HEALTH-ILLNESS

CONTINUUM
NSC 311
Bulus Inusa
 INTRODUCTION
•Health, wellness, and illness have many definitions and
interpretations.
•Any definition of health must consider the dimension of the
individual, including physical, intellectual, emotional,
socio-cultural, spiritual and environmental aspects.
 CONCEPTS OF HEALTH
•Traditionally health was defined in terms of the presence or absence
of disease.
•Florence Nightingale (1860/1969) defined health as a state of being
well and using every power the individual possesses to the fullest
extent.
•The World Health Organization (WHO) (1948) takes a more
holistic view of health. Its constitution defines health as “a state of
complete physical, mental, and social well-being, and not merely he
absence of disease or infirmity.”
 CONCEPT OF ILLNESS
•Illness is an abnormal process in which any aspect of a
person’s functioning is altered as compared to a previous
level.
• According to Kozier, “Illness is a condition characterized by a
deviation from a normal health state which is manifested by
physical & psychological symptoms.”
 CONCEPT OF ILLNESS
CONT’D…
•Also “Illness is a state in which a person’s physical,
intellectual, emotional, social or spiritual functioning is
diminished or impaired in comparison with the previous
experience”.
•Potter & Perry. Illness like health is defined and described by
the individual within his or her personal context.
 CONCEPT OF WELLNESS
•The Global Wellness Institute defines wellness as the active
pursuit of activities, choices and lifestyles that lead to a state of
holistic health.
• Basic aspects of wellness include self-responsibility; an
ultimate goal; a dynamic, growing process; daily decision
making in the areas of nutrition, stress management, physical
fitness, preventive health care, and emotional health; and, most
importantly, the whole being of the individual.
 CONCEPT OF WELLNESS
CONT’D….
•Anspaugh, Hamrick, and Rosato (2011) propose seven
components of wellness. To realize optimal health and
wellness, people must deal with the factors within each
component:
•Environmental. The ability to promote health measures that
improve the standard of living and quality of life in the
community. This includes influences such as food, water, and
air.
 CONT’D…..
•Social. The ability to interact successfully with people and
within the environment of which each person is a part, to
develop and maintain intimacy with significant others, and to
develop respect and tolerance for those with different opinions
and beliefs.
•Emotional. The ability to manage stress and to express emotions
appropriately. Emotional wellness involves the ability to
recognize, accept, and express feelings and to accept one’s
limitations.
 CONT’D…..
•Physical. The ability to carry out daily tasks, achieve fitness (e.g.,
pulmonary, cardiovascular, gastrointestinal), maintain adequate
nutrition and proper body fat, avoid abusing drugs and alcohol or
using tobacco products, and generally practice positive lifestyle
habits.
•Spiritual. The belief in some force (nature, science, religion, or a
higher power) that serves to unite human beings and provide
meaning and purpose to life. It includes a person’s own morals,
values, and ethics.
 CONT’D…..
•Intellectual. The ability to learn and use information effectively
for personal, family, and career development. Intellectual
wellness involves striving for continued growth and learning to
deal with new challenges effectively.
•Occupational. The ability to achieve a balance between work
and leisure time. A person’s beliefs about education,
employment, and home influence personal satisfaction and
relationships with others.
 CONT’D….
•The seven components overlap to some extent, and factors in
one component often directly affect factors in another. For
example, a person who learns to control daily stress levels from
a physiological perspective is also helping to maintain the
emotional stamina needed to cope with a crisis.
•Wellness involves working on all aspects of the model.
 HEALTH–ILLNESS
CONTINUUM
•The health illness continuum is a graphic illustration of a
wellbeing, concept first proposed by John.W. Travis in 1972.
•It describes how wellbeing is more than simply an absence of
illness, but also incorporates the individuals mental and
emotional health.
•Travis believed that the standard approach to medicines,
which assumes a person is well when there are no signs or
symptoms of disease, was insufficient.
HEALTH–ILLNESS CONTINUUM
CONT’D…
•Health–illness continua (grids or graduated scales) can be used
to measure a person’s perceived level of wellness.
•Health and illness or disease can be viewed as the opposite
ends of a health continuum from a high level of health a
person’s condition can move through good health, normal
health, poor health, and extremely poor health, eventually to
death. People move back and forth within this continuum day
by day.
 HEALTH–ILLNESS
CONTINUUM CONT’D…
•There is no distinct boundary across which people move from
health to illness or from illness back to health.
•How people perceive themselves and how others see them in
terms of health an illness will also affect their placement on the
continuum.
 HEALTH–ILLNESS
CONTINUUM CONT’D…
ILLNESS–WELLNESS CONTINUUM

•The illness–wellness continuum developed by Anspaugh,

Hamrick, and Rosato (2011) ranges from optimal health to
premature death.
•The model illustrates arrows pointing in opposite directions and
joined at a neutral point.
•Movement to the right of the neutral point indicates increasing
levels of health and wellness for an individual.
ILLNESS–WELLNESS CONTINUUM

•This is achieved through health knowledge, disease

prevention, health promotion, and positive attitude. In
contrast, movement to the left of the neutral point indicates
progressively decreasing levels of health.
•Some people believe that a health continuum is overly
simplistic and linear when the real.
 ADAPTATION
•“Adaptation is the physical or behavioural characteristic of an
organism that helps an organism to survive better in the
surrounding environment.”
•Adaptation is adjustment to the change so that the person is again in
equilibrium and has the energy and ability to meet new demands.
•This is the process of coping with the stress, a compensatory
process that has physiologic and psychological components.
 CONT’D….
•Adaptation means the ability to function adequately in the
presence of a stressor. In other words, adaptation means
enduring stress.
 TYPES OF ADAPTATION
Structural Adaptations
•These involve the physical features of an organism that help
them to survive in the environment including the different types
of terrestrial habitat. The physical changes are related to the
changes in the physical environment. For eg., camouflage,
which is the protective colouration that helps an organism to
blend in its environment. This protects them from predators and
increases their chances of survival.
 TYPES OF ADAPTATION CONT’D..
Behavioural Adaptations
•This is the change that affects the behaviour of an organism.
This could be caused due to the changes in the surrounding
environment or due to the actions of other species. For e.g.: The
rabbit freezes if it feels that it has been seen by a predator.
Changes in reproductive strategy, feeding habits, migration,
hibernation, communication methods are a few other examples
of behavioural adaptations.
 TYPES OF ADAPTATION
CONT’D..
Physiological Adaptations
•Like structural adaptations, the physiological adaptations also
involve physical changes in the species. However, physiological
adaptations are not always seen in the organism’s appearance.
This type of adaptation can be either due to changes in the
environment or due to the behaviour of other species.
 THEORY OF ADAPTATION

•The theory of adaptation was proposed by Charles

Darwin which states that an organism that is able to
adapt to the changing environment will survive, the rest
will be eliminated. This is known as survival of the
fittest.
 THEORY OF ADAPTATION CONT’D..
•According to the adaptation theory, there are different
changes that take place when the habitat changes:
•Habitat Tracking: This is when a species finds another
similar environment to which it has inhabited before.
•Extinction: When the species is unable to find such an
environment, it dies or becomes extinct.
•Genetic Change: This occurs when organisms with slight
genetic changes are better adapted to changed habitat with
better access to resources and mating partners.
 HAN SELYE’S GENERAL ADAPTATION SYNDROME
(GAS)
According to Selye’s, the body’s generalized response to a stress occurs
in four (4) stages
1. Alarm Reaction Stage
•During the alarm stage the body’s protective mechanism are alerted for
“fight or flight” this response prepares the body to counteract the
stressor or move away from it. The two major systems in the body are
active in the body response to stressor, the nervous system and the
endocrine system. The combine reaction of these systems is referred to
as neuroendocrine mechanism. If these compensatory mechanisms are
sufficient to deal with the stressor, the body returns to its normal state.
 CONT’D…..
2. The Stage of Resistance
•In case where the stressor is prolonged or not dealt with, the body
continues to work at the stimulated level. This however requires
energy to maintain a high level of resistance thus the name resistance
stage. This stage can also be called adaptation stage because the
body concentrates its activities on the organs that are most involved
in the defense. Once the stressor has been dealt with, the body returns
to normal.
 CONT’D…..
3. The Stage of Exhaustion
•The body cannot stay in the fight or flight stage for a
very long time. When too much stress is experience or if
the stress last for a long period of time and the stressor is
not controlled or removed, it begins to affect the body in
a negative way. The body becomes exhausted, and more
susceptible to illness and accidents
 CONT’D…..
4. The Return to Normal Stage
•During this stage, the parasympathetic nervous system is
activated, and the body returns to normal. The heart rate,
pulse and respiration decrease. The gastrointestinal and
genitourinary tracts begin to function once again.
 IMPORTANCE OF ADAPTATION
•Adaptation is essential for the survival of living organisms.
Animals, which are unable to adapt to changing environmental
changes die. These adaptations are a result of genetic changes. The
animals that survive pass on the mutated genes to their offspring’s.
This is known as natural selection.
•DNA mutations help in the longer survival of animals in dangerous
environments and these traits of survival are passed onto future
generations.
•These adaptations make it possible for a variety of creatures to
thrive on planet earth.
 HOMEOSTASIS
Introduction
•Maintaining balance requires the body to continuously
monitors its internal conditions.
• From body temperature to blood pressure to levels of
certain nutrients, each physiological condition has a
particular set point.
•A set point is the physiological value around which the
normal range fluctuates.
 INTRODUCTION CONT’D..
•A normal range is the restricted set of values that is optimally
healthful and stable.
•For example, the set point for normal human body
temperature is approximately 37°C (98.6°F).
•Physiological parameters, such as body temperature and
blood pressure, tend to fluctuate within a normal range a few
degrees above and below that point.
 INTRODUCTION CONT’D..
•Control centers in the brain play roles in regulating
physiological parameters and keeping them within the normal
range.
•As the body works to maintain homeostasis, any significant
deviation from the normal range will be resisted and
homeostasis restored through a process called a feedback
loop.
 DEFINITION
•‘Homeostasis is described as the relative constancy of the
internal processes of the body, such as blood oxygen and
carbon dioxide levels, blood pressure, body temperature,
blood glucose, and fluid and electrolyte balance’.
•Homeostasis, then, is the tendency of the body to maintain a
state of balance or equilibrium while continually changing.
 FEEDBACK LOOP
•A feedback loop has three basic components.
•A sensor, also known as a receptor, is a component of a
feedback system that monitors a physiological value.
•It is responsible for detecting a change in the environment.
•This value is reported to the control center.
•The control center is the component in a feedback system that
compares the value to the normal range.
 FEEDBACK LOOP CONT’D..
•If the value deviates to the extreme from the set point, then the
control center activates an effector.
• An effector is the component in a feedback system that
causes a change to reverse the situation and return the value to
the normal range.
• Effectors are muscles and glands.
FEEDBACK LOOP CONT’D..
 TYPES OF FEEDBACK LOOPS: NEGATIVE AND
POSITIVE
•Negative feedback is a mechanism in which the effect of the
response to the stimulus is to shut off the original stimulus or
reduce its intensity.
•Negative feedback loops are the body’s most common
mechanisms used to maintain homeostasis.
•The maintenance of homeostasis by negative feedback goes on
throughout the body at all times, and an understanding of
negative feedback is thus fundamental to an understanding of
human physiology.
 NEGATIVE FEEDBACK CONT’D..
•For example, in the control of blood glucose, specific endocrine cells in
the pancreas detect excess glucose (the stimulus) in the bloodstream.
•These pancreatic beta cells respond to the increased level of blood
glucose by releasing the hormone insulin into the bloodstream.
•The insulin signals skeletal muscle fibers, fat cells (adipocytes), and
liver cells to take up the excess glucose, removing it from the
bloodstream.
 NEGATIVE FEEDBACK CONT’D..
•As glucose concentration in the bloodstream drops, the
decrease in concentration—the actual negative feedback—is
detected by pancreatic alpha cells, and insulin release stops.
•This prevents blood sugar levels from continuing to drop
below the normal range.
 POSITIVE FEEDBACK
•Positive feedback intensifies a change in the body’s
physiological condition rather than reversing it.
•A deviation from the normal range results in more change, and
the system moves farther away from the normal range.
•Positive feedback in the body is normal only when there is a
definite end point.
•Childbirth and the body’s response to blood loss are two
examples of positive feedback loops that are normal but are
activated only when needed.
 POSITIVE FEEDBACK
•Childbirth at full term is an example of a situation in which the
maintenance of the existing body state is not desired.
•Enormous changes in the mother’s body are required to expel
the baby at the end of pregnancy.
•And the events of childbirth, once begun, must progress rapidly
to a conclusion or the life of the mother and the baby are at
risk.
•The extreme muscular work of labor and delivery are the result
of a positive feedback system.
POSITIVE FEEDBACK
 FAILURE OF HOMEOSTASIS
•Homeostasis can fail at any stage of the process. A problem
with the sensor, the brain, or the communication pathway can
wreak havoc on the entire body's homeostasis.
•Sometimes, the sensors and the brain work fine, but the body
isn't capable of completing the response. Diabetes mellitus is
an example of this type of homeostatic failure.
 FAILURE OF HOMEOSTASIS CONT’D…
•Blood glucose levels are controlled by sensors in the blood
vessels.
•When the glucose levels rise, it signals the pancreas to produce
insulin. However, if a person has Type I diabetes, they aren't
able to produce insulin.
• If they have Type II diabetes, then the cells of the body don't
respond to the insulin.
•In both types, the body isn't capable of completing the task that
the brain is telling it to do, and it can't remove the excess
glucose from the blood.
 FAILURE OF HOMEOSTASIS CONT’D…

•Excess glucose in the blood is one example of a breakdown in

maintaining homeostasis.
• If one part of the body's highly choreographed dance is
disrupted, multiple other systems can be affected.
•This is why diabetes causes symptoms throughout the body
 FAILURE OF HOMEOSTASIS CONT’D…
•Muscle and fat cells don't get enough glucose, or fuel. This
can make people feel tired and even cause muscle and fat
tissues to waste away.
•High blood sugar causes symptoms like increased urination,
thirst, and even dehydration. Over time, it can lead to more
serious complications.
 STRESS(INTRODUCTION)
•Stress is a universal phenomenon. All people experience it.
•Stress can result from both positive and negative experiences.
•Because of the overabundance of stress in our modern lives,
usually we think of a stress as a negative experience but from
a biological point of view stress can be a negative or positive
experience.
 INTRODUCTION CONT’D…
•Stress is not always bad in small doses, it can help an individual to
perform under pressure and motivate the best, but when it is constantly
running in emergency mode, mind and body pays the price.
•The concept of stress is important because it provides a way of
understanding the person as a being who responds in totality (mind,
body, and spirit) to a variety of changes that take place in daily life.
 CONCEPT OF STRESS

•Stress is a condition in which an individual experience change

in the normal balanced state.
•Selye define stress as the non-specific response of the body to
any demand made upon it to adapt, whether that demand
produce pain or pleasure.
 CONCEPT OF STRESS CONT’D..
•Stress is a state produced by a change in the environment that
is perceived as challenging, threatening, or damaging to a
person’s dynamic balance or equilibrium.
• A stressor is any event or stimulus that causes an individual
to experience stress.
•When a person faces stressors, responses are referred to as
coping strategies, coping responses, or coping mechanisms.
 SOURCES OF STRESS

•Internal stressors originate within a person, for example,

infection or feelings of depression.
•External stressors originate outside the individual, for
example, a move to another city, a death in the family, or
pressure from peers.
•Developmental stressors occur at predictable times throughout
an individual’s life.
 SOURCES OF STRESS CONT’D..
•Situational stressors are unpredictable and may occur at any time
during life. Situational stress may be positive or negative. Examples of
situational stress include:
• Death of a family member
• Marriage or divorce
• Birth of a child
• New job
• Illness.
 SOURCES OF STRESS CONT’D..
Common external causes of stress include:
•Major life changes
•Work or school
•Relationship difficulties
•Financial problems
•Being too busy
•Children and family
 SOURCES OF STRESS CONT’D..
Common internal causes of stress include:
•Pessimism
•Inability to accept uncertainty
•Rigid thinking, lack of flexibility
•Negative self-talk
•Unrealistic expectations / perfectionism
•All-or-nothing attitude
 SOURCES OF STRESS CONT’D..
•The degree to which any of these events has positive or
negative effects depends to some extent on an individual’s
developmental stage.
• For example, the death of a parent may be more stressful for
a 12-year-old than for a 40-year-old.
 SIGNS AND SYMPTOMS OF STRESS OVERLOAD
Cognitive symptoms:
•Memory problems
•Inability to concentrate
•Poor judgment
•Seeing only the negative
•Anxious or racing thoughts
•Constant worrying
 SIGNS AND SYMPTOMS OF STRESS OVERLOAD
CONT’D..
Emotional symptoms:
•Depression or general unhappiness
•Anxiety and agitation
•Moodiness, irritability, or anger
•Feeling overwhelmed
•Loneliness and isolation
•Other mental or emotional health problems
 SIGNS AND SYMPTOMS OF STRESS OVERLOAD
CONT’D
Physical symptoms:
•Aches and pains
•Diarrhea or constipation
•Nausea, dizziness
•Chest pain, rapid heart rate
•Loss of sex drive
•Frequent colds or flu
 SIGNS AND SYMPTOMS OF STRESS OVERLOAD
CONT’D
Behavioral symptoms:
•Eating more or less
•Sleeping too much or too little
•Withdrawing from others
•Procrastinating or neglecting responsibilities
•Using alcohol, cigarettes, or drugs to relax
•Nervous habits (e.g. nail biting, pacing)
 FACTORS THAT INFLUENCE STRESS
TOLERANCE
Support networks
1.

•A strong network of supportive friends and family members

is an enormous buffer against stress.
• When an individual has people he/ she can count on, life’s
pressures don’t seem as overwhelming.
•On the flip side, the lonelier and more isolated a person is,
the greater the risk of succumbing to stress.
 FACTORS THAT INFLUENCE STRESS TOLERANCE
CONT’D…
2. Sense of control.
•Having confidence in oneself and ability to influence
events and persevere through challenges, it’s easier to take
stress in stride.
• On the other hand, when one believes that he / she have
little control over life—that mean the individual is at the
mercy of his or her environment and
circumstances—stress is more likely to knock the
individual off course.
 FACTORS THAT INFLUENCE STRESS TOLERANCE
CONT’D…
3. Attitude and outlook.
•The way a person looks at life and its inevitable challenges
makes a huge difference in his or her ability to handle
stress.
•A hopeful and optimistic, persons will be less vulnerable.
•Stress-hardy people tend to embrace challenges, have a
stronger sense of humor, believe in a higher purpose, and
accept change as an inevitable part of life.
FACTORS THAT INFLUENCE STRESS TOLERANCE
CONT’D…
4. Ability to deal with your emotions.
•The ability to be calm and soothe oneself when feeling sad,
angry, or troubled, the individual is more likely to become
stressed and agitated.
•Having the ability to identify and deal appropriately with
emotions can increase tolerance to stress and help him or her
to bounce back from adversity.
FACTORS THAT INFLUENCE STRESS TOLERANCE
CONT’D…
5. Knowledge and preparation.
•The more he/she know about a stressful situation, including
how long it will last and what to expect, the easier it is to cope.
•For example, if an individual go into surgery with a realistic
picture of what to expect post-op, a painful recovery will be
less stressful than if the persons were expecting to bounce back
immediately.
 THE EFFECT OF STRESS ON HEALTH

•The human body is designed to experience stress and react to

it.
•Stress can be positive, keeping us alert, motivated, and ready
to avoid danger.
•Stress becomes negative when a person faces continuous
challenges without relief or relaxation between stressors.
•As a result, the person becomes overworked, and
stress-related tension builds.
 THE EFFECT OF STRESS ON HEALTH
•The body's autonomic nervous system has a built-in stress
response that causes physiological changes to allow the body
to combat stressful situations.
• This stress response, also known as the "fight or flight
response", is activated in case of an emergency.
•However, this response can become chronically activated
during prolonged periods of stress.
• Prolonged activation of the stress response causes wear and
tear on the body both physical and emotional.
 THE EFFECT OF STRESS ON HEALTH
•Stress that continues without relief can lead to a condition
called distress – a negative stress reaction.
•Distress can disturb the body's internal balance or equilibrium,
leading to physical symptoms such as headaches, an upset
stomach, elevated blood pressure, chest pain, sexual
dysfunction, and problems sleeping.
• Emotional problems can also result from distress.
 THE EFFECT OF STRESS ON HEALTH
•These problems include depression, panic attacks, or other
forms of anxiety and worry.
• Research suggests that stress also can bring on or worsen
certain symptoms or diseases.
•Stress is linked to 6 of the leading causes of death:
•heart disease, cancer, lung ailments, accidents, cirrhosis of
the liver, and suicide.
 THE EFFECT OF STRESS ON HEALTH
•Stress also becomes harmful when people engage in the compulsive
use of substances or behaviors to try to relieve their stress.
•These substances or behaviors include food, alcohol, tobacco, drugs,
gambling, sex, shopping, and the Internet.
•Rather than relieving the stress and returning the body to a relaxed
state, these substances and compulsive behaviors tend to keep the
body in a stressed state and cause more problems. The distressed
person becomes trapped in a vicious circle.
CENTRAL NERVOUS AND ENDOCRINE SYSTEMS
•The central nervous system (CNS) is in charge for “fight or flight”
response.
•In the brain, the hypothalamus gets the ball rolling, instructing the
adrenal glands to release the stress hormones adrenaline and cortisol.
•These hormones rev up the heartbeat and send blood rushing to the
areas that need it most in an emergency, such as muscles, heart, and
other important organs.
• When the perceived fear is gone, the hypothalamus instructs all
systems to go back to normal.
 CENTRAL NERVOUS AND ENDOCRINE SYSTEMS
CONT’D..
•If the CNS fails to return to normal, or if the stressor doesn’t
go away, the response will continue.
• Chronic stress is also a factor in behaviors such as overeating
or not eating enough, alcohol or drug abuse, and social
withdrawal.
 RESPIRATORY AND CARDIOVASCULAR
SYSTEMS
•Stress hormones affect the respiratory and cardiovascular
systems.
•During the stress response, breathe faster in an effort to
quickly distribute oxygen-rich blood to the whole body.
•For individual with breathing problem like asthma or
emphysema, stress can make it even harder to breathe.
•Under stress, the heart also pumps faster.
 RESPIRATORY AND CARDIOVASCULAR
SYSTEMS CONT’D..
•Stress hormones cause blood vessels to constrict and divert
more oxygen to the muscles for more strength to act.
•But this also raises the blood pressure.
•As a result, frequent or chronic stress will make the heart
work too hard for too long.
•When the blood pressure rises, so the risks for having a stroke
or heart attack.
 DIGESTIVE SYSTEM
•Under stress, the liver produces extra blood sugar (glucose) to give a
boost of energy.
•An individual under chronic stress, the body may not be able to keep
up with this extra glucose surge.
•Chronic stress may increase the risk of developing type 2 diabetes.
•The rush of hormones, rapid breathing, and increased heart rate can
also upset the digestive system.
• more likely the individual to have heartburn or acid reflux to an
increase in stomach acid.
 DIGESTIVE SYSTEM CONT’D..
•Stress doesn’t cause ulcers (a bacterium called H. pylori often
does), but it can increase the risk of causing existing ulcers to
act up.
•Stress can also affect the way food moves through the body,
leading to diarrhea or constipation.
•The person might also experience nausea, vomiting, or a
stomachache.
 MUSCULAR SYSTEM
•The muscles are tense up to protect themselves from injury
when stressed up. They tend to release again once relax, but
if under constantly stress, the muscles may not get the chance
to relax.
•Tight muscles cause headaches, back and shoulder pain, and
body aches.
•Over time, this can set off an unhealthy cycle as individual
stop exercising and turn to pain medication for relief.
 SEXUALITY AND REPRODUCTIVE SYSTEM
•Stress is exhausting for both the body and mind. It’s not
unusual to lose the desire when under constant stress.
•While short-term stress may cause men to produce more of the
male hormone testosterone, this effect doesn’t last.
•If stress continues for a long time, a man’s testosterone levels
can begin to drop. This can interfere with sperm production
and cause erectile dysfunction or impotence.
 SEXUALITY AND REPRODUCTIVE SYSTEM
CONT’D

•Chronic stress may also increase risk of infection for male

reproductive organs like the prostate and testes.
•For women, stress can affect the menstrual cycle. It can lead
to irregular, heavier, or more painful periods.
•Chronic stress can also magnify the physical symptoms of
menopause.
 IMMUNE SYSTEM
•Stress stimulates the immune system, which can be a plus for
immediate situations.
•This stimulation can help avoid infections and heal wounds.
• But over time, stress hormones will weaken the immune system and
reduce the body’s response to foreign invaders.
• People under chronic stress are more susceptible to viral illnesses like
the flu and the common cold, as well as other infections.
•Stress can also increase the time it takes to recover from an illness or
injury.
 STRESS MANAGEMENT
•The growth of stress management into a multimillion
dollar-a-year business attests to its importance in our society.
•Stress management involves the use of coping strategies in
response to stressful situations.
•Coping strategies are adaptive when they protect the
individual from harm (or additional harm) strengthen the
individual’s ability to meet challenging situations.
 STRESS MANAGEMENT CONT’D..
•Adaptive response helps restore homeostasis to the body and impede
the development of disease of adaptation.
•Coping strategies are considered maladaptive when the conflict being
experienced goes unresolved or intensifies.
• Energy resources become depleted as the body struggles to
compensate for the chronic physiological and psychological arousal
being experienced.
 ADAPTIVE COPING STRATEGIES
Awareness
•The initial step in managing stress is awareness, to become
aware of the factors that create stress and the feelings
associated with a stressful response.
•Stress can be controlled only when one recognizes that it is
being experienced.
•As one becomes aware of stress he or she can omit or avoid,
or accept them.
 ADAPTIVE COPING STRATEGIES CONT’D..
Relaxation
•Individuals experience relaxation in different ways.
•Some individuals relax by engaging in large-motor
activities such as sports, jogging and physical exercises
still others use techniques such as breathing exercises
and progressive relaxation to relive stress.
 ADAPTIVE COPING STRATEGIES CONT’D..
Meditation
•Practiced for 20 minutes once or twice daily, meditation has
been shown to produce a lasting reduction in blood pressure
and other stress-related symptoms (Davis, Eshelman, &
McKay, 2000).
• Meditation involves assuming a comfortable position, closing
the eyes, casting off all other thoughts and concentrating on a
single word, sound or phrase that has positive meaning to the
individual.
 ADAPTIVE COPING STRATEGIES CONT’D..
Interpersonal Communication with a Caring others
•As previously mentioned, the strength of one’s available
support systems is an existing condition that significantly
influences the adaptiveness of coping with stress.
•Sometime just “talking the problem out” with an individual
who is empathetic is sufficient to interrupt exhalation of
the stress.
 ADAPTIVE COPING STRATEGIES CONT’D..
Problem Solving
•An extremely adaptive coping strategy is to view the
situation objectively (or to seek assistance from another
individual to accomplish this if the anxiety level is too
high to concentrate), after an objective assessment of the
situation.
 ADAPTIVE COPING STRATEGIES CONT’D..
Pets
•Recent psychological studies have begun to uncover evidence
that those who care for pets especially dogs and cats are better
able to cope with the stressor of life (Allen, Blascovich, &
Mendes, 2002).
•The physical act of stroking or an intuitive sense of being
cared for and at the same time gives the individual the calming
feeling of warmth affection, and interdependence with a
reliable trusting being.
 ADAPTIVE COPING STRATEGIES CONT’D..
Music
•It is true that music can “soothe the savage beast” creating and
listening to music stimulate motivation, enjoyment, and
relaxation.
•Music can reduce depression and bring about measurable
changes in mood and general activity.
 BEHAVIOUR IN HEALTH AND ILLNESS
Health Behaviour
•It is an action taken by a person to maintain, attain or regain
good health and prevent illness. It reflects a person’s health
belief.
•It is any activity undertaken by an individual regardless of
actual or perceived health status, for the purpose of
promoting, protecting or maintaining health, whether or not
such behaviour is objectively effective toward that end.
 BEHAVIOUR IN HEALTH AND ILLNESS
CONT’D..
•Health behaviour are expressed by individuals to
protect, maintain or promote their health status.
•Lifestyle is closely associated with health behaviour and
factors influencing life style are socio-economic,
educational and cultural
BEHAVIOUR IN HEALTH AND ILLNESS CONT’D..
Model of Health Behaviour
•Health Behaviour Model: A tool that scientists use to try and
predict health behaviour. It is developed by Hochbaum, 1958;
Rosenstock, 1960. One of the longest establish theoretical model
designed to explain health behaviour by understanding people’s
beliefs about health.
•It is based on the theory a person’s willingness to change their health
behaviour is primarily due to the following factors:
 MODEL OF HEALTH BEHAVIOUR
•Perceived severity: the probability that a person will change
his/her health Behaviour to avoid a consequence depends on
how serious he or she considers the consequence to be.
•Perceived benefits: its difficult to convince people to change
a behaviour if there isn’t something in it for them
 MODEL OF HEALTH BEHAVIOUR
•Perceived barriers: One of the major reasons people don’t
change their health behaviour is that they think that doing so
is going to be hard.
•Sometimes its is not just a matter of physical difficulty, but
social difficulty as well. Changing health behaviour can cost
effort, money and time.
 BEHAVIOUR IN ILLNESS
•Mechanic and Volkart defined illness behaviour as the way
in which illness are perceived, evaluated and acted upon by a
person who recognizes some pain, discomfort or other signs
of organic malfunctions i.e. Physical illness or something
pathological.
•Illness behaviour therefore means any behaviour taken by
somebody for the purpose of defining the state of his health
and subsequently seeking for remedies.
 STAGE OF ILLNESS BEHAVIOUR
1. Symptom Experiencing: Also called transition stage because the
person passes from state of wellness to that of illness.
•The person now experiences some symptoms and realized that
something is wrong.
•He may exhibit denial or flight to health behaviour or he may exhibit
acceptance behaviour i.e. agreed that he is getting ill.
•The rapidity of movement through this stage to the next one is
influence by how seriously the person perceives his illness.
 STAGE OF ILLNESS BEHAVIOUR CONT’D…
2. Assumption of the Sick Role: This follow acceptance that
he is ill and begins to talk about his problem with others such
as spouse, parents, friends etc.
•He may not be ready to seek professional help at this time.
•They make provisional diagnosis, is usually frightening and
may alter activities of daily living. The condition may
improve, or get better and may become worse.
 STAGE OF ILLNESS BEHAVIOUR CONT’D…
3. Medical care Contact: in this stage the individual leaves
self-care and seek for professional/medical care in order to
confirm or authoritatively validate the diagnosis and treatment.
• The client tends to demonstrate a variety of behavioural
changes such as fear wariness, regression, over reaction etc.
 STAGE OF ILLNESS BEHAVIOUR CONT’D…

4. Dependent Patient Role: Some client at this stage wrestles

between dependence and independence with relative ease.
• Although dependence is typical of this stage of illness,
caregivers are increasingly encouraging patients to participate
in his care rather than depending on caregiver.
 STAGE OF ILLNESS BEHAVIOUR CONT’D…
5. Recovery and rehabilitation: This stage could be sudden
or gradual in which there is restoration of functioning to
maximal self-sufficiency.
•Recovery is a period of convalescence while rehabilitation
include temporary exemption from duty (sick leave) exercise,
training in use of special devices e.g. crutches, job retraining
etc.
 TYPES OF BEHAVIOUR IN ILLNESS
•1. Compliance: This is a self-submission or obedience to
the overt and implied demands of the condition prescribed
by the physician and others i.e. following or abiding with the
instruction in relation to the treatment of the illness e.g.
compliance with drug and dietary regimen.
 FACTORS RESPONSIBLE FOR
NON-COMPLIANCE
•Belief
•Economic factor
•Breakage/gap in communication
•Conflicting instruction
 FACTORS THAT CAN INFLUENCE
NON-COMPLIANCE
•Personal characteristic: - which includes level of education,
physical and mental development, past experiences, cultural
background and biases to medical treatment.
•Nature of the client illness: i.e. either curable or incurable
illness, cultural belief about the disease, troublesome or
non-troublesome disease e.g. Asthma.
 FACTORS THAT CAN INFLUENCE
NON-COMPLIANCE

•Nature of the treatment: cost of the treatment, convenient or

inconvenient nature of treatment e.g. time, taste and route of
treatment.
• Familiar network of the patient: if there are familiar people
around to encourage client or if such familiar people are not
available. If he does things on his own without support or
encouragement from anybody.
 TYPES OF BEHAVIOUR IN ILLNESS CONT’D..
2. Resistance: This is a kind of behaviour in which there are various
changes in the body in response to and or as defense against illness.
•This is a behaviour that attempt to adapt to the illness in which the
body eliminate the sign and symptom or suppress them while body
defense mechanism are mobilized until when acquired adaptation is
lost again.
 TYPES OF BEHAVIOUR IN ILLNESS CONT’D..
•Resistance behaviour is a kind of attitude developed by an
individual as a routine way of coping with illness.
• It is a manifestation of repressing forces or conservation
forces seeking to maintain the statu-quo.
 TYPES OF BEHAVIOUR IN ILLNESS CONT’D..
3. Avoidance Behaviour: Behaviour or responses that result in
drawing away from the stimulus, withdrawal behaviour and defense
reactions such as denial are types of avoidance behaviour i.e.
negatively oriented or moving away from reality.
4. Default Health Seeking Behaviour: Is a kind of non-compliance
behaviour in which the patient does not follow the instruction for
his/her treatment, no adherence to drug regimen, default in dietary
regimen, smoking cigarette and non-compliance to the prescription
for his illness.
 TYPES OF BEHAVIOUR IN ILLNESS CONT’D..

5. Delay Behaviour: Activities carried out by oneself as

self-medication, communicating the feeling to significant
others etc. that tend to delay the attempt to seek for help are
referred to as delay behaviour.
 Thank you for your
attention