APPROACHES TO THE STUDY OF MAN:
1. Atom Atomis isti ticc Appr Approa oach ch Views man as an organism composed of different organ systems, each system composed of organs and each organ composed of tissue cells. 2. Holi Holist stic ic Appr Approa oach ch Views man as a whole organism with interrelated and interdependent parts functioning to produce behavior unacceptable or acceptable to him or society.
IMPORTANCE: Atomistic and Holistic approaches are useful in the planning of care of the individual during illness or in its prevention.
MAN AS A BIOLOGICAL BEING
Man is a living organism who from birth is destined to die. As he lives, he has to contend continually with the forces in his environment, be it fr iendly or hostile. The environment influenced man’s behavior as an individual. In life, cellular behavior is the simplest functional unit. The cell is the basic unit or building blocks of structure of all forms of plant and animal life. The human body composed of trillions of cells. Each of these cells carries out precise and specialized functions that interweave harmoniously with the activities and functions of other cells in the body. The subordinate system is important in carrying out daily life activities that are vital to survival. Man’s feeling of well-being each day depends on the condition on various organ system. As man enlarges his interaction with his environment, his behavioral responses become more complex and variable. Superordinate system provides man with necessary framework of relationship which links him to the family, the community and the society. Together with the other members of his family, he copes with elements in his environment and his behavior is greatly influenced by his relationships.
A. Organismic Behavior: Based on two beliefs (Byrne and Thompson)
1. Man normally responds as a unified whole The mind and body operates as a whole and his body structure conform to the purpose for which each part was made. What affects one affects the other. 2. Man as a whole is different from and more than the sum of his component parts Organismic Behavior Refers to those observable features and actions that reflects man’s functioning as a unified whole within the environment in which he exist. Reflects the dynamic changes that occur in him as a result of alterations he has made or has met me his internal or external environment. B. Man as a System Buckley’s definition Whole which function as a whole by virtue of the interdependence of its parts? It has common or unifying boundaries with interrelated and interdependent parts. It is composed of subsystems. Each is designed to carry out an activity which in turn is necessary fro achieving the general purpose of the system. Closed System: Self-sufficient, totally isolated from other systems. It does not allow outside stimuli in any from penetrating its boundaries. It does not allow anything from within it to go beyond its boundaries. Life sustaining elements cannot enter, uses its reserves for energyeventually fails to function and disintegrates. Open System: Exchanges matter, energy or information with the environment It is directly affected by events or changes in other systems. A person is viewed as a living behavior system. The metabolic, the growth and the total processes of living are involved in the interchange of energy, matter or information among parts of the living organism, and between the living organism and its environment.
MAN AS A PSYCHO-BEING
Travelbee describes man as a unique, irreplaceable individual, a one time being in this world. Characteristics of Man: 1. Alike yet unalike. 2. Shows limited and unlimited nature. 3. Creature of contradiction. 4. Rational being yet irrational at times. 5. Maturity with core of immaturity.
MAN AS A SOCIAL BEING
Capable of relating with others From birth, he is endowed to know, to like, to love and to respond to and appreciate the uniqueness of others.
MAN AS A SPIRITUAL BEING
The spirit of man gives him life to his human body. Without the spirit, man does not know the reason for his existence on this earth.
Man’s Spiritual Nature: ♦ Intellect: It allows man to look for truth. It gives him the ability to perceive his surroundings or the forces within or outside him. It helps him understand the meaning of events as they relate to him and to his loved ones. ♦ Will: It expresses man’s own wishes, desires or longing to do what he has set his mind to do. It gives him the power of conscious and deliberate action or self-control in initiating, sustaining or terminating human activity.
Man believes that his life is governed by a power greater than he. He pays obedience to this supreme power regularly or infrequently, the frequency
dependent on man’s whims, caprices or feelings of despair whenever hit by adversity.
SPIRITUAL VIRTUES: ♦ Faith: Unquestioning belief in someone or something; complete trust or confidence or reliance one places in a person or thing. ♦ Hope: Nourishes faith; vital factor in health care setting. Its absence or presence often plays a part in determining the patient’s prognosis or illness, state of wellbeing and acceptance of the dying process. ♦ Charity: Love of man for his fellowman; enables him to overcome frustration because of love for another. Love makes one do things for another without complication. It allows one to give up one’s pleasure while serving another without even thinking of the sacrifice it entails.
NEED
Something that is essential to the emotional and physiologic health and survival of humans Something that is desirable, useful or necessary to maintain well-being and life. Things required by human beings in order to maintain physiologic and psychologic homeostasis Requirements for well-being.
Characteristics of Human Needs: 1. 2. 3. 4. 5. 6. 7.
Human needs are universal Human needs may be altered by individual priorities Human needs maybe deferred Human needs nay be met in different ways Human needs are aroused by either external or internal stimuli Human needs are interrelated An unmet need result in disruption of normal body activities and frequently leads to eventual illness.
ABRAHAM MASLOW’S HIERARCHY OF NEEDS
Maslow’s framework of basic needs is based on the theory that something is basic need if: ♦ Its absence results in illness ♦ Its presence prevents or signals health ♦ Meeting an unmet need restores health The central theme “humans have urged to grow and to attain their highest level potential” According to Maslow, needs at one level must be first met before the needs on the next level can be met. Physiologic Needs: Referred as the basic needs Physical needs that are inherent in all human beings. These must met at least minimally for life to continue. Below the level of subsistence death will occur. Safety/Security Needs: Both physiological and psychological Need for shelter and freedom fro harm or danger Need for awareness, sureness, familiarity and trustworthiness in people, things, places and events. Love and Belongingness Needs: The security we gain from love and belonging enhances the feeling of safety. Our feeling of structure and security is reinforced when we know where we stand in relation to others, and who we are to them. We all need mutually meaningful relationships with other people. Need for love encompasses both giving and receiving Belonging needs includes attaining a place in a group Self-Esteem Needs: Derived largely from the feeling that we are valued by those around us. Self-esteem also comes from within – it is related to the assessment of our own adequacy , our performance and our capacity in the various arenas of lives both personal and professional and others hold on high regard. Esteem from other. Self-Actualization Needs:
The need to reach one’s potential through development of one’s unique capabilities The process of self-actualization is the one that continues throughout life. Qualities that indicate achievement of one’s potential: ♦ Acceptance of self and others as they are ♦ Focus of interest or problems outside of self ♦ Ability to be objective ♦ Feelings of happiness and affection fro others ♦ Respect for all persons. ♦ Ability to discriminate between good and evil ♦ Creativity as guideline for solving problems and carrying out interest.
(Maslow does not believe that intelligence is required for self-actualization. He sees self-actualization as a product of maturity that comes about through relating to people in autonomous and competent way.)
HEALTH
State of complete physical, mental and social well-being and not merely the absence of disease or infirmity.
WELLNESS
An integrated method of functioning which is oriented towards maximizing the potential of which the individual is capable. A state of well-being. Seven components of wellness (Anspaugh,Hamrick, and Rosato) 1. Physical 2. Social 3. Emotional 4. Intellectual 5. Spiritual 6. Occupational 7. Environmental
It requires that the individual maintain a continuum of balance and purposeful direction within the environment where he is functioning It means engaging in attitudes and behaviors that enhances quality of life and maximize personal potential
MODELS OF HEALTH
A. CLINICAL/MEDICAL MODEL ♦
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Health is identified by the absence of signs and symptoms of disease or injury. Illness is the opposite of health is illness and injury People are viewed as physiologic systems with related functions Health practitioners used this model in their focus in the relief of signs and symptoms of the disease and malfunctioning
B. ROLE PERFORMANCE MODEL
Health ids defined in terms of the individual’s ability to fulfill societal roles. ♦ People who can fulfill their roles are healthy even they appear clinically ♦ In this model sickness is the inability to perform one’s work. C. ADAPTIVE MODEL ♦
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Focus in this model is adaptation Health is a creative process, disease is a failure in adaptation, maladaptation Aim of treatment is to restore the ability to adapt or cope. Extreme good health is flexible adaptation to environment and interaction with the environment to maximum advantage. Focus is stability, although there is an element of growth and change.
D. EUDOMONISTIC MODEL ♦
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Health is seen as a condition of actualization or realization of a person’s potential. In this model the highest aspiration of people is fulfillment sand complete development, which is actualization. Illness is a condition that prevents self-actualization.
E. AGENT-HOST-ENVIRONMENT MODEL/ECOLOGIC MODEL ♦
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This model is used primarily in predicting illness rather than in promoting wellness Three dynamic interactive elements of this model are: agent, host and environment. Because these factors constantly interact with others, Health is an ever-changing state. When the variable are in balance, health is maintained, when variables are not in balance, disease occurs.
F. HEALTH-ILLNESS CONTINUA ♦
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Health and Illness continuum can be used to measure a person’s perceived level of wellness. Health is a constantly changing state, with high level wellness and death being on the opposite ends of a graduated scale or continuum
On this continuum, people move back and forth day by day ♦ There is no distinct boundary across which people move from health to illness or to illness back to health. ♦ Good health and well-being involves continuous adaptation. Failure to adapt, to cope or poor reintegration result to illness, and when adaptation fails completely, irreversible damage to the body occurs, the death results. G. WORLD HEALTH ORGANIZATION ♦
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Health is state of complete physical, mental and social well-being and not merely the absence of disease.
H. NEEDS FULLFILMENT MODEL ♦
Health is a state in which needs are being sufficiently met allow an individual to function successfully in life with the ability to achieve the highest possible potential
I. HIGH LEVEL WELLNESS It refers to the functioning to one’s maximum potential while maintaining balance and purposeful direction in the environment ♦ Defined as functioning at one’s best; it means the potential of the individual is maximized and utilized with purpose and balance within individual’s environment ♦ A person state of well-being depends on the way person sees himself. ♦
VARIABLES INFLUENCING HEALTH STATUS, HEALTH BELIEFS AND HEALTH BEHAVIORS/PRACTICES Health Status State of health of an individual at a given time. Term may refer to describe the individual’s problem in general (anxiety, depression, or acute illness). It can also describe such specifics as pulse rate or body temperature. Health Beliefs Concepts of health that an individual believes are true. Such beliefs may or may not be founded on fact. Some of these are influenced by culture Health Behaviors
The actions people take to understand their heath state, maintain an optimal state of health, prevent illness and injury, and reach their maximum physical and mental potential. This is intended to prevent illness or disease or to provide for early detection of disease
FACTORS AFFECTING HEALTH & ILLNESS
I. Biologic dimension ♦ Genetic make-up, age, sex and developmental level all significantly influence a person’s health II. Psychologic dimension ♦ Emotional factors influencing health include mind-body interactions and self-concept ♦ Mind-body interactions can affect health status positively or negatively ♦ Self-concept is how a person feels about self (self-esteem), and perceives the physical self (body image), needs, roles, and abilities. III. Intellectual dimension
Encompasses cognitive abilities, educational background and past experiences. These influences a client’s responses to teaching about health and reactions to health care during illness ♦ A lifestyle choice is also a factor that influences health. Lifestyle refers to a person’s general way of living, including living conditions and individual patterns of behavior that are influenced by socio-cultural factor and personal characteristics. ♦
IV. Environmental dimension ♦ The environment has many influences on health and illness. Climate, housing, sanitation, pollution of air, water and soil, radiation, greenhouse effect and other environmental contamination like pesticides and chemicals used to control weeds and plant disease. V. Socio-cultural dimension ♦ Standard of living (reflecting occupation, income and education),family’s lifestyle and patterns of daily living, culture and social interaction influences how a person perceives, experiences and copes with health and illness.
VI. Spiritual dimension ♦ Spiritual and religious beliefs are very important components of the way the person behaves in health and illness.
HEALTH as a MULTIFACTORIAL PHENOMENON FACTORS AFFECTING HEALTH
I. POLITICAL FACTOR ♦
Involves one’s leadership, how one rules, manages and involves other people in decision making 1.
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Safety - the condition of being free from harm, injury or loss protection from exploitation working condition expanding access to social security Oppression - unjust or cruel exercise of authority or power Political will- determination to pursue something which is in
the interest of the majority 4. Empowerment- the ability of a person to do something - creating the circumstances where people ca use their faculties and abilities at the maximum level in the pursuit of common goals II. CULTURAL FACTOR ♦
Relating to the representation of nonphysical traits, such as values, beliefs, attitudes and customs shared by group of people passed from one generation to the next. Practices – a customary action usually done to maintain or promote health Beliefs – a state or habit of mind wherein a group of people place a trust into something or person
III. HEREDITARY FACTOR ♦
The genetic transmission of traits from parents to offspring; genetically determined
IV. ENVIRONMENTAL FACTOR ♦
The sum total of all conditions and elements that make up the surroundings and influence the development of an individual.
V. SOCIO-ECONOMIC FACTOR ♦ Refers to the production activities, distribution and consumption of goods of an individual ILLNESS
Is highly personal state in which the person’s physical, emotional, intellectual, social, developmental, or spiritiual functioning is thought to be diminished. It may or may not be elated to disease.
DISEASE
Is described as alteration in body functions resulting in a reduction of capacities or a shortening of the normal life span.
Three distinct criteria to determine illness: 1. Presence of symptoms 2. Perception of how they feel 3. Ability to carry out ADL Classification of Illness and Disease A. Acute Illness – is typically characterized by severe symptoms of relatively short duration. B. Chronic Illness – is the one that last for a extended period, usually 6 six months or longer and often fore the person’s life. Usually have slow onset and often have periods of remission, when the symptoms disappear, and exacerbation, when the symptoms reappear.
ILLNESS BEHAVIORS
A certain way of behavior of an ill person
It is a coping mechanism, involves ways describe, monitor, and interpret their symptoms, take remedial actions, and use the health care system
Parson (1979) described four aspect of the sick role:
1. Clients are not held responsible for their condition 2. Clients are excused from certain social roles and tasks 3. Clients are oblige to try to get well as quickly as possible 4. Clients or their families are obliged to seek competent help Suchman(1979) describes five stages of illness , not all clients progress through each stage. Stage I: Symptom Experiences ♦ Person is aware that something is wrong; recognizes a physical sensation or a limitation in functioning but does not suspect a specific diagnosis ♦ Three aspects of this stage; 1. physical experience of symptoms 2. the cognitive aspect 3. the emotional response ♦ The ill person usually consults the others about symptoms or feeling, validating that the symptoms are real. ♦ May try home remedies Stage II: Assumption of the Sick Role ♦ The individual now accepts the sick role ♦ Seeks confirmation from family or friends( social-phenomenon) ♦ Continues with self treatment and delay contact with health care professionals as long as possible. ♦ They may be excused from normal duties and role expectations. Stage III: Medical Care Contact ♦ When symptoms of illness persist, the person is motivated to seek professional help either on their own initiative or at the urging of significant others. ♦ Three types of information they ask from the professional: 1. Validation of real illness 2. Explanation of the symptoms in understandable terms 3. Reassurance that they will be all right or prediction of what the outcome the will be ♦ The client may accept or deny diagnosis
Stage IV: Dependent Client Role ♦ After accepting the illness and seeking treatment, the client becomes dependent on the professional for relief of symptoms ♦ Client accept care, sympathy and protection from the demands and stresses of life ♦ Client can adopt the dependent role in health care institution, at home, or in a community setting ♦ Client also adjust to a disruption of a daily schedule Stage V: Recovery or Rehabilitation ♦ The client is expected to relinquish the dependent role and resume former roles and responsibilities.
LEVELS OF PREVENTION
Edelman and Mandle (2002) Prevention in a narrow sense, means avoiding the development of disease in the future and in a broader sense consist of all interventions to limit the progression of a disease Leavell and Clark (1965) define three levels of prevention: I. PRIMARY prevention
Focuses on health promotion and Purpose is to decrease the risk or exposure of the individual or protection against specific health problems community to disease Applied generally to healthy individuals or groups II. SECONDARY prevention
Focuses on the early identification, prompt intervention and health maintenance for individuals experiencing health problems Its goal is to identify individuals in an early stage of a disease process and to limit future disability
III. TERTIARY prevention
Focuses on restoration and rehabilitation with the goal of returning the individual to optimum level of functioning within the constraints if disability
