Health education and health promotion : perceptions and practice of nurses in acute care settings
The aim of this study was to examine nurses' perceptions and practice of health
education and health promotion in the acute care setting.
Ward sisters (n=132) working on acute wards in nine District Health Authorities were
interviewed using a semi-stuctured schedule. Data were collected on perceptions of
health education and health promotion, nurses' role in these activities, and factors
influencing nurses' health education and promotion practice on the ward. Data were
analyzed using a combination of qualitative and quantitative methods. In the second
phase of the study, three wards were selected as case studies of nurses' practice. Data
collection methods employed to describe nurses' practice included: non-participant
observation, audio-recording of nurse-patient interactions, self-administered
questionnaires and reflective field notes. A largely qualitative approach was taken to
the analysis of these data.
The findings from the interviews indicated that the ward sisters had limited
understandings of the meaning of health education and health promotion and nurses'
roles in these activities. Findings from the case study wards as a whole suggested that
nurses' health education and promotion practice was generally extremely limited,
although there were some differences between wards in the extent of this evolution. A
number of factors may help explain these findings. These include: nurses' knowledge
and skills in health education and health promotion, the philosophy, organization and
management of care adopted, and the extent to which these offer opportunities for
empowerment in nursing.
It is suggested that nurses' perceptions and practice can be conceptualized with
reference to a continuum of health promoting nursing practice, and that only limited
progress has been made towards nurses' full potential. It is argued that if nurses are to
develop their health promoting practice, a philosophical shift in nursing is necessary.
Together with the acquisition of appropriate knowledge and skills, this may empower nurses to realise their potential.