Casey Dympna
Department of Nursing and Midwifery Studies, Centre for Nursing Studies, National University of Ireland, Galway, Ireland.
J Clin Nurs. 2007 Jun;16(6):1039-49. doi: 10.1111/j.1365-2702.2007.01640.x.
This paper presents an account of nurses' perceptions and understanding of health promotion in an acute setting.
Health promotion is considered the remit of every nurse. To engage in health-promoting practice, however, nurses need to understand the term 'health promotion' clearly.
A single qualitative embedded case study was used. Purposive sampling of eight nurses was employed. Initially, theses nurses were observed in practice and, following this, a semi-structured one-to-one interview was conducted with each observed nurse. Qualitative data analysis guided by work of Miles and Huberman was employed.
The data revealed one main theme: health-promoting nursing practice and this consisted of six categories and five subcategories. The findings indicated that nurses struggled to describe their understanding of health promotion, their understanding was limited and the strategies described to conduct health promotion were narrow and focused on the individual. Their perceptions and descriptions of health promotion were more in keeping with the traditional health education approach. Overall health promotion was reported to occur infrequently, being added on if the nurse had time. Factors relating to education, organizational and management issues were identified as key barriers prohibiting health-promoting nursing practice.
Nurses must recognize that health promotion is a broad concept that does not exclusively focus on the individual or lifestyle factors. Nurses must be educated to recognize health-promoting opportunities in the acute setting, as well as how to plan for and conduct health promotion so that it becomes integral to practice. A review of the methods of organizing and delivering nursing care is also advocated.
Ward managers have an important role in supporting nurses, creating a culture for health promotion and sharing power in decision-making processes, so that nurses feel valued and empowered.
本文阐述了护士对急性病环境中健康促进的认知与理解。
健康促进被视为每位护士的职责。然而，要开展促进健康的实践，护士需要清楚地理解“健康促进”这一术语。
采用单一的定性嵌入式案例研究。对八名护士进行了目的抽样。首先，观察这些护士的实际工作，随后，对每位被观察的护士进行一对一的半结构化访谈。采用了由迈尔斯和休伯曼的著作指导的定性数据分析方法。
数据揭示了一个主要主题：促进健康的护理实践，它由六个类别和五个子类别组成。研究结果表明，护士们难以描述他们对健康促进的理解，他们的理解有限，所描述的促进健康的策略较为狭隘且侧重于个体。他们对健康促进的认知和描述更符合传统的健康教育方法。总体而言，健康促进活动很少开展，只有护士有时间时才会附加进行。与教育、组织和管理问题相关的因素被确定为阻碍促进健康护理实践的关键障碍。
护士必须认识到健康促进是一个广泛的概念，并非仅仅关注个体或生活方式因素。必须对护士进行教育，使其认识到急性病环境中的健康促进机会，以及如何规划和开展健康促进活动，以便使其成为实践中不可或缺的一部分。还提倡对组织和提供护理的方法进行审查。
病房管理人员在支持护士、营造健康促进文化以及在决策过程中分享权力方面发挥着重要作用，这样护士才能感到自己受到重视并有能力开展工作。
