Models of Health and Illness

Models of Health and Illness

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A model is a theoretical way of understanding a concept.  Models represent different ways of approaching complex issues. Because health and illness are complex concepts, models are used to understand the relationships between these concepts and the patient’s attitudes towards health and health behaviors.

Health beliefs are a person’s ideas, convictions, and attitudes about health and illness. Health beliefs usually influence health behavior; they can positively or negatively affect a patient’s level of health. Positive health behaviors are activities related to maintaining, attaining or regaining good health and preventing illness. Common positive health behaviors include immunizations, proper sleep patterns, adequate exercise, stress management, and nutrition. Negative health behaviors include practices actually or potentially harmful to health such as smoking, drug or alcohol abuse poor diet, and refusal to take necessary medications.

Nurses developed the following health models to understand patient’s attitudes and values about health and illness and to provide effective health care. These nursing models allow you to understand and predict patient’s health behavior, including how they use health services and adhere to recommended therapy.

Health Belief Model

Rosenstoch’s (1974) and Becker and Maiman’s (1975) Health Belief Model Addresses the relationship between a person’s beliefs and behaviors. The HBM helps to understand factors influencing patient’s perceptions, beliefs, and behavior to plan to care that will effectively assist patients in maintaining or restoring health and preventing illness.

The First Component of this model involves an individual’s perception of susceptibility to an illness. For example, a patient’s needs to recognize familial link for coronary artery disease. After this link is recognized, particularly when one parent and two siblings have died in their fourth decade from myocardial infarction, the patient may perceive the personal risk of heart disease.

The Second Component is an individual’s perception of the seriousness of the illness. This perception is influenced and modified by demographic and psycho- sociological variables, perceived threats of the illness and cues to action (e.g. Mass media campaigns and advice from family, friends and medical professionals). For example, a patient may not perceive his heart disease to be serious, which may affect the way he takes care of himself.

The Third Component, the likelihood that a person will take preventive action- results from a person’s perception of the benefits of and barriers to taking action. Preventive actions include lifestyle change, increased adherence to medical therapies, or search for medical advice or treatment. A patient’s perception of susceptibility to diseases and his or her perception of the seriousness of an illness help to determine the likelihood that the patient will or will not take part in healthy behaviors.

Health promotion model

The health promotion model {HPM} purposed by Pender [1982: revised, 1996] it defines health as a positive, dynamic state, not merely the absence of disease.Health promotion is directed at increasing a patient’s level of well-being. The HPM describes the multi-dimensional nature of persons as they interact within their environment to pursue health.

The model focuses on the following three areas:

  • Individual characteristics and experiences
  • Behaviour-specific knowledge and
  • Affect behavioral outcomes

The HPM mentions that each person has unique personal characteristics and experiences that affect subsequent actions. Health promoting behavior is the desired behavioral outcome and the end point in the HPM. Health promoting behaviors result in improved health, enhanced functional ability, and better quality of life at all stages of development.

Maslow’s Hierarchy of Needs

Basic human needs are elements that are necessary for human survival and health (e.g food, water, safety, and love). Basic needs are met is a major factor in determining a person’s level of health.

Maslow’s hierarchy of needs is a model that nurses use to understand the interrelationships of basic human needs. This model provides a basis for nurses to care for patients of all ages in all health settings. The hierarchy of needs are Physiological needs (oxygen, fluids, nutrition, elimination, shelter, and sex), Safety and Security needs (physical safety and psychological safety), Love and Belonging needs, Self-Esteem needs, and Self-Actualization.


Holistic Health Models

Healthcare has begun to take a more holistic view of health by considering emotional and spiritual well-being. The Holistic Health Model of nursing attempt to create conditions that promote optimal health. In this model, nurses using the nursing process. In the holistic health model patients are involved in their healing process, thereby assuming some responsibility for health maintenance (Edelman and Mandle, 2010). Nurses using the holistic nursing model recognize the natural healing abilities of the body and incorporate complementary and alternative interventions such as music therapy, reminiscence, relaxation therapy, therapeutic touch, and guided imagery, economical, non-invasive, non-pharmacological complements to traditional medical care. Nurses use holistic therapies either alone or in conjunction with conventional medicine. For example, they use reminiscence in the geriatric population to help relieve anxiety for a patient dealing with memory loss or for a cancer patient dealing with difficult side effects of chemotherapy. Music therapy in the operating room creates a soothing environment. Relaxation therapy is frequently useful to distract a patient during a painful procedure. Breathing exercises are commonly taught to help patients deal with pain associated with labor and delivery.


Health and wellness are not merely the absence of disease and illness. A person state of health, wellness or illness depends on individual values, personality, and lifestyle. The health belief model considers the relationship between a person’s health beliefs and health behaviors. The health promotion model highlights factors that increase individual well-being and self-actualization. Maslow’s hierarchy of needs model emphasizes identifying a patient’s individual needs, prioritizing the needs and encouraging the patient’s individual discovery self. Holistic health models of nursing promote optimal health by incorporating active participation of patients in improving their health state. Health beliefs and practices are influenced by internal and external variables and should be considered when care is been planned. Health promotion activities help to maintain or enhance health. Wellness education teaches patients how to care for themselves.



Prof. M Chinna Devi

Dean, Faculty of Nursing

SGT University, Gurugram

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