FINAL COVERAGE

TFN ----- NOLA PENDER

‘THE HEALTH PROMOTION MODEL OF NURSING”
“Each person has unique personal
characteristics and experiences that affect
subsequent actions. The set of variables for
behavioral specific knowledge and effect have
important motivational significance. these variables
can be modified trough nursing actions. health
promoting behaviors should result in improve
health, enhanced functional ability and better
quality of life at all stages of development.
The Health Promotion Model
Nora Pender ---- former professor of Nursing at
the University of Michigan has developed a rational
–choice model of health care. This is not a theory
per se, but a psychological look at how human
beings perceive themselves, their health, and their
ability to change their lifestyle to promote health.
Features:
1. This model is based on the idea that human
being are rational and will seek their advantage in
health. but the nature of this rationality is bounded
by things like self esteem , perceived advantages of
healthy behaviors, psychological states and
previous behavior.
on the medical side in general, the main purposes
here is not merely to cure disease, but to promote
healthy lifestyle and choices that affect the health
of individuals.
Function
2. the central function of this theory is to show the
individual as self determining, but also determined
by personal history and general personal
characteristics.
Health is a dynamic process, not a static state.
health to put it differently, is a lifestyle conditioned
by a number of choices made by the individual to
actually live a healthy lifestyle.
Effects
3. The main effect of Penders model is that it puts
the onus (disagreeable necessity) reform on the
person, not on the profession.
healthcare is a series of intelligent, rational choices
that promote health concerning things like diet,
exercise and positive thinking… all of these are
choices and ingredients in living healthy. the real
struggle of the health profession, doctors and
nurses included, is to eliminate the self destructive
nature of unhealthy choices and replace them with
a healthy ones. unhealthy lifestyles . are the results
of distorted thinking that may be derived from
ignorance of lack of self esteem. if these thought
can be reformed (which is a lifelong process), then
rational choices can take their place, leading to a
truly healthy lifestyle.
Significance
4. Health is up to the person. the significance here
is that the medical profession is really not the main
ingredients in living a healthy lifestyle. they might
be an important part, but always serve a secondary
rule to the basic rational choices of healthy living.
the health profession, in other words is useless
unless individuals reform their own lives and
perceptions of what is healthy.
Considerations
5. As healthcare cost continue to climb, a rational
alternative to dependency on the medical
profession is the living of a rational e.g. healthy life.
a healthy lifestyle is the ultimate antidote to rising
healthcare cost, since a rational population is a
healthy one, which would naturally drivedown a
healthy cost.
Pender is an advocate of preventive medicine,
which is another word for rational, healthy thinking
and therefore healthy and rational living.
ERNESTINE WIEDENBACH(1964)
“CLINICAL NURSING --- A HELPING ART MODEL
The professional nurse has clarity of purpose,
mastery of needed skills, the ability to maintain
relationships, interest in advancing knowledge, and
dedication to furthering the good of humankind.
the practice of nursing involves identifying the
patients need for help, ministering the needed help
and validating that the actions were helpful.
History:
Ernestine Wiedenbach—was an early nursing
leader who is probably best known for her wotk in
theory development and maternal infant nursing.
 ms. weidenbach – was born into an affluent
family in 1900 and was brought in a refined and
gentile manor. her family immigrated from
Germany when she was young child and her
interest in nursing begun while watching the
care of her sickly grandmother .
  later she enjoyed hearing her sister’s friend who
was a medical student, accounts of his
experiences in the hospital setting.
 weidenbach was so impressed with the role of
nurses that after graduating from bachelor’s
degree in liberal arts from Wellesley college in
1922. she enrolled in nursing school much to
the dismay of her parents.
Overview of Weidenbach’s “The Helping Art of
clinical Nursing”
 According to her that nursing is nurturing and
caring someone in a motherly fashion.
 Nursing is a helping service that rendered with
compassion , skill, and understanding to those
in need of care, counsel and confidence in the
area of health.
 nursing wisdom is acquired through meaningful
experience.
Characteristics of a professional person that are
essential for the professional nurse include the
following;
 1. clarity of purpose
2. mastery ---- of skills and knowledge essential
for fulfilling the purpose .
3. ability ------ to establish and sustain purposeful
working relationship with others, both
professional and nonprofessional individuals.
4. interest----- in advancing knowledge in the
area of interest and in creating new knowledge.
5.. dedication ----- to furthering
the goal of mankind rather than to self
aggrandizement.

The art of nursing----- includes understanding

patients’ needs and concerns, developing goals and
actions intended to enhance patient’s ability and
directing the activities related to the medical plans
to improve the patients conditions.
The nurses also focus on prevention of
complications related in reoccurrences or
development of new concerns.
Three components in the practice of Nursing:
1. Identification of the patients need for help
2. ministration of the help needed.
3. validation ---- that the help provided was indeed
helpful to the patient.
Four distinct steps of the Identification component.
1. The nurse observes the patient, looking for
inconsistency between the expected behavior of
the patient and the apparent behavior.
2. she attempts to clarify what the inconsistency
means.
3. she determines the cause of inconsistency.
4. she validates with the patient that her help is
needed..
 in the “ministration” of the help needed
component, the nurse may give advice or
information, make a referral, apply a comfort
measure or carry out a therapeutic measure,
 may adjust the plan of action depending on the
response of the patient on what is being done,
 in the validation component of nursing practice,
the nurse verifies that the action were indeed
helpful. evidence must come from the patient
that the purpose of the nursing action has been
fulfilled .
 Three principles of Helping;
1. principle of inconsistency/consistency .
a. assessment of the patient to determine
some action word, or appearance that is
different from that expected-that is something
out of the ordinary for the patient.
2. principle of purposeful/perseverance ---- is
based on the nurse’s sincere desire to help the
patient. the nurse needs to strive to continue
her efforts to identify and meet the patient’s
need for help in spite of difficulties she
encounters while seeking to use her resources
and capabilities effectively and with sensitivity.
3. principle of self extension ----- recognize that
each nurse has limitations that re both personal
 and situational. it is important that she
recognize hens these limitations are reached
and that she seek help from others, including
through prayers.
Three concepts of Weidenbach prescriptive
theory.
1. the central purpose ---- which the
practitioner recognizes as essential to the
particular discipline.
2. prescription ----- for the fulfillment of the
central purpose.
3. the realities in the immediate situation ---
that influence the fulfillment of the central
purpose.

The Central Purpose:

 The nurse’s central purpose defines the quality
of health she desires to effect or sustain in her
patient and specifies what she recognizes to be
her special responsibility in caring for the
patient.
  It is that which the nurse wants to accomplish
through what she does.
 it is the overall goral toward which she is
striving.
 it is the nurses reason for being, the mission
she believes is hers to accomplish.
 this central purpose is based on the individual
nurses philosophy.
 philosophy, an attitude toward life and reality
that evolves from each nurses beliefs and code
of conduct, motivates the nurse to act, guides
her thinking about what she is to do and
influences her decisions.
The Prescription:
A prescription ----- is a directive to activity. it
specifies both the nature of the action that will
most likely, lead to fulfillment of the nurses central
purpose and the “thinking process” that determines
it.
 These actions may be voluntary (intended
response) or involuntary or unintended
response.
 A prescription --- is a directive of at least three
kinds of voluntary action:
 1. mutually understood and agreed upon action
( the patient and the nurse).
2. Recipient --- directed action (the patient-
directs the way it is to be carried out--- patient
participation).
3. practitioner ----- directed action (the nurse
carries out the action).
Once the nurse has established the prescription
(plan for patient care) she is ready to
implement it.

The Realities
 The nurse considers the realities of the situation
in which she is to provide nursing care, after she
had determined her central purpose and has
designed the prescription.
 Realities consist of all factors ---- physical,
physiological, psychological, emotional and
spiritual----- that influence the situation in
which nursing actions occur at any given
moment.
 Wiedenbach identifies the realities as follows.
1. the agent
2. the recipient
3. the goal
4. the means
5. the framework…

A. Agent
 is the practicing nurse or her delegate, is
characterized by personal attributes, capacities,
capabilities and most importantly, commitment
and competence in nursing.
B . The recipient
 is the patient, who is characterized by personal
attributes, problems, capabilities, aspirations
and most important, the ability to cope with the
concerns or problems being experienced.
 C. The Goal
 Is the desire outcome the nurse wishes to
achieve. the goal is the end result to be attained
by nursing action.
 the goal gives focus to the nurses action and
implies her reason for taking.
D. The Means
 it comprises the activities and devices through
which the nurse/practitioner is enabled to
attain her goal.
 the means includes skills, techniques,
procedures and devices that may be used to
facilitate nursing practice.
E. The Framework
 consist of human, environmental, professional
and organizational facilities that not only make
up its the context within which nursing is
practiced but also constitute its currently
existing limits.
IMOGENE KING

SYSTEM FRAMEWORK AND GOAL ATTAINMENT

THEORY…
History:
= Imogene king received her diploma in nursing
from St john;s hospital school of nursing in St.
louis, missouri in 1945 and her bachelor and
masters of science degree in nursing from st
loius university.
= Dr king receivethe American Nurses
Association Jessie M.Scott Award for her
contributions to demonstration the
interrelationship among nursing practice,
education and research.

king’s conceptual framework includes three

interacting system namely;
1. personal system
2. social system
3. interpersonal system
 A. Personal system:
 individuals are personal system . each individual
is an open, total, unique system in constant
interaction with the environment.
 following concepts contributes understanding
individuals as personal system;
1. perception
2. self image
3. growth and development
4. body image
5. SPACE
6. time
 Perception:===a process of organizing ,
interpreting, and transforming information from
sense of data and memory.