GENERAL PRINCIPLES OF HEALTH CARE ILLNESS

is a personal state in which the person feels

CONCEPTS OF HEALTH unhealthy

HEALTH is a state in which a person’s physical,

-Old English word for “heal” (hael) emotional, intellectual, social, developmental or
“WHOLE” spiritual functioning is diminished or impaired
Whole person and his or her integrity, compared with previous experience
soundness, or well-being
Precursor of Illness
HEALTH  HEREDITARY – family history for
-Is the state of complete physical, mental, and diabetes mellitus, hypertension, cancer
social well-being, not merely the absence of
disease or infirmity (WHO)  BEHAVIORAL FACTORS – cigarette
smoking, alcohol abuse, high animal fat
-Is the quality of life involving social, emotional, intake
mental, and biological fitness on the
part of the individual, which results in  ENVIRONMENTAL FACTORS –
adaptations from the environment overcrowding, poor sanitation, poor
supply of potable water
2 COMMON MEANINGS OF HEALTH FOR
EVERYDAY USE
Stages of Illness
THE DIMENSIONS OF HEALTH 1. SYMPTOM EXPERIENCE
 PHYSICAL HEALTH Examples:
 MENTAL HEALTH Transition stage
 EMOTIONAL HEALTH -The person believes something is
 SOCIAL /ENVIRONMENTAL HEALTH wrong
 SPIRITUAL HEALTH -Experience some symptoms
3 aspects:
HOLISTIC HEALTH  Physical – fever, muscle aches, malaise,
is an approach that identifies components of headache
health that function interdependently to  Cognitive – perception of “having Flu”
influence an individual’s health  Emotional (worry on consequences of
illness)
WELLNESS
Wellness is well-being. It involves engaging in 2. ASSUMPTION OF SICK ROLE
attitude and behavior that enhance quality of Examples:
life and maximize personal potential well-being -Acceptance of the illness
is a subjective perceptive of balance, harmony -Seeks advice, support for
and vitality decision to give up some
activities
Wellness is a choice
3. MEDICAL CARE
Wellness is a way of life Examples:
-Seeks advice of health
Wellness is the integration of body, mind and professionals for the following
spirit reasons
-Validation of real illness
Wellness is the loving acceptance of one’s self -Explanation of symptoms
-Reassurance or prediction of
Wellness can also be described as "the constant, outcome
conscious pursuit of living life to its fullest
potential. 4. DEPENDENT PATIENT ROLE
Examples:
Travi’s Wellness Model -The person becomes a client
dependent on the health
professional for help
-Accepts/rejects health
 professional’s suggestions hereditary
-Becomes more passive and factors, or
accepting prenatal
-May regress to an earlier infection;
behavioral stage present at birth

5. RECOVERY/REHABILITATION Metabolic due to diabetes

Example: disturbance or mellitus
-Gives up the sick role and abnormality in hyperthyroidis
returns to former roles and the intricate m
functions processes of
metabolism
DISEASE Deficiency results from osteomalacia,
-an alteration in body functions resulting in inadequate intake which is
reduction of capacities or a shortening of the or absorption of vitamin D
normal life span essential dietary deficiency in
factors adults
Common Causes of Disease Traumatic due to injury fractures
Allergic due to abnormal asthma, skin
1. Biological agents microorganisms response of the allergy
2. Inherited Genetic Achondroplasia body to chemical
Diseases or protein
3. Developmental imperforate anus substances or to
defects Cleft palate physical stimuli
4. Physical agents hot and cold Neoplastic due to abnormal
substances, or uncontrolled
radiation, growth of cancer
ultraviolet rays cells
5. Chemical agents lead, emissions Idiopathic cause in cancer
from smoke- unknown; self-
belching cars originated; of
6. Tissue response to fever, spontaneous
irritation inflammation origin
7. Metabolic process inadequate iodine Degenerati results from the osteoporosis,
causing goiter, ve degenerative osteoarthritis
inadequate insulin changes that
in diabetes occur tissue and
mellitus organs
8. Emotional/Physical anxiety, fear Iatrogenic results from the hypothyroidis
reaction to stress treatment of a m after
disease thyroid
surgery;
Risk Factors of a Disease alopecia (hair
o Genetic and Physiological Factors Loss) after
o Age chemotherapy
o Environmental
o Lifestyle
 According to Duration or Onset
Classification of Disease
 According to Etiologic Factors Acute illness usually has a appendicitis
Hereditary due to defect in diabetes short duration
the genes of one mellitus and is severe
or other parent hypertension Chronic illness usually longer hypertension
which transmitted than 6 months
to the offspring and can also
affect
Congenital due to a defect in cleft lip, cleft functioning in
the development, palate any dimension
 7. Endemic – present more or less continuously
period during or recurs in a community
a.Remission which the Examples: malaria in Palawan, goiter in
disease is Mountain Province
controlled and
symptoms are 8. Pandemic – an epidemic disease which is
not obvious extremely widespread involving an entire
country or continent
b.Exacerbation The disease
becomes more 9. Sporadic – a disease in which only occasional
active again at cases occur
a future time, Example: Dengue during rainy season,
with leptospirosis during floods
recurrence of
pronounced Health Promotion Model
symptoms  INDIVIDUAL PERCEPTIONS
 MODIFYING FACTORS
 PARTICIPATION IN HEALTH
Sub –acute symptoms are sub-acute
pronounced bacterial Individual Perception
but more endocarditis -Perceived susceptibility to an illness
prolonged than Example: Family history to diabetes mellitus
in acute increases risk to develop the disease
disease
-Perceived seriousness of an illness
Example: diabetes mellitus is a lifelong disease
Others. Diseases may also described as:
-Perceived threat of an illness
1. Organic –any health condition in which there Example: Diabetes mellitus causes damage to
is an observable and measurable disease the brain, heart, eyes, kidneys, blood
process, e.g. inflammation or tissue damage vessels

2. Functional – no anatomical changes are Modifying Factors

observed to account for the symptoms present, -Demographic variables
may result from abnormal responses to stimuli Examples: Age, Sex, Race

Examples: irritable bowel syndrome -Structural variables

Example: knowledge about the disease
3. Occupational – results from factors
associated with the occupation engaged in by -Socio-psychologic variables
the patient Examples: social pressure or influence from
peers
Examples: cancer among chemical factory
workers -Cues action
Examples: internal: fatigue, uncomfortable
4. Familial – occurs in several individuals of the symptoms; external: mass media, advice
same family from others
Examples: hypertensive, cancer
Leavell and Clark’s Agent Host-
5. Venereal – usually acquired through sexual Environment Model
relation 1. AGENT – any factor or stressor that can lead
to illness or disease
Examples: AIDS, gonorrhea
2. HOST – persons who may or may not be
6. Epidemic – attacks a large number of affected by a disease
individuals in a community at the same time
3. ENVIRONMENT – any factor external to the
Examples: SARS host that may or may not predispose the
person to a certain disease
HEALTH STYLE
-the sum of personal health decisions that affect Activities to Promote Health and Prevent
the individual and the community both very Illness
personal and very interpersonal -Have a regular physical examination (yearly)
-Women: Regular PAP test, Monthly BSE (breast
-It is described as being influenced by: self-examination)
-The information you have about your health -Men: Regular testicular self examination
-Your values -Annual dental examination
-Your social support -Regular eye examination
-Your health-related skills -Exercise regularly (3x/wk for 30 mins.)
-Your health-related resources -Do not smoke, avoid second hand smoke
-The momentum developed by your health- -Avoid alcohol, “recreational drugs”
related decisions -Reduce fat and increase fiber in diet
-Sleep regularly
Indicators of Health Status -Maintain ideal body weight
 PERSONAL HEALTH STATUS
Satisfaction with life HEALTH BACKGROUND
Zest for life -Sickness has been one of man’s greatest
Functional level of physical fitness adversaries
Minimum of illness -To identify or diagnose a specific disease or
injury
 COMMUNITY HEALTH STATUS Physicians, pharmacists, and other health care
professionals utilize clues
 MORBIDITY refers to the rate of illness in a
group. MORTALITY refers to the rate of MEDICINE
death in a group -Latin word “medicus”
-It is a healing art
 LIFE EXPECTANCY refers to the number of -Aims to help people become more active and
years a person is expected to live live longer and happier lives with less suffering
and disability
FACTORS that affect HEALTH Behavior and -Constant search
Status -New drugs
 Race -Effective treatments
 Sex -More advanced technology
 Income -Health care professionals can prevent, control
-Caucasian American have longer life or cure hundreds of diseases
expectancy than African American
-Women live longer than men -Has become a part of the health care industry
middle, high-income than in low-income groups -One of the largest industries in the world
-One of the leading employers in most
Predisposing, Reinforcing, and Enabling communities
Factors
-At the turn of the 20th century (1900)
PREDISPOSING FACTORS Men and women were frail by age 40
Life experience Life expectancy was 47.3 years
Knowledge Effective treatment for diseases were so scarce
Cultural and ethnic heritage
Beliefs and values -By the end of the 20th century
Medical advances
ENABLING FACTORS Life expectancy increased to 76 years
Abilities
Mental and Emotional capabilities -Today
Resources People in their 80s and 90s are independent and
Facilities physically active
Medical expansion has been expensive
REINFORCING FACTORS
Support
Encouragement and discouragement from
people in your life
HISTORY OF HEALTH CARE
Prehistoric medical practice
Study of ancient pictographs that show medical
procedures and surgical tools uncovered from
anthropological sites of ancient societies
Serious diseases were of primary interest to
early humans but they
were not able to treat them effectively
Diseases were attributed to the influence of
malevolent demons
Diseases were believed to project an alien spirit,
a stone, or a worm into the body of the
unsuspecting patient
Demons and Disability
It was once thought that demons or evil spirits
could cause disabilities such as mental illness
and physical deformities.
Diseases were warded off by
incantations,dancing, magic charms and
talismans, and various
other measures
Make the body uninhabitable to the demon by
beating, torturing and starving the patient
Trepanning
-Alien spirits are expelled by potions that caused
violent vomiting, or could
be driven out through a hole cut in the skull
-Remedy for insanity, epilepsy and headache
Trepanated skull, Iron age. The perimeter of the
hole in the skull is rounded off by ingrowth of
new bony tissue, indicating that the patient
survived the operation.
The Spinning Treatment was one of many
treatments that attempted to rid the body of
mental illness through physical means
The Spread Eagle Cure was used to treat
disorderly patients. Cold water was poured from
a height over the persons face until the patient
is "calm"
Mild electric shock was used to stimulate the
muscles and the mind in this 19th century cure
for mental illness known as Faradization.
Surgical procedures practiced in ancient
societies
Cleaning and treating wounds by cautery
(burning or searing tissue), poultices, and
sutures
Resetting dislocations and fractures, and using
splints to support or immobilize broken bones
Additional therapy included laxatives and
enemas to treat constipation and other
gastrointestinal diseases
Discovery of the narcotic and stimulating
properties of certain plant extracts
Many are still of use today
 Digoxin, a heart stimulant extracted
from foxglove (Digitalis purpurea)
 Opium poppy (Papaver somniferum) is
the species of plant from which opium
and poppy seeds are extracted. Opium
is the source of many opiates, including
morphine (and its derivative heroin),
thebaine, codeine, papaverine, and
noscapine.
Systems of medicine, based on magic, folk
remedies, and elementary surgery, existed
before
the coming of the more advanced Greek
medicine about the 6th century B.C.
HEALTH CARE PROFESSIONALS
11.6 million people work in health care in other
countries
778,000 physicians, 2.1 M nurses and
160,000 dentists
Work in health care services, involved in the
diagnosis and treatment of patients
Research, teaching or administration of medical
facilities
PHARMACIST
Has a unique body of knowledge and skills to
contribute in our health care system
Dispenses the appropriate drug product and has
the knowledge to assure safe and rational
use of drugs
EARLY FUNCTIONS OF PHARMACISTS
-Assisting in the selection of appropriate drug
therapy
-Preparing, compounding and manufacturing
drugs for individualized patients
-Dispensing and packaging the prescribed drug
products including proper labeling
-Advising and educating patients on proper use
of drugs
-Monitoring the outcome and responses of
patients to the effect of drugs, both beneficial
and adverse
-Serving as a community resource person on
drug and health information
THE TEN STAR PHARMACIST
Pharmaceutical Care Giver
Researcher
Manager
Communicator
Leader
Life-long learner
Decision-maker Welfare of humanity and the relief of human
Teacher suffering is the primary concern
Entrepreneur Must learn to view medication’s use from the
Agent of Positive Change patient’s perspective

CONCERNS AMONG HEALTH CARE AN OATH

PROVIDERS “ I will use knowledge and skills to the best of
Potential abuse, misuse and inappropriate my ability in serving the public and other health
Increase in health care cost professionals”
Patient suffering
HEALTH
A goal to strive for. It is not obtainable. No one
THE PATIENT-ORIENTED PROFESSIONAL ever achieves a “state complete mental,
Able to apply and provide drug knowledge to physical and social well being”
improve drug use in the health care system
CURE
PRIMARY AIM Latin word “cura” CARE
To attain success in the goals for therapy, CARE
pharmacist must approach the patient– Providing for the welfare of another
counseling encounter as a Attentive conscientiousness of devotion
HELPER and an EDUCATOR Conveys a compassionate state of being and not
merely an attitude
THE TRADITIONAL PHARMACIST Involves a profound respect for the “otherness”
Involved in the preparation and dispensing of of the other
medications
At the direction of the physician CHARACTERISTICS OF A CARING
Strongly allied with the medical profession BEHAVIOR: VITAL COMPONENTS OF A
View that the health professional should be in THERAPEUTIC RELATIONSHIP
control of the patient
Mutual respect
THE MODEL Honesty/Authenticity
Shift in the model of pharmacy Open communication
From focus on the medication to a focus on the Cooperation
patient Collaboration between patient and practitioner
Need for a shift in the pharmacist’s approach Empathy
From the health professional–centered Putting the patient first
MEDICAL MODEL to the patient–centered Offering reassurance
HELPING MODEL Confidence
Paying attention to the patient’s physical and
MEDICAL MODEL emotional comfort
Patient is passive Offering advocacy
Trust is based on expertise and the authority of
pharmacist Being willing to be held accountable for all
Pharmacist identifies problem and determine decisions made and recommendations given
solutions
Patient is dependent on pharmacist Competence
Parent–child relationship Trust
Exercising patience and understanding
HELPING MODEL Seeing the patient as a person
Patient is actively involved Promotion of patient independence
Trust is based on personal relationship Sensitivity
developed over time Supporting the patient
Pharmacists assist patients in exposing problem Assuming responsibility for intervention
and possible solution
Patient develops self-confidence to manage HEALTH CARE NEEDS OF A PATIENT
problems Medical Care I care
Equal relationship Mental Health Care Geriatric Care
Dental Care Pharmaceutical Care
PQL (Patient Quality of Life) Nursing Care Surgical Care
Chiro-practice Care Nutritional Care  Don’t assume patients don’t care or are
Pediatric Care Eye Care stupid
Maternal Care  Don’t assume patients will comply if they
understand
INTERACTIONS  Don’t assume others will monitor of follow–
With patients and other health care providers up
COUNSEL  Don’t assume patients will voluntarily seek
CONSULT help or information if there are problems
EDUCATION
WHAT A PHARMACIST CAN DO?
4 R’s OF THE PHILOSOPHY OF PRACTICE Patients on medications experience a lot of
Rules Relationship “drug misadventures”–
Roles Responsibilities adverse effects, drug interactions, errors in the
use of medication and
PHARMACEUTICAL CARE non–compliance
-A responsible provision of therapy for the MINIMIZE WASTE and MAXIMIZE
purpose of achieving definite BENEFITS of medical treatments
outcomes that improve the patients quality of
life Hepler and Strand OLD PARADIGM
-Applying knowledge to promote well- being of Emphasis on acute patient care
others Emphasis on treating illness
-Requires responsiveness, sensitivity and Responsible for individual patients
commitment to others All providers are essentially similar
-Generalist practice that emphasizes health, Success achieved by increasing market share of
prevention and care in-patient admissions
-A form of primary health care Goal is to fill beds
Hospitals, physicians, and health plans are
THE FOCUS separate
-Patient–centeredness
-Addressing both acute and chronic conditions NEW PARADIGM
-Emphasizing prevention Emphasis on the continuum of care
-Implementing documentation systems that Emphasis on maintaining and promoting
continuously record patient need wellness
and care provided Accountable for the health of define populations
-Being accessible to front–line first contact Differentiation based on ability to add value
-Ensuring integration of care Success achieved by increasing the number of
-Being accountable covered lives and keeping people well
-Placing emphasis on ambulatory patient Goal is to provide care at the most appropriate
-Including education/health promotional level
intervention Integrated health delivery system

5 FACTORS TO BE CONSIDERED IN THE ROLE OF THE NEW PHARMACIST

PHARMACEUTICAL CARE PRACTICE Has evolved from being product–oriented to a
A general understanding of how people feel patient–oriented professional
about being ill, the seriousness of the Extremely healthy for both patient and
disease(patient’s susceptibility to other factors) pharmacist
DENIAL–“Not me!” Dispensers of therapy and drug effect
ANGER–“Why me?” interpretations as well as drugs
DEPRESSION–“Yes, me!”
BARGAINING–“Yes me, BUT….” In the future, pharmacy services must be
ACCEPTANCE–“I’m ready” evaluated on patient outcome rather than the
number of prescriptions dispensed
VITAL POINTS
 Don’t assume patients had information It must evolved towards interpretation and
from the doctor patient consultation, related to the use of
 Don’t assume patients understand all medication technologies
information given
 Don’t assume patients have resources to
comply