Many years ago, people focused on disease and illness and not staying healthy or preventing illness from occurring. People did not go to the doctor for wellness checks but rather only if they had an ailment. Immunizations have removed some of the diseases that were causing death among the individuals that had contracted the illness. Health promotion has come to the forefront in medical practice since the movement of Healthy People that focuses on health and not illness.
Health promotion can be perceived differently by individuals. “Health promotion is the process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behaviour towards a wide range of social and environmental interventions” World Health Organization website (as cited in Casey 2007). Nurses have a vital role in health promotion in all health care settings, be it at home, in a clinic, hospital, or out in the community. It is important for the nurse to understand that health promotion is not only for the healthy but also for individuals that are disabled, have a chronic disease or are dying. By administering education and referrals to other health care professionals, the nurse is providing individuals the tools they need to experience the highest level of health possible for their given situation.
Often nurses are engaging in health promotion activities while interacting with patients and are not aware of this as it becomes automatic in daily practice. Health promotion in a hospital setting can be as simple as encouraging deep breathing exercises and early mobilization to prevent pneumonia. Nurses can serve as a role model and educator in different settings such as at home with their own family members, clinics, hospitals or in the community (Lazarou, C., & Kouta, C. 2010 ). One role of the nurse in health promotion is to collaborate with all providers involved.
Collaboration is especially important when working in a homecare setting to make sure a diagnosis hasn’t changed or the primary provider hasn’t changed the treatment plan. Supporting health promotion will help the economy by reducing illness and disease, allow faster recovery of illness and improve one’s quality of life. Effective health promotion teaching ultimately depends on how open the individual(s) is to change (Casey 2007).
Prior to providing health promotion material, it is important to assess the learner to obtain their preferred learning method and any cultural issues that would affect the teaching. The teaching material has to be age appropriate for the learner. If they do not understand what is being taught, the teaching will be a waste of time for the nurse as well as the individual(s) involved.
A nurse can passively mention a health promotion idea while caring for their patient to see their response to the concept. This passive approach could spur a conversation regarding the idea and make the patient more receptive to learning. After assessing the patient for learning readiness, providing written material and encouraging individuals to make a change is a good place to start a promotion activity. Another implementation approach would be to involve the patient’s family if the teaching involves cooking or other lifestyle changes.
This approach will add a support system for the patient but also make others in the household aware of changes that need to be made. Depending on what the lifestyle changes are, they could benefit the entire household, not just the patient. The patient should be involved when setting health promotion goals (Casey 2007). If the goals are set by the nurse, the patient will probably not be as receptive to making a lifestyle change. Another method effective for health promotion is motivational interviewing. The patient is involved during all stages of planning. They not only decide on the goal, but also figure out what barriers they may face that would hinder their success. This approach would work well for implementing health promotion for increased activity and incorporating more fruits and vegetables into one’s diet. (Whittemore et al., 2010)
There are three types of health promotion. The first type of health promotion is primary prevention. This type of prevention is often carried out in a community setting. Fluoridation of water to help lessen cavities, smoking bans in public areas and immunizations are examples of primary prevention as they remove the risk factors or causes of disease. The second type of health promotion is secondary prevention. Annual physicals, mammograms and colonoscopies are examples of secondary prevention because they are able to detect disease early, often before the patient is symptomatic. At this level of prevention, it is hoped that the disease is caught early enough so the effects can be reversed.
The third type of health promotion is tertiary prevention. During this stage of health promotion, the patient already has the disease so the aim is to slow the progression to allow the patient to have the highest quality of life possible. Blood glucose control for the diabetic to try to prevent blindness and limb amputations is one example of tertiary prevention. Rehabilitation after a stroke would also fall under tertiary prevention (Oberg 2010).
Over the years, health promotion is an important responsibility that has shifted from the physician to the nurse. They can participate in health fairs or partner with organizations and schools within the community to provide seminars. If funding for a program is an issue, grants might be available for funding. Physicians, dentists or dieticians may volunteer their time or help with the funding for school programs. Nurses could also participate with corporations to promote healthy lifestyle changes to lower health insurance premiums for their employees. As more people focus on wellness instead of illness, opportunities for the nurse to encourage health promotion are endless.
Casey, D. (2007). Nurses’ perceptions, understanding and experiences of health promotion. Journal Of Clinical Nursing, 16(6), 1039-1049. doi:10.1111/j.1365-2702.2007.01640.x
Lazarou, C., & Kouta, C. (2010). The role of nurses in the prevention and management of obesity. British Journal Of Nursing (BJN), 19(10), 641-647.
Oberg, E. (2010). Preventive services update. Integrative Medicine: A Clinician’s Journal, 9(4), 22-26.
Whittemore, R., Melkus, G., Alexander, N., Zibel, S., Visone, E., Muench, U.,
& … Wilborne, S. (2010). Implementation of a lifestyle program in primary care by nurse practitioners. Journal Of The American Academy Of Nurse Practitioners, 22(12), 684-693. doi:10.1111/j.1745-7599.2010.00562.x
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