SACH DAO TAO

Chu
nguyI n

Dinh dirdng

Cung urng
thuoc thiet
yeu

Tiem chung

sIG U YEN
Phong Bao ve
>C LIEU
chong siirc khoe
dich benh ba me tre em

NHA XUAT BAN Y HOC

 BO Y TE

GIAO DUC
VA NANG CAO SI/C KHOE
s Ac h d Ao t a o bAc Si d a k h o a

Ma so: D.01.Y.18

Chu bien: TS. NGUY§N VAN HIEN

DAI HQC THAI NGUYEN

TRUNGTAMHOGLllO

NHA XUAT BAN Y HOC

HA NOI - 2007
■
 CHI DAO BIEN SOAN:

Vu Khoa hoc va Dao tao, Bo Y te

CHIJ BIEN:

TS. Nguyen Van Hien

THAM GIA BIEN SOAN:

TS. Nguyln Van Hien

TS. Nguyen Duy Luat
TS. Vu Khac LUdng

THAM GIA TO CHQC BAN THAO:

ThS. Phi Van Tham

BS. Nguyen Ngoc Thjnh

© Ban quyen thuoc Bo Y te (Vu Khoa hoc va Dao tao)

2
 LOI GlCfl THIEU

Thuc hien mot so" dieu cua Luat Giao due, Bo Giao due & Dao tao va Bo
Y te da ban hanh chiidng trinh khung dao tao Bac si da khoa. Bo Y te to chiic
bien soan tai lieu day- hoc cac raon cd sd, chuyen mon va cd ban chuyen
nganh theo chUdng trinh tren nh&m tutng bifdc xay dung bo sach chuan trong
cong tac dao tao nhan luc y te.
Sach Giao due va nang cao siic khoe dutdc bien soan dUa tren chUdng
trinh giao due cua TrUdng Dai hoc Y Ha Noi tren cd s6 chUdng trinh khung da
diidc phe duyet. Sach dUdc cac nha giao giau kinh nghiem va tam huyet vdi
cong tac dao tao bien soan theo phUdng cham: kien thiic cd ban, he thong; noi
dung chinh xac, khoa hoc; cap nhat cac tien bo khoa hoc, ky thuat hien dai va
thuc tien Viet Nam.
Sach Giao due va nang cao sijfc khoe da dUdc Hoi dong chuyen mon tham
dinh sach va tai lieu day-hoc chuyen nganh bac si da khoa cua Bo Y te tham
dinh vao nam 2006. Bo Y te ban hanh la tai lieu day - hoc dat chuan chuyen
mon cua nganh y te trong giai doan 2006 - 2010. Trong qua trinh sU dung
sach phai dUdc chinh ly, bo sung va cap nhat.
Bo Y te xin chan thanh cam dn cac Nha giao, cac chuyen gia cua trUdng
Dai hoc Y Ha Noi da danh nhieu cong siic hoan thanh cuo'n sach nay, cam dn
GS.TS. Trifdng Viet Dung, TS. Le Phi Diet da doc, phan bien de cuon sach
dUdc hoan chinh kip thdi phuc vu cho cong tac dao tao nhan luc y te.
Lan dau xuat ban, chung toi mong nhan difdc y kien dong gop cua dong
nghiep, cac ban sinh vien va cac doc gia de lan xuat ban sau diidc hoan thien hdn

VU KHOA HOC VA 0AO TAO

BO Y TE

3
 LOI NOI OAU
Cham soc siic khoe ban dau la mot trong nhiing noi dung trong tarn trong
cong tac cua nganh y te, nham dat dUdc tinh trang siic khoe tot nhat cho moi
ngUdi. Trong Cham soc siic khoe ban dau To chiic Y te the gi6i da xac dinh noi
dung so' mot la Giao due siic khoe. C) nUdc ta hoat dong Giao due siic khoe ngay
cang phat trien. da gop ph&n ti'ch ciic trong cong tac bao ve va cham soc siic khoe
nhan dan. Hoat dong Giao due stfc khoe la noi dung quan trong cua Nang cao siic
khoe. dUdc thuc hien cho ca ca nhan va cong dong, cho ca ngUdi om va ngUdi khoe.
Tren cd sd tinh xa hoi rong rai, Giao due siic khoe va Nang cao stic khoe mang lai
cho ca nhan va cong dong kien thiic, hieu biet, each nhin nhan van de benh tat siic
khoe dung dan, loai bo cac nhan thiic sai trai ve siic khoe, benh tat. nhiing me tin.
di doan, phong tuc tap quan lac hau eo hai va thuc hanh cac hanh vi lanh manh co
ldi cho silc khoe va kiem soat dUdc toan bo siic khoe cua minh. ThUc hien Giao due
siic khoe va Nang cao siic khoe khong nhufng doi hoi can bo y te phai nam voing cac
kien thiic ve y hoe ma con phai eo du cac kien thiic ve tam ly, giao due, khoa hoc
hanh vi. khoa hoe xa hoi.
Viec trang bi cho sinh vien y khoa nhiing kien thiic cd ban ve Giao due siic
khoe va Nang cao siic khoe va ren luyen ky nang Giao due siic khoe va Nang cao siic
khoe la rat can thiet vi co lien quan chat che den nhiem vu nghe nghiep sau nay
cua ho. Dua theo chUdng trinh khung dao tao Bac si da khoa he 6 nam dUdc Bo
Giao due va Dao tao. Bo Y te ban hanh nam 2001. chung toi bien soan cuon sach
nay nham dap ling nhu cau hoc tap cua sinh vien, dong thdi co the dap ling mot
phan nhu cau tham khao cua mot so" ban doe quan tam, nhiing ngUdi dang thiic
hien nhiem vu Giao due siic khoe va Nang cao siic khoe .
Cuori sach dUdc bien soan gom 7 bai. dUdc sap xep theo trinh tii hdp ly lien
quan den cac noi dung cd ban cua Giao due siic khoe va Nang cao siic khoe. Sach
dUdc dung lam tai lieu day hoc chinh thiic cho sinh vien y da khoa. Khi sU dung
sach. sinh vien can doc va hoc theo trinh tii tii bai thii nhat den bai thii bay se
thuan ldi cho viec tiep thu va hieu noi dung chinh ve Giao due siic khoe. Vdi muc
dlch tham khao, ban doc co the chon doc bat ky noi dung nao lien quan trong
cuon sach.
Mac du da co nhieu co gang trong soan thao va bien tap nhUng ch^c ch in
cuon sach nay con nhieu thieu sot. Chung toi rat tran trong mong nhan dUdc tat
ca y kien dong gop cua cac ban doc gan, xa de siia doi, bo sung cho cuon sach
ngay cang hoan chinh hdn, dap ling tot hdn nhu cau dao tao va tham khao cua
doc gia.

Thay mat cac tac gia

TS. Nguyen Van Hien

5
 MUC
■ LUC
■

Lcti noi dau 5

Bai 1. Khai niem ve truyen thong giao due sufc khoe va 11
nang cao sufc khoe
TS. Nguyen Van Hien
1. Mot so" khai niem 11
1.1. Thong tin 11
1.2. Tuyen truyen 11
1.3. Giao due 12

1.4. Truyen thong giao due siic khoe (TT - GDSK) 12

1.5. Nang cao siic khoe 14
1 .6 . Mot so" khai niem khac lien quan den TT-GDSK 17
2. Vai tro cua truyen thong giao due siic khoe trong cong tac cham soc 18
siic khoe
3. He thong to chiic va trach nhiem thiic hien TT-GDSK 20
3.1. Tuyen trung UOng 20
3.2. Tuyen tinh/thanh pho" 21
3.3. Tuyen huyen/quan 21
3.4. Tuyen xa phUOng va thon/ban 22

Bai 2. Nguyen tac truyen thong giao due sufc khoe va nang cao 24
sufc khoe
TS. Nguyen Duy Luat
1. Khai niem 24
2. Cac nguyen tac truyen thong giao due siic khoe 24
2.1. Nguyen tac khoa hoc trong TT-GDSK 24
2.2. Nguyen tac dai chung trong TT-GDSK 29
2.3. Nguyen tac triic quan 31

2.4. Nguyen tac thiic tiln 31

2.5. Nguyen tac long ghep 32

2 .6 . Cac nguyen tac khac 33

7
Bai 3. Hanh vi sufc khoe, qua trinh thay doi hanh vi sufc khoe 35
TS. Nguyen Van Hien

1. Khai niem ve hanh vi va hanh vi sufc khoe 35

1.1. Khai niem ve hanh vi 35
1.2. Khai niem ve hanh vi siic khoe 35
2. Cac yeu to' anh hiidng den hanh vi sufc khoe 37
2.1. Suy nghl va tinh cam 37
2.2. Nhiing ngUdi co anh hiicfng quan trong 40
2.3. Nguon hie 41
2.4. Yeu to" van hoa 43
3. Mo hinh cac yeu to" anh htfcing den hanh vi sufc khoe 44
4. Cac biidc cua qua trinh thay doi hanh vi siic khoe 46
4.1. Cac budc cua qua trinh thay doi hanh vi stic khoe 46
4.2. Cac loai ngUdi khac nhau vdi viec tiep nhan kien thiic, hanh vi m6i 47
4.3. Cac cach lam thay doi hanh vi 48
4.4. Nhiing dieu kien can thiet cho thay doi hanh vi siic khoe 50

Bai 4. Noi dung truyen thong giao due sufc khoe 52

TS. Nguyen Van Hien

1. Cac nguyen tac liia chon noi dung TT-GDSK 52

1.1. Md dau 52
1.2. Mot so" nguyen tac trong liia chon noi dung TT-GDSK 53
2. Cac noi dung chinh can truyen thong giao due siic khoe 54
2.1. Giao due bao ve siic khoe ba me tre em 54
2.2. Giao due dinh diidng 60
2.3. Giao due siic khoe d triidng hoc 61
2.4. Giao due ve sinh va bao ve moi triidng 63
2.5. Giao due ve sinh lao dong, phong chong tai nan va benh nghe nghiep 65
2.6. Giao due phong chong benh tat noi chung 66
3. Vi du ve soan thao mot so" noi dung can TT-GDSK cho cong dong
ve giai quyet phan va niidc 67

8
 3.1. Giai quyet phan ngiidi °7
3.2. Nguon nude sach 70

Bai 5. Phifcfng tien va phtfcfng phap truyen thong giao due stfc khoe 73
TS. Nguyen Van Hien

1. Khai quat ve phUdng phap va phiidng tien TT-GDSK 73

2. Phtfdng phap giao due siic khoe 74
2.1. Khai niem 74
2.2. Cac phiidng phap giao due siic khoe gian tiep 77
2.3. Cac phUdng phap giao due siic khoe trUc tiep 83
3. PhUdng tien giao due siic khoe 105
3.1. Khai niem 105
3.2. Phan loai 105

Bai 6: Lap ke hoach truyen thong giao due siic khoe va quan ly 108
hoat dong truyen thong giao due siic khoe

TS. Vu Khac LiiOng

TS. Nguyen Van Hien

1. Mot so" diem can chu y khi lap ke hoach TT-GDSK 108
1.1. Xac dinh ro van de can phai TT-GDSK 108
1.2. Dii kien tat ca cac nguon lii co the sU dung trong TT-GDSK 108
1.3. Sap xep thdi gian hdp ly 108
1.4. Long ghep 108
1.5. Diia cac nguyen ly cua cham soc siic khoe ban dau vao hoat dong
TT-GDSK 109
2. Cac biidc lap ke hoach truyen thong giao due siic khoe 109
2.1. Xac dinh cac van de can truyen thong giao due siic khoe 110
2.2. Chon van de liu tien can truyen thong giao due siic khoe 110
2.3. Xac dinh doi tUdng dich va muc tieu cho chtfdng trinh TT-GDSK 110
2.4. Xac dinh nguon liic va lUa chon phiidng tien, phUdng phap TT-GDSK 116
2.5. Thii nghiem tai lieu, phiidng tien TT-GDSK 118
2.6. Xay dung chiidng trinh hoat dong cu the 121
2.7. Lap ke hoach danh gia chiidng trinh truyen thong giao due siic khoe 122
3. Quan ly hoat dong truyen thong giao due siic khoe 123
3.1. Khai niem ve quan ly hoat dong TT-GDSK 123
3.2. Muc dich cua quan ly hoat dong TT-GDSK 124
3.3. Cac noi dung quan ly dac trUng ve TT-GDSK 124
3.4. Giam sat danh gia cac hoat dong TT-GDSK 126

Bai 7. Ky nang truyen thong giao due stic khoe

TS. Nguyin Van Hien

1. Khai niem chung ve truyen thong 131
2. Cac khau cd ban va qua trinh truyen thong 132
2.1. Cac khau cd ban cua truyen thong 132
2.2. Mo hinh truyen thong cua Shannon va W earver 133
2.3. Qua trinh truyen thong 134
3. Cac yeu cau lam cho truyen thong giao tiep co hieu qua 138
3.1. Yeu cau can co cua ngiidi thiic hien truyen thong giao due siic khoe 138
3.2. Yeu cau doi vdi thong diep giao due siic khoe 138
3.3. Yeu cau vdi kenh truyen thong 142
4. Cac ky nang truyen thong giao tiep cd ban can ren luyen 143
4.1. Ky nang noi 143
4.2. Ky nang dat cau hoi 144
4.3. Ky nang nghe 145
4.4. Ky nang quan sat 146
4.5. Ky nang thuyet phuc 146
4.6. Ky nang khuyen khich, dong vien 147

4.7. Ky nang sii dung tai lieu TT-GDSK 147

4.8. Mot so' ky nang khac 148

Tai lieu tham khao 151

10
 Bai 1

k h a i n iem
■
DUC
v e t r u y e n t h o n g g ia o
■
S tic KHOE
VA NANG CAO SlfC KHOE

MUC Tl£u
1. Trinh hay khai niem, muc dich cua truyen giao due siic khoe va nang cao siit
khoe.
2. Phan tich diidc vi tri vai tro cua truyen thong giao due stic khoe trong cong tac
cham soc site khoe nhan dan.
3. Neu he thong to chiic truyen thdng giao due siic khoe trong nganh y te'Viet Nam.

1. MOT
• SO KHAI NIEM
•

1.1. Thong tin

Thong tin la qua trinh chuyen di cac tin tiic, sii kien tvf mot nguon phat
tin tdi doi tUdng nhan tin. Cung cap thong tin cho cac doi tUdng la mot phan
quan trong cua truyen thong giao due siic khoe (TT-GDSK), nhung TT-GDSK
khong chi la qua trinh cung cap cac tin tiic mot chieu tii nguon phat tin den
ndi nhan tin ma la qua trinh tac dong qua lai va co sU hop tac giuta ngUdi TT-
GDSK va doi tUdng dUdc TT-GDSK. Viec cung cap cac thong tin cd ban, can
thiet ve benh tat, siic khoe cho ca nhan va cong dong la budc quan trong de
tao nen nhiing nhan thiic dung d£n cua ca nhan va cong dong ve nhu cau
cham soc va bao ve siic khoe. Cac phUdng tien thong tin dai chung nhu dai, ti
vi cac an pham co vai tro quan trong trong viec cung cap thong tin noi chung
va thong tin ve siic khoe benh tat noi rieng.

1.2. Tuyen truyen

Tuyen truyen la hoat dong cung cap thong tin, thong diep ve mot chu de
nao do, nhiing dUdc lap di lap lai nhieu lan, bang nhieu hinh thiic nhii quang
cao tren cac phiidng tien bao, dai, ti vi, pa no ap phich, td rdi. Vdi hinh thiic
tuyen truyen, thong tin diidc chuyen di chu yeu la theo mot chieu. Tuyen
truyen qua quang cao co the diia lai ket qua tot nhiing nhiing thong diep
tuyen truyen lien quan den siic khoe phai diidc kiem duyet chat che de dam

11
bao nhiing thong diep do la dung khoa hoc va co ldi cho siic khoe, tranh
nhiing quang cao chi mang tinh thUdng mai thuan tuy, thieu ccf sd khoa hoc
da diidc chiing minh va co the co hai cho sufc khoe cong dong.

1.3. Giao due

Giao due la cd sd cua tat ca cac qua trinh hoc tap. Giao due la qua trinh
lam cho hoc tap diidc diin ra thuan ldi, nhu vay giao due gan lien vdi hoc tap.
Tuy nhien rat kho co the phan biet biet ro rang giiia giao due va hoc tap. Ca
giao due va hoc tap cua moi ngUdi deu dien ra qua cac hoat dong giang day
cua giao vien, cua nhiing ngiidi hiidng din , nhiing cung co the d iin ra bang
chinh cac hoat dong cua ban than moi ca nhan v6i cac dong cd rieng cua ho.
Theo tii dien tieng Viet (tac gia Bui Nhii Y) giao due la tac dong co he thong
den sii phat trien tinh than, the chat cua con ngiidi de ho dan dan co diidc
nhiing pham chat va nang liic nhu yeu cau de ra.

1.4. Truyen thong giao due stfc khoe

Truyen thong-Giao due siic khoe la mot trong nhiing hoat dong quan
trong trong cong tac y te dii phong, gop phan giup moi ngUdi dat diidc tinh
trang siic khoe tot nhat, thong qua cac hoat dong cham soc siic khoe chu dong
cua chinh moi ca nhan, moi cong dong. Siic khoe dUdc To chiic Y te the gidi
dinh nghia la trang thai thoai mai toan dien ve the chat, tinh than va xa hoi
chii khong chi bao gom tinh trang khong co benh hay thUdng tat. Siic khoe la
von quy nhat cua -moi ngiidi, la nhan to" cd ban trong sii phat trien cua moi ca
nhan va la bo phan trong toan bo qua trinh phat trien xa hoi. Co nhieu yeu to"
tac dong den siic khoe cua con ngiidi nhU: yeu to" xa hoi, van hoa, kinh te, moi
trUdng va yeu to" sinh hoc nhu di truyen, the chat. Muon co siic khoe tot phai
tao ra moi trUdng song lanh manh, loai bo cac yeu to nguy cd den siic khoe, vi
the doi hoi phai co sii tham gia tich ciic cua moi ca nhan, gia dinh va cong
dong vao cac hoat dong bao ve va nang cao siic khoe. Tren thiic te" cac ca
nhan, gia dinh va cong dong diia ra hau het cac quyet dinh cham soc siic khoe
cua ho chii khong phai la can bo y te". De co dUdc cac quyet dinh dung dan ve
cham soc siic khoe moi ngiidi can co hieu biet nhat dinh ve siic khoe va benh
tat. To chiic cung cap cac dich vu y te khong the dat diidc ket qua tot neu tach
rdi vdi hoat dong TT-GDSK. Vai tro cua TT-GDSK da dUdc To chiic Y te" the
gidi rat coi trong va dUdc dac biet nhan manh tai hoi nghi Alma Ata nam 1978
ve cham soc siic khoe ban dau. Day manh cong tac TT-GDSK la bien phap
quan trong giup moi ngUdi dan nang cao kien thiic ve cham soc siic khoe,
phong chong cac benh tat, tai nan, tii do co cach nhin nhan van de siic khoe,
benh tat dung miic va chu dong hanh dong dung dan vi siic khoe cua chinh
minh va cua nhiing ngiidi khac. 6 niidc ta tii triidc den nay hoat dong TT-
GDSK da dUdc nganh y te quan tam, cac hoat dong diidi cac ten goi khac
nhau nhu: tuyen truyen ve sinh phong benh, tuyen truyen bao ve siic khoe,
tuyen truyen giao due siic khoe, giao due ve sinh phong benh....nhUng du dudi

12
ten nao thi cac hoat dong cung nham gop phan bao ve va nang cao siic khoe
cho nhan dan. Hien nay ten goi TT-GDSK diidc sii dung kha pho bien va diidc
coi la ten goi chinh thiic d nUdc ta. Co the dinh nghla TT-GDSK nhu sau:
Truyen thong gido due siic khoe giong nhii gido due chung, la qud trinh
tdc dong co muc dich, co ke hoach den suy nghl va tinh cam cua con ngiicfi,
nham nang cao kien thiic, thay doi thdi do va thiic hanh hanh vi Idnh manh
de bao ve va nang cao siic khoe cho cac cd nhan, gia dinh va cong dong.
Truyen thong giao due siic khoe la qua trinh cung cap thong tin, giup dd,
dong Wen, tao dieu kien de moi ngUdi hieu dUdc van de siic khoe cua ho va
chon dUdc cach giai quyet thich hdp nhat van de cua ho.
Nhu vay hoat dong truyen thong giao due siic khoe tac dong vao 3 lmh
viic cua doi tUdng dUdc TT-GDSK: kien thiic cua doi tUdng ve van de siic khoe,
thdi do cua doi tUdng doi vdi van de siic khoe, thiic hanh hay cach ling xii cua
doi tuo'ng de giai quyet van de siic khoe, nham bao ve va nang cao siic khoe.
Dinh nghia nay cung cho thay TT-GDSK la mot qua trinh can dUdc tien hanh
thUdng xuyen, lien tuc, lau dai, ket hdp nhieu phUdng phap chii khong phai la
cong viec chi tien hanh mot lan.

Sd do 1.1. Moi lien quan giura ngi/di TT-GDSK va ngiidi diidc TT-GDSK

Thiic chat TT-GDSK la qua trinh day va hoc, trong do tac dong giiia
ngiidi thiic hien giao due siic khoe va ngUdi dUdc giao due siic khoe theo hai
chieu. Ngiidi thiic hien TT-GDSK khong phai chi la ngUdi "Day" ma con phai
biet "Hoc" tii doi tUdng cua minh. Thu nhan nhiing thong tin phan hoi tii doi
tudng dUdc TT-GDSK la hoat dong can thiet de ngUdi thiic hien TT-GDSK
dieu chinh. bo sung hoat dong cua minh nham nang cao ky nang, nang cao
hieu qua thiic hien nhiem vu TT-GDSK.
Trong TT-GDSK chung ta quan tam nhieu den nhiing van de la lam the
nao de moi ngudi hieu diidc cac yeu to nao co ldi va yeu to nao co hai cho siic
khoe. tu do khuyen khich ngUdi dan thiic hanh co ldi cho siic khoe va tii bo
cac thiic hanh co hai cho siic khoe. Tren thiic te do thieu hieu biet, nhieu
hanh vi co hai den siic khoe diidc ngudi dan thijc hanh tii lau, co the trd thanh
nhiing niem tin. phong tuc tap quan vi the de thay doi cac hanh vi nay can
thiic hien TT-GDSK lau dai, thUdng xuyen, lien tuc, bang nhieu phUdng phap
khac nhau chii khong phai la cong viec lam mot lan la dat dUdc ket qua ngay.
De thuc hien tot TT-GDSK doi hoi phai xay diing ke hoach lau dai, co sii quan
tam dau tu cac nguon liic thich dang.

13
 Triet ly cua TT-GDSK da dUdc de cap den trong cac tai lieu cua To chiic
Y te the gi6i. Sii tap trung cua TT-GDSK la vao ly tri, tinh cam va cac hanh
dong nham thay doi hanh vi co hai, thiic hanh hanh vi co ldi mang lai cuoc
song khoe manh, hvJu ich. TT-GDSK cung la phUdng tien nham phat trien y
thiic con ngUdi, phat huy tinh tii liic canh sinh va giai quyet van de siic khoe
cua ca nhan va cong dong. TT-GDSK khong phai chi la cung cap thong tin
hay noi vdi moi ngiidi nhiing gi ho can lam cho siic khoe cua ho ma la qua
trinh cung cap kien thiic, tao dieu kien thuan ldi ve moi trUdng de nang cao
nhan thiic, chuyen doi thai do ve siic khoe va thiic hanh hanh vi siic khoe
lanh manh. Dieu can phai ghi nhd la khong nen hieu TT-GDSK ddn gian nhu
trong suy nghl cua mot so" ngUdi coi TT-GDSK chi la cung cap that nhieu
thong tin ve siic khoe cho moi ngUdi.
Muc dich cd ban cua TT-GDSK la:
- Giup cho ca nhan va cong dong du kien thiic de xac dinh nhu cau cham
soc siic khoe cua ho va gidi thieu cac cd sd cung cap dich vu cham soc siic
khoe de ca nhan va cong dong co the tiep can va sii dung hdp ly.
- Hieu ro nhiing viec can lam de giai quyet cac van de siic khoe benh tat,
nang cao siic khoe bang nhiing kha nang cua chinh minh vdi sii giup dd,
ho tro cua can bo y te cung nhii nhiing ngUdi lien quan.
- Quyet dinh va thiic hien cac hanh dong thich hdp nhat de co cuoc song
khoe manh, dat diidc tinh trang siic khoe tot nhat co the diidc.
Truyen thong giao due siic khoe gop phan thiic hien mot trong nhiing
quyen cua moi ngiidi do la quyen dUdc cham soc va bao ve siic khoe va tao
dieu kien cho moi ngiidi co dieu kien thiic hien diidc trach nhiem cham soc siic
khoe cho ca nhan va cong dong.

1.5. Nang cao siic khoe

1.5.1. Khai niem

Thuat ngii "Nang cao siic khoe" dUdc sii dung cang ngay cang rong rai do
sii chu y vao nhu cau ca giao due siic khoe va cac hanh dong khac trong do co
cac hanh dong chinh tri anh hiidng den siic khoe. Tai cuoc hop d Canada nam
1986, To chiic Y te the gi6i da diia ra tuyen ngon Ottawa ve nang cao siic
khoe. Tuyen ngon nhan manh den nang cao siic khoe can phai lam nhieu hdn
chii khong chi la cung cap cac dich vu cham soc siic khoe. Hoa binh, nha d,
giao due, thiic pham, thu nhap, moi trUdng ben viing, cong bang xa hoi, binh
dang la tat ca cac yeu to" can thiet de dat dUdc siic khoe. Thiic hien cac noi
dung nay phai khuyen khich moi ngUdi hanh dong vi siic khoe thong qua
nhiing hoat dong chinh tri, kinh te", xa hoi, van hoa, moi triidng, hanh vi va
cac yeu to" sinh hoc.
Dudi day la khai niem ve nang cao siic khoe ma tuyen ngon Ottawa neu ra:

14
 Nang cao siic khoe la qud trinh giup moi ngiidi co du kha nang kiem soat
toan bo siic khoe va tang ciidng siic khoe cua ho. De dat diidc tinh trang hoan
toan khoe manh ve the chat, tinh than va xa hoi, cac cd nhan hay nhom phai
cd kha nang xac dinh va hieu biet cac van de siic khoe cua minh va bien
nhiing hieu biet thanh hanh dong de doi pho diidc vdi nhiing thay doi cua moi
triicfng tdc dong den site khoe.
Trong quan niem ve nang cao siic khoe, sufc khoe dUdc coi la nguon liic
cua ddi song hang ngay chii khong phai chi la muc tieu song. Siic khoe la khai
niem tich ciic nhan manh den khi'a canh nguon luc cua xa hoi va cua ca nhan.
Vi the, nang cao siic khoe khong chi la trach nhiem cua nganh y te ma la
trach nhiem cua moi ca nhan, moi cong dong dua tren cd sd la loi song lanh
manh de manh khoe.
Giao due siic khoe la mot bo phan quan trong nhat cua nang cao siic
khoe va bao gom sii ket hdp cac yeu to" de thuc day ap dung cac hanh vi nang
cao siic khoe, giup moi ngUdi dUa ra cac quyet dinh ve siic khoe cua ho va thu
dUdc cac ky nang va sii tu tin can thiet de thiic hanh cac quyet dinh.

1.5.2. Cac noi dung cua nang cao siic khoe

1.5.2.1. Xay diing chinh sach cong cong lanh manh

Nang cao siic khoe diia tren cham soc siic khoe. Dieu nay co nghla la
phai dUa siic khoe vao chUdng trinh hanh dong cua cac nha hoach dinh chinh
sach cua tat ca cac nganh d moi tuyen. Nhiing ngiidi triic tiep xay diing chinh
sach phai nhan ra tac dong den siic khoe cua cac quyet dinh ma ho dUa ra va
chap nhan trach nhiem cua ho doi v6i siic khoe nhan dan.
Chinh sach nang cao siic khoe co nhiing tac dong khac nhau nhung la
nhiing giai phap bo sung cho nhau, bao gom luat phap, bien phap tai chinh,
kinh te, thue quan va cac thay doi to chiic. Do la cac hoat dong phoi hdp d in
den nang cao siic khoe va cac chinh sach xa hoi gop phan day nhanh viec thiic
hien dich vu siic khoe mot cach cong bang. Cac hanh dong lien ket, phoi hop
gop phan dam bao an toan cho siic khoe, cung cap dich vu siic khoe cong cong
ngay cang tot hdn, moi triidng sach va lanh manh cho moi ngiidi cung hiidng.

1.5.2.2. Tao ra moi triidng ho tro

Nang cao siic khoe tao ra dieu kien song va lam viec an toan, sinh dong,
thoa man nhu cau. Danh gia co he thong ve anh hiidng siic khoe cua cac thay
doi nhanh cua moi trUdng, dac biet la trong linh viic ky thuat, cong nghe, san
xuat nang liidng va qua trinh do thi hoa - la rat can thiet va phai lap ke
hoach va hanh dong tiep theo de dam bao ldi ich siic khoe cua cong dong. Bao
ve moi triidng tii nhien va xay diing moi trUdng song lanh manh cung nhu bao
ton cac nguon liic tii nhien phai dUdc nha'n manh trong bat ky cac chien liidc
nang cao siic khoe nao.

15
1.5.2.3. Nang cao cac hanh dong cua cong dong

Nang cao hanh dong cua cong dong la qua trinh phat huy quyen liic, siic
manh cua cong dong, phat huy nguon tai nguyen rieng cung nhii sii kiem soat
cac no liic va van menh rieng cua cong dong. Su phat trien cua cong dong diia
vao nhan lUc, nguon tai nguyen hien co de md rong sii tu liic, tii ciidng va ho
trd xa hoi, dong thdi phat trien mot he thong mem deo de nang cao sii tham
gia cua xa hoi ma triic tiep la vao linh viic y te.

1.5.2.4. Phat trien ky nang cua con ngiidi

Nang cao siic khoe ho trd cho phat trien cua cac ca nhan va toan xa hoi,
thong qua viec cung cap thong tin ve bao ve siic khoe va md rong hudng dan
cac ky nang can thiet trong cuoc song ve phong benh, chuta benh. Bang cach
nay se lam tang len cac dieu kien san co, giup moi ngiidi co du dieu kien thiic
hanh kiem soat tinh trang siic khoe, moi triidng va liia chon cac bien phap
nang cao siic khoe. Dong vien moi ngUdi hoc tap trong cuoc song, chuan bi cho
chinh minh nhiing kha nang hanh dong d moi giai doan can thiet de doi pho
vdi cac nguy cd gay benh man tinh, chan thUdng, cac van de siic khoe co the
xay ra. Nhiing van de nay dUdc thuc day tai triidng hoc, tai moi trUdng gia
dinh, tai ndi lam viec va ngay tai cac ndi sinh hoat cong cong cua cong dong.
Cac chUdng trinh hanh dong diidc yeu cau thiic hien thong qua cac cd sd giao
due, cac to’ chiic chuyen mon, thUdng mai, cong dong va cac to chiic tii nguyen.

1.5.2.5. Dinh hiidng cac dich vu cham soc siic khoe

Trach nhiem doi vdi nang cao siic khoe diidc cac ca nhan, nhom cong
dong, cac nha chuyen mon, cac cd sd cham soc siic khoe va chinh quyen cac
cap cung chia se. Ho phai cung lam viec vdi nhau trong he thong cham soc siic
khoe va co trach nhiem dong gop vao sii nghiep nang cao siic khoe. Dinh
hudng cac dich vu cham soc siic khoe cung doi hoi sii quan tam chu y manh
hdn den cac nghien ciiu ve nhu cau cham soc siic khoe cung nhu nhiing thay
doi trong he thong giang day va dao tao can bo chuyen mon. Dieu nay dan
den thay doi thai do va to chiic dich vu cham soc siic khoe, trong do tap trung
vao tat ca cac nhu cau cua ca nhan, cung nhii cua cac nhom doi tiidng khac
nhau trong cong dong.
Nhu vay hoat dong nang cao siic khoe rat rong, trong dd TT-GDSK cd
vai trd quan trong nhat. TT-GDSK cd tac dong den nhieu hoat dong trong
nang cao siic khoe. Cd the tom tit moi lien quan giQa TT-GDSK va nang cao
siic khoe nhii sd do diidi day.

16
 Xay diing chinh sach
Cham soc siic khoe cong conr

Tao ra moi triidng ho tro

Nang cao hanh dong

cOa cong dong

Phat trien ky nang ca nhan

Dinh hiidng cac djch vu

cham soc siic khoe
)
Sd do 1.2. Moi lien quan TT-GDSK va nang cao siic khoe

1.6. M ot so k h a i n iem k h a c lien q u an d en TT-G D SK

Khai niem ve hanh vi cua con ngudi dUOc nha giao due My Lawrence
Green nhan manh. Ong da dinh nghla giao due siic khoe nhu la: bat ky sU ket
hop cd hoi hoc tap nao dUdc thiet ke de lam thuan ldi cho viec tu nguyen van
dung cac hanh vi nh&m duy tri va day manh siic khoe. Sii dung tii "tu
nguyen" ro rang la ly do dao diic. Dieu nay nhan manh la cac nha giao due
siic khoe khong dung siic ep de buoc ngUdi ta phai lam nhiing viec ma ho
khong muon lam. Thay vao dd la cac no liic giup moi ngudi hieu, dua ra quyet
dinh va liia chon hanh dong cho chinh ho.
Tac gia Helen Ross va Paul Mico da dua ra dinh nghia khac cd tinh thiic
te ve giao due siic khoe: la qua trinh vdi cac llnh vUc tri thiic, tam ly, xa hoi
lien quan tdi cac hoat dong nhSm nang cao kha nang cua con ngUdi trong viec
diia ra cac quyet dinh anh hudng tot den siic khoe ca nhan, gia dinh va cong
dong cua ho. Qua trinh nay dUa tren cd sd cac nguyen tic khoa hoc lam thuan
ldi cho tien trinh hoc tap va thay doi hanh vi cua ca hai doi tUdng la ngudi
cung cap dich vu chuyen mon va ngUdi sii dung dich vu, bao gom ca tre em va
thanh nien. Thuat ngii giao due siic khoe diidc sU dung d day bao ham cac
hoat dong giao due siic khoe va cac hoat dong rong rai khac dUdc thuc hien
diidi cac ten khac nhau. Mot so' cac thuat ngii dUdc sU dung dong nghia nhu
giao due siic khoe nhiing thay doi tuy thuoc vao quan nier

c" n h t h ' c t " ' TRUNG TAM HOC Llfl

- Thong tin, gido due va truyen thong (Informatioin-Educatiori and
Communication-IEC): la thuat ngii cd nguon goc tii chUdng trinh ke
hoach hoa gia dinh va gan day dUdc sii dung trong cac chUdng trinh
phong chong HIV/AIDS d cac niidc dang phat trien. Thuat ngii dUdc sxi
dung ngay cang nhieu nhii mot thuat ngii chung cho cac hoat dong

17
 truyen thong giao due sure khoe, nhat la trong cac chien dich nham nang
cao siic khoe cong dong.

- Ho tro truyen thong: la thuat ngii mo ta cac chuong trinh ho trd cho
gidi thieu giao due ve nUdc, ve sinh moi trUdng, ve sinh ca nhan. H eili
Perret dinh nghia ho tro truyen thong nhu la "thong tin, hoat dong giao
due va cac hoat dong thuc day, cac hoat dong nay dUdc thiet ke dac biet
de dong vien sU tham gia cua nhiing ngudi dUdc hudng ldi trong cac du
an, dong thdi de nang cao tac dong cua dii an den qua trinh phat trien".
- Tiep thi xa hoi: bao gom viec van dung tiep thi thUOng mai va cac giai
phap quang cao vdi siic khoe va dUdc sU dung cho thuc day sii dung bao
cao su va oresol.
- Van dong xa hoi: la thuat ngii hien nay dUdc UNICEF sU dung rong
rai de md ta giai phap trong chien dich phoi hdp cac phUdng tien thong
tin dai chung va lam viec vdi cac nhom va cac to chiic cong dong nham
nang cao siic khoe.

2. VAI TRO CUA TRUYEN THONG GlAO DUC S tic KHOE TRONG
CONG TAC CHAM SOC StTC KHOE

Siic khoe la von quy nhat cua moi ngUdi, la nguon luc cua xa hoi, nhUng
trong cuoc song hang ngay d nhieu ndi, nhieu cho chun g ta cd the d i dang
quan sat thay nhieu ngUdi thuc hanh cac hanh vi khong cd ldi cho siic khoe.
TT-GDSK qua viec cung cap cac kien thiic, hudng d in va hd trd thuc hanh
giup cho moi ngUdi cd the:
- Hieu biet va xac dinh van de siic khoe, nhu cau can cham soc va bao ve
siic khoe cua chinh ho va cua cong dong.
- Hieu dUdc nhiing viec ma ho can phai lam de giai quyet cac van de sdc
khoe, benh tat cua ho bang chinh no liic cua ban than va sii ho trd ben
ngoai.
- Quyet dinh thiic hien hanh dong thich hdp nhat de bao ve va nang cao
siic khoe cho ban than, gia dinh va cong dong, trong dd cd viec biet va sii
dung dung cac dich vu cham soc siic khoe cd sin .
Truyen thong-Giao due siic khoe la noi dung sd mot trong cac noi dung
cham soc siic khoe ban dau ma hoi nghi Quoc te ve cham soc siic khoe ban
dau tai Alma Ata nam 1978 da neu ra. Tat ca cac noi dung khac cua cham soc
^dc khoe ban dau’jdeu cd noi dung quan trong c ln TT-GDSK. TT-GDSK la noi
-dung cua chuan thii nhat trong Chuan Quoc gia ve y te xa dUdc Bo Y te ban
hanh nam 2002.
Hoat dong TT-GDSK khong thay the diidc cac dich vu cham soc sdc khoe
khac, nhiing no gop phan quan trong nang cao hieu qua cua cac dich vu cham
soc siic khoe khac. Vi du trong dieu tri khong the thieu viec giao due cho benh

18
nhan thiic hien dung cac chi dinh dieu tri, che do an uong nghl ngdi, khi benh
nhan ra vien khong the thieu viec giao due benh nhan duy tri che do sau dieu
tri, phuc hoi chiic nang. Hoat dong TT-GDSK la mot trong cac hoat dong xa
hoi rong ldn, thu hut diidc sii tham gia cua nhieu doi tac, co the tao ra diidc
nhiing phong trao hoat dong rong rai v6i sii tham gia tich ciic cua cong dong
nham giai quyet cac van de siic khoe, benh tat, tai nan thUdng gap, gop phan
cai thien va nang cao siic khoe.

Sd do 1.3. Moi lien quan TT-GDSK va cac noi dung cham soc sire khoe ban dau

Dau tu cho TT-GDSK chinh la dau tu co chieu sau cho cong tac bao ve va
nang cao siic khoe, the hien quan diem dii phong trong cham soc siic khoe,
mang lai hieu qua lau dai ben viing vi neu moi ngUdi diidc cung cap du kien
thiic va co nhiing ky nang nhat dinh ho co the chu dong quyet dinh hanh vi
cham soc siic khoe dung dan. TT-GDSK la nhiem vu trUdc mat va cung la
nhiem vu lau dai cua nganh y te, cua moi can bo y te cong tac tai cac tuyen, cac
cd sd y te. V6i sii phat trien cua y hoc va y te, vdi sii hieu biet cua ngUdi dan
cang cao, nhieu van de siic khoe, benh tat da, dang va se co the dUdc khong che
va loai trif, nhiing co the xuat hien nhiing van de siic khoe, benh tat m6i, vi the
hoat dong TT-GDSK can diidc duy tri va phat trien, dap ling nhiem vu trUdc
mat va lau dai trong cham soc va nang cao siic khoe cong dong.
Cac tuven y te tii trung Udng den cd sd deu phai co ke hoach to chiic thiic
hien va quan ly tot cac hoat dong TT-GDSK nham thay doi hanh vi co hai cho
siic khoe, thiic hanh hanh vi siic khoe lanh manh, gop phan phong chong
benh tat, nang cao siic khoe cho moi ca nhan va cong dong.

19
 Xa hoi hoa la mot chien liidc quan trong de dam bao thanh cong trong
cac chUdng trinh TT-GDSK. Khong chi nganh y te ma cac cap chinh quven,
ban nganh, doan the c ln phai tham gia vao cac hoat dong TT-GDSK. Nganh y
te phai biet phoi hdp, long ghep hoat dong TT-GDSK vdi cac hoat dong van
hoa xa hoi cua cong dong va cac hoat dong cua cac nganh khac mot cach thich
hdp de md rong cac hoat dong giao due siic khoe. Neu khong thu hut dUdc sU
tham gia cua cac to chiic chinh quyen, ban nganh, doan the khac vao hoat
dong TT-GDSK, chac chan ket qua va tac dong cua TT-GDSK den cai thien
siic khoe cong dong se rat han che.

3. HE TH O N G TO CHlTC VA TR A C H NHIEM T H l/C HIEN TT -G D SK

3.1. T u y en tru n g xidng

Trung tam Truyen thong-Giao due siic khoe Bo Y te la cd quan chuyen

mon cao nhat, co trach nhiem chi dao, thiic hien nhiem vu TT-GDSK trong
nganh y te. Chiic nang, nhiem vu chinh cua trung tam TT-GDSK nhu sau:
- Can cii dinh hudng chien liidc cham soc siic va bao ve nhan dan, ke
hoach TT-GDSK cua Bo Y te, xay dung ke hoach va chi dao thuc hien
hoat dong TT-GDSK trong pham vi ca nU6c.
- Chi dao va to chiic thuc hien dao tao, dao tao lai ve chuyen mon nghiep
vu TT-GDSK cho can bo tat ca cac tuyen.
- To chiic san xuat, cung cap cac phUdng tien, tai lieu TT-GDSK cho cac
dia phUdng.
- Tiep nhan, su dung va phan phoi nguon kinh phi danh cho TT-GDSK
cua nha nUdc cung nhu nguon kinh phi vien trd cua cac to chiic quoc te
mot cach hdp ly de dat hieu qua cao nhat cho hoat dong TT-GDSK.
- To chiic cong tac nghien ciiu khoa hoc ve TT-GDSK de nang cao chat
lUdng cac hoat dong TT-GDSK.

- Phoi hdp, hdp tac vdi cac cd quan, to chiic trong va ngoai nganh y te d
trung lidng, de trien khai thiic hien hoat dong TT-GDSK trong pham vi
ca nUdc.
- Thiic hien cac hoat dong hdp tac quoc te ve TT-GDSK theo dung chu
triidng, diidng loi cua Dang va cac quy dinh hien hanh cua Nha nUdc.
- Chi dao, hudng dan cac hoat dong toan dien cua cac trung tam TT-GDSK
cua sd y te cac tinh, thanh pho" triic thuoc trung Udng.
Tuyen trung Udng ngoai Trung tam TT-GDSK con co cac vien va benh
vien trung lidng, co bo phan chi dao tuyen, chi dao chiidng trinh y te theo
nganh doc thiic hien bien phap dii phong, dieu tri benh va giai quyet cac van
de siic khoe lien quan den chuyen nganh. Bo phan chi dao tuyen cung chi dao
cac hoat dong TT-GDSK theo chuyen nganh cua minh va thudng la chi dao

20
cac chien dich: thong tin, giao due, truyen thong (IEC ) va cung cap cac
phUdng tien tai lieu cho thiic hien TT-GDSK ve nhiing van de siic khoe benh
tat theo chuyen nganh. TT-GDSK cung la mot ph&n quan trong trong hoat
dong cua cac chUdng trinh muc tieu y te quoc gia va cac chUdng trinh dii an
cham soc siic khoe cong dong.

3.2. Tuyen tinh/thanh pho'

Trung tam TT-GDSK trUc thuoc cac S6 Y te tinh/thanh pho" triic thuoc
trung lidng, la cd quan chuyen mon thiic hien nhiem vu chi dao moi hoat dong
TT-GDSK trong pham vi tinh/thanh pho" cua minh. Nhiem vu chinh cua trung
tam TT-GDSK thuoc Sd Y te cac tinh thanh pho" la:
- Can cii vao chien ludc cham soc va bao ve siic khoe nhan dan, ke hoach
TT-GDSK cua Bo Y te va cua tinh/thanh pho' trUc thuoc trung Udng de
xay diing ke hoach TT-GDSK tren dia ban va to chiic trien khai thiic
hien ke hoach sau khi dUdc phe duyet.
- Xay diing, quan ly va chi dao cac hoat dong chuyen mon nghiep vu ve
TT-GDSK trong pham vi tinh/thanh pho".
- To chiic, phoi hdp dao tao va dao tao lai ve chuyen mon nghiep vu cho
can bo chuyen trach, cong tac vien va cac doi tUOng lam cong tac TT-
GDSK tren dia ban.
- Tham gia va to chiic cong tac nghien cUu khoa hoc ve TT-GDSK tren
dia ban.
- Quan ly va sii dung co hieu qua cac nguon luc, san xuat cac tai lieu ve
TT-GDSK cua don vi theo dung quy dinh cua phap luat.
- Thiic hien cong tac hdp tac quoc te ve TT-GDSK theo chu trUOng dUdng
161 cua Dang va cac quy dinh hien hanh cua Nha nUdc.
- Phoi hop vdi cac cd quan, ban nganh, doan the khac trong tinh, thanh
pho trien khai thiic hien cac hoat dong TT-GDSK.
- To chiic viec tuyen truyen giao due phap luat ve cham sdc va bao ve siic
khoe nhan dan va trien khai cac cong tac tuyen truyen khac trong llnh
viic y te khi dUdc Sd Y te giao cho.
Tuyen tinh ngoai Trung tam TT-GDSK con co cac ddn vi y te triic thuoc
Sd Y te nhuf cac benh vien, trung tam y te dii phong, trung tam Cham sdc sUc
khoe sinh san, cac trung tam chuyen nganh khac... chi dao thiic hien cac
chiidng trinh muc tieu y te theo nganh doc, trong dd cd hoat dong TT-GDSK.

3.3. Tuyen huyen/quan

Cac cd quan y te tren dia ban huyen bao gom phong y te, trung tam y te
dii phong va benh vien huyen can phoi hdp chi dao long ghep hoat dong TT-

21
GDSK vdi cac hoat dong, dich vu cham soc siic khoe khac. Theo quyet dinh so
26/2005/QD-BYT ngay 9-9-2005 ve viec ban hanh quy dinh chiic nang, nhiem
vu, quyen han va cd cau to chiic cua Trung tam y te du phong huyen trong do
co Phong Truyen thong giao due sUc khoe. Hau het cac chUdng trinh, du an y
te trien khai tren dia ban huyen/quan deu co hoat dong TT-GDSK can dUdc to
chUc chi dao thuc hien tot.

3.4. Tuyen xa phUdng va thon, ban

3.4.1. Tram y te xa

Tram trUdng y te xa/phUdng chiu trach nhiem chi dao trUc tiep m oi hoat
dong TT-GDSK trong pham vi xa, phUdng. Tat ca cac can bo cua tram y te
deu co trach nhiem thudng xuyen thuc hien TT-GDSK long ghep tai tram y
te, tai cong dong va gia dinh. Tram y te xa phUdng la tuyen y te dau tien
trong he thong y te nha nUdc, trUc tiep tiep xuc, phuc vu sUc khoe ngUdi dan
hang ngay, vi the cac hoat dong TT-GDSK cho dan rat can thiet va cd y nghia
thiet thuc trong cong tac nang cao sUc khoe cong dong. Cac can bo tram y te
xa, phUdng cd vai trd quan trong trong thuc hien xa hoi hoa con g tac y te ndi
chung va TT-GDSK ndi rieng. TT-GDSK d tuyen xa, phUdng se kh on g the dat
ket qua tot neu khong thu hut dUdc sU tham gia cua cac ca nhan, cac doan
the, cac to chUc xa hoi va toan the cong dong. N ang cao vai trd chu dong cua
cong dong trong giai quyet cac van de sUc khoe doi hoi can bo tram y te phai
day manh cac hoat dong TT-GDSK. De giai quyet mot so' van de ben h tat, sUc
khoe hien nay nhu lao, phong, HIV/AIDS, dan sd ke hoach hoa gia dinh v.v...
thi TT-GDSK cho cong dong van la mot trong cac bien phap hang dau ma trUc
tiep thuc hien nhiem vu nay la can bo cac tram y te xa, phUdng. Can bo tram
y te xa phUdng con cd nhiem vu trUc tiep hudng dan, chi dao cac hoat dong
TT-GDSK cho can bo y te thon ban.

3.4.2. Y te thon/ban

Mang ludi y te thon, ban d nUdc ta da dUdc hinh thanh theo chi dao cua
Bo Y te. Moi thon, ban cd mot can bo y te hoat dong, day la nhiing can bo y te
cham sdc sUc khoe sat dan nhat. Bo Y te da xac dinh can bo y te thon ban cd
nhiem vu chu yeu, trong tam la thuc hien cac hoat dong TT-GDSK cho nhan
dan ve ve sinh moi trUdng, ve sinh ca nhan, phong chong cac benh tat, tai
nan, ngo doc pho bien thudng gap, phat hien sdm cac benh thudng gap, thUc
hien sd cUu ban dau. De hoan thanh tot chUc nang nhiem vu cua minh, cac
can bo y te thon, ban can dUdc dao tao cac kien thUc va ky nang cd ban ve TT-
GDSK va lap ke hoach cho hoat dong TT-GDSK tai cong dong.
Tom lai: TT-GDSK la mot bo phan khong the tach rdi cua he thong cham
sdc sUc khoe, cua cac chUdng trinh y te, cua cac cd sd y te va moi can bo y te
chU khong phai chi la nhiem vu cac can bo, cac to chUc TT-GDSK theo nganh
doc. TT-GDSK can phai dUdc thuc hien thudng xuyen tai tat ca cac cd sd y te

22
nhu cac benh vien, phong kham benh, tram chuyen khoa, cac trung tam y te
du phong, trung tam y te nganh, cac khu dieu dtfdng phuc hoi siic khoe, cac
tram y te cd sd xa, phUdng, cd quan, trUdng hoc, nha may xi nghiep.... TT-
GDSK co the thuc hien tai nhutng ndi cong cong cua cong dong va ngay tai gia
dinh. M oi can bo y te du cong tac tai cd sd nao, tuyen nao deu co trach nhiem
va can co y thiic long ghep thUc hien TT-GDSK vao cong viec hang ngay. M oi
can bo cung can chu y lua chon noi dung va phUdng phap, phiidng tien thUc
hien hoat dong TT-GDSK mot cach linh hoat, phu hdp vdi llnh vUc chuyen
mon va dieu kien thUc te cua ddn vi minh.
TT-GDSK la mot trong cac noi dung cham soc siic khoe ban dau phai
dUdc xa hoi hoa de thu hut sti tham gia cua cong dong. ThUc hien TT-GDSK
khong chi la nhiem vu cua nganh y te ma day con la nhiem vu cua cac cap
chinh quyen, cac ban nganh, cac to chiic doan the quan chung co lien quan
trong xa hoi. Can xay dung ke hoach de cac cap chinh quyen va cac to chiic
doan the xa hoi tham gia vao hoat dong TT-GDSK mot cach chu dong, tich
cUc. Kinh nghiem thuc tien da chi ra rang hoat dong TT-GDSK se rat co hieu
qua neu biet long ghep vdi cac hoat dong van hoa, kinh te, xa hoi khac cua
cong dong va vdi sU phoi hdp, hdp tac cua nganh y te vdi cac nganh co lien
quan khac nhu giao due, van hoa thong tin, phat thanh truyen hinh v.v...
He thong to chiic TT-GDSK d nU6c ta da trai qua qua trinh hinh thanh
va phat trien de dap ling nhu cau ngay cang cao trong hoat dong TT-GDSK
cho cong dong. 6 tuyen trung Udng trung tam TT-GDSK trUc thuoc Bo Y te
can difdc quan tam dung miic, phat trien doi ngu can bo du ve so liidng va
trinh do de chi dao toan bo hoat dong chuyen mon trong TT-GDSK d moi
tuyen, ca trung UOng va dia phiidng. Xay dung cac chiidng trinh dao tao va to
chiic cac loai hinh dao tao can bo TT-GDSK thich hdp cho cac tuyen, cac
chiidng trinh y te hien nay can diidc coi la mot trong nhiing cong viec Uu tien
thUc hien tai cac trung tam TT-GDSK d trung Udng va dia phUdng.

CAU HOI Tlf LUQNG GIA

1. Trinh bay cac khai niem thong tin, tuyen truyen, giao due, truyen
thong giao due siic khoe va nang cao siic khoe.
2. Neu vi tri vai tro cua truyen thong giao due siic khoe trong cong tac
cham soc siic khoe ban dau.
3. Ve va giai thich sd do ve lien quan giQa truyen thong giao due siic
khoe va nang cao siic khoe.
4. Liet ke cac noi dung chinh cua nang cao siic khoe.
5. Trinh bay tom tat he thong to chiic truyen thong giao due siic khoe
trong nganh y te.

23
 Bai 2

NGUYEN TAC TRUYEN THONG GIAO DUC SLfC KHOE

VA NANG CAO SLfC KHOE

MUC TIEU
1. Trinh bay diidc cac nguyen tdc cd ban trong chi dao hoat dong truyen thong gido
due siic khoe (TT-GDSK) va nang cao siic khoe.
2. Van dung diidc cac nguyen tdc TT-GDSK vao trong cdng tdc TT-GDSK cua
minh.

1. k h Ai n ie m

Nguyen tac truyen thong giao due siic khoe la nhiing cd sd dinh hiidng
cho chi dao thiic hien moi hoat dong gido due siic khoe, cd sd cho viec liia chon
noi dung, phiidng phap, phiidng tien va cach thiic to chiic gido due siic khoe
sao cho phii hdp vdi muc dich va nhiem vu gido due siic khoe, diidc ling dung
trong hoat dong thiic tien truyen thong gido due siic khoe.
Xuat phat tvf muc dich, nhiem vu, ban chat cua truyen thong giao due
siic khoe, can cii vao thanh tUu y hoc va cac llnh vUc khoa hoc khac nhu tam
ly, giao due hoc v.v... va nhu cau thuc tien, hoat dong truyen thong giao due
siic khoe d Viet Nam dtidc tien hanh theo nhiing nguyen tac sau:
- Nguyen tac khoa hoc;
- Nguyen tac dai chung;
- Nguyen tac trUc quan;
- Nguyen tac thUc tien;
- Nguyen tac long ghep;
- Mot so nguyen tac khac.

2. CAC NGUYEN TAC TRUYEN THONG GlAO DUC SU*C KHOE

2.1. Nguyen tac khoa hoc trong TT-GDSK

Muc dich cua TT-GDSK la lam thay doi hanh vi va duy tri hanh vi siic
khoe mdi. De dat dUdc muc dich do, hoat dong giao due siic khoe khong the

24
 khong theo nguyen tac khoa hoc. Nguyen tac khoa hoc co the coi la chia khoa
de ngudi lam TT-GDSK md ciia budc vao con dvfdng dan tdi dich cua hoat dong
thuc tiln TT-GDSK. Ben canh do TT-GDSK va nang cao siic khoe con diidc coi
la mot lmh viic khoa hoc, do la khoa hoc hanh vi iing dung ket hdp vdi mpt
loat cac lmh vvic khoa hoc khac nhtf Stic khoe hoc cong dong, Tam ly hoc giao
due, Tam ly hoc nhan thiic, Tam ly hoc xa hoi v.v... thi nguyen tac khoa hoc
cua TT-GDSK cang diidc khang dinh.

2.1.1. Ca sd khoa hoc cua TT-GDSK

2.1.1.1. Nhiing cO sd khoa hoc y hoc

TT-GDSK co the dUdc coi la mot phan cua khoa hoc y hoc. Nhiing kien
thiic khoa hoc ve siic khoe noi chung, siic khoe cong dong noi rieng cung nhu
nhiing kien thiic ve benh tat: dau hieu, cach phat hien, cach xii tri, dieu tri va
de phong benh tat v.v... la rat can thiet khong chi doi vdi ngUdi lam TT-GDSK
ma con doi vdi ca doi tUdng TT-GDSK. Nhiem vu quan trong cua TT-GDSK la
pho bien kien thiic cua khoa hoc y hoc iing dung trong thuc tien cham soc va
bao ve siic khoe cho ca nhan va cong dong.

2.1.1.2. Nhiing cd sd khoa hoc hanh vi

Khoa hoc hanh vi nghien ciiu nhiing cach iing xU cua con ngUdi va vi sao
con ngUdi lai iing xii nhu vay. Hanh vi la mot phiic hdp nhiing hanh dong
chiu anh hUdng cua nhieu yeu to': moi trUdng, xa hoi, van hoa, kinh te, di
truyen... Rat kho co the phan dinh ro rang cac nguyen nhan iing xU cua con
ngUdi. Tuy nhien, co the thay moi hanh vi bao gom 4 thanh phan chu yeu tao
nen: kien thiic - thai do - niem tin va thuc hanh. Hanh vi siic khoe the hien d:
- Nhan thiic cua con ngUdi ve tinh trang siic khoe va benh tat cua ban
than va cong dong, cac dich vu y ie' co the sii dung diidc, cac bien phap tii
bao ve siic khoe cua ban than va cua cong dong, cac yeu to' nguy cd anh
hiidng den siic khoe...
- Thai do doi vdi cac van de siic khoe, cac thdi quen, lo'i song, phong tuc
tap quan, ke ca niem tin co ldi va co hai do'i vdi siic khoe.
- Nhiing cach thiic hanh, bien phap de tu bao ve va nang cao siic khoe cua
ban than va cua cong dong, phong chong dUdc benh tat va cac yeu to
nguy cd cho siic khoe.

2.1.1.3. Nhiing cd sd tam ly hoc gido due

Doi tudng cua TT-GDSK d tat ca cac do tuoi khac nhau. Hieu biet tam ly
tiing liia tuoi la yeu to thuc day cong tac TT-GDSK phu hdp. Trong TT-GDSK
cho ngiidi ldn, yeu to thuan ldi cd ban la ngUdi ldn cd nhiing dieu kien tam ly
cho viec hoc tap dat ket qua tot, dd la:

25
 - Thoai mai ve tinh than, the chat va xa hoi, tranh dUdc cac yeu to tac
dong anh hiidng bat ldi tu! ben ngoai va ben trong can trd viec tiep thu va
thay doi.
- Nhan ro muc dich cua viec hoc tap, tii do dinh hudng dung dan moi hoat
dong dan den sU thay doi.
- DUdc tich cUc hoa cao do de chu dong tham gia vao moi hoat dong tap
the thay doi hanh vi siic khoe cua ban than va cong dong, d day y thiic
tu giac va dong cd hoc tap giuf vai tro quyet dinh.
- DUdc doi xii ca biet hoa trong khi hoc tap cho phu hdp vdi trinh do, nhip
do va phong cach rieng cua moi ngudi.
- Kinh nghiem cua moi ngiidi phai dUdc khai thac, van dung de dong gop
vao ldi ich chung cua tap the va cong dong.
- DUdc thuc hanh nhiing dieu da hoc nh&m giai quyet cac nhu cau va cac
van de siic khoe cua ban than va cong dong.
- DUdc biet ve ket qua hoc tap va thiic hanh cua minh, thong qua viec
danh gia va tu danh gia de khong ngiing hoan thien va duy tri sii thay
doi da dat dUdc.
- Tu chiu trach nhiem, tu kiem soat va tu dieu chinh moi hoat dong cua
ban than trong hoc tap cung nhu trong thiic hanh.

2.1.1.4. Nhiing cd sd tam ly hoc xa hoi

Giao due so dong doi hoi phai biet cach tac dong cd hieu qua tdi nhiing
hoat dong tinh than cua nhieu ngUdi va biet sii dung nhiing tac dong tich ciic
cua tap the va xa hoi doi vdi y thiic cua tiing ca nhan. Doi vdi moi tap the can
dac biet chu y tdi:

- Viec giao due he thong nhu cau - dong cd hanh dong. He thong nhu cau
cua con ngUdi cd the diidc chia ra tii thap den cao theo sd do nhu sau:

26
 Sd do 2.1. Cac nhu cau cua con ngirdi theo tac gia Maslow

2.1.1.5. NhCtng cd sd tam ly hoc nhan thiic

Qua trinh nhan thiic cua con ngUdi diidc chia lam 2 giai doan: nhan thiic
cam tinh bang cac giac quan va nhan thiic ly tinh bang cac thao tac tii duy
(nhii so sanh, triiu tUdng hoa, khai quat hoa, phan tich tong hdp...). Co the
tom tat qua trinh nhan thiic bang cong thiic noi tieng cua V.I. Lenin trong ly
thuyet phan anh: "Tii triic quan sinh dong den tii duy triiu tiidng, roi tii tii
duy triiu tiidng den thiic tien, do la con diidng bien chiing cua sii nhan thiic
chan ly, cua sii nhan thiic hien thiic khach quan".
Truyen thong giao due siic khoe khong nhiing giup cho doi tUdng nhan
thiic bang cam quan ma quan trong hdn ca la giup cho ho chuyen sang nhan
thiic ly tinh, nhat la tii nhan thiic va cuoi cung la van dung diidc vao thiic te
giai quyet cac van de siic khoe va loi song, bien thanh thoi quen co ldi cho siic
khoe. Nhii vay, qua trinh thay doi hanh vi siic khoe la qua trinh nhan thiic tii
thap den cao.
Qua trinh nhan thiic doi hoi:
- Phai co stf chu y: can nhan thiic mot thong tin thi ngufdi ta phai chu y
tdi thong tin do. Noi mot cach khac khong phai bat cii thong tin gi den

27
 vdi cac giac quan deu dUdc nhan thiic. Nhu vay, trong viec tiep nhan
thong tin con ngUdi bao gid cung co sii lua chon va phu thuoc vao dong
cd, nhu cau cua moi ngUdi.
- Phai co sU sap xep: su sap xep thong tin thtfdng tuan theo cac dac tinh:
+ Dong nhat: ghep nhiing cai giong nhau thanh nhom.
+ Theo vi tri trong khong gian: ghep nhiing cai d gan nhau thanh nhom.
+ Theo vi tri ve thdi gian: gin nhiing sii viec hoac sU kien gan nhau ve
thdi gian.
+ Theo quan he rieng chung: gan cai dac trUng toan the cho mot bo
phan bat ke nao do cua no va ngUdc lai.
+ Theo tinh ghep hoa: ghep nhiing phan khong day du thanh mot dang
quen thuoc hoac co nghia nao do.
Tat ca nhiing dieu nay doi hoi ngUdi tien hanh cong tac giao due siic
khoe phai tranh tao ra nhiing thong tin khong day du, qua phiic tap, va
khong ro rang, neu khong co sii sap xep doi tUdng giao due siic khoe se cam
nhan theo cach rieng cua minh, nhieu khi se dan den hieu sai lac hoac khong
con nhd gi den thong tin do niia.
- Tinh hien thuc: nhan thiic la mot qua trinh m ang tinh rieng biet cua
moi ngUdi, no phu thuoc vao dac diem ca nhan, trinh do hoc van, kinh
nghiem song, gidi tinh, v.v... cua ngUdi tiep nhan. Day la dac diem dac
biet quan trong doi vdi ngUdi lam giao due siic khoe. Neu chung ta muon
doi tUdng tiep nhan thong tin de lam thay doi hanh vi siic khoe ciia ho
thi chung ta phai dat dia vi minh vao doi tUdng va du kien dUdc kha
nang ho tiep nhan van de dUdc giao due nhu the nao. Neu sii tiep nhan
ay khac vdi dii kien cua chung ta thi ho se giii nhan thiic ay cho den khi
chung ta hoac nhiing ngUdi khac tac dong thay doi dUdc nhan thiic av.

2.1.1.6. Ly thuyet pho bien sit doi mdi

Nhiing thay doi hanh vi siic khoe cua con ngUdi dUdc coi la sii doi mdi.
Giao due siic khoe bao gom nhiing hoat dong truyen thong nhkm dat dUdc sii
doi m6i do. Ly thuyet pho bien sii doi m6i dUdc nghien ciiu bdi Everer va
M.Rogers. Pho bien sit doi mdi la mot qud trinh pho bien mot sit doi mdi thong
qua cac kenh truyen thong trong mot thdi gian nhat dinh tdi cac thanh vien
cua mot he thong xa hoi.
Nhiing loai ngiidi chap nhan sii doi m6i rat khac nhau theo trinh tU:
nhiing ngUdi khdi xii6ng - » nhiing ngUdi sdm chap nhan —> nhiing ngUdi trong
nhom "da so s6m" —> nhiing ngUdi trong nhom "da so' muon" —> nhiing ngudi
lac hau, bao thii.
Nhiing giai doan cua sii chap nhan sii doi mcli d mot ca nhan hay mot tap
the: nhan ra sU doi mdi —> Hinh thanh mot tr ai do tich ciic doi vdi sii doi mdi —>

28
Quyet dinh thii nghiem sii doi mdi -> Thii nghiem sii doi mdi —» KhSng dinh
mot hanh vi mdi va thuc hien (hoac bo dd viec thiic hien hanh vi doi mdi do).

2.1.2. Nguyen tdc khoa hoc the hien trong viec xac dinh noi dung, Ixla
chon phiidng phap, phiidng tien truyen thong gido due site khoe mot
cach khoa hoc

Viec xac dinh noi dung giao due siic khoe mot each khoa hoc phai diia
tren co so dieu tra nghien ctiu toan dien ve y hoc, xa hoi hoc, tam ly hoc, dich
te hoc, kinh te - xa hoi cua moi cong dong va moi ngiidi trong cong dong de
phat hien nhiing van de can giao due siic khoe. Nhiing noi dung giao due siic
khoe phai thuc sii khoa hoc, da dUdc chiing minh bang khoa hoc va thiic tien.
Trong khi tien hanh giao due siic khoe khong dUdc dUa ra nhiing noi dung ma
cac nha khoa hoc con ban cai, chUa ro rang, chUa dUdc kiem nghiem trong
thuc tien. Trong khi tien hanh giao due siic khoe can phai sii dung nhiing
thanh qua nghien ciiu khoa hoc mdi nhat da dUdc cong bo", mang lai hieu qua
thiet thuc cho moi ngUdi trong cong dong.
Nhiing phUdng phap, phUdng tien giao due siic khoe cung phai dUdc liia
chon mot cach khoa hoc. Nguyen tac khoa hoc trong viec liia chon phUdng
phap, phUdng tien giao due siic khoe la dam bao cac phUdng phap, phiidng
tien do phu hdp vdi tiing doi tudng, tiing cong dong, tiing giai doan, tiing hoan
canh kinh te - xa hoi nhat dinh. Cac phUdng phap, phUdng tien co the phoi
hdp dUdc vdi nhau de nang cao chat liidng cac hoat dong TT-GDSK. Su dung
cac phUdng phap, phUdng tien va cac hinh thiic to chiic phai khuyen khlch,
thu hut dUdc sii tham gia cua cong dong, phat huy dUdc nhiing the manh cua
tiing cong dong. PhUOng phap TT-GDSK dUdc sii dung phai la nhiing phUdng
phap phu hdp vdi hoan canh thiic te, tao dieu kien de doi tUdng tham gia mot
cach hieu qua nhat. Nhiing vi du, tai lieu dung trong TT-GDSK phai dUdc
chuan bi phu hdp, tao diidc nhiing tu duy lo glc cho tiing loai doi tUdng, de
dang lam cho doi tUdng thay doi hanh vi siic khoe.

2.1.3. Nguyen tdc khoa hoc the hien trong viec dam bao tinh he thong,
tinh logic cua lap ke hoach va trien khai cac hoat dong truyen thong
gido due siic khoe

Lap ke hoach giao due siic khoe xuat phat tii nhiing van de can TT-
GDSK cua cong dong va nguon liic phu hdp dam bao tinh kha thi khi trien
khai ke hoach. Tien hanh lap ke hoach theo thii tii cac biidc: phan tich xac
dinh van de TT-GDSK => Xac dinh muc tieu => Xac dinh cac giai phap va hoat
dong => Lap tien trinh thiic hien theo hoat dong va giai phap => Viet va duyet
ke hoach v.v...

2.2. Nguyen tac dai chung trong TT-GDSK

Truyen thong giao due siic khoe khong nhiing tien hanh cho moi ngUdi
va vi ldi Ich cua moi ngiidi trong cong dong xa hoi, ma con dUdc moi ngudi

29
tham gia thuc hien. M oi ngiidi viia la doi tiidng cua giao due siic khoe viia la
ngUdi tien hanh giao due siic khoe.
Doi tiidng cua giao due siic khoe rat da dang, khong the cung mot luc
chung ta co the lam thay doi hanh vi siic khoe cua tat ca moi ngiidi vdi moi
van de siic khoe. Viec nghien ciiu doi tiidng trong mot dot hoac mot noi dung
la viec lam het siic quan trong cho phep chung ta dat dUOc muc tieu va hieu
qua cua giao due siic khoe. Khi nghien ciiu doi tiidng giao due siic khoe chung
ta cln chu y tdi nhiing diem sau:
- Doi tudng giao due siic khoe cua chung ta song trong cong dong Viet
Nam, phan dong la d nong thon. Nhiing gia tri dao diic, van hoa, tinh
than va nhan ban cua ngUdi dan Viet Nam quy dinh hanh vi cua cac
thanh vien trong cong dong. Trong cong dong nong thon Viet Nam
nhiing tu tudng, tuc le phong kien van con anh hUdng kha m anh me den
viec hinh thanh hanh vi siic khoe lanh manh.
- M oi cong dong mang tinh khep kin tUdng doi va m ang ban sac dac thu
cua dia phUdng. Cung la nong thon, cung chiu anh hUdng cua tu tUdng
phong kien, song dong bang khac vdi mien nui, mien Nam khac vdi mien
Bac. Neu khong tinh den nhiing dac diem ay, ta se khong hieu dung dan
doi tudng, se khong xay dung dUdc noi dung giao due siic khoe phu hdp
va phUdng phap dung dan.
- Ngay nay trong cong dong nong thon, dia vi xa hoi khong con dong vai
tro quyet dinh nhu xUa, nhUng du sao cac vi chiic sac d dia phUdng van
co tieng noi quyet dinh. Trong bol canh doi mdi ve kinh te, sii phan hoa d
nong thon dien ra kha manh me. Nhiing ngUdi biet lam an trd thanh
ngUdi co thu nhap cao. Ben canh do, hinh thanh ldp ngUdi ngheo mdi. Su
tiep thu cai mdi doi vdi hai nhom doi tUdng nay ro rang khac nhau.
- Yeu to ton giao: moi ton giao co chuan miic dao diic rieng, co nhiing dieu
ran, dieu cam ky rieng.
- Trinh do hoe van, giao due: trong khi tien hanh cong tac giao due siic
khoe can chu y den van de nay: noi dung, phUdng phap, phUdng tien giao
due siic khoe se rat khac nhau cho cac doi tUdng co trinh do hoc van,
giao due khac nhau.
- Yeu to dan toe, chung toe: sii dung ngon ngii dan toe, sii dung ngUdi
cung dan toe, chung toe tien hanh giao due siic khoe v.v... mdi mang lai
ket qua cao.
M oi noi dung, phUdng tien, phiidng phap giao due siic khoe phai m ang
tinh pho cap, phu hdp vdi tiing loai doi tUdng (theo tiing nhom tuoi, trinh do
van hoa, dia phUdng v.v...).
Truyen thong giao due siic khoe la mot nhu cau khong the thieu cua
cong dong. Tien hanh TT-GDSK phai xuat phat tii nhu cau bao ve siic khoe
biic thiet va nguon luc cua cong dong xa hoi va dap iing diidc cac nhu cau do.

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 - Noi dung de tien hanh giao due siic khoe phai tren cd sd cua viec chan
doan cong dong. Nhiing noi dung do mang tinh chat dac trUng cho ca the
gidi, mot quoc gia, mot tinh, mot huyen, mot xa va mot thon, ban trong
tiing giai doan nhat dinh.
- De dap iing dUdc cac nhu cau ve bao ve siic khoe doi hoi phai dong vien
dUdc moi tang 16p nhan dan, moi thanh phan xa hoi, moi liia tuoi cung
tham gia thiic hien cong tac giao due siic khoe.
- Hoat dong TT-GDSK la cong tac lau dai, doi hoi phai phat dong thanh
nhiing phong trao quan chung rong khap, lien tuc, trd thanh loai hinh
hoat dong xa hoi rong 16n va khong ngiing phat trien.
- Su dung siic manh tong hdp cua bo may nha nUdc, cac to chiic xa hoi va
nganh y te. Cung giong nhu mot hoat dong khac trong sU nghiep cham
lo, bao ve siic khoe cho nhan dan, giao due siic khoe cung can den nguon
liic va sii dung cac nguon liic do mot each co hieu qua nhat de dat dUOc
muc tieu cua minh. Nguon liic d day la nguon liic tong hop cua moi to
chiic khac nhau trong toan xa hoi.

2.3. Nguyen tac trtfc quan

M oi yeu to tac dong den con ngUdi trUdc het triic tiep vao cac giac quan
nhu mSt, tai, mui v.v... Tac dong triic quan nhieu khi gay dUdc an tUdng
manh, sau sac den tinh cam, niem tin cua moi ngUdi, lam thay doi hanh vi siic
khoe nhanh chong va ben viing.
Tren cd sd do, khi liia chon noi dung giao due siic khoe can chu y den
nhiing noi dung dUdc minh hoa cu the bang nhiing hinh tUdng sinh dong, tac
dong vao giac quan.
Trong khi sii dung phUdng tien triic quan phai tao dUdc thuan ldi cho doi
tUdng suy nghl va hanh dong de dat dude nhiing muc tieu da dinh. Tuy nhien
can tranh lam dung bat cii noi dung gi cung phai co phUdng tien triic quan.
Trong cong tac cham soc va bao ve siic khoe nhan dan, ban than moi can
bo y te va cd sd y te vdi toan bo nhiing hoat dong cua minh da la nhiing m lu
hinh triic quan sinh dong co tac dung giao due manh me nha't doi vdi nhan
dan. Tam giidng ngUdi can bo y te va cd sd y te thong qua cac hoat dong co the
diidc phan chieu thanh hai mat tich ciic va tieu ciic cho sii hinh thanh hay
thay doi hanh vi siic khoe nhan dan. Cong tac GDSK can thiet phai chu y
phat huy mat tich ciic cua nhiing tam giidng do.

2.4. Nguyen tac thtfc tien

Hoat dong truyen thong giao due siic khoe phai bat nguon tii cac van de
siic khoe cua cong dong va phai gop phan tich ciic giai quyet dUdc cac van de
siic khoe cua cong dong mot each thiet thiic, mang lai hieu qua mot cach cu
the bang viec nang cao siic khoe, giam benh tat, tu vong thi m6i co siic thuyet
phuc cao.

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 Nguyen tac thiic tien dUdc the hien trong qua trinh tu giao due svtc khoe.
Chinh nhan dan phai thiic sii bat tay vao lam nhiing cong viec nham bien doi
hien thuc chat liidng cuoc song, trong do co siic khoe cua ho.
Nguyen tac thiic tien con dUdc the hien trong viec lay cac ket qua cua
hoat dong giao due cham soc siic khoe cho ca nhan va cong dong trong thiic
tien de giao due, danh gia va cai tien toan bo hoat dong TT-GDSK.

2.5. Nguyen ta c long ghep

Long ghep khong nhiing la nguyen tic quan trong dUdc ap dung trong
truyen thong giao due siic khoe ma con la phUOng phap cong tac trong llnh
viic cham soc va bao ve siic khoe cho nhan dan noi chung va cua nganh y te
noi rieng.
Long ghep trong truyen thong giao due siic khoe la sii phoi hdp cac mat
hoat dong trong qua trinh giao due siic khoe; phoi hop mot so hoat dong cua
chUOng trinh giao due siic khoe co nhiing tinh chat giong nhau hoac co lien
quan mat thiet vdi nhau nham tao dieu kien ho trd va bo sung cho nhau de
dat hieu qua chung tot hon. Long ghep trong giao due siic khoe con la phoi
hop cac hoat dong cua giao due siic khoe vdi cac linh viic hoat dong khac cua
nganh y te va cac nganh khac, cac gidi va cac doan the nhan dan thanh mot
qua trinh chung nham tao dUOc nhiing loi song, hanh vi siic khoe lanh manh,
tif bo dUdc hanh vi siic khoe lac hau, co hai cho siic khoe cua moi ngUdi.
Long ghep trong truyen thong giao due siic khoe la nham phat huy moi
nguon liic san co de dat hieu qua cao hdn trong qua trinh giao due siic khoe,
tranh dUdc nhiing trung lap khong can thiet hoac bo sot cong viec, tiet kiem
nguon liic, tranh lang phi va nang cao chat liidng cong tac giao due siic khoe.
Long ghep hoat dong truyen thong gido due site khoe trong
nganh y te eo the ditoc the hien trong:
- Cac hoat dong chuyen mon: trong khi cac hoat dong chuyen mon nhu phong
benh, kham benh, chiia benh diidc thiic hien thi mot loat cac noi dung TT-
GDSK cung co the diidc cac can bo y te thiic hien v6i nhan dan hay vdi
ngUdi benh nhii nep song ve sinh, hUcing dan each phong benh, phat hien
benh, tu van nhiing phUdng phap phong benh, bao ve siic khoe v.v...
- Hoat dong cua cac cd sci y te tii trung Udng den dia phUdng: mot trong
nhiing noi dung nhiem vu cua cac cd sd y te la thiic hien truyen thong
giao due siic khoe. Trong khi tien hanh cung cap, dap iing cac dich vu y
te, nhiem vu truyen thong giao due siic khoe co the dUOc long ghep vao
cac dich vu do.

- Hoat dong cua cac cd quan dao tao can bo, nhan vien y te: hoat dong dao
tao can bo, nhan vien y te ban chat la mot hoat dong giao due siic khoe.
Co the coi day la hoat dong tao nguon nhan liic cho truyen thong giao
due siic khoe.

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 - Hoat dong cua tiing can bo, nhan vien y te: nhiem vu cua moi can bo,
nhan vien y te khong the thieu giao due siic khoe. Doi vdi nhiing can bo
nhan vien y te cd sd thi co the coi la nhiem vu hang dau, vi vay long
ghep hoat dong TT-GDSK vdi cac dich vu y te la viec lam can thiet va
thudng xuyen.
Long ghep truyen thong gido due site khoe vdi hoat dong cua cac
nganh khac:
- Long ghep giao due siic khoe trong nganh giao due: trong cac chUdng
trinh giao due pho thong, trUdng trung hoc, cao dang, dai hoc khong
phai nganh y cung da co nhieu mon hoc hoac mot so" noi dung mon hoc la
nhiing noi dung giao due siic khoe.
- Long ghep giao due siic khoe trong hoat dong cua cac co quan thong tin
dai chung: nhiing thong tin ve kien thiic y hoc thudng thiic, ve phong
benh, chQa benh va bao ve siic khoe van thudng xuyen dUOc cac cd quan
thong tin dai chung truyen di co luc bang chUdng trinh rieng biet, cd luc
la nhiing noi dung phoi hdp.
- Long ghep giao due siic khoe trong hoat dong cua quan chung nhan dan
hang ngay tai cac cong dong khac nhau: nhiing kinh nghiem phong benh
chiia benh, nhiing nep song, cach an d van hoa, hdp ve sinh v ln thudng
xuyen dUdc moi ngUdi trong cong dong truyen dat cho nhau thong qua
nhieu hoat dong khac nhau dien ra hang ngay.
- Long ghep giao due siic khoe trong hoat dong cua cac nganh ve kinh te -
xa hoi khac.
Long ghep ngay trong ban than hoat dong truyen thong gido due
siic khoe:
- Phoi hop cac nguon liic, sii dung cac nguon liic, sii dung phoi hdp cac
phUdng tien, hinh thiic v.v... mot cach cd hieu qua nhat.
- Trong khi tien hanh long ghep phai dam bao dUdc cac nguyen tac ve giao
due siic khoe da trinh bay d tren.

2.6. C ac nguyen ta c k h a c

2.6.1. Nguyen tdc vita site va vi/ng chac

- Noi dung va phuong phap giao due siic khoe phai thich hdp vdi dac diem
tam sinh ly cua tiing loai doi tUdng. Can nghien ciiu ro doi tUdng de thuc
hien cac noi dung, phuong phap, sii dung phUdng tien sao cho ho cd the
tiep thu diidc.
- Hoat dong TT-GDSK phai diidc lap di lap lai nhieu lan, dudi nhieu hinh
thiic va bang nhieu bien phap khac nhau de cung co nhan thiic va thay
doi dan thai do. hanh dong de cho cac hanh vi mdi trd thanh nhiing thdi

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 quen, nep song mdi hang ngay cua doi tUOng, tranh tinh trang rap
khuon va nong voi.

2.6.2. Nguyen tdc doi xit cd biet va dam bao tinh tap the

- Phai tim cach tiep can va tac dong khac nhau doi vdi tiing ca nhan va
tiing nhom, tiing tap the khac nhau, dac biet chu y den nhiing ca nhan
va nhiing cong dong co nhiing dac diem rieng biet.
- Phai biet tan dung vai tro va uy tin cua ca nhan doi vdi tap the, dong
thdi phai biet dua vao cong luan tien bo de giao due nhiing ca nhan
cham tien.

2.6.3. Nguyen tdc phat huy cao do tinh tich ciic, tu giac va chu dong,
sang tao cua cd nhan va cong dong

Nguyen t ic nay nhlm bien qua trinh TT-GDSK thanh qua trinh tu giao
due siic khoe de moi ngudi khong ngiing nang cao chat liidng cuoc song cua
chinh minh bang nhiing no liic thiic hien hanh vi siic khoe va 161 song lanh
manh. Giao due lam cho moi ngUdi nhan ro dUOc trach nhiem doi vdi siic khoe
cua minh va cua nhufng ngUdi khac, chu dong tich cue tham gia cac hoat dong
cham sdc siic khoe ngay tii khi khoe manh, bang chinh nhiJng hieu biet va
thiic hanh cua minh, tranh tu tUdng chi quan tam den siic khoe khi 6m dau,
benh tat, trong chd vao nganh y te va can bo y te.

CAU HOI TU LUONG GIA

1. Trinh bay khai niem ve nguyen t ic truyen thong giao due siic khoe
va liet ke cac nguyen tac TT-GDSK.
2. Neu cac cd sd khoa hoc cua TT-GDSK.
3. Trinh bay nguyen tac dai chung trong TT-GDSK.
4. Trinh bay nguyen tac trUc quan trong TT-GDSK.
5. Trinh bay nguyen t ic thuc tien trong TT-GDSK.
6. Trinh bay nguyen t ic long ghep trong TT-GDSK.

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 Bai 3

HANH VI SLTC KHOE, QUA TRiNH THAY DOI

HANH VI SLTC KHOE

MUC TIEU
1. Trinh bay khai niem ve hanh vi, hanh vi siic khoe.
2. Phdn tich ditoc cac yeu to tdc dong den hanh vi siic khoe.
3. Trinh bay ditdc cac biCdc cua qud trinh thay doi hanh vi va phdn tich cac yeu to
tdc dong den cac bitdc cua qud trinh thay doi hanh vi.

i. k h A i n ie m v e h An h VI vA h An h VI strc KHOE

1.1. Khai niem ve hanh vi

Moi ca nhan deu song trong mot tap the xa hoi va co quan he vdi nhiing
ngiidi xung quanh trong nhufng moi tac dong qua lai nhat dinh. Su tac dong
qua lai giuta ngUdi nay vdi ngUdi khac, hay giQa con ngudi vdi cac su viec,
hoan canh xung quanh dUdc the hien bdi mot hanh dong ddn le hay cac hanh
dong phoi hdp dUdc goi la hanh vi. Nhu vay hanh vi cua con ngudi dUdc hieu
la mot hanh dong hay nhieu hanh dong phiic tap trudc mot su viec,
hien tUOng md cac hanh dong nay lai chiu anh hudng cua nhieu yeu
to ben trong va ben ngoai, chu quan va khach quan. Cd rat nhieu yeu to
co the tac dong den hanh vi cua mot ngUdi nhu trinh do van hoa, phong tuc
tap quan cong dong, kinh te xa hoi, chinh tri, luat phap, nguon luc, ky nang,
phiidng tien ky thuat, thong tin.... Moi hanh vi cua mot ngUdi la bieu hien cua
cac yeu to' cau thanh nen no, dd la kien thiic, niem tin, thai do, cach thiic
hanh (hay ky nang) cua ngUdi dd trong mot hoan canh hay tinh huong cu the
nao dd. Mot hanh vi cd the thay d mot ca nhan, cung cd the thay trong thiic
hanh cua mot nhom ca nhan hay ca mot cong dong. Hanh vi dUdc lap di lap
lai nhieu lan trong thdi gian dai cd the trd thanh thdi quen.

1.2. Khai niem ve hanh vi sufc khoe

Hanh vi siic khoe la nhufng hanh vi cua con ngudi cd anh hudng tot hoac
xau den siic khoe cua chinh ban than ho, cua nhufng ngudi xung quanh va cua

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cong dong. Theo anh hiidng cua hanh vi den siic khoe, chung ta co the thay co
hai loai hanh vi siic khoe do la cac hanh vi co ldi cho siic khoe va cac hanh vi
co hai cho siic khoe.
- Nhiing hanh vi co ldi cho siic khoe:
+ Do la cac hanh vi lanh manh dUdc ngiidi dan thiic hanh de phong
chong benh tat, tai nan, bao ve va nang cao siic khoe, hay cac hanh
dong ma mot ngUdi thuc hien de lam cho ho hoac nhiing ngudi khac
khoe manh va phong cac benh tat, vi du nhii tap the due, dinh dudng
hdp ly, nuoi con bang sQa me, cho tre an sam dung, sU dung ho xi hdp
ve sinh, de thUa, thiic hanh ve sinh moi trUdng, danh rang, uong
thuoc phong benh, giam cac hanh vi lam ton hai siic khoe nhii: hut
thuoc la, nuoi con b&ng siia chai, uong rUdu qua nhieu...
+ Hanh vi sU dung dich vu y te dung: nhii kham thai dinh ky, cham soc
siic khoe tre em theo hudng dan cua thay thuoc, tiem chun g cho tre,
ke hoach hoa gia dinh, thiic hien cac chUdng trinh kham sang loc...
+ Hanh vi cua nhiing ngUdi om: nhan ra cac trieu chiing sdm va tim
kiem cac bien phap chan doan dieu tri day du, hdp ly, vi du nhu bu
nUdc bang dudng uong khi bi tieu chay, uong thuoc dung, du theo chi
dinh cua thay thuoc, an che do an dung theo chi dinh cua benh, ren
luyen theo hudng dan cua thay thuoc de phuc hoi chiic nang sau dieu
tri benh...
+ Hanh dong cua cong dong: hanh dong cua cac ca nhan va nhom de
thay doi va cai thien moi trUdng xung quanh co ldi cho siic khoe, dap
iing cac nhu cau cu the va sii quan tam chung cua cong dong.
Nhiem vu cua cac can bo y te la gidi thieu, khuyen khlch, dong vien,
hudng dan, tao dieu kien thuan ldi de moi ngUdi dan thay doi loi song khong
lanh manh, thiic hanh cac hanh vi lanh m anh nham bao ve va nang cao siic
khoe.
- Nhiing hanh vi co hai cho siic khoe:
La cac hanh vi cd nguy cd hoac cd tac dong xau den siic khoe do m ot ca
nhan, mot nhom ngUdi hay cd the ca mot cong dong thiic hanh. M ot so' hanh
vi co hai cho siic khoe do ca nhan va cong dong thiic hanh da lau va cd the trd
thanh nhiing thdi quen, phong tuc tap quan gay anh hudng ldn den siic khoe
cua nhieu ngUdi. Tren thiic te con ton tai nhieu hanh vi cd hai cho siic khoe d
cac cong dong khac nhau. Co the ke den nhieu hanh vi co hai cho siic khoe
nhu mot so ndi sii dung phan tUdi bon ruong, khong an chin uong chin, hut
thuoc la, lam dung va nghien rUdu, quan he tinh due biia bai thieu bao ve,
nghien hut, khong di kham chufa benh ma cau cung, boi toan khi bi dau om,
lam dung thuoc, an kieng khong can thiet nhat la d phu nii co thai va khi
nuoi con nho v.v... De giup ngUdi dan thay doi cac hanh vi co hai cho siic
khoe, doi hoi can bo y te phai tim hieu ky nguyen nhan vi sao ngUdi dan lai

36
thiic hanh cac hanh vi nay, tii do co bien phap thich hdp, kien tri thiic hien
TT-GDSK va gidi thieu cac hanh vi lanh manh de dan thiic hanh.
Ben canh nhiing hanh vi cd ldi va cd hai cho siic khoe, chung ta con thay
mot sd ca nhan hay cong dong thiic hanh cac hanh vi khong cd ldi va khong cd
hai cho siic khoe. Vi du mot so" ba me deo vong bac (hay vong hat cay) cho tre
em de tranh gio, tranh benh, cac gia dinh thudng cd ban de thd to tien trong
nha v.v... vdi cac loai hanh vi trung gian nay thi khong can phai tac dong de
loai bo, doi khi can chu y khai thac nhiing khia canh cd loi cua cac hanh vi
nay doi vdi siic khoe, vi du nhu hudng dan cac ba me theo doi do chat, long
cua vong co’ tay, co chan cua tre de danh gia tinh trang tang triidng cua tre.
Muc dich chung cua TT-GDSK la giup cho ca nhan va cong dong hieu rd
va loai bo cac hanh vi cd hai cho siic khoe va thiic hanh cac hanh vi cd ldi cho
siic khoe. Khuyen khich thiic hanh cac hanh vi lanh manh cd the ngan ngiia
dUOc nhieu benh tat nhu Bac sy Hiroshi Nakajima tong giam doc cua To chiic
Y te the gidi da phat bieu: "Chung ta phai nhan thay hau het cac van de siic
khoe chu yeu cua the gidi va nhiing trUdng hdp chet non cd the phong dUdc
qua nhiing thay doi ve hanh vi cua con ngudi vdi gia thap. Chung ta can phai
biet cac ky thuat giai quyet nhu the nao, nhUng cac ky thuat dd phai bien
thanh hanh dong cd hieu qua tai cong dong".

2. CAC YEU TO ANH HlTONG DEN HANH VI SlTC KHOE

Cd rat nhieu ly do dan den vi sao trUdc mot sii kien, mot van de ngudi ta
lai cd cac hanh vi nay ma lai khong cd hanh vi khac. Neu chung ta muon phat
huy vai trd cua TT-GDSK de thay doi hanh vi thi trUdc tien phai tim hieu ro
cac yeu to" cd the anh hudng den hanh vi siic khoe cua cac doi tUOng can dUdc
TT-GDSK.

2.1. Suy nghl va tinh cam

TrUdc cac sii kien, cac van de cua cuoc song, mdi ngudi chung ta cd the cd
cac suy nghl va tinh cam khac nhau. Nhiing suy nghl va tinh cam cua chung
ta lai bat nguon tii kien thiic, niem tin, thai do va quan niem ve gia tri. Chinh
trinh do kien thiic, niem tin, thai do va quan niem ve gia tri da lam cho chung
ta cd the quyet dinh thiic hanh hanh vi nay hay hanh vi khac.

2.1.1. Kien thuc

Kien thiic hay hieu biet cua moi ngiidi diidc tich luy dan qua qua trinh
hoc tap va kinh nghiem thu diidc trong cuoc song. Chung ta cd the thu diidc
kien thiic tii thay co giao, cha me, ban be, dong nghiep, nhiing ngudi xung
q u a n h , sach vd va cac phiidng tien thong tin dai chung cung cap. Trong cuoc
song, nioi ngudi chung ta co the tii kiem tra lieu hieu biet cua minh la dung
hav sai. Tii cac sii viec cu the gap trong ddi song hang ngay, cac kien thiic cua
m5 i ngiidi cung diidc tich luy. Tre em dua tay vao liia chung biet dUdc liia

37
nong va gay bong, tii do tre khong bao gid diia tay vao liia niia. Tre em co the
nhin thay mot con vat chay ngang dudng va bi xe can phai, tii sii viec nay tre
em biet diidc rang chay ngang dUdng co the nguy hiem va tii do khi di ngang
dudng chung phai can than. Kien thiic la mot trong cac yeu to quan trong
giup con ngudi cd cac suy nghl va tinh cam dung dan, tii dd dan den hanh vi
phu hdp trUdc mdi sU viec. Kien thiic cua mdi ngudi diidc tich luy trong suot
cuoc ddi. Cd cac kien thiic hay hieu biet ve benh tat, siic khoe va bao ve, nang
cao siic khoe la dieu kien can thiet de moi ngudi cd cd sd thiic hanh cac hanh
vi siic khoe lanh manh. Cac kien thiic ve cham sdc va bao ve siic khoe mdi
ngudi cd the thu dUdc tii cac nguon khac nhau, dUdc tich luy thong qua cac
hoat dong thiic tien. Vai trd cua nganh y te va can bo y te trong viec cung cap
kien thiic cho ngUdi dan trong cong dong la rat quan trong, thong qua viec
thiic hien nhiem vu TT-GDSK.

2.1.2. Niem tin

Niem tin la san pham xa hoi cua nhan thiic ca nhan cung nhu kinh
nghiem cua nhom. Mdi mot xa hoi deu hinh thanh va xay diing niem tin ve
tat ca cac khia canh cua ddi song. Hau het cac niem tin cd nguon goc tii lau
ddi va vi the xa hoi thudng chap nhan va it khi dat cau hoi ve gia tri cua niem
tin. Niem tin thudng bat nguon tii ong ba, cha me va tii nhiing ngudi ma
chung ta kinh trong. NgUdi ta thudng chap nhan niem tin ma khong can cd
gang de xac dinh niem tin dd la dung hay sai. Mot ngudi hinh thanh niem tin
do hoc tap trong suot cuoc song va quan sat nhiing ngudi khac. Cac niem tin
dUdc hinh thanh tii tuoi tre, hay tii nhiing ngUdi dUdc tin cay thudng rat kho
thay doi.
6 nhieu nUdc tren the gidi ngUdi ta thudng tin la phu nO cd thai can phai
an va tranh an mot so loai thiic pham nao dd. Vi du d mot dia phUdng ngiidi ta
tin la phu nut cd thai can tranh an thit mot sd loai dong vat, neu khong nhiing
diia tre sinh ra cd nhiing iing xU nhii iing xU cua cua cac dong vat ma ho da
an thit trong khi cd thai. Nhiing niem tin nay da khong khich le phu nii cd
thai an mot so loai thiic pham giau chat dinh dudng giup thai nhi phat trien
tot. Bat ky cong dong nao, nUdc nao cung cd nhiing niem tin rieng cua ho.
Nhiing niem tin cd the dung, cd the sai, cd niem tin cd ldi cho siic khoe, nhUng
ben canh dd cung cd niem tin cd hai cho siic khoe. Nhiing niem tin la mot
phan cua cach song con ngUdi. Niem tin cd the chi ra nhiing dieu gi moi ngiidi
chap nhan va nhiing dieu gi ngUdi ta khong chap nhan.
Niem tin cd siic manh, no anh hiidng den thai do va hanh vi cua con
ngUdi. Niem tin thudng kho thay doi. Mot so can bo y te va can bo lam TT-
GDSK thudng cho la tat ca nhiing niem tin truyen thong deu la khong dung
va can phai thay doi, dieu nay khong phai hoan toan dung. Nhiem vu cua
nhiing ngUdi lam TT-GDSK trUdc tien phai xac dinh diidc cac niem tin nao la
dung, la sai, niem tin nao cd ldi va niem tin nao cd hai cho siic khoe, tii do lap
ke hoach TT-GDSK thay doi hanh vi bat nguon tii cac niem tin cd hai cho siic

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khoe. Tuy nhien cung tuy tiing trUdng hdp cu the ma tien hanh TT-GDSK
thay doi hanh vi lien quan den niem tin cho phu hdp. Niem tin la phu nut co
thai khong dUOc an triing la mot niem tin co hai cho siic khoe ba me va thai
nhi vi triing la nguon thiic an co gia tri dinh diidng cao, rat giau protein.
Trudc khi muon thay doi niem tin nay ta can xem xet neu cac phu nii co thai
khong an triing, nhUng ho lai an cac loai thiic an khac nhii thit, ca, pho mat,
dau, viing, lac v.v... thi cung khong nhat thiet phai Uu tien TT-GDSK thay doi
niem tin lien quan den an kieng triing cua phu nii co thai. CJ mot dia phiiOng
ngUdi ta tin la neu phu nut co thai lam viec giiia trUa diidi trdi nang, nong thi
"quy ac" co the nhap vao co the ngiidi me va pha huy thai nhi. Niem tin nay la
khong dung, nhUng no lai co ldi cho siic khoe ba me, vi no khuyen ba me co
thai khong lam viec diidi trdi qua nang nong co hai cho siic khoe thai nhi. Vdi
nhiing loai niem tin khong dung, nhiing hanh vi lien quan den niem tin nay
lai co loi cho siic khoe thi can giai thich cho nhiing doi tUdng co niem tin nay
hieu ro cd sd cua cac hanh vi co loi cho siic khoe de ho duy tri.
Phan tich niem tin co y nghia trong thiic tien cho hoat dong TT-GDSK. Vi
du mot ngudi dong y nghien rUOu la nghiem trong va co the phong dUdc, nhUng
ngUdi do lai khong tin minh bi cam nhiem va trd thanh ngUdi nghien rUdu. Vi
the vdi trUdng hdp nay ta khong nen ton phi thdi gian va no liic tap trung giao
due ngUdi nay ve sii nghiem trong cua nghien rUdu ma nen tap trung vao van
de lam cho ngUdi do nhan ra r in g chinh minh la ngUdi co nguy cd nghien rUdu.
M ot phu nii tin r in g con chi co the bi mac sdi va d in den hau qua nghiem
trong. Tuy nhien chi co the lai khong tin la sdi co the phong dUdc bang tiem
chung. Trong trUdng hdp nay, cd sd quan trong cho chien liidc TT-GDSK lai can
tap trung vao thong diep la tiem chung phong dUdc benh sdi cho tre.

2.1.3. Thdi do

Thai do dUdc coi la trang thai chuan bi cua cd the de dap iing vdi nhiing
tinh hudng hay hoan canh cu the. Thai do phan anh nhiing dieu ngUdi ta
thich hoac khong thich, tin hay khong tin, dong y hay khong dong y, ung ho
hay ngan can.... Thai do thudng bat nguon tii kien thiic, niem tin va kinh
nghiem thu diidc trong cuoc song, dong thdi thai do cung chiu anh hUdng cua
nhiing ngiidi xung quanh. Nhiing ngUdi song gan chung ta co the lam cho
chung ta thay doi suy nghi, cach nhin nhan van de, miic do quan tam den van
de, tii do d in den thay doi thai do. Thai do cua chung ta co the bat nguon tii
nhiing ngiidi khac, dac biet la nhiing ngUdi ma chung ta kinh trong.
Thai do chiu anh hiidng cua moi trUdng, hoan canh. Trong mot so' hoan
canh nhat dinh khong cho phep ngiidi ta hanh dong phu hop vdi thai do cua
ho. V i du mot ba me rat muon dua con bi sot cao den tram y te de kham va
dieu tri nhiing vi ban dem, tram y te lai xa nen ba me buoc phai dem con den
kham bac sy tu gan nha. Hanh dong nay cua ba me khong co nghia la ba da
thay doi thai do khong tin vao can bo tram y te. Doi khi thai do chUa dung
cua con ngiidi diidc hinh thanh tii nhiing sii viec chUa co can cii xac dang,

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khong dai dien. Vi du mot ngUOi den mua thuoc tai tram y te ve dieu tri benh
nhiing benh khong khoi. NgUdi nay hinh thanh suy nghl la tram v te ban
thuoc khong tot, tii do co thai do khong tin vao tram y te va khong den tram
kham va mua thuoc niia. Trong trUdng hpp nay co the co nhieu ly do dan den
benh khong khoi, chii khong phai tram y te ban thuoc khong dam bao chat
lupng. Thai do rat quan trong dan den hanh vi cua moi ngiidi, do vay khi xem
xet mot thai do chUa hdp ly nao do doi vdi van de benh tat, siic khoe, can phai
tim hieu rd nguyen nhan cua thai do nay, tii dd tim phuong phap TT-G D SK
hpp ly de thuyet phuc doi tUpng thay doi thai do.

2.1.4. Gia tri

Gia tri la cac tieu chuan cd vai trd quan trong tac dong den suy nghl va
tinh cam cua con ngUdi. M ot tieu chuan nao dd dupe mot ngUdi coi la cd gia tri
vdi ho se la dong cd thuc day cac hanh dong. Gia tri con la pham chat trUdc
mot sii can trd nao do, vi du nhu long dung cam, sii thong minh. Gia tri doi
v6i mot ngUdi nao dd co the phan anh trong tuyen bo sau: "nhiing dieu quan
trong nhat doi vdi toi la... ". Vi du ve cac tieu chuan hay dac diem cd the dupe
cong dong cho la cd gia tri nhU:
+ Ba me cd nhieu con dupe xem la ba me hanh phuc,
+ Cac ba me cd cac con khoe manh la ba me hanh phuc;
+ Co nhieu gia cam, ruong vUOn rieng dupe ban be noi theo;
+ Trinh do van hoa cao dupe cong dong kinh trong;
+ Cd nhieu ban be la sang trong;
+ Siic khoe la von quy nhat cua mdi ngUdi...
Mdi ngUdi, mdi gia dinh, mdi cong dong cd the co nhiing quan niem gia
tri khac nhau. Cac quan niem ve gia tri thUdng trd thanh dong cd thuc day
cac hanh vi lien quan den phan dau de dat diidc nhiing tieu chuan gia tri
mong muon. Mdi ca nhan cd the cd cac tieu chuan gia tri rieng cua minh,
nhUng thudng thi gia tri la mot phan cua ddi song van hoa va dUdc chia se
trong cong dong hay trong mot niidc. Siic khoe la mot trong so cac gia tri quan
trong cua mdi ngUdi. Trong TT-G D SK chung ta can co g^ng lam cho moi
ngUdi hieu dupe gia tri cua cuoc song khoe manh, gia tri cua siic khoe, tii dd
dong vien moi ngUdi suy nghl ve gia tri cua siic khoe doi v6i cuoc song va thiic
hien nhiing hanh dong thiet thiic de duy tri va phat trien siic khoe.

2.2. NhiJng ngifdi c o anh hufcfng q u a n t r o n g

M ot trong cac ly do lam cho cac chUdng trinh giao due siic khoe khong
thanh cong cd the la do chiidng trinh chi chu y nham vao cac ca nhan ma
khong chu y den anh hUdng cua nhiing ngUdi khac den hanh vi cua ca nhan
dd. Tren thiic te chi cd mot so it ngUdi la quyet dinh hanh dong ma khong can
quan tam den y kien hay quan diem cua nhiing ngiidi xung quanh. Tat ca

40
chung ta deu chiu anh hudng cua nhiing ngiidi khac trong mang liidi quan he
xa hoi phiic tap. Khi mot ai do dUdc cong dong coi la nhiing ngiidi quan trong
thi cong dong thudng d l dang nghe, tin tUdng va lam theo nhiing dieu ho
khuyen hoac nhiing viec ho lam. Mot so ngUdi muon hanh dong nhiing nhiing
ngudi khac lai co quan diem ngUOc lai. Nhiing ngiioi co nhieu anh hiidng den
ca nhan, den cong dong phu thuoc vao quan he, hoan canh cua ca nhan, niem
tin, van hoa cong dong. Vi du trong mot so cong dong cac ba me vp va me
chong co anh hudng dac biet den hanh vi cham soc tre em. Trong mot so cong
dong khac nhiing ngiidi gia, bao gom ca co di chu bac co anh hUdng nhieu hdn
den cham soc tre em. Nhiing ngUdi co anh hUcfng ldn den hanh vi cua moi
ngudi co the thay doi theo khong gian va thdi gian cua cuoc song.
Thong thiidng nhiing ngudi co anh hUOng nhieu doi vdi chung ta la cha
me, ong ba, anh em, vd chong, thay co giao, ban be, ngudi lanh dao, dong
nghiep, nhiing ngUdi co nhieu kinh nghiem, trinh do cao, ky nang dac biet.
Cac can bo y te co anh hudng quan trong den hanh vi siic khoe cua ca nhan va
cong dong.
Doi vdi tre em khi con nho thi trudc het cha me, ong ba, anh chi em
trong gia dinh la nhiing ngUOi co anh hUOng quan trong nhat doi vdi tre, ldn
len di hoc thi thay co giao co anh hUdng vo cung quan trong. Hoc sinh cang
nho thi chiu anh hUcfng hanh vi cua cac thay co cang nhieu. Ban be cung hoc
tap, cung liia tuoi co anh hudng hanh vi lan nhau. Trong nhom ban chung ta
co the quan sat thay hanh vi iing xii cua cac thanh vien nhom giong nhau. Vi
du trong nhom tre vi thanh nien, mot em hut thuoc la co the thay cac em
khac hut thuoc la theo. Trong mot cO quan, hanh vi cua cac nhan vien co the
chiu anh hUOng cua ngudi quan ly lanh dao. Trong moi cong dong nhiing
ngUdi lanh dao cong dong co anh hUdng quan trong den hanh vi cua cac thanh
vien trong cong dong. Nhu vay khi tien hanh TT-GDSK can chu y den anh
hiidng cua nhiing ngUdi xung quanh t3i thay doi hanh vi cua cac doi tUdng.
Anh hiiOng cua nhiing ngUdi xung quanh co the tao ra ap liic xa hoi manh tac
dong den doi tudng. Vi du ve ap liic xa hoi la mot phu nii khong ap dung bien
phap tranh thai vi chong khong dong y, mot thanh nien tre bit dau hut thuoc
vi diidc ban be khich le. Ba me tre muon cho con uong nUdc bu khi con mSc
tieu chay nhUng lai bi ba ngan can. Nhieu tre em danh rang la vi chung danh
rang theo me. Cac gia dinh xay diing ho' xi hai ngan vi ngUdi lanh dao ton
giao trong cong dong muon ho xay diing ho xi hai ngan. Nhu vay ap liic xa hoi
co the anh hiicfng ca tich ciic va tieu ciic den nhiing thiic hanh bao ve va nang
cao sdc khoe. NgUdi thiic hien TT-GDSK can phat hien nhiing ngudi co vai tro
quan trong, tao ra cac anh hiidng tich ciic cho nang cao hanh vi co ldi cho siic
khoe va han che anh hUdng tieu ciic cua nhiing ngUdi can trd thiic hanh hanh
vi co ldi cho siic khoe cua doi tUdng.

2.3. Nguon life

De thiic hanh nhieu hanh vi nang cao siic khoe, phong chong benh tat,
cong dong hay ca nhan can co cac dieu kien can thiet ve nguon liic. Nguon hie

41
cho thuc hien hanh vi bao gom cac yeu to" nhu thdi gian, nhan luc, tien, cd sd
vat chat trang thiet bi. Nhieu ca nhan co du kien thiic, ho hieu rat ro nhu cau
cham soc siic khoe cua ho nhiing vi thieu cac dieu kien nguon liic nen ho
khong thiic hien dupe hanh vi mong muon. Tuy nhien trong thuc te ngUdi TT-
GDSK can chu y giao due mot so doi tUdng mac du co kha nang ve nguon liic
nhUng lay ly do thieu nguon liic de tii chol thiic hien cac hanh vi siic khoe
lanh manh.

2.3.1. Thdi gian

Thdi gian la mot trong cac yeu to" quan trong anh hiidng den hanh vi cua
con ngUdi. Co nhiing hanh vi can co thdi gian de thiic hanh hoac de thay doi.
Vi du mot ngUdi nong dan ch&ng may bi dau dau giQa mua thu hoach khong
den benh vien kham benh, vi sp cf benh vien dong benh nhan, phai chd ddi lau
mat thdi gian anh hUdng den thu hoach nen da quyet dinh den ong lang gan
nha de mua thuoc. Cac ba me dong con kinh te kho khan, mai lam an kiem
song nen khong co thdi gian dua tre di tiem chung va cham soc tre chu dao.

2.3.2. Nhan Itic

Nhan liic doi khi anh hUdng 16n den hanh vi siic khoe cua cong dong.
Neu mot cong dong nao do co the huy dong nguon nhan liic thi viec to chiic
cac hoat dong lao dong phuc ldi cho cong dong se dUdc thiic hien de dang. Vi
du nhu huy dong nhan liic tong ve sinh dudng lang, xom, cai tao cac nguon
cung cap nUdc, xay diing trUdng hoc, tram y te", cong trinh ve sinh cong cong...
Nhieu hoat dong TT-GDSK, nhat la cac hoat dong TT-G D SK ve thiic hien cac
bien phap du phong chung nhu ve sinh moi trUdng, cung cap nU6c sach... rat
can nguon nhan liic tii cong dong tham gia de tao nen cac phong trao, tac
dong den thay doi hanh vi siic khoe chung cua ca cong dong.

2.3.3. Kinh phi

Tien can thiet de thiic hien mot so" hanh vi. Vi thieu tien nen cac ba me
khong mua du cac thiic an giau dinh dudng cho tre mac du ho co du kien thiic
ve cham soc dinh dUdng cho tre. Co nhiing ngUdi thieu tien nen buoc phai
thiic hien nhiing cong viec nguy hiem thieu phUdng tien bao bo an toan lao
dong de kiem tien. 6 nong thon nhieu ngUdi thieu tien nen khong xay diing
dupe cac cong trinh ve sinh dat tieu chuan.

2.3.4. Co sd vat chat, trang thiet bi

Cd sd vat chat trang thiet bi la cac dieu kien can thiet h6 trd cho thay
doi mot so" hanh vi siic khoe. Neu tram y te co cd sd vat chat, trang thiet bi tot
se thu hut dupe ngUdi dan den sii dung cac dich vu kham chQa benh do tram
cung cap. Co cac phUdng tien ho trd chd hoat dong TT-GDSK nhu phUdng tien
nghe nhin, tai lieu giao due siic khoe in an dep... se hap dan doi tUpng den
tham du cac hoat dong TT-GDSK.

42
2.4. Yeu to' van hoa
Co the noi cac yeu to" anh hudng den hanh vi con ngiidi khac nhau giiia
cong dong nay vdi cong dong khac. Nhiing yeu to thong thudng tao nen hanh
vi nhu kien thiic, niem tin, cac gia tri xa hoi dupe cong dong chap nhan, cach
sU dung nguon liic trong cong dong, quan he giao tiep xa hoi, chuan miic d^.o
diic... do la cac yeu to" gop phan hinh thanh loi song va diipc hieu nhii la nen
van hoa. Van hoa la tong hdp cua nhieu yeu to" bao gom kien thiic, niem tin,
phong tuc tap quan, nghe thuat, dao diic, luat phap, thdi quen va tat ca
nhiing nang liic ma con ngUOi thu diipc trong cuoc song. Van hoa diidc the
hien trong cach song hang ngay cua cac thanh vien xa hoi hay van hoa la
"cach song" (theo dinh nghia cua tac gia Otto Klin Berg).
Nen van hoa dupe phat trien qua hang ngan nam cua nhiing ngUdi cung
chung song trong mot cong dong, xa hoi va chia se kinh nghiem trong moi
trUdng song nhat dinh. Nen van hoa dupe phat trien lien tuc, co khi nhanh,
khi cham nhu la ket qua cua qua trinh tii nhien va xa hoi, cung nhu sii giao
liiu van hoa giGa nhiing ngudi tii nhiing nen van hoa khac nhau. Hanh vi cua
con ngudi la bieu hien cua nen van hoa va nen van hoa co anh hudng sau sac
den hanh vi cua con ngudi. Khi quan sat, tim hieu ky cac cong dong, chung ta
co the nhin thay, nghe thay, hieu dupe nen van hoa cua cong dong. Moi nen
van hoa co cac dac diem dac trUng rieng, dai dien cho mot phUdng thiic ma
cong dong tim ra de chung song cung nhau trong moi trUdng cua ho. Can bo y
te, can bo TT-GDSK khi lam viec vdi mot cong dong phai tim hieu cac dac
trUng cua van hoa cong dong, biet lang nghe, quan sat de nghien ciiu ky
nguyen nhan cua cac hanh vi lien quan den siic khoe benh tat bat nguon tii
nen van hoa cua cong dong. Dieu nay se giup cho can bo TT-GDSK dupe cong
dong chap nhan va co the tim ra cac giai phap can thiep TT-GDSK phu hpp
vdi nen van hoa cong dong.
Nhu vay nhieu yeu to" anh hudng den siic khoe nhu cac hanh dong va
hanh vi thong thudng chii khong phai chi co thuoc men va cac dich vu y te.
Nhieu chUOng trinh giao due siic khoe khong thanh cong bdi vi khong
chu y den cac yeu to" van hoa, kinh te", xa hoi, chinh tri anh hudng den cac
hanh vi siic khoe cua ngUdi dan. Nghien ciiu day du cac yeu to" anh hudng den
hanh vi siic khoe cua con ngudi la can thiet de tranh nhiing that bai khi thiic
hien giao due siic khoe. Can phai xac dinh cac hanh vi nao la cua ca nhan
kiem soat va cac hanh vi nao do anh hudng cua cong dong va quoc gia. Hdn
niia can xac dinh cac kho khan, cac thii thach, sii khong cong bang trong cong
dong de co the hieu tat ca cac hanh vi cua ca nhan hay cong dong. Chung ta
cung can thuc day cac anh hiidng cua cac nha lanh dao den qua trinh hanh
dong cho nhiing thay doi chinh sach y te", xa hoi tac dong den hanh vi siic
khoe. Bang cach xac dinh hanh vi chi tiet chung ta co the nhan ra nhiing kho
khan cua cac ca nhan va gia dinh hay cong dong khi thiic hanh theo cac ldi
khuyen cua can bo y te, can bo giao due siic khoe.
Neu chi diing d viec tim hieu nguyen nhan cua hanh vi thi khong the
mong chd doi tiipng thay doi hanh vi ma can phai tiep tuc giup dd doi tUpng, tao

43
dieu kien de ho thiic hanh dUdc cac hanh vi mdi thay the hanh vi cu. Vi du neu
chi noi phai nuoi con bang siia me, dUa con di tiem chung, thuc hien ke hoach
hoa gia dinh, xay diing cong trinh ve sinh... thi khong du de ngiidi dan thUc
hien ma con phai xet den tinh co san cua dich vu, kha nang tiep can vdi cac
dich vu nay, thdi gian cua cac ba me, hudng dan ky nang can cd cho ba me de
thuc hien, cung nhu nguon liic can thiet de thiic hien cac hanh vi mong ddi.

3. MO HiNH CAC YEU TO ANH HUCfNG DEN HANH VI SLfC KHOE

Tii phan tich cac yeu to tren day chung ta co the thay hanh vi siic khoe
chiu anh hudng cua nhieu yeu to tac dong phiic tap, co lien quan den nhau.
Muon thay ddi cac hanh vi cd hai cho siic khoe thi can phai phan tich de tim
hieu nguyen nhan sau xa cua cac hanh vi dd, nghia la phai "Chan doan" dUdc
ly do vi sao doi tUdng lai thiic hanh hanh vi dd. Mot so mo hinh va ly thuyet
ve thay doi hanh vi da dUdc cac nha tam ly giao due va khoa hoc xa hoi phan
tich, phat trien. Dudi day la mot mo hinh cd tinh khai quat ddn gian ve cac
yeu to anh hudng den hanh vi siic khoe ndi chung. Md hinh giup cho can bo
TT-GDSK cd the xem xet hanh vi va cac budc trong viec ra quyet dinh ve TT-
GDSK nham thay doi hanh vi, dd la md hinh BASNEF. Md hinh BASNEF la
chii viet tat cua cac tii tieng Anh: niem tin (beliefs), thai do (attitude), chuan
miic cua chu the (subject norms) va yeu to’ co the anh hudng den hanh vi ca
nhan (enabling factors). Md hinh BASNEF nhu sau:

Sd do 3.1. Mo hinh BASNEF ve cac yeu to anh hi/dng den hanh vi

Ap dung mo hinh BASNEF bao gom viec xem xet cac hanh vi tii mong
muon cua cong dong. Khi bat dau lap ke hoach chUdng trinh giao due siic
khoe can phai tim ra cac yeu to quan trong bao gom niem tin, gia tri, ap liic
xa hoi va cac yeu to cd the anh hudng den cong dong. NgUdi thiic hien TT-
GDSK cd the neu ra cac cau hoi ve anh hiidng xa hoi, cac niem tin ve siic khoe

44
va tien hanh cac dieu tra, chan doan cong dong neu nguon liic cho phep. Khi
da co day du cac thong tin ve cac yeu to" anh hiidng theo md hinh BASNEF,
viec ra quyet dinh chUOng trinh TT-GDSK can chu y can nhac den cac khia
canh sau:
- Dam bao la thay doi hanh vi cu va thiic hanh hanh vi mdi se nang cao
siic khoe, mang lai lpi ich thiet thiic cho cong dong.
- Dam bao cac thay doi hanh vi cd kha thi: tranh cac hanh vi qua phiic
tap, qua ton kem nguon liic ma khong phu hpp vdi nen van hoa va thiic
hanh hien tai cua cong dong.
- Cung cap cac yeu to cd the can thiet giup thay doi hanh vi. Trong chiidng
trinh truyen thong chung ta can dam bao cac yeu cau ve nguon liic de
thiic hien mot so" hanh vi nhat dinh. Can xem xet dieu kien cua cong
dong nhu thdi gian, thu nhap, tinh trang nha d, cung cap nUdc, ve sinh
mdi trUdng, phat trien nong nghiep, lUOng thiic thiic pham. Giai quyet
cac yeu to" cd the thudng lien quan den long ghep, phoi hpp hoat dong
lien nganh ca d cap dia phUdng va cap cao hon.
- Chu y ap liic xa hoi tii gia dinh va cong dong: khi cac nguon liic da cd
siln thi cac trd ngai vdi thay doi hanh vi cd the la ap liic xa hoi - tieu
chuan chu the. Nhieu khi thuyet phuc ca nhan chUa du ma can thuyet
phuc cac thanh vien gia dinh, nhiing ngudi xung quanh va cong dong tac
dong den thay ddi hanh vi.
- Xac dinh tat ca cac niem tin co anh hudng den thai do: neu cong dong tin
tudng la hanh vi se dan den mot ket cuc khong tot thi ngudi thiic hien TT-
GDSK can phai tim ly do tai sao. Cong dong co the de dang dUdc thuyet
phuc neu ho thay ldi ich cua hanh vi dUdc chi ra mot cach ro rang. Thudng
thi de tac dong len cac niem tin cua ca nhan mdi thu dupe hdn la cac niem
tin da trd thanh phong tuc truyen thong cua ca cong dong.
- Tim ra cac yeu to" anh hiidng den hanh vi tac dong d miic do nao: ca nhan,
cong dong hay rong hdn. TrUdc day TT-GDSK thudng nhan manh den cac
ca nhan va it chu y den cac miic do khac nhu gia dinh, cong dong. Nhieu
van de siic khoe lien quan den hanh vi do can bo y te liia chon de thay doi
khong thiic te, khong thich hpp va cac thay doi hanh vi chi cd the dupe
giai quyet thong qua sii ldi keo cong dong cung tham gia va cung liia chon
cac muc tieu. Lam viec cung vdi cong dong se tao ra dupe siic manh va
quyen liic cua cong dong de giai quyet cac ach tac. Neu nhu cac van de
thiic hanh truyen thong can phai thay doi thi dieu quan trong la cong
dong diia ra quyet dinh qua trinh thay doi nhu the" nao.
Viec phan tich ky cac hanh vi hien tai cd hai cho siic khoe va cac hanh vi
mdi cd lpi thay the la cd sd cho lap ke" hoach can thiep TT-GDSK phu hdp va
hieu qua.

45
4. CAC Bl/CiC CUA QUA TRiNH THAY DOI HANH VI SlTC KHOE

4.1. Cac bufdc cua qua trinh thay doi hanh vi stic khoe
Bitdc 1. Nhan ra vain de mdi
Muon cho mot ca nhan hay cong dong thay doi hanh vi co hai cho siic
khoe va thiic hanh hanh vi co lpi cho siic khoe thi budc dau tien ngiidi TT-
GDSK can thiic hien la lam cho doi tUdng dupe giao due siic khoe nhan ra van
de cua ho, tiic la nhan ra dupe cac anh hudng xa'u cua van de can thay doi den
siic khoe cua ho. NgUdi thiic hien TT-GDSK can cung cap du thong tin, kien
thiic de ca nhan hay cong dong hieu dupe van de siic khoe cua ho la gi, co anh
hUdng gi den siic khoe cua ho. Bu6c nay co the thiic hien bang cach sii dung
cac phuong tien thong tin dai chung cung cap thong tin, neu can co the gap gd
triic tiep doi tUpng de cung cap kien thiic, giai thich bang cac vi du minh hoa
giup doi tiidng hieu dupe chinh van de cua ho, tii do tao dieu kien thuan lpi
cho cac budc sau cua qua trinh thay doi hanh vi. Se ra't kho de thay doi hanh
vi neu nhu ca nhan, cong dong chUa du kien thiic de nhan ra van de hay nhu
cau cham soc va bao ve siic khoe cua ho.
Bitdc 2. Quan tam den hanh vi mdi
Khi ca nhan va cong dong da co kien thiic va nhan ra van de siic khoe,
benh tat cua ho thi can lam cho ho co thai do tich ciic hay quan tam den van
de do. Co nghia la phai lam cho ho nhan thiic day la van de co anh hudng triic
tiep den siic khoe cua ho va can phai giai quyet. Vi du lam cho cong dong biet
benh tieu chay la benh nguy hiem doi vdi tre em dudi 5 tuoi va lam cho cong
dong tin la neu ho duy tri cac hanh vi thieu ve sinh, sii dung nUdc ban, sii
dung phan tuoi, thieu cac cong trinh ve sinh thi tre em se tiep tuc bi tieu chay
va anh hUdng den phat trien ca the liic va tri tue cua tre. Cung can giai thich
de cpng ddng tin tUdng benh tieu chay hoan toan co kha nang phong tranh
dupe, bang chinh nhiing co' gang cua moi ca nhan va cong dong nhu thiic hanh
hanh vi an uong ve sinh, giuf ve sinh moi trUdng. Neu ca nhan va cong dong
van tin la mac tieu chay la do so phan va khong tranh dUdc ho se khong
phong ngiia no du co diipc giao due ve benh tieu chay. De lam cho doi tUdng
quan tam den cac hanh vi mdi d giai doan nay can cac hoat dong giao due siic
khoe triic tiep, kien tri giai thich, cung cap cac thong tin bo sung, cac vi du
minh hoa, lam cho doi tiidng hiidng den thiic hanh cac hanh vi mdi.
Bitdc 3. Ap dung thit nghiem hanh vi mdi
Nhd co du kien thiic va thai do quan tam den hanh vi mdi, cung vdi moi
trUdng ho trd thuan ldi, doi tiidng diipc TT-GDSK ap dung thu cac hanh vi
mdi. Giai doan nay doi tiidng thiic hien hanh dong nen thudng la giai doan
kho khan, rat can diipc sii ho trd cua can bo y te, can bo TT-GDSK va nhiing
ngUdi xung quanh ve tinh than, cung nhii ve vat chat, cung vdi cac hudng d in
ky nang thiic hanh nhat dinh. Trong mot so hanh vi mdi, co the khi thii
nghiem can den mot so' nguon liic nhat dinh, nguon liic nay do doi tUpng co
kha nang, cung co the diipc ho trp them tii ben ngoai.

46
 Bitdc 4. Danh gia ket qud hanh vi mdi
Sau khi ap dung cac hanh vi mdi thUdng doi tiidng se danh gia ket qua
thu dupe, trong do co nhiing kho khan va thuan ldi khi thiic hien hanh vi mdi
va ldi ich tii thiic hien hanh vi mdi. Tuy nhien co doi tUpng co the khong thay ro
dupe ket qua cua thuc hien hanh vi mdi mang lai. Luc nay nhiem vu cua can bo
y te, can bo TT-GDSK la thao luan, phan tich de giup cho doi tUpng thay ro cac
ket qua da dat diidc va tac dong co lpi cua hanh vi mdi den siic khoe.
Bitdc 5. Khang dinh
Khi phan tich ket qua dat dupe cua viec thii nghiem hanh vi mdi, doi
tUpng se di den quyet dinh duy tri hanh vi mdi hay tii choi. Thong thiidng neu
doi tUpng danh gia dUdc ket qua thiic hien hanh vi mdi la tot, khong cd kho
khan gi dac biet va dupe ung ho thi ho tiep tuc duy tri hanh vi mdi. De doi
tUpng khang dinh duy tri hanh vi mdi, giai doan nay van can tiep tuc cac bien
phap ho trd tao dieu kien thuan lpi de doi tUpng duy tri hanh vi mdi. Neu doi
tUpng chUa thay dupe ket qua cua hanh vi mdi va gap kho khan khi thiic hien,
thieu sii ho trd tii ben ngoai thi ho cd the chUa chap nhan hanh vi mdi. Vdi
nhiing trUdng hdp nay cac can bo TT-GDSK lai phai tiep tuc co ke hoach giao
due siic khoe va bien phap ho trd thich hdp de doi tUpng thiic hanh lai va
■>
khang dinh duy tri hanh vi mdi.
Nhiing ngUdi lam TT-GDSK can hieu trinh tu cac budc thay doi hanh vi
siic khoe vi d moi giai doan khac nhau cua qua trinh thay doi hanh vi can
nhiing phUdng phap va ho trd khac nhau cho thich hdp vdi doi tUpng. V i du
neu ddi tUpng thieu hieu biet, chUa nhan ra van de cua ho thi can cung cap
them thong tin, neu doi tudng cd thai do chUa dung thi can giai thich, dua
them cac vi du minh hoa, ho trd tam ly. Giai doan thii nghiem can hudng dan
ky thuat hay ren luyen ky nang nhat dinh. Khi cac doi tUdng diipc TT-GDSK
tii choi viec thiic hien cac hanh vi mdi cd ldi cho siic khoe thi ngUdi giao due
siic khoe can phai tim hieu ro nguyen nhan tai sao, dd la do kien thiic chUa
dii, thai do chUa dung, chUa quan tam, thieu ky nang thiic hanh, thieu nguon
liic va mdi triidng ho trd, tii dd cd cac dieu chinh thich hpp trong phUdng phap
tiep can va giao due cho ddi tUpng giup ho thiic hien hanh vi mdi.

4.2. Cac nhom ngtfdi khac nhau vdi viec tiep nhan kien thtic, hanh vi mdi

Thong thiidng trong mot cong dong bao gid cung cd cac nhom ngUdi khac
nhau doi vdi viec tiep nhan cac van de mdi, theo tac gia Everett Rogers (1983
ve doi mdi qua trinh quyet dinh) cd the phan thanh 5 nhom ngudi nhu sau:
Nhom 1. Nhom ngUdi khdi xiidng doi mdi. Nhom nay chiem khoang
2,5%. Day la nhom tien phong, thudng dua ra cac y tUdng mdi va hanh vi mdi.
Nhom 2. Nhom nhiing ngUdi ung ho nhiing tu tudng, nhiing hanh vi mdi
sdm. Nhom nay chiem khoang 13,5%. Ho thudng dUdc goi la nhiing ngiidi
"lanh dao dii luan", cd the ho la nhiing ngudi lanh dao cong dong, cung cd the

47
hien tai ho khong phai la nhiing ngiidi lanh dao cong dong nhUng co uy tin doi
vdi cong dong, diidc cong dong tin tiidng va lam theo. Nhom nay thiidng co
trinh do hieu biet, nhan thiic nhanh vdi cac hanh vi mdi co ldi va s in sang
ung ho nhiing ngUdi khdi xUdng, gidi thieu cac van de mdi, hanh vi mdi va
van dong nhiing ngUdi khac tiep nhan nhiing van de mdi.
Nhom 3. Nhom da so" chap nhan nhiing tu tiidng, nhiing hanh vi mdi
sdm. Nhom nay chap nhan nhiing tu tUdng nhiing hanh vi mdi tiep theo nhom
thii 2, thudng chiu anh hudng sdm cua nhom 1 va nhom 2. Nhom nay chiem
khoang 34%.
Nhom 4. Nhom da so chap nhan nhiing tu tUdng, nhiing hanh vi mdi
muon. Nhom nay chiem 34%. Sii chap nhan cac tii tUdng, hanh vi m6i d nhom
nay muon hon vi the khi gidi thieu cac van de mdi, vdi nhom nay thi can co
mot thdi gian nhat dinh de nhom nay co the thay doi hanh vi. Nhom nay chiu
anh hudng nhieu cua nhiing ngudi trong nhom 3.
Nhom 5. La nhom cham chap bao thu doi vdi nhiing kien thiic, hanh vi
mdi. Nhom nay chiem 16%. Tac dong vao nhom nay rat kho khan nen phai het
siic kien tri, mem mong, tim cac giai phap thich hdp de han che anh hudng cua
nhom nay ddi vdi cac nhom khac vi nhom nay thudng co xu hudng chong ddi cac
tu tUdng va hanh vi mdi va ldi keo nhiing ngiidi khac lam theo ho.
Khi thiic hien TT-GDSK can chu y phat hien va phan loai cac doi tUdng
trong cong dong, dac biet can phat hien sdm nhiing ngUdi thuoc nhom 1 va
nhom 2 de tranh thu sii ho trd va hdp tac cua ho. Ho chinh la nhiing ngUdi
"lanh dao dii luan", nhiing hat nhan nong cot, tich ciic, giidng mau trong viec
thiic hien cac hanh vi siic khoe lanh manh, cd anh hudng ldn den loi cuon
nhiing ngUdi khac trong cong dong tham gia. Doi vdi nhiing ngUdi nay can
phai tac dong trUdc tien va sau dd ho trd thanh nhiing nhan to tien phong, co
tac dong ldn den cac thanh vien khac trong cong dong.

4.3. Cac cach lam thay doi hanh vi sufc khoe

Thay doi hanh vi siic khoe la mot qua trinh phiic tap, thudng dien ra lau
dai, ddi hoi sii giup dd ho trd tan tinh cua can bo y te, can bo TT-GDSK va cua
nhiing ngUdi cd lien quan, nhat la nhiing ngUdi than can va cd uy tin vdi doi
tUdng, cung vdi sii no liic cua chinh ban than doi tiidng. De doi tUdng thay do’i
mot hanh vi siic khoe cd hai nao dd, cd the cd 3 cach lam nhu sau:
- Cung cap cac thong tin, y tudng de doi tUdng suy nghl, nhan thiic ra van
de siic khoe cua ho hoac cua nhiing ngudi lien quan, tuf dd ho quan tam
den van de va thay doi hanh vi siic khoe. Cach nay cd hieu qua doi vdi
cac doi tiidng cd trinh do nhat dinh, cd the sii dung nhiing kien thiic va
kinh nghiem de nhan ra van de.
- Gap gd, thao luan, tao sii quan tam, ho trd giup doi tudng loai bo hanh vi
cd hai va liia chon thiic hanh hanh vi lanh manh. Cd the gap go va thao

48
 luan vdi ca nhiing ngiidi lien quan de tao moi triidng thuan ldi cho doi
tudng thay doi hanh vi. Day la cach lam thiidng dUdc ap dung nhieu
trong TT-GDSK, dem lai ket qua tot, giup doi tiidng thay doi va duy tri
lau dai hanh vi co ldi cho siic khoe.
- Dung ap luc ep buoc, triing phat buoc doi tUdng thay doi hanh vi. Day la
each lam khong tot va ket qua thiidng kem ben viing va tren thiic te it
sii dung trong TT-GDSK, tuy nhien de giao due viec ton trong thiic hien
cac luat le, quy dinh lien quan den siic khoe doi khi buoc phai sii dung
den bien phap nay.
Trong thiic te viec thay doi hanh vi siic khoe co the theo hai loai: thay
doi hanh vi dien ra tu nhien va thay doi hanh vi dien ra theo ke hoach.
- Thay doi hanh vi til nhien:
Trong cuoc song do dieu kien cua moi trUdng, hoan canh khach quan thay
doi, dan den cac hanh vi cua con ngUdi, trong do co cac hanh vi siic khoe thay
doi theo ma khong can phai suy nghl nhieu ve cac hanh vi do. Nhiing hanh vi
thay doi nay dupe goi la hanh vi thay doi tii nhien. VI du mot ba me thudng
mua triing ga cho con an nhUng vao thdi diem hien tai ngoai chp khong co
triing ga ban, do vay ba me phai mua triing vit thay the. Mua he ngUdi ta
thudng mac quan ao mong de chong nong con mua dong den ngUdi ta thUdng
mac quan ao day de chong lanh. Trong mot xom ngUdi dan thUdng den tram y
te kham benh. nhUng vao mua mUa dudng den tram y te bi ngap nen ngUdi dan
lai den cac phong kham tu nhan de kham benh va co the mua thuoc tai nhiing
ndi khac ngoai tram y te. Cac yeu to" khach quan co the dan den thay doi hanh
vi tii nhien anh hudng den siic khoe, ca co lpi va co hai, co the xay ra d bat ky
mot noi nao va co the n&m ngoai sii kiem soat cua can bo TT-GDSK.
- Thay doi hanh vi theo ke hoach:
Nhieu hanh vi co hai cho siic khoe can phai thay doi va nhiem vu quan
trong cua can bo y te, can bo TT-GDSK la lap ke hoach TT-GDSK de giup ca
nhan, cong dong thay doi cac hanh vi co hai va thiic hanh hanh vi co ldi cho siic
khoe. Ban than cac doi tUpng dUdc TT-GDSK cung can phai lap ke hoach cho
qua trinh thay doi hanh vi cua minh. Trong mot cong dong co the nhieu ngUdi
hut thuoc la, day la van de siic khoe ma can bo TT-GDSK can lap ke hoach TT-
GDSK de thay doi hanh vi hut thuoc la. Mot ca nhan nao do hut thuoc la khi
diipc giao due, nhan ra tac hai cua thuoc la co the lap ke hoach de bo hut thuoc
la. Mot ba me diidc TT-GDSK ve cach nuoi tre va tu minh lap ke hoach de thiic
hanh nuoi diiong tre dung phUdng phap. Nghien ciiu qua trinh thay doi hanh vi
ngiidi ta thay khi dua ra mot y tUdng hay mot hanh vi mdi, khong phai ngay
lap tiic ngiidi dan chap nhan, tren thiic te co nhiing van de mdi con bi chi trich,
phu nhan. De’ mot ca nhan, mot cong dong co kien thiic mdi, chap nhan mot tu
tUdng mdi, mot hanh vi mdi, can phai cd thdi gian va lap ke hoach cho qua trinh
thay doi hanh vi dien ra. Muc dich chinh cua hoat dong TT-GDSK la giup ngudi
dan thay doi cac hanh vi siic khoe theo ke hoach.

49
4.4. Nhufng dieu kien can thiet cho thay doi hanh vi sufc khoe

Muon thuc hien cac chUdng trinh TT-GDSK thanh cong, trUdc tien cac
can bo thiic hien TT-GDSK phai tim ra cac hanh vi la nguyen nhan cua cac
van de siic khoe va phan tich cac nguyen nhan cua hanh vi sufc khoe (do thieu
hieu biet, niem tin, phong tuc tap quan, ap liic xa hoi hay thieu thdi gian,
nguon liic hoac cac ly do cu the khac), tii do xay diing ke hoach cho chUdng
trinh TT-GDSK hdp ly. Trong qua trinh thiic hien TT-GDSK cho thay doi
hanh vi dien ra can dam bao cac dieu kien nhii sau:
1. Doi tUpng phai nhan ra la ho co van de siic khoe: qua viec cung cap
du kien thiic, doi tUpng dupe giao due siic khoe nhan ra dUdc van de,
sufc khoe cua ho ma trudc day ho chUa biet hoac biet chiia day du.
2. Ho quan tam va mong muon giai quyet van de: doi tUdng dUdc giai
thich day du ve tac hai va anh hUdng cua van de tdi sutc khoe, tii dd
ho quan tam tim hieu cach giai quyet van de cua ho.
3. Ho hieu ro cac hanh vi lanh manh de giai quyet van de siic khoe cua
ho: de thay the hanh vi cd hai cho sufc khoe, doi tUdng can hieu dUdc
cac hanh vi nao co the thay the b&ng hanh vi cd ldi cho siic khoe. Can
bo TT-GDSK phai gidi thieu day du cac hanh vi lanh m anh, phu hdp
vdi thiic te de thay the hanh vi cu cd hai. Can bo y te hay can bo TT-
GDSK can to chiic lam mau hudng dan cach thiic hien hanh vi mdi,
tao dieu kien cho doi tUdng dUdc thiic hanh de ddi tUdng cd diidc cac
ky nang can thiet va tii tin thiic hien hanh vi mdi.
4. Hanh vi lanh manh cd kha nang thiic hien va dUdc chap nhan:
nhiing hanh vi siic khoe dUdc gidi thieu cho doi tUpng phai la nhiing
thiic hanh ma doi tUpng cd du dieu kien thiic hien dupe tron g kha
nang co' g&ng cua doi tUpng, cong vdi sii ho trd tuf ben ngoai. Nhiing
dieu kien can can nhac de doi tUpng thiic hien hanh vi mdi la thdi
gian, nguon liic va ky nang cua doi tUpng. Hanh vi mdi khong diidc
mau th u ln vdi cac chuan miic, phong tuc tap quan, van hoa lanh
manh cua cong dong, khong gay sao tron ldn anh hUdng den cuoc
song binh thiidng cua ca nhan va cong dong, lam cho cong dong
khong chap nhan.

5. Doi tiidng phai diidc thu nghiem hanh vi lanh manh: thu nghiem de
cd diipc cac ky nang la dieu kien can thiet khi thiic hanh hanh vi
mdi. Khi ddi tUpng thiic hanh lan dau tien can phai dupe can bo
hiidng dan, lam m lu va theo doi cac budc thiic hanh cua doi tupng de
giup dd doi tUdng lam dung theo yeu cau.
6. Ddi tupng phai danh gia diipc lpi ich, hieu qua cua thuc hien hanh vi
mdi: khi cac doi tUdng da tii bo cac hanh vi cu cd hai cho siic khoe va
thiic hanh hanh vi mdi, c h ic c h in se diia den ldi ich va cai thien tinh

50
 trang siic khoe ca the chat va tinh than. Can bo y te, can bo TT-
GDSK can theo doi, giup dd de chi cho doi tUdng thay diidc ldi ich va
anh hudng tich ciic cua hanh vi mdi den siic khoe. Phai lam cho doi
tupng tin tudng vao ket qua da dat dUdc de lam cd sd vting chac cho
viec duy tri hanh vi.
7. Doi tupng phai chap nhan duy tri hanh vi mdi lanh manh: khi doi
tupng da thuc hanh hanh vi mdi va nhan ra cac ket qua dat dUdc,
v ln can tiep tuc ho trd, dong vien, tao cac dieu kien de doi tiipng duy
tri hanh vi. Can tiep tuc cung co niem tin cua doi tupng vao ket qua
tot hdn se dat dUdc neu duy tri hanh vi mdi, tii do dan den sii chap
nhan thiic hien hanh vi lau dai.
8. Ho trd moi trUdng va dam bao nguon liic can thiet de doi tupng thay
doi hanh vi: la yeu cau cd ban trong tat ca cac biidc cua qua trinh
thay doi hanh vi. Khi thiic hanh hanh vi mdi, tii bo hanh vi cu thi
moi triidng ho trd nhii sii ung ho cua nhiing ngUdi xung quanh, sii
quan tam giup dd ve tinh than cua can bo y te, to chiic dich vu y te
thuan lpi, tao dieu kien cho doi tUdng co thdi gian, hudng dan ky
nang bo sung cho doi tUdng thiic hanh...la cac dieu kien rat can thiet
cho doi tupng dupe TT-GDSK.
Dam bao nhiing yeu cau can thiet cho thay doi hanh vi siic khoe dien ra,
can bo TT-GDSK khong nhiing can co no liic ca nhan ma con phai phoi hdp
v6i cac ca nhan, gia dinh va nhiing to chiic lien quan de tao ra cac dieu kien
giup do, ho trd doi tupng thiic hanh thay doi hanh vi.

CAU HOI TI/ LLfONG GIA

1. Neu khai niem hanh vi va hanh vi siic khoe.
2. Trinh bay cac yeu to' cd ban anh hUdng den hanh vi siic khoe cua moi
ngudi.
3. Ve va trinh bay mo hinh BASNEF ve cac yeu to' anh hUdng den hanh
vi siic khoe.
4. Neu 5 nhom ngiidi khac nhau vdi viec tiep nhan kien thiic, hanh
vi mdi.
5. Trinh bay cac budc ciia qua trinh thay doi hanh vi.
6. Phan tich cac dieu kien can thiet cho thay doi hanh vi dien ra.
7. Neu vi du ve mot van de siic khoe, phan tich nguyen nhan co the co
cua van de siic khoe do va chi ra cac nguyen nhan do hanh vi khong
lanh manh gay nen.

51
 Bai 4

NOI
■ DUNG TRUYEN THONG GIAO DUC
■ S0C KHOE

MUC TIEU
1. Neu cac nguyen tdc chinh de liia chon cac noi dung TT-GDSK.
2. Liet ke diidc cac noi dung chinh can tien hanh TT-GDSK hien nay.
3. Trinh bay diidc nhiing noi dung cd ban cua cac van de sUc khoe, benh tat chinh
can tap trung TT- GDSK.

1. CAC NGUYEN TAC LUA CHON NOI DUNG TT-GDSK

1.1. M d d a u

To chiic Y te the gi6i da dinh nghia: siic khoe la mot trang thai thoai
mai toan dien ve the chat, tam than va xa hoi chii khong chi bao gom tinh
trang khong co benh hay thUOng tat. Tii dinh nghia cua To chiic Y te the
gidi ve siic khoe co the thay la co rat nhieu yeu to" tac dong den siic khoe vdi
nghia rong, ca siic khoe the chat, tinh than, xa hoi va TT-G D SK la nham
giup moi ngudi biet loai trii hoac han che cac yeu to" tac hai den siic khoe,
tao moi trUdng va thuc hanh lanh manh nham bao ve va nang cao siic khoe.
TT-GDSK la noi dung trong tanked lien quan den moi_noi dungJ^hac cua
cham soc siic khoe ban dau. Nhii vay co the nhan thay cac noi dung can TT-
GDSK cho cong dong ndi chung rat rong, bao gom tat ca cac van de lien
quan den siic khoe the chat, siic khoe tinh than va siic khoe xa hoi. Yeu cau
cua TT-GDSK khong chi bao gom giao due ve phong benh, phat hien benh,
dieu tri benh, phuc hoi siic khoe ma con nham gop phan loai bo tan gdc cac
nguyen nhan gay benh tao ra mdi trUdng song lanh manh cho nang cao siic
khoe. TT-GDSK khong chi vdi cac ca nhan ma con cho ca tap the, cong dong,
ca ngudi dm va ngudi khoe. Tuy nhien mdi noi, moi luc chung ta phai chon
nhiing noi dung, giao due siic khoe cho phu hpp vdi ca nhan, nhom hay ca
cong dong. Lua chon noi dung TT-GDSK con phu thuoc cu the vao linh vuc
chuyen mon cua ngudi thiic hien TT-GDSK. Dudi day la mot so" nguyen t ic
trong liia chon noi dung TT-GDSK.

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1.2. Mot so nguyen tac trong ltfa chon noi dung TT-GDSK

1.2.1. Ltfa chon noi dung TT-GDSK phai dap iing cac van de siic khoe
tfu tien

Van de siic khoe, benh tat Uu tien la nhiing van de siic khoe benh tat
pho bien. hien dang co anh hudng ldn den siic khoe cua ca nhan va cong dong.
Nhiing van de siic khoe can Uu tien trong TT-GDSK cho cac ca nhan va cong
dong cd the khac nhau, tuy theo tiing dia phUdng, khu viic va phu thuoc vao
tiing thdi gian. Cung cd the cd cac van de siic khoe, benh tat thiidng gap, hay
nhiing kien thiic khoa hoc thudng thiic ve siic khoe, benh tat can TT-GDSK
cho tat ca moi ngudi, hoac cho nhieu doi tupng trong cong dong, tren pham vi
rong va can thuc hien vao tat ca moi thdi gian, cung diidc chon la nhiing van
de siic khoe Uu tien cho hoat dong TT-GDSK.

1.2.2. Cac noi dung cu the can TT-GDSK cho doi ttfOng phai phu hop
vdi nhu cau va kha nang tiep thu cua doi ttfOng

Khong nen trinh bay noi dung qua di vao chi tiet vdi doi tupng, chi nen
nhan manh nhiing noi dung ma doi thudng can phai biet va can biet. Khong
nen trinh bay qua nhieu noi dung ddi tUdng nen biet. Viec nghien ciiu ky doi
tupng trUdc khi thiic hien TT-GDSK la can thiet de biet ro cac kien thiic, thai
do va thiic hanh cua doi tudng (KAP) d miic do nao de soan thao noi dung cu
the cho phu hpp. Noi dung phai dap iing dung, du cac muc tieu TT-GDSK da
dat ra.

1.2.3. Noi dung phai dam bao tinh khoa hoc, thtfc tien

Cac noi dung chuyen tai den doi tupng phai la noi dung dupe soan thao
tii cac tai lieu co cO sd khoa hoc, gom nhiing kien thiic, thiic hanh da dupe
kiem chiin g va chinh thiic diipc sii dung trong cac tai lieu, y van da dUdc lUu
hanh hdp phap. Noi dung lien quan thiet thiic va phai ap dung dUdc trong
hoan canh cua doi tupng.

1.2.4. Noi dung can dtfc/c trinh bay ro rang, don gian, de hieu

Trinh bay noi dung can tranh sii dung cac tCi, cum tii, thuat ngii chuyen
mon y hoc. Cac noi dung dupe the hien bang cac cau tii ng&n gon. du v. khong
nen giai thich cd che dai dong giup doi tupng de dang tiep thu va lam dupe.
Tot nhat la sii dung cac ngon ngii cua cong dong de dien dat noi dung. Doi vdi
cac vung dan toe it ngudi phai sU dung ngon ngii, hinh anh cua dia phUdng de
trinh bay.

1.2.5. Noi dung dtfOc trinh bay theo trinh ttf hop ly

Nhiing noi dung cua mot van de TT-GDSK can diidc trinh bay theo trinh
tii hop ly cua W duv Id gic, phii hdp vdi tam sinh ly cua doi tupng de doi tupng

53
de nhd, de thtfc hien. Vi du khi TT-GDSK cho cong dong ve phong chong mot
benh nao do co the trinh bay theo thii tii nhu sau:
- Tac hai hay anh hiidng cua benh den ca nhan, gia dinh, xa hoi.
- Nhiing nguyen nhan, dudng lay truyen benh.
- Bieu hien va cach phat hien benh sdm.
- Cach xti tri benh khi phat hien.
- PhUOng phap phong, chong benh.

- Tom tat nhiing noi dung chinh.

1.2.6. Noi dung ditcic chuyen tdi den doi tiicJng bang cac hinh thiic hap dan

Cd the sii dung ldi ndi triic tiep, phoi hdp vdi cac vi du, hien vat, hinh
anh minh hoa gay an tiipng manh cho doi tUdng de chuyen tai noi dung TT-
GDSK. Can nghien ciiu ky cac doi tiidng de chon phiidng phap chuyen tai noi
dung thong diep phu hdp nhat vdi doi tiidng, kem theo cac hinh anh, vi du
minh hoa lam cho doi tiipng tap trung chu y. Nhieu cong dong cd cac hinh
thiic sinh hoat van hoa, van nghe truyen thong nhii thd ca, nhac, kich, sinh
hoat cau lac bo, can bo TT-GDSK can tan dung cac thdi cd tot dd de long ghep
phoi hdp hoat dong TT-GDSK.

2. CAC NOI DUNG CHINH CAN TRUYEN THONG GlAO DUC SlTC KHOE

2.1. Giao due bao ve sufc khoe ba me tre em

2.1.1. Tam quan trong

Ba me va tre em la hai doi tiidng chiem so" dong trong xa hoi (chiem
khoang 60-70% dan so), neu nhii siic khoe cua ba me va tre em diidc bao ve va
nang cao thi cung cd nghia la siic khoe cua toan xa hoi diidc bao ve. Tre em la
ldp mam non tiidng lai cua dat niidc, quyet dinh den sii phat trien chung cua
toan xa hoi. Tre em la liia tuoi nhay cam, thiidng de bi m ic benh neu khong
diipc cham sdc dung d in va khi mac benh thiidng nang, anh hiidng lau dai
den sii phat trien the liic va tri tue cua tre. Ba me la doi tiidng triic tiep cham
sdc, nuoi diidng tre, ngoai mac cac benh chung, con mac cac benh phu khoa co
lien quan den siic khoe sinh san.

2.1.2. Noi dung chu yeu ve gido due bao ve siic khoe ba me tre em

Truyen thong giao due siic khoe ve bao ve siic khoe ba me tre em bao
gom rat nhieu noi dung, diidi day la nhiing noi dung cd ban can tap trung TT-
GDSK de gop phan cham sdc siic khoe cho ba me va tre em.

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2.1.2.1. Theo ddi thiidng xuyen sii phat trien tre em
- Dung bieu do theo doi tinh hinh siic khoe tre em ma quan trong nhat la
theo doi can nang tre em diidi 5 tuoi. Can nang la mot chi bao sdm va
quan trong phan anh tinh hinh dinh dudng va tinh trang siic khoe, benh
tat tre em, vi the neu dUdc theo ddi lien tuc hang thang, hang quy, hang
nam cd the phat hien tre cd tang can binh thiidng hay khong. Neu tre
khong tang can hay tut can cln diia tre di kham siic khoe va cd the phat
hien sdm diipc cac van de siic khoe, benh tat cua tre de giai quyet kip thdi.
- Can bo y te va can bo giao due siic khoe can hiidng dan cho cac ba me
theo doi thudng xuyen can nang, ghi dung can nang cua tre vao bieu dd
tang trudng va biet the nao la tre phat trien binh thudng, khi nao tre bi
tut can phat trien khong binh thudng can phai diia tre den cac co sd y te
kiem tra siic khoe.

2.1.2.2. Gido due bii niidc kip thdi bang diidng uong cho tre khi bi tieu chay

Tieu chay la benh pho bien d tre em, ty le tii vong cao, con gap d nhieu
nUdc tren the gidi, dac biet d cac niidc cham phat trien va dang phat trien.
Tieu chay cd ty le tii vong cao neu khong dupe xu tri dung din. O nude ta tieu
chay la nguyen nhan diing hang thii tii trong mudi benh cd ty le mac cao nhat
theo thong ke cua Bo Y te.
Tieu chay la di ngoai tii 3 lan/ngay trd len, phan nhieu niidc. Khi tre bi
tieu chay cd nhieu dau hieu khac nhau tuy theo miic do mat nUdc. M at nUdc
nhe tre chi quay khoe, kern an, mat nUdc nang hon tre mdi kho, da hoi nhan,
khoe nhieu... nang niia thop cd the lom, m lt trung, dau hieu Casper (+), tinh
than li bi, cd the dua den soc mat nUdc va de doa den tinh mang cua tre.
Tieu chay do nhieu nguyen nhan khac nhau (do nhilm khuan diidng
ruot, do che do an, do hau qua cua cac benh khac nhu viem phoi, viem tai
gitifa, roi loan vi khuan d dudng ruot). Nhd bien phap dung Oresol va nUdc
chao muoi diidng v.v... ty le tii vong do tieu chay da giam ro ret. Can bo y te
khi TT-GDSK cho cac ba me can hudng dan cac ba me biet diipc cac nguyen
nhan thiidng gap cua tieu chay, cach phat hien tre bi tieu chay va xii tri dung
tai nha khi tre bi tieu chay. Can trinh dien de hiidng d in cac ba me va ngiidi
cham sdc tre biet pha dupe va sii dung Oresol dung, cung nhu cac dung dich
uong bu mat niidc thay the Oresol nhii niidc chao muoi, niidc dudng, nUdc hoa
qua khi tre bi tieu chay.
Chi dinh dung thuoc cho tre tieu chay phai theo y kien cua can bo y te.
Chong lam dung thuoc khi bi tieu chay, dac biet la thuoc khang sinh vi cd the
lam cho tieu chay nang hon, trii khi ta biet ch ic ch in tieu chay do vi khuan
sau khi cd ket qua lam khang sinh do.
Dac biet can chu y TT-GDSK cho cac ba me, ngudi cham sdc tre, cong
dong biet va thuc hien cac bien phap phong chong tieu chay thong thiidng tai

55
cong dong nhii ve sinh ca nhan, ve sinh moi trUdng, ve sinh an uong, nuoi con
bang siia me, tiem chung day du cac loai vaccin phong benh cho tre.

2.1.2.3. Gido due nuoi con bang siia me va nuoi diidng tre

Suta me la thiic an tot nhat cho tre em, siia me bao dam s\i phat trien
binh thiidng cho tre ca the liic va tri tue. Can giao due cac ba me biet bao ve
nguon siia me, cach nuoi tre bang siia me, cu the can chuyen tai dupe cac noi
dung thong diep cO ban sau day den cac ba me va cong dong:
- Cho tre bu ngay sau khi de, cang sdm cang tot (bu siia non gia tri dinh
diidng cao, cd khang the bao ve cho tre).
- Khong nhat thiet phai cho tre bu theo gid giac ma cho tre bu theo nhu cau.
- Trong sau thang dau chi can cho tre bu siia me la du.
- Tii thang thii bay trd di phai cho tre an sam con goi la an bo sung hay
an dam.
- Tre om van phai tiep tuc cho tre bu siia me (vi du khi tre bi tieu chay).
- Khong nen cho tre bu chai, neu vi ly do nao dd tre khong bu me diidc thi
vat siia do bang thia cho tre.
- Nen cai siia muon, tii khi tre diidc 18 thang trd di.
- Che do an cua me trong thdi gian cho tre bu phai du chat va can doi,
khong nen kieng khem, chi can dam bao an uong an toan, hdp ve sinh.
- Dam bao che do an uong cd du bon nhom thiic an cung cap glucid, protid,
lipid, vitamin va cac muoi khoang.
Ngoai viec giao due cac ba me nuoi con bang siia me, can bo y te can
hiidng dan cho cac ba me cho tre an sam dung, biet cach liia chon, che bien va
cho tre an cac thiic an bo sung, thiic hien "To mau bat bot" hoac o dinh diidng
thiic an day du, tranh tinh trang kieng khem khong can thiet. Thiic hien tot
ve sinh ca nhan, ve sinh an uong, phong chong tieu chay va cac benh lay
truyen khac ma tre hay mac.

2.1.2.4. Gido due ve tiem chung phong benh

Tiem chung la mot noi dung dii phong tich ciic, quan trong trong cham
sdc siic khoe ban dau, mot bien phap dii phong mang tinh hieu qua cao de
phong 8 benh lay truyen nang (Bach hau, ho ga, uon van, bai liet, sdi, lao,
viem gan B va viem nao Nhat Ban) va mot sd benh khac nhu Rubella, quai
bi...d tre em
Tiem chung md rong nham tao mien dich chu dong trong cd the tre, giup
tre cd kha nang chong lai cac benh lay hay mac tren.
ChiiOng trinh tiem chung md rong d niidc ta da dat dupe nhiing thanh
tich dang ke, ty le tiem chung dat 96,6%. Phan ldn nhan dan da nhan thiic

56
diidc vai tro quan trong cua tiem chung md rong. Tuy nhien, d mot so cac
vung sau, vung xa, vung mien nui ty le tiem chung con chiia dat yeu cau, vi
the muc tieu cua ta hien nay v ln tiep tuc phai giao due ve cong tac tiem
chung, can tap trung giao due vao cac dia phiidng co ty le tiem chung dat d
miic thap de tiep tuc giam ty le mac benh va tien tdi thanh toan mot sd benh
nhiem trung pho bien va nang ne d tre em. Theo Chuan Quoc gia ve Y te xa,
trong cong tac tiem chung giai doan 2001-2010 phan dau:
- Duy tri ty le tiem chung dat 0 miic cao (tvl 95% trd len) d dong bang va
mien nui dat 90% trd len.
- Duy tri va bao ve thanh qua thanh toan bai liet, khong de virus bai liet
hoang dai tii nude ngoai xam nhap vao Viet Nam. Tiep tuc cho tre em
udng vaccin phong bai liet.
- Tiep tuc giam ty le uon van sd sinh xuong con 0,14/100.000 dan.
- Ty le mac sdi con 4/100.000 dan.
- Ty le mac benh bach hau con 0,05/100.000 dan.
- Tiing bildc trien khai rong rai trong toan quoic 4 loai vaccin: ta, thilOng
han, viem nao Nhat Ban B, viem gan B.
- Trien khai them vaccin Hib (Haemophilus influenzae) phong viem mang
nao va viem phoi cap d tre em.
Tiep tuc duy tri cong tac TT-GDSK ve tiem chung van can thiet de dat
diidc cac chi tieu tren, dac biet chu y doi vdi cac vung ma ket qua tiem chung
con dat thap so vdi ty le chung cua ca nUdc.

2.1.2.5. Gido due cho cac ba me cac kien thiic ve phong chong mot so benh
khac va cac tai nan thii&ng tich md tre em hay mac

Nhiing benh tat, tai nan hien nay van cd ty le m lc cao, cd anh hiidng ca
triidc mat va lau dai den siic khoe va phat trien cua tre can TT-GDSK phong
chong la:
- Nhiem khuan ho hap cap.
- Kho mat va mu loa do thieu vitamin A.
- Benh thap tim.
- Benh sot ret (d vung cd sot ret lilu hanh), sot xuat huyet...
- Cac tai nan thilOng tich tre em hay m&c nhii tai nan dien giat, di vat
diidng an va diidng thd, duoi niidc, tai nan giao thong...

Day la nhiing benh tat, tai nan thiidng gap d tre em, nhat la d cac vung
kinh te kho khan, dieu kien song con han che, thieu cham sdc chu dao.

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2.1.2.6. Gido due kien thiic bao ve siic khoe ba me

Ba me can diidc chu trong giao due cac noi dung lien quan den cac giai
doan dac biet nhu mang thai, sinh de, co nhieu nguy cO cao, co the anh hudng
den siic khoe, tinh mang cua ca me va con.
- Giao due cac kien thiic cham soc ba me triidc sinh:
+ Dang ky kham va quan ly thai sdm (phan dau 100% cac ba me cd thai).
+ Kham thai dinh ky toi thieu 3 lan trong thdi ky mang thai va tiem
phong du lieu vaccin phong uon van trudc khi sinh.
+ Phat hien sdm cac yeu to" nguy cO de bao ve thai nhi.
+ Giao due ve sinh dinh dudng trong thdi ky thai nghen.
- Giao due cac kien thiic cham sdc ba me sau khi de:
+ Cho con bu sdm sau de, rifa dau vu triidc va sau khi con bu.
+ Me an du chat, ngu 8 gid/ngay, van dong sdm.
+ Theo ddi san dich de phat hien sdm nhiem khuan hau san va cac nguy
cd khac.
+ Hudng dan cham sdc tang sinh mon.
+ Hiidng d in theo doi siic khoe va ghi chep phieu theo ddi siic khoe ba
me tai nha.
- Giao due ve dan so' ke hoach hoa gia dinh:
+ Giao due giup ngudi dan hieu diidc tam quan trong cua sinh de cd ke
hoach, hieu ve cac bien phap tranh thai va cac dich vu ke hoach hoa
gia dinh hien cd.
+ Mdi gia dinh biet liia chon va thiic hien cac bien phap tranh thai thich
hpp, thiic hien mdi cap vd chong chi nen cd tii 1 hoac 2 con. Phan dau
trong giai doan 2001 - 2010, ty le cap vp chong ap dung cac bien phap
tranh thai hien dai d dong bang va trung du la 70% trd len, mien nui
55% trd len. Thiic hien tot che do chinh sach ve dan so, dac biet la
hieu dung ve phap lenh dan so cua nha niidc mdi ban hanh, nhanh
chong han che viec gia tang dan so trong vai nam gan day de dat dupe
miic sinh thay the.
Truyen thong giao due siic khoe ve cham sdc bao ve siic khoe ba me tre
em la noi dung rat quan trong va phong phu. Noi dung giao due cd the tom tat
vao chiiOng trinh: GOBIFFF.
G (Growth Chart): theo doi sii phat trien cua tre bang ghi bieu do tang
triidng.
O (Oresol): bu niidc va dien giai bang dudng udng cho tre khi bi benh
tieu chay.

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 B (Breast Feeding): nuoi con bang siia me.
I (Immunization): thuc hien chiiOng trinh tiem chung md rong.
F (Food Supplement): cung cap thuc pham bo sung cho tre em va ba me
co thai va nuoi con nho.
F (Family Planning): thiic hien ke hoach hoa gia dinh.
F (Female Education): giao due tang kha nang hieu biet chung cua phu nii.
Tom lai: giao due bao ve siic khoe ba me tre em can chuyen tai dupe
mUdi thong diep quan trong nhat cua: "Nhiing dieu can cho cuoc song" den vdi
cac ba me va cong dong:
- Thii nhat: siic khoe cua phu nil va tre em co the nang cao mot cach dang ke
bang cach de cach nhau it nhat la 2 nam, tranh mang thai trUdc tuoi 18.
- Thii 2: giam nguy co rui ro khi sinh de, tat ca cac phu nii co thai can sii
cham soc cua can bo y te dupe dao tao va khi sinh de phai dUdc can bo y
te giup dd.
- Thii 3: trong cac thang dau tien sau sinh, siia me la nguon thiic an tot
duy nhat cho tre em. Tre em can cho an them cac loai thiic pham bo
sung khac khi tre dupe 6 thang tuoi trd len.
- Thii tu: tre em dudi 3 tuoi can sii cham soc dac biet, chung can dupe an
tii 5 den 6 lan trong ngay va thiic pham phai giau chat dinh dudng va bo
sung them cac loai rau, mot it chat beo va giau an.
- Thii 5: tieu chay co the lam cho tre bi chet vi mat cac dich cua cd the.
Vi the liidng dich tre bi mat sau moi lan tieu chay phai dupe uong bu
lai bang cac dich long thich hpp: nhu siia, nUdc sup, chao, hay cac chat
long dac biet nhu ORS (oresol). Neu bi tieu chay nang thi chung can
phai diipc sii giup dd cua can bo y te va can cac loai thiic pham giau
chat dinh diidng.
- Thii 6: tiem chung phong mot so benh co the dan den cham phat trien,
tan tat va chet 6 tre em. Tat ca cac vaccin phong benh can dupe tiem
chung cho tre em trong nam dau tien cua cuoc song va tiem vaccin
phong uon van cho tat ca phu nii 6 tuoi sinh de.
- Thii 7: hau het cac triidng hpp ho va cam lanh co the tii khoi. NhUng neu
tre em co ho va kho thd, nhip thd nhanh hon binh thudng va tre met hdn
thi can diia tre den ngay cac trung tam y te. Tre ho va cam can dUdc an
uong day du cac thiic an long.
- Thii 8: nhieu trudng hdp tre bi benh la do mam benh tham nhap qua
dudng an uong. Cac benh nay co the phong dupe bang sU dung ho xi hpp
ve sinh, riia chan tay sach bang xa phong sau khi di ve sinh va trudc khi
an, giO sach cac loai thiic pham va nUdc uong, uong nUdc soi neu khong
co nUdc may an toan.

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 - ThU 9: tre em bi benh se khong phat trien. Sau khi khoi benh tre can
dupe an nhieu bUa bo sung hang ngay de bu lai sU phat trien cua tre bi
cham.
- ThU 10: tre em tU 6 thang den 3 nam tuoi can dupe can hang thang, neu
2 thang lien tre khong tang can, tre co the co van de sUc khoe can dupe
kham phat hien.

2.2. Giao due dinh dtfdng

2.2.1. Tam quan trong

Dinh dUOng la nhu cau thiet yeu, van de cua ddi song hang ngay, lien
quan den tat ca moi ngUdi. Mac du loai ngudi da dat dupe nhiing thanh tUu vi
dai trong moi linh vUc khoa hoc, nhUng cho den nay nan doi va hau qua cua
no van con la mot thach thUc 16n doi vdi nhieu nUdc tren the gidi. O nUdc ta
tinh hinh bUa an thieu ve so' lupng va mat can doi ve chat lupng da anh hudng
ldn den sUc khoe va sUc lao dong cua nhan dan. Suy dinh dudng tre em dudi 5
tuoi van con cao tU 31% den 35% tuy theo dia phuong. Phu nO co thai thieu
mau dan den tinh trang suy dinh dudng tre em, tre sinh ra cd can nang dudi
2500 gram cung con kha pho bien nhat la d vung sau, mien nui va mot so
vung nong thon ngheo. Thieu vitamin A hien nay dupe coi la mot chi tieu
phan anh ve tinh trang ngheo ddi va la van de co y nghia cong dong d tat ca
cac vung trong ca nUdc. Theo so' lieu dieu tra cua Vien Dinh dudng Quoc gia
trong nhUng nam gan day, ty le tre em dudi 1 tuoi bi kho, nhun, loet giac mac
de doa den mu loa do thieu vitamin A la 0,07% cao hOn 7 lan so vdi ngUdng
bao dong cua To chUc Y te the gidi. Theo Udc tinh hang nam d nUdc ta co
khoang 5000 den 7000 tre em bi mu loa do thieu vitamin A. Mien nui va mot
so' vung dong bang so dan bi budu cd do thieu Iod rat cao, d vung nang co tdi
66% dan so' bi thieu Iod. O cac vung co ty le mac budu cd cao thi co tdi 2% tre
em bi dan don, co vung benh thieu nang tri tue con cao hdn.
Giao due dinh dudng gop phan lam tang hieu biet cua ngudi dan ve an
uong hpp ly, can doi va an toan, gop phan cai thien tinh trang sUc khoe. Muc
tieu cua ta hien nay la phan dau den cuo'i nam 2005, ty le suy dinh dudng d
tre em <5 tuoi giam xuong dudi 25%, ty le tre so sinh can nang <2.500 g giam
xuo'ng dudi 7%.
De giai quyet van de dinh dudng can phai co chinh sach, chien lupc va
cac bien phap phoi hpp hoat dong dong bo, trong do khong the nao thieu dupe
hoat dong truyen thong giao due ve dinh dudng.

2.2.2. Noi dung chu yeu ve gido due dinh diidng

Hoat dong giao due ve dinh dudng khong nhiing khong the thieu dupe
ma con phai la cong viec Uu tien trong chUdng trinh phong chong suy dinh
dudng ndi rieng cung nhu trong cac noi dung giao due sUc khoe ndi chung vi

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dinh diidng la cai nen cua siic khoe. Can co he thoiig va mang ludi giao due ve
dinh diidng. To chiic phong giao due dinh dUdng tai cac tram y te cO sd, neu co
dieu kien xay dung mang liidi cong tac vien ve dinh diidng d tuyen y te cd sd.
To chiic giao due dinh dudng theo nhom, giao due truyen mieng...
Noi dung giao due dinh dudng tap trung vao cac van de sau:
- Giao due kien thiic nuoi con cho cac ba me theo cuon sach "Lam me" do
Vien Dinh dudng bien soan nam 1990.
- Giao due an uong cua ba me cd thai va cho con bu.
- Giao due bao ve va nuoi con bang siia me.
- Cung cap thUc an bo sung cho tre.
- An uong cua tre khi bi dau o'm.
- Cach phong cac benh thong thudng d tre em dan den suy dinh dudng.
- Tao nguon thUc an bo sung cho bQa an: xay diing o dinh dudng trong he
sinh thai VAC (vudn, ao, chan nuoi) gia dinh.
- Nang cao ve sinh an toan thiic pham, ve sinh an uong, phong chong ngo
doc thUc an, nUdc uong...
- Giao due phong chong cac benh co lien quan den dinh dudng an uong,
cac benh do thUa dinh dudng hoac an uong khong hpp ly gay ra.
Nhiing noi dung giao due dinh dudng va noi dung giao due bao ve sUc
khoe ba me tre em gan lien vdi nhau, vi vay can long ghep vdi nhau va vdi
nhiing noi dung cham sdc sUc khoe ban dau khac.

2.3. G ia o d u e sufc khoe d trtfcfng hoc

2.3.1. Tam quan trong

Giao due sUc khoe d trudng hoc co tac dong rat ldn den hinh thanh cac
hanh vi sUc khoe, loi song lanh manh cho hoc sinh, vi giai doan hoc d trUdng
cua mdi hoc sinh thudng rat dai. Vdi tat ca moi ngudi, thdi gian hoc d trudng
la thdi gian quan trong co anh hudng ldn den toan bo sU phat trien toan dien,
ca ve the chat, tinh than va nhan cach, vi day la giai doan nhay cam, rat de
tiep thu, hoc hoi nhiing kien thUc mdi, hinh thanh thai do va hanh vi viing
ben cua mdi ngudi.
Giao due d thdi ky nay de dem lai hieu qua cao, no khong chi tac dong
den cac em hoc sinh ma thong qua cac em tac dong den nhiing ngudi xung
quanh, nhu nhiing ngUdi trong gia dinh, cong dong xa hoi. Moi hoc sinh co the
trd thanh nhan to tich ciic nhu mot nha "giao due siic khoe tu nguyen" trong
:ong dong.

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2.3.2. Noi dung chu yeu ve gido due siic khoe d trudng hoc

M uc tieu chinh cua chUdng trinh giao due sufc khoe d triidng hoc trUdc
het nham m ang lai cho moi hoc sinh mute do sufc khoe cao nhat co the diidc
bang each:
- Tao nhufng dieu kien moi triidng hoc tap tot nhat d trUdng hoc, phong
chong cac benh hoc diidng hay gap.
- Bao ve sUc khoe hoc sinh phong cac benh truyen nhiem va cac benh khac.
- Phat hien va phong chong nhufng triidng hdp phat trien the liic, sinh ly
bat thiidng cua hoc sinh.
- Cung cap cac kien thiic va phat trien thai do dung dan, giup cho moi hoc
sinh cd kha nang liia chon nhufng quyet dinh thong minh nhat de bao ve
va nang cao siic khoe.
- Tao cho hoc sinh nhufng thdi quen, ldi song lanh manh.
- Phoi hdp giao due siic khoe d triidng, gia dinh va xa hoi de nang cao siic
khoe cho hoc sinh.
Giao due sufc khoe triidng hoc khong chi bao ve va nang cao siic khoe cho
mdi hoc sinh ma con tao cho cac em hoc sinh nhan thufc ro trach nhiem bao ve
sufc khoe cua nhiing ngiidi khac. Cac noi dung giao due sufc khoe d triidng hoc
lien quan den sii phat trien cac kien thiic, hieu biet, thai do va thiic hanh cua
hoc sinh ve bao ve siic khoe, phong chong benh tat va nang cao sufc khoe cho
ban than cac em va nhufng ngUdi khac trong cong dong, chu trong den vai tro
gUOng mau cua hoc sinh trong xa hoi.

Kien thiic: cac kien thufc can trang bi cho hoc sinh nhii sau:
- Cung cap cho cac em nhufng kien thiic cd ban va dai ciidng ve: giai phlu,
sinh ly, phat trien the liic, tinh than cua ngiidi binh thiidng.
- Cac benh lay nhiem tU moi trudng, cac benh thiidng m&c d tuoi hoc sinh.
- Cac nguy cO gay tai nan thiidng tich, dac biet la tai nan giao thong va
duoi niidc.
- Anh hudng cua loi song khong lanh manh.
- Cac van de sUc khoe sinh san vi thanh nien.
- Cac bien phap ve sinh phong cac benh thong thudng va nang cao sUc khoe.
- Mot so luat le ve sinh lien quan den bao ve sufc khoe cho cong dong...
Thdi do: tao cho hoc sinh nhufng thai do:
- Mong muon dat dUdc mUc sUc khoe tot nhat, quy trong gia tri cuoc song
khoe manh.

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 - San sang thuc hanh cac bien phap co ldi cho sutc khoe cua minh cung
nhu cua gia dinh va cong dong xa hoi.
- Chap nhan trach nhiem bao ve sUc khoe cho ca nhan minh va cho nhiing
ngUOi khac.
- San sang cong hien quyen ldi ca nhan vi sUc khoe cua nhiing ngUOi khac.
- San sang thiic hien cac luat le ve bao ve sUc khoe va gop phan nang cao
thiic hien cac luat le do.
Thuc hanh:
- Thiic hanh cac bien phap ve sinh, cac thoi quen lanh manh cho sUc khoe
d trUdng hoc, 0 nha cung nhu 6 cong dong.
- ThUc hanh phong chong benh hoc dUdng.
- Tham gia cac hoat dong bao ve moi trudng, phong chong cac loai benh tat.
- Su dung cac dich vu y te can thiet de bao ve va nang cao sUc khoe...
De lam tot cong tac giao due sUc khoe 6 trUdng hoc can chu y dua chUOng
trinh giao due sUc khoe vao chUdng trinh chinh khoa cua cac cap hoc. Bien
soan chUdng trinh giao due sUc khoe phu hpp vdi cac doi tupng hoc sinh. Tao
moi trUdng song lanh manh d trUdng hoc vi chinh moi trudng 0 trUdng hoc
hang ngay tac dong den hoc sinh vi du nhu 0 cac trUOng hoc phai co day du
ban, ghe kich thudc phu hdp vdi hoc sinh, ldp hoc du anh sang, thong thoang.
TrUdng co du cac cong trinh ve sinh hpp ve sinh. Thay, co giao la nhflng tam
gUOng m lu miic ve thuc hien ve sinh, bao ve sUc khoe de cho hoc sinh noi
theo... Cac thay, co giao can dupe tap huan ve cac kien thUc va ky nang giao
due sUc khoe. Co sii ket hdp chat che giUa cd quan y te va nha trUdng de thuc
hien tot cac dich vu cham soc sUc khoe cho hoc sinh, phoi hpp chat che giUa
nha trUOng, gia dinh, cac to chUc xa hoi va ban nganh co lien quan trong cong
tac giao due sUc khoe cho hoc sinh.

2.4. Giao d u e ve sinh va bao ve moi trvfofng

2.4.1. Tam quan trong

Bao ve moi trUOng song la mot van de 16n co tinh toan cau chU khong chi
d mUc quoc gia. Ben canh nhiing van de 16n nhu sii bien doi khi hau toan cau,
sii tan pha rUng va tinh da dang sinh hoc, sii suy giam tang ozon va o nhiem
moi trUOng thi cac van de quan he xa hoi cua con ngUdi cung lam anh hUdng
den sii phat trien ben vUng cua moi trUOng. Bao ve moi trUOng se gop phan
lam giam cac nguy cO gay nen benh tat co lien quan den moi trUOng, dac biet
la cac benh truyen nhiem d in den thay doi mo hinh benh tat 6 nUdc ta va
giam dupe ty le m lc benh cung nhu tii vong. Giao due moi trUdng co y nghia
quan trong ca trudc m&t va lau dai. No giup cho moi ngUdi co cach nhin toan
dien, hpp vdi quy luat. Tren hanh tinh cua chung ta hien nay nhiing hoat

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dong dang lam bien doi moi trUOng chu yeu la cac hoat dong cua con ngUdi,
cac hoat dong bao gom ca cac hoat dong lam huy hoai moi trUdng va cac hoat
dong bao ve moi trudng, nhUng deu co tinh chat chung la xuat phat tU nhiing
quyet dinh cua con ngudi. Nhiing quyet dinh cua con ngudi lai phu thuoc vao
kien thUc, thai do va kha nang hanh dong cu the cua con ngudi ve moi trUdng.
Nhan manh viec nang cao nhan thUc cho moi ca nhan va cong dong co vai tro
then chot de lam thay doi thai do doi vdi cac van de moi trUdng va bao ve moi
trUOng. Giao due bao ve moi trUdng cung la dam bao cac dieu kien tao kha
nang cho moi ngudi trd thanh thanh vien tich ciic cho sii phat trien ben viing
cua moi trUOng. Giao due moi trUOng nham trang bi cac kien thUc ve moi
trudng cho hoc sinh, sinh vien va cong dong noi chung de giup ho tu chiem
linh cac kien thUc, ky nang va tu xay diing mot tinh yeu doi vdi thien nhien,
cay co sinh vat, dat, nUdc, khong khi va doi xii vdi moi trUdng tu nhien nhu
doi vdi ngoi nha rieng cua chinh minh. Trong cac trUdng hoc viec dao tao ve
moi trUOng chu yeu dUdc thuc hien theo phuong thUc tich hpp, qua viec long
ghep va lien he vdi nhiing mon hoc theo chUdng trinh cua mon hoc tii nhien
va xa hoi theo quy dinh. Cong tac giao due ve moi trUdng phai dupe thvic hien
sao cho phu hdp vdi trinh do, kha nang nhan thUc va dieu kien cu the cua
tUng nhom doi tUdng.
M uc dich cuol cung cua cong tac giao due va dao tao la dao tao ra nhiing
cong dan co nhan thUc ve moi trUdng va biet song vi moi trUdng. G iao due moi
trUdng can lam cho moi ngUdi hieu r in g moi trUdng khong phai la nhiing gi
xa la "d dau do" ma moi trUdng la cai de cho ho song, thong qua sii hit thd, an
uong, sinh hoat giai tri ... Moi trUdng can dUdc con ngUdi quan tam vi no quan
trong cho cuoc song hanh phuc cua tat ca moi ngUdi. Vi the giao due moi
trUOng phai dUdc dau tu thich dang ca thdi gian, cong sUc va tien cua nhUng
nhat dinh phai thUc hien.
Vdi cac nha hoach dinh chinh sach, nhiing ngUdi ra quyet dinh lien quan
den moi trUOng cung can dupe trang bi du cac kien thUc cd ban ve m oi trUdng
de giup ho co the quan ly dUdc tot cac van de moi trUOng d dia ph uong va ra
cac quyet sach khong gay phuong hai den moi trUdng. Trong cac thong diep ve
giao due moi trUOng nhiing nam gan day nhU: "Trai dat - Ngoi nha chun g cua
chung ta", "Vi sii song tren trai dat", hay "Vi mot moi trUdng cho sU phat trien
ben viing" va cac Cong Udc Quoc te ve bao ve moi trUOng da chi ra cho thay
vdi cac yeu cau vi mot moi trUdng phat trien ben viing can phai bien cac kien
thUc va hieu biet ve moi trUdng thanh cac hanh dong cu the, nham ngan chan
cac hiem hoa ddi vdi moi trUdng, co cac bien phap va chien lupc toan dien
n h lm k h lc phuc tan goc viec gay o nhiem, tan pha tai nguyen moi trUdng.

2.4.2. Noi dung chu yeu ve gido due ve sinh va bao ve moi triidng

Cac noi dung giao due ve sinh va bao ve moi trUdng rat rong va rat
phong phu. Can tap trung Uu tien giao due vao cac noi dung sau:

64
 - Vai tro quan trong cua moi trUOng vdi sUc khoe ca nhan va cong dong.
- Giai quyet cac chat thai bo cua ngUdi va sue vat, day van la van de can
dupe Uu tien vi nguy cd lay lan benh tat do cac chat thai bo cua ngUdi va
sue vat van con ton tai rat ldn, ca 6 cac vung do thi va nong thon.
- GiU gin ve sinh noi cong cong.
- Giai quyet cac chat thai bo trong san xuat cong nghiep va nong nghiep.
- Cung cap va sU dung nU6c sach, di doi vdi viec giai quyet xii ly cac nguon
nUdc thai de dam bao an toan cho sUc khoe.
- Khong che va tieu diet cac vat trung gian truyen benh.
- Ve sinh an toan lUOng thuc va thuc pham.
- Ve sinh nha 6.
- Trong nhieu cay xanh bao ve moi trUOng.
- Thuc hien cac luat le ve bao ve moi trUOng.
Bao ve moi trUOng can co nhiing giai phap thich hpp va no luc phoi hpp
chat che cua nhieu cO quan, to chUc va dac biet la sii tham gia cua cong dong.
Chon cac giai phap giao due sUc khoe cung se rat khac nhau giUa cac dia
phuong. Di doi vdi giao due sUc khoe can phai tao nhiing dieu kien thuan lpi
de moi ngUdi co the thay doi cach thiic hanh gifl gin va bao ve moi trUOng phu
hpp vdi phong tuc tap quan, van hoa va dieu kien cua dia phUOng.
Truyen thong giao due sUc khoe ve bao ve moi trUOng can phai lam thUdng
xuyen, lien tuc mot each co ke hoach. Phat huy vai tro cua chinh quyen dia
phUOng, cac to chUc chinh tri biet dUa vao cong dong, kien tri loi keo cong dong
tich cUc tham gia cong tac bao ve moi trUOng bang cac hoat dong cu the. Phai
long ghep tot ve y thUc trach nhiem, nghia vu va quyen lpi cua ca nhan va cong
dong. Muon lam tot cong tac bao ve moi trUOng trong moi cong dong can phai
dau tu ca tri tue, nguon lUc, lap cac chUOng trinh TT-GDSK thich hpp cho tUng
cong dong de dem lai lpi ich thiet thuc cho ca nhan, cong dong va quoc gia. Soan
thao cac noi dung sao cho thich hpp de giao due ca nhan va cong dong ve moi
trUOng cung can phai dupe tiep tuc nghien cUu day du.

2.5. Giao due ve sinh lao dong, phong chong tai nan va benh nghe nghiep

2.5.1. Tam quan trong

Bao ve moi trUOng lao dong tot, khong anh hudng den sUc khoe cua
ngUOi lao dong la mot trong nhUng noi dung quan trong cua bao ve moi
trUOng noi chung. La mot bien phap du phong hieu qua dem lai sUc khoe cho
ngudi trUc tiep lao dong lam ra cua cai vat chat cho xa hoi.
Giao due ve sinh lao dong, phong chong tai nan va benh nghe nghiep se
gop phan lam giam cac nguy cd gay nen benh nghe nghiep va tai nan lao

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dong. Hien nay mot so cac benh nghe nghiep hay gap nhii benh bui phoi 0 cac
nha may det spi, 6 ham mo; ung thii 6 cac nha may san xuat hoa chat; diec do
tieng dn 6 cac nha may cO khi... co the giam dupe neu cong nhan co du kien
thufc va y thUc phong tranh.

2.5.2. Noi dung chu yeu ve gido due ve sinh lao dong, phong chong tai
nan va benh nghe nghiep

Can giao due nang cao sii hieu biet ve cac bien phap phong chong tac hai
nghe nghiep, loai trU nguy co gay benh nghe nghiep va tai nan lao dong cho
ngUOi lao dong, tap trung vao mot sd noi dung quan trong nhii sau:
- Giao due cong nhan y thiic bao ve moi trUdng lao dong an toan.
- Giao due cong nhan thiic hien quy dinh ve an toan ve sinh lao dong, y
thufc sii dung cac phUdng tien phong ho lao dong.
- Giao due cong nhan thay dupe anh hUdng cua yeu to tac hai nghe
nghiep, y thUc phong chong cac benh nghe nghiep dac trUng cho cac
nganh san xuat cu the.
- Giao due cong nhan y thiic svL dung an toan cac cong cu lao dong, phong
chong tai nan lao dong.
- Giao due each so ciiu ban dau cac tai nan va ngo doc trong lao dong san xuat.
- Giao due cho ngUOi lao dong y thutc chu dong tii bao ve va nang cao siic
khoe cho ban than va nhiing ngudi xung quanh.
Trong cong tac giao due siic khoe cho ngudi lao dong can thiic hien giao
due dinh hiidng ve cac benh nghe nghiep va tai nan lao dong cua cac cd sd ma
ngudi lao dong de m&c. Nghia la phai diia vao tiing loai nganh nghe cu the,
tiing cO sd san xuat de soan thao cac noi dung giao due siic khoe cho phu hdp
vdi ngiidi lao dong. De lam tot cong tac giao due siic khoe phong chong benh
tat, tai nan nghe nghiep cho ngudi lao dong, tai moi cd sd san xuat can co sii
phoi hpp chat che giOa y te, cong doan, ban giam doc, bo phan bao ho an toan
lao dong va cac bo phan co lien quan de lap ke hoach va thiic hien giao due
thiidng xuyen cho ngiidi lao dong, chu trong tap trung vao cac doi tiidng mdi
nhan vao cac cO sd san xuat.

2.6. Giao due phong chong benh tat noi chung

2.6.1. Tam quan trong

Giao due phong chong benh tat noi chung gop phan trang bi cac kien
thiic cO ban ve benh tat ma moi ngUdi can co de phong chong benh tat, lam
tang trach nhiem cua ca nhan, cong dong ve bao ve va nang cao siic khoe. Mot
so benh tat thudng gap, nhat la cac benh theo mua, co ty le mac va chet cao
van can dupe giao due thudng xuyen cho cong dong y thUc phong chong, neu
loi long benh co the bung phat thanh dich va gay hau qua nghiem trong.

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2.6.2. Noi dung chu yeu ve gido due phong chong benh tat noi chung

Noi dung giao due phong chong benh tat noi chung kha rong, bao gom:
- Giao due phong chong cac benh lay va khong lay:
+ Cac benh tat pho bien theo mua, thanh dich, vi du nhU: sot xuat
huyet, ta, ly, thUOng han, cum, sdi, viem nao v.v...
+ Cac benh do ky sinh trung gay ra: giun san, amip, nam, vv...
+ Cac benh xa hoi: sot ret, lao, phong, HIV/AIDS, hoa lieu...
+ Cac benh lay truyen mdi xuat hien nhu: cum gia cam, SARS.
- Giao due phong chong cac benh cua nude phat trien:
+ Benh tim mach;
+ Cac benh ung thu;
+ Benh tam than;
+ Cac loai tai nan, tham hoa.
- Giao due phong chong tai nan lao dong va benh nghe nghiep: chu trong
thuc hien d cac ndi san xuat co yeu to' tac hai nghe nghiep va nguy cd cao
ve tai nan lao dong.
- Giao due sU dung dung cac loai thuoc phong benh va dieu tri benh, tranh
lam dung thuoc, sii dung an toan hpp ly ve thuoc.
NhU vay ta thay noi dung truyen thong giao due sUc khoe rat phong
phu, bao gom nhUng van de lien quan trUc tiep hoac gian tiep anh hudng den
siic khoe cong dong, ca siic khoe ve the chat, tam than va xa hoi. Viec lua
chon van de siic khoe, benh tat va noi dung giao due sUc khoe cu the phai tuy
theo tiing thdi gian, dia diem, nhu cau cua doi tupng va phu hpp vdi kha nang
nguon liic hien co cua cac dia phUdng. Tuy nhien cung co nhiing kien thiic cO
ban, pho cap ve siic khoe, phong chong benh tat va cham soc siic khoe ma moi
ngUOi trong cong dong deu can biet, do cung la nhiing noi dung Uu tien, can
dupe lap ke hoach TT-GDSK thudng xuyen.

3. VI DU VE SOAN THAO MOT SO NOI DUNG CAN TT-GDSK CHO

CONG DONG VE GIAI QUYET PHAN VA NUCiC

3. 1. Giai quyet phan ngtfdi

3.1.1. Phdn ngudi co the gay ra benh gi

- Phan ngUOi la nguon goc gay ra rat nhieu cac loai benh nguy hiem vi
phan ngUdi chUa rat nhieu con vat nhd (dupe goi la vi sinh vat) gay benh
cho ngUOi (con goi la mam benh) nhu giun, san ma ta co the nhin thay
nhUng con nhieu loai nhd ma ta khong nhin thay dupe bang mat thudng.

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 - Phan ngiidi lam lav truyen cac benh dudng tieu hoa: tieu chay, thiidng
han, ta, ly, bai liet, viem gan...
- Giun san la loai benh rat d i lay til phan ngudi. Giun san lam suy mon cd
the, giam siic de khang, giam sU phat trien ca the liic va tri thong minh
cua tre, gay suy dinh dUdng, tic ruot, tic mat, sdi mat, benh 6 gan, 0
phoi rat nguy hiem.
- Mot loai giun nguy hiem co trong phan ngiidi co the chui qua da chan tay,
vao cd the, moc vao ruot, hut mau gay benh thieu mau rat nguy hiem.
- Phan ngUOi khong diipc xU ly tot se tao dieu kien cho ruoi, nhang, gia
sue lam phat tan gay benh cho nhieu ngudi.
- Phan ngudi chay xuong ao ho, kenh rach, lam ban nguon nUdc an uong,
gay benh ngoai da va benh phu khoa nguy hiem cho phu nii.
- Mui hoi thdi cua phan ngUOi lam cho moi ngiidi kho chiu, mat canh
quan, thieu van minh cuoc song, lam anh hudng rat ldn den siic khoe ma
nhieu ngUOi khong biet va khong de y.

3.1 .2 . Lam the nao phdn ngiidi co the lam lay truyen benh

Thieu ho' xi, ho' xi khong hdp ve sinh thi ruoi nhang, chuot, ldn, cho, ga,
vit v.v... mang cac mam gay benh tii phan ngudi phat tan di nhiing nOi khac,
theo gio, bui, rOi vao nguon nUdc, thiic an, quan ao, lam ngudi ta an phai,
uong phai, hit phai, sd mo phai. Qua do cac mam gay benh vao ngiidi qua
diidng an uong, hit thd, qua da, gay benh ngay cho ngudi hoac chd khi cd the
suy yeu se phat benh nguy hiem.

Tom tat: neu quan ly, gidi quyet tot phdn ngiidi se phong diidc
rat nhieu benh tat lam cho cd the phat trien, tri tue thong minh.

3.1.3. Xii ly nhii the nao de phdn ngiidi khong gay benh

- Phan ngiidi phai dupe gom lai cho kin, ngan khong cho ruoi nhang,
chuot, ldn, ga vit, cho v.v... tiep xuc va phat tan ra moi triidng xung
quanh, gay o nhiem.

- Tot nhat la phai xay diing va sii dung dung ho' xi hpp ve sinh de giii
phan kin, u phan dung de tieu diet cac vat gay benh trong phan.

- Khong sii dung phan tiioi bon cay, nuoi ca, khong dung tay triic tiep boc
phan, dam len phan tiioi. Khong de phan lam ban niidc an udng tam giat.
- D ung phan bon cay phai diipc u ky vdi tro b£p, voi bot til 6 thang trd len
de giet chet cac loai sinh vat gay benh.

68
3.1.4. Loai ho xi nao la ho xi hpp ve sinh can xay dtfng

Ho' xi hdp ve sinh la loai ho xi dat cac tieu chuan sau:

- Thu gom va giii dupe phan kin khong de cho cac con vat co the tiep xuc
lam phan co the phan tan ra xung quanh, phan khong nga'm dUdc vao
nguon nUdc lam ban nguon nUdc an uong, sinh hoat.
- Giet dupe cac mam gay ra benh co trong phan (u du thdi gian lam mam
benh chet, be ga lam mam benh bi tieu diet).
- Du rong de co the chUa va u phan tai cho dam bao an toan.
- Tien lpi cho sU dung, khong co mui hoi tho'i, khong lam mat canh quan
cho gia dinh va xom gieng.
Ho xi hpp ve sinh la cac loai ho' xi dat 4 tieu chuan chinh tren. Hien nay
co 3 loai ho' xi hpp ve sinh pho bien doi vdi vung dong bang la:
- Ho xi 2 ngan: kin, kho, sach, u phan tai cho (sii dung mot ngan, mot
ngan u phan), sau khi u 6 thang phan dupe dung bon ruong.
- Ho' xi tham dpi nUdc: dam bao phai co dien tich du rong de xay dung, xay
dung dung ky thuat, cach xa nguon nUdc, bat buoc phai co du nUdc de
dpi sau moi lan di ve sinh.
- Ho xi tu hoai va ban tu hoai: thudng ton kern hon cac loai ho' xi khac,
hien nay thich hpp cho cac vung do thi, noi khong sU dung phan.

3.1.5. Sii dung ho xi hai ngan

- Ho' xi hai ngan xay dung, bao quan va sU dung tot thi co the tieu diet
dupe mam gay benh, dam bao an toan cho sUc khoe.
- Khi sU dung chi sU dung mot ngan. Sau moi lan di ngoai do tro xuo'ng
kin phan va day nap lai, ngan kia day de khi nao ngan sU dung da day
va dupe u thi mdi sU dung. Co ranh dan nUdc tieu rieng, khong de nUdc
tieu chay vao trong ngan ho xi.
- N ip day lo ia phai khit, nap do bang xi mang hoac bang go co can dai de
cam, sau moi lan di ngoai phai nhd day nap vao lo ia de tranh ruoi,
nhang va gia cam tiep xuc dupe vdi phan.
- Khi ngan sU dung day thi do mot ldp tro day hay voi bot tron da't kho
len, day kin lo ia lai de u phan. Chuyen sang sii dung ngan kia. Phan u
tU 6 thang thi co the dung bon ruong dupe. Ngan u phai that kin va du 6
thang thi mdi cd tac dung tieu diet cac mam gay benh trong phan.
Tom lai: phan la nguon chUa nhieu mam gay benh. Neu khong nghl den
viec xay dung ho xi hpp ve sinh de quan ly phan thi chung ta da thieu trach
nhiem vdi sUc khoe cua chinh minh va cua nhiing ngUdi khac trong gia dinh,
cong dong nha't la doi vdi cac the he tre sau nay. Moi ngUdi se nghl gi ve

69
tiicing lai cua mot dUa tre neu tre bi tieu chay do thieu ve sinh, d in den suy
dinh dudng coi coc, cham phat trien the hie va tinh th in . Chung ta da bao gid
nghl rang neu mot ngUdi trong gia dinh om vi mot benh lay truyen qua phan
ngUdi se lam ton hai den kinh te va siic khoe nhu the nao, neu so vdi chung ta
dau tu xay dUng mot ho xi hpp ve sinh thi se tranh dUdc ton hai bao nhieu.

3.2. N g u on ntfdc sa ch

3.2.1. The nao la niidc sach

Niidc sach la nUdc khong gay benh, gay hai cho siic khoe

- Nude sach la nUdc khong co mam gay benh, nghia la nUdc khong bi
nhiem ban do phan ngudi va phan gia sue.
- Nude sach la nUdc khong co cac chat hoa hoc gay doc cho ngudi nhu
thuoc trU sau diet co, phan bon hoa hoc, cac chat co m ui hoi thoi, mui la,
cac kim loai nang nhu asen.
- Nude sach la nUdc trong vat khong co van due, khong co mui, khong co vi.
- Nude tU cac mach nude ngam, nUdc gieng khoan, gieng khdi, nUdc mUa
dupe bao quan tot, nUdc m ay (d thanh pho) la nhiing loai nUdc sach sii
dung cho an udng va sinh hoat.
- Can phai sii dung nUdc sach de an uong va tim giat de phong tranh
benh tat

3.2.2. Sii dung nUdc sach cd lpi gi cho site khoe

- Dung nUdc sach de an uong thi khong dau bung, khong bi tieu chay,
giun san, khong bi benh thUOng han, ta, ly, benh viem gan...
- Dung nUdc sach tim rUa khong bi dau m lt hot, ghe Id, h ie lao, nam, di
Ung, ngUa ngay kho chiu.
- Phu nU dung nUdc sach ve sinh khong bi benh dudng sinh due, phong
tranh vo sinh.

- Nu6c sach an uong an toan, ngon mieng, tieu hoa tot d in den sUc khoe tot.

3.2.3. Cac nguon nude sach 6 nong thon

- Gieng khoan: day la nguon nUdc sach nhUng tien khoan gieng kha d lt
chi gia dinh co dieu kien mdi co the khoan gieng.
- Gieng khdi: gieng khdi chi dam bao sach khi xay gieng dung va bao quan
sU dung dung.

70
 - Niidc mUa cung la nguon nUdc sach nhUng thudng phai co be chtia 16n de
dung va dam bao ve sinh.
- Nude may: chi co 0 mot so' noi co dieu kien.

3.2.4. The nao la nitdc ban

Nude ban la nude eo kha nang gay ra benh tat cd hai cho site khoe

- Nude bi o nhilm do phan ngudi, phan gia sue, co nhieu loai sinh vat gay
benh va cac chat hoa hoc gay hai cho sUc khoe.
- Nude co lan xac sue vat, rac thai, cay coi muc nat, rong reu.
- Thudng nUdc ban due, cd mau khac thudng nhu vang, xanh hay den, cd
mui hoi thdi hay cac mui la khac.
- Cac mam gay benh va cac chat doc hai trong nUdc bang mat thudng
khong nhin thay dupe, vi vay nUdc nhin trong nhUng chUa chac da an
toan cho sUc khoe nen phai quan tam den kiem tra tieu chuan cac nguon
nUdc neu cd dieu kien.
- Cac loai nUdc ho, ao, song ngoi, suoi, nUdc ruong deu la nUdc ban.

3.2.5. Nude ban cd tdc hai nhu the nao

- An, uong nUdc ban gay dau bung viem da day ruot, tieu chay, giun, san
va mot so benh het sUc nguy hiem khac nhu benh ta, thudng han, ly,
viem gan, nhiem doc hoa chat.
- Nude ban rUa mat gay benh dau mat hot dan den giam thi luc cd the
mu loa.
- T im giat bang nUdc ban gay cac benh ghe Id, hac lao, nam, di Ung da.
- Phu nU tam giat bang nUdc ban de bi cac benh nhiem trung phu khoa,
lau ngay cd the dan den vo sinh.
- Nude ban cd hai tdi sUc khoe ca trUdc mat va lau dai
Neu khong cd cac cong trinh ve sinh de sU ly phan, rac, nUdc thai thi cac
nguon nUdc rat de bi nhiem ban va gay benh tat, doc hai cho sUc khoe.
Tuy goi la nUdc sach nhUng cac nguon nUdc nay van cd the cd mam gay
benh nen nhat thiet nUdc uong phai dUOc dun soi de giet cac con vat gay benh
trong nUdc.

2.2.6. Gieng khai cung cap nUdc dam bao tieu chuan ve sinh

Gieng khoi: gieng khOi khi xay dUng can dam bao cac tieu chuan sau:

71
 - Gieng phai xay cach nguon niidc ban, phan ngudi va phan gia sue it nhat
10 m.
- Thanh gieng phai xay cao, co n ip day de tranh ban va bao ve an toan.
- San gieng dupe do xi mang hoac lat gach de tranh ngam nUdc thai ban
xuong gieng.
- Gau muc nUdc gieng phai co gia treo tranh de ban.
- Xay ranh thoat nUdc thai d in ra ho- tham chtia niidc thai hoac ra xa
gieng de nude thai khong co kha nang ngam xuong gieng.
Tren day chi la mot vi du ve cac noi dung co the soan thao de TT-GDSK
cho cong dong nong thon ve giai quyet van de phan ngUdi va niidc sach. Tuy
nhien vdi mot cong dong cu the, can phai diidc nghien ciiu de chuan bi noi
dung TT-GDSK cho phu hpp. Ngiidi soan thao noi dung TT-GDSK nen nhd la
khong co noi dung nao la thich hpp cho TT-GDSK d moi cong dong.

CAU HOI TU LUONG GIA

1. Neu cac nguyen tac lua chon noi dung TT-GDSK.
2. Liet ke cac noi dung chinh can TT-GDSK hien nay.
3. Trinh bay tam quan trong va cac noi dung cd ban trong TT-GDSK ve
cham soc siic khoe ba me tre em, dinh dudng.
4. Trinh bay tam quan trong va cac noi dung cO ban trong TT-GDSK ve
ve sinh moi triidng.
5. Trinh bay tam quan trong va cac noi dung cd cd ban trong TT-GDSK
ve ve sinh lao dong, phong chong cac benh nghe nghiep, tai nan lao
dong.

72
 Bai 5

PHUONG TIEN VA PHUONG PHAP

TRUYEN THONG GIAO DUC
a SlTC KHOE

MUC T|£u
1. Trinh bay diidc khdi niem vi phiidng tien va phiidng phap truyen thong gido
due siic khoe.
2. Trinh bay diidc cac phiidng tien truyen thong giao due stic khoe.
3. Trinh bay diidc cac phiidng phap truyen thong gido due siic khoe triic tiep va
gian tiep.

1. KHAI QUAT VE PHlTdNG PHAP VA P H l/dN G TIEN TT-GDSK

Co nhieu phUOng phap va phUOng tien khac nhau dupe ap dung trong
truyen thong giao due siic khoe. Hien nay chUa co mot cach phan loai hoan
toan thong nhat ve cac phUOng phap truyen thong giao due siic khoe. Tuy
nhien co the chia thanh hai loai chinh nhu sau: phUdng phap TT-GDSK trUc
tiep la phuong phap co sU tiep xuc trUc tiep giUa ngUOi lam giao due sUc khoe
v6i doi tupng dupe giao due sUc khoe va phUdng phap gian tiep thong qua cac
phUOng tien thong tin dai chung. Ngay nay do sU tien bo cua khoa hoc ky
thuat nen cac phUdng tien thong tin dai chung sii dung trong truyen thong
noi chung va TT-GDSK noi rieng ngay cang hien dai.
Cac phUOng phap truyen thong giao due sUc khoe bao gid cung g in lien
v6i viec sxi dung cac phUOng tien TT-GDSK. NgUOi giao due sUc khoe phai biet
lua chon cac phUOng phap va phUOng tien phu hpp mcii dat hieu qua cao. Moi
phUOng phap, m6i phUdng tien truyen thong giao due sUc khoe deu co nhUng
Uu va nhUpc diem nhat dinh nen trong mot chUOng trinh giao due sUc khoe
ngUOi ta co the phoi hpp nhieu phUdng phap vdi sU h6 trp cua cac loai phUOng
tien khac nhau de nang cao hieu qua cua chUdng trinh truyen thong giao due
sUc khoe.
Viec lUa chon cac phUOng phap, phUOng tien cho mot chUdng trinh
truyen thong giao due sUc khoe se phu thuoc vao nguon luc san co, thdi gian,
dia diem, noi dung giao due va doi tupng dich.

73
2. PHUONG PHAP GlAO DUC SlTC KHOE

2.1. Khai niem

i
Phiidng phap giao due siic khoe la cach thiic ngudi lam giao due siic khoe
thiic hien mot chUOng trinh giao due siic khoe.
Co hai loai phUOng phap giao due siic khoe la: cac phUOng phap giao due
siic khoe triic tiep va cac philOng phap giao due siic khoe gian tiep.
- Giao due siic khoe gian tiep: la phiidng phap ma ngiidi lam giao due siic
khoe khong tiep xuc trUc tiep vdi doi tiipng giao due, cac noi dung diidc
chuyen tai tdi doi tUdng thong qua cac phUdng tien thong tin dai chung.
Day la phUdng phap hien nay van dUdc sit dung kha rong rai tren the
gidi cung nhii d nUdc ta. PhUOng phap nay co tac dung tot khi chung ta
cung cap, truyen ba cac kien thufc thong thiidng ve bao ve va nang cao
sUc khoe cho quang dai quan chung nhan dan m ot cach co he thong. Tuy
nhien phUOng phap gian tiep thong qua cac phUdng tien thong tin dai
chung thUdng doi hoi phai co dau tu ban dau, ngUdi sii dung co ky thuat
cao de van hanh, sii dung cac phUOng tien. Phai xay dUng ke hoach kha
chat che, ket hdp vdi cac ban nganh doan the co lien quan de dUa chUdng
trinh TT-GDSK vao thdi gian hpp ly. PhUOng phap gian tiep chu yeu la
qua trinh phat thong tin mot chieu, do do thudng tac dung tdi budc mot
va hai trong qua trinh thay doi hanh vi sUc khoe. Cac phuong tien thong
tin dai chung thUdng dUdc suf dung trong phUOng phap giao due sUc khoe
gian tiep la dai phat thanh, dai truyen hinh va cac tai lieu dUdc in an.
- Giao due sUc khoe trUc tiep: con goi la giao due sufc khoe mat doi mat,
ngUdi giao due sUc khoe trUc tiep tiep xuc doi tUOng giao due siic khoe.
NgUOi giao due co the nhanh chong nhan dUdc cac thong tin phan hoi tU
doi tupng giao due nen tinh dieu chinh cao trong phUdng phap nay. ThUc
hien TT-GDSK trUc tiep luon co hieu qua tot nhat trong viec giup dd doi
tupng hoc ky nang va thay doi hanh vi. Thiic hien cac phUdng phap nay
doi hoi can bo TT-GDSK phai dupe dao tao tot ve cac ky nang truyen
thong giao tiep, nhu sii dung giao tiep b&ng ldi va khong ldi... Cac
phUdng phap TT-GDSK trUc tiep co tac dung tot nhat vdi budc 3, 4 va 5
cua qua trinh thay doi hanh vi. Tren thuc te khi thuc hien TT-GDSK
trUc tiep co the ket hdp vdi cac phUdng tien giao due sufc khoe gian tiep
de nang cao hieu qua.
- Truyen thong giao due sUc khoe gian tiep thong qua sii dung phudng
tien thong tin dai chung la phUdng phap tot nhat de phat di nhanh cac
thong tin va cac sU viec ddn gian tdi so' dong doi tupng trong dien bao
phu rong. Neu nhu nhufng thong tin gin lien vdi cac van de sUc khoe
trong thiic te va thong diep da dupe thii nghiem trUdc thi thong diep co
the dupe truyen di chinh xac ma khong bi sai lech. Tuy nhien do cac
phUOng tien thong tin dai chung truyen tin den tat ca moi ngudi trong

74
 cong dong nen khong phai la phtfdng phap tot cho cac doi ttfOng chu dinh
cu the. Vi du nhtf sii dung phtfdng tien thong tin dai chung de chuyen
nhiing thong diep cho ngtfdi 16n ma tre em khong nen biet, dan den co
the co cac thong tin gay ra anh htfdng khong tot 6 tre em v.v... Su dung
phuong tien thong tin dai chung cung se kho khan doi vdi nhiing cong
dong khong tiep can dtfpc v6i phtfOng tien thong tin dai chung va nhu
cau khong giong vdi cac cong dong khac. Hon niia TT-GDSK can tac
dong den ca niem tin, thai do va phat trien cac ky nang giai quyet van
de, vi the cac tac dong co the bi han che neu chi sii dung cac phtfOng tien
thong tin gian tiep.

Bang 5.1. Cac dSc diem chinh cua truyen thong qua phirong tien
thong tin dai chung va truyen thong tri/c tiep
Cac dac diem Truyen thong qua phtfdng tien Truyen thong
thong tin dai chung trtfc tiep
- Toe do thong tin va so - Tdc do thong tin nhanh, tdi sd Itfdng - Thtfdng cham, gidi han ve
ngtfdi nhan thong tin dong doi ttfdng
- Chinh xac va khong bi sai - Mtfc do chinh xac cao - Cd the d i sai lac thong tin
lac (chu quan)
- Kha nang ltfa chon doi - Kho khan khi ltfa chon doi ttfdng dich - Cd kha nang ltfa chon doi
ttfdng dich ttfdng dich cao

- Htfdng - Mot chieu - Hai chieu

- Kha nang dap tfng nhu
cau dia phtfOng va cac
cong dong cu the
- Thong tin phan hoi
- Thtfdng chi cung cap cac thong tin - Dap tfng nhu cau dia
chung, khong cu the. phtfdng, cong dong.
- Cung cap thong tin phan hoi khong - Nhan phan hoi trtfc tiep ttf
trtfc tiep ma phai qua dieu tra. doi ttfdng

- Nang cao kien thtfc va nhan biet la - Thay doi thai do, hanh vi,
- Anh htfdng chinh ky nang giai quyet van de.
chu yeu

Doi vdi cac muc tieu TT-GDSK, kho khan nhat la dat dtfpc muc tieu thtfc
hanh thay doi hanh vi. Cac phtfOng phap giao due stfc khoe tich ctfc, trtfc tiep,
vdi stf tham gia cua doi ttfpng dtfpc giao due, bao gom thao luan nhom, chia se
kinh nghiem, bai tap giai quyet van de se co hieu qua hon trong thay doi
hanh vi.
Everett Rogers mot nha nghien ctfu ve truyen thong da tong quan nhieu
nghien ctfu ve nhiing thtfc hanh doi mdi dien ra nhtf the nao trong cac cong
dong. Ong da neu ra la khi ap dung mot thtfc hanh mdi, vi du nhtf sii dung ho
xi hay dieu tri bu ntfdc bang dtfdng uong dien ra qua cac giai doan: giai doan
khdi dau mot ngtfdi nhan ra stf co mat cua thtfc hanh mdi, ngtfdi nay trd nen
quan tam, sau dd di den quyet dinh thii nghiem, neu thay thoa man thi ap
dung va duy tri. Thuyet doi mdi trong truyen thong cua E. Rogers da cho rin g
cac phtfOng tien thong tin dai chung cd the cung cap cac thong tin cd ban can
thiet cho thay doi, nhtfng thtfdng thi kho dan den cac thay doi hanh vi rieng,

75
dac biet neu ta muon thay doi mot phong tuc tap quan co anh htfdng khong
tot den stfc khoe da ton tai rat lau. Hau het cac thay doi hanh vi siic khoe deu
can phai thtfc hien cac phtfOng phap TT-GDSK trtfc tiep, stf dung giai phap
dtfa vao cong dong, tham ho gia dinh, ttf van ca nhan, thu hut cac nha lanh
dao cac cap va stf tham gia cua cac ca nhan va cong dong.

Nhan ra van de ----------------------► Truyen thong dai chung

1
Quan tam

1
Thii nghiem ----------------------► Truyen thong trtfc tiep

i
Ap dung

Sd do 5.1. Anh htfOng cua cac phi/dng phap truyen thong den ap dung cac thay doi

Trong thtfc te khong don gian chi la stf dung phtfOng tien truyen thong
dai chung hay TT-GDSK trtfc tiep. Mot chtfOng trinh TT-GDSK dtfdc lap ke
hoach tot se bao gom viec chon ltfa can than phoi hdp ca hai nhom phtfOng
phap truyen thong dai chung va truyen thong trtfc tiep de phat huy cac tfu
diem khac nhau cua moi nhom phtfdng phap. Vi du mot chtfOng trinh giao due
phong chong tieu chay co the phoi hpp cac phtfOng phap khac nhau. Cac
chtfOng trinh cua dai dtfdc cung co bang cac hoat dong trtfc tiep cua nhan vien
y te cong dong va cac tai lieu in an dtfpc san xuat de ho trd chtfdng trinh giao
due stfc khoe trtfc tiep vdi ca nhan hay nhom. Cac phtfOng tien thong tin dai
chung co the thtfc hien truyen thong vao cac thdi gian thich hdp nhtf nhiing
thdi gian bat dau cao diem cua benh tieu chay xay ra.
Neu dtfpc lap ke hoach tot cac phtfOng tien truyen thong dai chung co
the la mot phtfOng phap co tac dong manh trong giao due nang cao stfc khoe
cho cong dong. Ngoai tac dong rieng cua moi chtfdng trinh theo muc tieu, cac
chtfOng trinh con co the tao ra mot moi trtfdng tot de cong dong hieu va quan
tam trtfdc tdi nhiing chu de ma can bo se tien hanh TT-GDSK trtfc tiep. Khi
khong co nhiing dieu kien thuan lpi va nguon ltfc de chuan bi mot chtfdng
trinh TT-GDSK rieng, cac can bo y te, can bo TT-GDSK van co the phoi hpp
sii dung cac phtfdng tien truyen thong dai chung de chuyen tai thong diep ve
stfc khoe.

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2.2. Cac phtfdng phap giao due stfc khoe gian tiep

2.2.1. Ddi phat thanh

Dai phat thanh trung Ucfng va cac dai phat thanh cac cap dia phUdng
thudng xuyen tham gia vao cac chUdng trinh giao due sUc khoe. Dai phat
thanh co the truyen tai cac noi dung giao due sUc khoe dudi nhieu hinh thUc.
Cac noi dung giao due sUc khoe co the dupe truyen tai di qua cac bai phong
sU, cac bai noi chuyen chuyen de, cac cuoc tra ldi phong van, hoi dap ve cac
van de §Uc khoe va thong qua cac chuyen muc pho bien kien thUc. Cac dai
phat thanh thudng co mot chUOng trinh thudng xuyen danh cho noi dung ve
sUc khoe ma qua do cac thong diep giao due sUc khoe dupe truyen di, ben canh
cac chUOng trinh khong thudng xuyen dupe phat bo sung nhu nhUng chUOng
trinh phat thanh theo chien dich (vi du chUOng trinh dac biet ve giao due
phong chong HIV/AIDS trong ngay the gidi phong chong benh AIDS hang
nam) v.v... Thdi gian phat thanh cac chuyen de dai hay ngan tuy theo noi
dung chuan bi va ke hoach dinh san.
Cac noi dung giao due sUc khoe con dupe chuyen tai bang nhUng hinh
thUc hap dan nhu kich, ca hat, tho, cac cau chuyen truyen thanh hay chUOng
trinh quang cao v.v... Qua cac hinh thUc nay, cac thong diep doi khi dupe
chuyen tdi doi tupng rat nhe nhang ma sau sac vi nhieu thinh gia da tiep
nhan thong diep giao due sUc khoe trong nhUng gid phut giai tri mot cach tu
nhien.
Doi vdi dai phat thanh trung UOng, doi tupng la toan bo dan chung trong
ca nUdc. ChUOng trinh giao due sUc khoe qua dai trung UOng co the pho bien
rong rai cac kien thUc cho nhan dan 0 moi mien dat nUdc. M ot chUOng trinh
phat song cd the den dupe vdi so' lUdng ldn dan. Tuy nhien, dai phat thanh
trung Udng cd the khong phu hpp vdi dan chung mot so vung ve khia canh
ngon ngU, cach ndi, cach viet, thdi gian phat song va nhu cau giao due sUc
khoe d tUng dia phuong. Viec sii dung cac dai phat thanh dia phuong vao cac
chUOng trinh giao due sUc khoe thudng phu hpp hon vi cd the sU dung ngon
ngtf dia phUOng, noi dung cua bai viet, cau chuyen, kich, hat dupe soan thao
phu hpp vdi van hoa, phong tuc tap quan va thi hieu cua nhan dan dia
phUOng, vi vay se hap dan doi vdi ngudi dan dia phuong hon. Ngoai ra cac dai
phat thanh dia phudng co the tap trung phat song cac chUOng trinh giao due
sUc khoe phu hpp vdi nhu cau giao due sUc khoe cua dia phuong lam cho cac
doi tupng chu y nhieu hdn. Co the sii dung cac y kien thao luan cua dia
phUOng de minh hoa cho cac noi dung giao due. Thdi diem phat song cua cac
dai dia phUOng cung phu hdp hdn vi ngUdi xay dUng chUdng trinh co the biet
dUdc vao thdi diem nao thi nhieu ngudi dan trong cong dong co thdi gian nghe
va thdi diem nao phu hpp nha't vdi tap quan sinh hoat cua dia phudng.

Cac chUdng trinh giao due sUc khoe nen long ghep vdi viec cung cap cac
thong tin hang ngay ma ngUOi dan can biet, do la cac thong tin lien quan den

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cuoc song, sinh hoat, chinh sach, nhiing tin tiic thdi stf ve san xuat, siic
khoe... de thu hut ngUOi dan dia phuong quan tam chu y.
Dai phat thanh la mot phUOng tien rat quan trong thtfc hien viec truyen
dat cac kien thUc bao ve va nang cao stfc khoe thong thtfdng nhat. Tuy nhien
cung can lUu y mot so thong tin quang cao tren dai ve nhiing van de cu the
nao do, vi chUa dtfpc kiem duyet chat che nen co the chi dung mot phan, hoac
khong dung hay chUa du co sd de xac dinh, nhUng vi muc dich thudng mai
nen chung vSn dtfpc truyen di. Neu cac quang cao nay co hai cho stfc khoe,
thong diep moi ngudi nhan dupe la sai thi mot phan trach nhiem cua can bo y
te cung nhu cua can bo giao due stfc khoe la giup moi ngtfdi nhan ra dieu sai
do va c&n than trong khi nhan nhiing thong tin nhu vay.
Khi stf dung dai phat thanh trong TT-GDSK can chu y mot so' hudng din
nhu sau de co the thu dupe ket ket qua tot:
- Bai phat thanh phai ngan gon: hay hinh dung ngudi nghe cam thay
buon te va de dang ‘tat’ may hoac thay met moi ve tinh than hay the
chat khi nghe mot bai qua dai.
- M ang tinh giai tri: ta't ca nhiing ngtfdi nghe dai deu m uon giai tri vdi
chUOng tinh phat thanh, hay lam cho chUdng trinh phat thanh trd nen
song dong va gay chu y hon. Co' gang lam cho cac thong diep de dang
dupe chap nhan hon bang cach sU dung am nhac, hai kich hoac kich noi.
Khong nen thuyet giang qua dai.

- Noi dung ro rang: khong nen che lap cac thong diep qua sau xa trong
viec giai tri, hoac lam cho thong diep trd nen khong ro rang. Bang cach
dOn gian, si’i dung ngon ngtf thong thtfdng de hieu (tho ngii dia phudng)
de the hien noi dung.
- Cac thong diep quan trong can nhac lai: vi du hay doc ro rang, khong
dupe voi vang va nhac lai cac dia chi, ngay thang va so dien thoai... (hoac
mot so ten quan trong hay con so) ma doi ttfdng can biet de lien he.
- Gay tac dong ldn nhat: luon luon co gang bat dau mot chUdng trinh vdi
mot dieu gi do gay stf chu y, vi du nhu tieng khoe cua tre con, nhac,
nhtfng tieng dong, va cham, hoac mot tii hay cau hoi gay an tupng. Ket
thuc vdi mot dieu gi do lam cho moi ngtfdi se ghi nhd dieu do.
- Hoi thoai hoac thao luan: luon luon tao nhieu dieu thu vi hdn vdi cac hoi
thoai, neu chi co mot ngUOi noi thi rat kho de giii dupe stf chu y.
- Chu y da dang hoa: khong nen doc qua nhieu ldi hoac dua nhieu doan
nhac vao. Hay co gang dat mot doan nhac nen vao trong bai phat bieu,
sU dung cac giong noi khac nhau, dat cac cau hoi lam cho ngtfdi nghe
chu y den noi dung se dupe de cap tiep theo, co' gang khong de ngudi
nghe co the du doan trudc dUdc moi dieu.

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 - Chon liia kl cang ngtfdi dtfpc phong van: khi can phong van hay chon
ngudi cong tac cho cac chUOng trinh thao luan phai chon ngudi can than.
Ho cung phai noi ro rang, gian di va gay stf chu y.
- Them “mau s ic ” vao cuoc phong van: tao nen cac bUc tranh trong ki Uc
cua ngudi nghe vdi viec dUa noi dung phong van vao dung boi canh de
thu hut stf tap trung cua ngudi nghe. Mo ta dupe boi canh xung quanh
dien ra nhu trong thtfc te de doi tupng nghe lien tudng den nhtfng dieu
dang xay ra.
- Hoi cac cau hoi “lam sao” va “tai sao” : cho phep moi ngudi phat bieu cac
y tudng va cac quan diem, tranh chi neu cac cau hoi vdi cau tra ldi chi la
“co” hay “khong” .
Neu co dieu kien can thu nhan cac y kien phan hoi cua doi tupng nghe
dai ve cac thong diep TT-GDSK ma ho da thu nhan de rut kinh nghiem soan
thao cac chUOng trinh thich hpp mang lai hieu qua tot hon.

2.2.2. Vo tuyen truyen hinh

Cac chUOng trinh truyen hinh ngay cang dupe phat trien khong chi 0
trung UOng ma ca 0 cac dia phUOng. So lupng ngudi stf dung may thu hinh
khong chi tang len 0 thanh thi ma con ca d cac vung nong thon. Truyen thong
giao due sUc khoe qua cac kenh cua dai truyen hinh trung UOng cd nhUng Uu
the ve stf pho bien rong, nhanh, nhUng lai kem Uu the so vdi dai truyen hinh
dia phUOng ve ngon ngtf, thdi gian phat song, sU phu hpp ve van hoa, phong
tuc tap quan v.v...
Vo tuyen truyen hinh thudng dupe moi ngudi quan tam chu y vi ngoai
ngon ngU ldi noi va chu' viet con cd cac hinh anh dong gay dupe hUng thu va
an tupng sau sac cho ngudi xem va co the hudng dan dupe ca cac thao tac, ky
thuat, qua do doi tupng cung co the hoc dupe cac ky nang.
Cac noi dung giao due sUc khoe co the truyen tai qua truyen hinh bang
nhieu hinh thUc rat phong phu nhu phong stf, tin tUc, hudng d in , chat van,
hoi dap truyen hinh, cau lac bo, chUOng trinh theo ttfng chuyen de sUc khoe.
Dac biet cac noi dung giao due sUc khoe con dupe chuyen den doi tupng mot
cach tu nhien, nhUng hap d in va gay an tupng sau s ic vdi nhieu ddi tupng
b ln g cac chUOng trinh phim truyen, tieu p h lm , ca nhac, mua roi, hoi thi....
Soan thao chUOng trinh giao due sUc khoe qua vo tuyen truyen hinh can phai
co nhtfng ngudi co ky nang nhat dinh. Viec chuan bi cac chu de kha cong phu,
can dupe thu nghiem trUdc va nhu vay thudng ton kem ve thdi gian va nguon
luc. Vdi chUOng trinh truyen hinh cac doi tupng phai co cac phUOng tien la
m ay thu hinh, dien thi mdi co the tiep can dupe cac noi dung giao due sUc
khoe qua phuong tien nay. ChUOng trinh giao due stfc khoe phat tren vo
tuyen truyen hinh chu yeu la qua trinh cung cap thong tin, thong diep mot
chieu, viec dieu chinh, bo sung, danh gia hieu qua thtfdng kho khan va cham.

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 Ngay nay truyen thong giao due siic khoe qua vo tuyen truyen hinh
ngay cang dtfpc phat trien, la mot hinh thtfc giao due hap dan vi ket hdp dtfpc
ca ngon ngtf, hinh anh, mau sac, am thanh, the loai phong phu nen thu hut
dtfpc stf chu y cua nhieu doi ttfdng, gop phan nang cao hieu biet, chuyen doi
hanh vi va thai do co hieu qua hOn so vdi mot so hinh thtfc giao due stfc khoe
gian tiep khac.

2.2.3. Video

Video la mot loai phtfOng tien nghe nhin hien dai, la mot dang cua
truyen hinh, nhtfng sii dung video cho giao due stfc khoe chu dong hon vo
tuyen truyen hinh. Video co the sii dung dtfpc cho mot nhom khan gia dich.
Ket hop sii dung video trong giao due stfc khoe trtfc tiep thtfdng lam cho
chtfOng trinh giao due stfc khoe sinh dong. Video thu hut dtfpc stf chu y cua
doi ttfpng, ngtfdi lam giao due stfc khoe co the chu dong sii dung cac bang
video trong cac chtfOng trinh giao due stfc khoe. Tuy nhien viec lam phim
video cung giong nhtf lam cac chtfOng trinh giao due phat tren vo tuyen
truyen hinh la can co thdi gian, ky thuat va tien de san xuat cac bang ghi
hinh. Cac bang ghi hinh ve giao due stfc khoe co the sii dung dtfpc nhieu lan
vdi dieu kien la no dtfdc bao quan tot. Mot dieu kien khong the thieu dtfpc do
la noi giao due stfc khoe phai co vo tuyen, dau video va dien, ngtfdi giao due
phai biet sii dung cac phtfOng tien nen day la phtfOng tien kha ton kem, ddi
hoi ky thuat cao. Video neu dung ket hpp vdi cac phtfOng phap giao due trtfc
tiep khac nhtf trong cac buoi ndi chuyen stfc khoe, thao luan nhom se dem lai
hieu qua giao due cao.

2.2.4. Tdi lieu in an

2.2.4.1. Bao, tap chi

Bao, tap chi la loai phtfOng tien thong tin dai chung kha pho bien, cd
nhieu loai bao, tap chi cd the dang tai cac bai viet vdi thong tin ve giao due
stfc khoe. Bao trung tfOng, bao dia phtfdng, bao cac nganh deu cd the long
ghep cac tin ttfc ve bao ve va nang cao stfc khoe. Cac bai viet, tin ttfc ve phong
chong benh tat, nang cao stfc khoe cd the dang tren tat ca cac loai bao, tap
chi, nhtfng cung can phai xem xet chon van de stfc khoe, benh tat dang tren
cac bao phu hpp vdi doc gia. Trong hoat dong giao due stfc khoe, khong the
nao thieu stf tham gia cua bao chi. U"u diem cua bao chi la cung cap cac thong
tin khoa hoc ve bao ve stfc khoe phong tranh benh tat mot cach he thong,
chinh xac. Bao chi cd the dtfpc ltfu trtf lau nen ddi ttfdng cd thdi gian doc di
doc lai de tim hieu ky van de stfc khoe ma ho quan tam, hoac cd the chuyen ttf
ngtfdi nay sang ngtfdi khac. Bao chi cung cd the chuyen tai cac thong tin giao
due qua cac tranh anh. Cac bai viet ve giao due stfc khoe cd the chon loc dang
d cac loai bao, tap chi cho thich hpp vdi cac ddi ttfpng vi moi loai bao, tap chi
cung cd "doi ttfpng dich rieng cua no". Tuy cd nhieu tfu diem nhtfng bao chi

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chi thuan ldi cho nhufng ngtfdi biet doc biet viet va co kha nang mua dtfpc bao
chi. Chu y bai viet dang tren bao chi can stf dung ngon ngtf pho thong, viet
ngSn gon, xuc tich va can dtfpc kiem duyet de dam bao tinh khoa hoc, chinh
xac, vi neu co sai sot thi kho suta.

2.2.4.2. Pand, dp phich

La nhtfng to giay ldn hoac nhtfng tam bang ve cac btfc tranh va cac bieu
ttfdng vdi ldi ngan gon nham the hien mot noi dung nhat dinh nao dd, vi du
nguyen nhan cua mot benh, hau qua cua benh, dtfdng lay truyen chinh cua
benh.... Pand, ap phich thtfdng dtfpc dtfng 0 nhtfng noi cong cong nen nhieu
ngtfdi dtfpc biet va thtfdng gay dtfpc stf chu y va suy nghi cua nhieu ngtfdi. Khi
san xuat pand, ap phich can chu y mot so diem sau:
- Xac dinh doi ttfpng dich phuc vu.
- Xac dinh noi dung y ttfdng muon dien dat.
- Chon hinh anh muon dien dat y ttfdng.
- Chon ttf ngtf can thiet de dien dat noi dung.
- Dung mau sac de nhan manh van de, thu hut stf chu y.
- Hinh anh phai de hieu, khi xem ngtfdi ta de hieu noi dung muon ndi ve
van de gi.
- Chi nen trinh bay mot van de trong mot tam ap phich, trinh bay nhieu y
ttfdng se lam roi va gay nham lan cho moi ngtfdi.
- Cang dOn gian, cang it chtf cang tot de ngtfdi khong biet doc cung cd the
hieu dupe.
- Pand, ap phich cd the dung rieng le hoac ket hpp vdi cac phtfOng tien
khac nhtf phoi hpp trong buoi giao due stfc khoe trtfc tiep, cac cuoc trien
lam, ho trp buoi chieu phim, dien kich... Khi dung pand, ap phich can
chu y tranh mtfa gio lam hong pand, ap phich.

2.2.4.3. Tranh lat hay sach lat

Tranh lat (hay sach lat) la mot bo cac btfc tranh, anh trinh bay mot van
de, mot cau chuyen mang tinh giao due, dtfdc dong thanh tap, cd gay soan 0
mep tren va cd de bang bia ctfng de cd the dat tren ban, lat ttfng trang khi sii
dung. Thtfdng mat trtfdc mdi trang la cac btfc tranh dtfpc ve hay anh chup ve
chu de giao due, mat sau la cac thong tin ngan gon hoac ldi giai thich. Tranh
lat cung cd the trinh bay mot bai hoc theo trinh ttf ve va'n de stfc khoe nao dd
mot cach dOn gian de ngtfdi doc cd the hieu dtfpc va'n de. Tranh hay sach lat
thtfdng dtfpc dung ket hpp khi giao due stfc khoe trtfc tiep. Khi stf dung tranh
hay sach lat can chi cho moi ngtfdi thay ro rang hinh ve va dung ldi ndi thong
thtfdng d i hieu de giai thich them cac hinh ve. Sau khi gidi thieu xong mot bo
tranh lat can tom tat noi dung chinh cua tranh lat cho ddi ttfdng de nhd.

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 Tranh lat hay sach lat co the gay diidc stf chu y cua doi ttfdng qua cac
hinh anh sinh dong va ldi chu giai ng&n gon.

2.2.4.4. Ta rdi (ta budm)

Td rOi la loai an pham thtfdng dtfpc sii dung pho bien nhat trong TT-
GDSK. Mot td rdi ddn gian nhat la mot trang giay don, in tren ca hai mat va
gap ddi hoac ba. Td rdi cd the bao gom nhieu trang giay. Mot loai td rOi cd ttf
nam trang trd len thtfdng dtfpc goi dtfdi thuat ngtf ‘sach bo tui’. Td rdi cd the
giup ich cho ca nhan va cd gia tri trong cac cuoc thao luan nhom va phuc vu
cho viec n h ic lai nhtfng diem chinh cua chu de TT-GDSK da lam. Td rOi cd
tranh anh hap d in cung cd the phat cho nhtfng ngtfdi khong biet doc, ho se
nhd nhtfng ngtfdi khac doc giup ho. Td rOi rat cd ich cho nhtfng chu de nhay
cam va te nhi nhtf gidi tinh, benh lay truyen qua dtfdng tinh due... khi mot so'
doi ttfpng ngai hoi trtfc tiep nhtfng lai cd the sii dung mot td rOi va doc nhtfng
thong tin trong dd. Nhtfng td rOi ve mot so van de stfc khoe benh tat pho bien
cd the da dtfpc san xuat san cd de dung trong cac chtfOng trinh TT-GDSK cua
can bo y te. Tuy nhien, cac td rdi dtfpc nhtfng ngtfdi khac san xuat cd the
khong thich hpp khi can bo TT-GDSK sii dung d mot dia phtfOng cu the, do
ngon ngtf hoac noi dung nen ddi khi phai san xuat nhtfng td rOi cho rieng ttfng
cong dong. Khi san xuat td rOi phai tinh den gia thanh. Td rOi khong the san
xuat vdi gia qua cao. Gia thanh san xuat td rOi se giam neu san xuat hang
loat, sii dung trong cac chu de can TT-GDSK cho nhieu ngtfdi, tren dien rong.
Mot diem khdi dau cd ich la xem xet tham khao cac td rdi do cac chtfOng
trinh khac san xuat hoac ttf ntfdc ngoai. Dieu nay se giup cho ngtfdi thtfc hien
TT-GDSK cd nhtfng y ttfdng lam the nao siia doi cac noi dung va hinh thtfc
cho phu hdp vdi hoan canh cua dia phtfOng va doi ttfpng dich. Hay stf dung
ngon ngtf don gian vdi tranh anh va thii nghiem trtfdc de ch ic c h in doi ttfpng
hieu dtfpc. Luon luon kem theo mot dia chi htfdng dan tren td rOi de moi ngtfdi
cd the tim hieu nhtfng thong tin cu the hon khi ho quan tam. Hay phat cho
ddi ttfpng trong cac cuoc ndi chuyen va trong cac buoi hpp dtfpc to chtfc d
nhtfng noi cong cong va chuan bi s in sang de sii dung sau mot chtfOng trinh
phat thanh hay truyen hinh. Hay suy nghl chon mot so' dia diem trong cong
dong, noi dd ta cd the dat cac td rOi va moi ngtfdi di qua dd de xem. Hay tim
nhtfng dip de phan phat cac td rdi, vi du nhtf sii dung td rdi khi phat ltfdng,
khi phat phieu bau cii, khi ngtfdi benh den cac phong kham, ciia hang ban
thuoc, khi can bo y te den tham ho gia dinh, trong cac buoi truyen thong giao
due stfc khoe true tiep cho ca nhan, nhom va cong dong.
Mot danh muc kiem tra don gian ma chung ta cd the sii dung de kiem
tra cac td rOi la:
- Cd gay stf chu y khi nhin vao khong?
- Cd mang nhtfng thong tin thich hpp cho cac doi ttfpng khong?
- Cd tranh dtfpc nhtfng thong tin khong thich hdp khong?

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 - Ngon ngtf trong do co de doc khong?
- Tranh anh co de xem va bat mat khong?
- Nhiing ldi khuyen the hien trong dd cd thiic te va mang tinh kha thi
khong?
- Cd cung cap nhiing thong tin dac biet ma nhiing doi tupng thiic sii muon biet?
- Cd cho moi ngtfdi biet, chd nao cd the tim hieu them thong tin chi tiet hOn?

2.2.4.5. Mot so tai lieu in an khac

M ot sd cac loai phtfOng tien khac cung dtfpc stf dung phoi hpp trong khi
giao due stfc khoe gian tiep nhtf cac tranh chuyen ve stfc khoe, cac cuon sach
chuyen de mong, sach hoi dap ve car van ri& L-yTaria khnp ci\c loai nay
thtfdng dtfpc stf dung phoi hop vdi cac loai phtfOng tien khac khi thtfc hien TT-
GDSK.

2.2.5. Bang tin

Bang tin cd the dat d nhtfng noi cong cong, khu trung tam cua cong
dong. Cac khau hieu, tranh cd dong vdi muc dich giao due stfc khoe cho cong
dong cd the dtfpc ke, ve tren cac bang tin, cac btfc ttfdng, cau lac bo, tru sd
cong cong... nhtfng ndi cd the thu hut dtfpc stf chu y cua nhieu ngtfdi. Cac btfc
tranh cd the ve dtfdi dang tranh hai htfdc, cham biem, da kich vao cac hanh vi
cd hai cho stfc khoe, vdi viec stf dung ngon ngtf cua cong dong kem theo se cd
tac dung giao due tot. Bang tin ngoai viec ke, ve tranh, khau hieu thi con cd
the neu cac tin ttfc ve benh tat tai dia phtfOng, htfdng dan ngan gon cach
phong chong. Ban tin cung cd the neu ra nhiing gtfOng ngtfdi tot, viec tot
trong cong dong da thtfc hien cham sdc stfc khoe tot va cd cac hanh vi lanh
manh cd lpi cho stfc khoe. Bang tin la mot phtfOng tien cd the cung cap dtfpc
nhieu thong tin ve stfc khoe nen c ln dtfpc xay diing va stf dung vdi muc dich
TT-GDSK tai cong dong.

2.3. C ac p h tfd n g p h a p g ia o du e stfc k h oe trtfc tiep

2.3.1. To chiic ndi chuyen gido due siic khoe

Ndi chuyen giao due stfc khoe theo chu de la ngtfdi thtfc hien giao due
stfc khoe trinh bay ve mot chu de stfc khoe, benh tat nao dd trtfdc mot nhom
nhieu ngtfdi. Bat ky cac chu de nao ve benh tat, stfc khoe cung cd the to’ chiic
ndi chuyen vdi muc dich giao due, vi du nhtf ndi chuyen ve benh suy dinh
dtfdng d tre em va cach phong chong, benh tieu chay, benh btfdu co, ve sinh
mdi trtfdng. HIV/AIDS v.v... Khi giao due stfc khoe qua ndi chuyen chuyen de,
chung ta muon moi ngtfdi phat trien kha nang tiep thu doc lap, suy nghl van
dung cach giai quyet van de cua chinh ban than ho. To chtfc cac cuoc ndi
chuyen stfc khoe giup cho moi ngtfdi trtfc tiep dtfpc nghe nhtfng thong tin mdi

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nhat ve cac van de siic khoe lien quan tdi ho, tdi gia dinh va cong dong ho.
Cac cuoc ndi chuyen siic khoe cd tac dung chu yeu la thay doi nhan thiic cua
doi tupng va giup ddi ttfpng suy nghl htfdng tdi viec thay do’i thai do va hanh
vi. Tuy nhien neu chi to’ chtfc ndi chuyen stfc khoe thi khong dam bao la doi
ttfpng cd thay doi hanh vi hay khong ma can phai ket hpp vdi nhieu bien phap
giao due va stf hd trp khac. Khi nhom doi ttfpng dong, khong cd kha nang to
chtfc cac cuoc thao luan nhom nhd vi thieu ngtfdi, khong cd du thdi gian va
nguon ltfc khac, hoac khi cd cd hoi nhtf ket hdp vdi cac cuoc hpp cua cong dong
cua cac doan the, cua cac to chtfc xa hoi... thi nen to chtfc ndi chuyen giao due
stfc khoe.

2.3.1.1. Chuan bi tritdc khi noi chuyen gido due siic khoe

~ - Tim cac co hoi trong thtfc te de thtfc hien giao due stfc khoe: cd the chon
thdi gian va dia diem de to chtfc ndi chuyen ve cac chuyen de stfc khoe
benh tat rieng, nhtfng cach thong thtfdng la cac nha TT-GDSK nen lien
he vdi nhtfng ngtfdi, nhtfng to chtfc, cO quan, trtfdng hoc v.v... cd to chtfc
hoi hpp de tranh thu thdi cO thtfc hien giao due stfc khoe. Thao luan vdi
nhtfng co sd cd to chtfc hoi hpp de dtfa phan ndi chuyen stfc khoe vao noi
dung chtfOng trinh chinh thtfc cua cac cuoc hoi, hpp trong cong dong.
__ - Sap xep trtfdc thdi gian va dia diem thuan tien cho doi ttfpng de dang
tham gia.
<- - Thong bao trtfdc cho ddi ttfpng tham dtf ve chu de, thdi gian dia diem to
chtfc ndi chuyen.
- Neu dong doi ttfpng can to chtfc 0 hoi trtfdng rong, cd micro de doi ttfdng
nghe ro.
— - Co g in g sap xep chd ngoi du, thoai mai de doi ttfpng theo ddi dtfpc buoi
ndi chuyen.
- - Tim hieu trtfdc cac doi ttfdng tham dtf de cd the ltfa chon noi dung thich hdp.
- Ngtfdi ndi chuyen phai chuan bi ky noi dung theo trinh ttf logic cua van
de ndi chuyen de ddi ttfpng de nhd, de lam.
- Can chuan bi them cac hinh anh, ttf lieu minh hoa cho buoi ndi chuyen
them sinh dong va hap dan, tao stf quan tam chu y cua ngtfdi nghe. Tot
nhat la cd the tim hieu, sii dung cac vi du minh hoa ngay chinh tai dia
phtfOng, lam cho doi ttfpng cd the nhin nhan van de mot cach thtfc te hon.
- Can chuan bi trtfdc ngtfdi to chtfc buoi ndi chuyen de on dinh to’ chtfc
trtfdc va trong khi ndi chuyen.

2.3.1.2. Thiic hien noi chuyen gido due siic khoe

- Cach bat dau noi chuyen

84
 + Khi nhiing ngtfdi tham dtf den ngtfdi noi chuyen can chao. hoi, lam
quen noi chuyen than mat vdi ho. Khi ho den day du hay mdTTip ngoi
vao cho da chuan bi trtfdc va xin phep dtfdc bat dau buoi ndi chuyen.
+ Chi nen bat dau khi moi ngtfdi da on dinh chd ngoi va sin sang nghe.
Hay bat dau bang cach chao hoi cam dn sii tham dtf cua doi ttfdng de
cd the tao ra mot khong khi than mat ngay ttf dau cuoc ndi chuyen,
thu hut stf chu y theo ddi cua ho.
+ Gidi thieu: ngtfdi ndi chuyen (can bo giao due stfc khoe) hay ttf gidi
thieu ve minh. Mdi mot vai ngtfdi tham dtf gidi thieu va cd" gangdtfa
ra mot so thong tin ve mot sd" ngtfdi tham dtf ma minh biet (vi du ten,
vai trd, chtfc vu v.v...) de tao cam giac cho doi ttfpng hieu la ngtfdi ndi
chuyen khong xa la doi vdi ho.
* Hay kheo lec^yeu cau cac thanh vien tham gia tap trung lang nghe.
* Hay neu ro va giai thich vdi ngtfdi tham dtf ve muc dich cua buoi ndi
chuyen.
* Ngtfdi ndi chuyen cho nhtfng ngtfdi tham dtf biet la minh san sang trao
doi va tra ldi nhtfng cau hoi cua nhtfng ngtfdi tham dtf de lam ho hieu ro van
HThOn.— --------
- Thuc hien noi dung noi chuyen:
+ Ndi to, rd rang de moi ngtfdi tham dtf nghe dtfdc, neu hoi trtfdng rong,
dong ngtfdi tham dtf can sii dung micro.
+ Ket hpp ngon ngtf bang ldi va ngon ngtf khong ldi khi ndi chuyen de
thu hut sU chu y cua doi ttfpng.
+ Quan sat, bao quat cac dien bien cua ngtfdi tham dtf de cd the dieu
chinh cach trinh bay cho hdp ly hdn.
+ Tap trung nhan manh cac noi dung trong tam cua van de ma doi
ttfpng phai biet, khong nen ndi nhieu noi dung biet dtfpc thi tot.
+ Nen ket hpp mot sd" phtfdng tien ho trp trong khi trinh bay de doi
ttfpng de hieu de nhd van de hon nhtf stf dung tranh anh, hien vat.
+ Neu cac vi du cu the sat vdi thtfc te ma doi ttfdng cd the de thay (tot
nhat la lay vi du ngay tai dia phtfOng cua doi ttfdng).
+ Thinh thoang nen dat ra cac cau hoi de hoi doi ttfpng va tim hieu
them nguyen vong chung cua ngtfdi tham dtf, nham thay doi khong
khi cua buoi ndi chuyen.
+ Dung cac ttf ngtf thong thtfdng ma doi ttfpng thtfdng dung, tranh dung
cac ttf chuyen mon lam doi ttfpng lung tiing, kho hieu.
+ Co' gang trinh bay theo logic cua van de dat ra.

85
 + Sau moi noi dung nen tom t it nhiing diem cot loi nhat va chuyen sang
noi dung tiep theo hpp ly.
+ Tranh mot so khuynh htfdng cd the xay ra trong khi ndi chuyen:
* Khong quan tam den thai do va stf lin g nghe cua doi ttfdng.
* Ndi lan man theo cam htfng, khong di vao trong tam da chuan bi,
khong chu dong ve thdi gian.
* Ndi trung lap noi dung.
* Khong cd cO hoi cho doi ttfpng neu cau hoi.
9

* Phe phan hay chi trich cac cau hoi, y kien khong phu hpp ma cac ddi
ttfpng neu ra lam cho doi ttfpng cam thay bi xuc pham.
* Phan bo' thdi gian ndi chuyen khong can do'i.
* Ket thuc van de voi vang khong hpp ly.

2.3.1.3. Ket thuc noi chuyen

- Ngtfdi ndi chuyen can tom tat noi dung buoi ndi chuyen, neu cac viec ma
doi ttfpng can nhd can lam7~~
- Dong vien va cam On nhtfng ngtfdi tham dtf, cam dn ngtfdi to chtfc.
- Cd the tiep tuc trao doi vdi mot so do'i tupng lam ro nhtfng y kien nhtfng
cau hoi rieng cua doi ttfpng ma ho chtfa cd dieu kien phat bieu.
- Tao dieu kien tiep tuc gap gd, giup dd do'i ttfdng neu cd yeu cau.

2.3.1.4. Bang kiem theo doi, giam sat thitc hien noi chuyen siic khoe

BANG KIEM QUAN SAT THL/C HANH NOI CHUYEN SLTC KHOE

Doi ttfpng dtf ndi chuyen: Ngtfdi quan sat:

Ngtfdi ndi chuyen:
Chu de ndi chuyen:
Thdi gian ndi chuyen: Noi ndi chuyen:

Noi dung Khong C o lam Ghi

lam chu
Chi/a Oat Tot
dat
1. Bo tri hoi trudng, cho ngoi hpp ly:

2. Bat dau hap d in :

3 Chao hoi lam quen vdi doi tupng trudc khi bat dau:
4 Ngifdi noi chuyen gidi thieu ve minh:

86
 5 Neu ro rang chu de noi chuyen:
6 Co neu ro muc tieu cua buoi noi chuyen:
7. Noi du to de moi ngudi ngh« ro:
8. Trinh bay noi dung chinh thich hpp cua chu de:
9. Quan sat bao quat dUdc doi tupng nghe:
10. SCr dung cac ngon ngU thong thUdng:
11. SCf dung cac tai lieu, phtfdng tien thich hpp:
12. Neu vi du minh hoa cho doi ti/png de hieu:
13. Ket hpp sCfdung ngon ngukhong IPi:
14. Tao dieu kien de doi tupng dat cau hoi:
15. Tra IPi ro het cac cau hoi cua doi tupng:
16. Tom tat noi dung mau chot ttfng phan trinh bay:
17. Tom tat toan bp chu de thao luan:
18. Nhan manh nhUng dieu can nhp can lam:
19. Cam on nguPi to chUc va doi ti/png khi ket thuc:
20.Tao dieu kien tiep tuc ho trp doi tupng.

Nhufng y kien nhan xet:

Ngtfdi giam sat
(ky, ghi ro ho ten)
De nang cao ky nang cho ngudi TT-GDSK trUc tiep, ngiidi theo ddi giam
sat buoi ndi chuyen chuyen de cd the xay dUng va sU dung cac bang kiem.
Ban than ngudi thuc hien TT-GDSK cung cd the su dung bang kiem de tu
xem xet, danh gia rut kinh nghiem nang cao ky nang trong hoat dong TT-
GDSK. Vdi cac phuong phap giao due sUc khoe trUc tiep deu cd the xay dung
cac bang kiem de sU dung va tu sii dung cho theo ddi, giam sat. Khi ndi
chuyen giao due sUc khoe cd the sU dung bang kiem tren de theo ddi, giam sat
va tu danh gia.

2.3.2. To chiic thao luan nhom gido due siic khoe

To chUc thao luan nhom vdi muc dich giao due sUc khoe la mot phUOng
phap giao due sUc khoe mang lai ket qua tot. Trong thao luan nhom cac do'i
tupng cd dip dupe suy nghl va phat bieu y kien cua minh trudc nhom ve cac
van de sUc khoe lien quan, qua dd the hien dupe kien thUc va kinh nghiem
cua ngudi tham du thao luan. NhUng ngudi tham gia thao luan nhom qua
lin g nghe y kien cua nhUng ngudi khac se thu dUdc them kien thUc, giup ho
hieu ro ve cac van de sUc khoe cua ho, thay ro gia tri, lpi ich cua cac thuc
hanh cd lpi cho sUc khoe va cd them cac kinh nghiem giai quyet van de. Trong
mot so trudng hpp cu the, tham gia thao luan se giup cac ca nhan nhan ra
nhu cau cham sdc sUc khoe cua ho va cuoi cung ho cd the di den thong nhat ve

87
quan diem, co thai do tich ctfc va hanh dong dung d in de nang cao siic khoe
cho ca nhan, gia dinh va cong dong. Vai tro cua ngtfdi htfdng d in thao luan la
bo sung cac kien thtfc, thai do va htfdng dan cac thtfc hanh cho ngtfdi tham dtf
de cd the giai quyet van de stfc khoe cua ho. Rat nhieu cac chu de stfc khoe,
benh tat cd the chon cho thao luan nhom 0 cong dong, dd la nhtfng van de stfc
khoe thtfdng gap nhtf ve sinh mdi trudng, ve sinh ca nhan, dinh dtfdng an
toan thtfc pham, mot so benh pho bien, phong chong tai nan ngo doc, stf dung
thuoc an toan, cham sdc stfc khoe sinh san, ke hoach hoa gia dinh...

2.3.2.1. Nhiing viec can chuan bi trtfdc thao luan

- Xac dinh chu de va noi dung thao luan: cac chu de va noi dung thao luan
dtfpc xac dinh qua cac thong tin thu dtfpc ttf cac nguon cd san hay ttf
dieu tra nghien ctfu cong dong va cac nhom doi ttfpng
- Xac dinh ro doi ttfpng tham gia thao luan, chuan bi mdi cac doi ttfpng cu
the cho mdi cuoc thao luan. Khi to chtfc thao luan nhom tai cong dong cd
the mdi khoang 10 ngtfdi tham dtf de tao dieu kien cho moi thanh vien
deu cd thdi co trinh bay y kien, quan diem, hieu biet va nhtfng de xuat
giai quyet van de. Nen mdi nhtfng thanh vien tham gia trong mot nhom
thao luan ttfOng doi dong deu ve trinh do, cung gidi tinh, ltfa tuoi va cac
dac diem kinh te, xa hoi giong nhau de ho cam thay thoai mai khi tham
gia thao luan va trao doi y kien, chia se quan diem.
- Thong bao trtfdc thdi gian, dia diem va chu de ro rang cho doi ttfpng chu
dong sap xep thdi gian tham dtf dong du.
- Chu y xem xet chon thdi gian va dia diem thich hpp de moi ngtfdi tham
gia day du. Cd the chon dia diem tai cau lac bo, nha van hoa thon hoac
mot gia dinh d trung tam cum dan ctf de to chtfc. Thdi gian nen chon vao
buoi trtfa hoac buoi toi luc moi ngtfdi da ket thuc cong viec.
- Chuan bi sSp xep chd ngoi theo vong tron hoac hinh elip de moi ngtfdi cd
the nhin thay tat ca cac thanh vien trong nhom va de tham gia thao luan.
- Ngtfdi htfdng dan thao luan phai chuan bi noi dung thao luan ky, the
hien bSng cac cau hoi cu the de thao luan va dtf kien trtfdc cac van de cd
the nay sinh trong khi thao luan.
- Chuan bi cac vi du minh hoa, md hinh, hien vat, tai lieu va phtfOng tien
lien quan de sii dung ho trp trong khi thao luan.

2.3.2.2. Thtfc hien thao luan nhom

- Cach bat dau thao luan nhom:

+ On dinh to chtfc thao luan nhom: khi nhtfng ngtfdi tham dtf den ngtfdi
htfdng dan can chao hoi ndi chuyen than mat vdi ho. Khi ho den day du
hay mdi ho ngoi vao chd da chuan bi trtfdc de cd the bat dau thao luan.

88
 + Chao hoi lam quen va gidi thieu: day la hoat dong giao tiep tii nhien,
thong thudng nhUng rat quan trong can phai thtfc hien. NgUOi hudng
d in thao luan sii dung cac cach chao hoi lam quen thong thudng, chu
y den cach xUng ho, cii chi, dang dieu, ngon ngO, phong tuc tap quan
khi lam quen. Ngudi hudng d in thao luan ttf gidi thieu ve minh va
mdi nhUng ngudi di cung (neu cd) ttf gidi thieu, mdi nhUng ngudi tham
gia tu gidi thieu ng&n gon ve ho. Ngudi hudng d in co gang nhd hay
ghi lai ten nhiing ngudi tham dtf de cd the goi ten ho trong khi thao
luan tao stf gan gui than mat.
+ Cach bat dau: ngudi hudng dan thao luan hay bat dau b ln g cac cach
de cd the tao ra khong khi than mat, tap trung ngay tU dau cuoc thao
luan, lam cho moi thanh vien thoai mai, ttf tin, tich ctfc tham gia,
tham gia mot cach binh dang trong thao luan. Tao ra moi quan he gan
gui giUa ngudi hudng dan va ngudi tham dtf.
+ Can kheo leo yeu cau vdi cac thanh vien tham gia thao luan chu y
lang nghe va ton trong y kien cua tat ca moi ngudi phat bieu trong
thao luan.
+ Neu ro rang chu de thao luan va muc dich cua buoi thao luan, giai
thich vdi moi ngudi trong nhom ve muc dich cua cuoc thao luan ngay
tU dau de thu hut stf chu y tham gia cua ho trong thao luan.
- Nen giai thich de nhUng ngudi tham dtf hieu la buoi thao luan khong
phai la buoi giang bai cua ngudi hudng dan ma ngudi hudng dan chi la
ngudi tap hpp nhUng hieu biet, nhtfng kinh nghiem va thong nhat cach
giai quyet van de cua nhtfng ngtfdi tham dtf ma thdi va ngtfdi htfdng dan
cung se hoc tap, chia se kien thtfc va kinh nghiem cua minh vdi nhtfng
ngtfdi tham dtf thao luan.
- Ngtfdi htfdng dan thao luan can the hien de nhtfng ngtfdi tham dtf biet
la minh san sang trao doi va tra ldi nhtfng cau hoi cua nhtfng ngtfdi
tham dtf.
- Thtfc hien thao luan nhom:
+ Lam cho tat ca moi ngtfdi chu y vao van de thao luan nhtfng khong
gay nen khong khi cang thang trong buoi thao luan.
+ Dong vien khuyen khich moi thanh vien tham gia thao luan, tao ra
dtfpc khong khi binh dang cho tat ca cac thanh vien tham gia.
+ Ton trong moi y kien cua cac thanh vien trong nhom thao luan.
+ Chu dong quan sat bao quat cac dien bien cua nhom thao luan de dieu
chinh, tap trung chu y cua moi ngtfdi tham gia.
+ Neu ro rang, lan ltfpt ttfng cau hoi de moi ngtfdi thao luan.
+ Tap trung thao luan vao cac cau hoi trong tam cua van de da chuan bi.

89
 + Thao luan theo trat ttf nhat dinh, theo logic cua van de dat ra.
+ Sau mdi cau hoi (noi dung) thao luan nen tom tat nhtfng diem chinh.
+ Dung ttf ngtf thong thtfdng phu hpp vdi doi ttfdng, tranh dung cac ttf
chuyen mon.
+ Sii dung phtfOng tien ho trd, vi du m inh hoa thich hdp de do'i ttfpng d !
hieu de nhd.
+ Chu y tranh mot so' khuynh htfdng cd the xay ra trong khi thao luan:
* Thao luan lan man khong di vao trong tam.
* Thao luan trung lap.
* Chi mot vai ngtfdi tham gia thao luan la'n at nhtfng ngtfdi khac lam cho
mot so thanh vien khac khong cd cO hoi phat bieu chinh kien cua minh.
* Mot so thanh vien khong quan tam, ndi chuyen hay lam viec khac.
* Cd cac y kien trai ngtfpc bat hoa, gay khong khi cang thang trong
thao luan.
* Phe phan chi trich cac y kien khong phu hpp.
* Phan bo' thdi gian thao luan khong can doi.

2.3.2.3. Ket thuc thao luan

- Tom tat noi dung chinh da thao luan, nhan manh nhtfng noi dung can
nhd, nhtfng viec can lam da thong nha't.
- Dong vien moi ngtfdi thtfc hien nhtfng viec lam can thiet va cam dn tat
ca moi ngtfdi da tham dtf thao luan va danh gia cao vai trd tham gia
cua ho.
- Cd the tiep tuc trao doi them vdi mot so ngtfdi tham dtf neu ho con cd y
kien, cau hoi rieng chtfa cd dieu kien trao ddi trong thdi gian thao luan
chinh thtfc.
- Tao dieu kien tiep tuc giup dd doi ttfpng thtfc hien cac hanh vi cd lpi cho
stfc khoe, bang cach chi dan den cac dia chi lien he hay cac diem cung
cap dich vu cham sdc stfc khoe de do'i ttfdng cd the tiep tuc nhan dtfpc cac
ttf van, ho trp.

2.3.2.4. Bang kiem theo ddi, giam sat thiic hien td chiic thao luan nhom GDSK

90
 BANG KI^M QUAN SAT THUC HANH THAO LUAN NHOM GDSK

Ngtfdi htfdng dan thao luan:

Chu de thao luan:
Doi ttfOng tham gia thao luan:
Thdi gian thao luan:
Dia diem thao luan:

C o lam
K hong
Noi dung G hi chu
lam Chua Dat To t
dat
1- Bo tri chd ngoi hpp ly, thoai mai:
2- Chao hoi than mat, lam quen:
3- Gidi thieu ngudi hudng din, ngudi tham du:
4- Neu ro chu de, muc dich buoi thao luan:
5- Dong vien, thu hut tham gia thao luan:
6- Neu cau hoi thao luan rd rang:
7- Tap trung thao luan noi dung thich hpp:
8- Quan sat bao quat toan bo nhom thao luan:
9- Sir dung ngon tCr phu hop, d i hieu:
10- Sir dung tai lieu, phuong tien hpp ly:
11- Neu vi du minh hoa cho doi tupng de hieu:
12- Ket hpp giao tiep bang ldi va khong ldi:
13- Tao dieu kien cho moi ngudi deu cd y kien:
14- Cham chu ling nghe doi tupng:
15- Tom tat noi dung co ban cua moi phan:
16- Thao luan het cac noi dung co ban:
18- Kiem tra lai nhan thCrc cua doi tupng:
17- Tom tat toan bo chu de thao luan:
19- Dong vien, cam an doi tupng khi ket thuc:
20-Tao dieu kien tiep tuc hd trp doi tupng:

Nhiing y kien nhan xet:

Ngtfofi giam sat

(ky, ghi rd ho ten)

91
2.3.3. Tu van gido due site khoe

2.3.3.1. Khdi niem va cac nguyen tdc tit van gido due siic khoe

Tu van la mot phtfdng phap giao due siic khoe trtfc tiep ngay cang dtfdc
stf dung nhieu, dac biet co ket qua tot doi vdi cac ca nhan va gia dinh co
nhtfng van de stfc khoe nhay cam. Ttf van trd thanh nhtfng hoat dong thong
thtfdng cua nhieu can bo y te, can bo TT-GDSK. Ttf van co the la nhtfng hoat
dong hang ngay lien quan den cong tac chuyen mon, cung co the la nhtfng
hoat dong mang tinh chuyen sau vdi nhtfng tinh huong phtfc tap doi hoi phai
co cac chuyen gia. Trong khi ttf van, ngtfdi ttf van tim hieu van de cua doi
ttfdng, cung cap thong tin cho doi ttfdng, dong vien doi ttfdng suy nghl, hieu
dtfdc van de cua ho. Ttf do giup ho hieu ro dtfdc nguyen nhan cua van de va
chon cac hanh dong rieng de giai quyet van de. Ttf van co vai tro quan trong
ho trd tam ly cho doi ttfdng khi ho hoang mang lo sd ve van de stfc khoe
nghiem trong cua minh khi chtfa hieu ro each giai quyet.
Trong moi trtfdng hdp, ngtfdi ttf van can dam bao nguyen tac gitf bi mat
cho cac doi ttfdng dtfdc ttf van, dac biet vdi cac doi ttfdng mac cac benh xa hoi
de bi dinh kien nhtf lao, phong, nhiem HIV/AIDS, cac benh lay truyen qua
dtfdng tinh due... Ngtfdi ttf van thtfdng chu dong giup cho doi ttfdng quyet
dinh cac van de stfc khoe co lien quan den ddi song, tao dtfng long ttf tin, gd bo
cac dinh kien, trong moi quan he ban, be, gia dinh, cong dong. Ttf van giup
cho doi ttfdng va gia dinh, cong dong co hieu biet dung dan ve van de cua ho,
co thai do thich hdp va ltfa chon cac bien phap giai quyet phu hdp nhat.
Khi ttf van ngtfdi ttf van giao due stfc khoe can dtfa ra cac thong tin quan
trong, chinh xac de doi ttfdng co the ttf danh gia, thay dtfdc ro van de cua ho
va co the ttf suy nghl nhtfng van de ma ho phai dtfdng dau, cuol cung giup ho
dtfa ra cac quyet dinh dung dan de co the giai quyet van de cua ho mot cach
tot nhat.
Dieu quan trong la ngtfdi ttf van phai tao ra dtfdc niem tin cho doi ttfdng
de ho co cd sd cho stf thay doi hanh vi phu hdp. Tuy theo doi ttfdng, phong tuc
tap quan, hoan canh cu the cua ttfng dia phtfdng, ttfng ndi, ttfng luc, ma chon
phtfdng phap ttf van cho thich hdp. Ttf van co the la nhtfng buoi tiep xuc, thao
luan chinh thtfc hoac khong chinh thtfc. Trong thtfc te nhtfng buoi tiep xuc
thao luan, tu van khong chinh thtfc cung co the dtfa lai ket qua tot. Ttf van
thtfdng co vai tro quan trong cho nhtfng ngtfdi bi benh dac biet, vi du nhtf
nhiem HIV/AIDS, lao, phong, tram cam... Khi mot ngtfdi dtfdc chan doan la
HIV (+) hoac bi AIDS co hang loat van de xay ra v6i ho. Tinh cam cuoc song
gia dinh, dinh kien xa hoi, hanh vi tfng xtf cua nhtfng ngtfdi xung quanh, viec
lam, dia vi... nhtfng thay doi nay dan den nhtfng khung hoang tinh than, tam
ly, niem tin cua doi ttfdng cung nhtf cua nhtfng ngtfdi than trong gia dinh ho.
Cong tac ttf van phai het stfc linh hoat, nang dong de co the giup do doi ttfdng
vtfdt qua dtfdc nhtfng khung hoang va hoa nhap dtfdc vdi cong dong. Ttf van
giup doi ttfdng, gia dinh ho va cong dong thay doi nhtfng hanh vi nhat dinh de

92
giai quyet van de cua doi ttfdng dang ton tai hoac chap nhan stf ton tai cua
van de. Ttf van giai quyet nhtfng van de stfc khoe cua ca nhan. qua do co the
giup bao ve stfc khoe cho gia dinh cua doi ttfOng va cong dong.
Hoat dong ttf van khong chi can thtfc hien true tiep cho doi ttfOng co van
de stfc khoe. benh tat ma con can thtfc hien cho ngudi than cua doi tudng va
cong dong de cd nhtfng hanh vi ho trd. giup do doi tudng, tao moi trudng tam
ly thuan loi cho doi tUOng. Ngtfdi can bo lam cong tac ttf van phai co ky nang
giao tiep tot, cd kien thtfc tam ly giao due. nhan biet nhtfng dien bien tam ly
cua doi tuong dtfdc ttf van. Ngudi ttf van phai hieu dUOc cac hoan canh xa hoi
xung quanh vi no co tac dong rat ldn tdi doi tuong. Phai biet phan doan cac
phan tfng cua doi ttfOng vo'i van de thao luan. cd the ho hoang mang. sd hai.
dau buon, chan nan... Trong nhtfng trudng hdp nay viec ho trO tinh than la
rat quan trong de giup ho binh tam. thao luan va lua chon cac bien phap giai
quyet cho ho. Nguoi tu' van can phai biet kien tri lang nghe va giai thich cho
doi tudng hieu van de ma khong bat ep doi tudng phai hieu. phai lam theo y
cua minh. Phai gitf bi mat nhung dieu rieng ttf cua doi tudng trong nhtfng
trudng hop cu the.
Nhtf vay ttf van la mot qua trinh kha phtfc tap giup doi tUOng xac dinh
ro van de. cung cap thong tin. giup doi ttfdng chon ltfa giai phap va dua ra
quyet dinh thich hop. ho trd doi tudng thuc hien cac quyet dinh lua chon.
Hien nay khi xa hoi ngay cang phat trien thi nhu cau cham sdc stfc khoe cung
tang len, trong dd cd nhu cau ve tu' van stfc khoe cho ca nhan. Nhieu van de
stfc khoe rieng ttf cua ca nhan chi cd the dUdc giai quyet bang chinh nhtfng
quyet dinh dung dan cua ho. Tu' van giao due stfc khoe la bien phap giup ca
nhan hieu rd van de stfc khoe cua ho va chu dong lua chon hanh dong dung
dan de giai quyet.
De tu' van thu dude ket qua tot ngudi ttf van can cd kien thtfc khoa hoc
va nghe thuat giao tiep trong ttf van.
Nhtfng nguyen tac sau day can dude chu y trong ttf van giao due stfc khoe:
- Chon thdi cd va dia diem thich hdp cho cac cuoc ttf van.
- Ngtfdi ttf van phai xay dung moi quan he tot vdi doi ttfdng ngay tu khi
tiep xuc ban dau va tao khong khi than mat tin can trong suot qua trinh
tu van. qua dd the hien stf quan tam va cham sdc giup dd eua ngtfdi ttf
van doi vdi doi tuong dUdc ttf van.
- Xac dinh ro cac nhu cau cua doi tudng. Thong qua tim hieu nhtfng hi£u
biet cua doi tuong ve van de can dude ttf van va van de cd lien quan.
- Phat trien stf dong cam vdi hoan canh cua doi ttfdng chtf khong phai la
stf thudng cam. buon ba. chan nan.
- De doi tudng trinh bay cac y kien, cam nghl va nhung dieu ho mong ddi.
Biet chu y lang nghe doi tudng qua anh m&t, cii chi cua ngtfdi ttf van.

93
 Thtfdng doi tiidng chi muon noi het van de cua ho doi vdi nhiing ngtfdi ho
tin ttfdng.
- Dtfa ra cac thong tin can thiet chu yeu nhat lien quan, giup do'i ttfdng ttf
hieu biet ro van de cua ho.
- Thao luan vdi doi ttfdng ve cac bien phap giai quyet van de, trong do co
cac bien phap thiet thtfc ho trd doi ttfdng. Cac bien phap nay co the lien
quan den gia dinh va cong dong ndi doi ttfdng sinh song va lam viec.
- Gitf bl mat, ngtfdi ttf van luon luon ton trong nhtfng dieu rieng ttf cua doi
ttfdng dtfdc ttf van. Neu phat hien nhtfng dieu bi mat cua do'i ttfdng can
phai gitf kin.
- Thong nhat va cung cam ket vdi doi ttfdng ve cac btfdc tiep theo de tiep
tuc ho trd do'i ttfdng thtfc hien.
- Trong nhieu trtfdng hdp ngtfdi ttf van phai lien he vdi gia dinh, cong
dong va mot so ban nganh, to chtfc de phoi hdp cac hoat dong giup dd cho
do'i ttfdng.
- Can lien he va n4m dtfdc cac hoat dong cua do'i ttfdng sau khi ttf van de
tiep tuc giup dd, ho trd do'i ttfdng.

2.3.3.2. Cac bitdc cd ban cua tii van va yeu cau ve pham chat cua can bo tii van

- Cac btfdc cd ban cua ttf van: trong moi cuoc ttf van noi chung c&n chu y
thtfc hien 6 btfdc nhtf sau:
+ Tiep don: chao hoi, lam quen vdi do'i ttfdng dtfdc ttf van, gidi thieu, tro
chuyen tao stf tin cay, tam ly thoai mai cho do'i ttfdng.
+ Hoi de thu nhan thong tin: hoi do'i ttfdng de xac dinh nhu cau, van de
can ttf van cua do'i ttfdng.
+ Giao tiep, trao doi: can bo ttf van cung cap thong tin, htfdng d in , tra
ldi cac cau hoi cua do'i ttfdng.
+ Giup dd: giup do'i ttfdng dtfdc ttf van hieu ro van de cua ho, giam lo
lang, ttf ltfa chon dtfdc cach giai quyet van de phu hdp vdi ho.
+ Giai thich: can giai thich tat ca cac ban khoan th&c m4c cua ddi ttfdng,
dtfa cac vi du, tai lieu hoac htfdng dan mo phong de do'i ttfdng hieu ro
van de hay cach thtfc hanh giai quyet van de cua ho.
+ Tiep tuc ho trd do'i ttfdng: hen gap lai do'i ttfdng de biet ket qua giai
quyet van de va tiep tuc giup dd ddi ttfdng mot cach thich hdp.
- Cac pham chat chinh cua ngtfdi ttf van: de dat dtfdc ket qua ttf van tot,
ngtfdi thtfc hien ttf van phai co cac pham chat chinh la:
+ Nam chac noi dung van de stfc khoe can ttf van.
+ Dtfdc dao tao ve ky nang ttf van, nam chac cac nguyen tac ttf van.

94
 + Co kha nang cam hoa, thuyet phuc doi ttfOng.
+ Stf dung phoi hdp cac ky nang giao tiep trong ttf van.
+ Nhay cam va linh hoat khi thtfc hien ttf van.
+ Nhiet tinh, co pham chat dao diic, ltfdng tam nghe nghiep.

2.3.3.3. Nhiing viec can chuan bi triidc khi tii van

- Xac dinh nhiing van de va doi ttfdng can dtfdc ttf van trong cong dong.
- Chon thdi gian va ndi ttf van thoai mai cho doi ttfdng. Co the ttf van ngay
tai ndi thuan tien cho doi ttfdng hoac tai cd sd y te da co cac phong danh
rieng cho ttf van d tram y te, trung tam y te, benh vien.
- Thdi gian va dia diem ttf van can dtfdc thong bao trtfdc de doi ttfdng biet
va chu dong. Neu co dieu kien co the thong bao, quang cao de cho doi
ttfdng chon thdi gian den cac dia diem ttf van phu hdp vdi ho.
- Ngtfdi ttf van phai nam chac noi dung cua chu de ttf van.
- Can chuan bi day du cac tai lieu, vat lieu, dung cu, mo hinh trUc quan
lien quan den chu de ttf van de co the stf dung trong khi ttf van. Neu can
trinh dien, htfdng dan cac ky nang thtfc hanh cho doi ttfdng thi phai
chuan bi cac phtfdng tien, dung cu can thiet de thuc hien.

2.3.3.4. Thiic hien tii van

- Cach bat dau mot cuoc tit van:

+ Khi gap doi tUdng ngtfdi ttf van can chu dong chao hoi than mat de tao
cam giac gan gui dau tien cua doi ttfdng la ngtfdi ttf van da san sang
de tiep don, giup dd doi ttfdng. Lam cho doi ttfdng cam thay thoai mai,
an tam ngay tii ban dau la tien de quan trong de doi ttfdng tin ttfdng,
trinh bay het van de va nguyen vong cua ho.
+ Chu dong mdi doi ttfdng ngoi vao cho da chuan bi khong nen de doi
ttfdng lung tung tim cho ngoi.
+ Gidi thieu: ngtfdi ttf van nen gidi thieu ng&n gon ve minh va mdi doi
ttfdng ttf gidi thieu ve ho.
+ Ngtfdi ttf van bat dau bang ndi chuyen thong thtfdng de cd the tao ra
mot khong khi ttf nhien ngay tii dau buoi tu van, lam cho doi ttfdng ttf
tin, chuan bi trang thai tam ly tot de trinh bay ro van de cua ho.
+ Hay ndi vdi doi ttfdng la moi thong tin ve do'i ttfdng se dtfdc hoan toan
dam bao bi mat.
+ Hay giai thich vdi doi ttfdng la ngtfdi ttf van sin sang nghe do'i ttfdng
neu tat ca cac van de cua ho, sin sang tra ldi cac cau hoi theo yeu cau
ma doi ttfdng dat ra, thao luan vdi ho de giup giai quyet van de cua ho.

95
 - Thuc hien tu van:
+ Trong suot thdi gian tu van, ngUdi tu van luon the hien thai do ton
trong, dong cam v6i hoan canh, van de cua doi ttfdng (trong cach noi,
giao tiep b&ng ldi va khong ldi, dang dieu ctf chi, dong tac, anh mat,
nu ctfdi v.v...)
+ Tim hieu ro ly do ma doi ttfOng den de dtfdc ttf van.
+ Khuyen khich doi ttfdng trinh bay het van de cua ho.
+ Tim hieu kien thtfc, thai do, thtfc hanh cua doi ttfdng ve van de ho can
ttf van giup dd.
+ Neu cac cau hoi ro rang de doi tUdng tra ldi.
+ Tra ldi ro rang va giai thich ky cac cau hoi cac van de cua doi ttfOng
dtfdc ttf van.
+ Stf dung ttf ngtf thong thtfdng de hieu, tranh sU dung cac ttf chuyen mon.
+ Cung cap day du cac thong tin chu choi de doi ttfdng hieu ro van de.
+ Su dung cac tai lieu, tranh anh, mo hinh... de giai thich cho doi ttfdng
de hieu de nh6. Co nhtfng van de co the trinh dien de doi ttfdng hieu ro.
+ Nhan manh nhtfng diem quan trong.
+ De giup doi tUdng lua chon quyet dinh can dtfa ra nhieu cach co the giai
quyet van de de doi ttfdng ltfa chon cach giai quyet thich hdp vdi ho.
+ Chu y tranh mot so tinh huong co the xay ra trong khi ttf van:
* De doi ttfdng phai chd lau trudc khi ttf van gay tam ly cang thang cho
doi ttfdng.
* Buoc doi ttfdng phai noi van de cua ho.
* Ld dang khong chu y den cac cau hoi va tra ldi cua doi ttfdng.
* Dua cdt vdi van de cua doi ttfdng.

* Ep buoc doi ttfdng theo cach giai quyet chu quan cua ngtfdi ttf van
* De nhtfng ngtfdi khong co nhiem vu nghe dtfdc cuoc ttf van.
* Keo dai cuoc ttf van khi doi ttfdng da met moi.
* De doa khong dung mUc, gay tam ly hoang m ang, lo sd lam cho doi
ttfdng khong cam thay nhe nhom hdn sau khi dtfdc ttf van.

2.3.3.5. Ket thuc buoi tii van

- Bao gid khi ket thuc cuoc ttf van cung can nhac lai nhtfng dieu cd ban da
thao luan v6i doi ttfdng, chu y nhan manh den nhtfng hanh vi ma doi
ttfdng nen thtfc hien nhtf ho da chon trong khi thao luan.

96
 - Dong vien va cam On doi ttfdng da den de dtfdc tii van.
- Vdi nhiing doi tiidng can diidc tii van tiep nen thao luan de ho chon thdi
gian thich hdp cho cuoc gap gd tu van tiep theo.
- Tao dieu kien tiep tuc giup dd doi ttfdng dtfdc ttf van tiep tuc giai quyet
van de cua ho. Htfdng dan cho doi ttfdng cac dia chi va dich vu lien quan
den van de de ho tiep tuc dtfdc ttf van ho trd mdi khi can thiet.

2.3.3.6. Bang kiem theo doi, giam sat thiic hien tii van GDSK

BANG KIEM QUAN SAT THL/C HANH TUVAN GDSK

Ho va ten ngtfdi dtfdc ttf van:

Chu de/van de ttf van:
Thdi gian ttf van:
Dia diem ttf van:

Co lam
Khong
Noi dung Chda Ghi chu
lam Dat Tot
dat
1- Bo tri cho ngoi hdp ly, thoai mai:
2- Chao hoi than mat, lam quen:
3- Gidi thieu ve minh:
4- Hoi ly do cua ngddi den td van:
5- Tim hieu KAP cua doi tuong ve van de can td van:
6- Dong vien doi tddng trinh bay het van de, hda giiir bi
mat cac van de rieng td c u a ho:
7- Cham chu lang nghe doi tddng:
8- Bo sung du kien thdc doi tddng chda biet:
9- Thao luan cac cach giai quyet van de cho doi tddng:
10- Be doi tddng ta chon cach giai quyet phu hdp:
11. Thao luan de doi tddng ro cach giai quyet ho chon:
12- Sir dung ngon td phu hdp, de hieu:
13- SCf dung tai lieu, phddng tien h6 trd hdp ly:
14- Neu vi du minh hoa cho doi tddng de hieu:
15- Ket hdp giao tiep bang ldi va khong ldi:
16- De cap het noi dung cd ban van de cua doi tddng:
17- Tra ldi het cau hoi, van de doi tddng muon biet:
18- Kiem tra lai nhan thdc va viec doi tddng nen lam:
19- Tom t i t noi dung cd ban cua buoi tdvan:
20- Dong vien, tao dieu kien tiep tuc h6 trd doi tddng,
cam dn doi tddng khi ket thuc:

Nhtfng y kien nhan xet:

Ngtfdi giam sat
(ky, ghi ro ho ten)

97
2.3.4. Tham ho gia dinh thuc hien TT-GDSK

Den tham tiing ho gia dinh de thtfc hien TT-GDSK la mot phtfdng phap
giao due stfc khoe trtfc tiep mang lai hieu qua cao vi co nhieu tfu diem. Day la
phtfdng phap giao due stfc khoe rat phu hdp vdi cac can bo y te, can bo giao due
stfc khoe cong tac tai tuyen y te cd sd, nhtfng ngtfdi sat nhat vdi cong dong. Dac
biet vdi can bo y te xa, phtfdng, can bo cua mot so chtfdng trinh y te can thiep
tai cong dong la nhtfng ngtfdi cd nhieu cd hoi va dieu kien tot de long ghep hoat
dong hang ngay vdi den tham va thtfc hien TT-GDSK tai gia dinh.
Svi dung phtfOng phap TT-GDSK tai ho gia dinh cd nhieu tfu diem nhtf sau:
- Ngtfdi can bo y te, can bo giao due stfc khoe xay dtfng dtfdc moi quan he
tinh cam tot dep vdi cac thanh vien trong gia dinh, nen dtfdc stf ung ho
va tin ttfdng cua cong dong;
- Dtfdc quan tam nen cac do'i tudng trong gia dinh de tiep thu va de chap
nhan thay doi hanh vi theo htfdng dan cua can bo TT-GDSK.
- Tai mdi trtfdng gia dinh nen cac thanh vien gia dinh cd tam ly thoai mai,
ttf tin de trinh bay va neu y kien cua ho.
- Hieu qua giao due cao vi moi ngtfdi tap trung chu y va de quan tam den
van de hdn.
- Can bo y te trtfc tiep quan sat dtfdc cac van de lien quan den stfc khoe
cua cac thanh vien gia dinh nen viec TT-GDSK thiet thtfc vdi dieu kien,
hoan canh cua gia dinh va dap tfng dung nhu cau cham sdc stfc khoe cua
gia dinh.
- Ngtfdi can bo y te, giao due stfc khoe cd the ket hdp phat hien va giai
quyet ngay mot so' nhu cau lien quan den stfc khoe cua cac thanh vien
trong gia dinh, vi the gia dinh d i tiep nhan kien thtfc, quan tam va thay
doi hanh vi.
De lam tot cong tac cham sdc stfc khoe cong dong thi ngtfdi can bo y te,
nhat la nhtfng ngtfdi cong tac tai tuyen cd sd khong the thieu hoat dong den
tham ho gia dinh va thtfc hien giao due stfc khoe cho gia dinh.

2.3.4.1. Chuan bi. triidc khi den tham gia dinh

- Khi cd ke hoach truyen thong giao due stfc khoe tai gia dinh, can bo y te
can hen va thong bao trtfdc vdi gia dinh ve thdi gian den tham de cac
thanh vien trong gia dinh cd mat tai nha de tiep can bo.
- Can bo TT-GDSK can thu thap mot so thong tin ve gia dinh nhtf so ngtfdi
trong gia dinh, ten cac thanh vien, nghe nghiep, tinh hinh stfc khoe v.v...
de tao dieu kien thuan ldi cho giao tiep va thtfc hien noi dung GDSK.
- Phai chon thdi gian thuan ldi de moi thanh vien gia dinh cd mat tham gia.
- Chuan bi ky cac noi dung can giao due stfc khoe cho gia dinh.

98
 - Chuan bi cac phiidng tien, tai lieu ho trd c ln thiet lien quan den chu de
can TT-GDSK cho gia dinh.

2.3.4.2. Khi den tham ho gia dinh

- Neu thay can thiet ngtfdi den tham co the gidi thieu ve minh de moi
thanh vien trong gia dinh biet.
- Md dau bang tham hoi tinh hinh chung cua gia dinh va tham hoi tinh
hinh stfc khoe cua cac thanh vien gia dinh.
- Neu ro muc dich cua buoi den tham ho gia dinh.
- Hoi de phat hien nhtfng ngtfdi om dau benh tat de ttf van giao due ngay
(quan tam den tre em, phu ntf, ngtfdi cao tuoi trong gia dinh).
- Tim hieu kien thtfc, thai do, thtfc hanh cua gia dinh doi vdi van de stfc
khoe, benh tat lien quan cua gia dinh.
- Thtfc hien ttf van giao due ve chu de theo ke hoach da chuan bi phu hdp
vdi thuc te cua gia dinh. Neu can cd nhtfng trinh dien, htfdng dan ky
nang thtfc hanh cho cac thanh vien trong gia dinh.
- Stf dung ttf ngtf thong thtfdng, de hieu, phu hdp vdi ngon ngtf cua dia phtfdng.
- Stf dung cac tai lieu ho trd, tranh anh, vi du minh hoa cho cac thanh
vien gia dinh de hieu, de nhd.
- Quan sat ho gia dinh de phat hien cac van de lien quan den stfc khoe, ttf
van cho phu hdp vdi hoan canh gia dinh.
- Gianh thdi gian de thao luan vdi cac thanh vien trong gia dinh ve van de
stfc khoe lien quan va cach giai quyet van de.
- Tao dieu kien khuyen khich moi thanh vien gia dinh tham gia thao luan
va neu cau hoi can thiet de hieu ro van de.
- Tra ldi rd moi cau hoi va nhtfng hieu biet hay nhtfng thac m lc cua cac
thanh vien trong gia dinh neu cd.
- Khong phe phan che trach nhtfng hieu biet chtfa day du, thai do chtfa dung,
hanh vi khong phu hdp cua cac thanh vien gia dinh ma luon cd stf khen ngdi,
dong vien, khich le de tao thuan ldi cho sU hdp tac cua gia dinh.

2.3.4.3. Ket thuc tham ho gia dinh

- Tom tat nhac lai cac dieu mau cho't da ttf va'n giao due cho gia dinh
thong qua viec hoi kiem tra lai cac thanh vien gia dinh.
- Nha'n manh nhtfng kien thtfc phai biet, nhtfng viec can lam.
- Tao dieu kien giup dd gia dinh tiep tuc giai quyet cac van de lien quan den
stfc khoe cua ho thong qua viec chi d in tdi cac dia chi can thiet de tiep tuc
nhan dtfdc cac y kien ttf van va stf hd trd trong dieu kien can thiet.

99
 - Chao hoi va cam dn stf hop tac, tiep don cua gia dinh.

2.3.4.4. Bang kiem theo doi, giam sat tham ho gia dinh thuc hien TT-GDSK

BANG KIEM QUAN SAT TT-GDSK TAI HO GIA DINH

Ho ten ngtfdi den tham ho gia dinh:

Ho ten chu ho gia dinh:
Dia chi ho gia dinh:
Thdi gian den tham:
Chu de giao due stfc khoe khi den tham ho gia dinh:

Co lam
Khong Ghi
Noi dung Chua
lam Dat Tot chu
dat
1- Chao hoi lam quen vdi cac thanh vien trong gia dinh:
2- S ip xep chd ngoi phu hdp:
3- Ngtfdi den tham gidi thieu ve minh:
4- Noi ro muc dich den tham gia dinh:
5- Tham hoi tinh hinh sUc khoe cac thanh vien gia dinh:
6- Hoi de tim hieu kien thifc, thai do, thuc hanh cua gia
dinh lien quan den chu de can GDSK:
7- Gdi y de thanh vien gia dinh trinh bay het cac van de
lien quan den sifc khoe benh tat:
8- Quan sat gia dinh de phat hien cac yeu to lien quan
den vain de stfc khoe cua gia dinh:
9- Bo sung cac kien thUc, thai do va thuc hanh can thiet
lien quan den van de sUc khoe cua gia dinh:
10- Giai thich ro rang, day du noi dung, viec can lam de
giai quyet van de sUc khoe:
11- SCf dung ngon ngCf thong thUdng, de hieu:
12- Ket hdp giao tiep bang ldi va khong ldi:
13- Ket hdp sir dung cac tai lieu, phifdng tien de giai
thich cho cac thanh vien gia dinh d l hieu, de nhd:
14- Neu ra cac vi du minh hoa cua dia phiTdng giup thanh
vien gia dinh de hieu, d l lam:
15- Tao dieu kien de moi thanh vien gia dinh hoi:
16- Tra ldi, giai thich ro cau hoi cua thanh vien gia dinh:
17- Kiem tra lai cac viec gia dinh can nhd can lam:
18- Tom t i t nhan manh noi dung can nhd, can lam:
19- Cam dn doi tUdng trirdc khi ket thuc buoi tham:
20- Tao dieu kien de tiep tuc ho trd do'i tifdng:

Nhtfng y kien nhan xet:

Ngtfdri giam sat
(ky, ghi ro ho ten)

100
2.3.5. Cac phiidng phap TT-GDSK true tiep khac a cong dong
Dtfa vao tinh hinh cu the cua cong dong va cac cO sd y te, cd the to chiic
mot so' phtfdng phap TT-GDSK khac d cong dong neu dieu kien cho phep.
- Ke chuyen
Ke chuyen la mot phUOng phap cd the sii dung trong TT-GDSK ket hdp
vdi cac phuong phap khac. Cac cau chuyen thudng dtfdc xay dtfng dtfa tren
nhtfng van de xay ra trong thtfc te, cd the dtfdc nhan cach hoa, qua dd cd tac
dong gay dtfdc nhieu anh hudng hdn la cac bai ndi bai viet. Moi ngtfdi thtfdng
thich nghe cac cau chuyen hdn; ho cd the cam nhan dtfdc cam xuc cua cac
nhan vat trong cac cau chuyen. Qua ke chuyen lam cho moi ngudi nhd cac
thong tin tot hdn la nghe mot bai dien thuyet hay mot bai giang kem hap dan.
Cac cau chuyen cd the dtfdc hieu cu the, chinh xac qua dd giup cho moi ngtfdi
tim cho ho nhtfng nguyen tac rieng. Chu de stfc khoe cd the la phan cot ldi cua
cau chuyen. Mot cach tiep can khac la xay dung cot truyen dtfa tren cac chu
de cd stfc cuon hut cao va dtfa cac van de cd lien quan den stfc khoe. Cac cau
chuyen cd the la nhtfng van de cd that trong thtfc te dtfdc sii dung nhu cac vi
du minh hoa cho nhtfng noi dung can TT-GDSK.
Mot cau chuyen hay, ranh mach se kich thich stf htfdng tfng cua moi ngtfdi
khi ho nhan thay nhtfng dieu dtfdc the hien trong cau chuyen gan gui vdi cuoc
song hang ngay cua ho. Ngtfdi ke chuyen c ln phai ke mot cach hap dan bang
viec thay doi am dieu, dang ve, cii chi cho phu hop vdi tUng nhan vat, tinh tiet
trong cau chuyen. NgUdi nghe se bi cuon hut vao cau chuyen khi ban dat ra
nhUng cau hoi nhU: “Vay bay gid ban cho rin g dieu gi sap xay ra?". Neu moi
ngUdi tin vao cau chuyen va thay dtfdc tinh cach cua cac nhan vat trong
chuyen, ho se thich thu hdn va ghi nhd cac thong diep, cd nhtfng hanh dong lam
thay doi tinh trang cua ho va lam theo nhtfng hanh vi nang cao stfc khoe.
- Trinh dien
Trinh dien thtfdng ket hdp thtfc hien vdi cac phtfdng phap ttf van, thao
luan nhom giao due stfc khoe. Trinh dien giup doi ttfdng dtfdc giao due stfc
khoe vtfa hieu them kien thtfc, vtfa hoc ky nang nghia la phoi hdp ca ly thuyet
va thtfc hanh. Vi du nhtf trinh dien pha oresol, dung dich muoi dtfdng cho tre
uong khi bi tieu chay, trinh dien viec chuan bi va che bien thtfc an sam cho
tre, trinh dien sii dung bao cao su... Trinh dien cd the thtfc hien vdi nhom hay
vdi ca nhan. Thtfc hien trinh dien cung phai lap ke hoach cu the gom cac btfdc
chuan bi thtfc hien va ket thuc. Khi quyet dinh trinh dien phai xac dinh rd do'i
ttfdng giao due stfc khoe can hoc ky nang gi. Phai chuan bi cac phtfdng tien,
dung cu, md hinh hien vat... cu the de thtfc hien trinh dien va cho do'i ttfdng
thtfc hanh. Can to chtfc d ndi du rong de do'i ttfdng theo doi dtfdc va tien hanh
thtfc hanh ky nang. Khi tien hanh trinh dien phai thtfc hien ttfng btfdc ro
rang, kem theo ldi md ta dong tac va dien giai. Ngtfdi htfdng d in trinh dien
xong can tom tat lai cac btfdc thtfc hanh va yeu cau nhtfng ngtfdi tham dtf
thtfc hanh cac ky nang. Gianh thdi gian cho doi ttfdng thtfc hanh ky nang 1i

101
rat can thiet va ngtfdi htfdng dan can quan sat khi doi ttfdng thtfc hanh de
giup dd doi ttfOng stfa chtfa nhtfng thtfc hanh chtfa dung. Sau khi cac doi
ttfdng da co thdi gian thtfc hanh can mdi mot so' doi ttfdng trinh dien lai trtfdc
nhom va yeu cau nhtfng ngtfdi khac theo ddi, cho y kien dong gop nhan xet.
Neu cd dieu kien can lap lai trinh dien de do'i ttfdng thtfc hanh nhieu l&n cho
thanh thao ky nang.
- Trien lam
Cac tranh anh, pand, ap phich, td rdi, md hinh, hien vat lien quan den
nhtfng van de stfc khoe benh tat neu cd nhieu cd the to chtfc trien lam tai cac
dia diem thich hdp trong cong cong nhtf tai cau lac bo, tram y te, nha van hoa,
hoi trtfdng thon, xa... Khi to chtfc trien lam can chon thdi gian va thong bao rd
de do'i ttfdng den xem. Tai ndi trien lam cd the ket hdp sii dung cac bang hinh
video, cd ngtfdi thuyet trinh va giang giai de ddi ttfdng hieu rd van de stfc
khoe, benh tat lien quan.
- To chiic sinh hoat cau lac bo, van hod, van nghe long ghep vdi
TT-GDSK
Day la phtfdng phap neu to chtfc se thu hut dtfdc nhieu ngtfdi tham dtf.
Cd the phat huy dtfdc ban sic, tiem nang van hoa cua cong dong, tinh giao
due cd the se rat sau sac. Khi to chtfc cac hoat dong cau lac bo stfc khoe, sinh
hoat van hoa, van nghe nen thong bao rong rai cho cac thanh vien cong dong
tham gia. Cd the td chtfc cac cuoc thi trtfc tiep tim hieu ve stfc khoe, benh tat,
mdi trtfdng... se rat hap dan. Can phoi hdp chat che vdi cac ca nhan, to chtfc,
ban nganh, doan the lien quan de td’ chtfc. Nen cd hinh thtfc dong vien thich
hdp vdi cac ca nhan, to chtfc, ddn vi cd nhieu dong gop, sang tao va tiet muc
dat chat ltfdng tot.

3.3.6. Cac bitdc chinh trong to chiic TT-GDSK va cac doi tdc can thu
hut tham gia TT-GDSK tai cong dong

2.3.6.1. Cac budc chinh trong to chiic TT-GDSK tai cong dong

Bat ky to’ chtfc mot hoat dong TT-GDSK nao d cong dong, ca trtfc tiep
hay gian tiep, ca cho ca nhan, nhom hay nhieu ngtfdi, trong chien dich hay
hoat dong thtfdng xuyen, deu can chu y thtfc hien theo 3 btfdc chinh nhtf sau
de dam bao cho hoat dong TT-GDSK dat ket qua tot.
Budc 1: Chuan bi
Chuan bi la btfdc dau tien quan trong quyet dinh den stf thanh cong cua
hoat dong TT-GDSK. Nhtfng noi dung can chu y trong btfdc chuan bi la:
- Chon thdi gian thich hdp.
- Chuan bi dia diem thich hdp.
- Chuan bi chu de va noi dung cu the de TT-GDSK phu hdp.

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 - Chuan bi du cac phtfdng tien, tai lieu can thiet.
- Xac dinh va ltfa chon doi ttfdng can dtfdc TT-GDSK.
- Chuan bi nhufng ngtfdi to chtfc va phoi hop ho trd thtfc hien hoat dong
TT-GDSK.
- Lap ke hoach chi tiet, cu the cho thtfc hien tiing hoat dong TT-GDSK.
Bitdc 2: Thuc hien
Khi thtfc hien cac hoat dong TT-GDSK can chu y den mot so diem cO ban
nhtf sau:
- Lam quen, gidi thieu ca ngtfdi thtfc hien TT-GDSK va doi ttfdng dtfdc TT-
GDSK tao nen khong khi than mat ngay tit btfdc dau.
- Neu muc tieu cua buoi TT-GDSK rd rang.
- Thtfc hien cac noi dung TT-GDSK theo dung ke hoach da dtfdc chuan bi.
- B ing nhieu cach linh hoat de khuyen khich, dong vien doi ttfdng tham gia.
- Sii dung cac ngon ttf phu hdp vdi doi ttfdng, vdi van hoa, phong tuc tap
quan cong dong.
- Phoi hdp stf dung cac phtfdng tien, tai lieu, vi du minh hoa thich hdp,
chu y den cac vi du thuc te cua tiing cong dong.
- Sau moi phan noi dung can tom tat va nhan manh nhiing dieu coit ldi.
Bitdc 3: Ket thuc
- Kiem tra lai nhan thiic cua doi ttfdng (neu la cac hoat dong TT-GDSK
trtfc tiep).
- Tom t it cac noi dung chu chot va nhiing viec c in lam.
- Cam dn stf tham gia cua cac doi ttfdng.
- Tiep tuc tao dieu kien ho trd doi ttfdng neu cd yeu cau.

2.3.6.2. Cac do'i tdc can thu hut tham gia TT-GDSK tai cong dong

Long ghep va phoi hdp lien nganh la mot nguyen t ic phai luon dtfdc chu
y khi thtfc hien TT-GDSK tai cong dong. Neu can bo y te thtfc hien TT-GDSK
khong cd stf tham gia, phoi hdp cua cong dong, cua cac to chiic chinh quyen,
ban nganh, doan the se rat kho thanh cong. Thong thtfdng moi cong dong deu
co cau true va to chiic nhat dinh, cd the dtfa vao dd de thtfc hien hoat dong
TT-GDSK. Den cong dong nao muon thtfc hien TT-GDSK cd the tranh thu stf
ung ho cua nhiing ngtfdi cd uy tin trong cong dong. Ho cd the la:
- Nhiing ngtfdi lanh dao Dang, Chinh quyen dia phtfdng d huyen, xa, thon.

103
 - Nhiing ngiidi lanh dao cac ban nganh, doan the nhii y te, van hoa, thong
tin, giao due, hoi phu ntf, doan thanh nien, hoi nong dan tap the, hoi ctfu
chien binh, hoi chut thap do, hoi ngtfdi cao tuoi, cac cau lac bo....
- Nhiing ngtfdi co dong gop nhieu cho cong dong va dtfdc cong dong tin
nhiem nhtf cac gia lang, trtfdng ban, trtfdng ho, linh muc, stf sai, thay co
giao, nhtfng ngtfdi tinh nguyen.
- Dtfa vao cac to chtfc sin co cua cong dong de TT-GDSK nhu long ghep
TT-GDSK vao cac cuoc hoi hop, sinh hoat cua cac ban nganh doan the, to
chtfc xa hoi, cau lac bo. Thtfc hien TT-GDSK cho cac thanh vien, hoi vien
cua cac to chtfc sin co trong cong dong se thu hut dtfdc dong dao ngtfdi
tham gia vi phat huy dtfdc y thtfc va tinh than trach nhiem cua cac hoi
vien, thanh vien trong to chtfc. Khi thtfc hien bat ky mot hoat dong TT-
GDSK nao d cong dong cung can tim hieu cong dong, tim ra cac nhan to'
tich ctfc de tranh thu stf tham gia va gitfp dd cua ho.
De thu hut dtfdc stf tham gia cua cong dong vao hoat dong TT-GDSK
ngtfdi can bo y te, can bo giao due stfc khoe can biet cach tiep can cong dong.
Tiep can cong dong tot co nghia la lam cho ngtfdi dan tin ttfdng tiep thu va
lam theo nhtfng dieu cd ldi cho stfc khoe ma can bo y te mong muon. De tiep
can dtfdc vdi ngtfdi dan trong cong dong trtfdc tien can phai nghien ctfu ve
cong dong de cd dtfdc cac thong tin ve cong dong. Cd the stf dung cac phtfdng
phap thu thap thong tin nhanh phat hien cac cd hoi long ghep hoat dong TT-
GDSK va stf dung cac dieu kien, phtfdng tien san cd cua cong dong thuc hien
TT-GDSK.
Tom lai cd hai loai phtfdng phap giao due stfc khoe: giao due stfc khoe
trtfc tiep va giao due stfc khoe gian tiep. Trong mdi loai lai cd cac phtfdng
phap khac nhau. Muon thtfc hien TT-GDSK dat hieu qua cao cach tot nhat
la phoi hdp cac phtfdng phap mot cach hdp ly, can ctf vao tinh hinh thtfc te
cua cong dong.
Ltfa chon phtfdng phap va cac phtfdng tien ho trd qua trinh TT-GDSK
phu thuoc vao nhtfng muc tieu mong muon dat dtfdc, cung nhtf phu thuoc vao
doi ttfdng dich va cac nguon ltfc cd dtfdc. Them vao dd can phai xem xet gia ca
thtfc te, stf phtfc tap va kha nang thtfc thi. Neu tai mot cong dong d vung xa,
mien nui thi rat cd the d dd khong cd kha nang tiep can vdi cac phtfdng tien
thong tin dai chung nhtf dai, ti vi va bao chi. Mot gdi y cd ich cho lap ke hoach
chtfdng trinh giao due stfc khoe la ngtfdi TT-GDSK hay b it dau b in g cac
phtfdng phap ddn gian, nhtf stf dung dai dia phtfdng, td rdi, pand va danh gia
hieu qua cua cac phtfdng phap dd. Neu cac phtfdng phap ddn gian khong cd
hieu qua thi can stf dung cac phtfdng phap d it hdn bao gom nang cao TT-
GDSK trtfc tiep gifla ngtfdi vdi ngtfdi. Linh hoat trong chon ltfa cac phtfdng
phap, phtfdng tien TT-GDSK, biet dtfa vao hoan canh thtfc te la mot trong cac
yeu td quan trong gop phan cho stf thanh cong cua cac chtfdng trinh TT-
GDSK tai cong dong.

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 3. PHU’CfNG TIEN GlAO DUC StfC KHOE

3.1. Khai niem

Phtfdng tien giao due siic khoe la cong cu ma ngtfdi giao due siic khoe sii
dung de thtfc hien mot phtfOng phap giao due siic khoe va qua do truyen tai
noi dung giao due siic khoe tdi doi ttfdng dtfdc giao due tot hon.
Phtfdng tien con dtfdc goi la dtfdng (kenh) ma ngtfdi giao due siic khoe sii
dung de chuyen noi dung thong diep giao due siic khoe den doi ttfOng.

3.2. Phan loai

Rat kho co mot each phan loai hoan chinh vi cac phtfOng tien giao due
siic khoe thtfdng dtfdc sii dung phoi hdp trong cac chtfdng trinh giao due siic
khoe. Tuy nhien ngtfdi ta co the chia cac phtfOng tien giao due siic khoe thanh
4 loai nhtf sau:

3.2.1. Phitdng tien bang ldi noi

Trong thtfc te ldi noi la cong cu dtfdc stf dung rong rai va rat co hieu qua
trong giao due siic khoe. Loi ndi cd the la ldi ndi trUc tiep khi ngtfdi lam giao
due siic khoe ndi trtfc tiep vdi doi ttfdng hoac cd the la ldi ndi gian tiep khi
thong tin truyen den doi ttfdng qua dai, ti vi v.v... Sii dung ldi ndi triic tiep
thudng cd hieu qua cao.
Sii dung ldi ndi cd the chuyen tai cac noi dung giao due siic khoe mot
cach linh hoat, phu hdp vdi doi ttfdng. Ldi ndi rat tien ldi, cd the sii dung d moi
ndi, moi cho, cho mot ngtfdi, mot gia dinh, mot nhom nhd hay cho nhieu
ngtfdi. Ldi ndi thtfdng dtfdc dung cung vdi stf ho trd, pho'i hop vdi cac phtfdng
tien khac nhtf tranh, anh, pand, ap phich, md hinh v.v... Tuy nhien viec stf
dung ldi ndi con phu thuoc vao ky nang cua ngudi giao due stfc khoe. Neu
khong ren luven va chuan bi ky trtfdc, khi ndi d l trd thanh viec cung cap
thong tin mot chieu, buon te, khong gay dtfOc chu y, tap trung va cam htfng
cho ngtfdi nghe, khong de lai an ttfdng lam doi ttfOng de quen. Ngtfdi ndi neu
khong n im ch ic dtfdc noi dung truyen dat cd the d in den dien dat khong
chinh xac, theo y chii quan va cd the gay hieu lam cho doi ttfdng.

3.2.2. Philcfng tien bang chu viet

Day la mot phtfdng tien de chuyen tai cac thong tin rong rai. Cd rat
nhieu hinh thtfc sii dung chtf viet nhtf qua cac bai bao, sach chuyen de, sach
giao khoa, td btfdm, td rdi, tap chi, khau hieu, bieu ngtf v.v...
Phtfdng tien b in g chtf viet cd the stf dung rong rai cho nhieu ngtfdi. Cac
tai lieu in an thtfdng ton tai lau vi vay doi ttfdng cd the doc di doc lai nhieu
lin de hieu rd, ho cd thdi gian de nghien ctfu. Ddi ttfdng ttf doc va ghi nhan
cac cac thong tin ttf cac tai lieu bao chi, sach vd se de tin ttfdng va nhd lau hdn

105
la neu nghe ngtfdi khac noi mot chieu buon te. Phtfdng tien giao due stfc khoe
bang chtf viet co the ltfu truyen ttf ngtfdi nay sang ngtfdi khac nhtfng chi stf
dung dtfdc khi doi ttfdng biet doc va hieu qua cua no phu thuoc rat nhieu vao
trinh do van hoa cua doi ttfOng. Doi khi cac bai viet cung co the dien dich sai
noi dung can truyen dat. Cac an pham bang chtf viet doi hoi phai co nguon
kinh phi nhat dinh de in an va phan phat. Cac thong tin phan hoi ttf cac
phtfdng tien bang chtf viet doi khi it va cham. Viec dieu chinh siia doi lai cac
noi dung qua chtf viet can co thdi gian va kinh phi. Cac phtfdng tien bang chtf
viet cung nen dtfdc stf dung ket hdp vdi cac phtfdng tien khac. Vi du trong mot
btfc tranh nen co nhtfng dong chtf chu giai hoac giai thich lam cho ngtfdi xem
tranh de hieu va de nhd.

3.2.3. Phitdng tien tdc dong qua thi giac

Loai phuong tien nay ngay cang phat trien trong giao due stfc khoe vi no
gay an ttfdng manh. Cac tranh anh, pand, ap phich, bang quang cao, md hinh,
tieu ban, trien lam v.v... dung de minh hoa lam sinh dong cac noi dung giao
due, giup doi ttfdng de cam nhan, nhd lau va hinh dung cac van de mot cach
de dang. Cac noi dung giao due thudng dtfdc dtfa ra ngan gon, don gian thong
qua hinh anh. no tac dong den nhieu ngtfdi vi no thtfdng dtfdc stf dung d
nhtfng ndi cong cong. Khi stf dung cac hinh anh khong nen dtfa nhieu noi
dung vao mot hinh thtfc. Viec sap xep cac hinh anh, chon mau sac cung can
theo thtf ttf hdp ly tao thuan ldi cho ttf duy lo gic, hap d in lam doi ttfdng quan
tam. Can ket hdp phtfdng tien nay vdi cac phtfdng tien khac se dat dtfdc hieu
qua cao. Thtf nghiem trtfdc cac phtfOng tien tac dong qua thi giac la rat can
thiet, neu khong thtf nghiem trtfdc cd the gay lang phi kinh te ma khong cd
hieu qua.

3.2.4. Phiidng tien nghe nhin

Day la loai phtfdng tien giao due stf dung cac ky thuat hien dai, trong dd
thtfdng phoi hdp ca ba loai phtfdng tien tren. Phtfdng tien nay tac dong tren ca
hai cd quan thi giac va thinh giac vi the no gay dtfdc a'n ttfdng sau s ic cho doi
ttfdng dtfdc giao due nhtf phim, vo tuyen truyen hinh, video, kich, mua roi.
Cac phtfOng tien nghe nhin thtfdng gay stf htfng thu va de ldi cuon stf tham
gia cua nhieu ngtfdi. Tuy cd nhieu tfu diem nhtfng sii dung phtfdng tien nghe
nhin thtfdng dat, san xuat ra cac phtfdng tien nay thtfdng ton nhieu kinh phi,
sii dung can phai cd cac dieu kien can thiet nhtf: dien, phtfdng tien, hoi
trtfdng, may chieu phim, ti vi, dau video... va can nhtfng ngtfdi biet van hanh,
bao quan va sii dung cac phtfdng tien.
Nhtf vay chung ta cd the nhan thay cac phtfdng tien sii dung trong giao
due stfc khoe rat da dang. Khong cd mot loai phtfdng tien nao la cd tfu diem
tuyet ddi cung khong cd mot loai phtfdng tien nao la hoan toan khong cd hieu
qua. Van de quan trong nhat la ngtfdi lam giao due stfc khoe phai biet ltfa
chon phtfdng tien nao cho phu hop vdi noi dung giao due, trinh do cua doi

106
ttfdng, dieu kien thtfc te, nguon ltfc va phUOng tien s in co cua dia phUOng. Tot
nhat neu co dieu kien nen stf dung phoi hdp ca ba loai phUOng tien tren mot
each hdp ly.
Khi ltfa chon phudng tien cho mot buoi, mot dot hay mot chUdng trinh
giao due stfc khoe cu the can dat ra mot so cau hoi nhtf sau:
- PhtfOng tien nao thi thich hdp vdi phtfdng phap va noi dung giao due?
(phtfOng tien co giup chuyen tai dung, du cac noi dung giao due khong?).
- Phtfdng tien do co phu hdp v6i doi ttfdng dtfdc giao due khong?
- Phtfdng tien do co dtfdc cong dong chap nhan khong? (co phu hdp vdi
phong tuc tap quan va van hoa cua dia phtfdng khong?).
- Phtfdng tien co san co va co du cac dieu kien de stf dung d dia phUdng khong?
- Can bo giao due stfc khoe co ky nang stf dung cac phtfdng tien do khong?
- Gia thanh san xuat va stf dung cac phudng tien co chap nhan dtfdc khong?
- Ket qua du kien dat dtfdc co ttfdng xtfng vdi nguon ltfc dau ttf khong?
Nen nhd la trong moi trtfdng hdp phtfdng tien giao due stfc khoe chi la
cong cu cua ngtfdi lam giao due stfc khoe, no khong the thay the dtfdc ngtfdi trtfc
tiep thtfc hien nhiem vu truyen thong giao due stfc khoe. Hieu qua stf dung cac
phtfdng tien giao due stfc khoe se hoan toan phu thuoc vao ngtfdi stf dung.
Phtfdng tien du cd tot, hien dai den dau di chang ntfa nhtfng khong biet stf
dung, sU dung khong dung luc, dung cho, dung ddi ttfdng thi cung khong cd tac
dung va ddi khi lai cd the cd tac dung phan giao due, cho nen can than trong
khi quvet dinh stf dung cac phtfOng tien trong truyen thong giao due stfc khoe.

CAU HOI TLf LlfpN G GIA

1. Trinh bay khai niem ve phtfdng tien va phtfdng phap TT-GDSK.

2. Trinh bay cac phtfdng phap TT-GDSK gian tiep.
3. Trinh bay cac btfdc to chtfc ndi chuyen giao due stfc khoe.
4. Trinh bay cac btfdc to chtfc ndi chuyen stfc khoe.
5. Trinh bay cac nguyen tac ttf van giao due stfc khoe
6. Trinh bay cac btfdc to chtfc ttf van giao due stfc khoe.
7. Trinh bay cac btfdc den tham ho gia dinh va thtfc hien TT-GDSK.
8. Liet ke cac doi tac cd the tham gia vao hoat dong TT-GDSK tai cong dong.
9. Neu cach phan loai phtfdng tien TT-GDSK.
10. So sanh cac dac diem cua thong tin dai chung va truyen thong trtfc tiep.

107
 Bai 6

LAP KE HOACH VA QUAN LY HOAT DONG

TRUYEN THONG GIAO DUC SLfC KHOE

MUC TIEU
1. Trinh bay diidc cac diem can chu y khi lap ke hoach TT-GDSK.
2. Phdn tich diidc noi dung cac bitdc lap ke hoach TT-GDSK
3. Trinh bay diidc cac noi dung quan ly dac triing trong TT-GDSK.

1. MOT
• SO DIEM CAN CHU Y KHI LAP
• KE HOACH
• TT-GDSK

1.1. Xac dinh ro van de can phai TT-GDSK

Khao sat, dieu tra nghien ciiu trtfdc de co dtfdc nhiing thong tin chinh
xac, khoa hoc, lam cd sd cho viec xac dinh dung dan cac van de can TT-GDSK.
Thong thtfdng cac van de can TT-GDSK cung la cac van de siic khoe pho bien
thtfdng gap cua cong dong co nhu cau can phai giai quyet.

1.2. Dtf kien tat ca cac nguon ltfc co the s \i dung trong TT-GDSK

Cac nguon ltfc can thiet nhtf nhan ltfc, kinh phi, cd set vat chat, thdi gian
can dtfdc chuan bi va dtf kien svt dung cho ke hoach TT-GDSK bao gom cac
nguon luc da co va cac nguon ltfc co the khai thac dtfdc.

1.3. Sap xep thdi gian hdp ly

Sap xep thdi gian thuan ldi cho moi ngtfdi co the tham gia mot cach tich
ctfc, day du nhat vao chtfdng trinh TT-GDSK. Chu y den ca thdi gian cua
ngtfdi thtfc hien va do'i ttfdng can dtfdc TT-GDSK.

1.4. Long ghep

Ke hoach TT-GDSK can dtfdc long ghep vdi cac ke hoach, chtfdng trinh y
te, van hoa, xa hoi dang trien khai tai dia phtfdng, dac biet la vdi cac hoat
dong cham soc siic khoe ban dau khac.

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1.5. Dtfa cac nguyen ly cua cham soc stfc khoe ban dau vao hoat dong
TT-GDSK
Truyen thong giao due siic khoe la mot noi dung cua cham soc siic khoe
ban dau vi the can thtfc hien cac nguyen ly chung cua cham soc siic khoe ban
dau do la:
- Tinh cong bang: quan tam va Uu tien nhutng doi ttfOng co nguy cO cao ve
benh tat, siic khoe can dtfdc TT-GDSK.
- Nang cao stitc khoe, dtf phong, phuc hoi siic khoe: chu trong TT-GDSK
vao cac bien phap dtf phong va nang cao siic khoe cung nhtf tap luyen de
phuc hoi siic khoe sau khi bi benh va tai nan chan thUOng.
- Stf tham gia cua cong dong: thu hut stf tham gia rong rai cua cac doi tUOng
trong cong dong vao cac hoat dong TT-GDSK, tao nen cac phong trao quan
chung thi dua cham soc va bao ve siic khoe phong chong benh tat.
- Ky thuat hoc thich hdp: sii dung cac phtfdng phap, phtfdng tien TT-GDSK
phu hdp vdi dieu kien thuc te va van de cung nhu cac doi tuong dich.
- Long ghep va phoi hop lien nganh: nh im xa hoi hoa cong tac TT-GDSK,
tao nen siic manh tong hdp, huy dong dtfOc moi ltfc ltfdng thich hdp trong
cong dong tham gia vao cong tac TT-GDSK va nang cao siic khoe.

2. CAC B tfo ic LAP KE HOACH TRUYEN THONG GlAo DUC SlTC KHOE
Lap ke hoach TT-GDSK gom cac btfdc cd ban theo sd do dtfdi day:

Sd do 6.1. Cac btfdc lap ke hoach TT-GDSK

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2.1. Xac dinh cac van de can truyen thong giao due sufc khoe

Can phai co nhtfng thong tin ve cac van de siic khoe quan trong cua dia
phtfdng do can bo y te, cac ca nhan, cac nhom ngtfdi hay cong dong cung cap.
Thong tin can phai day du, toan dien, dam bao do chinh xac tin cay va
phai cap nhat, c in chu y ca cac thong tin ve so' ltfOng va thong tin ve chat
ltfdng, co nhtf vay mdi dam bao lap ke hoach giao due siic khoe mot each sat
hdp dtfdc. Thu thap thong tin la khau dau tien cua lap ke hoach y te noi
chung va lap ke hoach TT-GDSK noi rieng, ngtfdi lap ke hoach can phai xac
dinh ro tam quan trong cua khau nay de co cac giai phap thu thap thong tin
dam bao cac yeu cau tren. Thong tin co the dtfdc thu thap qua nghien ciiu cac
tai lieu va cac bao cao dtfdc ltfu giut. To chiic phong van cac ddi ttfdng lien
quan la nguon thong tin tot cho xac dinh van de. Cd the td chiic cac cuoc thao
luan nhom hay phong van sau nhiing ngtfdi cd hieu biet ve van de quan tam.
B ing cach trtfc tiep den thtfc te va quan sat cung la nhiing phudng phap tot
de cd dtfdc thong tin day du cho xac dinh van de TT-GDSK.
Tii nhiing thong tin thu dtfdc can phan tich theo cac khia canh sau:
- So' ltfdng va ti le nhiing ngtfdi cd van de siic khoe.
- Nhiing loai hanh vi dan den van de siic khoe, benh tat dang ton tai.
- Ly do vi sao cac hanh vi nay lai dtfOc thtfc hanh.
- Nhiing ly do khac cua van de siic khoe.
- Kha nang giai quyet nhiing van de sdc khoe bang TT-GDSK: stf chap
nhan cua ngtfdi dan, stf ho trd cua chinh quyen va cac ban, nganh, doan
the, kha nang nguon ltfc cua cd sd de thtfc hien TT-GDSK bao gom ca cac
nguon ltfc tii trong va ngoai cong dong cd the khai thac.
Cach ddn gian de xac dinh van de can TT-GDSK la hop nhom lap ke
hoach hay doi cong tac lai, xem xet ki cac thong tin va so' lieu da cd, moi ca
nhan trong nhom xac dinh van de can TT-GDSK vdi stf phan tich cua minh,
sau dd dtfa ra nhom thao luan va can n h ic, cuo'i cung bieu quyet de chon cac
van de c in TT-GDSK.

2.2. Chon van de stfc khoe tfu tien can truyen thong giao due stfc khoe

Nguon ltfc cho cac hoat dong cham sdc sdc khoe ndi chung cung nhtf
nguon ltfc cho cac hoat dong TT-GDSK ndi rieng cua chung ta con rat han
hep. Tren thtfc te cd rat nhieu van de siic khoe, benh tat can dtfdc TT-GDSK
cho cong dong, vi the tuy theo thdi gian, dia diem va nguon ltfc cd sin . nhiing
ngtfdi lap ke hoach hoat dong TT-GDSK can phai chon cac van de tfu tien cho
phu hdp. Lua chon van de sdc khoe tfu tien can TT-GDSK ngtfdi ta thtfdng
dtfa vao mot so tieu chuan va xem xet thtfc te de cho diem tiing tieu chuan.
Thang diem cho moi tieu chuan cd the cho la 0, 1, 2, 3 diem. Cd the lap bang
cho diem de chon van de tfu tien nhtf sau:

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 Bang 6.1. Cho diem chon van de tfu tien TT-GDSK
Cho diem cac van de sure khoe
Cac tieu chuan de xet Uu tien
Van de 1 Van de 2 Van de 3 Van de X
1. Mire do pho bien cua van de:
2 . M l/c do tram trong cua van de:
3. Anh hirting den nhurng ngifcJi ngheo kho:
4. Da co ky thuat, phi/dng tien giai quyet:
5. Dupe cong dong chap nhan:
6. Kinh phi chap nhan dtfdc:
Tong diem

Chu y: vdi cac tieu chuan ttf 1 den 3, van de cang dien bien xau cho diem
cang cao va ngtfdc lai. Cac tieu chu&n con lai cang dien bien tot thi diem cang
cao, vi du: kinh phi co nhieu hay dtfdc nhieu ngtfdi dan trong cong dong chap
nhan thi cho diem 3.
Sau khi da cho diem, chon cac van de co tong so" diem cao hdn de trien
khai trtfdc. Van de co tong diem cao nhat la tfu tien TT-GDSK trtfdc tien.

2.3. Xac dinh doi ttfdng dich va muc tieu cho chtfdng trinh can TT-GDSK

2.3.1. Xac dinh doi tiidng dich

Vdi tiing chu de TT-GDSK can xac dinh ro doi ttfdng bao gom cac thong
tin ve: so ltfdng do'i ttfdng dich, ho la nhiing ai, thuoc gidi nao, nghe nghiep,
trinh do cua ho ra sao. Xac dinh ro doi ttfdng dich la rat can thiet de chuan bi
noi dung, phtfdng phap, phtfdng tien TT-GDSK phu hdp. Doi ttfdng dich d&u
tien thtfdng la nhiing ngtfdi cd hanh vi nguy cd cao can phai thay doi trtfdc
tien. Tiep den la nhiing ngtfdi cd anh htfdng tac dong trtfc tiep den nhom ddi
ttfdng dich dau tien va sau dd la nhom doi ttfOng cd kha nang giup dd, tao dieu
kien thuan ldi cho nhom doi tudng dich dau tien thay doi hanh vi va duy tri
hanh vi mdi. Xac dinh dung ddi ttfdng dich cd vai trd quyet dinh den stf thanh
cong cua hoat dong TT-GDSK. Vi du trong chtfdng trinh truyen thong ve
cham sdc trtfdc sinh cho phu nii mang thai thi doi ttfdng dich dau tien la cac
phu nii trong do tuoi sinh de, tiep den la cac ong chong, cac bac cha me. Cac
can bo hoi phu nii, thanh nien, cac ban nganh doan the dia phtfdng se la
nhiing doi ttfdng ho trd, tao dieu kien thuan ldi cho thtfc hanh va duy tri hanh
vi cham sdc trtfdc sinh.

2.3.2. Xac dinh muc tieu

2.3.2.1. Khdi niem ve muc tieu TT-GDSK

Muc tieu giao due siic khoe la nhiing mong ddi ve thay doi kien thiic,
thai do va hanh vi siic khoe cu the d do'i ttfdng dtfdc giao due siic khoe (doi

111
tiidng dich) trong mot giai doan thdi gian nhat dinh, trong do muc tieu thay
doi hanh vi la quan trong nhat. Nhiing thay doi hanh vi se d in den nhiing
thay doi ve tinh hinh siic khoe va benh tat cua doi ttfdng dtfdc giao due siic
khoe. Vi du: tang ty le cac ba me hieu biet ve vai tro cua suta me tii 50% hien
tai len 85% vao cuoi nam 2007. Giam ty le cac ba me cho tre an sam sdm trtfdc
4 thang tuoi tii 30% hien nay xuong con 10% vao cuoi nam 2007.

2.3.2.2. Tam quan trong cua xay diing muc tieu trong truyen thong gido due
siic khoe
Co the noi bat ky mot chtfdng trinh can thiep siic khoe noi chung hay
mot chtfdng trinh TT-GDSK nao cung can phai xay dtfng cac muc tieu. Muc
tieu lien quan den toan bo cac chien ltfdc, cac ke hoach hoat dong, den sii
dung cac nguon ltfc cua cac chtfdng trinh. Xay dtfng muc tieu la btfdc quan
trong cua lap ke hoach chtfdng trinh giao due siic khoe. Nhtf chung ta deu biet
cac nguon ltfc cho cham soc siic khoe noi chung hay cho cac chtfdng trinh giao
due siic khoe luon luon co gidi han. Trong thtfc te cd nhieu van de siic khoe
can dtfdc giao due vi the can bo giao due siic khoe phai xac dinh cac chtfdng
trinh tfu tien va trong moi chtfdng trinh can xac dinh dtfdc ro rang cac muc
tieu tfu tien dtfa tren kha nang ve nguon ltfc cd san.
Muc tieu cu the kich thich cac no ltfc cua can bo va dong vien can bo
phan dau thtfc hien, vi muc tieu giup danh gia dtfdc nang ltfc, cong siic cua
nhiing ngtfdi phan dau de thtfc hien muc tieu dd. Neu nhtf khong cd muc tieu
giao due siic khoe cu the thi khong the biet dtfdc cac no ltfc cua nhiing ngtfdi
thtfc hien chtfdng trinh nhtf the nao. Vi du nhtf neu cung mot nguon ltfc, cung
nhiing dieu kien, doi ttfdng nhtf nhau, hai can bo cung thtfc hien giao due siic
khoe, neu nhtf khong cd muc tieu cu the thi khong the biet dtfdc ai la ngtfdi da
co' g in g trong hoat dong giao due de dat dtfdc ket qua tot hdn.
Muc tieu se tac dong den ltfa chon chien ltfdc va cac hoat dong cu the
nham dat muc tieu. Khi da xay dtfng dtfdc muc tieu thi ngtfdi lap ke hoach
giao due siic khoe se dat ra cau hoi lam the nao de dat dtfdc muc tieu dd. Ndi
khac di ngtfdi lap ke hoach phai nghi den cac chien ltfdc thich hdp va vach ra
cac hoat dong cu the de dat dtfdc muc tieu da xay dtfng. Trong qua trinh thtfc
hien chtfdng trinh thi muc tieu giup cho viec dieu hanh va theo doi giam sat
chtfdng trinh theo htfdng dat dtfdc muc tieu va cd the dieu chinh cac hoat dong
cho thich hdp.
M uc tieu cung giup cho ngtfdi khac biet chinh xac ve ke hoach hoat dong
cua ngtfdi lap ke hoach nhtf the nao, muc tieu cd sat hdp, cd kha thi hay
khong. Xay dtfng muc tieu khong dung se khong the thtfc hien dtfdc hoac cd
the gay lang phi nguon ltfc va thdi gian, anh htfdng khong tot den cac chtfdng
trinh hay hoat dong khac
M uc tieu giup danh gia cac chtfdng trinh hoat dong cu the. Neu khong cd
muc tieu se khong danh gia dtfdc cac miic do dat dtfdc cua chtfdng trinh, bdi vi

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khi xay dtfng muc tieu ngtfdi lap ke hoach giao due siic khoe phai biet dtfdc
hien trang van de dang cf dau va ket thuc ke hoach ho mong muon dat dtfdc
den miic do nao.
Ngoai ra xay dtfng muc tieu dung se giup cac nha quan ly cac chtfdng
trinh TT-GDSK co the thtfc hien tot cong tac quan ly bang muc tieu.
Xay dtfng cac muc tieu TT-GDSK cung co the gap nhiJng kho khan do
thieu cac so' lieu cd ban de lam cd sd xay dtfng muc tieu, thieu nguon ltfc de
thu thap du thong tin. Mot so' ngtfdi sd bi ngtfdi khac phe phan khi khong dat
dtfdc muc tieu vi vay khong muon xay dtfng muc tieu cu the. Tuy nhien khong
dat dtfdc muc tieu cung khong dang che trach, neu nghiem tuc danh gia rut
kinh nghiem va tim ra ly do vi sao khong dat dtfdc muc tieu va tranh nhving
nhtfdc diem trong hoat dong trong ttfOng lai thi dieu do cung thtfc stf bo ich
cho can bo lam cong tac TT-GDSK.

2.3.2.3. Nhiing yeu to can chu y khi xay diing muc tieu TT-GDSK

• Phdn tich cac hanh vi stic khoe hien tai

Nhtf chung ta da biet viec thay doi hanh vi siic khoe la ca mot qua trinh
dien ra khong phai ddn gian trong choc lat ma co the keo dai, nhieu khi ca
ngtfdi giao due va do'i ttfdng dtfdc giao due phai rat kien tri mdi co the thay doi
dtfdc hanh vi. De thay doi hanh vi phai tac dong vao nhieu yeu to' cua moi
trtfdng, hoan canh va phai co stf ho trd cua nhiing ngtfdi xung quanh. Phan
tich cac hanh vi hien tai la can thiet de co the xay dtfng cac muc tieu thich
hdp cho nhiing thay doi hanh vi.
Mot hanh vi cua con ngtfdi co the la do ket qua cua nhieu yeu to' tac
dong. Phan tich nguyen nhan cua cac hanh vi la can thiet de biet dtfOc kha
nang co the thay doi hanh vi nhtf the nao, tii do lam cd sd xay dtfng muc tieu.
Neu mot hanh vi nao do la do thieu hieu biet thi co the dat ra muc tieu giao
due stic khoe la tang hieu biet cho do'i ttfOng. Do do phan tich cac nguyen
nhan cua hanh vi la btfdc can thiet de giup xay dtfng ke hoach can thiep sat
hdp va kha thi.
Ngtfdi ta thtfdng phan nan la cac chtfdng trinh giao due siic khoe khong
dat dtfdc muc tieu. Cong dong thtfdng Id di cac ldi khuyen va tiep tuc thtfc
hanh cac hanh vi to’n hai den siic khoe, ngay ca khi ho cung biet no cd hai cho
siic khoe. Mot dieu d l nhan thay la do cac niem tin truyen thong hoac do lac
hau nen kho thay doi. Ly do thtfc te cua stf tha't bai thtfdng la do cac nha giao
due siic khoe khong tinh den cac anh htfdng khac den siic khoe, bao gom cung
cap cac thong tin khong thich hop, thuc day cac thay do’i khong thtfc te, nham
vao nhiing do'i ttfdng khong dung va sii dung cac phtfdng phap khong hdp ly.
Vi the de tac dong thay do’i hanh vi can xac dinh cac yeu to lien quan cd anh
htfdng quyet dinh hanh vi cua ngtfdi dan.
- Xac dinh cac yeu to tdc dong den thay doi hanh vi

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 Co nhieu yeu to anh htfdng den siic khoe nhtf cac hanh dong va hanh vi
thong thtfdng chii khong phai chi cd thuoc men va cac dich vu y te. Nhieu
chtfdng trinh giao due siic khoe khong thanh cong bdi vi da khong chu y den
cac yeu to van hoa, kinh te, xa hoi, chinh tri anh htfdng den cac hanh vi.
Nghien ciiu day du cac yeu to' anh htfdng den hanh vi con ngtfdi la can thiet
de tranh nhiing that bai khi thtfc hien giao due siic khoe. Can phai phan tich
rieng cac hanh vi nao la cua ca nhan kiem soat va cac hanh vi nao do anh
htfdng cua cong dong va quoc gia. Hdn niia can xac dinh cac kho khan, cac thii
thach, stf khong cong bang trong cong dong de cd the hieu tat ca cac hanh vi.
Chung ta cung can thuc day cac anh htfdng cua cac nha chinh tri den qua
trinh hanh dong cho nhiing thay doi xa hoi.
M ot trong cac ly do lam cho cong dong khong thtfc hien cac hanh vi siic
khoe la do cac nha giao due siic khoe thtfdng khong di sau xac dinh rd cac yeu
to' anh htfdng den hanh vi, vi the dtfa ra muc tieu chu quan va thtfc hien cac
hoat dong theo quan diem rieng cua ngUdi can bo giao due siic khoe ma khong
n h im vao giai quyet nguyen nhan cua hanh vi.
De di den viec ra quyet dinh ve muc tieu cho nhiing thay doi hanh vi
trong chtfdng trinh giao due siic khoe ngtfdi lam giao due siic khoe can theo
cac btfdc sau:
+ Xem xet de dam bao la hanh vi mong muon d do'i ttfdng se nang cao
siic khoe: trtfdc khi quyet dinh sii dung nguon ltfc de thiic day hanh vi
can chac chan hanh vi dd thtfc stf mang lai ldi Ich cho cong dong.
Khong nen co' gang de dat muc tieu thay doi hanh vi cua ngtfdi dan
ma cd it ldi ich cho siic khoe.
+ Dam bao cac thay doi hanh vi la cd kha thi: tranh cac hanh vi qua
phiic tap, qua ton kem nguon ltfc ma khong phu hdp vdi nen van hoa
va thtfc hanh hien tai cua cong dong, chtfa dtfdc cong dong chap nhan.
+ Dam bao cung cap cac yeu to' cd the can thiet tac dong den hanh vi:
trong chtfdng trinh truyen thong giao due siic khoe chung ta can dam
bao cac yeu cau ve nguon ltfc. Can xem xet dieu kien cua cong dong
nhtf kha nang thu nhap, nha d, cung cap ntfdc, ve sinh moi trtfdng,
phat trien nong nghiep ... Giai quyet cac yeu to' cd the anh htfdng den
thay doi hanh vi siic khoe thtfdng lien quan den long ghep, pho'i hdp
hoat dong lien nganh ca d cap dia phtfdng va cac ca'p cao hdn.
+ Chii y ap ltfc xa hoi tu: gia dinh va cong dong: khi cac nguon ltfc da cd
san thi cac trd ngai vdi thay doi hanh vi cd the la ap ltfc xa hoi (cac
tieu chuan ma nhiing ngtfdi than, nhiing ngtfdi xung quanh, cong
dong mong muon). Nhieu khi thuyet phuc ca nhan chtfa du ma can
thuyet phuc "nhiing ngtfdi lanh dao dtf luan" d gia dinh va cong dong,
sii dung nhiing ngtfdi da thanh cong trong thtfc hanh cac hanh vi se
giup ich nhieu cho chtfdng trinh giao due siic khoe.

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 + Xac dinh tat ca cac niem tin co anh hiidng den thai do: neu cong dong
tin ttfdng la hanh vi se d in den mot ket cuc khong tot thi ngtfdi giao
due siic khoe can phai tim ly do tai sao. Cong dong cd the d l dang
dtfdc thuyet phuc neu ho thay ldi ich cua hanh vi dtfdc chi ra mot cach
ro rang. Thtfdng thi de tac dong len cac niem tin cua ca nhan mdi thu
dtfdc hdn la cac niem tin da trd thanh truyen thong cua ca cong dong.
+ Tim ra cac yeu to' anh htfdng den hanh vi lieu d miic ca nhan, cong
dong hay miic do cao hon: trtfdc day giao due siic khoe thtfdng nhan
manh den lam viec vdi cac ca nhan va it chu y den lam viec vdi cac
miic do khac nhtf gia dinh, cong dong. Nhieu van de ltfa chon khong
thtfc te, khong thich hdp va cac thay doi hanh vi cd the dtfdc giai
quyet thong qua stf ldi keo cong dong cung tham gia va cung ltfa chon
cac muc tieu. Lam viec cung vdi cong dong cd the tao ra siic manh va
quyen ltfc cua cong dong de giai quyet cac ach tic. Neu nhtf cac van de
thtfc hanh truyen thong can phai thay doi thi dieu quan trong la cong
dong dtfa ra quyet dinh qua trinh thay doi dd nhtf the nao.
- Can nhac den cac nguon luc
De xay dtfng muc tieu cd kha thi cung phai biet danh gia cac nguon ltfc
cho chtfdng trinh giao due siic khoe. Cac nguon ltfc nay cd the bao gom cac
nguon ltfc da dtfdc xac dinh theo ke hoach, cac nguon ltfc cd kha nang huy
dong them, can chu y nhat la cac nguon ltfc cua chinh cong dong ma chtfdng
trinh can thiep nh&m vao. Viec huy dong cac nguon ltfc cua cong dong vao
chtfdng trinh giao due siic khoe ban than no cung chinh la muc tieu cua
chtfdng trinh giao due siic khoe.

2.3.2.4. Cac yeu cau cua mot muc tieu gido due siic khoe
Khi xay dtfng muc tieu TT-GDSK can dat dtfdc cac yeu cau chung cua
xay dtfng muc tieu nhtf sau:
- Tinh dac thu
Muc tieu phai ndi ve van de can TT-GDSK cu the (van de tfu tien da
chon) va ddi ttfOng dich cu the nao dd, vi du nhtf: kien thiic cua cac ba me ve
suy dinh dtfdng, cac ba me cd the nhan biet dtfOc cac dau hieu sdm cua viem
phoi, cac ba me cd the pha dtfdc dung dich ntfdc uong bu niidc tai nha cho tre
khi tre bi tieu chay v.v...
- Tinh do ludng dupe
Muc tieu can ndi ro miic do thay doi, phai so sanh dtfdc vdi miic ban dau
de thay dtfdc ket qua dat dtfdc, tii dd cd the danh gia dtfdc ket qua theo muc
tieu va phan tich dtfdc hieu qua cua chtfdng trinh. Thtfdc do muc tieu cd the la
so tuyet doi (con sd) hay so ttfdng doi (ty le %), cung cd the b in g miic do dinh
tinh nhtf: tot, kha, trung binh, kem (trong trtfdng hdp nay lai can phai cd cac
tieu chuan cu the danh gia cho tiing miic do the nao la tot, kha, trung binh
hay kem.

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 - Tinh thich hap
Muc tieu phai phu hdp v6i van de TT-GDSK. Vi du neu TT-GDSK ve
tiem chung thi muc tieu la tang so' ba me hieu biet ve y nghia cua tiem chung,
tang so ba me da thuc hanh dua tre di tiem chung cac loai vaccin. Neu TT-
GDSK ve ke hoach hoa gia dinh thi muc tieu la tang so cap vd chong chap
nhan ke hoach hoa gia dinh va thuc hien cac bien phap tranh thai thich hop.
- Tinh thuc thi
Tinh thuc thi cua muc tieu la rat quan trong, de dam bao kha nang thuc
thi thi can phan tich ro tinh hinh, nhat la cac nguyen nhan cua hanh vi sUc
khoe, cac nguon luc co san va cac nguon lUc co the huy dong de thuc hien
chUdng trinh. Trong cham soc sUc khoe ban dau cung nhu trong giao due sUc
khoe cac nha lap ke hoach c in chu y den nguyen ly tham gia cua cong dong,
day la nguyen ly cO ban de dam bao sU thanh cong cua cac chUdng trinh cham
soc sUc khoe ban dau noi chung va giao due sUc khoe noi rieng. Can dong vien
cong dong tham gia vao qua trinh xay dUng cac muc tieu giao due sUc khoe.
- Tinh xac dinh ve thdi gian
M6i chUOng trinh, hoat dong deu co thdi han thuc hien nhat dinh, vi the
m6i muc tieu cua chUdng trinh giao due sUc khoe deu phai xac dinh cu the
dich thdi gian hoan thanh muc tieu, neu khong xac dinh dung thdi gian can
thiet de dat muc tieu thi se khong thuc day dUdc co' g in g de dat dUdc m uc tieu
va co the gay lang phi nguon luc va thdi gian.

2.4. Xac dinh nguon ltfc va ltfa chon phtfdng tien, phtfdng phap TT-GDSK

2.4.1. Xac dinh nguon liic

2.4.1.1. Xac dinh nguon nhan liic

Do la viec xac dinh ro nhUng ngUdi trUc tiep tham gia vao hoat dong TT-
GDSK. TrUdc tien la cac can bo y te, nhUng ngUdi co trach nhiem to chtfc, thuc
hien hoat dong TT-GDSK. Ngoai can bo y te la luc ltidng nong cot, can xem xet
cu the cac loai can bo khac co the tham gia vao hoat dong TT-GDSK nhu cac to
chUc quan chung ngoai nganh y te: cac cap chinh quyen dia phUdng nhu Uy ban
nhan dan, cac to chUc Dang, Hoi Chii thap do, Hoi nong dan, Hoi lien hiep phu
nU, Doan thanh nien, TrUdng pho thong cd sd, pho thong trung hoc, nha tre,
mau giao, cac to chUc ton giao, tti thien, nhiing ngUdi tinh nguyen... moi lUa
tuoi deu co the tham gia d tting linh vUc khac nhau.
Can chu y viec dao tao, huan luyen, bo tuc cho nhiing ngUdi tham gia ve
ky nang TT- GDSK de ho pho'i hdp tot v6i can bo y te, ke ca viec phan cong
hdp ly vdi tUng do'i tUdng.
Xac dinh phudng phap va phudng tien rat quan trong. Nguyen t ic chung
la tan dung cac phudng tien san co, dung phUdng phap va phudng tien co hieu
qua cao, chi phi chap nhan dUdc va dUdc do'i tUdng dich chap nhan.

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2.4.1.2. Xac dinh ngudn kinh phi
Mot so' chtfdng trinh TT-GDSK can phai co nhiing khoan kinh phi nhat
dinh de mua sim tai lieu, phtfdng tien trang thiet bi, dao tao can bo v.v...
nhiing nha lap ke hoach TT-GDSK phai xem xet cac nguon cung cap kinh phi.
Co the khai thac kinh phi tii cong dong hay ben ngoai cong dong.

2.4.1.3. Xac dinh thdi gian

Chon thdi gian thich hdp va du de tien hanh cac hoat dong TT-GDSK.
Nen chon thdi gian thich hdp vdi ca doi ttfOng va ngtfdi TT-GDSK de ce the
tien hanh dtfdc thuan ldi nhat, dat hieu qua giao due cao nhat va nen xac
dinh ro trinh ttf thdi gian cua cac hoat dong, hoat dong nao lam trtfdc, hoat
dong nao lam sau.

2.4.2. Xac dinh phtfdng phap truyen thong gido due siic khoe

Khi xay dtfng ke hoach TT-GDSK khong chi quyet dinh nhiing van de,
noi dung gi can giao due, giao due cho ai, khi nao, d dau ma con can phai
quyet dinh giao due bang cach nao. Trtfdc mot thong diep giao due can chuyen
den doi ttfOng, ngtfdi thtfc hien can suy nghi de tim ra each chuyen tai nao la
tot nhat. Ltfa chon phtfdng phap giao due siic khoe gan lien vdi ltfa chon
phtfdng tien giao due siic khoe. Phtfdng phap phai phu hdp vdi hoan canh thtfc
te, vdi van de, dac biet la vdi kha nang tiep can cua doi ttfdng, vi vay can phai
can nhac ky ltfdng. Cd nhieu phtfdng phap TT-GDSK, trtfdc khi ltfa chon
phtfdng phap tot nhat la can bo giao due siic khoe phai thii nghiem trtfdc de
xac dinh tinh thtfc thi.
Khi ltfa chon phtfdng phap va phtfdng tien cho mot chtfdng trinh truyen
thong giao due siic khoe cu the can neu ra mot so' cau hoi nhtf sau:
- Phtfdng phap va phtfdng tien cd thich hdp vdi muc tieu cua chtfdng trinh
TT-GDSK?
- Phtfdng phap va phtfdng tien cd thich hdp vdi dac tinh cua nhom do'i
ttfdng dich hay khong?
- Phtfdng phap va phtfdng tien cd de hieu vdi nhom do'i ttfdng dich hay
khong?
- Phtfdng phap va phtfdng tien cd kich thich qua trinh hoc cua ddi ttfdng
hay khong?
- Phtfdng phap va phtfdng tien cd phu hdp vdi kich thtfdc, quy mo cua
nhom doi ttfdng khong?
Cach tot nhat de khang dinh phtfdng phap TT-GDSK phu hdp la thik
nghiem phtfdng phap de danh gia tinh hieu qua trtfdc khi ap dung phtfdng
phap dd mot each rong rai.

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2.4.3. Ltfa chon phtfdng tien

De dam bao hieu qua cua giao due siic khoe dieu quan trong la phai hia
chon cac phtfdng tien thich hdp. Tinh thich hdp cua phtfdng tien can dtfdc xem
xet tii nhieu khia canh nhtf: stf s in co cua cac phtfdng tien, gia ca cua cac
phtfdng tien, phong tuc tap quan, van hoa lien quan den phtfdng tien, stf hap
d in va chap nhan cua doi ttfdng v6i phtfdng tien, kha nang sii dung cac
phtfdng tien, kha nang duy tri cac phudng tien.
Khi chuan bi cac phtfdng tien, nguon ltfc cho TT-GDSK can nghi den huy
dong cac nguon ltfc va phtfOng tien ttf ngay trong cong dong. Day la nguon
cung cap quan trong. Co the thay nguon ltfc, phtfdng tien cua cong dong rat
phong phu va da dang vi du nhtf: nhiing ndi thuan ldi co the to chiic hop, thao
luan nhom, trien lam, mot so ngtfdi co the dong gop tien mua tai lieu trang
thiet bi, mot so' trang thiet bi co san trong cong dong nhtf he thong truyen
thanh, ti vi. Mot so' ngtfdi co ky nang nhat dinh co the tham gia vao hoat dong
giao due siic khoe vdi cac hinh thiic rat hap dan nhtf dong kich, mua, hat, lam
thd. So' ngtfdi khac lai co kha nang dong gop siic lao dong tao ra cac phtfdng
tien cho TT-GDSK. Mot so' ngtfdi co kha nang cung cap cac phtfdng tien san co
cho hoat dong TT-GDSK v.v... Van de chinh la ngtfdi to chtfc TT-GDSK phai
biet khai thac, huy dong dtfdc cac nguon ltfc nay cua cong dong. Mat khac
cung can nghi den kha nang huy dong nguon ltfc, phtfdng tien ttf ben ngoai
cong dong. Trong mot so chtfdng trinh TT-GDSK co the can den cac phtfdng
tien, nguon ltfc ldn, ngoai kha nang cua cong dong vi the can tim kiem nguon
ltfc ben ngoai cong dong. Mot so' to chtfc, cong ty, bo nganh co kha nang ho trd
nguon kinh phi va ky thuat cho cac hoat dong y te va giao due siic khoe. Mot
so' phtfOng tien, tai lieu cho giao due siic khoe dtfdc san xuat vdi ky thuat cao
nhtf tranh anh, bang hinh, phim ... co the dtfdc cung cap ttf cac to chiic ben
ngoai cong dong. Ngtfdi lam TT-GDSK can phai nang dong tim kiem cac
nguon ltfc ttf ngoai cong dong. Khi da co ke hoach thtfc hien mot chtfdng trinh
TT-GDSK cu the can xac dinh rd phudng tien, tai lieu can thiet, so ltfdng bao
nhieu, can khi nao, can cho nhiing hoat dong hay doi ttfdng nao, ai la ngtfdi co
trach nhiem cung cap cac tai lieu phtfdng tien do dam bao du so' ltfdng, chat
ltfdng va thdi gian.

2.5. Thvif nghiem tai lieu, phtfdng tien TT-GDSK

2.5.1. Muc dich thit nghiem trtfdc cac phtfdng tien, tdi lieu TT-GDSK

Thii nghiem tai lieu, phtfdng tien TT-GDSK la btfdc can thiet de quyet
dinh trtfdc khi san xuat hang loat cac phtfdng tien, tai lieu de dtfa vao stf
dung trong cac chtfdng trinh TT-GDSK. Thii nghiem nham tiet kiem nguon
luc va thdi gian. Quan trong nhat cua thii nghiem la giup dieu chinh cac
thong diep can chuyen tai tdi do'i ttfdng cho phu hdp. Thtfdng khi thii nghiem
se phat hien ra dtfdc nhung khac biet giua y ttfdng mong muon ve thong diep
giao due siic khoe ma can bo san xuat, sii dung cac phtfdng tien tai lieu giao

118
due sufc khoe mong muon chuyen den doi ttfdng va thong diep thtfc stf ma doi
ttfdng da tiep nhan. Can ltfu y khi thii nghiem la chon cac nhom doi ttfdng thtf
nghiem phai dai dien cho cac nhom doi ttfdng dich cua chtfdng trinh giao due
siic khoe. Thong thtfdng cac cau hoi co the neu ra de thtf nghiem tai lieu la:
- Tai lieu co de hieu khong?
- Co day du thong tin khong?
- Gay long tin va thtfc hien dtfdc khong?
- Tai lieu co phu hdp vdi nen van hoa khong?
- Tai lieu co hap d in khong?
- Co tac dong thay doi khong?

2.5.2. Tien hanh thii nghiem

Mot nguyen tac can chu y la moi tai lieu, phtfdng tien TT-GDSK can
phai thtf nghiem. Can xac dinh ro muc dich cua tai lieu, phtfdng tien se dtfdc
sii dung de chuyen tai cac thong diep gi. Doi ttfdng dich cua tai lieu, phtfdng
tien la nhiing ai hay tai lieu dung cho ai, ho d dau. Trong thtfc te cac doi
ttfdng khac nhau co the hieu biet va chap nhan cac phtfdng tien, tai lieu giao
due siic khoe d cac miic do khac nhau. Stf chap nhan co the phu thuoc vao
trinh do van hoa, dan toe, tin ngtfdng, tuoi, gidi tinh, kinh nghiem trong cuoc
song. Do vay neu la tai lieu dinh sii dung cho nhieu doi ttfdng thi can phai thii
nghiem ky va co the phai siia doi de phu hdp vdi cac nhom doi ttfOng khac
nhau theo cac vung, cac dia phudng, dan toe, tin ngtfdng khac nhau.
Can giai thich ro muc tieu thii nghiem de cac do'i ttfdng dtfdc thii nghiem
cd stf cong tac chat che, giam bdt cac thong tin sai lech.
De thu dtfdc day du cac thong tin nhan xet ve cac khia canh khac nhau
cua tai lieu, phtfdng tien giao due siic khoe can thii nghiem, ngtfdi TT-GDSK
can dat ra cac cau hoi md de ngtfdi dtfdc phong van khong chi tra ldi la “cd”
hay “khong” ma ho con giai thich ly do vi sao lai nhtf vay.
Vi du khi thii nghiem mot biic tranh hay mot tam pano, ap phich ngtfdi
thii nghiem cd the neu ra mot so' cau hoi nhtf sau de hoi ddi ttfdng:
- Ban thay gi d biic tranh nay?
- Ban con thay gi niia? (cd the thao luan cac chi tiet cua biic tranh hay
pand, ap phich)
- Biic tranh nay cd y nghia gi vdi ban?
- Vi sao no lai cd y nghia nhtf vay?
- Biic tranh nay d§ hieu hay kho hieu?
- Nhiing dieu gi ban thay chtfa rd ve biic tranh?

119
 - Nhufng gi tren biic tranh lam ban thich nhat?
- Nhiing dieu gi tren biic tranh lam ban khong thich, kho chiu?
- Biic tranh nay noi ve ai, van de gi?
- Biic tranh nay noi den van de b dau?
- Biic tranh nay noi den van de khi nao? (hien tai, qua khut hay ttfdng lai
hay ket hop: qua khii-hien tai, qua khii-hien tai-ttfdng lai, hien tai-ttfdng
lai).
- Ban nhan xet ve mau s ic cua biic tranh nay nhtf the nao? ban co thich
khong?
- Ban co nhan xet gi ve cac chii viet tren biic tranh? (nhieu chut qua, chut
kho nhin, chut to hoac nho qua...).
- Ban hoc dtfdc gi d biic tranh nay?
- Nhiing ngtfdi khac co the hoc dtfdc gi d butc tranh nay?............
Neu nhtf ngtfdi thii nghiem dat ra dtfdc du cac cau hoi ve cac khia canh
cua tai lieu, phtfdng tien can thii nghiem thi se thu dtfdc day du cac thong tin
giup cho viec ra quyet dinh san xuat va sii dung tai lieu chinh thiic. Can thii
nghiem tren mot so' doi ttfdng du de co the co nhiing ket luan chung ve tai lieu
thii nghiem.
Nen thii nghiem vdi tiing ca nhan doi ttfdng de thu dtfdc cac thong tin
khach quan, ho khong bi anh htfdng y kien cua nhau. Chu y chon thdi gian va
dia diem thich hdp de thii nghiem khoi anh htfdng den ket qua thii nghiem.

2.5.3. Phdn tich ket qud thit nghiem va di den quyet dinh svl dung

Ngtfdi thii nghiem sau khi thii nghiem can dat ra cac cau hoi nhtf sau de
danh gia phan tich ket qua thii nghiem tai lieu:
- Ddi ttfdng cd hieu dtfdc tai lieu khong? Neu doi ttfdng tra ldi la ho hieu
dtfdc tai lieu cd nghia la cac thong tin, thong diep cd the chuyen tdi do'i
ttfdng thong qua tai lieu?
- Muc tieu cua sii dung tai lieu cd dat dtfdc khong?
- Doi ttfdng cd cho la tai lieu cd ich doi vdi ho khong?
- Tai lieu cd hap d in vdi do'i ttfdng khong? Ho cd thich tai lieu khong? Vi
sao ho thich?
- Cd noi dung, hinh thufc nao lam ho khong thich?
- Tai lieu cd lam doi ttfdng lung tung kho chiu khong?
- Nhuing gi can siia chuta bo’ sung de tai lieu hoan chinh?
- Neu siia chuta bo sung thi tai lieu cd tot hdn khong?

120
 Neu nhu viec thii nghiem cho cac ket qua tap trung co nghia la thu
nghiem thu dUdc ket qua tot. Can cU vao ket qua do tac gia cua tai lieu co the
cho san xuat, sii dung neu cac y kien nhan xet tot ve tai lieu, phUOng tien.
Neu co nhieu y kien nhan xet ve cac nhUdc diem nao do cua tai lieu thi tac gia
can siia chfla trU6c khi cho san xuat, sii dung chinh thUc.
Neu cac y kien thii nghiem phan tan, y kien trai ngUdc nhau, nhat la ve
noi dung cac thong tin, thong diep cua tai lieu, chUng to r in g tai lieu chua dat
dUOc muc dich sii dung. NgUdi thu nghiem phai xem lai mot cach nghiem tuc,
can siia doi va sau khi da siia chUa, bo sung cung can phai thu nghiem lai
chat che. Neu ket qua thii nghiem chi ra r in g doi tUdng hoan toan khong
hieu, khong thich tai lieu thi co the phai quyet dinh thay doi lai hoan toan tai
lieu hay hay nghl den bien soan mot tai lieu khac thich hop hdn.
Cac tai lieu phudng tien TT-GDSK trUdc het co the tham khao y kien
cua cac can bo lam cong tac TT-GDSK, sau do thii nghiem tren thiic dia, v6i
cac doi tUdng giong doi tUdng dich, dUdc chon tai dia phudng tUdng tu nhu ndi
se trien khai sii dung.
Nhieu tai lieu va phudng tien, neu khong dUdc thu nghiem trU6c se co
the phan tac dung giao due neu co sai sot va viec siia chUa nhieu khi kho
khan, dong thdi lai gay lang phi. Vi the can phai thii nghiem ky de sUa doi,
hoan chinh tai lieu va cac phUdng tien, cho den khi doi tUdng hieu dUdc va Ua
thich tai lieu va phUdng tien do. Sau khi thii nghiem can thao luan de co sU
dieu chinh thich hdp nhat. Doi khi viec thii nghiem co the phUc tap, phai dUdc
tien hanh mot vai lan trU6c khi tai lieu, phUdng tien dUdc in an, san xuat de
sii dung chinh thUc, rong rai.

2.6. Xay diing chtfdng trinh hoat dong cu the

ChUdng trinh TT-GDSK cu the phai the hien dUdc tat ca cac hoat dong
can thuc hien. Cac hoat dong nay dUdc s ip xep theo thU tu thdi gian hdp ly de
dat dUdc cac muc tieu cua chUdng trinh da dUdc xac dinh.
M oi hoat dong cu the trong chUdng trinh phai chi ro:
- Thdi gian thiic hien: bat dau thuc hien ttf khi nao va bao gid ket thuc;
- NgUdi thiic hien;
- NgUdi, cd quan phoi hdp;
- Ngtfdi theo doi giam sat ho trd;
- N guon lUc phUdng tien can thiet;
- Ket qua du kien cua hoat dong.

Co the sU dung m iu bang dudi day de xay dung ke hoach hoat dong cu
, s>

the:

121
 BAN KE HOACH TRUYEN THONG GIAO DUC SLTC KHOE

Ten chtfdng trinh TT-GDSK:

Muc tieu:
1..............................

2..........................

Ten hoat Thdi Ngudi Ngtfdi, Ngtfdi Nguon Ket qua

dong gian thtfc hien cd quan giam sat ltfc can dtf kien
phoi hdp thiet
T£r den

1.............
2.............

Trong giao due siic khoe can chu y den lap ke hoach hoat dong long ghep
giao due siic khoe vdi hoat dong khac cua cac chUdng trinh y te khac cung nhtf
cac hoat dong van hoa xa hoi cua cong dong.

2.7. Lap ke hoach danh gia chtfdng trinh truyen thong giao due stfc
khoe

Lap ke hoach danh gia phai dtfdc neu ra ngay ttf khi xay dtfng ke hoach
chung cua chtfdng trinh TT-GDSK. Khi lap ke hoach danh gia can xac dinh ro
mot so van de sau:
- Xac dinh muc dich cua danh gia: danh gia chtfdng trinh TT-GDSK
thtfdng nham xac dinh miic dat dtfdc cua chtfdng trinh so vdi muc tieu de
ra, rut ra cac tfu khuyet diem hay diem manh diem yeu trong thtfc hien
chtfdng trinh. Danh gia con gop phan dieu chinh cac ke hoach hoat dong
chtfdng trinh, xem xet kha nang md rong chtfdng trinh TT-GDSK, gop
phan nang cao trinh do can bo TT-GDSK, dong gop cho stf nghiep phat
trien hoat dong TT-GDSK.
- Xac dinh ro do'i ttfdng cua viec danh gia: danh gia ai, danh gia nhtfng gi
can dtfdc neu ro, vi du nhtf danh gia nhtfng ngtfdi tham gia chtfdng trinh,
danh gia doi ttfdng dich hay danh gia qua trinh hoat dong, tac dong,
hieu qua cua chtfdng trinh.

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 - Xay dtfng cac chi tieu, chi so' do ltfdng cac muc tieu da de ra: chon cac chi
so' danh gia phai thich hdp, dtfdc the hien trong cac cong cu thu thap
thong tin.
*>
- Xac dinh phtfdng phap danh gia thich hdp: vi du quan sat vdi bang kiem,
cau hoi tren phieu dieu tra, danh gia co stf tham gia cua cong dong...
- Xac dinh nguon ltfc va thdi gian danh gia: danh gia dtfdc thtfc hien khi nao,
d dau, cac nguon ltfc cho danh gia la gi, co dtfdc cac nguon ltfc do ttf dau.
Nhu vay chung ta thay co cac bu6c khac nhau trong qua trinh lap ke
hoach TT-GDSK, cac bu6c deu co lien quan chat che v6i nhau. Sau khi lap ke
hoach xong can phai xem xet lai ke hoach de danh gia tinh kha thi cua ke
hoach trUcfc khi thtfc hien.
Nhtf vay: lap ke hoach TT-GDSK phai giai dap dtfdc cac cau hoi sau:
1. Van de can TT-GDSK la van de nao tai sao lai can TT-GDSK ve van
de do.
2. Do'i tudng can TT-GDSK la nhtfng ai, tai sao ho dtfdc chon la doi
ttfdng dich?
3. TT-GDSK can dat dtfdc nhtfng muc tieu nao?
4. Noi dung nao can TT-GDSK cho cac do'i ttfdng?
5. Dung phtfdng phap TT-GDSK nao la thich hdp?
6. Dung tai lieu, phtfdng tien truyen thong nao?
7. Ai la nhtfng ngtfdi chiu trach nhiem thtfc hien cac hoat dong TT-GDSK?
8. Co can phai dao tao va huan luyen lai cho nhtfng ngtfdi thuc hien khong?
9. Ngan sach de huan luyen can bo, san xuat tai lieu phtfdng tien ttf
nguon nao?
10. Cac hoat dong nao can dtfdc thtfc hien? theo trinh ttf nhtf the nao?
11. Cac hoat dong tien hanh d dau, khi nao?
12. Danh gia ket qua cua TT-GDSK bang cach nao, khi nao, nham muc
dich gi?

3. QUAN LY HOAT DONG TRUYEN THONG GlAO DUC SlTC KHOE

3.1. Khai niem ve quan ly hoat dong truyen thong giao due stfc khoe

Hien nay nang cao cong tac quan ly de nang cao chat ltfdng cac hoat
dong cham soc stfc khoe dtfdc Bo Y te rat quan tam. Nhtfng va'n de yeu kem
trong cong tac quan ly ctfng da dtfdc cac chuyen gia cua To chtfc Y te the gi6i
de cap den, nhat la nhtfng cong viec nhtf phan tich tinh hinh de xac dinh van
de Uu tien can giai quyet, lap ke hoach, thtfc hien ke hoach va danh gia hieu
qua cua cac chUdng trinh CSSK trong do co TT-GDSK. Quan ly de nang cao

123
hieu qua stf dung cac nguon ltfc danh cho TT-GDSK la mot yeu cau cd ban cua
bat ky chtfdng trinh giao due stfc khoe nao. Quy trinh quan ly TT-GDSK cung
giong nhtf cac quy trinh quan ly chung. Quy trinh bao gom cac budc cd ban do
la: thu thap thong tin chan doan cong dong, phan tich xac dinh van de, chon
tfu tien, xay dtfng muc tieu, lap ke hoach cac hoat dong trong do co ke hoach
theo doi, giam sat tien do va danh gia. Ngoai thtfc hien cac btfdc cua quy trinh
quan ly y te chung, trong TT-GDSK co ba khau cd ban can dtfdc quan ly de
dam bao tot cac hoat dong TT-GDSK:
- Ngtfdi thtfc hien TT-GDSK (nguon phat tin).
- Kenh truyen thong (dtfdng truyen tin).
- Ngtfdi nhan thong diep TT-GDSK (nhom doi ttfdng dich).

3.2. Muc dich cua quan ly hoat dong truyen thong giao due stic khoe

Quan ly cac hoat dong TT-GDSK la lam cho tat ca cac khau, cac bo phan
tham gia vao qua trinh TT-GDSK hoat dong co ket qua va hieu qua cao, nh&m
dat dUdc cac muc tieu giao due stfc khoe mong ddi da neu ra.
Quan ly giao due stfc khoe cung co nghia la lam cho cac hoat dong giao
due stfc khoe ngay cang phat trien, dap tfng dtfdc chtfc nang cua giao due stfc
khoe la nang cao kha nang cham soc va bao ve stfc khoe cho ca nhan va cong
dong, ho trd dac ltfc cho cac chtfdng trinh va hoat dong y te, gop phan dat muc
dich cuoi cung la khong ngtfng cai thien va nang cao tinh trang stfc khoe cua
nhan dan.

3.3. Cac noi dung quan ly dac trifng ve truyen thong giao due stfc khoe

Ngoai viec xac dinh van de, xay dtfng cac ke hoach phu hdp, quan ly sii
dung tot cac nguon ltfc de nang cao hieu qua cua chtfdng trinh TT-GDSK,
ngtfdi quan ly cac chtfdng trinh TT-GDSK can chu y quan ly cac mat dac
trtfng trong TT-GDSK nhtf sau:

3.3.1. Quan ly nguon phat tin

Quan ly nguon phat tin la quan ly moi hoat dong cua cac can bo tham
gia vao chtfdng trinh TT-GDSK, trong do co cac can bo y te, can bo TT-GDSK,
nhtfng ngtfdi tinh nguyen... Nhtfng ngtfdi nay can dtfdc dao tao ve ky nang
truyen thong giao due stfc khoe mot cach day du va co he thong. Quan ly
nguon phat tin cung co nghia la quan ly nguon nhan ltfc cho TT-GDSK, la
nguon ltfc quan trong hang dau quyet dinh den thanh cong cua moi chtfdng
trinh TT-GDSK.
Noi dung cd ban trong quan ly nguon phat tin la can co ke hoach dao tao
va dao tao lai cho can bo thtfc hien TT-GDSK de nang cao cac ky nang TT-
GDSK cho ho. Giup ho nang cao kha nang ltfa chon cac phtfdng thtfc lam viec
thich hdp vdi ca nhan va vdi cong dong, trong dd ky nang giao tiep, ky nang

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lam viec nhom la nhtfng ky nang het stfc cd ban cua can bo lam giao due siic
khoe. Md rong quan he lam viec v6i cac dong nghiep va cac can bo lien quan
cua cac ban nganh doan the khac cung la nhufng ky nang ma ngiidi lam cong
tac y te cong dong noi chung cung nhu ngUdi thtfc hien TT-GDSK can ren
luyen. Dao tao kha nang cho can bo biet dua hoat dong TT-GDSK long ghep
vdi cac hoat dong khac b dia phudng, nhat la cac hoat dong van hoa truyen
thong cua cong dong la cach lam khon kheo de thtfc hien xa hoi hoa hoat dong
TT-GDSK.
Mot trong nhtfng noi dung quan trong trong quan ly TT-GDSK la viec
quan ly nguon nhan liic cho giao due siic khoe. De thiic hien tot nhiem vu TT-
GDSK ngUdi can bo can diidc trang bi kien thiic ve y hoc, kien thiic ve tam ly,
khoa hoc hanh vi, dac biet la ky nang truyen thong giao tiep vdi ca nhan vdi
nhom va vdi cong dong. Biet liia chon cac thong diep siic khoe truyen di nhu
the nao cho cd hieu qua doi hoi ngiidi lam cong tac giao due siic khoe phai
nam ch ic cac thong tin ve doi ttfdng dich, noi dung giao due, phtfdng phap
giao due, phtfdng tien va nguon ltfc stf dung cho TT-GDSK. Thiic hien dao tao
cac cong tac vien lam cong tac TT-GDSK cho ttfng chu de la mot bien phap
quan trong de nang cao nguon nhan ltfc cho giao due stfc khoe ma ngtfdi can
bo quan ly TT-GDSK can chu y. Ltfa chon va dao tao cac cong tac vien ngay
trong cong dong la viec lam mang lai hieu qua cao va cd tac dong ben vtfng,
lau dai. Giam sat ho trd cac can bo trtfc tiep thtfc hien TT-GDSK la mot trong
cac phtfdng phap quan ly rat hieu qua de nang cao ky nang cho can bo thtfc
hanh TT-GDSK.

3.3.2. Quan ly cac kenh truyen thong

Ltfa chon cac kenh truyen thong thich hdp, tranh cac yeu to' nhilu trong
qua trinh truyen thong diep la nhtfng van de quan trong gop phan dam bao
TT-GDSK hieu qua. Kenh truyen thong can phu hdp, hap d in va thu hut
dtfdc stf chu y cua do'i tUdng. Chon kenh truyen thong cung phai can ctf vao
do'i ttfdng, thdi gian va chu de giao due stfc khoe cho thich hdp. Chu y cac
thong tin phat ra b in g cac phtfdng tien thong tin dai chung hay trtfc tiep gitfa
ngtfdi vdi ngtfdi phai dam bao tinh khoa hoc, chinh xac, dung va du nghia,
tranh cac sai lac trong qua trinh chuyen tai thong tin. Cac noi dung giao due
cua cac bai viet, bai ndi, tranh anh, pano, ap phich, sach mong... dtfdc sii dung
chinh thtfc deu phai dtfdc kiem tra va thii nghiem trtfdc khi stf dung rong rai
de dam bao tinh khoa hoc, giao due va tinh kinh te. Ngtfdi quan iy TT-GDSK
can cd ke hoach thtfdng xuyen kiem tra, thu nhan cac thong tin phan hoi,
phat hien nhtfng khau yeu kem trong kenh truyen thong de kip thdi dieu
chinh, bo sung thich hdp.

3.3.3. Quan ly doi ttfdng dich

Noi dung quan trong la thu thap cac thong tin phan hoi ttf do'i ttfdng
dich de danh gia stf tiep nhan, hieu biet va ap dung cac thong diep giao due

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siic khoe cua doi ttfdng dich. Cac thong tin nay can diidc thu thap kip thdi de
dieu chinh, bo sung, ho trd doi ttfdng thay doi hanh vi stfc khoe mot cach tich
ciic hdn.
Quan ly cac nhom doi ttfdng dich can phai chtf y ltfa chon dung cac nhom
doi tudng dich can ctf vao muc tieu cua chtfdng trinh giao stfc khoe, tuy thuoc
thdi gian va khong gian. Lua chon dung doi ttfdng dich se quyet dinh den ket
qua cuoi ctfng cua chUdng trinh giao due stfc khoe. Ngoai hoat dong giao due
stfc khoe phai co cac hoat dong khac ho trd cac nhom doi ttfdng dich de thtfc
hien dUdc cac hanh vi stfc khoe mdi.
Thu nhan thong tin phan hoi ttf doi ttfdng dich day du con gitfp danh gia
toan dien ca noi dung phudng phap, phtfdng tien nguon ltfc lien quan den
chtfdng trinh TT-GDSK.
Nhtf vay trong quan ly hoat dong giao due stfc khoe chtfng ta phai quan
tam den ca ba khau tren. Co nghia la chung ta phai quan tam den ca ngtfdi
lam TT-GDSK. cac phtfdng tien stf dung trong TT-GDSK, doi ttfdng cua TT-
GDSK.
Vdi ngUdi nhan tin: can phai biet ho la nhtfng ai, trinh do nhtf the nao,
nhtfng niem tin va phong tuc tap quan, quan trong nhat la thu thap cac thong
tin phan hoi ttf ddi ttfdng de biet dtfdc mtfc do hieu biet cua doi ttfdng, thai do
cua ho doi vdi cac thong diep va dac biet la thtfc hanh cua doi ttfdng thay doi
nhtf the nao, qua dd can bo giao due stfc khoe cd the dieu chinh chtfdng trinh
TT-GDSK cho thich hdp. Ket thuc mdi giai doan hay mot chtfdng trinh TT-
GDSK, danh gia ve nhtfng thay doi kien thtfc, thai do, hanh vi cua doi tUdng
dich va cac y kien cua ho ve moi khia canh chtfdng trinh TT-GDSK la cac
thong tin can thiet khong the thieu cho cac nha quan ly, lap ke hoach chtfdng
trinh.

3.4. Giam sat va danh gia cac hoat dong truyen thong giao due stfc khoe

3.4.1. Giam sat cac hoat dong TT-GDSK

Giam sat hoat dong TT-GDSK la mot trong cac hoat dong quan ly quan
trong. nham nang ky nang thtfc hien TT-GDSK cho can bo.
Giam sat chtfdng trinh TT-GDSK cung nhtf giam sat cac chtfdng trinh
hoat dong v te cong cong khac la qua trinh dao tao lien tuc tren thtfc dia
nham gitfp cac can bo lam cong tac truyen thong giao due va nang cao stfc
khoe ren luyen ky nang truyen thong giao due stfc khoe, gop phan nang cao
ket qua va hieu qua cua chtfdng trinh TT-GDSK va nang cao stfc khoe.
Ddi vdi truyen thong giao due stfc khoe thi hinh thtfc giam sat trUc tiep
la hinh thtfc cd hieu qua nhat. Cu the la viec theo ddi, giup dd ho trd khi cac
can bo thtfc hien cac hoat dong TT-GDSK trtfc tiep nhtf: ndi chuyen chuyen de
stfc khoe. td chtfc thao luan nhom. den tham ho gia dinh, ttf van ca nhan. Tuy
nhien qua giam sat gian tiep cac hoat dong nhtf viet bai cho truyen thong, san

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xuat tai lieu, lap ke hoach cho cac chUdng trinh TT-GDSK va nang cao stfc
khoe ngtfdi giam sat cung co the dong gop nhieu y kien bo ich cho can bo thtfc
hien TT-GDSK.
Muc dich cua hoat dong giam sat TT-GDSK la thtfc hien cong tac dao tao
can bo lam truyen thong giao due va nang cao stfc khoe. Qua hoat dong giam
sat ngtfdi dtfdc giam sat biet dtfdc cac diem yeu cua minh trong hoat dong TT-
GDSK va dtfdc uon n&n tai cho, vi the hieu qua mang lai rat cao. Ngtfdi thtfc
hien giam sat cung thay dtfdc cac diem manh diem yeu cua ngtfdi dtfdc giam sat
va co the chi dan ngay cho ngtfdi dtfdc giam sat phat huy, siia chtfa hay co ke
hoach boi dtfdng giup dd ho trd tiep theo. Giam sat cung giup cho ngtfdi di giam
sat hoc dtfdc them kinh nghiem, biet dtfdc kha nang, nang ltfc hoat dong giao
due stfc khoe cua cac can bo dtfdc giam sat qua do co ke hoach giup dd cap dtf6i.
Truyen thong giao due stfc khoe doi hoi can bo phai co ky nang giao tiep vi the
mot trong cac noi dung giam sat quan trong la nham giup ngtfdi thtfc hien
truyen thong giao due stfc khoe ren luyen ky nang giao tiep.
Moi cuoc giam sat can chuan bi cu the noi dung giam sat, xac dinh ro
ngtfdi dtfdc giam sat, thdi gian giam sat, pham vi giam sat, dia diem giam sat.
Giam sat co the tien hanh dinh ky hay dot xuat. Trtfdc moi cuoc giam sat
ngtfdi di giam sat can bao cho ngtfdi dtfdc giam sat biet trtfdc.
Cac noi dung giam sat tap trung vao cac ky nang thtfc hien cac phtfdng
phap truyen thong giao due stfc khoe trtfc tiep. Cac noi dung giam sat dtfdc
the hien trong cong cu ma ngtfdi di giam sat chuan bi (thtfdng la bang kiem).
Tuy theo yeu cau cua hoat dong giam sat ma xac dinh cac noi dung giam sat
cu the, nhtfng nhin chung giam sat cac hoat dong TT-GDSK tap trung vao ky
nang giao tiep, chu yeu la cac ky nang sau:
- Ky nang xac dinh doi ttfdng dich.
- Ky nang xac dinh muc tieu.
- Ky nang soan thao noi dung cua chu de can truyen thong giao due, tap
trung chu yeu vao cac thong diep can chuyen tai tdi doi ttfdng.
- Ky nang ltfa chon phtfdng phap va phtfdng tien TT-GDSK.
- Ky nang lam quen.
- Ky nang sii dung giao tiep bang ldi
- Ky nang sii dung giao tiep khong ldi.
- Ky nang lin g nghe.
- Ky nang quan sat, dieu chinh.
- Ky nang tom tat.
- Ky nang dat cau hoi kiem tra doi ttfdng.
- Ky nang h6 trd giup dd doi ttfdng.

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 Cac noi dung giam sat can dtfdc the hien day du trong bang kiem (cong
cu) giam sat ma ngtfdi di giam sat can xay dtfng trtfdc khi thtfc hien giam sat.

3.4.2. Danh gia cac hoat dong TT-GDSK

Danh gia la qua trinh xac dinh ket qua dat dtfdc cua mot hoat dong hay
mot loat cac hoat dong cua mot chtfdng trinh TT-GDSK de xem xet chtfdng
trinh co thanh cong hay khong khi so sanh vdi cac muc tieu da dtfdc xay dtfng.
Danh gia bao gom qua trinh do dac hieu qua va ket qua cua chtfdng trinh.
Danh gia nham xac dinh cac ket qua da dat dtfdc, lam cd sd cho lap ke
hoach tiep theo de day manh chtfdng trinh, tang ctfdng kien thtfc va thtfc
h in h TT-GDSK.
Biet dtfdc cac ket qua cho phep chung ta cd the danh gia dtfdc hieu qua
cua chtfdng trinh ttf dd cd the cd dtfdc stf ung ho cua chinh quyen, cong dong
va cac cd quan chtfc nang. Danh gia con mang lai muc dich dong vien can bo
thtfc hien chtfdng trinh.
Mot so' noi dung quan trong can danh gia la:
- Danh gia ket qua cua chtfdng trinh truyen thong giao due stfc khoe: xem
xet lieu chtfdng trinh cd dat dtfdc muc tieu de ra hay khong? Xac dinh ro
cac chi so' de danh gia dtfdc cac mtfc do thay doi ve kien thtfc, thai do va
hanh vi cua doi ttfdng va so sanh vdi muc tieu mong ddi da neu ra.
- Danh gia hieu qua: cac ket qua dat dtfdc cd ttfdng xtfng vdi nhtfng no ltfc
nguon ltfc (nhan ltfc, tien, cd sd vat chat) bo ra hay khong?. Xay dtfng
dtfdc cac chi so' de danh gia dtfdc ve gia thanh va hieu qua cua hoat dong
giao due stfc khoe.
- Danh gia qua trinh: dieu hanh cac tien do trong khi thtfc hien chtfdng
trinh bao gom viec ltfdng gia cac muc tieu trung gian, nhtfng gi da dat
dtfdc cho den thdi diem hien tai. Xay dtfng cac chi so' de danh gia cac muc
tieu trung gian: vl du nhtf chi so ve tien do cac hoat dong trong chtfdng
trinh TT-GDSK.
- Danh gia tac dong anh htfdng: dd la danh gia nhtfng thay doi ve stfc khoe
va benh tat ma chtfdng trinh TT-GDSK da mang lai. Viec danh gia tac
dong anh htfdng cua TT-GDSK thtfdng khong phai de dang vi ngoai giao
due stfc khoe cd nhieu tac dong khac den tinh trang stfc khoe va benh tat
cua ca nhan cung nhtf cua cong dong.
Noi dung cua danh gia dtfdc the hien trong mot so cau hoi can dat ra khi
danh gia cac hoat dong TT-GDSK la:
- Cac hoat dong truyen thong cd dtfdc thtfc hien theo ke' hoach khong?
- Bao nhieu chtfdng trinh truyen thong dai chung da dtfdc thtfc hien?
- Bao nhieu cac buoi TT-GDSK trtfc tiep da dtfdc tien hanh?

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 - Bao nhieu cuoc hop cua cong dong da dtfdc to chtfc, bao nhieu cac td rdi
dtfdc phan phat?
- Bao nhieu do'i ttfdng dich da nhan dtfdc cac thong diep?...
- Cac doi ttfdng dich co chu y den cac hoat dong truyen thong hay khong?
- Cac doi ttfdng dich co hieu dtfdc cac thong diep hay khong?
- Bao nhieu ngUdi co the nhac lai dung cac thong diep tren cac ap phich,
chtfdng trinh cua radio, cac buoi noi chuyen, cac cuoc hop v.v... ?
- Cac thong diep co thuyet phuc dtfdc moi ngtfdi khong?
- Bao nhieu ngtfdi chap nhan va tin ttfdng vao cac thong diep?
- Cac thong diep co dan den thay doi hanh vi hay khong?
- Bao nhieu ngtfdi thay doi hanh vi stfc khoe do ket qua cua cac hoat dong
truyen thong giao due stfc khoe ?
- Cac hanh vi thay doi do co dan den nang cao stfc khoe hay khong?
- Bao nhieu ngtfdi stfc khoe dtfdc tang ctfdng la do ket qua cua chtfdng trinh?
- Mtfc do thay doi cua cua ty le benh, ty le mac benh mdi nhu the nao?.
Tuy nhien viec danh gia cac cac thay doi ve hanh vi va stfc khoe can phai
co thdi gian dai. Mot y ttfdng tot la can phai danh gia ngan han sdm sau khi
ket thuc cac hoat dong cua chtfdng trinh va theo doi sau dd de danh gia cac
thay ddi lau dai dien ra.
TT-GDSK la hoat dong y te cong cong quan trong n h im nang cao stfc
khoe cong dong. Trong thtfc te cd rat nhieu yeu td" cd the anh htfdng den ket
qua va hieu qua chtfdng trinh TT-GDSK. De nang cao chat ltfdng, hieu qua
can phai cd nhtfng nghien ctfu danh gia nghiem tuc ve nhieu khia canh cua
hoat dong TT-GDSK de rut ra cac bai hoc kinh nghiem quy bau cho hoat dong
TT-GDSK tiep theo.

CAU HOI TU LL/ONG GIA

1. Neu cac dac diem can chu y khi lap ke hoach TT-GDSK.
2. Ve sd do cac btfdc lap ke hoach TT-GDSK.
3. Neu cac tieu chuan ltfa chon van de can tfu tien TT-GDSK.
4. Trinh bay tam quan trong cua xay dtfng muc tieu TT-GDSK.
5. Phan tich cac yeu cau cua mot muc tieu giao due stfc khoe.

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 6. Tinh bay tam quan trong cua thu nghiem va cach tien hanh thu
nghiem cac phtfdng tien, tai lieu TT-GDSK.
7. Neu yeu cau cua mot hoat dong cu the trong chtfdng trinh TT-GDSK.
8. Neu cac cau hoi can tra ldi khi lap ke hoach TT-GDSK.
9. Trinh bay khai niem ve quan ly hoat dong TT-GDSK.
10. Phan tich cac noi dung quan ly dac trtfng trong TT-GDSK.
11. Neu khai niem, muc dich, noi dung cua giam sat hoat dong TT-GDSK.
12. Neu khai niem, muc dich, noi dung cua hoat dong danh gia TT-GDSK.

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 Bai 7

KY NANG TRUYEN THONG GIAO DUC SLTC KHOE

-. t f T f ■ t t - J ' «*»* »iy-*iOi*g» •.?ua>*jL-‘ -*« C*vvv'JaegfcJ ,v? y < v * : •

MUC TIEU
1. Trinh bay khdi niem chung vi truyen thong.
2. Phdn tich cac yeu cau lam cho truyin thong co hieu qud.
3. Trinh bay cac ky nang truyin thong giao tiep cd ban can ren luyen.

i. khAi n ie m c h u n g v e t r u y e n t h o n g

Truyen thong la mot trong cac ky nang quan trong nhat cua ngtfdi can
bo giao due stfc khoe. Tren thtfc te truyen thong cung la mot hoat dong khong
the thieu trong ddi song hang ngay. Moi ngtfdi khong the ton tai neu sinh ra,
ldn len va phat trien tach biet hoan toan vdi nhtfng ngtfdi khac va khong the
ttf dap tfng moi nhu cau cua chinh minh. Con ngtfdi song trong xa hoi vtfa doc
lap, vtfa phu thuoc va cd nhtfng quan he rang buoc vdi nhtfng ngtfdi khac
xung quanh. Phtfdng tien giup cho con ngtfdi cd moi lien he gan gui vdi nhau
trong mdi trtfdng song chinh la truyen thong qua ngon ngtf, ca bang ldi va
khong ldi (ngon ngtf cd the, dang dieu, ctf chi, dtfdc hieu thong qua nen van
hoa chung), vdi stf ho trd cua mot sd" phtfdng tien.
Shannon va Weaver (1949) dinh nghia truyen thong la tat ca nhtfng gi
xay ra gitfa hai hoac nhieu ngtfdi. Davis va Newstrom (1985) dinh nghia
truyen thong la "Truyen thong tin va giai thich thong tin ttf mot ngtfdi den
nhtfng ngtfdi khac". Truyen thong la cau noi gitfa ngtfdi vdi ngtfdi. Johnson
(1986) coi truyen thong nhtf la phtfdng tien, qua dd mot ngtfdi chuyen thong
diep den ngtfdi khac va mong nhan dtfdc stf dap lai (thong tin phan hoi).
Muc dich cua truyen thong:
Hewitt (1981) phat trien chi tiet hdn ntfa muc dich cu the cua qua trinh
truyen thong. Nhtfng muc dich sau day cung dtfdc nhtfng ngtfdi thtfc hien
truyen thong d ndi nay hay ndi khac sti dung mot cach rieng biet hay ket hdp:
1. Hoc hay day mot viec gi dd;
2. Tac dong den hanh vi cua ngtfdi khac;
3. Bieu thi cam giac, mong muon, y dinh;

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 4. Giai thich cac hanh vi rieng cua ngtfdi nay hay lam rd cac hanh vi
cua nhtfng ngtfdi khac;
5. Giai quyet van de dang xay ra;
6. Dat muc dich thay doi de ra;
7. Giam cang thang hay giai quyet cac xung dot;
8. Co vu, the hien quan tam cua chinh minh hay cua ngtfdi khac...

2. CAC KHAU C d BAN VA QUA TRiNH TRUYEN THONG

2.1. Cac khau cd ban cua truyen thong

Truyen thong bao gom 3 khau cd ban:

- Nguon phat tin
- Kenh truyen tin
- Ngtfdi nhan tin

Sd do 7.1. Ba khau cd ban cua truyen thong

Hieu qua cua qua trinh truyen thong phu thuoc vao ca 3 khau cd ban
nay. Neu tin ttfc dtfdc phat ra ttf nguon phat tin khong chuan bi ky cang thi
cac thong tin co the khong chinh xac, khong den dtfdc vdi ngtfdi nhan, hoac
thong tin den dtfdc vdi ngtfdi nhan nhtfng ngtfdi nhan khong hieu dtfdc thong
tin do cac thong tin khong du, khong phu hdp, kho hieu. Khi thong tin truyen
qua cac kenh truyen tin cd the cd cac yeu to lam nhieu hoac sai lac thong tin.
Trinh do, cac dac diem ca nhan va hoan canh thtfc te cua ngtfdi nhan cung
anh htfdng ldn den hieu qua cua viec tiep nhan thong tin.
Trong phan tich cac yeu to anh htfdng den stf thanh cong cua truyen
thong, viec tach rdi va xem xet rieng biet ttfng yeu to: ngtfdi nhan, nguon
phat, kenh truyen thong va thong diep se cd thuan ldi de xay dtfng chtfdng
trinh truyen thong hieu qua.
Btfdc dau tien trong lap ke hoach cua bat ky chtfdng trinh truyen thong
nao la quan tam den doi ttfdng dich dtf kien. Mot phtfdng phap cd the ap dung
thanh cong vdi doi ttfdng nay nhtfng lai that bai vdi doi ttfdng khac. Hai ngtfdi
cung nghe mot chtfdng trinh tren dai, xem cung mot ap phich hay cung nghe
mot buoi ndi chuyen nhtfng hieu va giai thich ve cac noi dung co the hoan
toan khac nhau. Mot so thong tin lien quan den ddi ttfdng dich can phai tim
hieu khi lap ke hoach truyen thong, dong thdi ngtfdi truyen thong cung phai

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quan tam den mot so" cau hoi ve pham vi anh hiidng cung nhif niem tin ve siic
khoe cua cac doi ttfdng dich.

2.2. Mo hinh truyen thong cua Shannon va Wearver

Mo hinh Shannon-Weaver nhan manh den qua trinh truyen va nhan

thong tin nen mo hinh dtfdc coi la mo hinh thong tin cua truyen thong. Mo
hinh dtfdc hai tac gia phat phat trien vao nam 1947. Day la mot mo hinh dac
trtfng ve truyen thong. Mo hinh Shannon-Wearver neu ra bat ky hoat dong
truyen thong nao cung bao gom 6 yeu to" nhtf sau:
- Nguon tin
- Ma hoa
- Thong diep
- Kenh
- Giai ma
- Nhan tin.
Sau yeu to" cua mo hinh Shannon-Wearver dtfdc neu ra trong trong sd dd
sau:

► (^^arrtin^)

So do 7.2. Mo hinh truyen thong cua Shannon-Wearver

Cac tac gia cua mo hinh da nhan manh den 3 van de:
- Nhtfng tin hieu truyen di co dtfdc dung mau khong: van de ky thuat.
- Nhtfng tin hieu truyen di co mang day du y nghia khong: van de noi
dung.

- Tac dong cua thong diep nhtf the" nao len doi ttfdng: van de hieu qud.
Ttf mo hinh cua Shannon va Weaver, Harrold Lasswell (1948) dtfa ra
cong thtfc cua qua trinh truyen thong gom 5 khau nhtf sau:

133
2.3. Qua trinh truyen thong

2.3.1. Cac budc ccf ban cua qud trinh truyen thong

Qua trinh truyen thong bao gom 5 btfdc cd ban theo cac tac gia: Berio
(1960), Chartier (1981), Davis va Newstrom (1985), Hein (1980), Hewitt (1981),
Johnson (1986), Long va Prophit (1981), Miller (1966), Pluckhan (1978).
Budc 1. Ngudi giti hinh thanh y tudng
Ngtfdi gtii co y ttfdng va mong muon truyen di y ttfdng do tdi ngtfdi khac.
Davis va Newstrom (1985) khang dinh la nhtfng ngtfdi gtii can phai nghl trtfdc
khi giii thong diep, day la btfdc cd ban. Ngtfdi gtii can cd y ttfdng rd rang trong
dau sau dd la ltfa chon ngon ngtf thich hdp de truyen dat y ttfdng da dtfdc ltfa
chon. Dieu can thiet la phai can nhac ca ngon ngtf bang ldi va ngon ngtf
khong ldi. Chon ngon ngtf va bieu ttfdng cd the la van de tfu tien cao nhat de
gtii thong diep chinh xac va lam cho thong diep dtfdc nhan chinh xac.
Budc 2. Md hoa
Cac y ttfdng dtfdc chuyen thanh ngon ttf hay bieu ttfdng, hinh anh chtfa
dtfng noi dung ma ngtfdi gtii muon giki den doi ttfdng, goi la stf ma hoa.
Budc 3. Chuyen thong diep qua cau noi hay kenh
Sau khi thong diep da dtfdc ma hoa thi dtfdc ngtfdi gtii gtfi qua cau noi
hay kenh truyen thong, bang ldi hay khong ldi. Ngtfdi nhan la ngtfdi phai tiep
can va dieu chinh theo cac kenh cua ngtfdi gtii de nhan thong tin.
Budc 4. Nhan va gidi md
Ngtfdi nhan nhan thong diep gtii den ttf ngtfdi gtii, qua kenh truyen
thong va thtfc hien giai ma ttf ngon ngtf, bieu ttfdng cua ngtfdi gtii de hieu
dtfdc noi dung thong diep.
Budc 5. Hanh dong dap lai
Ngtfdi nhan sau dd hanh dong de dap lai thong diep da dtfdc giai ma.
Thong diep cung cd the dtfdc gitf lai hay bi Id di (nghia la ngtfdi nhan khong
muon dap tfng hay khong cd dap ting). Ngtfdi nhan cd the truyen thong y
ttfdng khac den ngtfdi gtii, hoac ddn gian cd the la thtfc hien nhiem vu de dap
tfng lai thong diep ma khong quan tam day du den thong diep cua ngtfdi gtfi
do nhieu ly do.
Qua trinh ngtfdi nhan dap tfng lai thong diep cua ngtfdi gtii goi la thong
tin phan hoi, dd la thong diep gtii ngtfdc lai den ngtfdi gtii. Nhtf vay ngtfdi
nhan trd thanh ngtfdi gtii va qua trinh truyen thong lai bat dau. Vong truyen
thong nhtf vay tiep tuc d iln ra den khi ket thuc truyen thong. Qua thong tin
phan hoi ngtfdi gtii cd the danh gia dtfdc hieu qua ctia truyen thong, xem xet
muc tieu ctia truyen thong cd dat dtfdc hay khong va cd dtfdc nhtfng thong tin

134
giup phan tich tim ra cac yeu to anh htfdng den qua trinh truyen thong. Neu
muc tieu cua truyen thong chtfa dat dtfdc, ngtfdi gtii can phai phan tich cac
khau lien quan de tim ra cac ly do tai sao lai chtfa dat dtfdc muc tieu de ra,
tren cd sd do dieu chinh lai thong diep hoac phtfdng phap de cai thien hoat
dong truyen thong cua minh, nham dat dtfdc muc tieu da xay dtfng.
Ngudi gtii
Y tudng Ma hoa
(Ly do cCia truyen thong) (? tudng dUdc chuyen thanh
ngon tCr hay bieu tUdng)

Cau noi
(Thong diep dUdc chuyen qua kenh
bang ldi hay khong ldi)

Ngudi nhan

Giai ma ------------------------------------ ► Hanh dong dap lai

(Ngon tir hay bieu tudng (Phan hoi thong diep
chuyen thanh y tudng) lai ngudi guri)

Sd do 7.3. Qua trinh truyen thong

2.3.2. Tdc dong cua truyen thong den doi tiidng dich

Truyen thong cd the tac dong den doi ttfdng dich qua cac giai doan nhtf sau:
Giai doan I: truyen thong tdi dtfdc doi ttfdng:
Truyen thong chi cd hieu qua khi doi ttfdng phai nhin thay hay nghe
thay cac thong diep. Day la van de hien nhien ro rang ma khong can phai giai
thich b in g ly thuyet phtfc tap. Nhtfng tren thtfc te nhieu chtfdng TT-GDSK
that bai ngay ca d giai doan ddn gian nay. Nguyen nhan thong thtfdng ctia
that bai la do chtfa quan tam den kha nang tiep can ctia doi ttfdng, vi du nhtf
pand ap phich chi treo d cac phong kham benh, hay to’ chtfc ndi chuyen d cac
phong cham sdc trtfdc sinh, thong diep giao due chi cd the den vdi nhtfng
ngtfdi den ndi cd dich vu dd. Cac nhom can tiep can thong tin cd the ho khong
den cac phong kham, cung cd the ho khong cd dai, bao chi hoac do ban ron vdi
cong viec vao thdi gian cac bai truyen thong giao due stfc khoe dtfdc phat tren
cac phtfdng tien thong tin. Truyen thong giao due stfc khoe phai trtfc tiep den

135
vdi doi tiidng vao luc ma ho co the nhin dtfdc va nghe dtfdc. De dat dtfdc dieu
nay phai tim hieu doi ttfdng dich, phat hien nhtfng ndi ma ho co the xem dtfdc
pano, ap phich, va cac thoi quen nghe doc cua doi ttfdng.

Ngi/di gui ------------------ — ► Ngtfdi nhan

Tdi cac cd quan giac quan
I
Gay ra chu y

I
Hieu thong diep

I
Chap nhan/Thay doi
I '

Thay doi hanh vi

I
Nang cao sure khoe

Sd do 7.4. Cac giai doan anh hi/dng cua truyen thong den doi ttfdng dich

Giai doan II: thu hut stf chu y cua doi ttfdng
Bat ky hinh thtfc TT-GDSK nao cung can phai thu hut stf chu y cua doi
ttfdng, lam cho doi ttfdng phai co" g&ng de xem, nghe va doc thong diep. Vi du
ve stf that bai cua truyen thong d giai doan nay la:
- Doi ttfdng di qua cac ndi treo tranh anh, pano, ap phich ma khong xem.
- Khong chu y den dtf cac cuoc noi chuyen ve stfc khoe hay trinh dien d cac
cd sd y te, cac phong kham, nhtfng ndi cong cong.
- Khong dtfng lai de xem trien lam c( nhtfng ndi cong cong.
- T it dai va tivi khong nghe chtfdng trinh noi ve stfc khoe, benh tat.
Bat ky vao thdi gian nao khi ngtfdi ta tiep nhan thong tin ttf nam giac
quan (sd, ngiii, nghe, nhin va ne"m) ngtfdi ta thtfdng khong the tap trung chu y
vao tat ca moi stf tiep nhan cua cac giac quan. Stf chu y la ten goi cua qua
trinh ma ngtfdi ta co the chon nhtfng phan hap dan cua qua trinh phtfc tap
dang dien ra, de tap trung chu y vao mot stf kien nhat dinh nao do va bo qua
cac stf kien khac trong cung mot thdi gian. Co nhieu yeu to" cua moi trtfdng co
the lam cho ngtfdi ta chu y hay khong chu y den mot stf viec hay hien ttfdng
nao do, vi the" van de quan trong trong truyen thong la gay ra dtfdc stf chu y
cua doi ttfdng vao van de.

136
 Giai doan III: hieu cac thong diep
Mot ngtfdi chi chu y den thong diep khi ngtfdi do muon co gang de hieu
thong diep. Hieu thong diep con dtfdc goi la stf nhan thtfc. Nhan thtfc qua thi
giac la thuat ngtf dtfdc stf dung de chi thong diep dtfdc tiep nhan qua thi giac,
vi du nhtf nhan thtfc dien ra qua xem cac btfc tranh. Nhan thtfc la qua trinh
chu quan cua moi ngtfdi. Hai ngtfdi cung nghe mot chUdng trinh hay cung
xem mot btfc tranh nhtfng co the giai thich cac thong diep khac nhau hoan
toan va hieu y nghia noi dung thong diep ma ngtfdi giii mong muon cung khac
nhau d in den dap tfng khac nhau. Stf hieu lam thong diep cung co the xay ra
khi sii dung ngon ngtf phtfc tap va cac ttf chuyen mon, ky thuat xa la vdi doi
ttfdng. Cac tranh, anh bao gom nhieu chi tiet khong hap din , phtfc tap, neu
chu de khong quen thuoc. Stf hieu lam cung co the xay ra khi nhieu thong tin
dtfdc trinh bay lam ngtfdi ta khong tiep thu het.
Giai doan IV: thuc day cac thay doi
Truyen thong khong dtfng lai d tiep nhan, hieu biet thong diep ma no
phai dtfa den stf tin ttfdng va chap nhan thong diep. Ttf hieu biet thong diep
den tin ttfdng thong diep co nhieu yeu to" anh htfdng. Se de thay doi vdi cac
niem tin ma ngtfdi ta mdi thu nhan gan day. Ngtfdc lai se rat kho thay doi vdi
cac niem tin da co ttf lau va nhtfng niem tin da dtfdc phat trien tot ve mot chu
de. Thong thtfdng rat de thuc day stf thay doi niem tin neu anh htfdng cua no
cd the dtfdc minh hoa cu the bang cac vi du de nhan thay. Neu niem tin cd
trong toan bo cong dong hay niem tin la mot bo phan cua mot he thong niem
tin rong nhtf ton giao thi chung ta cd the dtf kien dtfdc la niem tin dd rat kho
thay doi bang stf dung cac phtfdng tien thong tin dai chung.
Giai doan V: tao ra va thay doi trong hanh vi
Truyen thong cd the dan den ket qua la nang cao nhan thtfc, thay doi
niem tin nhtfng van khong tac dong den thay doi hanh vi. Dieu nay cd the xay
ra khi truyen thong khong hudng vao niem tin ma niem tin dd cd anh htfdng
quan trong nhat den thai do cua mot ngtfdi htfdng tdi hanh vi cua ho. Vi du
nhieu chtfdng trinh truyen thong nhan manh den nhtfng nguy hiem cua benh
tieu chay va that bai vi khong nhan manh day du den vai tro cua mat ntfdc.
Mot ngtfdi cd the cd thai do tot va muon thtfc hien hanh dong nhtf sii
dung cac bien phap ke hoach hoa gia dinh, dtfa tre em di tiem chung ... tuy
nhien ap ltfc ttf nhtfng ngtfdi khac trong gia dinh hay cong dong cd the ngan
can ho lam nhtfng viec nay. Mot ly do khac lam cho mot ngtfdi khong thtfc
hien hanh vi vi thieu cac yeu td" cd the nhtf tien, thdi gian, ky nang hay cac
dich vu y te. Nhtf vay muon thay do’i hanh vi cua do'i ttfdng d giai doan nay
can tao ra moi trtfdng va cac dieu kien ho trd cho doi ttfdng.
Giai doan VI: nang cao stfc khoe
Nang cao stfc khoe chi xay ra khi cac hanh vi da dtfdc do'i ttfdng ltfa chon
va thtfc hien mot cach thich hdp, tren cd sd khoa hoc, vi the no cd tac dong

137
den stfc khoe. Neu cac thong diep loi thdi hay khong dung, co the moi ngiidi
lam theo thong diep nhtfng khong co tac dong tang cao siic khoe. Van de can
thiet la dam bao cac thong diep va ldi khuyen chinh xac, do cung la mot ly do
vi sao ma To chiic Y te the gidi, UNICEF va UNESCO da co sang kien dtfa ra
"Nhtfng dieu can cho cuoc song".

3. CAC YEU CAU LAM CHO TRUYEN THONG GIAO TIEP CO HIEU QUA

3.1. Yeu cau can co cua ngtfdi thtfc hien truyen thong giao due stfc khoe

De dat dtfdc ket qua va hieu qua tot trong cong tac, ngtfdi can bo lam
cong tac TT-GDSK can phai co cac tieu chuan sau:
- Co kien thtfc ve y hoc: ngtfdi TT-GDSK phai co du kien thtfc can thiet ve
van de TT-GDSK de soan thao cac noi dung va thong diep phu hdp vdi
ttfng loai doi ttfdng dich.
- Cd kien thtfc ve tam ly hoc, khoa hoc hanh vi: de phan tich tam ly, hanh
vi cua cac doi tudng dich, ttf dd chon cac cach giao tiep va cac phtfdng
phap TT-GDSK thich hdp.
- Cd kien thtfc va ky nang ve giao due hoc: thtfc chat cua TT-GDSK la qua
trinh day va hoc, vi the ngtfdi TT-GDSK can van dung cac kien thtfc giao
due hoc, tao dieu kien thuan ldi cho qua trinh hoc tap cua doi ttfdng.
- Cd kien thtfc va ky nang truyen thong giao tiep: day la dieu kien can
thiet de thtfc hien moi hoat dong TT-GDSK hieu qua.
- Hieu biet ve phong tuc tap quan, van hoa xa hoi va nhtfng van de kinh
te, chinh tri cua cong dong: de dam bao cd cach tiep can va giao due
thich hdp, dtfdc stf chap nhan cua doi ttfdng va cua cong dong
- Nhiet tinh trong cong tac TT-GDSK: dd la tieu chuan dao dtfc nghe
nghiep ma moi can bo y te, can bo TT-GDSK can phai cd.

3.2. Yeu cau doi vdi thong diep giao due sufc khoe

Thong diep chtfa dtfng nhtfng noi dung cot loi can dtfdc truyen thong,
bao gom nhtfng ttf, tranh anh, cac vat hap d in va nhtfng tieng dong dtfdc sii
dung de chuyen nhtfng y ttfdng qua dd. De dam bao TT-GDSK cd hieu qua cao
thi thong diep truyen di can dat mot so yeu cau cd ban nhtf sau:

3.2.1. Ro rang (clear)

Ngtfdi gtfi cd the lam cho thong diep ro rang b in g cach chuan bi can
than trtfdc khi chuyen thong diep di. C in xac dinh ro muc tieu giii thong diep
la gi, dieu gi ngtfdi giii muon ngtfdi nhan suy nghi va lam theo. Sau dd ngtfdi
giii sii dung cac ttf, cau ddn gian hoac bieu ttfdng de d iin dat y ma ngtfdi giii
cho la ngtfdi nhan de hieu va de thtfc hien theo. Neu can thi cd the nhac lai
thong diep gtfi va kiem tra thong tin phan hoi.

138
3.2.2. Chinh xac (concise)
Ngiidi giii can dam bao la thong diep cua minh chinh xac, dac biet la
ngiidi giii muon ngiidi nhan nhd va lam theo. Thong diep can phai ngan gon
de ngUdi nhan cd the n h ic lai dUdc. TrUdc khi ndi hoac viet can chon cac til
hoac cum tCr quan trong (til khoa) de chuyen tai thong diep ro rang va loai bo
cac til thiia, khong lien quan den thong diep cd the gay hieu nham cho doi
tUdng tiep nhan.

3.2.3. Hoan chinh (complete)

Ngiidi giii cd the lam cho thong diep gui di hoan chinh ban^ cach can
n h ic va chon thong tin chuyen tdi ngUdi nhan de ngUdi nhan hieu va thuc
hien day du cac hanh dong dUdc yeu cau. Vi du khi giii thong diep cho ngiidi
khac yeu cau lam mot viec nao dd, thong thudng can neu rd:
- Viec gi can phai lam?
- Vi sao phai lam viec dd?
- Lam viec dd nhu the nao?
- Ai la ngUdi lam viec dd?
- Lam viec dd khi nao?
- Lam viec dd d dau?.
Neu thong diep khong hoan chinh, ngUdi nhan thong diep cd the de hieu
nham va cd dap iing khong dung vdi yeu cau cua ngUdi giii.

3.2.4. Co tinh thuyet phuc (convincing)

Cac thong diep cua ngUdi giii can phai mang tinh thuyet phuc doi tUdng
nhan. De thuyet phuc dUdc doi tUdng, trong thong diep c in the hien dUdc tinh
khoa hoc, thiic tien va tinh dung dan cua hanh dong dUdc yeu cau thiic hien,
dap iing nhu cau hay giai quyet van de dang dat ra cua doi tudng nhan thong
diep. Neu can thiet cd the diia ra ly do vi sao phai thuc hien cac viec lam hay
hanh vi. Moi ngiidi thUdng cd phan iing tot hdn khi ho nhan thay vi sao cong
viec can phai diidc thiic hien theo cach nay ma khong theo cach khac. Dac biet
la neu ho cd the nhan thay ldi ich cua viec lam doi vdi ho va vdi ngUdi khac
neu lam theo cach dd. Can nhac de chon hinh thiic chuyen tai thong diep hdp
ly nhat cung la mot khia canh lam cho thong diep cd tinh thuyet phuc, dac
biet chu y cac til ngii, hinh anh minh hoa phai sue tich, gay an tUdng manh
me cho doi tUdng.

3.2.5. Co kha nang thiic hien diidc (capable o f being caried out)

Y nghia quan trong mang tinh thiic tien la thong diep can cd kha nang
lam cho ngiidi nhan thiic hien dUdc (phu hdp vdi hoan canh thiic te, van hoa
va nguon liic cua ngiidi nhan). Van de d day la ngUdi giii phai hieu ro ngUdi
nhan thong diep, dii doan diidc nhiing viec gi vdi sii no liic cua ban than va sii
ho trd cua nhiing ngiidi khac ho cd the lam dUdc va viec gi ho khong the lam

139
dtfdc. Mat khac cung khong nen danh gia thap kha nang sang tao cua ngtfdi
nhan thong diep trong cac hoan canh cu the.
Tren day la nam yeu cau cua thong diep, dtfdc coi la cac nguyen tac cd
ban de htfdng dan soan thao thong diep trong TT-GDSK.
Cac nguyen t ic cd ban nay can dtfdc ap dung cho ca cac thong diep ndi
va viet.
Mot thong diep chi cd hieu qua khi trinh bay ro rang ve van de cd lien
quan den doi ttfdng dich, thich hdp ve noi dung va hinh thtfc, dtfdc chap nhan
va dtfa ra b in g phtfdng phap cd the hieu dtfdc. Khi quyet dinh se dtfa ra thong
diep nao, ngtfdi TT-GDSK can phai dtf kien kha nang tiep nhan va hieu thong
diep cua doi ttfdng nhan. Cach tot nhat de dam bao thong diep tot la phai thtf
nghiem thong diep dd tren nhom doi ttfdng dich va tham khao y kien cac dong
nghiep trtfdc khi chinh thtfc stf dung rong rai trong cong dong.

Dung ve khoa hoc (V

Dap ling nhu cau thiic te

Yeu cau toi thieu ve thdi gian va no Il/ c de thtfc hien
Thiic thi (kha n3ng ve nguon liic)
► Chap nhan ve van hoa
Dap iing nhu cau tinh cam, hap dan
De hieu
De nhd

Sd do 7.5. Cac d3c diem cua thong diep tot

3.2.6. Hap ddn

Hap dan la cach ma chung ta to chtfc noi dung cua thong diep de thuyet
phuc hay gay long tin cho moi ngtfdi. Cd mot khuynh htfdng cho nhieu chtfdng
trinh truyen thong giao due stfc khoe la sti dung nhtfng thong diep vdi noi
dung nang ve chi tiet y hoc ma khong chu y nhieu den cach the hien noi dung
va hinh thtfc phu hdp vdi stf quan tam cua doi ttfdng dich. Cd nhieu cach khac
cd the sii dung de tao stf hap dan cho thong diep.
- Sd hai: thong diep cd the co' gang de de doa moi ngtfdi hanh dong b ln g
each dtfa ra hau qua nghiem trong do khong thtfc hien hanh dong. Cac
bieu ttfdng nhtf la ngtfdi chet, hinh hai bien dang, bo xtfdng, dau lau cd
the dtfdc sii dung. Cac b in g chtfng cho thay xuat hien sd hai trong dau
cd the dan den stf chu y va tao ra quan tam d in den thay doi. Tuy nhien
qua sd hai thi lam cho moi ngtfdi khong chap nhan va ttf choi thong diep.
Vi du: giao due stfc khoe ve hut thuoc la tai Anh da stf dung giai phap sd
hai bang cach neu ra cac benh ve phoi va mo ta anh hUdng xau cua hut

140
 thuoc. Viec lam nay mang lai hieu qua it doi vdi nhufng ngiidi hut thuoc
la vi ho da xay dung mot rao ch in va t£f choi cac thong diep. Giao due
siic khoe ve AIDS d nhieu niidc da sU dung giai phap hap dan sd hai bao
gom cac bieu tUdng ve chet nhu dau lau. Vdi mot so" ngUdi giai phap nay
d in den vui ciidi va that bai vi ho khong tii bo cac hanh vi nguy cd cao
vdi AIDS, vdi mot so" ngiidi khac giai phap nay d in den dap iing hoang
loan, soc va lo sd.
Tuy nhien lam cho ngUdi ta sd hai khong ddn gian chi la xem xet lieu cd
thuyet phuc ngUdi ta hanh dong hay khong ma no con bao gom ca van de dao
diic. Sd hai cd the xuat hien nhiing ngUdi ta khong thiic hien dUdc hanh dong
de thay doi - dieu nay cd the dan den phai can nhac den nhiing chan thudng
tinh than (stress) va lo lang xuat hien d doi tudng. Nhieu nha giao due siic
khoe nhan thay sai lam neu de doa ngUdi ta thiic hien hanh dong - trif khi cd
nhiing b in g chiing hien nhien ve ldi ich cho siic khoe va cd du cac yeu to cd
the (nguon liic) de thiic hien hanh dong.
- Hai hudc: thong diep dUdc chuyen di b in g cach buon ciidi nhu phim
hoat hinh, cac cau truyen, tranh biem hoa. Hai hudc la cach tot de thu
hut sii quan tam thich thu. Hai hudc cung dong thdi cd vai trd giam bdt
cang thang khi phai doi pho vdi nhiing van de tram trong. Thu gian va
giai tri cd the dan den hieu qua tot, lam ngUdi ta ghi nhd va hoc tap tot.
Tuy vay khong phai hai hudc luon luon dan den nhiing thay doi niem tin
va thai do. Hai hiidc cung mang tinh rat chu quan - nhiing dieu ma
ngiidi nay thay buon ciidi thi lai khong lam cho ngudi khac buon cUdi.
- Hap ddn lo gic/sU viec that: nhan manh vao cac thong diep bang cach
truyen di nhu cau can phai hanh dong qua dua ra cac sii viec that nhii
so lieu, thong tin ve nguyen nhan cua benh tat, van de siic khoe.
- Hap ddn ve tinh cam: co gang de thuyet phuc moi ngudi b ln g cach
kheu gdi tinh cam, nhiing tUdng tUdng, tinh cam hdn la dua ra cac sii
viec va so lieu, vi du nhii chi ra nu cUdi cua nhiing diia tre khoe manh,
nhiing gia dinh cd ho" xi ve sinh song manh khoe, nhiing hanh dong lien
quan den tinh due an toan tao nen hanh phuc.
- Thong diep mot mat: chi trinh bay nhiing liu diem cua thiic hien hanh
dong ma khong de cap den bat ky nhUdc diem cd the xay ra nao.
- Thong diep hai mat: trinh bay ca Uu diem va nhiidc diem khi thiic
hien hanh dong.
- Nhung thu hut qua thong diep tich cUc: truyen thong cd yeu cau moi
ngUdi lam nhiing viec gi dd: vi du nhii nuoi con bln g siia me, xay diing ho" xi.
- Thu hut qua thong diep dUOng tinh va dm tinh: thu hut am tinh sii
dung thuat ngii nhii la "tranh", "khong" de khuyen khich moi ngUdi
khong thiic hien nhiing hanh vi cd hai cho siic khoe, ch&ng han nhii
"khong nuoi con b ln g chai siia", "khong di dai tien bifa bai" v.v... Phan
ldn cac nha giao due siic khoe dong y r in g tot hdn la dung thong diep
dudng tinh de thuc day cac hanh vi cd ldi cho siic khoe vl du nhii "h£y
nuoi con b ln g siia me", "sii dung ho" xi hdp ve sinh".

141
 - Cau true thong diep: theo ly thuyet thong diep co sii dung bat ky giac
quan nao trong nam giac quan: nhin, sd, nghe, nem, ngUi. Tuy nhien
giac quan chung ta sii dung chinh trong truyen thong la nghe va nhin.
Nhiing thong tin co the chuyen di qua tieng dong. Cac tut co the d dang
noi hoac viet hay qua hat. Thong tin cung co the chuyen di dudi dang
khong phai b&ng tii ngii: truyen thong khong ldi. Truyen thong khong ldi
bao gom: dang dieu, cU chi tay chan, hiidng nhin, giong noi va ve mat.
Truyen thong khong ldi luon dUdc phoi hdp vdi truyen thong b&ng ldi
trong cac phudng phap truyen thong triic tiep. Cung mot thdi gian, cung
mot doi tudng ngudi TT-GDSK cd the su dung nhieu phudng phap de
truyen thong diep den doi tudng.
- Noi dung thiic sii cua thong diep: noi dung thiic sii cua thong diep
bao gom cac tuf, cac biic tranh va tieng dong tao nen sii hap dan cua
thong diep truyen di. Trong chUdng trinh cua dai noi dung cd the bao
gom: ldi khuyen, cac tii ngii, giong ndi, am nhac. Mot ap phich cd the bao
gom: nhiing biic tranh, cac tii hay cum tii ngkn gon, cac anh, cac bieu
tudng va cac loai mau sac khac nhau.
Trong truyen thong qua thi giac chung ta cd the thiic hien "phan tich thi
giac" va phan tich noi dung cua truyen thong thi giac mot cach cu the hoa:
+ Dieu gi thiic sii dUdc ndi den, tii nao diidc sU dung?
+ Kieu chii nao dUdc sii dung: chut in, chii thudng, chii thang hay chii
nghieng?
+ Kich thudc cua cac loai chii?
+ Mau va phudng phap in an?
+ Tranh diidc sii dung (minh hoa) la gi, cac loai anh nao dUdc dua vao,
cac dudng ve ddn gian hay chi tiet hoac tranh hoat hinh?
+ Kich thiidc va mau cua cac biic tranh ra sao?

3.3. Yeu cau vdi kenh truyen thong

- Kenh truyen thong phai phu hdp vdi do'i tiidng: khi chon kenh thong tin
phai quan tam den kha nang tiep can vdi kenh thong tin cua do'i tiidng
dich. Nguyen tac chon kenh truyen thong la dam bao toi da nhom do'i
tiidng dich cd du cac dieu kien de thu nhan dUdc thong tin tii kenh
truyen thong dd.
- Cac phudng tien, thiet bi phai dam bao cac tieu chuan ky thuat. Vi du
nhii cac phiidng tien nghe nhin chuyen tai cac hinh anh, am thanh, ldi
ndi, chii viet phai ro rang, day du. Can co' g&ng de han che den miic toi
da tinh trang true trac ky thuat xay ra khi dang truyen thong, cd the
gay gian doan hay lie che ngUdi nghe, ngiidi xem, lam cho ho khong tiep
tuc chu y den chiidng trinh.
- Khong bi cac yeu to' gay n h ilu (on, sai lac thong tin).
- Chuyen tai diidc thong tin, thong diep kip thdi, chinh xac va day du.
- De sii dung, sii dung diidc lau dai, thuan tien trong bao dudng...

142
4. CAC KY NANG TRUYEN THONG GIAO TIEP CO BAN CAN REN LUYEN

Trong thuc te chung ta co the nhan thay thiic hanh truyen thong, giao
tiep co hieu qua rat khac nhau d ngUdi nay va ngudi khac. Phan ldn nhiing
ngiidi cd ky nang truyen thong giao tiep tot la nhiing ngudi da trai qua hoc
hoi va ren luyen trong thiic te. Ho da nam chac cac nguyen tac cd ban khi sii
dung cac phudng tien, phiidng phap trong truyen thong giao tiep va biet van
dung cac kinh nghiem cua minh vao cac hoan canh cu the. Vdi nhiing can bo
TT-GDSK, yeu cau phai cd kha nang giao tiep de thuc hien tot nhiem vu.
Dudi day trinh bay mot so ky nang cd ban nhat ma cac can bo thiic hien TT-
GDSK ndi chung can ren luyen de cd the hoan thanh tot nhiem vu cua minh.

4.1. Ky nang noi

Ldi ndi la cong cu trong giao tiep hang ngay cua con ngiidi. Trong TT-
GDSK sU dung ldi ndi triic tiep thiidng dem lai hieu qua cao nhat. Tren thiic
te khong phai ai cung biet sii dung ldi ndi hieu qua. Ndi nhu the nao de ngUdi
nghe d l nhd va thuyet phuc ho hanh dong thi can phai ren luyen. Khi ndi
khong chi ndi bang ldi ma can ket hdp vdi cac giao tiep khong ldi nhu anh
mat, net mat, cac dong tac cua cd the. Ldi ndi phai the hien hai hoa vdi cac cii
chi, dong tac, net mat, anh m lt, thudng dUdc goi la ngon ngii khong ldi, ngon
ngii cua cd the.
Mdi ngUdi cd the lam cho cach ndi cd hieu qua hdn bang cach ap dung
cac nguyen tac cd ban khi ndi la:
- Dam bao tinh chinh xac: van de trinh bay cd day du cd sd khoa hoc va
thiic tien.
- Ndi rd rang: cac tii ngii phai dUdc chon liia can than, n g ln gon, sue tich.
- Ndi day du: dam bao du thong tin can thiet tranh hieu lam.
- Ndi theo he thong va logic: cac noi dung ndi phai lien tuc, noi dung trudc
md dudng cho noi dung sau, khong ndi trung lap, cac noi dung lien ket
chat che vdi nhau.
- Thuyet phuc do'i tudng: dam bao noi dung dap iing nhu cau cua do'i
tUdng, cach ndi hap d in thu hut sii chu y cua do'i tUdng nghe, mang tinh
giao due sau sac, phu hdp vdi hoan canh thiic te, d in den thay doi hanh
vi cua doi tudng nghe.
Nhung trong TT-GDSK, nhieu khi neu chi ndi thi chua du, ma can phai
ket hdp ndi vdi cac thao tac, hudng dan hoac chi cho ngudi ta thay dUdc neu cd
the. Ldi ndi se cd siic manh hdn neu dUdc ket hdp vdi sii dung cac hinh anh,
cac vi du minh hoa thiic te.
Khi ndi can chu y den 3 khia canh cua ldi ndi:
- Am to'c ldi ndi: ndi vdi toe do viia phai, mach lac, thich hdp vdi do'i tiidng
nghe, tranh ndi qua nhanh hoac qua cham va rdi rac.

143
 - Am liidng ldi noi: du to de moi ngiidi nghe ro rang.
- Am s ic ldi noi: co nhan manh, thay doi ngtf dieu tram bong cho phu hdp,
ngufng, ngat dung cho de moi ngUdi co the suy nghl va lien he ban than,
tranh noi deu deu gay buon ngu nham chan cho ngUdi nghe.
Khi noi can tranh cac yeu to' co the gay kho chiu cho ngUdi nghe nhii lap
di lap lai mot so' tvf dem khong can thiet, noi sai van pham, phat am khong
dung, dung tti khong pho thong, tii chuyen mon, cii chi dong tac khong phu
hdp vdi ldi ndi, khong chu y va ton trong ngiidi nghe...

4.2. Ky nang dat cau hoi

Dat cau hoi cung la ky nang ma can bo TT-GDSK can thiic hanh de sii
dung tot trong truyen thong giao tiep. Hoi n h im cd dUdc thong tin tii cac do'i
tudng dUdc TT-GDSK, dac biet la thu nhan thong tin phan hoi. Hoi de biet
nhan thiic, thai do, hanh vi cua dd'i tiidng dich, qua dd hiidng dan cac y tudng,
ldi khuyen, hanh dong thich hdp. Trong cac hoat dong TT-GDSK triic tiep hoi
n h im tham dd cac phan iing, tao nen khong khi giao tiep sdi noi, tich ciic, thu
hut sii tham gia, tap trung sii chu y suy nghi, kheu gdi nhiing sang kien, kinh
nghiem cua do'i tUdng, nhat la trong cac cuoc thao luan nhom. Cau hoi phai
the hien dUdc nhiing dieu cd ban la: cai gi, d dau, khi nao, ai va nhii the nao.
Cau hoi cd hai loai la cau hoi "Dong" va cau hoi "Md". Cau hoi dong de cho dd'i
tiidng tra ldi bang mot tii hay mot vai tii n g in gon nhii "cd" hay "khong", "roi"
hay "chiia"... Cau hoi dong cd the sii dung khi b it dau, ket thuc hay xen ke
trong khi giao tiep. Cau hoi md rat c in thiet diidc neu ra de thu thap dUdc
thong tin nhieu hdn, doi tiidng cd the tra ldi moi thong tin lien quan tuy y.
Cau hoi md thudng dat ra sau cau hoi dong.
Yeu c iu khi dat cau hoi:
- Cau hoi phai rd rang, sue tich?
- Cau hoi phai ngan, khong can phai giai thich tra ldi;
- Phu hdp vdi trinh do hieu biet va kinh nghiem cua doi tiidng;
- Tap trung vao van de trong tam;
- Kich thich tii duy, suy nghi cua dd'i tiidng;
- Sau khi dat cau hoi giii im lang;
- Chi nen hoi tiing cau hoi mot;
- Nen hoi xen ke cau hoi dong va cau hoi md;
- Ket hdp cac cau hoi de va cau hoi kho, cau hoi chung va cau hoi cu the
lien quan den noi dung TT-GDSK.
- Can tranh cac cau hoi cd the lam cho dd'i tiidng cam thay bi xuc pham.

144
 Trtfdc khi hoi doi tiidng, ngtfdi neu cau hoi can phai thu hut sii chu y,
xem xet xem do'i ttfdng da s in sang tiep nhan cau hoi chtfa, lieu cd ngtfdi nao
tra ldi dtfdc khong, cau hoi cd dieu gi kho khan va lam xuc pham den ddi
ttfdng tra ldi khong. Khi yeu cau hoi xong can ngtfng lai de ngtfdi nghe cd thdi
gian suy nghl tra ldi va quan sat, mdi ttfng ngtfdi muon tra ldi. Neu cau hoi
dung luc, dung chd va dung ngtfdi la mot bien phap kich thich qua trinh giao
tiep, thu hut stf tham gia cua doi ttfdng trong TT-GDSK. Ngtfdi thtfc hien TT-
GDSK phai the hien thien chi va tinh tich ciic trong giao tiep bang cach hoi
dap. Luon luon s in sang tiep nhan cac cau hoi ttf phia do'i ttfdng vdi thai do
ton trong va tra ldi het cac cau hoi cua dd'i ttfdng. Chu y gan noi dung tra ldi
vdi noi dung giao due stfc khoe, n h im khang dmh tinh dung d in cua cac kien
thtfc da truyen thong giao due va cac hanh vi lanh manh can thtfc hanh.

4.3. Ky nang nghe

Nghe la mot trong cac ky nang cd ban cua truyen thong giao tiep hang
ngay. Ngtfdi TT-GDSK can biet lang nghe dd'i ttfdng dtfdc TT-GDSK cua
minh de:
- Thu nhan cac thong tin chung ltfdng gia khai quat kien thtfc, thai do,
thtfc hanh va cac y ttfdng mdi cua do'i ttfdng.
- Cd dtfdc thong tin phan hoi dung, du de biet lieu noi dung thong tin,
thong diep truyen di cd dtfdc dd'i ttfdng tiep nhan dtfdc day du va hieu
dung hay khong.
- Cd them nhieu thong tin va y ttfdng de dieu chinh qua trinh TT-GDSK.
- Khich le ngtfdi dtfdc TT-GDSK tham gia tich ciic hdn.
- The hien stf dong cam, thau hieu cac van de va hoan canh cua dd'i ttfdng.
Yeu c iu khi lang nghe:
- Yen lang khi bat dau lang nghe.
- Tao dieu kien de dang cho ngtfdi ndi: giup ngtfdi ndi cam thay ttf tin khi
ndi, dieu nay thtfdng dtfdc goi la tao mdi trtfdng cho phep.
- Khong chi nghe b ln g tai ma phai nghe b ln g ca m it, b ln g cii chi, dang
dieu de khich le ngtfdi ndi.
- Nhin th in g vao mat ngtfdi ndi vdi the hien than thien, khich le ngtfdi ndi.
- Khong dot ngot ngat ldi ngtfdi ndi.
- Khong lam viec khac, ndi chuyen vdi ngtfdi khac, nhin di ndi khac khi nghe.
- Kien tri, khong the hien stf sot ruot kho chiu, lam chu khi nghe.
- Dat cau hoi: dat cau hoi hoac sii dung cac tii ngii phu hoa hdp ly dung
luc se co vu ngtfdi ndi va the hien la ngtfdi nghe dang cham chu nghe
ngtfdi ndi.

145
 - De nghi nhiing ngiidi khac cung chu y lin g nghe.

4.4. Ky nang quan sat

Quan sat cung ttfdng ttf nhtf nghe nhtfng d day chung ta stf dung m it de
thu thap thong tin. B in g quan sat ngtfdi truyen thong co the phan doan dtfdc
ngtfdi nhan thong tin co chu y den van de truyen thong hay khong, lieu ho co
hieu dtfdc noi dung khong. Mtfc do thong tin cung cap da thich hdp chtfa,
ngtfdi nhan co yeu cau them thong tin ntfa khong va lieu ho co s in sang hanh
dong hay khong. Quan sat nhtfng ngtfdi dtfdc truyen thong giup cho ngtfdi
thtfc hien truyen thong cd the hieu dUdc doi ttfdng cd nhiing phan hoi hay
hanh dong tich ctfc hay tieu ctfc de kip thdi cd cac dieu chinh thich hdp. Quan
sat gop phan lam cho doi ttfdng nghe tap trung chu y den van de dtfdc trinh
bay nhieu hdn.
Yeu cau khi quan sat:
- Bao quat dtfdc toan bo doi ttfdng;
- Phat hien dtfdc nhiing bieu hien khac thtfdng d ddi ttfdng de dieu chinh;
- N h ic nhd, thu hut stf chu y cua doi ttfdng;
- Dong vien stf tham gia tich cua doi ttfdng.

4.5. Ky nang thuyet phuc

Thuyet phuc cac doi ttfdng dtfdc TT-GDSK la mot ky nang tong hdp, vi
muc dich quan trong nhat cua TT-GDSK la thuyet phuc dtfdc doi ttfdng thtfc
hanh hanh vi cd ldi cho stfc khoe. De thuyet phuc dtfdc doi ttfdng thi can phoi
hdp nhieu ky nang khac nhtf lam quen, ndi, hoi, nghe, sii dung phtfdng tien va
hinh anh, vi du minh hoa, ho trd doi ttfdng. C in lam cho ngtfdi dtfdc TT-
GDSK tin ttfdng vao nhiing thong diep cua ngtfdi gxii la dung d in va dtfa lai
ldi ich cho stfc khoe, vi the phai thtfc hien theo. Ltfu y la thong thtfdng ngtfdi
ta cd khuynh htfdng dap tfng tot hdn theo htfdng cac ly do ve tinh cam hon la
chi cd ly do thtfc hanh ddn thuan va vi the chung ta c in stf dung tinh cam de
thuyet phuc ngtfdi nhan menh lenh hay thong diep. De thuyet phuc dtfdc doi
ttfdng can biet giai thich cho doi ttfdng. Giai thich la lam cho doi ttfdng hieu rd
hdn van de va cac thtfc hanh c in lam. Giai thich cd vai trd quan trong de
thuyet phuc doi ttfdng tin va lam theo ngtfdi TT-GDSK.
Yeu cau khi giai thich:
- Nam chac van de can giai thich;
- Giai thich day du, rd rang van de;
- Giai thich n g in gon sue tich;
- Sii dung ttf ngii de hieu;
- Sii dung cac vi du va tranh anh, tai lieu minh hoa de giai thich neu cd;

146
 - Giai thich tat ca moi cau hoi ma do'i ttfdng da neu ra;
- B in g ctf chi the hien stf dong cam, kinh trong doi ttfdng, khong dtfOc to
thai do coi thtfdng ho.
- Can co thai do kien tri khi giai thich.

4.6. Ky nang khuyen khich, dong vien

Khuyen khich, dong vien rat quan trong, lam cho doi ttfdng dtfdc TT-
GDSK ttf tin, phan khdi, dtfdc khen ngdi, danh gia cao nen san sang tiep nhan
cung nhtf cung cap het thong tin, de chap nhan nhtfng ldi khuyen ve thay doi
hanh vi.
Yeu cau khuyen khich dong vien
- The hien stf than thien ton trong moi doi ttfdng qua cach chao hoi giao
tiep b in g ldi va giao tiep khong ldi vdi doi ttfdng.
- Khong dtfdc phe phan nhtfng hieu biet sai, chtfa day du, viec lam chtfa
dung hay chtfa lam cua doi ttfdng.
- Cd" gang tim ra nhiing diem tot cua doi tUdng de khen ngdi du la nhd.
- Tao cd hoi de moi doi ttfdng tham gia qua cac cau hoi yeu cau doi ttfdng
trinh bay y kien, kinh nghiem cua ho.
- Thu hut stf dong tinh, ung ho cua nhtfng ngtfdi khac de dong vien doi ttfdng.
- Tao dieu kien tiep tuc ho trd doi ttfdng thtfc hien cac thtfc hanh hanh vi
lanh manh.
- Chu y dong vien ve tinh than, tam ly, nhtfng trong mot so trtfdng hdp
hoan canh nhat dinh neu cd dieu kien cd the dong vien b in g vat chat.
- Tao dtfdc mdi trtfdng xung quanh ho trd, khuyen khich dong vien doi
ttfdng (mdi trtfdng gia dinh, cong dong).

4.7. Ky nang suf dung tai lieu TT-GDSK

Phoi hdp stf dung tai lieu khi TT-GDSK trtfc tiep se tao nen tinh hap
d in cua hoat dong giao due va giup doi ttfdng de hieu van de hdn. Nhtfng hinh
anh vi du minh hoa dung luc, dung cho, dung noi dung, dung doi ttfdng cd the
cd tac dung thuyet phuc hdn nhieu so vdi ldi ndi.
Yeu cau khi stf dung tai lieu TT-GDSK:
- Tai lieu stf dung phai phu hdp vdi chu de va doi ttfdng;
- Stf dung cac tai lieu da dtfdc chinh thtfc ltfu hanh, cd cd sd khoa hoc, tai
lieu da dtfdc thtf nghiem.
- Stf dung dung luc, dung cho tai lieu de thu hut dtfdc stf chu y, tranh lam
cho doi ttfdng khong tap trung vao chu de TT-GDSK.

147
 - De moi doi ttfdng nhin ro hoac doc diidc tai lieu.
- Gidi thieu day du va giai thich cho doi ttfdng hieu rd tai lieu.
- Htfdng d in rd cau true logic cua tai lieu va cach sii dung tai lieu.
- Htfdng d in rd nhtfng dia diem cd cac tai lieu lien quan can thiet khac de
doi ttfdng cd the tim hieu them.

4.8. Mot so" ky nang khac

4.8.1. Chon thdi gian truyen thong gido due Stic khoe

Chon thdi gian thich hdp la mot yeu td" quan trong gop phan lam cho
truyen thong cd hieu qua. Stf tiep nhan thong tin phu thuoc vao trang thai
^tam ly cua doi ttfdng, thdi gian khac nhau trang thai san sang tiep nhan
thong tin khac nhau, vi the can phai chon thdi gian truyen thong hdp ly.
Truyen thong qua muon cd nghia la ngtfdi nhan cd it hoac khong cd
thdi gian de dap tfng hoac yeu cau them thong tin cua ngtfdi truyen thong
cho viec lap ke hoach hanh dong. Truyen thong qua muon thtfdng xay ra khi
chung ta quen giii di cac thong diep can thiet, do cong viec ban ron thieu
thdi gian hoac cac trd ngai khac. Hau qua cua truyen thong qua muon la
ngtfdi nhan khong thoai mai, dan den cong viec khong dtfdc thtfc hien hoac
thtfc hien khong day du.
Truyen thong qua sdm cd the lam cho ngtfdi nhan quen hoan toan hoac
quen mot phan thong diep, ho se khong dap tfng lai cac thong diep theo mong
muon. Neu ngtfdi giii muon truyen di thong diep mot thdi gian dai trtfdc khi
muon cd dap tfng vdi thong diep thi phai theo ddi va can n h ic lai thong diep dd.

4.8.2. Chon doi tiidng va dia diem truyen thong gido due site khoe
Mot dieu ddn gian la neu khong chon dung ngtfdi can truyen thong thi
thong diep se khong dtfdc thtfc hien, vi vay chon dung doi ttfdng dich de truyen
thong se la yeu td" quyet dinh viec dat dtfdc muc tieu cua truyen thong. Khi
chon doi ttfdng can chu y tfu tien trtfdc tien cho cac doi ttfdng cd anh htfdng
quyet dinh den thay ddi hanh vi ve van de truyen thong giao due stfc khoe.
Ndi de truyen thong cung gop phan quan trong cho viec tiep nhan cac
thong diep va dap tfng cua ngtfdi can nhan thong diep. Trong thtfc te ddi khi
cung mot thong diep nhtfng neu chung ta biet chon ndi thich hdp truyen
thong cho ngtfdi nay se cd hieu qua, nhtfng cung vdi thong diep dd, d ndi dd
vdi ngtfdi khac chtfa ch ic da cd hieu qua vi the" chung ta can can n h ic de chon
ndi truyen thong cho phu hdp. Cac can bo y te can phai biet sii dung cac thdi
cd thuan ldi de thtfc hien TT-GDSK nhtf d nhtfng ndi cong cong, ndi cd hoi
hop, sinh hoat cua cong dong, tai cd sd kham chtfa benh cua nha ntfdc, tap the
va ttf nhan vv...

148
4.8.3. Dat cau hoi kiem tra sau TT-GDSK

Kiem tra n h im danh gia kien thtfc thai do va hieu biet ve cac thiic hanh
cua doi ttfdng ngay sau buoi TT-GDSK trtfc tiep, ttf do co the bo sung ngay cac
thieu hut va tom t it nhan manh nhtfng gi can nhd, can lam tiep theo. Day la
cach thu nhan thong tin phan hoi nhanh ngay sau cac hoat dong TT-GDSK
trtfc tiep.
Yeu cau dat cau hoi kiem tra:
- Khon kheo khong de cho doi ttfdng cam thay bi xuc pham vi bi kiem tra,
danh gia.
- Dat cau hoi tap trung vao cac van de trong tam da TT-GDSK ma ddi
ttfdng can phai nhd, hoac can phai lam.
- Ket hdp cau hoi dong va cau hoi md de thu thap dtfdc du thong tin.
- Khi cau tra ldi cua doi ttfdng chtfa du, can bo sung ngay cho doi ttfdng.
- Khong nen truy xet doi ttfdng khi ho khong tra ldi dtfdc du.
- Luon khich le, dong vien de ho thoai mai khi tra ldi.
- Cam dn khi ho da tra ldi cau hoi.
- Can bo sung ngay cac noi dung quan trong ma doi ttfdng chtfa tra ldi dtfdc.

4.8.4. Chon cac phitong tien truyen thong dai chung

Cac phtfdng tien truyen thong dai chung ngay cang phat trien rong rai.
Khi thtfc hien cac noi dung giao due stfc khoe trong pham vi rong, can chuyen
tai thong tin nhanh, can bo truyen thong giao due stfc khoe can lien he, phoi
hdp vdi cac cd quan thong tin dai chung de long ghep, s\i dung cac phtfdng
tien nhtf: dai, tivi, bao chi cho muc dich truyen thong giao due stfc khoe. Khi
stf dung cac phtfdng tien thong tin dai chung nay vdi muc dich giao due stfc
khoe, can phai chuan bi noi dung chu dao, lap ke hoach thdi gian chat che de
chuyen tai thong diep kip thdi, chinh xac, phu hdp vdi van de, phu hdp va thu
hut dtfdc stf quan tam cua cong chung. Dac biet can chu y den pham vi va doi
ttfdng cd kha nang tiep can dtfdc vdi cac phtfdng tien thong tin dai chung de
quyet dinh ltfa chon phtfdng tien phu hdp vdi chtfdng trinh TT-GDSK.
Tom lai ngtfdi thtfc hien TT-GDSK can ren luyen rat nhieu ky nang de
dam bao cho hoat dong TT-GDSK thu dtfdc ket qua tot. Cac ky nang nay phai
dtfdc ren luyen lau dai trong suot qua trinh hanh nghe cua can bo y te, can bo
TT-GDSK. Cac can bo y te, can bo TT-GDSK phai can ctf vao dieu kien thtfc
te, biet sii dung phoi hdp cac ky nang, sii dung giao tiep b in g ldi va khong ldi,
truyen thong trtfc tiep va gian tiep qua phtfdng tien thong tin dai chung mot
cach hdp ly de cd the dat dtfdc hieu qua cao nhat trong thtfc hien nhiem vu
TT-GDSK, gop phan nang cao stfc khoe nhan dan.

149
CAU HOI TU LUONG GIA
1. Neu cac muc dich chinh cua truyen thong.
2. Ve sd do cac khau cd ban cua truyen thong.
3. Trinh bay cac btfdc cua qua trinh truyen thong.
4. Ve va giai thich sd do cac giai doan anh htfdng cua truyen thong den
doi ttfdng dich cua truyen thong.
5. Trinh bay cac yeu cau can co cua can bo truyen thong giao due stfc
khoe.
6. Neu 6 yeu cau doi vdi thong diep giao due stfc khoe.
7. Neu cac yeu cau doi vdi kenh truyen thong.
8. Phan tich cac ky nang truyen thong giao tiep cd ban can ren luyen de
thtfc hien TT-GDSK hieu qua.

150
 TAI LIEU THAM KHAO
■

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education and health promotion. M acm ilan Education LTD, London and
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151
 NHA XUAT BAN Y HOC ■

GIAO DUC VA NANG CAO StfC KHOE

Chiu trach nhiem xuat ban

HOANG TRONG QUANG

Bien tap: BS. NGUYEN TIEN D0NG

SCra ban in: BS. NGUY§N TIEN D0NG
Trinh bay bia: CHU HUNG
Kt vi tinh: LE HA NINH

In 1000 cuon, kho 19 x 27cm tai Xirdng in Nha xuat ban Y hoc.
So dang ky ke hoach xuat ban: 22 - 2007/CXB/751 - 151/YH
In xong va nop luU chieu quy I nSm 2007.