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บทบาทของคณะแพทยศาสตร์ในการจัดการศึกษาด้าน การสร้างเสริมสุขภาพ

บทบาทของคณะแพทยศาสตร์ในการจัดการศึกษาด้าน การสร้างเสริมสุขภาพ. อานุภาพ เลขะกุล คณะแพทยศาสตร์ มหาวิทยาลัยสงขลานครินทร์. Scope of Presentation. Concept of health promotion Medical school and HP. Health Promotion in Medical Curriculum, PSU. Medical Education. Health Care System.

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บทบาทของคณะแพทยศาสตร์ในการจัดการศึกษาด้าน การสร้างเสริมสุขภาพ

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  1. บทบาทของคณะแพทยศาสตร์ในการจัดการศึกษาด้านการสร้างเสริมสุขภาพบทบาทของคณะแพทยศาสตร์ในการจัดการศึกษาด้านการสร้างเสริมสุขภาพ อานุภาพ เลขะกุล คณะแพทยศาสตร์ มหาวิทยาลัยสงขลานครินทร์

  2. Scope of Presentation • Concept of health promotion • Medical school and HP Health Promotion in Medical Curriculum, PSU

  3. Medical Education Health Care System Medical Service Medical Education Health Promotion in Medical Curriculum, PSU

  4. Concept of Health Promotion Health Promotion in Medical Curriculum, PSU

  5. นโยบายสร้างเสริมสุขภาพนโยบายสร้างเสริมสุขภาพ สร้างนำซ่อม ใคร……สร้าง ใคร……ซ่อม สร้าง……อย่างไร Health Promotion in Medical Curriculum, PSU

  6. นโยบายสร้างเสริมสุขภาพนโยบายสร้างเสริมสุขภาพ การส่งเสริมสุขภาพ vs การสร้างเสริมสุขภาพ Health Promotion in Medical Curriculum, PSU

  7. Health Care Organization Human Biology Health Lifestyle Environment Lalonde, 1974 Health Promotion in Medical Curriculum, PSU

  8. How Poverty Affects Health Poverty Food poverty, Fuel poverty Poor housing, Poor transport Social isolation, Relative powerlessness Poor access to recreation/social facilities Behavioral changes Smoking Drug abuse Low exercise levels Poor diets Psychological Health Effects Stress Anxiety Depression Low self-esteem Physical Health Effects Low birth weights Infant deaths Poor growth in children Respiratory diseases Heart disease Accidents (Blackburn,1992) Health Promotion in Medical Curriculum, PSU

  9. Maslow’s Needs Self Actualization Esteem Needs Needs for Love & Care Safety Needs Physiological Needs

  10. Health Promotion (WHO) • A process of enabling people to increase • control over and improve their health • To reach a state of complete physical, • mental, social and spiritual well-being, • an individual or group must be able to • identify and to realize aspirations, to • satisfy needs, and to change or cope • with the environment Health Promotion in Medical Curriculum, PSU

  11. From disease prevention to health promotion Health Promotion in Medical Curriculum, PSU

  12. Levels of Disease Prevention • Behavioral • risk factors • Tobacco • Alcohol • Physical • inactivity • Diet • Physiological • risk factors • BMI (Obesity) • Blood pressure • Blood glucose • Cholesterol • Disease • outcomes • Heart disease • Stroke • Diabetes • Cancer • Accidents • COPD • Chronic diseases Health Promotion in Medical Curriculum, PSU

  13. Health Promotion (WHO) • A comprehensive social and political process • It not only embraces actions directed at • strengthening the skills and capabilities of • individuals, but also action directed towards • changing social, environment and economic • conditions so as to alleviate their impact on • public and individual health Health Promotion in Medical Curriculum, PSU

  14. Health Promotion • Health is, therefore, seen as a resource of everyday life, not objective of living • “…the health of populations will not be improved without the participation of all groups with an interest in and an influence on health care..” Health Promotion in Medical Curriculum, PSU

  15. Three Basic Strategies forHealth Promotion • Advocacy Political, economic, social, cultural, environment, behavioural and biological factors can all favour health or be harmful to it. • Enabling To support people in communities to achieve their full health potential and to reduce health inequalities • Mediating To coordinate and collaborate all groups concerned

  16. Five Priority Actions for Health Promotion (The Ottawa Charter, 1986) • Building a healthy public policy • Creating supportive environments • Developing personal skills • Strengthening community action • Reorienting health service • (from tertiary to primary) Health Promotion in Medical Curriculum, PSU

  17. Five Priority Actions for 21st Century Health Promotion (Jakarta Declaration, 1997) • Promote social responsibility for health • Increase investments for health development • Expand partnerships for health promotion • Increase community capacity and empower • the individual • Secure an infrastructure for health promotion Health Promotion in Medical Curriculum, PSU

  18. Key Issues in Health Promotion • Equity • Being fair and just, not equality • Effectiveness and evidence-based practice • Collaborative working Health Promotion in Medical Curriculum, PSU

  19. Effectiveness and Evidence-based Practice • Medical model • RCT, challenged extensively in the literature • Educational model • Ensure clients and patients have access to information • Behavioural model • Promote behavioral changes linked to health lifestyles • Social model • Modify people’s environment • Empowerment model • Empowerment of individuals and communities Health Promotion in Medical Curriculum, PSU

  20. Collaborative Working • Identify the need for shared objectives • Innovative work • Commitment of time • Resources and energy • Regular review procedures • Importance of key players • Impact of different professional and • organization culture • Impact of funding issues Health Promotion in Medical Curriculum, PSU

  21. Beattie’s Model of Health Promotion Mode of Intervention Authoritative Focus of Intervention Individual Collective Negotiated Health Promotion in Medical Curriculum, PSU

  22. Focuses/Levels of Health Promotion • An individual • Organization level Healthy cities, villages, islands Healthy promoting schools, hospitals, market places Healthy workplaces • Community level

  23. Medical School and HP Health Promotion in Medical Curriculum, PSU

  24. Medical Schools and HP • Health Promoting Hospital • Health Promotion in Higher Education • Health Promotion in Medical Curriculum • Medical Schools and Communities

  25. Medical Schools and HP • Health Promoting Hospital • Health Promotion in Higher Education • Health Promotion in Medical Curriculum • Medical Schools and Communities

  26. Health Promotion in Hospitals • Management Policy • Patient Assessment • Patient Information and Intervention • Promoting a Healthy Workplace • Continuity and Cooperation

  27. Medical Schools and HP • Health Promoting Hospital • Health Promotion in Higher Education • Health Promotion in Medical Curriculum • Medical Schools and Communities

  28. Health Promotion in Higher Education (ACHA) • Integration with the learning mission of higher education • Collaborative practice • Cultural competence • Theory-based practice • Evidence-based practice • Continuing professional development and service

  29. Medical Schools and HP • Health Promoting Hospital • Health Promotion in Higher Education • Health Promotion in Medical Curriculum • Medical Schools and Communities

  30. Planning a Curriculum • Identifying the need • Establishing the learning outcomes • Analysing possible constraints • (SWOT analysis) • Agreeing the content • Organising the content including the • sequence • Deciding the educational strategy Health Promotion in Medical Curriculum, PSU

  31. Planning a Curriculum • Deciding the teaching methods • Preparing the assessment • Communication about thecurriculum • Promoting an appropriate educational • environment • Managing the curriculum Health Promotion in Medical Curriculum, PSU

  32. What to Teach • Cognitive (Knowledge) • Skills • Affective Health Promotion in Medical Curriculum, PSU

  33. Application of HP Components in Teaching • Building a healthy public policy • Creating supportive environments • Building environment in favor of staff and • patient’s health • Developing personal skills • Learning and skills development in • communicating with patients and relatives Health Promotion in Medical Curriculum, PSU

  34. Application of HP Components in Teaching • Strengthening community action • Empower community of decide, of their • own, the right choices of their health • Reorienting health service • (from tertiary to primary) • Holistic approach for promotive, • preventive and curative Health Promotion in Medical Curriculum, PSU

  35. Examples of Core Content • Health behavior model • Determinants of health • Concept of healthy lifestyle and health • promotion • Social aspect of health and diseases • Health promotion model and level : • Individual, group/organization, community • Self-development and technique • Communication skills : counseling, group • dynamics, social marketing Health Promotion in Medical Curriculum, PSU

  36. Examples of Core Content • Health promotion : Individual level – life • cycle approach • Healthy eating • Oral health • Substance use – drug abuse, alcohol, • tobacco • Physical activity and exercise • Stress reduction • Healthy sex • Healthy elderly Health Promotion in Medical Curriculum, PSU

  37. Examples of Core Content • Health promotion : Organization level • Healthy workplace • Healthy city • Health promoting hospital • Health promotion : Community level • Health reform • People empowerment • Social movement • Civil society • Alternative medicine • Health promotion : Community level • Health reform • People empowerment • Social movement • Civil society • Alternative medicine Health Promotion in Medical Curriculum, PSU

  38. HP in Preclinical teaching • Topics related to health Anatomy Musculoskeleton – Working posture Osteoarthritis Accidents - fracture Cardiovascular – Coronary heart disease Respiratory – Occupation lung disease Smoking, COPD Health Promotion in Medical Curriculum, PSU

  39. HP in Preclinical teaching • Topics related to health Physiology Blood pressure – Hypertension Exercise Menopause, Aging process Biochemistry Carbohydrate metabolism – DM Lipid metabolism – Dyslipidemia Calcium metabolism – Osteoporosis Nutrition - Obesity Health Promotion in Medical Curriculum, PSU

  40. HP in Preclinical teaching • Topics related to health Genetics Prenatal diagnosis Genetic counseling GMO Microbiology AIDS Hygienic control Infection control Biological terrorism Parasitic infection SARS, Avian flu Health Promotion in Medical Curriculum, PSU

  41. HP in Preclinical teaching • Topics related to health Pharmacology Rational use of drugs Herbal medicines Pathology Pathogenesis of diseases Miscellaneous Hazardous risk management in Lab Healthy learning Health Promotion in Medical Curriculum, PSU

  42. Skills in Health Promotion • Social skills • Communication skills • Negotiation & empowerment skills • Research skills • Epidemiology skills • Professional (clinical) skills • Counseling skills • Education skills • ………………… Health Promotion in Medical Curriculum, PSU

  43. How to Teach • Separate or integrated teaching • Issues of number of hour available, • number of subjects taught • Educational strategies • Create learning environment • Extra(supporting)-curricular activities • How to integrate with existing • curricula • Start with students’ own lifestyle Health Promotion in Medical Curriculum, PSU

  44. Content-based Education Health Promotion in Medical Curriculum, PSU

  45. Outcome-based Education Health Promotion in Medical Curriculum, PSU

  46. Putting Health Promotion into the Curriculum • Unfamiliar to medical students, as well as • teachers • A hybrid/integrated discipline • Social sciences • (Sociology, Social policy, psychology) • Medical sciences • (Including Epidemiology, Biostatistic) • Not only function of Community Medicine • Inadequate body of knowledge/experiences Health Promotion in Medical Curriculum, PSU

  47. Putting Health Promotion into the Curriculum • Specialist (expert) can teach HP • Incorporate health-promotion principles • in learning approaches • Use practical vignettes enables students • to identify key characteristics of health • promotion • Practical and concrete illustrations of the • potential of health promotion Health Promotion in Medical Curriculum, PSU

  48. Putting Health Promotion into the Curriculum • Promote students’ health Starts with their own needs Encourages collaborative working Develops their personal skills Provide safe and secure environment in which to practise new skills and approaches Health Promotion in Medical Curriculum, PSU

  49. Improving HP Teaching • Role of institution • Creating HP environment • Staff development/Role model • Multidisciplinary and multiprofessional • approach • Concrete real-life experiences • Integrating HP into various clinical • specialties • Research for body of knowledge Health Promotion in Medical Curriculum, PSU

  50. Health Promotion in Medical Curriculum, PSU

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