In recent decades, the healthcare system has shifted its emphasis on health promotion and disease prevention. This approach has more benefits for patients, since they can avoid the negative consequences of disease and their health, financial state, and social life. At the same time, this approach cuts the expenses of providers and the state because disease prevention has a significantly lower cost than their treatment. Nurses play a significant role in promoting health because they usually have the most frequent and close communication with patients and provide care and treatment for them. Consequently, nurses must be highly competent to contribute to improving patient health effectively. For this reason, this paper will study some of the key concepts and approaches to health promotion and preventive medicine to determine their applicability in nursing practice.
The Concept of Population Health
The concept of population health is relatively new to healthcare and therefore has some controversial points. However, as quoted in their paper by Ariosto et al. (2018), public health refers to “health outcomes of a group of individuals, including the distribution of such outcomes within the group” (p.7). In other words, the concept of public health encompasses the study and influence on all economic, social, and cultural factors that affect human health. However, some scholars argue that this concept is an extended version of public health, although they have more significant differences (Valles, 2018). While public health policies aim to improve health services, promote healthy lifestyles, and prevent epidemics, population health emphasizes the allocation of resources for people’s health. Improved education, socio-economic equality, higher quality of life, and infrastructure contribute to this goal. For example, the Affordable Care Act, which has increased public access to health services and shifted the focus to preventive medicine, is part of population health policy. Thus, this concept implies many elements that contribute to human health but not just the healthcare sector.
This concept and its ideas are also necessary for an advanced practice nursing role as a healthcare professional can directly influence some aspects of population health. First, nurses should promote equal care for patients regardless of age, race, origin, gender, or religion. In addition, the nurse can collect and analyze information about patients and their characteristics to predict possible outcomes and prevent negative consequences. For example, a nurse can see the relationship between a patient’s income and the likelihood of taking preventive measures and can influence this information to shape future policy. The nurse can also impact patient education and help reduce barriers by being aware of the resources of the local community; for example, referring a patient to a free program. Thus, the advanced practice nursing role includes the direct responsibilities of treating and caring for patients and the contribution to population health.
The Health Belief Model of Health Promotion
Theories and models that support health promotion and preventative care are diverse as they consider various factors and take different approaches to their study. One such model is the Health Belief Model (HBM), which was developed in the 1950s by American social scientists (“The health belief,” n.d.). This model aims to understand the reasons for the reluctance of people to take preventive measures and screening tests for the early detection of diseases. The HBM is based on psychological theory, which suggests that people are guided by two ideas that determine their behavior. The first idea is the desire of a person to avoid illness or recover, and the second is based on the belief that a certain preventive measure or treatment is effective (“The health belief,” n.d.). Thus, the perception of these components determines the willingness of people to take action for disease prevention and treatment.
The HBM identifies six specific constructs that assess and determine the causes of human behavior. The first construct is perceived susceptibility, which defines a person’s attitude to the risks of a disease, which differs depending on the feelings of personal vulnerability to the illness (“The health belief,” n.d.). A prime example is the current coronavirus pandemic, since part of the population takes all precautions to avoid infection, while others believe that the virus is fiction or that they are protected from it. Perceived severity is the second construct that refers to a person’s perception of disease severity (“The health belief,” n.d.). This construct is also influenced by the likelihood of consequences such as death and disability, as well as social outcomes such as family life. The next construct of perceived benefits refers to a person’s belief in various measures to reduce and treat disease risk (“The health belief,” n.d.). An example is the refusal to vaccinate for various non-religious reasons. The perceived barriers construct examines a person’s perception of obstacles to performing recommended actions (“The health belief,” n.d.). A person can refuse treatment if it is expensive, dangerous, painful, unpleasant, or inconvenient if he or she believes that its effectiveness is lower than the efforts for its implication.
The next two constructs are added to the original model; however, they are important in clarifying a person’s motivation to receive preventive treatment. The first construct is the cue to action, which means a stimulus for making a decision, such as pain or other symptoms, or the influence of the family, doctor, media (“The health belief,” n.d.). Another component is self-efficacy, which means a person’s confidence in his or her ability to successfully complete treatment (“The health belief,” n.d.). For example, exercise and quitting bad habits can be preventive measures, but self-doubts can hinder their application.
Overall, the HBM is relevant and effective in understanding people’s reasons to avoid preventive measures. The dialogue of the nurse with the patient can help change the patient’s attitude to screening or life-style in many cases. For example, a nurse can describe the risks of developing the disease and its consequences, as well as the effectiveness of treatment. However, this model does not offer solutions but only describes the causes. For instance, a nurse is often unable to help a patient overcome economic or social acceptability barriers to initiate treatment. In addition, changing personal beliefs is also a challenging task that requires significant time and effort, especially if they are religious or irrational rather than erroneous. Consequently, while the HBM details and explains the reasons, nurses should look for options to promote preventive medicine to each patient.
Access to Healthcare Services
The HBM includes such a construct as perceived barriers, which is directly related to the topic of access to health services. The Healthy People 2030 website addresses this topic and notes that health insurance, medical services, and timeliness care are essential components of access to healthcare (“Access to health services,” n.d.). The absence of one of these components diminishes others’ importance, since in the lack of insurance, many people cannot afford preventive measures due to their high cost, and the geographical remoteness of hospitals and clinics impedes timely screening and treatment. In addition, significant attention is paid to building a trusting relationship between the healthcare provider and the patient, which increases the likelihood of understanding the patient’s problems and his or her adherence to recommendations (“Access to health services,” n.d.). If a nurse does not have socio-cultural competence and does not show enough respect and sensitivity to a patients’ features, then he or she cannot influence the patient’s perception of preventive medicine.
Moreover, the authors of the article consider the current problems that patients face in obtaining health care. First, 20 million Americans are still uninsured, despite the expansion of coverage by the Patient Protection and Affordable Care Act of 2010, and a significant proportion of insurance does not cover certain preventive services, such as dental checks (“Access to health services,” n.d.). Second, despite multiple laws against discrimination, people still receive a different quality of services based on age, gender, socioeconomic status, and race. In addition, a significant part of Americans does not have access to medical assistance due to their geographic remoteness, since they live in rural areas. At the same time, waiting times for receiving care have increased as the number of patients has increased, but providers are faced with a lack of funds and staff (“Access to health services,” n.d.). Consequently, these features need to be considered for future policy development and patient management.
This topic is also relevant to a family nurse practitioner as it helps to understand the barriers patients face in using healthcare preventive measures. First, the most important aspect is a nurse’s skill to build trust with patients, which requires him or her to have cultural sensitivity and competence. Family medicine involves working with adults and their children; therefore, children’s health also depends on the quality of communication between a nurse and parents. For example, if parents trust a nurse’s decisions and recommendations, they will not mind vaccinating their child. The second barrier that can be partially influenced by the nurse is geographic remoteness. For instance, a nurse can conduct some of the consultations online or by phone and facilitate the appointment of different types of screenings for the same day so that patients do not have to visit the clinic again. In addition, the nurse can also partially reduce financial barriers by offering less expensive alternatives to preventive measures or by providing information on available resources, such as free programs or relief funds. In this way, a family nurse practitioner can promote preventive medicine and helps patients avoid negative health consequences.
Therefore, this analysis demonstrates that the nurse has many opportunities for health promotion and preventive diseases. These options include exploring models and theories that support health promotion and preventative care, finding local community resources, and improving cultural competence and knowledge. However, this task requires a high level of professionalism to build trusting communication with patients, understand their problems, and propose the most appropriate options for early screening and treatment. Thus, although the modern healthcare system has some significant deficiencies, nurses take one of the central roles to mitigate them.
Ariosto, D.A., Harper, E. M., Wilson, M.L., Hull, S.C., Nahm, E.-S., Sylvia, M.L. (2018). Population health: A nursing action plan. JAMIA Open, 1(1), 7–10. Web.
Access to health services. (n.d.). Web.
The health belief model. (n.d.). Web.
Valles, S.A. (2018). Philosophy of population health: Philosophy for a new public health era. Routledge.