Primary health care theory to practice: Experience of first-year nursing students in Hong Kong

Headnote

ABSTRACT

In the past, nursing education in Hong Kong has focused on acute illness care, and institutions providing nursing education have been slow to modify the illnessfocused curriculum to a health-based curriculum. The nursing curriculum at the University of Hong Kong is unique in that it focuses on primary health care, and these concepts are introduced in both theory and practice in the first year of the baccalaureate program. In the second semester of the first year, students are required to develop and implement a primary health care project in a community setting. This article outlines the process and outcomes of the experience of 8 first-year nursing students who developed and implemented a primary health care project with older adults in a Hong Kong community. The Generalized Model for Program Development (McKenzie & Smeltzer) was used to guide the students in their practicum activities. The students demonstrated a high degree of competency in relation to health assessment skills; analysis of individual and community needs; development of appropriate health promotion sessions in relation to coronary artery disease, diabetes mellitus, and arthritis; and evaluation strategies to demonstrate effectiveness of the intervention. This experience early in the program provided a strong foundation for the students in primary heath care and grounded their nursing practice in scientific-based evidence.

The "Health for All" movement, initiated at the Alma Ata Conference, delineated that primary health care was the accepted infrastructure to guide policies in directing health care delivery systems regardless of the context (World Health Organization [WHO], 1978). The International Council of Nurses (1988) supported primary health care and advocated its acceptance by other intersectoral stakeholders. Subsequently, nurse educators involved in curriculum development have respected this direction (Macintosh & McCormack, 2000). Evidence indicates that in many countries, nursing curriculum has been restructured to educate practitioners to meet the needs of a changing health care system (Adams, Sherrod, et al., 2001; Term, 1995; Williams & Wold, 1996). This has not been the case in Hong Kong (Chan & Wong, 1999). However, since its inception in 1996, the Department of Nursing Studies at the University of Hong Kong has integrated the concepts of primary health care, in both the undergraduate and graduate programs, in terms of philosophical foundations and clinical practice.

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