Health Education as the empowerment of elderly people

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  • Ci sono gaps importanti tra alcuni indicatori di salute nei diversi paesi europei
  • Le diseguaglianze sociali nella salute sono differenze sistematiche nella salute tra differenti gruppi socio-economici Queste differenze sono ingiuste e siccome sono prodotte a livello sociale sono modificabili. Educazione: ascensore sociale Source: Whitehead M, Dahlgren G . Levelling up (part 1): a discussion paper on concepts and principles for tackling social inequities in health . Copenhagen, WHO Regional Office for Europe, 2006
  • Circa il 50% degli eventi morbosi nei paesi europei deriva da malattie acute o croniche evitabili con adeguati interventi di prevenzione . (WHO REPORT 2002). Dall’epoca del MRFIT, sono stati pubblicati i risultati di numerosi trials comprendenti pacchetti di interventi multi fattoriali e interdisciplinari complessi che andavano dall’educazione al paziente al trattamento farmacologiao attivo. Tutti gli interventi di prevenzione rivolti alle persone anziane hanno caratteristiche comuni e sono accomunati dall’obiettivo di: Mantenere la funzionalità fisica, Promuovere l’indipendenza. Limitare la disabilità Prolungare la vita attiva Nel 2005 la spesa in prevenzione si attestava allo 0,47%
  • Siamo stati chiamati all’azione non solo dal mondo scienrtifico ma anche dalle agenzie politiche europee. Numerosi stati membri dell’unione europea stanno gia’ implementando strategie regionalei o piandi diazione nel campo dell’alimentazone, dell’attivita’ fisica e del fumo. Community action may support and complement these activities, promote their coordination, and help to identify and disseminate good practice, so that other countries can benefit from experience gained. (From: "Promoting healthy diets and physical activity: a European dimension for the prevention of overweight, obesity and chronic diseases Commission of the European Community Brussels 2005) La conseguenza piu’ importante delle malattie croniche e’ la perdita di funzionalita’ fisica (disabilita’). Ad essa si associano : Perdita di auto-sufficienza e indipendenza Maggior utilizzo di risorse sanitaria e socio-sanitaria Maggior rischio di morte prematura
  • Educare gli anziani a stili di vita sani è considerato dalle maggiori agenzia sanitarie internazionali come un elemento di successo (importante tanto quanto le medicine) nella lotta alle malattie croniche. L’educazione del consumatore prima, e del paziente poi, è ritenuta un fattore chiave per prevenire le malattie croniche e per ridurre il rischio di disabilita’ conseguente.
  • Un sistema sanitario sostenibile e’ un sistema che mantiene il patto intergenerazionale e non obbliga le generazioni future a pagare i danni causati da comportamenti irresponsbili
  • Eppure spesso gli nterventi di prevenzione non raggiungono il risultato sperato. L’ inefficacia di interventi di prevenzione in pazienti con malattie croniche deriva spesso da: Mancanza di comunicazione e trasmissione di contenuti corretti: Sui fattori di rischio, sul decorso della malattia, le sue complicanze, la terapia, gli effetti collaterali dei farmaci con eventuali interazioni. Tra paziente, suoi familiari e professionisti. Le Agenzie Internazionali per la Salute considerano le iniziative per migliorare l’Informazione e la Comunicazione in tema di salute tanto importanti quanto lo sviluppo di nuovi farmaci . IN questi giorni, il nostro sistema sanitario e’ sottopost ad una pressione inaspettata legata alla campagna vaccinale antinfluenzale. Ebbene noi operatori ceh operaimo in un ambito di salute pubblica stiamo spendendo moltissimo tempo a comunicare, spiegare, consigliare piuttosto che nell’atto della vaccinazione vera e propria.
  • Con EHLE vogliamo dare strumenti ed opportunita’ per comunicare con , informare ed educare la persona anziana
  • Health Education as the empowerment of elderly people

    1. 1. Health Education as the Empowerment of Elderly People: the EHLE Project Training Toolkit Maria Chiara Corti EHLE Project Manager ULSS 16 Padova
    2. 3. Widening inequalities in health between countries in Europe
    3. 4. Definition of health inequalities <ul><li>Health inequalities are sistematic differences in health status according to different socio-economic groups </li></ul><ul><li>These differences are unfair but are modifiable </li></ul>Source: Whitehead M, Dahlgren G . Levelling up (part 1): a discussion paper on concepts and principles for tackling social inequities in health . Copenhagen, WHO Regional Office for Europe, 2006
    4. 5. The need for a preventive strategy based around identification and treatment of diverse modifiable risk factors has been identified more than 40 years ago* *(WHO REPORT 2002).
    5. 6. Unhealthy diets and lack of physical activity are the leading causes of avoidable illness, disability and premature death in Europe. The rising prevalence of obesity across Europe is a major public health concern…. .* (From: &quot;Promoting healthy diets and physical activity: a European dimension for the prevention of overweight, obesity and chronic diseases. Commission of the European Community Brussels 2005)
    6. 7. Higher levels of education are associated with increased active life expectancy.* Education is a social elevator * Guralnik, et al. New Engl J Med 1993;329:110
    7. 8. Diabetes Prevention Life-style Interventions Have Long-Lasting Effects <ul><li>The benefits of lifestyle intervention or metformin for preventing the development of diabetes in high-risk adults can persist for 10 years, according to a follow-up report from the Diabetes Prevention Program (DPP) trial published online in Lancet. </li></ul><ul><li>Researchers examined longer-term follow-up data on some 2800 high-risk adults who had been randomized to intensive lifestyle intervention, metformin, or placebo in the DPP trial. </li></ul><ul><li>Over a median of 10 years' total follow-up, benefits of the interventions persisted — overall diabetes incidence was reduced by 34% in the lifestyle group and by 18% in the metformin group, relative to placebo. </li></ul>Lancet, Early Online Publication, 29 October 2009doi:10.1016/S0140-6736(09)61457-4
    8. 9. If the person becomes responsible for the custody of his/her own health, we can build a sustainable health care.
    9. 10. Education is communication…and communication is care
    10. 11. Goal of the EHLE PROJECT <ul><li>To develop a Training System aimed at providing professionals dealing with older people with appropriate knowledge/tools to teach other older adults how to understand health related information and healthy lifestyle messages. </li></ul>
    11. 12. Project Assumption <ul><li>The output and outcomes of the project can be reached only if there is: </li></ul><ul><li>Support of policy makers </li></ul><ul><li>Involvement of stakeholders network </li></ul><ul><li>Survival of the project after the end of the eligibility period </li></ul>
    12. 13. Project Boundaries <ul><li>Project Target: health professionals </li></ul><ul><li>Final Beneficiaries: older persons </li></ul><ul><li>No profit products from the projects: copyleft instead of copyright </li></ul><ul><li>The EHLE project is not a study nor a research project </li></ul><ul><li>Recommendations were selected using evidence based studies with efficacy and validity measures. </li></ul><ul><li>Respect of local diversity in different Countries with different types of organizations involved in the project </li></ul>
    13. 15. 1. Perception Analysis <ul><li>Questionnaire on elderly people perception of healthy lifestiles </li></ul>300 older people interviewed 300 older people interviewed 300 older people interviewed 300 older people interviewed
    14. 16. 2. Development of the Training Concept <ul><li>Theoretical Framework: “Patient Empowerment”. </li></ul><ul><li>Key elements of the EHLE Project Approach: </li></ul><ul><ul><li>Empowerment through Patient Communication to improve the understanding of the problem </li></ul></ul><ul><ul><li>Attention to social network (friends, family, etc) the older person is in </li></ul></ul><ul><ul><li>Multidisciplinary/Multifactor Approach to health problems </li></ul></ul><ul><ul><li>Behaviour Change Approach </li></ul></ul><ul><ul><li>COMMUNICATE RISKS related to a certain lifestyle </li></ul></ul><ul><ul><li>MOTIVATE the older person to change through positive messages </li></ul></ul><ul><ul><li>SET SMART GOALS : Specific, Measurable, Achievable, Relevant, Timeable </li></ul></ul>
    15. 17. 3. Testing the training concept <ul><li>2 Pilot Trainings Italy </li></ul><ul><li>2 Pilot Trainings France </li></ul>
    16. 19. 5 modules <ul><li>Nutrition </li></ul><ul><li>Phisical Activity </li></ul><ul><li>Medical drugs </li></ul><ul><li>Tobacco and Alcohol </li></ul><ul><li>Emotional Health </li></ul>
    17. 20. EHLE Training toolkit <ul><li>Handbook with project description, training instructions, biblyography. </li></ul><ul><li>Project Poster </li></ul><ul><li>Flyers </li></ul><ul><li>DVD with Project Video </li></ul><ul><ul><ul><li>Interactive version of the handbook (hyperlinks) </li></ul></ul></ul><ul><ul><ul><li>Powerpoint Presentations </li></ul></ul></ul><ul><ul><ul><li>Training support material </li></ul></ul></ul><ul><ul><ul><li>Videos </li></ul></ul></ul>
    18. 21. Thanks to: Chiara Petrolito Valeria Blatt Giovanni Bilato Laura Bracconeri Claudio Casotto Christian Cuciniello Giorgio De Gobbi Laura Thorogood <ul><li>EHLE PROJECT TRAINERS: </li></ul><ul><ul><li>Caterina Angelini </li></ul></ul><ul><ul><li>Elena Chinellato </li></ul></ul><ul><ul><li>Anna Galiazzo </li></ul></ul><ul><ul><li>Umberto Gallo </li></ul></ul><ul><ul><li>Cosimo Guerra </li></ul></ul><ul><ul><li>Stefano Ivis </li></ul></ul><ul><ul><li>Maria Assunta Longo </li></ul></ul><ul><ul><li>Vincenzo Malatesta </li></ul></ul><ul><ul><li>Maurizio Schiavon </li></ul></ul><ul><ul><li>Giuseppe Sergi </li></ul></ul><ul><ul><li>Flavio Varotto </li></ul></ul><ul><ul><li>Sandra Scapolo </li></ul></ul>

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