IHL Semester Test

• Communication


  All methods that can convey thoughts or feelings between persons. It is a process of sending & receiving messages
• Effective communication


  • Use appropriate language that is appropriate to client's level of understanding
  • Make sure client has knowledge, but not feel overwhelmed
  • Develop relationship with clients/patients
  • Talk in a way that relieves anxiety and helps clients to recall
  • Provide feedback
• Effective communication CAN'T be taught, it requires lifelong practise
• Supportive communication climate


  • Descriptive rather than evaluative
  • Problem oriented rather than manipulative
  • Provisional rather that dogmatic
  • Egalitarian rather than superior
  • Empathetic rather that neutral
• Paraphrasing


  Make sure receiver understands message as intended by sender. Avoid talking too much & too soon
• Non-verbal communication


  • Appearance
  • Personal space (territories & zones: intimate, personal, social, public)
  • Signals/ gestures
• Interpersonal Communication model


  • Communication loop, with a message/feedback loop that can experience barriers
  • 5 components: Sender, Message, Receiver, Feedback, Barriers/interference

  
• Listening skills


  • Remember: Most people have a limited attention span, stop listening when uninteresting or don't see benefit, trust their instinct (non-verbal communication/judgement of speaker), media is competition to professional advice
  • Improve listening skills: Remember / decide to listen, Be objective & open-minded, Watch for non-verbal clues, Take your time, Find the real meaning, Respond to confirm your understanding
• Negotiation skills


  The process in which 2+ parties exchange goods or services & attempt to agree on the exchange rate for them. The exchange of alternatives for health behaviour between health professional & client/patient
• Negotiation process


  1. Prepare & plan

  2. Define ground rules

  3. Clarify & justify one another's position

  4. Bargaining & problem-solving discussion

  5. Closure & implementation
• Tips when negotiating


  • Begin on a positive note
  • Address problems, not personalities
  • Pay attention to initial discussions & efforts
  • Emphasize win-win solutions
  • Create & open & trusting climate
• Primary health care (PHC)

  Essential health care based on practical, scientifically sound & socially acceptable methods & technology made universally accessible to individuals & families in the community through their full participation & at a cost that the community & country can afford to maintain at every stage of their development in the spirit of self-reliance & self-determination
• Shift from bio-medical model of healthcare

  • Focused on physical/biological aspects of diseases & illness
  • Involved management of illness conditions once symptoms are present
  • Cantered around health professionals & hospitals who administer treatment
• Re-orientation of the healthcare provision model

  • Health is a Human Right not a privilege
  • Health & healthcare services are affected by social, cultural, & other political circumstances
  • Emphasis on equitable access to health
  • Decentralisation of health services
  • Limit unsustainable hospital based curative services
  • Focus on efficient & cost-effective healthcare services
• Principles of Primary health care

  • Accessibility
  • Public participation
  • Health promotion
  • Appropriate technology
  • Collaboration
• Health is a continuum. Will not end after appointment with doctor
• Priority rankings


  • Preventive
  • Promotive
  • Curative
  • Rehabilitative
• Sustainable Developmental goals (SDG) are global goals to make WORLD better
• Universal Health Coverage (UHC)


  PHC is starting point for good health. Connects with SDGs. UHC means everyone should get health care without facing financial problems
• Health promotion


  The process of enabling people to increase control over, & to improve, their health. To reach a state of complete physical, mental & social well-being, an individual or group must be able to identify & to realize aspirations, to satisfy needs, & to change or cope with the environment
• Ottawa Charter on health promotion

  • Building healthy public policies
  • Creating supportive environments
  • Strengthening community actions
  • Developing personal skills
  • Reorienting health services
• Community engagement


  • Leadership & ownership
  • Secure human rights
  • Enhance quality of living
  • Promote social justice
  • Participation
  • Assets/capital/resource mobilization
  • Sustainability
  • Respect indigenous views & local culture
  • Resilience & empowerment
• Creating a successful health promotion program starts with a careful needs assessment by a thoughtful healthcare advocate
• Outcomes


  • To describe/define health education/promotion, asset-based approach, health needs, SMART goals, Scaling a goal, Goal achievement
  • To identify health educational needs
  • To identify the message, you would like to convey using the interpersonal communication model
  • To graphically depict & formulate SMART goals based on the educational needs determined
  • To evaluate a health education programme
• Health promotion Program


  Process of enabling people to increase control over & improve their health. Covers a wide range of social & environmental interventions designed to benefit & protect individual's health & QOL by addressing & preventing the root causes of ill health, not just focusing on treatment & cure
• Health education principles & concepts

  • Promoting health & preventing diseases
  • Utilization of available resources & health services – accessibility & effectiveness
  • Highlight significance of early diagnosis & effective disease management
  • Empowering individuals to take proactive measurements of their well-being
• Types of prevention


  • Primary: Improve population health, Intended for communities with limited resources, Invoke agency within different community stakeholders
• 5 key action areas of Ottawa Chater for health promotion


  • Public Health policy
  • Supportive environment
  • Strengthen community action
  • Develop personal skills
  • Reorient health services
• Needs & asset assessment

  • Health needs are those that pertain to a particular group or community that can benefit from health care or from wider social & environmental changes
  • Health needs assessment is a review of health issues facing a group or community (unmet needs)
  • Asset-based approach: Recognising assets, promote sense of contribution & equality within community, emphasises building upon existing structures & skills in community, fostering sustainability & self-reliance
• Health promotion in South Africa: Significantly higher burden of diseases, Majority of causes are preventable, One of the PHC programmes, Based on intersectoral collaboration, Funding - Department of health budget & donor agencies (UN), Well-coordinated, monitored & evaluated
• Impact of NOT doing health promotion: Disease & illness are never just physical. They are also & always social, psychic & spiritual, & utterly human
• SMART goals


  Goals are built up using up to 4 parts: Target activity, Support needed, Quantification of performance, Time period to achieve

  
• Writing & weighting goals

  • Weight according to importance & difficulty, Importance determined by the community, Difficulty determined by healthcare professionals, The goal is weighted on a 3-point scale: 1 = little importance & difficulty, 2 = Moderate importance & difficulty, 3 = very important & difficult
• Goal attainment scaling is needed for well-defined & measurable goals
• Goal setting is not a once off event. It's ongoing process that requires evaluation to identify when progress is or is not made
• Quantification of performance


  Time period to achieve
• Goal attainment scaling


  • Needed for well-defined & measurable goals
  • Goal setting is not a once off event. It's ongoing process that requires evaluation to identify when progress is or is not made
• Writing & weighting goals

  1. Weight according to importance & difficulty

  2. Importance determined by the community

  3. Difficulty determined by healthcare professionals

  4. Goal is weighted on a 3-point scale: 1 = little importance & difficulty, 2 = Moderate importance & difficulty, 3 = very important & difficult

  5. Determine how will you measure performance: The goal you set in Step 1 (S.M.A.R.T.) is scored at 0, You must set 4 more performance levels - 2 better & 2 worse
• Outcome level


  • Much more than expected (+2): Health education will result in first time mums making appropriate diet choices for their toddler 80% of the time by the end of the discussion session
  • More than expected (+1): Health education will result in first time mums making appropriate diet choices for their toddler 70-80% of the time by the end of the discussion (Q & A session)
  • Expected outcome (0): Health education will result in first time mums making appropriate diet choices for their toddler 65% of the time by the end of the discussion (Q & A session)
  • Less than expected (-1): Health education will result in first time mums making appropriate diet choices for their toddler 50% of the time by the end of the discussion (Q & A session)
  • Much less than expected (-2): Health education will result in first time mums making appropriate diet choices for their toddler 50% of the time by the end of the discussion (Q & A session)
• RE-AIM framework


  • Reach (intended target population)
  • Efficacy (effectiveness)
  • Adoption (mobilisation of community/group member & resources)
  • Implementation (adaptations made to ensure proper delivery)
  • Maintenance (consider the intervention efforts over time)