Unit 1

Introduction
Presented by,
Pooja Barapatre
 INTRODUCTION
• Health is very important for every individual for
living on this earth. In the society, it is not only issue
of doctors, nurses, social services and hospitals, it is
also an issue of social justice. A most common
aspect in every culture is health.
• Some older definitions stated health as "Absence of
disease". No one having same viewpoint on the
health aspect. The ancient Indians and Greeks
consider health as normal body equilibrium and
disease as disturbance in body equilibrium.
• Every person is free to live by his/her own
ways. But sometimes people adopt many
irregular ways of living life, that they do not
understand the value or health until it is lost.
• As per the advancement of technology people
as come to know that health is a fundamental
human right and is essential for the
satisfaction of basic human needs and for the
improvement of life, that is why it is a world
wide social goal.
DEFINITION OF HEALTH
 DEFINITIONS OF HEALTH:
• Health is a state of well being of individual and
community. For an individual, health is the
optimal functioning of the individual, absence
of disease/illnesses/impairment or injury.

• WHO: defines, "Health is a state of complete

physical, mental, social and spiritual well-
being and not merely absence of disease."
• Pericles: Health is that state of moral, mental
and physical well being which enables a
person to face any crisis in life with utmost
grace of God and facility.

• H.S. Hayman: Health is a state of feeling

sound in body, mind and spirit with sense of
reserve power.
• R. Dubiois : Health is an adaptation and
function of adjustment.
• Liverpool school of Tropical Medicine: Health
is the achievement of a state of harmony
between man's internal and external milieu.
• Duhl: Health is a state of competence of
emotional, mental and physical strength
enabling to set goals, investigate alternatives,
make decisions and take actions to control
environment.
 Signs of Good Health:
To look for signs of good health, we must
examine all the three aspects:
1. Physical
1. Mental
2. Social
1.Physical health:
A person who enjoys good physical health is one who
• is energetic
• has good posture
• weighs normal for age and height
• has all body organs functioning normally
• has a clear and clean skin
• has bright eyes
• has good textured and shining hair
• has a clean breath
• has a good appetite
• gets sound sleep
2. Mental health:
Mental health implies -
• control on emotions
• sensitive to the needs of others
• confidence in one’s own abilities
• freedom from unnecessary tensions,
anxieties and worries
• A person is mentally healthy if he or she is
relaxed and free from any worries
3.Social heath:
A person with good social health -
• gets along well with people around
• has pleasant manners
• helps others
• fulfills responsibility towards others
• A person is socially healthy if he or she can
move in the society confidently with
others.
 CHANGING
CONCEPTS OF
HEALTH
 CHANGING CONCEPTS OF HEALTH

BIOMEDICAL ECOLOGICAL
CONCEPT CONCEPT

CHANGING
CONCEPT
OF HEALTH

PSYCHOLOGICAL HOLISTIC CONNCEPT

CONCEPT
1) Biomedical concept-Germ theory of disease
has given the biomedical concept health i.e. the
absence of disease. But as per the advancement
of technology and this concept is considered as
inadequate as it was considered as not merely
absence disease but the good health status of an
individual.
2) Ecological concept-This concept concentrates
around two aspects that are man/human being
as well as environment. It states that sometimes
man is not able to adapt/fit himself in a good
physical environment and sometimes the
environment is not feasible for the human living.
But it is not an adequate concept as per the
modernization.
3) Psychological concept -This concept has not
considered health as only a physical or only a
biological phenomenon. Because there are a
large number of factors that effect life in
different ways, such as cultural factors, social
factors, economic factors, psychological factors
etc. Hence, we do not take it only a bio-medical
phenomenon.
4) Holistic concept- This concept has given more
weightage on the promotion of health,
prevention of disease, alleviation of sufferings
and we consider all aspects of health as sound
mind, sound body, sound family as well as sound
environment. As all the factors like physical,
social, economic, cultural etc. are included in the
dimensions of health, that is the reason it is
considered as a holistic concept.
DIMENSION OF HEALTH
DIMENSION OF HEALTH
ENVIRO-
NMENT

MENTAL
SELF
GRTRE
PHYSICAL

SPIRITUAL
SOCIAL

ENVIRO
NMENT
 DIMENSIONS OF HEALTH
• Specific dimensions of Health as per WHO are as follows.
1)The Physical Dimensions : For the physical dimension, we
consider the accurate functioning of body, from the smallest
unit like cell to the functioning of a largest organ of body and
well-coordination of all the body organs. The signs of
physical health are as:
– a good complexion, bright eyes, moderate body build a good
– appetite, regular activity of bowels and bladder,
– smooth, easy co-ordinated bodily movements, organs functioning
– normally, special senses like hearing, vision, smell, taste are intact,
– Normal pulse, B.P. and exercise tolerence, considering age and sex.
2) Mental Dimension : It is ability to deal with every situation
of life whether it is favourable or unfavourable intelligentlly
and logically or we can say that it is a balance between the
individual and its surrounding world, living harmoniously in
the society, accepting reality of situations and adapt himself
according to the situation.
Characteristics of Mental Dimension :
• Strong sense of self-esteem, Well-adjusted Get along with
others
• Accepts criticism.
• Free from internal conflicts.
• Self-actualization
• knows needs, problems and goals. , Good self-control;
balances rationality and emotionality.
• Cope with stress and anxiety. Searches for identity.
• 3) Social Dimension- Social well-being implies
harmony and integration within the individual
as well as within the society. Social health
takes into account the individual as an integral
part of the family, community and the whole
world. It also accounts on the social and
economic factors of a person.
• 4) Spiritual Dimension :- This is that part of
individual which reaches out and strives for
meaning and purposes in life. It includes
integrity, principles and ethics, the purpose in
life and commitment to some higher being.
• Spiritual Health: According to Fridemonn,
Mounch and Racey : Spirituality is the act of
connecting to systems such as God, nature, or
other people to find meaning through
relationships. Spirituality can be the important
factor that helps individuals to achieve the
balance needed to maintain health and well-
being and to cope with illness.
5) Emotional Dimension : Emotional dimension
of health is related to 'feeling'. Assess the needs
of love, affection and any other.
• 6) Vocational Dimension: Work/job often plays an important
role in promoting physical and mental health. When a person
suddenly loses his job, it affects his psychology and mental
status. When mental health is impaired, physical health gets
automatically affected.
• 7) Other Dimensions
• Philosophical dimension,
• Cultural dimension
• Socio-Economic dimension
• Environmental dimension
• Educational dimension
• Nutritional dimension
• Curative dimension
• Preventive dimension
DETERMINANTS OF
HEALTH
 DETERMINANTS OF HEALTH
1) Genetic Make
up 7)Health Services

2) Environment 6)Occupation

4)Socio-
3) Life style economic 5) Education
Conditions
1. Genetic Make up : The physical and mental
traits of human being are to a large ex
determined by the nature of genes that are
generally transferred from the parents to the
offsprings. A number of diseases that results
due to transportation of genes or irregular
genes
Eg,Chromosomal anomalies, Errors of metabolism,
Mental Retardation, Some type of diabetes etc.
2) Environment : This is composed of internal
and external factors that determines the health.
Internal environment implies to cells, tissues,
organs and all the body system, External
environment composed of all the physical,
biological, social, cultural factors that affects the
health both positively as well as negatively and
makes a person more susceptible to illnesses.
3) Life style :
Life style is a very important determinant
of health. It is composed of socio- economic
status, habits of an individual, socio-cultural
factors, customs, religion etc. The habits of
smoking, alcoholism affect badly the health
status of an individual. Good environmental
sanitation, good nutrition, sound sleep,
sufficient physical activities etc. denote the
positive side of health status than the poor
environmental conditions etc.
4)Socio-economic Conditions : In the developed
country, there is very less percentage of
morbidity and mortality cases. Now a days due
to increase in economy of developing countries
the morbidity and mortality cases gradually
decrease. As the people with good socio-
economic status can buy better nutritional
component, have better sanitation conditions,
that helps in improving the health status of an
individual.
5) Education: Education too determines health
status, as an educated person have more
knowledge about the factors improving quality
of life than an illiterate person.
6)Occupation: Occupation plays a very
important role in determining health status. As
the persons who are involved in the occupation
that require only documentary work are more
susceptible to get obese and hence develop
heart diseases. And the persons who are
involved in an occupation that require more
physical activities are more active and healthy.
7)Health Services: Provision of health services
too determines health status. As now a days the
health services/facilities are provided better to
the urban community than the rural area people
that is why incidence of illness is low in urban
areas. Examples of health services are;
• Immunization of children.
• Provision of safe water supply.
• Care of pregnant women and
children.
• Primary health care.
Sick Healthy
HEALTH ILLNESS
CONTINUUM
 HEALTH ILLNESS CONTINUUM
• According to Neuman (1990) "Health on a
continuum is the degree of client wellness
that exists at any point in time, ranging from
an optimal wellness condition with available
energy at its maximum to death, which
represents total energy depletion."
• According to Health-illness continuum model,
• Health is a dynamic state that continuously alters as
a person adapts to Changes in the internal and
external environments to maintain a state of
physical, emotional, intellectual, social,
developmental and spiritual well being.
• Illness is 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.
MODELS OF HEALTH AND ILLNESS

Health and illness continuum

Death Optimal
wellness
 Health

RISK FACTOR
FOR
High level FUNCTIONING Severe illness
Wellness IN ALL
DIMENTION

Illness
 Spectrum of Health
Positive Health, Better Health
• Unrecognized sickness
• Mild sickness
• Severe sickness
• Death
• The spectrum indicates that health of a person is not a static
condition, there are always continuous changes that come
in the health status and it is not possible to attain health
once and for all.
• The literature supports the view that health and its
attainment is a central concept and a goal of nursing
practice.
1) A nurse can determine a client's level of health
at any point on the health illness continuum. A
client's risk factors (variables) are important in
identifying level of health. Risk factors include
genetic and physiological variables.
2) As a person progresses through the
developmental stages, certain risk factors are
common than others, eg. Body image changes
and self-concept.
3) To help clients set goals to reach an optimal
level of health, the nurse helps them identify
their positions on the health-illness continuum.