Health promotion in the practice setting: findings from a review of clinical issues.
BACKGROUND
Many agencies over the last few decades have called for the explicit inclusion and application of health promotion in all aspects of nursing practice. This article reviews the body of empirical (research-based) and theoretical (conceptual) literature addressing health promotion in nursing clinical practice, to uncover its nature, intention, and impact.


METHODS
The aim of this review was to identify from the nursing literature what is reported on in relation to health promotion activity, both theoretical and clinical in the practice setting. An extensive review identified that literature pertaining to these issues clustered around the categories of: theorising and conceptualising the meaning and purpose of health promotion in nursing practice, the development and testing of tools and models for practice, and the exploration of attitudes, behaviours, roles and functions of nurses and health professionals in practice.


RESULTS
Against more recent trends in health promotion, the literature shows that broader and wide-ranging health promotion reform has yet to have universal impact, whereas conventional health education activities remain the mainstay for the majority of "health promotion" activities in nursing practice. Where nurses purport to be conducting "health promotion" they are often conducting behavioural, lifestyle, and risk-orientated health education. The findings of this review therefore support the notion that much of nursing-related health practice is firmly located in reactive ill health and disease risk-specific preventive locations, instead of incorporating and instilling broader societal, economic, ecological, and political dimensions of health promotion. Recommendations for wider reform, developed from personal opinion and supported by the literature, are presented.


CONCLUSIONS
It is argued that nursing bodies, as well as individual nurses themselves, should seek current health promotion locations in nursing practice, and find effective ways to implement health promotion strategies and, subsequently, equip practitioners with the necessary resources and skills to engage with other health promotion agencies. Future research should be aimed at implementing and evaluating broad health promotion processes.
Whitehead
Dean
D
School of Health Sciences, Massey University, Palmerson North, New Zealand. d.whiteland@massey.ac.nz
D002983:Clinical Competence; D019317:Evidence-Based Medicine / Q000458:organization & administration; D015438:Health Behavior; D006293:Health Promotion / Q000458:organization & administration*; D006301:Health Services Needs and Demand; D006801:Humans; D008019:Life Style; D016294:Models, Nursing; D024802:Nurse's Role / Q000523:psychology; D009730:Nursing Assessment; D015403:Nursing Evaluation Research; D010353:Patient Education as Topic / Q000458:organization & administration*; D018802:Patient-Centered Care / Q000458:organization & administration; D010687:Philosophy, Nursing; D011057:Politics; D011209:Power, Psychological; D018570:Risk Assessment; D012648:Self Care / Q000379:methods / Q000523:psychology