Promoting Healthy Lifestyles - Perspectives from Nursing Practice, Media and the General Population

Abstract

Globally, non-communicable diseases such as cardiovascular diseases, cancers, chronic respiratory diseases and type 2 diabetes pose a growing threat to public health. These diseases are linked to unhealthy lifestyles, namely tobacco use, hazardous use of alcohol, unhealthy eating habits and low levels of physical activity. In health care, a move towards health-promoting and disease-preventing practices is suggested as important working tasks to support the members of the general population in healthier lifestyles. Also, the media is a communicator of health concerns. Thus, it can be assumed that the field of health promotion and disease prevention can be explored from different perspectives. The overall aim of this thesis was to explore health promotion and disease prevention from the perspective of nursing practice. Furthermore, to describe environmental aspects of importance regarding lifestyles and lifestyle counselling. In this thesis, qualitative and quantitative methods were used to conduct the four studies. Study I consisted of group interviews with clinically experienced registered nurses. Study II was collected through individual interviews with district nurses working at primary health care centres. Study III assessed the frequency of lifestyles addressed over time in Swedish newspapers. Study IV contained of a cross-sectional study among the general population’s likelihood of contacting a primary health care centre regarding lifestyles. The findings from study I was interpreted as nursing practice was about striving to be in close proximity to the patient but in tension with pervasive requirements and societal changes. The care commuted between a medical and holistic perspective, in which health promotion and disease prevention was rather invisible. In study II, it was understood as district nurses integrated health-promotive and disease-preventive work into every patient encounter, where health dialogues gave opportunities to build relationships and support patients in lifestyle changes. In study III, 1 324 newspaper articles between 1995 and 2021 were identified addressing lifestyles, where eating habits and tobacco use reported highest frequency. In study IV, a minority responded that they would be likely to contact a primary health care centre regarding lifestyle changes in which men, rural areas and few yearly visits to a primary health care centre were found as predictors for a lower such likelihood. In conclusion, health promotion and disease prevention are complex and to some extent invisible areas in nursing practice. Registered nurses focused on striving to be in close proximity to the patient, in which recognising patients’ unique needs was considered important. District nurses described health-promotive endeavours including building relationships with patients to support in lifestyle changes. However, primary health care centres were not the first choice for lifestyle counselling, regardless of lifestyles among members of the general population. Media is a player in society communicating lifestyles and there has been an overall increasing trend of newspaper articles exposing all four in recent years. The results highlight the importance to continuously discuss the role of primary health care centres as an arena to engage the general population in adopting healthier lifestyles.