CHAPTER II HISTORICAL

DEVELOPMENT AND CONCEPTS

AND HEALTH EDUCATION
 HEALTH EDUCATION
 Any combination of learning
experiences designed to facilitate
voluntary adaptations of behavior
conducive to health ( Green, et.al
,1980)
 A science and a profession of teaching
health concepts to promote, maintain
and enhance one’s health, prevent
illness, disability and premature
death through adoption of healthy
behavior, attitudes and perspective. It
draws health models and theories .
HEALTH EDUCATION
 Any combination of planned learning
experiences based on sound theories
that provide individuals, groups and
communities the opportunity to
acquire information and the skills
needed to make quality health
decisions. (Joint Committee on
Health Education and promotion
Terminology of 2001)
 HEALTH EDUCATION
Consciously constructed
opportunities for learning involving
some form of communication
designed to improve literacy,
including improving knowledge and
developing life skills which are
conducive to individual and
community health. (WHO)
PURPOSE OF HEALTH EDUCATION
Aims to positively influence the
health behavior and health
perspectives of individuals and
communities for them to develop
self –efficiency to adopt healthy
lifestyles resulting to healthy
community.
IMPORTANCE OF HEALTH EDUCATION
• Empowers people to be self sufficient
•Equips people with knowledge and
competencies to prevent illness,
maintain health
• Enhance the quality of life
•Creates awareness regarding the
importance of preventive and
Promotive care thereby reducing the
cost if not to avoid spending on the high
coat of medical treatment
 LEGAL BASIS OF HEALTH EDUCATION IN
NURSING CURRICULUM

 Rule IV, Art. VI, Sec. 28 of the Philippine

Nursing Act of 2002 (RA 9173)
a. Provide health education to individuals ,
families and communities.
b. Teach , guide and supervise students in nursing
education
c. Implement programs including the
administration of nursing services in varied
settings like hospitals and clinics.
 LEGAL BASIS OF HEALTH EDUCATION IN
NURSING CURRICULUM

 Specifically , the nursing education program shall

provide sound general and professional
foundation for the practice of nursing taking into
consideration the learning outcome based on
national and universal nursing core (Nursing
Process) competencies. The learning experience
shall adhere strictly to specific requirements
embodied in the prescribed curriculum as
promulgated by the Commission on Higher
Education’s policies and standards of nursing
education.
 FUNCTIONS OF A PROFESSIONAL NURSE
• Assess the client’s needs and
capabilities and identify both internal
and external resources in the
community
• Plan, develop and coordinate with the
different health and government
agencies and NGO’s regarding health
education programs
• Do community organizing and
outreach
 FUNCTIONS OF A PROFESSIONAL NURSE
• Conduct staff training and consult
with other health care provider about
behavioural, cultural or social barriers
to health
• Conduct regular periodic evaluation of
health education program
• Make referrals
• Develop audio, visual, print and
electronic materials to be used for
training and conduct health education
classes
• Conduct research work and write
scholarly articles.
 ROLE OF THE NURSE EDUCATOR
 Facilitates the development of policies and
procedures, interventions and systems
conducive to the health of the clients at all
levels . ( Joint Commission on Terminology,
2001 , p. 100)
 Help promote , enhance and maintain the
health of others,
 ROLE DELINEATION PROJECT
 To better understand the role of health educator
 A framework for the development of Competency
– Based Curricula for Entry Level Health
Educators (NCHEC,1985) , revised in 1996
wherein a competency based framework for the
professional development of Certified Health
Education Specialist
 7 IDENTIFIED AREAS OF RESPONSIBILITY
OF HEALTH EDUCATOR (NCHEC,1996)

 Implement health education strategies,

interventions and programs
 Administers health education strategies
interventions and programs
 Conduct evaluation and research in relation to
health education
 Serve as health education resource person

 Assess individual and community for health

education needs
 Communicate and advocate for health and health
education
CRITICAL HEALTH ISSUES RELATED TO
LEARNING OF STUDENTS

 Emotional health and positive health image

 Appreciation and care of human body and its
vital organs
 Physical fitness

 Health issues on alcohol, tobacco, drug use and

abuse
 Health misconceptions and myths

 Effects of exercise on the body system and

general well being
 CRITICAL HEALTH ISSUES RELATED TO
LEARNING OF STUDENTS

 Nutrition and weight control

 Sexual relation and sexuality

 Scientific, social and economic aspects of

community and ecological health
 Communicable and degenerative disease
including STI
 Safety and driving education

 Environmental factors and how these factors

affect the client at all levels
 ORGANIZATIONS AND AGENCIES
PROMULGATING STANDARDS

 Code of Ethics of the Society for Public Health

Education, Inc.
“ Health educators take the profound
responsibilities in using educational process to
promote health and influences well being.”
Article IV “ in designing strategies and methods,
the health educator..... Should be aware of his/
her possible impact on the community and other
health professionals and must not place the
burden of change solely on the target population
but must involve other appropriate groups to
bring about effective change.”
 ISSUES AND TREND IN HEALTH
EDUCATION
 Social impact
- aging population requires emphasis on self-
reliance and maintenance of healthy life status
over extended life span
- Lifestyle diseases that are preventable are the
major cause of morbidity and mortality.
 Economic- shift in payer coverage, emphasis on
manage care and earlier hospital discharge and
the issue in reimbursement for health services'
provided require more intensive patient
education to allow patient and his family a more
independent, compliant and confident manage
care.
 ISSUES AND TREND IN HEALTH
EDUCATION
 Political formulated goals and objectives of the
government will create awareness of health risk
and encourage the adoption of healthy life styles.
- The role of health educator in prevention of and
promotion of illness in containing the cost of
hospitalization and health care expenses.
 ISSUES AND TREND IN HEALTH
EDUCATION
 Biological, psychological and sociological issues
- BPS Model – (George l. Engel 1977) –a general
framework on health behavior – stated that
human experience of health and illness is
affected or determined by the interplay or
interrelatedness of the ff. Factors
a. Biological –functions of the organ system and its
coping like immunity level, genetics,
predisposition .
b. Psychological – perceptions, thoughts, emotions,
attitudes and behavior
 ISSUES AND TREND IN HEALTH
EDUCATION
c. Social factors- socio-economic, cultural beliefs,
poverty, technology, environment
- BPS disease process is due to the combination of
all three factors
CHARACTERISTICS OF EFFECTIVE HEALTH
EDUCATION (HUBLEY, 1983)
 Directed at people who are directly involved with
the situations and issues in the home and the
comunity
 Lessons are repeated and reinforced over time
using different methods
 Lessons are adoptable and use existing channels
of communication (songs, drama and story
telling)
 Entertaining and attracts the community’s
attention
CHARACTERISTICS OF EFFECTIVE HEALTH
EDUCATION (HUBLEY, 1983)
 Uses clear , simple language with local
expressions
 Emphasizes about the short benefits of action

 Provides opportunities for dialogue, discussion,

and learner participation and feedback
 Uses demonstration to show the benefits of
adopting the practices
RELATIONSHIP BETWEEN HEALTH
EDUCATION HEALTH PROMOTION

Health Education Health promotion

 Develop appropriate  Assess the needs of the

program in largest population
consultation with the  Develop goals and
objectives
people they serve
 Create interventions
thru; planning, that consider
implementing , peculiarities of the
evaluating the health setting
plans  Implementing
interventions
 Evaluating the resuts
HE TODAY AND THE FUTURE
 Technology will face the health educator with
enormous challenges
 There is a returned to population based health
promotion and maintenance vis a vis the
hospital based and preference for health care on
past few decade.
 Adaptation of healthy behaviors and lifestyle
through health empowerment of the people.
 Health educator is considered as a community
health worker
 HE TODAY AND THE FUTURE
 The call of global health strategies with the
integration of health education and action is now
a clamour that cannot be ignored.
( globalization, war, terrorism, social instability,
disease, poverty, and environmental degradation.
Pandemic HIV/AIDS,SARS, given priority)
 Clear strategies for global capacity building ,
adequate training of health professionals must
be prioritized.
 EMERGING TRENDS IN HEALTH CARE
 New health care economics- emphasis on primary
health care and continuing development of managed
care, to reduce insurances cost and prevent over
treatment.
 Emphasis on Health outcomes against process of care ;
health workers -patient ratio, qualifications of medical
and nursing staff, autoclaves, beds etc.
 Providers will increasingly establish centers for
excellence for effective services
 Decentralization of care- prosumerism- patient
opportunities to gain knowledge through the internet
and medical data base
 EMERGING TRENDS IN HEALTH CARE
 Alternative medicine as prosumerism- uses folk
practices to promote health and potentially cure
disease. Uses traditional herb, meditation,
guided imagery.
 Medical globalization health care. Also known as
medical tourism. Hospitals with world class
amenities
 EMERGING TRENDS IN HEALTH CARE

 Advances in medical technology

- Disease management – seek to improve patient
compliance by promoting proper appointment
keeping
 Closed circuit television where patient stays in
his room to watch the presentation.
 FUTURE DIRECTION FOR PATIENT CARE
 New settings an environmental linkages
a. Most teaching will occur in ambulatory setting
b. Inter-organizational linkages to enhance
cooperative endeavours in patient education will
increase
c. More people are unhappy of orthodox medicine
and turning to alternative medicine
d. Changing demographics resulting in
proportionally older population and greater
number of minority groups with unique health
challenge
 FUTURE DIRECTION FOR PATIENT CARE
 New technologies
a. The use of computer-based instruction for
hospitals, ambulatory care settings, physician’s
office or homes will increase
b. Use of interactive video programs resulting to
greater access to reliable information
 Greater emphasis on wellness

a. Wellness screening program will increase

b. Emphasis on illness prevention and health

promotion such as nutrition, diet, and exercise
with various educational offerings
 FUTURE DIRECTION FOR PATIENT CARE
 Increased third party reimbursement as cost
benifit , demonstrate the cost effectiveness of
consumers education as shown by shorter
hospital stay, efficient home care and
management , lesser incidence of complications
and hospital readmissions.
THEORIES IN HEALTH EDUCATION
 COMMON MISTAKES AND SOURCES OF
FRUSTRATIONS OF HE

 “tell” the client what they need to know and

expect them to obey and go through an attitude
and behaviour change. More often than not
produces negative results because the health
educator failed to conduct an assessment of the
learning needs of that particular client which
could provide the sound basis for teaching
learning activities”
 In planning health education content use
theories of models to explain human behavior
 CLASSIFICATION OF THEORIES
 Direction /level
- Individual (intrapersonal)

- Interpersonal

- Community

 Most common used health theories

a. Pender’s Health Promotion Theory

b. Bandura’s self –efficacy theory
c. Becker’s Health Belief Model
d. Gree’s precede-proceede Model
 HEALTH PROMOTION THEORY
 Develop in 1987 and revised by Pender in 1996
 Salient points:

- Emphasizes actualising health potential and

increasing the level of well-being using approach
behavior rather than avoidance of disease.
 6 major components and their variables

a. Individual characteristics and experiences

- Prior related behavior

- Personal factors
 HEALTH PROMOTION THEORY
b. behavior-specific cognition and affect
- Perceived benefits of action
- Perceived barriers to action
- Perceived self- efficacy
- Activity related effect
- Interpersonal influences
- Situational influences
c. Behavioural outcome
- Commitment to plan action
- Immediate competing demands and preference
- Health promoting behavior
 HEALTH PROMOTION THEORY
D. Activity related affect
E. Commitment to plan action
Factors with indirect effects on health promoting
lifestyles (Johnson, et al ,1993)
a. Age

b. Income

c. Education

d. Biological characteristics of body mass index

 BANDURA’S SELF –EFFICACY THEORY (
DEBARR K.A., 2004)

 Social learning theory/ social cognitive theory

(separate research by Rotter 1954 and Bandura
(1977)
- Emphasizes the cognitive aspect of learning
which explains human behavior by citing 3
factors which are in continues interaction
resulting in reciprocal determination or triadic
reciprocal causality;
- 1. personal factors:cognition , affect, and biologic
vents
- 2. behavior
- 3. environmental influence
 BANDURA’S SELF –EFFICACY THEORY (
DEBARR K.A., 2004)

 Social cognitive theory- cognition plays a critical

role in people’s capability to construct reality ,
self-regulate , encode information and perform
behavior.
 Self efficacy- single most important aspect of the
sense of self that determines one’s effort to
change behavior. It is equated with self-
confidence in one’s ability to successfully perform
a specific type of action.
 SELF EFFICACY CAN BE INCREASE
THROUGH

 Personal mastery of the task

 Observing the performance of others

 Verbal persuasion, like receiving suggestion

 Arousal of emotional state. Able to deal with any

source of anxiety in the surrounding in order to
learn
CONSTRUCT IN SOCIAL LEARNING THEORY
 Value expectancy theory
- Reinforcement = learning but

- Reinforcement + individual expectations of the

consequences = behavior
 Reinforcement can be accomplished in one of
three ways
1. Direct reinforcement - supplied directly to the
person
2. Vicarious – the participant observes someone
being reinforced for behaving in an appropriate
or inappropriate manner. (Social modelling or
behavioral modelling)
CONSTRUCT IN SOCIAL LEARNING THEORY
3. self-management record keeping by the
participants of his own behavior . The behavior is
performed correct he reward himself (self-
control)
 OTHER CONSTRUCT IN HE
1. Behavioural capability- knowledge and skills
necessary to do a behavior which influence
action. Clear instructions and training is
needed
2. Expectations- refers to the ability of human to
think , therefore expect certain results in
certain situation
3. Expectancies- values that people place on an
expected outcome. The more high the valued the
expected outcome the more people will perform
the needed behavior to yield the outcome
 OTHER CONSTRUCT IN HE
4. Efficacy expectations- are feeling of competency
5. Outcome expectation- the person believe that the
outcome behavior (reinforcement ) is not great or
good enough in terms of benefits, he may not
attempt the behavior inspire of the feeling of
competency or efficacy
 HEALTH BELIEF MODEL (HBM)
 One of the first model introduce by psychologist
in 1950 to find out why people refused to use
preventive services
 They assumed that people feared diseases and
that the health actions of people were motivated
by the degree of fear (perceived threat) and the
expected fear of reduction of actions, as long as
that possible reduction outweighed practical and
psychological barriers to taking action (net
benefits)
 4 CONSTRUCTS OF HBM (REPRESENT
HEALTH THREAT AND NET BENEFITS)

1. Perceived susceptibility- a person’s opinion of

the chances of getting a certain condition
2. Perceived severity- a person’s opinion of how
serious the condition is
3. Perceived benefits- a persons opinion of the
effectiveness of some advised action to reduce
the risk or seriousness of the impact
4. Perceived barriers- a person’s opinion of the
concrete and psychological costs of this advised
action
 CONCEPT OF CUES TO ACTION (HBM)
 These are internal or external events which
activate a person’s readiness to act and stimulate
an observable behavior.
 Ex. Of external to activate “readiness” ;
information sought delivered in print with
educational materials or through electronic
media, reminders by powerful others , persuasive
communication, personal experience and one on
one counselling.
 SELF –EFFICACY (HMB)
 To better meet the challenges of changing
unhealthy behavior (sedentary life style,
smoking, overeating) .
 A concept originally developed by Bandura.

 A person’s confidence in his ability to

successfully perform an action,
 help to search for “why” these behavior occur
and identify points for possible change and
design strategies like message to persuade an
individual to make a healthy decision.
 PRECEDE – PROCEED MODEL
(BASTABLE,2003)
 Based on epidemiological perspective on health
promotion to combat the leading causes of death.
 P – redisposing

 R – reinforcing

 E –nabling

 C- onsturcts in

 E -ducational

 D – iagnosis

 E – valuation

( Greene et. al , 1999)

 PRECEDE – PROCEED MODEL
(BASTABLE,2003)
 P – olicy
 R – egulatory

 0 – organizational

 C –onstruct in

 E –education and

 E –nvironmental

 D –evelopment

Core of the model is that health education is “any

combination of learning experiences designed to
facilitate voluntary action conducive to health”
PRECEDE-PROCEED
Precede Proceede

 Identify  Address the

priorities and criteria for policy ,
objectives implementations
and evaluation as
influenced by the
diagnosis in the
precede
 HBM
 Core of the model is that health education is
“any combination of learning experiences
designed to facilitate voluntary action conducive
to health”
 Health education is aimed primarily at planning
experiences that are designed to predispose ,
enable, and reinforce voluntary behavior
conducive to the health of individuals, groups, or
communities.” (Greene & Kreuter, 1999)
 PHASES OF PRECEDE-PROCEED MODEL

1. Social diagnosis- begin with the population self-

study /assessment relative to the quality of life
2. Epidemiologic diagnosis
3. Behavior and environmental diagnosis
4. Educational & organizational diagnosis-
addresses issues dealing with education
Administrative & policy diagnosis- addresses
issues dealing with education
5.Implementation
6. Process evaluation
7.Impact evaluation
8. Outcome evaluation
 PRECEDE-PROCEED MODEL
PRECEDE evaluation task : specifying measurable objectives and baseline

PHASE 4
Administrative
and policy PHASE 3 PHASE 2 PHASE 1
assessment Ecological and Epidemiological Assessment Social Assessment
and educational
intervention assessment
alignment

HEALTH Predisposing Genetics

PROGRAM

EDUCATIO
NAL
STRATEGI
ES Reinforcing Behavior

Quality of
Health
Life
POLICY
REGULATI Enabling environment
ON
ORGANIZA
TION

PHASE 5
IMPLEMEN PHASE 6 PHASE 7 PHASE 8
Process Evaluation OUTCOME EVALUATION
TATION

PROCEED evaluation task: monitoring & continuous Quality Improvement

 PRECEDE-PROCEED MODEL
Strength
 Lies in the inclusion of interventions from
population needs perspective
 Has predictive value in predicting changes

Use of the theory

 Relevant and useful to community health nurses

“ community is the center of gravity”

BEHAVIOURIST
LEARNING THEORIES
 RESPONDENT CONDITIONING MODEL OF
LEARNING

 Also termed as classical or Pavlovian

conditioning
 Emphasizes the importance of stimulus condition
and the association formed in the process
 NS- neutral stimulus that has no particular
value to the learner
 UCS- unconditioned stimulus , usually paired to
NS
 CS- conditioned stimulus occurs as learning
when associated with CR or conditioned respond
 RESPONDENT CONDITIONING MODEL OF
LEARNING

Ex.
Offensive odours Queasy feeling
( UCS) (UCR)
Hospital + offensive odour Queasy feeling
(NS) ( UCR) (UCR)
Several pairings of Hosp. + offensive odour
Queasy feeling
Hospital queasy feeling
(CS) ( CR)
 RESPONDENT CONDITIONING MODEL OF
LEARNING

Ex.
Operation Anxiety
(UCS) (UCR)
Operating Room + operation Anxiety
(NS) (UCS) (UCR)
Several Pairings + operation Anxiety
(experience, information)
Operating room Anxiety
 RESPONDENT CONDITIONING MODEL OF
LEARNING

Systematic desensitization – fear of particular

stimulus or situation is learned , so it can,
therefore , be unlearned or extinguish.
how?
 Relaxation technique – the fear producing
stimulus is gradually at a non threatening level
 RESPONDENT CONDITIONING MODEL OF
LEARNING

 Stimulus generalization- initial learning

experiences can be easily applied to other similar
stimuli. Ex. Other people’s same experience
becomes apparent that a highly positive or
negative encounter may color patient’s
evaluation of hospital stay .
 Spontaneous recovery- useful in relapse
prevention program. Help us understand why it
is difficult to completely eliminate unhealthy
habits and addictive behavior
 RESPONDENT CONDITIONING MODEL OF
LEARNING

 Operant conditioning- (Skinner, 1974, 1989) –

focuses on the behavior of the organism and the
reinforcement that occurs after the response.
 Reinforcer – is the stimulus / event applied that
strengthen the probability that the response will
be performed again. Behaviors can be increased
or decreased.
 OPERANT CONDITIONING; CONTINGENCIES' TO
INCREASE AND DECREASE THE RESPONSE
1. To increase the response
2. Extinguish or decrease
a. Positive reinforcement:
application of pleasant the response
stimulus a. Non-reinforcement- a
Reward conditioning- a response is note
pleasant stimulus followed by any kind of
following a response reinforcement
2. Negative reinforcement; b. Punishment –
removal of unpleasant
stimulus
following a response ,
an aversive stimulus
Escape conditioning the
response of the organism to
that the organisms
unpleasant stimulus cannot escape or avoid
Avoidance conditioning- is applied
anticipated aversive
stimulus makes the
organism avoid it
 COGNITIVE LEARNING THEORY
 The key to learning and changing is the
individual’s cognition (perception, thought,
memory and ways of processing and structuring
the information )
 Reward is not necessary

 Learner’s goal and expectations are important

 Past experiences must be recognize, diverse

aspirations, expectations and social influences
 Metacognition- understanding her way of
learning
 COGNITIVE LEARNING THEORY
Gestalt
 Each person perceives, interprets, and response
to any situation in his own way
 Psychological organization is directed toward
simplicity , equilibrium and regularity.
 Perception is selective- no one can attend to all of
the stimuli
 Attention given is influenced by past experience,
needs, personal motives structure of the situation
 COGNITIVE LEARNING THEORY
 Informationprocessing- emphasizes
thinking process; thought, reasoning,
and the way information is
encountered and stored, and memory
functioning
COGNITIVE LEARNING THEORY
INFORMATION PROCESSING MODEL
External Process Internal Process External Process
Stage 1 Stage 2 Stage 3 Stage 4
Attention Processing Memory Storage Action

Long
Sensory Short Term
Orienting Term Response
Memory Memory
Stimuli Memory

Physical
and
Enduring :
emotional ( Fleeting (Brief
But
properties Less than Less than
retrieval
Arouse 1 second ) 30 seconds)
problems)
interest
INFORMATION PROCESSING PERSPECTIVE
 Helpful in assessing problems in ;
- Acquiring
- Remembering
- Recalling information
Strategies:
1. Have learner indicate how they believe they
learn (metacognition0
2. Ask them to describe what they are thinking
while they are learning
3. Evaluate learners mistakes
4. Give close attention to their inability to
remember
 EVENTS AND PROCESS THAT ACTIVATE
EFFECTIVE LEARNING

 Gain the learners attention (reception )

 Inform the learner of the objectives and
expectations ( expectancy)
 Stimulate the learners recall of prior learning

 Present information ( selective perception)

 Provide guidance to facilitate the learner’s

understanding (semantic encoding)
 EVENTS AND PROCESS THAT ACTIVATE
EFFECTIVE LEARNING

 Have the learner demonstrate the information or

skill
 Give feedback to the learner (feedback)

 Assess the performance ( retrieval)

 Work to enhance retention and transfer through

application and varied practice ( generalization )
 COGNITIVE THEORY
 Cognitive Development- focuses on qualitative
changes in perceiving , thinking and reasoning
as individual grow.
 Cognition are based on how external events
conceptualized, organized and represented within
the mental framework or schema of the
individual.
 Learning is a sequential and active process
FOUR SEQUENTIAL STAGES OF COGNITIVE
DEVELOPMENT (PIAGET)

 Sensori-motor
 Preoperational
 Concrete operation
 Formal operation
These stages are evident over the course of infancy,
early childhood, middle childhood, and
adolescence .
 Learning can be assimilation- fitting the new
learned information with what they already
know or
 Accommodation- changing their perception and
interpretation in keeping with new information.
 ADULT LEARNER
 Some do not reach the formal stages in cognitive
development they might learned from concrete
approaches
 Advance stages of reasoning beyond formal
operation
 May demonstrate advance level of reasoning
derived on their wisdom and life experiences or
reflect lower stages of thinking due to lack of
education , disease, depression, stress, or
medication.
 Do better with self-directed learning ( learner
control, autonomy, initiative),problem oriented
rather than subject oriented
 STAGES OF COGNITIVE DEVELOPMENT

 Perception of children is important , children are

exploring , interacting and discovering in solitary
manner . (Piaget)
 The job of the adult is to interpret , respond and
give meaning to children’s action (Vygotsky) . A
clear , well designed instruction is needed to
advance person’s thinking and learning
THE PSYCHODYNAMIC THEORY IN
RELATION TO EDUCATION
 PSYCHODYNAMICS

 Importance of conscious and unconscious

motivation for better understanding of behaviour
 Negative emotions are important to recognize
and assess the nurse-patient-doctor-family
interactions
 Id is the primary source of motivation and based
on the libidinal energy ( the basic instinct,
impulses and desire we are born with)
- The Eros- desire for pleasure and sex known as
the life force
- Thanatos- aggressive, destructive impulses or
death wish)
 PSYCHODYNAMICS

 Superego- the conscience (internalized social

values and standard)
 Ego- mediator between the id and super ego.
Operates on reality principle. Rather on insisting
immediate gratification people take the long road
to gratification
 Healthy ego (self) development is important
consideration in health field.
 Ego strength to adjust to certain procedures on
the part of the client and avoid burn out in
performance of the role as educator
 EGO DEFENSE MECHANISMS ( TO
PERCEIVED THREATS)

 Denial- ignoring or refusing to acknowledge the

reality of the threat
 Rationalization- excusing or explaining away a
threat
 Displacement- taking out hostility and
aggression on other individuals rather than
directing anger at the source of the threat
 Suppression keeping unacceptable thoughts,
feelings , or action from conscious awareness
 Regression- returning to an earlier (less mature ,
more primitive) stage of behavior as way of
coping with threat
 EGO DEFENSE MECHANISMS ( TO
PERCEIVED THREATS)

 Intellectualization- minimizing anxiety by

responding to a threat in a detached , abstract
manner without feelings or emotion.
 Projection – seeing one’s own unacceptable
characteristics or desire to other people
 Reaction formation- expressing or behaving the
opposite of what is really felt
 Sublimation – converting repressed feeling s into
acceptable action
 Compensation- making up for weakness by
excelling into other areas
THE MASLOW’S HIERARCHY OF NEEDS

Self – Actualization
Needs to fulfil one’s
potential
Self esteem
Need to be perceived as
component, have
confidence and
independence , and
status of recognition and
Love and Belongingness
appreciation
Need to give an d receive
affection
Safety and security need for security ,
structure and protection as well as
freedom form fear

Physiological to have basic survival needs met

(Food , water, warmth, sleep)
QUIZ

Write the letter of your choice

1. Health education
a. Learning experience designed to promote healthy
behavior
b. Process that design, implement, evaluates health-related
educational program
c. Designed to promote the interest of the government
d. Aims to promote health empowerment of the people
1. A,D,C 2. A,B,C 3. A,B,D 4. B,C,D
QUIZ

2. Health education principles should focus on

a. Promoting good health practices

b. Treatment and cure of illness and disease

c. The use of prevention of illness and disease

d. Early referral of illness/case

1. a,b,c 2. b,c,d 3. a,c,d 4. a,b,d

QUIZ

3. The latest “health economics” dictated that

a. Patient should maximize the use of their
hospitalization benifits
b. Patients should be not discharged untilhe is
completely healed
c. Patients should be discharged the quickest or
earliest time possible
d. Patient should be treated with respect and
tender loving care (TLC)
1. A,B,C 2. B,C,D
QUIZ

4. The largest reform in the health care system,

known as “managed care”, is intendednto:
a. Implement early hospital discharge to save on
hospitalization cost
b. Bridge the gap between hospital confinement
and community-based services
c. Put the burden of recovery /rehabilitation on the
patient and family
d. Help the Health Maintenance Organizations
save on cost of hospitalization
QUIZ

5. It is another term for decentralization of medical

care.
a. Health care economics

b. Medical prosumerism

c. Managed care

d. globalization
QUIZ

1.Define health education and explain its

importance in 5 sentences (10).
2. Briefly define and explained biopsychosocial
model in 5 sentences (10)
3. In 5 sentences discuss Bandura’s self efficacy
theory and how it applies to health behavior of an
individual (10)