Well being

Biomedical concept:

• Traditionally, health has been viewed as an "absence of disease" and if one is free from disease, then the person is considered healthy. This concept is known as the "biomedical concept".
• MIRCO-ORGANISM → _enters → HUMAN BODY → _causes → ILLNESS/DISEASE

Ciriticsm of biomedical concept:

• According to biomedical concept, one factor i.e. gern is responsible for illness, but other factors which contirbute to the illness are not considered.
• But it has been seen that some of the health problems such as accidents, nutritional deficiency disorders, mental disorders, disease due to environment pollution also occur. Even germs also get an opportunity to multiply and thereby cause disease, it get appropriate environment inside the body to grow.

Ecological concept:

• The ecologist put form an attractive hypothesis which viewed health as a dynamic equilibrium between man and his environment.
• The ecological cocept raises two issues:
  1. Imperfect man
  2. Imperfect environment
• So in the view of ecologists health problems occur due to environment pollution or mans maladjustment or imperfect man environment.

Critisim of ecological concept:

• Ecologists have considered the external environment of human beings but internal environment is also responsible for disease.
• E.g.: Genetic inheritance, Hemophilia, Mental retardation.

Psychosocial concepts:

• Health is not only a biomedical phenomenon, but one which is influenced by social, psychological, cultural, economic and political factors of the people concerned.

Holistic concept:

• The holistic model is a synthesis of all the above concepts.
• It recognized the stronger of social, economic, political and environmental influences on health.
• The holistic approach implies that all sectors of society have an effect on health in particular, agriculture, animal husbandary, food, industry, education, housing, public works, communications and other sectors.
• The emphasis is on the promotion and protection of health.

Physical Dimensions

• Physical health means perfect functioning of the body in which each organ is working in harmony with the maximum capacity.
• Physical health is achieved by the exercise, healthy diet, adequate rest and sleep and no smoking or alcohol intake.
• To maintain proper physical health there is need for taking safety precautions, and regular follow up with the health care providers.
• Signs of physical health:
  • A good complexion
  • A clean skin
  • Bright eyes
  • Not too fatty
  • A sweet breadth
  • A good appetite
  • Sound sleep
  • Regular activities of bowels and bladder
  • Smooth, easy, and coordination bodily movements

Mental Dimensions:

• Mental health is a state of balance between body and mind. Earlier the body and mind were considered two separate entities.
• But these are interrelated as phsycial illness can result mental illness and vice versa.
• How mental illness influence physical health:

Characteristics of mentally healthy person:

• Mentally healthy person will be capable of making personal and social adjustment.
• Mentally healthy person is free from internal conflicts.
• He faces problems and tries to solve them intelligently.
• He has good self control balances rationally and emotionally.
• He knows him self his needs problems and goals.
• He has strong sense of self esteem.
• He serves for identity.
• He lives a well balanced life means able to maintain the balance between work, rest and recreation.

Social Dimensions

• An individual is socially healthy if he is able to maintain harmonious relationship with other members of society in which he lives.
• Social health rooted in "positive material environment" and "positive human environment" which is concerned with the social network of the individual.
• The social dimensions of health includes:
  • Communication
  • Intimacy
  • Respect
  • Equality
  • Social functioning

Spiritual Dimensions:

• Spirituality means in touch which deeper self and exploration the purpose of life, as people believe in some force that transcend physiology and psychology of human beings.
• It includes love, charity, purpose, principles, ethics, intigrity, hope of life.
• Medications, prayers, or spiritual gatherings are organized to maintain spiritual health.

Emotional dimensions:

• Emotional health is closely related to the mental health and is considered as an important element of health.
• Mental and emotional aspects of health are now viewed as two separate entities for human life.
• Cognition is related to the mental health whereas emotional health is related to the feelings of a person.
• Emotional health includes:
  • An emotionally healthy person has a positive thinking and is capable of coping and ajusting self.
  • An emotionally healthy person participates in all the activities which are related to personal growth and his self esteem.
  • Emotionaly well people has the ability to express feelings freely and manage feelings effectively.
  • They are also aware of and accept a wide range of feelings in themselves and others.

Vocational dimensions

• The choice of profession, job satisfaction, career ambitions and personal performance are all important components of this dimension.
• To be occupationally well, a person is ultimately doing exactly with what they want to do in life and are comfortable with their future plans.
• Vocational dimension of health can be assesed by:
  • Assessing the satisfaction level at job
  • Facilities attached to the job
  • Behaviour of the management and administrator and of colleagues at job.

Other dimensions:

A few other dimensions also suggested such as:

• Cultural dimensions
• Socio-economic dimensions
• Environmental dimensions
• Educational dimensions
• Nutritional dimensions
• Preventive dimensions

Human biology

It is one of the intrinsic determinant of health. It includes the factors such as:

1. Genetic inheritance: Genetic inheritance influences physical characteristics and intellectual potentials of an individual. Person with desirable physical characteristics and intellectual potentialities receive positive interaction and re- inforcement from people around them.
2. Age: Age affects illness susceptibility as well as behaviour. Infants and elderly persons are more susceptible to infection
3. Racial factor:It affect health because of different culture values and attitudes e.g sickle cell anemia is more common in Africans.
4. Self concept: Self concept implies individual self perception of his or her physical, intellectual and social abilities.

Environment

• Environment is one of the extrinsic factor which influence health and wellness of human beings it may be referred to as micro and macro environment.
• Mirco environment: it refers to the personal environment.
• Macro environment: it refers to the external environment which is outside the home environment.

Components of environment

• Physical environment: The physical environment is comprised of housing and building structures and wide variety of physical substances that affect health.
• Biological environment: The biological environment is comprised of plant and animal kingdom which help in maintaining ecosystem and thereby health of individual.
• Social environment: The social environment includes other people and social institution, sociocultural events, religious beliefs, moral and ethical values and social rules and regulations.

Life style

• Life style refers to people way of living. It is composite of daily living activities, behavioural and cultural practices including customs and traditions. Life style is acquired through formal and informal education.

Health and health allied resources

It includes

1. Health services: Health services are directly concerned with the improvement of health status of people. If the health services are available and accessible then it puts a great impact on the health status of the community.
2. Socio-economic condition: Socioeconomic condition have significant influence on the community health. Socioeconomic condition includes economic status, education, occupation and living standard.
   • The economic status is determined by the per capita gross net production. The increase in GNP will improve the economic status of the country and of people.
   • Education play a important role in health promotion. The educated person will understand to adopt a life style which is suitable to his/ her health.
   • Occupation contributes to health promotion. It keeps the individual busy less chances are there to get unhealthy life style.
3. Political system: The political system has A very strong role in health promotion of people. Decisions pertaining to health policy, allocation of funds, programmes, infrastructure and delivery of health services are made by the ruling party.
4. Health related services: The health related services include education, food and agriculture, industry, rural and urban development, social welfare manpower development, communication and transportation etc.

Health education

• This is one of the most cost-effective interventions. A large number of diseases could be prevented with little or no medical intervention if people were adequately informed about them and if they were encouraged to take necessary precautions in time.
• The targets of educational efforts may include the general groups, health providers, community leaders and decision-makers.

Environmental modification

• A comprehensive approach to health promotion requires environmental modifications, such as provision of safe water, installation of sanitary latrines, control of insects and rodents, improvement of housing etc.
• The history of medicine has shown that many infections diseases have been successfully controlled in many countries through environmental modifications.

Nutritional intervention

• These comprise food distribution and nutritional improvement of vulnerable groups: child feeding programmes, food fortification, nutritional education.

Life style and behavrioural changes

• The efforts are directed towards discouraging from adopting harmful lifestyles eg. smoking, eating patterns, lack of exercise, alcoholism etc.

Compares treatment model with a wellness model

• If treatment model is used, an individual can move right only to the neutral point.
  Eg; A hypertensive client who only takes his medications without making any other life style changes.
• If wellness model is used, an individual can move right past the neutral point.
  Eg: As hypertensive client not only takes medications but stops smoking, looses weight, starts an exercise programme etc.

Terminologies

• Diagnosis: It is the determination of the nature and extent of a disease.
• Prognosis: It is the forecast of the course and duration of a disease.
• Etiology: - It is the science of the cause of a disease.
• Signs: The presence of a disease that can been seen or elicited E.g. Fever.
• Symptoms: - Any evidence as to the nature and location of a diseases noted by the client.
• Subjective symptoms: When the symptoms are note by the client himself. E.g. Pain.
• Objective symptoms: When the symptoms are noted by the observer as well as by the client. E.g. Jaundice.

Health history

• It is a collection of subjective data in detail regarding client's health in a chronological order.

Factors affecting the collection of subjective data:

• Physical setting
• Client's personality and behaviour
• Nurses personality and behavior
• Communiaton skill
• Patient's problem

Format of health history

• Biographic data: Name, address, gender, age, marital status, occupation, religion, family income (monthly), educational qualificaiton etc.
• Chief complaints: It is a brief assessment of client's problem for which clients seeks medical care.
  It should be written in clients statement.
• History of present illness: Signs and symptoms, duration, treatment taken (if any), other complaints such as loss of appetite, insomnia, disorders of stomach etc. Client's health habits - eating, sleeping etc.
• Past health history: childhood illness, allergies, medical disease, surgery, hospitalization, obstetric history.
• Family history: family tree, information about family memers, family history of any illness.
• Occupational and environmental history: collecting data regarding clients job, nature of job, environment in job, exposure to any hazardous substances if any?
• Psychosocial history: Smoking, food habits, likes and dislikes, pattern of sleep, exercises.
• Review of systems: Information is gathered system wise.