society has entertained a variety of concepts of health (David, 2000). Smith (1983) describes four distinct models of health in her classic work: Clinical Model In the clinical model, health is defined by the absence and illness by the conspicuous presence of signs and symptoms of disease. People who use this model may not seek preventive health services or they may wait until they are very ill to seek care. The clinical model is the conventional model of the discipline of medicine. Role Performance Model The role performance model of health defines health in terms of individuals’ ability to perform social roles. Role performance includes work, family, and social roles, with performance based on societal expectations. Illness would be the failure to perform roles at the level of others in society. This model is the basis for occupational health evaluations, school physical examinations, and physician-excused absences. The idea of the “sick role,” which excuses people from performing their social functions, is a vital component of the role performance model. It is argued that the sick role is still relevant in health care today (Davis et al., 2011; Shilling, 2002). Adaptive Model In the adaptive model of health, people’s ability to adjust positively to social, mental, and physiological change is the measure of their health. Illness occurs when the person fails to adapt or becomes maladaptive to these changes. As the concept of adaptation has entered other aspects of American culture, this model of health has become more accepted. For example, spirituality can be useful in adapting to a decreased level of functioning in older adults (Haley et al., 2001).
Eudaimonistic Model In the eudaimonistic model exuberant well-being indicates optimal health. This model emphasizes the interactions between physical, social, psychological, and spiritual aspects of life and the environment that contribute to goal attainment and create meaning. Illness is reflected by a denervation or languishing, a lack of involvement with life. Although these ideas may appear to be new when compared with the clinical model of health, aspects of the eudaimonistic model predate the clinical model of health. This model is also more congruent with integrative modes of therapy (National Institutes of Health, National Center for Complementary and Alternative Medicine [NIH/NCCAM], 2011), which are used increasingly by people of all ages in the United States and the world. In this eudaimonistic model, a person dying of cancer may still be healthy if that person is finding meaning in life at this stage of development.
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