NCMA112

  COVERAGE Health Promotion

  1. History of Health Education - Any endeavor directed at enhancing the quality of health and
  2. Learning Theories related to Health Care wellbeing of individuals, families, groups, community,
  3. Principles of Teaching and Learning in HE through strategies involving supportive environments,
  4. Health Education Process coordination of resources and respect for personal choice
  5. Designing HE of Age specific group and values.
- Introduced in 1974 by Canadian Health Minister La Londe
HISTORY OF HEALTH EDUCATION (Macdonald & Bunton, 1992) and was not popular until the
Health 1980’s when the World Health Organization (WHO) began
- Condition of being sound in body, mind or spirit; a campaign for global public health.
freedom from physical disease or pain. Factors in the Ecosystem which Affect the Optimum level of
- It refers to the ability of a person to function effectively, Functioning (OLOF)
physically, socially, psychologically and spiritually. Political Factors
- The WHO (1946) good health is a state of complete - Power and authority to regulate the environment or social
physical, social and mental well-being and not merely climate.
the absence of disease or infirmity. - Ex: safety, oppression, people empowerment.
- A resource for everyday life, not the object of living and Behavioral Factors
is appositive concept emphasizing social and personal - A person’s level of functioning and is affected by certain
resource as well as physical capabilities. habits, their lifestyle, health care and child rearing practices
Health Education which are determined by one’s culture and ethnic heritage.
- A tool or mechanism for health-related learning - Ex: culture, habits and ethnic customs.
resulting in increase in knowledge, skill development Hereditary
and change in behavior. - Understanding of genetically influenced diseases and
- Directed toward changing behavior toward preset goal. genetic risks.
Dimension of Health Health Care Delivery System
1. Broader - Focus of healthcare is in the promotive, preventive, curative
- In the outer circle which are environmental and societal and rehabilitative aspects of care.
dimensions - Primary health is a partnership approach to the effective
2. Individual provision of essential health services that are community
- In the inner circle which are: based, accessible, acceptable sustainable and affordable.
a) Physical health – the state of one’s body like its fitness and Environmental influences
not being ill. - Menace of pollution, communicable disease due to poor
b) Mental health – positive sense of purpose and underlying sanitation, poor garbage collection, smoking, utilization of
brief in one’s own worth (self-esteem) like feeling good and pesticides, lack or absence of proper and adequate waste and
feeling able to cope. sewerage disposal system and management, noise,
c) Emotional health – ability to express one’s feelings radiation, air and water pollution are just some of the factors
appropriately and to develop and sustain relationship. Ex: is or situations which exert negative effects on the
the feeling of being loved. environment
d) Social health – involves the support system that is available Socio-economic influences
from family members and friends. - families in lower income group are the ones mostly served.
e) Spiritual health – recognition of a supreme being or force
and the ability to put into practice one’s moral principles or Ancient Times
beliefs. Babylonia (Iraq)
f) Sexual health – acceptance of the ability to achieve a Code of Hammurabi
satisfactory expression of one’s sexuality. - It is established standards and practices of living for
g) Societal health – the link between and the health and the Babylonians.
way a society is structured. This includes the basic - It was based on promoting fairness and equality.
infrastructure necessary for health and the degree of - With an “eye for an eye” premise, some of the regulation
integration or division within the society. seem drastic compared to a present-day standard.
h) Environmental health – the physical environment where Greece
people live, it involves housing, transport, sanitation, - Early Greeks are known for their practice of worshipping
pollution and pure water facilities. gods and goddesses.

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-Apollo was known as the god of health while his son China
Asclepius was the god of healing. - the greatest advocates for health promotion of all ancient
- Hygeia daughter of Asclepius, was the goddess of health cultures.
and another daughter Panacea, was the restorer of health. - They viewed a healthy lifestyle as one that stayed in
- Greeks focus on health with an emphasis on personal harmony with the universe by maintaining a perfect balance
health, hygiene, exercise, and healthy diet. between the dualistic forces of yin and yang (Bright, 2002),
Hippocrates - Yin was viewed as the female element associated with
- the Father of Medicine negative energy, passiveness, destruction, the moon,
- he believed health to be dependent upon equilibrium darkness and death.
among the mind, body and environment rather than the - Yang was viewed as the male element associated with
whims of the Gods. positive energy, action, generativity, the sun, light, and the
- This belief known as the holistic approach in health care creativity of life.
practice today. - Maintenance of this balance resulted in perfect health of the
mind, body and spirit.
Egypt
Health Promotion
- around 3000 B.C. contributed significantly to health through
Middle Ages
progress made in disease prevention.
- After the fall of Rome, during the period known as the Dark
- Egyptians are known for their efforts in developing hygiene
Ages, health and medicines of ancient worlds was lost,
and water sanitation.
(Cockerham, 1978).
- Developed sophisticated system to support pure water and
- The Roman Catholic Church claimed authority for the
dispose wastes
welfare of society, and purity of the soul became the highest
- They developed stringent regulation related to cleanliness,
of priorities.
food, drink exercise and sexual relation (Ellis & Hartley,
- Caring for the body such as daily bathing and exercise, was
2004)
viewed as a sinful indulgence resulting in neglect of the soul.
Palestine - Illness and death were associated with famine and infectious
- Their greatest contribution was the creation of the Mosaic disease epidemics.
Code, about 1500 B.C, reflected in the Old Testament. - After the Dark Ages, shifted into the Middle Ages, very little
- Under the leadership of Moses, Mosaic Code- differentiated was accomplished to promote health or to treat illnesses.
clean from unclean and emphasized the segregation of those - Although the emphasis on health by early Christians was on
with communicable disease. treating the disease and illness, they did much to increase
- The principle of quarantine was to be of great importance in the public’s awareness of health.
later history. - This was mainly accomplished with the development of the
concept of quarantine in response to repeated epidemics
Rome during the latter part of the Middle Ages.
- they lacked originality for health promotion and disease Renaissance (1500 – 1700)
prevention practices. - The European Renaissance brought about the return to
- Medical practices of the Romans were obtained from their scientific thought with attempts to understand and control
conquered regions and physicians from these countries life.
became slaves to the Roman Empire - This changed the holistic view of health and illness held by
- Roman accomplishments were mostly directed at public followers of Hippocrates to a disintegrated view
health with the establishment of regulations for sanitation, maintaining that the body was separated from the mind.
street cleaning, building construction, ventilation, and - During this time, the responsibility of society for public
heating among others (Clark, 2003) health and welfare was at least recognized.
- Health promotion practices of ancient Romans, which - There is improvement of medical technology.
included exercise, massage and other therapeutic baths. - Colonies in America were being established, the colonies
- The Greek physician Hippocrates and the Roman physician were sparsely populated and remained isolated for many
Galen both viewed health as an interaction between a person years.
and his/her environment. - Early colonial health was good compared to that of the
- Galen created definition of health that emphasized the crowded Europeans and the problems with communicable
ability of an individual to carry out the functions of daily life disease were minimal (Clarks, 2003).
without hindrance or pain (Moore& Williamson 1984)

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Period of Intuitive Nursing:  Nursing care was performed without any formal education
Contributions of Ancient Civilizations to Medicine and Nursing & by the people who were directed by more experienced
1. Rome nurses.
- The first organized visiting of the sick began with the  Religious orders of the Christian Church were responsible
establishment of the order of the deaconesses. for the development of this kind of nursing
- They endeavored to practice the corporal works of The Crusades
mercy: - were the holy wars waged in an attempt to recapture the
 Feed the hungry Holy Land from the Turks who denied pilgrims
 Give water to the thirsty permission to visit the Holy Sepulcher.
 Clothed the naked - Military religious orders established hospitals that were
 Visit the imprisoned staffed with men.
 Shelter the homeless Military Religious Orders
 Care for the sick  Knights of St. John of Jerusalem (Italian).
 Bury the dead - Devoted to religious life and nursing
2. Greece  Military Religious Orders (German)
- Nursing was the task of untrained slaves - Established tent hospitals for wounded.
- introduced the caduceus, the insignia of the medical  Knights of St. Lazarus (German)
profession today. - Was founded primarily for the nursing care of
- Hippocrates came to be known as the “Father of lepers in Jerusalem after Christians had
Scientific Medicine.” conquered the city.
 He made a major advance in medicine by The Alexian Brothers
rejecting the belief that diseases had - Were members of a monastic order founded in 1348.
supernatural causes. - They established the Alexian Brothers Hospital School
 He developed assessment standards for of Nursing, the largest school of nursing under a
clients, established overall medical standards, religious order.
recognized the need for nurses. - It operated exclusively for men.
3. China - In the United States, the school closed in 1969.
- Used massage therapy, hydrotherapy, and exercise as Early America
preventive health measures - The Industrial Revolution in the United States marked the
- They also used many herbs, minerals & acupuncture to transition of the country’s economic foundation from
heal the sick. agriculture to industry.
4. Africa - Shifting the population from rural to urban settings and
- The nurturing functions of the nurse included roles as resulting in inadequate living and working conditions.
midwife, herbalist, wet nurse, and carer for children and - General public health declined and death from preventable
the elderly. disease increased, esp. among children.
5. India Nursing in Americ:
- Early hospital was staffed by male nurses who were a) Nursing During the Civil War
required to meet four qualifications: - The American Medical association during the
1) Knowledge of the manner in which drugs Civil War created the committee on Training of
should be prepared for administration Nurses.
2) Cleverness - It was designed to study & make
3) Devotedness to the patient recommendations with regard to the training of
4) Purity of the mind and body nurses. Doctors realized the need for qualified
- Indian women served as midwifes and nurse’s ill family nurses.
members b) Important personages the time
 This period extends from the founding of religious nursing - Dorothea Lynde Dix – she was appointed as
orders in the Crusades which began in the 11th century and Superintendent of Female Nurses for the US
ended in 1836, when Pastor Fliedner & his wife established government
the Kaiserwerth Institute for the training of Deaconessess (a - Clara Barton – founded the American Red
training school for nurses) in Germany. Cross
 It is called the period of “on-the-job” training.

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Period of Educated Nursing - states that things freely learned are best learned.
- Began on June 15, 1860 when the Florence Nightingale - Conversely, if the audience is forced to learn something,
School of Nursing opened at St. Thomas Hospital in London the more difficult it is for them to learn.
Behaviorist Learning Theory
- The development of nursing during this period was strongly
- Focusing on what is directly observable
influenced by: - Learning is the product of stimulus condition(S) and
 Trends resulting from wars response(R)
 An arousal of social consciousness - It is useful in nursing practice for the delivery of health care
 The emancipation of women - Respondent conditioning or Classical conditioning (Pavlov)
emphasizes the importance of stimulus conditions and the
 Increased educational opportunities for women
association formed in the learning process.
LEARNING THEORIES RELATED TO HC - Example: Respondent conditioning is used to extinguish
Learning chemotherapy patient’s anticipatory nausea and vomiting
- defined as a relatively permanent change in mental - Systematic desensitization is a technique based on
respondent conditioning that is used by psychologists to
processing, emotional functioning, skill, and/or behavior as
reduce fear and anxiety in their clients
a result of experience.
- The assumption is that fear of a particular stimulus or
- It is the lifelong, dynamic process by which individuals situation is learned
acquire new knowledge or skills and alter their thoughts, - It can also be unlearned or extinguished
feelings, attitudes, and actions - With this approach, fearful individuals are first taught
- enables individuals to adapt to demands and changing relaxation techniques. While they are in a state of relaxation,
circumstances and is crucial in health care. the fear-producing stimulus is gradually introduced at a
 For patients and families to improve their health and nonthreatening level so that anxiety and emotions are not
adjust to their medical conditions aroused.
 For students acquiring the information and skills
necessary to become a nurse
 For staff nurses devising more effective approaches to
educating and treating patients and one another in
partnership
Learning Theory
- a coherent framework of integrated constructs and
principles that describe, explain, or predict how people
learn.
- The construction and testing of learning theories over
the past century contributed much to the understanding
of how individuals acquire knowledge and change their
ways of thinking, feeling, and behaving.
Principles of Learning
Readiness
- implies a degree of willingness and eagerness of an
individual to learn something new.
Exercise
- states that those things that are most often repeated are Classical Conditioning
the ones that are best remembered.  Unconditioned Stimulus is one that unconditionally,
Effect naturally and automatically triggers a response
- that learning is strengthened when accompanied by a  Unconditioned Response is the unlearned response that
pleasant or satisfying feeling — and that learning is occurs naturally in response to the unconditioned stimulus
weakened when associated with an unpleasant feeling.
 Conditioned Stimulus is previously neutral stimulus that,
- The learner will strive to continue learning as long as it
after becoming associated with the unconditioned stimulus,
provides a pleasant effect.
comes to trigger a conditioned response
Primacy
 Conditioned Response is the learned response to the
- the state of being first, often creates a strong impression
previously neutral stimulus
which may be very difficult to change.
Operant Conditioning
Recency
- It was coined by behaviorist B.F. Skinner.
- states that things most recently learned are best
- He believes that internal thought and motivations could not
remembered.
be used to explain.
Intensity
- He suggested at the external observable causes of human
- implies that a learner will learn more from the
behavior.
Freedom
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- Skinner used the term operant to any “Active behavior that • Then reorganizing the information into new insights or
operates upon the environment understanding

Kind of Reinforces - includes several well-known perspectives

Positive Reinforcers a) Gestalt
- favorable events or outcomes that are presented after the b) Information Processing
behavior. c) Human Development
- A response or behavior is strengthened by the addition of  Sensorimotor
something as praise or reward  Preoperational
 Concrete Operations
Negative Reinforcers  Formal Operations
- the removal of unfavorable events or outcomes after the d) Social Constructivism
display of a behavior. The Implications
- A response is strengthened by the removal of something • Nursing and other health professional education programs
considered unpleasant would do well to exhibit and encourage empathy and
Punishment emotional intelligence in working with patients, family, and
- the presentation of an adverse event or outcome that cause a staff and to attend to the dynamics of self-regulation as way
decrease in the behavior. to promote positive personal growth and effective
a) Positive punishment is a punishment by application, leadership.
involve s the presentation of an unfavorable event or • Research indicates that the development of these attributes
outcome in order to weaken the response in self and patients is associated with a greater likelihood of
b) Negative Punishment is punishment by removal, healthy behavior, psychological well-being, optimism, and
occurs when an favorable event or outcome is removed meaningful social interactions
after a behavior occurs. Benefits of Cognitive Theory
 Boosts confidence
 Enhances Comprehension
 Improves problem-solving skills
 Encourage continuous learning
Social Learning Theory
- largely based on the work of Albert Bandura (1977, 2001),
who mapped out a perspective on learning that includes
consideration of the personal characteristics of the learner,
behavior patterns, and the environment.
 Bandura emphasized behaviorist features and the
imitation of role models
Advantages and Disadvantages  The learner has become viewed as central (what
Advantages Bandura calls a “human agency
 This theory is simple and easy to use.
 It encourages clear objective analysis of observable
environment stimulus conditions, learners’ responses and
the effect of reinforcement on people’s action
Disadvantages
 This is teacher centered model in which learners assume are
assumed to be relatively passive and easily manipulated
 It focuses on extrinsic reward and external incentives
reinforces and promotes materialism rather self-initiative.
 Based on animal studies, result not applicable to human
behavior
 Clients changed behavior may deteriorate overtime. Central Concept
 Role modeling
Cognitive Learning Theory  Vicarious reinforcement
- The key to learning and changing is the individual’s Principles of Social Learning Theory
cognition (perception, thought, memory, and ways of Attentional phase
processing and structuring information). - a necessary condition for any learning to occur.
• It is highly active process largely directed by the Retention phase
individual - involves the storage and retrieval of what was observed.
• It involves perceiving the information Reproduction phase
• Interpreting it based on what is already known - during which the learner copies the observed behavior
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Motivational phase  Students must be motivated to learn
- focuses on whether the learner is motivated to perform  Students ate motivated when they attempt tasks that fall in a
a certain type of behavior. range of challenge
Application of Theory  When students have knowledge of their learning progress,
- Social learning theory has been applied extensively to the performance will be superior to what is
understanding of aggression (Bandura, 1973) and  Behaviors that are reinforced (rewarded) are more likely to
psychological disorders, particularly in the context of be learned.
behavior modification (Bandura, 1969).  Directed learning is more effective than undirected learning.
- It is also the theoretical foundation for the technique of  Problem-oriented approaches to teaching improve learning.
behavior modeling which is widely used in training Students learn what they practice.
programs. In recent years, Bandura has focused his work on  Supervised practice that is most effective occurs in a
the concept of self-efficacy in a variety of contexts (e.g.,
functional education experience.
Bandura, 1997).
 To be most effective, reward (reinforcement) must follow as
immediately as possible.
PRINCIPLES OF TEACHING AND LEARNING IN HE
 Students are motivated through their involvement in setting
Health Education
goals and planning learning activities
- A process concerned with designing, implementing and
Principles of Good Teaching Practice
evaluating educational programs that enable families,
 Practice communicates high expectations
groups, organization and communities in achieving,
protecting and sustaining health  Respects diverse talents and ways of learning
Concept of Learning  Gives prompt feedback
 Leaning is about a change: the change brought about by  Practice emphasizes time on task
developing a new skill, understanding a scientific law,  Encourages student-faculty contact
changing an attitude  Encourages cooperation among students
 The change is not merely incidental or natural in the way  Encourages active learning
that our appearance changes as we get older
 Learning is relatively permanent change, usually brought
about intentionally.
Concept of Learning
 Teaching is a set of events, outside the learners which are
designed to support internal process of learning
 Teaching (Instruction) is outside the learner. Learning is
internal to learners
 You cannot motivate others if you are not self-motivated.
Motives are not seen, but behaviors are seen.
 Learning is both motive and behavior but only behavior is
seen, learning is internal, performance is external
Purposes
 To contribute to health and well-being by promoting
lifestyles, community actions and conditions that make it
possible to live healthful lives.
 Recent developments in the field of health care is to
highlight the important role of education in “helping the
patients and their families assume responsibility for self-
care management”
Hallmarks of Good or Effective Teaching in Nursing
 Professional competence
- Possession of skillful interpersonal relationships with
the students
- Desirable personal characteristics of the teacher
 Teaching practice
- Evaluation practice
- Availability to students in the laboratory clinical area
Principles of Teaching and Learning
 When the subject matter to be learned possesses meaning,
structure is clear to students learning proceeds rapidly
 Readiness is a prerequisite for learning

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HEALTH EDUCATION PROCESS  Experiential readiness:
Educational Process - Level of aspiration
- A systematic, sequential, logical, scientifically based, - Past coping mechanisms, cultural background,
planned course of action consisting of two major locus of control, orientation
interdependent operations: teaching and learning.  Knowledge Readiness:
- This process forms a continuous cycle that also involves - Present knowledge base
two interdependent players: the teacher and the learner. - Cognitive ability, learning disabilities, learning
- similar across the practice of many of the health styles
professions.
- the nursing process consists of the basic elements of Learning styles
assessment, planning, implementation, and evaluation - Learning style refers to the ways individuals process
- focuses on the planning and implementation of information (Guild & Garger, 1998).
teaching based on an assessment and prioritization - way the learners learn that takes into account the cognitive,
of the client’s learning needs, readiness to learn, and affective and physiological factor
learning styles. - Each learner is unique and complex
Assessment of Learner - The learning style models are based on the characteristics of
- needs are gaps in knowledge that exist between the desired style are biological in origin, others are sociologically
level of performance and actual level of performance. developed as a result of environmental influences.
- 3 determinants of learning: - Recognizing that people have different approaches to
 Learning needs learning.
 Readiness to learn - Determining learning styles:
 Learning style  Observation of the learner
Method of assessing learning needs:  Interview
 Informal conversations  Administration of learning styles instruments
 Structures interviews
 Focus groups Right-brain/ Left-brain and Whole-brain thinking
 Self-administered questionnaires - There is no “correct” or “wrong” side of the brain.
 Tests - Giving pre-test before planned teaching can help - Each hemisphere gathers in the same sensory information
identify the knowledge level of potential learners and but handles the information in different ways.
can assist in identifying learning needs  - One hemisphere may take over and inhibit the other in
Assessing processing information, or the task may be divided between
Observations Documentation learning needs of the two sides, with each handling the part best suited to its
nursing staff way of processing information.
Observing health Initial Written job - Knowledge of one’s own brain hemispherical performance
behavior helps the assessments, description can aid educators in identifying strengths and weaknesses in
educator draw progress notes, Formal and
their teaching methods.
conclusions about nursing care plan informal request
patient pattern of and discharge Quality Assurance
behavior planning can Reports
provide Chart Audits
information about Rules and
learning needs regulation
Self-Assessment
Gap Analysis
 

Readiness to learn
- can be defined as the time when the learner demonstrates an
interest in learning the type or degree of information
necessary to maintain optimal health or to become more
skillful in a job.
 Physical readiness
- Measures of ability of complexity of task,
environmental effects, health status and gender
 Emotional readiness
- Anxiety level
- includes support system, motivation, risk-taking
behavior, frame of mind, developmental stage
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Dunn and Dunn Learning Style Model Kholbs Learning
- a self-reporting instrument that is widely used in the  Kolb's learning theory (1974) sets out four distinct learning
identification of how individuals prefer to function, learn, styles, which are based on a four-stage learning cycle.
concentrate, and perform in their educational activities  He explains that different people naturally prefer a certain
- In 1967, Rita and Kenneth Dunn set out to develop an single different learning style.
instrument that would assist educators in identifying those  Kolb’s theory on learning style is that learning is a result of
characteristics that allow individuals to learn in different past experiences, heredity, and the demands of the present
ways. environment.
 Knowing each learner’s preferred style, the nurse educator
is better equipped to assist learners in refining or modifying
these preconceived ideas so that real learning can occur.

Myers and Briggs Learning Style

Theory of Multiple Intelligence
- Gardner’s early work in psychology and later in human
cognition and human potential led to the development of the
initial six intelligences.
- He identified nine kinds of intelligence located in different
parts of the brain: linguistic, logical-mathematical, spatial,
musical, bodily kinesthetic, interpersonal, intrapersonal.
Naturalistic, Existential.
- These intelligences (or competencies) relate to a person’s
unique aptitude set of capabilities and ways they might
prefer to demonstrate intellectual abilities

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DESIGNING HEALTH EDUCATION OF AGE Developmental Stages of the Learner
SPECIFIC GROUP Infancy (first 12 months of life) and
- An individual’s developmental stage sig-nificantly toddlerhood (1-2 years of age)
influences the ability to learn. Physical:
- Pedagogy, andragogy, and gerogogy are three different - Dependent on environment, needs security, explore self
orientations to learning. and environment, natural curiosity
- To meet the health-related educational needs of learners, a Cognitive:
 Sensorimotor stage
developmental approach must be used.
- Learning is enhanced through sensory experiences and
- Lifespan development refers to age related changes from
through movement and manipulation of objects in the
birth throughout the person’s life into and during old age
environment capacity.
- Developmental task arises or about a certain period in life,
- The toddler has basic for reasoning, understands object
unsuccessful achievement of which leads to inability to
permanence, has the beginnings of memory, and begins
perform task associated with the next period or stages in life.
to develop an elementary concept of causality.
Psychosocial:
Developmental Characteristics
- Chronological age is only a relative indicator of someone’s  Trust vs. mistrust: During this time, children must work
physical, cognitive, psychosocial stage of development through their first major dilemma of developing a sense
- Developmental stage will be used based on the confirmation of trust with their primary caretaker
by psychologists that human growth and development are  Autonomy vs. shame: Toddlers must learn to balance
sequential but not always specifically age-related. feelings of love and hate and learn to cooperate and
control willful desires
Pedagogy Teaching Strategies:
- the art and science of helping children to learn.  Orient teaching to caregiver
 Use repetition and limitation of information
- The different stages of childhood are divided according to
 Stimulate all the senses
what developmental theorists
 Provide physical safety emotional and security
- Educational psychologists define as specific patterns of  Allow play and manipulation of object
behavior seen in particular phases of growth and Early Childhood (3-5 years)
development, throughout all of childhood, learning is Physical:
subject centered. - Fine and gross motor skills become increasingly more
refined and coordinated so that they are able to carry
Andragogy out activities of daily living with greater independence
- the term coined by Knowles (1990) to describe his theory of - They develop imaginary playmates, and believe they
adult learning, is the art and science of helping adults learn. can control events with their thoughts
- Education within this framework is more learner-centered Cognitive
and less teacher-centered; that is, instead of one-party  Preoperational period
imparting knowledge on another, the power relationship - The young child continues to be egocentric and is
between the educator and the adult learner is much more essentially unaware of others’ thoughts
horizontal (Milligan,1997). - Preschoolers are very curious, can think intuitively,
- The concept of andragogy has served for years as a useful and pose questions about almost anything.
framework in guiding instruction for patient teaching and Psychosocial
for continuing education of staff.  Initiative versus guilt: Ability to be self-starter to
initiate one’s own activity
Gerogogy Teaching Strategies:
- The teaching of older persons
 Use warm approach, build trust, use repetition of
- For teaching to be effective, gerogogy must accommodate
information,
the normal physical, cognitive, and psychosocial changes
 Allow manipulation of equipment.
that occur at this phase of growth and development
 Explain procedures briefly.
 Provide safe environment,
 Use positive reinforcement.
 Use play therapy with dolls and puppet to stimulate
senses

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School Age (6-11 years) Psychosocial:
Physical:  Identity versus role confusion
 The gross- and fine-motor abilities of school-aged - These children indulge in comparing their self-image
children are increasingly more coordinated so that they with an ideal image
are able to control their movements with much greater - Adolescents find themselves in a struggle to establish
dexterity than ever before. their own identity, match their skills with career
 Girls more so than boys on the average begin to choices, and determine their “self.
experience prepubescent bodily changes and tend to Teaching Strategies:
exceed the boys in physical maturation  Explore emotional and financial support
Cognitive:  Determine goals and expectations
 Concrete operations  Assess stress level
- During this time, logical thought processes and the  Respect values and norm
ability to reason inductively and deductively  Engage in teaching 1:1 without parents present.
develop.
- School-aged children are able to think more Young Adulthood (20-40 years)
objectively, are willing to listen to others, and will Physical:
selectively use questioning to find answers to the - Young adults are at their peak, and the body is at its
unknown optimal functioning capacity.
Psychosocial: - Autonomous, self-directed
 Industry versus inferiority - Uses personal experience to enhance or interfere with
- Begin to establish their self-concept as members of learning
a social group larger than their own nuclear family - Intrinsic motivation
and start to compare family values with those of the - Able to analyze critically
outside world. Cognitive:
Teaching Strategies: - The cognitive capacity of young adults is fully
 Encourage independence and active participation developed, but with maturation, they continue to
 Use logical explanations accumulate new knowledge and skills from an
 Establish role models expanding reservoir of formal and informal
 Uses play therapy experiences.
 Provides group activates - Young adults continue in the formal operations stage.
 Use diagram, models or pictures Psychosocial:
 Intimacy versus isolation.
Adolescence (12-19 years) - During this time, individuals work to establish a
Physical: trusting, satisfying, and permanent relationship
- Abstract, hypothetical with others
- Can build on past experiences - They strive to establish commitment to others in
- Motivated by desire for social acceptance their personal, occupational, and social lives.
- Peer group is important Teaching Strategies:
Cognitive:  Use problem centered focus
 Formal operations  Draw on meaningful experiences
- They are capable of abstract thought and complex  Encourage active participation
logical reasoning  Allow to set own pace
- Adolescents can conceptualize and internalize  Organize materials
ideas  Recognize social role
- Adolescents are able to understand the concept of  Apply new knowledge through role playing and hands-
health and illness, the multiple causes of diseases, on practice
the influence of variables on health status, and the
ideas associated with health promotion and disease
prevention

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 NCMA112
Middle Adulthood (41-64 years)
Physical:
- During middle age, many individuals have reached the
peak in their careers, their sense of who they are is
well developed, their children are grown, and they have
time to pursue other interests.
- Skin and muscle tone decreases, metabolism slows
down, body weight tends to increase, endurance and
energy levels lessen, hormonal changes bring about a
variety of symptoms, and hearing and visual acuity
begin to diminish.
Cognitive:
 Formal Operations: The life experiences and their
proven record of accomplishments often allow them to
come to the teaching–learning situation with
confidence in their abilities.
Psychosocial:
 Generativity versus self-absorption and stagnation:
Midlife marks a point at which adults realize that half
of their life has been spent. This realization may cause
them to their level of achievement and success.
Teaching Strategies:
 Focus on maintaining independence
 Assess positive and negative past experiences
 Assess potential cause of stress caused by midlife
issues
 Provide information that coincide with life concerns
and problems
Adulthood (65 and above)
Physical:
- Most older persons suffer from at least one chronic
condition, and many have multiple condition.
- The sensory perceptive abilities that relate most closely
to learning capacity are visual and auditory changes.
- Hearing loss, which is very common beginning in the
late forties and fifties, includes diminished ability to
discriminate high-pitched sounds.
Cognitive:
 Formal Operations: Aging affects the mind as well as
the body. Cognitive ability changes with age as
permanent cellular alterations invariably occur in the
brain itself.
Psychosocial:
 Ego integrity versus despair: This phase of elderly
includes dealing with the reality of aging, the
acceptance of the inevitability that we all will die.
Teaching Strategies:
 Involve principal caregiver
 Encourage participation
 Provide resources for support
 Assess coping mechanism
 Provide written instructions for reinforcement
 Provide anticipatory problem
Lahat yan galing lang sa ppt ni Mam Uayan (except un History,
kinuha ko kay mam Concepcion) tsaka sa handouts na nasa
canvas hihi. Review well!! Good luck :)) – Aki

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