Unit 3 Health Promotion E mail 670537614qq com

Unit 3 Health Promotion 四川大学华西第二医院 彭文涛 E -mail： 670537614@qq. com

Teaching Objectives of Unit 3 • Describe the purposes of health promotion • Understand the roles of nurses in health promotion • Apply the nursing process to health promotion

Health promotion is a planned combination of educational, political, regulatory, and organizational supports for actions and conditions of living conducive to the health of individuals, groups or communities ———Green and Kreuter 1999

Ottawa charter definition of health promotion • Health promotion is the process of enabling people to increase control over, and to improve their health. To reach a state of complete physical, mental and social well-being, an individual or group must be able to identify and to realize aspirations to satisfy needs, and to change or cope with the environment. • Health is, therefore, seen as a resource for everyday life, not the objective of living. Health is a positive concept emphasizing social and personal resources, as well as physical capacities. • Therefore, health promotion is not just the responsibility of the health sector, but goes beyond healthy life-styles to wellbeing.

The Ottawa charter At the first International Conference on Health Promotion which was help in Ottawa on 21 November 1986, the WHO presented a charter for action to achieve the Goals of Health for All by the Year 2000

MODEL OF HEALTH PROMOTION 1: FOUR PARADIGMS OF HEALTH PROMOTION (CAPLAN AND HOLLAND - 1990) RADICAL HUMANIST 激进人文主义 Radical change • Holistic view of health • De-professionalization Nature of society RADICAL STRUCTURLIST 激进结构主义 • Health reflects structural inequalities • Need to challenge inequity and radically transform society. • Self-help networks Subjective 主观 Objective Nature of knowledge HUMANIST TRADITIONAL • Holistic view of health • Health = absence of disease • Aims to improve understanding and development of self • Aim is to change behaviour • Client-led Social regulation • Expert-led

MODEL OF HEALTH PROMOTION 2: HEALTH PROMOTION METHODS USING BEATTIE’S TYPOLOGY (BEATTIE – 1991) MODE OF INTERVENTION Advice Authoritarian Education Behaviour change Mass media campaign Legislation Policy making and implementation Health surveillance Individual Collective Focus of intervention Counselling Lobbying Education Action research Group work Skills sharing and training Group work Negotiated Community development

MODEL OF HEALTH PROMOTION 3: A TYPOLOGY OF HEALTH PROMOTION (FRENCH – 1990) DISEASE MANAGEMENT • Curative services • Management services DISEASE PREVENTION • Caring services • Preventive services HEALTH EDUCATION • Agenda setting • Medical services • Empowerment and support • Behaviour change • Information POLITICS OF HEALTH • Social action • Policy development • Economic and fiscal （财 政）policy

MODEL OF HEALTH PROMOTION 4: TANNAHILL’S MODEL OF HEALTH PROMOTION (DOWNIE et al – 1990) 1. Preventive services, e. g. immunization, cervical screening, hypertension case finding, developmental surveillance, use of nicotine chewing gum to aid smoking cessation. 2. Preventive health education, e. g. smoking cessation advice and information. 5 Health education 2 1 Prevention 7 4 3 6 Health protection 6. Positive health protection, e. g. workplace smoking policy. 7. Health education aimed at positive health protection, 3. Preventive health protection, e. g. lobbying for a ban on tobacco fluoridation（加氟） of water. advertising. 4. Health education for preventive health protection, e. g. lobbying for seat belt legislation（法律）. 5. Positive health education, e. g lifeskills with young people.

MODEL OF HEALTH PROMOTION 5: THE CONTRIBUTION OF EDUCATION TO HEALTH PROMOTION (TONES et al – 1990) Public pressure Healthy public policy Lobbying Advocacy Mediation Empowered participating community Healthy social and physical environment HEALTH Critical consciousness raising Agenda setting Healthy choices Education for health Healthy promoting organisation Healthy services Professional education

The core activities u Advocating for health intends to make the political, economic, social, cultural, environmental, behavioural and biological conditions favourable for health. u Enabling people to achieve their fullest health potential addresses, in particular, the issues of equity by providing access to information, life skills and a supportive environment. u Mediating with government and nongovernment agencies, industry and media to achieve coordinated action amidst a range of differing interests.

The Ottawa Charter for Health Promotion (WHO 1986) identified the following features that it believed were necessary for good health: • · Peace • · Shelter • · Education • · Food • · Income • · A stable ecosystem • · Sustained resources • · Social justice • · Equity

Health promotion • Words world behavioural adj. 行为的 Behavioural Science 行为科学 e. g. This should include both behavioural and research interventions that can reinforce each other favourable adj. 有利的、顺利的 favourable price优惠价格 e. g. When circumstances are favourable, we must not forget that there will still be difficulties.

Strategy u. Build health public policy u. Create supportive environments u. Strengthen community action u Develop personal skills u. Reorient（使适应） of health service

Health promotion • Words world Community n. 社区、共同体 e. g. : The development was bitterly opposed by the local community. 这一开发项目遭到了当地社区的愤怒抵制 Community care 社区护理 Community health 社区保健

Health promotion Activities directed towards increasing the level of well being Basic : health history 健康史 physical examination 体格检查 physical-fitness assessment 体能测评 nutrition assessment营养评估 Health risk appraisal 健康风险 life-style assessment 生活方式 Health beliefs review 健康信念 life-stress review生活压力

Health promotion • Words world Nutrition n. 营养，（ nutrit 营养+ion表名词→n. 营养，营养学) Malnutrition n. 营养不良（mal坏+nutrition 营养→ 营养不良） e. g. : Their bodies had suffered contortion as a result of malnutrition Physical adj 身体的，物质的 n. 体格检查 Physic 医学医术（physi 自然、物理+c →与自然、物理结合的学术—医术） e. g. : Drugs taken during pregnancy may cause physical deformity in babies

Health promotion • Health plans needs to be developed according to the needs , desires and priorities of the client • e. g: P : would you please tell me something about diabetes ? N : certainly , diabetes is the metabolic disorder of carbohydrates owing to low function of pancreas Blood glucose meter 血糖仪 High sugar food 高糖饮食

Health promotion • Words world Insulin n. 胰岛素 Diabetes n. 糖尿病， 多尿症 ↓ e. g. : Diabetes is caused by a fault in the insulin production of the body Urine: 小便 ↓ ↓ Polyuria 多尿症 Aphagia: 吞咽不能 多 多 Polydypsia多饮 ↓ ↓ Polyphagia多食症 e. g. : The typical symptoms of DM are polydypsia, polyphagia, polyuria, emaciation and urinary glucose caused by hypergly‘caemia ↓ Hyperglycaemia n. 多糖症

Health promotion • Words world Pancreas n. 胰腺 Pancre’atic adj. 胰腺的 e. g. : insulin is secreted (分泌）by pancreas Insulin n. 胰岛素 词根：insul Insulin 胰岛素（insul 岛屿，sul有“单独”之意+in表示“…. 素”）→n. 胰岛素 e. g. : Diabetes is caused by a fault in the insulin production of the body Hyper adj. 亢奋的 Glycaemia n. 血糖 ↓ ↓ Hyperglycaemia 多糖症

Health promotion • In conclusion : roles of nursing activities in health promotion 1: act as model 2: facilitate involvement 3: teach client self-care 4 : improve nutrtion 5: manage stress 6: assist clients

Health promotion • In conclusion : roles of nursing activities in health promotion 7: teach clients to be health care consumers 8: guide clients’ development in effective problem and decision making 9 : reinforce health promoting behaviors 10: promote a healthy environment

Health Promotion Means Changing Behavior at Multiple Levels A Individual: knowledge, attitudes, beliefs, personality B Interpersonal: family, friends, peers C Community: social networks, standards, norms D Institutional: rules, policies, informal structures E Public Policy: local policies related to healthy practices Source: Adapted from National Cancer Institute, Theory at a Glance: A Guide for Health Promotion (2003), available online at http: //cancer. gov.

Health Promotion Tools • • • Mass media Social marketing Community mobilization Health education Client-provider interactions Policy communication Source: Robert Hornik and Emile Mc. Anany, “Mass Media and Fertility Change, ” in Diffusion Processes and Fertility Transition: Selected Perspectives, ed. John Casterline (Washington, DC: National Academies Press, 2001): 208 -39.

Just for you fate doesn‘t decide everything ，people get to choose -------命运不能决定一切 我们 可以去选择 (电影：全民超人)

Thank You !