Models of Health and Illness in Nursing Practice

Key Points

• Health models shape how nurses assess needs, communicate risk, and design interventions.
• Biomedical models focus on disease processes, while holistic and wellness models include psychosocial and contextual factors.
• Behavior models such as the Health Belief Model and Health Promotion Model guide prevention counseling.
• Need-based models, including Maslow, help prioritize interventions safely.

Pathophysiology

Health models are conceptual frameworks rather than biologic pathways. They organize decision-making by defining what counts as “health,” what drives behavior change, and how risk is interpreted.

Model selection affects care outcomes: narrow disease-only framing can miss social and behavioral drivers, while broad holistic framing may improve long-term adherence and prevention.

Classification

• Biomedical model: Disease-centered diagnosis and treatment emphasis.
• Holistic/wellness model: Integrated physical, mental, social, and spiritual dimensions.
• Behavioral models: Health Belief Model and Health Promotion Model for risk perception and behavior change.
• Need-priority model: Maslow hierarchy for sequencing care priorities.

Nursing Assessment

NCLEX Focus

Match model choice to the clinical problem: acute physiologic instability versus long-term behavior change.

• Assess whether current plan overemphasizes disease treatment and underaddresses behavior/context.
• Assess patient beliefs about susceptibility, severity, benefits, and barriers.
• Assess readiness for health-promoting behavior change.
• Assess unmet basic needs that block higher-level engagement.
• Assess model fit across acute, chronic, and preventive care contexts.

Nursing Interventions

• Use biomedical framing for urgent physiologic stabilization needs.
• Integrate holistic assessment into chronic and recovery planning.
• Apply belief- and motivation-based counseling for prevention goals.
• Use staged, realistic health-promotion goals tailored to readiness.
• Reassess and shift model emphasis as patient context changes.

Model Rigidity Risk

Applying one model rigidly to all situations can produce incomplete plans and weaker outcomes.

Pharmacology

Medication plans improve when biomedical prescribing is combined with behavior-focused adherence support and contextual barrier assessment.

Clinical Judgment Application

Clinical Scenario

A patient with hypertension repeatedly misses follow-up and declines lifestyle changes despite understanding diagnosis details.

Recognize Cues: Biomedical understanding exists, but behavior change is limited. Analyze Cues: Belief, motivation, or barrier factors are likely unaddressed. Prioritize Hypotheses: Health-belief and promotion models are needed in addition to disease model. Generate Solutions: Elicit perceived barriers, set small goals, and align supports. Take Action: Implement mixed-model care plan with follow-up coaching. Evaluate Outcomes: Adherence and risk-factor control improve.

Related Concepts

• maslows-hierarchy-of-needs - Need-priority framework for safe sequencing.
• healthy-people-2030-health-equity-and-social-determinants - Population-level prevention orientation.
• evidence-based-decision-making-in-nursing - Model-informed decision integration with evidence.

Self-Check

1. When is a biomedical model necessary but insufficient?
2. How do Health Belief and Health Promotion models differ in practical use?
3. Why should model selection evolve over the course of care?