Discussion: Health Promotion Model used to Initiate

Discussion: Health Promotion Model used to Initiate Behavioral Changes

There are many health promotion models that are used, and Pender’s health promotion model is used to initiate behavioral changes. This model sees the family as a unit of assessment and intervention (Whitney, 2018). This was recognized by Nola Pender who saw that clinicians were only treating the disease and not changing the lifestyle behind why theses were occurring. There are three main components to this model and they include recognizing experiences and characteristics of each individual, implementing behavioral outcomes and understanding behavior specific cognition and affect (Whitney, 2018).

This model helps teach behavioral changes by assessing the learned behaviors we gain from our family and community environment. These behaviors have an impact on the individuals ability to partake in behavioral changes. Also, through motivation, the individual is able to prevent illness and promote well being and behavioral changes. The nurse should also assess the individuals self worth, benefits for change and barriers to change. Barriers to change can include the environment that surrounds them (social, financial, and physical).

These can include actual toxins in the environment, low funds to initiate change, or due to restricted access to resources. Other barriers include lack of feedback, lack of immediate consequences (such as in smoking), or lack of autonomy (Association of Talent Development, n.d.). A patient’s readiness to change has a direct impact on the outcome.

References:

Association of Talent Development. (n.d.). 5 Barriers to behavioral changes. Retrieved from https://www.td.org/insights/5-barriers-to-behavior-change

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Whitney, S. (2018). Teaching and Learning Styles. In Health Promotion: Health and Wellness Across the Continuum. Retrieved from https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/#/chapter/1

Describe a health promotion model used to initiate behavioral changes. How does this model help in teaching behavioral changes? What are some of the barriers that affect a patient’s ability to learn? How does a patient’s readiness to learn, or readiness to change, affect learning outcomes?

Read “Patient-Education Tips for New Nurses,” by Smith and Zsohar, fromNursing 2013(2013).

URL:

https://journals.lww.com/nursing/Pages/articleviewer.aspx?year=2013&issue=10000&article=00024&type=Fulltext

Read “Patient Education in Home Care: Strategies for Success,” by Ashton and Oermann, fromHome Healthcare Now(2014).

URL:

https://www.nursingcenter.com/journalarticle?Article_ID=2460148&Journal_ID=2695880&Issue_ID=2460020

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The health belief model is one of the oldest models of health behavior, but it’s still very relevant when discussing health behavior change. This model addresses the readiness to act upon a health behavior based upon several individual beliefs. If individuals perceive they are susceptible to a condition (1) and that the condition could be severe (2), they will most likely take action to avoid the condition. The likelihood of action is enhanced if the perceived benefits (3) outweigh the perceived barriers (4).

Reference

Purdue Extension. (Vicki Simpson) Health and human sciences. https://extension.purdue.edu/extmedia/hhs/hhs-792–w.pdf 

Patient’s belief and perception about health and wellness determines his response to health promotion and disease prevention. Belief is the acceptance that a statement is true or that something exists. When a patient have a particular belief system, it’s difficult to desuade him from such and hence its affects the way in which the person seeks for Healthcare

I totally agree with you about the health belief model and taking that into account when providing health teaching. One example that comes to mind is the example of Jehovah’s witness because due to the religious fact that they cannot accept blood transfusion or blood products if we ever have to take care of a GI bleed patient that is also a Jehovah’s witness it adds to the standard process of management of GI bleed since we cannot transfuse blood or blood products the care team would have to do alternative interventions which are there and are also effective but we must respect the patients belief and choices and then tailor our care plan based off of that information.

The health promotion concept emphasizes that an individual’s qualities and life experiences directly influence their health-related activities and decisions.Pender‘s health promotion module goes beyond disease treatment and promotes healthy lifestyles. This model believes that health is not just the absence of disease, but a positive dynamic and the way a person interacts within their environment to promote health. This module focuses on individual characteristics and experiences, behavior-specific cognitions and affect,and behavioral outcomes.

Everyone has experiences that affect learning and changecapability ( Khodaveisi,2017). The nurse should figure out what the patient needs to learn, what kind of learner he or she is, and what kinds of things might get in the way of learning. There are many things that can affect a patient’s ability to learn, such as their age, level of education, mental attitude about their health, cultural beliefs, motivation, and what they know about their current health. After figuring out what the patient needs to learn, we can plan for how to teach them. (Whitney, 2018).

Getting family members to make changes along with the patient will help improve everyone’s health and give encouragement and support for change. For this module to work, the patient must be willing to change their own behavior and make changes to their environment that will improve their health. The nurse must also play a role in teaching the patient and their family about how to change their behavior.

Reference

Whitney, S. (2018). Teaching and Learning Styles. Health promotion: Health and wellness across the continuum. (Chapter 1). Grand Canyon University. https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/#/chapter/1

Khodaveisi, M., PhD, Omidi, A., Ms, Farokhi, S., Ms, & Soltanian, A. R., PhD (2017). The Effect of Pender’s Health Promotion Model in Improving the Nutritional Behavior of Overweight and Obese Women. International journal of community based nursing and midwifery, 5(2), 165–174.

I believe you when say health education has become a challenge for healthcare providers. Brochures have taken over the person to person teaching. Patient’s on discharge many times leave the education brochures in the room. There are many cultures, languages and beliefs that are not captured in the health education brochures. I work in the post partum floor. When educating the mothers, you will find they don’t know some of the basic things. I think if personnel are designated just for health education of patients from the clinic to the hospital in-patients, it will be of much benefits to patients. Electronic interpreter services has helped with language barriers. Having health education channels with other language captions tailored to patients need will also help.

Excellent post! Pender’s Health Promotion Model is great for nurses to use positive reinforcement for patients who respond best to this method. Using a patient’s personal goals, experiences, and learning style should be immensely productive in changing behaviors. My favorite take-away from this model is using self-efficacy to enhance a patient’s execute health wellness and daily living. This model is a great guide for preventing illness but I wonder if this model neglects how patients with actual medical issues and how to treat them (Masoudi et al., 2020). 

Masoudi, R., Lotfizade, M., Gheysarieha, M. R., & Rabiei, L. (2020). Evaluating the effect of Pender’s health promotion model on self-efficacy and treatment adherence behaviors among patients undergoing hemodialysis. Journal of education and health promotion, 9, 197. https://doi.org/10.4103/jehp.jehp_747_19

Models and theories can help us understand behavior and plan health promotion programming. They also can remind us to consider and address the many variables and factors that affect the behavior change process at the individual, group, and community levels. This model may help an educator determine what interventions are appropriate to move individuals along the continuum toward behavior change.

I totally agree with you on the effect of one’s experience on thier health and participation in health promotion. People who has had a negative past experience either in childhood or adulthood tends to have split personality disorders and thier attitudes to health promotion is different from who had a good experience. They face difficult times adjusting and have regrets in thier late adulthood. They have depression and mood disorders. As nurses we should try to give our patients good memories as we don’t know how much impact it will make on their mental health

Health care delivery and education have become a challenge for providers. Nurses and other professionals are challenged daily to assure that the patient has the necessary information to make informed decisions. Patients and their families are given a multitude of information about their health and commonly must make important decisions from these facts. Obstacles that prevent easy delivery of health care information include literacy, culture, language, and physiological barriers.

It is up to the nurse to assess and evaluate the patient’s learning needs and readiness to learn because everyone learns differently. Receiving information doesn’t guarantee to learn. That’s because external barriers to learning, such as environmental and sociocultural factors, as well as internal barriers to learning, including psychological and physiological factors, can influence a person’s learning experience and ability.

Environmental factors can include things like interruptions, which sort of ties in with a lack of privacy, another barrier to learning. When people are constantly looking over their shoulders, it’s going to make them uncomfortable.

Sociocultural factors include language barriers. If you’re educating a foreign patient that doesn’t really understand English very well, they might be willing to learn but simply won’t be able to. Other sociocultural barriers include a person’s value system. Some cultures may not value advice from a particular person or about a particular topic. A person’s educational background is an important barrier to learning as well. If you’re educating a person with a Ph.D. in the sciences, you’ll be able to talk with them on a different level than someone who hasn’t completed high school.

Moreover, internal barriers include psychological and physiological factors. Psychological barriers include things like: “Fear”, “Anger”, “Anxiety”, “Depression” while physiological barriers to learning include: “Fatigue”, “Pain”, “Sensory deprivation”. If a person has sensory deprivation, such as poor hearing, that can significantly impede their learning abilities.

Reference

Beagley, L. (2011, September 19). Educating patients: Understanding barriers, learning styles, and teaching techniques. Journal of PeriAnesthesia Nursing. Retrieved February 26, 2022, from https://www.sciencedirect.com/science/article/abs/pii/S1089947211003595

Cheprasov, A. (2016, January 30). Take online courses. earn college credit. Research Schools, Degrees & Careers. Study.com | Take Online Courses. Earn College Credit. Research Schools, Degrees & Careers. Retrieved February 27, 2022, from https://study.com/academy/lesson/nursing-patient-education-learning-barriers-domains.html

I definitely agree that language is a very significant barrier to learning. As a nurse, I have seen many situations where a patient is willing to learn but there is a barrier in communication between the nurse and the patient. This is why the use of medical interpreters is very important. “Medical interpretation is the translation of complex medical information to those patients who speak a foreign language. An interpreter is responsible for ensuring medical communication’s clarity and safety. Between physicians, nurses, medical staff, and patients.” (The Language Doctors, 2022, p.1) I am glad that the use of interpreters is prominent nowadays because this country is a melting pot with so many different cultures, and it is such a shame that some patients arrive at the hospital and don’t receive the care they deserve due to language barriers.

References:

The Language Doctors. (2022, March 9). 5 steps on how to become an interpreter for a hospital. The Language Doctors. Retrieved September 30, 2022, from https://thelanguagedoctors.org/how-to-become-an-interpreter-for-a-hospital

I like the way you analyzed the barriers to effective learning itemizing it according to its possible categories. You did a good job. I also want to add that a patient’s mental and cognitive capacity can be a barrier. You can imagine educating a patient with dementia on the important of good nutrition. The teaching would not be very effective as the patient does not have the mental and cognitive capacity to retain your teaching

I agree with you that there are a large number of sociocultural factors that we must take into account when providing healthcare delivery as well as the psychological barriers you discussed. I work in a psych unit as well and sometime we have a hard time discharging homeless patents safely because they do not have a primary place to go but when we do find them a shelter or place to discharge to it is the psychological “fear” or “anxiety” and they will often find ways to delay their own discharge and end up staying at the hospital unit even if they have been medically clear for discharge long ago. It really is frustrating but that is just one of the things in the psychological barriers that we have to deal with unfortunately.

Bandura’s self efficacy theory of behavior changes is a health promotion model that was developed by Albert Bandura in 1977. This theory focuses on that “self efficacy can lead to competency”, basically individuals have the ability to bring about their own outcomes. There are three factors that affect this outcome that is the patient’s behavior, environment and personal cognitive factors. This model helps teach behavioral changes because it empowers the patient to be in control of their decisions, which in turn affects their health and healthcare outcomes.

There are barriers that can affect a patient’s ability to learn. They can be pain, lack of emotional support, lack of resources, distractions etc. Depending on the patient and the situation, circumstances the barriers maybe different. Sometimes the barriers to learning can be removed and teaching can occur later on. In some circumstances, the barriers can permanently effect the ability to learn in the case of permanent damage from a stroke, financial limitations, limited resources etc.

Patient’s readiness to learn and change significantly affects learning outcomes. For example, if a patient has recently been diagnosed with hypertension and put on hypertensive medications, hypertension is the silent killer and puts them at a significant increase for stroke and or heart attack if they do not control their blood pressure with medication. If the patient knows the potential long term or short term complications without compliance or change in lifestyle choices, they are more responsive to learning.

If a patient is unwilling to learn or ready to change the outcome of their learning is usually not positive. Many times due to the unwillingness this then affects their health long term, mentally, physically and emotionally. I have seen situations where there was resistance to learning initially but then thru persistence the willingness and receptiveness changes. Sometimes this learning can be affected in a positive manner by the nurse.

Alligood, M. R. (2013). Nursing Theory-E-Book: Utilization & Application. Elsevier Health Sciences.

Murdaugh, C. L., Parsons, M. A., & Pender, N. J. (2018). Health promotion in nursing practice. Pearson Education Canada. [Link]

The nurse educator should consider susceptibility toward health threat, the severity of health threat, benefits of action to reduce the threat of illness, barriers to initiating preventative action, and ability to take preventative action or self-efficacy when educating the patients and this will help him understand whether the patient will utilize the information positively or not (Whitney 2018).

For example, the component of severity to threat will affect the outcome of the education, this was seen during the Covid 19 pandemic when the death toll and the cases surged most people would always put o their face masks but when the cases dropped people would walk around in the streets without face masks. Patients would always weigh the benefits of the action before acting and if they feel that they do not benefit from it then they won’t take action.

Reference

Whitney, S. (2018). Health Promotion: Health & Wellness Across the Continuum. Teaching and Learning styles. https://lc.gcumedia.com/nrs429vn/health-promotion-health-and-wellness-across-the-continuum/v1.1/#/chapter/1

One aspect of this baccalaureate degree program I love so much is this peer-to-peer learning approach. I have not heard of this Bandura self efficiency of behavioral changes theory before. Your write up prompted me into making research on it and honestly I learnt more. Students learn more when they learn from one another as everyone brings in thier own knowledge to expand the knowledge of others rather than the traditional way of learning where the lecturers gives note and sets questions based on the knowledge he passed unto the students . Thank you Paula for your write up

A health model that is used to initiate behavioral changes is the participatory health model. The participatory health model incorporates shared decision making between providers, the patient, and their families with the use of evidence-based practice along with their familial values goals (Whitney, 2018). The participatory health model allows families and health care providers form an effective team leading to positive health care outcomes.

The Society for Participatory Medicine described this model as the best practice in health care creating an active relationship between professionals and patients leading to patient cooperation with health promotion (Coughlin, Roberts, O’Neill, & Brooks, 2018). Shared decision-making allows the patient to remain engaged when with lifestyle choices while also making them accountable for their own health. Patient engagement and participation are required to have successful patient behavioral changes.

Obstacles that can affect a patient’s ability to learn are literacy, language, culture, environmental, and physical barriers. These barriers make health care delivery and education more challenging for nurses and other health care professionals. Patients and their families should have the necessary information regarding health prior to making important health care decisions.  Barrier such as literacy can be due to low socioeconomic status related to lack of finances, resources, and education (Whitney, 2018). Immigrants residing in the United States often struggle with language and literacy barriers. It is the nurse’s duty to identify these obstacles and barriers that can hinder a patient’s ability to learn.

Patient’s readiness to learn and readiness to change affects learning outcomes. If a patient is unwilling to learn or change, the outcome of the patient education and health promotion will be unsuccessful. Unwillingness to learn or adhere to positive behavioral changes can affect their health in the long run. For example, a patient with diabetes should be educated about following prescribed medications, consistent exercise, and diabetic diet. The patient should also be informed about potential complications that may occur if lifestyle changes are not made and non-compliance to treatment.

Reference

Coughlin, S, Roberts, D, O’Neill, K, & Brooks, P. (2018). Looking to tomorrow’s healthcare today: a participatory health perspective. Wiley Online Library. Retrieved from https://onlinelibrary.wiley.com/doi/full/10.1111/imj.13661

Patient’s participation in their care encourages the care providers to search for more evidence-based practice that can help them. The patient will be given or directed to different strategies that will make for their health promotion. Patients can be referred to education classes, videos, books, websites etc. that will help them knowing that they want to learn. Nurses can help ameliorate certain barriers and challenges the patient faces like language, immigration, finances etc., and will refer them to where they can get help.

The participatory health model is used to initiate behavioral changes in an individual. Participation in shared decision-making is referred to as a process in which a patient and a healthcare practitioner come to a choice together after taking into account the patient’s beliefs and preferences as well as the best available evidence regarding the various treatment alternatives.

In this, we investigate the impact that an actively involved customer may have on the future of healthcare. Our vision is both a notion about a potential future and an investigation into something that we see as unavoidable in the world. We intend to spark a conversation about how to promote “large” and most likely disruptive ideas in the healthcare industry by posing questions with the intention of being challenging.

Health can be defined as the state of physical, mental, and social well-being and not just the absence of disease. Wellness can be defined as the attitudes and decisions made by an individual that results in positive behaviors and health outcomes. Health promotion can be defined as the process of empowering individuals and communities to make healthy lifestyle choices to improve overall health and wellness. The Health Promotion Model (HPM) was developed to explain the interactions that occur between an individual and their environment during the behavior change process.

The goal of the HPM is to help individuals make behavioral changes that will improve health outcomes, in addition to preventing and minimizing the risk of disease. The Health Promotion Model aims to explain the factors underlying motivation to engage in health-promoting people’ss,. It also focuses on people’s interactions with their physical and interpersonal environments during attempts to improve health.

This model can be instrumental in designing health promotion programming. For example, most individuals are very aware that obesity often leads to the development of diabetes. The interventions aim to educate individuals to increase their perceived susceptibility to and seriousness of diabetes as an outcome of obesity. Education also helps individuals discover the benefits of decreasing their risk of diabetes by losing weight. Helping individuals identify and eliminate barriers may help them see that the benefits outweigh the barriers, thus encouraging actions to avoid the development of diabetes by dealing with their obesity.

Discussion: Health Promotion Model used to Initiate Behavioral Changes