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…

Reflective questions in health counseling.

This study explores questions that nurses ask patients in order to awaken reflection on their health behavior in health counseling. Thirty-eight counseling situations were videotaped in a hospital. The data were analyzed using conversation analysis which was adapted for the purpose of this study. Nonverbal communication supported speech and was interpreted alongside it. This study found that nurses used only a few reflective questions, most of which were future-oriented or introduced hypotheses. In a nonreflective discussion, nurses used only check-up and alternative questions to get information about patients' illnesses and health care measures. Findings indicated that reflective conversa…

Communicator styles of hospital patients during nurse-patient counseling.

Abstract This article describes nurse–patient communication during counseling sessions. It focuses on the patient as a participant in a discussion and aims at a description of patients’ communicator styles, which were observed on videotape based on 38 counseling sessions transcribed word by word. Interviews of the participating nurses and patients were used for partial support of the interpretations. The analytic method chosen was typology, and it has been used for achieving a multifaceted qualitative description of patient communication. The research material yielded seven types of communicator styles: Quietly Assenting, Emotionally Expressive, Storyteller, Stoic Observer, Inquisitive of D…

Developing empowering health counseling measurement

Abstract Objective This article describes the derivation of an instrument (Empowering Speech Practices Scale) for assessing the empowerment of dyadic counseling, the evaluation of the validity and reliability of the ESPS and the results acquired with the instrument from hospital counseling. Methods ESPS was constructed on the basis of empowerment theory and foregoing conversation analytic research. Nurses and patients assessed the same counseling session by way of parallel statements. Structure and reliability of the scale were evaluated with Cronbach alpha, percentage of agreement, factor analysis and logistic regression analysis. Results According to these preliminary results, ESPS descri…

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…

Teachers’ views on curriculum development in health promotion in two Finnish polytechnics

This study describes teachers' views on how to improve the health promotion element in the curricula of two health care polytechnics in Finland. The theoretical background of this study draws on curriculum development in nursing education and how to promote a human- or resource-centred approach in health promotion. The research data were collected by interviewing 10 teachers from both the schools involved in nursing or public health nursing education since August 1997. The data were analysed using content analysis. The findings showed that most of the teachers interviewed were involved in local curriculum development. This work was impeded by lack of time and real commitment, as well as the…

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…

Questioning and advising in health counselling: results from a study of Finnish nurse counsellors

The purpose of this study is to describe the main ways in which nurse coun sellors' questions and advice are initiated, received, accepted or refused during health counselling. Thirty-eight health counselling situations were videotaped in a Finnish hospital and the data were examined using adapted conversation analysis. We found two types of health counselling models, which fluctuated during the encounters. Empowerment, 'reciprocal' health counselling began with the nurse counsellors' reflective questioning which took the form of check up questions about the patient's condition, followed by questions about the patient's feelings. The patients' answers guided the conversation. 'Non-recipro c…

Health promotion in the curricula and teaching of two polytechnics in Finland

Abstract The purpose of this study was to examine the manifestation of health promotion in two Finnish health care and nursing polytechnic curricula for students starting their studies in August 1997. Another goal was to explore students’ and their teachers’ perceptions of which modules contained health promotion, as well as to find out which modules contained integrated health promotion. In this study, data and investigator triangulation were used. The data consisted of the curricula of two polytechnics of health care and of interviews with 20 student nurses and their teachers. The data were analysed using content analysis. Health promotion studies were integrated with other studies in the…

Kokemuksellisen oppimisen kautta kohti terveyden edistämisen asiantuntijuutta : hoitotyön ammattikorkeakouluopiskelijoiden terveyden edistämisen oppiminen hoitotyön harjoittelussa

Students' and teachers' experiences of a problem-based learning method in health promotion in a Finnish polytechnic

Objective This study explored students' and their teachers' experiences of a problem-based learning method (PBL) and its manifestation in health promotion education. Design The study was based on a more extensive follow-up research project that investigated the teaching and learning of health promotion in two polytechnics of health care from 1997 to 2000. Settings A Finnish polytechnic of health care and nursing within a larger multidisciplinary educational institution. Method The data consisted of interviews with nine student nurses and ten teachers, conducted in 1999 and 2000. The data were analysed using inductive content analysis. Results During the first year when the polytechnic star…

Empowering counseling--a case study: nurse-patient encounter in a hospital

This study illustrates practices that a nurse uses in order to empower patients. The emphasis is on speech formulae that encourage patients to discuss their concerns and to solicit information about impending surgery. The study is a part of a larger research project and a single case was selected for presentation in this article because it differed from the rest of the data by manifesting empowering practice. A videotaped nurse-patient health counseling session was conducted in a hospital and transcribed verbatim. The investigator interviewed the nurse and the patient after the conversation, and these interviews were transcribed as well. The encounter that is presented here as a case study …

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…

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…