健康行为概论11研.pptx

,单击此处编辑母版标题样式,#,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,单击此处编辑母版标题样式,单击此处编辑母版文本样式,第二级,第三级,第四级,第五级,#,健康行为学,Health Behavior,公共卫生学院,社会医学与健康教育系,孙昕霙 副教授,xysun73,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,教学安排,一、健康行为学概述（讲授）,二、个体健康行为理论（讲授与讨论）,三、群体行为改变理论（讲授与讨论）,四、健康行为测量（报告与讨论）,五、不良行为生活方式研究（实践）,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,教学要求,课前阅读参考资料或文献，能提出,1-2,个问题,课堂积极参加讨论,分组实践方案设计，汇报,完成综述,成绩,课堂（,10%,）,+,综述（,50%,）,+,小组方案（,40%,）,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,教学要求,综述,主题：健康行为研究,内容：理论及其应用、研究方法、,自己的观点：归纳、评述,文献：不少于,25,篇,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,教学要求,实践方案,研究某行为的必要性、意义,研究目的,理论依据,研究的理论框架,研究方法,研究工具,*鼓励实践（有加分，满分不超出,40,分）,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,健康行为学概论,Introduction of Health Behavior,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,内容,一、行为与健康,二、健康行为学基本概念,三、人类行为一般分析,四、影响因素,五、健康相关行为分类,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,一、行为与健康,遗传生物因素 行为生活方式因素,健康,环境因素 卫生服务因素,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,行为因素,行为作为非感染性疾病的危险因素,行为作为感染性疾病的传播途径,行为与预防保健服务利用,行为在疾病治疗与康复中的作用,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,1,、吸烟、酗酒、物质滥用,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,有关数据,：,2007,年中国控制吸烟报告,：我国男性人群现在吸烟率为,53.9%,，吸烟人数为,3.5,亿，居世界各国之首,;,城市和农村人群接触二手烟的比例分别为,49.7%,和,54.0%,，被动吸烟人数达到,4.5,亿。,北京市卫生局,2009,年公布：中小学生吸烟率为,7.05%,；男性医生、教师和公务员等重点人群吸烟率分别为,33.9%,、,40.0%,和,57.8%,。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,有关数据,：,2006,年中国禁毒报告,到,2005,年年底,中国登记的吸毒人数大约有,116,万；,吸毒者中,35,岁以下人群占,70%,，女性比例增加。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,2,、缺乏运动、不合理膳食、超重,78.4%,城市居民不锻炼，经常锻炼男性,14.9%,，女性,15.1,。,肉类、油脂消费快速上升，谷物类消费明显下降，食盐摄入居高不下。,18,岁以上超重率：城市男,31.1,，女,25.8,；农村男,19.6%,，女,21.4%.,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,3,、与利用卫生服务有关的行为,2010,年中国卫生统计年鉴：,2009,年全国产前检查率,92.2%,，住院分娩率,94.7%,（县），婚检率,17.1%,；,2008,年全国卫生服务总调查：两周患病未就诊比例,37.6%,。,2002,年我国,18,岁及以上人群高血压治疗率,24.7,，女性高于男性，城市高于农村。,WHO,调查显示，中国住院患者抗生素药物使用率高达,80%,，其中联合使用两种以上抗生素的占,58%,，远高于,30%,的国际水平。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,慢性非传染性疾病,高血压：,18,岁以上人群患病率达到,18.8%,，比,1991,年增长了,31%,，估计患病人数超过,1.6,亿。,糖尿病,:,18,岁以上人群患病率为,6.07%,、,3.74%,、,1.83%,，估计患病人数为,2346,万，每年新增,120,万。,据,WHO,预测：到,2020,年，非传染性疾病占我国死亡原因的比例将上升到,79%,，其中心血管疾病将占首位。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,新老传染病,结核病：,结核病负担排全球第二位，,2000,年抽样调查有现患涂阳肺结核病人,150,万。,艾滋病：,截至,2009,年,10,月,31,日，全国累计报告艾滋病病毒感染者,318977,例，病人,102323,例，死亡,49845,例；,2009,年新发现,4.8,万。性传播为主要传播途径，其中同性传播占,32%,。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,行为生活方式因素,遗传因素,环境因素,健康,卫生服务因素,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,二、健康行为学基本概念,Working definition of health behavior,Health behavior are those personal attributes such as beliefs,expectations,motives,values,perceptions,and other cognitive elements;personality characteristics,including affective and emotional states and traits;and overt behavior patterns,actions and habits that relate to health maintenance,to health restoration and to health improvement.,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,二、健康行为学基本概念,1,、健康行为,操作定义,与维持、恢复和增进健康有关的个人品质（如信念、期望、动机、价值、认识等认知因素），个性特征（包括情感、情绪）和外在行为表现、活动以及习惯。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,二、健康行为学基本概念,健康行为要点,人们自己为行为主体；不包括医生给予的治疗、免疫接种、生理功能恢复、健康状况等，但寻求治疗、为康复而采取的行为、对健康状况的认识属于健康行为。,不仅包括可以直接观察到的活动，还包括心理、情感等需要间接,“,观察,”,/,测量的活动。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,2,、,健康行为分类（,1966,，,Kasl&Cobb),（,1,）预防与保护行为,Preventive and protective behavior,“those actions undertaken by persons who believe they are well,and who are not experiencing any signs or symptoms of illness,for the purpose of remaining well.”,个体从事的自认为健康的、以预防或早期发现无症状疾病,为目的的任何活动,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,一级预防相关行为,：吃早餐、体重管理、运动、不吸烟、驾车使用安全带、遵守交通规则、遵守工作场所安全操作规则等。,二级预防相关行为,：定期体检、口腔检查、防癌检查等。,其他因人而异的预防与保护行为,：冬泳、祈祷、服用维生素。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,2,、健康行为分类,（,2,）患病行为,Illness behavior,“those actions undertaken by persons who are uncertain about whether they are well;who are troubled or puzzled by bodily sensations or feelings that they believe may be signs or symptoms of illness;who want to know what to do if they are not well.”,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,患病行为是人们认为自己有了疾病征兆或症状，受到躯体或心理感受的困扰，为了明确自身感受是否意味着疾病以及如何应对而采取的行动。包括：,1,对征兆或症状采取的应对措施；,1,向自己认为有权威性的人或熟人寻求建议与指导；,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,2,、健康行为分类,（,3,）病人角色行为,Sick-role behavior,“those actions undertaken by persons who have already been designated as being sick,either by others or by themselves.”,那些经他人确认或自己确信自己已经患病的人们所采取的行为。包括接受医学处置、减少活动，减少个人、家庭、社会责任，康复相关行为等。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,二、健康行为学基本概念,3,、健康行为学,健康行为学是研究健康相关行为发生、发展规律的科学，应用行为科学的理论和方法研究人类个体和群体与健康和疾病有关的行为，探讨其动因、影响因素及其内在机制，为改变人们危害健康的行为，形成有益于健康的行为提供科学依据。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,三、人类行为一般分析,1,行为的基本概念,行为指的是有机体在内外环境刺激下所引起的反应，包括生理、心理和外在表现的变化。,S O R,刺激 有机体 反应,Stimulus Organism Reaction,Woodworth,的,S,模式,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,人的行为,指具有认知、思维能力，并具有情感、意志等心理活动的人对内外环境刺激所做出的能动的反应。分为：,外显行为：可直接观察到的行为。,内隐行为：不能被他人直接观察到的行为。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,2,人类行为的属性,（,1,）生物属性,-,行为的遗传性,-,行为以生理形态和功能为前提,-,具有本能行为：摄食行为、性行为、躲避与防御行为、探究行为、睡眠。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,（,2,）社会属性,社会行为,指人在社会化（,socialization,）过程中形成的，与环境相适应的行为。包括社会生活技能、劳动技能、社会生活行为规范、社会角色行为等。,-,后天习得,-,环境影响,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,3,、人类行为的特点,（,1,）适应性,-,反射：通过反射弧来实现。,-,自我控制：追求奖励性行为后果。,-,调适：与其他个体、群体的相互配合与适应。,-,顺应：改变自己以适应客观环境。,-,应对：决定是否做、如何做以实现自身需要。,-,应激：肌体非特异性反应，激发潜能。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,（,2,）目的性：人的行为有明确的目的性和计划性，指向有益于自身的结果。,（,3,）可塑性：人的行为在不断变化发展中。,（,4,）差异性：受遗传素质、个性心理特征、外部环境的影响。,（,5,）发展性：连续而不平衡；表现为个体认知活动逐渐深入和复杂化；个体与环境关系的改变；个体行为日益完善。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,4,、行为发展的四个阶段,行为的发展,是指个体在其生命周期中行为形成与发展的过程，即在个体出生以后，随着生理的发育、心理的成熟以及社会交往的不断扩大，个体行为不断变化和发展的过程。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,34,（,1,）被动发展阶段（,03,岁）,依靠遗传和本能的力量发展而来。,“三翻六坐七滚八爬”,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,35,（,2,）主动发展阶段（,312,岁）,主动行为大量出现，克制能力增强，爱主动探究、好攻击、爱自我表现。,“不”、“为什么？”,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,36,（,3,）自主发展阶段（,12,成年）,通过对自己、他人、环境、社会的综合认识，调整自己的行为。,两大特征：自我行为调控,行为定型,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,37,（,4,）完善巩固阶段（成年以后）,调整,完善,调整,完善,通过对行为的不断调整实现对自己和周围环境的最佳适应。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,38,5,、行为形成和发展的影响因素,（,1,）遗传因素,基因的稳定性,基因突变、整合,基因的复杂性,（,2,）环境因素,生态环境、风俗信仰、社会经济、伦理道德等,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,39,（,3,）学习因素,模仿,无意模仿,有意模仿,强迫模仿,系统教育,强化教育,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,6,、影响行为改变的自身因素,需要（,needs,）与动机（,motivation,）,刺激 需要 动机 目标导向,新的 需要 目标行动,需要 满足,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,-,认知（,cognition),指人们获得和利用信息的全部过程和活动。,刺激 感知 选择 解释 行为,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,-,态度（,attitude,）,指个体对人、物、事件的反应倾向，是一种内部的准备状态，由三部分构成。,认知：赞同与否、相信与否,情感：喜欢与否,意向：意图与行动准备,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,-,态度（,attitude,）,态度变化的三个阶段：,服从：被迫的表现顺从，并非心甘情愿；,同化：自愿接受，自愿顺从；,内化：真正从内心接受，成为内在的行为倾向。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,-,情绪与情感（,emotion and feeling,）,情绪为短暂而强烈的、具有情景性的感情体验，情感指稳定而持久的、更为深刻的感情体验。,情绪和情感是认知发展的契机，激发人的认识、行动。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,五、健康相关行为分类,健康相关行为,：指个体或团体的与健康和疾病有关的行为，分为促进健康行为和危害健康行为两类。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,1,促进健康行为,促进健康行为：指个体或群体表现出的客观上有利于自身和他人健康的一组行为。,特点：（,1,）有利性,（,2,）规律性,（,3,）和谐性,（,4,）一致性,（,5,）适宜性,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,1,促进健康行为分类,（,1,）基本健康行为,（,2,）戒除不良嗜好行为,（,3,）预警行为,（,4,）避免有害环境行为,（,5,）合理利用卫生服务行为,预防保健、求医行为、,遵医行为、康复行为,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,七项与人们的期望寿命 和良好健康显著相关行为,避免零食；,每天吃早餐；,每周,2,3,次的适量运动；,适当的睡眠（每晚,7,8,小时）；,不吸烟；,保持适当的体重；,不饮酒或少饮酒。,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,2,危害健康行为,危害健康行为：指个体或群体表现出的偏离个人、他人和社会健康希望的一组行为。,特点：（,1,）有害性,（,2,）潜在性,（,3,）习得性,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,2,危害健康行为分类,（,1,）不良生活方式与习惯,（,2,）致病行为模式,A,型行为,C,型行为,（,3,）不良疾病行为,（,4,）违反法律行为,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,参考文献,Glanz,Rimer,Viswanath,Health Behavior and Health Education:Theory,Research,and Practice,4,th,，,Hossey-Bass Publishers,San Francisco(ch3-6,8,13,16),Committee on Health and Behavior,Research,Practice,and Policy,Institute of Medicine,Health and Behavior,the interplay of biological,behavioral,and social influences,National Academy Press,Washington,D.C.(ch1-3,5,8),Neil Schneiderman,Marjorie A.Speers,etc.Integrating Behavior and Social Sciences with Public Health,American Psychological Association,Washington,D.C.(ch1-3,9,12),Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,参考文献,马骁主编，健康教育学，人民卫生出版社，,2003,年（第,2-4,章）,Mechieal P.O Donnell,主编，常春主译，工作场所健康促进，化学工业出版社，,2009,年（第,6-8,章）,吕姿之主编，健康教育与健康促进（第二版），北京大学医学出版社，,2002,年（第三、五章）,Evaluation only.,Created with Aspose.Slides for.NET 3.5 Client Profile 5.2.0.0.,Copyright 2004-2011 Aspose Pty Ltd.,