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For centuries the aim of medical science has been to cure and prevent diseases. This effort has been founded on natural science and technological development which has influenced the understanding of the concept of health. Traditionally health has been conceived of as a biological function of the body, as a health-illness dichotomy where pathogenesis has prevailed.
But health is much more than absence of illness. Aaron Antonovsky’s research has led to the Salutogenetic idea: The theory of the origin and genesis of health. Salutogenesis focusses on the learning processes of real life. From this point of view, new paths within the field of healthwork can be explored. Pedagogical awareness and thinking, however, are demanded from a health system which, in spite of its name, still focusses on illness.
According to the existing public health legislation health education is an essential part of the health dialogue between the school nurse and the school child. Within a theoretical concept of learning the school nurse’s perspectives on health and learning are discussed, i.e. how she prepares the health dialogue, and what didactic means she takes into consideration.
The health dialogue ought to form a whole for the pupil and should be in connection with the health education at school.
The point of view in the article is that the pupil will experience high quality of the health dialogue if the school nurse is aware of her own health concepts, view on learning theories and pedagogical approach.
Through the last century the historical settings for nurses in Denmark have been to talk about health and health promotion. By localizing discourses described in law text, articles and books it seems as if a transformation in health and nursing care has taken place. Focus has moved from sickness and illness to the idea of health promotion. A matrix of risks has been pointed out including all aspects of life, and for the community strategies of health have been developed. Actually nurses make assessment activities based on these risks, and that’s why the question arises: Can nurses practice individual nursing based on strategies for groups and the community? And will it be a problem, when all life is included in health promotion and all subjects are potential patients?
In times of heavy workloads and staff shortages, nursing and care staff often just manage to deliver the care required by pulling out all the stops, but just as often they have the feeling that they are not able to provide the required quality. Monitoring tools have now been developed to check whether this really is the case and provide a basis for action to improve the situation.
The county hospital of Fredericia has carried out a project „Arthritis School“ concerning a multidisciplinary educational program for patients with rheumatoid arthritis. The purpose of this project was that every individual through learning and self-help method could increase the ability of mastering his own life situation. This article describes the method of „Arthritis school“, method of evaluation and the results of the project.
It is the authors’ conclusion that the project was successful and effective for the participants.
The phenomenon of pain is approached from a cultural perspective. The article tries to explain a possible importance of certain living conditions, and hereby a pre-adjusted behaviour, when certain people feel sick and express pain. If the health staff wants to understand the importance of the cultural background for a patient’s expression of pain they must remember that they have to pay attention to the meaning of this particular act according to the patient’s culture. Furthermore they should look for the cultural setting in which the act is performed. Caring for this group of patients not only requires awareness of a difference in behaviour, but also adjustment to this difference in order to avoid preconceived imaginations.
In terminal care infusion is often administered as a routine. This is problematic since infusion to this group of patients can have inexpedient physical and psychosocial consequences. Infusions is a treatment, and according to legal and ethical guidelines patients have a right to renounce this kind of treatment. Nurses however seldom regard infusion as a treatment. Therefore they don’t realise that the patient’s right of self-determination is disregarded when decisions of infusion are based on a routine instead of an individual assessment. Without information and joint influence the dying patient doesn’t have the possibility of refusing infusion.
The concept of the service school is carried out in collaboration between Department of Endocrinology and the Patient Hotel at Odense University Hospital. The service school consists of education and external service and internal service, conflict analysis, and conflict management.
After training the new knowledge is implemented into every day tasks by going over all situations having service in focus. From these situations, areas/indicators are chosen where standards and manuals for good communication and service are prepared. The aim is to gain a common position as well as a common set of values to be implemented into the departments – for the benefit of users of the health care system.