Prepared by
Community health and
Geriatric nursing staff
1
Pages
1.
Terms
2
2.
Health education
7
3.
Health Education models
16
4.
Health educator
24
5.
Method of health education
37
6.
Teaching materials (aids)
46
7.
Health promotion
58
8.
Communication
73
9.
Health and human behavior
83
10. Health literary
101
11. Electronic health learning
108
12. Blended learning
112
13. Tele-health
119
14. Educational Programs
130
2
Terms
▪ Health
Is a state of complete physical, mental and social wellbeing and not merely the absence of disease or infirmity
▪ Illness
Illness is defines as a state in which a person’s physical,
emotional, intellectual, social, developmental
and
spiritual functioning is diminished or impaired
▪ Wellness
It is the condition in which an individual function at
optimal levels.
▪ Health education
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.
Another definition
Health education defined as teaching process, aiming to
changes in the health knowledge, attitude, and practice
of people.
3
Health Educational Models: Are strategy for change
behavior, they are a framework to give educator
direction.
Health behavior: An action taken by a person to
maintain, attain, or regain good health to prevent illness.
Patient education:
Is a part of health education aimed to provide patient
with needed information and skills to use whatever
purpose is desired
▪ Health literacy:
Is an individual ability to read, understand and use
healthcare information to make decisions and follow
instructions for treatment.
Another definition: the ability of individuals to access
and use health information to make appropriate health
decisions and maintain basic health
▪ Information:
A collection of useful briefs or detailed, ideas, processes
data and theories that can be used for a certain period of
time.
4
▪ Education:
A complex and planned learning experiences that aims
to bring about changes in cognitive (knowledge),
affective (attitude, belief, value) and psychomotor (skill)
domains of behavior.
▪ Communication:
The process of sharing ideas, information, knowledge,
and experience among people using different channels.
▪ Nutrition education:
Is education directed at the promotion of nutrition and
covers choice of food, food-preparation and storage of
food.
▪ Family life education:
Education of young people in a range of topics that
include family planning, child rearing and childcare and
responsible parenthood.
▪ Health promotion:
The process of enabling people to increase control over,
and to improve, their health.
▪ Perception:
Interpretation of the meaning given to sensory
information.
5
▪ Knowledge:
It is storage of information in the brain. (learning facts
&gaining insight)
▪ Skills:
Performing any action (ability to do well(
▪ Attitudes:
Are relatively constant feelings, predispositions, or sets
of beliefs directed toward an idea, object, person or
situation. Put another way attitudes are beliefs with an
evaluative component. (Likes and dislikes)
▪ Values:
Are enduring beliefs or systems of beliefs regarding
whether a specific mode of conduct or end state of
behavior is personally or socially preferable (belief +
attitude)
▪ Motivation:
Is a combination of forces which initiate, direct and
sustain behavior towards goal (intrinsic or extrinsic
forces)
6
▪ Telehealth nursing:
It is the delivery, management, and coordination of care
and
services
provided
via
telecommunications
technology within the domain of nursing.
▪ Telehealth:
It is the transmission of health-related services or
information over the telecommunications technology.
▪ Telemedicine:
It is the exchange of medical information from one site
to another through electronic communications.
Prevention:
Action taken to reduce the likelihood of some future
undesired event or condition or to increase the likelihood
of some future desired event or condition
▪ Blended learning
Is the use of traditional classroom teaching methods
together with the use of online learning for the same
students studying the same content in the same course.
7
Health Education
Out Line:Introduction
Definition of health education
Objectives of health education
Principles of health education
Content of health education
Techniques of heath education
Health education settings
.
8
1- Introduction
Health education is a critical part of improving the
health of populations through the promotion of healthy
behaviors. It focuses on building individuals’ capacities
to control and improve their own health through
educational, motivational, and skills-building activities
The object of health education is "to win friends and
influence people".
11- Definition of health education
WHO definition: 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.
Anther definition Health education has been defined as
teaching process, aiming to changes in the health knowledge,
attitude, and practice of people .
111- Objectives of health education
a. Informing people or disseminate scientific knowledge about
prevention of disease and promotion of health.
b. Motivating people is more important than informing because
simply telling the people about health is not enough.
9
They must be motivated to change their habits and ways of
living because many of our daily health problems need change
of human behavior.
c. Guiding into action: health education should be conducted
by a variety of health, education and communication personnel
in a variety of settings starting with the physician.
d. To equip the people with skills, knowledge and
attitudes to enable them solve their health problems by
their own actions and effort.
e. To promote the development and proper use of
health services.
IIIV - Principles of health education
1- Interest:
The health educator will have to bring about
recognition of the needs before he proceeds to tackle them.
2- Participation:
Participation is based on the psychological principle
of active learning; it is better them passive learning, group
discussion, and workshop. All of the previous is provide
opportunities for active living
3- Known to unknown:
10
In health education work, must proceed from
the known to the unknown i.e. start where the people are and
with what they understand and then proceed to new knowledge
4-Comprehension:
In health education must know the level of
understanding, education and literacy of people to whom the
teaching is directed. One barrier to communication is using
words, which cannot be understood. Teaching should be within
the mental capacity of the audience.
5-Reinforcement:
repetition at intervals is extremely useful and assists
comprehension and understanding.
6-Motivation:
Every person, there is a fundamental desire to learn.
Awaking this desire is called motivation
7- Learning by doing (practice and skills).
8- Communication:
Education is primarily a mother of communication.
The health educator must know how to communicate
with his audience.
9- Good human relation:
The health educator must be kind and sympathetic and
11
the people must accept him, as their real friend.
10- Leaders:
Psychologists have shown and established that we
learn best from people whom we respect. In the field of
health education, we try to penetrate the community though
the local leaders.
Contents of health education:
1- Human biology:
Teach about structure and functions of the body and
how to keep physical fit. Also the need for exercise, rest
and sleep are tough. The effect of alcohol, smoking,
resuscitation and first aid.
2- Nutrition:
The aim of health education in nutrition is to guide
people to choose optimum and balanced diet who
contain nutrient necessary for energy growth and repair.
3- Hygiene
This has two aspects
a) Personal
b)Environmental
4-Mother and child health care as
Antenatal care
12
Post natal care
Hygienic care of mother and child.
Weaning
Family planning
Immunization
Prevention of accident among children.
5-Prevention of communicable disease
The aim of education in prevention of communicable
Is to prevention of infection and importance of
immunization
6-Mental health
The aim of education in mental health is to help
people to mentally healthy and to prevent a mental breakdown.
7- Prevention of accident
Safety education should direct to the three main areas
homes, road and place of working
8- Use of health services
One of the declared aims of health education IS to inform
public about the health services that are available in the
VIII- Techniques of health education:
The techniques of health education are mainly the following:
I-Face to face heath education concept:
13
The educators are facing the recipients directly
with any intermediate.
Situation:
One educator facing one recipient.
One educator facing multi recipients.
Multi educators are facing one recipient.
Multi educators are facing multi recipient.
Advantage of face to face methods:There is more involvement and participation of the recipient.
It is two way of communication.
It provides immediate and personal rewards for competence of
Punishment.
It is flexible (change topic according to recipient).
11- Mass Media:
This technique is refereed to when to when a health
education message is needed to be communicated to masses of
people. This mass is a heterogeneous group of people with
different needs and interests.
Types of mass media:
The following types of mass media could be used for
health education
Auditor media:
14
Microphone
Magnetic tap recording
Visual media:
Book, booklets, pamphlets
Periodicals
Pictures, posters
Motion pictures and T.V
Advantage of mass media
It helps communication with great many of the population at
one time.
It attracts the listener attention and might persuade him to act.
Disadvantage:
They needs effort to produced good effect.
It is one-way communication so the recipient do
not participate in the educational process.
There is a great probability that the recipient feels that ideas are
strong to him and they are imposed upon him.
111- Community organization:
Community organization is one of the technique,
used in social work and adopted in health education.
Community organization is a process by which a community
identifies its needs or objectives orders or
15
rank, these needs or objectives develop the confidence and will
to work at these ne eds or objectives find the resources to deal
with these needs or objectives
Steps of community organization:
1. Identifying needs or objectives.
2. Order or rank the needs or objectives.
3. Develop confidence and will to work on these
needs or objectives.
4. Finding of community leaders.
5. Forming an executive committee.
6. Finding the resources to deal with the patient.
7. Taking action.
Health education settings
Communities
Health care facilities
Work sites
Schools
Prisons
16
Health Education models
Outlines:
Introduction
Definition of Health educational models
Definition of health behavior
Health educational models:A-The rational model
B- Health Belief Model
C- The Trans theoretical model of change
D- The theory of planned behavior
E-PRECEDE – PROCEED model
17
Introduction
Health behavior reflects a person's health beliefs.
Some common health behaviors are exercising
regularly, eating a balanced diet, and obtaining
Necessary inoculations.
Definition Health Educational Models : Are strategy
for change behavior , they are a framework to give
educator direction.
Definition of health behavior: An action taken by a
person to maintain, attain, or regain good health
to prevent illness.
Health educational models:A. The rational model
Within this model education strategies target individuals
and groups and strive to encourage positive and prevent
negative health behavior choices. This is done by
presenting relatively unbiased information. This model,
also known as the knowledge, attitudes, practices model
(KAP), is based on the premise that increasing a person’s
knowledge will prompt a behavior change.
Change in knowledge------ change in attitudes/beliefs---- change in behavior
18
B- Health Belief Model
The Health Belief Model (HBM) was one of the earliest
behavior change models to explain human health
decision-making and subsequent behavior. And is a
psychological model that attempts to explain and predict
health behaviors. This is done by focusing on the
attitudes and beliefs of individuals.
Constructs Health Belief Model
1- Perceived Susceptibility
An individual's assessment of their risk of getting the
condition.
Example: I am at risk of getting breast Cancer.
2- Perceived Severity
An individual's assessment of the seriousness of the
condition, and its potential consequences.
Example: Breast cancer is a hopeless disease
3- Perceived Benefits
An individual's assessment of the positive consequences
of adopting the behavior.
19
Example:- "Having a mammogram will help me find
breast lumps early"
4- Perceived Barriers
An individual's assessment of the influences that
facilitate or discourage adoption of the promoted
behavior.
Example: past history of breast cancer, risk or threat
perceptions, and perceived social support.
5- Cues to action: strategies or conditions in one‟s
environment that activate readiness to take action.
6- Self-efficacy: one‟s confidence in one‟s ability to
take action to reduce health risks.
C- The transtheoretical model of change
Is an integrative health behavior change theory that
describes the process of how people change their
behavior. The central organizing construct in the theory
is stages of change, which are five distinct stages of
readiness to change behavior, ranging from not ready to
change (pre contemplation), thinking about change
(contemplation), preparing to change (preparation),
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changing
(action),
and
maintaining
the
change
(maintenance).
D- The theory of planned behavior:
The theory of planned behavior asserts that achieving
and maintaining behavior change requires intent to
adopt a positive behavior or abandon a negative one.
The theory holds that intent is influenced not only by
the attitude toward the behavior but also the perception
of social norms
E-PRECEDE – PROCEED model:-
PRECEDE
(Predisposing,
Reinforcing,
and
Enabling Constructs in Educational Diagnosis and
Evaluation) outlines a diagnostic planning process to
assist in the development of targeted and focused
public health programs
PRECEDE has five phases:
• Phase 1: Social assessment
• Phase 2: Epidemiological diagnosis
• Phase 3: Behavioral and environmental diagnosis
• Phase 4: Educational and organizational diagnosis
• Phase 5: Administrative and policy diagnosis
21
-PROCEED (Policy, Regulatory, and Organizational
Constructs
in
Development)
Educational
guides
the
and
Environmental
implementation
and
evaluation of the programs designed using
PROCEED has four phases:
• Phase 6: Implementation
• Phase 7: Process evaluation
• Phase 8: Impact evaluation
• Phase 9: Outcome evaluation
PRECEDE - PROCEED
Phase 1 - Social Assessment
• Assessment means…
–Identify
–Describe
–Prioritize
- Phase 1: seeks to subjectively define the QOL(quality
of life (problems & priorities) of priority population
- Self-assessment of needs & aspirations
22
Phase 2 - Epidemiological diagnosis
Epidemiology - study of the distribution & determinants
of disease such as (Mortality, Morbidity, Disability,
Fertility, Incidence rates Prevalence rates).
-Ranking the health goals or problems
Phase 3 - Behavioral & Environmental Assessment
-
Determining
&
prioritizing
behavioral
&
environmental risk factors or conditions linked to the
health problem
- Environmental factors - determinants outside an
individual that can be modified to support behavior,
health, or QOL such as (Genetic, Predisposition, Age,
Gender, Existing Disease, Workplace, and adequacy of
Health Care Facilities).
- Once identified, must be prioritized
Phase 4 - Educational & Ecological Assessment
- Identifies & classifies factors that have potential to
influence behavior or change the environment.
23
- Predisposing factors - antecedent; impact motivation;
e.g., knowledge, attitudes, beliefs, values
- Enabling factors - antecedent; barriers & vehicles; e.g.,
access, availability
- Reinforcing factors - subsequent; positive or negative
feedback & rewards; e.g., incentives, disincentives
- Priorities become focus of intervention
Phase 5 - Administrative & Policy Assessment
- Assess limitations and constraints
- Select the best combination of methods and strategies
- Determine if capabilities & resources are available to
develop &implement program
- Close to the end of PRECEDE & moving toward
PROCEED
Phase 6 - Implementation
- Beginning of PROCEED
- Selection of methods and strategies of the intervention,
for example, education &/or other resources
24
- Program begins
Phases 7, 8, & 9 - Evaluation
- Process evaluation - measurements of implementation
to control, assure, or improve the quality of the program
-Impact evaluation - immediate observable effects of
program
-Outcome evaluation -long-term effects of the program
25
Health Educator
Outlines:Introduction
Definition of Health Educator
Characteristics of Health educator
Essential Responsibilities and Duties
Qualifications
26
Introduction
The health education field is that multidisciplinary
practice
which
is
concerned
with
designing ,implementing And evaluating educational
programs that enable individuals , groups ,organizations
and communities to play active roles in achieving ,
protecting and sustaining health.
Definition of Health Educator
Health Educator Is participate in promoting,
maintaining, and improving individual and community
health; to assess individual and community needs; plan,
implement and evaluate effective health education and
promotion programs; provide and communicate health
education information
Characteristics of Health educator
personal Characteristics
◼ Self confidence .
◼ Cheerful ,optimistic.
27
◼ Has a sense of humor.
◼ Good observer .
◼ Patient .
◼ Fair and objective .
◼ Has physical energy and vitality
◼ Sociable .
◼ Provocateur .
◼ Flexible .
◼ Respect his learners .
◼ Anticipate individual needs .
◼ Perceiving value of time .
◼ Honest .
Professional characteristics:
◼ Competent :Health educator should be :✓ Knowledgeable and skillful .
✓ Decision-maker : decide what is important to
teach .
✓ Choose appropriate learning material
✓ Provide appropriate learning environment.
✓ Teach home management of special problems.
✓ Monitor learners understanding by asking
28
questions and provide feedback.
▪ Caring :
✓ Have sympathy with learner .
✓ Provide encouragement .
✓ Recognize learners needs and concerns .
✓ Show sensitivity to patient mood
▪ Communication :
Health educator should communicate effectively by
using verbal &non verbal communication.
Non-verbal communication include :
✓ Gesture or body language :(The use of body
movement to communicate as head nodding ,
finger pointing ) .
✓ Facial expression : Face is the personality window
. It express large messages as anger , fair , surprise
✓ Eye contact
✓ Paralanguage include:
-Voice Volume :high or low
-Speaking rate : Is how fast or slow you are speaking
✓ Proximiecs :
29
-Personal space . It include the distance between
sender and receiver as : Intimate , personal ,and
social zone.
- Touch : It is an important mean ,it conveys
interest ,warmth, and reassurance but should based
on culture.
- Culture artifacts .
Verbal communication
This
consist
of
written
or
spoken
words
.communication
Techniques include :
✓ Active listening.
✓ Using silence.
✓ Broad opening : ex. "What are doing today?".
✓ Use open ended questions. It is open field for
communication.
✓ Reflection: reflect what he said.
✓ Restatement: repeating the spoken words as it is.
✓ Paraphrasing: repeating the spoken words in the
same meaning using another words.
✓ Clarification: ex. "Tell me more about that".
✓ Focusing : make stress on important points.
30
Essential Responsibilities and Duties
Responsibility 1.Assessing individual and community
needs for health education
1– Obtain health-related data about social and cultural
environments, growth and development factors,
needs and interests
2 – Distinguish between behavior that fosters and that
which hinders wellbeing
3 – Infer needs for health education on the basis of
obtained data
31
Responsibility 2.Planning effective health education
programs
1 – Recruit community organizations, resource
people and potential participants for support and
assistance in program planning
2 – Develop a logical scope and sequence plan for a
health education program
3– Formulate appropriate and measurable program
objectives
4– Design educational programs consistent with
specified program objectives
Responsibility
3.Implementing
health
education
programs
1 – Exhibit competence in carrying out planned
educational programs
2 – Infer enabling objectives as needed to
implement instructional programs in specified
settings
3 – Select methods and media best suited to
implement program plans for specific learners
32
4 – Monitor educational programs, adjusting
objectives and activities as necessary
Responsibility 4.Evaluating effectiveness of health
education programs
1– Develop plans to assess achievement of program
objectives
2 – Carry out evaluation plans
3 – Interpret results of program evaluation
4 – Infer implications from findings for future
program planning
Responsibility 5.Coordinating provision of health
education services
1– Develop a plan for coordinating health-education
services
2 – Facilitate cooperation between and among levels
of program personnel
3 – Formulate practical modes of collaboration among
health agencies and organizations
4 – Organize in-service training programs for
teachers, volunteers, and other interested personnel
33
Responsibility 6.Acting as a resource person in
health education
1– Use computerized health information retrieval
systems effectively
2 – Establish effective consultative relationships with
those requesting assistance in solving healthrelated problems
3 – Interpret and respond to requests for health
information
4 – Select effective educational resource materials for
dissemination
Responsibility 7.Communicating health and health
education needs, concerns, and resources
1 – Interpret concepts, purposes, and theories of
health education
2 – Predict the impact of societal value systems on
health education programs
3 – Select a range of communication methods and
techniques for providing health information
4 – Foster communication between health-care
providers and consumers
34
Qualifications of Health Educator
1. Knowledge of:
•
Basic principles and practices of community health
promotion
programming,
social
marketing,
evaluation, and coalition building
•
Electronic communications technology
•
Current public health issues including, but not
limited to, wellness, nutrition, tobacco control,
physical fitness, injury prevention and preventive
health care
•
Pertinent Federal, State, and local laws, codes, and
regulations
2. Ability to:
•
Learn local public health issues including wellness,
nutrition, tobacco, physical fitness, and preventive
health care
•
Assist with the coordination and implementation of
assigned health education program
•
Learn and apply Federal, State, and local policies,
procedures, laws and regulations
35
•
Gain
cooperation
through
discussion
and
persuasion
•
Communicate public health issues clearly and
concisely, both orally and in writing
•
Establish
and
maintain
cooperative
working
relationships with those contacted in the course of
work
3. Training and Experience Guidelines
Training:
•
Equivalent to a bachelor's degree from an
accredited college or university with major course
work in community health education, public health
education, communications, or a related field.
C.H.E.S. (Community Health Education Specialist)
certification is highly desirable
Experience:
•
No experience required
Health Educator II
In addition to the qualifications for Health Educator
I: Knowledge of:
36
•
Advanced principles and practices of community
health promotion programming, social marketing,
evaluation, and coalition building
•
Current public health issues including, but not
limited to, wellness, nutrition, tobacco control
,unintentional injury prevention, physical fitness,
and preventive health care
•
Electronic communications technology
•
Pertinent Federal, State, and local laws, codes, and
regulations
Ability to:
•
Develop
and
administer
community
health
education programs
•
Coordinate and implement the assigned health
education program
•
Analyze problems; identify alternative solutions,
project consequences of proposed actions and
implement programs in support of program goals
•
•
Interpret and apply Federal, State, and local
policies, procedures, laws and regulations
Develop community partnerships and coalitions
•
Communicate public health issues clearly and
concisely, both orally and in writing
37
•
Act as a public health advocate
•
Establish
and
maintain
cooperative
working
relationships with those contacted in the course of
work
Training and Experience Guidelines
Training:
•
Equivalent to a bachelor's degree from an
accredited college or university with major course
work in community health education, public health
education, communications, or a related field.
C.H.E.S. (Community Health Education Specialist)
certification is highly desirable
•
Experience:
•
Two years
experience
of
community
38
health
education
Methods of health education
Outlines
Introduction
Definition of methods of health education
Common health education methods
Types of health education
Individual methods
Group method,
Mass media method
39
Introduction
Methods of health education are generic
descriptions of how change is to be brought about
within the target group.
While planning health
education programs, it is not that any method can be
used (as delivering lectures to all concerned) but rather
the most appropriate method most suited for the topic
and the target audience should be selected. The methods
which have proved to be most effective are those which
take into account the interests of the learner and which
offer him the opportunity of participating actively in the
learning process.
Definition of educational methods
They are the techniques or ways in which series of
activities are carried out to communicate ideas,
information and develops necessary skills and attitudes.
40
Commonly Used Health Education Methods
informal methods
Formal methods
- health talk
- Conference
- lecture- discussion
- workshop
- brainstorming
- seminar
- group discussion
- Panel discussion
- Buzz group
- Symposium
- demonstration
- Inquiry
Learning
- Role play - Simulation
(an
- Drama
which
- Case studies
formulate and test
- Traditional media
their
approach
students
hypothesis)
Types of health education (HE) method
1- individual HE Method
41
in
own
This method involves person to person or faces to
face
communication
which
provides
maximum
opportunity for two way flow of idea, knowledge and
information. Adequate interaction between the health
educator and his client help provide health education
successfully resulting in attitude and expected behavior
change.
Way of successful individual HE method is
counselling and interview.
For example
when an individual come to the dental clinic or the
health center because of illness , the opportinuity should
be used to educate him on matters of interest such as the
cause and nature of his illness, its prevention, beneficial,
diets, oral hygien etc.
This approach can also be used by public health
personnel, since they will be visiting home and
interacting with individual and family member.
2- group HE method
An ideal group may consist of 6- 12 members
depending upon situation. This method is very effective
42
"two way" communication of educating the community,
promoting behavioral change, influences opinion,
develop critical thinking and increase motivation.
In spite of the advantage of individual methods for
health education cannot be use due to the time limitation
and shortage of manpower.
So it will be more
practicable for him to provide education in group as
well.
Group method include•
Group discussion,
•
Brain storming,
•
Demonstration,
•
Panel discussion,
•
Mini-lecture
•
Role play,
•
Problem solving
•
Field trip/ educational
•
Workshop
•
Seminar
tour/ campaign
•
Symposium.
3- Mass Media Method
This method is especially meant for a large number of
heterogeneous people. Mass method includes43
•
Lecture,
•
Exhibition,
•
Audio aid – radio cassette player,
•
Video aid- posters, pamphlets, flip chart, flannel
graph, butte tin board etc.
•
Audio- visual aids such as television, documentary
films& sound, videotape movies.
•
health information booklets , internet
All Terms in Health Education Methods
Items
Definition
lecture
Carefully prepared oral presentation of facts,
organized thoughts and ideas by a qualified
person.
brain
is a group creativity technique by which efforts
storming
are made to find a conclusion for a specific
problem
by
gathering
a
list
of
ideas
spontaneously contributed by members.
or it is a means of elicting from the participants
their ideas and solution on health issues
simulation
Is an artificial representation of a real world
process to achieve educational goals through
44
experiential learning.
role play
It is a type of drama in a simplified manner. It
portrays expected behavior of people.
demonstration Is carefully prepared presentation to show how to
perform a skill or procedure.
panel
composed of 4-8 speakers who are qualified to
discussion
talk and discuss about a problem or a topic in
front of a large group or audience
symposium
Series of speeches on a selected subjects.Each
person or expert present an aspect of the subject
briefly.
Buzz group
A large group is divided into small groups not
more than 10-12 members in each each group &
they are given a time to discuss the problem.
work shop
consists of meetings, usually four or more with
the
emphasis
on
individual
work,
wehre
participant get fully involved in the learning
process under expert guidance
Conference
It composed of two to fifty persons representing
several organizations, departments. They gather
information and discuss mutual problems with a
reasonable solution as the desirable end.
45
Seminar
A group of persons gathered for the purpose of
studying a subject under the leadership of an
expert or learned person. It
involves paper
reading on a theme and followed by group
discussion to clarify the complex aspects of the
theme
46
Teaching aids
Outlines:Definition of teaching aids
Needs for teaching aids
Classification of teaching aids
Some examples of teaching aids
The teacher as teaching aids
How to use of teaching aids
Advantages of teaching aids
Characteristics of good teaching aids
47
Definition of teaching aids?
Teaching aids (TAs): Teaching aids are objects
(such as a book, picture, or map) or device (such as a
DVD or computer) used by a teacher to enhance or
enliven
classroom
instruction.
They
could
be
audiovisual teaching aids such as videos and guest
lectures or tactile like 3D models.
Teaching aids are tools that teacher use them in the
classroom such as flash cards, maps, cassette&
blackboard
48
Needs for teaching aids
reinforce what you are saying,
ensure that your point is understood,
signal what is important/essential,
enable
students
to
visualise
or
experience
something that is impractical to see or do in real
life,
engage students’ other senses in the learning
process,
facilitate different learning styles.
proper use of teaching aids helps to retain more
concepts permanently.
Students can learn better when they are motivated
properly through different teaching aids
Teaching aids develop the proper image when the
students see, hear, taste and smell properly.
Teaching aids provide complete example for
conceptual thinking.
49
Types and classification of teaching aids:
Classification 1
Non-electronic – Chalkboards, flip boards, slates,
photos, telescopes,
Electronic – Powerpoint slideshows, videos, Augmented
reality/Virtual reality goggles, AV-room equipment
Classification 2:
Visual aids
The aids which use sense of vision are called visual aids.
For example: actual objects, models, pictures, charts,
maps, chalkboard, overhead projector, slides. etc.Out of
these blackboard and chalk are the commonest ones.
Audio Aids:
The Aids that involve the sense of hearing are called
Audio aids. For example:- radio, tape recorder,
gramophone.
Audio-Visual Aids:
The aids which involve the sense of vision as well as
hearing are called Audio-Visual aids. For example:television, Projector, etc.
50
Some examples of teaching aids:-
WHITE-/BLACKBOARD
Advantages
No advanced preparation required,
except when displaying a complex table/chart/
diagram.
Technology is not dependent on electricity or
other possible glitches.
Can be used by students for problem-solving, etc.
Disadvantages
Time-consuming if you have a lot to write.
51
Handwriting may be difficult to read (legibility,
size, glare, etc.).
Turn your back on audience.
Cleaning the board (chalk dust, permanent marker,
etc.)
Can’t go back to something you’ve erased.
OVERHEAD PROJECTOR
Advantages
Allows you to prepare all your slides in advance.
Particularly suited for complex diagrams, charts
and illustrations.
Can build up information point-by-point through
the use of overlays.
Don’t have to turn your back on the audience.
Disadvantages
A blown bulb or power failure can spoil all your
hard work.
Image quality can also be a problem.
Can be disorienting to manipulate transparencies
on projector plate.
52
POWER POINT PRESENTATION
Advantages
Good for large rooms and audiences
Can be action oriented or words oriented
Allows for reference back to previous slides
Disadvantages
Expensive
Can be difficult to produce – easier with
computer graphics
Room must be darkened somewhat
Requires equipment and knowledge of that
equipment
Relatively portable
Order easily arranged
OTHER MEDIA AUDIO TAPES or CDs
When to USE:
Particularly suited for language learning, media
studies, English literature, etc.
53
Valuable when referring to recorded historical
events (e.g. Martin Luther King’s “I have a
dream” speech).
Background music can also be played before
class starts and during group activities.
TIPS
Check the room and equipment beforehand.
Can it be heard from the back of the room?
Find the right spot on the tape/CD and queue it
up in advance.
Don’t play more than a few minutes of audio at
one time.
Break
up
longer
clips
into
segments,
interspersed with discussion or other activities.
OTHER MEDIA VIDEO TAPES or DVDs
When to USE:
Adds a dimension not available through audio
alone - helps students to visualise.
Essential when illustrating things that are
impractical to do in real life.
54
Particularly suited for language learning, media
studies, engineering, etc.
Valuable when referring to recorded historical
events.
TIPS
Same as for CDs/audio tapes
Check equipment beforehand.
Can images be seen from the back of the room?
Queue up the tape in advance.
Break viewing into short segments, interspersed
with discussion or activities.
The teacher as a teaching aid - In my experience as a
teacher I have discovered that I can involve students
more in classroom discussion and activities if I follow
certain simple steps.
Movement
Use body language
Eye contact
Gesture
Facial expression
55
Speech
Student talk
Names
How to use teaching ads
Teaching aids should be simple and brief
Teaching aids should be related to the objects of
teaching
Teaching aids should be big door to be seen by all
the students
Teaching aids should be prepared and planned in
advance
Teaching
aids
should
be
properly
selected
according to the physical and mental level of the
student
Teaching aids should be meaningful and interesting
Teaching aids should be colorful and should have
direct impact on the lesson
Teacher must use proper Teaching aids according
to the interest of the student.
Teaching aids must be ( well prepared, well
presented,
readable,
legible,
visible
to
appropriate format for room and audience size
56
all,
Teaching aids must be relevant, pertinent to topic,
up-to-date, consistent with local protocols.
Advantages of teaching aids
Supplement in verbal instructions
Teaching aids make learning permanent.
Teaching aids provide variety
Teaching aids are helpful in attracting attention to
the students
Teaching aids saves time and energy
Teaching aids encourages healthy classroom
interaction
Teaching aids are helpful in creating positive
environment for discipline
Teaching aids are helpful in meeting individual
differences
Characteristics of good teaching aids
A few Characteristics of good teaching aids are as
follows:Teaching aids are large enough to be seen by the
students for whom they are used.
57
Teaching aids are meaningful and they always
stand to serve a useful purpose.
Teaching aids are simple, cheap and may be
improvised.
Teaching aids are accurate and realistic.
Teaching aids are according to the mental level of
the learners
Teaching aids helps in realization of stipulated
learning objects.
Teaching aids are really very useful and can be
used in many lessons and at different class levels
58
Health promotion
Outlines:Definition of health promotion
Objectives of health promotion
Health Promotion Strategies according to WHO:Component of health promotion
59
✓ Definition of health promotion:is the process of enabling people to increase
control over & improve their health by
developing their resources to maintain or
enhance well being.
✓ OR Health promotion: Refers to programs or
interventions that focus on behavior changes
directed toward improved health and well-being of
individuals, groups, communities, and nations in
relation to their environment.
✓ Definition of health promoting:- is an action
for health using knowledge, communication &
understanding
Objectives of health promotion:1.
Increase quality and years of healthy life
2.
Maintain function
3.
Eliminate health disparities
4.
Increase independency
5.
Improve (enhance) quality of life
6.
Extend life expectancy → ↓ premature
mortality
caused
diseases
60
by
chronic&
acute
Health Promotion Strategies according to WHO:1. Advocacy
2. Mediation
3. Empowerment (Enabling)
1. Advocacy for Health is a combination of individual
and
social
actions
designed
to
gain
political
commitment, policy support, social acceptance and
systems support for a particular health goal or program.
Advocacy can take many forms including the use of the
mass media and multi-media, direct political lobbying,
and community mobilization.
2. Mediation: In health promotion, a process through
which the different interests (personal, social, economic)
of individuals and communities, and different sectors
(public and private) are reconciled in ways that promote
and protect health.
3. Empowerment (Enabling): In health promotion,
enabling means taking action in partnership with
individuals or groups to empower them, through the
mobilization of human and material resources, to
promote and protect their health.
61
Component of health promotion
1. Exercise
2. Nutrition
3. Rest & sleep
4. Periodic medical check up
5. Health related behavior
6. Spiritual well-being
7. Psychosocial well-being
1- Exercise
Psychological
Benefits
of
exercise
Physical
Social
Physical benefits of exercise
1. Increase consumption of body fat
62
2. Improve cardio-vascular capacity( by↑ blood
flow----- keep tissue healthy
3. Control hypertension& blood sugar
4. Improve respiratory function
5. Improve joint flexibility
6. Improve pattern of sleep & rest
7. ↑ independency
8. Improve sense of well –being & relaxation
9. Maintain mind’s function
10. Promote sense of normality
11. Peristaltic movement
Psychological benefits of exercise
1. Improve mood state
2. Improve self-image
3. Reduce stress
4. Enhance sleep
5. Improve depressive state of elderly
Social benefits of exercise
Improve social interaction & relation with other
Types of exercise:
A-Isotonic exercise:
63
This type of exercise is also called dynamic or
cardiovascular exercise, and it describes the kind of
activities where you move the joints and muscles in your
arms or legs. This is usually the best kind of exercise for
people with a heart condition, but you need to check
with your specialist before you do it for the first time.
Isotonic exercise includes:
•
Leisurely walking.
•
Swimming.
•
Cycling.
•
Walking fast.
•
Dancing.
Some heart conditions mean that you might not be
able to do very high-intensity isotonic activities like
basketball, triathlon, competitive level swimming,
cycling or running, so make sure you check with your
specialist.
B-Isometric exercise:
This type of exercise is also called static, weight or
resistance exercise. It doesn’t involve very much joint
64
movement as it is mostly muscle work. Often people
with heart conditions need to avoid some of these
exercises because they put a strain on your heart and
blood vessels. Check with your specialist before you
join a gym or start doing any of these.
Isometric exercise includes:
•
Weight-lifting.
•
Rock-climbing.
•
Boxing, wrestling.
•
Martial arts.
2- Nutrition
It is neglected especially those living alone or with
low income.
Factors affecting nutritional status:
1. Psychosocial factors
2. Economic factors
3. Cultural factors
Psychosocial factors
• Depression
retirement,
is
common
change
of
65
(
losses,
body
death,
appearance,
impaired vision &poor physical fitness) this
will lead to lack of interest in eating& anorexia
and ↓ food intake.
• Living alone also will lead to lack of incentive
to cook &eat.
Economic Factors
• Low income
• Limited access to food and food choices
• Inadequate facilities to food storage and
preparation
Cultural factors
• Eating habits may miss certain food group as
vegetarians.
3- Rest& sleep
✓ Person spend 1/3 of his life in sleep
✓ Sleep is time for cell growth& repair
✓ Elderly need 5-7 hrs at night
Importance of Rest& sleep:
• Conserve energy
• Provide organ respite (rest)
66
• Restore the mental alertness& neurological
efficiency
• Relieve tension
• Emerge feeling of well being
Nursing measures adopted to promote sleep
1. Engage in exercise program
2. Avoid exercise within 3-4 hr. of bedtime.
3. Spend time out door in the sunlight each day
but avoid period between 12 PM to 3 PM
sunshine exposure.
4. Engage in relaxing activities near bedtime.
5. Avoid tobacco at bedtime
6. Avoid drink any caffeinated beverages before
midafternoon.
7. Limit fluid intake after the dinner hour if
nocturia is a problem.
8. Limit daytime naps to 30 minutes or less.
9. Avoid using the bed for watching TV, writing
bills, and reading.
4- Periodic medical examination
o Importance of Periodic medical examination:
67
o Assess the level of well-being
o Detect early signs of disease
o Educate client how to promote his health
o Reinforce + ve promoting & protecting
behaviors
o If examination done at home, it permit
evaluation of environment ( hazards care
giver…)
Types of health screening
Health screening
Period
Bl. P
Each Dr. visit or 3-6 months
Ht & wt
Periodically
as
comprehensive
examination
Dental check up
Once / year( annually)
Fecal occult blood&
( annually)
sigmoidoscopy
Vision
including
Every 2 years
glaucoma test
Hearing
Evaluate periodically
68
part
of
physical
Cholesterol level
Every 5 years
Cancer screening
Annually
Mammography for
1-2 years
women
under
70
years
5- High Risk Behavior
It is behavior that damage physical health.
It includes:
• Smoking
• Over
counter
medication
(multiple
medications)
• Caffeine
Smoking:
• Nicotine & toxic substances in cigarette has impact on
detoxication process in the body------- cell damage&
variety of diseases as cancer, respiratory, CVD, ↑ risk of
osteoporosis.
• Cessation of smoking improves cerebral blood flow&
↑ pulmonary function.
69
Multiple medications:
• Older people consume many medications-------↑adverse drug reaction.
• The most common over the counter medication:
Analgesics, laxatives& antacids followed by cough
products, eye wash& vitamins.
Caffeine:
• Found in coffee, tea, soft drinks, chocolate.
• It is mood elevator.
• It stimulates sympathetic nervous system.
• ↑Motor activity.
• ↑ Muscle capacity & alertness.
• ↑ Rapid pulse.
• ↑ Calcium excretion.
7- Spiritual Well- being
Spiritual well-being is the practice and philosophy of
the integral aspects of mental, emotional and overall
wellbeing.
• Spiritual well-being is a state in which the positive
aspects of spirituality are experienced, incorporated and
70
lived by the individual and reflected into ones
environment.
Signs of spiritual distress:
• Doubt.
• Despair.
• Guilt.
• Boredom.
• Expression of anger toward god.
Measures to increase Spiritual well being
✓ Identify ways that believes give meaning to
life
✓ Use problem solving to solve any conflict
related to spirituality
✓ Meeting with religious man at regular
intervals
✓ Presence of religious literatures in the
immediate environment such as Quran on
beside table
✓ Reading in religious books & praying
✓ Discuss role of spirituality in one’s life
71
Role of the nurse in health promotion:1. Assessment physical health, Psychosocial Wellbeing, lifestyle pattern, hobbies, high risk
behaviors, knowledge, believes& attitudes that
affect health & wellbeing.
2. Assess health needs
3. Assess social , environmental & cultural
influences on health behaviors
4. Lifestyle modifications is a comprehensive
approach
for
effective
change
in
heath
promotion behaviors
5. Nurse role should directed toward helping
elderly to cope with his function level -----delay disabilities & impairments.
6. Nurse identify environmental hazards & make
necessary modifications
7. Identify social needs & encourage participation
& social support groups.
8. Nurse should inform elderly & caregivers about
aging process, common disorders & disabilities
, different services available
72
9. Encourage elderly to take better care to them,
avoid high risk behaviors,& hazards affecting
their health.
10.
Regular and continuous evaluation is
important aspect of nurse’s role.
73
Communication
Outlines:
Introduction.
Definition.
Component or elements of communication.
Types of communication.
o Verbal
o Nonverbal
Barriers of communication.
Measures to improve communication
Reference.
74
Introduction:
Communication is an important behavioral skill that
allows us to survive in and interact with our world.
Through our ability to communicate, we express our
needs and wishes, understand others’ needs and wishes,
negotiate adversity, and convey our feelings to others.
We rely on our ability to communicate effectively to
gather and share information as well as to build
relationships with patient and families. This information
should promote development of the skills needed to
communicate effectively and promote optimal health for
older adults.
Definition of communication:
 Communication is two –way process concerned with
conveying a message or an idea between two or more
individual, one person is sender and one is the receiver
of message.
 Communication is the process or means by which an
individual relates experiences, ideas, knowledge, and
feelings to another
75
The communication process:
Communication occurs as a sequence of events. The
process consists of seven basic parts that work together
to result in the transference and understanding of
meaning.
1. A message
The first part of communication process is a message,
which is an expression of the purpose of communication.
Without the message, there can be no communication.
2. A sender
Sender is the person (or persons) conveying a message.
3. A receiver
76
A receiver is the person (or persons) to whom the
message is directed and who the intended recipient of the
message.
Encoding
Encoding which refers to the sender's conversion of the
message into symbolic form. This involves how the
sender translates the message to the receiver.
4. A channel
A channel or medium through which the sender conveys
the message the channel may be a written, spoken, or
nonverbal expression. Examples include an e-mail
stating a request, a report providing information, a
written care plan, a verbal request for clarification, or a
facial expression indicating confusion.
5. Decoding
Decoding which is the sixth part of the communication
process. The receiver's ability to decode the message is
influenced by the knowledge of the topic, skills in
reading and listening, attitudes, and sociocultural values.
6. A feedback loop
77
A feedback loop which refers to the receivers indicating
that the message has been understood (decoded) in the
way that the sender intended (encoded).
Types of communication
Communication can be classified in the following
different ways.
• Verbal communication:The basis of communication in the interaction between
people. Some of the key components of verbal
communication are sound, words, speaking, and
language.
Characteristics of verbal communication
1. Verbal or oral communication is the use of language to
convey message.
2. It
implies,
attitudes,
thought,
feeling
that
communicated through spoken or written words which
be clear, concise, purposeful, and direct.
3. Verbal communication is largely conscious, because
people choose the words they use. The words used very
among individual according to culture, socioeconomic
background, age and education.
78
4. The sender of verbal communication should choose the
right time and environment to convey message.
The effective verbal communication:
Using TACTFUL conversations:
T= thinking before you speak.
A= apologize quickly when you blunder.
C= converse, don't compete.
T= time your comments.
F= focus on behavior not on personality.
U= uncover hidden feelings.
L= listen for feedback.
• None verbal communication:Is the process of transmitting message without spoken
words, sometimes called body language? Message can
be communicated through facial expression, gestures and
posture; many include the space we use around us.
Object communication includes clothing, hairstyles,
decoration, and shoes.
Elements of nonverbal communication:
79
1- Personal appearance:
It include physical characteristic. Manner of' dress and
grooming, make up, jewelry, hairstyle, This factors help
in communicate personality, social status, occupation
and religion first impression are based on appearance so
the nurse can develop general impression about client
wellbeing, and emotional status.
2- Facial expression:
Facial expressions are the most important source of nonverbal communication. They generally communicate
emotions e.g. Anger, sadness, joy, fear and surprise that
reveal little about what they are thinking or feeling.
Some people are extremely expressive, and other is
masked.
3- Eye contact:
Eye contact is another very important cue in
communication.
- maintaining eye contact during conversation show
respect and willingness to listen.
- Lake of eye contact may indicate anxiety, discomfort
80
or that person is avoiding communication.
4-Posture and gait:
The way of people sitting, standing and move reflect
altitude, emotions and self-concept. E.G." erect posture
and quick communicate indicates confidence and
wellbeing; slow shuffling gait indicate depression,
fatigue or illness.
5- Para language.
Is the non-verbal aspect of verbal communication. It
includes tone of voice, volume "loudly, softy" and
sound" e.g. Crying, gasping, singing".
E.g. Speaking loudly may indicate feeling of anger.
Speaking softly may indicate a concern.
6- Touch:
It is a powerful tool that conveys either negative or
positive expression, therapeutic use of touch is effective
in conveying non-verbal message and feeling of love, it
include hand shaking, hugging, holding hands and
affected by culture.
7- Gesture:
81
Body gestures provide clues about persons and about
how they feel toward others. Hand gesture can
communicate anxiety. Indifference and inpatient, Body
position gives cues about how open a person is to
another person, or how interesting and attractive one
person is to another. E.g. depressed patient may take
fetal position.
8- Personal space (proximities):
Personal space refers to an area with invisible
boundaries surrounding the person's body, that other is
expected not to invade.
The range of personal space is culturally learned as well
as individually determined, based on personal comfort.
Also it depends on nature of relationship and situation.
Communication Barriers
A) Barriers related to sender level:
1-Does not know the subject.
2-Cannot communicate the message.
3-Does not formulate clearly the objectives.
4-Does not formulate well the message.
5-Does not choose the language of the receptor.
82
6-Does not adapt the tone of voice.
B) Barriers related to message level:
1-Difficult words.
2-Is not interested to the receiver.
3-Is not relating to the stated objectives.
4-Unclear confusing not brief.
C) Barriers related to channel level:
1-Noise.
2-Not adapted to the message transmission.
3-Not accessible to the receptor.
D) Barriers related to the receiver level:
1- Indifferent to the message.
2- Could not decode the message.
3- Cannot receive the message.
4- Poor listening condition.
E) Barriers related to environment.
1-If the location of communication is overcrowded.
2-If location is noisy.
3-If the place is threatened &discomfort.
4-If climate is too cold or too hot.
Measures to improve communication:
• Maintain active listening. E.g. maintain eye contact,
83
give full attention.
• Accept the patient's mode of communication with
appropriate
response,
conveying
interest
and
understanding.
• Minimize your verbal participation; so the patient will
have the chance of leading the verbalization.
• Accept periods of silence.
• Avoid offering reassurance too quickly, changing the
patient's conversation topic or defending.
• Provide the amount of information the person could
handle rather than the amount you might won't to give.
• Be ready to give feedback.
• Utilize
effective
and
therapeutic
technique
communication according to the situation.
• Provide right climate and environment
84
of
health and human behavior
outline:Introduction
Definition of behaviors and other related terms
Examples of behaviors promoting health and
preventing diseases
Levels of diseases prevention ( past and advanced)
Factors affecting behavior
Predisposing factors
Enabling factors
Reinforcing factors
Healthy Behaviors for a Healthier Lifestyle
85
Introduction
Human behavior is among the major determinants of the
health of individuals, families or communities. Healthy
behaviors contribute to the overall health of individuals
and communities and unhealthy behaviors adversely
affect the quality of life people at different levels. The
promotion of health and prevention of diseases will
usually involve some changes in lifestyles or human
behavior.
Definition of behaviors and other related terms
Behavior is an action that has a specific frequency,
duration and purpose whether conscious or unconscious.
People stay healthy or become ill often as a result of
their own action or behavior
The following are examples of how peoples actions can
affect health:
• Feeding children with bottle put them at risk of
diahrrhea
• Defecating in an open field will lead to parasitic
infection
86
• Unsafe sex predisposes people to unwanted
pregnancy.
Hiv\AIDS and other STDs
N.B: The word actions, practices and behaviors are
different words of the same thing
Lifestyle: refers to the collection of behaviors that
make up a persons way of life- including diet, clothing,
family life, housing and work.
Customs: it presents the group behavior. It is the
pattern of action shared by some of all members of the
society.
Traditions: are behaviors that have been carried
out for along time and handed down from parents of
children
Culture: is the whole complex of knowledge,
attitude, norms, belief, values, habits, customs, traditions
and any other capabilities and skills acquired by man as
a member of society.
Examples of behaviors promoting health and
preventing diseases
87
Healthy
behaviors:
actions
that
healthy
people
undertake to keep themselves or others healthy and
prevent disease
(Good nutrition, Breast feeding, reduction of health
damaging behaviors like smoking)
utilization behavior:- utilization of health services such
as antenatal care, child health, immunization, family
planning….etc
illness behavior: recognition of early symptoms and
self- referral for treatment.
Compliance
behaviors:
following
a
course
of
prescribed drugs such as for tuberculosis.
Rehabilitation behaviors: what people need to do after
a serious illnesss to prevent further disability.
Levels of disease prevention (past and recent)
Prevention, as it relates to health, is really about
avoiding disease before it starts. It has been defined as
the plans for, and the measures taken, to prevent the
onset of a disease or other health problem before the
88
occurrence of the undesirable health event. There are
three distinct levels of prevention.
1 Primary prevention
Primary prevention — those preventive measures that
prevent the onset of illness or injury before the disease
process begins. Examples include immunization (Figure
4.1) and taking regular exercise.
2 Secondary prevention
Secondary prevention — those preventive measures
that lead to early diagnosis and prompt treatment of a
disease, illness or injury to prevent more severe
problems developing. Here health educators such as
Health Extension Practitioners can help individuals
acquire the skills of detecting diseases in their early
stages. Examples include screening for high blood
pressure and breast self-examination; you will learn
about both of these in the Module on NonCommunicable Diseases, Emergency Care and Mental
Health.
89
3 Tertiary prevention
Tertiary prevention — those preventive measures
aimed at rehabilitation following significant illness. At
this level Health Extension Practitioners can work to
retrain, re-educate and rehabilitate people who have
already developed an impairment or disability.
90
91
Recent levels of prevention:1-Primordial prevention:
In primordial prevention, efforts are directed
towards discouraging elderly from adopting harmful
lifestyles.
2-Primary level of prevention:
(Health promotion, disease prevention/ specific
protection) includes all activities that actively promote
optimal health and prevent disease through specific
prevention.
Primary prevention aimed at healthy individuals, to
prevent disease from occurring. Examples include:
•
Vaccinations.
•
Adopting a healthy lifestyle. For example: Diet,
Weight, Exercise, avoidance of smoking.
3-Secondary prevention:
This is aimed at patients with an existing pathology, to
reduce the risk of recurrence or progression. For
example:
92
•
Aspirin in arterial disease.
•
Beta-blockers and angiogenesis-converting enzyme
(ACE) inhibitors after myocardial infarction.
•
Smoking
cessation
in
Chronic
Obstructive
Pulmonary Disease (COPD) and established arterial
disease.
4-Tertiary prevention:
Efforts are used to manage clinical diseases in order to
prevent them from progressing or to avoid complications
of the disease, as when beta blockers are used to help
remodel the heart in congestive heart failure.
5-Quaternary prevention:
Methods to avoid results of unnecessary or
excessive interventions in the health system. In other
words, not spending money and effort on things that
don’t work.
Factors affecting behavior
Three factors affecting behavior can be identified:
1. Predisposing factors
93
2. Enabling factors
3. Reinforcing factors.
1. Predisposing factors
Predisposing factors are those characteristics of a
person or population that motivate behavior before the
occurrence of that behavior. Peoples’ knowledge,
beliefs, values and attitudes are predisposing factors and
always affect the way they behave.
Knowledge
Knowledge is usually needed but is not enough on its
own for individuals or groups to change their behavior.
At least some awareness of health needs and behavior
that would address that need is required.
Usually, however, for behavior change some additional
motivation is required. For example, even if a mother
knows in general about using oral rehydration salts
(ORS) when her child is dehydrated due to diarrhea, she
may need a reinforcing message from you before she
will actually use them.
94
Beliefs
Beliefs are convictions that something is real or true.
Statements of belief about health include such negative
comments as, ‘I don’t believe that exercising daily will
improve my health’. More positive health beliefs might
include statements such as, ‘If I use an insecticide
treated bed net at night I will probably not get malaria.’
Often a potent motivator related to beliefs is fear. The
fear results from beliefs about the severity of the health
threat and one’s susceptibility to it, along with a feeling
of hopelessness or helplessness to do anything about the
threat.
Values
Values are the moral and ethical reasons or justifications
that people use to justify their actions. They determine
whether
people
consider
various
health-related
behaviors to be right or wrong.
Of interest is the fact that people often hold conflicting
values. For example, a teenage male may place a high
value on living a long life; at the same time, he may
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engage in risky behaviors such as chewing khat and
drinking alcohol.
Attitudes
Attitudes are relatively constant feelings directed
toward something or someone that contains a judgment
about whether that something or someone is good or
bad. Attitudes can always be categorized as positive or
negative.
For
example,
a
woman
may
feel
that
using
contraception is unacceptable. Attitudes differ from
beliefs in that they always include some evaluation of
the person, object or action.
Self-efficacy
The most important predisposing factor for selfregulating one’s behavior is seen to be self-efficacy, that
is the person’s perception of how successful he or she
can be in performing a particular behavior. Self-efficacy
is learning why particular behaviors are harmful or
helpful. It includes learning how to modify one’s
behavior, which is a prerequisite for being able to
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undertake or maintain behaviors that are good for your
health.
2 Enabling factors
Enabling factors are factors that make it possible (or
easier) for individuals or populations to change their
behavior or their environment. Enabling factors include
resources, conditions of living, social support and the
development of certain skills.
Skills
A person or population may need to employ a number of
skills to carry out all the tasks involved in changing their
behavior. For some positive health behaviors it might be
necessary to learn new skills.
For example if a breast feeding mother is not well
trained on positioning and attachment of her baby she
may have difficulty in properly breastfeeding her child.
Similarly, if the mother is not well trained at a later stage
on the preparation of complementary feeding, the child
may not get the nutrition they require.
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Healthcare resources
A number of healthcare resources may also need to be in
place if an individual or population is to make and
sustain a particular health-related behavior change. The
availability, accessibility and affordability of these
resources may either enable or hinder undertaking a
particular behavior.
For example, in a given health post the lack of
availability of the family planning method of choice for
a mother may discourage her from utilization of the
service in the future.
3. Reinforcing Factors
Reinforcing factors are the positive or negative
influences or feedback from others that encourage or
discourage health-related behavior change. The most
important reinforcing factors are usually related to social
influences from family, peers, teachers or employers.
Social influence
Social influence is the positive or negative influence
from those influential people around us that might
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encourage or discourage us from performing certain
health-related behaviors.
For example a mother who is planning to start family
planning (FP) She might be influenced by her family:
‘My family members do not all support the idea of using
FP methods, especially my husband and my mother-inlaw. They would really be mad at me if I use FP’. She
may also be aware that her community society or culture
generally may not be supportive: ‘Everyone in our
community is against FP and it is seen as a sin in our
society’.
An individual’s behavior and health-related decision
making — such as choice of diet, condom use, quitting
smoking and drinking, etc. — might very well be
dependent on the social networks and organizations they
relate to. Peer group, family, school and workplace are
all important influences when people make up their
minds about their individual health-related behavior.
Healthy Behaviors for a Healthier Lifestyle
lifestyle and behavior, Daily habits like the foods you
eat, the time you go to sleep and how much activity you
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get throughout the day have a significant influence on
your health. Each of these behaviors positively or
negatively affects you and dictates the overall state of
your health.
There are several aspects of your lifestyle that might
be influencing your health:
Nutrition habits: The foods we eat have a direct
influence on the health of bodies. Instead of eating to
feel full, focus on eating to increase energy levels,
benefit digestive health and improve overall health.
Hydration habits: To maintain good health, have to
drink plenty of water. A daily minimum of 3 liters (14
cups) of fluid is recommended for men and 2.2 liters (9
cups) for women. Try drinking water instead of sodas or
juices throughout the day.
Physical activity: Staying physically active can help
maintain a healthy weight and body composition,
reducing the risk of weight-related medical conditions. It
can also help maintain the health of muscles, bones and
joints with age.
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Stress management: Stress triggers a survival response
that can help in the short-term but become damaging if it
persists for a prolonged period. Learning how to control
stress can help retain your mental and physical health.
Sleeping habits: The amount of sleep get every night
dictates energy level, feelings of mental alertness and
ability to maintain a healthy weight level. Try to get
between seven and nine hours of sleep every night.
Daily supplements: Vitamins, nutrients and herbs are
big
supporters
of
health
and
wellness.
Taking
supplements and managing health through detoxification
and other treatment methods can encourage a healthier
lifestyle.
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Health literary
Out line:Introduction
Definitions
Importance of Health Literacy
Factors Affecting health literacy
High Risk for Low Health Literacy
Effects of Low Health Literacy
Role of Communication in Health Literacy
Role of Health care providers
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Introduction
Health literacy is increasingly recognized as a
necessary element of all efforts to improve health.
Health literacy is critical for people’s search for and use
of health information; adoption of healthy behaviors;
and decision-making about health issues in the
workplace, community, and society. Furthermore, health
literacy is central to people’s ability to access the public
health and healthcare systems, communicate with health
professionals, and engage in self-care and chronic
disease management.
Definition s:
Functional Literacy:
The basic skills of reading, writing and numeracy taking
context into account
Health literacy
It is the ability to obtain, process, and understand basic
health information and services needed to make
appropriate health decisions and follow instructions for
treatment.
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Importance of Health Literacy:
Health literacy affects our ability to:
Make healthy lifestyle choices (nutrition labels)
Find & understand health & safety information
Locate appropriate health services
Communicate with health providers.
To understand health-related instructions
To follow discharge instructions
Engage in self-care and chronic disease management
Adopt health-promoting behaviors
Factors Affecting health literacy
Health literacy depends on both individual and
systemic Factors
a. Personal Factors:Literacy skills
Cognitive skills
Motivation
Physical and emotional health
Experience with health care (people with limited
knowledge about the body and the causes of disease may
not Understand the relationship between lifestyle factors
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(such as diet and exercise) and health outcomes,
recognize when they need to seek care and
** Specific health condition:
Beliefs about health
Socioeconomic status
Social supports
Culture
b. System Factors:Provider's communication skills (include literacy
skills (e.g., reading, writing, and numeracy), oral
communication skills, and comprehension).
Complexity of health information
Characteristics of healthcare setting
System demands and expectations upon patients
(individuals need to read, understand, and complete
many kinds of forms in order to receive treatment and
payment reimbursement…etc).
Time pressures upon health care professionals
High Risk for Low Health Literacy
1. Elderly
2. people with chronic diseases
3. People with low income
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4. People with limited education
Effects of Low Health Literacy
⚫ Poor Health Outcomes
⚫ Under-utilization of preventive services
⚫ Over-utilization of health services
⚫ Unnecessary health care expenditures
⚫ Limited effectiveness of treatment
⚫ Higher patient dissatisfaction
⚫ Higher provider frustration
Role of Communication in Health Literacy
Good communication is crucial for a successful
clinician-patient relationship and effective exchange of
information. Breakdowns in communication can lead to
confusion for patients, poor health outcomes, and even
malpractice lawsuits against clinicians
1. If a provider thinks a patient is having difficulty
understanding written or spoken directions, a good
approach is to say, “A lot of people have trouble
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reading and remembering these materials. How can I
help you?”
2. Use commonly understood words. For instance, use
“keeps
bones
strong”
instead
of
“prevents
osteoporosis.”
3. Slow down and take time to listen to a patient’s
concerns. Create an atmosphere of respect and
comfort. Build trust with the patient.
4. Limit information given to patients at each visit.
Remember that less than half of the information
provided to patients during each Visit is retained
Role of health care (SPEAK):S: Speech - How will the healthcare provider’s speech
be received by the patient and/or caregiver?
P: Perception - How will the patient and/or caregiver
perceive both the verbal and written content during
the communication with the health care provider?
E: Education - What is the education level of the patient
and/or caregiver?
A:
Access – How will the patient and/or caregiver
access the health care system?
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K: Knowledge – How will assessment of health
literacy be carried out, and what tools will be used?
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Electronic Learning
Out lines
introduction
Definition of E- learning
Types of E- learning
Advantages of E- learning
Disadvantages of E-learning
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Introduction
Electronic learning (e- learning) is a store house of
education, information, communication, and knowledge
and performance management.
It is not intended to
replace conventional methods and learning in class
room.Its aim is to create an augmented learning
environment where technology is used to deliver a
combined range of teaching and learning techniques
Definition of e- learning
It is a teaching and learning process by using internet,
media, internet or other computer network in order to
give the material to the students.
or
It is a means of education that incorporates selfmotivation, communication, efficiency and technology.
Types of E- Learning
o
Synchronous e- Learning
Learning and teaching takes place in same time. In
synchronous learning, the learners and the teacher are
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online and interact at the same time from different
locations. They deliver and receive the learning
resources via mobile, video conference, Internet or
chat. In this type of learning the participants can share
their ideas during the session and interact with each
other and they get detailed queries and solutions.
Synchronous e - Learning is gaining popularity
because of improved technology and Internet
bandwidth capabilities. Such as Virtual Classroom,
Audio and Video Conferencing, Chat, Webinars,
Application Sharing and Messaging instantly
2. Asynchronous E-learning
The trainer prepares the courseware material
before the course takes place. Student directed, selfpaced learning. In this type of e- Learning the learner
and the teacher cannot be online at same time.
Asynchronous eLearning may use technologies such as
email, blogs, discussion forums, e- Book’s, CDs, DVDs,
etc. Learners may learn at any time, download
documents, and chat with teachers & also with colearners.
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N. B. In fact, many learners prefer asynchronous
instead of synchronous learning because learners can
take online courses to learn at their preferable time by
not effecting their daily commitments.
Advantages of E- Learning
❖ Promotes active and independent learning.
❖ Able to link the various resources in several
varying formats.
❖ It is a very efficient way of delivering courses
online.
❖ It is a very convenient and flexible, and confidence
❖ Is more cost saving & cost effective than traditional
learning.
❖ Diminishes problems related to in-classroom
teaching of audiences
❖ Access by learners to teachers and resources,
worldwide
❖ Reduce environmental impact.
❖ Reduce overall cost.
❖ Reduce learning time.
Disadvantages of e- learning
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Lack of equipment. Learners need to have access to
a computer as well as the internet.
Lack of knowledge and skills.
Learners need to
have computer skills such as word processing,
internet browsers, e- mail.
No self dicipline and no face to face interaction.
Lack of input from trainers.
It also requires just as much time for attending
completing
assignments
as
any
traditional
classroom course.
Students may feel isolated from the instructor.
Slow or unreliable internet connections can be
frustrating.
Teachers' lack of knowledge and experience to
manage virtual teacher- student interaction.
Lack of direct and immediate feedback from
teachers.
Bias toward students over non technical students
Asynchronous
communication
exchange of question
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hinders
fast
blended learning
Outlines :
Introduction
Definition of blended learning
Models of blended learning
Main Characteristics of Blended Learning
The basic requirements for implementing a
successful blended learning
Advantages of Blended Learning
114
Introduction
The educational system at present is in a transition stage.
To meet the challenges of expansion and for catering
individuals need it is trying to adopt new technologies
and exploring new paths to reach the goal of quality
educational opportunities for all, at the same time due to
various factors like deficient budgets, lack of facilities,
advantages of face to face interaction, it is not
completely ready to leave the traditional modes of
knowledge transfer.
Definition of blended learning
Is the use of traditional classroom teaching methods
together with the use of online learning for the same
students studying the same content in the same course.
Models of blended learning
MODEL 1: Blended presentation and interaction:
Activity-focused face-to-face sessions blended with
online resources. For example, the flipped curriculum
model combines on short lecture podcasts, online
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resources
with
face-to-face
tutorial/seminars
for
interaction and presentation of group work.
MODEL 2: Blended block:
Combination of intensive face-to-face sessions as one
day or half days, weekly online tutorial/seminars for
activities and interaction and online content and
resources.
MODEL 3: Fully online:
Combination of short lecture podcasts with online
resources and learning activities, online tutorials
(synchronous) and interaction via online collaboration,
discussion forums and/or group work
Main Characteristics of Blended Learning
1-Students have the option of the two modes
2-Teachers are well versed with both the modes
3-Students get face to face interaction as well they
interact in virtual space
4-Students get full experience in using new technology
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5-Students get training in different life skills
6-All round development of personality is targeted.
7-Physical development is possible with in school
campus
8-Students get wide exposure and new perspectives of
the course content
9-It has a human touch
10-It provides multicultural and multi dimension
approach to teaching learning process
11-Diverse role of teacher
12-Student constructs knowledge rather than just
consuming it
The
basic
requirements
for
implementing
a
successful blended learning as the following:
1. Well trained teachers :
2. Teachers with scientific attitude
3. Teachers with wider outlook and positive approach
towards
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4. Complete facilities like well-furnished computer
lab, internet connection, provision for video
chatting
5. Students have access to internet at their private
computers
6. Flexibility in the system
7. Fully aware and agreed Parents
8. Formative evaluation and continuous internal
assessment
Advantage of Blended Learning:
1-teachers and students get more time in the classroom
for creative and cooperative exercise.
2-Students gain advantage of online learning without
losing social interaction element and human touch of
traditional teaching’
3-It
provides
more
scope
for
communication.
Communication cycle is completed in blended learning
which is not possible if we follow only traditional
approach
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4-Students become more techno savvy and they gain
enhanced digital fluency
5-Students have more strengthened professionalism as
they develop qualities like self-motivation, selfresponsibility, discipline
6-It updates course content and so gives new life to
established courses.
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Telehealth
Outlines:
Introduction
Definitions
The Need of telehealth
Forms of telehealth
Benefits of telehealth
Clinical uses of telehealth technologies
Nonclinical uses of telehealth technologies
Telehealth modes
Factors that influencing development of telehealth
services
Methods of telehealth
Challenges
Disadvantage of telehealth
References
120
Introduction:
Telehealth is the provision of health care over a
distance. Telehealth is simply using digital information
and communication technologies, such as computers and
mobile devices, to manage your health and well-being.
Telehealth, also called e-health or m-health (mobile
health), includes a variety of health care services.
Definitions
▪ Telehealth is the transmission of health-related
services
or
information
over
the
telecommunications technology.
▪ Telemedicine is the exchange of medical information
from
one
site
to
another
through
electronic
communications.
▪ Telenursing: use of telecommunications technology
in delivery, management and coordination of nursing
care to enhance patient care. Or
▪ Telehealth nursing is the delivery, management, and
coordination of care and services provided via
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telecommunications technology within the domain of
nursing.
The Need of telehealth:
• Administrative meetings
• Aging population
• Clinical education program
• Clinician shortages
• Delayed treatment
• Language barriers
• Misdistribution of providers
• Rural/Urban underserved
• Travel time, cost & hardship
Forms of telehealth delivery:
▪ Simple as two health professional discussing a case
over the phone
▪ Sophisticated as using video conferencing between
providers at facilitates in two countries
▪ Complex as robotic technology
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Benefits of telehealth
1. Improve the way patients and their families access
information
2. Improved health outcomes for patients.
3. Empower consumers and communities by providing
accessible health education and decision-making
options.
4. Improve the way healthcare providers deliver care,
access information, and learn.
5. Enhance recruitment and retention of healthcare
providers in rural or remote areas.
6. Lower healthcare costs, reduce travel, minimize time
off work, and decrease patient waiting time.
7. Decrease self-reported patient anxiety.
8. Eliminate unnecessary repeat diagnostic procedures or
tests.
9. Improve early diagnostic capabilities.
10. Improve
administrative
and
communication
capabilities.
11. Improve emergency triage.
12. Prevent unnecessary delays in receiving treatment.
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13. Reduce or eliminate the separation of families
during difficult and emotional time
14. Allow patients to spend less time in waiting rooms
Clinical uses of telehealth technologies:
1. Transmission of medical images for diagnosis (often
referred to as store and forward telehealth)
2. Groups or individuals exchanging health services or
education
live
via
videoconference
(real-time
telehealth)
3. Transmission of medical data for diagnosis or disease
management (sometimes referred to as remote
monitoring)
4. Advice on prevention of diseases and promotion of
good health by patient monitoring and follow up.
5. Health advice by telephone in emergent cases
Nonclinical uses of telehealth technologies
1. Distance education including continuing medical
education, grand rounds, and patient education
2. Administrative
uses including
meetings among
telehealth networks, supervision, and presentations
3. Research on telehealth
4. Online information and health data management
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5. Healthcare system integration
6. Asset identification, listing, and patient to asset
matching, and movement
7. Overall healthcare system management
8. Patient movement and remote admission
Telehealth modes:
1- Store-and-forward telehealth
In store-and-forward telehealth, digital images, video,
audio, observations of daily living and clinical data are
captured and "stored" on the client computer or mobile
device; then at a convenient time they are transmitted
securely ("forwarded") to a clinic at another location
where they are studied by relevant specialists. The
opinion of the specialist is then transmitted back. Based
on the requirements of the participating healthcare
entities, this round trip could take between 1 minute to
48 hours. In the simplest form of telehealth application,
basic vital signs like blood pressure, weight, and blood
sugar values are monitored and trended for long term
chronic care.
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2- Real-time telehealth
In real-time telehealth, a telecommunications link
allows instantaneous interaction. Videoconferencing
equipment is one of the most common forms of realtime
(or
"synchronous")
telemedicine.
Peripheral
devices can also be attached to computers or the videoconferencing equipment which can aid in an interactive
examination. With the availability of better and cheaper
communication channels, direct two-way audio and
video streaming between centers through computers is
leading to lower costs.
Examples of real-time clinical telehealth include:
• Tele-audiology
• Telecardiology
• Teledentistry
• Teleneurology
• Telenursing
• Telerehabilitation
3- Remote patient monitoring
In remote monitoring, the patient has a central
system that feeds information from sensors and
monitoring equipment, e.g. Blood pressure monitors and
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blood glucose meters, to an external monitoring center.
This could be done in either real time or the data could
be stored and then forwarded.
Examples of remote monitoring include:
• Cardiac and multi parameters monitoring of remote
ICU
• Home telehealth
• Disease management
4- Remote Training
Telehealth also provides opportunities for health care
professionals in remote locations to receive training. In
the United States, the Extension for Community
Healthcare Outcomes or ECHO project uses a telehealth
platform to help urban medical center specialists train
primary care doctors in rural settings. The training
allows these general practitioners to provide specialty
care, especially chronic condition services, that would
otherwise be unavailable to patients in these areas.
Examples of remote monitoring include:
•
Home-based nocturnal dialysis.
•
Cardiac and multi-parameter monitoring of remote
ICUS
127
•
Disease management including COPD, Chronic Heart
Failure, Diabetes, Coagulation, Arthritis, Depression,
Obesity
Factors that influencing development of telehealth
services
1. Aging population: the needs of aging health care
consumers have initiated efforts to develop and adopt
better telehealth system outside institutional walls,
system that would be better geared for home- based
application
2. Cost containment: telehealth system are facilitating
redistribution of health care services, reducing
duplication, reducing number of drug interaction and
reducing patient and professional travel
3. Access: demand is increasing for equitable access to
health care services for inhabitants of isolated
geographic areas
4. Technology: ever more powerful technology and
communication band width are becoming available at
decreasing cost
5. Demand: the increasing demand for wellness and
health information
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Methods of telehealth:
The use of advanced telecommunication technology
to exchange information and provide health care
services across geographic, time, social barriers:
▪
Telephone, radio, other voice modalities
▪
Picture phone, teleconferencing
▪
Fax, email
▪
Computers for data/ imaging
▪
Interactive video
Challenges of telehealth:
• Break down in the relationship between health
professional and patient.
• Break down in the relationship between health
professionals.
• Issues concerning the quality of health information.
• Organizational difficulties.
Disadvantages of Telehealth
• Regulatory barriers
State laws are either unclear or may forbid practice
across state lines.
• Lack of repayment for consultative services
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Most third party payers do not provide reimbursement
unless the client is seen in person.
• Fear of healthcare system changes
Personnel may fear job loss as more clients can be
treated at home and hospital units close
• Costs for equipment, network services, and
training time
Equipment capable of transmitting and receiving
diagnostic-grade images is expensive.
• Lack of acceptance by healthcare professionals
This may stem from liability concerns and discomfort
over not seeing a client face-to-face.
• Lack of acceptance by users
This may stem from discomfort with technology, the
relationship with the provider, and concerns over
security of information and confidentially.
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