Health of an individual can be defined as a state free of illness, having a healthy behavior and a good state of mind. Health care industry is now focused on preventing illness by promoting wellness enhancing strategies which nurses have an important role to play as care provider and educator. Levels of preventive care are primary prevention – health education, immunization and fitness activities, secondary prevention – diagnosis and prompt intervention and tertiary prevention – minimizing the effect of long term disease.
In 1948 the World Health Organization (WHO) defined health as “state of complete physical, mental, and social well-being and not merely the absence of disease, but moves beyond this definition to encompass spiritual, developmental, and environmental aspects over time”. (Edelman, C. & Mandle, C. 2010, p. 7). The increase in health care cost made people to think about prevention of disease and now a day’s industry is more and more advocating people for health promotion and wellness.
Health promotion is the science and art of helping people change, their lifestyle to move toward a state of optimal health (Potter, P., & Perry, A. 2005). Health promotion not only focuses on individual but on community itself like eliminating or containing contagious diseases. It educates and provides guidance to individuals to choose healthy living standards, nutritional foods, social and spiritual developments etc. thereby reducing the chance of getting disease.
It also focuses on individuals to take measures from worsening an existing disease and rehabilitation thereafter. Health promotion has two strategies involving individual – passive and active. Passive strategies are like recent United Nations resolution advocating less use of mercury which is harmful to human beings. Here an individual participation is less wherein active strategies require individual commitment and involvement.
An example is daily exercise to reduce weight and cessation of smoking and alcoholism to prevent heart disease. Changing population statics and demographics have resulted in shifting focus from acute hospital based care to preventive and community based care (Edelman, C. & Mandle, C. 2010). Due to these changes nursing role had also shifted from care giver – which is still the public image of nurse, to an advocate, care manager, consultant, educator, healer and researcher.
Nurses with their knowledge and skill can be proactive in the prevention of disease and promotion of health across a wide setting. Various community and other health promotion, disease prevention and wellness awareness programs are available where a nurse can play a role of educator or consultant.
Educating people makes nurse a care giver and as a care manager nurse makes sure that patient is receiving the best care, not overcharged for services and takes forward the entire staff as a team. Nurses often participate in research process by contributing data’s they collected during nursing diagnosis and interventions and thereby improving the quality of care.
Everybody is aware of their health and this awareness bring opportunities for nurses in influencing people and communities to choose healthy behaviors, nutrition’s and take steps in improving their own health. To bring health promotion into practice nurses use nursing process of assessment, diagnosis, planning, implementation and evaluation. Assessment includes finding the physical health history, physical examination, assessing stress factor, family support, cultural and values they believe and practice.
These assessments are used for proper nursing diagnosis. With the help of this diagnosis a clear intervention is being planned and created on the request and needs of the client which will assist them in developing a healthy environment not only free of disease but attaining optimal health. During implementation stage, nursing intervention depends upon the needs of client like counseling, care giver, educator or care manager.
After implementation period, short-term and long-term results are evaluated and changes are made if necessary to attain the end goal. Nursing care to health promotion can be classified into primary prevention, secondary prevention and tertiary prevention. In primary level emphasis is given on health promotion like education, immunization, periodic physical examination etc.
The primary level places importance on reducing the chance of a client being contracting illness by following healthy life style. In case of educating people about type 2 diabetes is to understand what diabetes is, signs and symptoms, educating client about glucose level, counseling for weight loss and increasing physical activities, reducing use of tobacco, alcohol, and choosing nutritional food (Thomas, P. 2012).
Secondary level prevention focuses on individuals who already have health problem or are at risk of developing illness. Early diagnosis and prompt treatment will cure and prevent disease spreading. A person with type 2 diabetes requires regular medication, weight control, physical activity and healthy diet to reduce further complication such as stroke, heart attack, eye and vision problems, kidney damage, nerve damage, foot ulcers or circulation problems in the legs and feet (Nazarko L. 2010).
Regular monitoring of blood glucose level is also required to determine the dosage of medication or to move from oral tablets to insulin injection. Tertiary prevention occurs when an illness had made a permanent disability or damage to a client and this level mainly includes rehabilitation procedures.
The main objective is to help the client maintain functional activities as long as possible without help from others. Patients with type 2 diabetes should be counseled about the complications arising out of this disease and limiting them, managing blood sugar level through diet and medication and how to overcome mobility disabilities.
They should be encouraged to set a rehabilitation goal and seek advice of people who are in same position to overcome various barriers. Health promotion will bring enhancement in quality of life by preventing illness and attaining optimal health. However, a nurse should appreciate that a client’s perspective of health and illness may be different from that of nurse and clients values and beliefs about his state of health or wellness should be considered before providing appropriate nursing intervention.
ReferencesBriggs, F., Hunt, B., Renosky, R., Ulbrecht, J., Wray, L. (2008). Counseling people living with diabetes. Journal of Rehabilitation, 2008, Volume 74, No. 4, 31-40 Edelman, C. & Mandle, C. (2010). Health promotion throughout the life span, (7th Ed.) Mosby Elsevier, ISBN 9780323056625
Naazarko, L. (2010). Treatment of type 2 diabetes. British Journal of Healthcare Assistants, March 2010, Vol 04 No 03Potter, P., & Perry, A. (2005). Fundamentals of nursing (6th ed.) Mosby Elsevier, ISBN 0-323- 02586-2Saylor, C. (2003). Health redefined : A foundation for teaching nursing strategies. Nurse Educator, 2003, Volume 28, Number 6, pp 261-265.Thomas, P. (2012). The importance of structure diabetes education programmes. Practice Nursing, 2012, Vol 23, No 10