- A model is a theoretical way of understanding a concept
- Models represent different ways of approaching complex
- There are different models of health.
- The absence of signs and symptoms of disease indicates
- Illness would be the presence of conspicuous signs and
symptoms of disease.
- People who use this model of health to guide their use
of healthcare services may not seek preventive health
services , or they may wait until they are very ill to
- Clinical model is the conventional model of the
discipline of medicine.
- Health is indicated by the ability to perform social
- Role performance includes work, family and social
roles, with performance based on societal expectations.
- Illness would be the future to perform a person’s roles
at the level of others in society.
- This model is basis for work and school physical
examination and physician –excused absences.
- The sick role, in which people can be excused from
performing their social roles while they are ill, is a
vital component of the role performance model.
- The ability to adapt positively to social, mental, and
physiological change is indicative of health.
- Illness occurs when the person fails to adapt or
becomes inadaptive toward these changes.
- As the concept of adaptation has entered other aspects
of culture , this model has become widely accepted.
- This model is useful for examining causes of disease in
- The agent, host and environment interact in ways that
create risk factors, and understanding these is important
for the promotion and maintenance of health.
- An agent is an environmental factor or stressor that
must be present or absent for an illness to occur.
- A host is a living organism capable of being infected or
affected by an agent.
- The host reaction is influenced by family history, age,
and health habits.
- This model recognizes health as an ongoing process
toward a person’s highest potential of functioning.
- This process involves the person, family and the
- He describes high-level wellness as “the experience of a
person alive with the glow of good health, alive to the
tips of their fingers with energy to burn, tingling with
vitality – at times like this the world is a glorious
- The wellness- illness continuum (Travis and Ryan 1988)
is a visual comparison of high-level wellness and
traditional medicine’s view of wellness.
- High level wellness according to Ardell(1977) is a
lifestyle focused approach which you design for the
purpose of pursuing the highest level of health within
- Holism represents the interaction of a person’s mind,
body and spirit within the environment.
- Holism is based on the belief that people (or their
parts) can not be fully understood if examined solely in
pieces apart from their environment.
- Holism sees people as ever charging systems of energy.
- In this model, nurses consider clients the ultimate
experts regarding their own health and respect client’s
subjective experience as relevant in maintaining
health or assisting in healing.
- In holistic model of health, clients are involved in
their healing process, thereby assuming some
responsibility for health maintenance.
- Florence Nightingale’s environmental theory focuses on
preventive care for populations.
- She suggested that disease was more prevalent in poor
environments and that health could be promoted by
providing adequate ventilation, pure water, quiet, warmth,
light and cleanliness.
- "Poor environmental conditions are bad for health and
that good environmental conditions reduce disease."
- This is one way to measure a person’s level of
- This model views health as a constantly changing state,
with high level wellness and death being on opposite ends
of a graduated scale, or continuum.
- This continuum illustrates the dynamic state of health,
as a person adapts to changes in the internal and external
environments to maintain a state of well-being..
- Nancy Milio developed a framework for prevention that
includes concepts of community – oriented, population-
- Milio stated that behavioural patterns of the
populations-and individuals who make up populations – are
a result of habitual selection from limited choices.
- She challenged the common notion that a main determinant
for unhealthful behavioural choice is lack of
- Milio’s framework described a sometimes neglected role
of community health nursing to examine the determinants of
a community’s health and attempt to influence those
determinants through public policy.
- This model, advocated by Leavell and Clark in 1975, has
influenced both public health practice and ambulatory care
- This model suggests that the natural history of any
disease exists on a continuum, with health at one end and
advanced disease at the other.
- The model delineates three levels of the application of
preventive measures that can be used to promote health and
arrest the disease process at different points along the
- The goal is to maintain a healthy state and to prevent
disease or injury.
It has been defined in terms of four
- Primordial prevention
- Primary prevention
- Secondary prevention
- Tertiary prevention
- Prevention of the emergence or development of risk
factors in population or countries in which they have not
- Efforts are directed towards discouraging children from
adopting harmful lifestyles.
- An action taken prior to the onset of disease, which
removes the possibility that the disease will ever
- It includes the concept of positive health, that
encourages the achievement and maintenance of an
“acceptable level of health that will enable every
individual to lead a socially and economically
- Action which halts the progress of a disease at its
incipient stage and prevents complications.
- The domain of clinical medicine.
- An imperfect tool in the transmission of disease.
- More expensive and less effective than primary
- All measures available to reduce or limit impairment and
disabilities, minimize suffering caused by existing
departures from good health and to promote the patient's
adjustment to irremediable conditions.
- This model is based on the premise that for a behavioral
change to succeed, individuals must have the incentive to
change, feel threatened by their current behaviour, and
feel that a change will be beneficial and be at acceptable
- They must also feel competent to implement that change .
- The purpose of the model is to explain and predict
preventive health behavior.
- Health Education:
communication activity aimed at enhancing well-being and
preventing ill-health through favorably influencing the
knowledge, beliefs, attitudes and behavior of the
- Health Protection:
refers to the policies and codes of practice aimed at
preventing ill-health or positively enhancing
well-being, for example, no smoking in public places.
Health Protection is responsible for the development and
implementation of legislation, policies and programs in
the areas of Environmental Health Protection, Community
Care Facilities, and Emergency Preparedness
- Prevention: refers to
both the initial occurrence of disease and also to the
progress and subsequently the final outcome
- It is based on knowledge of the experience, views and
practices of people with disabilities.
- It locates the problem within society, rather than
within the individual with a disability
- Rules are determined within a framework of choice and
independent living with strong support from organized
- The biases of the social model include:
- limiting the causes of disability either exclusively
or mainly to social and environmental policies and
- advancing perceptions of disability that emphasize
individual rights rather than advancing broader
- The ultimate goal is to stop violence before it begins.
- Prevention requires understanding the factors that
- CDC uses a four-level social-ecological model to better
understand violence and the effect of potential prevention
- This model takes into consideration the complex
interplay between individual, relationship, community and
- It allows us to address the factors that put people at
risk for experiencing or perpetrating violence.
- purpose of mental health promotion for people with
mental illness is to ensure that individuals with mental
illness have power, choice, and control over their lives
and mental health, and that their communities have the
strength and capacity to support individual empowerment
- The person with mental illness is the central focus:
participating in her/his community, involved in
decision-making about mental health services, and choosing
which supports are most appropriate.
- There are four key resources which should be available
to the person to support their mental health:
- a) mental health services;
- b) family and friends;
- c) consumer groups and organizations; and
- d) generic community services and groups.
- It believes change is a process. Individuals must go
through with different factors affecting movement.
- This model proposes that the further an intervention
helps clients to progress on the stage continuum, the more
likely they are to exhibit change.
- Individuals must pass through three stages;
A) Labeling - one must
label their actions as risky for contracting HIV (i.e.
problematic). Three elements are necessary
B) Commitment – this
decision-making stage may result in one of several outcomes
- Knowledge about how HIV is transmitted and prevented,
- Perceiving themselves as susceptible for HIV and
- Believing HIV is undesirable
C) Enactment – This
includes three stages:
- Making a firm commitment to deal with the problem
- Remaining undecided,
- Waiting for the problem to solve itself, or
- Resigning to the problem: Weigh cost and benefits-
giving up pleasure (high risk) for less pleasure (low
- Seeking information,
- Obtaining remedies, and
- Enacting solutions.
- Nursing must expand its efforts to design and implement
interventions which support promotion of health and
prevention of disease/illness and disability.
- Preventing illness and staying well involve complex,
multidimensional activities focused not only on the
individual, but also on families, groups and populations.
- Approaches to prevention should be comprehensive,
encompass primary, secondary and tertiary levels of
prevention and involve consumers in their formulation.
- Prevention strategies are more likely to be adopted by
citizens who participate in influencing and developing
- Nurses have developed many health models to understand
the client’s attitudes and values about health and illness
so that effective health care can be provided.
- These nursing models allow nurses to understand and
predict client’s health behaviour, including how they use
health services and adhere to recommended therapy.
- Craven RF, Hirnle CJ. Fundamentals of Nursing Human
Health and Function.5th edn. Lippincott;
- Taylor C, Lillis C, Lemone P. Fundamentals of nursing
the art and science of nursing care. 5th edn. Lippincott;
- Potter PA, Perry AG. Fundamentals of nursing.6th
- Black JM, Hawks JH. Medical Surgical nursing clinical
management for positive outcomes. Vol1. 7th edition.
Saunders; India : 2005, Pp 134-136.
- Allender JA, Spradley BW. Community health nursing
concepts and practice.
5thedition.Lippincott;Philadelphia:2001, Pp 10-12.
- Park K. Text book of Preventive and social medicine,
- Kulkarni. Text book of community medicine,6th edition,