WHAT CHANGES IN HEALTH BEHAVIOR MIGHT NURSES LOGICALLY EXPECT FROM THEIR HEALTH-EDUCATION WORK

This paper examines nurses' health education work from a philosophical perspective. Two key concepts, choice and autonomy, are explored by analysing examples of the health education work of the practice nurse and the health visitor. As a result, the question, 'what changes in health behaviour might nurses logically expect from their health education work?' is considered. The individualistic assumption within nurses' health education work, that individual patients and clients face certain choices and are able to exert some control over their health status, is reviewed. Choices related to healthy eating, for example, are recognized to be constrained by issues such as finance, time and social circumstances. The choice not to smoke is similarly constrained, for example, by social deprivation, cultural patterns and advertising. The paper both rejects an overly determined conception of patients and clients where they are viewed as unable to make any choices, but also cautions against the danger of victim-blaming. Constraints on patients' and clients' autonomy in health education by nurses are also considered. These limitations on health education work include, for example, a lack of scientific knowledge related to an individual's propensity to develop disease. In contrast, health education work within nursing may also be seen as enabling people to be more autonomous in relation to their health by imparting knowledge about health risks. Health education work by nurses thus emerges from the analysis as a constrained but valuable activity.