The Illness-Wellness Continuum
What motivates us to be as healthy, strong and active as we can be? Is it intrinsic forces, extrinsic forces or both that pushes us to make good choices about our lifestyles? My guess is you don't know the answer to that, nor do I, because it's always changing.
What matters is that whatever the motivating factor is for people, they have to harness it and use it to continue going in the right direction.
As nurses, it is our job to help our patients find their inspiration and what their driving factor will be to put them on the path to better health.
One tool that nurses can use to help guide their patients in the right direction is the health continuum, also called the illness-wellness continuum.
The illness-wellness continuum is an illustration that draws a connection between the treatment paradigm and the wellness paradigm.
Where they meet in the middle is considered the neutral point. Some examples of the continuum include the 6 components of personal health. These are categories within each of our daily lives that must be balanced in order to attain optimal health.
This is a great tool that nurses can use to help their patients visualize, plan and achieve their goals for a healthier lifestyle. Consider the farther down the continuum your patients go towards illness the closer they are to death; rather, the farther up the continuum your patients go towards wellness the closer they are to optimal health.
Nurses are not only responsible for treating their patients but educating them on how prevention and lifestyle choices can help them move towards health and wellness.
Examples of the Continuum
The continuum can be visualized many different ways, but here are a few examples:
The illness-wellness continuum was first imagined by Dr. John W. Travis in 1972.
The wellness paradigm spans the entire length of the continuum, since this is the direction our patients must be facing in order to achieve high-level wellness. The treatment paradigm, however, only leads patients to the neutral point or, in other words, a non-illness state.
Our goal as nurses should be to move our patients beyond that to a more optimal level of health. As you can see from the illustration, the way to achieve this is through awareness, education and individual growth.
In this illustration you can see that not only is the health continuum moving from optimum wellness to premature death with the various stages in between, but the 6 components of personal health are surrounding the continuum as well. The components are revolving around the continuum and contingent upon each other in a continuous state.
6 Components of Personal Health
The 6 components of personal health consist of:
- Physical health: Is our body functioning as well as it could be?
- Emotional health: Can we express ourselves adequately?
- Mental health: Does stress consume us or can we cope when needed?
- Social health: Do our friends and family help us or hinder us?
- Environmental health: Is our air, water, and food clean and safe?
- Spiritual health: Are we following our own code of ethics, morals and values?
All of these are factors that affect which direction our patients go on the illness-wellness continuum. These states are not fixed, and even the slightest of changes can make a difference to their overall health.
Let's look more closely at each of the 6 components of personal health.
Unfortunately, as hard as we try to eliminate the causative agents of various disease processes, we can't be 100% immune, unless we live in a bubble.
We can, however, give our bodies a fighting chance through prevention methods, such as hand washing, immunizations, health screenings and proper diet and exercise. Factors that we have no control over, yet have an enormous impact on our physical health, are our age and genetics.
As hard as we may try to stop or reverse the hands of time, it is inevitable. Likewise, we have no control over our genetic makeup.
Being able to adequately express feelings in a constructive way, while difficult, can be very enlightening to not only ourselves but to those around us as well.
It's unrealistic to imagine a life with no conflict, but it is realistic to imagine a life where feelings can be addressed in a way that is the least damaging to all those involved.
Much like our physical health, we cannot control all aspects of our lives that can impact our mental health. Demands of our daily lives can change from one minute to the next, so the key is how we manage those demands and how we cope when we can't. When faced with a stressful situation, do we deal with it head on, do we sit back and let it play out? Or does it depend?
While for the most part we get to choose our friends, that is not the case with family. Our friends and family are our main sources of support in times of need. The quality of those relationships and the meaningfulness behind them is what makes or breaks them. We want our sources of support to empower us and guide us along any path we may choose.
If we find ourselves in relationships that are discouraging, we must ask ourselves why and either alter those relationships or terminate them.
Many issues can affect one's environment, and since we have already come to the conclusion that we can't live in a bubble, we have to do our best to maintain today's standards of sanitation and safety with regards to our environment, food and water.
Chemical and radiological terrorism, along with many other environmental exposures, such as lead, can be extremely harmful and are continuously being monitored by the National Center for Environmental Health.
No matter the god or higher power, if we choose any, it is expected that we follow our internal compass in regards to what is right and what is wrong. Being connected spiritually to another person, place or thing can give us direction and a sense of harmony.
Creating a Specific Plan
Visualizing the health continuum allows our patients to set goals for themselves to ensure a healthier lifestyle by becoming more educated and aware of what is needed to reach high levels of wellness.
As nurses, just showing patients the continuum and describing it is not enough. Specific plans that are tailored to each individual patient are important. For example, consider a patient who is struggling with obesity and other health conditions related to this, such as high blood pressure or diabetes.
This places them within the treatment paradigm. You can show them that they have the ability to move past the neutral point into the wellness paradigm by working with them to decide on a realistic and motivating weight loss regimen and an exercise plan will give them direction and purpose versus just wishful thinking.
Helping them to analyze their own 6 components of personal health and what they mean to their overall well-being is another tool nurses can use to show their patients where improvements are needed within their everyday life. Nurses are the front-line educators for their patients, and it is their job to keep patients on the path of wellness. As the old saying goes, 'practice what we preach.' Therefore, it's important that we ourselves stay on the right side of the continuum.
The health continuum is an excellent visual resource for nurses to use when educating their patients about their overall health now and where it has the potential to go in the future. Although there are numerous examples of the continuum, some use the 6 components of personal health as an adjunct to the continuum. Each of the 6 components are important separately but come together as a cohesive unit when optimal wellness is achieved.
After completion of the lesson, you should be able to:
- Identify what the health continuum is
- Understand the importance of the continuum to nurses
- Describe the six components of personal health
- Detail the use of a specific health plan