There are some misconceptions about health education as a tool for health promotion and health promotion as a broad concept in the hospital setting
Hi Patience,
You are indeed correct that there is a lot of misconception on this matter. I have spent more than a decade 'unpacking' this issue conceptually and contextually and trying to 'mobilize' nurses to become more effective health promoters. If you go to my home page you will be able to see multiple articles which put forward how I, and colleagues I have collaborated with, see the issue. From a health-promoting hospital perspective, nurses can play an active 'health education' role i.e. giving health-related information to clients and relatives but, overall, it's often quite a limited intervention with limited outcomes. Don't get me wrong though - there are certainly examples of health education programmes in hospitals (involving nurses and other health practitioners) that are expansive, effective and result in good health outcomes - but they are more the exception.
A health-promoting nurse, in the hospital setting, would have a far more expansive role and be instrumental in affecting organisational change and reform through influencing policy, process and structure - and linking those activities to the wider community. You are correct on the matter that health education can, and usually is, a component of health promotion strategy - especially where empowerment occurs - but it cannot be the other way around. Health promotion is a much broader intervention. Part of the misconception problem continues to be that health practitioners use the two terms interchangeably. Many practitioners feel that they conduct and practice health promotion on the misguided basis that they work in 'health' care or 'health' service settings. I have argued that a more recent phenomena has caused further confusion. In some parts of the world, it is common for nurses to describe their health education interventions as 'health promotion (or promoting) behavior'.
Nurses play a critical role in health promotion in hospital especially with the epidemic of chronic diseases such as cardiovascular disease and diabetes. I always highlight to nursing students that each admission is just part of the jigsaw and it is essential to ensure the patient is given as much information about their condition as possible.
However it appears that many nurses in acute care do not prioritise health promotion due to the lack of time etc. and it is only when specialist nurses are in place is health promotion done...
Thank you Dean for your input, and I totally agree with your notion of what health promotion is and what it is not. Health promotion is more than health education or health information giving. In health epidemic of chronic diseases, the sociopolitical context of the individual and the occurrence of the disease must be considered. It may require nurses working with the workplace unions and associations to ensure policies that encourage physical activities/exercises, access to good nutrition, and stress reduction or buffering policies and prevention of substance abuse. Advocacy for support group formation and advocacy for hospitals to work with community action groups (women groups, youth and others.). Hospital health promotion also focuses on infection control of which nurses are indispensable..
No problem Patience - and glad to see that we have similar views. Influencing health policy and hospital/community advocacy approaches are indeed important aspects of health promotion strategy for nurses. If only all nurses felt that way. Of course, many nurses are involved in such work - but, given the national and global sizes of the professional nursing workforce working in hospitals, it could be a lot more. I take Geraldine's earlier point about the fact that it is often specialist nurse practitioners who are most active in the field. Where that is the case, their practice and outcomes are not always noticed by 'grass roots' nurses - and that's part of the dilemma.
Dear Dr. Patience Edoho Samson-Akpan
The World Health Organization (WHO) defines health promotion as a process of enabling people to increase control over and to improve their health. To facilitate that process, we must provide people with appropriate information. Nurses have a key role in providing that information in the form of health teaching. Nurses are highly educated, experienced health professionals who are accessible through many settings such as hospitals.
Nader - that is as may be but, at the end of the day, does not change things related to my previous posts on this thread. The WHO
Thank you Nader for being involved in this discussion. However, health promotion is more than health information or education.
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