Page 238 - Encyclopedia of Nursing Research

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of nursing for the future. In this context,
HealtH ConCeptualization the intention of the descriptive analysis is
to understand the aims, goals, and crite-
ria of success in current nursing practice.
The concept of health is a critical concept for Investigators are trying to understand, sys-
nursing as it informs the profession’s goals, tematize, and render coherent what nurses
scope, and outcomes of practice. The goals understand themselves to be doing and to
of nursing are to restore, to maintain, and to clarify the different forms that disease or
promote health; the scope of nursing’s con- failures of health can take. Assessing the
cern is with problems of health. When nurs- results of this approach amounts to deter-
ing practice assists people back to a healthy mining which conception makes better
condition, successful outcomes are correctly sense of nursing practice and how the differ-
declared. To be effective, nurses must have ent parts of nursing practice fit together.
an understanding of health. To most nursing clinicians and research-
Health has been conceptualized in ers, regardless of specialty area, the concep-
many ways in our society, including physi- tion of health most applicable to practice is
cal, emotional, mental, spiritual, and social health as the absence of signs and symp-
well-being; what people in a culture value or toms of physiological malady and disability.
desire; maximization of potential; high-level Most nurses spend their careers observing,
wellness; fulfillment of personal goals; suc- administering, modifying therapies, inter-
cessful performance of social roles; success- preting conditions, and treating people who
ful interaction with the environment; and are sick and need to be restored to health
proper functioning. Health has also been or teaching them how to stay free of those
viewed as subjective or relative (self-report), signs and symptoms. There are many the-
objective (measured against an agreed-upon ories that illustrate this approach. These
standard), comparative (a more-or-less con- include Florence Nightingale’s conceptual-
dition viewed as a continuum or gradation), ization of health as an innate process that
classificatory (a dichotomy), holistic (indi- could be influenced by education, lifestyle
visible), a state (condition), and a process changes, and improvement of environment
(continuous change over time). Thus, with (Nightingale, 1860/1969). Smith’s (1981) clini-
such multiple, sometimes overlapping, often cal, role performance, and adaptive models of
redundant, sometimes contradictory concep- health also illustrate this approach as do the
tions of health, the term has to be understood conceptual models, including the self-care
in terms of the purposes to which it is being framework (Orem, 2001). Orem identified
applied. health as the state of being whole and sound,
What is the meaning of health for nurs- where sound means strength and absence of
ing science, that is, for human responses to disease and whole means nothing is missing.
actual and potential health problems? The She conceptualized health as an outcome
concept of health has been dominated by of self-care and as an influencing factor on
two broad approaches: (a) descriptive analy- both self-care agency and self-care demand.
sis and (b) visioning the goals and practice Finally, theories focused on stability, balance,