Health Promotion in Nursing Practice

What is health promotion? Health promotion is defined as the process of enabling people to increase control over and improve their health (World Health Organization, n.d.). It involves a combination of health education and related organizational, political, and economic changes aimed at improving health (Hooyman & Kiyak, 1999). Health promotion also focuses on empowering individuals, families, and communities in developing competence and capabilities t required gaining control over daily life events and circumstances, thereby achieving a sense of security. Therefore, the ultimate goal of the health promotion model is to promote a sense of well-being, health maintenance, balance in all aspects of life and not just the absence of disease. (GCU, 2013)
According to WHO, health promotion is creating the framework for health for all people in their everyday lives. (Fry & Rissel, 2010). For decades, the primary focus of health care has been on the care of the sick but in present day and time, the focus has broadened to determining the cause of illness and prevention of disease, thus enhancing the quality of life and life expectancy in general which can only be achieved by educating the public in health promotion which includes prevention and early detection. With improved health standards and statistics, health care providers have been able to conduct researches helping them isolate the cause, develop treatment and establish methods to decrease the spread of the disease. General medical research and specific research for the cause and cure of cancer, lung disease, acquired immunodeficiency syndrome, heart disease and many other life threatening conditions continue to be integral parts of health care system in this country. (Christensen & Kockrow, 1991/2006)
Government has taken initiatives like Healthy People, to improve quality of life and eliminate health discrepancies, communities are working together and nurse are working diligently in changing health care system from a traditional acute care setting based, illness and cure model to a health promotion, health maintenance and disease prevention model, thus improving the lives and empowering individuals and families through education. (GCU, 2013). In today’s health care system, nurses are providing care in collaboration with other nurses, psychologists, therapists, individuals, physicians, social workers, nutritionists and community groups, playing a variety of roles. (Edelman & Mandle, 2010). With the recent changes in health care, nurses are required to be competent in health promotion as one of the skills required in their daily practices.
According to Whitehead (2008) study,
It is well established that nurses often use the paradigms of Health promotion and health education interchangeably within the parameters of their practice (Kulbok et al. 1997,
Morgan & Marsh 1998, Norton 1998, Shields & Lindsey 1998, Smith et al. 1999, Gonser & McGuiness 2001, Whitehead 2001, Reeve et al. 2004, Cross 2005, Rush et al. 2005, Casey 2007, Irvine 2007). (Whitehead, 2008)
According to Whitehead (2008), health education and health promotion are interrelated but not interdependent, and many nurses might not be aware of it. Health education can be a part of health promotion but not the other way around. Nurses need to be health promotion practitioners by defining their roles and engaging themselves as health promoters. Health promotion teaching includes life-style change and behavior modification and health promotion in health maintenance involving community participation and empowerment. (Whitehead, 2008). Thus the role of nurses is shifting from acute, hospital-based care to preventive, community-based care with increased knowledge base and use of evidence-based practice, giving them opportunity to work independently. Nurses are acting as Advocates ensuring all individuals receive high quality, appropriate, and cost effective care. They also work as Care managers, preventing duplication of services contributing to cost reduction. They also provide individuals and groups consultation services in areas of expertise, sharing their knowledge about health promotion and disease prevention. Other roles played by nurses include, educator, healer, deliverer of services, and a very important role as researcher enhancing the quality and value of individual care by evidence-based practice.
There are three levels of health promotion prevention. According to USPSTF, Primary preventive measures avoids or blocks the onset of a sickness in an individual (for example, well child exams and immunizations, counseling and chemoprevention), whereas secondary prevention process identifies and treats persons who have already developed risk factors or symptoms of possible disease, but are asymptomatic (for example, screening for diabetes ,colon cancer, or breast cancer). Preventive care involving the treatment and management of persons with clinical disease are usually considered tertiary prevention. (U.S. Preventive). Primary prevention can be achieved by providing education to the public in community settings on topics like smoking cessation, exercise, diet, alcohol and drugs, violence prevention, safe sex, mental health screening etc.
Secondary prevention involves early detection of disease, early treatment and disability limitation whereas tertiary prevention consists of restoration and rehabilitation process.
References
Christensen, B. L., & Kockrow, E. O. (2006). Foundations and Adult Health Nursing (5th ed.). St Louis, Missouri: Mosby, Inc. (Original work published 1991)
Edelman, C., & Mandle, C. (2010). Health Promotion Throughout the Life Span (7th Ed.). Retrieved from http://evolve.elsevier.com
Fry, Gleeson, & Rissel. (2010). Health promotion and secondary prevention: response to Millet, O’Hara and Develin. Health Promotion Journal of Australia, 21(2), 86-91. Retrieved July 13, 2013, from http://ehis.ebscohost.com.library.gcu.edu:2048/eds/pdfviewer/pdfviewer?sid=82f0daab-3a75-4cf4-8c92-b7d6c1e2fd60%40sessionmgr111&vid=5&hid=116
GCU. (2013). NRS-429V: Health Promotion in Nursing Care, Lecture 2 Notes. Retrieved from https://lc-ugrad1.gcu.edu/learningPlatform
U.S. Preventive Services Task Force. (n.d.). Overview of U.S. Preventive Service Task Force Structure and Processes [Procedure Manual]. Available from http://www.uspreventiveservicestaskforce.org/uspstf08/methods/procmanual1.htm
Whitehead, D. (2008). An international Delphi study examining health promotion and health education in nursing practice, education and policy. Journal of Clinical Nursing, 17, 891-900. doi:1111/j.1365-2702.2007.02079.x