NCMA112
  COVERAGE
  1. History of Health Education
  2. Learning Theories related to Health Care
  3. Principles of Teaching and Learning in HE
  4. Health Education Process
  5. Designing HE of Age specific group
HISTORY OF HEALTH EDUCATION
Health
- Condition of being sound in body, mind or spirit;
freedom from physical disease or pain.
- It refers to the ability of a person to function effectively,
physically, socially, psychologically and spiritually.
- The WHO (1946) good health is a state of complete
physical, social and mental well-being and not merely
the absence of disease or infirmity.
- A resource for everyday life, not the object of living and
is appositive concept emphasizing social and personal
resource as well as physical capabilities.
Health Education
- A tool or mechanism for health-related learning
resulting in increase in knowledge, skill development
and change in behavior.
- Directed toward changing behavior toward preset goal.
Dimension of Health
1. Broader
- In the outer circle which are environmental and societal
dimensions
2. Individual
- In the inner circle which are:
a) Physical health – the state of one’s body like its fitness and
not being ill.
b) Mental health – positive sense of purpose and underlying
brief in one’s own worth (self-esteem) like feeling good and
feeling able to cope.
c) Emotional health – ability to express one’s feelings
appropriately and to develop and sustain relationship. Ex: is
the feeling of being loved.
d) Social health – involves the support system that is available
from family members and friends.
e) Spiritual health – recognition of a supreme being or force
and the ability to put into practice one’s moral principles or
beliefs.
f) Sexual health – acceptance of the ability to achieve a
satisfactory expression of one’s sexuality.
g) Societal health – the link between and the health and the
way a society is structured. This includes the basic
infrastructure necessary for health and the degree of
integration or division within the society.
h) Environmental health – the physical environment where
people live, it involves housing, transport, sanitation,
pollution and pure water facilities.
Health Promotion
- Any endeavor directed at enhancing the quality of health and
wellbeing of individuals, families, groups, community,
through strategies involving supportive environments,
coordination of resources and respect for personal choice
and values.
- Introduced in 1974 by Canadian Health Minister La Londe
(Macdonald & Bunton, 1992) and was not popular until the
1980’s when the World Health Organization (WHO) began
a campaign for global public health.
Factors in the Ecosystem which Affect the Optimum level of
Functioning (OLOF)
Political Factors
- Power and authority to regulate the environment or social
climate.
- Ex: safety, oppression, people empowerment.
Behavioral Factors
- 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 and ethnic customs.
Hereditary
- Understanding of genetically influenced diseases and
genetic risks.
Health Care Delivery System
- Focus of healthcare is in the promotive, preventive, curative
and rehabilitative aspects of care.
- Primary health is a partnership approach to the effective
provision of essential health services that are community
based, accessible, acceptable sustainable and affordable.
Environmental influences
- Menace of pollution, communicable disease due to poor
sanitation, poor garbage collection, smoking, utilization of
pesticides, lack or absence of proper and adequate waste and
sewerage disposal system and management, noise,
radiation, air and water pollution are just some of the factors
or situations which exert negative effects on the
environment
Socio-economic influences
- families in lower income group are the ones mostly served.
Ancient Times
Babylonia (Iraq)
Code of Hammurabi
- It is established standards and practices of living for
Babylonians.
- It was based on promoting fairness and equality.
- With an “eye for an eye” premise, some of the regulation
seem drastic compared to a present-day standard.
Greece
- Early Greeks are known for their practice of worshipping
gods and goddesses.
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-Apollo was known as the god of health while his son
Asclepius was the god of healing.
- Hygeia daughter of Asclepius, was the goddess of health
and another daughter Panacea, was the restorer of health.
- Greeks focus on health with an emphasis on personal
health, hygiene, exercise, and healthy diet.
Hippocrates
- the Father of Medicine
- he believed health to be dependent upon equilibrium
among the mind, body and environment rather than the
whims of the Gods.
- This belief known as the holistic approach in health care
practice today.
Egypt
- around 3000 B.C. contributed significantly to health through
progress made in disease prevention.
- Egyptians are known for their efforts in developing hygiene
and water sanitation.
- Developed sophisticated system to support pure water and
dispose wastes
- They developed stringent regulation related to cleanliness,
food, drink exercise and sexual relation (Ellis & Hartley,
2004)
Palestine
- Their greatest contribution was the creation of the Mosaic
Code, about 1500 B.C, reflected in the Old Testament.
- Under the leadership of Moses, Mosaic Code- differentiated
clean from unclean and emphasized the segregation of those
with communicable disease.
- The principle of quarantine was to be of great importance in
later history.
Rome
- they lacked originality for health promotion and disease
prevention practices.
- Medical practices of the Romans were obtained from their
conquered regions and physicians from these countries
became slaves to the Roman Empire
- Roman accomplishments were mostly directed at public
health with the establishment of regulations for sanitation,
street cleaning, building construction, ventilation, and
heating among others (Clark, 2003)
- Health promotion practices of ancient Romans, which
included exercise, massage and other therapeutic baths.
- The Greek physician Hippocrates and the Roman physician
Galen both viewed health as an interaction between a person
and his/her environment.
- Galen created definition of health that emphasized the
ability of an individual to carry out the functions of daily life
without hindrance or pain (Moore& Williamson 1984)
China
- the greatest advocates for health promotion of all ancient
cultures.
- They viewed a healthy lifestyle as one that stayed in
harmony with the universe by maintaining a perfect balance
between the dualistic forces of yin and yang (Bright, 2002),
- Yin was viewed as the female element associated with
negative energy, passiveness, destruction, the moon,
darkness and death.
- Yang was viewed as the male element associated with
positive energy, action, generativity, the sun, light, and the
creativity of life.
- Maintenance of this balance resulted in perfect health of the
mind, body and spirit.
Health Promotion
Middle Ages
- After the fall of Rome, during the period known as the Dark
Ages, health and medicines of ancient worlds was lost,
(Cockerham, 1978).
- The Roman Catholic Church claimed authority for the
welfare of society, and purity of the soul became the highest
of priorities.
- Caring for the body such as daily bathing and exercise, was
viewed as a sinful indulgence resulting in neglect of the soul.
- Illness and death were associated with famine and infectious
disease epidemics.
- After the Dark Ages, shifted into the Middle Ages, very little
was accomplished to promote health or to treat illnesses.
- Although the emphasis on health by early Christians was on
treating the disease and illness, they did much to increase
the public’s awareness of health.
- This was mainly accomplished with the development of the
concept of quarantine in response to repeated epidemics
during the latter part of the Middle Ages.
Renaissance (1500 – 1700)
- The European Renaissance brought about the return to
scientific thought with attempts to understand and control
life.
- This changed the holistic view of health and illness held by
followers of Hippocrates to a disintegrated view
maintaining that the body was separated from the mind.
- During this time, the responsibility of society for public
health and welfare was at least recognized.
- There is improvement of medical technology.
- Colonies in America were being established, the colonies
were sparsely populated and remained isolated for many
years.
- Early colonial health was good compared to that of the
crowded Europeans and the problems with communicable
disease were minimal (Clarks, 2003).
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Period of Intuitive Nursing:
Contributions of Ancient Civilizations to Medicine and Nursing
1. Rome
- The first organized visiting of the sick began with the
establishment of the order of the deaconesses.
- They endeavored to practice the corporal works of
mercy:
 Feed the hungry
 Give water to the thirsty
 Clothed the naked
 Visit the imprisoned
 Shelter the homeless
 Care for the sick
 Bury the dead
2. Greece
- Nursing was the task of untrained slaves
- introduced the caduceus, the insignia of the medical
profession today.
- Hippocrates came to be known as the “Father of
Scientific Medicine.”
 He made a major advance in medicine by
rejecting the belief that diseases had
supernatural causes.
 He developed assessment standards for
clients, established overall medical standards,
recognized the need for nurses.
3. China
- Used massage therapy, hydrotherapy, and exercise as
preventive health measures
- They also used many herbs, minerals & acupuncture to
heal the sick.
4. Africa
- The nurturing functions of the nurse included roles as
midwife, herbalist, wet nurse, and carer for children and
the elderly.
5. India
- Early hospital was staffed by male nurses who were
required to meet four qualifications:
1) Knowledge of the manner in which drugs
should be prepared for administration
2) Cleverness
3) Devotedness to the patient
4) Purity of the mind and body
- Indian women served as midwifes and nurse’s ill family
members
 This period extends from the founding of religious nursing
orders in the Crusades which began in the 11th century and
ended in 1836, when Pastor Fliedner & his wife established
the Kaiserwerth Institute for the training of Deaconessess (a
training school for nurses) in Germany.
 It is called the period of “on-the-job” training.
 Nursing care was performed without any formal education
& by the people who were directed by more experienced
nurses.
 Religious orders of the Christian Church were responsible
for the development of this kind of nursing
The Crusades
- were the holy wars waged in an attempt to recapture the
Holy Land from the Turks who denied pilgrims
permission to visit the Holy Sepulcher.
- Military religious orders established hospitals that were
staffed with men.
Military Religious Orders
 Knights of St. John of Jerusalem (Italian).
- Devoted to religious life and nursing
 Military Religious Orders (German)
- Established tent hospitals for wounded.
 Knights of St. Lazarus (German)
- Was founded primarily for the nursing care of
lepers in Jerusalem after Christians had
conquered the city.
The Alexian Brothers
- Were members of a monastic order founded in 1348.
- They established the Alexian Brothers Hospital School
of Nursing, the largest school of nursing under a
religious order.
- It operated exclusively for men.
- In the United States, the school closed in 1969.
Early America
- The Industrial Revolution in the United States marked the
transition of the country’s economic foundation from
agriculture to industry.
- Shifting the population from rural to urban settings and
resulting in inadequate living and working conditions.
- General public health declined and death from preventable
disease increased, esp. among children.
Nursing in Americ:
a) Nursing During the Civil War
- The American Medical association during the
Civil War created the committee on Training of
Nurses.
- It was designed to study & make
recommendations with regard to the training of
nurses. Doctors realized the need for qualified
nurses.
b) Important personages the time
- Dorothea Lynde Dix – she was appointed as
Superintendent of Female Nurses for the US
government
- Clara Barton – founded the American Red
Cross
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Period of Educated Nursing - states that things freely learned are best learned.
- Began on June 15, 1860 when the Florence Nightingale - Conversely, if the audience is forced to learn something,
School of Nursing opened at St. Thomas Hospital in London the more difficult it is for them to learn.
Behaviorist Learning Theory
- The development of nursing during this period was strongly
- Focusing on what is directly observable
influenced by: - Learning is the product of stimulus condition(S) and
 Trends resulting from wars response(R)
 An arousal of social consciousness - It is useful in nursing practice for the delivery of health care
 The emancipation of women - Respondent conditioning or Classical conditioning (Pavlov)
emphasizes the importance of stimulus conditions and the
 Increased educational opportunities for women
association formed in the learning process.
LEARNING THEORIES RELATED TO HC - Example: Respondent conditioning is used to extinguish
Learning chemotherapy patient’s anticipatory nausea and vomiting
- defined as a relatively permanent change in mental - Systematic desensitization is a technique based on
respondent conditioning that is used by psychologists to
processing, emotional functioning, skill, and/or behavior as
reduce fear and anxiety in their clients
a result of experience.
- The assumption is that fear of a particular stimulus or
- It is the lifelong, dynamic process by which individuals situation is learned
acquire new knowledge or skills and alter their thoughts, - It can also be unlearned or extinguished
feelings, attitudes, and actions - With this approach, fearful individuals are first taught
- enables individuals to adapt to demands and changing relaxation techniques. While they are in a state of relaxation,
circumstances and is crucial in health care. the fear-producing stimulus is gradually introduced at a
 For patients and families to improve their health and nonthreatening level so that anxiety and emotions are not
adjust to their medical conditions aroused.
 For students acquiring the information and skills
necessary to become a nurse
 For staff nurses devising more effective approaches to
educating and treating patients and one another in
partnership
Learning Theory
- a coherent framework of integrated constructs and
principles that describe, explain, or predict how people
learn.
- The construction and testing of learning theories over
the past century contributed much to the understanding
of how individuals acquire knowledge and change their
ways of thinking, feeling, and behaving.
Principles of Learning
Readiness
- implies a degree of willingness and eagerness of an
individual to learn something new.
Exercise
- states that those things that are most often repeated are Classical Conditioning
the ones that are best remembered.  Unconditioned Stimulus is one that unconditionally,
Effect naturally and automatically triggers a response
- that learning is strengthened when accompanied by a  Unconditioned Response is the unlearned response that
pleasant or satisfying feeling — and that learning is occurs naturally in response to the unconditioned stimulus
weakened when associated with an unpleasant feeling.
 Conditioned Stimulus is previously neutral stimulus that,
- The learner will strive to continue learning as long as it
after becoming associated with the unconditioned stimulus,
provides a pleasant effect.
comes to trigger a conditioned response
Primacy
 Conditioned Response is the learned response to the
- the state of being first, often creates a strong impression
previously neutral stimulus
which may be very difficult to change.
Operant Conditioning
Recency
- It was coined by behaviorist B.F. Skinner.
- states that things most recently learned are best
- He believes that internal thought and motivations could not
remembered.
be used to explain.
Intensity
- He suggested at the external observable causes of human
- implies that a learner will learn more from the
behavior.
Freedom
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- Skinner used the term operant to any “Active behavior that • Then reorganizing the information into new insights or
operates upon the environment understanding

Kind of Reinforces - includes several well-known perspectives

Positive Reinforcers a) Gestalt
- favorable events or outcomes that are presented after the b) Information Processing
behavior. c) Human Development
- A response or behavior is strengthened by the addition of  Sensorimotor
something as praise or reward  Preoperational
 Concrete Operations
Negative Reinforcers  Formal Operations
- the removal of unfavorable events or outcomes after the d) Social Constructivism
display of a behavior. The Implications
- A response is strengthened by the removal of something • Nursing and other health professional education programs
considered unpleasant would do well to exhibit and encourage empathy and
Punishment emotional intelligence in working with patients, family, and
- the presentation of an adverse event or outcome that cause a staff and to attend to the dynamics of self-regulation as way
decrease in the behavior. to promote positive personal growth and effective
a) Positive punishment is a punishment by application, leadership.
involve s the presentation of an unfavorable event or • Research indicates that the development of these attributes
outcome in order to weaken the response in self and patients is associated with a greater likelihood of
b) Negative Punishment is punishment by removal, healthy behavior, psychological well-being, optimism, and
occurs when an favorable event or outcome is removed meaningful social interactions
after a behavior occurs. Benefits of Cognitive Theory
 Boosts confidence
 Enhances Comprehension
 Improves problem-solving skills
 Encourage continuous learning
Social Learning Theory
- largely based on the work of Albert Bandura (1977, 2001),
who mapped out a perspective on learning that includes
consideration of the personal characteristics of the learner,
behavior patterns, and the environment.
 Bandura emphasized behaviorist features and the
imitation of role models
Advantages and Disadvantages  The learner has become viewed as central (what
Advantages Bandura calls a “human agency
 This theory is simple and easy to use.
 It encourages clear objective analysis of observable
environment stimulus conditions, learners’ responses and
the effect of reinforcement on people’s action
Disadvantages
 This is teacher centered model in which learners assume are
assumed to be relatively passive and easily manipulated
 It focuses on extrinsic reward and external incentives
reinforces and promotes materialism rather self-initiative.
 Based on animal studies, result not applicable to human
behavior
 Clients changed behavior may deteriorate overtime. Central Concept
 Role modeling
Cognitive Learning Theory  Vicarious reinforcement
- The key to learning and changing is the individual’s Principles of Social Learning Theory
cognition (perception, thought, memory, and ways of Attentional phase
processing and structuring information). - a necessary condition for any learning to occur.
• It is highly active process largely directed by the Retention phase
individual - involves the storage and retrieval of what was observed.
• It involves perceiving the information Reproduction phase
• Interpreting it based on what is already known - during which the learner copies the observed behavior
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Motivational phase  Students must be motivated to learn
- focuses on whether the learner is motivated to perform  Students ate motivated when they attempt tasks that fall in a
a certain type of behavior. range of challenge
Application of Theory  When students have knowledge of their learning progress,
- Social learning theory has been applied extensively to the performance will be superior to what is
understanding of aggression (Bandura, 1973) and  Behaviors that are reinforced (rewarded) are more likely to
psychological disorders, particularly in the context of be learned.
behavior modification (Bandura, 1969).  Directed learning is more effective than undirected learning.
- It is also the theoretical foundation for the technique of  Problem-oriented approaches to teaching improve learning.
behavior modeling which is widely used in training Students learn what they practice.
programs. In recent years, Bandura has focused his work on  Supervised practice that is most effective occurs in a
the concept of self-efficacy in a variety of contexts (e.g.,
functional education experience.
Bandura, 1997).
 To be most effective, reward (reinforcement) must follow as
immediately as possible.
PRINCIPLES OF TEACHING AND LEARNING IN HE
 Students are motivated through their involvement in setting
Health Education
goals and planning learning activities
- A process concerned with designing, implementing and
Principles of Good Teaching Practice
evaluating educational programs that enable families,
 Practice communicates high expectations
groups, organization and communities in achieving,
protecting and sustaining health  Respects diverse talents and ways of learning
Concept of Learning  Gives prompt feedback
 Leaning is about a change: the change brought about by  Practice emphasizes time on task
developing a new skill, understanding a scientific law,  Encourages student-faculty contact
changing an attitude  Encourages cooperation among students
 The change is not merely incidental or natural in the way  Encourages active learning
that our appearance changes as we get older
 Learning is relatively permanent change, usually brought
about intentionally.
Concept of Learning
 Teaching is a set of events, outside the learners which are
designed to support internal process of learning
 Teaching (Instruction) is outside the learner. Learning is
internal to learners
 You cannot motivate others if you are not self-motivated.
Motives are not seen, but behaviors are seen.
 Learning is both motive and behavior but only behavior is
seen, learning is internal, performance is external
Purposes
 To contribute to health and well-being by promoting
lifestyles, community actions and conditions that make it
possible to live healthful lives.
 Recent developments in the field of health care is to
highlight the important role of education in “helping the
patients and their families assume responsibility for self-
care management”
Hallmarks of Good or Effective Teaching in Nursing
 Professional competence
- Possession of skillful interpersonal relationships with
the students
- Desirable personal characteristics of the teacher
 Teaching practice
- Evaluation practice
- Availability to students in the laboratory clinical area
Principles of Teaching and Learning
 When the subject matter to be learned possesses meaning,
structure is clear to students learning proceeds rapidly
 Readiness is a prerequisite for learning

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HEALTH EDUCATION PROCESS  Experiential readiness:
Educational Process - Level of aspiration
- A systematic, sequential, logical, scientifically based, - Past coping mechanisms, cultural background,
planned course of action consisting of two major locus of control, orientation
interdependent operations: teaching and learning.  Knowledge Readiness:
- This process forms a continuous cycle that also involves - Present knowledge base
two interdependent players: the teacher and the learner. - Cognitive ability, learning disabilities, learning
- similar across the practice of many of the health styles
professions.
- the nursing process consists of the basic elements of Learning styles
assessment, planning, implementation, and evaluation - Learning style refers to the ways individuals process
- focuses on the planning and implementation of information (Guild & Garger, 1998).
teaching based on an assessment and prioritization - way the learners learn that takes into account the cognitive,
of the client’s learning needs, readiness to learn, and affective and physiological factor
learning styles. - Each learner is unique and complex
Assessment of Learner - The learning style models are based on the characteristics of
- needs are gaps in knowledge that exist between the desired style are biological in origin, others are sociologically
level of performance and actual level of performance. developed as a result of environmental influences.
- 3 determinants of learning: - Recognizing that people have different approaches to
 Learning needs learning.
 Readiness to learn - Determining learning styles:
 Learning style  Observation of the learner
Method of assessing learning needs:  Interview
 Informal conversations  Administration of learning styles instruments
 Structures interviews
 Focus groups Right-brain/ Left-brain and Whole-brain thinking
 Self-administered questionnaires - There is no “correct” or “wrong” side of the brain.
 Tests - Giving pre-test before planned teaching can help - Each hemisphere gathers in the same sensory information
identify the knowledge level of potential learners and but handles the information in different ways.
can assist in identifying learning needs  - One hemisphere may take over and inhibit the other in
Assessing processing information, or the task may be divided between
Observations Documentation learning needs of the two sides, with each handling the part best suited to its
nursing staff way of processing information.
Observing health Initial Written job - Knowledge of one’s own brain hemispherical performance
behavior helps the assessments, description can aid educators in identifying strengths and weaknesses in
educator draw progress notes, Formal and
their teaching methods.
conclusions about nursing care plan informal request
patient pattern of and discharge Quality Assurance
behavior planning can Reports
provide Chart Audits
information about Rules and
learning needs regulation
Self-Assessment
Gap Analysis
 

Readiness to learn
- can be defined as the time when the learner demonstrates an
interest in learning the type or degree of information
necessary to maintain optimal health or to become more
skillful in a job.
 Physical readiness
- Measures of ability of complexity of task,
environmental effects, health status and gender
 Emotional readiness
- Anxiety level
- includes support system, motivation, risk-taking
behavior, frame of mind, developmental stage
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Dunn and Dunn Learning Style Model
- a self-reporting instrument that is widely used in the
identification of how individuals prefer to function, learn,
concentrate, and perform in their educational activities
- In 1967, Rita and Kenneth Dunn set out to develop an
instrument that would assist educators in identifying those
characteristics that allow individuals to learn in different
ways.
Myers and Briggs Learning Style
Kholbs Learning
 Kolb's learning theory (1974) sets out four distinct learning
styles, which are based on a four-stage learning cycle.
 He explains that different people naturally prefer a certain
single different learning style.
 Kolb’s theory on learning style is that learning is a result of
past experiences, heredity, and the demands of the present
environment.
 Knowing each learner’s preferred style, the nurse educator
is better equipped to assist learners in refining or modifying
these preconceived ideas so that real learning can occur.
Theory of Multiple Intelligence
- Gardner’s early work in psychology and later in human
cognition and human potential led to the development of the
initial six intelligences.
- He identified nine kinds of intelligence located in different
parts of the brain: linguistic, logical-mathematical, spatial,
musical, bodily kinesthetic, interpersonal, intrapersonal.
Naturalistic, Existential.
- These intelligences (or competencies) relate to a person’s
unique aptitude set of capabilities and ways they might
prefer to demonstrate intellectual abilities
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DESIGNING HEALTH EDUCATION OF AGE
SPECIFIC GROUP
- An individual’s developmental stage sig-nificantly
influences the ability to learn.
- Pedagogy, andragogy, and gerogogy are three different
orientations to learning.
- To meet the health-related educational needs of learners, a
developmental approach must be used.
- Lifespan development refers to age related changes from
birth throughout the person’s life into and during old age
- Developmental task arises or about a certain period in life,
unsuccessful achievement of which leads to inability to
perform task associated with the next period or stages in life.
Developmental Characteristics
- Chronological age is only a relative indicator of someone’s
physical, cognitive, psychosocial stage of development
- Developmental stage will be used based on the confirmation
by psychologists that human growth and development are
sequential but not always specifically age-related.
Pedagogy
- the art and science of helping children to learn.
- The different stages of childhood are divided according to
what developmental theorists
- Educational psychologists define as specific patterns of
behavior seen in particular phases of growth and
development, throughout all of childhood, learning is
subject centered.
Andragogy
- the term coined by Knowles (1990) to describe his theory of
adult learning, is the art and science of helping adults learn.
- Education within this framework is more learner-centered
and less teacher-centered; that is, instead of one-party
imparting knowledge on another, the power relationship
between the educator and the adult learner is much more
horizontal (Milligan,1997).
- The concept of andragogy has served for years as a useful
framework in guiding instruction for patient teaching and
for continuing education of staff.
Gerogogy
- The teaching of older persons
- For teaching to be effective, gerogogy must accommodate
the normal physical, cognitive, and psychosocial changes
that occur at this phase of growth and development
Developmental Stages of the Learner
Infancy (first 12 months of life) and
toddlerhood (1-2 years of age)
Physical:
- Dependent on environment, needs security, explore self
and environment, natural curiosity
Cognitive:
 Sensorimotor stage
- Learning is enhanced through sensory experiences and
through movement and manipulation of objects in the
environment capacity.
- The toddler has basic for reasoning, understands object
permanence, has the beginnings of memory, and begins
to develop an elementary concept of causality.
Psychosocial:
 Trust vs. mistrust: During this time, children must work
through their first major dilemma of developing a sense
of trust with their primary caretaker
 Autonomy vs. shame: Toddlers must learn to balance
feelings of love and hate and learn to cooperate and
control willful desires
Teaching Strategies:
 Orient teaching to caregiver
 Use repetition and limitation of information
 Stimulate all the senses
 Provide physical safety emotional and security
 Allow play and manipulation of object
Early Childhood (3-5 years)
Physical:
- Fine and gross motor skills become increasingly more
refined and coordinated so that they are able to carry
out activities of daily living with greater independence
- They develop imaginary playmates, and believe they
can control events with their thoughts
Cognitive
 Preoperational period
- The young child continues to be egocentric and is
essentially unaware of others’ thoughts
- Preschoolers are very curious, can think intuitively,
and pose questions about almost anything.
Psychosocial
 Initiative versus guilt: Ability to be self-starter to
initiate one’s own activity
Teaching Strategies:
 Use warm approach, build trust, use repetition of
information,
 Allow manipulation of equipment.
 Explain procedures briefly.
 Provide safe environment,
 Use positive reinforcement.
 Use play therapy with dolls and puppet to stimulate
senses
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School Age (6-11 years) Psychosocial:
Physical:  Identity versus role confusion
 The gross- and fine-motor abilities of school-aged - These children indulge in comparing their self-image
children are increasingly more coordinated so that they with an ideal image
are able to control their movements with much greater - Adolescents find themselves in a struggle to establish
dexterity than ever before. their own identity, match their skills with career
 Girls more so than boys on the average begin to choices, and determine their “self.
experience prepubescent bodily changes and tend to Teaching Strategies:
exceed the boys in physical maturation  Explore emotional and financial support
Cognitive:  Determine goals and expectations
 Concrete operations  Assess stress level
- During this time, logical thought processes and the  Respect values and norm
ability to reason inductively and deductively  Engage in teaching 1:1 without parents present.
develop.
- School-aged children are able to think more Young Adulthood (20-40 years)
objectively, are willing to listen to others, and will Physical:
selectively use questioning to find answers to the - Young adults are at their peak, and the body is at its
unknown optimal functioning capacity.
Psychosocial: - Autonomous, self-directed
 Industry versus inferiority - Uses personal experience to enhance or interfere with
- Begin to establish their self-concept as members of learning
a social group larger than their own nuclear family - Intrinsic motivation
and start to compare family values with those of the - Able to analyze critically
outside world. Cognitive:
Teaching Strategies: - The cognitive capacity of young adults is fully
 Encourage independence and active participation developed, but with maturation, they continue to
 Use logical explanations accumulate new knowledge and skills from an
 Establish role models expanding reservoir of formal and informal
 Uses play therapy experiences.
 Provides group activates - Young adults continue in the formal operations stage.
 Use diagram, models or pictures Psychosocial:
 Intimacy versus isolation.
Adolescence (12-19 years) - During this time, individuals work to establish a
Physical: trusting, satisfying, and permanent relationship
- Abstract, hypothetical with others
- Can build on past experiences - They strive to establish commitment to others in
- Motivated by desire for social acceptance their personal, occupational, and social lives.
- Peer group is important Teaching Strategies:
Cognitive:  Use problem centered focus
 Formal operations  Draw on meaningful experiences
- They are capable of abstract thought and complex  Encourage active participation
logical reasoning  Allow to set own pace
- Adolescents can conceptualize and internalize  Organize materials
ideas  Recognize social role
- Adolescents are able to understand the concept of  Apply new knowledge through role playing and hands-
health and illness, the multiple causes of diseases, on practice
the influence of variables on health status, and the
ideas associated with health promotion and disease
prevention

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 NCMA112
Middle Adulthood (41-64 years)
Physical:
- During middle age, many individuals have reached the
peak in their careers, their sense of who they are is
well developed, their children are grown, and they have
time to pursue other interests.
- Skin and muscle tone decreases, metabolism slows
down, body weight tends to increase, endurance and
energy levels lessen, hormonal changes bring about a
variety of symptoms, and hearing and visual acuity
begin to diminish.
Cognitive:
 Formal Operations: The life experiences and their
proven record of accomplishments often allow them to
come to the teaching–learning situation with
confidence in their abilities.
Psychosocial:
 Generativity versus self-absorption and stagnation:
Midlife marks a point at which adults realize that half
of their life has been spent. This realization may cause
them to their level of achievement and success.
Teaching Strategies:
 Focus on maintaining independence
 Assess positive and negative past experiences
 Assess potential cause of stress caused by midlife
issues
 Provide information that coincide with life concerns
and problems
Adulthood (65 and above)
Physical:
- Most older persons suffer from at least one chronic
condition, and many have multiple condition.
- The sensory perceptive abilities that relate most closely
to learning capacity are visual and auditory changes.
- Hearing loss, which is very common beginning in the
late forties and fifties, includes diminished ability to
discriminate high-pitched sounds.
Cognitive:
 Formal Operations: Aging affects the mind as well as
the body. Cognitive ability changes with age as
permanent cellular alterations invariably occur in the
brain itself.
Psychosocial:
 Ego integrity versus despair: This phase of elderly
includes dealing with the reality of aging, the
acceptance of the inevitability that we all will die.
Teaching Strategies:
 Involve principal caregiver
 Encourage participation
 Provide resources for support
 Assess coping mechanism
 Provide written instructions for reinforcement
 Provide anticipatory problem
Lahat yan galing lang sa ppt ni Mam Uayan (except un History,
kinuha ko kay mam Concepcion) tsaka sa handouts na nasa
canvas hihi. Review well!! Good luck :)) – Aki

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