Health promotion in Nursing curricula: the knowledge of teachers and the meanings attributed by students: systematic literature review

Abstract

ntroduction: One of the main challenges of nursing education is to expand the capacity of students to be health promoters in the 21st century. Scientific evidence suggests that the creation of a grand theme in the curricula of undergraduate and postgraduate courses would help give students skills and credibility related to Health Promotion (HP). Health Promotion (HP) includes determining factors such as the ecology, culture, socio-political context, and economy, which require systematic investigation and knowledge of HP. Objective: To describe and analyse the empirical studies on HP in nursing education and to highlight their results.
Methods: A Systematic Literature Review (SLR) with PI[C]OD method to answer the following questions: What is taught about HP in nursing curricula? What are the meanings attributed by students when taught HP? The research was conducted in Portuguese and English and was restricted to the period between 2000-2009, in online databases, digital libraries, and open repositories of universities, following a systematic process from research to the critical appraisal of studies. The corpus for analysis consisted of eight qualitative studies, a systematic literature review of qualitative empirical studies, a Masters thesis with qualitative methodology, and a Ph.D. thesis with mixed methods. The participants were teachers and/or students. Results – Research findings conclude that teachers’ knowledge is weak concerning the substantive side of the curriculum. The content is focused on the activities of Health Education (HE) and skills are centred on prevention. The content is fragmented and there is no communication between modules. Students attribute different meanings, they consider HP to have little relevance to the real world experiences of nursing, showing a clear need for a specific teaching bock for the basic concepts, integrated blocks to add depth and to understand HP. They also feel they need concrete practical examples in order to reflect on the theory. The Master’s thesis showed that the students’ development of skills within the training and intervention of HP mainly refer to a categorisation paradigm focused on prevention. The PhD thesis points out that, in the nursing course, the predominant group of values of the HP program are the Pathogenic values. Conclusions: Given the demands on nurses as health promoters in the XXI century, and knowing that HP is a process with positive effects on citizens’ health, the patients themselves being participants in it, HP should be included in nursing curricula so that students can consolidate their knowledge and develop certain attitudes and skills. The development of curricula is
focused on a traditional dominant paradigm of HE, although there is some experience in the constructivist paradigm of HP. The meanings attributed by the students to HP learning clearly reveal the traditional paradigm during theoretical and practical training. From this analysis three themes emerged: the knowledge of teachers in curriculum construction which encompasses the socio-political side, substantive side and socio-professional side; the knowledge of teachers on HP in curricular development include HP conceptual references, contents, and pedagogic strategies; and the meanings attributed by students to HP learning with the which include HP conceptual references, curriculum construction, curriculum operationalization, personal beliefs, pedagogic strategies, and experiences in the clinical practice.