1. Chapter 14
Wellness Concepts

2. Health Wellness Health Promotion Wellness
World Health Organization: State of complete physical, mental, and social well-being
Wellness
State of optimal health
Seven Areas of Wellness
Health Promotion
Assisting individuals to better health, functioning, and well-being to maximize their potential
Health: Generally accepted definition from World Health Organization: State of complete physical, mental, and social well-being. Not merely absence of disease or infirmity
Wellness is considered to be a state of optimal health in which a person moves toward integration of human functioning, maximizes human potential, takes responsibility for health, and has greater self-awareness and self-satisfaction. Seven areas of wellness have been described: emotional, mental, intellectual, vocational, social, spiritual, and physical. Emotional wellness is reflected in people who understand their feelings and express them appropriately, who accept their limitations, can adjust to change, and are optimistic and enjoy life
Wellness
State of optimal health
Maximize human potential and move toward integration of human functioning
Have greater self-awareness and self-satisfaction
Take responsibility for health
Seven Areas of Wellness
Emotional
Mental
Intellectual
Vocational
Social
Spiritual
Physical
Health Promotion
Assisting individuals to better health, functioning, and well-being to maximize their potential
Focuses on choosing healthy behaviors
Rather than on escaping illness
Appropriate for individual and entire population
Requires self-responsibility

3. Illness Prevention Primary Secondary Tertiary
Practices designed to keep health problems from developing
Secondary
Early identification and treatment of disease
Tertiary
Maximization of recovery after illness or injury
Prevention of long-term complications
Prevention is concerned with taking advanced measures against something possible or probable, such as hindering development of illness or disease. Preventive health practices are necessary in all stages of life and range from lifestyle changes to sophisticated technical procedures. There are three types of prevention—primary, secondary, and tertiary—that encompass all stages of health. Primary prevention includes practices that deter the development of health problems and usually provides the greatest benefit for the least expenditure. Examples of primary prevention include getting childhood immunizations, refraining from smoking, and eating a balanced diet. Secondary prevention includes efforts at early detection, diagnosis, screening, and intervention to minimize the consequences of a health problem; these efforts are particularly important to identify potential health problems for which there is no specific primary prevention practice. In some instances, a disease or illness may be detected before the person has developed any symptoms or functional impairment. Examples of secondary prevention include screening for health problems such as hypertension or tuberculosis; reducing dietary intake of saturated fats and cholesterol in people who have a family history of coronary artery disease; and engaging in breast or testicular self-examination. Tertiary prevention includes activities that are appropriate for treating an illness or disease that will minimize disease progression or potential complications. Having a ruptured appendix removed before peritonitis develops or taking medication to control diabetes mellitus are examples of tertiary prevention. If complications do occur, rehabilitative efforts to restore function or to minimize further deterioration are important aspects of tertiary prevention. Participating in a structured program of activities and lifestyle changes after a severe heart attack is another example of tertiary prevention.
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4. Healthy People 2000/2010 Important issues and goals:
Personal responsibility
Health benefits for all people
Health promotion and disease prevention
Increasing span of healthy life
Reducing health disparities
Achieving access to preventive services
Healthy People 2000/2010-Important issues and goals:
Personal responsibility
Health benefits for all people
Health promotion and disease prevention
Increasing span of healthy life
Reducing health disparities
Achieving access to preventive services

5. Prevention Health Care Team
Individual combines knowledge of preventive health care with behavioral changes
Nurses do initial health screening
Provides opportunity for teaching prevention and health promotion
Primary physicians
Family doctors seen on regular basis
The prevention health care team consists of the client, nurses, and primary physicians. The client is at the center of the prevention health care team, as the person who has the ultimate responsibility for health care; the client must knowingly incorporate preventive health practices into her or his daily life. Nurses, particularly those with advanced practice skills such as nurse practitioners, are often responsible for initial client screening in various health care settings; they can be effective teachers and role models of preventive health and health promotion activities. Individuals generally see primary physicians on a regular basis; they may be family practice physicians, pediatricians, or internists. If a client has a health problem requiring specialized attention, the primary physician can refer the client to another physician whose practice is specialized in one area, such as cardiology, orthopedics, or respiratory care; the client then returns to the primary physician for follow-up care.

6. Factors Affecting Health
Genetics and human biology
Environmental influences
Personal behavior
Health care
Factors affecting health: Genetics and human biology, Environmental influences, Personal behavior, Health care
Genetics and Human Biology Inherited traits have impact on person’s state of health. Genetic makeup may include inherited disorders or chromosomal anomalies. Normal body functioning prevents some illnesses and makes people more susceptible to other illnesses
Environmental Influences Geographic location and living conditions Natural biological irritants Exposure to chemicals Exposure to solar radiation Natural disasters Man-made crises E.g., wars, pollution, overpopulation
Personal Behavior Has biggest effect on health and wellness Controlled entirely by person’s decision making Includes diet, exercise, personal care, sexual relationships, level of stress, tobacco use, drug use, alcohol use, and safety
Health Care Health promotion and disease prevention more effective uses for health care Health care should include:
Physical examination
Immunizations
Tests
Dental exams
Eye exams

7. Guidelines for Healthy Living
Provide education so clients can make choices to promote wellness and optimal functioning
Many of today’s leading causes of death can be linked to lifestyle choices. Think about these causes of death and the role of nurses in helping clients make lifestyle choices that will promote wellness and optimal functioning
Among the leading causes of death associated with lifestyle factors that can be controlled are heart disease, associated with tobacco use, diabetes, obesity, high cholesterol levels, high blood pressure, and lack of exercise; cancer, associated with tobacco use, alcohol abuse, environmental exposure, and inadequate diet; stroke, associated with tobacco use, high blood pressure, high cholesterol, and lack of exercise; accidents, associated with abuse of alcohol and drugs, fatigue, stress, failure to use seat belts, and recklessness; chronic lung disease, associated with tobacco use and environmental exposure; pneumonia and influenza, associated with environmental exposure, tobacco use, alcohol abuse, chronic lung disease, and lack of immunizations; diabetes, associated with obesity, lack of exercise, improper diet, and excessive stress; suicide, associated with drug and alcohol abuse and excessive stress; liver disease, associated with alcohol abuse, lack of immunizations, and exposure to toxins; and atherosclerosis, associated with high blood pressure, high cholesterol, lack of exercise, and tobacco use. Nurses can teach clients, in formal or informal settings, about the factors that are associated with actual or potential health problem(s) and about choices that will minimize the risk of developing or exacerbating the health problem(s). For example, reinforcing the importance of weight loss and a balanced diet can be important for a client who is at risk of developing diabetes mellitus; for the client who has already been diagnosed with diabetes, reinforcing the prescribed schedule of medication, exercise, and diet can contribute to successful control of the disease.
Nurses can also be personal role models of healthy living by practicing the health habits they teach. For example, nurses are examples of healthy living when they get adequate sleep, maintain their weight within normal limits for their height, and avoid smoking or abusing alcohol.
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8. Ten Crucial Health Practices
Avoid any use of tobacco or drugs
Consume no more than 2 ounces of alcohol per day
Eat low-fat, low-sodium, low-cholesterol, high-fiber diet
Exercise regularly
Stay lean
Drive safely
Avoid excessive stress
Minimize exposure to pollutants and other environmental hazards
Avoid sexually transmitted diseases
Obtain regular medical care
Avoid any use of tobacco or drugs
Consume no more than 2 ounces of alcohol per day
Eat low-fat, low-sodium, low-cholesterol, high-fiber diet
Exercise regularly
Stay lean
Drive safely Drive cars with air bags Wear seat belts Drive prudently Avoid drinking and driving
Avoid excessive stress
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9. Globesity
An estimated 2.3 billion adults are borderline overweight, with 700 million expected to cross that line by 2015.  Due to this rise in obesity, people are putting themselves at risk for other serious diseases, some ultimately resulting in death.
On the global scale, it is estimated that there are 300 million obese individuals (Yach, 2003).  This trend in deteriorating health is expected to continue, and by 2015 it is proposed that there will be 2.3 billion overweight adults, 700 million of which will fall under the category of clinically obese (“Scientists,” 2008).