Peter Chiira

 Nursing Theory Analysis Paper Name Institution Theory/author name and background The mid-range theory to analyze for the purpose of this paper is the Health Promotion Model (HPM) designed and proposed by Nola J. Pender in 1982. The model aimed at improving the patient’s level of well-being in the long-term. It also describes the nature of a person to have several dimensions as they interact with a certain environment in their pursuit of improving their health. The primary cause of health problems in the world has shifted from the infectious diseases to chronic illnesses. The majority of the chronic illnesses result from lifestyle issues like physical exercise, diet, and stress management. Therefore, the management of these chronic diseases requires making several changes to the lifestyle factors. The different professionals in the health care sector have an aim of assisting patients, and their families to improve their health and their lives. These objectives also aim at improving patients’ quality and longevity of life. The Health Promotion Model has become very popular among nurses as a model that meets the goals of improving the longevity and quality of life of chronical patients (Peterson & Bredow, 2013). This theory is a model for providing nursing care to support health promotion behaviors. The model targets individuals, families, groups, and communities. It comprises of three primary areas that nurses can use to assess the health promotion behaviors of patients. These areas include the previous behavior and personal factors, the specific practices (perception of benefits or barriers to action) and the behavioral outcome. The theorist, Nola Pender, has been a nurse instructor for more than four decades where she has trained scholars at the different education levels while also coaching others. Nola was born in 1941 and earned her Bachelor of Nursing (BSN from Michigan State University in 1964, and her master’s from the same university in 1965. She advanced her education and earned her Ph.D. in 1969 from Northwestern University. Nola has had a lot of interest in conducting research in nursing, which led to the Health Promotion Model. She has also contributed to the nursing profession through her time, service and knowledge. She currently works as Professor Emeritus at Michigan University. Nola began researching on health promoting practice in the 1970s and published the model in 1982. She said that she designed the model from theories and added a nursing viewpoint. Nola has written a book that has six editions. She published the first edition in 1982 and the rest in 1996, 1987, 2002, 2006, and 2013. These books offer a theoretical and practical focus on the national health promotion priorities identifies by the different medical and health associations in the country. The books also cover overviews of the best health behavior change models that physicians can use to enhance the health of people, households, and societies. The current editions also offer primary and updated concepts for comprehending and improving the practice of promoting health. The 2013 edition introduces the fundamental models and theories for guiding health promotion for individuals and communities in a practice environment. The edition also covers new concepts and legislations like the Healthy People 2020, latest research and terminologies and other modern medical approaches critical for improving the health of the nation and contemporary health promotion technologies. The primary concern that led to the development of this theory is that the health care focused on the treatment of illness rather than on disease prevention. The model addresses the personal biological, psychological and socio-cultural factors that require being incorporated when planning for health promotion activities (Zaccagnini & White, 2010). It also addressed the problems of planning and providing care in a clinical setting. The model also aimed at determining the influence of health promoting practices on prior individual promotion behaviors, the pressing competing interests, and devotion to a program of action (Orshan, 2008). Theory description The Health promotion model is based on inductive reasoning and existing research. The reason for this is that the theorist idea about the theory started from observation of the different patterns in health promotion practices, which resulted in her creation of a tentative hypothesis. The hypothesis then resulted in the creation of the theory. In other words, the theorist started by observing the nursing activities, discerned the pattern, generalized about the industry and then inferred the theory. Major concepts of the theory The first major concept of this theory is the individual characteristics and experience. This concept includes the previous behavior and the personal factors. The idea of change in behavior depends on the direct and indirect effects or the likelihood of the individual to engage in health promoting practices in addition to the frequency of having the same actions in the past (Ritter & Lampkin, 2011). The general issues that affect the individual’s health behavior include age, personality structure, race, ethnicity and the socio-economic status. The second major concept is behavior-specific cognition and affect. This concept refers to the perceptions and feelings the individual has towards the advantages and obstacles to action, self-efficacy, and the reaction to the desires and demands of others. Perceived benefits of performance refer to the perceptions that lead to positive or reinforcing results of adopting a health behavior. The perceived barriers to action relate to the beliefs of the hurdles and costs of implementing the health behavior. Other concepts include learned self-efficacy, activity-related influence, interpersonal forces, situational forces, dedication to a particular required plan, and immediate competing interests and choices. Activity-related effect relates to the emotions that an individual has before, during and following certain health practices. Interpersonal influences refer to a person’s beliefs about behaviors and attitudes concerning others about engagement in a particular health behavior. The situational influences relate to the patient’s perspectives concerning the context of life and the environment in which the patient undertakes the health practices. The devotion to a required action relates to the patient’s intention to engage in the required health behavior together with determining the necessary strategies to have a successful implementation of the change of behavior. The issue of competing interests and choices refer to the various practices that may have an influence on the adopted courses of action before the start of the expected health behavior. The combination of these factors has an effect on the patient’s commitment to the plan of action, which also affects the kind of health promoting behavior that the patient will adopt. The last fundamental concept of his theory is the behavioral outcomes. The desired behavioral outcome or the result of this model is health-promoting behavior. These actions should cause an improvement in improved health, improve the ability of the patient to function normally and improve the quality of life of the individual. The nurse and person should make all the necessary attempts to remove any obstacles that may hinder or derail these actions aimed at promoting his or her health status. The major concepts are explained in an explicit manner. The theorist explains all the three concepts mentioned above and comprehensively and cleared expressed and does not leave anything to be implied. The theorist also clearly states the ideas, spells out their main features and leaves no room for confusion. The author also clearly explains the relationship between the three concepts and how their outcomes and results affect each another. The three top concepts are the previous behavior related to health and personal factors, the different perceptions the patient have concerning health and what influences the perspectives and the adopted behavior for promoting health. These three concepts are related in that the past behavior influences the types of cognitions and perceptions that the individual has and finally has an effect on the kind of health-promoting behaviors that the patient will pursue. Evaluation Assumptions underlying the theory The theory has seven assumptions that have both behavioral science and nursing perspectives. These assumptions put an emphasis on the responsibility of the patient to start and maintain health behaviors and making the necessary changes in the environment (Butts & Rich, 2013). The assumptions are that individuals always desire to determine the circumstances they want to live in and the ones they believe will help them to express and use the human health potential, people have the capability to determine their personal abilities and assess their capabilities. Others are every individual desire to advance in the right direction as the individual tries to establish a balance between the change of behavior while maintaining health stability and that people want to have control over their actions (Ritter & Lampkin, 2011). Others are that every individual interact with their environment, change the environment to suit their needs and the people also evolve over time, and the professionals working in the health sector are a critical element of the interpersonal environment and have an effect on peoples’ lives. The other assumptions are that it is necessary for an individual to undertake personal initiatives to change the interactions with his or her environment to have a successful behavior change (Masters, 2014). The theory’s explanation of the four concepts of the nursing metaparadigm Nola’s Health Promotion Model identifies the four-metaparadigm concepts of nursing. According to Pender, the person concept of the model is the individual who is also the focus of the theory. According to the model, each has distinct attributes that influence his or her actions. An individual acquires certain behaviors depending on the family and the community they live in. The model proposes different elements for assessment and interventions at the individual, family and community levels. The environment concept according to the model is the physical, financial and interpersonal circumstances in which the person resides. The state of this environment is affected by the non-occurrence of toxic substances, the availability of corrective measures, and the availability of all the resources necessary for an individual to have a healthy life (Masters, 2014). The socioeconomic conditions include lack of employment, poverty, high crime rates and prejudice have negatives affects an individual’s health. However, if a person is able to maintain a good balance with the surrounding, he or she will acquire environmental wellness. The theory perspective of health is that health is a state of being that differs depending on internal and external influencers. Pender defined health as the human potential achieved through purposed behavior, engagement in self-care practice. In Nola Pender’s perspective, the nurse plays an significant role in providing the client with all the necessary information to enhance and improve the health status of the patient. The nurse performs this function better if he or she has sufficient confidence in his or her skills and knowledge. The most important goal of the nurses according to this theory is to assist the patients under their care to help the patients take care of themselves. The clarity of the theory The theory is clear. The theorist clearly explains her experiences and the conclusions she makes from those experiences in nursing. The theory also clearly explains the major concepts and assumptions. All the parts of the theory show consistency. Application How the theory would guide nursing actions The model offers nurses with a framework that assists them to offer nursing care aimed at improving the health and functioning ability of the patient’s under their care. The model provides an approach for the nurses to use to evaluate the health promoting behavior that the patient has and identify ways to change the behaviors. The model also provides the nurses with a systematic way to assess the different perceptions concerning the different personal and environmental factors that have had an impact on the type of health behavior that an individual patient has. The model also guides nursing actions by suggesting some of the interventions that nurses can make to change the client’s perceptions concerning health behaviors. If the nurses succeed in altering the patients’ perceptions, they increase their likelihood to influence the patient to change his health behavior and have improved wellness. How to use this theory in my area of nursing I work in a nursing home, which cares for older adults most of whom suffer from chronic illnesses. The people suffering from chronic diseases require good care to manage the conditions. I will use this theory in the nursing home by first assessing the health behaviors of each of the patients under my care. I will also determine the personal factors, the individual perceptions that the patients have concerning their health. These screenings will assist me to identify the needs of each of the patients, and will then determine the health promotion practices to use and tailor them according to the patient’s and family needs, values and beliefs. Effecting changes in the patients’ perceptions will involve identifying the cause of those perceptions and then teach the patients about the new practices and the need to change. I will then train the patients on the best way to use implement the vital health promoting behaviors, assist them to make the necessary change behaviors and evaluate the results of the behavior change on their state of health. The evaluation will include determining whether each of the patient’s health status has improved during the period and after making the change. The major areas I will consider for making interventions for health promotion will include social support, stress management, diet and physical exercise. The health promotion behavior to adopt will depend on the patient’s condition and ability. References Butts, J. B., & Rich, K. L. (2013). Philosophies and Theories for Advanced Nursing Practice. Burlington: Jones & Bartlett Publishers. Masters, K. (2014). Nursing Theories: a Framework for Professional Practice. Burlington: Jones & Bartlett Publishers. Orshan, S. A. (2008). Maternity, Newborn, and Women's Health Nursing: Comprehensive Care Across the Lifespan. Philadelphia: Lippincott Williams & Wilkins. Peterson, S. J., & Bredow, T. S. (2013). Middle Range Theories: Application to Nursng Research. Philadelphia: Lippincott Williams & Wilkins. Ritter, L. A., & Lampkin, S. M. (2011). Community Mental Health. Burllington: Jones & Bartlett Publishers. Zaccagnini, M. E., & White, K. (2010). The Doctor of Nursing Practice Essentials: A New Model for Advanced Practice Nursing. Burlington: Jones & Bartlett Publishers.