
Health is no longer recognised as merely being the absence of illness but rather a point on a continuum of wellness. All people have potential for wellness, which is unique to their own personal and environmental contexts. Moreover, this potential can be realised through genuine partnerships in health and health care decisions. Such partnerships require health practitioners explicitly to acknowledge that all individuals, families and groups bring knowledge to health care encounters regarding their own subjective experiences of health, wellness and health care.
A state of wellness is compatible with the presence of chronic disease and disability, depending on the perceptions of individuals and the ways in which health conditions are managed.
The International Classification of Functioning, Disability and Health (ICF) for example, emphasises wellness in its major components of ‘body structures and function’, ‘activities’, and ‘participation’, rather than illness-focused components like ‘impairment’, ‘disability’ and ‘handicap’ represented in earlier frameworks (World Health Organization 2001). Notably, the ICF suggests that all people have potential for wellness, or meaningful ‘participation’, and that this can be understood as a dynamic interaction between the limitations in body structures and function and the personal and environmental context. To that end, it dismantles the dichotomous and fixed view of able-bodied versus disabled-bodied people.
Similarly the concept of recovery promotes the notion of possibilities rather than pathologies and problems. The recovery paradigm promotes the idea that an individual may lead a meaningful and fulfilling life despite the presence of a health condition or disability. Although the recovery movement has evolved within mental health services, it also has wider application to other areas of health care. For example, a recovery focus challenges the prevailing focus on symptoms and impairments in chronic illness and disability management and has potential for more innovative practices.
The key challenge for health practitioners in adopting a wellness or recovery focus is to shift beyond the traditional ‘illness’ focus that is implicit within the biomedical and biopsychosocial frameworks and to empower individuals to be true partners in their own health care, rather than being passive recipients of ‘expert’ care.
This necessarily involves relinquishing the ‘professional’ status to some extent and more importantly, developing a keener ‘whole-of-life’ focus of individuals rather than purely a symptomatic or bodily focus. At the crux of this is the willingness of health practitioners to be genuinely person-centred in enabling individuals to articulate desired outcomes and goals for the purpose of service planning.
Health care practice that is inclusive of clients’ own wellness aspirations as well as practitioner expertise, and which incorporates collaborative engagement and partnership with clients towards the realisation of their wellness aspirations, is likely to produce effective practice outcomes, strong client and practitioner satisfaction, and positive service evaluation.
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