Nurses as Role Models in health promoting behaviour: Concept Development and Analysis.

This report reflects on a period of study for the duration of second year Professional Doctoral studies at University of Bath. This period has included completion of all taught components of the doctorate before progressing to the research phase, which commenced September 2014.

The two-year part time taught programme is aimed at developing expert practitioners and research in practice. In parallel during the taught element a full research and ethics proposal is produced for a novel independent piece of research. This report provides updated progress on the protocol submission for the study entitled “Nurses as Role Models in health promoting behaviour: Concept Development and Analysis”. The study is currently being examined and a transfer interview is being organised by University of Bath for January 2015 when data collection and analysis can proceed. An ethics application has been submitted and reviewed and is currently awaiting transfer interview results to grant approval.

The study proposes to clarify and conceptualise the phenomenon of nurses as role models in health promoting behaviour and to explore implications for nursing practice using a hybrid model for concept development (Schwartz-Barcott & Kim 1986). This model integrates Walker and Avant’s (2014) concept analysis framework to develop a theory for the concept of role modeling for nurses in the context of the NMC requirement to be role models in health promoting behaviours. Data will be retrieved through a systematic literature review process, and from new data generated from focus groups with (i) 3rd year student nurses towards the end of their education (ii) nurse educators and (iii) registered nurses preparing to become registered mentors to student nurses.

There is evidence that the actual behaviour of nurses includes high levels of smoking, stress and alcohol consumption with high prevalence of obesity (Miller et al 2009, Clarke et al 2004, King et al 2009,Timmins 2011) which conflicts with the statutory competency for nurses to encourage healthy behaviour through role modelling. The Nursing and Midwifery Council Competency framework for student nurses states that a statutory requirement for registration as a nurse is that “All nurses must take every opportunity to encourage health promoting behaviour through education, role modeling and effective communication” (NMC. 2014). Recent government documents suggest that nurses should be role models in healthy lifestyles  (DH 2009, 2010, 2011); “nurses and midwives must acknowledge that they are seen as role models for healthy living, and take personal responsibility for their own health” (DH 2010: 6). The term role modelling is used within nursing literature (Blake et. al. 2011, Miller et al 2008, Rush et al. 2005, Timmins 2011, Zapka et al 2009) with the assumption that there is agreed understanding and plausibility of the concept. There is however very little existing research exploring the concept of the role model within nursing theory in general despite the statements made above by both government and professional bodies.  Furthermore the use of the term role model in the context of encouraging health- promoting behaviours is far removed from the original meaning. If student nurses are required to become role models in health-promoting behaviours upon registration then it is important to clarify what is understood by the concept.

Other assessed components have included a) a detailed portfolio b) a health policy analysis and c) a service improvement project. This work has involved developing, planning, and planning evaluation of a self-care component to integrate into the curricula of nurses and health professionals’ education. A health policy analysis of the Human Papillomavirus vaccination policy in Western Europe: A Comparative Study has been successfully completed and a manuscript has been submitted to The Journal of Public Health Policy.

During this period of study the scholar has been employed as Programme Leader for Nursing and Health Programmes at an institute of higher education in the United Kingdom. The personal journey of study has enhanced the scholar’s knowledge for her professional role within education.

The scholars’ research interest in the health and well being of student nurses has raised certain questions and provides the motivation to further explore the topic in depth for this doctoral research. The last two years sourcing and reviewing literature of related topics and discussing related topics with nurses, nurse experts, academics and laypersons have provided the foundation to developing the protocol outlined in this report. Further reference is made to gathering information and knowledge through visits, presenting at conference, publication and appointment as a nurse expert to the NHS Research Ethics Committee

Further information will be available on completion of the study. A copy of the full 36-page report including full protocol is available from the Florence Nightingale Foundation.

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