• Health education

Health education has been defined by the WHO (36th World Health Assembly, 1983) as “any combination of planned activities leading to a situation where people want to be healthy, know how to attain health, do what they can individually and collectively, and seek help when needed”.

More specifically, the WHO indicates that “health education is the component of health care that aims to encourage the adoption of healthy behaviours. [...] It helps people become aware of their own behaviour and realize the impact of their behaviour on their state of health. They are encouraged to make their own choices for a healthier life. They are not forced to change. [...] Health education does not fully achieve its purpose unless it encourages people to participate actively in their health and choose for themselves. Thus, health education is not simply telling people to adopt healthy behaviour”. (Manuel d'éducation pour la santé dans l'optique des soins de santé primaires. Geneva : WHO ; 1990).

As it has been defined in the National Health Education Plan (French Ministry of Employment and Solidarity, Secretary of State for Health, February 2001), "the purpose of health education is for all citizens to acquire throughout their lives the skills and means necessary to promote their health and quality of life as well as those of the community. [...] Health education is aimed at the entire population in all of its diversity and has to be accessible to everyone. [...] Health education helps each person, according to his needs, expectations and abilities, understand and assimilate health information to apply it in his life".

• Therapeutic patient education

In 1998, a WHO working group offered the following definition (adopted in France by the Haute autorité de santé and the Institut national de prévention et d’éducation pour la santé, 2007): "Therapeutic patient education aims to help patients acquire or maintain the skills they need to manage their lives with a chronic disease in the best way possible. It is an integral and a continuing part of patient care management. It covers organized activities, including psychosocial support, designed to make patients aware of and informed about their disease, care, hospital organization and procedures, and behaviours related to health and illness. It helps patients (and their families) understand their disease and their treatment, collaborate with each other and take responsibility for their own care, in order to maintain and improve their quality of life”.

In their report "Pour une politique nationale d’éducation thérapeutique du patient" submitted to the French Health Minister Roselyne Bachelot (September 2008), Christian Saout, Professor Bernard Charbonnel and Professor Dominique Bertrand offered a more operational definition focused on the need for independence of patients with chronic disease : “Therapeutic patient education is a process integrated in health care that strengthens patient’s (and family’s) abilities to deal with his illness". It aims to make the patients more independent by enabling them to assimilate health knowledge and skills to change their own behaviour at crucial stages in their care (eg start of treatment, change of treatment, intercurrent events) and more generally throughout the care scheme in order to ensure acceptable quality of life”.

The article 84 of the French law “Hospital, Patients, Health and Territory” (Law No. 2009-879 of 21 July 2009) has included therapeutic patient education (TPE) in the French Public Health Code (Articles L. 1161-1 to L. 1161-6). Thus, TPE is officially recognized as an integral part of patient care.

• Prevention

Prevention covers all measures that aim to avoid or reduce the number and the gravity of illnesses or accidents. We distinguish among three levels of prevention:
- Primary prevention takes place before health problems occur. It aims to decrease the incidence of a disease or an accident, and thus to reduce the risk of new cases ocurrring.
- Secondary prevention takes place at the very start of the disease. It aims to decrease the prevalence of a disease, and thereby to reduce its duration. It includes early screening and treatment of the disease.
- Tertiary prevention aims to avoid recurrences and complications of a disease. It attempts to reduce the functional disabilities resulting from an illness.