Lindsey E, Hartrick G
School of Nursing, University of Victoria, British Columbia, Canada.
J Adv Nurs. 1996 Jan;23(1):106-12. doi: 10.1111/j.1365-2648.1996.tb03142.x.
Health promotion is gaining widespread recognition throughout the world as the most efficacious practice in achieving health for all. In Canada, the philosophy of health promotion is driving both federal and provincial health initiatives. Such a philosophy is derived from a human science paradigm and is in direct opposition to the natural science paradigm from which the biomedical approach to health care emerged. There now exists a tension between these contrasting paradigms as health care shifts to embrace a health-promotion perspective. The nursing process is based in the natural science paradigm and on a biomedical approach to health care. In order for nurses to embrace health promotion fully, they must move away from the philosophy of the natural sciences and adopt a human science perspective. Such a shift requires a radical transformation in nursing practice as nurses move away from the 'top-down' approach of the nursing process and adopt a 'bottom-up' approach to health-promoting nursing practice. The purpose of this paper is to compare and contrast the nursing process with the principles of health promotion, and to challenge our use of the nursing process in current nursing practice. In particular, a framework for health-promoting nursing practice will be provided.
健康促进作为实现全民健康最有效的实践方法，正在全球范围内得到广泛认可。在加拿大，健康促进理念推动着联邦和省级的健康倡议。这一理念源自人文科学范式，与生物医学保健方法所源自的自然科学范式直接对立。随着医疗保健转向接受健康促进视角，这两种截然不同的范式之间目前存在着紧张关系。护理程序基于自然科学范式和生物医学保健方法。为了让护士全面接受健康促进，他们必须摒弃自然科学理念，采用人文科学视角。这种转变要求护理实践进行彻底变革，因为护士要从护理程序的“自上而下”方法转向健康促进护理实践的“自下而上”方法。本文旨在比较并对比护理程序与健康促进原则，并对我们目前护理实践中使用护理程序提出质疑。特别是，将提供一个健康促进护理实践的框架。
