Posted at 12.14.2018
This thesis paper tries to figure out 'the importance of health communication and telemedicine technology for the integral growth of medical care management in the rural and remote part of India'. In some of the rural areas of India the telemedicine technology is integrated successfully and individuals for the reason that area are acquiring better professional medical services than before. This technology is quite new in the country like India and lot of work needs to be done in future to improve the use of this newly developed technology to deliver quality of medical service and thus to enhance the health status rural and remote population.
India is having an enormous population and most of the people are in rural areas. Most them don't possess proper usage of education and health care services. So there exists need of good health communication to boost delivery of medical care services. By this, necessary knowledge can be imparted to the people that will help them to boost their own health status on a regular basis. Telemedicine might be useful in these areas as it helps to truly have a successful communication among the healthcare pros and patients who are present at different places. This newspaper points out the actual requirement of telemedicine technology which is one of the various tools of having health communication and the judgment of the medical care pros as well as the patients regarding its importance.
In this interpretive review established thesis, fourteen interviews of professional medical specialists and a survey of twenty patients by by using a questionnaire have been conducted to illustrate the value of health communication (mainly health education) and telemedicine.
First and foremost, I am heartily thankful to my honourable supervisor Eivor Oborn, whose encouragement, guidance and support from the initial to the final level allowed me to develop an understanding of the subject. Your active assistance and valuable ideas have been highly important for me to complete this analysis. I have learned a whole lot from you.
I wish to convey my genuine thanks to Dr Neminath Magadum, the Chairman of "The Gomtesh Education Society's Ashirwad Medical center" for assisting me throughout this review. I because of all the interviewees for spending their treasured time with me at night and providing valuable information.
I owe my deepest gratitude to beloved Course director, Professors, Administrator, Librarians and classmates of Kingston University for their ongoing help, support and advice.
I very cordially thank my classmates during bachelors study Manjunath, Shantesh, Harish & Kadir. Without them it would have never been easy for me to carry out review of the patients.
I am also thankful to my brothers Ameetakumar and Anand; my friends Jamir, Arun, Sunil, Sandeep, Yakub, Abhijeet, Gaurav and Saket for pushing me throughout my studies.
I devote this paper to my parents Bhupal & Kasturi, sisters Sanmati and Deepali whose contribution and support forced me to reach for this level.
Lastly I thank to all of these who recognized me in any respect during the conclusion of this task.
-WARDHAMAN BHUPAL BANAWANE.
In this swiftly developing world, the guidelines of healthcare are also being broadened and the concentration is shifted to advertising of wellbeing & elimination of diseases in community as well as home based care rather than only hospital based care. This shift can be facilitated by implementing telemedicine technology which is a method of health care carried out at a distance at even real time (Jones, 1997).
Health is a concern of everyone for everybody. Healthy people 2010 define health communication as "the artwork and approach of informing, influencing and motivating individual, institutional and general population viewers about important medical issues. " The conditions 'health communication & health education' are being used synonymously the majority of the times. On this era the importance of health education is came to the realization increasingly because which today 'health education' became speciality in itself. The medical care systems seem to be to be inefficient without proper health education programs even though whole lot of planning is performed in execution of medical care services. It shows that health communication isn't just mere exchange of health information but also much more than that.
Health communication is means of facilitating the interaction between healthcare pros and patients or in between the two or more healthcare professionals regardless of working together in same or different organizations situated at distance places. Most of the organizations mainly concentrate on adopting advanced technology used for diagnostic and surgical procedures to meet targets of the patients and to improve organization's capacity. However they often forget the value of interacting with the individuals in rural and remote areas to provide health education and create health awareness in them which in turn can prevent range of diseases. Telemedicine can help the healthcare pros working at area and regional hospitals or multispecialty private hospitals to communicate with the people in rural areas who don't possess proper usage of healthcare services. It will help these professionals to know the issues of rural and distant population.
Telemedicine is a wide strategy. Here the delivery of health services relies upon software of telecommunication. Showing or copy of knowledge in terms of distance education and remote consulting & medical diagnosis within different medical domains can be included in the idea of telemedicine. Purpose (1990) defines telemedicine as "the exploration, monitoring, management and education of the patients as well as personnel that allows ready access to expert advice and patient information regardless of location of patient or relevant information". General public and private health areas have to do much by making use of effective telemedicine technology. It can definitely contribute a lot to health sectors by making utilization of available resources better in a variety of telemedical services (Nymo, 1993).
An upcoming challenge mainly for the general public health services is to meet up with the demand of immensely increasing inhabitants especially in the expanding countries with the use of available resources (cash, healthcare professionals & technology). It isn't possible to displace the doctor or other medical care professionals involved with a patient relation employing this technology. But the thing is the fact that it can facilitate in delivering involved healthcare service to the patients. Thus telemedicine can play a vital role by providing economical benefits to the professional medical system of individual country.
Telemedicine technology can act as a lifeline for most of the individuals who come under poor cost-effective background mainly from producing country like India where there is inequality in delivery of medical care services. More than 70% of the populace live in rural area. Alternatively these folks don't receive quality of professional medical services due to insufficient variety of healthcare experts especially in public areas medical centres and insufficient infrastructure. Because of lack of facilities in these areas helps it be more challenging to hold on to speciality healthcare experts in rural and remote areas. That is why most of the specialists are located in region and capital places. The rural people have to spend additional time and money as well to get assessment from specialists. Telemedicine will reduce the unneeded wastage of cost and time by bridging rural health centres with the region and multispecialty private hospitals located in big cities (Kuppuswamy & Pandian, 2008).
All researchers coping with information technology and health care have said that information solutions play a vital role to make a healthcare system more successful. Nowadays in early on stage of onset of disease, people in rural and distant area where there is unavailability of specialists in health care need not to see right to the specialists in locations to get consulted from them. Development of advanced communication technology like telemedicine will make it easy for these people to get treatment at initial stage without going to cities which will reduce further issues related to particular diseases.
But development and implementation of any IT system in medical care is not an easy process. As Collen (1995) have explained, "developing a detailed medical information system is a far more complex activity than putting a man on the moon have been". Many organizations have encountered difficult situations while applying telemedicine or any other e-Health systems because of different reasons. Before putting into action any change within the organizational set up it is very important to learn the views of stakeholders who will mixed up in process. It needs good planning and management to make the change successful. According to Collins (2000), it's important to understand views, experiences and purposes of the providers as well as users of healthcare services to address the problems and resolve the issues before full implementation of telemedicine.
Identifying, understanding and explaining the key aspects of effective health communication and information system (Telemedicine) as well as making the use of studies as a basis for the success of professional medical management in both private and general public sector are the main aims of the research study. Within this thesis paper I'll discuss the value of health communication (especially providing needed health education to the under and uneducated people in remote and rural part of India) and use of telemedicine to deliver better healthcare services to the rural people. I will make an effort to understand the thoughts of medical specialists and patients regarding this subject matter. The main purpose behind this is to make further development for the important growth of health care management in rural and remote control regions of India.
This research is targeted to learn the answers relevant to the next research questions:
What do we know about effective health communication and telemedicine?
How will it be possible to talk to the individuals in rural areas?
What are the opinions of medical specialists and patients regarding 'importance of health education and use of telemedicine system'?
In what ways might telemedicine influence information seeking, communicating and creating health recognition in a rural community of India?
According to the above mentioned research questions, this thesis will first of all try to discuss the important notions of health communication and telemedicine and secondly interpretation of the studies of interviews of professional medical professionals and reviews of the patients from questionnaire. The entire goal of this research is to know the importance of health communication and telemedicine through qualitative research and utilize that knowledge for the further progress of medical management in rural community of India.
Objectives of the research study are-
To analysis the role of health communication and telemedicine in rural health care.
To know various methods those are used by healthcare experts to provide health education to the people of rural area.
To know how health communication and telemedicine can play a essential role in changing behaviour of rural populace.
Health communication addresses, how specific and community decisions about knowledge of health and techniques are enlightened and influenced through communication. As explained by Rai (1999), communication is the means by which we practice and effect to bring changes in the views and behaviour of others, inspire them and maintain a healthy relation with them. In other words it's the cycle of exchanging emotions, ideas and views in the form of information in between sender and receiver. Health communication links back to you the regions of health and communication and regarded as an important element of efforts in enhancing public and personal health status (Jackson & Duffy, 1998).
There is specific purpose behind doing any act. Communication is done to make someone think in a particular way, to take action or do something. There will vary functions of communication as explained by Andal (1998).
To achieve something.
To find out or make clear something.
Social Contact Function
To make pleasant environment.
To get you to definitely behave in a particular way.
To communicate the feelings or present oneself in a particular way.
Role Related Function
Situation requires it.
To transmit knowledge.
To bring interest.
To provide leisure activity.
Cultural Advertising Function
To reinforce ethnical rites.
Effective communication: -
The main reason for having communication is the exchange or transfer of information by means of thoughts and ideas (Ramchandran & Dharmalingam, 2001). It really is the main facet of educational process which aims at change in behaviour or attitude and improves level of knowledge. We can say communication was effective only when the message is properly interpreted by the receiver and utilised it for improvement of the knowledge. Thus effective communication means not only getting of information but also enabling the receiver to acquire change in information or improvement in knowledge.
Health communication includes understanding and use of communication strategies to boost community and specific decisions to improve the current health position. It binds the domains of health insurance and communication to improve the health of the populace. Health communication can add largely in protection and campaign of diseases, to boost health provider-patient relationships, in activity of open public and individual health risk information, formulation of public health text messages, in providing education o the population about how exactly to find access to the public healthcare delivery system and total development of telemetric applications as well as connection of individuals to clinical advice (Feng H, 2006).
"Health communication is the utilization of communication techniques and solutions to positively effect organizations, individuals and people for the intended purpose of promoting conditions conducive to human being and environmental health. It could include various activities such as physician-patient interactions, self help categories, classes, mailings, media events and campaigns" (US office of health and human being services, 2000).
"Health communication is the dissemination and interpretation of health related announcements" (Donohew & Ray 1990, Steinberg 2007).
"Health communication is a cross field that derives from communication studies, marketing, journalism and pr and also overlaps with health education and health promotion" (Cline, 2003).
As explained by WHO (1946), "Health is circumstances of complete physical, mental and interpersonal well being rather than merely the lack of disease or infirmity". Health encircles the essence of health education by making neighborhoods as well as individuals as equal partners in the process of assuring independence from disease or diseases and achieving the highest degree of physical, social and mental health (Gupta & Mahajan, 1991). In identifying the Physical wellbeing of the individuals, the factors such as where they work, with whom they have interaction and the type of work they actually should be considered to boost health.
A group of operational tasks have to be completed in the process of development of any health communication. At the basic level, these duties may contain choosing credible sources, choosing the strategy of subject matter and deciding the ideal channels or settings through which the communication is usually to be provided (Kreuter & Wray, 2003). Each solo activity of these provides an opportunity to improve the request of communication to its designed audience. Communication may contain designed or unplanned content which includes the capability to present positive, negative or neutral health text messages to the community. Usually specific strategies are implemented behind planned communications because of its formulation and location. These are intended to change behaviour, values and behaviour of people.
Thus health communication can be an important part of medical which is aimed at promoting healthy behaviour. Health education is a type of medium which can be used to make people aware of healthy behaviour patterns and its importance. But the success of health communication or health education programs will depend upon the interest of the individuals. It is vital that they should involve positively in it. We can not enforce visitors to change; we can stimulate them to look at healthy life. It really is a notoriously sophisticated and problematic task to change one's health related behavior (Lawrence, 1999). It really is exhibited through research that client's attachment with their own health status is the important factor in their adoption to a behavioural health change (Callaghan, 1999).
Health communication may take place between health care providers and patients or health care providers and people in the community. It may take place straight or indirectly at even real-time. Development of information systems is very important to make health communication successful at broader level. People in rural and remote control areas don't obtain proper medical services due to numerous problems. So it is very important to talk to them to learn the problems they may be facing and make the necessary planning and execution to resolve those.
By means of communication technology like telemedicine it will be possible to own communication between your healthcare experts at speciality nursing homes situated in locations and people of rural and remote areas. This will help to solve many health problems of rural inhabitants. Apart from this it'll make easy for healthcare experts at public main health centres or even who doing private practice in rural areas to get communication with specialists in multispecialty clinics. It will help these professionals to make the decisions, examination and treatment. It will also help these pros to revise their own knowledge.
Various stations used for having health communication are as below,
Health related articles in newspaper are important channels to send out information.
If information is presented well in the magazines then these can become valuable mean of communication.
These are created colourful to appeal to the attention of people and convey the health messages to them. This is the best and cheapest way of disseminating information to the people. They are widely employed by the healthcare experts at hospital and community to provide health information to a small group of people.
These are expensive and difficult to get. Alternatively are appropriate to audience. Can communicate intended health concept to a huge number of people in less time.
An important route of providing health education. But health talks shouldn't be too long.
It is quite expensive at the start of establishment but after that it becomes the most effective channel as meaning can be delivered to huge number of folks within short time.
If it is well targeted and arranged properly then can catch the attention of and arouse large numbers of people.
Difficult to implement but can reach to remote and rural people easily.
Easy and cheap way of communication. But less effective in a country with low literacy rate.
(Babu S 2004. Review in community treatments; pg 181)
Health education programs related to behavioural change are considered as a mainstay of health care activity. The effect of these programs depends through to the nature of their intention and the way they are supplied (Whitehead & Russel, 2004). Health education is a public science that pulls from the medical, biological, physical, environmental and subconscious sciences to avoid the starting point of diseases and promote health through education powered behaviour changing activities. Quite simply, health education is the development of a person or group or community health knowledge, skills and behaviour with the aid of systemic strategies.
Throughout this century health education has been an important component of action in prevention of diseases and campaign of health. Health campaigns to prevent communicable diseases, to market maternal and child health, to promote immunization, to teach about family planning methods as well as its importance and other precautionary health services have long record. Health education directed towards these goals in almost all of the growing countries remains an essential weapon in prevention of diseases and campaign of health (Nutbeam D, 2000). The primary objective behind providing health education is to positively influence health related behaviour of the city and individuals. In addition, it helps to influence living and working conditions that improve their health.
"Health education is the procedure which includes activities like providing information, motivating and supporting people to choose and keep maintaining healthy lifestyles, advocates environmental modifications that are required to assist in this goal and carry out research and professional training" (Baride & Kulkarni, 1998).
Health education relates to changes in emotions, knowledge and behaviour of individuals. It targets developing healthy lifestyles and thought to attend the perfect state of health (Dharmalingam & Ramchandram, 2001). It's the process carried through the productive involvement of people directed at initiation of healthy behaviour and knowing the people's prejudices and methods that are determent to health for attaining the goal of health.
A series of stages and people efforts independently are involved in the process of health education. Health education is an activity which might be required for each individual anytime. It is a continuous ongoing process of learning from others. Anyone who knows that what is essential for the maintenance of good health can offer health education to the others by using proper communication route and ideas. As health education has to do with health, it is very important to have large and right knowledge regarding health and diseases for disseminating or transmitting ideas for the purpose of developing necessary behavior and frame of mind.
In the procedure of health education theories and key points of education and learning are applied. That is why a person who is trained properly for providing healthcare is way better fit to provide health education to the community. It doesn't mean that any person who's from non medical background cannot are likely involved of health educator but only reveals the importance of possession of right and complete knowledge related to health, diseases and their application. As the primary motto of health education is to change behaviour of folks, health educator must learn and cultivate skills to connect, educate, involve and encourage them. Health educator should be known to theories of community corporation as well as knowledge and rules of social psychology.
Different planning models are being used for the introduction of health education interventions. Public health models used in social drugs and epidemiology are somewhat different from public health models used in health education. As mentioned by Kok and et al (1997), interventions of behaviour focused health advertising and health education are usually predicated on planning models of pursuing type,
Behaviour that is determinant of the problem
Psychosocial and environmental determinants of behaviour
Development and implementation of the intervention
Not only epidemiologic examination but also a behavioural knowledge approach to involvement execution and psycho-social examination is necessary in this kind of planning model. If behaviour is an essential aspect behind lifestyle of health problem then it's important to analyze the determinants of the behavior. These determinants may be environmental or psycho-social (emotional level of resistance, risk perception, perceived norms, knowledge etc. ). Most of the times the concentration is given only on individual behaviour but it is important to target social as well as physical environment for health education interventions.
Approaches to health education:-
According to Tones (1986), there are three approaches to health education as follow,
It focuses on specific. Its goal is to convince the given individual to choose needed lifestyle to prevent onset of diseases and hence reduce morbidity and mortality in the populace. The real reason for this is; in the American industrialized modern culture the curative medication cannot offer effectively with the modern-day burden of disease. And not only high technology is ineffective but also it is iatrogenic and expensive.
Health education have major role in extra as well as tertiary reduction aside from its potential for primary reduction. Another good thing about it is that it offers financial savings to the federal government by lowering the demands on health service.
According to this way health education is concerned with freedom of choice and rationality. It expresses that only provision of information regarding medical issues is not sufficient to bring behavioural change. To accomplish decision making is recognized as the principal goal of health education irrespective of the type of decision that will be made ultimately. The rule of voluntarism has been followed by the World of Public Health Teachers of America in its code of ethics. Thus it could be argued that model of health education has 'Formal' approval. Authors such as Green (1980) have regularly supported fostering informed health choices and protecting free will.
This way has its critics regarding the aspect of genuine free choice. It is clear in lots of ways that freedom of preference can be limited. It really is less apparent reality that an individual's convenience of making rational and voluntaristic selections can be reduced by particular kinds of socialization especially which occurs in the framework of the 'culture of poverty'. Alternatively, individuals have higher degree of genuine choice whose socialization has provided them with self applied empowering skills and
experiences. In many instances freedom of choice is slice short
manifestly by negative social circumstances. Hence, it is will be inadequate and unethical to teach people in such circumstances.
Steinberg, S (2007). An advantages to communication studies, Juta and co. Publication, Cape town.
Preamble to the Constitution of the World Health Business as used by the International Health Seminar, New York, 19-22 June, 1946; agreed upon on 22 July 1946 by the representatives of 61 States (Official Files of the World Health Firm, no. 2, p. 100) and got into into force on 7 April 1948.