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Review of Literature Brittany M. Warnke
Grand Canyon University: NRS- 429V
May 12, 2014

Review of Literature According to the World Health Organization, “Health promotion is the process of enabling people to increase control over, and to improve, their health” (2014). It is no surprise that a large cause of death in the United States is often a combination of genetic and environmental factors, as well as lifestyle choices (Chiverton, Votava,& Tortoretti, 2003). Health promotion has always been apart of the nursing profession, but the push toward health promotion is larger now than ever before. In regards to health promotion, this essay will examine the purpose of health promotion in nursing, the evolving roles nurses will take on and how nurses can effectively implement teaching of health promotion in patients.
Purpose of Health Promotion
In light of the new health care reforms, preventative care is becoming the new gold standard of health care. Community-based care has much more emphasis than it ever has in the past. As patient acuity continues to rise, the need for better community-based care and health prevention education has never been clearer. Promotion of wellness is one of the main curriculum taught in nursing education and is also built into the job description of the nursing profession. Nurses are able to have more interactions with patients than any other health care discipline, which helps provide the opportunity of forming a trusting relationship with the individual. Creating this type of relationship gives nurses the opportunity to teach patients important health promotion strategies that are tailored to each individuals needs. The main goal of health promotion is to help promote a long healthy life free from preventable diseases.
Nursing Roles and Responsibilities Evolving in Health Promotion Due to many changes in health care over the years, nurses do their best to keep up with the many demands of their job description. Unfortunately, a lot of the time this means health promotion education does not get the deserved attention it should. New care models must focus on keeping individuals healthy to avoid getting caught up in the vicious cycle of managing and treating illnesses, which leaves no time for health promotion (Chiverton et al., 2003). In the past, nurses have educated patients on how to manage illness once the illness has been diagnosed. The new goal of nursing is to assess patients for risk factors, identify and then educate patients on how to transform their lifestyle to lower their risk of being susceptible to identified illnesses. In order for nurses to become successful in health promotion, they must first become an effective educator. One part of becoming an effective educator is being able to evaluate the retention of information by the individual. If information is not being retained, the nurse then needs to reevaluate teaching methods and create a new plan centered on the patients needs. Making sure patients understand information is a vital part of a nurse’s job, this ensures patients have the knowledge needed to lead a healthy lifestyle and avoid illness.
Implementation Methods for Health Promotion When implementing health promotion it is necessary to set objectives through clear communication. Using medical jargon when teaching someone with little health care background knowledge may lead to ineffective teaching and poor patient outcomes. Once the objectives of teaching are clear and information has been taught to the individual, the nurse should then assess if the individual was able to retain the information. Teach-back method is a positive way to evaluate if the individual was able to understand what the nurse has taught. Health promotion teaching should not end with the initial teaching. Follow-up conversations should be had between the nurse and patient to evaluate positive or negative outcomes since first teaching sessions. From there, the nurse can then provide feedback and reinforcement of initial teaching if necessary. Continual monitoring and encouragement may be needed from the nurse in order to reach set health promotion objectives.
Levels of Health Promotion Prevention Within the realm of health promotion there are three levels of prevention; primary, secondary and tertiary prevention. Primary prevention is used before there is any disease present in individuals and focuses mainly on health promotion. Examples of primary prevention could be visiting a primary care physician regularly, receiving immunizations and becoming educated about physical activity. The main goal within this level of prevention is to create awareness within individuals and decrease vulnerability to illnesses (Edelman, Kudzma & Mandle, 2014, p. 11). Primary prevention is most likely to produce positive outcomes if education is started at a young age (Doering, et al., 2014).
Not all illnesses are preventable, and that is where secondary prevention plays a key role. A common example of secondary prevention includes regular health screenings to promote early detection and treatment of illnesses such as breast cancer. Secondary prevention can also be used for those with illnesses that could have been prevented at the primary level like a heart attack. The goal of this level of prevention is early detection of illnesses to limit the amount of disability the illness may cause (Edelman, et al., 2014, p.15). Secondary prevention is pivotal in the adult population, and for this reason has become highly studied by nurse scientists (Tingen, Andrews, & Stevenson, 2009). Finally there is a tertiary level of prevention, which is used when there is permanent disability or damage from an illness. An example of tertiary prevention could be regaining mobility to a livable level of functioning in an individual who has suffered from an amputation secondary to uncontrolled diabetes. The goal at this level of prevention is to rehabilitate a person to a “useful place in society” (Edelman, et al., 2014, p.15). Tertiary prevention usually includes a combination of self-help and professional help (Quick, Wright, Adkins, Nelson, & Quick, 2013). Providing the disabled individual with resources and services is essential to help enable them to reach their highest level of recovery and functioning.
Conclusion
Health promotion will continue to be an important role in the nursing profession. Being able to effectively educate patients and create individualized plans will help each patient reach optimal outcomes. Finally, understanding the different levels of health promotion, and starting education at a young age is ideal for positive patient outcomes.

References
Chiverton, P. A., Votava, K., & Tortoretti, D. M. (2003). The future role of nursing in health promotion. American Journal Of Health Promotion, 18(2), 192-194.
Doering, N., Hansson, L. M., Andersson, E., Bohman, B., Westin, M., Magnusson, M., & Rasmussen, F. (2014). Primary prevention of childhood obesity through counseling sessions at Swedish child health centres: design, methods and baseline sample characteristics of the PRIMROSE cluster-randomised tri. BMC Public Health, 14(1), 1-24. doi:10.1186/1471-2458-14-335
Edelman, C., Kudzma, E., Mandle, C. (2014). Health Promotion Throughout the Life Span, 8th Edition [VitalSource Bookshelf version]. Retrieved from http://pageburstls.elsevier.com/books/978-0-323-09141-1
Quick, J., Wright, T. A., Adkins, J. A., Nelson, D. L., & Quick, J. D. (2013). Tertiary prevention for individuals: Healing the wounds. Preventive stress management in organizations (2nd ed.). Washington, DC US: American Psychological Association. doi:10.1037/13942-012
Tingen, M., Andrews, J., & Stevenson, A. (2009). Primary and secondary tobacco prevention in youth. Annual Review Of Nursing Research, 27171-193. doi:10.1891/0739-6686.27.171
World Health Organization. (2014). Health promotion. Retrieved from http://www.who.int/topics/health_promotion/en/

References: Chiverton, P. A., Votava, K., & Tortoretti, D. M. (2003). The future role of nursing in health promotion. American Journal Of Health Promotion, 18(2), 192-194. Doering, N., Hansson, L. M., Andersson, E., Bohman, B., Westin, M., Magnusson, M., & Rasmussen, F. (2014). Primary prevention of childhood obesity through counseling sessions at Swedish child health centres: design, methods and baseline sample characteristics of the PRIMROSE cluster-randomised tri. BMC Public Health, 14(1), 1-24. doi:10.1186/1471-2458-14-335 Edelman, C., Kudzma, E., Mandle, C. (2014). Health Promotion Throughout the Life Span, 8th Edition [VitalSource Bookshelf version]. Retrieved from http://pageburstls.elsevier.com/books/978-0-323-09141-1 Quick, J., Wright, T. A., Adkins, J. A., Nelson, D. L., & Quick, J. D. (2013). Tertiary prevention for individuals: Healing the wounds. Preventive stress management in organizations (2nd ed.). Washington, DC US: American Psychological Association. doi:10.1037/13942-012 Tingen, M., Andrews, J., & Stevenson, A. (2009). Primary and secondary tobacco prevention in youth. Annual Review Of Nursing Research, 27171-193. doi:10.1891/0739-6686.27.171 World Health Organization. (2014). Health promotion. Retrieved from http://www.who.int/topics/health_promotion/en/

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