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Putting health promotion theory into practice

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As nurses we often hear repeatedly that health promotion is vital, and that is necessary to recognise the signs and symptoms of common ailments and diseases.

How vital this knowledge was to the health of my learning disability clients became apparent to me recently when I was able to recognise what was later diagnosed as skin cancer.

I had read several articles (Buchanan, 2001; Turner, 2002; Godsell, 2003) on recognising and detecting skin cancer and was able to remember salient points and warning signs of skin cancer, namely change in size, pigmentation and irregular border

I was making a routine visit to the home of a married couple who are both my clients. Paul (not his real name) had no shirt on when I arrived and I noticed a mole on his back.

I asked if he would mind if I took a closer look and upon inspection the mole had an irregular border and ranged in colour from light to dark brown. I immediately became suspicious and asked Paul if I could make him an appointment with his GP.

Paul was happy for me to do this and a week later a support worker accompanied him to see his GP. Paul was referred to the local hospital?s dermatology department and he was seen a week later in outpatient?s clinic where the lesion was excised.

Another week passed and the results of the biopsy showed that Paul had a malignant melanoma. This is the most serious skin cancer and early diagnosis is essential for a good prognosis. The melanoma was thin so there is an excellent chance of a full recovery.

Paul did have more tissue removed the following week after diagnosis to be certain that no traces of the cancer remained and he is having regular check-ups at the dermatology outpatient clinic.

Paul?s diagnosis has, of course, had implications for his lifestyle and he will need to be particularly careful in terms of sun exposure. Because Paul has communication difficulties I am developing, in consultation with Paul and a speech and language therapist, some straightforward guidelines on sun safety.

This incident has showed me that professional development is essential if we are to provide care that is timely and up-to-date, and that we must continue to read and access information about the signs and symptoms of disease and not restrict our professional development to topics directly connected with our area of practice.

I have always considered health promotion as a vital part of my job and the reality is that it is has also become truly life-saving.

Buchanan, P. (2001) Skin Cancer. Nursing Standard; 15: 45, 45-52.
Godsell, G. (2003) Recognising the signs of skin cancer. Nursing Times; 99: 31.
Turner, S. (2002) Malignant Melanoma. Nursing Times; 98: 30.

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