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NÂNG CAO SỨC KHỎE

NÂNG CAO SỨC KHỎE. GS TS BS Lê Hoàng Ninh. Định nghĩa nâng cao sức khỏe. 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 & Kreuter , 1999.

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NÂNG CAO SỨC KHỎE

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  1. NÂNG CAO SỨC KHỎE GS TS BS Lê Hoàng Ninh

  2. Định nghĩa nâng cao sức khỏe • 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 & Kreuter, 1999

  3. Định nghĩa nâng cao sức khỏe WHO, 1986 • The process of enabling people to increase control over and improve their health… • a commitment to dealing with challenges of reducing inequities, extending the scope of prevention, and helping people to cope with their circumstances… • creating environments conducive to health, in which people are better able to take care of themselves

  4. NHỮNG ĐẶC TRƯNG CƠ BẢN CỦA NÂNG CAO SỨC KHỎE • Enabling people to take control over, and responsibility for, their health as an important component of everyday life. • Requiring the close cooperation of sectors beyond the health services. • Combining diverse, but complimentary, methods or approaches. • Encouraging effective and concrete public participation. The Working Group on Concepts and Principles in Health Promotion, 1987

  5. THE TRIAD OF HEALTH PROMOTION HEALTH EDUCATION HEALTH PROTECTION DISEASE PREVENTION

  6. The Health Promotion Triad

  7. PHÒNG NGỪA BỆNH TẬT BA CẤP ĐỘ CẤP I (Primary) CẤP II(Secondary) CẤP III (Tertiary)

  8. Phòng ngừa cấp I Phòng ngừa cấp II Phòng ngừa cấp III Cure Chronic disease Biological onset of disease Clinical Course of disease Healthy individual Disability Death Functional Status Risk Factors Asymptomatic signs Symptoms and signs Rehabilitation Support Immunization Health Education Prophylaxis Sànglọcbệnh Diagnosis Treatment Compliance Adherence Các giai đoạn phòng ngừa bệnh theo tiến trình tự nhiên của bệnh

  9. Phòngngừacấp I(PRIMARY PREVENTION) • - Action taken to avert the • occurrence of disease • Interventions: • o Medical • oLegislative • oSocietal • o Educational • o Individual efforts

  10. PRIMARY PREVENTION • - The more directly a behavior is • linked to a health problem as a • risk factor, the better • candidate it is for primary • prevention efforts Simons-Morton, Greene, & Gottlieb, 1995

  11. Phòng ngừa cấp II(SECONDARY PREVENTION) • Action taken to identify • diseases at their earliest stages • and to apply appropriate • treatments to limit their • consequences and severity. J. Thomas Butler, 2001

  12. Phòng ngừa cấp III(TERTIARY PREVENTION) • Specific interventions to assist • diseased or disabled persons in • limiting the effects of their • diseases or disabilities; also may • include activities to prevent • recurrences of a disease. J. Thomas Butler, 2001

  13. Prevention

  14. GIÁP DỤC SỨC KHỎE(HEALTH EDUCATION) • Planned process, • Combines a variety of educational • experiences, and • Facilitates voluntary adaptations • or establishment of behaviour • conducive to health J. Thomas Butler, 2001

  15. GIÁO DỤC SỨC KHỎE(HEALTH EDUCATION) • Aims primarily at the voluntary • actions people can take on their • own part, individually or • collectively, for their own health • or the health of others and the • common good of the community Greene & Kreuter, 1999

  16. Learning Domains

  17. Cognitive Domain • Aspect of health education that comprises information and knowledge • Information gained from health education can be • A new information • A reinforcement

  18. Psychomotor Domain • Aspect of health education that deals with skill acquisition and reinforcement

  19. Affective Domain • Aspect of health education that is mainly concerned in • Habit formation • Behavior change • New practice

  20. BA MỤC ĐÍCH CHÍNH CỦA GIÁO DỤC, NÂNG CAO SỨC KHỎE TƯƠNG ỨNG VỚI BA CẤP ĐỘ DỰ PHÒNG • Promotion of health and illness • prevention • Restoration of health when one • becomes ill • Maintenance of health while • coping with chronic, long-term • conditions Potter & Perry, 1993

  21. HEALTH PROMOTION MODELS • THREE SPHERES • Health Education • Prevention • Health Protection • SEVEN DOMAINS • Prevention • Lifestyle • Preventive Policies • Policy Maker • Education • 5. Health Education • 6. Health Protection • 7. Policy Support

  22. Prevention(Preventive Services): • This domain includes primary preventive measures, such as immunization and exercise programs, and secondary preventive measures, such as pap smears, hypertension case-finding, and smoking cessation programs.

  23. Lifestyle(Preventive Health Education) • This includes education efforts to influence lifestyle to prevent health-related problems and to encourage the uptake of preventive services.

  24. HEALTH PROMOTION MODELS • THREE SPHERES • Health Education • Prevention • Health Protection • SEVEN DOMAINS • Prevention • Lifestyle • Preventive Policies • Policy Maker • Education • 5. Health Education • 6. Health Protection • 7. Policy Support

  25. Preventive policies(Preventive Health Protection) • This sphere represents health protection, including fluoridation of public water supplies and inspections of restaurants. • It can be viewed as a policy commitment to the provision of preventive services such as those described under domain 1.

  26. HEALTH PROMOTION MODELS • THREE SPHERES • Health Education • Prevention • Health Protection • SEVEN DOMAINS • Prevention • Lifestyle • Preventive Policies • Policy Maker • Education • 5. Health Education • 6. Health Protection • 7. Policy Support

  27. Policy maker education(Health Education for Preventive Health Protection) • Given that health protection measures do not emerge spontaneously, education of policy makers is important. • Example of this is the lobbying by safety-conscious groups to encourage mandated use of automobile seat belts in the face of much public apathy.

  28. Efforts to stimulate a social environment that demands or accepts preventive health protection measures are also part of this domain (Downie, Tannahill, & Tannahill, 1996), • As is a policy commitment to preventive health education.

  29. HEALTH PROMOTION MODELS • THREE SPHERES • Health Education • Prevention • Health Protection • SEVEN DOMAINS • Prevention • Lifestyle • Preventive Policies • Policy Maker • Education • 5. Health Education • 6. Health Protection • 7. Policy Support

  30. Health education(Positive Health Education) • This domain comprises all aspects of positive health education, including influencing behavior by helping individuals, groups, or whole communities develop positive health attributes, such as life skills and self-esteem.

  31. Health promotion encompasses • health education...and is aimed at • the complementary social and • political actions that will facilitate • the necessary organizational, • economic, and other • environmental supports for the • conversion of individual actions • into health enhancements and • quality of life-gains. Greene & Kreuter, 1999

  32. Health protection(Positive Health Protection) • This domain includes implementation of a workplace policy forbidding smoking, graduated drivers’ licenses, and commitment of public funds to provide safe-walking areas and bicycles paths.

  33. Policy support(Health Education Aimed At Positive Health Protection) • This domain embraces raising awareness of, and securing support for, positive health protection measures among the public and policy makers. • It includes a policy commitment to positive health.

  34. HEALTH PROMOTION MODELS • THREE SPHERES • Health Education • Prevention • Health Protection • SEVEN DOMAINS • Prevention • Lifestyle • Preventive Policies • Policy Maker • Education • 5. Health Education • 6. Health Protection • 7. Policy Support

  35. HEALTH PROTECTION • Comprises legal or fiscal controls, • other regulation policies, and • voluntary codes of practice, aimed • at the enhancement of positive • health and the prevention of ill- • health J. Thomas Butler, 2001

  36. HEALTH PROTECTION MISSION – reduce the likelihood that people will encounter environmental hazards or behave in unsafe or unhealthy ways. Downie, Tannahill, & Tannahill, 1996

  37. Health Protection • Philippine Medical Act of 1959 • PHILHEALTH • Generics Law; National Drug Policy and Formulary • Dangerous Drugs Act • Cheaper Medicine Bill • Code of Sanitation of the Philippines

  38. Health Protection • Disability Act • Senior Citizens Law • Child Protection Laws and Policies • Clean Air Act • MMDA Waste Management Policies

  39. HEALTH PROMOTION Strategies

  40. Strategies • Educational Interventions • Organizational Interventions • Political/ Legislative Interventions • Community and Social Interventions • Economic Interventions

  41. Educational Interventions • Stress management classes for middle-management employees in the workplace • Mail-outs to the public describing positive steps a person can take to reduce exposure to HIV • Educational programs designed to reduce personal vulnerability to crime • Primary school programs to develop the skills to cope with peer pressure

  42. Organizational Interventions • Annual hearing and vision screening in schools • Automobile, bicycle, and firearm safety programs conducted by law enforcement agencies • Identification of designated smoking areas and development of a smoking policy in a worksite • Official recognition by business management of alcoholism as a disease and not a weakness in character • Development of support groups by nonprofit organizations and facilities that provide services to people with special needs

  43. Political/ Legislative Interventions • Passage of laws requiring use of helmets while riding motorcycles and bicycles • Legislation requiring environmental polluters to measure their pollution and implement effective plans to reduce the pollution • Fluoridation of the water supply • Regulations requiring agencies and companies to monitor air pollution and governmental actions to reduce it • Regulations aimed at reducing youth access to tobacco products and alcohol

  44. Community and Social Interventions • Organization and training of out of school youth to reduce vulnerability to sex or drug crimes • Formation of neighborhood walking clubs • Health fairs at shopping malls

  45. Economic Interventions • Tax incentives to landlords of low-income housing to encourage maintenance of property and reduction of pest infestation • Incentives from insurance companies to those who practice healthy lifestyles • Incentives from employers to employees who stay healthy and do not miss work

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