Search

Aim. This paper is a report of a concept analysis of community health. Background. Community health is a term that has been broadly used in both research and practice. Although local communities are invested in community health improvement, this process often occurs without a clear definition of the concept of community health. Data sources. Data sources included a sample of 537 papers covering the period 1990 to 2004 and representing the disciplines of nursing, public health, medicine and sociology and landmark works concerning community health, six community health assessment instruments and interviews with seven key community health informants. Review methods. Rodgers' Evolutionary Method of Concept Analysis was used to design the study and analyse the data. The professional literature was analysed and compared with the use of the concept of community health in community health assessment instruments and by key informants. Results. Dynamic and contextual, community health is achieved through participatory, community development processes based upon ecological models that address broad determinants of health. The primary focus of this collaborative work is population-based health promotion and disease prevention. Conclusion. The definition derived from the concept analysis of community health makes explicit the importance of community-based participatory action in local health improvement processes. Identification of the attributes of community health will enhance communication across disciplines involved in community health practice, research and education. [ABSTRACT FROM AUTHOR]

AIM: This paper is a report of a concept analysis of adolescent smoking cessation self-efficacy. BACKGROUND: Smoking cessation is a key preventive care/health promotion strategy offered by nurses worldwide. Most programming is tailored to adults although the reasons for smoking, along with coping strategies, resources and developmental stage, differ in adolescence. Understanding of the concept of self-efficacy as it relates to the adolescent population will assist nurses in addressing smoking cessation behaviours with this population. DATA SOURCES: The CINAHL and Proquest Nursing databases were searched for papers published between 1977 and 2007 using the keywords self-efficacy, adolescents and smoking cessation. The Walker and Avant method of concept analysis was applied. FINDINGS: Adolescent smoking cessation self-efficacy is the confidence, perceived capacity and perceived ability that the teen possesses to quit smoking. Identified antecedents include developmental stage, past life support, emotional support, coping strategies, resources and emotional status. Consequences are smoking cessation: positive or negative. Empirical measures are identified. CONCLUSION: Levels of self-efficacy have been shown to be an important consideration in the approach of nurses to smoking cessation counselling with the adolescent client. The theoretical definition for this concept will provide the basis for nurses to design appropriate interventions for use in smoking cessation programmes targeted to adolescents. This definition identifies the key attributes of this concept that should be addressed when caring for this population. [ABSTRACT FROM AUTHOR]

AIM: This paper is a report of a study to evaluate the development of an innovative Service User Academic post in mental health nursing in relation to student learning and good employment practice in terms of social inclusion. BACKGROUND: Institutions providing professional mental health education are usually expected to demonstrate user involvement in the design, delivery and evaluation of their educational programmes to ensure that user voices are central to the development of clinical practice. Involvement can take many forms but not everyone values user knowledge as equal to other sources of knowledge. This can lead to users feeling exploited, rather than fully integrated in healthcare professional education processes. Development of the post discussed in this paper was stimulated and informed by an innovative example from Australia. METHOD: An observational case study of the development and practice of a Service User Academic post was undertaken in 2005. Participants were purposively sampled and included the User Academic, six members of a user and carer reference group, 10 educators and 35 students. Data were collected by group discussions and interviews. Data analysis was based on the framework approach. FINDINGS: The evaluation revealed tangible benefits for the students and the wider academic community. Most important was the powerful role model the Service User Academic provided for students. The post proved an effective method to promote service user participation and began to integrate service user perspectives within the educational process. However, the attempts to achieve socially inclusive practices were inhibited by organizational factors. The expectations of the role and unintended discriminatory behaviours had an impact on achieving full integration of the role. Furthermore, shortcomings in the support arrangements were revealed. CONCLUSIONS: The search for an optimum model of involvement may prove elusive, but the need to research and debate different strategies, to avoid tokenism and exploitation, remains. [ABSTRACT FROM AUTHOR]

AIM: This paper reports a literature review to synthesize the evidence that breastfeeding is a health-promoting behaviour for Hispanic women and to demonstrate the usefulness of the Health Promotion Model in understanding and increasing breastfeeding behaviours in Hispanic women. BACKGROUND: While breastfeeding has been shown to promote the health of both mother and infant, it has not been widely viewed from the perspective of the Health Promotion Model. METHODS: The CINAHL and MEDLINE databases were searched using the terms 'Hispanic' or 'Latina', 'breastfeeding' and concepts specific to the Health Promotion Model (interpersonal relationships, social support, acculturation, self-efficacy, barriers, benefits, and commitment). Only papers in the English language from 1990 to 2003 (except for classic papers) that used research techniques were reviewed. Only those addressing breastfeeding intention, initiation or duration were included. The reference lists of each paper were examined for additional empirical papers that linked any of the determinants of the Health Promotion Model to breastfeeding among Hispanic women. Papers were organized using the ten determinants as headings: prior related behaviour, personal factors, perceived benefits, perceived barriers, perceived self-efficacy, activity-related affect, interpersonal influences, situational influences, immediate competing demands, and commitment to a plan of action. The review was conducted in 2003. FINDINGS: The literature verifies that each of the 10 determinants of health-promoting behaviour also promotes breastfeeding for Hispanic women, particularly through the constructs of acculturation, interpersonal support, self-efficacy and immediate competing demands. Breastfeeding is not consistently defined in all studies, nor are Hispanic population groups uniformly classified according to country of origin. Specific interventions to promote breastfeeding have been implemented for women of Latin American origin, but randomized designs to measure outcomes have not been consistently employed with Hispanic women in the United States of America. Further intervention research is needed to confirm breastfeeding as a health-promoting behaviour and to inform breastfeeding education for this group. [ABSTRACT FROM AUTHOR]

hallett c.e., abendstern m.&wade l. (2004) Journal of Advanced Nursing48(3), 257–265The struggle for sanitary reform in the Lancashire cotton mills, 1920–1970This paper reports one aspect of a larger study. The aim of this aspect was to explore the role of the‘welfare officer’ in promoting the health of cotton mill workers during this period.The paper considers one element of a broad exploratory study of the health of women cotton mill workers in the North West of England. The original purpose of the study, which was conducted in 2002 in two towns, Oldham and Ashton-under-Lyne, was to explore the women's own perceptions of the impact of their work on their health, and to find out what, if any, help and support they obtained. During the course of the study it was discovered that‘welfare officers’, some of whom were trained nurses, had an important role in promoting the health of these workers. The study was therefore expanded to incorporate data obtained directly from interviews with a small sample of welfare officers. The present paper focuses on the issue of sanitary reform and considers the role of the‘welfare officer’ in promoting public health in the workplace.The study employed a combination of archive searches and oral history interviewing. In total, 31 interviews were undertaken between June 2001 and October 2002. The interpretive process focussed both on the ideological power structures which influenced the perspectives of participants, and on evidence for those aspects of participants’ experiences which impacted on their health.In considering their health, female cotton-mill workers recalled that the poor sanitary conditions in their workplaces during the middle years of the 20th century had been a source of some concern to them. They also observed that mill welfare officers took a hand in promoting improvement in available facilities. Welfare officers themselves recounted their own concern regarding the poor sanitary conditions in the mills, and their efforts to improve conditions for the mill workers.The paper demonstrates the role of a little-known group of health workers in the middle years of the 20th century, and demonstrates the importance of oral history work in re-capturing elements of nursing work and experience, which do not appear extensively in the written record. The study's relevance to contemporary practice lies in the insight it offers into the autonomy with which these occupational health workers defined their roles and performed their work. [ABSTRACT FROM AUTHOR]

This paper describes findings from a systematic review of the literature on the effectiveness of school nurses in promoting the health of school children. The paper gives a brief account of the background to the study and the search strategy adopted. Some key findings are presented and discussed. The brief for the review was to seek evidence of effectiveness in the practice of school nurses. The results of the review were disappointing, in that little research of acceptable quality was found and little could be said about effectiveness. The result is therefore a more diffuse review that gives a summary of descriptive research and current views and opinions, although it does also present some pointers for future research. The study was funded by Health Promotion Wales. [ABSTRACT FROM AUTHOR]

Clinical supervision is a commonly discussed concept within nursing. There appears to be a common belief that it is a good thing for nursing. Many practitioners, however, are still unsure what clinical supervision is and what is expected of them. A number of definitions and models of supervision have been developed but it remains ill defined. This paper develops a conceptual analysis of clinical supervision using the method developed by Rodgers (1989). A review of the literature precedes description of the attributes, antecedents, consequences and references. A model case is outlined prior to a proposed definition of supervision being given. It is hoped that this paper will stimulate further exploration and study of this concept. [ABSTRACT FROM AUTHOR]

This paper is an analysis of the concept of empowerment and its use in nursing practice, education, research and health promotion. The paper adopts an eclectic approach to concept analysis, incorporating the methods advocated by Walker & Avant and Rodgers. The concept is analysed and a theoretical definition given. Defining attributes, related concepts, antecedents and consequences of empowerment are proposed and a model case presented. The analysis demonstrates that empowerment is: a helping process; a partnership valuing self and others; mutual decision making; and freedom to make choices and accept responsibility. Implications for practice conclude the paper. [ABSTRACT FROM AUTHOR]

Health visitors are community nurses who define their role specifically in terms of health promotion, although they have often found difficulty in explaining how their seemingly diffuse and unfocused practice achieves this. The grounded theory study reported here set out to uncover some of the hidden processes and features embedded within health visiting, so the practice might be more clearly articulated. This paper reports one aspect of that study, which suggests that health visitors treat health as a lifelong process, involving the accumulation and use of 'resources for health'. The relevance of approaches which appeared both caring and educational will be set in the context of therapeutic nursing and adult education theories. Historically, health visitors have links with both nursing and health education; the analysis presented here helps to clarify the relationships between these different areas of work. The paper will explain how treating health as a process allows multiple competing views and ideas about health and health promotion to be integrated into a manageable form, thus allowing positive health to be promoted within a broad, acceptable socio-cultural context. However, the analysis also highlighted various points at which treating health as a process contradicts the firmly measurable requirements of the market-orientated health service. Nevertheless, where health visitors are sufficiently skilled, and are permitted by their employing authorities to use this approach, it may serve to protect clients from intrusive and accusing interventions, made in the name of health promotion. [ABSTRACT FROM AUTHOR]

Pressure on British health workers to be more explicit in articulating the function, purpose and outcome of their role has increased with the introduction of general management and shift to a market-place orientation, since implementation of the NHS and Community Care Act (1990). However, a recurring theme in the history of health visiting has been the difficulty which practitioners experience in trying to explain exactly what it is that they do. This has often been portrayed as a major failing, and possibly even a reason to discontinue the service. This paper will offer a potential explanation for this difficulty, and suggest that the management of uncertainty and ambiguity are central to the role. It will draw on a grounded theory study which explored how health visitors choose which approach to use in any particular situation encountered in their work. The analysis suggested that health visiting's central focus is on situations which are unpredictable, ambiguous or anomalous. The study revealed an approach to health promotion which requires a highly developed ability to cope in a safe and therapeutic way with shifting, uncertain and ill-defined health needs, and to recognize and respond to complex, potentially risk-filled situations. Drawing on examples which illustrate the implications of these concepts in practice, the paper suggests that, much as midwives have long claimed that a 'normal delivery is one that is over', so in health visiting a 'routine visit' can only be recognized as such once it has taken place. Nevertheless, it will be contended that the particular approach to practice revealed in this study represents a valuable and necessary aspect of health promotion, which has the potential to ensure relevance and acceptability, and which maximizes unexpected opportunities for prevention. [ABSTRACT FROM AUTHOR]

Health promotion is gaining recognition as a health care strategy. The major premise of this paper is that the nature of health promotion is emerging. Rising into view, health promotion offers many challenges and opportunities to all health care professionals. Many of the influences that health promotion will have on nursing have not yet been fully explored. What is health promotion? What concepts are inherent in health promotion? Are there models of health promotion that are specific to nursing? What will be nursing’s role in health promotion? What changes are required by the nursing profession to enable nurses to emerge within this new frontier? These are central questions for nurses as health promotion professionals to ponder, and attempts are made in this paper to answer these questions. [ABSTRACT FROM AUTHOR]

Family nursing assessment has traditionally followed an illness-care model. This paper proposes a re-evaluation of traditional family assessment and suggests an approach which is fundamentally based in health promotion. The paper includes a discussion of varying perspectives of health and health care, the health promotion perspective adopted by the World Health Organization, and the relevance of these perspectives for family nursing practice. Central elements of health promotion are outlined and serve as the guiding principles for family nursing assessment. Two inherent aspects of health-promoting family nursing practice are proposed and described. These include an emphasis on a human caring nursing ontology, and a framework for guiding family nursing assessment. This health-promoting assessment framework contains four essential components: (a) listening to the family; (b) participatory dialogue; (c) recognizing patterns; and (d) envisaging action and positive change. These components are described, together with the strategic elements inherent in each. Based on this health-promoting family nursing assessment, implications for nursing practice are discussed, and recommendations are made for research into this assessment framework. [ABSTRACT FROM AUTHOR]

Patient education, which is central to nursing practice, is evolving as a body of theory and in its application to groups of clients. This paper outlines a new body of theory known as self-efficacy theory, which has considerable potential to improve patient outcomes from teaching. This theory posits that patient belief that he can perform a necessary behavior (self-efficacy) can be affected by four principal sources of information: performance attainments, vicarious experience, verbal persuasion, and perceived physiological states. This paper also describes new applications of patient education for psychiatric patients and notes the potential for the expanded educational services for geriatric patients. These program have the potential to save hospital costs and to improve quality of life but appear to be in early stages of program development. Active development and management of a field's theory base and practice applications is fragmented in the patient education field but important to the field's continued relevance and vigor. [ABSTRACT FROM AUTHOR]

AIM: This paper is a report of a study conducted to compare middle-aged female family caregivers and non-caregivers in terms of: (a) differences in quality of life and health-promoting lifestyle behaviors; and (b) the relationship between health-promoting lifestyle behaviors and quality of life. BACKGROUND: Caregiving for older relatives is a stressful responsibility that detracts from the quality of life of female caregivers and imposes barriers to practising healthy behaviors. Recent studies on caregiving responsibilities have been primarily conducted in Western cultural contexts, with few studies of Chinese groups. METHOD: This cross-sectional, comparative study included a convenience sample of 39 female caregivers and 98 non-caregivers recruited in southern Taiwan in 2007. Data were collected using the World Health Organization Quality of Life Instrument-BREF Taiwanese version and Health Promotion Lifestyle Profile II. RESULTS: The majority of caregivers reported a low level of caregiving input with family support. They also reported a statistically significantly higher proportion of health-promoting behaviors than non-caregivers, although quality of life did not differ between the two groups. Practising healthy behaviors may more strongly influence quality of life in caregivers than in non-caregivers. CONCLUSION: Policymakers should consider direct family support and uphold the value of family cohesion in order to maintain healthy behaviors and a high quality of life in family caregivers. Further studies with larger and more comparably-sized participant groups are recommended to investigate the interactions between levels of care, family support, caregiving consequences, health-promoting behaviors and the caregivers' quality of life. [ABSTRACT FROM AUTHOR]

Title. Engaging with nature to promote health: new directions for nursing research. Aim. The aim of this paper is to offer a conceptual framework for nature-based health promotion in nursing and provide related recommendations for future nursing research. Background. Empirical data suggest that interaction with nature has direct health benefits. When people attend to outdoor habitats, gardens and other forms of nature, they are more likely to engage in physical activity and other behaviours that improve health. Engaging with nature can even cultivate ecological sensibilities that motivate us to protect the health of our planet. Data sources. Multidisciplinary theoretical and research publications from 1985 to 2008 were examined in the development of the framework. Discussion. As the health of our planet continues to deteriorate, there is a pressing need for theoretically informed, ethical, sustainable ways of engaging with nature to promote human and environmental health. We adapt principles and socio-ecological thinking from the fields of nursing, health promotion and ecological restoration to delineate the essential elements of the proposed framework. Implications for nursing. Although evidence-based knowledge about nature-based health promotion is not readily used in nursing and health care, its development and application are critical to designing effective strategies to strengthen both human and environmental health. Conclusion. Nurses can use nature-based health promotion concepts to work with citizens, health practitioners and policymakers to explore and optimize reciprocal, health promoting relationships among humans and the natural environment. To the extent that nurses integrate nature-based health promotion into their research efforts, we can expect to contribute meaningfully to both environmental and human health in communities across the globe. [ABSTRACT FROM AUTHOR]

AIM: The paper reports on a study to describe the determinants of physical activity according to physical activity level among rural women in Korea. BACKGROUND: The benefits of physical activity for promoting health and preventing illness are well known, and gender and regional disparities in physical activity have been reported. Although the number of women who perform physical activity has increased, many still do not meet the recommended levels to gain health benefits. METHOD: A cross-sectional descriptive study was conducted using a structured questionnaire. A convenience sample of 245 women living in a rural area of Korea was recruited during 2004. Self-efficacy, benefits, barriers and sociodemographics were examined in relation to three levels of physical activity: inactive, insufficiently active and active. Descriptive statistics and multinomial logistic regression were used for data analysis. RESULT: Perceived self-efficacy, benefits and barriers were statistically significant determinants only when the insufficiently active group was compared with the inactive group. Sociodemographic factors related to work and family roles statistically significantly explained the physical activity levels of rural women. CONCLUSION: Nursing interventions to increase self-efficacy and benefits, or decrease perceived barriers could be effective for initiating physical activity for inactive women, whereas the same may not apply for insufficiently active women. Insufficiently active women may have false confidence that their physical activity will help them gain health benefits. Reducing the burdens of work and family roles of rural women might improve their physical activity levels. [ABSTRACT FROM AUTHOR]

Title. Jordanian nurses’ knowledge and practice of breast self-examination. Aim. This paper is a report of a study to evaluate the knowledge and practice of Jordanian nurses in relation to breast self-examination. Background. Studies have shown that women who have learned about breast self-examination have positive attitudes toward breast cancer and practise breast self-examination more frequently, and that nurses who teach their clients about methods of early detection and breast self-examination are more knowledgeable about breast cancer screening and breast self-examination techniques than those who do not. Therefore, it is important to understand nurses’ knowledge about breast cancer and its early detection. Methods. A cross-sectional design was used, with a convenience sample of 347 Registered Nurses at three large cities in Jordan (response rate 95%). Data collection took place in 2005 using a self-administrated questionnaire with three parts and based on the American Cancer Society’s guidelines: demographics, knowledge, and practice of breast self-examination. Results. Nurses reported high levels of knowledge of breast self-examination (M = 7·6,sd. 2·7). A high proportion of nurses reported doing breast self-examination in the past 12 months (85%), but only 17·7% reported doing so on a monthly basis. None of the demographic characteristics was found to be associated with the practice of breast self-examination. Conclusion. More health education about monthly breast self-examination and prevention strategies is needed for nurses and their women patients, especially for Arabic women. [ABSTRACT FROM AUTHOR]

Aim. This paper is the report of a pilot study to assess if an Integrated Health Programme would reduce sick leave and subjective health complaints, and increase coping in a population of nursing personnel. Background. The work group in Norway with most sick leave is healthcare workers. More than 50% of the sick leave is because of subjective health complaints. Work place physical exercise interventions have a documented positive effect on sick leave. Method. After baseline screening, employees who had agreed to participate ( n = 40) were randomized to an intervention or control group. The intervention group participated in an Integrated Health Programme twice weekly during working hours. The programme consisted of physical exercise, stress management training, health information and an examination of the participants' workplace. The control group was offered the same intervention after the project was finished. This study was carried out from 2001 to 2002. Findings. There were no statistically significant effects on sick leave or health-related quality of life. The intervention group reported fewer neck complaints compared to the control group, but otherwise there were no effects on subjective health complaints. However, the subjective effects were large and highly statistically significant, the intervention group reporting improvement in health, physical fitness, muscle pain, stress management, maintenance of health and work situation. Conclusion. The Integrated Health Programme was not effective in reducing sick leave and subjective health complaints, but may be of use to employers wanting to increase employee job satisfaction and well-being. [ABSTRACT FROM AUTHOR]

Title. Older people’s expectations regarding ageing, health-promoting behaviour and health status. Aim. This paper is a study to explore the influence of expectations regarding ageing on physical and mental health status, and to examine the mediating effects of health-promoting behaviour on the relationship between these expectations and physical and mental health. Background. To achieve healthy ageing, it is necessary for older people to play an active role in maintaining good health. Without any expectations for healthy ageing among older people themselves, encouraging them to participate in health-promoting behaviour and thereby to maintain good health would be unsuccessful. Method. A convenience sample of 99 community-residing Korean older people was surveyed in 2007 via questionnaire using a short version of the Expectations Regarding Aging questionnaire, Health Promoting Lifestyle Profile II, and Medical Outcomes Study 12-item short form. Findings. Having a higher expectation about ageing was associated with better physical and mental health, after adjusting for age, gender and education. Expectations about ageing were partially mediated through the health-promoting behaviour that influenced physical and mental health. Conclusion. It may be necessary for nurses to make an effort to improve older people’s expectations about ageing to help them achieve good health. Nursing interventions to improve these expectations need to be used in conjunction with an emphasis on older people’s active involvement in health-promoting behaviour. [ABSTRACT FROM AUTHOR]

Title. Stages of Change – Continuous Measure (URICA-E2): psychometrics of a Norwegian version. Aim. This paper is a report of research to translate the English version of the Stages of Change continuous measure questionnaire (URICA-E2) into Norwegian and to test the validity of the questionnaire and its usefulness in predicting behavioural change. Background. While the psychometric properties of the Stages of Change categorical measure have been tested extensively, evaluation of the psychometric properties of the continuous questionnaire has not been described elsewhere in the literature. Method. Cross-sectional data were collected with a convenience sample of 198 undergraduate nursing students in 2005 and 2006. The English version of URICA-E2 was translated into Norwegian according to standardized procedures. Findings. Principal components analysis clearly confirmed five of the dimensions of readiness to change (Precontemplation Non-Believers, Precontemplation Believers, Contemplation, Preparation and Maintenance), while the sixth dimension, Action, showed the lowest Eigenvalue (0·93). Findings from the cluster analysis indicate distinct profiles among the respondents in terms of readiness to change their exercise behaviour. Conclusion. The URICA-E2 was for the most part replicated from Reed’s original work. The result of the cluster analysis of the items associated with the factor ‘Action’ suggests that these do not adequately measure the factor. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study performed to identify the predictors of mammography uptake for Korean women according to the stage of change, as determined by the transtheoretical model. Background. Although breast cancer is the most common female cancer in South Korea, its early detection rate here is low when compared with other developed countries. The transtheoretical model can be used to facilitate health promotion based on individual health behaviour and to devise stage-tailored interventions. Method. The participants were a convenience sample of 920 women aged >/=40 years between December 2005 and February 2006. A cross-sectional design was used in which participants completed a questionnaire that consisted of measures of the transtheoretical model. To provide a standard of measure, the variables were converted from raw scores to standard scores and then to T scores (mean = 50,sd = 10). Logistic regression analysis was then used to estimate predictors of the stage of maintenance of mammography uptake. Findings. The most frequent stage of mammography uptake was 'contemplation'. Predictors of mammography uptake included decisional balance, commitment to regular screening and avoiding contact with the healthcare system. Commitment to regular screening and breast self-examination were strongly related to mammography maintenance. Conclusion. The results of this study can be used for the development of theory-based and empirically supported mammography uptake intervention strategies and programmes directed towards women aged >/=40 years. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study to describe nurses' experiences of information technology-based standardized patient education in inpatient psychiatric care. Background. Serious mental health problems are an increasing global concern. Emerging evidence supports the implementation of practices that are conducive to patient self-management and improved patient outcomes among chronically ill patients with mental health problems. In contrast, the attitude of staff towards information technology has been reported to be contradictory in mental health care. Method. After 1 year of using an Internet-based portal (Mieli.Net) developed for patients with schizophrenia spectrum psychosis, all 89 participating nurses were asked to complete questionnaires about their experiences. The data were collected in 2006. Fifty-six participants (63%) returned completed questionnaires and the data were analysed using content analysis. Findings. Nurses' experiences of the information technology-based standardized patient education were categorized into two major categories describing the advantages and obstacles in using information technology. Nurses thought that it brought the patients and nurses closer to each other and helped nurses to provide individual support for their patients. However, the education was time-consuming. Conclusion. Systematic patient education using information technology is a promising method of patient-centred care which supports nurses in their daily work. However, it must fit in with clinical activities, and nurses need some guidance in understanding its benefits. The study data can be used in policy-making when developing methods to improve the transparency of information provision in psychiatric nursing. [ABSTRACT FROM AUTHOR]

Aim. The paper is a report of a review of the literature on the effects of school-based drama interventions in health promotion for school-aged children and adolescents. Background. Drama, theatre and role-playing methods are commonly used in health promotion programmes, but evidence of their effectiveness is limited. The educational drama approach and social cognitive theory is share the assumption that learning is based on self-reflection and interaction between environment and person. However, educational drama also emphasizes learning through the dialectics between actual and fictional contexts. Data sources. A search was carried out using 10 databases and hand searching for the period January 1990 to October 2006. Methods. A Cochrane systematic review was conducted. Results. Nine studies met the criteria for inclusion. Their topics included health behaviour (five studies), mental health (two) and social health (two). Actor-performed drama or theatre play followed by group activities was the intervention in five studies, and classroom drama in four studies. Four of the studies were randomized controlled trials and five were non-randomized controlled studies. Four reports gave the theory on which the intervention was based, and in eight studies at least some positive effects or changes were reported, mostly concerning knowledge and attitudes related to health behaviour. The diversity of designs and instruments limited comparisons. Conclusion. There is a need for well-designed and theory-based studies that address drama interventions in health promotion for children and families. The challenge is to find or develop a theory, which combines educational, drama and health theories with valid and reliable measurements to examine the effects of the intervention. [ABSTRACT FROM AUTHOR]

AIM: This paper is a report of a study to identify family caregivers' needs and satisfaction levels in adult day healthcare services for older adults with stroke. BACKGROUND: With a growing number of older people suffering from chronic illnesses, the demand for adult day care is growing worldwide. However, in Asia, caregivers face unique challenges in selecting and using culturally acceptable models of care for older people with stroke, and there are still unmet needs in adult day healthcare services. METHOD: A cross-sectional descriptive survey was carried out in 2006 with a convenience sample of 119 family caregivers from nine centres in Korea. The questionnaire included the Modified Caregiver Satisfaction Scale. FINDINGS: Korean family caregivers of older people with stroke were moderately satisfied with the adult day healthcare services. In particular, health management was an area with a high level of needs but with a low level of satisfaction. Respondents also had unmet needs such as speech therapy, patient-tailored exercise and physical therapy. There was a statistically significant difference in degree of satisfaction according to whether or not Registered Nurses delivered care at the centres. CONCLUSION: It is important to reflect family caregivers' needs by providing quality care, which is culture-specific adult day healthcare services and focuses on health management and skilled nursing care. [ABSTRACT FROM AUTHOR]

AIM: This paper is a report of a study to examine the effects of a Roy Adaptation Model-based experimental education, exercise and social support programme on adaptation in persons with heart failure. BACKGROUND: In the past 20 years, a large number of studies have evaluated heart failure. Several studies of other chronic diseases have been based on the Roy Adaptation Model and show that this approach is useful in promoting adaptation for patients. METHOD: A randomized, parallel, controlled clinical trial was conducted in 2005 with 43 patients (21 intervention and 22 control patients). A booklet for patient training was given to those in the intervention group. Participants received a patient identification form, assessment form for physiological data, the Minnesota Living with Heart Failure Questionnaire, Interpersonal Support Evaluation List and the 6-Minute Walk Test. RESULTS: Patients in the intervention group adapted well to their condition and the four adaptive modes of Roy Adaptation Model were interrelated. Patients' quality of life was enhanced, their functional capacities increased and social support within the interdependence dimension improved in patients in the intervention group. CONCLUSION: This is the first study to use the Roy Adaptation Model in a study of patients with heart failure. Roy's model is an effective guide for nursing practice when caring for patients with heart failure. [ABSTRACT FROM AUTHOR]

Title. Health promotion and health education practice: nurses’ perceptions Aim. This paper is a report of a study to explore nurses’ perceptions of health promotion and health education practice in a Chinese provincial hospital. Background. Health promotion and health education practices are based on universal constructs. Therefore, such practices should share common principles. To date, most nursing-related studies have been conducted in Europe or in North America. Method. A Husserlian phenomenological approach was adopted. Interviews were conducted in 2006 with a sample of eight nursing students and eight senior nurses. The interviews were audio-recorded and transcribed from Mandarin to English. Data analysis adhered to the framework developed by Giorgi. Results. Reported health education and health promotion-related practices showed results similar to those reported in Europe and North America. Hospital-based nurses were often aware of what health promotion is, but did not have the scope or opportunity to implement it in practice. Instead, they were likely to conduct more limited forms of health education. Actual understanding of health promotion and health education constructs was high with most participants, underpinned by active clinical-based educational support. Some participants were able to conduct broader health promotion activities on a voluntary basis in their own communities. Conclusion. Health education and health promotion are universal health-related constructs. Thus, there is an expectation that all nurses will implement these in a similar fashion. Where possible, hospital-based nurses should strive to improve their health education practices and further embrace wider perspectives of health promotion practice. [ABSTRACT FROM AUTHOR]

Aim. The paper is a report of a study to demonstrate how the use of schematics can provide procedural clarity and promote rigour in the conduct of case study research. Background. Case study research is a methodologically flexible approach to research design that focuses on a particular case - whether an individual, a collective or a phenomenon of interest. It is known as the 'study of the particular' for its thorough investigation of particular, real-life situations and is gaining increased attention in nursing and social research. However, the methodological flexibility it offers can leave the novice researcher uncertain of suitable procedural steps required to ensure methodological rigour. Method. This article provides a real example of a case study research design that utilizes schematic representation drawn from a doctoral study of the integration of health promotion principles and practices into a palliative care organization. Discussion. The issues discussed are: (1) the definition and application of case study research design; (2) the application of schematics in research; (3) the procedural steps and their contribution to the maintenance of rigour; and (4) the benefits and risks of schematics in case study research. Conclusion. The inclusion of visual representations of design with accompanying explanatory text is recommended in reporting case study research methods. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study to assess the effect of an adapted arthritis self-management programme with an added focus on exercise practice among osteoarthritic knee sufferers. Background. Osteoarthritis of the knee is a major source of loss of function in older people. Previous studies have found self-management programmes to be effective in increasing arthritis self-efficacy and in mastery of self-management practice. Method. A randomized control trial was carried out from December 2002 to May 2003 and 120 participants (65.9%, including 67 in intervention group and 53 in control group) completed the 16-week postintervention assessments. Outcome measures included arthritis self-efficacy, use of self-management techniques, pain intensity and daily activity. Findings. At 16 weeks, there was a 'statistically' significant improvement in the arthritis self-efficacy level (P

Title. Occupational health nurses’ perceptions of their current and future roles Aim. This paper is a report of an investigation of Australian occupational health nurses’ perceptions of their current and future roles. Background. Occupational health nurses are expected to engage in a variety of traditional curative activities as well as emergent role activities focusing on injury prevention, health promotion, wellness, management and research. However, little is known about the importance they place on traditional and emergent activities in both current and future practice. Method. The 416 members of the Australian College of Occupational Health Nurses were asked in 2002–03 to complete a questionnaire with items based on the College's areas of practice. The items related to perceived importance and time dedicated to traditional and contemporary role activities. One hundred completed questionnaires were returned, but only 93 were suitable for analysis (response rate 22%). Findings. Currently, Australian occupational health nurses engage in traditional curative and emergent wellness, management and research activities, but traditional activities dominate their work. Participants perceived that in the future activities related to wellness, management and research will be more important to their practice and that they will need to devote more time to them. Conclusion. Education programmes will need to address specifically the knowledge and skills required for wellness-based models of practice in occupational health nursing, as well as research and negotiating skills for working with others in the workplace. [ABSTRACT FROM AUTHOR]

Aim. This paper is a report of a study to describe the dietary acculturation of hypertensive and normotensive Korean Americans and native Koreans by comparing dietary pattern and diet quality. Background. Dietary acculturation is a major factor that influences the risks for cardiovascular disease in immigrants. Nurses play a key role in educating immigrants about dietary acculturation. Limited studies have examined dietary acculturation of Korean immigrants with hypertension. Method. A descriptive study of hypertensive and normotensive Korean Americans and native Koreans (n = 398) was conducted in 2003-04, using the 24-hour dietary recall method. Dietary pattern was measured by consumption frequency of Korean, American and common food, and eating outside the home. Diet quality was measured by the revised version of the Diet Quality Index. Findings. Korean Americans showed greater consumption of American food, common food and fast food, and ate away from home more often than native Koreans. Overall Diet Quality Index scores were not statistically significantly different between the two groups after matching. Compared with native Koreans, Korean Americans consumed lower amounts of sodium, potassium, vegetables and fruits, and energy from carbohydrates. Hypertensive Korean Americans consumed fewer vegetables and fruits, and less sodium and potassium than hypertensive native Koreans. No statistically significant differences were found between hypertensive and normotensive Korean Americans in dietary acculturation. Conclusion. Dietary acculturation of immigrants is a common phenomenon regardless of the country from which they immigrate. Healthcare professionals should consider the advantages and disadvantages of dietary acculturation in health promotion for immigrants. [ABSTRACT FROM AUTHOR]

AIM: This paper is a report of a study of the perspectives of homeless individuals on their health and healthcare needs. BACKGROUND: Many studies show the high incidence and severity of diseases, physical and mental, amongst the homeless populations. However, the views of homeless people themselves are usually omitted. In order to provide appropriate care, healthcare professionals need to be aware of these perspectives. METHOD: A descriptive, exploratory design, using semi-structured interviews and observational field notes, was chosen for this qualitative study. A convenience sample of 24 participants experiencing homelessness was recruited in one Canadian city in 2005. FINDINGS: Participants described their health and healthcare needs in a holistic sense. They reported concerns about physical illnesses, mental health, addictions and stress. Shelter life promoted spread of diseases and lacked privacy. Violence was rampant in shelters and on the streets, leading to constant fear. There was emotional distress over social exclusion and depersonalization. Participants wanted to work and to be housed, yet felt trapped in a dehumanizing system. CONCLUSION: The recommendations are (a) elimination or mitigation of most health problems of the homeless through safe, affordable housing; (b) reintegration into the community through job counselling, treatment of addictions and employment. Negative societal attitudes towards these clients need to change. Healthcare professionals, particularly community nurses, have opportunities to collaborate respectfully with these clients and work for changes in public policies, such as national housing and addiction treatment policies, and for streamlined, humanized services to smooth the processes of social reintegration. [ABSTRACT FROM AUTHOR]

Title. Turkish adaptation of the parental health beliefs scale Aim. This paper reports an adaptation of the English version of the Parental Health Beliefs Scale for use with Turkish parents and an evaluation of its psychometric properties. Background. As a profession, nurses are particularly concerned with cross-cultural influences that affect the health beliefs of populations. Although the international literature describes questionnaires and specific scales in health promotion and health beliefs, adequate Turkish-language instruments are scarce. Therefore, suitable instruments need to be developed or adapted for the Turkish parents. Method. This was a psychometric study. A convenience sample ( n = 257) was recruited in 2003 from parents who attended a primary healthcare centre in Erzurum, Turkey. Translation and back-translation of the original English instrument and content validation by an expert panel were the first two steps. The third step was psychometric testing of the adapted instrument to establish internal consistency, inter-item correlation and construct validity. Data were collected using the Parental Health Beliefs Scale. Socio-demographic data were also collected. The investigators visited the centre every workday, and interviewed the samples. The parents read and self-completed the questionnaire. Findings. Content validity procedure resulted in a final scale that consisted of 20 items. Cronbach's alpha was 0·75. Factor analysis yielded three factors related to chance, internality and powerful others. Conclusion. Although acceptable levels of reliability and validity of the Turkish version of the Parental Health Beliefs Scale for parents were reached, cultural factors appeared to play a role in the applicability of the scale. Further validation research is therefore needed before the scale can be recommended for use in nursing research and practice. [ABSTRACT FROM AUTHOR]

Aim. This paper reports a study to determine the factors affecting communitydwelling older Chinese people's health-promoting behaviour in the domains of physical activity, healthy dietary practices and stress management, and to identify any barriers to these behaviours. Background. Previous studies have identified factors affecting different types of health-promoting behaviours, including perceived self-efficacy, perceived benefits and five individual characteristics (age, sex, marital status, education and perceived health) of older non-Chinese people. However, few studies have simultaneously taken these factors into account in examining community-dwelling Chinese older people's health-promoting behaviour. Method. Individual face-to-face interviews were completed in 2002-2003 with a convenience sample of 896 community-dwelling older Chinese people in Hong Kong aged between the ages of 60 and 98 (years mean 76). Participants had no apparent communication and cognition impairments. A structured interview schedule was used to collect the data. Results. Multiple regression analysis showed that perceived self-efficacy, perceived benefits and sex together explained 38Æ4% of health-promoting behaviour among community-dwelling older Chinese people in Hong Kong. Fatigue during and after physical activity, enjoyment of unhealthy foods and inadequate family and peer support were the most frequently reported barriers to health-promoting behaviour. Conclusion. When developing health promotion programmes to motivate community- dwelling older Chinese clients to participate in health-promoting behaviour and to minimize barriers, community nurses should include some activities to increase both the perceived self-efficacy and perceived benefits of health-promoting behaviour. Future studies should include more critical factors based on theories, empirical evidence and knowledge of culture with samples that are random and from more diverse community settings. [ABSTRACT FROM AUTHOR]

AIM: This paper reports a study exploring the effectiveness of an osteoporosis prevention education programme for young adults. METHODS: A quasi-experimental study was carried out with two groups, using pre-, post- and follow-up measures and was conducted in one integrated services centre during the period July 2005 to November 2005. RESULTS: The results showed statistically significant increases in the reported follow-up for each outcome: osteoporosis knowledge test scores, osteoporosis health brief scores, and osteoporosis self-efficacy scores, for those in the intervention group compared with those in the control group. On the satisfaction score, most participants in the intervention group rated the nurse's performance in the educational programme positively. CONCLUSION: Strategies used in this programme may provide guidance for the design of future programmes. [ABSTRACT FROM AUTHOR]

Aim. This paper reports a study exploring nurses’ provision of opportunistic health education on smoking for hospital patients. Background. Smoking cessation guidelines recommend assessment of patients’ smoking habits and provision of smoking cessation advice when possible, and highlight the importance of the role of nurses in health promotion and health education. In the past, nurses have been criticized for lack of knowledge, skills and confidence in relation to health education and the perception that it is additional to, rather than integrated with, nursing care. Methods. A qualitative case study design was selected to explore the health education practice of 12 nurses working in acute wards in three general hospitals in Scotland. Data were collected in 2000 through non-participant observation, semi-structured interviews and the use of a radio-microphone to record nurse–patient interactions. The data analysis was guided by four key elements of health education practice: ‘the teachable moment’, ‘readiness to learn’, ‘the provision of health information’ and ‘oral communication’. Findings. Smoking was part of the nurses’ agenda, as most recognized opportunities to introduce health education on smoking during nursing care, suggesting a tentative move towards the integration of health education with nursing care. Evidence from patients’ interactions indicated ample opportunity for nurses to provide smoking-related health information. However, the content of nurses’ interactions on smoking was variable, with some limited by poor communication skills and inadequate knowledge of smoking and smoking cessation. The context of the interactions was also important in understanding some of the restrictions on conversational progress. Conclusions. Nurses require the knowledge and skills to perform a health education role, and the inclusion of smoking cessation guidelines in nursing curricula would contribute to this. Where patients are in hospitals for short periods of time, opportunistic health education on smoking needs to be introduced as the basis for more specialist intervention. [ABSTRACT FROM AUTHOR]

Aim. This paper reports a study investigating health visitors’ and practice nurses’ attitudes, beliefs and practice associated with routinely advising patients about physical activity. Background. There is worldwide concern about increasing rates of obesity and decreasing population levels of physical activity, and it has been argued that primary healthcare professionals are ideally placed to promote physical activity within local communities. In recent years, the public health role of primary care-based nurses in the United Kingdom has been considerably expanded to include playing a key role in improving the health of their local practice populations. A systematic literature search revealed that very few studies investigating nurses’ views and experiences of this type work have been published. The limited amount of research that has been conducted is generally small-scale and primarily concerned with general medical practitioners’ practice and attitudes, and not those of nurses. Methods. A questionnaire survey ( n = 630) and 20 in-depth interviews were conducted with health visitors and practice nurses in four health regions in Scotland between March and April 2004. The response rate was 63% overall. Results. Ninety per cent ( n = 149) of health visitors and 88% ( n = 186) of practice nurses said that they were very likely or likely to recommend all apparently healthy adult patients to take moderate exercise. Health visitors were more likely to discuss psychological benefits than practice nurses. However, only 9% ( n = 15) of practice nurses and 11% ( n = 15) of health visitors correctly described the current recommendations – an accumulation of 30 minutes of moderate physical activity five times a week. Interview data suggested that most nurses gave physical activity advice based on their beliefs about the patient's willingness to change and their impressions of the patient's presenting condition, underlying physical condition and life circumstances. No measure of underlying physical fitness was used. There was a lack of agreement between the questionnaire and interview data associated with levels of physical activity advising. Conclusion. There were high levels of enthusiasm for physical activity promotion amongst health visitors and practice nurses. However, nursing leaders and opinion-makers should challenge practitioners’ current beliefs and assumptions about physical activity promotion in the general population. [ABSTRACT FROM AUTHOR]

Aims. This paper reports a study describing community nurses’ health promotion work with older people aged 50 years and above, and exploring particular health promotion initiatives for older people that would have transferability potential. Background. With the ageing of populations worldwide, community nurses in primary healthcare settings have a key contribution to make to the health improvement agenda for older people, yet little is known of the extent of this aspect of their work. Methods. Questionnaires were sent to 1062 community nurses in six Scottish National Health Service Boards – public health nurses/health visitors, district nurses, general practice nurses, community psychiatric and learning disability nurses and combined duty nurses; 373 (35%) responded, 30 of whom were interviewed by telephone. The data were collected in 2003–2004. Findings. Findings confirmed the wide scope of health promotion, much of which may be embedded and unrecognized. Creative group work showed promise in achieving heath gain for older people, and a range of partnership approaches – interdisciplinary, multidisciplinary and interagency – was evident. Theoretical input and project opportunities within educational programmes had been a catalyst for health promotion initiatives in practice. However, evidence of audit, evaluation, and active involvement of older people in planning health promotion was limited. Funding of health promotion initiatives was vital to sustainability. Conclusion. There is merit in making the health promotion work of community nurses more visible through audit and systematic evaluation; promoting the active involvement of older people; strengthening partnership working; and further raising the profile of health in later life within undergraduate and postgraduate community nursing programmes. [ABSTRACT FROM AUTHOR]

Aim. This paper reports an evaluation of a nurse-initiated education programme on four specific osteoporosis prevention behaviours which led to their adoption or to positive attitude changes. Background. In the past, osteoporosis was a serious health concern that most commonly affected women in Northern Europe and the United States of America, but was less commonly seen in Asian women. However, in Hong Kong, osteoporosis is currently among the top five conditions causing disability and prolonged hospital stay for older people. From an economic perspective, the most cost-effective approach is to focus on primary prevention via education, and nurses often have the responsibility of providing such educational programmes. Method. A randomized controlled study was conducted from July 2004 to March 2005 with 76 women (38 cases and 38 controls) recruited in two private beauty clinics in Hong Kong. Pre-, post- and follow-up education data were compared regarding attitudes and adoption frequency before and after the education programme. Results. The results showed statistically significant increases for each behaviour: consumption of soy foods (P < 0.001), milk (P < 0.001), more exercise (P = 0.01) and vitamin D/exposure to sunlight (P < 0.001) for the case group compared with the control group. Most participants either disagreed (n = 15, 39.0%) or strongly disagreed (n = 23, 61.0%) that there was not enough information provided in the education programme to motivate them to change. They rated the nurse's performance as either satisfactory or very satisfactory on presentation, ability to answer their questions and ability to describe each behaviour clearly. Conclusion. Although positive results with a nurse-initiated education programme were demonstrated, future research examining the effects of education and occupation on these four adoption behaviours should focus on more diverse populations with respect to age, income or ethnicity. The findings suggest the value of creative approaches in future health education for the prevention of osteoporosis, and the need for a critical appraisal of current strategies and a re-evaluation of services and funding. [ABSTRACT FROM AUTHOR]

Aim. The aim of this paper is to report patients' experiences of cardiac rehabilitation and perceptions of the mechanisms and contexts influencing its long-term effectiveness. Background. Cardiac rehabilitation programmes for the secondary prevention of coronary heart disease are common. The effects of these programmes, however, can be inconsistent and little is known of the personal and contextual factors that influence service effectiveness. Method. Forty-seven participants with a formal diagnosis of coronary heart disease who had attended a programme of cardiac rehabilitation in Scotland 3 years previously were included in focus groups to discuss their perceptions and experiences (30 males and 17 females). The data were generated in 2002 and analysed using the realist approach of Pawson and Tilley (1997). Results. Participants' accounts indicated that the didactic content of cardiac rehabilitation was not strongly linked to longer-term health behaviour change. The main positive effects of cardiac rehabilitation were related to the effect of participation on mediating social and body-focused mechanisms that were triggered when the rehabilitation setting was perceived to be safe. Social mechanisms identified included social comparisons, camaraderie, and social capital. Body-focused mechanisms included greater knowledge of personal physical boundaries and a greater trust in the heart-diseased body. Collectively, these mechanisms had a positive effect on confidence that was perceived as being imperative to maintain health behaviour change. Conclusions. More support is required to promote health behaviour change after the completion of cardiac rehabilitation. Use of community-based exercise services and conventional or web-based support groups for coronary heart disease patients should be encouraged, as these appear to extend the positive health effects of the mechanisms that promote behaviour change. At the completion of cardiac rehabilitation programmes, patients should be referred to safe and appropriate community-based exercise services. Further research is needed to examine the effects on health outcomes of mechanisms and contexts related to cardiac rehabilitation. [ABSTRACT FROM AUTHOR]

cross r. (2005) Journal of Advanced Nursing 51(5), 474–483 Accident and Emergency nurses’ attitudes towards health promotion This paper presents a study exploring Accident and Emergency nurses’ attitudes towards health promotion. Much has been written about nurses and health promotion. Research has focused mainly on community nurses, less on nurses working in acute hospital settings, and apparently not at all on those working in Accident and Emergency units. Q methodology, a technique for extracting subjective opinions, was used. Eleven nurses working in Accident and Emergency departments completed 33-item Q-sorts and wrote personal definitions of health promotion. Based on published literature in the field, the Q sample was structured with reference to nurses’ attitudes as they related to health promotion. Factor analysis was performed on the data, and the resulting factors were interpreted. The data were collected in 2003. Three alternative constructions emerged from the data, representing three alternate views about health promotion. The most widely held opinion (representing nine of the 11 nurses) was a positive view of health promotion and the nurses’ role in health promotion in Accident and Emergency environments. It is not possible to generalize the findings of this study due to the small number of participants. However, their knowledge of, and commitment to, health promotion is encouraging. Recommendations for practice are that there is continued and increased post-registration education in health promotion for nurses and continuing exploration of the hospital nurses’ health promotion role. Further research is needed to explore nurses’ perceptions of barriers to effective health promotion and nurses’ health promotion activities in Accident and Emergency environments. [ABSTRACT FROM AUTHOR]

AIM: This paper reports an analysis of the concept of health literacy in order to clarify its meaning, reduce ambiguities associated with references to it, and promote consistency in using the concept in nursing dialogue and research. BACKGROUND: Health literacy is a relatively new concept in health promotion research. Only within the last decade have researchers identified the problems associated with health literacy, the role it plays in an individual's ability to comprehend health and self-care information, and its relationship to health outcomes. Clarifying the concept is essential so that nurses develop an awareness of the phenomenon and its relationship to the outcomes of their communication and health education efforts. METHOD: The method used for this concept analysis was that of Walker and Avant (1995). FINDINGS: Health literacy empowers people to act appropriately in new and changing health-related circumstances through the use of advanced cognitive and social skills. The defining attributes of health literacy are reading and numeracy skills, comprehension, the capacity to use information in health care decision-making, and successful functioning as a healthcare consumer. Antecedents of health literacy are literacy and a health-related experience. Consequences of health literacy include improved self-reported health status, lower health care costs, increased health knowledge, shorter hospitalizations, and less frequent use of health care services. Empirical referents of the concept are the Test of Functional Health Literacy in Adults and the health literacy component of the National Assessment of Adult Literacy. CONCLUSIONS: An analysis of the concept of health literacy enhances nurses' ability to assess more accurately their clients' levels of health literacy, thus identifying those at risk for misunderstanding health care instructions, shame associated with inadequate reading skills, and inability to adhere to health care recommendations. [ABSTRACT FROM AUTHOR]

AIM: This paper reports a study comparing, over a 5-month period, two different methods of increasing physical activity: a traditional exercise programme and one based on motivational interviewing. BACKGROUND: Chronic heart failure is associated with poor quality of life that can be improved by increased physical activity. Patients who are directed to engage in physical activity have a record of low compliance. METHOD: Sixty older aged heart failure patients were randomly assigned to standard care, motivational interviewing or both treatments. The primary outcome was physical activity (kcal/kg/day), with the 6-minute walk test as a secondary outcome. FINDINGS: At entry, no significant differences were observed between the three groups. Following treatment, the 'motivational interviewing' and 'both treatments' groups reported an increase in their level and type of activities, whereas the 'standard care' group did not. All groups significantly increased their 6-minute walk distance. CONCLUSIONS: Motivational interviewing, which incorporates established behaviour change principles and a flexible approach to promotion of activity, increases reported physical activity in older patients with heart failure over a short period. In terms of level and type of activity, this approach gives a better outcome than standard care, and nurses should explore alternative strategies to promote health in this population. [ABSTRACT FROM AUTHOR]

AIM: This paper reports a study whose aim was to describe how nurses in a paediatric unit promote the health of families of children with chronic conditions during the children's hospitalization. BACKGROUND: It is stressful for a family when a child has a chronic condition and hospitalized. Nurses have the opportunity to promote family health while a child is hospitalized, and previous studies contain a wealth of recommendations on how this should be done. However, there is little research evidence about family care and how nurses promote the health of a family with a chronically ill child. METHODS: Forty nurses who worked in two paediatric units providing care for children with chronic conditions and their families participated in the study. Data were collected in two Finnish hospitals in 2002 using group interviews, and nursing actions were observed in both units for a period of 84 hours. Data analysis was based on the grounded theory method, proceeding to the stage of axial coding. Data were collected until theoretical saturation was reached. FINDINGS: Family care was based on three distinctive strategies. Nurses used a systematic, selective or situation-specific strategy while promoting family health during a child's hospitalization. CONCLUSIONS: The findings indicate that nurses used different strategies while promoting family health during a child's hospitalization. The systematic way of working with families identified in the study seems a useful strategy. All three strategies of family nursing described here should be tested in other paediatric wards and in other geographical locations. [ABSTRACT FROM AUTHOR]

AIMS: This paper reports a study examining the relationships among mother's resilience, family health promotion (i.e. health work) and mother's health-promoting lifestyle practices in single-parent families led by adolescent mothers by testing hypotheses derived from the Developmental Model of Health and Nursing. BACKGROUND: Research on families led by adolescent mothers has focussed primarily on negative maternal and child outcomes while ignoring the capacities of these families, including their efforts to promote the health and well-being of both mothers and children. METHODS: This replication study was conducted with convenience sample of 41 adolescent mothers recruited using a variety of strategies. Mothers were asked to provide verbal responses to items on three study instruments: The Resilience Scale, a measure of mother's resilience, the Health Options Scale, a measure of family health work and the Health Promoting Lifestyle Profile a measure of mother's health promoting lifestyle practices, as well as a demographic questionnaire. RESULTS: Consistent with the theory, moderate positive relationships were observed between mothers' resilience and both family health work (r = 0.34, P = 0.01) and mothers' health-promoting lifestyle practices (r = 0.42, P < 0.001). As predicted, moderate correlations were also observed between health work and mother's health promoting lifestyle practices (r = 0.62, P < 0.001). With the effects of employment status and professional support held constant, mother's resilience and health work explained 30.2% of the variance in mother's health-promoting lifestyle practices. CONCLUSIONS: The study validates theoretical relationships among concepts in the developmental model of health and nursing and contributes to better understanding health promotion in families led by adolescent mothers. [ABSTRACT FROM AUTHOR]

BACKGROUND: For women from minority ethnic groups to make informed decisions about their health, and particularly about whether to participate in breast cancer screening programmes, access to a range of appropriately designed high quality, culturally-specific and sensitive health information is needed. AIMS: Through a critical review of the literature, this paper aims to determine the breast health and breast cancer screening information needs of women from minority ethnic groups and to discuss the implications of cultural difference for nurses in relation to the development and dissemination of health information. METHODS: A critical review of the research literature published in English between 1996 and 2002 was conducted. Electronic and the relevant Cochrane Collaboration databases were searched using a range of search terms to retrieve literature specifically relevant to the aims of the review. The use of personal contacts and posting a request for information on the mailing list at minority-ethnic-health@jiscmail.ac.uk facilitated the retrieval of grey literature. All references retrieved were entered on a bibliographic database. The title and abstract of each was examined to assess it for inclusion in the review. FINDINGS: There was little published information about specific breast cancer screening information needs from the perspective of women from minority ethnic groups. In comparison with the indigenous population, the information needs of people from minority ethnic groups differ in relation to their cultural beliefs and values and the effects of these on health care practices. Inadequate knowledge about breast health and breast cancer screening may be a consequence of the provision of insufficient or culturally inappropriate information. CONCLUSIONS: There is a dearth of research highlighting breast health and breast cancer screening information needs of women from minority ethnic groups. In providing information, their needs appear to have been an 'add on'. Health care professionals' lack of understanding about cultural beliefs, values and knowledge, together with racial stereotyping and misconceptions about cancer in minority ethnic groups, pose challenges to information dissemination. Health care professionals need to work collaboratively with women from minority ethnic groups, identifying culturally-specific beliefs and values about breast cancer, breast cancer risk and screening, in order to develop appropriate and acceptable information and dissemination strategies. [ABSTRACT FROM AUTHOR]

BACKGROUND: Health education and health promotion activities are a fundamental requirement for all health professionals. These two paradigms are closely related but are not inter-dependent. Despite this, it is known that many nurses confuse the terms and use them interchangeably. With this in mind, it is necessary to re-conceptualize the terms in an attempt to bring them to a current form of 'maturity'. AIM: The aim of the paper is to provide an up-to-date analysis of health promotion and health education that serves as a conceptual and operational foundation for clinicians and researchers. METHOD: A concept analysis following the criterion-based methods described by Morse and her colleagues was applied to the terms health education and health promotion, using generic and nursing-related literature. RESULTS: The conceptual literature on health education is consistent between generic and nursing-related sources. On the contrary, earlier nursing literature on health promotion is now at odds with more recent socio-political and community action models of health promotion, in that it focuses on individualistic and behavioural forms of 'health promotion'. A significant proportion of later nursing-related literature, however, suggests a maturing of the concept that brings it further in line with a socio-political health promotion agenda. CONCLUSION: While the theoretical and conceptual literature surrounding health education has remained relatively constant and unchanged over the last decade or so, the same cannot be said for the health promotion literature. The evolving dominance of socio-political action in health promotion has overtaken individualistic and behaviourally-related forms. While the recent nursing literature addresses and acknowledges the place of socio-political activity as the mainstay of health promotion interventions, this is largely from a theoretical stance and is not applied in practice. [ABSTRACT FROM AUTHOR]

whitehead d., keast j., montgomery v. & hayman s. (2004) Journal of Advanced Nursing 47(1), 15–24 A preventative health education programme for osteoporosis Osteoporosis is a preventable disease that is usually not managed until the disease becomes evident, although it places huge economic and social burdens on societies worldwide. It is predicted that this burden will grow if left unchecked. Despite this, evidence suggests that osteoporosis prevention activity is given a low priority, and services often only provide biomedically-based programmes, in which resources are predominantly allocated to screening and pharmacological treatments. Referral to these services mostly occurs when a client is already known to have osteoporosis or to be at risk, rather than as an early preventative intervention. This paper reports an action research project with one hospital osteoporosis service. The aim of the project was to assess the current service, identify areas where change was needed, and evaluate the implementation of such changes. Participatory action research was used, with group meetings and reflective journals to collect data for analysis. The process involved assessment of a preventative osteoporosis service, and determination of clinical issues and problems, and it aided decisions on an appropriate course of organizational reform and evaluated any change processes as they occurred. It also encouraged participants to reflect on and evaluate their experiences of using a participatory framework. A change programme was implemented that focused on preventative health education activity in a range of clinical settings. Over the two and a half years of the project, the osteoporosis service expanded its programme to include a wide range of preventative activities, running alongside other organizational reforms. [ABSTRACT FROM AUTHOR]

AIM: To investigate the place and validity of contemporary social cognitive models for health education practice in nursing settings and, in doing so, develop and put forward a specific model for this purpose. BACKGROUND/RATIONALE: The last decade or so has seen a marked increase in the amount of health educational/health promotional activities that nurses are expected to undertake. This has followed on from concerted calls to make health education a familiar and recognized part of nursing practice. Despite this, past and current evidence identifies that nurses have been, and continue to be, ineffective and inconsistent health education practitioners. Where health education activity does take place it tends to centre specifically on social cognitive behavioural change strategies. Subsequently, it is argued here that any failure on the part of nurses successfully to apply health educational initiatives into practice has been compounded by the lack of any nursing-specific social cognitive model process. This paper seeks to redress this imbalance by putting forward the case for such a model, developing it, and demonstrating how it can be incorporated into the practice setting. METHOD: A systematic review of the literature has been conducted and the article draws upon this in order to develop an evolving theoretical perspective for health education practice. The proposed model has evolved from this new perspective. Development of this model has drawn on contemporary social cognitive behavioural models--using them as a means to develop a further conceptual framework for nursing. CONCLUSION: Social cognitive behavioural models are valuable tools that nurses can incorporate routinely into existing frameworks of practice. The proposed model is designed to make the adoption of health-related behavioural change in clients easier and more realistic. If the current situation continues whereby social cognitive behavioural models are not adopted as a concerted and routine part of nursing practice, then nursing may well continue to fall behind other health professions in the discipline of health education. [ABSTRACT FROM AUTHOR]

AIM: To investigate the validity of a stage planning programme model for health education/health promotion practice in nursing settings and to develop a specific model for this purpose. Background/rationale. The last decade or so has seen a marked increase in the amount of health educational/health promotional activities that nurses are expected to undertake. This has followed concerted calls to make health promotion a familiar and recognized part of nursing practice. Despite this, however, current health-related practices are still unstructured, haphazard and under-evaluated. This state of affairs is further compounded by the lack of any generic and systematic nursing planning process model by which health education/health promotion programmes are applied in practice. This paper puts forward the case for such a model, develops it, and demonstrates its possible application in clinical settings. METHOD: A systematic literature review was conducted in order to develop a new theoretical perspective for health promotion/health education nursing practice. The proposed model has evolved from this new perspective. The process of developing this model has drawn on existing contemporary planning models - using them as a means to develop a conceptual framework. Consequently, the proposed model seeks to critique, adapt and adopt some of their components within a nursing context. CONCLUSION: If the current situation continues, in which planning process models are not adopted as a routine part of practice, then nursing may well remain a 'bystander' in health promotion/health education. [ABSTRACT FROM AUTHOR]

Health education, behavioural change and social psychology: nursing’s contribution to health promotion? Aims. To critically review the complex processes that underpin the modification of a client’s health-related behaviour. This paper also seeks to contextualize the operational differences between health-educating and health-promoting activities – as a means of rationalizing current practice. Background. In ‘health promotional’ encounters, there is a plethora of evidence that suggests that nurses work predominantly within a ‘traditional’ preventative framework of practice. The prevalence of a culturally inherent biomedical framework, governing most nursing practice, tends to reduce health-related client interventions to little more than one-off, reductionist information-giving exercises. The expectation on clients to respond to and subsequently modify their health behaviour, when presented with such information, is unrealistic in most cases. Nurses are often unaware of the extremely complex human phenomena associated with modifying health-related behaviours and the resultant change processes. In nursing-related health encounters, the planned or unplanned intervention and the subsequent outcomes are mostly viewed within a too simplistic and superficial context. Design. A selective review of the relevant literature. Conclusion. Where many nurses believe themselves to be health promotionalists, the likelihood is that they are instead more likely to be traditional health educationalists. Not that this is the main problem, in itself – but if nursing is to progress on this issue, it must first become more effective in delivering its current health education initiatives. Armed with further knowledge and understanding of their practices, health educators are far more likely to achieve a degree of success in their behavioural-change encounters as well as approach the intervention with a far more realistic expectation of outcome. Without this further understanding, it is argued that the integration of health educational initiatives into nursing practice will generally do little or nothing to change the health status of clients. [ABSTRACT FROM AUTHOR]