**2. Health education: defining a concept**

The concept of health education has changed over time. In fact, it is an expanding and evolving field. Several authors have defined the concept, and the analysis of some of these definitions allows us to verify the presence of common aspects, such as the cognitive (knowledge), and behavioural dimensions.

The role of the person and the community in advocating for their health is also introduced. Other aspects highlighted were the combination of teaching methods, the introduction of the term 'facilitating', which emphasises the role of the educator as a facilitator of behaviour change, as well as the reference to the participation of the patient in behaviour change towards the adoption of healthy behaviours [26].

What is health education:

*"All intentional activities leading to learning related to health and disease […], producing changes in knowledge and understanding in ways of thinking. It can influence or clarify values, provide changes in beliefs and attitudes, facilitate the acquisition of skills, and also lead to changes in behaviour and lifestyles" ([26], p. 25) (1st ed.).*

#### Whitehead and colleagues health education is:

*"An activity that seeks to inform the individual about the nature and causes of health/ disease and the individual's level of personal risk associated with their lifestyle-related behaviour. Health education seeks to motivate the individual to accept a process of behaviour change through the direct influence of their value, belief and attitude systems, where it is deemed that the individual is particularly at risk of or has already been affected by illness/disease or disability" ([28], p. 313).*

Both definitions bring together essential factors of health education, namely, to inform, motivate, change, and facilitate, aiming at the acquisition of skills and knowledge to change behaviours and lifestyles that are unhealthy for the person.

In this sense, health education is a teaching and learning process focused on wellbeing, prevention and health promotion. The main focus is on changing and improving health behaviours. It is very similar to patient education, but in this case, the focus is on assessment, diagnosis, and the individual needs of the person. In both approaches, patients take a more active and informed role in decisions related to their health. The role of health professionals is to support the patient in this journey.

This clearly refers to the World Health Organisation's definition of health education: "The process which enables populations to exercise much greater control over their health and to improve it" [15].

In this field, three generations of health education have emerged alongside sociopolitical changes and risk factors: the first generation, based on information and inspired by the biomedical model, the patient should follow the doctor's indications and recommendations; the second generation, centred on behaviour, takes into consideration the need to reduce high morbidity and mortality due to unhealthy lifestyles, while information is only part of the process; the third generation takes participation as the main focus and advocates alternatives for social change, given that not everything depends on the people [29].

Several models support the many perspectives of health education; however, we will only refer to some of these models because they go beyond the scope of this work.

The medical model belongs to the first generation and is characterised by the mechanistic view of medicine, which sees the body as a machine whose parts need to be repaired. It is associated with the authoritarian and paternalistic line of medicine.

The Health Beliefs Model assumes that people act if they perceive (i) they are susceptible to the disease-health condition (ii) the condition would seriously affect their lives (iii) the benefits of their action outweigh the difficulties and (iv) they can perform the action. It means that the person's behaviour is influenced by their beliefs [30].

The Diagnostic Assessment of Predisposing Factors, Reinforcers, Facilitators and Educational Causes Model is used to diagnose and plan educational practices, based on the analysis of the predisposing, facilitating, and reinforcing factors of behaviour, and should be combined with behaviour change models [31].

The Critical and Participatory Models present the proposal of social change and integrate the dialectical interaction between people and their context, promoting the participation of the person and the group [26].

The Empowerment Model seeks to develop the person's capacity to control their health status in their environment. The model seeks to develop life skills, such as decision-making and problem solving, so that the person can take control of their own life. People are encouraged to develop critical thinking and to create critical awareness. Creating critical awareness implies that the person is empowered in their beliefs, feelings, and skills. The model argues that the targets of education are people in general, health professionals and others involved in social and environmental change resulting from political pressures. The main aim is to maximise genuine and voluntary choice. The model also stresses that it does not matter what choice a person makes, as long as it is a rational choice [26].

*The Dialogue between the Patient's Educational Needs and the Knowledge Transmitted by Nurses… DOI: http://dx.doi.org/10.5772/intechopen.103891*
