Child health promotion: Sun Safety Jake

Date: 30-11--0001
Pages: 4 - 8
Resource topics: Child health promotion, Health promotion tool, Sun safety
Author(s): Carly Shaw

The following article was written to support a health promotion tool for the branch of nursing being studied; paediatric nursing. The health promotion tool, Sun Safety Jake, was created in the form of a game and designed for children between the ages of four and five years old. Throughout this article the concept of health will be defined along with the determinants of health and holistic health. In turn this will identify the influencing factors of the patient’s health and their needs and how successful health promotion could lead to the improvement of a patient’s health.

Ewles and Simnet (2003) discuss that British children believe that to be healthy you must be physically active and eat healthy foods. However, according to Naidoo and Wills (2000) this definition is also different for the different social classes - the middle class have a more positive view of health which relates to being fit and active; whereas the working class believe that their health is more ‘functional’ and is focused on not being unwell. This relates closely to the inequalities in health, due to the diversity of health experiences for different population groups for example: different classes and ethnicities (Black Report, 1980). This was highlighted in The Black Report (1980) as it showed that people in the upper socio-economic classes had a greater chance of avoiding illnesses than those in lower classes (Ewles & Simnet, 2003). The Acheson report (1998) also highlighted a range of areas where health inequalities could be reduced. It went on to state that ‘poverty has a disproportionate effect on children’ and that ‘1 in 3 children are in poverty.’ (BBC online network, 1998).

According to Cmich (1984) the term “holistic health” is a perspective on health that considers many of the individual’s personal factors (body – mind – spirit) and is based around placing much emphasis on the person as a whole, incorporating the individual’s responsibility for their life and well-being. Although this may be a dated definition, it still has a lot of relevance within health care in today’s society, as to be healthy it must cover the person as a whole rather than for example: only considering the spiritual health of the individual.

In order to understand health further, different influencing factors of a child’s health should be identified, so that health promotion can be successful in improving the well being of children. Ewles and Simnet (2003) establish seven influencing factors, which attempt to determine the degree of the patient’s health and highlight the complexity of the subject. These include: physical health (concerned with the bodies functions), mental health (a positive sense of purpose and ability to think clearly), emotional health (ability to recognise emotions and express them appropriately), social health (ability to maintain relationships with other people and having support available from family and friends), spiritual health (may be connected with religious beliefs or personal creeds) and finally societal health (related to everything surrounding that person for example: family and education). However, these definitions of influential factors fail to explain and recognise the issue of sexual health. Naidoo and Wills (2000) go on to explain that sexual health is the acceptance and ability to achieve a satisfactory expression of the individual’s sexuality; for example: the person you are, how you look and the relationships you have.

Patient needs

The next issue that needs to be established are the health needs of patients, in order to improve their health and lifestyle. However, this may also be a difficult term to define as it is hard to distinguish between something a person needs, with something they want and demand. Ewles and Simnet (2003) recognise four different types of needs, these include: Normative need based on the judgements of experts or professionals; felt needs are needs people ‘feel they want’; expressed needs are what people say they need and may result in a request or demand and comparative needs are where contrasts are made between different communities. By looking at these needs the health promotion tool produced will be more effective, as it will appeal to a wider audience and recognise the needs of the whole population and the clinical experts.

The Department of Health (2004) recognises children through their growth

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and development thus creating particular needs and demands which are of a different order from those affecting adult patients. This highlights that for a child health promotion tool it is important to consider the different needs experienced by children as opposed to those of adults. This framework aims to give children, young people and their parents increased information and involvement in planning their care (DH,2004).

A wide range of activities are undertaken to promote the health of children and a variety of skills are needed. Many professionals work in multidisciplinary teams, for example health visitors and school nurses and health promotion activities are usually shared and carried out by teams rather than one individual providing all the expertise on their own (Hall & Elliman, 2003). Hall and Elliman (2003) go on to discuss that some types of health promotion programmes focus on single issues, for example the specific sun safety health promotion tool I devised. However, they state that it is much easier to increase knowledge than to change attitudes and behaviour, as no single model of care can cater for all issues. Other health promotion workers may adopt a more holistic view when developing health promotion tools and the National Healthy School Programme aims to put these concepts into action (Hall & Elliman, 2003).

The World Health Organization describes health promotion as: ‘The process of enabling people to increase control over, and improve their health’ (Ewles & Simnet, 2003). Useful tools of analysis may require different models of health promotion and Ewles and Simnet (2003) identify five different approaches:

  • The medical approach which mainly uses a prominent method in that it identifies the freedom from medically defined disease and disability, for example: parents bring their child to a health care environment for their immunisations.
  • The behavioural approach which aims to change the individuals’ attitudes and behaviours so that they can adopt a ‘healthy’ lifestyle.
  • The client-centred approach is for clients to work together on their own terms and for them to make their own decisions and choices.
  • The societal change approach focuses on changing society and shaping the environment to make it more conductive to good health.
  • The educational approach which is used within the following assignment. It aims to provide information, ensure knowledge and understanding of health issues, thus enabling well informed decisions to be made. This approach values the educational process and involves identifying with clients their personal health issues, ultimately being in their best interest.

The health promotion tool devised takes the form of a game and is intended to help children between the ages of four and five to learn through play and interaction. The game provides knowledge and information on the subject of sun safety in a fun and interesting way, which should have a long lasting effect and therefore potentially lead to improvements in the health of young children for the future. All in all it is a bold, child friendly game.

Sun Safety Jake

It is anticipated that primary health education will also be used alongside the game as this focuses on improving the quality of health and therefore the quality of life rather than merely focusing on preventing illness (Ewles & Simnet, 2003), and consequently enabling the child to learn about their health and undertake voluntary changes.

Health education

The World Health Organization (WHO, 2006) recognises that schools are an excellent place to teach healthy behaviours and can help to prevent overexposure to the sun, in an environment that is geared towards learning. Teachers themselves can play a major role in influencing children’s knowledge, attitudes and behaviour regarding sun protection. This highlights some of the limitations of the health promotion tool produced as it was made for use at home with the aid of an adult. Furthermore, the fact that some parents can’t read or don’t spend time with their children was not taken into consideration. It was also difficult to put an age on the game as different children learn at different levels and ages. If the game was to be manufactured on a large scale then different cultures would have to be catered for. Changes in clothing and language would be essential for example for the Muslim faith. The game could be distributed out by primary health care providers such as health visitors and school nurses. It could then be used in homes, schools and Sure Start projects so that all children are made aware of the dangers of the sun and are able to learn from the health promotion tool.

The health promotion tool was created after exploring the issue of sun safety and observing how dangerous over exposure to the sun can be. The sun radiates light to earth, and part of that light consists of three different types of invisible ultraviolet (UV) rays – UVA, UVB and UVC. Over exposure to these can cause sunburn, aging of the skin, cataracts and increase the risk of skin cancer (Nemours Foundation, 2006).

Sun safety

The delicate skin of babies and young children is particularly sensitive to the suns ultraviolet rays (Nemours Foundation, 2006). The ultraviolet light in sunlight damages the DNA in the skin cells and this damage can happen years before cancer develops, emphasising just how important it is to raise children’s awareness from an early age. Within the childhood years the child’s skin is more susceptible to the sun as their skin is much thinner and more sensitive, therefore, only a short time outdoors during mid day can result in serious burns (Cancer Research UK, 2005). Estimates suggest that that up to 80 per cent of a person’s lifetime exposure to ultraviolet is received before the age of 18 (WHO, 2001). Fair skinned people, especially those with freckles are more at risk of sun damage than dark skinned people; this is because their skin makes less of the protective pigment called melanin (Cancer Research UK, 2005).

The incidence of malignant melanoma of the skin has been rising rapidly in the white populations around the world for several decades (National Statistics, 2002), each year there are over 8,000 new cases of malignant melanoma diagnosed in the UK; over half of these cases are in women. Official figures record over 65,400 cases of non-melanoma skin cancer diagnosed each year in the UK. Most skin cancers are caused by long term exposure to the sun (Cancer Research UK, 2005). Four out of five skin cancer cases are preventable. Protection from excessive exposure to the sun is an important preventative measure, in 1998

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one third of men reported not using sun cream compared with one fifth of women (National Statistics, 2002).

The World Health Organization (WHO, 2001) recognises a need for health promotion within sun safety. They describe that sun protection programmes raise awareness and provide changes in the public’s lifestyle (WHO, 2001). They state that it is a problem as they explain that health effects of sun exposure is a global concern and that peoples behaviour in the sun is the main cause of the rise in the rate of skin cancer, due to an increase in popular outdoor activities, which has changed sunbathing habits, resulting in excessive ultraviolet exposure (WHO 2001). WHO (2001) set up a ‘task force’ for the protection of children’s environmental health in July 1999. Protecting children from the harmful ultraviolet radiation is one of the topics covered by the task forces activities. They explain that educational programmes in schools enhance children’s knowledge and modify their attitudes and behaviour regarding sun protection (WHO, 2001).

In 1999 Tessa Jowell the then Minister for Public Health launched sun awareness week in order to protect those vulnerable to sun damage particularly children and teenagers (DH, 1999). Many people associate a sun tan to be a symbol of attractiveness and good health (WHO, 2001). WHO (2001), however, say that a sun tan is a sign of ultraviolet damage and represents the skins defence to prevent further harm.

To conclude, the issue of health promotion regarding sun safety for children has been explored, and a health promotion tool has been created in the form of a game, through this it has been identified that there is a need for children to receive a greater level of health promotion on the issue of sun safety due to government policies and statistics. The health promotion tool was chosen because although children develop at different stages, they learn through play and interaction with others (DH, 2004). The aim is that the game should produce a lasting effect so that the children are able to grow up with the knowledge and awareness that overexposure to the sun can be harmful. This improved knowledge could potentially lead to improvements in the health of future generations.

References

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