Health And Nursing: Evolving One Concept by Involving the Other

Abstract

Five years ago I was one of the four nurses involved in a study of the development of health behaviour in children1. It was that project which first set me thinking about health. As we observed children in one situation and then another we could see them taking on various health ideas, attitudes and practices from a very young age. When we looked carefully at each child across situations we noticed another level of behaviour _ a way of dealing with reprimands or difficult tasks, a way of deciding what to do or a way of getting along with other people. We wondered whether health behaviour was part of these general ways of behaving. Is health behaviour more than specific ideas, attitudes and practices? As we went on to observe school-age children and adolescents these questions continued to intrigue us. Parents remarked on changes in the health practices of their older children. "He used to be so meticulous... in the bathroom all the time. Now we can't get him near water". They also talked about ways of behaving. "(Nine-year-old) Sandy is a born detective... has to figure things out for herself. But (five-year-old) Jamie! He actually likes rules... always making up a new one... drives us crazy sometimes. But he is more cooperative than Sandy." Although a child's specific ideas and practices changed from time to time, his way of behaving seemed to take shape and become quite consistent early in life. We questioned whether his general way of behaving was influencing the health ideas and practices which he accumulated or discarded along the way. These were fundamental questions about health and health behaviour which had not been identified and developed in the health literature.