The Role of Jordanian Hospital Nurses in Promoting Patients' Health

Abstract

Background/Rationale: In recent years growing attention has been given to health and the development of health promotion within the hospital setting. This is in order to tackle the soaring medical costs and foster health improvement in the population. Given their unique relationship with patients, hospital nurses are urged to promote the patient's health, yet internationally, little is known about their role in health promotion and, specifically, no Jordanian study was found that examines such a role. Purpose of the Study/ Setting: To understand the nature of nurses' roles in heath promotion in a large teaching hospital in Jordan. Study Design/Methods: An in-depth constructivist case study design using a multiple method triangulation strategy was used. The study involved four phases. The first phase examined nurses' role in health promotion using focus group discussions (n=8), non-participant observations and semi-structured questionnaires. The second phase focused on patients' understanding of health and health promotion using focus group discussions (n=8). The third phase examined health promotion from the perspective of hospital stakeholders and a nursing educator. The fourth phase included documentary review of nurses' job descriptions and nursing philosophy of care. Data Analysis: Whilst quantitative data were analysed using SPSS, qualitative data were thematically analysed using N-Vivo (2) and filing and colour index method. Findings: Generally, hospital nurses' views towards their role in health promotion were positive. However, their perceived role and actual practice of health promotion were largely restricted to individualised information giving and behavioural change approaches. The thesis identified diverse contributing factors to this situation. This includes lack of time, shortage of nursing staff, lack of knowledge in heath promotion, power imbalance between doctors and nurses, low public image of nursing and gender issues related to nursing. Conclusion: The way hospital nurses' role in health promotion is currently perceived and operationalised in practice is inconsistent with the recent health promotion ideas operating at the level of empowerment and political actions. Addressing the identified barriers therefore, together with a radical reform from curative services towards health promoting health agenda, is crucial. Unless this happens, hospital nurses' ability to promote health might continue to be questioned. The thesis develops a conceptual model illuminating Jordanian hospital nurses' role in health promotion together with contributing factors.