Health and medicine

1. :
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2. • BIOGRAPHY OF NOLA PENDER
• INTRODUCTION TO HEALTH PROMOTION MODEL
• METAPARADIGM OF HEALTH PROMOTION MODEL ‘
• MAJOR CONCEPT
• SUBCONCEPT
• MAJOR ASSUMPTIONS OF HEALTH PROMOTION
MODEL
• PROPOSITON OF THE MODEL
• STRENGHTS AND WEAKNESS OF THE MODEL
• APPLICATION OF HEALTH PROMOTION MODEL TO
COMMUNITY HEALTH NURSING
• CONCLUSION

3. Nola J. Pender (1941– present) is a nursing theorist
who developed the Health Promotion Model in 1982.
 She is also an author and a professor emeritus of
nursing at the University of Michigan. She started
studying health-promoting behavior in the mid-1970s
and first published the Health Promotion Model in
1982.
Her Health Promotion Model indicates preventative
health measures and describes nurses’ critical function
in helping patients prevent illness by self-care and bold
alternatives.
 Pender has been named a Living Legend of the
American Academy of Nursing.

4. Nola Pender’s Health Promotion Modeltheory was
originally published in 1982 and later improved in 1996
and 2002. It has been used for nursing research,
education, and practice.
 Applying this nursing theory and the body of knowledge
that has been collected through observation and
research, nurses are in the top profession to enable
people to improve their well-being with self-care and
positive health behaviors.

5. CONT....
• According to Nola J. Pender, Health Promotion and Disease Prevention
should focus on health care. When health promotion and prevention fail to
anticipate predicaments and problems, care in illness becomes the
subsequent priority.
• 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 effect have important
motivational significance. These variables can be modified through nursing
actions. Health-promoting behavior is the desired behavioral outcome and
is the endpoint in the Health Promotion Model.
• Health-promoting behaviors should result in improved health, enhanced
functional ability, and better quality of life at all development stages. The
final behavioral demand is also influenced by the immediate competing
demand and preferences, which can derail intended health- promoting
actions.

6.  The “first meta-paradigm of health promotion is person” Pender’s
model treats human beings as autonomous and unique creatures.
The theorist focuses on the best concepts and ideas towards
improving the health outcomes of every patient. This meta-
paradigm also includes “social groups, vulnerable populations,
healthy societies, patients, and families
 The second meta-paradigm is health. Nola does not identify
health as a clinical subject. According to the theorist, health exists
within “the context of the issues and concerns affecting different
people”. The model promotes the best health outcomes in every
human being.

7.  The “third nursing meta-paradigm is environment” Every health
outcome depends on the stability of the surrounding environment.
Human beings have both internal and external environments. The
model explains how the environment influences the health
experiences of different patients. Socio-cultural, economic, and
religious dimensions also affect people’s health practices.
 Nursing practice is the fourth meta-paradigm. Caregivers can use
this theory to provide evidence-based support to their patients.
Pender’s theory offers numerous strategies towards better nursing
practice. The model explains why “nursing focuses on health support
and disease prevention This meta-paradigm “combines every aspect
of nursing such as the environment and human health.

8. • Health promotion is defined as behavior 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 behavior motivated desire to actively avoid
illness, detect it early, or maintain functioning within illness constraints.
They include;
• Individual characteristics and experiences (prior related behavior and
personal factors).
• Behavior-specific cognitions and affect (perceived benefits of action,
perceived barriers to action, perceived self-efficacy, activity-related
affect, interpersonal influences, and situational influences).
• Behavioral outcomes (commitment to a plan of action, immediate
competing demands and preferences, and health-promoting behavior)

9. SUBCONCEPT OF HEALTH PROMOTION
MODEL
• Personal Factors
Personal factors are categorized as biological, psychological, and socio-cultural. These
factors are predictive of a given behavior .
Personal biological factors include variables such as age, gender, body mass index ,
pubertal status, aerobic capacity, strength, agility, or balance.
Personal psychological factors Include variables such as self-esteem, self-
motivation, personal competence, perceived health status, and definition of health.
Personal socio-cultural factors Include variables such as race, ethnicity,
acculturation, education, and socioeconomic status.
• Perceived Benefits of Action
Anticipated positive outcomes that will occur from health behavior. Perceived Barriers
to Action Anticipated, imagined, or real blocks and personal costs of understanding a
given behavior.

10. Cont…
• Perceived Self-Efficacy
The judgment of personal capability to organize and
execute a health-promoting behavior. Perceived self-
efficacy influences perceived barriers to action, so higher
efficacy results in lowered perceptions of barriers to the
behavior’s performance

11. .
• Situational Influences
Personal perceptions and cognitions of any given situation or context
can facilitate or impede behavior. 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 behavior.
• Commitment to Plan of Action
The concept of intention and identification of a planned strategy leads
to the implementation of health behavior.
Health-Promoting Behavior A health-promoting behavior is an
endpoint or action-outcome directed toward attaining positive health
outcomes such as optimal wellbeing, personal fulfillment, and
productive living.

12. • Individuals seek to regulate their own behavior actively.
• Individuals in all their biopsychosocial complexity interact
with the environment, progressively transforming the
environment and being transformed over time.
• Health professionals constitute a part of the interpersonal
environment, which influences persons throughout their
life span.
• Self-initiated reconfiguration of person-environment
interactive patterns is essential to behavior change

13. • Theoretical statements derived from the model provide a basis for investigative
work on health behaviors. The HPM is based on the following theoretical
propositions: 1. Prior behavior and inherited and acquired characteristics influence
beliefs, affect, and enactment of health-promoting behavior.
• 2. Persons commit to engaging in behaviors from which they anticipate deriving
personally valued benefits
• 3. Perceived barriers can constrain commitment to action, a mediator of behavior
as well as actual behavior
• . 4. Perceived competence or self-efficacy to execute a given behavior increases
the likelihood of commitment to action and actual performance of the behavior.
• 5. Greater perceived self-efficacy results in fewer perceived barriers to a specific
health behaviour
• Positive affect toward a behavior results in greater perceived self-efficacy, which
can in turn, result in increased positive affect.
• 7. When positive emotions or affect are associated with a behavior, the probability
of commitment and action is increased.

14. • Strengths
The Health Promotion Model is simple to understand, yet
diving deeper shows its complexity in its structure.
Nola Pender’s nursing theory focused on health
promotion and disease prevention, making it stand out
from other nursing theories.
 It is highly applicable in the community health setting.
 It promotes the nursing profession’s independent
practice, being the primary source of health-promoting
interventions and education.

15. • The Health Promotion Model of Pender could not define
the nursing metapradigm or the concepts that a nursing
theory should have, man, nursing, environment, and
health.
• The conceptual framework contains multiple concepts,
which may invite confusion to the reader.
• Its applicability to an individual currently experiencing a
disease state was not given emphasis

16. • The model can be used to prevent diseases and health-related
infections or injuries.
• It helps Nurses to consult clients to promote well-being.
• It is used to explain the patients’ risk factors.
• it helps Nurses to plan for behavior modification with the aim of
assisting in health improvement.
• it helps Nurses to prevent unhealthy behaviors.
• The model has had an impact on increasing health awareness.
• Health promotion model has made the value of a healthy
lifestyle become more significant.

17. • The thinking behind health promotion departs from the
biomedical model of health and considers how biological,
psychological and social factors interact to affect the
health and health outcomes of individuals, communities
and population groups
• It gives an accurate and in-depth understanding of what
health means to people and how health is experienced
enables healthcare professionals, planners and
policymakers to develop and deliver health promotion
interventions that prevent suboptimal health and address
health inequalities.