Nursing-Theories-on-Health-and-Nursing-Practice.pdf

Nursing Theories on Health and Nursing Practice Prof. Tyrone Hora RN, MAN, JD. Presentation Outline: Learning Outcomes Describe the following nursing theories related to health. Health as Expanding Consciousness – Margaret Newman Health Promotion Model – Nola Pender Health Belief Model –...

Nursing Theories on Health and Nursing Practice Prof. Tyrone Hora RN, MAN, JD. Presentation Outline: Learning Outcomes Describe the following nursing theories related to health. Health as Expanding Consciousness – Margaret Newman Health Promotion Model – Nola Pender Health Belief Model – Irwin Rosenstock Discuss the major concepts of the theories. Health as Expanding Consciousness – Margaret Newman: Theoretical Assertion – (declaration) The theory asserts that; - every person in every situation, no matter how disordered and hopeless it may seem, is part of the universal process of expanding consciousness. Health as Expanding Consciousness – Margaret Newman: Theoretical Assertion – (declaration) Expanding consciousness – is a process of becoming more of oneself, of finding greater meaning in life, and of reaching new dimensions of connectedness with other people and the world.” Health as Expanding Consciousness – Margaret Newman: Major theoretical concepts (Newman, 2004) Time, space, and movement are dimensions of pattern and consciousness. As her theory evolved, the major concepts of her theory includes; health, consciousness, patterns of movement and space-time. Margaret Newman: Major theoretical assumptions According to Newman, 2008, these are her theoretical assumptions which supports her theory which includes; 1. Health encompasses conditions heretofore described as illness or, in medical terms pathology. 2. These pathological conditions can be considered as manifestation of the total pattern of an individual. 3. The pattern of the individual that eventually manifests itself as pathology is primary and exist before structural and functional changes. Margaret Newman: Major theoretical assumptions According to Newman, 2008, these are her theoretical assumptions which supports her theory which includes; 4. Removal of pathology itself will not change the pattern the pattern of an individual. 5. If becoming ill is the only way an individual’s pattern can manifest itself, then, that is health for the person. 6. Health is an expansion of consciousness. Health as Expanding Consciousness – Margaret Newman According to Newman, “The theory of health as expanding consciousness (HEC) was stimulated by concern for those for whom health as the absence of disease or disability is not possible. Nurses often relate to these people: people facing the uncertainty, debilitation, loss and eventual death associated with chronic illness. Health as Expanding Consciousness – Margaret Newman According to (Newman, 1994), “When we begin to think of ourselves as centers of consciousness…within an overall pattern of expanding consciousness, we can begin to see that what we sense of our lives is that is the person; then, broadening the focus, the pattern of consciousness that is the family and physical surroundings; then, the pattern that is the community, the person’s larger environmental affiliations, such as work or school; and ultimately the pattern of the world. It is this pattern of the whole that is the phenomenon of nursing’s practice.” Health as Expanding Consciousness – Margaret Newman: Model/ Theory Illustration Health Promotion Model by Nola Pender  Health Promotion Model by Nola Pender According to (Nola Pender,1982) “Each person has a unique personal characteristics and experiences that affects subsequent actions. The set of variables for behavioral specific knowledge and effect have important motivational significance. These variables can be modified through nursing actions.”  Health Promotion Model by Nola Pender According to (Nola Pender,1982) “Health promoting behaviors should result in improved health, enhanced functional ability and better quality of life at all stages of development.” Health Promotion Model: Theoretical Assumption 1. Individuals seek to actively regulate their own behavior. 2. Individuals in all their biopsychosocial complexity interact with the environment, progressively transforming the environment and being transformed overtime. Health Promotion Model: Theoretical Assumption 3. Health professionals constitute a part of the interpersonal environment, which exerts influence on person throughout their life span. 4. Self initiated reconfiguration of the person-environment interactive patterns is essential to behavior change. Health Promotion Model: Major Concepts HPN Major Concepts includes; individual characteristics and experience, prior related behavior, personal factors, perceived benefits of action, perceive barrier to action, perceived self efficacy, behavioral outcomes, commitment to plan of action, and health promoting behavior. Health Promotion Model: Major Concepts illustration What is Health Promotion Model? “Health promotion is directed at increasing a patient’s level of well being.” “Patient’s quality of life could be improved by the prevention of problems before this occurred, and health dollars could be saved by the promotion of healthy life style.” Nola Pender(1982, 1996) What is Health Promotion Model? The focus of HPN is to increase the patient’s well being and achieved ideal health(Pender, 2011). HPN is foundation for determining motivation and guides nurses intervention (Alkhalaileh, Bani Khaled, Baker, and Bond, 2011). Health Promotion VS Disease Prevention Health Promotion Model: Relevance Health Promotion Model: Relevance Health Belief Model: by Irwin Rosenstock The Health Belief Model This theory suggests that individuals’ beliefs about their health and the actions they take are influenced by their perceptions of susceptibility to illness, the severity of the illness, the benefits of taking preventive actions, and the barriers to taking those actions. It was developed in the 1950s by social psychologists Irwin M. Rosenstock, Godfrey Hochbaum, Stephen Kegels. The Health Belief Model Irwin M. Rosenstock, Godfrey Hochbaum, Stephen Kegels Originally developed to explain people’s participation in programs to prevent and detect disease and their behaviors in response to diagnosed illnesses, the Health Belief Model (HBM) has been successfully adapted to topics across diverse fields of study. The Health Belief Model: Theoretical assumption Irwin M. Rosenstock, Godfrey Hochbaum, Stephen Kegels An assumption of HBM is that demographic, structural, and psychosocial factors moderate individual beliefs and indirectly influence health behaviors. However, the model does not specify how such factors operate or interact with other constructs. The Health Belief Model: Theoretical assumption Irwin M. Rosenstock, Godfrey Hochbaum, Stephen Kegels The HBM posits that people are likely to engage in a health-related behavior if they believe that: 1. They are susceptible to a condition (at risk for a disease); 2. The condition could have potentially serious consequences; 3. The behavior could be of benefit in reducing their susceptibility to, or the severity of, the condition; 4. Their perceived barriers (or costs) are outweighed by the benefits and are not strong enough to prevent action; and 5. They believe that they can carry out the behavior successfully. The Health Belief Model: Major concepts Irwin M. Rosenstock, Godfrey Hochbaum, Stephen Kegels Individual beliefs Perceived Susceptibility – One’s beliefs about the risk of getting a health-related condition. Perceived Severity – One’s beliefs about the seriousness of a health-related condition, including medical and social consequences. Perceived Threat – The combination of one’s beliefs about their susceptibility to, and severity of, a condition. The Health Belief Model: Major concepts Irwin M. Rosenstock, Godfrey Hochbaum, Stephen Kegels Perceived Benefits – One’s beliefs about the positive aspects of adopting a behavior (e.g., the effectiveness of the behavior in reducing risk or serious consequences). Perceived Barriers – One’s beliefs about obstacles to performing a behavior, and the negative aspects (both tangible and psychological costs) of adopting a behavior. Perceived Self-efficacy – One’s beliefs about their ability to successfully perform a behavior. Action Cues to Action – Internal (e.g., health symptoms) or external (e.g., family pressure) factors that trigger the decision to engage in a behavior. The Health Belief Model Irwin M. Rosenstock, Godfrey Hochbaum, Stephen Kegels a The Health Belief Model Irwin M. Rosenstock, Godfrey Hochbaum, Stephen Kegels a The Health Belief Model: Relevance to practice Irwin M. Rosenstock, Godfrey Hochbaum, Stephen Kegels The HBM predicts whether and why people will take action to prevent, detect, or control health conditions. The model applies to behaviors with the potential to reduce risk of developing a disease as well as the effects of an existing disease (e.g., medication adherence).  The Health Belief Model: Relevance to practice Irwin M. Rosenstock, Godfrey Hochbaum, Stephen Kegels Example application to risky behavior Unhealthy eating habits and obesity Thank you…