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A holistic-existential approach to health promotion.
Nordic Council of Ministers, Nordic School of Public Health NHV.
Nordic Council of Ministers, Nordic School of Public Health NHV.
2003 (English)In: Scandinavian Journal of Caring Sciences, ISSN 0283-9318, E-ISSN 1471-6712, Vol. 17, no 4, 384-91 p.Article in journal (Refereed) Published
Abstract [en]

Health promotion seems to be implicit in many nursing theories, but the theoretical and philosophical basis of health promotion in nursing is not always explicitly stated. The interpretation of health promotion is closely related to the interpretation of man, health, illness and nursing. There is a need to clarify, refine and redefine health promotion in nursing because the concept is partly nonspecific and has not been used to identify a distinctive nursing focus. The aim of this study was to formulate a stipulative definition of health promotive nursing with a holistic-existential approach. A philosophical frame of reference in combination with conceptual analysis and theoretical synthesis were used as the methodological approach. The philosophical framework served as a basis in selecting the nursing theories and influenced the analysis. Two nursing theories and one nursing model were selected due to their influence on Norwegian nursing and because of their philosophical basis. Through analysis and synthesis of the selected nursing theories, the concepts man, health, illness/disease and nursing were analysed. The paper proposes a stipulative definition of health promotion in nursing based on a holistic-existential approach, supported by five necessary conditions. The definition and conditions needs to be further investigated by both empirical studies and by comparing with other relevant nursing theories, in order to formulate theoretical statements. The proposed definition may be the first step in a process of developing a theoretical framework of health promotive nursing with a holistic-existential approach.

Place, publisher, year, edition, pages
2003. Vol. 17, no 4, 384-91 p.
Keyword [en]
Holistic-Existential Apporoach, Health Promotion, Theroretical Analysis, Nursing Therories
National Category
Medical and Health Sciences
Identifiers
URN: urn:nbn:se:norden:org:diva-3426PubMedID: 14629641OAI: oai:DiVA.org:norden-3426DiVA: diva2:749400
Available from: 2014-09-24 Created: 2014-09-23 Last updated: 2017-12-05Bibliographically approved
In thesis
1. Å fremme den eldre sykehuspasientens helse i lys av et folkehelse- og et holistisk-eksistensielt sykepleieperspektiv
Open this publication in new window or tab >>Å fremme den eldre sykehuspasientens helse i lys av et folkehelse- og et holistisk-eksistensielt sykepleieperspektiv
2007 (Norwegian)Doctoral thesis, comprehensive summary (Other academic)
Abstract [no]

Bakgrunn og hsysykelighet. Forskningsfunn indikerer at en multsykelighet, høyere funksjonsnivå. Avhandlisykehuspasiensykehuspasientens helse. Datakilder og mdelstudier. Helse gjennomført som teoretisk-begrepslig analyse og syntese av begrepene menneske, helse, sykdom og sykepleie slik de var beskrevet i tre sykepleieteorier. I delstudie 2 ble ti eldre sykehuspasienter intervjuet gjennom kvalitative forskningsintervjuer. Temaet for intervjuene var hvordan de forsto helse, og hva som skulle til for å bedre deres helse. Delstudie 3 ble gjennomført ved deltagendesamtaler med sykepleiere i en medisinsk sykehusavdeling. Delstudie 4 var en utforskende studie. Begrepene empowerment, helse og å fremme helse relatert til den eldre sykehuspasienten ble introdusert litteratur. Hensikten var å skape en felles teoretisk plattform før deres deltagelse i refleksjonsgruppedialoger. To grupper sykepleiere deltok i tre dialoger styrt av en moderator og en assistent. Dialogene ble tatt opp på bånd og transkribert. Hver dialog ble analysert med kvalitativ innholdsanalyse. Funn: Avhandlingen foreslår en stipulativ definisjon av helsefremmende sykepleie med en holistisk-eksistensiell tilnærming støttet av fem nødvendige forutsetninger. Definisjonen og forutsetningene kan danne et utgangspunkt for et teoretisk grunnlag for helsefremmende sykepleie. Helse ble av de gamle sykehuspasientene beskrevet som å være i stand til gjennom å være den personen man er, i stand til å kunne gjøre og å føle seg vel og ha krefter. Å fremme helse ble beskrevet som å bli i stand til gjennom å kjenne seg som den personen man er, å få informasjon og kunnskap og gjennom det å ha håp og motivasjon. Sykepleiernes forståelse av helse og dermed å fremme den eldre sykehuspasientens helse var preget av en veksling mellom to tilnærminger: en biomedisinsk tilnærming og en holistisk sykepleietilnærming. I sitt daglige arbeid viste sykepleierne seg som mestre i å danse på en stram line, avhengig av å ha en profesjonell de motiveres. kompetanse som gjør dem i stand til å mestre og kunne forholde seg til en dynamisk og stadig skiftende arbeidssituasjon. Refleksjonsgruppedialogene avdekket et tosidig forhold til makt og empowerment hos de deltagende sykepleierne. Sykepleierne understreket en individuell tilnærming i det å fremme den eldre pasientens helse, hvor respekt for individet og normalisering av situasjonen utheves som viktig elementer. Konklusjon: Avhandlingens foreslåtte stipulative definisjon og fem nødvendige forutsetninger kan tjene som en retning og tilnærming for en helsefremmende sykepleie til den eldre sykehuspasienten. Hvordan helse og å fremme helse forstås, er avhengig av vitenskapelig og faglig grunnlag og hvordan den enkelte opplever sine erfaringer. Både sykepleieres og eldre sykehuspasienters forståelse av å fremme helse var delvis vag og uklar, men dialoger og diskusjoner fremmer forståelsen. Empowerment er muligens en anvendbar strategi ettersom sykepleiere og eldre pasienter anerkjenner betydningen av å ha kontroll og innflytelse over egen situasjon. Uansett forutsetter empowerment en bevissthet om egen makt og maktposisjon. Ifølge de eldre sykehuspasientene i denne studien fremmes deres helse gjennom at de ses som en person, når de får adekvat informasjon og kunnskap om sin situasjon, og når Refleksjonsgruppedialogene kan være en strategi for å øke sykepleiernes bevissthet og derigjennom implementere forskningsfunn, og for å fokusere på å fremme den eldre sykehuspasientens helse.

Abstract [en]

Background and aim: The number of elderly hospital patients is increasing in line with tidisciplinary eriatric approach reduces illness, re-hospitalization and costs as well as improving dge about health and health erly hospital patients from a public health and nursing erspective. ploys a combination between different data collection methods, data urces and analytical techniques in order to investigate health and health promotion . Study three illustrated and explored the life world of empowerment, health and health promotion were introduced to nurses in the advancing age of the population. Old people are a heterogeneous group when itcomes to health status and sickness. Research findings suggest that a mulgsurvival rates and functional level. The aim of this thesis was to describe and develop knowlepromotion related to eldpData sources and methods: The thesis, which comprises four studies, has a qualitative approach that emsoamong elderly hospital patients. Study one was conducted as a theoretical conceptual analysis and synthesis of the concepts of man, health, nursing and illness/disease based on description of the concepts in three nursing theories. Study two described and explored health and health promotion from the perspectives of ten elderly hospital patients using qualitative interviewsfive nurses and their understanding of health promotive nursing related to the elderly hospital patient by means of participant observation. Study four was an explorative study. The conceptsorder to give a mutual theoretical platform before participating in reflection group dialogues. Two groups of nurses participated in three dialogues that were conducted by a moderator and an assistant. The dialogues were tape-recorded and transcribed verbatim. Each dialogue was analysed with qualitative content analysis. Findings: The thesis proposes a stipulative definition of health promotive nursing with a holistic-existential approach based on five necessary preconditions. The definition and preconditions may serve as a theoretical basis for health promotion in nursing. The elderly hospital patients reported that health was being able to be the person I am, to do what I want, to feel well and have strength. Health promotion was described as being enabled by being seen as the person I am, through information and knowledge as well as hope and motivation. The nurses’ attitude to health and health promotion was influenced by two different views; the biomedical and the holistic nursing view, between which they moved. In their work the nurses were masters at balancing on a tightrope and interacting with a professional competence that makes it possible to manage a constantly changing work situation. Reflection group dialogues revealed a dual relation among the about participating nurses to empowerment and power. The nurses highlighted the importance of using an individualised approach in order to promote the health of elderly hospital patients with focus on respect for the individual and normalization of the situation. Conclusion: The thesis proposes a stipulative definition of health promotion as well as five preconditions that may serve as guidance and offer a health promotive nursing approach for elderly hospital patients. How health promotion and health are understood depends on one’s scientific and professional background as well as the experience of caring for the individuals in one’s charge. The understanding of health promotion on the part of both nurses and elderly hospital patients was somewhat vague, but improved as a result of dialogue and discussions. Empowerment may be a suitable strategy, as it helps both nurses and elderly patients to acknowledge the necessity of controlling and influencing their situation. However, empowerment implies a consciousness of one’s own power. According to the elderly hospital patients in this study, health is promoted when they are seen as a person, when they receive adequate information and knowledge their condition and when they feel motivated. Reflection group dialogues may be a strategy to increase the professional consciousness of nurses to implement research findings and to focus on promoting the health of elderly hospital patients.

Place, publisher, year, edition, pages
Göteborg: Nordic School of Public Health NHV Göteborg, Sweden, 2007. 87 p.
Series
NHV Reports and Doctor of Public Health-Theses, ISSN 0283-1961 ; NHV Rapport 2007:7
Keyword
public health, holistic-existential approach, qualitative methods, elderly hospital patients, individual health promotive nursing and empowerment, folkehelse, holistisk-eksistensiell tiln ærming, kvalitative metoder, den eldre sykehuspasienten, individuell helsefremmende sykepleie og empowerment
National Category
Medical and Health Sciences
Identifiers
urn:nbn:se:norden:org:diva-3430 (URN)978-91-85721-25-2 (ISBN)
Public defence
2007-12-18, Nordic School of Public Health NHV, Göteborg, Sweden, 13:57 (Norwegian)
Opponent
Supervisors
Available from: 2014-10-09 Created: 2014-09-24 Last updated: 2014-10-09Bibliographically approved

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