TEACHING HEALTH EDUCATION

Die vak Teorie en Praktyk van Gesondheidsvoorligting word vir gemeenskapsverpJeegstudente aan Medunsa aangebied. ’n Vraelys is aan hierdie studente versprei om hulle houding teenoor verskeie aspekte van die vakgebied te bepaal. Response het onder andere getoon dat dit 'n interessante en belangrike vak is en dat die studente se motivering om gesondheidsvoorligting te doen oor die algemeen verhoog is. Voorbeelde van programme wat studente opgestel het word gegee om hulle inisiatief en vordering te illustreer. INTRODUCTION For the past three years the subject Theory and Practice of Health Educa­ tion has been offered to prospective community health nurses by the De­ partment of Nursing Science at the Medical University of Southern Africa (Medunsa). The purpose of introducing this course was to promote the practice of health education — an integral part of health care and thus of community nursing care — by guiding community health nurses to — synthesise appropriate and applic­ able theoretical concepts from vari­ ous fields of science including educa­ tion, anthropology, psychology, so­ ciology and nursing as a premise on which to base health education — apply theoretical concepts gleaned from various fields of science to the field of health education -— develop reasonable skill in selecting, planning, preparing, utilising and evaluating teaching/learning aids — evolve a favourable attitude towards health education — undertake simple studies related to health behaviour — identify authorities concerned with health education on local, national and international level and know their contributions. The subject called Theory and Prac­ tice of Health Education includes 120 lesson periods over two semesters. Practica undertaken in addition to lesson periods requires students to — structure, conduct and interpret an interview with a limited number of persons, belonging to a pre-selected target group, regarding their needs for health education — plan* a short health education pro­ gramme comprising a minimum of five topics to meet the needs for health education — direct or conduct teaching/learn­ ing/evaluation experience — visit a number of institutions/per­ sons to learn more about where to obtain and how to make and use audio-visual material DETERMINING THE SUCCESS OF THE SUBJECT


INTRODUCTION
For the past three years the subject Theory and Practice of Health Educa tion has been offered to prospective community health nurses by the D e partm ent of Nursing Science at the Medical University of Southern Africa (Medunsa).The purpose of introducing this course was to prom ote the practice of health education -an integral part of health care and thus of community nursing care -by guiding community health nurses to -synthesise appropriate and applic able theoretical concepts from vari ous fields of science including educa tion, anthropology, psychology, so ciology and nursing as a premise on which to base health education -apply theoretical concepts gleaned from various fields of science to the field of health education --develop reasonable skill in selecting, planning, preparing, utilising and evaluating teaching/learning aids -evolve a favourable attitude towards health education -undertake simple studies related to health behaviour -identify authorities concerned with health education on local, national and international level and know their contributions.The subject called Theory and Prac tice of Health Education includes 120 lesson periods over two semesters.
Practica undertaken in addition to lesson periods requires students to -structure, conduct and interpret an interview with a limited number of persons, belonging to a pre-selected target group, regarding their needs for health education -plan* a short health education pro gramme comprising a minimum of five topics to meet the needs for health education -direct or conduct teaching/learn ing/evaluation experience -visit a num ber of institutions/per sons to learn more about where to obtain and how to make and use audio-visual material

DETERMINING THE SUCCESS OF THE SUBJECT
A questionnaire was compiled to deter mine how students doing the subject Community Nursing Science felt about the various aspects of health education.
Seventeen respondents each received and completed a questionnaire.

The subject
An analysis of the responses (see table 1) regarding the Theory and Practice of Health Education as a subject, indi cated that -fourteen (82 % ) respondents agreed that it is an interesting subject and that it should be undertaken by all registered nurses following a nursing course at a university -fifteen ( 8 8 % ) respondents agreed that it should be included in medical courses offered at Medunsa -twelve (70 % ) respondents agreed that it should be included in all courses offered at Medunsa.-while eleven (65 %) respondents agreed that the subject is necessary, three (18 %) were doubtful and three (18 % ) disagreed -in addition to two respondents not replying, the larger num ber ( 1 1 out of 15) were doubtful (4 = 24 % or disagreed (7 =41 % ) that it was necessary for the subject to contain more theory -eleven (65 % respondents were doubtful (6 ) or disagreed (1 ) strongly, that more time should be spent on self activity -ten respondents (59 % ) agreed that the subject was interesting while the others found it doubtful or disagreed and one did not respond -none of the respondents felt that the subject is unnecessary as there was no time for health education in the respondent's working situation.

The practice of health education
With regard to health education in prac tice -eight respondents strongly agreed and seven agreed (total 8 8 % ) that registered nurses, w herever they work, have opportunities to under take health education.One was, however, doubtful and one dis agreed that such opportunities exis ted.
-eight respondents (47 % ) agreed, while five disagreed and four strongly disagreed (53 % ) that reg istered nurses avoid their responsibi lities with regard to health educa tion.
Concerning motivation to undertake health education, thirteen respondents (76 % ) indicated that they were more motivated than before coming to Medunsa.Two students were doubtful and two disagreed that their motivation had increased.
The largest group of the respondents (13 = 76 % ) will be returning to work in nursing colleges as tutors while two will be working as clinical tutors, one as a ward sister and one as a matron.

MAART 1984 CURATIONIS
Some of these respondents however, would rather have liked to work in other positions than those they ex pected to occupy.While eight of the thirteen returning as tutors to nursing colleges were satisfied, the other nine respondents indicated a wish to occupy a different position.The respondents who would rather have liked to spend their time working in a different pos ition indicated that they would have liked to be: a health educator : 1 a college tutor: 9 a ward sister and tutor: 4 a ward sister and health educator: 2 a matron: 1 a medical doctor: 1 It is interesting to note that none would prefer to be clinical tutors.

General comments
An open-ended question on viewpoints or feelings regarding the Theory and Practice of Health Education as a sub ject elicited the following comments: -it should be integrated with Com munity Nursing Science (5 respon dents) -more practical experience is re quired such as facing the community (although the impossibility of in creasing practica due to a lack of time was acknowledged (5 respon dents) C o m m e n ts m a d e by in d iv id u a l (single) respondents although not all were clear, are as follows: -health education should be a subject in the school curriculum -a separate course for health educa tors is required Illustration 1: Learning objectives for a group of mothers of epileptic children

INTRODUCTION
The needs of the target group, that is mothers with children suffering from epi lepsy, were determ ined by a structured interview.T hereafter objectives for five learning experiences were formulated.

IMMUNISATION
At the end of the learning session mothers of epileptic children should be able to: Explain the purpose of receiving a full course of immunization Tell when to take the children for immunization Manage their children when ill-effects occur after receiving immunization Report delay in progress of milestones .
Educate other mothers about immunization .

MANAGEMENT OF SEIZURES
At the end of the learning session mothers of epileptic children should be able to: Recognise the onset of seizures Act quickly to limit injuries Support the head during a seizure Show how they will allow free jerking movements Position the child after seizure when in a deep sleep

TREATMENT
At the end of the learning session mothers of epileptic children should be able to: Explain the importance of continuous taking of medications Carry out instructions given with medications Recognise side-effects and what action to take Tell about the dangers of overdosage Report any doubts about treatm ent ----------------------------------------------------  Comments aimed at the way in which the subject was presented included the following:

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-the theory and practice of health education as a subject should be • taught in the clinical situation • part of every topic dealt with -students should be involved in plan ning the curriculum for the subject Theory and Practice of Health Edu cation -other disciplines should be included in the health education projects which community nurses have to undertake -projects are necessary to implement the health education skills learnt -the theory of health education is fine but the practice is difficult to under stand and apply -the technology and method of health education is not understandable -a more practical and motivating way of teaching projects is necessary -learning and practising to give orga nised talks and conduct meetings and join in community activities should be a part of the theory and practice of health education -clinics should be used more often and clinic sisters involved in order to practice the skills of health educa tion -more use should be made of films and video to illustrate techniques and methods of health education -health education must be processoriented because successful health education depends on how people were taught, that is the approach, the manner and the ability of the educator to motivate people.-health education is impracticable.

CONCLUSIONS BASED ON THE FINDINGS
Conclusions based on the findings are that -nurses have opportunities for health education although these are not always utilised -the theory and practice of health education is an important and inte resting subject which could well fit into medical courses and to a lesser extent all courses offered at Me dunsa  Illustration 4: in this example a poem is used to invite persons who hear strange voices and experience strange feelings to make use of the health services, the doctors and nurses.Time and space unfortunately do not permit inclusion of more examples.The ones provided will serve to indicate in creased awareness of the needs for health education and the many ways in which snatches of information and bits of education can be conveyed to clients, patients, families and the community by the efforts of nurses who have learnt to transmit some of what they know, with initiative and skill, to those who know less.
Illustration 5: this is a pamphlet or bro chure to be folded in four parts and to be given to mothers of epileptic chil dren.Two languages are used as well as brightly coloured pictures.
-< BEHAVIOUR At the end of the learning session mothers of epileptic children should be able to: Describe different ways in which their children show emotion about their distur bances Explain the difficulties their children find in associating with other children Suggest ways of coping with the disturbed child Tell how they will prevent interpersonal pressures and tensions in the home > Explain how they will encourage their children to play with others y REHABILITATION \ At the end of the learning session mothers with epileptic children should be able to: Prevent their children from becoming invalids Tell how they will protect children from sustaining injuries Keep children constructively occupied Supervise them in their respective occupations Tell how they will encourage children to function independently Illustration 2 Game to teach children how to care for their ears waarvolgens vroedvroue die moeder-en kindverbintenis in die neonatale tydperk binne die huidige struktuur van verloskunde in Suid-Afrika kan optimaliseer.D ie oogmerk is om die nadelige gevolge van moedersorgsteurnisse te voorkom en om die gebeure rondom die geboorte vir sowel die moeder as die baba sinvol te maak.Om hierdie doel te bereik, is aandag geskenk aan die behoeftes en interaksiepotensiaal van die pasgeborene, moederlikheid, die moeder-en-kind-verbintenis en die effek van skeiding van die m oeder en die kind.Verskeie kliëntestudies is onderneem om die rol van die vroedvrou in die optimalisering van die verbintenisgebeure te konstrueer.Uit die ondersoek blyk dit dat interaksie tussen die moeder en die pasgeborene noodwendig die moederen-kindverbintenis voorafgaan.Die huidige praktyk, met die hospitaal as plek waar die geboortegebeure afspeel, inhibeer die vroeë interaksiegebeure tussen die moeder en die kind, ongeag of die skeiding fisies, psigies of chemies van aard is.H ierbenewens is daar weinig sprake van vader-en-kindinteraksie en is die peuters van die gesin totaal uitgesluit by die gebeure.Die vroedvrou kan deur die uitskakeling van hierdie nadelige praktyke, hoogs instrumenteel fungeer in die bevordering van die moeder-en-kind-verbintenis.

into my ears The method of Evaluation is TRUE or FALSE 1 must report and from my ears to the nurse at the Ears are used for talking clinic immediately. One does not hear very well when one's ears have My ears give spice to happy excessive wax in 1 therefore and value my It is correct to use sharp instruments for removing ears excessive wax from one's ears For my ears mean more than Pain and discharge from ears is normal 1 must report pain and discharge from ears immedi ately at the clinic
lecturers from all faculties at Medunsa should first learn to be good role models in health educa tion before they accompany students to the clinical area