Health Promotion & Disease Prevention

Health o Customary action done to maintain /

promote health
 Highly individual perception  Beliefs
 Presence / absence of disease (traditional) o Embrace values
 State of well being & using every power o State / habit of mind wherein grp.
individual possesses to fullest extent (Florence People place trust into something
Nightingale)
 State of complete physical, mental & social Hereditary factor
well-being & not merely absence of disease
(WHO)  Genetic transmission of traits from parents to
offspring
Wellness
Environment factor
 Integrated method of functioning which is
oriented toward maximizing potential of  Sum total of all conditions, circumstances &
individual is capable elements that make up surroundings &
 Requires that individual maintains continuum of influence development of individual
balance & purposeful direction within  Environmental hazards:
environment where he is functioning o Pollution of water, air, soil
o Cigarette smoke
Illness o Radiation from sun’s UV rays /
machines & drugs which emit
 State in which someone’s needs are not
radiation
sufficiently met to allow individual to have
o Greenhouse effect
sense of physical & psychosocial well-being
o Sources of environmental
 Alteration in body functions resulting in
contamination (pesticides &
reduction of capacities / shortening of normal
chemicals)
life span
Socio-economic factor
FACTORS AFFECTING HEALTH
 Production act., distribution & consumption of
goods of individual
 Social & economic conditions are reflected in
individual’s standard of living

LEVELS OF HEALTH PREVENTION

Primary prevention

 Provide specific protection against disease to

prevent its occurrence in most desirable form of
prevention
 Preventive measures:
o Counseling
o Education
o Adoption of specific health practices /
changes in lifestyle
Political factor  Focuses on:
o Health promotion
 Involves leadership, governance &
o Protection against specific health
management of society which affect well-being
& welfare of community & individuals problems
 Political arm of society maintains order, Secondary prevention
enforces law & implements public health
regulation to protect people from diseases  Organized, direct screening efforts on
 Essential considerations: education of public to promote early case
o Political will finding of individual w/ disease so that prompt
o Empowerment intervention can be instituted to halt pathologic
o Oppression processes & limit disability
o Safety
Tertiary prevention
Cultural factor
 Begins in early in period of recovery from
 Nonphysical traits (values, beliefs, attitudes & illness & consist of act. As consistent &
customs) shared by grp. Of people & passed appropriate administration of medications to
from 1 generation to next optimize therapeutic effects, moving &
 Practices positioning to prevent complications of
o Attitudes & customs immobility & passive & active exercises to
prevent disability
 THEORIES RELATED TO HEALTH PROMOTION AND
HEALTH EDUCATION
Pender’s Health Promotion Theory (HPM)
 “Complementary counterpart to models of
health protection:
 Define health as (+) dynamic state not merely
absence of disease
 Describes multi-dimensional nature of persons
as they interact within environment to pursue
health
 “health promotion is sci. & art of helping people
change their lifestyle to move toward state of
optimal health”
 4 assumptions:
o Individuals strive to control own
behavior
o Individuals work to improve
themselves & environment
o Health professional compromise
interpersonal environment which
influences individual behaviors
o Self-initiated change of individual &
environmental characteristics is
essential to changing behavior
 Theoretical propositions
o Prior behavior & inherited & acquired
characteristics influence beliefs,
affect & enactment of health-
promoting behavior
o Person commit to engaging in
behaviors which they anticipate
deriving personally valued benefits
o Perceived barriers constrain
commitment to action, mediator of
behavior as well as actual behavior
o Perceived competence or self-
efficacy to execute a given behavior
increases the likelihood of
commitment to action and actual
performance of the behavior
o Greater perceived self-efficacy
results in fewer perceived barriers to
a specific health behavior
o Positive affect toward a behavior
results in greater perceived self-
efficacy, which can in turn, result in
increased positive affect
o When positive emotions or affect are
associated with a behavior, the
probability of commitment and action
is increased
o 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
o 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
o Situational influences in the external
environment can increase or
decrease commitment to or
participation in health promoting
behavior
o The greater the commitments to a
specific plan of action, the more likely
health promoting behaviors are to be
maintained over time
o 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
o 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
o Persons can modify cognitions,
affect, and the interpersonal and
physical environment to create
incentives for health actions
 Key concepts in nursing defined as basis for
HPM
 Major concepts of HPM
o Individual characteristics &
experiences
o Behavior-specific cognitions & affect
o Behavioral outcome – health
promoting behavior
Individual factors & experiences
 prior – related behavior (frequency of same /
similar health behavior in past)
 personal factors:
o biological
o sociocultural
o psychological
behavior-specific cognitions & affect
 perceived benefits of action
o anticipated positive outcomes that
occur from health behavior
 perceived barriers to action
o perceptions of block, hurdles &
personal costs of understanding
health behavior
 perceived self-efficacy
o judgement of personal capability
to organize & execute health
behavior
 activity-related affect
o subjective feeling states /
emotions occurring prior to,
during & ff. specific health
behavior
 interpersonal influences
 o cognition concerning behaviors,
beliefs / attitudes of others
o sources: families, peer, healthcare
providers
 situational influences (options, demand
characteristics, aesthetics)
o perceptions of compatibility of life
context / environment w/ engaging
in specific health behavior
 commitment to plan of action
o intention to carry out health
behavior including identification of
specific strategies to do
successfully
 immediate competing demands & Physical & emotional states - how one experiences
preferences
o alternative behaviors that intrude
into consciousness as possible
courses of action prior to intended
occurrence of planned health
behavior
behavioral outcome – health promoting behavior
 health promoting behavior
o desired behavioral end pt. /
outcome of health decision-
making & preparation for action
Social Cognitive Theory (albert Bandura)
 self-efficacy
o belief in one’s ability to succeed in
achieving outcome / reaching goal
o belief that one has the capabilities to
execute the courses of actions
required to manage prospective
situations
 self-efficacy influences 5 sources
Performance experience - one’s previous and related
experiences, which can influence their perception of
whether or not one has the competence to perform
the task at hand; influences self-efficacy the most
Vicarious experience - observed performances and
experiences of others like oneself in a similar
situation
Social persuasion - verbal encouragement or
discouragement about a person’s ability to perform;
more credible the source, the more impact this
source is likely to have on a person’s self-efficacy
Imaginal experience - person’s use of their
imagination to envision his or her success at a task
physical sensations and emotional states when
facing the task or challenge
 self – efficacy affects human function as well as
health behaviors
o Self-efficacy beliefs are cognitions
that determine whether health
behavior change will be initiated, how
much effort will be expended, and
how long it will be sustained in the
face of obstacles and failures.
o Self-efficacy influences the effort one
puts forth to change risk behavior
and the persistence to continue
striving despite barriers and setbacks
that may undermine motivation
Health Belief Model (HBM)
 understand the failure of people to adopt
disease prevention strategies or screening tests
for the early detection of disease
 uses of HBM were for patients' responses to
symptoms and compliance with medical
treatments
 suggests that a person's belief in a personal
threat of an illness or disease together with a
person's belief in the effectiveness of the
recommended health behavior or action will
predict the likelihood the person will adopt the
behavior
 derives from psychological and behavioral
theory two components of health-related
behavior
o desire to avoid illness, or conversely
get well if already ill
o belief that a specific health action will
prevent, or cure, illness
 components of HBM:
 o Perceived susceptibility - person's with the desired health behavior;
subjective perception of the risk of perceived severity was less often
acquiring an illness or disease associated with the desired health
o Perceived severity - person's feelings behavior
on the seriousness of contracting an o e individual constructs are useful,
illness or disease depending on the health outcome of
o Perceived benefits - person's interest, but for the most effective use
perception of the effectiveness of of the model it should be integrated
various actions available to reduce with other models that account for the
the threat of illness or disease environmental context and suggest
o Perceived barriers - person's feelings strategies for change
on the obstacles to performing a
recommended health action
o Cue to action - stimulus needed to
trigger the decision-making process
to accept a recommended health
action
o Self-efficacy - level of a person's
confidence in his or her ability to
successfully perform a behavior

 Limitations of HBM
o does not account for a person's
attitudes, beliefs, or other individual
determinants that dictate a person's
acceptance of a health behavior
o does not take into account behaviors
that are habitual and thus may inform
the decision-making process to
accept a recommended action
o does not take into account behaviors
that are performed for non-health
related reasons such as social
acceptability
o does not account for environmental
or economic factors that may prohibit
or promote the recommended action
o assumes that everyone has access
to equal amounts of information on
the illness or disease
o assumes that cues to action are
widely prevalent in encouraging
people to act and that "health"
actions are the main goal in the
decision-making process
 HBM is based on understanding that person
take health-related action if that person:
o feels that a negative health condition
can be avoided
o has a positive expectation that by
taking a recommended action, he/she
will avoid a negative health condition
o believes that he/she can successfully
take a recommended health action
o perceived susceptibility, benefits, and
barriers were consistently associated