The health promoting nurse and brain research and the early years

Health promotion has long been accepted as a mainstay of nursing practice, and indeed many community child health nurses would cite health promotion as a major activity in their daily work. However, there is a lack of clarity in the nursing literature regarding the concepts and activities of health promotion and studies on nurses‚ understanding of the term indicates some confusion and ambiguity (Macleod Clark et al, 1993). This is often compounded by the diversity of ways in which health promotion theory is cited and applied in the non-nursing literature: it is in many ways a ‘contested concept’ (Naidoo & Wills, 1994). Within the nursing literature there has been discussion on the concept of the ‘health promoting nurse’ and this paper will discuss the features of health promoting practice, beginning with a brief outline of the evolvement of health promotion into its present diversity of practice. The term ‘health promotion’ is of recent usage as prior to 1980 most writings cite definitions of health education and refer to health education, health prevention or health protection as activities to promote health (Maben, 1995). Early in its development in the 1960s health education was associated with bio-medicine where it was seen as an arm of preventative medicine (O’Connor & Parker, 2001). In this medical model health education was that which was delivered to patients as medical advice to maintain their health or as part of their instructions for improving their health status. ---------------------------------- In recent years there has been an explosion of new research pointing to the importance of the first three years of life. The results provide important confirmation of what we have all felt intuitively, and that early childhood researchers have known for over a decade – that the caregiving environment that an infant and toddler experiences in those early years plays a significant role in shaping later outcomes. The report by J. Fraser Mustard expands on our understanding of how nurturing by parents in the early years has “a decisive and long lasting impact on how people develop, their capacity to learn, their behaviour, and ability to regulate their emotions and their risk of disease later in life.”  This new evidence helps us to understand that the way children turn out is a complex and dynamic interplay between genes and the environment. Whilst genes provide the “map” for future brain development it is the experiences an infant has after birth that shape the way the brain develops. Healthy development depends on a good environment – good nutrition, health, and nourishing and stimulating relationships