Stress, Health

,Illness Behavior
and Disease
Prevention
NURSING ENHANCEMENT
PROGRAM I
 Man
• Bio
• Psycho
• Socio
• Cultural
• Spiritual being
 FACTORS INFLUENCING
HEALTH/
DETERMINANTS OF HEALTH
Dimensions of Wellness
 Variables influencing health
status, belief, and practices
• Internal Variables:
1. Biologic
• genetic makeup
• age
• developmental level
• race
• gender
Variables influencing health status,
belief, and practices
2. Psychologic or Emotional
• Mind-body interaction

3. Cognitive or Intellectual
• Cognitive abilities
• Educational background
• Past experiences
Variables influencing health status,
belief, and practices
4. Spiritual
• Spiritual and religious beliefs and values
Variables influencing health status,
belief, and practices
External Variables
• Physical environment
• Standards of living
• Family and cultural beliefs
• Social support networks
Basic Human
Needs
 Need

something that is desirable, useful or

necessary
 Basic Human Needs
• physiologic and psychologic
conditions that an individual must
meet to achieve a state of health or
well-being
Maslow’s Hierarchy of
Needs
Self-
actualization

Self -esteem

Love and belonging

Safety and security

Physiologic
Abraham Maslow’s Hierarchy of
Basic Human Needs

Self –actualization
Self-knowledge Aesthetics
Achievement Openness
Universal knowledge

• Independence Self-esteem • Motivation

• Competence • Learning
• Exploration • Leisure
• Roles • Spiritual beliefs
• Loving: giving and receiving • Social interaction
• Affection Love and Belonging • Communication
• Intimacy • Human caring
• Sexual expression • Family community
Safety and security
• Psychological comfort • Assistance in meeting • Comfortable
needs environment

• Oxygenation Physiologic
• Activity
• Nutrition • Rest and comfort
• Sexual procreation
• Elimination • Hygiene
 Characteristics of Human Needs

• Needs are universal.

• Needs may be met in different ways
• Needs may be stimulated by external
and internal factor
• Priorities may be deferred
• Needs are interrelated
ealth, Wellness, and Illness
 Models of Health and Well Being

• Smith’s 4 models of health

1. Clinical Model
2. Role Performance Model
3. Adaptive Model
4. Eudemonistic Model
 Models of Health and W ell Being

• Leavell and Clark’s

5. Agent-Host-Environment Model

6. Health-Illness Continuum
 Models of Health and Well Being

1. Clinical Model
– People viewed as physiologic systems
– Health identified by the absence of signs and
symptoms of disease or injury
 Models of Health and W ell Being

2. Role Performance Model

– Ability to fulfill societal roles
– Healthy even if clinically ill if roles
fulfilled
 Models of Health and W ell Being

3. Adaptive Model
– Creative process
– Disease is a failure in adaptation or
maladaption
– Extreme good health is flexible adaptation to
the environment
 Models of Health and W ell Being

4. Eudemonistic Model
– Comprehensive view of health
– Condition of actualization or realization
of a person’s potential
– Illness is a condition that prevents self-
actualization
 Models of Health and Well Being

5. Agent-Host-
Environment Model
– Each factor constantly
interacts with the others
– When in balance, health is
maintained.
– When not in balance,
disease occurs.
 Models of Health and Well Being
6. Health and Illness Continuum
– Measure person’s perceived level of wellness
– Dunn’s high level wellness grid
– Travis’s illness – wellness continuum
– Health Belief model
Concept of Health
and Wellness
 Concept of Health

• state of complete physical, mental, and social

well-being,and not merely the absence of
disease or infirmity (WHO)

• the ability to maintain the internal milieu

(Claude Bernard)
 Concept of Health

• state the characterized by soundness or

wholeness of developed human structures and
of bodily and mental functioning (Orem)

• is a dynamic state in the life cycle;illness is an

interference in the life cycle (King)
 Concept of Health

• the ability to maintain homeostasis or

dynamic equilibrium (Walter Cannon)

• maintained through prevention of diseases via

environmental health factors (Florence
Nightingale)
 Concept of Health

• viewed in terms of the individual’s ability to

perform 14 components of nursing care
unaided (Henderson)

• a state of a process of being becoming an

integrated and whole as a person (Roy)
 Concept of Health

• reflected by the organization, interaction,

interdependence and integration of the
subsystems of the behavioral system
(Johnson)
 Concept of Wellness

• the condition in which all parts and subparts of

an individual are in harmony with the whole
system (Neuman)
Integral model of health

health

person
Concept of Illness
and Disease
 Concept of Illness

• a state in which a person’s physical,

emotional, intellectual, social, developmental,
or spiritual functioning is diminished or
impaired compared with previous experience.

• Can be acute or chronic type of illness

 Suchman’s Stages of Illness
• Stage 1: Symptom experience
– Believe something is wrong
• Stage 2: Assumption of the sick role
– Accepts the sick role and seeks
confirmation
• Stage 3: Medical care contact
– Seeks advice of a health professional
 Suchman’s Stages of Illness
• Stage 4: Dependent client role
– Becomes dependent on the professional
for help
• Stage 5: Recovery or rehabilitation
– Relinquish the dependent role
– Resume former roles and responsibilities
 Precursor of Illness
1. Heredity. e.g. family history for diabetes mellitus,
hypertension, cancer.

2. Behavioral factors. e.g. cigarette smoking, alcohol

abuse, high animal fat intake.

3. Environmental factors. e.g. overcrowding, poor

sanitation, poor supply of potable water.
 Effects of Illness
1. Loss of Privacy
2. Altered Autonomy
3. Financial burden
4. Altered Life-style
5. Family and
significant others
 Concept of Disease

• An alteration in body function resulting

in reduction of capacities or a
shortening of the normal life span.
 Risk Factors of A Disease

1. Genetic and Physiological Factors

2. Age

3. Environment

4. Lifestyle
 Common Causes of Disease

1. Biologic Agents
2. Inherited Generic Defects
3. Physical Agents
4. Chemical Agents
5. Tissue response to irritation/injury (fever, inflammation)
6. Faulty chemical or metabolic process
7. Emotional or physical reaction to stress
 Classification of Disease
According to Etiologic Factors
1. Hereditary

2. Congenital

3. Metabolic

4. Deficiency

5. Traumatic
 Classification of Disease

According to Etiologic Factors

6. Allergic

7. Neoplastic

8. Idiopathic

9. Degenerative

10. Iatrogenic
 Classification of Disease

According to Duration or Onset

1. Acute Illness - short duration and severe

2. Chronic Illness- Slow onset. Persists, usually

longer than 6 months

3. Sub-Acute- Symptoms are pronounced but more

prolonged than the acute disease.
 Classification of Disease

Other classification:
1. Organic
2. Functional
3. Occupational
4. Sporadic
5. Venereal
6. Familial
7. Epidemic
8. Endemic
9. Pandemic
 Behaviors
• Health behavior-maintains health, prevent
disease, or treat health problems

• Illness behavior-monitoring and using of

health care facilities

• Sick role behavior- undertakes activity to get

well
 Terminologies
• Disease. Disturbance of structure or of function of
the body or its constituent parts.

• Morbidity. Condition of being diseased.

• Morbidity Rate. The proportion of disease to health

in a community.

• Mortality. Condition or quality of being subject to

death.
 Terminologies
• Epidemiology. Study of the patterns of health and
disease, its occurrence and distribution in man, for
the purpose of control and prevention of disease.

• Prognosis. Prediction of the course and of a disease,

medical opinion as to the outcome of a disease
process..

• Recovery. Implies that the person has no observable

or known after effects from his illness; there is
apparent restoration to the pre-illness state.
 Terminologies
• Susceptibility. The degree of resistance the potential
host has against the pathogen.

• Etiologic Agent. One that possesses the potential for

producing injury or disease. (e.g. Streptococcus,
Staphylococcus)

• Virulence. Relative power or the degree of

pathogenicity of the invading microorganism, the
ability to produce poisons that repel or destroy
phagocytes.
 Terminologies
• Symptom. Any disorder of appearance, sensation or function
experienced by the patient indicative of a certain phase of a
disease.

• Sign. An objective symptom or objective evidence or physical

manifestation made apparent by special methods of
examination or use of sense.

• Syndrome. A set of symptom, the sum of which constituents a

disease.
 Terminologies
• Pathology. The branch of medicine which deals with
the cause, nature, treatment and resultant structural
and functional changes of disease.

• Diagnosis. Art or act of determining the nature of a

disease, recognition of a diseased state.

• Complication. A condition that occurs during or after

the course of an illness.
 Levels of
Prevention
 Levels of Prevention

1. Primary Prevention
 Wellness activities
2. Secondary Prevention /Health
Maintenance
 health maintenance
3. Tertiary Prevention
 Rehabilitation
Asepsis and
Infection
 Asepsis
• condition in which pathogens are absent or controlled

2 Types
1. Medical
2. Surgical
 55

Medical Asepsis
Clean technique - based on maintaining
cleanliness to prevent spread of
microorganisms
 56

Medical Asepsis
Sanitization – reduction of
the number of
microorganisms
Disinfection – destruction of
infectious agents on an
object
Sterilization – removal of all
microorganisms
 57

Surgical Asepsis
Keep the surgical
environment completely free
of all microorganisms.
Sterile technique used for
even minor operation or
injections.
Object is either sterile or not
sterile; if unsure then it is not
sterile.
 58

Body’s Defenses
Immunity – resistant to pathogens and the disease they cause

If defenses are not functioning properly, person will become

susceptible to invasion and infection.

• Lines of Defense
 Skin
 Normal flora
 Staying healthy
Defenses Against Disease
Infection is the  Nonspecific Defenses
presence of a  Species resistance
pathogen in or on the  Mechanical barriers
body  Chemical barriers
Nonspecific defenses  Fever
- mechanisms to  Inflammation
protect us against  Phagocytosis
pathogens in general
59
 60

Disease Process
Begins with  Damage is caused by:
microorganisms finding  Depleting nutrients
host  Reproducing themselves
 Making body cells the
Grows with specific target of body’s own
requirements defenses
 Produce toxins
Proper temperature, pH,
and moisture level
 61

Cycle of Infection
Transmission
▫ Airborne transmission
▫ Blood-borne transmission
▫ Ingested transmission
▫ Touching
▫ During pregnancy or birth
 63

Personal Protective Equipment

 Disposable, sterile, exam & utility gloves
 Masks and protective eyewear or face
shields
 Protective clothing
Specific Defenses Against Disease
Immunity  Lymphocytes and
▫ Protects the body against macrophages are the
very specific pathogens major cells

 Antibodies and
complement are the
major proteins involved
in specific defenses
64
Immunization,
ouch!
 66

Types of Immunity
 Naturally acquired active – naturally
exposed to an antigen (usually long lasting)
 Artificially acquired – being injected with a
pathogen (immunizations or vaccines)
 Naturally acquired passive – immunity
through his mother (short-lived)
 Artificially acquired passive – immunity
when person is injected with antibodies (short-
lived)
Stress
Hans Selye: Father of Stress Research
 Austrian-born, Canadian
physician
 Injected ovarian extracts
into rats attempting to
identify new sex
hormone
 Discovered triad of
stress effects
 is ...
Definition St r es
s

 Stress
Non-specific state of physical and
psychological arousal to stressor

 Stressor
Any stimulus that triggers stress response
Three Classification of Stress

EUSTRESS

NEUSTRESS

DISTRESS
4 Major types of stress
1. Frustration – blocked goal

2. Conflict – two or more incompatible motivations

 Approach-approach, approach-avoidance, avoidance-
avoidance

3. Change – having to adapt

4. Pressure – expectations to behave in certain ways

 Perform/conform
 Definition
 Adaptation
 refers to the behavior utilized by an individual I
order to ensure optimal position in health-illness
continuum

 change that takes place as a result of the response

to a stressor
Adaptation
 Local Adaptation Syndrome
 localized response of the body to stress
 involves only a specific body part (tissue, organ)
instead of the whole body

 General Adaptation Syndrome

 describes the body’s general response to stress
Responses to Stress
Responding to Stress Physiologically
 Physiological
Responses Stage 1
Alarm
 Fight-or-flight
response Stage 2
Resistance
 Selye’s General
Adaptation
Syndrome Stage 3
Exhaustion
The Stress Response
(fight or flight response GAS)
 Introduced by Walter Cannon
 in 1914.
 A survival instinct to fight or run.
 Meant for physical stressors.
4 Levels of Anxiety
1. Mild-

2. Moderate-

3. Severe-

4. Panic-
STRESS MANAGEMENT
 Breathing exercise
 Relaxation
 Meditation
 Psychological counselling
THE END