Illness-Wellness Continuum

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The Illness-Wellness Continuum is a graphic illustration of a wellbeing concept first proposed by John W. Travis in 1972.[1] It describes how wellbeing is more than simply an absence of illness, but also incorporates the individual's mental and emotional health. In this it echoes the view of the World Health Organization.[2] In addition, it contrasts the way professionals using these two fundamentally different paradigms relate to their constituents. Professionals using the Treatment Paradigm relate to their patients as parent to child, while those using the Wellness Paradigm relate to their clients as peers.

Concept

Travis believes that the standard approach to medicine, which assumes a person is well when there are no signs or symptoms of disease, was insufficient. This led to his development of the Continuum. The right side of the Continuum reflects degrees of wellness, while the left indicates degrees of illness.[3] The Illness-Wellness Continuum has been used to highlight how, even in the absence of physical disease, an individual can suffer from depression, anxiety or other conditions— indicating a lack of wellness.[4]

While standard medicine (see "Treatment Paradigm"), typically treats injuries, disabilities, and symptoms, to bring the individual to a "neutral point" where no illness is present, the Wellness Paradigm seeks to move the individual’s state of wellbeing further along the continuum towards optimal emotional and mental states.[2][5][6][7] The concept is premised on the idea that wellbeing is a dynamic rather than a static process.[6][8] In this, the Illness-Wellness Continuum reflects the view of the World Health Organization, which has defined health as "a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity."[9]

The Illness-Wellness Continuum proposes that individuals can move further to the right, towards health and wellbeing, through awareness, education, and growth.[10] Conversely, worsening states of health are reflected by signs, symptoms, and disability. In addition, a person's outlook plays a major role moving along the Continuum in either direction. A positive outlook will enhance the individual’s health and wellbeing, while a negative outlook will hinder it, independent of present health status. For example, a person who demonstrates no symptoms of disease, but is constantly complaining, would be facing the left side of the Continuum, toward an early death.

However, a person having a disability, but still maintaining a positive outlook, will be facing to the right, toward a high level of wellness.[11] It is less important where a person is on the continuum than which direction they are facing.

The Illness-Wellness Continuum has been praised for promoting preventive treatment—improving wellbeing before an individual presents with signs or symptoms of illness, as well as educating people to be aware of, and consequently avoiding risk factors, protecting against pathology and an early death.[12]

Historical context

In developing the concept of the Illness-Wellness Continuum, Travis built on the work of Halbert L. Dunn, M.D., who first coined the phrase "high-level wellness" in the 1950s and subsequently published a book with the same name in 1961. It was also partly influenced by Abraham Maslow’s concept of self-actualization and Lewis Robbins M.D.’s health risk continuum, the foundation for his creation of the health risk appraisal.

Travis originally began developing the concept in 1972 and it was first published in 1975 in the Wellness Inventory.[13] It is still utilized in numerous textbooks and guides as a fundamental wellness resource.[14]

Acceptance

The Illness-Wellness Continuum is one of the oldest models of wellness still in use.[15] In the years since it was first published, the concept has been integrated into a diverse range of fields, including medicine,[16][17] nursing,[18][19][20] counseling, physical therapy,[1][12][21] public health,[4] and organizational development.[22]

References

  1. 1 2 Sharon Elayne Fair (22 October 2010). Wellness and Physical Therapy. Jones & Bartlett Publishers. pp. 9–. ISBN 978-1-4496-1034-0.
  2. 1 2 Thomas J. Sweeney (18 May 2009). Adlerian Counseling and Psychotherapy: A Practitioner's Approach, Fifth Edition. Taylor & Francis. pp. 34–. ISBN 978-0-203-88614-4.
  3. ↑ Ferguson, Tom. "How Health Workers Can Promote Self-Care". www.healthy.net. Retrieved 30 December 2013.
  4. 1 2 G. E. Alan Dever (1 January 1997). Improving Outcomes in Public Health Practice: Strategy and Methods. Jones & Bartlett Learning. p. 18. ISBN 978-0-8342-0637-3.
  5. ↑ Huhn, Robert (2007). "Linda Crane Lecture Improving the Health of Society One Individual at a Time". Cardiopulmonary Physical Therapy Journal 18 (2).
  6. 1 2 "A New Vision of Wellness". wellpeople.com. Retrieved 2013-12-09.
  7. ↑ "Wellness-A New Perspective for Leisure and Tourism Wellness Philosophy" (PDF). Haaga-Helia University of Applied Sciences. Retrieved 2013-12-09.
  8. ↑ Jobson, Roy (2003). "Wellness in South Africa". South African Family Practice 45 (3).
  9. ↑ "WHO definition of Health". www.who.int. WHO. Retrieved 26 August 2014.
  10. ↑ "Promoting Wellness in Health and Illness". www.desales.edu. DeSales University. Retrieved 25 August 2014.
  11. ↑ Tooman, Heli. "Wellness - A New Perspective for Leisure and Tourism" (PDF). www.pc.parnu.ee. Retrieved 25 August 2014.
  12. 1 2 Catherine Rush Thompson (2007). Prevention Practice: A Physical Therapist's Guide to Health, Fitness, and Wellness. SLACK Incorporated. pp. 5–. ISBN 978-1-55642-617-9.
  13. ↑ Jeanne M. House; Courtney Arnold; Dawson Church; Randy Peyser; Barbara Stahura (March 2008). Peak Vitality: Raising the Threshold of Abundance in Our Material, Spiritual and Emotional Lives. Elite Books. pp. 10–. ISBN 978-1-60070-013-2.
  14. ↑ "Spas and the Global Wellness Market - synergies and opportunities March 2010" (PDF). www.sri.com. SRI International. Retrieved 28 August 2014.
  15. ↑ http://samples.jbpub.com/9780763758219/58219_CH01_FINAL.pdf (PDF). Jonas and Bartlett Publishers, LLC http://samples.jbpub.com/9780763758219/58219_CH01_FINAL.pdf. Retrieved 25 August 2014. Missing or empty |title= (help); External link in |website= (help)
  16. ↑ Thomas M. Wolf (18 August 2000). To Your Health: Achieving Well-Being During Medical School. SAGE Publications. pp. 18–. ISBN 978-1-4522-6760-9.
  17. ↑ Robert B. Taylor (January 1983). Fundamentals of family medicine. Springer-Verlag. ISBN 978-0-387-90705-5.
  18. ↑ Lewis, Emily. "Understanding the Health Continuum: A Guide for Nurses". http://education-portal.com/. Retrieved 25 August 2014.
  19. ↑ Mengistu, Daniel. "Community health nursing" (PDF). http://www.cartercenter.org/. Retrieved 25 August 2014.
  20. ↑ Clint Douglas; Geraldine Rebeiro; Jackie Crisp; Catherine Taylor (1 February 2012). Potter & Perry's Fundamentals of Nursing - Australian Version. Elsevier Health Sciences. pp. 424–. ISBN 0-7295-7862-3.
  21. ↑ Elsevier India; Potter (10 June 2013). Potter's fundamentals of nursing Adaptation, 1/e. Elsevier India. pp. 6–. ISBN 978-81-312-3436-5.
  22. ↑ Dennis Farrell; Neil Lilford; Mariaan Ellis (1 September 2008). Operations and Management Principles for Contact Centres. Juta and Company Ltd. pp. 151–. ISBN 978-0-7021-7704-0.
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