Respond to this paragraph with a substantive response. Substantive means that you expand on the paragraph, add an additional point or pose a question, and include a citation to support your view.

Health has been historically defined through negation and the absence of disease, which when creating theories and concepts can be of benefit as they are easy to operationalize and measure. Nursing’s goal is to help facilitate a client’s achievement away from the illness end of the health-illness continuum but is removing millions of Americans who have a chronic disease. Pender (2013) proposed a system of five dimensions to classify expressions of health in a promotional aspect and how combining objective and subjective data can redefine how health is defined in our modern world. The five dimensions Pender (2013) discussed are affect, attitudes, activity, aspirations, and accomplishments which should be evaluated in terms of daily fluctuations in addition to evolving patterns over time. Affect is defined as “emotions and feelings as subjectively experienced” and contains concepts like serenity, harmony, vitality, and sensitivity to dictate the person’s overall health and well-being (Pender, 2013, p. 147). Attitudes reflect the emotions in affect but can be applied to their current and/or future situations with concepts relating to optimism, relevancy, and competency (Pender, 2013). Activity is defined in terms of work and play where an individual learns to cultivate a balanced lifestyle to increase health promotion through the concept of invigorating play, meaningful work, and positive life patterns (Pender, 2013). Aspirations allow for the person to excel in their life based on their interests and utilize concepts of self-actualization and social contribution to discuss how individuals have a choice in all actions which can have a negative or positive impact on their health (Pender, 2013). Accomplishments are the personal feelings of fulfillment and can be viewed as daily achievements, life attainments, or states experienced after death utilizing concepts of enjoyment, creativity, and transcendence to further discuss the relation to health (Pender, 2013). The definition of health should be re-focused to understand the individual's perception of their health in terms of emotion in addition to objective data to add support for health promotion theories. 

References

Pender, N. J. (2013). Expressing health through lifestyle patterns. In Cody, W. K. (Ed). Philosophical and theoretical perspectives (4th ed., pp. 143-153). Boston: Jones and Bartlett Publishers