The Future Role of Nursing in Health Promotion - Essay Example

The Future Role of Nursing in Health Promotion Healthcare promotion is a concept that has acquired priority in the agendas of global organizations. Health promotion allows individuals to have control over their lifestyle choices and also on the resources that would enable them to adopt a healthy standard of living. Underlying this general notion is a comprehensive framework of strategies and principles that provide foundation to overall regime of health promotion. These strategies like development of legislations, individual skills etc., and principles including empowerment, participation and equity etc, also highlight the importance of healthcare professionals especially nurses and role played by them in spreading awareness about general health. Original regime of health promotion was determined to improve overall health of people and communities which has been an old issue in the agendas of global organizations. However, this agenda has transformed in last few decades as health promotion has emerged as a concept with more concrete basis. According to World Health Organization, health promotion is "the process of enabling people to increase control over, and to improve, their health..."In extension to that, Ottawa Charter for Health Promotion further illustrates health promotion by stating that in order to develop a holistic wellbeing, a person or a community is required to be capable of identifying their needs and realizing their aspirations. In addition to that, satisfying their needs and coping with environment is also another prerequisite for suitable health wellbeing. Hence, health can be perceived as a tool assisting in better quality of life and not a purpose of living. This concept further encompasses resources borne by individuals and society along with their physical capacities. Therefore, health promotion is a combined responsibility of society as well as individuals in order to have a long lasting impact (Keleher, MacDougall, Murphy, 2007). There are five distinct health plan actions outlined by Ottawa Charter (1986). Firstly, developing an extensive public policy is an underlying foundation for further health promotion strategies. Followed by it, developing personal skills, strengthening community actions define how individuals as well as groups can play their role in promoting health. Lastly, creating supportive environment and reorienting health services provide cornerstones of further strategies required to be followed for health promotion. It is important to note that like any other social regime, health promotion also requires an extensive framework. Therefore, an effective health promotion will encompass a range of activities such as public policies, organizational awareness and transformation, preventive measures (vaccinations, screening etc), community drives, adoption of environment-friendly strategies (recycling), health education (trainings, public awareness programs against AIDS) and economic regulations (restriction on smoking and alcohol). The given set of activities entails that along with public and private sector, other social forces are also responsible for effective health promotion mechanism (Better Health Channel, 2012). Ottawa Charter further identifies three basic strategies that encompass above mentioned actions (Better Health Channel, 2012). In the light of doctrines mentioned by this charter, to advocate, enable and mediate are the three fundamental strategies. Advocacy for health provides a direction for quality of life considering social, political, economic environmental factors. On the other hand, enabling individuals to achieve control over life’s quality helps in ensuring that equal opportunities are available to everyone so that differences in social health can be reduced. Furthermore, mediation extends responsibility of healthcare from health sector to public and private sector. This area allows government, welfare organizations, employers and communities to play their role in health promotion. Underlying these basic strategies are few fundamental principles that not only provide foundation to health promotion strategies but to other areas of human rights. These principles include empowerment, participation, holistic view, equitability, inter-sectoral approach, sustainability, and multi-strategy (Rootman et al. 2001). Empowering individuals allow them to have greater control and authority over the decisions that may affect their health. Furthermore, participation allows individuals and communities to take part in social and political decision making. This principle allows sharing of views that can actually support diversity. Having a holistic view defines how different dimensions of decisions can be and should be considered in order to have an effective health promotion regime. Having an equitable strategy allows benefits to be extended to all the end-users of a service. Intersectoral approach defines a framework through which different sectors and agencies along with private bodies can play their role in promoting health and general awareness about it. Sustainability provides long-term effectiveness to the measures taken for health promotion. Lastly, multi-strategy defines a framework of policies, programs and procedures that may provide shape to health promotion regime (WHO, 2013b). Understanding strategies and principles encompassing health promotion allows healthcare professionals to understand the social determinants that are responsible for inequities and inequalities in healthcare access and overall service provision. According to WHO (2013a), “The social determinants of health are the conditions in which people are born, grow, live, work and age, including the health system. These circumstances are shaped by the distribution of money, power and resources at global, national and local levels.” Hence factors like, income, social values and norms, community support, education, employment, living conditions, health services, culture and ethnicity play a considerable role in overall health promotion. Considering these factors, it can be established that there is an eminent difference between health promotion and overall quality of healthcare services in developed and developing parts of the world. Even in developed countries, cultural and ethnic backgrounds also act as a criterion for healthcare access. In a general term, equity specifies inapplicability of any bias while granting access to different rights. Hence, being just and fair can be defined as being equitable. Here arise concepts of horizontal and vertical equity that define allocation of resources at equal need’s level and different levels of need respectively (PAHOWHO, 1999, p.3). In the light of equitable distribution of resources, it can be established that there is a considerable difference between equality and equity as prior means being equal whereas later involves social justification. Hence, impacts of social determinants provide direction towards a framework that can help in reducing disparity in healthcare access. As it can be seen that major reason of inequity and failure to access healthcare is unfair and inequitable distribution of power, money and resources, therefore for reducing these differences, a holistic regime considering social, political, cultural and economic factors has to be adopted (Chapman, 2010; CSDH, 2008). Impacts of social determinants of health allow evaluating equity in healthcare system. According to Aday et al. (in PAHOWHO, 1999), “healthcare equities means extending services to those who are suffering from illness”. This definition provides a mechanism of suitable distribution of healthcare resources according to different levels of need. Hence, it can also be established that healthcare services bear different worth than other commodities that are easily tradable in general market due to their social significance. The gist of this conception is to reduce overall disparity in healthcare system and allowing individuals to have fair access to healthcare services irrespective of other external factors. In the absence of equitable and easily accessible healthcare system, population would be exposed to natural variation, health damaging behavior which leads to adoption of injurious lifestyle choices, transient advantage of one community over other, inadequate access to essential healthcare services, and unhealthy and stressful living conditions (Whitehead, 1991). These unnecessary and avoidable differences in healthcare pose a greater challenge for governing bodies in healthcare at national level as well as global scale in the form of increased rate of infections and malnutrition. Addressing disparities in social determinants such as income, social status, gender, education and ethnicity highlights the importance of general principles like empowerment and inter-sectoral effort. Empowerment provides equitable opportunity to individuals as well as communities to survive. On the other hand, other principles ensure participation of different sectors for reducing this disparity in power, income and resources. Disturbance in equity and social justice in healthcare levies greater burden on the developing part of the world and explains disruption in the global morbidity and mortality rate caused by disturbed social and sexual behavior, stress, hypotension etc (Orach, 2009). According to CSDH report (2008), political dimension of inequality and inequity in healthcare access should be addressed through legalization. Hence, constitutional rights related to access to healthcare and suitable living conditions would allow general public and respective members of the society to have fair access to resources. Economic dimension of this framework defines how overall social resources’ distribution can help in enhancing overall health and mitigating disparities. Social dimension of this framework helps in extending networking among communities, social groups and different sectors in a society. Lastly, cultural dimension addresses how considering local norms and values can help in devising a healthcare system that is within access of all the social forces. With increasing emphasis on overall health promotion practice, role of nurses has become more prominent in this practice. Since nurses play an evidently significant role in healthcare provision, they are required to participate in enhancing health promotion irrespective of the fact that they are practical nurses, educators or assistants in ongoing research. Where previously this responsibility rested with educators who were responsible to teach patients how to deal with their respective illnesses, this responsibility is extended to letting patients and other individuals become aware of practices that would alleviate their personal health. According to Chiverton et al. (2003), “Nurses must have an evidence-based understanding of the significant effect that can be made through health promotion interventions and communicate this understanding to the public at large.” For providing knowledge to general public, it is important that nurses are well-versed with basic healthcare strategies. Considering research of Callaghan, Fun and Yee (1997), it can be said that nurses make an attempt to follow basic healthcare practices themselves. According to this research, “The health-related behaviors of a random sample (n=92) of Hong Kong nurses were assessed by a questionnaire written either in English or in English and Chinese. Hong Kong nurse reported negligible smoking or an alcohol use, low levels of breast self-examination, cervical screening behavior and regular exercising, seat belt use and driving within the speed limit.” Further assessment involved intake of proper diet and following reasonable work routine ensuring work-life balance. In addition to that, Whitehead et al. (2007) conducted a research to determine the role played by perception regarding health promotion in Chinese nurses. It was found that overall effectiveness of education and practical implementation of health promotion by nurses is dependent on their perception regarding this very concept. The role of nurses in spreading awareness about health cannot be undermined. Being a front face of healthcare institutions, nurses come in contact with not only patients but their families and other community agents as well. Therefore, it is important that nurses are aware of necessary information that may alleviate the quality of life of user. Furthermore, using nursing sub-sector for healthcare promotion is also convenient since these agents are available through varied settings. Other than providing first-hand information related to a particular disease, nurses can also enhance their knowledge through research available on print and online media and integrate it into information disseminated to patients. Hence, every instance of communication between a client and a nurse is an opportunity of educating a member of a society. While doing so, it is important that nurses are well-aware of their scope and limitations of training provided to them. Nurses can play their role in overall health and general awareness by embracing and recognizing their role in health promotion. While doing so, they have to be aware of clients’ needs as well and their respective background along with assessment of social and cultural factors can help in evaluating clients’ needs for further information. It is further important that nurses are well-versed with the importance of inter-professional practice and address roles of assessments made by other healthcare experts (Funnel, Koutoukidis & Lawrence, 2008). Nursing in particular community can also allow nursing practitioners to play their role effectively. For this purpose, it is important nurses recognize specific needs of a community. Furthermore, they also take part in health promotion activities at different levels in order to acquire community penetration. Also, being aware of practices that would help community members to become empowered and have access to healthcare provisions is another responsibility of such nurses (Funnel, Koutoukidis & Lawrence, 2008). Developing general awareness about community, their norms and values would help nurse educators in attaining community advocacy. According to Bastable (2008), a nurse can be a facilitator of change, contractor in formal and informal manner while promoting learning objectives, organizer of a learning situation and an educator in such programs along with general instances. Health promotion acts as cornerstone of health education. Global bodies like WHO have recognized its importance and its overwhelming impact in not only fighting disease but also in alleviating overall quality of life. The fundamental doctrine behind health promotion is allowing everyone to have knowledge about and access to healthcare services in fair and just manner. Other than basic strategies and principles, roles of healthcare professionals especially nurses are considerably important. Since nurses are in contact with patients and clients from all kind of sectors and ethnic backgrounds, they can play a significant role in educating general public and acting as a change agent facilitating healthy variations in lifestyle choices. References Bastable, S.B. (2008). Nurse As Educator: Principles of Teaching and Learning for Nursing Practice. Jones & Bartlett Learning. Better Health Channel. (2012). Ottawa Charter for Health Promotion. Retrieved from http://www.betterhealth.vic.gov.au/bhcv2/bhcarticles.nsf/pages/Ottawa_Charter_for_Health_Promotion Callaghan, P., Fun, M. K. and Yee, F. C. (1997), “Hong Kong nurses' health-related behaviours: implications for nurses' role in health promotion”, Journal of Advanced Nursing, 25: 1276–1282. doi: 10.1046/j.1365-2648.1997.19970251276.x Chapman, A.R. (2010). “The Social Determinants Of Health, Health Equity, And Human Rights”, Health and Human Rights, 12(2): 17-30. Chiverton, P.A., Votava, K.M. & Tortoretti, D.M. (2003). “The Future Role of Nursing in Health Promotion”, American Journal of Health Promotion, 18(2): 192-4. CSDH (2008). Closing the gap in a generation: health equity through action on the social determinants of health. Final Report of the Commission on Social Determinants of Health. Geneva, World Health Organization. Retrieved from http://whqlibdoc.who.int/publications/2008/9789241563703_eng.pdf Funnel, R., Koutoukidis, G. & Lawrence, K. (2008). Tabbner’s Nursing Care: Theory and Practice. Elsevier Australia. Orach, C.G. (2009). “Health Equity: Challenges in Low Income Countries”. African Health Sciences, 9(S2): S49–S51. PAHOWHO. (1999). Principles and Basic Concepts of Equity and Health. Retrieved from http://www.paho.org/english/hdp/hdd/pahowho.pdf Rootman, Irving, Michael Goodstadt, Louise Potvin, and Jane Springett, eds. 2001. Evaluation in health promotion: principals and perspectives. Denmark: World Health Organization. Retrieved from http://www.euro.who.int/__data/assets/pdf_file/0007/108934/E73455.pdf Keleher, H., MacDougall, C. & Murphy, B. (2007). Understanding Health Promotion. Oxford University Press Australia & New Zealand. Whitehead, M. (1991). The Concepts and Principles of Equity and Health, WHO, EURO Report. Whitehead D., Wang Y., Wang J., Zhang J., Sun Z. & Xie C. (2007). “Health Promotion And Health Education Practice: Nurses’ Perceptions”. Journal of Advanced Nursing, 61(3): 311-320. World Health Organization. (2013a). Social Determinants of Health. Retrieved from http://www.who.int/social_determinants/en/ World Health Organization. (2013b). The Ottawa Charter for Health Promotion. 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