporadic – a disease in which only occasional cases occur. (E.g. dengue, leptospirosis)
Asepsis

• Asepsis is the state of being free from disease-causing contaminants (such as bacteria, viruses,
fungi, and parasites) or, preventing contact with microorganisms. The term asepsis often refers
to those practices used to promote or induce asepsis in an operative field in surgery or medicine
to prevent infection.

Medical Asepsis

• Includes all practices intended to confine a specific microorganism to a specific area

• Limits the number, growth, and transmission of microorganisms

• Objects referred to as clean or dirty (soiled, contaminated)

Surgical Asepsis

• Sterile technique

• Practices that keep an area or object free of all microorganisms

• Practices that destroy all microorganisms and spores

• Used for all procedures involving sterile areas of the body

Principles of Aseptic Technique

1. Only sterile items are used within sterile field

2. Sterile objects become unsterile when touched by unsterile objects.

3. Sterile items that are out of vision or below the waist level of the nurse are considered unsterile.

4. Sterile objects can become unsterile by prolong exposure to airborne microorganisms.

5. Fluids flow in the direction of gravity.

6. Moisture that passes through a sterile object draws microorganism from unsterile surfaces
above or below to the surface by capillary reaction.

7. The edges of a sterile field are considered unsterile.

8. The skin cannot be sterilized and is unsterile.

9. Conscientiousness, alertness and honesty are essential qualities in maintaining surgical asepsis
Infection

Signs of Localized Infection

• Localized swelling

• Localized redness

• Pain or tenderness with palpation or movement

• Palpable heat in the infected area

• Loss of function of the body part affected, depending on the site and extent of involvement

Infection2

Signs of Systemic Infection

• Fever

• Increased pulse and respiratory rate if the fever high

• Malaise and loss of energy

• Anorexia and, in some situations, nausea and vomiting

• Enlargement and tenderness of lymph nodes that drain the area of infection

Factors Influencing Microorganism’s Capability to Produce Infection

• Number of microorganisms present

• Virulence and potency of the microorganisms (pathogenicity)

• Ability to enter the body

• Susceptibility of the host

• Ability to live in the host’s body

Anatomic and Physiologic Barriers Defend Against Infection

• Intact skin and mucous membranes

• Moist mucous membranes and cilia of the nasal passages

• Alveolar macrophages

• Tears

• High acidity of the stomach

• Resident flora of the large intestine

• Peristalsis

• Low pH of the vagina

• Urine flow through the urethra