HEALTH-AS-PROCESS - A HEALTH VISITING PERSPECTIVE

Health visitors are community nurses who define their role specificall y in terms of health promotion, although they have often found difficu lty in explaining how their seemingly diffuse and unfocused practice a chieves this. The grounded theory study reported here set out to uncov er some of the hidden processes and features embedded within health vi siting, so the practice might be more clearly articulated. This paper reports one aspect of that study, which suggests that health visitors treat health as a lifelong process, involving the accumulation and use of 'resources for health'. The relevance of approaches which appeared both caring and educational will be set in the context of therapeutic nursing and adult education theories. Historically, health visitors h ave links with both nursing and health education; the analysis present ed here helps to clarify the relationships between these different are as of work. The paper will explain how treating health as a process al lows multiple competing views and ideas about health and 'health promo tion to be integrated into a manageable form, thus allowing positive h ealth to be promoted within a broad, acceptable socio-cultural context . However, the analysis also highlighted various points at which treat ing health as a process contradicts the firmly measurable requirements of the market-orientated health service. Nevertheless, where health v isitors are sufficiently skilled, and are permitted by their employing authorities to use this approach, it may serve to protect clients fro m intrusive and accusing interventions, made in the name of health pro motion.