Health and illness continum

Prepared by

Kalyani Moharana .Bsc(N).R.N.R.M

Health and illness continum

Introduction:

Health is a common theme in most culture. In fact all communities have their concepts of health as a part of their culture. Health and illness are defined according to the values of society to which a person belongs. When a person is able to adjust and adapt to his environment he is said to be healthy. A person with good mental health functions comfortably with society. He is satisfied with himself and achievements.

Definition of health:

According to WHO,’ Health is a state of complete physical, mental and social well-being and not merely absence of disease or infirmity.’

Meaning of health:

The WHO definition of health has been criticized as being too broad. Some argue that health can’t be defined, as a’state’at all but must be seen as a process of continuous adjustment to the changing demand of living and of the changing meanings we give to life. It is a dynamic concept. It helps people live well, work well and enjoy themselves.
The WHO definition of health is therefore considered by many as an idealistic goal than a realistic proposition. Some consider it irrelevant to everyday demands, as nobody qualifies as healthy that is perfect biological, psychological and social functioning. That is if we accept the WHO definition, we are all sick.

In spite of the above limitations, the concept of health as defined by WHO is broad and positive in its implications; it sets out the standard, the standard of ‘positive’ health. The state of positive health implies the notion of ‘perfect functioning’ of the body and mind. It conceptualizes health biologically, as a state in which every cell and every organ is functioning at optimum capacity and in perfect harmony with the rest of the body. Psychologically as a state in which the individual feels a sense of perfect well being and of mastery over his environment. Socially as a state in which the individual’s capacities for participation in the social system are optimal.

Recently, a broader concept of health has been emerging-that of improving the quality of life which heath is an essential component. This at once brings to focus that positive health depends not only on medical action, but also on all the other economic, cultural and social factors operating in the community.


Meaning of mental health:

Mental health in a narrow sense, it is describe as a health mind. But it can’t be described without physical, social and spiritual health. Therefore mental is a part of general health. It requires a balance between the body, mind, spirit and environment in which a person lives.

Definition of illness:

According to Susser [83], ‘ Illness is a subjective state of the person who feels aware of not being well.’

Meaning of illness:

As definition of health definition of illness are also individualized to each person, who experience an alternation in health. So illness is the responses, the person has, to a disease; it is an abnormal process in which the person’s level of functioning is changed compared with a previous level. The response is different for each preson, and is influenced by self-perceptions; other perceptions, the effects of changes and body, structure and functions, the effects of those changes on roles and relationships and cultural and spiritual values and beliefs.


Meaning of mental illness:

Mental illness occurs when a state of physical, mental, social and spiritual well-being is disturbed. Personality of a person and use of various defense mechanism, help the individual to adjust to various stressful situation of life. When the capacity to adjustment of the individual is not able to adjust to the situation, he may develop maladaptive behaviour and become mental ill.

Concept of health and illness continum:

Health and disease lie along a continuum and there is no single cut-off point. The lowest point on the health and disease spectrum is death and highest point corresponds to the WHO definition of positive health .It is thus obvious that health fluctuates within a range of optimum well being to various levels of dysfunction, namely the death. The transition from optimum health to ill health is often gradual, and where state ends and the other begin is a matter of judgment.

So the spectral concept of health of an individual is not static. It is a dynamic phenomenon and a process of continuous change, subject to frequent stable variations. What is considering maximum health today may be minimum tomorrow?

That is a person may function at maximum level of health today and diminished level of health tomorrow. It implies that health is a state not to be attained once and for all, but ever to be renewed. There are degrees or ‘levels of health ‘as there are degrees or severity of illness. As long as we are alive there is some degree of health in us.

According to R.Dubois views health as adaptation, a function of adjustment. He believes a utopian state of health can never be so perfectly adapted to the environment that life will not involve struggle, failure and suffering. Human can adapt to environment but each new adaptation procedures new problems that demand new solutions.

Illness is more then signs and symptoms. It is a process and an experience. It is failure of the person’s adaptive power to maintain physical and emotional balance and to utilize the usual health promoting resources in the face of internal and external stressors.
It is a disturbance or adaptation of the person, with observable or felt changes, discomforts and social behavior expectations appropriate to customary role and status.


H.S.Sullivan defines mental or emotional illness as inappropriate interpersonal behavior or behavior that is inadequate for the social context. Sullivan believes that each person has some small degree of illness. Physical or emotional even when he or she feels and looks well. The illness may be minor aches, temper flares, inappropriate forgetfulness, or over use of certain defense mechanisms such as rationalization or forgetfulness. Similarly the emotionally ill person manifests some degree of health. Some appropriate thinking and behavior.


Health illness continuum model:

Health always involves a continuum a range of degree from optimal health at one end to death or total disability at the other. The health of an individual moves back and forth along this continuum throughout life according to health and illness continuum model.
Health is a dynamic state fluctuates as a person adapts to change in the internal and external environment. To maintain a state of total well-being.

High level of wellness and severe illness are at opposite ends of the continuum. According the Neumann’s 1990 health on a continuum is the degree of clients wellness that exist at any point in time running from an optimal wellness condition, with available energy at its maximum to death. Which represents total energy depletion. Risk factors are important in identifying level of health. They include genetic and physiological variables such as age, lifestyle, and environment.

Nursing approach:

It is important for a psychiatric nurse to know her own behavior first, though it is difficult in the beginning. She may not be able to identify her strength and weakness as psychiatric nurse. Her strength may be that she is good at developing rapport with the patient weakness could not be that she lacks good knowledge of the psychiatric nursing subject. This would be able to acquired gradually.

The basic approach or step of caring process is as follows:

1. Assessment and identification of needs
2. Plan of action.
3. Implementation.
4. Evaluation.
   
   The basic principles of nursing are to provide a sense of individuality, safety and comport to the patient. He or she should economies his or her time and energy judiciously while nursing the patient. Maximum therapeutic effectiveness should be the goal of nursing care.
   
   However some of the other principles technique of nursing a mentally ill patient are as follows:
   
   Accepts the patient as a human being
   
   Focus on the strength of the patient.
   
   Skill in developing professional relationship with the patient.
   
   Be non-judgmental and non-punitive.
   
   Be an active lisner.
   
   Show professional interest.
   
   Talk with specific objectives.
   
   Be consistent in behavior.
   
   Use self-awareness as therapeutic tool.
   
   Avoid physical and verbal restrains.
   
   Conclusion:
   
   The health and illness continuum and nursing approach to mentally ill provides a framework of some of the common reaction of a nurse to the patient’s behaviors.
   Through caring process nurse able to provide optimum care to the patient. The principles of in caring for the psychiatric patient, accepting him as a holistic human being and using his strength are important in helping the patient towards the role road to recovery.
   
   References:
   
   1.K.Park. “Text book of preventive and social medicine”. 17th ed.2002. Banarasidas bharath.Jabalpur.Pp 16-32, and 582- 581.
   
   2.Potter.A.Patricia and Perry Anne Griffinn “ fundamentals of nursing” 6thy ed.2005.Mosby.St.louis miesouri. Pp 91 – 103.
   
   3.Niraj ahuja. “A short textbook of Psychiatry “. 1st edition.1995.Jaypee brothers.Newdelhi.Pp – 1 –2.
   
   4.Stuart.Gail.W.Laria.Michele.T.Principles and practice of psychiatric nursing.8th edition.2007.Mosby: St .Louis.Pp 445 – 472.