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Communication and health promotion
Health promotion is a key aspect of any health consultation. Encouraging patients to
take responsibility for improving their health by promoting healthy behaviour is vital
in our role as holistic practitioners. Problems such as alcohol dependency continue to
make huge demands on healthcare services and, with an ageing population, health
promotion is vital.
What is health promotion?
Health promotion is the process of enabling people to exert control
over the determinants of health and thereby improve their health. As
a concept and set of practical strategies it remains an essential guide
in addressing the major health challenges faced by developing and
developed nations, including communicable and non-communicable
diseases, and issues related to human development and health.
Health promotion is a process directed towards enabling people to
take action. Thus, health promotion is not something that is done on
or to people; it is done by, with and for people either as individuals
or as groups. The purpose of this activity is to strengthen the skills
and capabilities of individuals to take action and the capacity of
groups or communities to act collectively to exert control over the
determinants of health and achieve positive change.
Communication in the consultation
Communication in the consultation can be divided into verbal and non-verbal.
Surveys of family practitioners in the US examining the relationship between verbal
communication and health promotion suggested that doctors are pessimistic about
patients' abilities to improve their health through behavioural change. They also cite
lack of consultation time for such interventions.
Research papers in the 1980s showed the pattern of illnesses in western society was
changing and that patients were increasingly presenting to doctors with problems that
were behavioural rather than pathological in origin. The researchers, who studied
videoed consultations, concluded that the eye contact and movements of the body
were of great importance in effective communication between doctors and patients.
Eye contact and posture, when coupled with open questions and silences, were vital if
the patient was to disclose their problem and effective communication was to follow.
The conclusion was that poor non-verbal communication could hinder or even prevent
an effective dialogue.
You may wish to look at various health promotion models to understand the processes
involved in behaviour change.
It is imperative to meet the patient where they are on their journey towards a healthier
life. Do not make assumptions about the patient's understanding about their health -
most people know that smoking is bad for them but not everyone will realise that
regularly drinking too many units of alcohol is also harmful.
Try to identify which stage the patient is at, for example, are they keen to change their
behaviour? Then endeavour to move them along to the next stage.
Prochaska stages model for change:
Patients may appear some distance from changing their behaviour but health
promotion messages at every opportunity can help them make the change.
Summarising the consultation
Once the consultation has finished, it is helpful to write down the outline of the
discussion, including what stage the patient is at and what the patient's beliefs and
expectations are. This will help the clinician at the next consultation revisit the topic
at an appropriate opportunity.
Think about consultations where you could have (or did) approach health promotion.
How could you have improved your approach.
Try these tips with your next ward patient. Reinforcement in a sensitive manner does
not damage the doctor patient relationship and may be the encouragement which the
patient needs.