Biomedical subjects
Publications and source records attributed to Dean Whitehead.
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For many nurses, fulfilling a nursing role and career will inevitably mean that they come into contact with the University setting--at both a pre- and post-qualifying level. Many nurses throughout the world have their educational needs determined by and delivered by University-based institutions. Since the mid-1980s, the World Health Organisation (WHO) has sought to define and encourage the implementation of concerted health promotion programmes that adopt a 'setting-based' approach. Recently, the literature has begun to identify the emerging role and function of the Health Promoting University (HPU) as another component of the settings-based movement. As much as nurses are duty-bound to consolidate and incorporate health education and health promotion practices in the clinical setting, this paper argues that they have a similar responsibility in the Higher Education setting.
Behavioural-change-related health education programmes represent a mainstay of health care activity. Where adopted, however, the theoretical and practical constructs and constraints are not always considered. The failure of many health education programmes to achieve their intended life-style-related behavioural-change outcomes is often directly related to the complexity of the task itself. Changing a client's health behaviour is notoriously difficult and requires concerted and systematic activities to ensure any measure of success. This article draws upon existing literature to develop a critical theoretical and practical perspective for health education practice in nursing. It aims to explore the underpinning theoretical considerations for undertaking behavioural-change health education programmes. This article also proposes specific recommendations for nurse's current and future health education practice, as a means for facilitating a more structured approach to health education programme planning and evaluation.
Back in 1986, the World Health Organization (WHO) produced the Ottawa Charter for Health Promotion. The intention of the charter was to create a framework that conveyed the notions of capacity building into a structured process for health promotion action in specific settings. This charter subsequently provided the vehicle from which the Health Promoting Hospital (HPH) initiative was launched, culminating in the Budapest Declaration of Health Promoting Hospitals (WHO, 1991). The aim of this paper is to investigate the nature and progress of the European HPH movement. Despite the fact that 'pockets' of concerted and progressive activity and evaluation have emerged from the HPH initiative, the majority of the available literature demonstrates a more limited impact than perhaps the WHO might have anticipated for its efforts over the last 15 years or so. Indications are that many of the member European HPH states have struggled to move beyond the 'project' phases of their planned programmes. This is not to detract from the considerable efforts that have been made to establish HPH networks or the continuing attempts to recruit further members/institutions into the movement. Nevertheless, this account concludes that a more concerted evaluation of European HPH progress is needed to accurately measure its impact and progress. If the situation remains unchanged, perhaps a fundamental review of the strategy is worth considering.
BACKGROUND: Osteoporosis is a preventable disease that is usually not managed until the disease becomes evident, although it places huge economic and social burdens on societies worldwide. It is predicted that this burden will grow if left unchecked. Despite this, evidence suggests that osteoporosis prevention activity is given a low priority, and services often only provide biomedically-based programmes, in which resources are predominantly allocated to screening and pharmacological treatments. Referral to these services mostly occurs when a client is already known to have osteoporosis or to be at risk, rather than as an early preventative intervention. AIM: This paper reports an action research project with one hospital osteoporosis service. The aim of the project was to assess the current service, identify areas where change was needed, and evaluate the implementation of such changes. METHOD: Participatory action research was used, with group meetings and reflective journals to collect data for analysis. The process involved assessment of a preventative osteoporosis service, and determination of clinical issues and problems, and it aided decisions on an appropriate course of organizational reform and evaluated any change processes as they occurred. It also encouraged participants to reflect on and evaluate their experiences of using a participatory framework. CONCLUSION: A change programme was implemented that focused on preventative health education activity in a range of clinical settings. Over the two and a half years of the project, the osteoporosis service expanded its programme to include a wide range of preventative activities, running alongside other organizational reforms.
BACKGROUND: Health education and health promotion activities are a fundamental requirement for all health professionals. These two paradigms are closely related but are not inter-dependent. Despite this, it is known that many nurses confuse the terms and use them interchangeably. With this in mind, it is necessary to re-conceptualize the terms in an attempt to bring them to a current form of 'maturity'. AIM: The aim of the paper is to provide an up-to-date analysis of health promotion and health education that serves as a conceptual and operational foundation for clinicians and researchers. METHOD: A concept analysis following the criterion-based methods described by Morse and her colleagues was applied to the terms health education and health promotion, using generic and nursing-related literature. RESULTS: The conceptual literature on health education is consistent between generic and nursing-related sources. On the contrary, earlier nursing literature on health promotion is now at odds with more recent socio-political and community action models of health promotion, in that it focuses on individualistic and behavioural forms of 'health promotion'. A significant proportion of later nursing-related literature, however, suggests a maturing of the concept that brings it further in line with a socio-political health promotion agenda. CONCLUSION: While the theoretical and conceptual literature surrounding health education has remained relatively constant and unchanged over the last decade or so, the same cannot be said for the health promotion literature. The evolving dominance of socio-political action in health promotion has overtaken individualistic and behaviourally-related forms. While the recent nursing literature addresses and acknowledges the place of socio-political activity as the mainstay of health promotion interventions, this is largely from a theoretical stance and is not applied in practice.
A plethora of literature suggests that many nurses struggle in their attempts to develop a political role that allows them to directly influence and implement health policy activity. Nursing curricula are an integral part of ensuring that nurses are capable of taking on a more active role in initiating and developing health policy processes, through a broadening of the health promotion curriculum that focuses on socio-political approaches to health care provision. Despite this, the available literature suggests that the majority of nursing curricula are yet to fulfil this role. Such a role could be supported by attempts to define and promote a specific career route that develops nurses as health policy experts and entrepreneurs early on in their careers. This article aims to put forward a rationale for developing such a position in nursing education.
AIMS: To investigate the place and validity of effective process in evaluating health promotion practice in nursing and, in doing so, develop a specific model for this purpose. BACKGROUND/RATIONALE: The failure of many nurses to provide successful health promotional programmes is underpinned by a distinct lack of evaluation research activity. Without this type of activity, health-related nursing practice remains limited in its scope and nature. This article seeks to redress this situation by proposing a specific evaluation model that assists the nurse in their attempts to include evaluative research activity in future health promotion practice. METHOD: This article draws on existing literature to develop an evolving theoretical perspective for health promotion practice in nursing. The proposed model was developed from this perspective. CONCLUSION: Evaluation is an essential activity for any health promotion programme. Failure to include it in practice ensures that attempts to conduct health promotion are usually rendered ineffective and unsuccessful. Evaluation models are valuable tools that nurses can incorporate routinely into existing frameworks of practice, alongside other models of health education/health promotion, such as planning models. The development of this model is intended to enable nurses to review their current practice and offer a further framework for those who wish to extend their current health promotion repertoire.
A criticism laid at the door of many nurses in relation to their health promotion activity is that they almost exclusively adopt a biomedical/preventative health education approach. When it comes to adopting socio-political health promotion approaches, there is scant evidence that nurses implement these activities in clinical practice. This article is designed to raise awareness and signpost the types of activities that nurses could be involved with if they wish to influence the broader social and political health promotion agenda. In doing so, it has developed an 'effect' programme model for socio-political health promotion practice as a framework for those practitioners who wish to review their current health-related activities and/or who are seeking to extend their range of health promotional practice. This article draws upon a critical review of the literature in order to develop an evolving theoretical perspective for health promotion practice. The proposed model was developed from this new perspective as were recommendations for practice.
This paper aims to conceptualize the issues that surround the notion of existential health. It also seeks to establish the impact that existential issues have upon the health of the individual client and how these might explicitly be applied in clinical practice settings. The ability of clients to draw upon their own existential resources as a fundamental part of their health care experience often goes unrecognized in nursing. Whilst existential mechanisms may be theoretically recognized, as a valid aspect of an individual's unique and personal identity, they are not an established part of the health care activity of nurses. Entrenched biomedical frameworks of care delivery and the interchangeable use of metaphysical health states with existential health states in the established literature present particular dilemmas for the acknowledgement of existential health in clients. A review of the literature has been conducted. This account argues that the failure to recognize and assess a client's existential health status represents a major omission on the part of the clinical nurse. These nurses are, in effect, denying their clients the right to exercise and mobilize an important and valuable health resource.
A recognized 'paradigm war' exists between the two distinct approaches of health education and health promotion practice. This tension is both unhealthy and unhelpful and is known to have a profound effect on nursing activity. Leading health promotionalists have begun to acknowledge the futility of the stated paradigm tension, realizing that health education and health promotion interventions are not that dissimilar in their origins and intentions. Progressive health education and health promotion programmes acknowledge the interrelatedness of both approaches and seek to incorporate favourable aspects of the two. The aim of this article is to present arguments and stances that help to diffuse/avoid the stated paradigm conflict, as a basis for health education and health promotion reform in nursing. It also seeks to clarify the nature of both health education and health promotion practice so as to avoid contextual confusion. In doing so, this article draws significantly from the author's previous work. This article concludes that the constructive review of any intended health education/health promotion programme lies in the consideration of each approach according to its own relative merits, what is required of the programme, and the nature of the setting in which the intervention takes place.
AIMS: To investigate the academic writing experiences of a group of preregistration nursing students. To explore issues surrounding how academic writing skills were developed, integrated and received into the student's educational programme and how these skills impacted on various aspects of their educational and clinical experience. BACKGROUND: The development of an academic writing style is seen to be an integral skill that the student must be willing to learn and undertake within higher education settings. Academic styles of writing have been imported into nursing education as a consequence of its integration into higher education. I wanted to investigate the experiences of learning an academic style of writing for students early on in their nursing career. There is little, if any, research that seeks to investigate or measure these experiences of nursing students. METHODS: A phenomenological approach to investigate the academic writing experiences of a group of preregistration students. FINDINGS: There is an expectation that preregistration students will quickly acquire academic writing skills when most will have had little or no prior experience. There appeared to have been little emphasis placed on facilitating the development of these skills in the educational programme. The lack of emphasis and support proved to be problematical for these nursing students. The emergence of a theory-practice divide also figured strongly. Students were, however, able to appreciate the need and place for academic writing skills and most were able to identify the structural processes that were integral to acquiring such skills. CONCLUSION: A plethora of anecdotal evidence, supported by the findings in this study, suggests that most nursing students' struggle with the demands placed upon them when writing academic assignments. The need for greater emphasis and support throughout the whole period of training are highlighted in the findings of this study. It is known that nursing loses large numbers of its students to the academic rigors of its educational programmes. Where this is the case, the findings of this study support the need for nurse educationalists and curriculum planners to revise and reform the way that they approach and deliver the demands of an academic style of writing with their students.