A quantitative and qualitative analysis of nurses' lifestyles and community health practice in Denpasar, Bali.

Background Health promotion (HP) provision is regarded as an integral component of the health professional’s role, particularly for nurses working in a primary healthcare (PHC) context. In Indonesia, community health centres called Puskesmas serve as the main functional healthcare organisation unit. In all Puskesmas, nurses are considered to have a pivotal role in maximising the health of the general population, having sufficient knowledge, skills, positive attitudes and behaviours towards health-promoting lifestyles (HPLs). Purpose The purposes of this study were: to describe the personal health-promoting lifestyles among nurses working across all Puskesmas in the Denpasar area, Bali, Indonesia • to determine any significant differences between selected socio-demographic variables and the health-promoting lifestyles of nurses working in Puskesmas • to obtain an understanding of how nurses view, experience and integrate their personal and professional health promotion practice. Methods This study employed a parallel mixed-methods design using self-administered questionnaires and telephone interviews. The questionnaire was adapted from an existing instrument (Health-Promoting Lifestyle Profile II/HPLP-II), while the semi-structured telephone interview was guided by a list of questions developed through reviewing the literature pertinent to the chosen topic. Quantitative data were analysed using SPSS version 20 for Windows, while qualitative data from eight telephone interviews were subject to in-depth thematic analysis. To generate final conclusions, inferences from each strand were linked, combined and integrated. Results It was found that based on particular socio-demographic characteristics of the participants, the means of several HPLP-II subscales were significantly different, namely, in spiritual growth (working experience, employment status, income, general health status), nutrition (employment status, income), stress management (income), and in total scale, health responsibility and interpersonal relations (general health status). Six key themes were yielded from the thematic analysis and included how the nurses view, experience and integrate their personal and professional HP practice. Conclusions Three major conclusions can be drawn from this study. First, the Puskesmas nurses showed sufficiently positive HPL patterns, except in the physical activity domain. Second, there were significant differences found in several HPLP-II subscales based on the participants’ particular socio-demographic characteristics. Finally, by integrating, combining or linking findings from the quantitative and qualitative strands, it can be concluded that there is a connection between the Puskesmas nurses’ personal and professional HP practice. More precisely, it was characterised by the notion of being imperfect role models and a blurred boundary between the nurses’ personal and professional identity.Thesis (M.Nurs.Sc.) -- University of Adelaide, School of Nursing, 201