Health promotion has become a key part of healthcare in today’s health industry. Promoting healthy lifestyles and behaviors and prevention of disease has shifted to a forefront position in the arena of healthcare. Health promotion is defined by the World Health Organization as “the process which enables people to improve control over the determinants of health and as a result to improve their own health.”(Jadelhack, 2012, p. 65) Promoting wellness and developing strategies to obtain this including confrontation of obstacles and barriers to wellness has become mainstream in nursing practice.
Nurses now incorporate areas of education, practice, methodology, and research which has set them at the cutting edge in health promotion. Studies have shown that health promotion is highly cost-effective and as health costs rise, targeting diseases that are preventable such as hypertension, obesity, diabetes, COPD, and communicable diseases such as Hepatitis and HIV can greatly diminish healthcare costs.
Promoting prevention rather than just curing disease after it occurs will reduce healthcare costs exponentially.
In the past, nurses provided patient education arranged at teaching patients how to manage current illness, the focus was on the present. In today’s nursing the focus is now on maintaining optimum health and behaviors that promote healthy lifestyles in effect heading off disease before it occurs. The spotlight is now on future health and management of wellness and on remaining healthy. In order to do this, nurses must possess a strong understanding of the disease process and interventions that can be made in order to guide the patient and communities.
They also must be well educated and knowledgeable in evidence-based practice and methods to coach and teach patients as well as family members. Nurses play a key role in guiding decisions in health by individuals, families and communities. They must understand theories, models and practices and be equipped to implement interventions as well as evaluate effectiveness and redesign the approach to meet the desired outcome.
As people become more aware of the benefits of good health and aware of their own health, community wellness is likely to improve. In order to facilitate and implement these changes, information delivery must be adequate and appropriate. Nurses must be educated in the delivery of health education and equipped to head off barriers to learning before they happen. Understanding cultural diversity and learning models promote better education of patients and communities. Advocating for healthy behaviors and lifestyles must be implemented and promoted at every contact with the patient. This is already seen in action by incentives for smoking cessation and weight loss by organizations and insurance companies. The public must be given the appropriate tools to enable them to make the changes necessary to promote wellness goals. In addition, optimizing opportunities during patient contact must be made. Every contact is an opportunity to advance healthy behaviors and to education patients and families. Clinic visits alone should not be the only interaction nurses utilize to address health promotion.
Dressing changes, injections, home health visits, and telephone contact are all optimal times to promote healthy behavior and educate patients. The platform for teaching comes in many settings for nurses and must be utilized to the highest extent possible. Health promotion comes in three formats, primary, secondary, and tertiary. The first level of health care, or primary prevention is provisioned to promote health and prevention of disease. The second level or secondary prevention is aimed at early identification of disease. Targeting high risk individuals in which the disease process has not yet manifested itself in order to promote measures that minimize the effects of disease. The third level of health care is known as tertiary prevention. This level of care involves care of disease that is already established. It works to restore the best level of function and disease management. It also promotes diminishing any further advancement of the disease process. The main difference between the three levels of care is primarily the extent of disease and the level of affliction faced by the patient.
Primary level of care deals mainly with healthy individuals who have not yet displayed evidence of disease. This level deals with lessening the propensity for disease through methods such as vitamins, immunizations, weight control, smoking cessation and other healthy lifestyle behaviors. The secondary level addresses care geared towards maintaining the level of health the patient is currently at and preventing advancement of disease. An example of this would be a patient who has a family history of hypertension whose blood pressure readings are increasingly elevated. Health promotion would be designed to avoid onset of the disease as well as health lifestyle changes to limit the already present risk. In tertiary prevention, care involves addressing health conditions and disease that have already manifested.
The goal of this level is to return the patient to an optimal level of functioning and preventing further progression of the disease. Support of the patient’s current health status and educating them to prevent complications as a result of the disease. This is demonstrated as educating a Hepatitis C patient on the importance of discontinuing alcohol consumption and safe sex practices to prevent transmission and coinfections. The nursing role extends well beyond primary care and basic skills. Health promotion is a progressive way nurses can assist patients, providers and communities in implementing and advocating for wellness and prevention of disease.
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