Health Promotion and Public Health for Nursing Students

Daryl Evans, Dina Coutsaftiki, C. Patricia Fathers

• Publisher: Learning Matters
• Year: 2017
• eBook ISBN: 9781526412126
• Edition: 3
• Topic: Medicine
• Subtopic: Nursing

Preventing illness and improving the general health of the population is a vital priority for the health service with nurses expected to play a central role. Written using clear language this book explains what health promotion is and how it interacts with public health. It shows how health promotion can be implemented while drawing on the main theories, models and evidence that inform practice. The book covers the essential topics like lifestyle changes, health screening and patient education giving you the necessary tools and confidence to integrate health promotion into your day to day nursing practice. Transforming Nursing Practice is a series tailor made for pre-registration student nurses. Each book in the series is:

• Affordable
• Mapped to the NMC Standards and Essential Skills Clusters
• Focused on applying theory to practice
• Full of active learning features

'The set of books is an excellent resource for students. The series is small, easily portable and valuable. I use the whole set on a regular basis.' - Fiona Davies, Senior Nurse Lecturer, University of Derby

Chapter 1

Thinking health promotion

NMC Standards for Pre-registration Nursing Education

This chapter will address the following competencies:

Domain 1: Professional values

2. All nurses must practise in a holistic, non-judgemental, caring and sensitive manner that avoids assumptions, supports social inclusion, recognises and respects individual choice and acknowledges diversity. Where necessary, they must challenge inequality, discrimination and exclusion from access to care.

3. All nurses must support and promote the health, well-being, rights and dignity of people, groups, communities and populations. These include people whose lives are affected by ill health, disability, ageing, death and dying. Nurses must understand how these activities influence public health.

7. All nurses must appreciate the value of evidence in practice, be able to understand and appraise research, apply relevant theory and research findings to their work, and identify areas for further investigation.

Domain 3: Nursing practice and decision-making

5. All nurses must understand public health principles, priorities and practice in order to recognise and respond to the major causes and social determinants of health, illness and health inequalities. They must use a range of information and data to assess the needs of people, groups, communities and populations and work to improve health, well-being and experiences of healthcare; secure equal access to health screening, health promotion and healthcare; and promote social inclusion.

NMC Essential Skills Clusters

This chapter will address the following ESC:

Cluster: Organisational aspects of care

9. People can trust the newly registered graduate nurse to treat them as partners and work with them to make a holistic and systematic assessment of their needs; to develop a personalised plan that is based on mutual understanding and respect for their individual situation promoting health and well-being, minimising risk of harm and promoting their safety at all times.

By the second progression point:

3. Understands the concept of public health and the benefits of healthy lifestyles and the potential risks involved with various lifestyles or behaviours, for example substance misuse, smoking, obesity.

4. Recognises indicators of unhealthy lifestyles.

By the third progression point:

18. Discusses sensitive issues in relation to public health and provides appropriate advice and guidance to individuals, communities and populations, for example contraception, substance misuse, smoking, obesity.

Chapter aims

By the end of this chapter you will be able to:

• define health and health promotion;

• discuss the contribution of the World Health Organization (WHO) to the development and practice of health promotion;

• appreciate the contribution of health promotion strategies to the promotion of good health and well-being;

• understand and integrate theories and models of health promotion into nursing practice.

Introduction

This chapter will encourage you to think about health promotion in relation to your nursing practice. Thinking like a health-promoting nurse will enable you to integrate the principles and practice of health promotion into your nursing care. How do you think like a health promoter? To do so, you need to view patients beyond their presenting medical diagnosis or condition and be mindful that you can contribute and support patients to improve their health by adopting an empowering approach while delivering care related to recovery from illness.

The chapter explores the concept of health and how this informs your health promotion practice. It enables you to develop your knowledge and understanding of the health promotion concept and its contribution to improving the health and quality of life of the individual and the population at large. The chapter explores the origin of health promotion and discusses international and national health strategies and their contribution to the development of your health promotion practice. Theories and models of health are examined in order to enable you to structure your health promotion practice.

What does it mean to be healthy?

Case study: What does it mean to be healthy?

Peter, a 52-year-old school teacher, underwent pancreatectomy and chemotherapy following a diagnosis of an advanced pancreatic cancer. As a result of removing his pancreas he is on insulin injections. He says:

‘I have accepted my diagnosis and now I want to live a normal life. I am confident and competent in self-injecting the prescribed insulin. Shahita, my partner, is my rock. We are able to set realistic and achievable daily goals. Since my illness we have adopted a healthy lifestyle. Our diet, including the diet of Leon (our dog), is much healthier and also we are more physically active. I take Leon for a walk in the nearby park daily. I enjoy the fresh air and meeting the regular dog walkers.

I am back to full-time work. I enjoy teaching and I get a lot of personal satisfaction knowing that I contribute to my pupils’ learning and development. I value the daily structure and social interaction offered by my work. I receive encouragement and support from my colleagues. We are able to have a laugh. However, I am aware that some colleagues feel that I am too ill to be working. They all know that my expected survival time is 18 months.

I have accepted that I do not have long to live; however, 18 months is still a long time. I still have inspirations and dreams. I want the remainder of my life to be lived in full. Shahita and I decided to get married and to have a huge wedding in three months’ time. We have booked our holiday to Australia where we are planning to have our honeymoon. I feel that I am doing the things I always wanted to do but somehow I never got around to doing. I have made a will: I want to put my financial and private affairs into order before the inevitable happens.

Shahita and I talk a lot about death. I am not afraid of dying but I am afraid of how I will die. Will I be in pain? I am very lucky to live next door to Helen, a retired midwife and health visitor. I have known her all my life. She actually delivered me! I have frequent conversations with Helen, updating her with my medical progress, and I am able to seek her advice. She is able to explain things to me. I find her a great emotional support. I have very open and confidential conversations with Helen. I can shed a tear in front of Helen without feeling embarrassed or less of a man.

In the evenings I feel quite tired. I tend to spend most evenings reading, for example, the Bible or one of the many novels I have in my library. I also watch television, mainly the daily news programmes as I like to keep abreast of the day’s events. Some evenings my siblings will come to visit. I enjoy reminiscing with them about the past and the good old days. Overall I have good and bad days like everybody else.’

The case study illustrates that different people have different views of what it means to be healthy. For example, some of Peter’s work colleagues view health as being free from disease. Peter, on the other hand, is in remission and views health as personal fulfilment.

Exploring the concept of health

You need to develop a comprehensive understanding of the health concept because it informs and shapes your health promotion practice. One important point to bear in mind is that an individual’s health status is not static. It is constantly changing throughout the day and is evolving throughout a lifetime. Have you noticed how you feel different at different times of the day – for example, in the morning you may have felt very energetic and by midday you may feel exhausted – or how your mood fluctuates during the day?

Health encompasses the following different dimensions.

• Physical: this is quite obvious as it relates to the functions of your body, for example, ‘I am not well because I have a headache.’

• Emotional: this can relate to how you cope with feelings, such as anxiety and depression, or your ability to recognise your own emotions, such as fear and joy.

• Intellectual: this means that you have the ability to think clearly and coherently.

• Sexual: this means that you have the ability and freedom to establish intimate, loving relationships as well as the choice and ability to procreate.

• Social: this means that you have the ability to make and maintain relationships with other people, for example, having friends.

• Spiritual: this means that you are able to achieve peace of mind or are able to be at peace with your own self. As a nurse you must recognise that this is not only associated with religion. People who do not have a religion can achieve spiritual health by adopting principles of behaviour that lead to spirituality.

Activity 1.1 is designed to enable you to develop a clear understanding of the above health dimensions.

Activity 1.1 Critical thinking

Review Peter’s case study above and discuss either with your peers or with a member of your family the following questions regarding Peter’s health.

• Is he physically healthy?

• Is he emotionally healthy?

• Is he intellectually healthy?

• Is he sexually healthy?

• Is he socially healthy?

• Is he spiritually healthy?

Were there any differences of opinion? Were all of you able to support your argument?

An outline answer is provided at the end of the chapter.

Activity 1.1 has demonstrated to you that health is a very difficult concept to define. When you discussed Peter’s health dimensions, what personal factors influenced your own assessment?

The meaning of health can be influenced by a multitude of factors, such as family and cultural background, religion, educational level, gender, ethnicity and social class. Outside influences include the effects of the media, social environment and government policies. In addition, the individual’s personal life experience will influence his or her views of health.

These influences apply equally to lay people and health professionals. For example, if you reflect back from the start of your nursing studies up to the present time, you may realise that your past and current views about health are different. This can be attributed to the influence of your professional socialisation in the clinical practice and the nursing knowledge you have gained. As a result your health views have been reshaped as you have been exposed to a new professional culture and have developed new expertise.

Lay perceptions of health

As a nurse you are working in partnership with patients and their families, aiming to establish an interactive therapeutic relationship that encourages patients and families to participate in their care and to take responsibility for their health. Therefore, you need to give ‘voice’ and ‘choice’ to patients (DH, 2006a). To facilitate this process you have to seek out their health views. Knowing their health views enables you to design and implement health promotion programmes relevant to patients and communities.

Lay people’s perspectives of health have been researched extensively over the last 50 years. Some people may view health:

• in terms of not being ill – ‘I am well today because I do not have a cold or a headache’;

• in the context of physical fitness – taking regular exercise and being fit;

• in terms of control and risk – binge drinking is seen as a health risk while being able to drink ‘normal’ amounts of alcohol is seen as being in control and having the ability to manage health;

• in terms of not having a health problem that interferes with daily life – an elderly person may consider being healthy as being able to walk or cook or going out to visit friends;

• in the context of social relationships – having friends and family around for social support and interaction;

• as psychosocial well-being – emotional well-being is being happy and undertaking recreational activities such as going on holidays.

As you can see, lay people’s concept of health is diverse, ranging from the functional and medical perspective to the psychosocial perspective. The different views are associated with social class issues, for example working-class people may see health from the functional perspective while the higher socio-economic status groups may see health from the psychosocial perspective. Age and gender are contributing factors; young men may view health from the physical a...

Table of contents

• Cover Page
• Halftitle
• Advertisement
• Title
• Copyright
• Contents
• Transforming Nursing practice
• About the Author
• Introduction
• 1 Thinking Health Promotion
• 2 Tackling Lifestyle Change
• 3 Encouraging Health Screening
• 4 Teaching Patients
• 5 Supporting Self-Management
• 6 Considering Public Health
• 7 Managing Health Promotion in Practice
• 8 Keeping Up Your Skills
• Glossary
• References
• Index