Abstract
BackgroundUK public health policy requires hospitals to have in place health promotion services which enable patients to improve their health through adopting healthy behaviours, i.e. health education. This study investigated hospitalised patients' experiences of health education for smoking, alcohol use, diet, physical activity, and weight, and their views concerning the appropriateness of hospitals as a setting for the delivery of health education services.MethodsRecently discharged adult hospital patients (n = 322) were sent a questionnaire asking about their smoking, alcohol use, diet, physical activity, and weight. For each of these risk factors, participants were asked whether they agreed with screening for the risk factor, whether they received health education, whether it was "helpful", and if they wanted to change their behaviour. Participants were also asked a set of general questions concerning health education within hospitals.Results190 patients responded (59%). Over 80% agreed with screening for all risk factors. 80% of smokers, 52% consuming alcohol above recommended limits, 86% of obese, 66% consuming less than five fruit and vegetables a day, and 61% of physically inactive participants wanted to change their respective behaviour. However only a third reported receiving health education. While over 60% of patients wanted health education around discharge, the majority of those receiving health education did so at admission. The majority agreed that "hospital is a good place for patients to receive" health education (87%) and that "the hospital should provide patients with details of community organisations that provide" health education (83%). Only a minority (31%) reported a preference for health education from their GP instead of hospital.ConclusionWhile the delivery of health education to patients within hospital was poor, hospitals are viewed by patients as an appropriate, and in some cases preferred setting for the screening of risk factors and delivery of health education.
Highlights
UK public health policy requires hospitals to have in place health promotion services which enable patients to improve their health through adopting healthy behaviours, i.e. health education
This study aimed to provide an insight into the provision of health education for smoking, alcohol misuse, obesity, diet, and exercise within a UK hospital following UK public health policy changes highlighted above and the World Health Organisation Health Promoting Hospitals (WHO HPH) strategy for health promoting lifestyle development for patients; and to address the paucity of research on patients' views of the appropriateness/acceptability of the hospital as a setting for the delivery of health promotion services for lifestyle development
Rationale A search of the literature at the time of developing this study indicated that there was no one survey tool that adequately met the study research questions: What lifestyle development services do patients want from a hospital setting? Is the hospital a suitable setting for the delivery of health education services? And how are patients' views related to their lifestyles? A self-administered questionnaire was deemed the most appropriate tool for investigating the research questions as it could be distributed to a relatively large number of patients and allowed for anonymity, increasing the likelihood of honest opinions about views and experiences of health education within the hospital [17]
Summary
UK public health policy requires hospitals to have in place health promotion services which enable patients to improve their health through adopting healthy behaviours, i.e. health education. The Ottawa charter for health promotion, 1986 provides a broad definition of health promotion as "the process of enabling people to increase control over, and to improve, their health" [5]. This can only be achieved through coordinated action from governmental and nongovernmental organisations, the health, social and economic sectors, voluntary organization, local authorities, industry, the (page number not for citation purposes). One of the core aims of the WHO HPH network is to facilitate change within the quality management of hospitals, with health promotion a core quality dimension [9] To this end the WHO HPH network has recently developed a strategic and quality framework for health promoting hospitals [4]. The first three strategies (PAT 1 to PAT 3) should be delivered by all health promoting hospitals as they aim to further develop the health promoting quality of the hospital services and setting, whereas strategies PAT 4 through to PAT 6 are viewed as additional health promotion strategies which hospitals can offer
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