Lifelong learning health education The issue of health and hygiene of life appears in philosophy and humanities, especially in medicine, since ancient times. The current increase in the interest of various social-scientific disciplines in the issue of health is associated with threats related to cultural-civilizational changes, as well as changes in the environment. Health is becoming an increasingly valued value and at the same time a wider than medical problem. Health education has been a stable part of lifelong education and training in every period of human civilizational history. Basic program documents related to lifelong learning, for example, the White Book of the European Union, Memorandum on lifelong learning, etc. include the issue of health education among the basic areas of education and training of adults. The purpose of the submitted contribution is to point out the concept of health education and related concepts in the context of the necessity of lifelong education and training in health issues.

The content of the term health is unusually broad. It can be viewed from different perspectives - objective and subjective, professional and lay, individual and social. It is currently almost impossible to give a uniform definition of health: for example, a doctor understands the term health as the absence of illness or injury, a sociologist understands a healthy person as a person who is able to function well in all his/her social roles, a humanist uses the words healthy person to denote a person who is able to cope positively with life's tasks, an idealist imagines a healthy person as a person who is well - physically, mentally, spiritually and socially (Křivohlavý, 2001). Constant interest in the issue of health has accompanied humanity since the earliest times. The concept of a wise way of life in antiquity also included the concept of health - to live healthy meant "to live wisely and well. The Greek word ischio meant being healthy and strong. Similarly, the Greek hygiaio, known from today's term hygiene, means to be healthy and capable of living. This also includes the Greek term holocteria - perfect health. The terminology of the concept of health includes the terms of disease. In Greek astheneia means weakness and astheneo to weaken (we also have a similar term in Slovak with the meaning of asthenic, weak). Arrostos - one who is not fit (able to do something) belongs to the area of Greek terms. Nosos meant "disease". The Greek herapeuo (a derived Slovak term therapy) and apokathistemi mean to heal. it carried three meanings:

  1. to save a person in danger of life - either loss of the physical body or in danger of losing the meaning of life,
  2. helping a person to be a "whole" person, healthy not only physically, but also mentally and spiritually,
  3. heal the sufferer.

We also encounter a similar broader concept of health and healing in other languages. For example, in Hebrew the greeting - wishing shalom - meant not only whole health, but also inner peace and tranquility, of a person as an indivisible physical, mental and spiritual whole. It also meant a tendency towards maturity and prosperity, a characteristic of "doing things safely in life and accomplishing what one has set out to do. On important occasions, we still wish for health and a lot of health as the most important value in life. In the twentieth century, we encounter a wide range of meanings of the term health. Some definitions focus on the health of the body, others understand health as a commodity, or as a mysterious power that a person receives at birth and with which he must manage carefully in his life (Brukkerová, 2008a, Křivohlavý, 2001). In the professional literature, the most frequently cited definition of health is the World Health Organization's constitution from 1948: "Health is a state of complete physical, mental and social well-being, not just the absence of disease and infirmity (Constitution, 1978)." Its importance lies in the fact that it does not exclusively monitor objective health indicators, it is also based on the subjective perception of health by individuals. The disadvantage is the indication of an ideal state, rather than a precise and formal definition of the term (Liba, 2002).

A shift in the definition of the term health is brought by the later WHO challenge Health for all by the year 2000, in which the definition of health appears as "the ability to lead a socially and economically productive life" (Dunovský et al., 1999). Thus, health ceases to be an end in itself, but becomes a means for realizing a harmonious human life. The given definitions can be understood as a certain effort to combine objective indicators with subjective and social data. The goal is to comprehensively monitor the overall condition of the individual. Emphasizing one approach - either only objective or subjective factors - leads to simplification that can harm the individual. Preventive medicine seeks to quantify risk symptoms that may conflict with a person's subjective feelings (Liba, 2002).

Human health can therefore be understood as a certain immediate state, but also as an ongoing process that has its own dynamics. From a scientific point of view, we distinguish different degrees of health, as well as different degrees of disease. The desirable state is the so-called positive health. Achieving it is a long-term goal especially of preventive scientific departments, but also of preventive efforts and measures of society. The positive aspect of health focuses on supporting moments that maintain and strengthen the individual's well-being. According to Břicháček (1987), it is based on the following experiences:

  1. specific forms of behavior increase the risks of developing serious diseases (inappropriate lifestyle, incorrect lifestyle, smoking, etc.),
  2. an individual's behavior can be systematically and deliberately changed and thereby reduce the effectiveness of risk factors,
  3. Purposefully chosen programs aimed at behavioral changes are economically less demanding than additional treatment of already established or developed disorders or diseases.

Human health has a number of aspects that are reflected in theoretical considerations. With a certain simplification, we can define four categories, when the mentioned categories actually overlap and indicate that simplified views of the health category miss the point. (Dunovský et al., 1999):

  1. a holistic approach that emphasizes the concept of a person (and social groups) as an indivisible and integrated whole with the acceptance of biological, psychological and social components,
  2. a dynamic approach, which analyzes the variability of the state of health over time and understands health as a variable phenomenon that prevails in a lifelong perspective,
  3. social approach, which includes the individual in a wider network of family and group social relations and considers health in social contexts,
  4. the interactive principle, which follows a person in his wider (natural and political) environment.

Education for health

The current creation of terminology is necessary for the exchange of experience, the assessment of the achieved level, as well as the further development of the theory and practice of each scientific discipline. Creating a unified terminology is not only extremely necessary, but also difficult. The terminological apparatus in the field of health education contains many terms taken from border disciplines (psychology, pedagogy, sociology, art, etc.). Sometimes archaic and ambiguous terms and definitions are used, which can lead to misunderstandings in scientific and practical work. Already the International Dictionary of Health Education (1983) was the result of an effort to unify and organize terminology, to create a "common language" for experts and all those involved in the work of health education. The unification of terminology can support a more rational use of health education opportunities in increasing health awareness, and at the same time contribute to increasing the health potential of the population. Historically, health education has long been an organic part of adult education and training. This is also confirmed by the fact that we found the term "health education" relatively widely elaborated in the pedagogical dictionaries available to us, or in dictionaries of adult education and training, such as the Pedagogical Encyclopedia of Slovakia (1985), the terminological and explanatory dictionary of Adult Education and Education - Andragogy (2000) and the Explanatory Dictionary of Adult Education (Palán, 1997).

In addition to the term health education, other terms were used practically as synonyms in the professional literature. In older literature, it is mainly the term health education and health education. (e.g. Ganický et al., 1962) In contemporary health literature, the term health education appears most often, especially the term health education in recent times. Until the 80s of the last century, the designation health / medical education was more commonly used in our country. It was about emphasizing the importance of health measures, such as vaccination, highlighting the medical side of the issue. Currently, emphasis is placed not only on obtaining health information, but above all on forming an active attitude of a person towards the protection and support of his health, many contemporary authors therefore think the term health education is more appropriate (Beniak, Beniaková, 2003, MZ SR, 1996). In the international terminology we can find: in English Health Education, in French Éducation pour la santé, in German Gesundheitserziehung and in Russian Sanitarnoje prosveščenije (International, 1983).

Health education is a dynamic term, the definition of this term is therefore very complex and not always uniform due to its extensive scope. Another term with a related content, which in recent years has been preferred above all in health literature, is health promotion - Health Promotion. Health promotion is defined as the process of enabling people to take control of their health. At the social level, it is a set of legislative measures and societal and community-wide programs that serve to preserve or improve health. (Hegyi, et. al., 2004) Health education is a related term that refers to the process leading to the responsible use of health information. Currently, however, it is necessary to perceive health education not only as the transmission of information, but also as a process aimed at changing behavior (Wiegerová, 2000). A more detailed definition of health education can be found in the Terminological Dictionary of Andragogy (2000), which views health education on three levels. He understands it as:

  1. an interdisciplinary medical field whose mission is to provide and expand knowledge, attitudes and habits aimed at protecting and promoting health in individuals and population groups.
  2. medical-andragogic-pedagogical department of a multidisciplinary nature, the mission of which is to expand and shape the knowledge, attitudes and habits of the inhabitants, aimed at the protection and promotion of health.
  3. educational and awareness-raising activity, focused on an active attitude towards health, increasing health awareness and health knowledge, expanding care for a healthy way of life for people and creating a healthy environment with the aim of increasing the quality of life.

The first level of the given definition represents a specific medical field. It is a level irreplaceable for the content quality of health-educational activities. It applies primarily to doctors - lecturers at health education activities. The second level expands the medical aspect with andragogic-pedagogical aspects within the field of multidisciplinary nature, whose mission is to expand and shape the knowledge, attitudes and habits of the inhabitants, aimed at protecting and promoting health. Both definitions emphasize the scientific basis of health education. From the point of view of andragogy, the third level of this definition is equally important. Health education can also be defined as a process through which individuals and groups of people learn to behave in a way that leads to the promotion, maintenance or restoration of health. Health education can therefore also be defined as "educational activities that promote understanding of health problems, develop attitudes towards a healthy lifestyle, hygienic habits and health practices in accordance with the health needs of the individual, family and community" (Švec, 2002).

Health promoting school

Education and training for a healthy lifestyle is important in a lifelong context. In professional literature, this issue is the most developed in relation to younger age categories. The Health Promoting Schools project has been implemented in the Slovak Republic since 1992. It arose from the initiative of the World Health Organization, the Council of Europe and the European Parliament. The goal of the project is primarily health promotion in schools and disease prevention in terms of health protection strategies, health education and health prevention. A healthy school focuses on ensuring that pupils, teachers and employees lead a healthy lifestyle. The concept offers opportunities to create a safe and health-enhancing social and physical environment for the lives of all parties involved.

The main objectives of the project are:

  • creation of a healthy environment and its protection, personal health care and environmental education,
  • humanization and democratization of the educational process,
  • support of mental, physical and social health,
  • rational lifestyle, drinking regime, healthy lifestyle,
  • support and protection of health, strengthening, prevention of diseases,
  • support of physical activities and sports, development of physical fitness and active use of free time,
  • increasing safety at work, reducing the risk of accidents,
  • addiction prevention. (Tomková, 2009)

Health education in schools as a means of effective primary prevention of health problems and socio-pathological phenomena is not currently structured as a separate teaching subject. Within the curriculum, health and prevention topics are part of subjects such as: natural science, homeland science, ethical education, history, civic education, physical education, biology, etc. They affect a wide area of ​​educational activity with the aim of saturating an adequate curriculum of information, knowledge and skills together with the formation and stabilization of expected attitudes, interests and value criteria. (Liba, 2007) A. Wiegerová (2005) deals primarily with curricular issues of health education, who in her work promotes the establishment of health education as an independent subject in the institutional system of education and training in Slovakia. The Slovak network of health-promoting schools relies on the innovative National Health Promotion Program and on the global programs of the World Health Organization (WHO) and its current "Health 21" program. The national Healthy Kindergarten project is in the same spirit.

Goals and tasks of health education

According to the Concept of the Department of Health Education, issued by the Ministry of Health of the Slovak Republic on May 7, 1996, the main goal of health education is to strengthen, protect, support and motivate the active participation of the population in taking care of their health and thus the health of the whole society. At the same time, the concept establishes sub-goals of health education, according to which it is necessary to achieve that residents acquire correct knowledge about their health, acquire correct attitudes and habits, develop active, conscious, personal and effective protection of individual and social health (Ministry of Health of the Slovak Republic, 1996). Beniak and Beniaková (2003) consider the dominant role of health education to be increasing health awareness, the level of which is conditioned by objective and subjective factors. Health education acts in the direction of forming a conscious relationship to health, helps the formation of a health culture and, above all, prospective health behavior. Health behavior is a reflection of health attitudes. It can be positive - where there is no need for change in the direction of strengthening health, and negative - where it is necessary to look for adequate methods and forms to change behavior in the direction of strengthening health. According to Wieger (2000), Positive health behavior is characterized by:

  • activities aimed at improving your physical and mental condition,
  • by renouncing such forms of behavior that harm one's own health and the health of other people,
  • by participating in health promotion, in shaping an environment that supports health,
  • creating adequate working and living conditions, forming a positive attitude towards the environment.

Summarizing, we can state that health education is primarily a purposeful, systematic educational activity aimed at creating the right knowledge, skills, habits and attitudes in matters of health protection and strengthening. It is an important means of health development and disease prevention (Brukkerová, 2006). The goal of health education is to equip individuals to be able to make decisions in matters that affect their health and sense of well-being, expand their knowledge, create and change their life attitudes, values, opinions and create the right skills and habits. Fulfillment of this goal depends on external (material and social environment of the person) and internal conditions (the health awareness of the person itself). The content of health education consists of selected medical information related to the protection and development of health, which differ depending on whether it is primary health education (aimed at a healthy population, the goal is prevention and improving the quality of life), secondary health education (teaching the patient about his condition and changes in his behavior in order to comply with the treatment regimen) or tertiary health education (enabling patients and their relatives to make the best use of current options health status and prevention of complications). The goal of health education is not the medical education of lay people, but their education in appropriate health-beneficial actions (Jarošová, 1998). High-quality health education with demonstrable results is possible only with the mutual cooperation of all participating implementers of health-educational activities - medical, pedagogical, cultural-educational workers, governmental and non-governmental institutions, church organizations and professional associations active in the field of human health development (Brukkerová, 2006, 2008b).

Conclusion

If we have to briefly summarize what has been said - health is a prerequisite for the existence and functioning of other values. Personal behavior is considered by many authors to be one of the most important determinants of health. Cultivating and internalizing healthy lifestyle habits is one of the defining tasks of health education in the family, school and other participating components of society. A general shift towards the opinion that health is primarily a matter of one's own responsibility for life is evident. Antoine de Saint-Exupèry once expressed the idea: "Man is great by feeling responsibility." This idea takes on a special meaning in relation to health. By the way we live, we are primarily responsible for ourselves and our loved ones. Responsibility is a harmonious complement to our freedom (Schultz, 2002). In the context of the above, the role of lifelong education and training in relation to health is irreplaceable.

Authors: Zuzana Filípková, Darina Brukkerová Faculty of Public Health, Slovak Health University, Bratislava Literature**

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The paper was presented at the 5th annual conference entitled ,,Psychology of health 2010", which took place on May 19, 2010 in Bratislava. The conference was organized by the health psychology section of the SPS at SAV in cooperation with the health section of the Ministry of Health of the Slovak Republic. The following participated in the preparation of the event: National Institute of Heart and Vascular Diseases in Bratislava, VŠZaSP St. Elizabeth in Bratislava, WHO Office in Slovakia, KISH Košice, Department of Psychology FF KU in Ružomberok and Department of Psychology FF TU in Trnava.

Proceedings from the 5th conference of health psychology, Bratislava, 2010 was published only in electronic form Availability: http://www.prohuman.sk/psychologia/zbornik-prispevkov-z-konferencie-psychologia-zdravia-2010