Investigating student nurses' constructions of health promotion in nursing education

This article describes student nurses' constructions of health promotion and the change of these constructions during their nursing education in two Finnish polytechnics. The data consisted of essays written by the 19 student nurses before they began their nursing education in 1997 and of stimulated recall interviews with the same students during the second year of their education in 1998. The data were analyzed by using thematic analysis. During the first study year, 13 students' constructions of health promotion changed. Six students had initially broad constructions of health promotion and their constructions remained unchanged. Four basic changes were found in the students' construction…

Patients' readiness for dietary change at the beginning of counselling: a transtheoretical model-based assessment.

Background  The purpose of this study was to explore patients' readiness for dietary change within a theoretical framework of the transtheoretical model. The patients were recently diagnosed to have type 2 diabetes or impaired glucose tolerance. We discuss the theoretical aspects of appropriate dietary counselling strategies from a standpoint of patient-specific stages of change. Methods  The data included 32 audiotaped diabetes counselling sessions with 16 patients conducted by two nurses. The transcribed data was analysed by using deductive content analysis. Results  The patients were at different stages of change of diabetes-affected dietary behaviour. Their stages of change varied in di…

Speech practices that facilitate patient participation in health counselling - A way to empowerment?

Objective This study described nurse-patient communication during health counselling and focused on the linguistic realisations of empowering speech practices that emphasised patient participation. It aimed at a description of nurses' speech practices that facilitated the inclusion of patients' perspectives and preferences and encouraged patients to express themselves. Design and setting Thirty-eight videotaped nurse-patient health- counselling sessions that were conducted in a hospital were transcribed verbatim. Method The analysis of the videotaped data was based on the adaptation of Conversation Analysis (CA) and was carried out on a turn-by-turn basis. Results The research material rev…

Taciturn patients in health counseling at a hospital: passive recipients or active participators?

This study explored patients’ taciturnity as observed on videotape during hospital health counseling situations with a nurse. Health counseling sessions, 38 in number, were videotaped, transcribed verbatim, and analyzed by using an adaptation of conversation analysis. The data analysis included information on 18 selected patients who spoke little and did not introduce new topics, but rather supported the discussion on the theme chosen by the nurse. When we examined nurses’ and patients’ speech word by word, we discovered four participation frames that produced taciturnity: in the hands of professionals, compliant, guilty, and polite. These could fluctuate during interaction. The findings i…

Negotiation in Type 2 Diabetes Counseling: From Problem Recognition to Mutual Acceptance During Lifestyle Counseling

Negotiation, an essential communication activity in lifestyle counseling, has rarely been studied at the micro level of interaction. Furthermore, the evidence for interpersonal negotiation to occur in counseling practice is inconclusive. In this study, the authors describe how negotiation focused on lifestyle changes was produced in nurse-patient interaction. The research data, 73 videotaped diabetes counseling situations, were analyzed using conversation analysis. The process of negotiation consisted of recognizing the problems in the patients' health behavior, offering proposals as solutions to the problems, and reaching an agreement on them. Negotiation had characteristics similar to th…

From nurse-centered health counseling to empowermental health counseling.

The main goals of this study were to examine aspects of the delivery and reception of advice and questions in interaction between nurses and patients and to describe linguistic features that constructed nurse-centered and empowermental health counseling. The research data, 38 health counseling sessions, were videotaped, transcribed verbatim, and analyzed by using an adaptation of conversational analysis. During nurse-centered discussions, the nurses' advice did not correspond to the patients' need for information. These counseling sessions began with check-up questions about the patients' condition and continued with factual questions about their illnesses and health care measures. During e…

Terveyskäsitykset kartalla : ammattikorkeakouluissa opiskelunsa aloittaneiden sairaan- ja terveydenhoitajien terveyskäsitykset käsitekarttamenetelmällä analysoituna

The development of reflective learning in the context of health counselling and health promotion during nurse education.

The development of reflective learning in the context of health counselling and health promotion during nurse education Aims and background. The purpose of this follow-up study was to describe the development of reflective learning of 16 student nurses in the context of health counselling and promotion during clinical training of a 3-year nursing education programme in two Finnish polytechnics. The first aim was to analyse the levels of reflectivity in the student nurses’ reflections on their videotaped counselling situations. The second aim was to explore the qualitative features of the reflective health counselling learning process in the context of health promotion. The theoretical backg…