Every person’s features and experiences, according to the Health Promotion Model (HPM), influence their subsequent behaviors. The collection of variables for behaviorally particular knowledge and impact has much motivating power. Nursing interventions can change these factors and alter the current care regimen. The targeted behavioral objective and endpoint of the HMP are promoting healthy behaviors. At all phases of development, such practices should result in increased health, functional capacity, and quality of life (McEwen & Wills, 2019). The main purpose is to assess the Health Promotion Model by using the example of a specific population category and analyzing the relevance of the theory. The individual aspects of the selected sample, particularly older adults, will be analyzed based on the possibilities of promoting health in the face of existing constraints and restrictions. As the core of the model in question, the background is that the immediate competing demand and preferences impact the ultimate behavioral demand, derailing planned health-promoting acts.
Overview of the Health Promotion Model
Individual features and experiences, and the analysis of the previous behavior, including its frequency and probability of its resurgence are all significant aspects of the Health Promotion Model. Biological, psychological, and sociocultural elements are the three types of personal factors that are directly connected with a particular behavior (Pender et al., 1988). Age, gender, BMI, pubertal state, aerobic capacity, strength, agility, and balance are examples of personal biological factors. Self-esteem, self-motivation, personal competence, perceived health state, and concept of health are examples of personal psychological aspects. Race, ethnicity, acculturation, education, and socioeconomic level are socio-cultural and personal aspects.
The model describes health from the standpoint of a positive dynamic state but not as the absence of disease. Health promotion aims to improve the well-being of the patient by describing the multifaceted nature of people as they interact in their environment in search of well-being, with nurses being an essential part of this environment (Pender et al., 1988). When summarizing its structure, the HPM focuses on three areas: characteristics and individual experiences, cognitions and specific behavioral effects, as well as behavioral outcomes.
Characteristics and Individual Experience
The theory states that every person has unique personal characteristics and experiences that influence their subsequent actions. The set of variables for specific knowledge and the influence of behavior have important motivational implications (McEwen & Wills, 2019). Health-promoting behavior is a desired behavioral outcome that should lead to improved health, functionality, and quality of life at all stages of development. Ultimate behavioral demand is also affected by demand and immediate competitive preferences, which can disrupt planned actions to promote well-being.
Cognitions and Specific Behavioral Affects
Personal factors are classified as biological, psychological, and sociocultural ones. These factors are predictors of a given behavior and are determined by the nature of the objective behavior in question (Pender et al., 1988). Biological, psychological, and socio-cultural factors are included in this category. Situational influences are personal and cognitive perceptions that can facilitate or hinder behavior. These include the perception of available options as well as demand characteristics and aesthetic characteristics of the environment in which health promotion is offered.
In a behavioral outcome, there is a commitment to an action plan. It is the concept of intention and the definition of a planned strategy that leads to the implementation of healthy behavior. Competing demands are those alternative forms of behavior that people control (Pender et al., 1988). This is due to daily unforeseen circumstances such as work responsibilities or family care. Health-promoting behavior is the result of action to achieve a positive health outcome, optimal well-being, personal satisfaction, and productive life. Thus, the HPM takes into account the importance of the social and cognitive process, as well as their significance in human behavior and how all this affects the promotion of human health. Moreover, it considers the transformation of the environment and an individual’s perception of it over time, which helps approach the older population.
The subjective positive or negative emotion that develops as a result of the stimulus qualities of the behavior itself is known as activity-related affect. They have an impact on self-efficacy, which indicates that the more positive one’s subjective feelings are, the higher one’s sense of efficacy is (Pender et al., 1988). The HPM was presented as a paradigm for merging nursing and behavioral science perspectives on health behavior issues. The model is used as a guide to investigating the biopsychosocial mechanisms that encourage people to participate in health-promoting behaviors (McEwen & Wills, 2019). Increased sentiments of effectiveness, in turn, can lead to more pleasant sensations. Interpersonal influences are cognitions about other people’s activities, opinions, or attitudes. Norms (significant persons’ expectations), social support (instrumental and emotional encouragement), and modeling are all examples of interpersonal influences (vicarious learning through observing others engaged in a particular behavior) (Porter et al., 2022). Families, peers, and healthcare professionals are the most common sources of interpersonal impact.
To sum up, the HPM’s purpose is not simply to assist patients to avoid sickness by changing their beliefs and attitudes; it is also to find ways to achieve more excellent health or values. The HPM, according to Pender et al. (1988), makes four assumptions:
- Individuals seek to be in charge of their actions.
- Individuals strive to better themselves and their surroundings.
- Individual actions are influenced by the interpersonal environment created by health practitioners.
- Changing behavior requires self-initiated changes in individual and contextual variables.
These assumptions might assist clients in prioritizing other requirements, particularly health-related issues.
My Encounter with Veteran
I work at the VA as a homecare coordinator, namely, I provide some home care services to veterans through VA and home health agencies. Therefore, I often deal with the older population, who has not only age-related problems with physical well-being but also mental issues. In addition, social aspects are also negative health drivers for the population in question. While being alone, older people experience a depressed moral state; they develop obsessions, depression, and other anxiety disorders. They, in turn, do not allow people to follow the course of promoting health and fulfilling medical prescriptions responsibly.
Specifically, I worked with a male veteran with such social issues, which hindered the improvement of his condition. As I know, physical functioning, spiritual contentment, and a sense of achievement are all improved when older persons participate in community-based health promotion programs. To have the long-term impact of HPM, engagement in at least 12 weeks was necessary. Moreover, as Murwani et al. (2019) stated, the health of older adults can be improved by increasing their independence using health education efforts that impact health behavior and enhance services and infrastructure. Thus, my role was to maximize a veteran’s resources, abilities, and potential for the best health outcomes to be achieved.
Firstly, as the veteran felt lonely and depressed, it was important to expand his social circle to create a better environment, as emphasized by the HPM. I organized some collective sessions with other veterans, which helped to improve morale through his interaction with peers. This was also made concerning the behavioral aspect of the HPM, as afterward, the veteran initiated such sessions himself. Secondly, I gave some health education lectures where I explicitly explained the possible health problems in this population category and how to approach them without medical assistance. As a result, the veteran was able to meet his daily health needs on his own, thereby avoiding the risk of complications and feeling more independent. After three months, the patient demonstrated significant improvements in both physical and mental conditions, resulting in better analysis results and overall joy with life.
Application of Theory
Wellness has become more popular as a nursing specialty and current state-of-the-art clinical practice incorporates health promotion teaching. The HPM is significant to nursing workers since it applies to people of all ages and may be used in several contexts. In the United States, more than 30% of older persons have two or more chronic diseases, such as diabetes, heart failure, arthritis, or dementia, which can lead to more hospitalizations or nursing facility stays (Chen & Hsieh, 2021). Therefore, special attention should be paid to this population category. The strategy incorporates neighborhood partnership development, such as the organization of collective sessions in my example, with environmental considerations (Pender et al., 1988). Adapting appropriate behavioral habits incorporated into the daily routine is a real supportive measure to improve health outcomes and learn the necessary self-care principles. Individuals who do not engage in preventive and health promotion impose financial, human, and environmental costs on society (Aqtam & Darawwad, 2018). By giving a way of understanding how consumers might be encouraged to achieve personal health, the HPM adds a nursing answer to health policy and healthcare reform.
In the US, the HPM is commonly utilized in both graduate and undergraduate nursing education. Historically, health promotion was less critical than sickness care, so the HPM was a breakthrough on this issue. Nowadays, this model is widely used in the nursing curriculum as part of health assessments, community health nursing, and wellness-focused courses (Chen & Hsieh, 2021). Therefore, it can be applied directly to the target audience of this paper – older adults – in the geriatric nursing field. Establishing outpatient care programs for such patients is one of the tools to improve the health of this population. Considering the mental conditions of this group, the HPM, directed at the improvement of the interpersonal environment, is an appropriate method. The feeling of loneliness that is widely observed by the aging population can lead to serious mental breakdowns, as it was in the exemplar, and thus, should be addressed with HPM. Related tasks can also be solved by reducing the burden on healthcare and minimizing the number of readmissions due to effective self-care taught to patients, for instance, by organizing lectures with the explanation of basic tools. In addition, collective self-help practices can be developed, which will also contribute to educating the population.
It is also worth mentioning that the HPM is a research tool. Pender’s research program and those of other scholars have investigated and reported on the model’s empirical accuracy. The model’s resulting Health-Promoting Lifestyle Profile serves as the operational definition for health-promoting behaviors (Porter et al., 2022). The HPM model includes applications that emphasize the necessity of assessing factors that are thought to impact changes in health behavior. Concerning the older population, in addition to social factors, economic indicators of development can be assessed as valuable information that characterizes their respective needs and interests. Failure to meet daily health needs on one’s own exacerbates health outcomes, and to promote health successfully, the target population can develop technical skills, such as remote communication. The HPM’s perspective is not limited to auxiliary interventions and may also include real therapeutic proposals designed to improve health outcomes.
The health promotion model’s major assumptions emphasize that the person is in charge of developing and maintaining their health habits within their environment. Healthcare practitioners have a significant impact on the patient’s surroundings. It must be self-initiated for a behavioral change to take place and be sustained. Previous behavior and features of the individual are to be considered since they might directly impact future health-promoting behavior. Self-worth, as well as perceived personal value or advantage, can be motivators for engagement. When people in their surroundings encourage and demonstrate the activity, it is a significant indicator of dedication to health-promoting behavior.
The health promotion model’s simplicity allows it to be quickly adopted in a community health environment. A health promotion model is a helpful tool in nursing research as well. The importance of maintaining a certain healthy lifestyle is also present in the Bible: “wine is a mocker, strong drink is raging: and whoever is deceived thereby is not wise” (Proverbs 20:1). It echoes the theme because due to the HPM, a person can get rid of bad habits to maintain health. Today, healthy lives and habits are even more important, as health insurance is becoming increasingly out of reach for many people owing to rising costs. By using the example of older patients, the application of the model is considered, and this population group needs qualified assistance to adopt appropriate self-care practices. The favorable interpersonal environment that is created with the help of the HPM, improves their health, including mental one, and behavior. To establish a health-promoting behavioral change, the nurse must personalize their teaching to fit patients’ individual and environmental needs, according to Pender’s health promotion model.
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