The patient's approach to wellness

The patient's own approach to wellness is receiving increasing attention as the potential for self-responsibility in assuming wellness behaviors is recognized as one, if not the most, significant factor determining health status. Shifts in patterns of illness and potential for illness intervention are acknowledged as central in moving the focus from illness to wellness. Recognition of the deleterious impact of lifestyle and existing behaviors has raised awareness of the need to promote change in wellness behaviors and mechanisms. The scope and quality of information becoming available related to health promotion is bewildering and often contradictory. Information becomes available daily on nutrition, exercise, stress and relaxation, relatedness and support systems, and consciousness and spirituality . Desires and motivations are complex, combining a wish to perpetuate an affluent lifestyle with recognition that depletion of resources and environmental contaminations are risks to the well-being of individuals and society. Nurses, as well as other health care providers, are concerned with health promotion. We need to view our arena realistically and with full cognizance of balancing reasonable caution in scrutinizing new information with openness to ideas that will expand both the potential for wellness and our potential to contribute to health promotion. We practice in a quagmire of uncertainty, unsubstantiated truths, and demands for assurances and answers. We are asked to provide quality care and to perform responsibly in a cost-effective manner. We are pressured for pragmatics . We need to recognize our urge to capitulate to demands. Since historically we are a caring, responsive practice, we can be trapped into "false assurance." While recognizing appropriate limitations in providing assurances, it is possible to offer assistance in ferreting out information and understanding the degree of confidence with which it can be viewed and to support increasing autonomy. Educational programs can be used in conjunction with relationship skills in enhancing health care, the recipient's adoption of wellness behaviors that promote health.