CONCEPTS OF HEALTH AND WELLNESS

◼ Health 5. Environmental Influences

 Derived from the old English word for heal: HAEL which means whole
o concerns the whole person and his integrity, soundness or well-being
o Holistic (Total health) ,includes the different dimensions
◼ Dimensions of Health
 Individual
o Physical
o Mental (Psychological/Intellectual)
o Emotional
o Social
o Spiritual
o Sexual
 Broader
o Environmental
o Societal
Individual Dimensions of Health Physical health
▪ Refers to the state of one’s body like its fitness and not being ill
▪ Biological integrity of an individual where there is optimum functioning
of the physical and physiological abilities and freedom from disease or
disability
Individual Dimensions of Health Mental Health (psychological health)
▪ Intellectual capabilities
▪ Refers to the positive sense of purpose and underlying belief in one’s
own worth like feeling good and feeling able to cope
Emotional Health
▪ Involves the support system that is available from family members and
friends
Social Health
▪ The ability to express one’s feelings appropriately and to develop and
sustain relationships
Spiritual Health
▪ The recognition of a Supreme Being or Force and the ability to put into
practice one’s moral principles or beliefs
Sexual health
▪ Refers to the acceptance of and the ability to achieve a satisfactory
expression of one’s sexuality
BROADER---
Societal Health
 The link between health and the way a society is structured
 Includes the basic infrastructure necessary for health (ex: shelter,
peace, food, income ) and the degree of integration or division within
the society
Environmental Health
 Refers to the physical environment where people live
 Involves housing, transport, sanitation, pollution and pure water
facilities
Health Defined….
◼ Health
 State of complete physical, mental and social well-being and not
merely the absence of disease and infirmity (WHO)
 A state characterized by soundness and wholeness of human
structures, bodily and mental functions (Orem)
 the goal of public health in general and of community health nursing
 the optimum level of functioning (OLOF ) of individuals, families
and communities which is affected by several factors in the ecosystem
(modern concept)
Factors which Affect the Optimum Level of Functioning (OLOF)
◼ Political
◼ Behavioral
◼ Heredity
◼ Health Care Delivery System
◼ Environmental Influences
◼ Socio-economic Influence
1. Political Factors
▪ Involve power and authority to regulate the environment or social
climate
▪ Ex: safety, oppression, people empowerment
2. Behavioral
▪ Refers to a person’s level of functioning and is affected by certain
habits, their lifestyle, health care and child rearing practices which are
determined by one’s culture and ethnic heritage
▪ Ex: culture, habits, mores and ethnic customs
3. Heredity/Hereditary Factors
▪ Refers to the understanding of genetically influenced diseases and
genetic risks
▪ Includes congenital defects, strengths, and health risks which can be
familial, ethnic or racial
4. Health Care Delivery System- totality of all policies, infrastructures,
facilities, equipment, products, human resources & services which address
the health needs & concerns of the people
▪ Primary Health Care – a partnership approach to the effective
provision of essential health services that are community-based,
accessible, acceptable, sustainable and affordable
▪ Focus of healthcare is in the promotive, preventive, curative and
rehabilitative aspects of care
▪ Menace of pollution, communicable diseases due to poor sanitation,
poor garbage collection, smoking, utilization of pesticides, lack or
absence of proper & adequate waste & sewerage disposal system &
management, urban/rural milieu, noise, radiation, air &water pollution
6. Socio-economic Influence
▪ Families in lower income group are the ones mostly served
▪ Ex: employment, education and housing
Health as Basic Human Right
◼ Universal Declaration of Human Rights
 Article 25, Sec 1
 Everyone has the right to a standard of living adequate for the
health and well-being of himself and of his family, including food,
clothing, housing and medical care and necessary social services and
the right to security in the event of unemployment, sickness,
disability, widowhood, old age, or lack of livelihood in circumstances
beyond his control
◼ Philippine Constitution of 1987
 Article XIII, Sec 11
 The State shall adopt an integrated and comprehensive approach
to health development which shall endeavor to make essential
goods, health and other social services available to all the people at
affordable cost. There shall be priority for the needs of the
underprivileged sick, elderly, disabled, women, and children. The
State shall endeavor to provide free medical services to paupers
◼ World Health Organization (1995)
 Believes that governments have a responsibility for the health of
their people which can be fulfilled only by the provision of adequate
health and social measures
3 basic positive concepts of health
▪ Reflecting concern for the individual as a total person
▪ Placing health in the context of the env’t.
▪ Equating health with productive & creative living
Health and Wellness as Conceived in Today’s World
◼ Wellness is a positive quality and the integration of the physical,
intellectual, emotional, environmental, spiritual, and social dimensions
of health to form a whole “health person”(Greenberg, 1992 and
Donatelle and Davis, 1996)
Health and Wellness?
◼ What is health? What is wellness?
 Health is the ever-changing process of achieving individual potential in
the physical, emotional, social, mental, spiritual, and environmental
dimensions.
 Wellness is the achievement of the highest level of health possible in
each dimension of health. It is a measure of our status in each of the
dimensions of health and is the key to unlocking an individual’s
full potential
◼ High Level Wellness (HLW) is an integrated method of functioning . It
is the ability to maintain a continuum of balance and purposeful
direction within the environment where he/she is functioning. (Dunn,
1977)
Difference between Health and Wellness
HEALTH
▪ Some aspects of health are determined by genes, age, and other
factors which may be beyond one’s control
WELLNESS
▪ Wellness is largely determined by the decisions one makes about
how to live his/her life; It is now the new health goal
▪ Wellness is a state of mind, a way of life which involves options
that an individual takes to enjoy a health life.
HISTORY OF HEALTH EDUCATION
1800s -- Florence Nightingale – ULTIMATE EDUCATOR
▪ Developed the first school of nursing
▪ Devoted a large portion of her career to teaching nurses, physicians
and health officials about the importance of proper conditions in
hospitals and homes to improve the health of people
▪ Emphasized the importance of teaching patients of the need for
adequate nutrition, fresh air, exercise and personal hygiene to
improve their well-being
◼ Early 1900s-public health nurses understood the significance of the
role of the nurse as teacher in preventing disease and in maintaining
the health of society
◼ For decades, patient teaching has been recognized as an
independent nursing function
• 1918-The National League of Nursing Education (NLNE) in the United
States (now the National League for Nursing-NLN) observed the
importance of health teaching as a function within the scope of nursing
practice
◼ Two decades after, this organization recognized nurses as agents for
the promotion of health and the prevention of illness in all settings in
which they practiced
◼ 1950-the NLNE had identified course content in nursing school
curricula to prepare nurses to assume the role of teachers of others
• Most recently – the NLN developed the first certified nurse educator
(CNE) exam to raise the visibility and status of the academic nurse
educator role as an advanced professional practice discipline with a
defined practice setting
◼ American Nurses Association(ANA)- put forth statements on the
functions, standards and qualifications for nursing practice of which
patient teaching is a key element
 ◼ International Council of Nurse (ICN) has long endorsed the nurse’s
role as educator to be an essential component of nursing care
delivery
◼ Today, all state nurse practice acts include teaching with the scope
of nursing practice responsibilities
◼ Since 1980s-the role of the nurse as educator has undergone a
paradigm shift- from disease-oriented approach to a more prevention-
oriented approach
 Focus is on teaching for the promotion and maintenance of
health
▪ Education has become part of a comprehensive plan of care that
occurs across the continuum of the healthcare delivery process
◼ Transition toward wellness has entailed a progression from Disease-
oriented patient education (DOPE) to prevention-oriented patient education
(POPE) to ultimately become health-oriented patient education (HOPE)
• At the time of Alma Ata declaration of Primary Health Care in 1978,
health education was put as one of the components of PHC and it was
recognized as a fundamental tool to the attainment of “health for all”.
• ALMA - ATA DECLARATION OF 1978
❑ emerged as a major milestone of the 20th century in the field of
Public Health and it identified Primary Health Care as the key of the
goal of “Health for All” around the globe
• Adopting this declaration, Ethiopia utilizes health education as a
primary means of prevention of diseases and promotion of health. In
view of this, the national health policy and Health Sector Development
Program of Ethiopia have identified health education as a major
component of program services.
HEALTH EDUCATION AND HEALTH EDUCATOR
INTRODUCTION(CONCEPT)
Health education forms an important part of the health promotion activities.
o These activities occur in schools, workplaces, clinics and communities
and include topics such as healthy eating, physical activity, tobacco
use prevention, mental health, HIV/AIDS prevention and safety.
o Health + Education
o Health education is an active learning process, that
aims at favorably changing attitudes and influencing
behavior and health practices
DEFINITION
o Health education is any combination of learning experiences designed
to help individuals and communities improve their health, by
increasing their knowledge or influencing their attitudes (WHO)
HEALTH EDUCATION:
‘‘A process aimed at encouraging people to want to be healthy, to know
how to stay healthy, to do what they can individually and collectively to
maintain health, and to seek help when needed’’
(Alma-Ata declaration(1978)
Health literacy is an outcome of effective health education, increasing
individuals’ capacities to access and use health information to make
appropriate health decisions and maintain basic health.
IMPORTANCE OF HEALTH EDUCATION
❑ Empowers people to decide for themselves what options to choose to
enhance their quality of life,
▪ When you educate children and believe in them, you empower those
kids to go after their dreams.
▪ Help the spread of community health clinics. This can be done by
volunteering yourself, or donating money. Either way, it can be vital in
helping those who have problems affording health care to realize that
they are still valued individuals and that their health matters.
▪ Project positivity and eliminate negative thoughts. This positivity
will then be returned by others.
❑ Equips people with knowledge and competencies to prevent illness,
maintain health or apply first aid measures to prevent complications or
premature deaths and improves health status of individuals, families,
communities, states and the nation.
❑ Enhances the quality of life by promoting healthy lifestyles.
❑ Creates awareness regarding the importance of preventive and
promotive care thereby avoiding or reducing the costs involved in
medical treatment or hospitalization
PURPOSE OF HEALTH EDUCATION
• To positively influence the health behavior and health perspectives of
individuals and communities for them to develop self efficacy to adopt
healthy lifestyles resulting to healthy communities.
AIMS OF HEALTH EDUCATION
1. Motivating people to adopt health-promoting behaviors by
providing appropriate knowledge and helping to develop positive attitude.
2. Helping people to make decisions about their health and acquire
the necessary confidence and skills to put their decisions into practice.
LEGAL BASIS OF HEALTH EDUCATION IN THE NURSING
CURRICULUM:
❑ Duties of a nurse in Rule IV, Art. VI, Sec 28 of the Philippine Nursing
Act ( RA 9173)
▪ Provide health education to individuals, families and communities.
▪ Teach, guide and supervise students in nursing education
▪ Implement programs including the administration of nursing services
in varied settings like hospitals and clinics
Why study health education?
◼ Education in health care today-both patient education and nursing
staff/student education – is a topic of utmost interest to nurses in
every setting in which they practice
◼ Teaching is a major aspect of the nurse’s professional role
◼ The current trends in health care are making it essential that clients
be prepared to assume responsibility for self-care management
◼ Health Education is an essential component of any program to
improve the health of a community and has the major role in
promoting (Hubley, 1983)
 Good health practices (Sanitation, clean drinking, water, good hygiene,
breast feeding, infant weaning, and oral rehydration
 The use of preventive services like immunization, screening, antenatal
and child health clinics
 The correct use of medications and the pursuit of rehabilitation
regimens (for TB and leprosy)
FUNCTIONS OF A PROFESSIONAL HEALTH EDUCATOR:
1. Assess individual and community needs and capabilities and
identify both internal and external resources in the community.
2. Plan, develop and coordinate with the different health and
government agencies and NGO’s regarding the health education programs.
3. Do community organizing and outreach.
4. Conduct staff training and consult with other health care
providers about behavioral, cultural or social barriers to health.
5. Conduct regular periodic evaluation of health education
programs
6. Make referrals
7. Develop audio, visual, print and electronic materials to be used
for training and conduct of health education classes.
8. Conduct research work and write scholarly articles.
THE ROLE OF THE HEALTH EDUCATOR:
Health Educator
❑ Is a professionally prepared individual who serves in a variety of roles
and is specifically trained to use appropriate educational strategies
and methods to facilitate the development of policies, procedures,
interventions, and systems conducive to the health of individuals,
groups, communities
❑ Is to help promote, enhance and maintain the health of others
SEVEN AREAS OF RESPONSIBILITY OF A HEALTH EDUCATOR
(BASED FROM COMPETENCY BASED FRAMEWORK FOR THE
PROFESSIONAL DEVELOPMENT OF CERTIFIED HEALTH EDUCATION
SPECIALISTS , NCHEC, 1996)
1. Assess individual and community needs for health education.
2. Plan health education strategies, interventions and
programs.
3. Communicate and advocate for health and health education.
4. Implement health education strategies, interventions and
programs.
5. Administer health education strategies, interventions and
programs.
6. Conduct evaluation and research in relation to health
education.
7. Serve as a health education resource person
THE TEACHING OF HEALTH EDUCATION
A comprehensive health education curriculum consists of planned
learning experiences which will help students achieve desirable
attitudes and practices related to critical health issue like:
1. Emotional health and positive self image
2. Appreciation and care of the human body and its vital
organs
3. Physical fitness
4. Health issues of alcohol, tobacco, drug use and abuse
5. Health misconceptions and myths.
6. Effects of exercise on the body’s systems and on general well-being
7. Nutrition and weight control
8. Sexual relationships and sexuality
9. The scientific, social and economic aspects of
community and ecological health
10. Communicable and degenerative diseases
including sexually transmitted infections.
11. Disaster preparedness
12. Safety and driver education
13. Environmental factors and how those factors affect
an individual’s or population’s environmental health,
life skills, choosing professional medical and health
services and choices o health careers.
CHARACTERISTICS OF EFFECTIVE HEALTH EDUCATION ( HUBLEY)
1. Directed at people who are directly involved with health elated situations
and issues in the home and the community.
2.Lessons are repeated and reinforced over time using different methods.
3.Lessons are adaptable and use existing channels of communication
( songs, drama, story telling)
4. Entertaining and attracts the
community’s attention
5. Uses clear, simple language with local
expressions.
6. Emphasizes short term benefits of
action
7. Provides opportunities for dialogue,
discussion and learner participation and
feedback.
8. Uses demonstrations to show the benefits of adopting the practices.
Relationship between Health education and Health Promotion
The primary role of health educators is to develop appropriate health
education programs in consultation with the people they serve through:
a. Planning
b. Implementing
 c. Evaluating the health plans/programs. Learning Theories
Steps in developing a health education/promotion program ( Cottrell - Put together concepts and propositions to explain “why people learn
et. Al 2001) and predict under what circumstances they will learn”
1. Assessing needs of the target population - No single theory as the best
2. Developing appropriate goals and objectives - Definition of learning generally depends on the perspective of the
3. Creating an intervention that considers the peculiarities of the setting learning theory that us being used
4. Implementing the intervention - Contributions of Learning Theories
5. Evaluating the results - Help us to understand the process of teaching and learning on how
APPLYING LEARNING PRINCIPLES AND THEORIES TO individuals acquire knowledge and change the way they think feel and
HEALTHCARE PRACTICE behave
• LEARNING - In the practice of healthcare: helped the health professionals to
- relatively permanent change in mental processing, emotional functioning employ sound methods and rationales in their health education efforts
and/or behavior as a result of experience involving patients/clients, staff training and education and in carrying
- lasting or permanent change in behavior as a result of experience out continuing health education and promotion programs
determined or influenced by the environment - To understand the nature of the learner:
❖ Learning experience occurs - health professional needs to know some basic principles involved in the
- as individual interacts with his/her environment development and maturation of the individual
- incorporates or applies new information or experiences to what he/she o Human Development
already knows or has learned o A dynamic process of change
❖ Environmental Factors: o Starts from the conception to death (from womb to tomb)
o society and culture o Changes:
o structure and pattern of the stimuli o Growth (quantitative) involving increase in the size of the body parts
o effectiveness and credibility of role models and reinforcements o Development (qualitative) involving gradual changes in character
o feedback for correct and incorrect responses o Person grows and develops
o opportunities to process and apply learning to new situations
o others: 2 major processes takes place:
o own way of taking in and processing information (learning styles); 1. Learning
type, nature and level of motivation - relatively permanent
❖ What kind of experiences facilitate or hinder the learning process? - brought about by experiences
a) Teacher’s selection of learning theories and structuring or type of 2. Maturation
learning experiences - bodily changes, genetically determined
b) Teacher’s knowledge of the nature of the learner, materials to be - Programmed inherited biological patterns are reflected in maturation
learned, teaching methods to be employed, communication skills, - 5 Major Learning Theories:
ability to motivate the learner - Behaviorists
c) Teacher’s ability to relate new knowledge to previous experiences, - Cognitive
values, self-perception and the learner’s readiness to learn - Social Learning
❖ Common Principles of Learning: - Psychodynamic
- 10 learning principles that motivate the learner - Humanistic
a. Use several senses
- how much people are able to retain what has been learned
- shown in Fig. 6 The Experience Cone
❖ RLE (Related Learning Experience)
- done in the nursing skills laboratory
- imitate the procedures demonstrated by the instructor (role modeling)
- graded according to the skills they exhibit and degree of comprehension of
the rationale
- expectation: imitating = 70% of the lesson is retained
- applying these skills and knowledge in the actual care of patients in the
hospital further reinforced by :
✔ additional practice
✔ review of the principles and procedures
✔ extra care and caution in their application and performance
> Will result to 90% retention
b) Actively involve the patients or clients in the learning process
- interactive methods
c) Provide an environment conducive to learning
- comfort and convenience
d) Assess the extent to which the learner is ready to learn: as affected by
emotional status or physical conditions
e) Determine the relevance of the information
- importance or usefulness = easier to learn and retain
f) Repeat the information
- applying to different situation, rewording, giving practical applications
g) Generalized Information
h) Make learning a pleasant experience
i) Begin with what is known; move toward the unknown
- organized manner
j) Present information at an appropriate rate
- pace of presentation
❖ What helps ensure that learning becomes relatively permanent?
a) Organizing the learning experience
b) Practicing or rehearsing new information
c) Applying reinforcement through rewards or recognition
d) Assessing or evaluating whether learning has taken place
immediately after the experience or some later point in time
❖ Learning Theories
- coherent framework
- set of integrated constructs and principles that:
o describe, explain or predict how people learn,
o how learning occurs
o what motivates people to learn and change
o Emphasizes more on:
o Teaching and learning techniques and strategies based on scientific
studies and principles
o Assessment and evaluation techniques
o “mentoring the mentor” or “training the trainer”
o Educational Psychology as being Research-Based:
o Catalyst for the scientific study of teaching, learning and assessment
o Concerned with systematic evidence and data gathering which are
used to test theories and hypotheses about learning