1

2
The health promotion model
(HPM)
⮚proposed by Nola J Pender (1982;
revised, 1996)

⮚was designed to be a
“complementary counterpart to
models of health protection.”
4 The model focuses on following
three areas:

1.Individual characteristics and

experiences

2.Behavior-specific cognitions and

affect

3. Behavioral outcomes
 Concepts Of The Theory

❑ Prior Related Behavior: this concept determines the

extent to which past behaviors are has an influence
on present health promoting behaviors.

❑ Personal Factors: The extent to which biological,

psychological, and sociocultural predicts or shapes
the individual(s) health promoting activities.

❑ Perceived Benefits of Action: the benefits which are

earned as a result of embarking on health activities.

(Alligood & Tomey, p 438 – 439)

 Concepts of the Theory
❑ Perceived Barriers to Action: known or imaginary
obstacles, such as finances, which may impede
health promoting activities.

❑ Perceived Self-Efficacy: A self-awareness of one’s

strengths and how it motivates the individual to
pursue and achieve health promoting behaviors.

❑ Activity – Related Effect: interplay of how other

activities unrelated to health promotion, affect the
individual outlook on health promotion activities.
(Alligood & Tomey, p 438 – 439)
 Concepts Of Theory
❑ Situational Influences: how the unforeseen and
unpredicted activities influence the individual, or whether
unexpected situations gear the individual toward, or steer
the individual from partaking in health promotion activities.

❑ Commitment to a Plan of Action: Specific plans outlined to

ensure health promotion strategies.

❑ Immediate Competing Demands and Preferences: this

includes family, friends, school, work, all of which are
important elements of the individual’s life, but when not
managed properly can be deterrence to the achievement
of health promoting behaviors.
(Alligood & Tomey, p 438 – 439)
 Concepts of the Theory
❑ Health Promoting Behavior: includes activities
such as exercising, eating a healthy diet,
managing stress, nurturing ones’ self spiritually,
ensuring sufficient rest, all of which aims to
generate positive health outcomes

❑ Interpersonal Influences: how the various

relationships in the individual(s) life affect their
participation in health promotion behaviors.

(Alligood & Tomey, p 438 – 439)

Transcultural Nursing

(1925 – 2012)

Madeleine
Leininger
TRANSCULTURAL NURSING

odefined “as a discipline of study and

practice focused on comparative culture
care differences and similarities among
and between cultures in order to assist
human beings to attain and maintain
meaningful and therapeutic health care
practices that are culturally based”
(Leininger)
Concepts Culture Care Theory:

oCare “as those assistive,

supportive, and enabling
experiences or ideas towards
others with evident or anticipated
needs to ameliorate or improve a
human condition or lifeway”
(Leininger)
Concepts Culture Care Theory:

oCaring Culture

⮚Defined as the learned, shared,

and transmitted values, beliefs,
norms, and lifeways of a particular
culture that guides thinking,
decisions, and actions in patterned
ways and often intergenerationally.
Concepts Culture Care Theory:

oEmic and Etic Care- to identify

differences and similarities among and
between cultures.

❖Emic refers to the local, indigenous,

or insider’s cultural knowledge and view
of specific phenomena.
❖Etic refers to the outsider’s or
stranger’s views and often health
professional views and in situational
knowledge of phenomena.
Concepts Culture Care Theory:

o Social structure factors of clients

include:
▪ religion (spirituality) ▪ technology
▪ kinship (social ties) ▪ political factors
▪ politics ▪ philosophy of life
▪ legal issues ▪ cultural beliefs, values
▪ education with gender and class
differences
▪ economics
Concepts Culture Care Theory:

o Ethnohistory – defined as the past

facts, events, instances, and
experiences of human beings,
groups, cultures, and institutions that
occur over time in particular contexts
that help explain past and current
lifeways about culture care
influencers of health and wellbeing or
the death of people.
Concepts Culture Care Theory:

o Environmental context - refers to

the totality of an event, situation, or
particular experiences that gives
meaning to people’s expressions,
interpretations, and social interactions
within particular physical,
ecological, spiritual, socio political,
technologic factors in cultural settings
Concepts Culture Care Theory:

oNursing Worldview - refers to the

way people tend to look out upon
their world or their universe to form a
picture or value stance about life or
the world around them
Concepts Culture Care Theory:

o Culturally Congruent Care - refers

to culturally based care knowledge,
acts and decisions used in sensitive
and knowledgeable ways to
appropriately and meaningfully fit the
cultural values, beliefs, and lifeways
of clients for their health and
wellbeing, or to prevent illness,
disabilities, or death
Concepts Culture Care Theory:

o Care Diversity - refers to the

differences or variabilities among
human beings with respect to culture
care meanings, patterns, values,
lifeways, symbols or other features
related to providing beneficial care to
clients of a designated culture.
Concepts Culture Care Theory:

o Culture Care Universality - refers

to the commonly shared or similar
culture care phenomena features of
human beings or group with recurrent
meanings, patterns, values, lifeways,
or symbols that serve as a guide for
care givers to provide assistive,
supportive, facilitative, or enabling
people care for healthy outcomes.
KEY COMPONENTS OF
THEORY:

oCultural preservation

oCultural accommodation

oCultural repatterning
CULTURAL PRESERVATION:

oAn attempt to preserve patient

culture by incorporating this into the
plan of care.
CULTURAL ACCOMMODATION:

oAdapting or adjusting a patient’s

plan of care to meet their specific
cultural needs.

oAlso referred as cultural

negotiation
CULTURAL REPATTERNING:

o“Working with clients to develop

new patterns that extend beyond
the client’s usual way of doing
things, while respecting traditional
values and beliefs.” (“Practice
Guidelines,” 2009, p. 11)
TRANSCULTURAL NURSING THEORY:

oThis theory is considered a Grand theory

since it can be universally applied across
the field of nursing.

oGrand theories are broad in scope and

can be used in all nursing situations
(Meleis , 2012).
26

Margaret Newman
(1933 – Present)
27

Major Concepts
1) Health:

▪ In Newman’s theory, health is an

expansion of consciousness defined as the
informational capacity of the system and
seen as the ability of the person to interact
with the environment
▪ According to Newman “Health is the
pattern of the whole, and wholeness is One
cannot lose it or gain it”.
28

Major Concepts
2) Consciousness:

▪Consciousness includes not only the

cognitive and affective awareness normally
associated with consciousness, but also the
interconnectedness of the entire living system,
which includes physiochemical maintenance
and growth processes as well as the immune
system.
29

Major Concepts
3) Pattern:

▪Pattern characterized by “movement,

diversity, and rhythm” and is described as a
“design, or framework as is seen in person-
environment interactions”
30

Major Concepts
3) Pattern:

▪Pattern recognition is the “insight or recognition of a

principle, realization of a truth, or reconciliation of a
duality” and is “key to the process of evolving to a
higher level of consciousness”.
31

▪ Three Correlates of Consciousness(Movement-

Space-Time): Pattern has dimensions of
movement and Parallel between Newman’s
theory of expanding consciousness and
Young’s stages of human evolution
32