Evaluation of health promotion activities in community nursing practice

The purpose of this research was to study the extent to which community nurses (CNs) were involved in health promotion activities and to investigate whether these activities were meeting the needs of their clients. A cross-sectional survey by multiple methods was designed and carried out in four district health authorities (DHAs) in one regional health authority in England. Two hundred and fifty-one (83.67%) completed questionnaires were returned by CNs working in primary health care (PHC). Sixty sessions with CNs were observed and 249 interviews were conducted with clients. Additionally, as part of the observation 155 clinical records were examined. CNs reported involvement in a wide range of opportunistic and organized health promotion activities. Lifestyle advice and ill-health prevention were most frequently used by all groups. Health visitors (HVs) were involved significantly more in group and community wide activities. District nurses (DNs) were mainly involved in opportunistic health promotion. Practice nurses (PNs) were found to be involved significantly more in health promotion activities organized on an individual basis. Observation revealed that opportunistic health promotion was carried out in almost half of the consultations observed, of which lifestyle advice was the most frequent. Records however showed that this information was rarely recorded. The clients of PNs were mostly aware of other health promotion activities available within the general practice, while almost half of the HVs' clients knew what other health promotion activities were available to them and few DNs' clients were aware of any.