The mind and body are no longer seen by the medical professional as existing independently of each other. The shift from what was known as a bio-medical notion of health has now been overtaken through the embrace of the biopsychosocial model by the healthcare system and its practitioners. Such a theoretical framework views both illness and health as the complex interaction between biological, psychological and social domains, in determining ones health (Ogden, 2004). The model thus holds a number of propositions in regards to health and illness. Firstly, that illness is multi-causal in its initiation – a number of factors may work together in order for illness to result (Coolican, 1999) The interaction of the individual’s social world such as relationships, spirituality and socio-economic status (financial resources and position within the community) are also involved in the health process and this is seen at a macro-level of process (e.g. available social support) which then interacts with more micro-level processes (biological factors such as chemical imbalances in the body) to result in subsequent health or illness.
In regards to nursing specifically, amongst health practitioners, traditionally attention has been focused on meeting patients physical and mental health needs but with substantial evidence pointing to the combination and interaction of macro and micro level processes on our health and in the cause of illness, this means that nurses need to understand health from a more holistic approach. A holistic approach in regards to health can be explained and defined by “the need to consider the person as a whole if one is to fully understand his or her health status,” (Coolican, 1999: p171) and therefore in regards to ill-health, nurses are thus required to understand the illness of the individual under their care, from the perspective of the patients actual life-situation.
A large body of literature has proven that a number of factors and variables impact upon health status (current state of health) and health outcome (long-term health and well-being), and these will now be discussed with examples from each of the three domains; biology, psychology and the social context. For the purposes of this essay, health will be viewed as a spectrum with well-being on one pole, and illness on the other.
One of the major categories within the biological domain of factors that can influence health status is our genetic make-up – and more specifically the case of genetic disorders which predispose individuals to various conditions that can be damaging to health if not fatal Genetic disorders have been found to exist for the majority of the bodies systems, and are wide ranging in the numbers of individuals they affect, and the degree to which the compromise health. Examples of such conditions include Blood and Lymph system disorders such as Sickle Cell Anemia (SCA) which through an abnormality of the blood’s hemoglobin shape can cause pain, chronic anemia and increased experience of severe infections. Genetic disorders can also involve a predisposition to some cancers; breast cancer has an especially high incidence