Chapter 3 Health, Illness, and Disparities

1. Chapter 3Health, Illness, and Disparities

2. Definitions of Health States • Health—a state of complete physical, mental, and social well-being, not merely the absence of disease or infirmity • Illness—the unique response of a person to a disease; an abnormal process involving changed level of functioning • Wellness—an active state of being healthy by living a lifestyle promoting good physical, mental, and emotional health

3. Acute Illness • Generally has a rapid onset of symptoms and lasts only a relatively short time • Examples: appendicitis, pneumonia, diarrhea, common cold

4. Question Which is an example of an acute illness? A. Diabetes B. Rheumatoid arthritis C. Pneumonia D. Osteoporosis

5. Answer Answer: C. Pneumonia Rationale: Pneumonia is an acute illness that has a rapid onset of symptoms and lasts only a relatively short time. Diabetes, rheumatoid arthritis, and osteoporosis are chronic illnesses that cause a permanent change, require special patient education for rehabilitation, and require a long period of care or support.

6. Chronic Illness • A broad term that encompasses many different physical and mental alterations in health • Usually has a slow onset and may have periods of remission and exacerbation • Examples: diabetes mellitus, lung disease, arthritis, lupus

7. Characteristics of a Chronic Illness • It is a permanent change. • It causes, or is caused by, irreversible alterations in normal anatomy and physiology. • It requires special patient education for rehabilitation. • It requires a long period of care or support.

8. Stages of Illness Behavior • Stage 1: Experiencing symptoms • Stage 2: Assuming the sick role • Stage 3: Assuming a dependent role • Stage 4: Achieving recovery and rehabilitation

9. Question Tell whether the following statement is true or false. A person who is experiencing a productive cough and fever takes a sick day to recuperate and decide whether to make an appointment with the doctor. This person is said to be in stage 3 of illness behavior: assuming a dependent role. A. True B. False

10. Answer Answer: B. False Rationale: A person who defines oneself as sick and self-medicates or visits a doctor is said to be in stage 2 of illness behavior: assuming the sick role.

11. Factors Influencing Health Disparities • Racial and ethnic groups • Poverty • Gender; age • Mental health • Educational level • Disabilities • Sexual orientation • Health insurance and access to health care

12. Factors Affecting Health and Illness • Basic human needs • The human dimensions • Self-concept • Risk factors for illness or injury

13. The Human Dimensions Affecting Health • Physical dimension—genetic inheritance, age, developmental level, race, and gender • Emotional dimension—how the mind affects body function and responds to body conditions • Intellectual dimension—cognitive abilities, educational background, and past experiences • Environmental dimension—housing; sanitation; climate; pollution of air, food, and water • Sociocultural dimension—economic level, lifestyle, family, and culture • Spiritual dimension—spiritual beliefs and values

14. Question Tell whether the following statement is true or false. A person who keeps in touch with neighbors in an attempt to foster a “community feeling” is promoting one’s emotional human dimension. A. True B. False

15. Answer Answer: B. False Rationale: A person who keeps in touch with neighbors in an attempt to foster a “community feeling” is promoting one’s sociocultural human dimension.

16. The Human Dimensions Composing the Whole Person

17. Health Promotion and Illness Prevention • Primary: directed toward promoting health and preventing the development of disease processes or injury. • Examples are immunization clinics, family planning services, poison-control information, and accident-prevention education. • Secondary: focus on screening for early detection of disease with prompt diagnosis and treatment of any found • Examples are assessing children for normal growth and development and encouraging regular medical, dental, and vision examinations.

18. Health Promotion and Illness Prevention (cont.) • Tertiary: begins after an illness is diagnosed and treated, with the goal of reducing disability and helping rehabilitate patients to a maximum level of functioning • Examples include teaching a patient with diabetes how to recognize and prevent complications, using physical therapy to prevent contractures in a patient who has had a stroke or spinal cord injury, and referring a woman to a support group after removal of a breast because of cancer.

19. Question What is an example of a nursing activity that promotes secondary prevention as a level of preventive care? A. Conducting a smoking cessation class B. Performing a blood pressure screening at a local mall C. Performing range-of-motion exercises on a bedridden patient D. Promoting safer sex practices in school settings

20. Answer Answer: B. Performing a blood pressure screening at a local mall Rationale: Secondary preventive care focuses on early detection of disease, such as heart disease in this example. Primary preventive care is directed toward promoting health and preventing diseases. Tertiary care begins after an illness is diagnosed to reduce disability and rehabilitate patients.

21. Models of Health and Illness • The health belief model • The health promotion model • The health–illness continuum • The agent–host–environment model

22. Question Which model of health and illness views health as a constantly changing state, with high-level wellness and death being on opposite ends of a graduated scale? A. Agent–host–environment model B. Health–illness continuum C. Health promotion model D. Health belief model

23. Answer Answer: B. Health–illness continuum Rationale: The health–illness continuum measures a person’s level of health on a graduated scale. The agent–host–environment model refers to the interaction of the agent, host, and environment creating risk factors that must be examined. The health promotion model illustrates how people react to their environment as they pursue health. The health belief model is concerned with what people believe to be true about their health.

24. Agent–Host–Environment Model (Leavell and Clark) • Views the interaction between an external agent, a susceptible host, and the environment as causes of disease in a person. • It is a traditional model that explains how certain factors place some people at risk for an infectious disease. • These three factors are constantly interacting, and a combination of factors may increase the risk of illness. • The use of this model is limited when dealing with noninfectious diseases.

25. The Agent–Host–Environment Triangle

26. The Health–Illness Continuum • Conceptualizes a person’s level of health • Views health as a constantly changing state with high-level wellness and death on opposite sides of a continuum • Illustrates the dynamic (ever-changing) state of health

27. The Health–Illness Continuum

28. The Health Belief Model (Rosenstock) • Concerned with what people perceive to be true about themselves in relation to their health • Modifying factors for health include demographic, sociopsychological, and structural variables. • Based on three components of individual perceptions of threat of a disease • Perceived susceptibility to a disease • Perceived seriousness of a disease • Perceived benefits of action

29. The Health Promotion Model (Pender) • Developed to illustrate how people interact with their environment as they pursue health • Incorporates individual characteristics and experiences and behavior-specific knowledge and beliefs, to motivate health-promoting behavior • Personal, biologic, psychological, and sociocultural factors are predictive of a certain health-related habit. • Health-related behavior is the outcome of the model and is directed toward attaining positive health outcomes and experiences throughout the lifespan.

30. Risk Factors for Illness • Age • Genetic factors • Physiologic factors • Health habits • Lifestyle • Environment