Concepts of Health, Health Care And Health Promotion.

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South Bank University

Number: 9905890

May 2000: Group 3

Unit 6

Concepts of Health, Health Care

and

Health Promotion.

Personal Tutor: Alma Ramanuth

Word Count: 1,647

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Concepts of Health, Health Care

And

Health Promotion.

?

Unit 6

CONTENTS

TITLE PAGE 2

CONTENTS 3

ASSIGNMENT ESSAY 4

APPENDIX 14

REFERENCE 15

BIBLIOGRAPHY 19

Word count (excluding references and charts) 1,647

"Making the healthy choice the easier choice"

(Milio1986 cited in Naidoo J, Wills J. 2000: 84)

Health promotion has come a long way since the 'Band of Hope' lectured young people on the "virtue of abstinence ", in the late eighteen hundreds (Naidoo J, Wills J. 2000: 72). The emphasis was on reform or damnation, after nearly a century of telling people what not to do attitudes began changing.

The World Health Organisation (WHO) recommend "advocacy, enablement, and mediation " as effective methods (Baric L. 1996:129), defining modern health promotion as,

"...the process of enabling people to increase control over, and to improve, their health." (Ewles L, Simnett I. 1999: 23)

Nurses are ideal health promoters as they are present at significant moments in their patients' lives (DoH 1999:132); they have long been required to be competent in

"advising on the promotion of health and the prevention of illness..."

(Statutory Instrument cited in Perry A. 1997: 58).

But what is health? The1948 WHO definition of health as,

"...a state of complete physical, mental and social well-being, and not merely the absence of disease and infirmity" (Hogston R, Simpson P. 1999:27)

has been openly questioned, as most people who consider themselves 'healthy' would not say they had 'complete' well-being. Many diabetics and asthmatics live 'healthy' lives despite their 'illnesses'.

As the concept of health differs between individuals, it may seem easier to define ill health using Miles' definition, (cited in Perry A. 1997: 232)

"...ill health represents a breakdown in the normal, expected state of health, a situation where things go wrong, a deviation from how things should be, and usually are."

This again raises debate, with views on 'normal' differing widely between social classes and cultures.

Accepting that health is multidimensional encompassing physical, mental, emotional, social and spiritual factors, their significance influenced by the society and environment (Ewles L,Simnett I.1999:7) the WHO revised it's definition.

" [health is] the extent to which an individual or group is able, on one hand, to realise aspirations and satisfy needs; and, on the other hand, to change or cope with the environment. Health is therefore, seen as a resource for everyday life, not an object of living; it is a positive concept emphasising social and personal resources, as well as physical capacities." (Naidoo J, Wills J. 2000: 23)

The many theories of health lead to many approaches to health promotion. Tones and Tilford described empowering people to make their own choices as "central to the ideology and practice of health promotion" (Naidoo J, Wills J. 1998: 245).

The traditionally approach has been medical, implemented in three stages; using family planning as an example,

* Primary: prevention by education; contraception methods

* Secondary: early treatment; providing emergency contraception

* Tertiary: reduction of ill effects; advice and counselling on unplanned pregnancy (DoH 1993: 67).

The control in this model is with the medical profession and to be successful requires the patients to be compliant (Naidoo J, Wills J. 2000: 93).

The other models greater emphasis is placed on empowerment and accepting the different values and beliefs target groups may hold. For instance a health promoter may discourage unprotected sex to prevent sexually transmitted disease (STD's), but the client may see unsafe sex as an expression of love and trust (Kenworthy N. et al 1996:153).

Aims, activities and values of five approaches,

Aim

Activity

Values

Medical

Freedom from medically-defined disease and disability

Promotion of medical intervention to prevent or ameliorate ill-health
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Patient compliance with preventive medical procedures

Behaviour change

Individual behaviour conducive to freedom from disease

Attitude and behaviour change to encourage adoption of 'healthier' lifestyle

Healthy lifestyle as defined by health promoter

Educational

Individuals with knowledge and understanding enabling well informed decisions to be made and acted upon

Information about cause and effects of health-demoting factors. Exploration of values and attitudes. Development of skills required for healthy living

Individual right of free choice. Health promoter's responsibility to identify educational content

Client-centred / Empowerment

Working with clients on the ...

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It is not clear what the purpose of the essay is. The reader should quickly get a sense of what the writer intends to achieve, hence the importance of a clear introduction. Some of the references are quite dated, the writer should ensure that recent literature is used. The cycle of change is generally explained well using a relevant example, but the pre-contemplation stage needs more clarification