Conceptual Framework of the Curriculum: Health Promotion Throughout Life
The conceptual framework of the nursing curriculum at Georgia Southern University is Health Promotion Throughout Life. Health promotion is “behavior motivated by the desire to increase well-being and actualize human health potential” (Pender, 2011, p.5) which includes primary, secondary, and tertiary prevention throughout all life stages. The emphasis of primary prevention is health education and protection from illness and injury; secondary prevention is directed toward limiting illness; and tertiary prevention involves rehabilitation, restoration of health or support for end-of-life care. Central to the Health Promotion Framework are the metaparadigm concepts of nursing, person, health, and environment. Educating reflective nurse professionals requires a curriculum that is built on a liberal arts background and that incorporates professional values, core competencies, core knowledge, and role development.
A person is a holistic being central to nursing, with a unique culture, values, and beliefs. Having certain rights and responsibilities, a person is capable of self-actualization and self-determination. Whether alone or in families, groups, or communities, a person interacts with his or her environment.
Nursing is a practice discipline involving human caring that is concerned with improving quality of life and promoting, maintaining, and restoring health in partnership with persons, families, groups, and communities. The evolving art and science of nursing consists of a unique body of knowledge based on theory, research, and practice in nursing and other disciplines. Nursing strives to improve the quality of life not only in institutional and community arenas, but to positively influence health globally. More specifically, rural nursing involves the delivery of nursing care to underserved and vulnerable populations, including those living within rural areas. These underserved and vulnerable populations include diverse groups of persons who live and work within an environment which may be relatively isolated from the influence of metropolitan areas. Vulnerable populations have increased risk to health related problems, reduced access to care, and diminished quality of life. Rural nursing is unique in that it requires of the nurse highly developed levels of assessment, decision making, and communication skills, as well as the ability to live and work in close association with family and friends who may require care. Often, based on isolation and scarcity of health care providers, independent decision making and the ability to interface with other members of the health care team are the hallmark of rural nursing practice. Nursing practice is actuated through therapeutic nursing interventions which enhance health promotion of persons, families, groups, and communities. Therapeutic nursing interventions are based on an ethic of human care that is contextually and culturally relevant to the receiver. Therapeutic nursing interventions are purposeful strategies and informed actions performed by a nurse for or with a person using primary, secondary, and/or tertiary prevention. Evidence based interventions are developed through synthesizing evidence from theory, research, and experience. Therapeutic nursing interventions require the use of critical thinking, psychomotor, psychosocial, and communication skills. Factors that enable the nurse to perform therapeutic interventions include: human caring, communication, ethical principles, critical thinking, empowerment, research, healthcare technologies, cultural appropriateness, leadership, and professional roles and responsibilities. At the undergraduate level, therapeutic nursing interventions are developed through the nursing process with a goal to facilitate health of persons, families, groups, and communities. Subsequently, the focus of therapeutic nursing interventions at the graduate level is on influencing the health of persons, families, groups, communities, and healthcare systems.
Health is a state of complete physical, mental and social well-being and not merely the absence of disease or infirmity (WHO, 2003). Health promotion and disease prevention at the individual and population level are necessary to improve population health. In partnership with the nurse, health is defined by individuals, families, groups, communities, and populations across the lifespan and across the continuum of healthcare environments.
Environment constitutes the internal and external influences that affect or are affected by the person. These influences include, but are not limited to, biological, psychological, and spiritual factors, population density, socioeconomic status, cultural diversity, social values and beliefs, and scientific and technological development.
Nurses, in partnership with persons, families, groups, and communities, engage in the dynamic process of Health Promotion. While the metaparadigm concepts of nursing, person, health and environment form the foundation of the Health Promotion Framework, the following curriculum threads shape the Health Promotion process.
Human Caring in nursing is a set of interpersonal acts that extend beyond concern, emotion, and benevolent desire. Caring in this context involves values, intent, commitment, knowledge, actions, and outcomes.
Communication, within the context of nursing, is a dynamic and interpersonal process that requires at least one messenger and one receiver. The process, which includes interprofessional collaboration, can be either verbal (oral or written) or nonverbal and is influenced by a person’s culture, setting, values, beliefs, and perceptions. Undergraduate and graduate students engage in increasingly complex levels of communication skills.
Ethical Principles, which include altruism, autonomy, integrity, freedom, veracity, privacy, beneficence, fidelity, human dignity, and social justice, are used to clarify and resolve identified moral problems and ethical dilemmas. The beliefs and values outlined in the American Nurses Association’s Code for Nurses provide guidelines for ethical nursing practice.
Critical Thinking is an active process of analysis exploring relevant phenomena and making judgments to intervene in a therapeutic manner. This reflexive, transferable process involves the ongoing integration and application of a complex set of abilities. The critical thinking process is made public through various modes of communication.
Empowerment is an interpersonal process of providing resources, tools, and environment for people to achieve their optimal potential and well-being. Nursing’s role is to support people to actively participate in their healthcare decision-making to improve health care outcomes.
Research is the systematic inquiry that uses disciplined methods to answer questions or solve problems (Polit & Beck, 2006). The nurse translates current research findings, or evidence, into professional nursing practice. At the undergraduate level, evidence based research is critiqued, analyzed, and applied to the provision of care of persons, families, groups, and communities. At the graduate level, evidence based research related to nursing and healthcare is conducted, synthesized, disseminated, and integrated within nursing practice.
Cultural Appropriateness is the skilled delivery of care based on the appreciation for and knowledge of the diversity in backgrounds of persons. The nurse who is culturally competent takes into account the person’s view of the world which is transmitted from generation to generation. The person’s world view, which is manifested in beliefs, practices, likes, dislikes, customs, norms, and rituals, is incorporated within appropriate therapeutic nursing interventions. In addition, ethnic sensitivity takes into account the person’s group affiliation or membership.
Healthcare Technologies are utilized and managed by nurses in various settings. Technology may enhance nursing practice in direct and indirect patient care, health related communication, nursing informatics, and clinical information management. Nurses must therefore maintain the knowledge and skills necessary to provide care that is technologically current while maintaining a caring, interactive approach.
Leadership in nursing is an awareness of complex systems, and the impact of power, politics, policy, and regulatory guidelines on these systems. Leadership skills emphasize ethical and critical decision-making, initiating and maintaining effective working relationships, using mutually respectful communication and collaboration, care coordination, delegation, and conflict resolution. The nurse uses leadership skills to promote high quality patient care and patient safety within organizational and community arenas (AACN, 2008).
Health Policy is the compilation of decisions made within the government, and sometimes private entities, regarding health and health care. Policies influence health in areas such as access to care, patient care delivery, and financing. It is therefore incumbent upon the nursing profession to consider the impact of health policy on professional nursing practice and to participate in policy development as warranted (Harrington & Estes, 2008).
Professional Roles and Responsibilities include delivering safe care and designing, managing, and coordinating care as a member of the interprofessional team. The professional nurse evaluates one’s own practice as well as contributes to the support and advancement of the profession. The professional nurse focuses on continuous self-evaluation and lifelong learning. The nurse who upholds professional roles and responsibilities advocates for quality health care and functions as a leader in the community and profession (AACN, 2008).
References for Conceptual Framework:
- American Association of Colleges of Nursing. (2008). Revision of the essentials of baccalaureate education for professional nursing practice. Washington, DC: Author.
- Harrington, C., & Estes, C. L. (2008). Health policy: Crisis and reform in the US health care delivery system (5th ed.). Sudbury, MA: Jones & Bartlett.
- Pender, N. J., Murdaugh, C. L., & Parsons, M. A. (2011). Health promotion in nursing practice(6th ed). Upper Saddle River, NJ: Prentice Hall.
- Polit, D. F., & Beck, C. T. (2006). Essentials of nursing research: Methods, appraisal, and utilization (6th ed.). Philadelphia: Lippincott, Williams, and Wilkins.
- World Health Organization. (2003). Definition of health. Retrieved November 17, 2008, from http://www.medterms.com/script/main/art.asp?articlekey=11087
(Revised and Approved 11-2008; Revised reference 5/2010)
Last updated: 7/29/2013