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  • 1.  PRESENTED BY : EUSIVIA PASI HEALTH, ILLNESS AND REHABILITATION
  • 2. CONTENTS CONCEPT OF HEALTH AND DISEASE  Health and well-being  Dimensions of health  Determinants of health  Disease ,sickness and illness  Levels of health care  Levels of fitness CONCEPTS OF REHABILITATION  Public awareness to the various disabilities  Communications.  Message generation and dissipation
  • 3. CONCEPT OF HEALTH AND DISEASE
  • 4. CONCEPT OF HEALTH BIOMEDICAL CONCEPT ECOLOGICAL CONCEPT PSYCHOSOCIAL CONCEPT HOLISTIC CONCEPT
  • 5. DEFINITIONS HEALTH is a state of complete physical , mental and social well being and not merely an absence of disease or infirmity (WHO 1948) More recently, WHO has stated that the „ultimate outcome‟ of health is well-being and quality of life (WHO 2003)
  • 6. OPERATIONAL DEFINITION OPERATIONAL DEFINITION OF HEALTH BY WHO – A condition or quality of human organism expressing adequate functioning of the organism in given conditions genetic or environmental
  • 7. HEALTH AND WELL BEING Positive health – it implies the notion of perfect health in body and mind .it cannot become a reality , it always remain a dream because everything in our life is subject to change . “Wellness is a multidimensional state of being describing the existence of positive health in an individual as exemplified by quality of life and a sense of well –being “.
  • 8. GOOD HEALTH TRAID PHYSICAL STATUSSOCIAL STATUS MENTAL STATUS
  • 9. DIMENSIONS OF HEALTH
  • 10. DETERMINANTS OF HEALTH Determinants are those predisposing factor which influence the health of a particular community
  • 11. FOUR HEALTH DETERMINANTS HEALTH SOCIAL & PSYCHOSOCIAL ENVIRONMENTAL ECONOMIC BIOLOGICAL
  • 12. INDICATORS OF HEALTH An index is an objective measure of an existing situation Indices are defined as relative numbers expressing the value of certain quantity as compared with another CHARACTERISTICS OF AN INDICATOR: 1. Valid 2. Precise 3. Sensitive 4. Specific
  • 13. USES OF HEALTH INDICATORS a) Reflect changes in the health profile over a specified time span b) Enable delimitation of backward and priority areas in a country. c) Permit international comparison d) Allow evaluation of health services and specific interventions e) Help to diagnose community needs and perceptions. f) Helpful to program planners and health administrators for charting out progress g) Allow projections for the future.
  • 14. CLASSIFICATION OF INDICATORS 1.Baseline indicators Progress indicators  Evaluation indicators 2. Evaluative indicators 3. Comparative indicators
  • 15. TYPES OF INDICATORS  VITAL INDICATORS a) MORTALITY INDICATORS b) MORBIDITY INDICATORS c) DISABILITY INDICATORS d) SERVICE INDICATORS e) COMPOSITE INDICATORS  BEHAVIOURAL INDICATOR.
  • 16. SPECTRUM OF HEALTH POSITIVE HEALTH BETTER HEALTH FREEDOM FROM DISEASE UNRECOGNISED DISEASE MILD DISEASE SEVERE DISEASE DEATH
  • 17. CONCEPT OF DISEASE
  • 18. CONCEPT OF DISEASE SICKNESS DISEASE PROCESS DISEASE ILLNESS
  • 19. WHAT IS ILLNESS Is a personal state in which the persons feels unhealthy Physical, emotional ,intellectual ,social ,developmental or spiritual functioning is diminished or impaired compared with previous experience Illness is not synonymous with disease Disease is an alteration in body functions resulting in reduction of capacities or a shortening of the normal life span
  • 20. PRECURSORS OF ILLNESS HEREDITY BEHAVIORAL FACTAL FACTORS ENVIRONMENTAL FACTORS
  • 21. STAGES OF ILLNESS
  • 22. 1. SYMPTOMS EXPERIENCE  Transition stage  The person believes something is wrong  Experiences some symptoms (physical, cognitive , emotional
  • 23. 2.ASSUMPTION OF SICK ROLE Acceptance of the illness Seeks advice ,support for decision to give up some activities
  • 24. 3.MEDICAL CARE CONTACT  Seeks advise of health professionals for the following reason :  validation of real illness  Explanations of symptoms  Reassurance or prediction of outcome
  • 25. 4.DEPENDENT PATIENT ROLE Become dependent to health professionals Accepts/rejects health professional‟s suggestions Become more passive and accepting May regress to an earlier behavioural stage
  • 26. 5. RECOVEY /REHABILITATION Gives up the sick role and returns to former roles and functions
  • 27. DEFINITION OF DISEASE  Ecological point of view ,disease is defined as “a maladjustment of the human organism to the environment “  The simplest definition is that disease is just the opposite of health .i.e.,. Any deviation from normal functioning or state of complete physical or mental well-being
  • 28. DISTINCTION BETWEEN DISEASE, ILLNESS AND SICKNESS The term disease literally mean “without ease “ Illness refers to the presence of a specific disease and also to the individuals perceptions and behaviour in response to the disease ,as well as the impact of that disease on the psychosocial environment . Sickness refers to a state of social dysfunction . Disease is a physiological/psychological dysfunction Illness is a subjective state of the person who feels aware of not being well
  • 29. EPIDEMIOLOGICAL TRAID Environment Agent Host
  • 30. HEALTH CARE AND FITNESS
  • 31. HEALTH CARE Health care is a multitude services provided to individuals ,families ,or communities by health professions or other for achieving the objectives of promoting ,maintaining, monitoring or restoring health
  • 32. CHARACTERISTICS OF HEALTH CARE  COMPASSION : feeling of pity about suffering of others  CONSCIENCE : sense of right and wrong ,feel of guilty  COMMITMENT : seriously take the responsibilities  CONFIDENCE : feeling sure about ones ability  COMPETENCE : do the best to be done .
  • 33. LEVELS OF HEALTH CARE PRIMARY LEVEL SECONDARY LEVEL TERTIARY LEVEL
  • 34. PRIMARY HEALTH CARE  WHO (1978) defines PHC as essential care made universally accessible to individuals and families in the community by means acceptable to them through their full participation and at a cost that the community and country can afford at every stage of development  The term „primary health care‟ (PHC)gained widespread currency following the 1978.
  • 35. PRINCIPLES OF PRIMARY HEALTH CARE Equity Acceptable Accessible Affordable Community participation Appropriate technology Inter-sectoral co-ordination
  • 36. COMPONENTS OF PRIMARY HEALTH CARE  Health education  Food supply and nutrition  Safe drinking water and sanitation  Maternal and child health, family planning  Expanded programme on immunization (EPI)  Prevention and control of endemic diseases  Appropriate treatment of common diseases , injuries and accidents  Provision of essential drugs.
  • 37. SECONDARY HEALTH CARE  The first referral level ,deals with more complex problems ,which provides mainly curative and rehabilitative services  Health facilities level includes hospitals and rehabilitative centres
  • 38. TERTIARY HEALTH CARE  More specialised level such as teaching hospital and specialized hospital  The care is usually given by the specialist ,major surgeries are included in this level
  • 39. FITNESS AND ITS LEVEL
  • 40. FITNESS ACSM defines fitness as the ability to perform moderate to vigorous levels of physical activity without undue fatigue and the capability of maintaining such ability throughout the life.
  • 41. COMPONENTS OF FITNESS components of fitness Muscular strength Speed or velocity Body composition Cardiovascular endurance Flexibility or suppleness Muscular endurance
  • 42. LEVELS OF FITNESS Level I – Healthy beginner Level 2 – Intermediate athlete Level 3 – Advanced athlete Level 4 – Elite athlete
  • 43. LEVEL -I HEALTHY BEGINNER.  Basic standard for health and fitness. Lacking these basic levels of strength, flexibility, and work capacity may limit you in life activities.  The complete Level I should be attainable within 3 to 12 months for those with no significant limitations.  A proper basic movements such as hip flexion and active shoulder use while healed injuries and structural problems are resolved.
  • 44. LEVEL -II INTERMEDIATE ATHLETE. All healthy adults can aspire to this level of fitness. Basic movements are perfected and advanced skills are introduced. The complete Level 2 may take from six months to several years to reach after achieving Level I.
  • 45. LEVEL-III ADVANCED ATHLETE. Few people possess this level of general fitness any healthy person can achieve it. The strength, work capacity, power and skill required to meet these goals can prepare to tackle any kind of physical performance with competence and confidence. Expect to invest another three to five years of consistent effort.
  • 46. LEVEL-1V ELITE ATHLETE.  This level of achievement requires long-term dedication and a passion for fitness.  The skills required of Level 4 are very advanced and represent a highly skilled and well-rounded athlete. While few may attain all of the Level 4 skills,  should continually seek improvement and get closer to achieving each one
  • 47. CONCEPT OF REHABILITATION
  • 48. DEFINITION OF REHABILITATION ILO‟s Definition “Rehabilitation involves the combined and coordinated use of medical, social, educational and vocational measures for training or retraining the individual to the highest possible level of functional ability”
  • 49. REHABILITATION  Defined as “combined and coordinated use of medical , social , educational and vocational measures for training and retraining the individual to the highest possible level of functional ability “  Areas of concern in rehabilitation : • Medical rehabilitation • Vocational rehabilitation • Social rehabilitation • Psychological rehabilitation
  • 50. THE MEDICAL MODEL Definition of disability was composed by the World Health Organisation (WHO) in the early 1980s. IMPAIRMENT - loss or abnormality in structure or function; DISABILITY - inability to perform an activity within the normal range for a human being, because of impairment; HANDICAP - inability to carry out normal social roles because of an impairment/disability.
  • 51. DEFINITION WHO definition of CBR “CBR involves measures taken at the community level to use and build on the resources of the community, including the impaired, disabled and the handicapped persons themselves, their families and their community as a whole”.
  • 52. THE REHABILITATION PROCESS Identify problems and needs Relates problems to modifiable and limiting factors Define target problems and target mediators ,select appropriate measure Plan ,implement ,and co ordinate interventions Assess effects
  • 53. Health condition Activities Participation Environmental factors Personal factors Body structures and functions The WHO (2001) framework of disability (after Hurri 2003). Functioning and disability depend on complex interactions between all the components.
  • 54. EVOLUTION OF REHABILITATION SERVICES The discipline of rehabilitation developed after the Second World War. In 1951 the UNO established a Rehabilitation Unit with the aim of facilitating the transfer of these new medical and technical advances to developing countries.
  • 55. PUBLIC AWARENESS TO THE VARIOUS DISABILITIES
  • 56. PROMOTIONAL IDEAS FOR DISABILITY HISTORY AND AWARENESS WEEKS
  • 57. Hang banners in schools and/or use school marquee to recognize Disability History and Awareness Week.  Allow students to design posters, fliers, and/or buttons related to Disability History and Awareness. Post student- designed posters and fliers in the school.  Use school and district Web sites to promote disability history and awareness.  Ask schools to include biographical information on famous people with disabilities in morning announcements
  • 58. Encourage district school board to pass a resolution recognizing Disability History and Awareness Week Distribute a letter announcing Disability History and Awareness Weeks, including a flier to all parents  Ask the local PTA/PTO to include articles related to disability history and awareness in their newsletters and October meetings
  • 59.  Ask teachers to incorporate into their lesson plans information about disability history and awareness  Post a timeline of disability history in every school. Allow students to design timelines.  Encourage school libraries to do a book exhibit to expand students‟ understanding and awareness of individuals with disabilities and related history and on the disability rights movement.  . Contact local media outlets concerning articles and stories related to disability history or awareness during Disability History and Awareness Week.
  • 60.  Recognize the achievement of local and other people with disabilities all year. Focus on their abilities and achievements through the district Web site, newsletters, morning announcements, and working with local media for stories and articles.  Encourage schools to host school-wide Disability History & Awareness event(s).  Involve parents and other members of the community in planning and implementing activities at the district and school level.  Encourage student councils/student government in planning and implementing activities at district and school level.
  • 61. Provide training for teachers concerning disability history and awareness -- give inservice points for participation.  Encourage district and school personnel to participate in Disability Mentoring Day. Additional information on Disability Mentoring Day can be found at: http://www.aapd.com/site/c.pvI1IkNWJqE/b.5606851/k.CD B/Welcome_to_the_Disability_Mentoring_Program.htm  Designate a point person to coordinate disability history and awareness activities for the district.
  • 62. WHAT IS COMMUNICATION? Communication is any act by which one person gives to or receives from another person information about that person's needs, desires, perceptions, knowledge, or effective states. Communication may be intentional or unintentional, may involve conventional or unconventional signals, may take linguistic or non- linguistic forms, and may occur through spoken or other modes.
  • 63. COMMUNICATION PROCESS Sender Message Channel Receiver Awareness Interest Adoption Evaluation
  • 64. LEVELS OF COMMUNICATION  Intrapersonal, Interpersonal and  Group communications
  • 65. MODES OF COMMUNICATION Communication occurs through words, actions, or a combination of words and actions. Verbal messages are messages communicated through words, and language, either spoken or written. Non-verbal messages are messages communicated without words, i.e., through body language Some of the non –verbal communications are facial expressions, posture, gestures and touch.
  • 66. COMMUNICATION SKILLS 1. Eye contact: 2.Body language: 3.Question: 4.Reinforcement:
  • 67. Physiological barrier Psychologic al barrier S Cultural barrier Environmental barrier COMMUNICATION BARRIER Education Class difference language variation Attitude Religion Beliefs Customs
  • 68. OBJECTIVES OF HEALTH EDUCATION 1. To ensure that health is valued as an asset to the community 2. To equip the people with skills, knowledge and attitudes to enable them solve their health problems by their own actions and efforts ,and 3. To promote the development and proper use of health
  • 69. HEALTH EDUCATION
  • 70. DEFINITION “Health education is a process that informs, motivates and helps people to adopt and maintain healthy practices and lifestyles, advocates environmental changes as needed to facilitate this goal and conducts, professional training and research to the same end”
  • 71. APPROACHES TO PUBLIC HEALTH There are three well known approaches to public health (1) REGULATORY APPROACH (2) SERVICE APPROACH (3) EDUCATIONAL APPROACH
  • 72. CONTENT OF HEALTH EDUCATION Divided into 8 main divisions: (1) HUMAN BIOLOGY (2) NUTRITION (3) HYGIENE (4) ENVIRONMENTAL HYGIENE (5) FAMILY HEALTH CARE (6) CONTROL OF COMMUNICABLE AND NON-COMMUNICABLE DISEASES (7) MENTAL HEALTHA (8) PREVENTION OF ACCIDENTS
  • 73. PRNCIPLES IN HEALTH EDUCATION 1. Unless there is motivation people will not lean. 2. There should be an interest or a desire to learn 3. The worker or the physiotherapist should include the people or community in health education programmes 4. One should start educating people from what they know already and then expose them to new knowledge 5. We should know the level of understanding ,education and background of people
  • 74. 6. Education should be repeated 7.Imparting knowledge to people by positive approach will give better results than the negative approach. 8. People remember better while doing 9. The physiotherapist would be able to communicate better if she knows thoroughly the existing practices ,religious ,belief, habits ,taboos, and customs of people prior to the education programmes.
  • 75. 10.Establish good interpersonal relationships 11. Adequate planning is essential ,even if it is a five-minute talk 12. Health education should be carried out with the co- operation of local leaders, school teachers, dais and other prominent persons
  • 76. CONTENTS OF HEALTH EDUCATION It depends upon 1. Interest of the group and their needs. 2. What the group knows already 3. Age and sex. 4. Health problem of the community
  • 77. METHODS OF HEALTH EDUCATION 1. Lecture 2. Group discussion 3. Demonstration 4. Panel discussion 5. Symposium
  • 78. 6. Workshop 7. Institute 8. Role playing 9. Programmed instruction 10. Stimulation exercises
  • 79. AUDIO-VISUAL AIDS The advantages of AV Aids are : 1. They create interest in the learners 2. They make learning permanent 3. They increase the thinking of the people 4. They give opportunity for variety of learning 5. They offer reality of experience
  • 80. VARIOUS AUDIO-VISUAL AIDS 1. Motion pictures or movies 2. Film strip 3. Exhibits 4. Black board or white board 5. Bulletin boards 6. Flannel graph 7. Flash cards
  • 81. 8. Posters 9. Puppets 10. Television 11. Radio 12. Health museum 13. Health magazines 14. Computer and internet
  • 82. FLANNELBOARD With suitable pictures a story can be very effectively told using a flannel board.
  • 83. MAKING POSTERS Posters can convey a single, simple message very strongly. They can be displayed in health centres, clinics, schools, or in public places.
  • 84. HEALTH MUSEUM
  • 85. COLOUR SLIDES AND FILMSTRIPS
  • 86. USING PUPPETS
  • 87. FUNCTION OF HEALTH COMMUNICATION 1. Information 2. Education 3. Motivation 4. Persuasion 5. Counselling 6. Raising morals 7. Health development 8. Organization
  • 88. CONDUCTION OF HEALTH EDUCATION AT THREE LEVELS a)Individual and family health education b)Group health education c)Mass health education
  • 89. REFERENCES 1. Neelamkumari ;A text book of community health nursing -1 2. Kasthuri Sunder Rao :An introduction to community health nursing ;4th edition (chapter 30) 3. K.Park : Preventive and social medicine .20th edition 4. www.wcpt.org 5. www.disabilityindia.org