penders_health_promotiona_model.pptxbsc n

BSc nursing

1. Theory Evaluation of Pender’s Health Promotion Model ( HPM )

2. Purpose and Topics Critically evaluate Nola J. Pender’s Health Promotion Model (HPM ) High prevalence and cost of conditions that are caused by poor lifestyle choices – conditions that are largely preventable According to Pender (1996), “in the United States, it is estimated that unhealthy lifestyles are responsible for 54% of the years of life lost prior to age 65, environment for 22%, and heredity for 16%” ( p. 5). Potential to decrease the pervasiveness of lifestyle-related conditions and achieving cost savings through health promotion and illness prevention.

3. Nola J. Pender : Background Born 1941 in Lansing, Michigan Masters degree in human growth and development at Michigan State University in 1965 This background contributed to the formation of a research program for children and adolescents,’ stated Pender” ( Sakraida , 2006, p. 453). PhD in psychology and education in 1969 at Northwestern University in Evanston, Illinois ‘ introducing me to considerations of how people think and how a person’s thoughts motivate behavior ’” Shift in her thinking toward defining the goal of nursing care as the optimal health of the individual Also influenced by husband Albert Pender, associate professor of business and economics

4. Overview “The HPM is an attempt to depict the multidimensional nature of persons interacting with their environment as they pursue health” (Pender, 1996, p. 53).

5. Contd…. Model “In contrast, a model is a description or an analogy used as a pattern to enhance our understanding of something that is known”

6. Pender’s Health Promotion Model Revised Health Promotion Model. (From Current Nursing (2010) Health Promotion Model. Retrieved from http://currentnurisng.com/nursing_theory/health_promotion_model.html )

7. Importance of health Perceived control of health Perceived self-efficacy Definition of health Perceived health status Perceived benefits of health-promoting behavior Perceived barriers to health-promoting behaviors COGNITIVE-PERCEPTUAL FACTORS Demographic characteristics Biologic characteristics Interpersonal influences Situational factors Behavioral factors MODIFYING FACTORS Likelihood of engaging in health-promoting behavior Cues to action PARTICIPATION IN HEALTH-PROMOTING BEHAVIOR

8. Main Structural Elements: Concepts Individual characteristics and experiences Prior related behavior and personal factors I mportance of their effects depends on target behavior and population Behavioral-specific cognitions and affect Major motivational significance and modifiable through nursing actions Perceived benefits of action, perceived barriers to action, perceived self-efficacy, activity-related affect, interpersonal influences, and situational influences Behavioral outcomes Commitment to a plan of action, immediate competing demands and preferences, and health-promoting behavior (the end-point or action outcome in HPM )

9. Assumptions and Point of view Pender’s motivation for developing the Health Promotion Model. Personal experience - As a young girl observed professional nurses caring for her aunt and developed a belief that “the goal of nursing was to help people care for themselves” ( Sakraida , 2010, p. 434). Educational influences – A master’s degree in human growth and development facilitated and interest in health over the human life span. A PhD in psychology and education lead to thoughts about “how people think and how a person’s thoughts motivate behavior” ( Sakraida , 2010, p. 434).

10. Influences of Pender’s philosophy Personal experiences Parents were advocates for women pursuing education. Family support of her going to school to become a Registered Nurse. Educational experiences Master’s degree in human growth and development helped her to develop a holistic approach to health over the human lifespan. PhD in psychology and education led to ideas about how individual’s thoughts influence behavior.

11. Information and Concepts Eleven major concepts of Nora Pender’s Health Promotion Model (2006 ). Pender recognized that there are particular behaviors that promote individual ownership of prevention of illness and continued awareness of personal health. The Health Promotion Model focuses on prior behavior and personal factors that contributed to the outcome. Prior related behavior A similar behavior in the past that can be direct or indirect effects of health promoting behaviors. Personal factors Biological , psychological, and socio-cultural are personal factors considered that are predictive of target behavior being addressed. Personal biological factors Age , gender, body mass index, pubertal status, menopausal status, aerobic capacity, strength, agility and balance are considered variables . Personal psychological factors Personal self-esteem, self-motivation, competence, perceived health status, and definition of health are analyzed variables . Personal sociocultural factors Race , ethnicity, acculturation, education and socioeconomic status are included variables. Also considered are behavioral-specific cognitions and affects that are indicative of nursing actions.

12. Information and Concepts Perceived benefits of action Anticipated positive outcomes from actions resulting in healthy behavior are perceived benefits. Perceived barriers to action Anticipated, imagined or real blocks from actions are perceived barriers. Also considered is personal cost of the given behavior. Perceived self-efficacy Personal capability to organize and execute a health promoting behavior is perceived self-efficacy. An ability to analyze personal barriers and creating action for these barriers demonstrates this capability. Activity-related affect Subjective positive and negative feelings that occur before, during and following behavior based on the stimulus properties of the behavior itself. Interpersonal influences Influential cognitions are concerning behaviors, beliefs, or attitudes of others that directs ones thoughts. Some influences include norms, social support, and modeling. Situational influences These are personal perceptions and cognitions of any given situation or context that can facilitate or impede behavior. The perceptions can be available options, demand characteristics, and aesthetic features of the environment that health-promoting behaviors are proposed to take place. Situational influences can be direct or indirect.

13. Information and Concepts Commitment to a plan of action A description of commitment of intention and identification of a planned strategy the leads to implementation of healthy behavior. Immediate competing demands and preferences Competing demands are alternative behaviors over which individuals have low control. Competing preferences are alternative behaviors over which individuals exert relatively high control. Health-promoting behavior The end point or action outcome that is directed toward attaining positive health outcomes such as optimal well-being, personal fulfillment, and productive living. Global concepts The four global concepts are addressed in the Health Promotion Model as follows: Human-being- Pender ascertains in her theory that individuals are responsible to create healthy choices for their own human health potential. These persons must be able to reflect on their behaviors. Environment- The individual creates an environment to pursue and maintain for optimal health. Health- Pender encourages healthy prevenative behaviors throughout the lifespan. Nursing- Nursing provides interpersonal influence to aid in commitment to healthy behaviors

14. Interpretation & Inference and Implications & Consequences Examples Geriatrics - “Older adults may underestimate their capabilities, inadvertently leading them to engage in risky health habits such as stress, poor nutrition, and physical inactivity ( Byam & Salyer , 2010, p. 115)”. Meals on wheels is an excellent example of promoting better nutrition for this group. Low income families - Instruction about a balanced diet, exercise and the importance of early detection of illnesses might even be added to food pantries in the community. Obstetrics – Increase in prenatal care. Pediatrics – Well child checkups.

15. Conclusion . The Health Promotion Model has 11 major concepts. The idea behind the model is helping people change their lifestyles, and move toward a state of optimal health. The model effects everyone, healthy or not. The problem is finding a way to attract people to change a bad habit for a good one.

16. Resources and Web-links Scholary articles related to Pender’s Health Promotion Model Agazio , J., & Buckley, K. (2010). Finding a balance: health promotion challenges of military women. Health Care for Women International , 31 (9), 848-868. Retrieved from CINAHL database. This journal discusses health promotion in military women. The military women used different tools to evaluate factors effecting their performance in health promoting activities. Self-efficacy and interpersonal influences most influence on health promotion. This article focused on working military women meeting health promotion activities. It also concentrates on how to best support their ability to participate in healthy behaviors. Byam -Williams, J.B. (2010), Salyer , J. Factors influencing the health-related lifestyle of community-dwelling older adults. Home Healthcare Nurse, 28 (2), p 115–121, doi : 10.1097/NHH.0b013e3181cb5750 People are living longer, but are not necessarily healthier. This study examined factors influencing health related life styles with a goal of increasing knowledge to encourage healthy lifestyles. Pender's revised Health Promotion Model (HPM) guided the study. A self-administered questionnaire was used to collect data. It points out that nurses in the community setting could function in supportive and educational roles. This could be done in churches and senior apartments by developing strategies to encourage older adults to use existing skills to practice more behaviors that contribute to a healthy lifestyle.

17. Case Study Sally , a 25 year old, Caucasian student wants to lose weight. She would like to have more energy during the day. She is tired of seeing the scale in the 180s. High blood pressure runs in her family. Her father has had three stents put into his heart by the age of 50 and had a mild heart attack. Upon assessment her blood pressure is 118/44 mmHg, height is 5’3”, weight 182 lbs. Sally States that her stress level is high. She is unable to get a job, and has two children to take care of. He husband works full-time making minimum wage. She is a non smoker. She levels the office to have more blood work completed. Questions What evidence would show Sally is ready for weight loss management? What are some perceived barriers and perceived benefits of action? What are some personal factors that affect her weight loss and health? What are some behavior options to go over with Sally?

18. Case Study Answer Key 1 . What evidence would show Sally is ready for weight loss management? She came to the office on her own She is tired of the scale being in the 180s Family history 2. What are some perceived barriers and perceived benefits of action? Perceived barriers Not having enough time or energy to exercise Not having money to buy healthy foods High stress level Perceived benefits of action More energy to play with children Healthier Decreased chances of heart disease

19. Case Study Answer Key 3. What are some personal factors that affect her weight loss and health? Young adult BMI is obese Sees self as overweight Lower socioeconomic status Caucasian College education 4. What are some behavior options to go over with Sally? Help establish an exercise routine that fits into her schedule Set short and long term goals Schedule weekly weight checks Go over a healthy diet Talk about stress management Address any dietary concerns

20. References Byam -Williams, J.B. (2010), Salyer , J. Factors influencing the health-related lifestyle of community- dwelling older adults. Home Healthcare Nurse . 28(2), p 115–121, doi:10.1097/NHH.0b013e3181cb5750 Current Nursing. (2010). Health Promotion Model. Retrieved from http://currentnursing.com/nursing_theory/health_promotion_model.html Kelley, J. A., Sherrod, R. A., & Smyth, P. (2009). Coronary artery disease and smoking cessation intervention by primary care providers in a rural clinic.   Online Journal of Rural Nursing & Health Care , 9(2), 78-90. Retrieved from Academic OneFile  database. Nursing Theory. (2010). Health Promotion Model. Retrieved from http://www.nursingtheory.net /mr_healthpromotion.html Pender, N. J., Murdaugh , C. L., & Parsons, M. (2006). Health Promotion in Nursing Practice. Upper Saddle River, New Jersey: Pearson Prentice Hall. Sakraida , T.J. (2010). Nola J. Pender: Health Promotion Model. In M. R. Alligood , & A. M. Tomey (Eds.), Nursing Theorists and Their Work (pp.434-454) (7th ed ). Maryland Heights, MO: Mosby Elsevier.