What is it about?

Part of the ongoing process of National Health Service (NHS) reforms involves bringing about fundamental change in the way that primary health care is delivered in the UK (Department of Health and Social Security (DHSS), 1987; Department of Health (DoH), 1989a, 1996; Standing Nursing and Midwifery Advisory Committee (SNMAC), 1995). A considerable amount of discursive and legislative documentation has accompanied these reforms, which served to provide a ‘spring- board’ for debate on current and future directions of health-related policy (DoH, 1989b, 1993a,b, 1997, 1998). There has also been a concerted and long- standing request for community nurses to adopt and incorporate both health promotion and educational activities into their workload.

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Why is it important?

In the late 1980s, in its document Promoting Better Health: the Government’s Programme for Improving Primary Health Care, the DHSS (1987), set out to clarify its position for all community nurses in relation to the promotion of health-related practices. This report affirmed that members of the primary healthcare team were well-positioned to accommodate this new direction in their practice and also stated that community nurses were particularly well-placed to initiate such change. The DoH (1992) stated that the opportunity for nurses to adopt a ‘special role’ in promoting health education, in community settings, was ‘unparalleled’ in relation to all the other health professional groups.

Perspectives

Despite the large amount of literature on health promotion, inconsistency in practice is manifest in the profession, and a clearer consensus is required on health promotion/education practices. Evidence on whether community-based nurses have progressed over the past decade, as well as to what degree they may or may not have moved on in this field, is essential in order to establish a clear base-line for current practice. Further investigation that determines how collective practice is, or whether disparity exists between different groups, would also be useful. As Gallagher and Burden (1993) state: ‘Nursing needs to take a long look at health promotion and understand the theoretical [and practical] considerations that underpin its practice...’ This is particularly the case for community-based nursing. Until more research is undertaken in this area, or until all health promoting practice is seen to be equitable and consistent across all disciplines of community nursing, this will remain a controversial and problematic issue.

Dr Dean Whitehead
Flinders University

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This page is a summary of: The role of community-based nurses in health promotion, British Journal of Community Nursing, December 2000, Mark Allen Group, DOI: 10.12968/bjcn.2000.5.12.7116.
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