http://currentnursing.com/nursing_theory/health_promotion_model.html 21SEP2010 |
INTRODUCTION The health promotion model (HPM) proposed by Nola J Pender (1982; revised, 1996) was designed to be a “complementary counterpart to models of health protection.” It 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. The health promotion model describes the multi dimensional nature of persons as they interact within their environment to pursue health. The model focuses on following three areas:
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.
ASSUMPTIONS OF THE HEALTH PROMOTION MODEL The HPM is based on the following assumptions, which reflect both nursing and behavioral science perspectives:
THEORETICAL PROPOSITIONS OF THE HEALTH PROMOTION MODEL Theoretical statements derived from the model provide a basis for investigative work on health behaviors. The HPM is based on the following theoretical propositions:
THE MAJOR CONCEPTS AND DEFINITIONS OF THE HEALTH PROMOTION MODEL
PERSONAL FACTORS Personal biological factors
Personal psychological factors
Personal socio-cultural factors
PERCEIVED BENEFITS OF ACTION
PERCEIVED BARRIERS TO ACTION
PERCEIVED SELF EFFICACY Judgment of personal capability to organise and execute a health-promoting behaviour. Perceived self efficacy influences perceived barriers to action so higher efficacy result in lowered perceptions of barriers to the performance of the behavior. ACTIVITY RELATED AFFECT Subjective positive or negative feeling that occur before, during and following behavior based on the stimulus properties of the behaviour itself. Activity-related affect influences perceived self-efficacy, which means the more positive the subjective feeling, the greater the feeling of efficacy. In turn, increased feelings of efficacy can generate further positive affect. INTERPERSONAL INFLUENCES Cognition concerning behaviours, beliefs, or attitudes of the others. Interpersonal influences include: norms (expectations of significant others), social support (instrumental and emotional encouragement) and modelling (vicarious learning through observing others engaged in a particular behaviour). Primary sources of interpersonal influences are families, peers, and healthcare providers. SITUATIONAL INFLUENCES Personal perceptions and cognitions of any given situation or context that can facilitate or impede behaviour. Include perceptions of options available, demand characteristics and aesthetic features of the environment in which given health promoting is proposed to take place. Situational influences may have direct or indirect influences on health behaviour. Behavioural Outcome COMMITMENT TO PLAN OF ACTION The concept of intention and identification of a planned strategy leads to implementation of health behaviour. IMMEDIATE COMPETING DEMANDS AND PREFERENCES Competing demands are those alternative behaviour over which individuals have low control because there are environmental contingencies such as work or family care responsibilities. Competing preferences are alternative behaviour over which individuals exert relatively high control, such as choice of ice cream or apple for a snack HEALTH PROMOTING BEHAVIOUR Endpoint or action outcome directed toward attaining positive health outcome such as optimal well-being, personal fulfillment, and productive living. REFERENCES
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Health promotion theories and models
http://www.healthpromotionagency.org.uk/Healthpromotion/Health/section5.htm
21SEP2010
There are a number of significant theories and models that underpin the practice of health promotion. It would be useful to make a differentiation between theories and models. |
Theory |
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Examples: Social Cognitive Theory, Theory of Planned Behaviour |
Model |
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Examples: Health Belief Model, Transtheoretical Model |
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The main models and theories utilised can be summarised as follows: |
1. Those theories that attempt to explain health behaviour and health behaviour change by focusing on the individual. |
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2. Theories that explain change in communities and community action for health. |
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3. Models that explain changes in organisations and the creation of health- supportive organisational practices. |
Theories of organisational change |
Summary of Theories: Focus and Key Concepts
| Theory | Focus | Key concepts |
Individual Level | Stages of Change Model | Individual's readiness to change or attempt to change toward healthy behaviours | Precontemplation |
| Health Belief Model | Person's perception of the threat of a health problem and the appraisal of recommended behaviour(s) for preventing or managing the problem | Perceived susceptibility |
Interpersonal Level | Social Learning Theory | Behaviour is explained via a 3-way, dynamic reciprocal theory in which personal factors, environmental influences and behaviour continually interact | Behaviour capability |
Community Level | Community Organisation Theories | Emphasises active participation and development of communities that can better evaluate and solve health and social problems | Empowerment |
| Organisational Change Theory | Concerns processes and strategies for increasing the chances that healthy policies and programmes will be adopted and maintained in formal organizations | Problem definition (awareness stage) |
| Diffusion of Innovations Theory | Addresses how new ideas, products and social practices spread within a society or from one society to another | Relative advantage |
Stages of change
In the transtheoretical model as of 1997, change is a "process involving progress through a series of six stages"[
- Precontemplation - "people are not intending to take action in the foreseeable future, usually measured as the next 6 months"
- Contemplation - "people are intending to change in the next 6 months"
- Preparation - "people are intending to take action in the immediate future, usually measured as the next month"
- Action - "people have made specific overt modifications in their life styles within the past 6 months"
- Maintenance - "people are working to prevent relapse," a stage which is estimated to last "from 6 months to about 5 years"
- Termination - "individuals have zero temptation and 100% self-efficacy... they are sure they will not return to their old unhealthy habit as a way of coping"
In addition, the researchers conceptualized "relapse" (recycling) which is not a stage in itself but rather the "return from action or maintenance to an earlier stage
SINCERE THANKS TO PROF. RAMESH
It was the first time my granddaughter came to me and confided about her battle with oral and genital herpes and her self destructive thoughts.
ReplyDeleteA gaping vacuum of fear and love opened inside me. I knew what it felt like for her to be in such a situation. But after hearing how someone I loved so dearly struggled I have no option but to promise her help. I wanted to help in all possible ways. I sought counsels from an old and experienced nurse whom I've known to deal on natural herbs because I believed in nature. After hearing from me she smiled and before I could say another word she replied me there's cure but natural herbs. I don't care as long as my child is cured! I shouted. She told me about a doctor in Africa who has cured people of herpes. She gave me his email drutuherbalcure@gmail.com ,I contacted him immediately and then ordered medicine for my child which he sent through the UPS courier to me. My daughter started medication and the next day her mouth sores were physically healing and she told me it's working and within four weeks she testified to me that she was cured! I've always believed that nature has cure for any diseases and I'm happy to tell everyone my child is cured.
Six months later we went for another test to be sure and here is the result,
Six months after medications;
Her hsv1&2 test results;
Igm - 1.49
IgG - 0.36
She don't have any symptoms again and has moved on happily and is now in a serious relationship with her fiancee.
It was the first time my granddaughter came to me and confided about her battle with oral and genital herpes and her self destructive thoughts.
ReplyDeleteA gaping vacuum of fear and love opened inside me. I knew what it felt like for her to be in such a situation. But after hearing how someone I loved so dearly struggled I have no option but to promise her help. I wanted to help in all possible ways. I sought counsels from an old and experienced nurse whom I've known to deal on natural herbs because I believed in nature. After hearing from me she smiled and before I could say another word she replied me there's cure but natural herbs. I don't care as long as my child is cured! I shouted. She told me about a doctor in Africa who has cured people of herpes. She gave me his email drutuherbalcure@gmail.com ,I contacted him immediately and then ordered medicine for my child which he sent through the UPS courier to me. My daughter started medication and the next day her mouth sores were physically healing and she told me it's working and within four weeks she testified to me that she was cured! I've always believed that nature has cure for any diseases and I'm happy to tell everyone my child is cured.
Six months later we went for another test to be sure and here is the result,
Six months after medications;
Her hsv1&2 test results;
Igm - 1.49
IgG - 0.36
She don't have any symptoms again and has moved on happily and is now in a serious relationship with her fiancee.