A discourse and Foucauldian analysis of nurses health beliefs: Implications for nurse education

Aims of study: The aim of this study was to investigate nurses' constructions of health in order to determine what influence these have on their health education practices and their implications for nurse education. Background: Burgeoning literature on health promotion claim that health promotion is central to nursing practice. This is a rote that has grown in the context of a rapidly ageing population, emergence of new diseases and variants of old diseases, ecological and environmental concerns and apparent social fragmentation. Within the United Kingdom this has led to nurses being identified by agencies, such as the UK government, as having a leading rote to play in what has become the 'holy grail' of patient lifestyle change. But this role has been based on the seemingly uncritical assumption that the UK nurse education system engenders the necessary knowledge, attitude and skills required by nurses for them to effectively promote lifestyle choices. This study draws upon discourse and Foucauldian social analysis to uncover, through nurses' narratives, how they construct health and enact their health education practices. Methods: Twelve newly registered UK nurses were interviewed using hierarchical focused interviews. Data were analysed using discourse analysis. Findings: The process of discourse analysis unearthed two opposing value positions held without any feeling of contradiction by respondents: a holistic view- the role-based/public account, and a victim blaming view - personal agency/private account. Conclusion: This dual set of values raises important concerns over the teaching of health promotion. Nurse education may need to revise its approach to health promotion by taking into account the power of private accounts of health promotion that prevail among some nurses. (C) 2007 Elsevier Ltd. All rights reserved.