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Silliman University

Patrice Camille G. Divinagracia

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nursing lifestyle-related diseases non-communicable diseases public health

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This document is a compiled set of topics potentially related to a nursing course at Silliman University, Dumaguete City, Philippines, covering lifestyle-related diseases and nursing leadership.

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COLLEGE OF NURSING Silliman University Dumaguete City Nursing Leadership, Management and Professional Adjustment NCM 73 RLE - B4 RESOURCE UNIT ON LIFESTYLE-RELATED DISEASES PROGRAM...

COLLEGE OF NURSING Silliman University Dumaguete City Nursing Leadership, Management and Professional Adjustment NCM 73 RLE - B4 RESOURCE UNIT ON LIFESTYLE-RELATED DISEASES PROGRAM Submitted by: Patrice Camille G. Divinagracia IV - B4 Submitted to: Dr. Freslyn Lim-Saco LEARNING CONTENT TIME TEACHING-LEARNING EVALUATION METHOD OBJECTIVES ALLOTMENT STRATEGY At the end of Lecture discussion with the Online Interactive Game the discussion, use of PowerPoint the learners will Presentation slides. be able to: Oral recitation 1. Accurately I. Description 1 minute explain Non-communicable diseases (NCDs) include cardiovascular what the conditions (hypertension, stroke), diabetes mellitus, lung/chronic program is respiratory diseases and a range of cancers which are the top causes all about. of deaths globally and locally. These diseases are considered as lifestyle related and is mostly the result of unhealthy habits. Behavioral and modifiable risk factors like smoking, alcohol abuse, consuming too much fat, salt and sugar and physical inactivity have sparked an epidemic of these NCDs which pose a public threat and economic burden. 1 minute 2. Restate the II. Vision and Mission program’s ❖ Vision - A Philippines free from the avoidable burden of vision and NCDs mission. ❖ Mission - Ensure sustainable health promoting environments and accessible, cost-effective, comprehensive, equitable and quality health care services for the prevention and control of NCDs, and guided by the principle of “Health in All, Health by All, Health for All” whereas Health in All refers to Health in All Policies, Health by All involves the whole-of-government and the whole-of-society and the Health for All captures the KP (Kalusugan Pangkalahatan) or the Universal Health Care (UHC). 2 minutes 3. Enumerate III. Objectives at least 1. To raise the priority accorded to the prevention and control three of non-communicable diseases in national, regional and objectives local health and development plans of the 2. To strengthen leadership, governance, and multisectoral program. actions for the prevention and control of non-communicable diseases 3. To reduce modifiable risk factors for non-communicable diseases and underlying social determinants through creation of health-promoting environments 4. To strengthen health systems and increase access to quality medicines, products and services, especially at the primary health care level, towards attainment of universal health coverage 5. To promote and support research and development for the prevention and control of non-communicable diseases 6. To monitor the trends and determinants of non-communicable diseases and evaluate progress in their prevention and control 5 minutes 4. List the IV. Program Components four ❖ Cardiovascular Disease program Cardiovascular diseases (CVDs) encompass a range component s. of conditions affecting the heart and blood vessels, including: Coronary Heart Disease: Affects the blood vessels supplying the heart muscle. Cerebrovascular Disease: Impacts the blood vessels supplying the brain. Peripheral Arterial Disease: Involves the blood vessels supplying the arms and legs. Rheumatic Heart Disease: Results from rheumatic fever, which damages the heart muscle and valves due to streptococcal bacteria. Congenital Heart Disease: Refers to birth defects that alter the normal development and function of the heart due to structural malformations present at birth. Deep Vein Thrombosis and Pulmonary Embolism: Involves blood clots in the leg veins, which can travel to the heart and lungs. Heart attacks and strokes are typically sudden events caused by blockages that obstruct blood flow to the heart or brain. These blockages are often due to the accumulation of fatty deposits in the inner walls of the blood vessels. Strokes can also result from bleeding in the brain or from blood clots. The primary behavioral risk factors for heart disease and stroke include an unhealthy diet, physical inactivity, tobacco use, and excessive alcohol consumption. Air pollution is a significant environmental risk factor. Behavioral risk factors can lead to intermediate conditions such as high blood pressure, elevated blood glucose, increased blood lipids, and overweight or obesity. These conditions, which can be assessed in primary care settings, signal a higher risk of heart attack, stroke, heart failure, and other complications. Signs and symptoms: Chest Pain or Discomfort Shortness of Breath Fatigue or Weakness Focuses on preventing and managing heart-related conditions, such as hypertension and heart attacks, through lifestyle modifications, early detection, and appropriate treatment. ❖ Diabetes Mellitus Diabetes is a chronic medical condition that occurs when the body either cannot produce enough insulin or cannot effectively use the insulin it produces. Types of Diabetes Type 1 Diabetes: An autoimmune condition where the immune system attacks and destroys insulin-producing cells in the pancreas. As a result, the body produces little to no insulin, and individuals with type 1 diabetes require daily insulin injections or an insulin pump. This type usually develops in childhood or adolescence but can occur at any age. Type 2 Diabetes: The most common form of diabetes, where the body either becomes resistant to insulin or the pancreas doesn't produce enough insulin. This type is often associated with obesity, poor diet, and physical inactivity. It typically develops in adults. Gestational Diabetes: A temporary form of diabetes that occurs during pregnancy. It usually resolves after childbirth but increases the risk of developing type 2 diabetes later in life. Prediabetes: A condition where blood sugar levels are higher than normal but not yet high enough to be classified as type 2 diabetes. Signs and symptoms: Increased Thirst (Polydipsia) Frequent Urination (Polyuria) Increased Hunger (Polyphagia) Aims to control and prevent diabetes by promoting healthy eating, regular exercise, early diagnosis, and proper medication management. ❖ Cancer It is a group of diseases characterized by the uncontrolled growth and spread of abnormal cells in the body. Types of Cancer Lung Cancer: It begins in the lungs and is one of the leading causes of cancer deaths worldwide. It is most commonly associated with smoking, though non-smokers can also develop lung cancer. Breast Cancer: It originates in the breast tissue, typically in the ducts (ductal carcinoma) or lobules (lobular carcinoma). It is the most common cancer among women worldwide, though men can also develop it. Colorectal Cancer: It starts in the colon or rectum, parts of the large intestine. It typically begins as polyps, which are abnormal growthsthat can become cancerous over time. Prostate Cancer: It develops in the prostate gland, which is part of the male reproductive system. It is one of the most common cancers in men, especially in older age. Melanoma: It is the most serious type of skin cancer, arising from the pigment-producing cells (melanocytes) that give skin its color. Signs and Symptoms: Unexplained Weight Loss Fatigue Lumps or Swelling Involves early detection and treatment of various cancers, alongside prevention strategies like reducing tobacco use and promoting regular screenings. ❖ Chronic Respiratory Disease Chronic respiratory diseases are long-term conditions that affect the airways and other structures of the lungs. Types of Chronic Respiratory Diseases Chronic Obstructive Pulmonary Disease (COPD): It is a group of lung diseases that block airflow and make breathing difficult. It includes emphysema and chronic bronchitis. Smoking is the primary cause of COPD, but long-term exposure to irritating gases or particulate matter can also contribute to its development. Asthma: It is a chronic condition in which the airways become inflamed, narrow, and produce extra mucus, making it difficult to breathe.5. Asthma symptoms can be triggered by allergens, exercise, cold air, or stress. Chronic Bronchitis: It is a type of COPD characterized by inflammation of the bronchial tubes, which carry air to and from the lungs. The condition leads to a persistent cough that produces mucus, often due to long-term exposure to irritants like cigarette smoke. Signs and Symptoms: Shortness of breath (dyspnea) Chronic cough Wheezing Targets the prevention and management of conditions like asthma and COPD through smoking cessation programs, air quality improvement, and medication adherence. 5. Identify at V. Policies and Laws 2 minutes least 3 policies/la 1. AO No. 2011-0003 or The National policy on Strengthening ws and the Prevention and Control of Chronic Lifestyle Related accurately Non-Communicable Diseases explain The Lifestyle-Related Non-Communicable Diseases each. (NCDs) policy seeks to reduce NCDs like cardiovascular diseases, diabetes, cancer, and respiratory diseases by promoting healthy lifestyles, reducing key risk factors, and enhancing early detection and treatment, with a focus on multi-sectoral collaboration and integrating prevention into existing health programs. 2. AO No. 2012-0029 or The Implementing Guidelines on the Institutionalization of Philippine Package of Essential NCD Interventions (PhilPEN) on the Integrated Management of Hypertension and Diabetes for Primary Health Care Facilities The PhilPEN guidelines integrate hypertension and diabetes management into primary health care, ensuring community access to prevention, early detection, and treatment. They emphasize training health workers to reduce NCDs, improve patient outcomes, and enhance health care efficiency in the Philippines. 3. AO No. 2013 – 0005 or The National Policy on the Unified Registry Systems of the Department of Health (Chronic Non-Communicable Diseases, Injury Related Cases, Persons with Disabilities, and Violence Against Women and Children Registry Systems) The National Policy on Unified Registry Systems streamlines data collection for chronic NCDs, injuries, PWDs, and VAWC cases, improving health policies, service delivery, and resource allocation. It enhances coordination among health providers and ensures timely interventions for vulnerable groups. 4. AO 2015-0052: “National Policy on Palliative & Hospice Care in the Philippines The National Policy on Palliative and Hospice Care in the Philippines establishes a framework for accessible, quality care for individuals with life-limiting illnesses. It integrates palliative care into all healthcare levels, emphasizes multidisciplinary teams, and ensures healthcare professionals are trained. The policy also promotes public awareness, ensures access to essential medications, and aims to improve quality of life, reduce hospitalizations, and honor end-of-life wishes. 5. AO 2016-0001: “Revised Policy on Cancer Prevention and Control Program The Revised Policy on Cancer Prevention and Control in the Philippines aims to reduce cancer incidence, morbidity, and mortality through a comprehensive approach. It strengthens prevention, early detection, treatment, palliative care, and survivorship support, with a focus on public awareness, risk reduction, and expanding screening programs. The policy enhances healthcare capacity, promotes affordable treatment, and develops cancer registries for data-driven decisions. It also ensures equitable access to cancer services, especially for underserved populations, and encourages collaboration among stakeholders to improve cancer control nationwide. 6. AO 2016 – 0014 – Implementing Guidelines on the Organization of Health Clubs for Patients with Hypertension and Diabetes in Health Facilities The Implementing Guidelines for Health Clubs for Hypertension and Diabetes establish a structured approach to support patients through regular monitoring, education, and group activities. They include health education on diet, exercise, and medication adherence, and outline healthcare providers' roles in medical assessments and personalized care. The guidelines emphasize peer support to improve treatment adherence and recommend collaboration with local units and organizations for sustainability. The goal is to empower patients, reduce complications, and enhance chronic condition management at the primary care level. 6. Discuss the VI. Conceptual Framework (Administrative Order-2011-0003 2 minutes conceptual National Policy On Strengthening the Prevention and Control of framework Chronic Lifestyle Related Non-Communicable Diseases) in their own words. 7. Restate at VII. Relevant Statistics least 3 ❖ National Nutrition Survey – Food and Nutrition Research relevant Institute (20 years old and above): statistics in relation to Prevalence of Hypertension (2015): 23.9 the Prevalence of High Fasting Glucose (2013): 5.6 program. Prevalence of High total Cholesterol: 18.6 3 minutes Prevalence of Binge Drinking (2015): Males: 58.8, Female: 41.9 Prevalence of Insufficiently Physically Active Adults (2015): 42.5 Prevalence of Overweight and Obese and Adult (2013): Males: 27.6, Females: 34.4 ❖ Global Adult Tobacco Survey 2015: Prevalence of Current Tobacco Use: 23.8 ❖ Hypertension National statistical data (Philippine Heart Association, 2021) 12-18 years old: 5% Elderly: 72% Males: 52% Females: 48% Local statistical data (City Health Office of Dumaguete City, 2021) Males: 304 Females: 362 ❖ Diabetes 7.5% prevalence rate 4,303,899 total cases of diabetes in adults ❖ Chronic lung diseases - 3.6% prevalence rate in 2023 ❖ Cancer - 466,012 cases in the last 5 years 8. Briefly VIII. Program Accomplishments/Status 2 minutes enumerate ❖ Finalization of the Philippine Multi-sectoral Strategic Plan at least four program for the Prevention and Control of NCDs (2017 – 2025) accomplish ❖ The Philippine Package of Essential NCD Intervention for ments. the integrated management of hypertension and diabetes is being implemented nationwide. This is being supplemented by developing the DOH Hypertension and Diabetes Health Clubs in primary health care facilities which will ensure continuity of care and provision of NCD drugs. A registry of hypertensives and diabetics was also developed and is maintained by the department. ❖ Training on Diabetes management using Insulin for Regional Offices and LGUs ❖ Provision of NCD drugs through the Medicine Access Programs (Breast Cancer, Childhood Cancer, Colon and Rectum Cancer, Insulin, NCD maintenance medicines for hypertension and diabetes) ❖ Training on cervical cancer screening using visual inspection using acetic acid (VIA) among health care workers started in 2013 and on-going. Monitoring of trained institutions started in 2014. ❖ NCD indicators are integrated in existing DOH current performance reporting systems like Field Health Service Information System, Local Government Unit scorecard ❖ DOH support for proposed legislative bills focusing on addressing the harmful effects of alcohol consumption, and integrating palliative and hospice care into the healthcare system 1 minute 9. Identify at IX. Partner Institutions least five 1. Health Justice Philippines partner 2. WHO Philippines institutions. 3. National Nutrition Council Philippine Society of Endocrinology, Diabetes and Metabolism 4. Philippine Heart Association 5. Philippine Academy of Family Physicians 6. Philippine Cancer Society, Inc. 7. Philippine College of Physicians 8. Philippine Thyroid Association 9. Philippine College of Chest Physicians 10. Philippine Society of Nuclear Medicine 11. UP College of Public Health 12. UP National Institutes of Health 13. UP Philippine General Hospital 14. Philippine Coalition for the Prevention and Control of Non Communicable Diseases 10. List at least X. Calendar of Activities 3 calendar ❖ Goiter Awareness Week of ❖ National Cancer Consciousness Week activities. ❖ Philippine Heart Month ❖ International Childhood Cancer Day ❖ Hypertension Awareness Month ❖ Cervical Cancer Consciousness Month ❖ International Thyroid Awareness Week ❖ World No Tobacco Day ❖ National No Smoking Month ❖ Nutrition Month ❖ Thyroid Cancer Awareness Week ❖ Obesity Awareness and Prevention Week ❖ Breast Cancer Awareness Month ❖ World Diabetes Day 11. Identify at XI. Nurse’s Roles 2 minutes least four 1. Health educator roles of Nurses educate patients about the risk factors nurses in associated with lifestyle-related diseases, such as relation to the smoking, poor diet, physical inactivity, and program. excessive alcohol consumption. They provide guidance on healthy eating, exercise, weight management, and stress reduction. Educate patients on managing conditions like hypertension, diabetes, and hyperlipidemia through lifestyle modifications. 2. Patient advocate Nurses advocate for personalized care plans that cater to the specific needs of each patient. They help patients access necessary resources, such as community support groups, exercise programs, and nutritional counseling. 3. Care coordinator Nurses work with a team of healthcare professionals to ensure coordinated care for patients, including physicians, dietitians, and physical therapists. They track patients’ progress and ensure follow-up care is provided, including regular monitoring of blood pressure, glucose levels, and cholesterol. 4. Disease prevention specialist Nurses conduct screenings for lifestyle-related diseases, such as hypertension, diabetes, and obesity. Administer vaccines that can help prevent certain lifestyle-related diseases, like the flu vaccine for those with chronic conditions. 5. Behavioral counselor Nurses use techniques like motivational interviewing to encourage patients to make and sustain lifestyle changes. Provide ongoing support and counseling to help patients overcome barriers to healthy living. 6. Community outreach worker Nurses participate in or lead community education programs that aim to raise awareness about lifestyle-related diseases. Organize and participate in health fairs, workshops, and other community events to promote healthy lifestyles. 7. Data manager Nurses may be involved in tracking patient outcomes, compiling data on the prevalence of lifestyle-related diseases, and reporting these to relevant authorities. They may also participate in research studies related to lifestyle-related diseases and evaluate the effectiveness of interventions. 8. Support system Nurses provide emotional and psychological support to patients dealing with the challenges of lifestyle-related diseases. Ensure patients understand their condition, treatment options, and the importance of lifestyle modifications in managing their disease. COLLEGE OF NURSING SILLIMAN UNIVERSITY Dumaguete City S.Y. 2024-20245 RESOURCE UNIT ON THE HEALTHY AND PRODUCTIVE AGEING PROGRAM OF THE DEPARTMENT OF HEALTH (DOH) (pictures from https://www.philhealth.gov.ph/news/2016/celebrating_life.html; https://demography.cass.anu.edu.au/events/determinants-health-and-well-being-among-older-persons-philippines) Prepared by: Ella Julianne V. Hisoler Presented to Dr. Freslyn Lim-Saco September 6, 2024 Specific Teaching-Lea Evaluation Objectives/Learning Content rning Method Outcomes Activities At the end of the Asking questions discussion, the throughout the learners will be able to: I. INTRODUCTION presentation to A. Statistics encourage active The World Health Organization reports that global populations are aging rapidly. The proportion of people participation and aged 60 and above is expected to double from 11% in 2000 to 22% by 2050. The number of people in this Interactive interactive age group is projected to increase from 900 million in 2015 to 1.4 billion by 2030 and 2.1 billion by 2050. Discussion In the Philippines, according to the University of the Philippines Population Institute, there were about 7.5 discussion. million senior citizens aged 60 and over in 2017, accounting for 7.5% of the population. The regions with the highest senior citizen populations are CALABARZON, NCR, and Region 3, while ARMM has the fewest. This represents a 0.7% increase from 2010. According to a study by Cruz, Marquez, Rodriguez, and Kabamalan (2019), physician-diagnosed illnesses such as hypertension, arthritis, cataracts, diabetes, and angina are common among older Filipinos, with their actual prevalence likely being higher due to undiagnosed cases, especially in those with limited access to healthcare. The study by Cruz, Marquez, Rodriguez, and Kabamalan (2019) also reveals significant gaps in health-seeking behaviors among older persons (OPs) in the Philippines, with 30% reporting unmet medical needs due to financial constraints. Among those diagnosed, 27% with hypertension and 32% with diabetes do not take medications. Although free medications are available, only 31% of hypertensives and 18% of diabetics consistently receive them. Awareness of free vaccination programs is also low, with only 41% aware of the pneumococcal and 30% of the flu vaccination programs. 1. Identify the vision, B. Program Description mission, Mandated by Republic Acts 9257 (The Expanded Senior Citizens Act of 2003) and Republic Act 9994 objectives, and the services the (Expanded Senior Citizen Act of 2010), the Healthy and Productive Ageing program aims to promote the program provides health and wellness of senior citizens and improve conditions for those with degenerative diseases. to enhance the quality of life for This program primarily aims to promote quality life among older persons and contribute to nation building senior citizens. through providing equitable access to quality healthcare. With the goal of Health and Wellness Program for Senior Citizen of promoting quality of life among older persons and contribute to the nation building, the HWPSC intends to provide the following: ○ focused service delivery packages and integrated continuum of quality care ○ patient-centered and environment standard to ensure safety and accessibility for senior citizens ○ equitable health financing ○ capacitated health providers in the implementation of health programs for senior citizens ○ database management, and ○ strengthened coordination and collaboration with other stakeholders involved in the implementation of programs for senior citizens. C. Vision - A country where all Filipino senior citizens are able to live an improved quality of life through healthy and productive aging. D. Mission - Implementation of a well-designed program that shall promote the health and wellness of senior citizens and improve their quality of life in partnership with other stakeholders and sectors. - II. POLICIES AND LAWS 2. Describe in 5 sentences the key provisions of the POLICY/LAW DESCRIPTION Expanded Senior RA 9257 Expanded Senior Citizen The Republic Act No. 9257, also known as the "Expanded Senior Citizens Act Citizens Act (RA Act of 2003 of 2003," grants various benefits and privileges to Filipino senior citizens 9257 and RA (those aged 60 and above). The law aims to improve the welfare of senior 9994) and the citizens by providing a 20% discount on goods and services, such as medicines, Universal Health transportation fares, and healthcare services. It also includes exemptions from Care Act (RA the value-added tax (VAT) on certain purchases. The act mandates government 11223) as well as assistance for social services like employment, education, and training, as well other relevant as improved access to affordable housing and health services. Additionally, it policies that protect promotes the establishment of support programs, such as a monthly social the rights and pension for indigent seniors, free medical and dental services, and discounts on welfare of senior utility bills, to enhance the quality of life for the elderly. citizens RA 9994 Expanded Senior Citizen The RA 9994 Expanded Senior Citizens Act of 2010 provides numerous Act of 2010 benefits for senior citizens in the Philippines, including a 20% discount and exemption from the Value Added Tax (VAT) on essential goods and services such as medicines, medical and dental services, transportation fares, and food establishments. It also includes a 5% discount on basic necessities and utilities, a monthly social pension for indigent seniors, and free medical and dental services in government facilities. Additionally, the law mandates government assistance in the form of death benefits, exemption from income taxes for low-income seniors, and priority in government services and programs, thereby enhancing their quality of life and ensuring their welfare and dignity. RA 11223 Universal Health Care Act Republic Act No. 11223, also known as the Universal Health Care (UHC) Law of 2019, aims to provide comprehensive health care coverage and services to all Filipinos. The law automatically enrolls all citizens into the National Health Insurance Program, which guarantees equitable access to quality and affordable health care services. Under the UHC Act, every Filipino is entitled to preventive, promotive, curative, rehabilitative, and palliative health services at all levels of care, whether public or private. The act provides for the expansion of health benefit packages, including free consultations, laboratory tests, and diagnostic services, and aims to reduce out-of-pocket expenses for medical services. It also mandates the improvement of health facilities, the hiring of more health professionals, and the integration of local health systems into province-wide and city-wide health systems to ensure more efficient and effective delivery of health care services. 2010-0032-A Guidelines and Administrative Order No. 2010-0032-A provides guidelines for implementing Mechanisms to Implement the the provisions of Republic Act No. 9994, specifically regarding the sale of Provisions of Republic Act No. 9994, medicines to senior citizens and the sharing of the 20% discount mandated by on the Sale of Medicines and the the act. The order mandates that all drugstores, hospitals, and similar Sharing of the 20% Senior Citizens’ establishments provide a 20% discount and exemption from the Value Added Act Discount Tax (VAT) on the sale of prescription and non-prescription medicines to senior citizens. It also details the procedures for the proper documentation and verification of a senior citizen's eligibility to avail of this benefit. The discount is to be shared between the drugstore and the pharmaceutical manufacturer, with the manufacturer reimbursing the drugstore the value equivalent to 20% of the suggested retail price for every discounted sale. This administrative order ensures that senior citizens receive their entitled benefits efficiently while outlining the responsibilities and mechanisms for businesses and government agencies to implement the discount correctly. Department Memorandum No. Department Memorandum No. 2020-0384 outlines interim guidelines to ensure 2020-0384 Interim Guidelines on the the continuous provision of health services to senior citizens during the Continuous Provision of Health COVID-19 pandemic in the Philippines. The guidelines emphasize the Services for Senior Citizen amid prioritization of senior citizens in accessing health services due to their C-19 Pandemic heightened vulnerability to COVID-19. It includes measures such as ensuring uninterrupted access to essential health services, including routine check-ups, medication refills, and telemedicine consultations to minimize exposure risk. The memorandum also stresses the need for community-based healthcare support, including the delivery of medicines and health supplies to the homes of senior citizens, and providing psychosocial support to address mental health concerns. Additionally, it mandates the proper coordination among local government units, health facilities, and other stakeholders to effectively implement these services and protect the health and well-being of senior citizens during the pandemic. III. TYPES OF SERVICES 3. Discuss in 5 A. PhilHealth Benefit Package sentences the a. Geriatric Training for Primary Service Providers various services i. aims to enhance the skills and knowledge of healthcare professionals in caring for older adults. It provided under the equips providers with the competencies to address the unique health needs of seniors, promote healthy Healthy and aging, and manage age-related conditions. The program seeks to improve the quality, accessibility, Productive Ageing and comprehensiveness of healthcare services for the aging population, ultimately leading to better program health outcomes and well-being for older adults. b. Pre-retirement orientation and training i. prepares individuals for retirement by offering guidance on financial planning, health management, and psychological readiness. The program aims to help retirees maintain a healthy, active, and fulfilling lifestyle. c. Work in the Pipeline: Expansion of PhilHealth Package Utilizing CPG, 2019 i. aims to enhance the scope and quality of healthcare services covered by PhilHealth for older adults. By integrating updated clinical practice guidelines, the program seeks to provide comprehensive and accessible healthcare, addressing common geriatric conditions and ensuring that senior citizens receive appropriate and timely medical care. This expansion is part of DOH’s broader efforts to promote healthy and productive aging in the Philippines ii. 4. Identify 5-10 IV. PARTNERS ORGANIZATION different A. National/Government partners/organizati a. Department of Social Welfare and Development (DSWD) ons involved in the i. Initiated the Plan of Action for Senior Citizens (2017-2022) which ensure proper efforts to implementation of address challenges brought about by population aging the program. b. PhilHealth c. Department of Trade and Industry (DTI) d. Commission on Human Rights (CHR) i. Protect the rights and well-being of older Filipinos by participating in the United Nations (UN) Open-Ended Working Group on Ageing e. Office for Senior Citizens Affairs (OSCA) 5. Recognize the B. Local/Youth/CSOs, NGOs importance of intersectoral a. Department of Geriatric Services (National Center for Geriatric Health) of Jose R. Reyes Memorial Medical collaboration. Center b. Coalition of Services of the Elderly c. Association of Department of Health Retired Employees C. International Partners a. World Health Organization (WHO) b. United States Agency for International Development (USAID) c. United Nations Population Fund (UNFPA) d. V. PROGRAM ACCOMPLISHMENT STATUS Presidential Proclamation No. 470, series of 1994 declares the First Week of October of every year as Elderly Filipino Week (Linggong Katandaang Pilipino) Celebration Elderly Filipino week (Walk for Life) Celebration Provision of influenza and pneumococcal vaccine Wellness camp for senior citizens VI. NURSES’ ROLE IN THE IMPLEMENTATION OF THE PROGRAM 6. Discuss the various roles of nurses in Direct Client Care: Nurses provide comprehensive assessments, manage chronic conditions, and deliver the implementation client-centered care to promote healthy aging. of the program. Health Education and Counseling: Nurses educate senior citizens and their families on healthy lifestyles, disease prevention, and management of chronic illnesses. Development and Implementation of Care Plans: Nurses create individualized care plans tailored to the unique needs of each elderly patient and coordinate multidisciplinary care. Advocacy for Senior Citizens: Nurses advocate for the rights and well-being of senior citizens, ensuring access to necessary services and resources. Policy Implementation and Compliance: Nurses ensure adherence to DOH guidelines and relevant laws, contributing to the effective implementation of the program. Facilitating Access to Resources: Nurses assist senior citizens in accessing healthcare services, benefits, and community support, ensuring continuity and quality of care. REFERENCES Cruz, G. T., Marquez, M. P. N., Rodriguez, R. N., & Kabamalan, M. M. M. (2019). Ageing and health in the Philippines. In G. T. Cruz, C. J. P. Pacete, & Y. Saito (Eds.), Ageing and health in the Philippines (Chapter 14, pp. 245-270). Economic Research Institute for ASEAN and East Asia. https://www.eria.org/uploads/media/Books/2019-Dec-Ageing-and-Health-Philippines/20-Ageing-and-Health-Philippines-Chapter-14-new.pdf Cruz, G. T. & University of the Philippines Population Institute. (2019). Philippine aging and health policies. In Regional Workshop on Integrating Policy and Research on Ageing in ASEAN: Conversations Across the Policy and Research Divide. https://www.duke-nus.edu.sg/docs/librariesprovider3/education-docs/3)-policies-on-the-health-of-older-adults-(philippines)-by-dr-grace-cruz.pdf?sfvrsn=b671e343_4 SY 2024-2025 COLLEGE OF NURSING Silliman University Dumaguete City RESOURCE UNIT ON DOH Smoking Cessation Program Submitted to: Asst. Prof. Freslyn Lim-Saco Prepared by: Mercader, Eduardo Miguel F. Specific Objectives Content T-L Strategies Time Assessment Allotment After the lesson, the learners will Lecture- 45 Short be able to: Discussion minutes questions at with visual for the the end of aid lecture- every assistance discussi segment in through the on. the Lecture- use of Discussion. PowerPoint presentatio n. 1. Provide 3 facts regarding I. DOH SMOKING CESSATION PROGRAM What are 3 the overview of the DOH ○ Tobacco use is widely acknowledged as a facts you can Smoking Cessation common behavioral risk factor contributing to provide Program. four major non-communicable diseases (NCDs): regarding the cardiovascular diseases, cancer, chronic overview of respiratory diseases, and diabetes mellitus. It the DOH stands out as one of the most significant and Smoking preventable risk factors for premature death and Cessation chronic illness linked to tobacco-related Program. conditions, necessitating urgent attention. The Tobacco Control component of the Lifestyle Related Diseases Prevention and Control Program is focused on reducing NCDs caused by cigarette smoking. This program implements the World Health Organization's (WHO) MPOWER measures, which involve monitoring tobacco use and policies, protecting people from secondhand smoke exposure, offering support to quit tobacco use, warning about the dangers of tobacco, enforcing bans on tobacco advertising, and reducing the affordability of tobacco products. Through these efforts, the program aims to create a supportive environment for quitting tobacco, shielding people from secondhand smoke, and preventing youth from starting to smoke. 2. Provide 3 facts regarding II. PHILIPPINE TOBACCO TRENDS What are 3 the trends of tobacco ○ Usage Rate - In 2022, an estimated 16.4 million facts you can usage and tobacco-related people (14.7 million males and 1.7 million provide deaths in the Philippines. females) aged 15 years and older were tobacco regarding the product users in the Philippines. This positions trends of the country as the 15th globally and the 4th in tobacco the WHO Western Pacific Region in terms of usage and number of tobacco users. tobacco-relat ○ Smoking-Related Death Rate - Over 112 000 ed deaths in Filipinos die from tobacco-related diseases each the year and about 23% of male deaths and 10% of Philippines. female deaths are caused by tobacco. Over 20% of non-communicable disease-related deaths are attributable to tobacco use. 3. Enumerate the III. MPOWER STRATEGY What are the MPOWER strategy ○ M- Monitor: Tracking tobacco use and MPOWER employed by the prevention policies. strategies Smoking Cessation ○ P- Protect: Enforcing smoke-free environments. employed by Program. ○ O- Offer: Providing help to quit tobacco. the smoking ○ W- Warn: Raising awareness about the dangers cessation of tobacco. program. ○ E- Enforce: Implementing bans on tobacco advertising, promotion, and sponsorship. ○ R- Raise: Increasing taxes on tobacco products. 4. Define the Vision and IV. VISION AND MISSION Provide a Mission of the DOH ○ VISION- Tobacco Free Philippines: Healthier definition of Smoking Cessation People, Communities and Environment. the Vision Program. and Mission ○ MISSION- Guarantee the design and of the DOH Implementation of an Integrated Comprehensive smoking and Whole System of Government – Society cessation Response program. 5. Provide a summary of 3 V. POLICIES AND LAWS Enumerate 3 Policies and Laws that ○ Republic Act 10351 An Act Restructuring the Policies and aid in Smoking Excise Tax on Alcohol & Tobacco Laws and Cessation. - Also known as the Sin Tax Reform Act of provide their 2012, this restructured the excise tax system on summary. alcohol and tobacco products in the Philippines. It simplified the tax structure and increased taxes on these products to generate additional government revenue and promote public health by discouraging consumption through higher prices. ○ Republic Act No. 10643 An act to effectively instill health consciousness through graphic health warnings on tobacco products - Also known as the "Graphic Health Warnings Law.” This mandates the inclusion of graphic health warnings on tobacco product packaging in the Philippines. The law aims to effectively instill health consciousness among consumers by requiring tobacco companies to display vivid and explicit images showing the harmful effects of smoking, thereby discouraging tobacco use and promoting public health awareness. ○ Executive Order No. 26 Providing for the Establishment of Smoke-Free Environments in Public and Enclosed Places - This establishes smoke-free environments in public and enclosed spaces in the Philippines. The order prohibits smoking in all public places, including schools, workplaces, and public transportation, to protect people from the harmful effects of secondhand smoke. It also mandates designated smoking areas away from the general public and requires the posting of clear "No Smoking" signs to promote a healthier environment. ○ Republic Act No. 11467 - This amends the excise tax rates on alcohol, heated tobacco products, and vapor products in the Philippines. The law increases taxes on these products to generate additional government revenue and reduce consumption by making them more expensive. The revenue generated is intended to fund universal health care programs and other health-related initiatives, while the tax hikes aim to discourage harmful consumption and promote public health. ○ Executive Order No. 106 - This regulates the manufacture, distribution, marketing, and sale of unregistered and/or adulterated electronic nicotine and non-nicotine delivery systems, heated tobacco products, and other novel tobacco products in the Philippines. The order aims to protect public health by ensuring that these products meet safety and quality standards. It also restricts the sale of these products to minors, limits advertising and promotion, and establishes guidelines for their use, sale, and distribution to prevent health risks associated with these products. 6. Provide a summary of the VI. GOAL AND SPECIFIC OBJECTIVES Provide a Goal and Specific ○ GOAL- Reduce morbidity rates and premature summary of Objectives of the DOH mortality rates due to 4 major chronic disease: the goal and Smoking Cessation cardiovascular, diabetes, cancer and COPD specific Program. attributable to tobacco use. objectives. ○ SPECIFIC OBJECTIVES - To reduce the prevalence of tobacco use among youths and adults. - To increase the protection level of the public from secondhand tobacco smoke 7. Provide 3 Types of VII. TYPES OF SERVICES What are 3 Services that are offered ○ PHILHEALTH BENEFIT PACKAGES types of by the DOH Smoking PhilHealth Circular No. 20 s. 2013: services that Cessation Program are offered by Adoption of the Philippine Package of the DOH Essential Non-Communicable Disease Smoking Cessation (NCD) Interventions (PhilPEN) in the Program Implementation of PhilHealth’s Primary Care Benefit Package PhilHealth Circular No. 31 s. 2013: All Case Rates (ACR) Policy No. 1 – Governing Policies in the Shift of Provider Payment Mechanism from Fee-for-Service to Case-based Payment PhilHealth Circular No. 15 s. 2014: Primary Care Benefit 1 (PCB1) Now Called “Tsekap” Package Guidelines for CY 2014 PhilHealth Circular No. 17, s. 2014: Implementing Guidelines for the Primary Care Benefit 2 (PCB2) Package (Out-patient Medicines for Hypertension, Diabetes, and Dyslipidemia) at Selected Innovation Sites PhilHealth Circular No. 2, s. 2015: Governing Policies on the Expanded Coverage of the Primary Care Benefit Package: “Tamang Serbisyo sa Kalusugan ng Pamilya” (Tsekap) ○ TRAINING Training on Brief Tobacco Intervention 8. Provide 3 partner VIII. PARTNER ORGANIZATIONS What are 3 organizations of the DOH ○ Lung Center of the Philippines partner Smoking Cessation ○ Philippine College of Chest Physician organizations Program ○ Philippine General Hospital of the DOH ○ World Health Organization Smoking ○ Philippine Academy of Family Physicians Cessation ○ Philippine Medical Association Program. ○ Framework Convention on Tobacco Control ○ Psychological Association of the Philippines ○ Seventh Day Adventist ○ Philippine Ambulatory Pediatric Association ○ Philippine Psychiatric Association ○ Metropolitan Manila Development Authority 9. Provide 3 roles that a IX. ROLES OF A NURSE IN IMPLEMENTING THE What are 3 nurse can do in SMOKING CESSATION PROGRAM roles a nurse implementing the ○ Patient Education: Nurses provide information can do in smoking cessation on the risks of smoking and the benefits of implementing program. quitting, ensuring patients understand the impact the smoking cessation of tobacco use on their health. program. ○ Counseling and Support: Nurses offer emotional and psychological support, helping patients through the difficult process of quitting smoking. They may use brief tobacco interventions to initiate conversations about quitting. ○ Implementing Interventions: Nurses are trained to deliver evidence-based smoking cessation interventions, such as nicotine replacement therapy (NRT) and other pharmacotherapies. They work closely with patients to create personalized quit plans, set goals, and monitor progress. ○ Referral to Resources: Nurses connect patients with additional resources, such as support groups, hotlines, or specialized smoking cessation clinics. They also guide patients through accessing PhilHealth benefits related to smoking cessation. ○ Advocacy and Policy Implementation: Nurses advocate for smoke-free environments and ensure that the healthcare setting adheres to relevant policies. They also educate patients about laws like RA 10351 (Sin Tax Law) and RA 10643 (Graphic Health Warnings Law). ○ Monitoring and Follow-Up: Nurses continuously monitor patients' progress, providing follow-up care to prevent relapse. They track outcomes and report on the effectiveness of interventions, contributing to the overall evaluation of the program. Provide a 10. Provide a summary X. COLLABORATION statement regarding community and ○ The success of the smoking cessation program regarding healthcare provider roles. heavily relies on community involvement and your the role of healthcare providers. Partner understandin organizations work to amplify the program's g toward reach, while healthcare providers are trained to community and offer direct support to individuals, guiding them healthcare through the cessation process and utilizing provider available resources effectively. roles. 11. Provide a summary XI. FUTURE DIRECTIONS Provide a regarding the future ○ Expanding Access to Resources: Increasing statement directions of the smoking the availability of smoking cessation clinics, regarding cessation program.. especially in rural and underserved areas, to your ensure more people can access support. understandin g toward the future ○ Leveraging Technology: Developing mobile direction of apps and online platforms that provide the smoking personalized cessation plans, progress tracking, cessation and virtual counseling. program. ○ Strengthening Policy Enforcement: Enhancing the enforcement of smoke-free laws and increasing public awareness campaigns to further reduce tobacco use. ○ Integrating Cessation Support into Routine Healthcare: Encouraging healthcare providers to incorporate smoking cessation as a standard part of patient care in all medical settings. ○ Research and Innovation: Investing in research to identify new cessation methods and better understand the factors contributing to relapse, allowing for more effective interventions. ○ Targeting High-Risk Groups: Focusing on vulnerable populations, such as adolescents and individuals with mental health conditions, by tailoring interventions to their specific needs. SY 2024-2025 COLLEGE OF NURSING Silliman University Dumaguete City RESOURCE UNIT ON National HIV, AIDS, and STI Prevention and Control Program Source: https://encrypted-tbn0.gstatic.com/images?q=tbn:ANd9 Source: https://files.hiv.gov/s3fs-public/campaign-lets-stop-hiv-together.jpg Source: https://region5.healthresearch.ph/images/Article_image/doh_hiv.jpg GcS5_tv_c0aV-IcjHKPjxE6vaM8_dHSQn9zxHw&s Submitted to: Dr. Freslyn S. Lim-Saco Prepared by: Mira, Kaith P. August 31, 2024 LEARNING PLAN Specific Objectives Content Learning Strategies Time Allotment Evaluation Method At the end of the I. OVERVIEW OF HIV, AIDS, AND STIs Engaging lecture 5 minutes Post-presentation 20-minute discourse review on the concepts lecture-discussion, A. Description of National HIV, AIDS, facilitated with the learners shall: STD stands for sexually transmitted disease, also known and STI Prevention and the aid of a as sexually transmitted infections (STIs). STDs are Control Program 1. Define Sexually PowerPoint through a mini-game, infections that spread from person to person through Transmitted presentation. consisting of the sexual activity, including anal, vaginal, or oral sex. STDs Infections following questions: are caused by bacteria, parasites, and viruses (Mayo (STIs). Integration of Clinic, 2024). 1. What are Sexually interactive 2. Differentiate HIV (Human Immunodeficiency Virus) is a sexually Transmitted teaching methods, HIV (Human transmitted infection that attacks the immune system, Infections (STIs)? including games Immunodeficien specifically the CD4 cells, making the body more cy Virus) and or icebreakers 2. How is HIV vulnerable to infections and certain cancers. If untreated, AIDS featuring different from HIV can progress to AIDS (Acquired Immunodeficiency (Acquired pertinent AIDS? Syndrome), the most severe phase of HIV infection, Immuno- questions related deficiency characterized by a significantly weakened immune system to the topic. Syndrome). (Department of Health, n.d.-b). B. Epidemiology According to Department of Health (2023): From October to December 2023, 3,738 people were confirmed HIV-positive, with 29% having advanced HIV at diagnosis. This represents a 6% increase compared to the same period in 2022, with an average of 41 cases reported daily. Of the newly confirmed HIV cases during this period, 94% were males and 6% were females. The ages of the newly reported cases ranged from 1 to 75 years old, with a median age of 28 years. At the time of diagnosis, less than 1% were under 15 years old, 30% were between 15 and 24 years old, 47% were between 25 and 34 years old, 20% were between 35 and 49 years old, and 2% were 50 years or older. Cumulatively, 126,378 confirmed HIV cases have been reported to the HIV/AIDS and ART Registry of the Philippines since the first reported HIV case in the Philippines in 1984. As stated in the Philippine News Agency: PHO records showed that Negros Oriental logged a total of 560 HIV cases from January 1984 to July 2023 with 64 deaths. Of the total cases, 94 percent were male patients. Dumaguete City has the highest number of HIV cases at 188, being the capital as well as the socio-economic hub (Partlow, 2024). 3. Identify at least C. Transmission 3. What are two 2 modes of HIV The virus can be passed from an HIV-positive mother to common modes of transmission. her child during pregnancy, birth, or breastfeeding, as well HIV transmission? as through unprotected penetrative sex and needle sharing. HIV is most commonly found in four bodily fluids: sperm, vaginal fluid, blood, and breast milk. However, there is some good news: you can't get it from the air you breathe, tears, saliva, or sweat. Insects and pets are also not a risk. Moreover, people cannot become infected with HIV through ordinary day-to-day contact, such as sharing utensils, food, drinks, toilets, and even hugs and kisses. People living with HIV who are taking ART and have an undetectable viral load will not transmit HIV to their sexual partners (World Health Organization, 2024). II. NATIONAL HIV, AIDS, AND STI PREVENTION AND 15 minutes CONTROL PROGRAM 4. Recognize the A. Vision 4. What is the vision vision and goal Zero New Infections, Zero Discrimination, Zero AIDS-related and main goal of of the National Deaths the National HIV, HIV, AIDS, and AIDS, and STI STI Prevention Prevention and and Control B. Goal Control Program? Program. By 2020, the country will have maintained a prevalence of less than 66 HIV cases per 100,000 populations by preventing the further spread of HIV infection and providing treatment care and support to reduce the impact of the disease on individuals, families, sectors and communities. C. Objectives National Targets to Achieve from 2015-2020: 1. Maintain a prevalence rate of less than 1% HIV prevalence. 2. Reduction of HIV incidence among MSM to

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