健康促进医院的理念与实践探索

发表时间:2020/1/9   来源:《中国医学人文》2019年9月9期   作者:曹滴 黄秋月
[导读] 随着人们健康观念的转变,医学形式也发生了微妙的变化,从简单的治疗类型到保健,生活质量,疾病的预防和健康的维持。
 
 
曹滴  黄秋月
(德阳第五医院;四川德阳618000)
摘要:随着人们健康观念的转变,医学形式也发生了微妙的变化,从简单的治疗类型到保健,生活质量,疾病的预防和健康的维持。健康促进医院(HPH)是未来医院建设和发展的方向,前景不容小觑。为了不断提升员工的健康认知,养成健康生活、科学饮食的好习惯,不断提高健康知识水平和生活质量,HPH的建设势在必行。通过建立健康促进医院,保护和促进患者及其家人和医护人员的健康,创造健康有益的医疗环境和生活方式,同时提高医院服务的整体质量,降低医疗成本,促进医院的可持续发展。
关键词:健康促进;医院;实践;探索
医院为人类活动中不可缺少的一部分,在社会中发挥着相当重要的作用。从上世纪八十年代以来,人们对健康的需求已不满足于疾病的治疗,而趋向于融合健康促进理论,提倡集医疗、预防、保健和康复为一体的医疗模式[1]。建设HPH必须将理论与实践相结合,以患者的需求和健康为中心。在新世纪的医学模式发展中,健康促进是在整个医学领域中极为重要的一部分。良好的健康教育和健康促进既可以令人们自愿采取趋于健康的行为和生活方式,提升患者对医护工作者的信任感和依从性,也可以满足患者的心理保健。有助于医护人员深入了解自己的职责所在,用资深的服务的意识,优雅的服务用语,为医务工作的服务行为做出表率[2]。孙美娇[3]等研究结果表示:在三级专科医院中已创立HPH的25个三级指标中有23个指标优于未创立,占92%;在二级综合医院中已创建医院的15个指标优于未创建,占60%。因此,HPH具有不同等级和不同性质的医院的广泛实际应用。但是有调查显示我国HPH建设中存在着相当多的问题。
1健康促进医院的现状:
1.1HPH管理体系其实不够完善,经验不足,医务人员及患者对HPH的了解不够深,不能踊跃的参与此中。因此参与程度低,实施过程也比较慢。
1.2缺乏有医院特色的健康促进活动,缺少活动基金支持。
1.3当前,我国HPH的建设仍是一个相对薄弱的范畴,因为HPH理论知识的不全面,造成了理论与实践不能很好融合的近况,缺乏合理、有效的管理模式[1]。总而言之,我国健康促进医院的发展受到顶层设计缺如、保障机制不全、实践研究不深入、人才培 养不足、医疗环境恶劣等因素的制约[4]。
2健康促进医院的实施
为了更为全面的了解HPH领域的发展趋势,倡议广大人民积极参与建设HPH,迫切需要成立一个契合具体情况和特点的HPH的基本做法和运作流程,并拟定出符合医院实际情况的目标体系。
近年来,关于健康促进医院的研究成果的发表接踵而至,学者们一致认同的观点是:健康促进医院的建设需要通过健康促进的做法,建立健康的医院环境,继而提高医院的服务质量,满足广大人民需求,促进医院的发展与进步[5]。
2.1健康促进医院的实施细则
2.1.1实行HPH项目
我们必需认识到HPH为一项并立的任务,要激励各个部门的积极参与,领导管理层应当要注重项目的进展,建立相关的健康促进政策,并带领大家逐一实施,加大管理力度,通过各职能部门的积极配合,调动医院员工的积极参与,努力营造良好的医院环境,促进健康发展。
2.1.2建立健康场所,开展针对性教育
医院作为一个健康促进场所,保持环境清洁、舒适,全面贯彻6S管理体系。医护人员为病人提供全面,连续,系统,个性化的健康服务,同时建立一个以医护人员为实施体,促进健康医院为目标的健康促进活动。医院健康教育是整体护理的重要组成部分,它既是一种治疗门径,亦然是预防疾病、维持身心健康的重要方式[2]。总之,在医院这个健康场所,全面实现健康促进医院的个性教育。
2.2社区健康促进
江伊恋,张颖杰等人的研究成果表示,通过社区-医院协同管理能提高患者的知识水平,健康行为水平及生活品质,达到较好的二级预防效果[6]。 可见社区健康促进在健康促进医院的建设中起到至关重要的作用。

                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                                          
社区及医院应该有计划地结合世界卫生日主题开展健康宣教活动,提倡及普及卫生知识。每个人都期待健康,每个人都应该向健康的生活方式发展,每个人都想拥有健康的体魄。积极参与社区各项健康促进工作,针对不同需求的人群,联合公共卫生服务,进行有组织、有计划、有步骤、分层次的健康教育,传播健康知识,构建和谐社区,体现健康向上的生活状态。拟定健康教育及健康促进活动经费的使用规划,争取院领导对创建HPH工作的支持,落实必要的活动经费。
2.3做好病人、患者家属、职工的健康促进工作
如今,人们的健康需求不再满足于维持生命和缓解痛苦,而是维持和促进健康。这一目标的实现最直接、经济、有效的便是健康教育,如何才能体现医院高水准服务的健康教育是整体护理所面临的艰巨任务。对于医院病人及家属的特殊性,展开有个性化的健康教育,充分发挥医患、护患、及其家属之间的合作关系,从而实现更佳的一级预防[1]。于职工而言,要定期开展各项预防接种检查工作,为职工提供健康营养的工作餐、健身锻炼娱乐的场所,积极开展各项健康活动等。
3健康促进医院的成果
在竞争日益激烈的大环境下,健康促进医院的发展没能得到很好的落实。随着时代的变迁,人们越来越重视健康问题,因此医学基础知识的普及尤为重要,健康教育和健康促进活动具有投资少,宣传效果明显的优点,因此备受重视[7],也是HPH建设的关键所在。HPH的目标是提高经济利益和社会效益,促进医院的可持续发展。医院领导通过改善医院环境,促进员工,社区居民和患者的健康,更加认可了建设HPH是提升医院品牌效益的重要手段和途径。
4我院健康促进的特色
我院于2019年度参加WHO-HPH工作任务,并依据HPH工作手册监测18项核心指标进行改进监督。其中有显著成效的有肺癌及流感疫苗注射率逐年提升达90%以上。导入个案管理师做个体化疾病追踪管理,长期追踪个案,以慢性病为主,如高血压、高血脂、风湿病、COPD、心血管疾病等,值得一提的是糖尿病个案管理中心做的风生水起,是我院一大特色服务。
5小结
健康是每个人应当享有的基本权利,更是人全面发展的基础。随经济的增长,生活水平的提高,我国乃至全球慢性病的患病率及疾病负担与日俱增,因此掀起一股健康教育,健康促进的热潮[8]。随着医学模式和现代医学发展的转变,医院开展健康促进工作已是必然趋势,即是时代的需要,更是医院发展的必经之路[9]。建立HPH,开展健康教育和健康促进将有助于减少医疗费用并节省医疗资源;有利于促进医患和谐,减少医疗纠纷,提高患者满意度;有利于医院文化建设。在医院文化建设中强调关爱,尊重员工,激励员工的潜在动力,将HPH充分的融入到医院文化中,提供优质的就医环境,通过随访等方式提高医院健康管理的实施。
我们过去所认识到的健康教育模式一般为“一对一”或者“一对多”的服务模式,具有缺乏个性定制的弊端,继而影响健康教育的效果。在未来的工作中,我们应该利用现代新技术来吸引注意力,充分利用信息技术来实施员工健康管理软件,并利用居民的电子健康档案来跟踪和评估人口,制定个性化的健康干预措施[10]。
 
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