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:
2.1.1. 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.