What is it about?

A critical review of: Health Promotion in Nursing Practice by Nola Pender, Carolyn Murdaugh and Mary-Ann Parsons, 5th edn. 2006. Pearson – Prentice Hall, Saddle River, NJ, USA. ISBN 013119 4364. 367pp.

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Why is it important?

This is the fifth edition of this seminal health promotion title for nursing. The original author, Nola Pender, remains principal author. This book though, we find out in the foreword and preface, notes the current retirement of Nola Pender after a long period of service to the cause of health promotion and health education in nursing practice.


Prior to reviewing this text, I really wanted to have good things to say about it, as there are not too many good quality nursing-related health promotion books out there. On the completion of reading this book I can say that there is much to commend about it but, at the same time, this needs to be tempered against some poorer points. I am the first to admit that I have been openly critical of Nola Pender’s work – and in particular her Health Promotion Model (Whitehead 2005). To me, this model and Nola Pender’s research is far more represen- tative of conventional health education processes and not health promotion. This said, and whether this might be the influence of the other authors of this book, health promotion elements are more notable and visible than in previous editions. This book is well-written, well-structured and presents the process of health education and health promotion in a systematic manner. Its main flaw, for a health promotion book, is its predominant focus on health education. Despite this main focus, and a major omission for any text on health promotion, the term health education is never used. Contrary to the vast majority of con- ceptual health promotion and health education literature, these authors use health promotion as a catch-all phrase to mean any health-related activity. The content then, as already stated, has a health education structure and process as its main focus. This is aptly demonstrated in several ways. Chapter 2 on ‘individual models to promote health behaviour’ is devoted entirely to the socio-cognitive models of health behaviour (including Pender’s Health Promotion Model) associated with conventional health education process. Chapters 3 through to 10 follow in much the same mode as Chapter 2 – focusing on individualized health assessment and planning against mainly physical health-related constructs. I realize that much of this book will be founded on the major influences of a conventional US public health model, which has often been criticized as being out of step with much of the international health promotion community. This then, represents another limitation of the text. There is, as you might expect, a heavy US emphasis in the book that may not seem so relevant to readers in other countries. It is not until the last two ‘short’ chapters in this book that the reader encounters ‘health pro- motion in community settings’ and ‘pro- moting health through social and environmental change’ as more representative examples of what health pro- motion more appropriately aspires to in today’s context. Despite my stated reservations, I still view this text for what it is; a solid account of health-related structures and processes as they pertain to nursing theory, policy and practice. If you favour behaviourally orientated health education approaches over wider health promotion, then this book represents a literary feast. If you favour wider health promotion approaches this is not so much the case, but you may still enjoy the offered meal – albeit a contextually flawed one. Reference Whitehead D (2005) Editorial letter – A cri- tique of Pender’s health promotion model. Research in Nursing & Health 28, 357– 359.

Dr Dean Whitehead
Flinders University

Read the Original

This page is a summary of: Health Promotion in Nursing Practice, Journal of Clinical Nursing, December 2007, Wiley,
DOI: 10.1111/j.1365-2702.2006.01886.x.
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