Herqutanto

Dhanasari
Indah Suci

Tujuan sesi ini : mahasiswa

mampu
Memahami dan menjelaskan faktor faktor yang

mempengaruhi kesehatan dengan member i contoh

Menjelaskan hubungan konsep terjadinya penyakit

(riwayat alamiah) dengan 5 tingkat pencegahan

dengan memberi contoh.
Memahami dan menjelaskan proses perubahan

perilaku individu dengan perjalanan penyakit

Memahami program kesehatan dalam aspek

pencegahan

Health is a state of complete physical, mental

and social well-being, not merely absence of
disease or infirmity

physical

Health &
well being
mental

social

WHO constitution

Well-being
the condition of being contented, healthy, or
successful; welfare.

UU RI, No.23 tahun 1992 tentang kesehatan

Kesehatan adalah sejahtera dari badan, jiwa

dan sosial yang memungkinkan setiap orang
hidup produktif secara sosial dan ekonomis

What is health?
A dynamic state
A given person functioning in a given physical

& social environment

Physical & mental state fairly free of discomfort
and pain
Permits the person to function effectively
(optimum level function), as long as possible
Emphasized an ability to live an economically
productive life
Enable a person to enjoy all the opportunities
that life may present

P
Illness/wellness
continuum
r
e
m
a
t
u
r
e
d
e
a
t
h

disability symptoms signs

Treatment model

Wellness model
awareness

NEUTRAL POINT
No discernible illness or wellness

education

growth

H
i
g
h
l
e
v
e
l
w
e
l
l
n
e
s

Dimensions of health
Positive Health - associated with the

capacity to enjoy life and to withstand

challenges; it is not merely the absence of
disease.
Physical Health - absence of disease and
disability; energy to accomplish daily tasks
and active leisure without undue fatigue.

Dimensions of health (2)

Mental Health- absence of mental disorders;

ability to meet daily challenges and social

interactions without undue mental, emotional,
or behavioral problems.
Social Health - Ability to interact effectively
with other people and the social environment,
enjoying satisfying personal relationships.

The Mandala of Health

A model of human ecosystem

culture
community
lifestyle
family

Personal
behavior
Sick
care
system

spirit
body

Human
biology

Psycho-socioEconomic
Environment

mind

work

Physical
environment

Human-Made Environment
biosphere

The concept of Blum

environment

genetics

Health status

Health services

behavior

AGENTS:
-physics
-chemistry
-biologic
-physiologic
-psychologic

HOST

DISEASE

ENVIRONMENT

Gordon & Le Richt

TRIAD EPIDEMIOLOGY

HOST :
Characteristic : Age,
Gender, Behavior

AGENT :
Lipid, Glucose,
Bacterial, etc

ENVIRONMENT :
Family, Occupation,
Housing, Sanitation,
etc

Health Belief Model

Individual
Perceptions

Modifying Factors

Age, gender, ethnicity,

Personality,
Socioeconomics,
Knowledge

Perceived susceptibility/
Severity of disease

Health Behavior and

Health Education,
Glanz et al, 1997

Perceived threat
of disease

Cues to action :
Education,
Symptom, illness
Media Information

Likelihood
Of Action
Perceived benefits
Minus perceived
Barriers to behavior
change

Likelihood of
Behavior change

Behavior changes

Stages of change, patient characteristics and clinical strategies

Pre contemplation

Denies problem, reluctant -ask permission to discuss

to discuss the
problem
problem,high risk of
Inquire about patients
argument
thoughts

Contemplation

Express
concern
Shows openness to talk, -Elicit
patients
perspective first
read, and think about
Help identify pros and cons of
problem
change
Can be obsessive about
Ask what would promote
problem and prolong
commitment
stage
Suggest trial

Behavioral Medicine in Primary Care, A practical Guide, Feldman & Christensen, 2003

Preparation / determination Understand that change -Summarize patients reasons

is needed
for change
Begins to form
commitment to specific
goals, methods and
timetables

Encourage patient to
announce publicly
-

Arrange a follow up contact

or shortly after start date
-

Can picture overcoming

obstacles
May setting starting date
of change

Action

Follows the plan

Describe the detail
Shows commitment

Show interest in specific of

plan
Discuss difference between
slip and relapse

Maintenance

Has accomplished chance or

improvement through focused
action

Show support

Inquire about feelings and

expectations and how well
Has feelings about how much the they meet
change has actually improved life
Reflect on the long term - and
May be developing lifestyle that
possibly permanent- nature of
precludes relapse into former
this stage as opposed to
problems
more immediate gratification
of initial success

Relapse

Consistent return to problem

Frame relapse as a learning
behavior after period of resolution of opportunity in preparation
for next action stage
Begins as slips that are not
effectively resisted
Ask about specifics of change
and relapse
May have cycle back

Family Factors
Family relationships, dynamics, and social

supports are strongly related to healthy

individual functioning. Marital relations have
the strongest influence on health.
Positive relationships support health
functioning, and negative relationships
contribute to stress and adverse health
outcomes

The Familys influence on health, Bray & Campbell in Textbook of Family Medicine, 7th ed,2007

Any problem with

social support?

Family
factors
case
A middle
age women
seestudy
a PHC doctor with

a severe headache. The headache come and

go in 3 days. Doctor asked whether any
other problem that she would like to share.
The women started to cry and tell how tired
she was as breadwinner after her husband
had post stroke paralyzed.Her husband
always complain about the food and the
children didnt help.

Any problem with

marital relationship?

Any problem with

family relationship?

The familys influence on

health

Familys dynamic : structure, life cycle,

function
Family as a resource for health promotion
Family as care giver and partner in chronic
diseases
Family stress
Impact of divorce on the family

Gaya Hidup
Perilaku
Sehat
sehat

Lingkungan
sehat

Akses
yankes
Bermutu &
Merata
Status
kesehatan
optimal
AZRUL AZWAR21