HELTH AND ILLNESS ( FON ).pptx, (FON) , BSC nursing

This ppt contain the whole chapter of Health and Illness, which in the chapter of FON subject of nursing course

1. SUB : FUNDATION OF NURSING UNIT –1 : HEALTH AND ILLNESS BY . SUNANDA VASAVA NURSING TUTOR

2. INTRODUCTION Health :- Health means different things to different people , depending in the situation. Level of functional metabolic efficiency of a living organism Good health is a prerequisite of human productive and developmental process.

3. DEFINITION In 1948 the world health organization (WHO) defines health as,. "A health is a state of complete physical, mental, social, spiritual wellbeing and not merely absence of disease or infirmity“ Dynamic state in which the individual adapts to changes in internal and external environments to maintain a state of well being *

4. Wellness (health) - An active state, oriented toward maximizing the potential of the individual "Well being is a subjective perception of vitality and feeling well....can be described objectively , experienced, and measured ....and can be plotted on a continuum"

5. Illness - Response of a person to disease, which is based on the person's perception.

6. Persons physical ,emotional, intellectual, social, developmental or spiritual functioning is diminished or impaired Disease. A pathologic change in structure and function. SIGN Disease can be described as an alternation in body functions resulting in reduction of capacities or a shortening of the normal life span.

7. CONCEPT OF HEALTH Health is evolved over the centuries as a concept from individual concern to world wide social goal and encompasses the whole quality of life. Changing concept of health till now are, Biomedical concept Ecological concept Psychosocial concept Holistic concept

8. BIOMEDICAL CONCEPT Traditionally , health viewed as an "absence of disease",. The medical profession viewed the human body as a machine, disease as a consequence of the breakdown of he machine

9. ECOLOGICAL CONCEPT Health is viewed as a dynamic equilibrium between human being and environment Disease a maladjustment of the human organism to environment. According to Dubos *Health implies the relative absence of pain and discomfort and a continuous adaptation and adjustment to the environment to ensure optimal function."

10. PSYCHOSOCIAL CONCEPT According to psychosocial concept ,"health is not only biomedical phenomenon, but is influenced by social, psychological, cultural , economic and political factors of the people concerned,“

11. HOLISTIC CONCEPT Its the synthesis all the above concepts. It recognizes the strength of social, economic political and environmental influences on health. It described health as a unified or multidimensional process involving the wellbeing of whole person in context of his environment.

12. Dimension of health

13. 1) PHYSICAL WELLNESS It is the ability to maintain a healthy quality of life that allows us to get through our daily activities without undue fatigue or physical stress .

14. continue ...... The individual should posses adequate body weight, height and circumference as per age and sex with acceptable level of vital signs, vision hearing and movements

15. continue ...... The ability to recognize that our behaviors have a significant impact on our wellness and adopting healthful habits ( routine check ups, a balanced diet exercise, etc) while avoiding destructive habits ( tobacco, drugs, alcohol) will leads to optimal physical wellness.

16. 2) MENTAL/ EMOTIONAL WELLNESS It is the ability to understand ourselves and cope with normal stresses/ challenges life can bring.

17. Continue… The ability to acknowledge and share feelings of anger, fear sadness or stress, hope, love, joy and happiness in a productive manner contributes to our emotional wellness. A mentally normal person has the ability to mix up with others, makes friendships, behaves in a balanced manner and observes adequate personal hygiene.

18. 3) social wellness It is the ability to relate to and connect with other people in the world.

19. Continue… The ability to establish and maintain positive relationships with family , friends and co-workers contributes to our social wellness. Other dimentions include spiritual ,environmental ,intellectual and occupational wellness.

20. 4)Spiritual wellness This dimensions is considered as the ability to establish peace and harmony in our lives.

21. CONTINUE …. The ability to develop congruency between values and actions and to realize a common purpose that binds creation together contributes to our Spiritual wellness

22. 4) Environmental Wellness It is the ability to recognize our own responsibility for the quality of the air, the water and the land that surrounds us.

23. CONTINUE …. The ability to make a positive impact on the quality of our environment – be it our homes , our communities or our planet contributes to our Environmental Wellness.

24. 5) Intellectual Wellness It is the ability to open our minds to new ideas and experiences that can be applied to personal decisions , group interaction and community betterment.

25. continue … The desire to learn new concepts ,improve skills and seek challenges in pursuit to lifelong learning contributes to our Intellectual Wellness.

26. 6) Occupational Wellness It is the ability to get personal fulfillment from our jobs or our chosen career fields while still maintaining balance in our lives.

27. continue …. Our desire to contribute in our careers to make a positive impact on the organizations we work in and to society as a whole leads to Occupational Wellness.

28. Maslow`s hierarchy of needs

29. BASIC HUMAN NEED

30. Abraham Maslow Abraham Maslow (1908 - 1970) was a professor in Psychology at Brandeis University. He was the founder of Humanist Psychology . He proposed Basic Human Needs Model which is useful for establishing priorities of care . The model of basic human needs is a foundation for nursing care and interventions .

31. continue… Basic human needs are elements necessary or human survival and health. All people share the basic human needs. Basic human needs have the following characteristics: The absence of a basic human need results in illness.

32. CONTINUE … The presence of basic human needs helps to prevent illness or promote health. Meeting the basic human needs restores health. It is preferred over other satisfactions when unmet. A person feels something missing when need is unmet. He feels satisfied when needs are met.

33. CONTINUE … Maslow's Hierarchy of needs is a model that is used to understand the inter relatedness of human basic needs. Certain needs are more basic than others. All people have the same needs.

34. CONTINUE …. Needs at the bottom of the pyramid are basic physical requirements including the need for air, water, food, shelter, sleep, warmth and sex. Once the lower-level needs have been met, people can move on to the next level of needs, which are for safety and security.

35. As people progress up the pyramid, needs become increasingly psychological and social. Soon the need for love , belongingness, and intimacy becomes important. Further up the pyramid, the need for self-esteem and feelings of accomplishment take priority. Maslow emphasized the importance of self-actualization, which is a process of growing and developing as a person in order to achieve individual potential.

36. PHYSIOLOGICAL NEED

37. Basic Human Needs : Level 1 : Physiological Needs : – It is the most basic in the hierarchy and needs the highest priority. It includes the things that are vital to our survival .

38. CONTINUE … example of air (oxygen), water, food , warmth, sexuality, physical activity and rest. Usually it can be met through self-care, but many people who are ill require assistance.

39. Level 2: Safety and Security

40. Level 2: Safety and Security It involves both physical and emotional components. One needs adequate shelter :, safe environment, protection from violence and safe emotional environment. People want control and order in their lives . So, this need for safety and security contributes largely to behaviors at this level.

41. CONTINUE … Some of the basic security and safety needs include: Financial security Health and wellness Safety against accidents and injury Finding a job, obtaining health care Moving into a safe neighborhood are all examples of actions motivated by the security and safety needs.

42. Level 3:Love and belonging needs These needs in Maslow hierarchy include such things as love, acceptance understanding and belonging from families, friend and community. At this level, the need for emotion Relationships drives human behavior. Some of the things the satisfy this need include: Friendships Romantic attachments Family Social groups Community groups

43. CONTINUE … In order to avoid problems such as loneliness, depression and anxiety. It is important for people to feel loved and accepted by other people. Personal relationships with friends, family. Religious groups, sport teams etc play an important role. Include family in the care of the patients , Establish good nurse patient relationship.

44. Level 4: Self-Esteem Needs At the fourth level in Maslow's hierarchy is the need for appreciation and respect. When the needs at the bottom three levels have been satisfied, the Esteem needs begin to play a more prominent role in motivating behavior. Self-esteem is the person's overall subjective, emotional evaluation of his/ her own worth.

45. CONTINUE … The person needs to feel pride or good about self and a sense of accomplishment. Respect and appreciation, People need to sense that they are valued by others and feel that they are making a contribution to the world. Self-esteem gives confidence to the individual .

46. CONTINUE … Participation in professional activities, academic accomplishments, athletic or team participation and personal hobbies can all play a role in fulfilling the esteem needs.

47. Level 5: Self -Actualization Needs - At the very peak of Maslow's hierarchy are the self-actualization needs. "What a man can be, he must be," Maslow explained, referring to the need people have to achieve their full potential as human beings. Such people seem to be fulfilling themselves and to be doing the best that they are capable of doing.

48. CONTINUE … It is the highest expression of one's individual potentials. It allows for the discovery of self. Example : people like Mahatma Gandhi, Mother Theresa etc could go up to the highest levels of utilizing their potentials and capabilities.

49. The Health, Illness - Wellness Continuum Health Absence of symptoms of illness and ability to carryout activities. Illness A state in which the person fills unhealthy may or may not related to disease. Wellness A state of optimal health or optimal functioning.

50. ILNESS WELLNESS CONTINUUM

51. CONTINUE … The Illness-Wellness Continuum is a graphical illustration of a wellbeing concept. It was first proposed by Travis in 1972. It proposes that wellbeing includes mental and emotional health as well as the presence or absence of illness. Wellness is a process, never a static state.

52. CONTINUE … Health and illness are the dynamic process and each person is located on a graduated scale or continuum ranging from wellness and optimal functioning in every aspect of ones life at one end to wellness of health and at the other end is death .

53. CONTINUE … The right side of the continuum reflect degress of wellness while the left side indicates degree of illness . moving from the center toward the left , it show a progressively worsening State of health . moving to the right from the center , it indicates increasing level of health and wellbeing .

54. CONTINUE … The treatment paradigm typically treats injuries , disabilities and symptoms to bring the individuals to a natural point `` where the symptoms of diseases have been alleviated .

55. CONTINUE … The wellness paradigm helps to move toward higher levels of wellness . The wellness paradigm encourage moving as far to the right as possible . if you become ill , treatment is important but don’t stop at the neutral point.

56. CONTINUE … Instead use the wellness paradigm to move toward high level of wellness . The illness - wellness continuum process that individuals can move farther to the right , toward heath and wellbeing, passing through the stages of awareness , education , and growth .

57. CONTINUE … cancer can be brought on by excessive stress that weakens etc often set the stage for physical and mental diseases. Even Emotional states such as depression, stress, tension, anxiety ect . Often set the stage for physical and mental diseases.

58. CONTINUE … stop at the neutral point, instead use the wellness paradigm with it. If you become it, treatment is important, but don't on the left side of the continuum, but to work in harmony as possible.

59. CONTINUE … It is not meant to replace the treatment paradigm. The wellness paradigm encourages moving as far to the right paradigm helps to move toward higher levels of wellness.

60. CONTINUE … It is not meant to replace the treatment paradigm on the left side of the continue , but to work in harmony with it .

61. CONTINUE … If you become ill , treatment is important , but don’t stop at the neutral point , instead use the wellness paradigm to move toward high level wellness

62. CONTINUE … Emotional state such as depression , stress , tension , anxiety, etc . Often set the stage for physical and mental disease . Even cancer can be brought on by excessive stress that weakness the immune system .

63. CONTINUE … High level wellness does it attempt to deny that death is a natural part of life . The illness - wellness continuum propose that individuals can move father to right . To , ward right , toward greater health and wellbeing , passing through stages of awareness , education , and growth .

64. CONTINUE … worsening states of health are reflected by sign , symptoms and disability . A persons out look can play a major role in moving along the continuum in ether direction . A positive outlook will enhance the individuals health and wellbing , whie a negative outlook will hinder it .

65. CONTINUE … A positive outlook will enhance the individuals health and wellbing , whie a negative outlook will hinder it . for example , a person who has no symptoms of disease , but is constantly complaining , will be away from a state of high level wellness .

66. FACTORS INFLUENCING HEALTH

67. FACTORES INFLUENCING HEALTH INTERNAL VARIABLES EXTERNAL VARIABLES DEVELOPMENTAL STAGE INTELLECTUAL BACKGROUND EMOTIONAL FACTORS SPIRITUAL FACTORS FAMILY PRACTICES SOCIO-ECONOMICS FACTORS CULTURAL BACKGROUND

68. INTERNAL VARIABLES INTERNAL VARIABLES : internal variables that influence a client’s health includes a person’s development stage, intellectual background, perception of functioning and emotional and spiritual factors

69. Developmental stage: Health belief of a person change in different stages of growth and development. The health belief of an adult is different than that of a child. The nurse must consider the client’s level of growth and development while planning for care. Sick children may exhibit more of fear and anxiety. Concept of illness depend on the developmental stage of a child, adolescent or adult.

70. Intellectual Background a person’s health belief is shaped by factors such as person’s conception about body functions and illness, knowledge level, educational background, past experiences etc.

71. Perception of functioning: people differ in their perception about physical functioning. While doing assessment the nurse gathers subjective data about the way the client perceives physical functions, such as level of fatigue, shortness of breath or pain. Objective data about the actual functioning such as blood pressure, heart rate measurement, and lung sound.

72. Emotional factors: The client’s emotions such as stress, depression or fear can influence health belief and practices. A client who is very calm, may have little emotional response during illness. But an individual who is depressed or in stress may over react to illness.

73. Spiritual factors: Spirituality is an important aspect of health. Religious practices are one way that people exercise spirituality. There are some religions that restrict the use of certain form of medical treatment. Nurses must understand client’s spiritual level to involve them effectively in nursing care

74. There are some religions that restrict the use of certain form of medical treatment. Nurses must understand client’s spiritual level to involve them effectively in nursing care

75. EXTERNAL VARIABLES External variables that influence a person’s health believes and practices include family practice, socio-economic factors and cultural background

76. family practice : The health of an individual highly depends on how his family uses health care services Family’s response to disease and their preventive care behaviors can influence health of its members.

77. Socio-economic factors: social and psychosocial factors influence health and health practices. Psychosocial variables include the person’s marital intimate relationship , life style habits and occupational environment. economic status of the family directly or indirectly affects the health. Poverty leads to unhygienic environment, malnourishment and deficiency disease .

78. Cultural Background Cultural background of the individual influences health and health related practice. It influences an individual’s belief about causes of illness treatment or practice to restore health The nurses should be aware of the cultural patterns of their clients so that they can recognize and understand client’s behaviors and beliefs and can provide better care

79. CAUSES AND RISK FACTORS FOR ILLNESS

80. CAUSES FOR ILLNESS: Illness result from a disease- physiological or psychological or from an injury that affects body functioning . “disease is define as a pathological process with characteristic signs and symptoms affecting the whole body or any of its part”

81. CONTINUE .. Most health problems have multiple causative factors. Causative agent such as poor immunity, poor health, accumulation of toxins inside body, Exposure to micro organisms, poor thoughts etc.

82. PHYSIOLOGICAL CAUSES / INJURIES INCLUDE : Physical injuries : includes those caused by; Mechanical trauma Heat and cold Electrical discharges Changes in pressure Radiation

83. Diseases of biotic origin Biotic agents include; living organisms that range in size from the smallest virus measuring approximately 20 nanometres to tapeworms having lengths of meters. These agents are commonly grouped as ; Viruses Bacteria Fungi Parasites

84. Abnormal growth of cell : Diseases arising from uncontrolled cell growth constitute the second most common cause of human death. Two type of tumours –malignant or benign are the collectively referred to as neoplasm, and their study is known as oncology. chemical injury : poisoning is any substance that cause illness or death when ingested.

85. PSYCHOLOGICAL CAUSES; Genetics (heredity): Mental illnesses sometime run in families. Susceptibility is passed on in families through genes. it occurs from the interaction of multiple genes and other factors such as stress, abuse, or a traumatic event which can influence or trigger an illness in a person who has an inherited susceptibility to it,

86. Life experiences: Se, such as emotional, physical, or sexual abuse An important early loss, such as the loss of a parent or divorce Neglect from family members or any other important people Poor ability to relate to others.

87. psychological trauma during childhood Feeling of inadequacy, low self esteem Anxiety, anger, or loneliness Changing jobs or schools Social or cultural expectations. Ex. A society that associates beauty with thinness can be a factor in the development of eating disorders. Substance abuse by the person or the person’s parents. It has been linked to anxiety, depression, and paranoia

88. CONTINUE …. Other factors: poor nutrition and exposure to toxins, such as lead, may play a role in the development of mental illnesses. Certain infection have been linked to brain damage and the development of mental illness or the worsening of its symptoms.

89. Neurotic disorders: Stressors in childhood and adolescence; research has shown that stressors in childhood and adolescence are typically responsible for neuroticism. High present stress index. The current level of stress also plays a role in neurosis. Heritability, neuroticism can be inherited. Many studies have found that children of neurotic parents, are more likely to become neurotic as well.

90. Psychotic disorders: It can be caused by mental illnesses such as schizophrenia, bipolar disorder etc Genetics: people with a family history of psychotic disorders such as schizophrenia have a slightly increased chance of developing psychotic disorders; Recreational drugs : psychosis can be triggered by the use of drug, including cannabis, amphetamines etc.

91. RISK FACTORS OF ILLNESS

92. RISK FACTORS OF ILLNESS RISK FACTORS OF ILLNESS GENETICS FACTORS PHYSIOLOGICAL FACTORS SPIRITUAL FACTORS IMMUNOLOGIC FACTORS ECONOMIC STATUS SOCIAL FACTORS LITRACY LEVELS BIOLOGICAL FACTORS DIETARY HABIT AGE LIFE STYLE ENVIRONMENT FACILITES AVAILABLE

93. CONTINUE … A risk factors is anything that increase the vulnerability of an individual or community to an illness or accident If a risk factors is present, it does not mean that the individual will develop disease, but it only increase the chance for experiencing the disease.

94. Genetic factors Genetic or hereditary predisposition for developing many disease Ex. An individual with family history of diabetes/hypertension/heart disease is at greater risk for developing the disease in future. receive from our ancestors not only the color of our hair or tendency toward diabetes or heart diseases. Also a variety of psychological stress , Trauma, and pain also People also strongly suffer from emotional trauma inherited from parents who lived with hidden and unsolved rejection

95. Physiological factors : Physical functioning of the body Ex, being pregnant or obesity places increased stress in the body and causes illness. Environment : environment in which an individual lives determines hoe he lives. Eats, work. Exposure to polluted air can predispose to disease such as cancer, chronic lung disease Chemical used in industry can be cause for many occupational disease Stress, suppression, negative thought, fear, lack of love, lack of joy, lack of desire to live, lack of physical activity etc increase the risk of illnesses

96. Environment : Environment in which an individual lives determines hoe he lives. Eats, work. Exposure to polluted air can predispose to disease such as cancer, chronic lung disease Chemical used in industry can be cause for many occupational disease Stress, suppression, negative thought, fear, lack of love, lack of joy, lack of desire to live, lack of physical activity etc increase the risk of illnesses

97. Age: Age is a major factor that determine the risk for diseases. The children and elderly are more at risk for contacting illnesses as compared to adults. In elder disease such as cancer, heart disease increases as advances. Children especially newborn and infant are more susceptible for infection.

98. Life style: Lifestyle practice affect the health positively or negatively. Practice which has negative outcome are risk factors. Risk factors include lack of knowledge, poor lifestyle habit, environment factors, unhealthy diet. Exposure toxins, exposure to microorganism , parasitic animal, unpleasant life situations

99. Dietary habit Dietary habit play a major role in the development of illnesses. Poor dietary choices lead to either under nutrition or over nutrition Diet deficient in essential nutrients is affecting biochemical processes inside our cells. It is also affecting digestion and preventing internal natural detoxification.

100. ILLNESS BEHAVIOUR

101. INTRODUCTION Illness is a state in which the physical, social, developmental, intellectual, emotional or spiritual functioning of the individual is diminished or impaired Illness can be acute or chronic

102. CONTINUE … Acute illness is one which has a short duration and is mostly severe. It starts abruptly and subsides in a relatively short period(less than six month) Chronic illness persists for more than six months and may affect functioning of the body systems in any dimension, up to the level of disability, chronic illnesses and disabilities remain as a major health problem.

103. Nurse has an important role in educating and helping the clients to manage their illness or disability The way the sick person acts is called illness behaviour . Different people act in a different way to same type of illness. It involves how they interpret and view the symptoms, use remedial measures or utilize the health care facilities If the symptoms are distressing or disrupting the normal routines or if it is life threatening they seek medical assistance. Some may react in a different way They may not seek medical assistance as they fear serious illness.

104. Edward such man described five stage of illness behavior model

105. Stage-1: Symptom experience At first, the person could not identify what is wrong with him, why he is feeling differently. Gradually he realizes from his perception and some symptoms like pain, rashes that he is having a health problem. The emotional response includes in the stage like fear concern and anxiet

106. Stage-2: Assumption of sick role Assumption of sick role starts when an individual accepts that he or she is sick. After that individual seeks information from others, because an individual could not sufficiently confident to decide on their own that they are sick. All most all cases individual follows advice given by with whom he or she has discussed.

107. Stage-3: Medical care contact At this stage, individually take the help from medical professionals. He or she takes advice and permission to be sick from a “scientific” source rather than a lay source. If a medical professional denied, he may return to normal activities. Sometimes an individual could not satisfy himself by consulting one professional, in this stage individual go for many called “doctors shop”. Most common treatment in this stage is one or more medication prescribed by the physician.

108. Stage-4: Dependent client care Dependent client care starts when an individual makes the decision to give full control to the physician and follow the treatment. At this stage sick individual becomes patient. Most individual believe and adhere to physicians treatment and they also become dependent on family. Some individual could not believe that they are ill and deny taking the help.

109. Stage-5: Recovery and rehabilitation This is the final stage, in which both medical professional and lay caregivers agree that patient is fit to return to his normal duties. This stage holds special significance with chronic conditions. An ill person can do everything to return to his normal conditions but the person with chronic condition losses hope to become cure and return to his normal duties. This put pressure on both patients and lay caregiver .

110. Impact Of Illness On Patient And Family

111. IMPACT OF ILLNESS ON PATIENT AND FAMILY; Illness affect both patient and family in many ways. Let us discuss the impact of illness on patient and family members.

112. IMPACT OF ILLNESS ON PATIENT AND FAMILY Behavioral and emotional changes Impact on family roles and family dynamics Impact on self-concept and self-esteem Impact on body image

113. Behavioral and emotional changes : Illness always puts a patient under stress. Behavioral and emotional reaction depend on the nature of illness or the diagnosis Hearing the diagnosis of a serious illness, eg , cancer, may make the patient frustrated and he may lose his hope for life. He may react to it in many ways. He will show anger, resentment, anxiety, hopelessness, shock, denial, withdrawal. In the beginning, the nurse should assist the client and family to cope with the stress. Spirituality and spiritual leaders will have lots of effect on the illness and will try to adjust with it

114. Impact on family roles and family dynamics The illness brings additional stress if the client is the bread winner of the family. The financial problems will be an additional burden to the family. Role reversal occurs as any other member of the family assume the responsibility of the client and family.

115. May be the elder child, sibling or parent. The family easily adjusts if it is a short term illness. In case of long term illnesses the family requires counselling and guidance to cope with the role changes. The family dynamics also changes. It is the process by which the family function, makes decisions and gives support to the individuals.

116. CONTINUE….. If the parent is ill, it affects the family activities and decision making and it will delay or halt the activities Help the family to gain maximum level of functioning.

117. Impact on self-concept and self-esteem : Illness has an impact on the self concept of the client Self-concept is that what a person views about his own strength and weakness in all aspect of personality The components of self-concept are identity, body image and role performance. It gives a positive feeling toward the self and it also gives s sense of meaning, wholeness and consistency to a person.

118. CONTINUE …. Self esteem is a person’s overall feeling of self worth It is the emotional appraisal of self-concept It is the most fundamental self evaluation. The self-esteem is comes from self concept and self- esteem influences self concept. Self concept is important to maintain relationship with other member of family.

119. Impact on body image : - Certain illness result in changes in the physical appearance of the client. Clients react differently to these changes depending on the type of changes. If it is short term changes they will accept it readily but when it is a permanent changes such as amputation of a limb or permanent colostomy they may show reactions in phases Shock Withdrawal Acknowledgment Acceptance, finally rehabilitation