There has been much written about the importance of promoting "wellness" in value-based care. Yet there is no definitive definition of the concept. In this post I offer a conceptual framework for
discussion in which I attempt to delineate many of the key factors discussed in
the literature, along with my observations as a clinical psychologist.
Proposed
definition: Wellness is a measure of a person’s overall state of health, which
is greatest when a person has and uses a set of abilities, desires, behaviors,
and resources to avoid, manage, and cope with physiological, psychological
(mental and emotional), and mind-body health problems to the extent possible.
The
Following delineates some of the concepts in this proposed wellness definition.
1. Health problems include (but not
limited to):
1.1. At-risk, acute, subacute, chronic,
catastrophic, and end-of-life conditions.
1.2. Illness, injury, dysfunction,
disability, disfigurement, and debilitating distress with associated causes (e.g.,
contagion, trauma, genetics, etc.) and signs and symptoms (physical, emotional,
behavioral, and cognitive).
1.3. Mind-body (biopsychosocial) health
problems in which psychological distress adversely affects a person’s physical
health and vice versa.
2. Requisite abilities, resources, and desires
include:
2.1. Abilities:
2.1.1. Psychological capabilities that
enable people to cope
effectively with their health problems in a way that reduces the likelihood of denial,
ignorance, self-deception, debilitating depression, irrational despair/discouragement
and fear, hostility, blame, shame, and self-destructive behavior. These
capabilities include focused awareness, rational and adaptive beliefs/thoughts/cognitions,
open-mindedness, adequate drive/motivation/will and impulse control, self-determination,
reasonable self-confidence, self-understanding, self-acceptance, sound/logical
reasoning, reliable knowledge, and intelligence.
2.1.2. Behavioral capabilities characterized
by proactive, competent, and responsible actions that include adherence to
evidence-based care plans/guidelines and making recommended lifestyle changes.
2.2.
Social,
economic, and environmental resources (e.g., having access to quality healthcare,
good health literacy, money, time, a healthy/safe living environment,
social/family support, education and access to useful information, access to
foods that support healthy eating patterns.
2.3.
Desire
to live and develop one’s potential for a fulfilling life characterized love,
learning, accomplishment, and other positive activities, experiences, and
feelings.
