Healthisastateofcompletephysical,mental

andsocialwell-beingandnotmerelythe
absenceofdiseaseorinfirmity.(WHO)
Healthistheabilitytomaintaininternalmilieu,
homeostasisordynamicequilibrium.

Healthisbeingwellandusingonespowertothe
fullestextent.Healthismaintainedthrough
preventionofdiseaseviaenvironmentalhealth
factors.(Nightingale)Healthisviewedinterms
oftheindividualsabilitytoperform14
componentsofnursingcareunaided.
(Henderson)

Healthisastateandaprocessofbeingand
becominganintegratedandwholeperson.
(Roy)Healthisastatethatischaracterized
bysoundnessorwholenessofdeveloped
humanstructuresandofbodilyandmental
functioning.(Orem)Healthisadynamicstate
inthelifecycle.(King)

Healthisanelusive,dynamicstateinfluenced
bybiologic,psychologic,andsocialfactors.
Healthisreflectedbytheorganization,
interaction,interdependenceandintegration
ofthesubsystemsofthebehavioral
systems.(Johnson)Illnessistheresultof
failuretomaintaintheinternalenvironment.
Wellnesssymbolizespositivehealth.Itisa
valuetermdefinedbythecultureorindividual.

DIMENSIONS OF HEALTH
PHYSICAL SPIRITUAL
MENTAL EMOTIONAL
SOCIAL VOCATIONAL

Body size, shape, sensory acuity
&responsiveness, fitness, and
susceptibility to disease and
disorders
Ability to perform activities of daily
living (ADLs)
The techniques of physical health
assessment are general and
specific observations, questioning,
physical and chemical
examinations and investigations,
nutrition and dietary assessment.
There are 3 major characteristics:
He is free from internal conflicts and
tensions. He knows himself and
neither underestimates nor
overestimates, accepts his
shortcomings. He is self confident
and has self identity and self
esteem. He does not have undue
spells of depression or elated
mood.
He is able to feel a part of others and
has harmonious relation with others
He is well adjusted and able to meet
the demands of life and able to
solve the problems intelligently
SOCIAL HEALTH
Manisasocialwellbeing.

Socialhealthisrootedin-
--Positivematerial
environment(focusingon
financialandresidential
matters)and
--Positivehuman
environmentwhichis
concernedwiththesocial
networkoftheindividual.
SPIRITUAL HEALTH
Belief in supreme being

Feeling of oneness with
others and nature

Guiding sense of
meaning or value

Purpose in life

EMOTIONAL HEALTH
Abilitytoexpressemotions
appropriately,controlling
emotions
Selfesteemandself
confidence
Abilitytotrust,love,etc.

Mentalhealthcanbeseen
asknowingorcognition
whileemotionalhealth
relatestofeeling.
VOCATIONAL

The vocational dimension is part of human

existence.


When work is fully adapted to human
goals, capacities and limitations, work
often plays a role in promoting both
physical and mental health.


Physical work is usually associated with
an improvement in physical capacity,
while goal achievement and self
realization in work are a source of
satisfaction and enhanced self esteem
IntellectualDimension-encompassescognitive
abilities,educationalbackgroundandpast
experiences.Theseinfluenceresponsesto
teachingabouthealthandreactionstonursing
careduringillness.Theyalsoplayamajorrole
inhealthbehaviors.
EnvironmentalDimensionhousing,sanitation,
climateandpollutionofair,foodandwaterare
elementsintheenvironmentaldimension.

Illnessisahighlypersonalstateinwhichthe
personsphysical,emotional,intellectual,social,
developmentalorspiritualfunctioningisthought
tobediminished.Illnessishighlysubjective
anditisnotsynonymouswithdiseaseandmay
ormaynotberelatedtodisease.

DiseasecanbesimplyexplainedAs
dis=No,ease=comfortable=dis-comfortable
orillhealthDeviationfromnormalfunctionA
disturbanceinequilibriumbetweenmanandhis
totalenvironment.Diseaseisadisorderor
malfunctionofthemindorbody,whichleadsto
adeparturefromgoodhealth.Canbea
disorderofaspecifictissueororganduetoa
singlecause.
Webster:Aconditioninwhichbodyhealthis
impaired,adeparturefromstateofhealth,an
alterationofhumanbodyinterruptingthe
performanceofvitalfunctions
Oxford:Aconditionofthebodyorsomepartor
organofthebodyinwhichitsfunctionsare
disruptedorderanged

EcologicalDef.:amaladjustmentofthehuman
organismtotheenvironment
Sociological:diseaseisasocialphenomena,
occurringinallsocietiesdefinedandfoughtin
termsofparticularculturalforcesprevalentin
thesociety
SUPERNATURALTHEORYOFDISEASE
GERMTHEORY-LouisPasteur,RobertKoch
EPIDEMIOLOGICALTRIAD
MULTIFACTORIALTHEORY
Webofdiseasecausation,
Wheelofcausation

SUPERNATURALTHEORYOF
DISEASE:
Intheearlypast,thediseasewasthought
mainlyduetoeitherthecurseofGodordueto
theevilforceofthedemons.Accordingly,
peopleusedtopleasetheGodsbyprayersand
offeringsorusedtoresorttowitchcrafttotame
thedevils.
Germtheorybecamepopularinthe19
th
andearly
partof20
th
century.Thistheoryattributes
microorganismsareearlycauseofdisease.
Accordingtothistheorythereissinglespecific
microorganism(Causativeagentstoevery
disease.Thisreferstoonetoonerelationship
betweencausativeagentanddiseasesoitis
calledassinglecausetheory.
E.g.CholeraduetoVibriocholere

Causativeagent Man Disease

Cause Effect

Thistheoryislimitedtoinfectiousdiseasesonly.
Thistheorywasfurthersupportedby
identificationofotherspecificagentsas
causativeagentsforcertainhealthproblems.
e.g.lackofVit.Cwasfoundtocausescurvy.

Thegermtheoryorsinglecausetheoryhasmany
limitations
e.g.T.B.
AllthosewhowereexposedtotheT.B.didnot
sufferfromtuberculosis.Onlythosewhowere
undernourished,liveindarkanddirtyplaces
andwhodidnothaveimmunityagainst
Tuberculosisgotthedisease.

Thismeansitwasnotonlythecausativeagent
thatwasresponsibleforcausingdiseasebut
therewereotherfactorsrelatedtoagent,host
andenvironmentwhichcontributedtothe
occurrenceofdiseasesthisleadstotheoryof
epidemiologicaltriadinepidemiologicalmodel.
-Agent:Itisconsideredtobeprimaryfactor
E.g.bacteria,amoeba,viruswithoutwhich
diseasecantoccur
-Host:Humanbeingswhocarriesintocontact
withtheagents.Thehostrelatedfactorswhich
playimportantrolei.e.genetic,age,sex,race,
immunity,healthbehavioretc.
-Environment:Itincludesexternaltohostand
agentbutmayinfluenceinteractionbetween
them.

EpidemiologicalTriadmodelisapplicableto
infectiousdiseaseonly.Ithelpstounderstand
differentfactorsrelatedtocommunicable
diseasebutitisnotapplicabletononinfectious
andchronicdiseaseslikeheartdisease,arthritis
Itisbecausethesediseasesarenotlinkedwith
specificcausationagentandcantbeprevented
andcontrolbyisolation,immunization
techniquesandimprovementofsanitationlike
infectiousdisease.

Thesediseasescausedbymultiple
factorsfore.g.coronaryheart
diseaseisassociatedwithlifestyle
activitieslike
smoking
ingestionoffood(cholesterol)
lackofexercise
Increasedmentalandemotionalstress.
Environmentalpollution
TheWebofcausationDevelopedtode-
emphasizeagentChainofcausationMultiple
factorspromoteorinhibit
Emphasizesmultipleinteractionsbetweenhost
andenvironmentIllustratestheinter-
connectednessofpossiblecauses
SuitedforchronicdiseasesUsefulindeveloping
possibleinterventions

Thetermnaturalhistoryofdiseaseisakey
conceptinepidemiologyitssignifiestheway
inwhichadiseaseevolvesovertimefrom
earlieststageofitspre-pathogenesisphaseto
itsterminationasrecovery,disabilityordeath,
inabsenceoftreatmentorprevention.Each
diseasehasitsownuniquenaturalhistory
whichisnotnecessarilythesameinall
individuals.
Accordingtothisconceptdiseasemaybe
comparedwithiceberg-thefloatingtip
oftheicebergrepresentstheclinical
cases[s/s]
Thevastsubmergedportionoficeberg
representsthehiddenmassofdisease
thatislatent.inapparent,pre-symptomic
andundiagnosedcases