HOLY FAMILY COLLEGE OF
NURSING
SUBJECT: ADVANCED NURSING
PRACTICE
AN ASSIGNMENT ON
‘HEALTH PROMOTION
MODEL’
SUBMITTED TO SUBMITTED ON SUBMITTED BY
Ms. Smitha jose 15 /04/2024 Ms. Priya
Professor M.sc Nursing 1st year
Holy Family College of Nursing Holy Family College of Nursing
HEALTH PROMOTION MODEL
INTRODUCTION
It is proposed by Nola J Pender (1982; revised,1996) was designed to be a "complementary counterpart to
models of health protection". She defines health as a positive dynamic state not merely the absence of
disease. It is directed at increasing a client's level of well-being. It describes the multi-dimensional nature of
persons as they interact within their environment to pursue health.
DEFINITION
According to Nola J Pender, "Health promotion is the science and art of helping people change their
lifestyle to move towards a state of optimal health".
ASSUMPTIONS OF HEALTH PROMOTION MODEL
o Individuals seek to actively regulate their own behaviour.
o Individuals in all their biopsychosocial complexity interact with the environment, progressively
transforming the environment and being transformed over time.
o Health professionals constitute a part of the interpersonal environment, which exerts influence on
persons throughout their lifespan.
o Self-initiated reconfiguration of person environment interactive patterns is essential to behaviour change.
MAJOR CONCEPTS OF HEALTH PROMOTION MODEL
Health promotion is defined as behaviour motivated by the desire to increase well-being and actualize
human health potential. It is an approach to wellness. On the other hand, health protection or illness
prevention is described as behaviour motivated desire to actively avoid illness, detect it early or maintain
functioning within the constraints of illness.
1. Individual characteristics and experiences (prior related behaviour and personal factors).
2. Behaviour-specific cognitions and affect (perceived benefits of action, perceived barriers to action,
perceived self-efficacy, activity-related affect, interpersonal influences and situational influences.
3. Behavioural outcomes (commitment to a plan of action, immediate competing demands and preferences
and health-promoting behaviour).
SUB-CONCEPTS
1. Personal Factors
Personal factors categorized as biological, psychological and socio-cultural. These factors are predictive of a
given behaviour and shaped by the nature of the target behaviour being considered.
(i) Personal Biological Factors: It includes variable such as age, gender, body mass index, pubertal status,
aerobic capacity, strength, agility or balance.
(ii) Personal Psychological Factors: It includes variables such as self-esteem, self-motivation, personal
competence perceived health status, and definition of health.
iii) Personal Socio-Cultural Factors: It includes variables such as race, ethnicity, acculturation, education
and socio-economic status.
2. Perceived Benefits of Action
It anticipated positive outcomes that will occur from health behaviour.
3. Perceived Barriers to Action
It anticipated, imagined or real blocks and personal costs of understanding a given behaviour.
4. Perceived Self-Efficacy
The judgment of personal capability to organize and execute a health-promoting behaviour. Perceived self
efficacy influences perceived barriers to action so higher efficacy result in lowered perceptions of barriers to
the performance of the behaviour.
5. Activity-Related Affect
It is based on subjective positive or negative feeling that occurs before, during and following behaviour
based on the stimulus properties of the behaviour itself. It influences perceived self-efficacy, which means
the more positive the subjective feeling, the greater the feeling of efficacy. In turn, increased feelings of
efficacy can generate further positive affect.
6. Interpersonal Influences
It is cognition concerning behaviours, beliefs, or attitudes of the others. Interpersonal influences include:
norms (expectations of significant others), social support (instrumental and emotional encouragement) and
modeling (vicarious learning through observing others engaged in a particular behaviour). Primary sources
of interpersonal influences are families, peers and healthcare providers.
7. Situational Influences
Personal perceptions and cognitions of any given situation of 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.
8. Commitment to Plan of Action
The concept of intention and identification of a planned strategy leads to implementation of health
behaviour.
9. Immediate Competing Demands and Preferences
Immediate competing demands are those alternative behaviours over which individuals have a lesser control
because there are environmental contingencies such as work or family care responsibilities.
10. Health-Promoting Behaviour
These competing preferences are alternative behaviours over which individuals exert relatively high control,
such as choice of ice cream or apple for a snack.
PROPOSITIONS OF HEALTH-PROMOTION MODEL
o Prior behaviour, inherited and acquired characteristics influence beliefs, affect and enactment of health
promoting behaviour.
o Persons commit to engaging in behaviours from which they anticipate deriving personally valued
benefits.
o Perceived barriers can constrain commitment to action, a mediator of behaviour as well as actual
behaviour.
o Perceived competence or self-efficacy to execute a given behaviour increases the likelihood of
commitment to action and actual performance of the behaviour.
o Greater perceived self-efficacy results in fewer perceived barriers to a specific health behaviour.
o Positive affect towards a behaviour results in greater perceived self-efficacy, which can in turn, result in
increased positive affect.
o When positive emotions or effects are associated with a behaviour, the probability of commitment and
action is increased.
o Persons are more likely to commit to and engage in health-promoting behaviours when significant others
model the behaviour, expect the behaviour to occur, provide assistance and support to enable the
behaviour.
o Families, peers, healthcare providers are important sources of interpersonal influence that can increase or
decrease commitment to and engagement in health-promoting behaviour.
o Situational influences in the external environment can increase or decrease commitment to or
participation in health-promoting behaviour.
o The greater the commitments to a specific plan of action, the more likely health-promoting behaviours
are to be maintained over time.
o Commitment to a plan of action is less likely to result in the desired behaviour 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 behaviour when other actions are
more attractive and thus preferred over the target behaviour.
o Persons can modify cognitions, affect the interpersonal and physical environment to create incentives for
health actions.
HEALTH PROMOTION INTERVENTIONS
Health promotion is the process of enabling people to increase control over, and to improve health. It is not
directed against any particular disease, but is intended to strengthen the host through a variety of approaches
(interventions). The well known interventions in this area are
i. Health education
ii. Environmental modification
iii. Nutritional interventions
iv. Life style and behavioral changes
1. Health education
This is one of the most cost effective interventions. A large number of diseases could be prevented with little
or no medical interventions. If people were adequately informed about them and if they were encouraged to
take necessary precautions in time "the extension to all people of the benefits of medical, psychological and
related knowledge is essential to the fullest attainment of health". The targets of educational efforts may
include the general public, patients, priority groups, health providers, community leaders and decision
makers.
2. Environmental modifications
A comprehensive approach to the health promotion requires environmental modifications such as provision
of safe water, installation of sanitary latrines, control of insects and rodents, improvement of housing etc.
The history of medicine has shown that many infectious diseases have been successfully controlled in many
countries through environmental modifications, even prior to the development of the specific vaccines or
chemotherapeutic drugs. Environmental interventions are non clinical and do not involve any physician.
3.Nutritional interventions
These comprise food distribution and nutrition improvement of vulnerable groups, child feeding
programmes, food fortification, nutrition education etc.
4. Life style and behavioral changes
The conventional public health measures and interventional public health measures and interventions
have not been successful in making inroads into life style reforms. The action of prevention in this case is
one of the individual and community responsibilities for health. The physician and in fact each health team
worker acts as an educator than a therapist. Health education is the basic element of all health activity. It is
of paramount importance in changing the views, behavior and habits of people.
Hence health promotion consist of a broad spectrum of activities, a well conceived health promotion
programme would attempt first to identify the target groups or at risk individuals in a population and then
direct more appropriate message to them. Goals must be defined. Means and alternative means of
accomplishing them must be explored. It involves organizational, social, political and economic
interventions designed to facilitate environmental and behavioral adaptations that will improve
to protect health.
STRENGTHS OF HEALTH PROMOTION MODEL
o It is simple to understand, yet it is complex in structure.
o Her theory gave much focus on health promotion and disease prevention making it stand out from other
nursing theories.
o It is highly applicable in the community health setting.
o It promotes the independent practice of the nursing profession being the primary source of health
promoting interventions and education.
WEAKNESSES OF HEALTH PROMOTION MODEL
o The model of Pender was not able to define the four most important concepts that a nursing theory
should have: man, nursing, environment and health.
o The conceptual framework contains multiple concepts which may invite confusion to the reader.
o Its applicability to an individual currently experiencing a disease state was not given emphasis.
SUMMARY
Health promotion is the science and art of helping people change their lifestyle to move towards a state of
optimal health. At the beginning of the 20 century, a new concept, the concept of health "promotion" began
to take shape. It was realized that public health had neglected the citizen as an individual, and that the state
had a direct responsibility for the health of the individual. Consequently in addition to disease control
activities, one more goal was added to public health, ie health promotion of the individuals. It was initiated
as personal health services such as mother and child health services, mental health and rehabilitation
services. Public health departments began expanding their programmes towards health promotional
activities. This programme tried to do too much too quickly with inadequate resources. It was a great
opportunity lost, because it failed to survive. However, the establishment of primary health centres and
subcentres provided the much needed infrastructure of health services' especially in the rural areas. Health
promotion is the process of enabling people to increase control over, and to improve health.
CONCLUSION
The health promotion model notes that each person has unique personal characteristics and experiences that
affect subsequent actions. The set of variables for behavioral specific knowledge and affect have important
motivational significance. These variables can be modified through nursing actions. Let us promote health
make the universe disease free.
BIBLIOGRAPHY
1. Brar.N.K., Rawat.H.C, Text book of advanced nursing practice, 1 st edition, Jaypee Publication:
Haryana,2015, Page no
2. Gauttam,V.K., A comprehensive text book for advanced nursing practice, 1st edition, Kumar publishing
house: New Delhi, 2009, page no 666-670
3. Basheer,S.P., Khan, S.Y., A concise text book of advanced nursing practice, 2 nd edition, EMMESS
Publications :New Delhi,2017, page no 689-690
