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Chapter 14Chapter 14Health Promotion andHealth Promotion and Client Learning NeedsClient Learning Needs

健康促进和病人学习的需要

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Basic Concepts Definition Health Promotion and Disease PreventionApplications 1.Motivation 2.Frameworks for Assessing Learner Reassigns Health promotion Model

Trans-theoretical Model of Change

Social Learning Theory

OUTLINE

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3.Factors Affecting Readiness to Learn Previous Knowledge and Experience Changes in Social Support Active Involvement of the Learner Inclusion of Family Members Physical Barriers to Learning Summary

OUTLINE

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At the end of the chapter, the student will be able to 1.Define health promotion 2.Contrast motivational frameworks in health

promotion 3.Identify factors related to a client's readiness

to learn 4.Describe factors related to a client's ability to

learn 5.Discuss the role of self-awareness in health

promotion

OBJECTIVES

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Health promotion is defined in clinical practice as organized actions of efforts that enhance, support, or promote the well-being or health of individuals, families, groups, communities or societies 。

Health promotion

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健健健健：通过临床实践，促进、支持、提高个人、家庭、社区、群体、社会在智力、心理、生理、职业、社会、达到完美状态，形成均衡的生活方式，改善健康前景，提高生活质量。

Health promotion

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老年人需要： 工作、依存、和睦、安静、支配、尊

敬、直爽、伴侣老年人保健：少食多餐、多散步、 多

参加有益身心活动、多看书、注意营养平衡、充足睡眠、控制油脂摄入

Health promotion

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缓解心理压力： 1 ：准备一条冷毛巾，随时檫脸，以助清醒。 2 ：不断告诉自己，要能容忍别人不同的观点、意见 3 ：不要总是抱怨事情落在自己头上，而是想老天让

我与日俱增经验和智慧，生活因此丰富。 4 ：简化生活欲望，因为生活越复杂，压力越大。 5 ：喝一杯酸梅汤或果汁醋，疏通肝气。 6 ：和一位乐观朋友聊天或倾诉，发泄情绪，多赞美、

鼓励自己。

Health promotion

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Healthy People 2000:Priority Areas

Health Protection Unintentional injuries Occupational safety and health Environmental health Food and drug safety Oral health

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相关链接相关链接 牙刷的选择：头宽窄适合，柄扁平而直，

每组毛长度相等，间距适当，无柱状。材料：硬毛清洁效果较好，但磨损作用和损伤也强，软毛却不能完全去除菌斑。

原则：按自己口腔情况选择大小、形状、软硬中等、刷头较小即可。

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牙膏的选择： 普通型：适合牙齿健康情况好。 药物型：在口中时间短，难发挥药效；过长

时间会发生化学变化。 加氟型：增强抗腐能力， 发生率降低 40%，

但氟为巨毒物，过多会引起中毒。国家规定：3-4岁前儿童不宜使用。

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Primary prevention ：根据病人年龄、文化、病情教会病人如何预防可能发生的疾病。

Secondary prevention ：根据病情观察，提高诊断，及时治疗，减轻对机体伤害。

Tertiary prevention ：减轻疾病致残因素，最大限度恢复病人的健康。

Disease Prevention

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Applications

Characteristics of the helping relationship are important in health teaching for health promotion and paralleled those found in Carl Rogers’ (1969) client-centered teaching process.

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be congruent with her student

show acceptance and regard

demonstrate a genuine understanding

the student would be likely to learn

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Learners differ in their abilities, intellectual curiosity, motivation for learning, learning styles, and rate of learning.

readiness to learn

ability to learn

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Finding ways to engage clients in the learning process is the first step in planning effective teaching interventions

Motivation is the force that activates behavior and directs it toward a goal. It is a fundamental component of learner

readiness.

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Frameworks for Assessing Learner Readiness

Health Promotion Model

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This model proposes that a person's willingness to engage in health promotion behaviors is best understood through examining a person's beliefs about the seriousness of a health condition and his or her ability to influence personal health and well-being

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Motivation Frameworks for Assessing Learner Readiness

Health promotion Model

Trans-theoretical Model of Change

Social Learning Theory Factors Affecting Readiness to Learn

Previous Knowledge and Experience

Changes in Social Support

Active Involvement of the Learner

Inclusion of Family Members

Physical Barriers to Learning

Applications

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Nurses need to remember that learning is never smooth or linear in its development. Rather than challenge the client’s learning pattern, the nurse needs to understand it and incorporate it into new opportunities for learning

Factors Affecting Readiness to Learn

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Past experience, perceptual associations, and talking with others about their symptoms have provided the client with a set of assumptions and knowledge that must be factored into the teaching process.

Previous knowledge and Experience

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Previous knowledge, although often an asset, can present barriers and confusion for the client in learning new information.

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Changes in social support or the health status of significant others can affect the client's willingness or ability to learn. Many elderly clients have depended on others for direction and for overseeing treatment .

Changes in Social Support

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Most people learn best when they engage more than on sense in the learning process. Practical learning takes place through doing.

Active involvement of the Learner

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A highly participatory learning format with the opportunity to try out new behaviors is far more effective than giving simple instructions to a client or family or doing it for them because it is easier and faster to do so.

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Active learning also requires critical decisions to determine the extent to which family members are to be involved either in supportive role or as the primary recipients of the teaching process.

Inclusion of Faunally Members

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On the other hand, family members take supportive roles in cases involving teenagers, clients in crisis, elderly clients with intact cognitive abilities, and those with a depressive disorder that compromises concentration.

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Sometimes the client's condition precludes teaching.

Physical Barriers to Learning

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Ability to Learn

Low Literacy

The Learning-disabled Client

Developmental Level

What about the ability to learn?

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Many clients are ready to learn, but they are not able to learn with traditional learning formats

Clients give up or "tune out", not because they do not want to k now the information but because they lack the skills to obtain and assimilate it.

Ability to Learn

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Low literacy is not the same as low intelligence .

A persistent stigma about low literacy and learning disabilities exists even though it is unfounded.

Low Literacy

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The learning-disabled client, whether because of mental illness, learning disability, or attention deficit disorder (ADD), may require adaptation of normal teaching strategies to learn new material.

The Learning-disabled Client

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1.Teach the smallest amounts possible to do the job.

2.Make your point as vividly as you can. (Use visual aids and examples for emphases are.)

3.Incorporate as many senses as possible in the learning process.

4.Have the client restate and demonstrate the information.

5.Review repeatedly.

How to help the learning-disabled client?

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Developmental level affects both teaching strategies and subject content.

Teaching strategies for young children should be simple, concrete, and directly linked with the child's immediate life experience.

Developmental Level

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Culture adds to the complexity of the teaching learning process in health care.

In many cultures, the family assumes a primary role in the care of the client even w hen the client is physically and emotionally capable of self-care.

Culture

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Health promotion is a mutual interpersonal process. The nurse is responsible for the health teaching. The client assumes responsibility for the outcome.

self-awareness

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Thank you!!Thank you!!Thank you !!