Konsep Sehat dan SakitItsna Luthfi K., S.Kep., Ns.

Setelah mengikuti kuliah ini mahasiswa akan mampu:1.Mendefinisikan istilah-istilah kunci2.Mengeksplorasi mengenai konsep kesehatan, kesejahteraan dan kesakitan3.Mendapatkan overview mengenai model sehat dan sakit4.Mengidentifikasi implikasi konsep sehat dan sakit dalam merumuskan rencana asuhan keperawatan

Kata-kata Kunci:HomeostasisKesehatanKesejahteraanDeterminan KesehatanSakit

Mental

Fisik

Sistem Manusia

Homeostasis

Aspek yang Mempengaruhi Kondisi Tubuh Seseorang

Aspek yang Mempengaruhi Kondisi Tubuh Seseorang

Riset-riset tentang SehatCalnan (1987 cit. Sidell, 1995) Konsep

Sehat pd 60 wanita di Southeast England Health as never illHealth as being able to get through the day, to

carry out routinesHealth as being fit and active, taking exerciseHealth as being able to cope with stresses and

crises in life

Blaxter & Paterson, 1982 (cit. Sidell, 1995) Health and Lifestyles Survey (HLS) pada 9000 responden:Health as not illHealth as absence of disease Health as reserve (strenght)Health as behaviour, health as the ‘healthy life’Health as physical fitnessHealth as energy, vitalityHealth as social relationships (relating well to

others)Health as functionHealth as psycho-social well-being

Definisi sehatHealth is a state of complete physical, mental, and

social well-being and not merely the absence of disease or infirmity ( WHO, 1985 cit. Sidell, 1995)

Health is not a condition, it is an adjustment. It is not a state but a process. The process of adaptation of an individual to not only physical, but also psychosocial environment (United States President’s Commission on Health Needs of the Nation)

Keadaan sejahtera dari badan, jiwa dan sosial yang memungkinkan setiap orang hidup produktif secara sosial dan ekonomi ( UU no. 23/1992 tentang Kesehatan)

Faktor-faktor yang Mempengaruhi Kesehatan

Health

Gender

Age & developmental stage

Family dynamics

Parenting style

Employability

Culture

Family finances Biological factors

Geographical mobility

Social resources

(Potter & Perry, 2005)

Definisi Kesejahteraan (Wellness)A choice or a decision that you made to move toward optional

healthA way of live – a life style you design to achieve your highest

potential for well-beingA process – a developing awareness that there is no end point,

but that health and happiness are possible in each moment, here and now

Efficient handling of energy – energy received from the environment, transformed within you.

Integration of body, mind and spirit – the appreciation that everything you do, and you think, and feel and believe has an impact on your state of health

Loving acceptance of self(Travis and Ryan, 1998)

Hal-hal yang Mempengaruhi Praktik Sehat Variabel internal

Usia dan tingkat perkembanganPersepsi tentang fungsiFaktor emosiNilai, keyakinan dan spiritual

Variabel eksternalLatar belakang pendidikanKebiasaan keluargaFaktor sosial ekonomiLatar belakang budaya

Factors that contribute to wellness

Good physical self carePrevention of illness/injuryUsing one’s full intellectual potentialExpressing emotions and managing stress

appropriatelyMaintain good interpersonal relationshipsConcern about one’s environment and

condition throughout the world

Model Sehat-SakitA model or template that has been developed

as a guide to understand the various components of a complex issue

Developed by researching various factors and the link between them and using this information as a basis for predicting possible needs and/or outcomes.

Model Sehat-SakitHealth-Illnesses Continuum (Elwin, 2003)

Mid-point representing little awareness of health status

Mental & Physical

Functionality

Mental & Physical Dysfunctionality

High level of wellness

Severe Illness

Model sehat-sakit

Illness Death

WellnessNormal health Illness area

The health-illness continuum (Dunn, 1977)

High Level of WellnessHigh Level of Wellness

Model sehat-sakit

Kesehatan tergantung pada hubungan antara agen, host dan lingkungan yang dinamis

Agent-host-environment model (Leavell, 1965)

Host

EnvironmentAgent

Community nursing

Nurses’ ResponsibilityTo help clients to identify their place

(position) on the health-illness continuum

To assist clients to adopt some measures (take actions) in order to reach a well state of health

Konsep SakitIllness is a state of disturbance in the normal

functioning of the total human individual, including both of the state of organism as a biological system and his person and social adjustment (Parson, 1972)

Disease is an abnormal condition of an organism that impairs bodily functions, associated with specific symptoms and signs

Views of DiseaseAncient views of disease

Ghosts and gods attach to the bodyUnbalance between negative and positive

Modern views of diseaseA state in which there is a fall of the needs of a human Be discomfort, suffering and painA loss and change of social behaviourAn abnormity of function, structure and shape of

organism The destroy of homeostasis of organism A reaction of the organism to harmful factors

Kategori Penyimpangan dari Normal

Organic and functional disease (including disability)

Hereditary disorderCongenital disorderInfectious diseasePsychological problemMetabolic disorderNeoplasmic diseaseTraumatic injuryOccupational disease

Faktor yang Mempengaruhi Perilaku SakitInternal

UsiaJenis kelaminKeseimbangan

psikologisKepribadianKoping yang dimiliki

EksternalPekerjaanSosio ekonomiAgamaBudayaPendidikan

Tahapan sakit

Symptom experienceAssumption of the sick roleMedical care contactDependent patient roleRecovery and rehabilitation

Efek sakitPerubahan tingkah laku dan emosi: cemas,

shock, denial, marah, menarik diriPerubahan gambaran diriPerubahan konsep diriPerubahan peran dalam keluargaPerubahan dinamika keluarga

Peran perawatMembantu klien dan keluarga untuk

menyesuaikan diri dengan kondisinya sekarang

Memotivasi koping yang efektif untuk menghadapi kondisi yang potensial

Health promotion and illness prevention to promote a better health

Health promotionAktivitas untuk memotivasi seseorang untuk

bertindak secara positif agar dapat mencapai tingkat kesehatan yang lebih stabilKegiatan pasif: individu mendapat keuntungan

dari aktivitas orang lain tanpa ia melakukan apapun

Kegiatan aktif : individu dimotivasi untuk mengadaptasi program kesehatan tertentu

Illness preventionMemotivasi orang untuk menghindari

penurunan kesehatan atau fungsiLevel pencegahan:

Primer: promosi kesehatan dan proteksi spesifik melawan penyakti

Sekunder: deteksi penyakti secara dini, intervensi bagi individu yang menderita sakit termasuk mencegah komplikasi dan kecacatan

Tersier : setelah sembuh dari sakti dan terdapat kecacatan, fokus pada rehabilitasi individu dan mengembalikan fungsinya pada level optimum.

Peran perawat dalam promosi kesehatanAdvokatKonsultanPendidikKoordinator pelayanan

Pilar strategis Pembangunan Kesehatan Nasional Paradigma sehat menentukan mind set

perilaku sehatDesentralisasi memandirikan masing-

masing wilayah untuk melakukan self health management

Jaminan pemeliharaan kesehatan masyarakat

Profesionalisme

Indonesia sehat 2010Menggerakkan pembangunan nasionalMemelihara dan meningkatkan kegiatan

individu, keluarga dan masyarakat beserta lingkungan

Memelihara dan meningkatkan pelayanan kesehatan yang bermutu, merata dan terjangkau

Mendorong kemandirian masyarakat untuk sehat

Referensi1. Ellis, JC; Nowlis, EA. 1994. Nursing A Human Need Approach.

5th ed. Pennsylvania: J.B. Lippincott Company2. Potter & Perry. 2005. Fundamentals of Nursing: Concepts,

Issues and Opportunities. 4th ed. Philadelphia: Lippincott-Raven Publisher

3. Stuart, Gail Wiscarz & Sundeen, Sandra J. 1995. Principles & Practice of Psychiatric Nursing. St. Louis: Mosby Year Book

4. Taylor C, LilisC, Le Mone, P. 1997. Fundamentals of Nursing: The Art and Science of Nursing Care. Philadelphia: Lippincott-Raven Publishers.

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