concepts of health & disease

7/31/2019 Concepts of Health & Disease

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Concepts of Health & Disease


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Lecture Objectives:At the end of the lecture the students are expected to

1- To Define the terms :Health

DiseaseIllness/ sickness

2- To know the general factors affecting health status3- To know the general factors affecting illness perception and

illness behavior4- To know the relation between and magnitude of illness and

disease5- To know the different indicators used to measure Quality of

Life and Wellbeing


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Historical backgroundHealth was neglected after WW1 in the League of

Nation, added later.Same happened after WW2 in the United Nation

Charter. Later W.H.O was for established andconstitution approved in 1948 .1977 The 30th World Health Assembly the

attainment by all citizens of the world by the year2000 of a level of health that will permit them to lead

a socially and economically productive life

HFA/2000( Health For All by Year 2000)1979 UN Health is an Integral part of the Socio-

economic Development plans


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Definition of disease, illness, and

sickness The Oxford English Dictionary defines disease

as a condition of the body or some part or

organ of the body in which its functions aredisrupted or deranged.

From an ecological point of view, disease isdefined as a maladjustment of the human

organism to the environment

.

The WHO has defined health but not disease.


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Defining Health:

1- The WHO Definition Health is the complete of status of physical, mental and social well-

being and not only the absence of disease or infirmityA Healthy Person is leading a socially and economically active live"

2- Health is the presence of a positive capacity to lead energeticsatisfying and productive life.

3 -Ecological definition:health is a state of optimal physical, mental and social

adaptation to ones environment.

Health is a relative, not an absolute concept-always involves

many levels or degrees


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Changing Concepts of Health1- Biomedical : health is the absence of

disease- Germ theory of disease.

Minimized the role of : Environmental, Social,Psychological, Economic, Cultural and otherdeterminants.

Germ theory could not solve : Nutritional,

Chronic diseases, Accidents, Substanceabuse, Psychological diseases, pollution,population explosion and other health noncommunicable health problems.


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Changing Concepts of Health2- Ecological Concept:

Health is an Dynamic Equilibrium between

Man and his Environment. Imbalance resultsin Disease.

( Imperfect man and Imperfect Environment)

** Adaptation of Man to his Environment

leads to better health and longer lifeexpectancy even in the absence of Modernhealth services.


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Changing Concepts of Health3-Psychosocial concept:

Biomedical ( Biological) in addition to: Psychological,Social, Cultural , Economic, Political factors

4-Holistic concept:

Include all the factors of the other concepts inaddition to all human activities such education,communication, agriculture, industry, housing ,

recreation etcEmphasis on Promotion and Protection of Health


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sickness Disease, illness, and sickness are not

synonymous. The term disease literallymeans without ease, the opposite of ease-

when something is wrong with bodilyfunction.( Professional definition based on apathological process- OBJECTIVE)

Illness refers to the individuals perceptions

and behavior in response to being ill ( loss offunction , not feeling well- SUBJECTIVE) Sickness refers to a state of social

dysfunction.( from disease or illness)


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sickness Disease is a physiological/psychological

dysfunction defined professionally

Illness is a subjective state of theperson who feels aware of not beingwell

Sickness is a state of social dysfunctionbased on professional and socialagreement


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Sick Role( If a person is diagnosed as patient by a health

professional (Disease) or considered ill by family orcommunity ( Illness )- is labeled as SICKsuch person has TWO RIGHTS associated with TWO

DUTIESRIGHTS :

1- exempt from usual responsibilities.2- not expected to take care or get well by himself

DUTIES :

1 -should want to get well2- should seek expert advice and make effort to get

well


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Health-sickness spectrum There are degrees or levels of health as

there are degrees or severity of illness.

positive healthbetter healthfreedom from sickness

unrecognized sicknessmild sicknesssevere sicknessdeath


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SPECTRUM OF ILLNESS

EPISODESOut of 1000 adults at risk IN PERIOD OF 2

4 WEEKS :

- 750 report a sickness episode ( ILLNESS )

- 250 of them consult health professionals( the other 500 persons took other actions

Enumerate other actions )- 9 of the 250 persons are admitted to

general hospitals- 5 of them referred to a specialized hospital

- 1 of them admitted in the Intensive CareUnit


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General factors affecting

health and illness 1- Physical dimension:

Physical health means perfect functioning of the body. All theorgans of the body are of average size and function normally;all the special senses are intact; the resting pulse rate, BP and

exercise tolerance are all within the range of normality for theindividuals age and sex.

Genetic make-up, age, developmental level, race and sex are allpart of an individuals physical dimensionEx: A young woman who has a family history of breast cancer

and diabetes and therefore is at higher risk to develop theseconditions.


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General factors affectinghealth and illness

2-Mental dimensionDefined as the state of balance between theindividual and the surrounding world, a stateof harmony between oneself and others.

Psychological factors can induce all kinds ofillness, not simply mental ones(give

examples). Long term stress affects thebody systems; conversely, calm andrelaxation can actually change the bodyresponse to illness.


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Mental dimension (cont.)

The following characteristics are attributes of a

mentally healthy person: a) he is free frominternal conflicts, b) he accepts criticism, c)he searches for identity, d) he has a strongsense ofself-esteem, e) he knows himself, f)

he has a good self-control, g) he facesproblems and tries to solve them.


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3-Social and economic dimensionsSocial well-being implies harmony and integrationwithin the individual, between each individual and

other members of the society and betweenindividuals and the world in which they live.

Health practices and beliefs are strongly influencedby a persons economic level, life style, family and

culture. Low-income groups are less likely to seekhealth care to prevent or treat illness; high-incomegroups are more prone to stress-related habits andillness


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4-Spiritual dimensionIt includes principles and ethics, the purpose in life, religiousbeliefs and values; all are important components of the way theperson behaves in health and illness.

5-Vocational dimensionWhen workis fully adapted to human goals, work often plays arole in promoting both physical and mental health. Theimportance of this dimension is exposed when individualssuddenly lose their jobs or retire.

6-Other dimensionsEnvironmental, educational, nutritional..


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Stages of illness behavior

STAGE 1: SYMPTOM EXPERIENCE

The person is aware that "something is

wrong". A person usually recognizeschange such as pain, a rash or alimitation in functioning but does not

suspect a specific diagnosis.


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STAGE 2 : ASSUMPTION OF THE SICKROLE

If symptoms persist and become severe, clientsassume the sick role. At this point the illnessbecomes a social phenomenon, and sickpeople seek confirmation from their families

and social groups that they are indeed ill andthat they be excused from normal duties androle expectations.


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STAGE 3: MEDICAL CARE CONTACT

If symptoms persist despite the home

remedies, become severe, or requireemergency care, the person ismotivated to seek professional health

services.


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STAGE 4 : DEPENDENT CLIENT ROLEThe client depends on health care professionals for the

relief of symptoms. The client accepts care,

sympathy and protection. A client can adopt thedependent role in a health care institution, at home,or in a community setting. The client must alsoadjust to the disruption of a daily schedule.

STAGE 5 : RECOVERY AND REHABILITATIONThis stage can be full recovery . In the case of chronicillness, the final stage may involve in an adjustmentto a prolonged reduction in health and functioning.


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New philosophy of Health

*Fundamental right

*Interesctorial

*Integral part of Development*Central to Quality of Life

*Involves Individuals, Families, CommunitiesLocal, National and International

responsibilities*Social Investment

*World wide Social Goal.


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Concept of Wellbeing

1*Standard of Living ( Expenditure,Consumed goods, Services enjoyed,Educational level, Employment status, Food,

Dress, Housing, Recreational activities andFacilities2*Level of Living : used by UN consists of

Nine components :Health, Food consumption,

Education, Occupation and workingconditions, Housing, Social security, Clothing,Recreation , Leisure and Human Rights.

Health is the Most Important of All of them


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Concept of Wellbeing

Subjective:Quality of Life-*3Component of Wellbeing. Perception by

the individual or a group of individuals .Objectiveis based onLevel of Living

Criteria , Quality of Life is based on the

Person own Subjective evaluation ofthese criteria in form of levels ofhappiness , Satisfaction etc..


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Physical Quality of Life IndexPQLI

One Composite Index consisting of :

1-Infant Mortality Rate IMR

2-Life Expectancy at age ONE3-Literacy rate

Each is given Equal Weight .

The Total Score is 100 which is the Bestperformance and 0 the Worstperformance


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Human Development IndexHDI

One Composite Index Range from 0 1Minimum to Maximum . consisting of :

1-Life Expectancy at age Birth-(Minimum 25 Maximum 85 years)

2-Knowledge (Adult Literacy and Mean Yearsof Schooling )

Minimum 0% Maximum 100 %)(3- Income ( Real Gross Domestic Product

GDP per capita ).(Minimum US$100 ,Maximum US$40000 )


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New Concepts

Gender- Related Development Index

(GDI)

Gender Empowerment Measure

(GEM)

They reflect gender inequalities humandevelopment or economic and politicalopportunities.


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Human Poverty IndexHPI

HDI measures average ACHIEVEMENTSin basic dimensions of human

developmentHPI measures DEPRIVATION in those

dimensions


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Thank you

BEST WISHES TO ALL

concepts of health & disease

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