Health Promotion

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Throughout this assignment the author will demonstrate knowledge of health promotion and its link in addressing health needs. The role of the nurse in delivering health promotion at primary, secondary and tertiary levels will be discussed and how national policy influences that delivery on the chosen topic of smoking. Barriers to health promotion will also be discussed and how these barriers could be overcome.

To define health promotion, health should first be defined. There are many definitions of health, one of which is the Western Medical Model, which describes health as in the “absence of disease and illness” (Seedhouse, 2004, p1). Irvine, (2010, p2) describes it as “a challenging concept to define as it means different things to different people, and our understanding of health is influenced by cultural, socio-economic and personal contexts”. A heavy smoker with mild emphysema may adapt their lifestyle to cope with reduced lung function and describe themselves as well whereas the medical model would categorise them as ill. In criticism of the medical model, the medical writer Thomas Mckeown wrote that improved sanitation and living conditions of the 19th century had eradicated more disease and improved mortality rates than the invention of antibiotics and immunization programmes (Naidoo & Wills, 2009, p 8).

It is essential to understand, therefore, how people view their own health and to study health beliefs of the local population if successful health promotion is to be achieved (Tones & Green, 2004, p81). Greig (2007, p9) explains that diversities in religion, culture and social economic status mean that health beliefs are varied and may differ greatly from that of the nurse’s. Good interpersonal skills are required and a client centred approach used when assessing health needs. This should ensure that the health promotion is directed towards enabling a person to take action, with the patient autonomous in planning lifestyle changes rather than the nurse persuading or coercing, which is not only unethical but unlikely to be effective. (Maville & Huerta, 2002, p92).

Defining health promotion has become more difficult as it encompasses theory from

many areas such as psychology, social policy, social health, and health education

(Cross, 2010, p42). Tanahill described it as “a meaningless concept as it was used so

differently” (cited in Naidoo & Wills, 2009, p52). According to the Health Protection

Agency (HPA) “health promotion is a process directed towards enabling people to

take action. Thus, health promotion is not something that is done on or to people; it is

done by, with and for people either as individuals or as groups. The purpose of this

activity is to strengthen the skills and capabilities of individuals to take action and the

capacity of groups or communities to act collectively to exert control over the

determinants of health and achieve positive change” (HPA, 2009, p1).  
Health promotion models are used to theorise what influences the public health beliefs and lifestyle choices and assist in finding pathways to tackle health issues (Davies, 2006, p252). Nutbeam (2006, p35) theorises the Social Cognitive Theory helps to explain that human behaviour is shaped by internal and external influences. That human’s have the ability to modify their behaviour by using past experiences and learning from others; can then set goals for change by self motivation and visualising the benefits to change. Self belief and environmental factors can act as both negative and positive to effecting change. This model works on the theory that an individual has reached the decision to change. Prochaska and DiClemente’s trans theoretical model, (1984) “the stages of change” explain that an individual will go through stages of “precontemplation” where change is not even considered, “contemplation” where a change is thought about and then “preparation to...
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