Community nurses and health promotion: ethical and political perspectives

Examining the correspondence of theoretical and real interpretations of health promotion

AIMS AND OBJECTIVES

The aim of the research was to identify how the development of concept analyses have influenced practising nurses' understanding of health promotion. More specifically the aim gives rise to the objective of establishing how they translate their understanding into practice.

BACKGROUND

The acknowledgement that nurses are confused about health promotion has led to attempts to define the term through the production of concept analyses, which aim to clarify the term for nursing education, research, policy and practice.

DESIGN AND METHODS

A qualitative approach, using semi-structured interviews was undertaken with a purposive sample of 21 district nurses, based throughout Wales. Thematic content analysis was used to order, describe and interpret the data.

RESULTS

Generally the respondents gave definitions of health promotion that were confined to the traditional conceptualization of health promotion, comprising actions aimed at changing the behaviour of individuals. These interpretations were translated into practice, where district nurses adopted a mainly reactive and individualistic approach to health promotion.

CONCLUSIONS AND RELEVANCE TO CLINICAL PRACTICE

The paper concludes that the more contemporary definitions of health promotion that focus on empowerment, community development and socio-political action are yet to reach practising district nurses. Considerable effort is required from educationalists and practitioners if nurses are to include these 'new paradigm' approaches to health promotion in their practice.

Are techniques used in cognitive behaviour therapy applicable to behaviour change interventions based on the theory of planned behaviour?

The Theory of Planned Behaviour (TPB) is increasingly being used to inform the development of interventions to promote health behaviour change. However, although the theory can be used to identify the determinants of particular health-related behaviours, it offers little guidance on how to change these determinants and hence how to promote behaviour change. There is evidence that Cognitive Behaviour Therapy (CBT) can be used to support health behaviour change. This article discusses the similarities and differences between the two approaches, and considers whether techniques used in CBT are applicable to interventions based on the TPB.

Political involvement in nursing--education and empowerment

Political apathy in the nursing profession can be attributed to numerous factors, including a lack of knowledge of the political process and public policy formation, feelings of powerlessness, and a perceived ethical conflict between professional values and political involvement. Nursing as a profession has arrived at a prestigious point in development where the word "nurse" now is synonymous with the words "patient advocate," thus giving the specialty an important image to fulfill. The public, however, will not recognize nurses as patient advocates until they begin to champion public health and social issues at the Institutional, community, and national levels. Numerous changes in health care delivery methods, together with politicians' increased involvement in health care development, have left nurses in a precarious position even though nurses are the largest group of health care workers in the United States. In this article, the first of a two-part series, the lack of knowledge of the political process and feelings of powerlessness in the nursing profession will be examined, along with their effects on political involvement among nurses.