Discuss about the Health Planning and Promotion for Social Determinant.
Disease prevention and enhancing health outcome is an important part of primary health care. It focus not on the treatment after the pathogenesis of disease, rather it involves ways to prevent those disease from occurring. To promote disease prevention, it is necessary to educate the public about health issues through different range of health promotion activity. Nurse also has an important role in teaching patients about healthy living habits and preventing diseases. It is a way to engage and empower the community to get involved and make changes in life to reduce the risk of chronic diseases (Kemppainen, Tossavainen, & Turunen, 2013). By these health promotion programs, nurse and other staff can educate the people about social determinants of health (Social, economic, cultural and political condition of people) which has an impact of modifiable risk behaviors (Eating habits, substance abuse, physical activity and many others. The range of program may include communicating healthy behavior by public announcements, media campaigns, health education training, regulating public health policies and modifying the environment to make feasible changes in the society. This report particularly discusses the benefits of health literacy in primary care and describes strategy taken by nurse to educate Anne about practicing breast awareness.
Primary health care (PHC) is the first level of interaction with the community to provide universally accessible and scientific health care service with the support of multi-disciplinary health care team (Smolowitz et al., 2015). It focuses on giving treatment to patients most in need of care and enhancing health outcome. The main purpose of PHC is to maintain health equity and health workers play a role in reducing social disparities in inaccessibility in health services. They main objective of PHC is achieved by health promotion. Health promotion in PHC involves educating individual and communities about ways to promote illness. PHC staff plays a role in the development of community through health literacy program and they collaborate with each other to enhance equity and access to health service. Health care staff make public aware of social determinant of health. Efficient service is delivered by collaboration with other health care facility to increase and enhance public health outcome. The range of activities of PHC may include health promotion, community empowerment, rehabilitation, treatment and disease prevention. The existence of PHC is important as they reduce the additional pressure of hospitals to maintain high quality sustainable health care services (Keleher & Lim, 2015).
According to Ottawa Charter, health literacy/health education is defined as the attainment of current health knowledge and interpersonal skills to improve living condition and health outcome (Fry & Zask, 2016). Health education is an important part of health promotion programs as it helps in making people aware of necessary health care information and their capability to use that information effectively in life activities. Health literacy aids in creating a supportive environment for health, increasing people’s control over health issues and developing personal skills of people for better management of chronic condition. This form of health promotion activities helps in reorienting the health system and fosters participation of public in achieving health goals (Tone, Robinson, & Tilford, 2013). Health literacy will enable people to better understand diagnosis of disease and engage in health care decisions. Nurse who engage in health promotion first need to be match their personal care with individual patient needs and then identify the economic, social, political factors that have an impact on people health status. By health education activities, they serve to promote continuity of care in health care setting (Hsieh, 2013).
Advocacy is an important aspect of health promotion. Although health literacy program was not practiced earlier, however health care facilities are now paying more attention to it due its overall benefit on health of people. Health literacy enable people to understand the cause of diseases, effectively share health issues with physicians and nurses, engaging in disease management and controlling risky behavior that led to diseases. It also promotes adherence to diseases. Behavior of lifestyle of people may also have impact on health outcome. Sometimes people do not adhere to treatment because of negative experiences in the health care system. In such case, health literacy also helps to remove those wrong notions about the health care system and increase people’s trust with the health care system (Edwards, Wood, Davies & Edwards, 2015). Knowledge about diseases enables people to take better health decisions and decide what is best for them. Nurses and medical staff help people to find relevant information and appropriate health services too. Hence, it lead to development of the community as people can easily decide what service and information is best for them and how they should proceed with the information to achieve positive health outcome. Therefore, familiarity with medical terms and body functioning system helps people to evaluate the risk in health decisions and empower them to play an active role in the management of their diseases (Sørensen et al., 2012).
A study also reported the relationship between health literacy and adherence to treatment procedure. Colbert, Sereika and Erlen, (2013) reported that effective health literacy lead to better adherence to medications as people develop skills to manage and prevent disease. With the relevant knowledge about disease, they modify their lifestyle to minimize the morbidities associated with diseases. This study particularly studies about HIV/ AIDS self-management. It has been found that many people face challenges with adhering to medication despite various tools to assist in taking medicines efficiently. The researcher studied about the impact of health literacy on medication taking efficiency of patients with HIV/ AIDS. It was found that health education about making antiretroviral medications led to better medicine taking efficiency in patients.
This section discusses the strategies that can be taken by nurse to provide health education to Anne. In order to effectively plan health education strategy for Anne, it is important to identify what knowledge deficit Anne has. On analysis of case study, it is seen that Anne Giovanni is a 19 year old Italian woman who lives with her grandmother and has been hospitalized recently due to exacerbation of her asthma. As a practice nurse I was assigned the duty to provide health education to Anne. My first duty was to assess the level of knowledge deficit in Anne. On interaction with Anne, I got to know that Anne left school at the age of ten only and she has no knowledge about the cause of asthma and the things that aggravates the condition. Although, she takes her puffer many times a day. In order to check how she uses it, I asked her to demonstrate puffer technique. I found her technique to be inappropriate. Another serious finding for me was that she has no knowledge about breast awareness and she never had a pap smear.
It will be a challenge for me to provide health education to Anne as she had not continued her schooling and she might not have adequate knowledge compared to other patients of the same age. Therefore, my first strategy will be to explain her about etiology of asthma and make her aware about breast cancer in simple and engaging manner. Since, Anne has left her study; she may have problem in understanding medical terms and figure. My strategy will be to create a good learning environment for Anne. I will demonstrate the pathophysiology of disease and breast awareness by simple video presentation for better understanding of the disease. I will explain everything to her in simple language without use of medical terms. Clear communication style will be crucial during my interaction with Anne so that I can make her aware about the triggers of Asthma and how to practice breast awareness (Gaude, Hattiholi, & Chaudhury, (2014). Even well-educated people face problem in understanding medical terms and concepts of disease. In case of Anne, I will give simple and clear instruction and make sure that I review all the instruction with Anne to evaluate her learning after each session. Due to low literacy skills, Anne may feel ashamed to ask questions and so I will speak slowly to increase retention of information. I will stop after each point to ask question so that Anne repeats back the information. This will help in building an effective learning environment (Murray & O’Neil, 2016).
Regarding knowledge about the etiology of asthma and breast awareness, Anne may have little knowledge about it due to her Catholic background. Asthma is a condition that leads to inflammation and obstruction of the airways. People may have asthma attacks due to various inflammatory triggers or allergies like air pollutants, pollens, moulds, dust mites, insects, chemical fumes, food additives, smoke and many others (Doeing & Solway, 2013). I will encourage Anne check what triggers her asthma so that she can keep check on those triggers. My health education strategy will be to explain Anne about airway inflammation through simple figures to enhance her concept of disease. Another crucial thing for me will be to demonstrate her inhaler technique and give information in specific food allergy. Correct technique of taking inhalers will help Anne to gain maximum benefit from the medication. It will mean giving her repeated hands-on training on correct use of inhalers to prevent the risk of repeated asthma attacks and hospitalization. Anne will also be advised to take her preventer for asthma as it will protect her from exacerbation of asthma. It will help relieve her symptoms during asthma flare-ups (Levy, Hardwell, McKnight & Holmes, 2013).
Knowledge about breast awareness practice is essential for Anne to prevent cases of breast cancer. High mortality rate is seen due to late diagnosis of cancer and lack of awareness about breast awareness practice. Hence, it will be necessary that Anne learn breast-self-examination technique so that early detection and long-term survival becomes possible. It will not mean doing a breast examination, but it will mean Anne should feel the breast from time to time to assess if everything is normal. A pap smear is essential for Anne if she is taking medications for asthma. This is because excessive coughing due to asthma put additional strain on pelvis muscle and increases risk of cervical cancer. In my health education program, I will teach Anne to self-examine her breast regularly. It will mean examining her breast in the mirror every month and using palpation technique with three fingers to detect abnormal changes. It may help to detect lump in early stage of cancer development. With this teaching, she will be able to manage her breast problems. I will provide her written and verbal information about what signs are normal for breast and what signs of breast changes may be problematic (Jones et al., 2015). I will encourage her to voice her concern regarding any issues related to breast management so that she clears her doubt. She must regularly check signs of tightness of breast. I will also make her aware about screening methods so that early detection becomes possible. This education about the body will help Anne to empower Anne to control her health issues. Hence Anne needs to be breast aware to detect any abnormal signs so that she can easily seek help. It will lead to better health condition as Anne ages. After the end of health education program, I will evaluate her understanding of the condition by asking her to repeat about the information on breast awareness and asthma medication technique.
This report emphasized on the importance of health education in health education programs and gave an idea about how to develop best health education strategy by giving example on case study of Anne. The report gives an understanding of the role of primary health care in health promotions activities and how health literacy fit into the program. A range of benefits of the health literacy was provided such as adherence to treatment protocol, disease prevention and management, building trust with the health care system and making confident health care decision. Through the analysis of case study on Anne who has asthma, the report provided answers to the role of nurse in identifying knowledge deficits of the condition. The report demonstrated how nurse can plan to teach patients who have low level of literacy and how to teach them in an efficient manner to achieve the objective of health promotion. Through this approach one can understand the importance of health literacy to empower the society to bring positive changes in their lifestyle to get better health benefits.
Reference
Colbert, A. M., Sereika, S. M., & Erlen, J. A. (2013). Functional health literacy, medicationâ€Âtaking selfâ€Âefficacy and adherence to antiretroviral therapy. Journal of advanced nursing, 69(2), 295-304.
Doeing, D. C., & Solway, J. (2013). Airway smooth muscle in the pathophysiology and treatment of asthma. Journal of Applied Physiology,114(7), 834-843.
Edwards, M., Wood, F., Davies, M., & Edwards, A. (2015). ‘Distributed health literacy’: longitudinal qualitative analysis of the roles of health literacy mediators and social networks of people living with a longâ€Âterm health condition. Health Expectations, 18(5), 1180-1193.
Fry, D., & Zask, A. (2016). Applying the Ottawa Charter to inform health promotion programme design. Health promotion international, daw022.
Gaude, G. S., Hattiholi, J., & Chaudhury, A. (2014). Role of health education and self-action plan in improving the drug compliance in bronchial asthma.Journal of family medicine and primary care, 3(1), 33.
Hsieh, E. (2013). Health literacy and patient empowerment: The role of medical interpreters in bilingual health communication. Reducing health disparities: Communication intervention, 35-58.
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Keleher, H., & Lim, D. (2015). Population health planning and health promotion: Opportunities and challenges to improve social determinants.
Kemppainen, V., Tossavainen, K., & Turunen, H. (2013). Nurses’ roles in health promotion practice: an integrative review. Health Promotion International, 28(4), 490-501.
Levy, M. L., Hardwell, A., McKnight, E., & Holmes, J. (2013). Asthma patients’ inability to use a pressurised metered-dose inhaler (pMDI) correctly correlates with poor asthma control as defined by the global initiative for asthma (GINA) strategy: a retrospective analysis. Primary Care Respiratory Journal, 22, 406-411.
Murray, B., & O’Neil, M. (2016). Nurses Role in Delivering the Message: The Value of Health Promotion and Patient Education in the Self-Care Management of Adults with Asthma. J Nurs Care, 5(351), 2167-1168.
Smolowitz, J., Speakman, E., Wojnar, D., Whelan, E. M., Ulrich, S., Hayes, C., & Wood, L. (2015). Role of the registered nurse in primary health care: Meeting health care needs in the 21st century. Nursing outlook, 63(2), 130-136.
Sørensen, K., Van den Broucke, S., Fullam, J., Doyle, G., Pelikan, J., Slonska, Z., & Brand, H. (2012). Health literacy and public health: a systematic review and integration of definitions and models. BMC public health, 12(1), 1.
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