Nursing and health promotion : an exploration of pre-registration nursing students' perceptions of the concept
Considerable conceptual confusion exists regarding the meaning of health promotion, yet nurses are called to be leaders in the movement. Pre-registration nursing curricula have been designed purporting to incorporate health promotion principles. In the United Kingdom this change in nursing education has been called Project 2000. Empirical evidence in the United Kingdom suggests that nurses perceive health promotion from an individualistic biomedical perspective. Chapters 1- 4 explore the philosophical and social origins of the concept. It is argued that this is evolutionary, rooted in health education, derived from ancient Greek philosophy. The development of health promotion theory and application to nursing is examined through the development of nursing theory in the United States. Critical comparisons are made by review of national and international literature relating to the focus of health promotion in nursing. Chapters 5-11 contain the main body of the thesis. Three longitudinal case studies investigate Project 2000 nursing student's perceptions of the concept. Three intentions aim to determine the students' health beliefs and values of health promotion on entry to nursing, to establish if any changes in their perceptions of health promotion could be attributed to the philosophical shift from intervention to prevention in nurse education and healthcare generally, and finally to develop an instrument to be used to measure changes in perception as part of curriculum evaluation. The results of the study are reported and contextualised by the influence of teachers, the curriculum and the climate of change in healthcare at that time. The properties of the instrument and the implications for its purpose are addressed. Weaknesses in the design of the strategy are examined. The thesis concludes with a review of the evidence presented. More recent conceptual development is examined. Final conclusions lead to recommendations for further refinement of the instrument, by development of psychometric properties.