Enhancing Oral Health: A Focus on Health Promotion in the Workplace

The effectiveness of Health Promotion Principles within Health and Social Care was evaluated in the workplace, with a specific focus on how health and social care workers promote oral health for patients. The study also analyzed policies pertaining to health promotion and public health.

Bunton (1992) emphasizes the importance of customizing health promotion interventions to cater to the unique needs of individuals, utilizing insights from diverse fields including sociology, social psychology, education, communication, economics, ethics, and epidemiology.

Health promotion, as defined by the World Health Organisation (WHO 1986), is about empowering individuals to take control of their lives.

This involves helping people identify their own issues and develop the skills and confidence needed to address them. Unlike other approaches, this method takes a 'bottom-up' approach and requires health promoters to have a range of skills. Instead of being seen as authorities, health promoters act as facilitators who encourage action before stepping back.

Self-empowerment refers to the utilization of counseling techniques and client-centered approaches in order to assist individuals in taking charge of their lives and enhancing their overall well-being (Nutbeam 2009).

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In order to attain empowerment, individuals must acknowledge their lack of power, be open to making changes, and possess the required resources and skills for those changes.

The "Ottawa Charter for Health Promotion" (1986) was a significant factor in the realm of health promotion, introduced at the initial international conference on Health Promotion in Ottawa in 1986 with the aim of attaining 'Health for all by the year 2000'. This event tackled increasing worldwide needs for a fresh public health movement, building upon advancements achieved through the 'Declaration on Primary Health Care' in Alma-Ata and the World Health Organization's goals detailed in the 'Health for All' document.

According to Ewles and Simnett (2005), health promotion revolves around empowering individuals and groups to improve their health by increasing control. The goal is to enhance overall well-being in physical, mental, and social aspects, viewing health as a valuable resource for daily life rather than just a target. This emphasizes the significance of social, personal, and physical resources in maintaining health.

Health promotion is not only about encouraging healthy lifestyles but also about promoting overall well-being. It is a collective responsibility that extends beyond the health sector. As outlined in the Ottawa Charter (1986), health promotion encompasses advocating for healthy public policies, establishing supportive environments, empowering community actions, enhancing personal skills, reorienting healthcare services, and embracing future-focused approaches. This worldwide effort has prompted governments to incorporate these principles into their national policies.

The paper briefly discusses a health promotional campaign on an older person's rehabilitation unit, targeting the staff who work on the wards. A practitioner at the hospital has been appointed as the oral hygiene champion for older people with the aim of implementing the program trust-wide. Following an induction, the practitioner is ready to introduce an oral care regime in their workplace.

The role entails facilitating change, promoting and educating colleagues about the programme. A six-week period is suggested to collaborate with the team and ensure everyone is on board. The champion will implement assessments of all patients' oral health upon admission using new documentation, follow up on referrals, and oversee the process to overcome any barriers. In recent years, various standards, statements, and tools have been created and assessed to guide and support best practices in oral care.

Encouragement and support are crucial for maintaining oral hygiene in debilitated patients, those with cognitive impairment, or other medical issues. Nurses and practitioners play a vital role in promoting good oral health, preventing discomfort and inadequate nutrition, early detection of oral diseases, and improving outcomes. The WHO emphasized the importance of health for older individuals through the 'Ageing and Life Course' program in 2000, focusing on 'active ageing.' In 2002, the WHO introduced the 'Active Ageing - A Policy Framework' document highlighting health, social participation, and security as essential components for healthy ageing. Minimizing risk factors and maximizing protective factors can lead to a longer life with higher quality of life.

By implementing policies and programmes that support the elderly in various aspects such as labour market, employment, education, health, and social activities, individuals can continue to contribute significantly to society as they age. These initiatives also ensure that the elderly receive protection, dignity, and care when they are no longer able to care for themselves, addressing their social, financial, and physical security needs and rights.

Oral health is a crucial aspect of 'Active Ageing' and is integrated into health policy proposals, one of the fundamental pillars. The document highlights the effects of oral diseases on the overall health and well-being of older individuals and stresses the importance of promoting oral health. The significance of oral care is acknowledged as an overlooked area of practice (Migel and Watchel 2009) and considered a vital element of nursing in Essence of Care 2010: Benchmarks for Personal Hygiene (Department of Health (DH) 2010).

The importance of the locus control theory in health promotion and behavior changes in social psychology was emphasized by Julian Rotter (1954). This theory has become a significant aspect of personality studies, with Mackey (2006) noting that individuals with an internal locus of control tend to actively seek information about their health problems. In contrast, those with an external locus of control, as mentioned by Nancarrow (2006), are less inclined to seek out information and are more likely to accept the information presented to them. The concept of locus of control has sparked numerous studies across various fields within psychology.

In fields like educational psychology, health psychology, and clinical psychology, the construct discussed is relevant. The purpose of this study was to evaluate the significance of implementing public health policies and principles. By evaluating various models of health promotion and behavior, this paper closely analyzes their role in current practice and how they help individuals or client groups maintain well-being by addressing physical, psychological, emotional, spiritual, social, and vocational health dimensions.

Various models have emerged in recent years, offering a valuable framework for understanding the interconnected aspects of health promotion. In the context of the practitioner's role, Tannahill's model (1985) can be utilized. This model illustrates health promotion as three overlapping circles of health education, prevention, and health protection. According to Downie (1990), "Health promotion involves efforts to improve overall health and prevent illness by addressing health education, prevention, and health protection."

During the planning of the health promotion intervention, various decisions were made. This included evaluating the unit's current oral care regime to assess the situation. The practitioner then created a strategy to implement a health education program for staff in order to establish procedures for oral assessment and patient care. An email was sent out to inform all staff members about the program.

Once the required training was finished, testing was conducted on the new documentation and tools. Surveillance systems were utilized to monitor oral health in elderly individuals, monitor advancement towards oral health objectives, and collect data for cost-effectiveness analysis of oral health initiatives. This is consistent with Tannahill's (1985) concept of "prevention," which considers disease progression, improvement, and final results.

Ajzen (1985) expanded on the theory of reasoned action to develop the Theory of Planned Behaviour, emphasizing the significance of intention in behavior. The theory emphasizes that behavior is impacted by an individual's control over the behavior and their intention to engage in it, especially when confronted with external factors beyond their control.

Bandura (1997) introduced the concept of self-efficacy as part of social cognitive theory. According to Bandura (1986), expectations related to motivation, performance, and frustration resulting from failures play a crucial role in influencing emotional and behavioral responses. He distinguished between two types of expectations: self-efficacy and outcome expectancy. Self-efficacy, as defined by Bandura (1986), is the belief in one's ability to perform the necessary behaviors to achieve desired outcomes.

Outcome expectancy, the belief that a particular behavior will result in specific outcomes, is influenced by self-efficacy which affects coping mechanisms. Nurses have created health models to enhance their understanding of patient views on health and illness, ultimately improving patient care. The healthcare sector needs to enhance its tactics for implementing interventions that support health promotion and disease prevention.

Preventing illness and maintaining wellness involve a range of complex activities that focus on individuals, families, groups, and populations. Various references such as Ajzen (1985), Bunton & McDonald (1992), Bandura (1997), Downie et al. (1990), Essence of Care (2010), Ewles & Simnett (2005), Mackey & Nancarrow (2006), and Migel & Watchel (2009) provide insights and guidelines on promoting health and enhancing quality of life through different disciplines and practices.The International Journal of Older People Nursing 4, 2, 97-113 by Nutbeam, D. (2009) provides a practical guide to health promotion theories. Tannahill (1985), as cited in Papadopoulos, I. (2006) on transcultural health and social care. The Ottawa charter (1986) by the WHO in Ontario, Canada. The World Health Organization (2002) produced a Policy Framework on Active Ageing in Geneva, Switzerland. WHO Europe (1999) published Health 21 - Health for all in the 21st Century in Copenhagen.