Health, Wellness, and Health Promotion
The health care system of the United States, which traditionally has been disease oriented, is currently placing greater emphasis on health and its promotion. Similarly, a significant portion of nurs-ing’s workforce formerly was focused on the care of patients with acute conditions, but now a growing portion is directing its efforts toward health promotion and disease prevention.
How health is perceived depends on how health is defined. In the preamble to its constitution, the World Health Organization (WHO) defines health as a “state of complete physical, mental, and social well-being and not merely the absence of disease and infirmity” (Hood & Leddy, 2002). Such a definition of health does not allow for any variation in degrees of wellness or illness. On the other hand, the concept of a health–illness continuum al-lows for a greater range in describing a person’s health status. By viewing health and illness on a continuum, it is possible to con-sider a person as having neither complete health nor complete illness. Instead, a person’s state of health is ever-changing and has the potential to range from high-level wellness to extremely poor health and imminent death. The model of the health–illness con-tinuum makes it possible to view a person as simultaneously pos-sessing degrees of both health and illness.
The limitations of the WHO definition of health are clear in relation to chronic illness and disability. A chronically ill person cannot meet the standards of health as established by the WHO definition. However, when viewed from the perspective of the health–illness continuum, people with chronic illness or disability can be understood as having the potential to attain a high level of wellness, if they are successful in meeting their health poten-tial within the limits of their chronic illness or disability.
Wellness has been defined as being equivalent to health. Cook-fair (1996) indicated that wellness “includes a conscious and de-liberate approach to an advanced state of physical, psychological, and spiritual health and is a dynamic, fluctuating state of being”. Leddy and Pepper (1998) contended that wellness is in-dicated by the capacity of the person to perform to the best of his or her ability, the ability to adjust and adapt to varying situations, a reported feeling of well-being, and a feeling that “everything is together” and harmonious. With this in mind, it becomes evi-dent that the goal of health care providers is to promote positive changes that are directed toward health and well-being. The fact that the sense of wellness has a subjective aspect emphasizes the importance of recognizing and responding to patient individual-ity and diversity in health care and nursing.
Today, increasing emphasis is placed on health, health promo-tion, wellness, and self-care. Health is seen as resulting from a lifestyle that is oriented toward wellness. The result has been the evolution of a wide range of health promotion strategies, includ-ing multiphasic screening, genetic testing, lifetime health moni-toring programs, environmental and mental health programs, risk reduction, and nutrition and health education. A growing in-terest in self-care skills is evidenced by the large number of health-related publications, conferences, and workshops designed for the lay public.
Individuals are increasingly knowledgeable about their health and are encouraged to take more interest in and responsibility for their health and well-being. Organized self-care education programs emphasize health promotion, disease prevention, man-agement of illness, self-medication, and judicious use of the pro-fessional health care system. In addition, well over 500,000 self-help groups and numerous web sites and chat groups exist for the purpose of sharing experiences and information about self-care with others who have similar conditions, chronic dis-eases, or disabilities.
Special efforts are being made by health care professionals to reach and motivate members of various cultural and socioeco-nomic groups concerning lifestyle and health practices. Stress, improper diet, lack of exercise, smoking, drugs, high-risk behav-iors (including risky sexual practices), and poor hygiene are all lifestyle behaviors known to have a negative effect on health. Health care professionals are concerned with encouraging behav-ior that promotes health. The goal is to motivate people to make improvements in the way they live, to modify risky behaviors, and to adopt healthy behaviors.
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