Health is defined as a state in which human needs are met in an autonomic way, and is not limited to the absence of disease or disablement (V. Henderson). Optimal health is a lively, self-motivated equilibrium of physical, intellectual, spiritual, emotional, and social well-being. The concept of health promotion delineates the method of empowering people to increase control over, and to advance their own overall health.
The main purpose of health promotion is to heighten people’s motivation to strive for optimal health, while assisting them in making lifestyle modifications that will help them advance their wellbeing to an ideal state. Modifications of the unfavorable way of living can be enabled through a combination of strategies and learning experiences that enhance awareness and rise motivation; most importantly, the change is made possible through the creation of opportunities that permit access to situations that make positive health practices an easy choice.
Individuals and communities require a great deal of health education in order to achieve optimal health levels. The development of health promotion has allowed the nurse to reinforce the profession’s role on health promotion and disease prevention, propagate information that promotes an educated public, and assist individuals and communities to change established negative health behaviors.
The nursing roles in health promotion vary greatly depending on the individual or group’s needs, and their level of readiness to take action toward lifestyle change and behavior modification. In order to be an efficient educator, the nurse has to perform a self-awareness assessment of own health beliefs and practices. In health promotion, it is of great importance that the educators live what they teach, hence becoming models of healthy lifestyle behaviors and attitudes. A nurse who will teach the importance of smoking cessation must not be a smoker; the reason is clear and obvious.
Should the client learn that she smokes, he will lose confidence in her role of health advocate, and undervalue the importance of smoking cessation. The trust of the nurse-client relationship might be compromised, and the likelihood that the client will stop smoking will decrease significantly. An extensive approach of health promotion can be achieved through the nursing process including assessment, diagnosis identification, planning, implementing, and evaluating outcomes. Even though the process is alike, the nurse gives emphasis to teaching the client accountability for self-care. After the client and the educator agree to the goals together, the health-promotion plans are established; thereafter, the client takes accountability for the success of the plans. A comprehensive assessment of the individual health status is fundamental to health promotion.
The nurse has to take in consideration multiple factors, and collect significant data from the client’s milieu before beginning to design a plan of health promotion education. Some elements of assessment should include the health history and physical examination, physical fitness assessment, lifestyle assessment, spiritual assessment, social support systems review, health risk assessment, health beliefs review, and life-stressors review.
Planning has to be done according to the needs, desires and priorities of the client. The client decides on health promotion goals, and the actions and interventions to achieve those goals. During the planning process the nurse acts as a resource person rather than as a counselor. The nurse provides information, highlighting the importance of gradual change, and appraises the client’s goals to ensure that they are realistic, quantifiable, and satisfactory to the client. Implementation is the “acting” towards behavior change. The nurse gives emphasis to self-responsibility for implementing the plan. Depending on the client’s needs, nursing interventions may consist of supporting, counseling, teaching, consulting, modeling, and enhancing the behavior change.
The nurse has to offer ongoing and non-judgmental support that focuses on the desired behavior change. Moreover, the nurse will help the client identify his social support system, which is vital in the goal attainment process. Evaluation of the outcomes should not be sporadic, but rather done on a continual basis in shared collaboration of nurse and client. Evaluation is the time of celebrating successes, or a time when the client may choose to rearrange priorities, or adjust strategies. Health promotion aims a wide range of targets at different levels in the community.
The huge benefits resulted from health promotion and disease prevention efforts make many realize that this domain of health care is worth to be invested in. The focus is shifted evermore from the medical to the preventative approach, from treating the disease to avoiding the onset of it. Nurses have a fundamental role in health promotion by their position and interaction with the community. In acute care settings, they see the people at their toughest times of their lives. It is there nurses can assist patients make important informed decisions in regards to their health. The nurse has the role of assisting the patient in moving in the right direction on the health-illness continuum.
Someone might argue that there is no more room for prevention once the illness occurred, but the truth is that there is always something to be prevented. For example, the patient who was admitted with diabetic ketoacidosis (without even knowing that he had diabetes) will need a lot of information and support on how to manage the disease and prevent complications. The nurse in the acute setting will begin the health promotion process for this patient, and furthermore refer him to diabetes specialists. Once the patient follows-up with them, the odds are that another nurse at the doctor’s office will continue the process of teaching the patient about the disease management. Disease prevention is included under health promotion umbrella, and consists of three levels of prevention: primary, secondary, and tertiary.
The difference between them is determined by the specific point in time in the course of the disease progression when the health promotion is initiated. The primary prevention targets health promotion and protection before disease or dysfunction arise. It includes but it is not limited to immunizations, routine health check-ups, and risk assessments for specific diseases, family planning services and marriage counseling, health education on various threats to well-being. The main goal of primary prevention is to reduce the risk of exposure of the individual and the community to potentially harmful sources.
In comparison, secondary prevention concentrates attention on a timely recognition of health issues and a rapid intervention to lessen health problems. Its main goals are to identify individuals in an initial stage of disease and to limit forthcoming disability. For example, a patient who experiences an acute heart attack can benefit from emergent cardiac stent placement. After this initial step of treatment, the patient will not only need a continual adherence to the recommended regimen, but also making appropriate lifestyle changes in order to prevent further health problems linked to the initial cause of injury.
Health promotion at the secondary level is very important because the patient who experienced a life-altering event may be able to return to prior level of quality of life, in conjunction with the appropriate lifestyle modifications. Some examples of secondary prevention are: teaching self-examination for breast and testicular cancer, yearly screening colonoscopy after 50 years of age, or yearly mammograms after the age of 40. At last, tertiary prevention places emphasis on restoration and rehabilitation with the goal of helping the individual to reinstate an optimal level of functioning.
Chronic disease management is an example where tertiary prevention comes in to assist the client regaining control and quality of life to a certain extent, as permitted by the disease process. Education and support about managing chronic illness at home to prevent complications is part of the tertiary prevention. The levels of prevention can overlap in practice because same interventions can serve different causes. For example, if a person decides to follow the Weight Watchers nutrition plans to lose weight for the reason of increasing overall health and state of well-being, this will be primary level health promotion.
On the other hand, if the same person decides to lose weight with the motivation to decrease the risk for cardiovascular disease, then it is considered a behavior of secondary level of prevention. In conclusion, health promotion is a vital component in society because it helps its citizens reach to a qualitative life. Without health promotion and disease prevention programs, mortality and morbidity would always be our next door neighbor. By health promotion we can see more people laughing, dreaming, and enjoying the excitement of life.
Bennett, C., Perry, J., & Lawrence, Z. (2009). Promoting health in primary care. Nursing Standard, 23(47), 48-56. Blacksher, E. (2009). Health reform: what’s prevention got to do with it?. The Hastings Center Report, 39(6), inside. Marcus, S. (2012). Poison prevention: engineering in primary
prevention. Clinical Toxicology (Philadelphia, Pa.), 50(3), 163-165. doi:10.3109/15563650.2012.658474 Kozier, B. (2007). Fundamentals of nursing: Concepts, process, and practice. Upper Saddle River, N.J: Prentice Hall Health.