Question: Formulate and evaluate a care plan on health promotion for an individual or group
Identify a health issue or issue that can affect health, state that you will design health promotion care plan, and evaluate the care plan.
Identify a health issue- at an individual/ family/community/ national/ global levels and provide brief background of the health issue including who is at risk, risk factors, and how it presents.
Design a health promotion care plan: Problem– what is the health issue/ problem.
Assessment, assess- how do you assess for the existence of the health issue/ problem.
Goal- what do you hope to achieve
Intervention: how are you going to achieve your goal? (1000 words)
Evaluation: of your care plan. Did you achieve or not achieve your goal. Give reasons for your achievement or non-achievement. What are alternative assessment, goals, and interventions?
Summarise what you have done: what is the implication of this experience for your professional and personal development.
ISSUES TO CONSIDER
Lack of green space
There are link to some of the core concepts of re=addressing inequality relating to the social determinant of health, locally, nationally and globally.
Short Description ( introduction to module)
This module introduces public health concepts and contemporary public health issues, the principles of which can then be applied at an individual and population level and within a local, national and global context. This module of study is aligned to the NMC Standard Platform 2, Promoting health and preventing ill health (NMC 2018, Future nurse: Standards of proficiency for registered nurses).
Knowledge and Understanding:
Examine the contribution of social influences, health literacy, individual circumstances, behaviours and lifestyle choices to health and well being.
Apply knowledge of the aims and principles of health promotion, health protection and health improvement and consider and evaluate public health priorities, strategies and methods used with individuals, groups and communities.
Articulate and demonstrate the use of up-to-date approaches to behaviour change which enable people to use their strengths and expertise, and make informed choices when managing their own health and making lifestyle adjustments.
Identify, retrieve and analyse credible health data at a local, national and global level, and discuss how this may be used to improve health and prevent ill health.
Support and enable individuals, families and communities to apply life enhancing activities.
The registered nurse will be able to understand and apply the aims and principles of health promotion, protection and improvement and the prevention of ill health when engaging with people.
The registered nurse will understand the factors that may lead to inequalities in health outcomes and how the nurse can contribute to the reduction of health inequalities.
Factors influencing health outcomes and the social determinants of health.
To understand the purposes of community health care
Why community care
Why being connected with other people matter
To understand the components of family community
Healthcare in community the and homes or places where patients live
Helps to improve patient satisfaction and well being
-care in comforting own surrounding
Improve the quality of life those with long term conditions
-Promotes and support long -term self-care and independence.
Ease the burden on primary care and secondary
Reduce health inequalities within a local area or community
Voice and Voice control control – people get greater say in their lives and health
Equity – leading to reduction in avoidable inequalities
Social connectedness – leading to to healthier more cohesive healthier more cohesive communities
Recognise & mobilise community / individual
Promote community health and wellbeing
Promote equity in health and healthcare
Help increase individual’s control over their health and lives
Use participatory methods to facilitate active public involvement
Community centred –approach
Use of community assert s-skills knowledge and social networks
Community engagement and outreach – behaviour change interventions
Support from peers who share similar life experiences
Break social isolation and loneliness- associated with higher risk of mortality and morbidity
Social gradient/ social capital
High levels of social capital can buffer some of the effects of stress
Deprivation and inequalities ‘erode’ the resources needed for good mental inequalities for good mental health.
People living in deprived areas of– about 15%have a lack of social support about 1/4th (26%) have some lack
Communities’ health asserts
The skills, knowledge, social competence and commitment of individual community members.
Friendships – intergenerational solidarity, community cohesion and neighbourliness within a community.
Local groups and community voluntary associations – formal organisations s to informal, mutual aid networks such as babysitting circles to informal
Physical environmental and economic resources within a community
Assets brought by external agencies, public private and third sector
Power and participation to health
INDIVIDUAL empowerment –a sense of control over their lives and health
Developing personal skills, self-confidence, coping mechanisms
Community empowerment: people working collectively to shape that influence their lives and health.
Supporting local initiatives,. Community development, deciding together, consultation and information
Community development, Partnership development, consensus building, communication and feedback and presentation and promotion
We can help you achieve what you want within guideline
We want to carry out joint decision together
These are the options what do you think
Here is what we are going to do
(Adapted from: Wilcox, The guide to effective participation.1994:15
Associated with w better health, lower mortality, functioning, life satisfaction and decrease in depression
Taking part in community life, democratic and political processes
Community leadership and representation Long tradition of PH involvement in citizen activism
Access to contraception
Volunteer and peer roles
Community members being connectors
Signposting to services and information
Supporting people to improve their health and wellbeing
Peer based interventions:
Recruits and train people of same or similar characteristics as the target
Aim to reduce communication barriers, improving support mechanisms and social connections
Volunteer health roles
Focus on reducing health inequalities
Common health improvement models
Walking g for health Walking
Environment health volunteering projects
Emphasis on community self-help co production, supporting personalisation of health and care.
For planning and regulatory powers to create safe, sustainable environments environments Think Think Think Local Act Personal (TLAP) partnership Local Act Personal (TLAP) partnership Local Act Personal (TLAP) partnership -a group of over 30 national that are committed to real change in adult social care.
FAMILY OF COMMUNITY CENTRED APPROACH
Strengthening communities – building community capacity to take action on community health and the social determinants of health.
Volunteer/peer role enhancing individuals’ capabilities to advice, inform, , support or organise activities for community and wellbeing.
Collaborations and partnership with communities to and/or deliver services and programmes
Access to community resources connecting people, information and social activities
Community development: addressing imbalances in power and bring about change founded on social justice, equality inclusion
Asset-based approaches:: identifying inventory of for planning and developing social action health
Social network approaches: strengthening community and social support between people by collective or community organising activities.
HEALTH TRAINERS AND HEALTH CHAMPIONS
Programme that aim to address health inequalities by involving people from disadvantaged groups or those at risk of poor health groups.
Make up an important part of the wider public health workforce in England.
Support individuals to make positive changes improve their lives and health
offer ‘support from next door’ rather than professional ‘advice
Focusing on common approach to behaviour commoN
Work in primary health care, settings community, specialised services like ex-Offenders
‘Altogether ‘Better’ is an example based on empowerment principles, recruiting over 20,000 to date
Volunteers who draw on their own local knowledge and life experience activities and also establish groups to meet local needs. Social activities and also establish groups to meet local needs.
CENTRAL LONDON COMMUNITY HEALTH CARE
Borough of Barrett, Hammersmith and Fulham, Kensington, Chelsea, Westminster. Merton, Wansworth, Harrow, Hertfordshire.
Walk in and major injury centres/ District nurses/ health visiting /school nurses/ child and family services/ Rehabilitation and palliative care services/ continuing care services/ specialist services/ offenders health services
3000 health professionals and staff
Nursing contribution to PH
MARY Seacole British1881): British -Jamaican business woman, nurse, set woman, nurse, set woman, nurse, set woman, nurse, set woman, nurse, set woman, nurse, , set-up the “British Hotel” behind lines during Crimean War, comfort c quarters for convalescent sick officers, aided for wounded servicemen on wounded servicemen on wounded servicemen on battlefield
Florence Nightingale (1820 English social reformer founder of modern nursing, manager and trainer of nurses during the Crimean War, and trainer of nurses during the Crimean War, organised care for wounded care for wounded care for wounded soldiers
RCN believes that RCN believes that RCN believes that RCN believes that RCN believes that RCN believes that RCN believes that RCN believes that
Nursing should Nursing should be at the heart of minimising impact illness, promoting health helping people to function at home, work. Leisure.
Improving public health should be seen as part of all nursing and midwifery roles. public health should be seen as part of all nursing and midwifery roles. public health should be seen as part of all nursing and midwifery roles.public health should be seen as part of all nursing and midwifery roles.
Nursing and PH
CORE AREAS OF PUBLIC HEALTH
Promoting, preventing and protecting
Some generic aim
Enough food and water
Well informed population regarding personal health
Healthy life style choices
Free from pollution
No /little class disparity in terms of disease and life expectancy
PHE VISION 2025
Lower smoking rate
Less sugar, calories and salt in the food eaten everyday
Less pollution in the air that we breathe
Measurable improvement in mental health
Improve mental health literacy
Reduced inequalities in infant mortality
Reduced gap in smoke rate
Fewer cases of poor health among vulnerable people
Health Protection, Detection, Immunisation and Screening
It time to focus on health prevention and promotion ( Derek Yach)
“Registered nurses make an important contribution to the promotion of ill health. They do this by health, protection and the prevention of ill health. They do this by empowering people, communities and populations to exercise choice, take control of their own health decisions and behaviours.
Understand and apply the aims principles of health promotion, protection and improvement and the prevention of ill when engaging with people
HEALTH- physical, emotional, intellectual, sexual, social and spirit
THREE LEVELS OF DISEASE PREVENTION
This is about policy to protect health and outlining priorities. They look at financing and delivery of healthcare.
Early detection allows effective and efficient preventive measures to be started in order to avoid or minimise impact on health
In the UK, there is a list of 32 notifiable diseases (Health Protection (Health Protection Regulations, 2010); this includes acute encephalitis, infectious hepatitis, Regulations, 2010); anthrax, cholera, food poisoning, measles, mumps, rubella; all of which anthrax, cholera, food poisoning, measles, mumps, rubella;, all of which have to be notified a proper officer within 3 days (or 24 hours for urgent a proper officer within 3 days (or 24 hours for urgent
Collating this information allows accurate monitoring of a disease and Collating this information allows accurate monitoring of a disease and can provide early warning of potential outbreaks.
National screening programmes:
. NHS antenatal screening
WHAT IS IMMUNIZATION?
“Vaccination is a miracle of modern medicine. In the past 50 years, it’s saved more “worldwide lives than any other medical product or procedure.” than any other medical product or procedure (NHS 2016)
Principle around since ancient Chinese.
Small pox vaccination successfully attempted by Jenner in by Jenner in the 18 th Century
Generally used for diseases which are both serious and relatively common.
NURSES ROLE IN PROTECTING DETECTION, SCREENING AND IMMUNIZATION
Lecture 4 Learning outcomes
Identify and discuss approaches to health
“A state of complete physical, mental and social well -being and not merely the absence t of disease (WHO, 1946)
Sense of living that is consistent with balanced growth in the physical, spiritual, emotional, intellectual, social, and psychological dimensions of human existence
“… the process of enabling people and groups) to increase control over and to improve their health (WHO, 1988) health (WHO, 1988) health
Helping people / groups to live healthy lives
Increasing knowledge and awareness of healthy choices
Enabling action to improve their health
Ensuring situations for healthy choices
What approaches can help achieve these goals at individual, community, national and population levels?
You may have considered health education; developing personal skills, strengthening community action, reorienting health services, building healthy public policy, creating policy, creating supportive environments
1986 – 1st International Conference on Health Promotion in Ottawa Ottawa
“Health for All” by 2000 and beyond
Strategies – advocate for factors which encourage health, enable people to advocate for factors which encourage health, enable people to advocate for factors which encourage health, mediate through collaboration to achieve health equity,
2016 – 9th global conference in Shanghai
Sustainable Development goals Health for all and all for health’ health’
Global health promotion
Good governance: policies for sustainable system which promote health and wellbeing for all
Health l literacy: increasing individuals literacy: and communities capacities to make appropriate health decisions.
Healthy cities: promoting wellbeing and multi -disciplinary approaches to health within everyday urban life urban life urban
Health promoting schools: strengthening the capacity of schools to be healthy settings for living, learning and working
Social mobilisation: engaging mobilisation: engaging and galvanising people at all levels, , to act for good health and well-being and gives Community.
APPROACHES OF HEALTH PROMOTION
Medical or preventive
THE MEDICAL OR PREVENTIVE APPROACH
Aims to reduce morbidity and premature mortality
Target whole population or high risk group
Primary intervention of onset of disease
Secondary intervention of progression of disease
Tertiary prevention of reducing further disability or suffering in person perceive health
Identify health conditions and discuss primary, secondary and tertiary preventive health promotion approaches.
Behaviour changes approach
Health is the property of individual
Persons can make real improvement to their health by choice of life
Responsibility for self
Attitude change is essential
Individuals adopt healthy behaviour which improve health
Identify health behaviour and discuss behaviour strategies for them.
Enabling people to make inform choices about their health behaviour
Providing knowledge and information
Developing the necessary skills
Information NOT persuasion or motivation
Outcome is reliance on person’s self-choice
Identify health behaviour and discuss educational approaches for them.
Support people to;
Identify their own concerns
Gain the skills and confidence necessary to act on their concerns
Set their own agenda and increase control over their own life
Recognised their powerlessness
Feel strongly about their situation to want to change it
Feel capable of changing the situation
How can nurses empower persons/communities to change health?
Social change approach
Changing society not individual
Making healthy choices available and accessible
Targeting groups and populations
Using methods such as public information about the need for change, raising awareness, policy planning, negotiating, implementation and evaluation
Identify health condition and discuss social change approach for them.
Knowledge and skills for promoting behaviour change
Normal and abnormal pathophysiology
Epidemiology of disease
Protective health behaviours
Theories of health behaviour change
Ecological approaches to behaviour change
Local and community resources
Ability to assess readiness to change
Draws from the biological, environmental, psychological, and medical sciences to promote health and prevent t disease, disability disease, disability disease, disability and premature death
Intends to change certain behaviour in a strategic, systematic and targeted manner.
Can be adapted Can to age, gender, education, health problem, social education, health problem, social
Encourages personal investment of personal investment of individual
Respects environment of an individual
It is part of an overall health promotion process that is trying to impact individual or community change
Is the health outcome of a group/ individuals?
It aims to improve the health of an entire population
Understand a clear health problem and set clear goals for improvement
Focus on all determinant of health not just healthcare
Generate share accountability for improving population health
Empower people or communities and develop their capabilities
Embed health equity as a core part of a population health strategy.
Population health education
What are the strategies for health education of:
HEALTH PROMOTION EMBLEM
Lecture 5: Social Determinants of Health
Social Determinants of Health
The Social Determinants of Health (SDH) are the conditions in which people are born, grow, work, live and age and the wider set of forces and systems that shape our
Conditions of daily life
Social Determinants of Health
7Io 9 minutes
Social Determinants of Health
People’s health is determined primarily by a range of social, economic and environmental factors. Social prescribing seeks to address people’s needs in a holistic way. It also aims to support individuals to take greater control of their own health.
Tackling Health Inequalities
Marmot Review (2010)
The ‘Marmot Review’ proposed an evidence-based strategy to address inequalities in the health, distribution of health, and social and economic conditions across.
Give every child the best start in life;
Provide education and lifelong learning;
Provide employment and working conditions;
Define and provide a minimum income for healthy living;
Provide safe and sustainable housing and communities;
Use a ‘social determinants’ approach to disease prevention
Life Course Perspective
The seven social classes
1.5 million Patient contact every year
Lecture 6: What is Epidemiology?
Study of the distribution and determinants of health related states or related states or events, including disease, and using this information to control diseases events and other health problems. (WHO, 2018)
Encompasses the sick, well, exposed, non-exposed..
Target population, group not individual, comparison with similarities and differences
Planning, evaluation, prevent illness, management of health
PURPOSE OF EPIDIOMOLOGY
Informs policy decision evidence- based practice
Helps nurses understand:
Aetiology or the cause of disease and the risk factors
Natural history and prognosis of diseases or health diseases or health conditions.
Extent of disease in the population
Predisposing characteristics for ill –health
Existing and new preventive and therapeutic measures
Best strategies for ill-health health
Best treatment and management of health conditions
Routine registration and notification birth, death, marriage Cancer registry
Communicable / non Communicable / diseases
International Classification of disease
NHS statistics, length waiting length of bed stay
Service uptake and utilisation
Measures of deprivation
Health and disease scales
Quality of life surveys
General household survey
Social information unemployment, Smoking and food, Breastfeeding
Vaccination and Teenage (under 18) conceptions sexual health data
Termination, smoking cessation, hospital activity, prescribing, food bank useage
Risk factor: increase likelihood
Incidence: number of new cases disease or health condition
Prevalence: numbers of cases disease or health condition:
Population: defined group of people, e.g., people with diabetes Population:
Years of Life Lost (YLL): potential life lost due to premature death
Years Lived with Disability (YLD): burden years) of disease.
Disability Adjusted Life Years (DALY): years lost due to ill health
Quality Adjusted Life Year (QALY): years lived in perfect health
Burden of Disease (GBD): mortality and morbidity from major diseases
TERMS AND DATA
Crude Mortality Rate (CMR) per 1000 – ratio of the number deaths during the year to average population in that year – UK 9.2 Scotland 10.7, , England 9
Age Standardised Mortality Rate (ASMR) (per 100000)) – average of the age-specific mortality rates specific mortality rates specific mortality rates specific mortality rates specific mortality rates specific–& Wales 1124 (Males), 837 females)
Neonatal mortality rate (NMR) per 1000)) – number of neonatal (0 number of neonatal l (0 -27 days) deaths per live birth– England &wales 2.8
Infant mortality rate (IMR) (per 1000)– number of deaths under one year age occurring among live births – England & Wales 4
(Office for National Statistics “ “ ONS”, 2019)
UK CANCER INCIDENCE
363000 NEW CASES EVERY YEAR (<990) (2014- 2016)
New diagnoses every two minutes
Breast, prostrate, lung, bowel cancer accounted for 53% of cases.
365 of diagnoses in people age 75 or over
Highest incidence of all cancers in people age 85-89
UK CANCER MORTALITY.
164,000 CANCER DAETH EVERY YEAR or 450 daily- 28% of all daeth
Male 82,200 cancer death
Female 77, 900
Cancer death in every four minutes
Lung, bowel, breast and prostate cancer for 45% of cancer deaths 1/5th from lung cancer
53% of all cancer death are in people age 75% or over
Mortality rates for all cancer death is highest for people age 90+
UK CANCER SURVIVAL
50% of people survive their disease for 10+ (2010-2011)
Higher survival in women than in men
Survival is improving
Survival is higher in people aged under 40 years old
Higher middle age survival for breast, bowel and prostate,
UK CANCER RISK
1 in 2 people born after 1960 will be diagnosed with some form of cancer during their life time
Risk of cancer depends on many factors, including age, genetics, and exposure to risk factors.
4 in 10 cases can be prevented or 135,000 every year: 112000 ( England), 13000 (Scotland), 7200 (Wales) 3500 ( Northern Ireland) Smoking is the largest cause of cancer.
Measuring health outcomes and epidemiology.
The rise of non-communicable diseases and health behaviours.
Health promotion approaches.
Health protection, immunisation and screening.
Approaches to behaviour change.
Examples of health promotion in nursing practice in workplaces, prisons, schools, emergency care, mental health.
Supporting self-management and patient involvement.
Community capacity building and asset mapping.
Public health policy.
Mental health in public health.
Nutrition and malnutrition.
Summative assessment: Formulate and evaluate how a care plan for an individual patient could promote health. 3000 Words.
Baggot, R. (2011) Public Health Policy and Politics. 2nd ed. Basingstoke: Palgrave Macmillan.
Laverack, G. (2019) Power, Empowerment and professional practice. 4th ed. London: Red Globe Press.
Marmot, M., Allen, J. and Goldblatt, P. (2010) Fair society, healthy lives: strategic review of health inequalities in England post 2010. London: The Marmot Review. Available from: http://www.instituteofhealthequity.org/resources-reports/fair-society-healthy-lives-the-marmot-review/fair-society-healthy-lives-full-report-pdf.pdf
Naidoo, J. and Wills, J. (2016) Foundations for Health Promotion. 4th ed. London, Elsevier.
Wills, J. (2014) Fundamentals of Health Promotion for Nurses. 2nd ed. Chichester: John Wiley & Sons Inc.
Bambra, C., Smith, K. and Kennedy, L. (2015) Politics and Health, in Naidoo, J. and Wills, J. (eds.) (2015) Health Studies: an introduction. 3rd ed. Basingstoke: Palgrave Macmillan, pp. 265-292.
Department of Health (2010) Health Lives, Healthy People: our strategy for public health England. London, Department of Health. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/216096/dh_127424.pdf.
Department of Health. (2018) Prevention is better than cure: Our vision to help you live well for longer. London. Department of Health. Available from: https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attachment_data/file/753688/Prevention_is_better_than_cure_5-11.pdf.
Harvey, J. and Taylor, V. (eds.) (2013) Measuring Health and Wellbeing. Los Angeles, California: Sage.
Laverack, G. (2014) A-Z of health promotion. Basingstoke: Palgrave
Local Government Association. (2013) Changing Behaviours in Public Health: To Nudge or Shove. Available from:
Nutbeam, D. (2000) Health literacy as a public health goal: a challenge for contemporary health education and communication strategies into the 21st century. Health Promotion International, 15(3), 1, pp. 259–267.
Marmot Review Team Marmot (2020) Health Equity in England: The marmot review 10 years on. London: UCL Health Equity Unit.
Pickett, K. and Wilkinson, R. (2010) The Spirit Level: Why More Equal Societies Almost Always Do Better. New York: Bloomsbury Press.
Scriven, A. (2017) Ewles and Simnett’s Promoting health: a practical guide. Edinburgh: Elsevier.
Townsend, P., Davidson, N. and Whitehead, M. (1992) Inequalities in Health (The Black Report and the Health Divide). 2nd ed. London: Pelican.
Other Learning Resources
C3 Collaborating for Health – https://www.c3health.org/our-programmes/overview/
The Cochrane library – https://www.cochrane.org/evidence
The Institute of Health Equity – http://www.instituteofhealthequity.org/home
International Union of Health Promotion and Education – https://www.iuhpe.org/index.php/en/
Local Authority Health profiles – https://fingertips.phe.org.uk/profile/health-profiles
Child and Maternal Health – https://fingertips.phe.org.uk/profile/child-health-profiles
NHS England – https://www.england.nhs.uk/
NHS Health Checks – https://www.healthcheck.nhs.uk/
National Institute for Health and Care Excellence (NICE) Guidance – https://www.nice.org.uk/guidance
The Kings Fund – https://www.kingsfund.org.uk/
Public Health England (2018) All our Health Framework- https://www.gov.uk/government/publications/all-our-health-about-the-framework
Public Health England – https://www.gov.uk/government/organisations/public-health-england
WHO The Ottawa Charter for Health Promotion (1986) – http://www.who.int/healthpromotion/conferences/previous/ottawa/en/
WHO Sustainable development goal – https://www.un.org/sustainabledevelopment/
WHO European healthy cities network – http://www.euro.who.int/en/health-topics/environment-and-health/urban-health/who-european-healthy-cities-network
Wanless – the fully engaged scenario – securing out future health – (https://www.yearofcare.co.uk/sites/default/files/images/Wanless.pdf