Health promotion is the process of improving health by enabling an individual’s control over the health (World Health Organization, 1986). The focus of the essay is obesity. Since 1975, obesity rate is tripled. Obesity is the burning problem across the world. In 2016, more than 1.9 billion adults were found overweight and all were 18 years and older. Among them 650 million were found obese. In the same year, 41million children were obese or overweight and they were under age of 5 (World Health Organization, 2018). Australian Health Survey in 2011-2012 revealed that 63.4% of Australian adults are overweight or obese and 28.3% are to be obese (AIHW, 2018). Obesity kills more people than underweight and yet it is the preventable disease. It is caused by sedentary lifestyle, low physical activity, and eating fast food (high calorie and fat rich food) that increases weight of the individuals. It leads to several health complications such as diabetes, hypertension making health quality of life poor (Bombak, 2014). Therefore, the aim of the essay is to disease the role of the nurse or midwife in health promotion for obesity patients. It will disused in respect to the five major strategies for health promotion identified in the Ottawa Charter for Health Promotion (World Health Organization, 1986).
Nursing services use the Ottawa Charter as a framework for health promotion and is considered an innovation and a quality improvement exercise (Potvin & Jones, 2011). According to Ottawa charter for health promotion the first strategy is to build healthy public policy. There is the dire need of such policy in Australia and in many other countries to manage and prevent obesity. The role of the nurse is to incorporate health in public policy decisions. The nurses may participate in the intersectoral collaboration by visiting villages like Kulumburu where people are lacking awareness and support for healthy behaviour. Nurses can play crucial role in document analysis, conducting workshops and in role playing games with local stakeholders or interviewing the experts. The nurse can emphasise on active living of obese people and quit sedentary lifestyle. The nurses can encourage the transdisciplinary dialogue between the planning processes to help promote health (www.betterhealth.vic.gov.au, 2018). There are inadequate studies addressing the complications of obesity and economical harm of the obesity. The nurse must contribute to healthy policy to use as a future tool for change. For this purpose the nurse must perform intense assessment. They must participate in the planning of political, socio-cultural and economical factors contributing to obesity (Hearn et al., 2017). The nurse may then identify the policy makers in the respective regions by disseminating formation to formulate proposal and introduce in committee. Policy can be adopted based on evidence from experience for instance the legislation on ban on the selling of junk food in school premises. To promote the program the nurses can use evidence based strategies like education of clinicians through workshops and seminars, incorporation of guidelines into quality assurance projects for obesity management, allow public to express their opinions through public hearings. Then policy can then be implemented by government support thorough effective communication strategies, community programs, health care and training (Meyer et al., 2016; McMurray & Clendon, 2015).
The second strategy of the Ottawa Charter is to create supportive environments (McMurray & Clendon, 2015). The role of the nurses is to encourage all the people to recognise the healthy behaviour by conserving and capitalising the resources needed for good health. The nurse may assist the community people and those visiting hospitals to develop infrastructure to support physical activity. The nurses can collaborate with other health care professionals and Non-governmental organisations to develop centres for gym, aerobics, swimming or yoga for free for those with low socioeconomic status (Mama, et al., 2015). The nurse or midwifes must collaborate with the social workers to address the patients economic determinants. The midwife may help the patient preserve the resources by wise economic choices. The nurses and midwifes must stay committed to be fair in allocation of resources across all groups in population. It is their role to prevent discrimination and access to health care by encouraging the people to visit the youth community resources, engage in healing circles or educational programs. In hospital nurses and midwifes may help patient feel comfortable through seating play areas for children, making friendly waiting room with portraits and arts to respect Indigenous people. Further the nurses and midwifes must ensure equitable access to supportive environment for health. They can mediate between the conflicting interests in society. For instance, by involving people with disabilities in the community plans inclusive environment can be created (Meyer et al., 2016).
The third strategy of the health promotion as per Ottawa Charter is to strengthen the community action (McMurray & Clendon, 2015). The communities are empowered by learning opportunities and information through social media campaign. It will help the patients to make the informed choices leading to community capacity development. The role of the nurse in this case would be to advocate for obese people and their families to implement the activities based on evidence that can reduce excess weight gain (Naidoo & Wills, 2016). The nurse may advocate for changes at the community, school and policy level. The nurses may empower people for acceptance of policy change and political commitment. The nurse may investigate the attitudes of people towards obesity through comprehensive studies to be used as baseline data for future evolution of policy. To promote healthy behaviour the community nurses or midwifes can share information about the obesity management. The nurses may work with individual patients for implementing strategies for behaviour change. The nurses may assist the patients in identifying the barriers to change through education about required behavioural modifications. To create learning opportunities the nurse or midwives may provide sustainable living programs like “4Km, walking program, cycling programs, workplace stress management providing healthy snack options in vending machines, reducing television time, sound sleep techniques” (McMurray & Clendon, 2015; Dietz et al., 2015).
The fourth strategy of the health promotion as per Ottawa Charter is to develop personal skills. It refers to guiding communities and giving them opportunities to develop skills to influence people to use resources effectively for attaining health (McMurray & Clendon, 2015). The nurses may promote the skills set for changing specific health behaviour of people. It can be promoted through behavioural counselling on physical activity and healthy eating (fruits, vegetables and less fat rich food). In schools the nurses can teach young people about nutrition and adverse heath affects of obesity. In community the nurses can teach the parents about the cooking healthy food in cultural or traditional manner, reading labels on food packets, portion sizes appropriate for their children. The nurses may teach the disadvantaged communities the skills to research the health needs of locals. It will help the individuals to take control of their health and environment (Tucker & Lanningham-Foster, 2015; Mama et al., 2015).
Reorienting the health services is the fifth strategy of the health promotion as per Ottawa Charter (McMurray & Clendon, 2015). It refers to promoting the health by positioning the health promotion as a basic political priority across all sectors with free sharing of informations. The nurses must work together with the health care system contributing to the pursuit of health. The nurses and midwifes must work beyond their responsibility for providing curative services. The nurses must provide health promotion programs that are respectful of cultural needs. The nurse must pay stronger attention to obesity health research to refocus on the total needs of the individual (Johansson et al., 2010). The nurses may actively participate to promote screening programs and mental health programs to help people quit alcohol, fast food and lose weight. Create public awareness about gym memberships and health insurance companies. Guidelines in this aspect may include addressing ineffective perception, lack of time, poor weight losing skills, lack of motivation among patients, reluctance raising issue due to patient sensitivity (McMurray & Clendon, 2015; Johansson et al., 2010).
In conclusion the essay discusses the obesity as the burning problem in the world. Obesity is associated with the various comorbidities such as diabetes, hypertension, cardiovascular disease and others. It is the cause of millions of deaths across the world. It calls for health promotion. The essay discussed the role of the health promotion by nurses and midwifes using the five major strategies identified in the Ottawa Charter for Health Promotion. The nurses’ role can be summarised as review of expert’s guidance through from public, private, and governmental health advocacy organisations. Further, they play key role in the early childcare settings, schools, families, worksites, communities in addition to health care settings. The nurse uses the strategies of the Ottawa charter to promote healthy eating changes and easier food choices. For broad community the nurses can promote wide changes in the activity and environment. Through social media campaign the nurse can implement obesity prevention strategies linking to toolkits and useful guidelines based on evidence and different policy approaches. These nursing activities will help improve food and physical activity environments.
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