Fundamentals of Health Promotion for Nurses

Jane Wills, Jane Wills

• Publisher: Wiley-Blackwell
• Year: 2014
• ISBN:
  9781118515761
• Edition: 2
• Topic: Medicine
• Subtopic: Nursing

Fundamentals of Health Promotion for Nurses is a concise, accessible introduction to health promotion and public health for pre-registration nursing students and newly qualified nurses. Promoting the health and wellbeing of patients is a vital part of the nursing role, and the updated second edition of this user-friendly book discusses the foundations for health promotion practice using practical examples, activities and discussion points to encourage readers to reflect on their values, debate the issues and apply their knowledge and understanding to practice.

Part One
Health Promotion and Public Health

Chapter 1 Health and health promotion

Chapter 2 The patient in their social context

Chapter 3 Approaches to promoting health

Chapter 4 Creating supportive environments for health

Introduction

Part One defines and illustrates what health promotion and public health mean in practice, including their multidisciplinary nature and complex and wide-ranging activities. It shows how nurses must look beyond traditional views: the biomedical mechanistic view of health in which patients present with a problem needing treatment and the expert-led approach to nursing in which patients are encouraged to adhere to advice. Instead, it suggests that a health promotion approach includes:

• a holistic view of health;
• a focus on participatory approaches that involve patients in decision-making;
• a focus on the determinants of health, the social, behavioural, economic and environmental conditions that are the root causes of health and illness which influence why patients now present for treatment or care;
• multiple, complementary strategies to promote health at the individual and community levels.

The three perspectives on health that influence health promotion practice (Naidoo and Wills, 2009) are as follows:

• the biomedical views health as the absence of diseases or disorders;
• the behavioural views health as the product of making healthy lifestyle choices;
• the socio-environmental views health as the product of social, economic and environmental determinants that provide incentives and barriers to the health of individuals and communities.

These perspectives represent three different ways of looking at health and influence the ways in which health issues are defined. They also influence the choice of strategies and actions for addressing health issues. If health is viewed simply as the absence of disease, then health promotion is seen as preventing disease principally through treatment and drug regimes. If health is viewed as the consequence of healthy lifestyles, then health promotion is seen as education, communication of health messages, giving information and facilitating self help and mutual aid programmes. If, on the other hand, health is seen as a consequence of the socio-economic and environmental circumstances in which people live, then health promotion becomes a matter of tackling these issues to make healthy choices easier. The first two perspectives are much in evidence in nursing practice. A socio-economic and environmental perspective is more challenging for a setting which still emphasizes one-to-one care.

Chapter 1 introduces the fundamental features of health promotion and details the broad range of activities that can come under the umbrella of health promotion, and describes the health promotion role of the individual nurse.

Chapter 2 summarizes some of the evidence showing how social factors can affect health. Inequalities in health status exist across geographical areas, social class, ethnicity and gender. People may also not have equal access to health services and often those most in need have least access or the worst services. The delivery of care may be discriminatory, making it harder for individuals because of their language, race, age or disability. Material disadvantage has been shown to be a major factor not only directly in restricting opportunities for a healthy life but also indirectly in educational attainment and employment options. There is also emerging evidence of psychosocial risk factors for poor health especially weak social networks and stress in early life.

Current health policy (DH, 2010) is committed to tackling inequalities in health and a raft of government legislation is designed to: address areas of deprivation, increase the opportunities for disadvantaged and marginalized groups, and take children out of poverty. Public health thus reflects ideological debates about the rights and responsibilities of individuals and the state for the nation's health. Throughout this book we challenge the individualistic model which focuses on the presenting patient's problems alone and encourage the nurse to be aware of significant economic or social circumstances that might make it difficult for individuals, families and communities to adopt or experience healthier lifestyles despite being informed and offered advice. We urge the nurse to avoid victim blaming in which individuals are encouraged to feel responsible and guilty for their own health status. This sort of approach runs the risk of increasing inequalities by which only the most educated, articulate and confident individuals will be able to accept and adopt health messages.

Chapter 3 discusses the various models of health promotion which have attempted to describe approaches to a health issue. Many practitioners do not use theory when planning health promotion and work far more from intuition or existing practice wisdom, which is often rooted in a t...

Table of contents

• Cover
• Titles of related interest
• Title Page
• Copyright
• Preface
• Acknowledgements
• Glossary of key terms
• Contributors
• How to use your textbook
• About the companion website
• Part One: Health Promotion and Public Health
• Part Two: Public Health Priorities
• Part Three: Skills for Health Promotion
• Part Four: Health Promotion and the Nurse
• Index
• End User License Agreement