Question

This week, we are learning about the various roles that health professionals play in disease prevention and health promotion. Select a topic from below and post your discussion.

Discuss the roles that education plays in the development of medicine. Select a medical specialty (e.g. infectious disease), and provide an example of the impact of that medical specialty has in the advancement of public health and improving health outcomes.

Discuss the continuum of public health education and identify educational pathways for becoming a public health professional; provide an example (e.g. epidemiologist).

Discuss the educational options in nursing and provide two examples.

Discuss how overall changes in health professional education impacts public health and improving health outcomes.

Discuss the components of prevention and public health that are recommended for inclusion in clinical education. Provide two examples.

Discuss the concept and goals of primary care and differentiate it from secondary and tertiary care. Provide examples of primary, secondary care, and tertiary care delivery systems.

Discuss the range of mechanisms used to compensate clinical health professionals and explain their advantages and disadvantages. Provide two examples

Your post must be at minimum two paragraphs (five sentences per paragraph) in APA format (in text citations, references and bibliography).

Public health.

Answer 1

The improvement and maintenance of health requires actions directed to the different aspects and complexities of life, a fact requiring the feasibility of educational approaches that promote health, both individually and collectively.

Thus, health promotion involves several human approaches that take organic aspects into consideration, but efforts are being made to overcome this context, with housing, psychological, environmental, social, cultural, and other aspects being introduced in relation to health. This is why it becomes important to understand the difficulties of health professionals in the everyday practice of health education. In turn, this requires appropriate training as well as the articulation between theory and practice

Health education is defined as the shift of a predominantly biological and curative focus to one of prevention and promotion of health, encompassing the various contexts (social, cultural, environmental, etc.) in which humans function and making it worthwhile to listen and to accept the reality of learners, thus predominating a health practice dimension that is subjective, humanized, and focused on the citizen. The Ministry of Health (MOH) has highlighted the unpreparedness of health professionals in dealing with such dimension^(5-8).

This new paradigm converges with the works of Paulo Freire, which can contribute significantly to the education for health by increasing the possibilities of pedagogical conceptions and practices⁽⁹⁾. A review study of the publications of the MOH from 1980 to 1992 found that the central idea of the educational process in educational programs for health was based on Freire. Since the 1970s, these programs have been strongly influenced by Freire's thoughts and theory of libertarian education. Such programs evidence the change of the official discourse on health education, which changed from a traditional approach of imposing models to a more critical approach focused on community participation.

In 2009, the MOH created the National Policy for Continuing Education in Health to consolidate an integrated strategy for educational action in this area. The document criticizes the traditional model of education, in an attempt to break with the methodological process that reduces education to techniques that are disjointed from each other. It emphasizes the need for coordinated action to address comprehensive and complex problems, with a commitment to conduct learning in organizational and social contexts.

Continuing education for health must be integrated into the social, health, and service contexts, starting from the problems of everyday life; it should be reflective, participatory, perennial, and focused on joint construction of problem solving, considering that problems do not arise without the individuals who create them. It combines various moments and specific arrangements, aiming at a global project that organizes the development of institutional change of teams and social subjects and at the transformation of collective practices in pursuit of self-reflection and action research

This new paradigm converges with the works of Paulo Freire, which can contribute significantly to the education for health by increasing the possibilities of pedagogical conceptions and practices⁽⁹⁾. A review study of the publications of the MOH from 1980 to 1992 found that the central idea of the educational process in educational programs for health was based on Freire. Since the 1970s, these programs have been strongly influenced by Freire's thoughts and theory of libertarian education. Such programs evidence the change of the official discourse on health education, which changed from a traditional approach of imposing models to a more critical approach focused on community participation^(9-10).

In 2009, the MOH created the National Policy for Continuing Education in Health to consolidate an integrated strategy for educational action in this area. The document criticizes the traditional model of education, in an attempt to break with the methodological process that reduces education to techniques that are disjointed from each other. It emphasizes the need for coordinated action to address comprehensive and complex problems, with a commitment to conduct learning in organizational and social contexts.

Continuing education for health must be integrated into the social, health, and service contexts, starting from the problems of everyday life; it should be reflective, participatory, perennial, and focused on joint construction of problem solving, considering that problems do not arise without the individuals who create them. It combines various moments and specific arrangements, aiming at a global project that organizes the development of institutional change of teams and social subjects and at the transformation of collective practices in pursuit of self-reflection and action research⁽¹¹⁾.

Methods:

This is a qualitative, descriptive, and exploratory study that uses the methodology of action research. It is part of a larger study that investigates the thoughts of nurses concerning health education among other issues, in order to encourage the construction of new paradigms related to the topics studied.

This study is oriented to answer the following question: What does health education mean to you?

To answer this question, it was considered that the action research would be the most appropriate investigative process, a methodology in which researchers coordinate with the participants to jointly construct perspectives on the theme. The horizontal nature of the methodological construction considers that the production of science cannot be vertical, but can be developed in conjunction with the participating social subjects, considering equally all the knowledge involved and enabling the understanding of social reality and the identification of their problems, even though the proposed educational activity is triggered by the researcher and jointly developed by all participants⁽¹⁵⁾.

In this study, it is understood that health research is intrinsically a complex reality that involves biological, physical, psychological, social, and environmental aspects, and that the health-disease binomial is related to historical, cultural, political, and ideological burdens and cannot be reduced to numerical formulas or statistical data^(13-15).

Action research, in turn, began with Lewin and Corey, North American authors of the 1960s who sought to approximate the dynamics of social practice with a theory of society. This line of thought proposed the accurate observation of the processes of social change, triggering reflection and the production of research aimed at social action and not just the production of books^(16-18).

Between 1960 and 1970, another aspect to which this research is linked originated from the thoughts of Paulo Freire, educator and theorist, whose works had a strong, emancipatory, political nature and a liberating pedagogical proposal that sought the political transformation of the participants, involving them in the process of knowledge construction.

The present study was conducted based on the theoretical-methodological references of Freire, adapted by Bueno⁽¹⁵⁾, and bounded by two phases: the first was a survey of socio-demographic data and the thematic universe from which generating themes were identified; the second was the execution of educational activities.

The techniques used for data collection were: 1) participant observation, with the field diary as an instrument for recording the data observed by the researcher, and 2) individual interviews, using as an instrument a questionnaire that contained questions about the data identification of participants and guiding questions about the theme in focus and was to be filled out by the participants.

The application of the described techniques allowed the immersion of the researcher in the complexity of the actual context, i.e., in the nurses' workplace, as well as the reconnaissance of their knowledge achieved academically, and their views, values, and beliefs derived from the daily practice on education for health. By merging these overlapping spheres in a continuum of reality, the problematizing view on which this research is founded has been supported.

The proposal of the study was to address only the nurses allocated to the public health service of a city in the countryside of São Paulo, with the criteria that the public sector contributes daily to the consolidation of the Unified Health System (SUS). The city chosen is located 450 kilometers from the city of São Paulo-SP and has approximately 40,000 inhabitants; its economy is based on agribusiness (the sugar and alcohol sector).

Since May 2006, the city has been entitled to full management control of Municipal Health. The municipal public health service has nine family health units, a basic health unit, a medical specialties outpatient unit, one emergency department (PA), and a Center for Psychosocial Care (CAPS). It also has a philanthropic hospital and a mental health outpatient unit (in which there are no nurses), the latter two not being part of the study.

All nurses allocated to the public health service of the city were invited to participate in the study, and all participants were considered to be representatives, in terms of this study. Inclusion criteria were: a) that the participants be part of public health services in order to assess the problems of this sector, b) that they give their consent for participant observation, and c) that they submit the questionnaire by the agreed deadline.

Thus, 12 nurses took part in the study; one nurse from a basic care unit refused to participate, one PA nurse was ill at the time of the study and could not participate, and the CAPS nurse did not meet the predetermined criteria. The research sites were all of the family health units, the outpatient medical specialties, the basic health unit, and the PA. Participants in this study were identified by the letter P followed by a number from 1 to 12 to preserve confidentiality and anonymity.

This study met the scientific rigor and ethical precepts required by the National Research Ethics Committee and was approved by the Research Ethics Committee of the Ribeirão Preto Nursing School, University of São Paulo (ethical process approval No.1077/2009). Upon agreeing to participate in the study, the nurses signed a Free and Informed Consent Form. Data collection occurred in the second half of 2009.

It is worth mentioning that at that time, the change (exchange) of municipal managers occurred.

Finally, the second phase (educational activity) was planned and executed from the listed generator categories/themes.

Category 1: Provision of information

... providing information to the public... P1.

(...) informing the public... P2.

It is the teaching of educational measures... P3.

... enhancing the professional as well as directing the result to the customers... P4.

... transmitting knowledge to other team members and customers of the health unit P5.

... keeping up to date on issues related to the area... P9.

Category 2: Disease prevention and health promotion

... providing information to the people who lead to the promotion of health and disease prevention in the community P1.

... adopting and maintaining healthy living standards P2.

... teaching educational measures for the maintenance of health P3.

... aiming to use the technical-scientific knowledge for preventive action, not only focused on disease but on the health of the individual P6.

... keeping up to date on issues related to the field, exchanging information and ideas with other professionals P9.

Category 3: Proper use and structuring of health services

Informing the public to correctly use the health services that are at their disposal P2.

They are means to structure and implement a health system P10.

Category 4: Health Autonomy

Developing in people a sense of responsibility for their own health... P2.

Category 5: Improved quality of life

... the foundation for the individual and his environment being able to live in harmony, consequently resulting in a better quality of life P7.

... is essential because it helps increase the quality of life of the population P11.

Category 6: Humanization and citizenship

Humanization; rights of all citizens P8

Primary Prevention: Could this event or condition have been prevented Through health promotion strategies (e.g., lifestyle changes) Through specific protections (e.g., vaccines, safety precautions)

Secondary Prevention: Can this event be prevented from happening again Can this condition be prevented from worsening Through screening for and monitoring related risk factors .Through early intervention and treatment of related risk factors

Tertiary Prevention: How can health and function be restored or maximized