week 8 nursing theory
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Chapter183.pptxThe Health Promotion Model: Nola J. Pender
Chapter 18
Overview of Pender’s Health Promotion Model
Three major categories to consider in Pender’s health promotion model:
Individual characteristics and experiences
Behavior-specific cognitions and affect
Behavioral outcome
Individual Characteristics and Experiences: Prior Behavior
Prior behavior directly and indirectly effects likelihood of engaging in health-promoting behaviors
Direct effect of past behavior on current health-promoting behavior is due to habit formation
Prior behavior indirectly influences health-promoting behavior through perceptions of self-efficacy, benefits, barriers & activity-related affect
Individual Characteristics and Experiences: Personal Factors
Personal biological factors include age, body mass index, pubertal status, menopausal status, aerobic capacity, strength, agility, or balance
Personal psychological factors include self-esteem, self-motivation, perceived health status
Personal sociocultural factors include education, ethnicity, acculturation, socioeconomic status
Behavior-Specific Cognitions and Affect
Perceived benefits of action or the anticipated positive outcomes resulting from health behavior
Perceived barriers to action or anticipated, imagined, or real blocks or personal costs of a behavior
Behavior-Specific Cognitions and Affect
Perceived self-efficacy or the judgment of personal capability to organize and execute a health-promoting behavior
Activity-related affect or the subjective positive or negative feelings that occur before, during, and following behavior based on the stimulus properties of the behavior
Behavioral Outcome
Commitment to a plan of action marks the beginning of a behavioral event
Interventions in the health promotion model focus on raising consciousness related to:
Health-promoting behaviors
Promoting self-efficacy
Enhancing the benefits of change
Control of environment to support behavior change
Managing the barriers to change
Major Concepts of Nursing According to Pender
Person: the individual who is the primary focus of the model
Environment: the physical, interpersonal, and economic circumstances in which persons live
Health: a positive high-level state
Major Concepts of Nursing According to Pender
Nursing: role of nurse includes raising consciousness related to health-promoting behaviors, promoting self-efficacy, enhancing the benefits of change, controlling the environment to support behavior change, and managing barriers to change
Assumptions of the Health Promotion Model
Persons seek to create conditions of living through which they can express their unique human potential
Persons have the capacity for reflective self-awareness, including assessment of their own competencies
Persons seek to actively regulate their own behavior
Assumptions of the Health Promotion Model
Persons value growth in directions viewed as positive and attempt to achieve a personally acceptable balance between change and stability
Persons, in all their biopsychosocial complexity, interact with the environment progressively, transforming the environment and being transformed themselves over time
Assumptions of the Health Promotion Model
Health professionals constitute a part of the interpersonal environment, which influences persons throughout their life span
Self-initiated reconfiguration of person–environment interactive patterns is essential for behavior change
Propositions of the Health Promotion Model
Prior behavior and inherited and acquired characteristics influence health beliefs, affect, and enactment of health-promoting behavior
Persons commit to engaging in behaviors when they anticipate deriving valued benefits
Perceived barriers can constrain commitment to action, mediators of behavior, and actual behavior
Propositions of the Health Promotion Model
Perceived competence or self-efficacy increases the likelihood of commitment to action and actual performance of behavior
Greater perceived self-efficacy results in fewer perceived barriers to a specific health behavior
Positive affect toward a behavior results in greater perceived self-efficacy, which can lead to increased positive affect
Propositions of the Health Promotion Model
When positive emotions or affect is associated with a behavior, the probability of commitment and action are increased
Persons are more likely to commit to and engage in health-promoting behaviors when significant others model the behavior, expect the behavior to occur, and provide assistance and support to enable the behavior
Propositions of the Health Promotion Model
Family, peers, and healthcare providers are important sources of interpersonal influence that can either increase or decrease commitment to and engagement in health-promoting behavior
Situational influences in the external environment can either increase or decrease commitment to or participation in health-promoting behavior
Propositions of the Health Promotion Model
The greater the commitment to a specific plan of action, the more likely that health-promoting behaviors will be maintained over time
Commitment to a plan of action is less likely to result in the desired behavior when competing demands over which persons have little control require immediate attention
Propositions of the Health Promotion Model
Commitment to a plan of action is less likely to result in the desired behavior when other actions are more attractive and preferred over the target behavior
Persons can modify cognitions, affect, and the interpersonal and physical environments to create incentives for health actions
Brief Critique of the Health Promotion Model
Formulated using inductive reasoning and existing research
Simple to understand language
Health promotion is popular concept in nursing practice
Relationships among the various factors are linked and relationships are identified and consistently defined
Pender’s Health Promotion Model as a Framework for Nursing Practice
Assessment: nurse gathers data on prior related behavior of the person, personal factors and perceptions of benefits from actions, barriers to action, efficacy, and activity-related effects and competing demands
Planning: nurse and patient work together to develop a health promotion plan and patient commits to the plan
Pender’s Health Promotion Model as a Framework for Nursing Practice
Implementation: actual incorporation of the health-promoting behavior into the patient’s routine and life
Evaluation: based on the achievement of the action outcome or the incorporation of a health-promoting behavior
