Unit (1): Introduction to Health Education PDF

# Unit (1): Introduction to Health Education ## Outlines 1. Introduction 2. The concept of Health and its related terms 3. Definition of Health Education 4. Objectives and goals of Health Education 5. Content of health education 6. Stages in adoption of new ideas and practices 7. Basic principles o...

# Unit (1): Introduction to Health Education ## Outlines 1. Introduction 2. The concept of Health and its related terms 3. Definition of Health Education 4. Objectives and goals of Health Education 5. Content of health education 6. Stages in adoption of new ideas and practices 7. Basic principles of Health Education 8. Setting of health education ## Learning outcomes At the end of this chapter, the students will be able to: 1. Explain the concept of Health and its related terms 2. Define Health Education 3. List objectives and goals of Health Education. 4. Enumerate content of health education 5. Discuss stages in adoption of new ideas and practices 6. State basic principles of Health Education 7. Describe setting of health education ## Introduction An individual's physical and mental well-being is the concern of two similar areas of education: health education and physical education. Both deal with habits of exercise, sleep, rest, and recreation. Since physical well-being is only one aspect of a person's overall health, physical education is often thought of as a part of health education. ## Definition of key terms ### Health The WHO defines health in 1948 as a state of complete physical, social and mental well-being, and not merely the absence of disease or infirmity. ### Physical health It refers to anatomical integrity and physiological functioning of the body. To say a person is physically healthy: * All the body parts should be there. * All of them are in their natural place and position. * None of them has any pathology * All of them are doing their physiological functions properly. * And they work with each other harmoniously. ### Mental health It is ability to learn and think clearly. A person with good mental health is able to handle day-to-day events and obstacles, work towards important goals, and function effectively in society. ### Social health It is ability to make and maintain acceptable interactions with other people. ### Lifestyle "A way of living based on identifiable patterns of behavior which are determined by the interplay between an individual's personal characteristics, social interactions, and socioeconomic and environmental living conditions." ### Prevention "Measures not only to prevent the occurrence of disease, but also arrest its progress and reduce its consequences once it is established. " ### Disease Is the existence of some pathology or abnormality of the body, which is capable of detection using, accepted investigation methods. ### Health literacy "The degree to which people are able to access, understand, appraise and communicate information to engage with the demands of different health contexts in order to promote and maintain good health across the life-course." ## Health Education concepts and practice ### Definition of Health Education It is a series of planned teaching/learning activities designed for individuals, families, or groups aiming at changing people's knowledge, attitude, and practice toward health. ### The goals of health education Health education is an essential component of any program to improve the health of a community, and it has a major role in:- * Reaching good health practice; for example, sanitation, clean drinking water, good hygiene, breast feeding, infant weaning, and oral rehydration. * Using preventive services - for example, immunization, screening, antenatal, and child health clinics; * The correct use of medications and the pursuit of rehabilitation regimens - for example for tuberculosis and leprosy respectively; * Recognizing early symptoms of disease and promoting early referral; * Community support for primary health care and government control measures. * Enable people to increase control over their health and quality of life. **Empowerment:** Empowered learners feel competent and confident about making health decisions that are right for them. ### Components of health education * **Educator (sender)** who is responsible for giving the message of education to recipients. * **Recipients**, target individuals and groups who are exposed to the process of education. * **Message**, material of education. * **Methods of education**, how message of education reaches recipients. ### Contents of health education: * Human Biology * Hygiene * Nutrition * Family Health Care * Control of Communicable and Non-Communicable Diseases * Mental health * Prevention of Accidents * Use of Health Services 1. **Human biology** Teach about structure and functions of the body and how to keep physical fit. Also, the need for exercise, rest and sleep, the effect of alcohol, smoking, resuscitation and first aid. 2. **Nutrition** The aim of health education in nutrition is to guide people to choose optimum and balanced diet who contain nutrient necessary for energy growth and repair 3. **Hygiene** This has two aspects * Personal * Environmental 4. **Mother and child health care as** * Post natal care -Antenatal care * Hygienic care of mother and child. * planning Family -Weaning * Immunization * Prevention of accident among children 5. **Prevention of communicable disease:-** The aim of education in prevention of communicable disease is to prevention of infection and importance of immunization. 6. **Mental health** The aim of education in mental health is to help people to mentally healthy and to prevent a mental breakdown. 7. **Prevention of accident** Safety education should direct to the three main areas, homes, road and place of working. 8. **Use of health services** One of the aims of health education is to inform the public about the health services that are available in the community, and how to use them. ## Stages in adoption of new ideas and practices | Stage | Description | |---|---| | Stage of unawareness | Not aware of new idea or practice | | Stage of awareness | Gets some information but not Know much | | Stage of evaluation | & Find out advantages Disadvantages | | Stage of interest | Shows interest to know more Listen, read | | Stage of trial | Puts it into practice | | Stage of adoption | Accepts new idea as beneficial to him & adopts it | ## Principles of Health Education 1. **Interest:** The health educator will have to bring about recognition of the needs before he proceeds to tackle them. 2. **Participation:** Participation is based on the psychological principle of active learning; it is better them passive learning, group discussion, and workshop. All of the previous is provide opportunities for active learning. 3. **Known to unknown:** In health education work, must proceed from the known to the unknown i.e. start where the people are and with what they understand and then proceed to new knowledge. 4. **Comprehension:** In health education must know the level of understanding, education and literacy of people to whom the teaching is directed. One barrier to communication is using words, which cannot be understood. Teaching should be within the mental capacity of the audience. 5. **Reinforcement** Few people can learn all that is new in a single period. Repetition at intervals is extremely useful, it assists comprehension and understanding. 6. **Motivation** In every person, there is a fundamental desire to learn. A waking this desire is called motivation. 7. **Learning by doing (practice and skills).** 8. **Communication** Education is primarily a mother of communication. The health educator must know how to communicate with his audience. 9. **Good human relation** The health educator must be kind and sympathetic and the people must accept him, as their real friend 10. **Leaders** Psychologists have shown and established that we learn best from people whom we respect. In the field of health education, we try to penetrate the community though the local leaders. ## Settings of Health Education There are five major settings particularly relevant to health education; schools, communities, work sites, health care settings and the consumer market place. 1. **Schools** Health education in schools includes classroom teaching, teacher training, and changes in school environment that support healthy behavior. School health education programs around the world have proven their value for the health and wellbeing of children, the young and communities. 2. **Communities** Community based health education draws on social relationship and organizations have a significant effect on shaping an individual's attitude and behavior to reach large population by media and interpersonal strategies. 3. **Work site** Because people spend too much time at work, the work place is situated ideally as both a source of social support. Effective work site programs can harness social support as a buffer to stress, with the goal of improved workers health and health practices. 4. **Health care setting** Health education for patients, their families, and the surrounding communities and in-services training for health care providers are all part of health care today. Health education in these settings focuses on preventing or detecting disease and managing acute and chronic illness. 5. **The consumer market place** The advent of home health and self-care products as well as the use of health appeals to sell consumer goods, has created new opportunities for health education and for misleading consumers about the potential health effects of items they purchase. # Unit (2): Nursing health education and educators ## Objectives:- At the end of this unit, the students will be able to: * Identify health education and educators. * Describe aim of health education profession. * Discuss the roles of health educators. * Identify characteristics of health educators. * Enumerate barriers of health education. ## Introduction: For many years, organizations governing and influencing nurses in practice have identified teaching as an essential responsibility of all registered nurses in caring for both well and ill clients. For nurses to fulfill the role of educator, no matter whether their audience consists of patients, family members, nursing students, nursing staff, or other agency personnel, they must have a solid foundation in the principles of teaching and learning. The main objectives of studying nursing education are to: * Build knowledge and appropriate attitudes concerning relevant health programs and strategies. * Improve practical skills * Prepare students to support and follow local guidelines and polices and work within the national health system. ## Definition of Nurse Educator Is a nurse who teaches and prepares licensed practical nurses (LPN) and registered nurses (RN) for entry into practice positions. They can also teach in various patient care settings to provide continuing education to licensed nursing staff. They teach in graduate programs at masters and doctoral level which prepare advanced practice nurses, nurse educators, nurse administrators, nurse researchers, and leaders in complex healthcare and educational organizations. ## Characteristics of health educators To be a good health educator you must be: 1. Knowledgeable of subject matter and related areas. 2. Willingness to be flexible, to be direct or indirect as the situation demands. 3. Ability to perceive the world from the learners' point of view. 4. Have good communication skills 5. Skill in asking questions (as opposed to seeing self as a kind of answering service.) 6. Reflection of an appreciative attitude (evidenced by nods, comments, smiles, etc.). 7. Use of conversational manner in teaching-informal, easy style. 8. Provision of well-established examination procedures. ## Role of the nurse as educator: 1. The role of educator is not primarily to teach, but to promote learning and provide for an environment conductive to learning. 2. Motivates individual to learn and makes it possible for them to learn. 3. To create the teachable moment than just waiting for it to happen. 4. The role of the nurse as teacher of patients and families, nursing staff, and students certainly should stem from a partnership philosophy. 5. The provision of information to the learner, who ever that learner may be, should stress the fact that teaching and learning are participatory processes. 6. Actively involve learners in the education process. 7. Assessment of learning needs the planning and designing of a teaching program, the implementation of instructional method & and materials. 8. The evaluation of teaching and learning should involve both the educator and the learner. 9. No longer should teachers see themselves as simply transmitters of content and controllers of the learner. 10. The role of the educator has shifted from the traditional "giver of information" position to that of a process designer and manager. ## Nürsing education should prepare students to function in the following key roles: * **Care givers:** who consider each patient holistically as an individual and provide high-quality, comprehensive, continual and personalized care within a relationship based on trust. * **Decision-makers:** who choose interventions and technology in an ethical and cost effective way? * **Communicators:** who are able to ask appropriate questions, listen, and advice, encourage, counsel, and educate individuals and groups to help them improve and protect their health? * **Community leaders:** who advocate for health and initiate health activities on behalf of community. * **Managers:** who work effectively with colleagues, staff and organizations and who collect, analyze and use health data to meet the health needs of individuals and communities. ## Education process parallels nursing process: | Nursing Process | Education Process | |---|---| | Appraise physical and psychosocial needs | Ascertain learning needs, readiness to learn, and learning styles | | Develop care plan based on mutual goal setting to meet individual needs | Develop teaching plan based on mutually predetermined behavioral outcomes to meet individual needs | | Carry out nursing care interventions using standard procedures | Perform the act of teaching using specific instructional methods and tools | | Determine physical and psychosocial outcomes | Determine behavior changes (outcomes) in knowledge, attitudes, and skills | The education process, like the nursing process, consists of the basic elements of assessment, planning, implementation, and evaluation. There different in that the nursing process focuses on the planning and implementation of care based on the assessment an diagnosis of the physical and psychosocial needs of the patient. The education process, on the other hand focuses on the planning and implementation of teaching based on an assessment and prioritization of the client's learning needs, readiness to learn, and learning styles The outcomes of the nursing process are achieved when the physical and psychosocial needs of the client are met. The outcomes of education process are achieved when changes in knowledge, attitudes, and skills occur. Both processes are ongoing, with assessment and evaluation perpetually redirecting the planning and implementation phases of the process. ## Potential outcomes of effective teaching by the nurse: 1. Increase consumer satisfaction 2. Improve quality of life Ensure continuity of care. 3. Decrease client anxiety 4. Effectively reduce the complications of illness and the incidence of disease. 5. Promote adherence to treatment plans. 6. Maximize independence in the performance of activities of daily living 7. Energize and empower consumers to become actively involved in the planning of their care. ## Methods to determine learning needs of nursing staff: The following are methods that can be used specifically to determine the learning needs of nursing staff. (1) **Written job Description** A written description of what is required to effectively carry out job responsibilities is a source to determine potential learning needs of nursing staff. It can be the basis of establishing content in an orientation program for new staff or of designing continuing education opportunities for seasoned nurses. (2) **Formal and Informal Rquest** Many times staff' will be asked for ideas for educational programs. which reflect what they perceive as needs. When doing a formalized educational program, the educator must verify that these requests are congruent with the needs of other staff members. (3) **Quality Assurance Reports** Trends found in incident reports indicating safety violations or errors in procedures are a source for establishing learning needs of staff that education could adequately address. (4) **Chart Audits** Audits of charts help identify trends in practice. Does the staff have a learning need in terms of the actual charting? Is an intervention being newly implemented that was not done before? Does the record indicate some inconsistency with implementation (5) **Regulations** A thorough knowledge of hospital, professional, and healthcare "requirements helps to identify possible fearning needs of staffs'important for the educator to monitor new rules of practice that may arise from changes occurring within an institution or external to the organization that have implications for the delivery of care. ## Barriers to education and obstacles to learning: ### Barriers to education: Numerous authors have addressed major barriers interfering the ability of nurses to carry out their roles as educators. The following are the key organizational, environmental and educational factors that serve as impediments to educating others: 1. Lack of time to teach is cited by nurses as the greatest barrier to being able to carry out their educator role effectively. 2. Many nurses and other healthcare personnel are traditionally ill prepared to teach. 3. Personal characteristics of the nurse educator play an important role in determining the outcome of a teaching-learning interaction. 4. Until recently, low priority was often assigned to patient and staff education by administration and supervisory personal. 5. The lack of space and privacy in the various environmental settings where nurses are expected to teach and learners are expected to learn is not always conductive to carrying out the teaching-learning process. 6. An absence of child-party reimbursement to support patient education programs relegates teaching and learning to less than high-priority status. Nursing services within healthcare facilities are subsumed under hospital room costs. 7. Some nurses and physicians qüestion whether patient étfucation is effective as a means to improve health outcomes. They view patients as impediments to teaching when patients do not display an interest in changing behavior. 8. There are a multitude of healthcare providers covering much of the same content, but not necessarily with consistency. ### Obstacles to Learning: The following are some of the major obstacles interfering with a learner's ability to attend to and prows information. 1. The stress of acute and chronic illness, anxiety, sensory deficits, and low literacy in patients are just a few problems that can diminish learner motivation and interfere with the process of learning. 2. The negative influence of the hospital environment itself, resulting in loss of control, lack of privacy, and social isolation, can interfere with a client's active role in health decision making and involvement in the teaching-learning process. 3. Lack of time to learn due to rapid patient discharge from care can discourage and frustrate the learner, impeding the ability and willingness to learn. 4. Personal characteristics of the learner have major effects on the degree to which predetermined behavioral outcomes are achieved. 5. The extent of behavioral changes needed, both in number and in complexity, can overwhelm learners and dissuade them from attending to and accomplishing learning objectives and goals. 6. Lack of support and ongoing positive reinforcement from the nurse and significant others serve to block the potential for learning. 7. Denial of learning needs, resentment of authority, and lack of willingness to take responsibility (locus of control) are some psychological obstacles to accomplishing behavioral change. 8. The inconvenience, complexity, inaccessibility, fragmentation, and dehumanization of the healthcare system often result in frustration and abandonment of efforts by the learner to participate in and comply with the goals and objectives for learning. # Unit (3): Health Counseling ## Out Lines: * Introduction * Concepts of counseling * General principles of counseling * Skills and characteristics of effective counselor * Visual aids and other tools for counseling * Steps of counseling(GATHER) * Factors influencing counseling outcomes