Basic concepts

in nursing science

Rajesh Kumar Sharma

Associate Professor
Himalayan College of Nursing,
SRHU
 Health

1. Concept of health
2. Concept of disease
3. The relationship between
health and illness
 Concept of health

(1) Definition of health

(2) Model of health
(3) Factors that affect health
 Definition of health

1) Absence of disease

2) Feel comfort

3) Well-balanced functional activities

4) Well-balanced physiological
and psychological activities

5) WHO’s definition of health

 WHO’s definition of health

WHO——The World Health Organization

“a state of complete physical, mental

and social well-being, and not merely
the absence of disease or infirmity.”
(holistic view of health)
 Model of health
——Health-illness continuum model

(1) Definition
(2) Characteristics
(3) Nurses’ responsibilities
Illness: -

Illness is a state in which a

person’s physical, emotional,
intellectual, social, developmental,
or spiritual functioning is
diminished or impaired.
 Disease: -

Disease is a medical term which

describe as an alteration in body
functions resulting in a reduction of
capacities or a shortening of the
normal life span.
CONCEPT OF ILLNESS

Disease is used to describe as an alteration

in body functions resulting in a reduction of
capacities or a shortening of the normal
life span.

• Etiology – causation of the disease.

Etiologic description includes
identification of all factors that act
together to bring a disease condition.
CONCEPT OF ILLNESS
Risk Factors of a Disease

1. Genetic and Physiological Factors

• Heredity, or genetic predisposition to
specific illness, is a major physical risk
factor. - for example
2. Age
• Age increases or decreases susceptibility to
certain illnesses (the risk of heart diseases
increases with age for both sexes)
• The risk of birth defects and complications
of pregnancy increase in women bearing
children after age 35.
CONCEPT OF ILLNESS
3. Environment
• The physical environment in which a person
works or lives can increase the likelihood that
certain illnesses will occur. - for example

4. Lifestyle
• Many activities, habits and practices involve
risk factors. Lifestyle practices and behaviors
have positive or negative effects on health.
• Stress can be a lifestyle risk factor if it is
severe or prolonged, or if the person is unable
to cope.
• Stress can threaten mental health & physical
well-being
CONCEPT OF ILLNESS
Common Causes of Disease

1. Biologic Agents
2. Inherited Generic Defects
3. Physical Agents
4. Chemical Agents
5. Tissue response to irritation/injury (fever, inflammation)
6. Faulty chemical or metabolic process
7. Emotional or physical reaction to stress
CONCEPT OF ILLNESS
Classification of Disease

According to Etiologic Factors

1. Hereditary. Due to defect in the genes of one or other
parent which is transmitted to the offspring.

2. Congenital. Due to a defect in the development, hereditary

factors, or prenatal infection; present at birth. (e.g. cleft lip,
cleft palate)

3. Metabolic. Due to disturbances or abnormality in the

intricate processes of metabolism.
CONCEPT OF ILLNESS
4. Deficiency. Results from inadequate intake of absorption
of essential dietary factors.

5. Traumatic. Due to injury.

6. Allergic. Due to abnormal response of the body to

chemical or protein substances or to physical stimuli.

7. Neoplastic. Due to abnormal or uncontrolled growth of

cells.

8. Idiopathic. Cause is unknown; Self-originated; of

spontaneous origin.
CONCEPT OF ILLNESS
9. Degenerative. Results from the degenerative changes that
occur in tissue and organs.

10. Iatrogenic. Results from the treatment of a disease.

CONCEPT OF ILLNESS
According to Duration or Onset

1. Acute Illness. Usually has a short duration and severe.

• The signs and symptoms appear abruptly, are
intense and often subside after a relatively short
period.
• Following an acute illness a person may return to
normal level of wellness
CONCEPT OF ILLNESS
2. Chronic Illness. Slow onset. Persists, usually longer than 6
months and can also affect functioning in any dimension.
• Chronically ill person have long term disease
process
• The client fluctuate between maximal functioning
and serious relapses that may be life threatening.
Characterized by:
 Remission - Period during which the
disease is controlled symptoms are not
obvious
 Exacerbation - The disease becomes
more active again at a future time,
recurrence of pronounced symptoms.
CONCEPT OF ILLNESS
Other classification of disease may be described as:

Organic – results from changes in the normal structure, from

recognizable anatomical changes in an organ or tissue of the
body

Functional – no anatomical changes are observed to account

for the symptoms, present may result from abnormal
response to stimuli.

Occupational – results from factors associated with the

occupation engaged in by the patient (e.g. cancer among
chemical factory workers.
CONCEPT OF ILLNESS
Familial – occurs in several individuals of the same family (e.g.
hypertension, cancer)

Venereal – Usually acquired through sexual relation (AIDS,

gonorrhea)

Epidemic. Attacks a large number of individuals in a

community at the same time (SARS)

Endemic. Present more or less continuously or recurs in the

community.

Pandemic. Epidemic diseases which is extremely widespread

involving an entire country or continent.
 Definition of health-illness
continuum model

Health and illness or disease can be viewed

as the opposite ends of a health continuum.
From a high level of health a person’s
condition can move through good health,
normal health, poor health, and extremely
poor health, eventually to death.
 People move back and forth within this
continuum day by day. There is no distinct
boundary across which people move from
health to illness or from illness back to
health. How people perceive themselves and
how others see them in terms of health and
illness will also affect their placement on
the continuum.
 Health-illness continuum model

good health, normal health, poor health, extremely poor health, eventually to death.
 Characteristics of health-illness
continuum model

(a) At any time any person’ health

status holds a place on certain point
between two ends of health-illness
continuum
(b) any point on the health-
illness continuum is a synthetical
representation of various (all)
aspects of individual in physiology,
psychology, and society.
 Nurses’ responsibilities

(a) to help the clients to identify

their place (location) on the health-
illness continuum

(b) to assist the clients to adopt some

measures (take actions) in order to reach a
well state of health.
Factors that affect health

(1) Biological factors

(2) Environmental factors

(3) Life style

(4) Psychological factors

 Biological factors

1）Pathogenic microorganism

2）Biologic-heredity factor

3）Other factors
 Environmental factors

1) Natural environment:

2) Social environment:
 Concept of disease

(1) Definition of disease

(2) Effect of disease

(3) Measures of preventing disease

 Definition of disease

1) Ancient view of disease

2) Modern view of disease

 Ancient view of disease

Ghosts and gods attach to the body

Unbalance between negative and positive

 Modern view of disease

(a) A state that is treated by physician and

falls short of the needs of human being

(b) Be discomfort, suffering and pain

(c) A loss and change of social behaviors,

especially the loss and change of labor force
(d) An abnormity of function, structure
and shape of organism

(e) The destroy of homeostasis of organism

(f) A reaction of the organism to harmful

factors
 Effect of disease

1) The effect on individual

2) The effect on family

3) The effect on society

The effect on individual

1）Positive effect
2）Negative effect
 The effect on family

1) Economic burden is increased

2) Family member’s psychological stress
is increased
3) The emotion change of family member
 The effect on society

1) Social productivity is decreased

2) Medical resources are consumed or wasted
3) To infect others and threaten other’s
health
 Measures of preventing
disease

1) Primary prevention (etiological prevention)

2) Secondary prevention (pre-clinical prevention)

“Three early” : To discover early

To diagnose early
To treat early
3) Tertiary prevention (clinical prevention)
 The relationship between
health and illness

1）No distinct boundary；A relative relationship

2）Be dynamic changing

3）Be mutual transform under definite condition

4）Be exist at the same time on one individual

 Nursing

1. Concept of nursing
2. Evolvement process of the
concept of nursing
3. The relationship between
nursing and health
 Concept of nursing

(1) Definition of nursing

(2) The content of concept of

nursing
(3) The connotation of concept
of nursing
 Definition of nursing

(a) Nightingale’s definition of nursing

(b) Henderson’s definition of nursing
(c) American Nurse Association’s definition
of nursing
(d) International Council of nurses’ definition
of nursing
Nursing:-

Nursing, as an integral part of

the health care system, encompasses the
promotion of health, prevention of illness, and
care of physically ill, mentally ill, and disabled
people of all ages,in all health care and other
community settings
 The content of concept
of nursing

(1) The nursing science is an

independent applying science
that synthesizing natural
and social sciences.
(2) Nursing is a profession that
helps human being and serves
for health of human being
(3) Nursing can assist individual
to meet the basic needs of
human being and enforce the
ability of self-care.
(4) The tasks of nursing are:
 To promote health
 To prevent disease
 To help ill-person to healing
 To assist the dying patient to pass
away with quietude, peace, and
dignity.
(5) The client is a holistic
human being, including
suffering person and
healthy person.
(6) The working place is not
only in the hospital, but
also in family, community
and whole society.

(7) Nursing is not only a

science, but also an art
(8) The nursing science attaches
importance to human being’s
living environment and the
interrelation between human
being and its environment.
(9) The nursing science is a
gradually perfect and
developing science.
 The content of concept
of nursing
(1) Caring: lasting topic
(2) Humanism: humanistic perspective
(a) Respect individual
(b) Pay attention to the human nature
(c) Treat equally without discrimination
(3) The helping relationship
 Evolvement process of the
concept of nursing

(1) Developmental stages of nursing

model

(2) The meaning and significance of

holistic nursing
 The relationship between
nursing and health

WHO(1978) : “……to help patient to

resume to health , help healthy
person to promote health.”
ICN: right and obligation of
nurses are:
(a) To maintain life
(b) To lighten suffering
(c) To promote health
Tasks of nursing:
 To promote health
 To prevent disease
 To assist healing
 To ease suffering
 Medical Surgical Nursing: -

Medical-surgical nursing is a nursing

specialty area which focuses on adult
patients with acute or chronic illness
and their responses to actual or
potential alterations in health.