The promotion of health : is the health promoting hospital the way forward?.
This thesis investigates whether the Health Promoting Hospital (HPH) is the
way forward in the promotion of health. To address this, a number of key
areas are considered. Firstly, the thesis places the HPH into historical context,
as it is from a long the tradition of efforts to promote health and prevent
disease that the HPH emerges. In order to understand the complex field of
health promotion, the thesis examines the legacy of health promotion and its
impact on contemporary health promotion and therefore on the potential of the
HPH. The answers to this provide the immediate context from within which
the HPH would be implemented.
There is a need not only to understand the HPH as a theoretical concept but
also to understand how it has been translated into practice. Thus how the
HPH has been adopted as a basis for modelling practice is examined. If the
HPH is to be a way forward for health promotion, then it will need to be
adopted widely by hospitals that have had little previous interest in, or
experience of, promoting health. To investigate the prospect of such
widespread adoption, a study was carried out of the attitudes, perceptions and
practices of nurses and patients at a typical UK teaching hospital outside the
HPH movement. The findings of this study, which drew on Communication of
Innovation Theory as a conceptual framework, are reported. For effective
health promotion, there is also need to address the legacy of weaknesses that
have hitherto hampered progress. Thus the thesis examines the extent to
which the HPH can address the contemporary weaknesses of health
promotion and, broadening out from this, it suggests other initiatives that
might be taken to advance the effective promotion of health and the
effectiveness of the HPH.
The thesis argues that the Health Promoting Hospital is a useful vehicle to
support the development of health promotion in the hospital setting but that
effectiveness is hampered by the fundamental weaknesses of health
promotion that it is insufficient, on its own, to counter. Initiatives are
suggested that can begin to redress this.