CHAPTER 1: Concept of Man, Health, and Illness PDF

DON MARIANO MARCOS MEMORIAL STATE UNIVERSITY South La Union Campus COLLEGE OF COMMUNITY HEALTH AND ALLIED MEDICAL SCIENCES Bachelor of Science in Nursing Program NUPC 104: FUNDAMENTALS OF NURS...

DON MARIANO MARCOS MEMORIAL STATE UNIVERSITY South La Union Campus COLLEGE OF COMMUNITY HEALTH AND ALLIED MEDICAL SCIENCES Bachelor of Science in Nursing Program NUPC 104: FUNDAMENTALS OF NURSING PRACTICE SSSY 2024-2025 CHAPTER 1: CONCEPT OF MAN, HEALTH AND ILLNESS A. FACTORS AFFECTING MAN, HEALTH AND ILLNESS CONCEPT OF MAN MAN: ✓ The concept of man provides us clue on how we are going to provide a PHC that is individualized, holistic and quality care. 4 Attributes of Human Being 1. The capacity to think or conceptualize on the abstract level. 2. Family formation 3. The tendency to seek and maintain territory. 4. The ability to use verbal symbols as language, a means of developing and maintaining culture. Definitions and Perspectives Biological Perspective: Man is viewed as a biological organism with physical and physiological processes necessary for survival and health. Psychological Perspective: Man is a thinking, feeling, and willing being, capable of understanding, decision-making, and emotional responses. Social Perspective: Man is a social being who interacts with others, forming relationships and functioning within cultural, societal, and environmental contexts. Spiritual Perspective: Man is a spiritual entity with beliefs, values, and a sense of purpose that influence health and well-being. Philosophical Views of Man Holistic View: Man is a unified whole, and each dimension (physical, emotional, social, spiritual) interacts with and influences the others. Humanistic View: Emphasizes individual dignity, autonomy, and the potential for self- actualization. Existential View: Focuses on man’s ability to find meaning and purpose in life despite challenges. Man as a Holistic Being Physical Dimension: Includes anatomy, physiology, nutrition, and activities of daily living. Emotional Dimension: Covers emotions, mental health, stress management, and coping mechanisms. Social Dimension: Addresses relationships, roles, and cultural influences. Spiritual Dimension: Involves beliefs, values, faith, and spiritual practices. Man in the Context of Nursing Man as a Patient: Viewed as a recipient of care with unique needs and preferences. NUPC 104 // Instructor: ROLANDO P. RONCAL JR Page 1 of 7  Man as a Partner: Actively involved in decision-making and care planning. Man as a Family Member: Recognized within the context of family dynamics and support systems. Man as a Community Member: Assessed as part of a larger societal and environmental context. Key Nursing Theories and Their Concept of Man Florence Nightingale’s Environmental Theory: Man is affected by the environment, and health is restored by modifying environmental factors. Virginia Henderson’s Need Theory: Man has 14 basic needs that nursing addresses to achieve independence. Jean Watson’s Theory of Human Caring: Man is a unique being to be cared for, respected, nurtured, and assisted toward self-healing. Dorothea Orem’s Self-Care Deficit Nursing Theory: Man has self-care needs, and nursing intervenes when these needs cannot be met independently. Human Needs Model 14 Fundamental Needs of Man 1. Breath 8. Keeping Self Clean 2. Food and drink 9. Avoiding Danger 3. Elimination 10. Communication 4. Move and Maintain Posture 11. Worship 5. Sleep and Rest 12. Work 6. Clothing 13. Play 7. Maintaining Internal Environment 14. Learn Characteristics of Basic Human Need: 1. Universal 2. Met at different ways. 3. Simulated by external and internal factors. 4. Priorities may be altered. 5. Needs may be deferred. 6. Needs are interrelated Maslow’s Framework of Basic Needs is based on the theory that something is a basic need if its absence results in illness, its presence prevents illness or signals health, & meeting an unmet need restores health. Image 01 – 01: Maslow’s Hierarchy of Needs CONCEPT OF HEALTH AND ILLNESS: HEALTH: - “State of complete physical, mental & social well-being, and not merely the absence of disease or infirmity” (WHO, 1947) - Health is a state of being that people define in relation to their own values, personality & lifestyle. Each person has a personal concept of health. Individual’s view of health can vary among different age groups, gender, race, and culture. - Pender (1996) explains that “all people free of disease are not equally healthy”. NUPC 104 // Instructor: ROLANDO P. RONCAL JR Page 2 of 7 ILLNESS: - A process in which the functioning of a person is diminished or impaired in one or more dimensions when compared with the person’s previous condition. - It is not synonymous with disease; although health care providers must be familiar with different kinds of diseases and treatments, they are concerned more with illness, which may include disease, but also the effects on functioning and well-being in all dimensions. RISK FACTORS: - Any situation, habit, social or environmental condition, physiological or psychological condition, developmental or intellectual condition, or spiritual or other variable that increase the vulnerability of an individual or groups to an illness or accident. - The presence of risk factors does not mean that a disease will develop, but risk factors increase the chances that the individual will experience a particular disease or dysfunction. - Risk factors can be placed in the following categories: genetic & physiologic factors, age, physical environment & lifestyle WELLNESS: An integrated method of functioning which is oriented toward maximizing the potential of which the individual perceives or views the experience of health HEALTH BELIEFS: A person’s ideas, convictions, and attitudes about health & illness. They may be based on factual information or misinformation, common sense or myths, or reality or false expectations. HEALTH BEHAVIORS – client’s attitudes towards health HEALTH PROMOTION: - Anticipating guidance - Health promotion activities such as routine exercise and good nutrition, helps clients maintain or enhance their present levels of health; motivate people to act positively to reach more stable levels of health. Dimension of Wellness: Physical The ability to carry out daily tasks, achieve fitness (e.g., pulmonary, cardiovascular, gastrointestinal), maintain adequate nutrition and proper body fat, avoid abusing drugs and alcohol or using tobacco products, and generally to practice positive lifestyle habits. Social The ability to interact successfully with people and within the environment of which each person is a part, to develop and maintain intimacy with significant others, and to develop respect and tolerance for those with different opinions and beliefs. NUPC 104 // Instructor: ROLANDO P. RONCAL JR Page 3 of 7  Emotional The ability to manage stress and to express emotions appropriately. Emotional wellness involves the ability to recognize, accept, and express feelings and to accept one’s limitations. Intellectual The ability to learn and use information effectively for personal, family, and career development. Intellectual wellness involves striving for continued growth and learning to deal with new challenges effectively. Spiritual The belief in some force (nature, science, religion, or a higher power) that serves to unite human beings and provide meaning and purpose to life. It includes a person’s own morals, values, and ethics. Occupational The ability to achieve a balance between work and leisure time. A person’s beliefs about education, employment, and home influence personal satisfaction and relationship with others. Environmental. The ability to promote health measures that improve the standard of living and quality of life in the community. This includes influences such as food, water, and air. MODELS OF HEALTH AND WELLNESS 1. Clinical Model: - The narrowest interpretation of health occurs in this model. - People are viewed as physiological systems. - It is considered the state of not being “SICK”. 2. Role Performance Model: - Health is defined in terms of an individual’s ability to fulfill societal roles. - People who can fulfill their roles are healthy even if they appear clinically ill. - It is assumed in this model that sickness is the inability to perform one’s work role. 3. Adaptive Model: - Health is creative process; disease is a failure in adaptation of maladaptation. - Extreme good health is flexible adaptation to the environment and interaction with the environment to maximum advantage. 4. Eudaimonistic Model: - Health is seen as a condition of actualization or realization of a person’s potential. - In this model, the highest aspiration of people is fulfillment and complete development, which is actualization. - Illness, in this model, is a condition that prevents self-actualization. 5. Agent – Host – Environment Model (Ecologic Model): - Used primarily in predicting illness rather than in promoting wellness. - The model has three dynamic interactive elements: Agent, Host and Environment NUPC 104 // Instructor: ROLANDO P. RONCAL JR Page 4 of 7  6. Health – Illness Continuum Model: - The Health-Illness Continuum Model illustrates the dynamic and ever-changing state of health. - Health: Represented on one end of the continuum, it signifies optimal well-being and the absence of disease or dysfunction. - Illness: Represented on the opposite end, it indicates poor health, disease, or incapacity. - Individuals constantly move along the continuum due to various factors such as lifestyle, environment, genetic predispositions, and healthcare interventions. - The model emphasizes: o Holistic Approach: Health is influenced by physical, emotional, social, and spiritual dimensions. o Proactive Care: Encourages actions to maintain or improve health, rather than focusing solely on treating illness. o Dynamic Nature: Recognizes that health and illness are not static but fluctuate throughout an individual’s life. ILLNESS AND DISEASE: Stages of Illness: Stage 1: Symptom Experiences - At this stage the person comes to believe something is wrong. - Stage 1 has three aspects: ✓ The physical experience of symptoms ✓ The cognitive aspect (the interpretation of the symptoms in terms that have some meaning to the person) ✓ The emotional response (e.g., fear or anxiety). Stage 2: Assumption of the Sick Role - The individual now accepts the sick role and seeks confirmation from family and friends. - Often people continue with self-treatment and delay contact with health care professionals as long as possible. - During this stage people may be excused from normal duties and role expectations. - Emotional responses such as withdrawal, anxiety, fear, and depression are not uncommon depending on the severity of the illness, perceived degree of disability, and anticipated duration of the illness. - When symptoms of illness persist or increase, the person is motivated to seek professional help. Stage 3: Medical Care Contact - Sick people seek the advice of a health professional either on their own initiative or at the urging of significant others. - Three types of information: ✓ Validation of real illness ✓ Explanation of the symptoms in understandable terms ✓ Reassurance that they will be all right or prediction of what the outcome will be. NUPC 104 // Instructor: ROLANDO P. RONCAL JR Page 5 of 7 Stage 4: Dependent Client Role - After accepting the illness and seeking treatment, the client becomes dependent on the professional for help. - For some clients, illness may meet dependence needs that have never been met and thus provide satisfaction. - Other people have minimal dependence needs and do everything possible to return to independent functioning. - A few may even try to maintain independence to the detriment of their recovery. Stage 5: Recovery or Rehabilitation - During this stage the client is expected to relinquish the dependent role and resume former roles and responsibilities. For people with acute illness, the time as an ill person is generally short and recovery is usually rapid. Classification of Illness and Disease: Acute Illness: Typically characterized by severe symptoms of relatively short duration. Chronic illness: One that lasts for an extended period, usually 6 months or longer, and often for person's life. Impact of Illness on the Client & Family: Changes that take place on the patients when there is illness: 1. BEHAVIORAL & EMOTIONAL CHANGES - People react differently to illness or the threat of illness; reactions depend on the nature of the illness; the client’s attitude toward it; the reaction of others to it, & the variables of illness behavior - Short term, non-life-threatening illnesses evoke few behavioral changes in the functioning of the client or family - Severe illness, particularly one that is life threatening, can lead to more extensive emotional & behavioral changes such as anxiety, shock, denial, anger & withdrawal 2. IMPACT ON BODY IMAGE - Body image is the subjective concept of physical appearance; some illnesses result in changes in physical appearance, & clients & families react differently to these changes. - These reactions of clients & families to change in body image depend on the following: a. the types of changes (e.g. loss of a limb/organ) b. their adaptive capacity c. the rate at which changes take place d. support service available - When a change in body image occurs, the client generally adjusts in the following phases: shock, withdrawal, acknowledgement, acceptance, & rehabilitation. 3. IMPACT ON SELF-CONCEPT - One’s mental image – projected as personality - Self-concept is a mental self-image of strengths & weaknesses in all aspects of personality; depends in part on body image & roles but also includes other aspects of psychology & spirituality. - The impact of illness on the self-concepts of clients & family members may be more complex & less readily observed than role changes. NUPC 104 // Instructor: ROLANDO P. RONCAL JR Page 6 of 7  - A client whose self-concept changes because of illness may no longer meet family expectations, leading to tension or conflict 4. IMPACT ON FAMILY ROLES - People have many roles in life. When an illness occurs, parents & children try to adapt to major changes resulting from a family member’s illness - Role reversal is common; such as reversal of the usual situation can lead to stress, conflicting responsibilities for the adult child, or direct conflict over decision making. 5. IMPACT ON FAMILY DYNAMICS - Family dynamics is the process by which the family functions, makes decisions, give support to individual members & copes with everyday change & challenges. - If a parent in a family becomes ill, family activities & decision making often come to a halt as the other family members wait for the illness to pass, or they delay action because they are reluctant to assume the ill person’s roles or responsibilities. Levels of Preventive Care I. Primary Prevention - “True Prevention”, it precedes disease or dysfunction & is applied to clients considered physically & emotionally healthy - aimed at health promotion includes health education programs, immunization, & physical & nutritional fitness activities II. Secondary Prevention - focuses on individuals who are experiencing health problems or illnesses and who are at risk for developing complications or worsening conditions - activities are directed at diagnosis & prompt intervention, thereby reducing severity & enabling the client to return to a normal level of health as easy as possible III. Tertiary Prevention - Occurs when a defect or disability is permanent & irreversible. It involves minimizing the effects of long-term disease or disability by interventions directed at preventing complications & deteriorations. - Activities are directed at rehabilitation rather than diagnosis & treatment; care at this level aims to keep clients achieve as high a level of functioning as possible despite the limitations caused by illness or impairments. B. HEALTH CARE DELIVERY SYSTEM: Types of Health Care Delivery Systems 1. Managed Care: This is a planned way of taking care of people, where doctors, nurses, and places where you get medical help work together to give services at the lowest price they can. 2. Concierge Services: This requires a monthly payment in exchange for health care services from mostly private facilities, which allows doctors to charge a patient to have complete access to the services they offer. 3. Self-Directed Services: This allows patients to make their own decisions when it comes to their health, which is handled by an agency. It also allows patients to recruit their desired providers for their own needs. 4. Telemedicine: Patients do not need to physically visit doctors; instead, they can undergo assessments using technology such as video calls or text messaging to communicate with their physicians. NUPC 104 // Instructor: ROLANDO P. RONCAL JR Page 7 of 7