{

NOLA PENDER’S HEALTH PROMOTION MODEL

“ Very early in my nursing career, it became apparent to me that health professionals intervened only after people developed acute or chronic disease and experienced compromised lives... I committed myself to the proactive stance of health promotion and disease prevention with the conviction that it is much better to experience exuberant well-being and prevent disease than let disease happen when it is avoidable and then try and cope with it.”

Quotable quotes

August 16,1941 – an only child to parents who were advocates for the education of women

Background of the theorist and timeline of events

Early interest in nursing started during her aunt’s hospitalization at the age of 7.1962- received her diploma from the School

of Nursing at West Suburban Hospital in Oak Park, Illinois after which she worked in medical-surgical and pediatric nursing

After earning her Ph.D., Pender notes a shift in her thinking toward defining the goal of nursing care as the optimal health of the individual

1975- Published “A Conceptual Model for Preventive Health Behavior” which was a basis for studying how individuals made decisions about their own healthcare in a nursing context

Series of conversation with Dr. Beverly McElmurry at Northern

Illinois University

Influences

Marriage to Albert Pender, an associate professor of business and economics

Reading High-Level Wellness by Halbert Dunn

Social Cognitive theory (Albert Bandura)

Theoretical Sources

Expectancy-Value Model of Human Motivation (Feather)

- defines health as a positive dynamic state not merely the absence of disease. Health promotion is directed at increasing a client’s level of wellbeing.

HEALTH PROMOTION

MODEL

HEALTH PROMOTION MODEL

The health promotion model notes that each person has unique personal characteristics and experiences that affect subsequent actions.

The set of variables for behavioral specific knowledge and affect have important motivational significance.

These variables can be modified through nursing actions.

Health promoting behavior is the desired behavioral outcome and is the end point in the HPM.

Health promoting behaviors should result in improved health, enhanced functional ability and better quality of life at all stages of development.

The final behavioral demand is also influenced by the immediate competing demand and preferences, which can derail an intended health promoting actions.

1. INDIVIDUAL CHARACTERISTICS AND EXPERIENCES

PRIOR RELATED BEHAVIOR PERSONAL FACTORS

MAJOR CONCEPTS AND DEFINITIONS

2. BEHAVIORAL-SPECIFIC COGNITIONS AND AFFECT

• Perceived benefits of action• Perceived barriers to action

• Perceived self-efficacy• Activity related

effect• Interpersonal influences

• Situational influences

3. BEHAVIOR OR BEHAVIORAL OUTCOMES

Commitment to a plan of action

Immediate competing demands and preferences

4. HEALTH-PROMOTING BEHAVIOR

Individuals

seek to create conditions of living through which they can express their unique human potential.

have the capacity for reflective self-awareness, including assessment of their own competencies.

HPM is based on the following ASSUMPTIONS…

Individuals… value growth in directions viewed as

positive and attempt to achieve a personally acceptable balance between change and stability.

seek to actively regulate their own behavior.

In all their biopsychosocial complexity interact with the environment, progressively transforming the environment and themselves over time.

HPM is based on the following ASSUMPTIONS…

Health professionals constitute a part of the interpersonal environment, which exerts influence on persons throughout their life span.

Self-initiated reconfiguration of person-environment interactive patterns is essential to behavior change.

HPM is based on the following ASSUMPTIONS…

1.  Prior behavior and inherited and acquired characteristics influence beliefs, affect, and enactment of health-promoting behavior.2. Persons commit to engaging in behaviors from which they anticipate deriving personally valued benefits.3. Perceived barriers can constrain commitment to action, a mediator of behavior as well as actual behavior.4. Perceived competence or self-efficacy to execute a given behavior increases the likelihood of commitment to action and actual performance of the behavior.5. Greater perceived self-efficacy results in fewer perceived barriers to a specific health behavior.

THEORETICAL PROPOSITIONS OF THE HEALTH PROMOTION MODEL

6. Positive affect toward a behavior results in greater perceived self-efficacy, which can in turn, result in increased positive affect.

7. When positive emotions or affect are associated with a behavior, the probability of commitment and action is increased.

8. 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.

9. Families, peers, and health care providers are important sources of interpersonal influence that can increase or decrease commitment to and engagement in health-promoting behavior.

10. Situational influences in the external environment can increase or decrease commitment to or participation in health-promoting behavior.

11.The greater the commitments to a specific plan of action, the more likely health-promoting behaviors are to be maintained over time.

12. 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.

13. Commitment to a plan of action is less likely to result in the desired behavior when other actions are more attractive and thus preferred over the target behavior.

 14. Persons can modify cognitions, affect, and the interpersonal and physical environment to create incentives for health actions.

Health Promotion Health ProtectionNot disease oriented

Illness or injury specific

Motivated by personal, positive “approach” to wellness

Motivated by “avoidance” to illness

Seeks to expand positive potential for health

Seeks to thwart the occurrence of insults to health and well being

HPM-health protection vs. HPM-health promotion

Health Promotion Model

Kozier, Barbara et al. 2004. Fundamentals of Nursing. 7th ed. Pearson Education South Asia PTE LTD. Philippine Edition.

McEwan, Melanie and Evelyn Wills. 2007. Theoretical Basis for Nursing. 2nd ed. Lippincott Williams and Wilkins. Philippine Edition.

Sitzman, Kathleen and Lisa Wright Eichelberger. 2010. Nursing Theory: A Creative Beginning. Boston: Jones and Barlett Publishers.

Tomey, Ann and Martha Aligood. 2002. Nursing Theorists and Their Work. Singapore: Elsevier.

References:

Thank you! ;)