Health education: a Rogerian concept analysis

Objectives: The concept of health education has traditionally focused on enabling people to change unhealthy behaviours and lifestyles. Although, at the theoretical level, there exist definitions of the concept, it remains complex and ambiguous. Furthermore, nurses often confuse the concept with other related terms, such as health information or health promotion. The aim here is to report a concept analysis of health education and elucidate a current definition.

Design: Rodgers' evolutionary concept analysis.

Data sources: A systematic search was conducted using PubMed and CINAHL for articles written in English or Spanish, published between 1986 and 2017. A manual search was performed, and grey literature was also reviewed. A pre-determined template of study inclusion-related questions assisted the process.

Review methods: Rodgers' evolutionary method guided the narrative analysis. The attributes of health education, as well as its antecedents, consequences, related terms and contextual bases were extracted and synthesized.

Results: Based on the review of 31 studies on health education, the attributes are a learning process, health-oriented, multidimensional, person-centred and partnership. The antecedents are professional awareness of health education, training of health professionals, available resources, individual's willingness to act, and health as an individual's priority in life. The consequences are the increase in knowledge, skills and/or attitudes; change in health-related behaviours, individual capability and empowerment; positive health outcomes; and positive social/economic impact. The related terms are health information, patient education, counselling, health coaching and health promotion. Health education is defined as a continuous, dynamic, complex and planned teaching-learning process throughout the lifespan and in different settings that is implemented through an equitable and negotiated client and health professional 'partnership' to facilitate and empower the person to promote/initiate lifestyle-related behavioural changes that promote positive health status outcomes. Health education takes into account individuals'/groups' internal and external factors that influence their health status through potentially improving their knowledge, skills, attitudes and beliefs in relation to their health-related needs and behaviour, within a positive health paradigm.

Conclusions: The theoretical definition and conceptual framework provided in this study contribute to and extend the current knowledge base among nurses and other health care providers. The findings elucidate the clinical role of health educators, enabling them to identify the realities of its practice, building a common reference point, and highlighting the main recommendations for its use at the clinical, education, policy and research interface.