The World Health Organization defines health promotion as the “process of enabling people to increase control over, and to improve, their health” (WHO, 2013). Throughout these past decades, the concept of health promotion has expanded from mainly focusing on lifestyles and the individuals towards taking into account socio-ecological factors including “economic inequalities, social problems, and environmental issues” (Rangruber, 2012, p. 36). With these changing perspectives, the role of nurses in health care has also expanded. WHO recognizes that nurses have an important role in the way society’s current challenges would be addressed (Linsley, Kane & Owen, 2011).
Nurses are among the enablers of people to improve their health and numerous studies have been conducted to investigate the various aspects related to nursing and health promotion. Among the huge volume of available materials, this researcher has selected three articles from medical journals accessed through the PubMed database. Each article represents a category in health promotion prevention. The Determinants of the intention of elementary school nurses to adopt a redefined role in health promotion at school by Chabot et al. ( 2010) is for the primary intervention. The article Health promotion services for patients having non-communicable diseases: Feedback from patients and health care providers in Cape Town, South Africa by Volker et.al (2011) represents secondary prevention while A Double Whammy: Health Promotion Among Cancer Survivors with Pre-Existing Functional Limitations by Volker, et.al . (2013) is for the tertiary prevention. A discussion about specific contents of these materials is presented in the succeeding sections.
Levels of health promotion prevention
As mentioned above, the selected articles represent each of the three levels of prevention. The activities in the primary prevention level are geared towards protecting healthy individuals from acquiring illnesses. This is the context of the study carried out by Chabot, Godin & Gagnon (2010) which discusses health promotion in schools. Here, the authors emphasized that elementary school nurses are already very active in promoting health in schools and could take on more strategic roles in the interventions. The secondary prevention level refers to interventions provided to individuals who already know what their illnesses are. They have been diagnosed about their medical condition. Health promotion at this level is aimed at controlling the illness or preventing it from coming back. The article produced by Parker, Steyn, Levitt & Lombard (2012) discussed the methods of health promotion and the effectiveness of the materials used. This study showed that nurses are the second most preferred health education provider next to the doctors. The health professionals also perceive that they contribute largely to the education and empowerment of their patients. The tertiary prevention level is accessed by those who are recuperating from a major disease such as cardiac arrest or cancer as well as those who are experiencing chronic illnesses, thus the research done by Volker, et al. (2013) about cancer survivors chronicles how health promotion is provided for this group.
Definition of health promotion
There is no explicit definition of health promotion in all three articles. However, the concept of nurses as enabling people to improve their health is alluded to in the paragraph that says elementary school nurses have a “strategic role [since they can become persons of] influence with partnership skills able to work with a broad range of actors and increasingly involved in the planning and health-promotion projects” Chabot, Godin & Gagnon (2010). The impact of health promotion activities is enumerated in the study of Volkner et al. (2013) which states that these interventions in the context of cancer survivorship “can positively impact survivors by improving quality of life, psychological function, and fatigue” (p.65).
Nursing roles and responsibilities in health promotion
The implementation methods for health promotion include individual counseling, joining support groups, watching videos, and reading posters/pamphlets/books. In the study at Cape Town, each of these methods had their own benefits. Books and pamphlets can be read at the patient’s or client’s convenience while posters are easily accessible. The individual counseling, however is most preferred because this provides opportunity for clarifications and in-depth discussion. Since nurses are second to doctors in terms of health education providers, nurses find that health promotion is increasingly part of their responsibilities. In the study of elementary school nurses, mentioned above, nurses are also recognized as possessing leadership qualities to promote health in different settings.
Over the years, the role of nurses in health promotion has evolved. In accordance to the increasing emphasis of underlying causes of diseases, such as inequalities and other socio- environmental factors, nurses do not only provide information on how to protect the body from acquiring disease, they also take on additional roles such as being involved in planning for appropriate methods and interventions. Facilitating support group activities especially for patients who have life-long medical conditions can present challenges especially since such interventions require being sensitive to the needs of the patients. The study of Volkner et al. pointed out that “new education efforts must be made to provide nurses and other health care providers with skills and tools to care for survivors” (p.71). Patients have also recognized that support groups contribute to their own empowerment in managing their lives, and many of these support interventions are also spearheaded by nurses. Thus, in the field of health promotion, nurses have a significant role to enable patients and clients to be actively involved in living and managing healthy lives.
References
Chabot, G., Godin, G. & Gagnon, M. (2010). Determinants of the intention of elementary school nurses to adopt a redefined role in health promotion at school. Implementation Science, 5 (93), doi 10.1186/1748-5908-5-93. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3003233/
Parker,W., Steyn, N.P., Levitt, N.S. & Lombard, C.J. (2012). Health promotion services for patients having non-communicable diseases: Feedback from patients and health care providers in Cape Town, South Africa. BMC Public Health, 12 (503). Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3433333/pdf/1471-2458-12-503.pdf
Raingruber, B. (2012 ). Contemporary Health Promotion in Nursing Practice. Burlington, MA: Jones & Bartlett Publishers.
Volker, D.L., Becker, H, Kang, S.J. & Kullberg, V. (2012). A double whammy: Health promotion among cancer survivors with preexisting functional limitations. Oncology Nursing Forum, 4 (1), pp. 64-71. doi. 10.1188/13.ONF.64-71. Retrieved from http://www.ncbi.nlm.nih.gov/pmc/articles/PMC3531904/
WHO (2013). Health promotion. Retrieved from http://www.who.int/topics/health_promotion/en/
