A Qualitative Exploration of the Meaning of Wellness in Contemporary Australia

Wellness

Wellness was established by the World Health Organization in 1948, and its inferred meaning has subsequently been adjusted to match several definitions by many theories. Scholarly research on the meaning of wellness has resulted in a multidimensional definition of wellness. The purpose of this research was to better understand the issues surrounding the definition of wellbeing and how different people interpret the phenomena. "What does wellbeing imply for one adult living in contemporary Australia?" was the research question. To answer the question, the wheel of wellness model was used as a choice theory, and a personal oral interview with a 56-year-old asthmatic male was organized. The interview took place in Richmond Sydney, and lasted for approximately 30 minutes. The respondent described wellness in terms of physical, mental, spiritual and financial wellbeing, which is close to what the wheel of wellness defines.

Keywords: Multidimensional, Wellness, Wheel of wellness.

Introduction

In 1948, the World Health Organization (WHO) defined health as ‘a state of complete physical, mental and social well-being, and not merely the absence of disease and infirmity, and not merely the absence of disease and infirmity” (Daugherty, Julian, Lynch, Chen, Whipple & Ginsburg, 2016). The essence of this definition was to inspire a movement away from deficiency in illness orientations towards a broader understanding of wellness and growth (Daugherty et al. 2016, p.404). The definition provided by WHO led to a paradigm shift from the traditional illness-based model of wellness where people would only receive medication at times of reported illness (Myers, Sweeney & Witmer, 2000). From the modern thinking paradigm, numerous models of wellness have been invented, including the Six Dimensions of Wellness model, and the Wheel of Wellness and the 5F-Wel. These models have a common theme of emphasizing on wholeness and purpose (Daugherty et al., 2016). Wellness, then, is a complex, multidimensional concept (Duff, Rubenstein & Prilleltensky, 2016; Snook & Oliver, 2015), that integrates physical health, social engagement, cultural fit, self determination and being mentally and spiritually nourished at all times (Snook & Oliver, 2016).

The growth of scholarly and lay interest in wellness has led to wellness attracting lots investments that now take up to USD3.7 trillion dollars of the global economy (Statistics & Facts, 2017). In this analysis, the largest proportion of the market is taken by Beauty and Anti-Ageing and Wellness Tourism sectors (Statistics & Facts, 2017). The total investment in the two sectors takes up to USD 1.5 trillion (Statistics & Facts, 2017). The current problem is that researchers fail to agree on the best fit definition of factors that constitute wellness (Daugherty et al., 2016; Keller, 2017; Snook & Oliver, 2015). To some, the contemporary neo-liberal society has become too sensitive to the issue of wellness thereby making it an ideology (Cederstrom & Spicer, 2015). In this latter perspective, failure to conform to wellness injunctions becomes a stigma, with those not conforming ‘demonized as lazy, feeble or weak-willed’ (Cederstrom & Spicer, 2015, p.3).

Aim of Study

Given that wellness is understood in the literature to be multidimensional, constantly evolving and controversial, it is important to be informed of lay-person understandings of wellness. This project is an important one for psychology, given that the concept of wellness has inspired the positive psychology movement (Duff, Rubenstein & Prilleltensky, 2016). Today wellness is a global industry that is permeating the lives of many individuals living in the post-industrial Western world, paradoxically generating anxiety, self-focus and guilt when they fail to meet wellness injunctions (Cederstrom & Spicer, 2015). Therefore, this study aims at finding the meaning of wellness from a layman’s point of view.

Research Question

What does wellness mean for one adult living in contemporary Australia?

Theory: The Wheel of Wellness

The traditional way of looking at wellness was concerned with treating illnesses in the most appropriate manner. Thus, wellness was equated to having no disease or infirmities that limit the body’s functions. However, modern paradigms span beyond the thought of just being well to include aspects of wellness that do not relate to any disease. In the modern paradigms, physical wellness is just a single aspect of the wellness parametric equation.

Sweeny and Whitmer (1991/2) developed the model which looked at the holistic definition of a person’s wellness (Myers et al., 2000). According to Myers et al. (2000), a person experiencing optimal levels of wellness must show spiritual, emotional, intellectual, financial, physical, social, and environmental robustness. Diagram 1 below is a simplified representation of the wheel of wellness model.

Source: (Burnt Out? From Wilted to Holistic Wellness, 2014)

Methodology

Unlike descriptive studies, exploratory research allows for the development of a study design that works with limited display of bias. Thus, an exploratory study is the starting point of a series of studies that will develop more conclusive answers. This study takes the form of a personal interview with only one participant.

Participants

This research takes the form of a personal interview and it will have only one respondent. The respondent is a 56 year old man by the name Mr. MM, a retired civil servant living in Richmond Australia. During his childhood days, Mr. MM was diagnosed with Asthma, and has lived with the condition for all these years. He maintains a low key life with mild physical activity. He does not drink and is a committed Christian.

Data Collection Method

Data were collected using a semi-structured interview that sought to determine the physical, spiritual, and social aspects of the interviewee. The questions were asked in succession, often veering off from the question list so as to gather more detailed information. Some of the answers to the questions span beyond the current questions on the questions list. The first three questions sought to determine the personal attributes of the interviewee. The next fifteen questions tried to determine the level of physical, social and spiritual engagement of the interviewee. Finally, the last three questions tried to establish the meaning of wellness to Mr. MM.

Procedure

In this study, a respondent was approached in person and a token of AUD 100 was given. On the date of interview, the respondent was also required to fill the informed consent and his confidentiality was guaranteed by the use of pseudo name MR. MM. According to Allmark, Boote, Chambers, Clarke, McDonnell, Thompson & Tod (2009), personal interviews can be emotionally draining, thus keeping the anonymity of the interviewee is essential. The interview started at 1500 ACT at PP Restaurant on Thursday 30th March 2017. The interview was audio recorded and transcribed verbatim as shown in Appendix B. The research received the full approval of the NPI Human Research Ethics Committee before commencement.

Analytic Strategy

The data analysis was done through coding. The essence of coding is to: (1) reduce the data to more understandable forms; (2) to understand the phenomenon; and (3) develop a construct and the theory that fits every of its contexts. Usually, the process of coding starts with making codes, sorting, synthesizing and lastly abstracting. In the sequence from coding to abstraction, the researcher makes codes which help them to categorize the data, after which themes are developed and later a theory is developed. This study used the narrative coding style where essence was the main parameter of determining themes. Thus, the analysis will take the thematic model of qualitative data analysis. The data was classified into four themes that are derived from the wheel of wellness and generalized to fit the wheel of wellness paradigm.

Reflexive Statement

In our discussion, we talked about many aspects that relate to health and wellness, but more fundamentally the discussion dwelt mostly on the seven aspects of wellness as postulated by Sweeny and Whitmer. Most of our discussion was based on physical health, social health and mental health. From the discussion, it is easy to note that wellness is not just about being physically fit but also being in an environment that is nurturing. The interview process was good, and it enabled both of us to understand some of the aspects of wellness that are often ignored by many people.

Results

The adult interviewed is a 56 year old man, retired civil servant and asthma patient. Analyzing his responses, it is evident that wellness to Mr. MM means four main things. First, it means being physically fit, which entails having a balanced diet and exercising on regular basis. Mr. MM admits to having been an active player of volleyball while still in school. He also says that he still does it at age 56.

Secondly, he mentions a stable state of mind where he insists that a stable person does not suffer insanity. He also reiterates that a stable person in mind has limited stress, which is the stress that is required for the normal functioning of a human. According to Mr. MM, having a balanced emotional state attracts people and the good things in life. He attributes positive thinking to wellness by associating his asthmatic condition to that of Theodor Roosevelt and Woodrow Wilson by saying that despite having asthma, they did not stop being excellent in whatever they did.

The third component of wellness according to Mr. MM is the spiritual aspect of a human. In the lens of spirituality, he mentions being affiliated to a particular religion as well as subscribing to some belief system that comprises beliefs, ethics and value systems. To demonstrate this, Mr. MM admits to being a regular church goer for spiritual nourishment.

Lastly, the respondent says that finances are important for a person’s wellness. He states that despite life and health being purely acts of God, money improves the wellbeing of the person. With money, one can be in a position to get all the god things that life can offer thereby improving both physical and emotional health. Table 1 below is a summary of the findings.

Table 1: Summary of Findings Table

Theme

Meaning in Brief

Evidence from Data

Physical

Eating well, exercising, avoiding stress, free from ailments

Respondent has asthma and that is the main problem he has experienced over life; he exercises regularly and has good diet; he avoids stress at all times.

Emotional

Stable state of mind with limited stress

Respondent says being positive irrespective of problems in life is the only way a person can have a stable emotional outlook.

Spiritual

Understanding beliefs, values and ethics

Respondent admits to going to church regularly

Financial

having a source of income and planning for the money that one receives

In times of illness, money can be a good aid

Discussion

According to Sweeny and Whitmer (2000), changes in one aspect of wellness affect the other elements of wellness. Therefore, in analyzing the case of Mr. MM, it is necessary to get familiar with the concept of wellness in the lens of the wheel of wellness. The wheel of wellness paradigms uses concentric rims that stand for primary needs of wellness which are: love, friendship, and work and leisure. Then, the outer rim summarizes the secondary needs of wellness, are religion, education, family, media, community, government and business and industry. The concentric circles are held in position by spokes which shade the differences between the needs.

The respondent brings out a concept of wellness using a four point theme of physical, spiritual, financial and emotional states of wellbeing. However, based on the wheel of wellness paradigm, wellness is more than just the four elements. Mr. MM’s definition of wellness is however sufficient to come up with a parallel paradigm that can explain wellness. Holistically, it can be agreed that the physical and mental components of wellness carry the biggest proportion of the wellness concept. In fact, the two are superficial, and they are the very first that people start considering so as to consider that someone is unwell. The other components are of persuasive authority and either blend with the four elements that Mr. MM suggests or reinforce them. For instance, the spiritual component of wellness as suggested by the respondent can be linked to the social and emotional elements in the wheel of wellness. On the other hand, the financial element seems to complement the rest of the elements of wellness as depicted on the wheel of wellness. Therefore, the responded has a persuasive way of looking at wellness that meets the threshold of theory. The respondent understands some of the elements of wellness and his views can be used to enhance the existing theory of wellness.

Limitations of the Study

This study was largely successful. However, the time allowed for the study was limited to the extent that the researcher had to fix the interview in a very short time without really considering the suitability of the respondent. Secondly, the study does not consider all the relevant questions due to the total time allowed to interrogate the respondent. One of the ethical concerns was to avoid boring the respondent with many uncomfortable questions, which made the researcher use a time limit of only 30 minutes. Lastly, not all questions were asked, and this limited the scope of discovery.

Conclusion

Wellness means dissimilar things to different people. To some, it is one-dimensional while to others it is multidimensional. However, to most people, physical and mental wellness is seen as the holistic way of looking at the concept. Theory is the best way to start investigating the meaning of wellness and individual conclusions are also important for the sake of understanding people and giving psychological help.

References

Allmark, P., Boote, J., Chambers, E., Clarke, A., McDonnell, A., Thompson, A., & Tod, A. M. (2009). Ethical issues in the use of in-depth interviews: literature review and discussion. Research ethics review, 5(2), 48-54.

Cederstrom, C. & Spicer, A. (2015). The wellness syndrome. London, UK: Wiley.

Daugherty, T., Julian, H. M., Lynch, N. M., Chen, S. J., Whipple, T. L. & Ginsburg, A. F. (2016). Beyond the absence of disease or infirmity: The case for sexual wellness. College Student Journal, 50(3), 404-408.

Duff, J., Rubenstein, C. & Prilleltensky, I. (2016). Wellness and fairness: Two core values for Humanistic Psychology. The Humanistic Psychologist, 44(2), 127-141. DOI:10.1037/hum0000020

Myers, J. E., Sweeney, T. J., & Witmer, J. M. (2000). The wheel of wellness counseling for wellness: A holistic model for treatment planning. Journal of Counseling & Development, 78(3), 251-266.

Snook, J. D., & Oliver, M. (2015). Perceptions of wellness from adults with mobility impairments. Journal of Counseling & Development, 93(3), 289-298.

Statistics & Facts. (2017). Global Wellness Institute. Retrieved 22 April 2017, from https://www.globalwellnessinstitute.org/press-room/statistics-and-facts/

Appendices

Wellness Interview Questions

​How would you describe wellness?

​What might it mean to be unwell? Probes: How would you describe an unwell person to someone else? What might an unwell person look like?

How would you describe wellness to someone else?

Describe a significant event in your own life that formed your understanding of wellness. Probes: When did it happen? How old were you? What happened? Who was important to you in achieving this wellness?

What do you do to maintain wellness?

Who were your earliest role models in terms of wellness? How did they shape your understanding of wellness?

What sorts of things might block your ability to be well? How might these things stop you from being well? Would these things be the same for others?

And what sorts of things might promote your ability to be well? Would these things be the same for others?

How has your idea of wellness changed over time? What things were important in shifting your understanding (or keeping it the same)?

How important is wellness in life?

It’s quite common to hear a lot about wellness in our society and in various media platforms. What are your thoughts on the depiction of wellness in our society and in the media? How do these depictions affect you? (e.g., experiencing pressure to engage in wellness practices.

I’d like now to give you the opportunity to tell me anything about your experience of wellness that I might have missed. Is there anything else important that you think it might be useful or helpful for me to know?

Copy of Transcript

This is a clean verbatim transcription of the discussion between Mr.MM and I as I sought to find out what wellness means to him. After introduction and catching up on some personal issues, the interview began and proceeded as flows:

Me: Thanks for accepting my invitation to this interview. So, to start with, I would like to know, how would you describe wellness?

Mr. MM: Ah! Well. To me wellness implies a person having good physical health and a stable mind. Stable in the sense that they are not insane or with so many worries.

Me: Alright! And what might it mean to be unwell?

Mr. MM: Mmmh! I would say that to be unwell means that you are sick, or disturbed in some way. In the same sense, I would describe an unwell person as one who is probably sick and needs medical attention.

Me: Okay! And how would you describe an unwell person to someone else?

Mr. MM: it all depends on the kind of situation the parson am describing is in. Personally I would describe an unwell person as one who is sick and needs to see a physician. It could be flue or typhoid fever or just some other condition that is making them not to function normally.

Me: What might an unwell person look like?

Mr. MM: That is subjective, but I would describe an unwell person as one that looks frail and cannot be in a position to handle his or her business in the usual manner. Such a person may be on drugs or in hospital. For instance, someone with HIV/AIDS or malaria fever is unwell.

Me: Great! We are going on well. Now, how would you describe wellness to someone else?

Mr. MM: To someone else I would describe wellness as a state of having good health- at least in the physical and mental state. If someone is not sick and they have a sound mind then they are experiencing wellness.

Me: Now, let’s get back to you. I need you to describe a significant event in your own life that formed your understanding of wellness. When did it happen and what was it? How old were you?

Mr. MM: Right! As far as am concerned, I have not experienced wellness for the most my life. I have had asthma from when I was ten years old, and I still manage the disease. However, I recall one time when I did not have an asthma attack for a period of close to 12 months. That was during my sophomore year. At that time I was 20.

Me: Who was important to you in achieving this wellness?

Mr. MM: Well! I can’t really attribute it to any specific person, but I must admit that this is a time when I first had a positive image of myself. I was ripe to face life and this was manifested by my newly found love. I dated for the first time and was enjoying life.

Me: Wow! That must have been splendid. I can just imagine. So, what do you do to maintain wellness?

Mr. MM: Despite the challenge presented by my situation, I really used to exercise and I do mild physical exercise today. In school I used to play volleyball and am still good at it. To me, I believe the body needs lots water and exercise. Most importantly, I cover my nose with a piece of cloth when exercising to prevent cold air from affecting me while training. I also kep my inhaler close just in case I need to supplement my air.

Me: Great! I can see the enthusiasm in you. I bet you can still beat me in doing cardio exercises yet you are clearly more than 30 years older than me. Definitely it is almost impossible to do all this without a role model. Who were your earliest role models in terms of wellness? And how did they shape your understanding of wellness?

Mr. MM: Mmmh! You have definitely heard about two US presidents: Theodore Roosevelt and Woodrow Wilson. These are two individuals that battled with the same situation am in. They surmounted all the challenges and even became the number one citizens of America during their prime. Asthma did not stop them. They ruled their lives. And as I also struggled, I looked up to them for encouragement. Closer home, my grandpa had cancer of the prostate. Yet he battled the disease to end, without losing hope. Every day was a good day to him till he died. Everyone that attended the funeral eulogized him for his courage. When I remember the battles he fought I see nothing that should stop me from living 100 years.

Me: I see! That’s a good way of looking at life. But, what sorts of things might block your ability to be well? How might these things stop you from being well? Would these things be the same for others?

Mr. MM: To me, many things can make me not unwell. The list is endless, but I just to summarize, sickness, bad habits and stress can cause someone to be unwell. In the obvious sense, being sick makes anyone not function normally and diseases are many. On the other hand, bad habits like taking drugs or eating too much have a negative effect on one’s health. I prefer doing almost everything in moderation. Even too much exercise can make one unwell. Stress on its part has the effect of altering one’s state of mind towards instability. These things affect everyone, and whoever does not avoid them finds him or herself in bad condition.

Me: And what sorts of things might promote your ability to be well? Would these things be the same for others?

Mr. MM: As already mentioned, good nutrition, exercise, avoiding drugs and stress make me feel better and well. The same things may not necessarily be good for another. For instance, a blind person my not find exercise by running good for them since it will increase their risk of getting hurt.

Me: How has your idea of wellness changed over time? What things were important in shifting your understanding (or keeping it the same)?

Mr. MM: Initially I used to think wellness is all about not being sick and having lots of money. It is not until I saw my grandpa die of cancer despite the fact that he had lots of money. Since that day, I started seeing wellness in the lens of the whole person being at peace. In fact, wellness is a state of wellbeing of the mind.

Me: Well! That is a unique way of looking at wellness. So, how important is wellness in life?

Mr. MM: I believe wellness is everything. Without wellness life is full of unnecessary struggles.

Me: It’s quite common to hear a lot about wellness in our society and in various media platforms. What are your thoughts on the depiction of wellness in our society and in the media? How do these depictions affect you?

Mr. MM: Okay! That is a bit off from what I imagined all along. But I think people have taken it overboard. Wellness is not supposed to be the much hyped way of living in the media. In fact, wellness is found in keeping things on low profile. Moderation is the key strategy to wellness. Doctors tell as to avoid red meat and latter tell us to eat it. They say it is wrong to cook tomatoes only to tell us that cooked tomatoes have lycopene which is good in fighting cholesterol. All these are twisted truths. Society will fall into a state of having to depend on medication for wellness in future.

Me: Alright. As we wind up, I’d like now to give you the opportunity to tell me anything about your experience of wellness that I might have missed. Is there anything else important that you think it might be useful or helpful for me to know?

Mr. MM: Fine! I think I have exhausted everything that I know about wellness, and the combination of all these revelations shows that wellness is subjective, and every man knows what it means to be well in their own sense. However, from the flow of the discussion, I have come to see two more perspectives that must be addressed. First, there is the financial part of wellness, knowing that with money many things go right. There may be some cases like when chronic illness comes and money cannot help, but it is very important. Secondly, there is need for good morals which I believe are instilled by both culture and religion. Fr wellness to be fully defined, one must be spiritually and culturally fit.

Me: Thanks Mr. MM, and have a good time. You are now my friend, and will be calling on you whenever am in Richmond.

Mr. MM: You too. Have a good time and success in your academics.