Nursing
Health, and Health promotion definition
Health is a fundamental concept in human lives and according to Naidoo and Will, (2016), and concerns a person’s integrity, well-being, and soundness. Health can be both negative and positive where negative health is the absence of disease in the body, a health definition according to the western scientific medical model. Positive health implies the condition or state of well-being, which the World Health Organization has interpreted in its provisions as a complete state of mental, social, and physical well-being, not just disease absence. The World Health Organization states that health is a positive aspect that emphasizes the physical capacities, personal and social resources. Health is also an everyday life resource, but not the life objective
The World Health Organization defines health promotion as a process that enables persons to improve and increase control over their health. WHO further notes that people or groups need to take part in the identification and realization of goals, satisfy the needs, and transform or put up with the environment. According to Naidoo and Wills, (2016), health promotion was first used in the mid-1970s. the term symbolizes a complete political and social process not only embracing actions channeled at strengthening capabilities and skills of an individual, but also actions that change the social, economic, and environmental conditions intending to alleviate their effect on individual and public health.
Health promotion enables people to take control of their health determinants thereby improving their health. As a concept, health promotion can be understood as a discipline drawing from other disciplines such as education, sociology, and psychology to understand a certain problem (Taggart et al., 2018). It can also be understood as a process of seeking to empower individuals or groups by equipping them to address their personal needs and value their experiences. The Department of Health of Welsh Academy further adds that it is a field of activity that envelops helping people to develop personal skills on health, to foster participation in public, partnership building, policy, and strategy coordination.
The social hygiene period is health promotion development’s first phase with origin in both health education and public health. Health promotion’s inception resulted from the eruption of an epidemic disease that gradually resulted to pressure for sanitary changes for the industrial towns that were overcrowded in the United Kingdom, ( while in terms of public health, the idea emerged to educate the public and sensitize them for the good of health (Arroyo-Johnson and Mincey, 2016). According to Scott and Havercamp, (2016), the second phase of health promotion in the United Kingdom is personal service which focuses on personal behavior.
The process involves public policy addressing determinants of health like housing, income, employment, food security, and quality condition of work (Goldblatt, 2016). Health promotion aligns with health equity, a tenet that most Non-Governmental Organizations have focused on through dedication to human rights and social justice advocacy. ….health promotion in hospitals focuses on increasing health gains through the support of the health of patients, staff, and the community at large. The process is achieved in a hospital setting through the integration of concepts, strategies, and values on health promotion into the organizational structure or culture of the health facility. This involves setting a structure of management that involves both non-medical and medical staff in health promotion, formulating plans of action for health promotion policies, and measurement of health results and effects for patients, staff and the larger community (Den Broeder et al., 2018)
The health promotion process succeeds in all sectors and settings where people reside, work an associate. In workplaces, for instance, its focus revolves around prevention and intervention that lowers the health risks of employees. Bakker-van Gijssel et al., (2017) view that there is a strong connection between health status and improvement of an individual and physical activity, further alluding that physical activities are done regularly if the most effective behavior towards disease prevention. Such programs lower the anxiety feeling, depression, reduce obesity, and risk of chronic diseases like high blood pressure.
Epidemiological, Demographic, and Genomic Data in Health Promotion
According to Saddoughi et al., (2018) epidemiology refers to the study of distribution and determinants of health-related events or states in a specific population and how it applies to that particular study to contain problems related to health. Epidemiology study is data-driven and depends on a systematic or logical approach to the process of collection, analysis, and interpretation of data. Methods of epidemiology also depend on keen observation and utilization of accurate groups of comparison in assessing whether the observation made e.g. the number of disease cases observed during a period differs from the expectation. Liu et al., (2018) points that there are challenges in the study of the effectiveness of cancer screening, stating that it has detrimental impacts with just a few types of cancer benefitting from the process. In recent times, epidemiology is faced with difficulty in dealing with distinct data levels such as factors associated with social status, genetics, and lifestyle in the reconstruction of causal traits of cancer.
Epidemiology is impotent in providing information on cancer distribution in population and on determinants of cancer and the knowledge is applied in the control of the disease (Noone et al., 2017). Cancer surveillance is an important attribute of public health and epidemiology because it assists in providing intelligence data on the intensity of various cancer types in a specific population, and via evidence-based programs. Related traits apart from health results in cancer patients like post-diagnosis survival and treatment are also part of epidemiology, which may offer solutions as far as strategies for controlling cancer is concerned(Noone et al., 2017)
According to WHO, half of the patients developing cancer can be cured by resources that are currently available, however, the other half die of the disease. WHO further allude that about 40% of all cancer cases can be prevented through resource allocation for the management of the disease (Den Broeder et al., 2018). Cancer prevention is largely informed by epidemiological data that maps it efficiently by defining its traits and location. The process involves identification of the link between the disease and risk factors and a successful strategy of preventing cancer ought to be tailored to the demography (population) and individual improvement of usability (Patel et al., 2020).
The strategies for preventing cancer differ in terms of ethnicity and race, location and place, gender identity, sexual orientation, and age. Effective prevention approaches can take center stage at the community and levels of health system through direct engagement with the community. However, Dixon-Ibarra et al., (2017) point out that on a wider scope, programs engaging the community fully through participation and development in leadership, and assessing strategies for cancer prevention have long term impact. Such programs engage cancer patients in their health care and health needs by providing culturally sensible and competent education on cancer health for prevention and screening.
Genomic data and health promotion of cancer patients
According to Ryan et al., (2020), cancer is a condition emanating from the gene, hence assessment of risk is fundamental because various cancers are hereditary. Response to medication by patients of cancer is also affected by genetic variation and exposure to the environment, as there are tests capable of predicting how a cancer patient’s body is responding to specified therapy that is conducted through clinical trials and routine (Den Broeder et al., 2018)cancer care. Efforts towards improving outcomes in many advanced patients of cancer insist on using targeted therapy that monitor cancer growth and progress, for instance, the use of therapy that targets the growth of epidermal factor receptor results in improved patients’ survival.
Family history is an important element of health data as (Taggart et al., 2018) point out. Acquiring a family history that is systematic addresses variation risks of cancer, and with the assistance of a genetic expert, it serves as a significant predictor of cancer dangers and a basis for recommending strategies of prevention in many populations aimed to lower morbidity and early deaths in cancer. Genomic data suggests a broader understanding of the significance of history of family health among people. The analysis of family history on cancer risks emanating from bloodlines may carry along some limitations in a culturally wide setting for instance polygamous and/or polyandrous families. Hereditary cancer forms provide the opportunity for early detection and prevention among members of a family e.g. familial adenomatous polyposis and Lynch Syndrome have been identified to depict high chances of developing CRC (Bakker-van Gijssel et al., 2017).
Genetic tests have been made easily available in most countries of the world as Den Broeder et al., (2018) imply, however, some population remain hesitant to undergo them. This refusal as viewed by Scott and Havercamp, (2016) is caused by cultural factors, which should be explored as intervention targets. A study carried out among Asian females who rejected the test dis so out of fear of stress and genetic information burden, approximated at 16%, those who perceived of no change in medical management were approximately 15%, while those who were reluctant due to fear of emotional burden stood at 15%.
Learning difficulty envelops a wide range of persons requiring additional assistance with learning, and in most cases, children with this challenge often do not have the diagnosis that can be identified as stated by Ng et al., (2019). Learning difficulty among young people and children signifies learning impairment and can be of different types such as Dyslexia, Attention Deficit Hyperactivity Disorder, and Autistic Spectrum Disorder.
Marmot Review on health inequalities, Social and Environmental consideration
The review proposes a strategy that is evidence-based in addressing the social determinants of health, the state in which people are born, growth, how they live, and age that can lead to inequalities in health. The review succeeds in this by looking at the differences in the well-being and health between social groups, describing how the social inclination on health inequalities reflects the social phenomenon such as educational attainment, income, employment, neighborhood among others (Marmot, 2020). The review draws attention to the manifestation that a majority of people in England spend a longer period in illness, further implying that the “Fair Society, Healthy Lives” report 2010 proposes a new way of reducing health inequalities; arguing that initially, government policies have channeled resources on selected societal segments. The social gradient is significant in improving health for everyone and reducing unfair health inequalities (Marmot, 2018).
The need to create a condition for individuals to take control of their own lives is vital according to Marmot’s approach to health inequalities. Creating such a condition requires action across social health determinants and beyond the National Health Services reach. The review also visions beyond economic benefits and costs towards the objective of a sustainable environment and as (O’Connor et al., 2018) argue, the creation of a sustainable future goes hand in hand with health benefits such as reducing health inequalities via the promotion of sustainable local groups or communities, food production, zero emissions of carbon, and active transportation.
Marmot’s review designs an action framework under 2 policy objectives, which include, creating a society that is enabling that maximizes personal and societal potential, secondly, ensuring sustainability, health, and social justice are core in all policies. Bakker-van Gijssel et al., (2017) deduce that the review recognizes that disadvantage commences before birth and accumulates as life goes on; sentiments that are echoed in the six objective policies in Marmot’s review. The policies include giving all children the best start in life, ensuring all young people, children, and adult maximize their capabilities thereby controlling their own lives, creation of equal employment and work for everyone, ensuring a healthy living standard, developing places and communities that are sustainable, and finally to strengthen the role and impact of preventing ill-health.
Collaborative approaches for health promotion
In a collaborative approach, different groups come together intending to share their ideas and knowledge on a specific area for improvement. Health professionals such as nurses recognize the benefits of collaboration when it comes to planning and service delivery, and in influencing the present and future practices. (Hubley and Copeman, 2018). They further point out that the overall nursing standard can improve further through collaboration.
Patient-direct intervention is one of the collaborative approaches commonly used in health promotion. The PACE system, or otherwise Presenting, Asking, Checking, Expressing, is an education system for patients designed for the improvement of their communication with health practitioners, who in this case is a nurse, to enhance adherence of the patient. This tool of patient communication emphasizes on acquiring proficiency in 4 main categories; seeking to know whether desired information is yet to be provided, checking patient’s understanding of given information giving detailed information regarding the emotional feeling of the patient, and expression of any concern regarding recommended treatment (Scott and Havercamp, 2016)
Collaboration among nurses and cancer patients improves their (patients) education and engagement during their time of care. Behavioral changes like seeking information and effective information delivery become more advanced when patient’s get involved in making decisions, and participation in self-care (Berenguera et al., 2017). When relaying information to cancer patients, consistent approaches that are also responsive ensures understanding hence enabling patients to take part in personal care decisions. The reason is that patients are the primary actors in medical decision-making, as nurses adopt a supportive role. There is variation in terms of desires, learning needs, style, and capacity among patients, and for this reason, nurses have the responsibility of coordinating amongst themselves on methods of instructing and educating the patients in an appropriate and more consistent manner (Noone et al., 2017).
Role of oncology nurse in health promotion
A registered nurse caring for and educating patients with cancer is referred to as an oncology nurse. (Hardcastle et al., 2018) They work in many disciplinary teams, in various settings e.g. inwards for inpatients, units for a bone marrow transplant, and in communities. Patient assessment is the primary role of these nurses as they are responsible for checking on the patients presenting as a result of the side effects of treatment; this assessment can be conducted before, during, or after chemotherapy. They fully understand pathological results and their implications, they also have a deeper understanding of the anticipated side effects of treatment of cancer as explained by Cavioni et al., (2017)Thorough preparation for patients is important in improving compliance with treatment procedures and may positively influence treatment results as well. Oncology nurses develop a nursing plan in response to a specific need established from the assessment. The plan promotes and elevates the understanding of the patient on therapy objectives and preparation for therapy psychologically.
Oncology nurse plays a role in the coordination of care by coordinating the numerous complex technologies used in the diagnosis of cancer. Coordination envelops direct care for a patient, documenting medical records, management of symptoms, and conducting counseling during diagnosis. The nurse is the patient’s first communication line, and the patients’ families interact with them before proceeding to see their patient (Zheng et al., 2019).
Oncology nurse uses interpersonal skills in listening to cancer patients, evaluating their knowledge of the disease and its process, which also involves assessing the emotional state of the patient. They play a significant role in ensuring that cancer patients are well informed about their cancer type and the treatment involved, and in doing so, they also get to interact with families of their patients, educating them as well. These nurses are responsible for the organization of patient referrals to other health care facilities or providers such as social workers, dieticians, or pathologists of language (Siengsukon et al., 2017)
In conclusion, this paper has addressed five areas of the discussion by first introducing the concept of health promotion. Health promotion has been defined by WHO, Naidoo, and Mills (2020) and according to NMC Code. The second discussion has assessed data on three disciplines I.e. epidemiology, demography, and genome, linking them with cancer patients and those with learning difficulties. The paper has also identified the collaborative approaches that promote health, and how persons with a learning difficulty and cancer patients interact with nurses. The final discussion has elaborated on the roles of an oncology nurse by first explaining who an oncology nurse is.
Work Cited
Arroyo-Johnson, C., Mincey, K.D., 2016. Obesity epidemiology worldwide. Gastroenterol. Clin. 45, 571–579.
Bakker-van Gijssel, E.J., Lucassen, P., Hartman, T.O., Van Son, L., Assendelft, W.J.J., van Schrojenstein Lantman-de Valk, H.M.J., 2017. Health assessment instruments for people with intellectual disabilities—A systematic review. Res. Dev. Disabil. 64, 12–24.
Berenguera, A., Pons-Vigués, M., Moreno-Peral, P., March, S., Ripoll, J., Rubio-Valera, M., Pombo-Ramos, H., Asensio-Martínez, A., Bolaños-Gallardo, E., Martínez-Carazo, C., 2017. Beyond the consultation room: proposals to approach health promotion in primary care according to health-care users, key community informants and primary care centre workers. Health Expect. 20, 896–910.
Cavioni, V., Grazzani, I., Ornaghi, V., 2017. Social and emotional learning for children with Learning Disability: Implications for inclusion.
Den Broeder, L., Devilee, J., Van Oers, H., Schuit, A.J., Wagemakers, A., 2018. Citizen Science for public health. Health Promot. Int. 33, 505–514.
Dixon-Ibarra, A., Driver, S., VanVolkenburg, H., Humphries, K., 2017. Formative evaluation on a physical activity health promotion program for the group home setting. Eval. Program Plann. 60, 81–90.
Goldblatt, P.O., 2016. Moving forward monitoring of the social determinants of health in a country: lessons from England 5 years after the Marmot Review. Glob. Health Action 9, 29627.
Hardcastle, S.J., Kane, R., Chivers, P., Hince, D., Dean, A., Higgs, D., Cohen, P.A., 2018. Knowledge, attitudes, and practice of oncologists and oncology health care providers in promoting physical activity to cancer survivors: an international survey. Support. Care Cancer 26, 3711–3719.
Hubley, J., Copeman, J., 2018. Practical health promotion. John Wiley & Sons.
Liu, N., Johnson, K.J., Ma, C.X., 2018. Male breast cancer: an updated surveillance, epidemiology, and end results data analysis. Clin. Breast Cancer 18, e997–e1002.
Marmot, M., 2020. Health equity in England: the Marmot review 10 years on. Bmj 368.
Marmot, M., 2018. Nordic leadership and global activity on health equity through action on social determinants of health. Scand. J. Public Health 46, 27–29.
Ng, K., Sainio, P., Sit, C., 2019. Physical Activity of Adolescents with and without Disabilities from a Complete Enumeration Study (n= 128,803): School Health Promotion Study 2017. Int. J. Environ. Res. Public. Health 16, 3156.
Noone, A.-M., Cronin, K.A., Altekruse, S.F., Howlader, N., Lewis, D.R., Petkov, V.I., Penberthy, L., 2017. Cancer incidence and survival trends by subtype using data from the surveillance epidemiology and end results program, 1992–2013. Cancer Epidemiol. Prev. Biomark. 26, 632–641.
O’Connor, C.A., Dyson, J., Cowdell, F., Watson, R., 2018. Do universal school-based mental health promotion programmes improve the mental health and emotional wellbeing of young people? A literature review. J. Clin. Nurs. 27, e412–e426.
Patel, M.I., Lopez, A.M., Blackstock, W., Reeder-Hayes, K., Moushey, A., Phillips, J., Tap, W., 2020. Cancer disparities and health equity: A policy statement from the American Society of Clinical Oncology. J. Clin. Oncol. JCO–20.
Ryan, M., Bradley, L., Kikayi, M., Gallagher, S., Bartrop, J., 2020. Use of glycated haemoglobin blood test (HbA1c) screening for health promotion in surgical gynaecology oncology patients. Cancer Nurs. Pract. 19.
Saddoughi, S.A., Abdelsattar, Z.M., Blackmon, S.H., 2018. National trends in the epidemiology of malignant pleural mesothelioma: a national cancer data base study. Ann. Thorac. Surg. 105, 432–437.
Scott, H.M., Havercamp, S.M., 2016. Systematic review of health promotion programs focused on behavioral changes for people with intellectual disability. Intellect. Dev. Disabil. 54, 63–76.
Siengsukon, C.F., Al-dughmi, M., Stevens, S., 2017. Sleep health promotion: practical information for physical therapists. Phys. Ther. 97, 826–836.
Taggart, L., Truesdale, M., Dunkley, A., House, A., Russell, A.M., 2018. Health promotion and wellness initiatives targeting chronic disease prevention and management for adults with intellectual and developmental disabilities: recent advancements in type 2 diabetes. Curr. Dev. Disord. Rep. 5, 132–142.
Zheng, R.S., Sun, K.X., Zhang, S.W., Zeng, H.M., Zou, X.N., Chen, R., Gu, X.Y., Wei, W.W., He, J., 2019. Report of cancer epidemiology in China, 2015. Zhonghua Zhong Liu Za Zhi 41, 19–28.