NÂNG CAO SỨC KHỎE

NÂNG CAO SỨC KHO�E

GS TS BS Lê Hoàng Ninh

Định nghĩa nâng cao sức kho�e

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, 1999Green & Kreuter, 1999

Định nghĩa nâng cao sức kho�e

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

WHO, 1986WHO, 1986

NHỮNG ĐẶC TRƯNG CƠ BA�N CỦ�A NÂNG CAO SỨC KHO�E

1. Enabling people to take control over, and responsibility for, their health as an important component of everyday life.

2. Requiring the close cooperation of sectors beyond the health services.

3. Combining diverse, but complimentary, methods or approaches.

4. Encouraging effective and concrete public participation. The Working Group on Concepts and The Working Group on Concepts and

Principles in Health Promotion, 1987Principles in Health Promotion, 1987

THE TRIAD OF HEALTH PROMOTION

HEALTH HEALTH EDUCATIONEDUCATION

HEALTH HEALTH PROTECTIOPROTECTIO

N N

DISEASE DISEASE PREVENTIOPREVENTIO

NN

The Health Promotion The Health Promotion TriadTriad

PHÒNG NGỪA BỆNH TẬT

BA CẤP ĐỘ

CẤP I (Primary)

CẤP II(Secondary)

CẤP III (Tertiary)

Phòng ngừa cấp I

Phòng ngừa cấp II

Healthy individual

Biological onset of disease

Risk Factors

Immunization Health EducationProphylaxis

Sàng lọc bệnh

RehabilitationSupport

Asymptomaticsigns

FunctionalStatusSymptoms

and signs

Diagnosis TreatmentComplianceAdherence

Các giai đoạn phòng ngừa bệnh theo tiến trình tự nhiên của bệnh

Clinical Course of disease

Chronic disease

CureDisability

Death

Phòng ngừa cấp III

Phòng ngừa câ0p I(PRIMARY PREVENTION)

- Action taken to avert the occurrence of disease

-Interventions:o Medicalo Legislativeo Societalo Educational

o Individual efforts

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, 1995Simons-Morton, Greene, & Gottlieb, 1995

Phòng ngừa câ0p II(SECONDARY PREVENTION)

- Action taken to identifydiseases at their earliest stages and to apply appropriate treatments to limit their consequences and severity.

J. Thomas Butler, 2001J. Thomas Butler, 2001

Phòng ngừa câ0p 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, 2001J. Thomas Butler, 2001

PreventionPrevention

GIÁP DỤC SỨC KHO�E(HEALTH EDỦCATION)

- Planned process,- Combines a variety of

educational experiences, and

- Facilitates voluntary adaptations

or establishment of behaviour

conducive to healthJ. Thomas Butler, 2001J. Thomas Butler, 2001

GIÁO DỤC SỨC KHO�E(HEALTH EDỦCATION)

- 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

communityGreene & Kreuter, 1999Greene & Kreuter, 1999

Learning DomainsLearning Domains

Cognitive DomainCognitive Domain

Aspect of health education that comprises information and knowledge

Information gained from health education can be A new information A reinforcement

Psychomotor DomainPsychomotor Domain

Aspect of health education that deals with skill acquisition and reinforcement

Affective DomainAffective Domain

Aspect of health education that is mainly concerned in Habit formation Behavior change New practice

BA MỤC ĐÍCH CHÍNH CỦ�A GIÁO DỤC, NÂNG CAO SỨC KHO�E TƯƠNG ỨNG VỚI

BA CÂ0P 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, 1993Potter & Perry, 1993

THREE SPHERES• Health Education• Prevention• Health

Protection SEVEN DOMAINS1. Prevention2. Lifestyle3. Preventive

Policies4. Policy Maker

Education5. Health

Education6. Health

Protection7. Policy Support

HEALTH PROMOTION MODELS

1. 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.

2. Lifestyle(Preventive Health Education)

This includes education efforts to influence lifestyle to prevent health-related problems and to encourage the uptake of preventive services.




Education5. Health

Education6. Health



3. 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.




Education5. Health

Education6. Health



4. 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.

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.




Education5. Health

Education6. Health



5. 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.

- 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, 1999Greene & Kreuter, 1999

6. 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.

7. 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.




Education5. Health

Education6. Health



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, 2001J. Thomas Butler, 2001

HEALTH PROTECTION

MISSION – reduce the likelihood that people will encounter environmental hazards or

behave in unsafe or unhealthy ways.

Downie, Tannahill, & Tannahill, 1996Downie, Tannahill, & Tannahill, 1996

Health ProtectionHealth Protection

Philippine Medical Act of 1959 PHILHEALTH Generics Law; National Drug Policy

and Formulary Dangerous Drugs ActDangerous Drugs Act Cheaper Medicine Bill Code of Sanitation of the Philippines

Health Protection

Disability Act Senior Citizens Law Child Protection Laws and Policies Clean Air ActClean Air Act MMDA Waste Management PoliciesMMDA Waste Management Policies

Strategies

HEALTH PROMOTION

Strategies

Educational Interventions Organizational Interventions Political/ Legislative

Interventions Community and Social

Interventions Economic Interventions

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

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

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

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

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

Documents

NÂNG CAO SỨC KHỎE