4.KOnsep Sehat Sakit

8/16/2019 4.KOnsep Sehat Sakit

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Wellness, Health

and Illness


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Concept of Health and Wellness

HealthDenition:Sehat merupakan suatu keadaan yang sempurna baik sik,

mental dan sosial, sehingga tidak hanya bebas dari penyakitatau kelemahan

Sehat bukan merupakan suatu kondisi, tetapi merupakanpenyesuaian. Bukan merupakan suatu keadaan, tapimerupakan proses. roses di sini adalah adaptasi indi!idu yangtidak hanya terhadap sik mereka, akan tetapi terhadaplingkungan sosialnya

dene health as the follo"ing: being free of symptoms of disease and pain as much as possible being able to be acti!e and able to do "hat they "ant or must do

being in good spirits most of the time


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Denisi Sehat Dalam #epera"atanDenisi Sehat ender $%&'()

Sehat merupakan per"u*udan indi!idu yang

diperoleh melalui kepuasan dalamberhubungan dengan orang lain $+ktualisasi).erilaku yang sesuai dengan tu*uan pera"atandiri yang kompeten. Sedangkan penyesuaian

diperlukan untuk mempertahankan stabilitasdan integritas struktural.


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Denisi Sehat aune $%&')

Sehat merupakan fungsi efektif dari sumber-sumber pera"atan diri $self care esouces)yang men*amin tindakan untuk pera"atan diri$ self care +ktions) secara adekual.

Self care esoureces ----mencakuppengetahuan, keterampilan dan sikap.

Self care +ktions ------ perilaku yang sesuaidengan tu*uan diperlukan untuk memperoleh,mempertahankan dan menigkatkan fungsi

psicososial da piritual


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Components of Wellness

1.physical, e.g.:ability to carry out daily tasks

achie!e tness

maintain nutrition and proper body fata!oid abusing drugs, alcohol, or using tobacco products

generally to practice positi!e life-style habits

2.social, e.g.:

ability to interact successfully "ith people and "ithin theen!ironment of "hich each person is a part

de!elop and maintain intimacy "ith signicant others

de!elop respect and tolerance for those "ith di0erentopinions and beliefs


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3. emotional, e.g.:ability to manage stress and e/press emotions appropriately

ability to recogni1e, accept, and e/press feelingsability to accept one2s limitations

4.intellectual, e.g.:ability to learn and use information e0ecti!ely for personal, family,

and career de!elopmentstri!ing for continued gro"th and learning to deal "ith ne"

challenges e0ecti!ely

5.spiritual, e.g.:belief in some force $nature, science, religion, or a 3higher po"er3)

that ser!es to unite human beings and pro!ide meaning and purposeto life

includes a person2s morals, !alues, and ethics


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6. occupationalability to achie!e a balance bet"een "ork and leisure time

beliefs about education, employment and home in4uence

personal satisfaction and relationships "ith others

7. enironmentalability to promote health measures that promote the

standard of li!ing and 5uality of life in the community

in4uences include: 6oodWaterair


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!odels o" healthand illness


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Smith2s modelsof health and illness

clinical modelnarro"est interpretation7 medically-oriented model health is seen as freedom from disease

illness is seen as the presence of disease

role performance modelability to perform "ork, that is fulll societal roles,

essential

to the model7 assumption of the model is that a person2smost important role is their "ork role health is seen as the ability to fulll societal roles illness is seen as the inability to fulll societal roles


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adapti!e modelability to adapt to the en!ironment and interact "ith

it to ma/imum ad!antage essential to the model health is seen as adaptation illness is seen as a failure of adaptation, or maladaptation

eudaemonistic model

most comprehensi!e, holistic, !ie" of health7 abilityto become self-actuali1ed essential to the model health is actuali1ation or reali1ation of one2s potential

illness is seen as the failure to actuali1e or reali1e one2spotential


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8ea!ell and Clark2s ecologic model $agent-host-en!ironment model)

en!ironment

Hostagent


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used primarily in predicting illness rather than promoting "ellness

model is composed of three dynamic, interacti!e elementsthe agent factor $biologic, chemical, physical, mechanical,

psychosocial) that must be present or absent for anillness to occur, e.g.:presence of the legionella bacillus

the host li!ing beings $e.g., human or animal) capable of being infected or a0ected by the

agent, e.g.:

8egionnaire at the 8egionnaire2s Conference at the Belle!ue-Stratford Hotel inhiladelphia

en!ironment e!erything e/ternal to the host that makes illness more or less likely, e.g.:presence of stagnant "ater in the air conditioning system at the Belle!ue-Stratford Hotel

in hiladelphi


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!ie" of health and illnesshealth is seen "hen all three elements are in

balance

illness is seen "hen one, t"o, or all threeelements are not in balance


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Health-illness continum


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Dunn2s High-8e!el Wellness 9rid

ery 6a!orable;n!ironment

eak Welness

ery


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composed of t"o a/is2s+ health a/es "hich ranges from peak "ellness

to death

+ en!ironmental a/es "hich ranges from !eryfa!orable to !ery unfa!orable


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the t"o a/is2s form four 5uadrantshigh-le!el "ellness in a fa!orable en!ironment e.g., a person "ho implements healthy lifestyle beha!iors and has the

biopsychosocialspiritual resources to supportthis life-style

emergent high-le!el "ellness in an unfa!orable en!ironment e.g., a "oman "ho has the kno"ledge to implement healthy life-style practices but

does not implement ade5uate self-care practices because of family responsibilities, *ob demands, or other factors

protected poor health in a fa!orable en!ironment e.g., an ill person "hose needs are met by the health care system and "ho hasaccess toappropriate medications, diet, and health care instruction

poor health in an unfa!orable en!ironment e.g., a young child "ho is star!ing in a drought ridden country


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osenstock=Becker2s Health-Belief >odel

based on moti!ational theory

composed of three components:

an indi!idual2s perceptions, e.g.: of percei!ed susceptibility of percei!ed seriousness percei!ed threat

modifying factors $factors that modify an indi!idual2s perceptions), e.g.: .demographic !ariables

e.g., age, gender, race, ethnicity, etc. sociopsychologic !ariablese.g., personality, social class, peer and reference group pressure, etc.

structural !ariablese.g., kno"ledge about the disease, prior contact "ith the disease, etc.

cues to actione.g., mass media campaigns, ad!ice from others, reminder postcard from a

physician or dentist, illness of family member or friend, ne"spaper or maga1inearticle


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ariables in4uencing health status, belief,

and practicesariables in4uencing health status, belief, and practices

?nternal ariablesBiologic genetic makeup

+ge de!elopmental le!el

race

gender

sychologic or ;motional

>ind-body interaction

Cogniti!e or ?ntellectual Cogniti!e abilities

;ducational background

ast e/periences


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Spiritual Spiritual and religious beliefs and !alues

;n!ironmentalHousing Sanitation Climate ollution of air, food, "ater

Sociocultural ;conomic le!els 8ifestyle 6amily Culture


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Health Care +dherence

+dherence;/tent of "hich an indi!idual2s beha!ior

coincides "ith medical or health ad!ice


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6actors in4uencing +dherence Client moti!ation to become "ell

Degree of lifestyle change necessary

ercei!ed se!erity of the health care problem

alue placed on reducing the threat of illness

Di@culty in understanding and performing specic beha!iors

Degree of incon!enience of the illness itself or of the regimens

Beliefs that the prescribed therapy or regimen "ill or "ill not help

Comple/ity, Side e0ects, and duration of the proposed therapy

Specic Cultural heritage that may make adherence di@cult

Degrees of satisfaction and 5uality and type of relationship "iththe health care pro!iders

A!erall cost of prescribed therapy


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ursing action on on +dherence

%. ;stablish "hy the client is not follo"ing theregimen

(. Demonstrate caring

. ;ncourage healthy beha!iors through positi!ereinforcements

.


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Concept of ?llness and Disease

Diseasepathologic change in the structure or function of the body or

mind

?llnessthe response a person has to a disease7 it is an abnormal

process in "hich the person2s le!el of functioning is changedcompared "ith a pre!ious le!el

in4uenced by the follo"ing: self-perceptions others2 perceptions the e0ects of changes in body structure and function the e0ects of those changes on roles and relationships cultural and spiritual !alues and beliefs


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;tiologyCausation of the disease


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Eypes of illness

acute illnesshas a rapid onset of symptoms that lasts for a limited and

relati!ely short period of time

e.g., typically less than si/ monthschronic illnesshas a gradual onset of symptoms that lasts for an

e/tended and relati!ely long period of time e.g., typically si/ months or longer

characteri1ed by periods of remission and e/acerbation remission symptoms disappear

e/acerbation symptoms reappear


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?llness Beha!iors

beha!ior of indi!iduals "hen they are ill

"ays indi!iduals describe, monitor, andinterpret their symptoms, take remedialactions and use the health care system


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arsons four aspect s of the sick role%. Clients are not responsible for their

conditions

(. Clients are e/cused from certain social rolesand tasks

. Clients are obliged to try to get "ell as5uickly as possible

. Clients or their families are obliged to seekcompetent help


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Suchman Stages of ?llness

%. Symptom e/periences

a. hysical

b. Cogniti!e

c. ;motional(. +ssumption of the sick role

. >edical Care Contact

a. alidation of real illness

b. ;/planation of the symptoms in understandable terms

c. eassurance that they "ill be alright or prediction of"hat the outcome "ill be

. Dependent Client ole

. eco!ery or ehabilitation


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;0ects of ?llness

?mpact on ClientBeha!ioral Change

;motional Change

hysical Changes

8ifestyle Changes


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?mpact on the 6amily6actors:>ember of the family "ho is ill

Ehe seriousness and length of the illness Cultural and social customs the family follo"s

Changes in the family: ole Changes

Eask reassignments and increased demands on time ?ncreased stress

6inancial problems

8oneliness as a result of loss and separation

Change in social customs


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Health promotion and "ellness

health promotion is any acti!ity undertaken for the purpose ofachie!ing a higher le!el of health and "ell-being

Healthy eople (F%Ft"o goals help indi!iduals of all ages increase life e/pectancy and impro!e the

5uality of lifeparticularly +frican-+mericans currently life e/pectancy is G.& years for ;uropean-+mericans and '

years for +frican- +mericans

eliminate health disparities among di0erent segments of the populationparticularly +frican-+mericans currently, years of healthy life is years for ;uropean-+mericans and

( years for Hispanics, and years for +frican-+mericans


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8e!els of Health romotion

$8ea!ell and Clark)rimary re!entionHealth promotion

rotection against specic health problems

Secondary re!ention;arly identication of health problems

rompt inter!ention to alle!iate health

problems Eertiary re!entionestoration and rehabilitation


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Eypes of health promotion programs%. Community Based

(. Hospital Based

. Health-organi1ation programs. School Health-promotion programs

. Worksite programs for health promotion


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rograms for health promotion

?nformation disseminationhealth promotion programs that use a !ariety of media to o0er information to the public about

the risk or particular lifestylechoices and personal beha!ior, as "ell as the benets of changing that beha!ior and impro!ingthe 5uality of life

e.g., billboards, posters, brochures, ne"spaper features, books, health fairs

health risk appraisal="ellness assessment programshealth promotion programs that appraise indi!iduals of the risk factors inherent in their

lifestyles in order to moti!ate them to reduce specic risks factors and de!elop positi!e health

habits

e.g., tools such as Health-Style: + Self-Eest

lifestyle and beha!ioral change programshealth promotion programs geared to"ard enhancing the 5uality of life and e/tending the

lifespan through implementation of a healthy lifestyle or beha!ioral change in the indi!idual

en!ironmental control programshealth promotion programs de!eloped in response to the recent gro"th in the number of

contaminants of human origin that ha!e been introduced into our en!ironment


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Ehe ursing rocess and Health romotion+ssessment

%. Health History

(. hysical ;/amination

. hysical 6itness ;/amination

. 8ifestyles assessment

. Spiritual Health assessment

. Social support System re!ie"

G. Health risk assessment'. Health Beliefs re!ie"

&. 8ife stress re!ie"

%F. alidating assessment data


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DiagnosisWellness diagnosis Ieadiness for enhancedJ

lanning?dentify health goals related beha!ior change options

?dentify beha!ior or health outcomes

De!elop Beha!ior change plan

+ddress en!ironmental and interpersonal facilitatorsand barriers of change

Determine a time for implementation

Commit to beha!ior-change goals


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?mplementationSupporting

Counseling

?ndi!idual Eelephone

6acilitating

Eeaching

Consulting

;nhancing beha!ior change

>odeling

;!aluation

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