According to the World health organization (WHO), health promotion is defined as the process of enabling people to increase control over, and to improve, their health. It moves beyond a focus on individual behavior towards a wide range of social and environmental interventions. (World Health Organization, 2014) Nurses play a pivotal role in health promotion that include disease prevention, follow-up treatment, patient education and behavioral changes in respect to their health. Health promotion by nurses have led to positive outcomes including patient awareness, knowledge of diseases process, self-management, and improved quality of life. (Kemppainen, Tossavainen, & Turunen, 2013) This paper will focus on health promotion in the nursing practice through literature review, the evolution of nursing roles and responsibilities in health promotion, the implementation methods for health promotion that encompasses all areas of nursing, and the three levels of health promotion prevention. Primary Prevention
Primary prevention is the first level of health promotion. The goal is to protect healthy individuals from acquiring a disease or experiencing injury before it occurs. Primary interventions used by nurses include but are not limited to education about nutrition, the importance of daily exercise, seat belt and helmet use, dangers of tobacco and other related drugs, routine exams, screenings, immunizations, and identifying potential hazards in the work place. (Institute for work and health, 2009) The concept of primary prevention is traditionally used in reference to physical health but in the article, “Education in primary prevention in psychiatric-mental health nursing for the baccalaureate student”, it focuses on the concept of primary prevention in reference to mental health. This can be difficult for nurses because mental and emotional problems are related to complex emotional and behavioral factors. For primary prevention the focus for nurses is on providing interventions to groups before a crisis situation could occur. The focus from this article was on implementation of preventative programs for target groups. Alcoholism prevention, prevention of child abuse, and child care for the populations of elementary and junior high school children. Rape prevention, loss or bereavement, drug or alcoholism prevention, and teen-age pregnancy prevention for adolescents. Parenting, child-birth classes, child abuse prevention, stress management for young adults. Reproductive and sexual concerns for middle aged adults. Sensory loss, rape prevention, loss of loved ones for elderly patients. (Welch, Boyd, & Bell, 2009) Secondary prevention
The next level of health promotion is secondary prevention. These interventions used by nurses are used after the patient has an illness or is at serious risk. The goal is to recognize the disease process at its earliest stage and slow or stop its progression. Interventions include medication compliance for example: reminding patients to continue their low-dose aspirin to prevent further heart attacks, TIA’s, or strokes. Regular exams and screenings are recommended for those patients at risk. (Institute for work and health, 2009) In the article,” Primary and secondary tobacco prevention”, primary prevention focused on education and prevention of experimentation and use. Secondary prevention is used for individuals who are currently using tobacco products. Interventions used are successful cessation courses, evidence-based treatment of tobacco dependence, pharmacotherapy, individual and group counseling. This is utilized at the earliest stages of tobacco addiction to help patients quit and remain smoke free. (Tingen, Andrews, & Stevenson, 2009)
The last level in health promotion is tertiary prevention. These interventions focus on the management and care of patients with disease and the prevention of further deterioration while maximizing the quality of life. (Institute for work and health, 2009) Tertiary prevention is used when managing long-term health problems such as diabetes, heart disease, and cancer. Some examples of tertiary prevention include programs for cardiac or stroke patients, support groups, and pain management programs. In the article, “Tertiary prevention for individuals: Healing the wounds”, prevention is focused on healing. Primary and secondary preventions were used in the treatment of stress but with all the interventions stress continues to occur in most individuals. Tertiary treatment was designed to return those individuals suffering from high levels of stress back into their home or work environment and minimize the recurrence of stress. Tertiary prevention relies on both help from the individual and help from other medical professionals. It reaches out for additional assistance from employers and outside resources to ensure appropriate programs are available. (Quick, Wright, Adkins, Nelson, & Quick, 2013) Evolution of nursing roles and responsibilities
Health promotion used by nurses is commonly associated with the general principles of basic nursing. Patient education is a regularly used intervention used by nurses in an everyday setting. Health educators are taught health promotion, interventions, state regulations, specific policies, and they must have the ability to apply this education to their patients. Because of the growing diverse population, nurses must become more patient-focused health promoters. While general education is still used, the different patient groups require different health promotional needs. (Kemppainen, Tossavainen, & Turunen, 2013) Implementing health promotion skills is a must for all nurses. The most important skill is effective communication. They must be able to encourage their patients and their families to have an active participation in their treatment planning. The patients must feel comfortable expressing their feelings about their plan of care. Nurses can help their patients by leading by example. This can be achieved by being healthy role models, living healthy lifestyles, and through positive and caring attitudes that promote health and well-being. Nurses must also possess skill-related competencies including teamwork, time management, data collection, critical thinking, and interpretation of information given from a variety of sources. (Kemppainen, Tossavainen, & Turunen, 2013) Conclusion
In conclusion, health promotion is more important than ever. Health promotion includes primary, secondary, and tertiary preventions. These include education, practice, research, and reinforcement that teaches patients how to prevent and manage diseases. The future of nursing focus on keeping individuals healthy. Nurses must have a strong understanding of health promotion in order to communicate to a variety of groups. As the population grows and becomes more educated through primary prevention overall health of the population will improve.
Institute for work and health. (2009). What researchers mean about primary, secondary, and tertiary prevention. Retrieved from Institute for Work & Health: http://www.iwh.on.ca Kemppainen, V., Tossavainen, K., & Turunen, H. (2013). Nurses' roles in health promtion practice: an integrative review. Oxford journals. Quick, J., Wright, T., Adkins, J., Nelson, D., & Quick, J. (2013). Preventive stress management in organizations. American Psychological Association, 183-198. Tingen, M., Andrews, J., & Stevenson, A. (2009). Primary and secondary tobacco prevention in youth. Annual review of nursing research, 171-193. Welch, M., Boyd, M., & Bell, D. (2009). Education in primary prevention in psychiatric-mental health nursing for the baccalaureate student. International nursing review, 126-130. World Health Organization. (2014). Health Promotion. Retrieved from World health organization: http://www.who.int/topics/health_promotion