Health and illness models: Nursing

Nurse Bintou works on a surgical oncology floor where clients are admitted following surgical procedures related to cancer. Today, Nurse Bintou will be caring for a client named Helen who underwent a right total mastectomy yesterday for treatment of breast cancer. Before meeting the client, Nurse Bintou checks in the electronic health record, or EHR, to read Helen’s most recent progress note from the healthcare provider which states, “Client will require around the clock pain medication secondary to surgical trauma.” Nurse Bintou enters Helen’s room to introduce herself and finds Helen weeping quietly. Nurse Bintou says, “Helen, my name is Bintou and I’ll be your nurse today. It seems like you’re in pain?” Helen looks up, visibly shaken, and responds, “Yes, but the medicine isn’t going to help my pain; I keep telling everyone that!” Nurse Bintou moves to sit at the edge of the bed, gently touches Helen’s hand and asks her to clarify. Helen sighs and says, “Yes, my incision does hurt, but nothing compares to the pain in my heart.” Nurse Bintou nods as Helen continues, “How will people ever look at me the same when I’m not whole anymore?” Nurse Bintou realizes Helen’s priority need is psychosocial in nature instead of physiological. Nurse Bintou will use what she knows about health and illness models to support and care for Helen.

Okay, so health is a state of complete physical, mental and social well-being which is different for each person based on their values and beliefs. Health is more than just a person being free from illness, which is the subjective experience of physical or mental symptoms which usually accompanies a disease diagnosis. So, now that you understand what health and illness are, it's time to examine the models used to understand them. There are several health and illness models, but we will focus on three that are commonly used by nurses; The Health Belief Model, Maslow’s Hierarchy of Needs, and The Holistic Health Model. First, the Health Belief Model helps clinicians comprehend the relationship between a client’s beliefs and their health behaviors. This model looks at a client’s perception of how susceptible they are to an illness, like how much their diet can contribute to developing heart disease; the client’s perception of the seriousness of the illness, which depends on where they get their health information, like through media sources, a medical professional, or advice from family and friends; and lastly, the likelihood that a client will take preventative measures against an illness, which can be affected by their perception of the illness as well as any barriers they may have to taking action. For example, if a client doesn’t own a vehicle, this could be a barrier to picking up their prescriptions despite the fact that they perceive their illness as serious and preventable.