Health & Wellness

● Ottawa Charter [Grabowski et al, 2017)

"Health is created and lived by people within the settings of their everyday life; where they learn, work, play and love"

Healthy Lifestyle:

"The ways to being healthy include healthy eating, physical activities, weight management, and stress management."

Well-being:

"the state of being comfortable, healthy, or happy." ~subjective feeling

•Intellectual wellness

- communicate effectively - see more than one side of an issue - keep abreast with global issues - exhibit good time management skills

•Spiritual wellness

- examine personal values & beliefs - search for the meaning/purpose of life - understands what is right or wrong - appreciate natural forces in the universe

•Physical wellness

- exercise regularly & eat a balanced-diet - safe, responsible sexual bahavior - make informed choices about medicinal & medical care - maintain a positive, health-promoting lifestyle

•Emotional wellness

- sense of humor - express her/his feelings - strive to meet emotional needs - take responsibility for his/her behavior

•Occupational wellness

-Feel a sense of accomplishment in his/her work -Work-life balance -Creative & innovative -Seek challenge at work

●Environmental wellness

-an awareness of the unstable state of the earth -the effects of your daily habits on the environment -a way of life that maximizes harmony with the earth and minimizes harm to the environment. -being involved in socially responsible activities to protect the environment.

•Social wellness

-positive relationships with loved ones - relationships with friends - enjoy being with others - effectively communicate with others who are different

Health Challenges next decade (WHO)

1. Climate 2. Health care delivery in areas of conflict and crisis 3. Health care equity 4. Access to treatments 5. Infectious disease prevention 6. Epidemic preparedness 7. Unsafe products 8. Underinvestment in health workers 9. Adolescent safety 10. Improving public trust of healthcare workers

Activities that can be done by PT's for Health & Wellness

1. Screening 2. Education 3. Intervention 4. Consultation 5. Critical Inquiry 6. Administration

Key components of Cultural Competency:

1.Awareness 2.Attitude 3.Knowledge 4.Skill

"CULTURAL COMPETENCE CONTINUUM" (levels)

1.Cultural destructiveness 2.Cultural incapacity 3.Cultural blindness 4.Cultural pre-competence 5.Cultural Competence - enough level for PTs 6.Cultural Proficiency

multicultural competence

A set of congruent behaviors, attitudes and policies that come together as a system to work effectively in cross-cultural situations.

PHA Triple Burden of Disease

A. Communicable B. Non-communicable C. Disease of Rapid Urbanization

PHA Guarantee 1

All Life Stages & Triple Burden of Disease - Services for Both the Well & the Sick Pregnant - Newborn - Infant - Child - Adolescent - Adults - Elderly

body language

An often overlooked aspect of communication is

Non-communicable diseases & Malnutrition

CA, diabetes, Heart disease, Risk factors - obesity, smoking, diet, sedentary lifestyle, malnutrition

Wellness is outcome-oriented

Do not become trapped by focusing on problems. As soon as you identify a problem, put your energy into the solutions.

Wellness is an active process

Do not wait for good health to happen or be dependent on someone else to fix your problems. You must be actively involved in your health in order to achieve wellness.

Cultural Proficiency

Employ staff, consultants, and consumers with expertise in cultural and linguistic competence in health, education, and research. Support and mentor other organizations as they progress along the cultural competence continuum. Advocate with, and on behalf of, populations who are traditionally unserved and underserved.

PRINCIPLES OF HEALTH PROMOTION

Empowerment Participative Holistic Equitable Intersectoral Sustainable Multi Strategy

a firm comprehension of why people make important choices for their health.

Every professional in a medically related field must have

PHA Guarantee 3

Financial Freedom when Accessing Services; ●Services are financed predominantly by PhilHealth ●PHILHEALTH AS MAIN REVENUE SOURCE FOR PUBLIC HEALTH CARE PROVIDERS SIMPLIFY PHILHEALTH RULES PHILHEALTH AS THE GATEWAY TO FREE AFFORDABLE CARE ●100% of Filipinos are members of Philhealth

Communicable Diseases

HIV/AIDS, TB, Malaria, Dengue, Lepto, Ebola, Zika

Health-disease/wellness-illness continuum.

Health ------------ Disease Wellness --------------- Illness search on this~ u can be healthy but feel ill healthy means no wrong physically - mentally and emotionally poor! u can have a disease but well ka cancer pt pero ok ra and happy ra

person's perception:

Health depends very much on •"people with disease may live joyful, positive, healthy lives - people without a disease may be despondent, unhappy, feel sick".

The self is the only true healer

Health professionals can only help facilitate the healing process. It is your body, mind, and spirit that do all the healing.

Health Promotion Glossary, 1998

Health promotion is the process of enabling people to increase control over, and to improve their health."

Screening

Identify individuals or groups who would benefit from education, intervention, or referral to an appropriate health-care provider.

Prevention eliminates the need for treatment

It takes very little time, money, and energy to prevent problems. Truly, an ounce of prevention is worth a pound of cure.

Critical Inquiry:

Obtaining, synthesizing, and utilizing current research, interpreting data, and/or participating in research.

Philippine Health Agenda

PHA

grasp the impact of family and socioeconomic status on decision-making

Physical therapists must have a solid understanding of cultural competence to

Administration

Planning, developing, and managing all aspects of a prevention or wellness project including budget, human resources, and space

Primary prevention:

Preventing a target problem or condition in an individual or in a community at risk; for example, developing fitness programs for children to prevent obesity.

Three levels of prevention (WHO):

Primary prevention Secondary prevention Tertiary prevention

Education

Provide information on prevention, health, wellness, and fitness topics.

Intervention:

Provide interventions as identified from screening sessions.

Consultation

Providing expertise and knowledge

Wellness is holistic

Rather than focusing on symptoms, it is important to integrate body, mind, and spirit as one whole person.

PH Guarantee 2

Service Delivery Network ●Functional Network of Health Facilities; Complete Equipment, Medicines, Health Professional. ●AVAILABLE 24/7 & EVEN DURING DISASTERS

Steps to Develop and Implement Prevention, Health, Wellness, and Fitness Programs (Kisner & Colby)

Step 1: identify a need Step 2: goals & obj Step 3: develop the intervention Step 4: implement the intervention Step 5: Evaluate the Results

Principles of Wellness (Hooper Institute)

Wellness is holistic The self is the only true healer Wellness is your responsibility Positivity is empowerment Wellness is an active process Wellness is outcome-oriented. Prevention eliminates the need for treatment.

Health

a state of complete physical, mental, and social well-being and not merely the absence of disease. (WHO, 1947)

Empowerment

a way of working to enable people to gain greater control over decisions and actions affecting their health

Wellness

an approach to personal health that emphasizes individual responsibility for well-being through the practice of health promoting lifestyle behaviors. (Hurly & Schlaadt, 1992) ~also includes habit, not just exercises -individual responsibility, us PTs only guide/help (Facilitators)

A poor diagnosis due to lack of cultural understanding

can have fatal consequences, especially in medical service delivery.

Secondary prevention

deals with early detection; this improves the chances for positive health outcomes. ~eg htn pero ayaw mo ma progress sa stroke activity e.g. preventing effects of HTN through regular bp screening

Equitable

ensuring fairness of outcomes for service users.

Sustainable

ensuring that the outcomes of health promotion activities are sustainable in the long term.

150 mins per week

exercise recommended by WHO 30 mins per day moderate to intense =search on this!

Tertiary prevention

focus on improving treatment and recovery. Decreasing the degree of disability and promoting rehabilitation for individuals with chronic or irreversible diseases; for example, developing fitness programs for individuals with spinal cord injury e.g. naa nay stroke to prevent further complications like being bed ridden

Primary prevention

improving the overall health of the population; actions aimed at avoiding the manifestation of a disease.

Diseases of Rapid Urbanization

injuries and their risk: substance abuse, obesity, mental illness, smoking, diet, pandemics, sedentary lifestyle, health consequences of climate change, disaster

Cultural pre-competence

is a level of awareness within systems or organizations of their strengths and areas for growth to respond effectively to culturally and linguistically diverse populations. Characteristics: the organization expressly values the delivery of high quality services and supports to culturally and linguistically diverse populations; hiring practices that support a diverse workforce.

Cultural blindness

is an expressed philosophy of viewing and treating all people as the same . Characteristics may include: approaches in the delivery of services and supports that ignore cultural strengths; little value placed on training and resource development that facilitate cultural and linguistic competence; workforce and contract personnel that lack diversity (race, ethnicity. language, gender, age etc.)

Cultural destructiveness

is characterized by attitudes, policies, structures, and practices within a system or organization that are destructive to a cultural group.

Cultural incapacity

is the lack of capacity of systems and organizations to respond effectively to the needs, interests and preferences of culturally and linguistically diverse groups. for some cultural, ethnic, or racial groups

Health promotion

is the process of enabling people to increase control over, and to improve their health." (Health Promotion Glossary, 1988)

Logistics

location, time, length of program, no. of participants, identify who will do the program (self or with assistance), develop the presentation program, include handouts for the participants, develop a budget, determine costs and charge to participants

Cultural Competence

mission statement for your organization that articulates principles, rationale, and values for cultural and linguistic competence; Implement specific policies and procedures that integrate cultural and linguistic competence; Implement policies and procedures to recruit, hire, and maintain a diverse and culturally and linguistically competent workforce.

Mortality:

number of deaths per unit of population in a specific region, age range, or other group.

Disease Prevention

population-based and individual-based interventions for primary and secondary (early detection) prevention, aiming to minimize the burden of diseases and associated risk factors.

Morbidity:

ratio of persons who are diseased to those who are well in a given community.

Incidence :

refers to the occurrence of new cases of disease or injury in a population over a specified period of time. (CDC)

Prevalence

refers to the total number of cases of disease existing in a population

Culture

represents "the values, norms, and traditions that affect how individuals of a particular group perceive, think, interact, behave, and make judgments about their world

Step 3: Develop the Intervention

screenings, education, exercise, logistics

Holistic

taking account of the separate influences on health and the interaction of these dimensions.

Competency

the ability to do something successfully or efficiently; a set of demonstrable characteristics and skills that enable, and improve the efficiency.

Participative

where people take an active part in decision making

Intersectoral

working in partnership with other relevant agencies/organisations.

Multi Strategy

working on a number of strategy areas such as programmes, policy.

The ABC's of Health Promotion

• A—Assess your patient for their needs regarding helpful behavior changes. • B—Extol the Benefits of the behavior change rather than the negatives of continued current behaviors. • C—Use Clinical preventive care or check-up visits as the jumping-off point toward making this a part of your routine. • S—Provide Stay-the-Course Messages when patients seem to be having a tough go at behavior changes. This will encourage them to keep trying at a time when the doctor may be their only ally.

Whole Person Wellness

•Emotional wellness •Intellectual wellness •Spiritual wellness •Occupational wellness •Social wellness •Physical wellness ●Environmental wellness

Philosophy of Holistic Health

•The unity of mind, spirit & body. •Symptoms of disease viewed as an imbalance in a person's state of being. •Example: Headache - caused by emotional stress - tightening of the muscles in the head & neck - increase blood pressure - headache

Awareness

●Being aware of your own individual biases and reactions to people who are of a culture or background significantly different from your own. ●By being aware of your own internal biases you can begin to work towards other aspects of Cultural Competency.

Dimensions of Wellness

●Dynamic, ever-changing, ●It is a lifestyle ●a personalized approach to living life in a way that allows you to become the best kind of person

All for Health towards Health for all - by PHA

●Filipinos, especially the poor, marginalized, and vulnerable are protected from high cost of health care. ●Filipinos attain the best possible health outcomes with no disparity. ●Filipinos feel respected, valued, and empowered in all of their interaction with the health system. UES

Skill

●Practices of cultural competency and repeating them until they become integrated into one's daily behaviors. ●The most important aspect of the skills component is having an excellent grasp on effective and respectful communication. An often overlooked aspect of communication is body language and extreme variation in the meaning of gestures between one culture and another.

PT's Role in Health & Wellness

●Promoting fitness and wellness. ●Encouraging active living, providing early diagnosis of disease and prescribing targeted activity interventions (NCBI)

Attitude

●To delineate the difference between just being aware of cultural differences and actively analyzing your own internal belief systems and developing awareness.

Knowledge

●We are often ignorant as to the degree of difference between our beliefs and our actions. ●Understanding this disconnect is why knowledge is considered a key aspect of developing one's own cultural competence.

Physical Therapists

●have the knowledge, skills, and abilities to guide people toward optimal health and well-being ●by supporting and facilitating behavior change for enhanced quality of life.

Cultural competence

●is the ability to understand how behaviors and attitudes coincide with cultural issues. ●refers to an ability to interact effectively with people of different cultures. requires that organizations have a defined set of values and principles, and demonstrate behaviors, attitudes, policies, and structures that enable them to work effectively cross-culturally is beneficial because it can prevent non-discriminatory practice based on factors like race, age, ethnicity, religion, and social status. ●This trait is also essential for physical therapists who want to communicate effectively with their clients.

Principles of a Culturally Competent Physical Therapist

●one who understands cross-cultural relations ● must possess the ability to listen in order to foster successful communication. ●Mutual respect and understanding must exist between a patient and a physical therapist. ●Socioeconomic systems also come into play when you address the cost of physical therapy treatments. ●Culturally competent physical therapists understand the differences that exist in the self-care of patients.