Health and the Individual

NURS 502 Lecture 1

 Health
 Defined by the World Health Organization (WHO) in
1948 as “a state of complete physical, mental, and
social well-being and not merely the absence of
disease or infirmity”
 In 1986, WHO expanded its concept of health adding
to its definition “the ability to identify and to realize
aspirations, to satisfy needs, and to change or cope
with environment. Health is a positive concept
emphasizing social and personal resources, as well
as physical capabilities.”

Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 2

 Wellness
 Good health and sense of well-being on many levels
(i.e. emotional as well as physical), as described or
experienced by an individual
 Goes beyond having good health and considers how
a person feels about their health as well as their
quality of life
 The concept of wellness embraces several
categories, known as the dimensions of wellness.
The number of elements and how they are labelled
may vary in different wellness models

Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 3

Dimensions of Wellness (1 of 2)

Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 4

 Dimensions of Wellness (2 of 2)
 Physical wellness: Maintaining a healthy body
 Mental wellness: Being in relative harmony with the dimensions
of health and wellness
 Emotional wellness: Displaying an ability to understand oneself
and recognize personal strengths and limitations
 Intellectual wellness: Displaying an ability to make informed
decisions that are appropriate and beneficial
 Social wellness: Relating effectively to others
 Spiritual wellness: Personal and frequently involves a search for
a sense of purpose
 Environmental wellness: Engaging in a lifestyle that is friendly to
the environment
 Occupational wellness: Occurs when a person feels secure,
confident, and valued in his or her workplace

Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 5

 Illness
 Often used to denote the presence of disease
 Can also refer to how a person feels about
his or her health, whether or not a disease is
present
 A person may feel ill as a result of tiredness,
stress, or both

Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 6

 Disease
 A condition in which a person’s bodily or
mental functions are different from normal.
May also be used to describe a group of
symptoms which are not related to a clear-cut
disease process.
 A mental disease (such as schizophrenia)
has a biological or biochemical explanation
and results in behavioural or psychological
alterations.

Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 7

 Disability
 A physical or mental incapacity that differs
from what is perceived as normal function. A
disability can result from an illness or
accident or be genetic in nature.
 A disability can be physical, sensory,
cognitive, or intellectual.
 The language used to describe people with a
disability has moved toward more sensitive
terminology.
 People with disabilities are entitled to the
same rights and opportunities as all other
members of society.
Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 8
 Health Models (1 of 2)
 A health model is a concept of an approach to care, including
the development of a treatment plan and involvement and
communication with a patient.
 Examples of health models include:
 The Medical Model, which was founded on the idea that health is
the absence of disease.
 The Holistic Model, which considers all parts of the person and
focuses on the positive aspects of health.
 The Indigenous Wholistic Theory for Health considers the mental,
physical, cultural, and spiritual well being of not only the individual,
but of the entire community
 The Wellness Model, which builds on the medical and holistic
models and considers health a process that continues to evolve
and to progress toward a future state of improved health. This
model is most common in our current health care climate.
Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 9
 Health Models (2 of 2)
 The International Classification of Functioning
Disability and Health (ICF) is also a health model
 The ICF was introduced in the 1980s by the World Health
Organization
 As a model, the ICF holds that disabilities are common and
that everyone will experience some type of disability during
their lifespan
 This model considers the social components of living with a
disability and it emphasizes the effects of a disability rather
than the cause

Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 10

 Changing Perceptions of Health
and Wellness
 Past Approaches
 Until the early 1960s, doctors and patients functioned within
the paternalistic medical model. Few people recognized the
impact of lifestyle on their health and safety.
 With the help of government initiatives (such as
ParticipACTION) and the establishment of a population
health approach to health care, Canadians began to take
more responsibility for their own well-being in the 1960s and
1970s
 The 1980s and 1990s saw the beginning of changes in
structure and function of how primary care was delivered,
encouraging individuals to not only take responsibility for
their own health, but to participate in making decisions about
their treatment, which is the norm today.
Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 11
 The Psychology of Health
Behaviour
 Health behaviour has a significant impact on what a
person does to maintain good physical and
psychological health.
 Many factors, including what a person believes to be
true about health, prevention, treatment, and
vulnerability, influence how people act when they are
ill or perceive they are ill.
 Health behaviour also depends on a person’s level of
health knowledge, personal motivation, cognitive
processes, and perceived risk factors. One’s culture
and ethnicity will invariably affect all of these areas.

Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 12

 The Psychology of Health
Behaviour (1 of 2)
 To explain human health behaviour, several
models have been developed, including the
following:
 The Health Belief Model explains that people’s
beliefs about their personal health and
susceptibility to illness affect their health
behaviour. Culture and religion also influence
health beliefs and value systems
 The Transtheoretical Model proposes that people
progress through a series of steps before their
health behaviour completely changes or improves

Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 13

 The Psychology of Health
Behaviour (2 of 2)
 The Social–Ecological Model maintains that many
levels of influence shape one’s health behaviour,
including a person’s education, occupation, or
profession, type of social support, environment,
and public policies of various levels of government
 Protection Motivation Theory asserts that self-
preservation is what motivates a person to change
his or her health behaviour. Fear of illness,
physical decline, physical disability, mental health
problems, or even death can encourage adaptive
(or maladaptive) health behaviours. The person’s
actions depend on how severe he or she
perceives a threat to be.
Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 14
The Wellness–Illness Continuum
 A method of measuring one’s state of health
at any given point in time
 The wellness–illness continuum includes all
of the dimensions of health and wellness,
from physical, mental and emotional health to
social, spiritual and environmental health
 Movement on the continuum is constant
 Two people with the same physical health
may place themselves on different places on
the continuum

Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 15

The Health Continuum

Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 16

 Sick Role Behaviour (1 of 2)
 When people are ill, their behaviours, roles, and
attitudes change.
 The stress of being ill can alter people’s perceptions
and the way they interact with others.
 A person’s illness can also influence the behaviour of
those associating with him or her.
 The majority of people respond to their illness in an
adaptive manner.

Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 17

 Sick Role Behaviour (2 of 2)
 Sick role behavior may be affected by the
setting
 Hospitalization is most likely to affect how
someone responds to an illness because they
are removed from their home and community
and their activities are highly restricted
 Language barriers or cultural or religious
beliefs are likely to affect how a patient
responds to hospitalization and medical care

Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 18

 Stages of Illness: Influence on
Patient Behaviour
 A patient’s acceptance of a diagnosis and
treatment plan normally follows a relatively
predictable path through the stages of illness
 Preliminary phase: Suspecting symptoms
 Acknowledgment phase: Sustained clinical signs
 Action phase: Seeking treatment
 Transitional phase: Diagnosis and treatment
 Resolution phase: Recovery and rehabilitation

Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 19

 Self-Imposed Risk Behaviour
 Examples of self-imposed risk behaviours include
smoking, unhealthy eating habits, inactivity, alcohol
or drug abuse, and sexual promiscuity
 People engage in risk behaviours for a number of
reasons, including simple enjoyment, habit (which
often becomes addictive behaviour) and thrill-seeking
 Health promotion and illness prevention initiatives
aim to reduce risk behaviour to ease the financial
burden on our health care system and to promote the
health of Canadians

Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 20

 The Health of Canadians Today
(1 of 2)
 The life expectancy for Canadians continues to rise:
based on the latest data (2014) life expectancy
reached 79.6 years for men, and 83.8 years for
women
 Among the Indigenous population the Inuit
community have the lowest projected life expectancy.
The life expectancy for Canada’s Indigenous
population has increased by about 2 years since the
early 2000s
 Canada’s national infant mortality rate has declined
over the last several decades, but not as fast as the
rate in other developed nations
Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 21
 The Health of Canadians Today
(2 of 2)
 The leading causes of death are:
 Congenital abnormalities for infants
 Accidents for those aged 1-34
 Accidents, suicide, and homicide for young adults
(15-24)
 Cancer for those aged 35-84
 Heart disease for those aged 85 and older

Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 22

Leading Causes of Death in
Canada (1 of 4)

Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 23

 Leading Causes of Death in
Canada (2 of 4)
 Cancer
 One in two Canadians are expected to develop cancer in
their lifetime
 The incidence of different types of cancer is influenced by
such things as risk behaviour, environmental factors,
socioeconomic factors, lack of education related to disease
prevention and health promotion, and access to cancer
medical services such as cancer screening
 Lung cancer remains the leading cause of all cancer-related
deaths in both men and women
 Breast cancer is the second leading cause of death in
women
 Prostate cancer is the most common type of cancer in men
but mortality rates are relatively low because of early
diagnosis, treatment, and because most prostate cancers
are slow growing
Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 24
 Leading Causes of Death in
Canada (3 of 4)
 Cardiovascular Disease
 This is a disease that affects the heart and
vascular system (i.e., blood vessels).
 It is the second leading cause of death in Canada:
cardiovascular disease is responsible for almost
29% of deaths
 Primary risk factors include smoking, high blood
pressure, high cholesterol, inactivity and obesity,
as well as genetics.
 Population health initiatives on the part of both
federal and provincial/territorial governments have
contributed to lower mortality rates from heart
disease and a healthier lifestyle
Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 25
 Leading Causes of Death in
Canada (4 of 4)
 Cerebrovascular Disease
 Includes a number of conditions that affect the
flow of blood to the brain, the most serious of
which is stroke
 Stroke is the leading cause of adult disability, the
third cause of death, and is more common in
women than men
 Nine in ten Canadians have at least one risk factor
for stroke; the risk factors are the same as those
for heart disease
 Heart disease and stroke together are the leading
cause of hospitalization in Canada and cost the
Canadian economy $20.9 billion/year
Copyright © 2020 by Elsevier, Inc. All Rights Reserved. 26