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of Hong Kong. 1. Guide to Good Nursing Practice. Health Promotion. Preamble.
Guide to Good Nursing Practice Health Promotion Preamble Health is “a state of complete physical, social and mental well-being, and not merely the absence of disease or infirmity.” It is a resource that permits people to lead an individually, socially and economically productive life. Moreover, it is a fundamental human right (World Health Organization, 1998). Nevertheless, the health of an individual, family, community and population-at-large is determined by many factors, including shelter, food, education, social security, health and social services, income, employment and respect for human rights. People should be given opportunities, knowledge and access to services and resources so that they are enabled to have better control over these health determinants and to build their own health as well as the health of their families by their own actions. Central to the maintenance or improvement of health of the individual, families, groups and communities are health promotion and disease prevention activities. As a key member of the health care team, the nurse has an important role to play in health promotion and related activities.
Definition According to the World Health Organization (WHO), health promotion is the process of enabling people to increase control over the determinants of health and thereby improve their health. Participation is essential to sustain health promotion actions (WHO 1998, p.2). Health promotion is to be achieved through three basic strategies: 1. Advocacy - to create essential conditions for health. 2. Enabling - to enable all people to achieve their full health potentials. 3. Mediating - to mediate between the different interests in the society in the pursuit of health. These strategies are to be supported by five priority action areas: 1. Build healthy public policy. 2. Create supportive environment for health. 3. Strengthen community action for health. 4. Develop personal skills. 5. Re-orient health services. [Ottawa Charter (1986)] Hence, in terms of actions, health promotion embraces not only actions directed at strengthening the skills and capabilities of individuals, but also actions directed towards changing social, environmental and economic conditions so as to influence public and individual health. It encompasses political and social interventions designed to change policies and services as well as to promote social responsibility for health.
Principles To develop good practice in health promotion, the nurse needs to consider the following: 1. Incorporate health promotion as an integral part of nursing practice in different health care settings and in the community. 2. Facilitate and empower individuals, families and communities to increase control over the determinants of health via capacity building strategies. 3. Work in partnership with other disciplines and sectors in promoting the health of the community. 1 Developed by the Professional Development Committee of the Nursing Council of Hong Kong
4. Evaluate the outcome of health promotion activities and pursue continuous improvement. 5. Participate in and contribute to the development of evidence-based practice in health promotion. 6. Advocate for the individual, families and communities, and contribute to the formulation of public health policies for promoting the health of the population at large.
Responsibilities of the nurse 1. Assessing health needs The nurse should assess the health needs of the individual or the public and provide them with information and education that enable them to promote health, assume self-care at different stages of their lives; and to cope with acute/chronic illnesses and injuries. 2. Building capacity in health promotion The nurse should acquire specialized skills and competence in health promotion through lifelong learning. He/she should then adopt various health promotion strategies that help people to build capacity in controlling their own health and in making healthy life choices. 3. Participating as a proactive key player in inter-sectoral collaborations The nurses working in diverse settings should contribute to the implementation of health promotion strategies in partnership with other interested parties, as nursing acknowledges inter-sectoral contribution to health promotion. 4. Tackling multiple health determinants The nurse has an important role to play in promoting health in a wide range of settings, including schools, workplaces, hospitals and local communities, as well as at a broad societal level. By raising the awareness of people of the multiple and changing determinants of health and their responsibilities in controlling them, the nurse may helps to remove obstacles to health promotion. 5. Evaluating health promotion activities The nurse should include evaluation strategies in his/her initial planning for health promotion activities so that the effectiveness of the programmes and health outcome could be evaluated as appropriate. This is important for making continuous improvement for future activities. 6. Generating new knowledge and understanding on health promotion by research The nurse should participate in conducting research and/or disseminating research findings on both health promoting information and health promotion programmes so that a scientific database is built for the development of evidence-based practice. Moreover, new concepts and strategies would be generated to guide future practices. 7. Advocating for the individual and community at political and social levels The nurse should advocate for community development and social involvement, as well as lobby for public and social policy change conducive to promoting the health of the population at large.
Bibliography Academy of Medical-Surgical Nurses. (2000). AMSN Official Position Statement on: General Health and Wellness. Retrieved March 23, 2003, from http://www.medsurgnurse.org/position/general.htm
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Academy of Medical-Surgical Nurses. (2000). AMSN Official Position Statement on: Political Awareness for the Registered Nurse. Retrieved March 23, 2003, from http://www.medsurgnurse.org/position/politica.htm American Nurses Association. (1995). Position Statements: Promotion and Disease Prevention. Retrieved March 23, 2003, from http://nursingworld.org/ International Council of Nurses. (2000). Fact Sheets: Mobilising Nurses for Health Promotion. Retrieved March 22, 2003, from http://www.icn.ch/ Keller, L. S., et al. (1998). Population-Based Public Health Nursing Interventions: A Model from Practice. Public Health Nursing, 15, 3, June, 207-215. Royal College of Nursing, Australia. (2000). Position Statement: Health Promotion. Retrieved March 22, 2003, from http://www.rcna.org.au/ Standing Committee of Nurses of the European Union. (2001). Development of a Continuous Professional Training Programme for Nurses in Public Health Within the European Union: Guidelines. EU: Author. Texas Department of Health. (1996). Quality in Health Promotion, Texas Department of Health Standard of Practice for Health Promotion and a Long Range Action Plan. Retrieved September 4, 2002 from http://www.tdh.state.tx.us/php/qual_hp.htm World Health Organization. (1947). Chronicle of WHO. Geneva: Author. World Health Organization. (1986). First International Conference on Health Promotion, Ottawa, 21 November 1986. Retrieved May 28, 2003, from http://www.who.int/hpr/archive/docs/ottawa.html World Health Organization. (1998). Health Promotion Glossary. Geneva: Author.
Working Group Members Convenor: Ms Anne Marie WONG, Department of Health (till March 2005) Miss Sannie CHAN, Department of Health (since April 2005) Member: Ms Rubby KWOK, Health InfoWorld, Hospital Authority Dr. Edith LOH, Hong Kong Oncology Associates’ Limited Dr. TONG Wah-kun, Princess Margaret Hospital Ms Cynthia WONG, Department of Health Ms Peggy WONG, Hospital Authority
Printed in September 2006
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