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Nursing
A companion to nursing theories and models
Research -------------------------------------------------------------------------------------------------------------------------
Nursing Updates ----
Nursing Theories
HEALTH PROMOTION MODEL
Nursing Reviews
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Abstract Index ----------------------------------------------------------------
News & Jobs INTRODUCTION
Nursing The health promotion model (HPM) proposed by Nola J Pender (1982; revised,
Management
Mental Health 1996) was designed to be a “complementary counterpart to models of health
Nursing protection.” It defines health as a positive dynamic state not merely the absence
Clinical Nursing of disease. Health promotion is directed at increasing a client’s level of
Specialties wellbeing. The health promotion model describes the multi dimensional nature
We comply of persons as they interact within their environment to pursue health. The model
with the focuses on following three areas:
HONcode
standard for • Individual characteristics and experiences
trustworthy
health
• Behavior-specific cognitions and affect
information: • Behavioral outcomes
verify here
The health promotion model notes that each person has unique personal
characteristics and experiences that affect subsequent actions. The set of
Theories &
variables for behavioral specific knowledge and affect have important
Models motivational significance. These variables can be modified through nursing
• Introducti actions. Health promoting behavior is the desired behavioral outcome and is the
on to end point in the HPM. Health promoting behaviors should result in improved
Nursing
health, enhanced functional ability and better quality of life at all stages of
Theories
development. The final behavioral demand is also influenced by the immediate
• Develop
competing demand and preferences, which can derail an intended health
ment of
Nursing promoting actions.
Theories
• Virginia
Henderso
n’s Need
Theory
• Theory if
 Interpers
onal
Relations
• Faye
Glenn
Abdellah'
s Theory
• Jean
Watson's
theory
• Johnson’s
behavior
system
model
• Theory of
Goal
Attainme
nt
• Betty
Neumann
’s system
model
• Levin's
Four
Conserva ASSUMPTIONS OF THE HEALTH PROMOTION MODEL
tion
The HPM is based on the following assumptions, which reflect both nursing and
Principles
behavioral science perspectives:
• Nursing
Theorists 1. Persons seek to create conditions of living through which they
• Martha can express their unique human health potential.
Roger’s 2. Persons have the capacity for reflective self-awareness, including
Science
of unitary
assessment of their own competencies.
human 3. Persons value growth in directions viewed as positive and
beings attempts to achieve a personally acceptable balance between
• Theories change and stability.
Based on
Interactiv 4. Individuals seek to actively regulate their own behavior.
e Process 5. Individuals in all their biopsychosocial complexity interact with
• Orem's the environment, progressively transforming the environment and
Self-Care being transformed over time.
Deficit
6. Health professionals constitute a part of the interpersonal
Theory
• Nursing
environment, which exerts influence on persons throughout their
Theories: lifespan.
An 7. Self-initiated reconfiguration of person-environment interactive
Overview patterns is essential to behavior change.
• Research
and THEORETICAL PROPOSITIONS OF THE HEALTH PROMOTION MODEL
Nursing Theoretical statements derived from the model provide a basis for investigative
Theories work on health behaviors. The HPM is based on the following theoretical
• Roy's propositions:
Adaptatio
n Model
1. Prior behavior and inherited and acquired characteristics influence
• Orlando's beliefs, affect, and enactment of health-promoting behavior.
Nursing 2. Persons commit to engaging in behaviors from which they
Process anticipate deriving personally valued benefits.
• Applicatio
n Goal 3. Perceived barriers can constrain commitment to action, a
 Attainme
mediator of behavior as well as actual behavior.
nt Theory
• Applicatio 4. Perceived competence or self-efficacy to execute a given behavior
n Orem's increases the likelihood of commitment to action and actual
Self-care performance of the behavior.
Deficit
5. Greater perceived self-efficacy results in fewer perceived barriers
Theory
to a specific health behavior.
• Understa
nding the 6. Positive affect toward a behavior results in greater perceived self-
works of efficacy, which can in turn, result in increased positive affect.
Nursing
Theorists 7. When positive emotions or affect are associated with a behavior,
:A the probability of commitment and action is increased.
creative
8. Persons are more likely to commit to and engage in health-
beginning
promoting behaviors when significant others model the behavior,
• Health
Promotio
expect the behavior to occur, and provide assistance and support
n Model
to enable the behavior.
• Health 9. Families, peers, and health care providers are important sources
Belief of interpersonal influence that can increase or decrease
Model commitment to and engagement in health-promoting behavior.
• Theories
10. Situational influences in the external environment can increase
used in
Communi or decrease commitment to or participation in health-promoting
ty Health behavior.
Nursing 11. The greater the commitments to a specific plan of action, the
• Applicatio more likely health-promoting behaviors are to be maintained over
n of
time.
Suchman’
s Stages 12. Commitment to a plan of action is less likely to result in the
of Illness desired behavior when competing demands over which persons
Mode have little control require immediate attention. 13. Commitment
• Applicatio to a plan of action is less likely to result in the desired behavior
n of Betty
Neuman'
when other actions are more attractive and thus preferred over
s the target behavior.
Systems 13. Persons can modify cognitions, affect, and the interpersonal and
Model in
Nursing
physical environment to create incentives for health actions.
Care THE MAJOR CONCEPTS AND DEFINITIONS OF THE HEALTH PROMOTION MODEL
• Applicatio Individual Characteristics and Experience
n of
Roy's PRIOR RELATED BEHAVIOR
Adaptatio Frequency of the similar behaviour in the past. Direct and indirect effects on the
n Model
likelihood of engaging in health promoting behaviors.
in
Nursing PERSONAL FACTORS
Process Personal factors categorized as biological, psychological and socio-cultural.
• Applicatio These factors are predictive of a given behavior and shaped by the nature of the
n of
target behaviour being considered.
Peplau's
Interpers Personal biological factors
onal
theory in
Include variable such as age gender body mass index pubertal
Nursing status, aerobic capacity, strength, agility, or balance.
Process Personal psychological factors
• Applicatio Include variables such as self esteem self motivation personal
n of
Nursing
competence perceived health status and definition of health.
Theories Personal socio-cultural factors
• Transcult
 ural
Include variables such as race ethnicity, accuculturation,
Nursing
education and socioeconomic status.
• Helping
and Behavioural Specific Cognition and Affect
Human PERCEIVED BENEFITS OF ACTION
Relations
hips Anticipated positive out comes that will occur from health behaviour.
Theory: PERCEIVED BARRIERS TO ACTION
Robert R.
Carkhuff Anticipated, imagined or real blocks and personal costs of understanding a given
• Models of behaviour
Preventio PERCEIVED SELF EFFICACY
n
Disclaimer Judgment of personal capability to organise and execute a health-promoting
Exclusive articles behaviour. Perceived self efficacy influences perceived barriers to action so
published in this
site are personal
higher efficacy result in lowered perceptions of barriers to the performance of
references of the the behavior.
editors or
authors, and are
ACTIVITY RELATED AFFECT
not suggested as Subjective positive or negative feeling that occur before, during and following
a replacement to
standard
behavior based on the stimulus properties of the behaviour itself. Activity-
references. related affect influences perceived self-efficacy, which means the more positive
Contact us at: the subjective feeling, the greater the feeling of efficacy. In turn, increased
editor@currentnursi
ng.com
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
1. Marriner TA, Raile AM. Nursing theorists and their work. 5th ed. Sakraida
 T.Nola J. Pender. The Health Promotion Model. St Louis: Mosby; 2005
2. Polit DF, Beck CT. Nursing research:Principles and methods. 7th ed.
Philadelphia: Lippincott Williams & Wilkins; 2007
3. Black JM, Hawks JH, Keene AM. Medical surgical nursing. 6th ed.
Philadelphia: Elsevier Mosby; 2006.
4. Potter PA, Perry AG. Fundamentals of nursing. 6th ed. St.Louis: Elsevier
Mosby; 2006.

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