Theoty Application in Research

7/28/2019 Theoty Application in Research

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Mrs.RAJESHWARI SIVAPROFESSOR

COLLEGE OF NURSING,CMC,VELLORE


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CONCEPTUAL MODELS CONCEPTS

Building blocks of a theory thatabstractly describe an object or

phenomenon BRICKS

Eg. Anxiety, Health, Adaptation


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MODELS Symbolic representations of a

conceptualization

Less formal attempts at organizing

phenomena than theories Deal with abstractions(concepts) that are

assembled by virtue of their advance to a

common theme Broadly presents an understanding of the

phenomenon of interest and reflects the

assumptions and philosophic views of themodels designer


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FRAMEWORK

FrameworkA framework is the overall conceptualunderpinnings of a study

THEORETICAL FRAMEWORKIf based on a theory

( Orems Selfcare theory)

CONCEPTUAL FRAMEWORK

If based on a specified conceptual model

( Systems model.. Input, process andOutput)


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HEALTH BELIEF MODEL

The HBM is essentially a concept thatintegrates psychological motivators withphysical and social settings.


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ORIGIN OF HBM

Initiated in 1952 by three socio-psychologists,Godfrey Hochbaum, Stephen Kegels and IrwinRosenstock.

1950's the society realized a need to preventdisease rather than cure it.

Through a series of studies over a decade theoriginators of the HBM conducted systematicstudies in order to present a mode of behaviorthat would help prevent health problems.

In 1952 Godfrey Hochbaum presented the first

research study that would provide theidentification of symptoms pointing towards achest x-ray in order for the early diagnosis of TB.[Brown, 1999]"


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HEALTH BELIEF MODEL

HBM includes General health motivation

Peoples response to illness

Compliance with medication

Health behavior

Illness behavior

Sick- role behavior


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HEALTH BEHAVIOUR Is any activity undertaken by individuals

who believe themselves to be healthy forthe purpose of detecting and preventing

disease in any asymptomatic stage


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HEALTH BEHAVIOUR-HEALTH BELIEFS

One is susceptible to health problems Health problems have undesirable

consequences

Health problems and their consequencesusually are preventable

If health problems are to be overcome,

barriers or costs have to be overcome


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PHASES OF HBM

Individual Perceptions Modifying Factors

Likelihood of Action


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Perceivedsusceptibility to

disease XPerceived seriousness(severity ) of disease X

DEMOGRAPHICVARIABLES

(age,gender,race,ethnicity,)

Sociopsychologic variables

(personality, social class,peer and reference group

pressure,etc.)STUCTURAL VARIABLES

(knowledge about the

disease, prior contact withthe disease,etc.)

Perceivedpreventive benefits

action minusPerceived barriers

to preventiveaction

Perceived threat of

disease X

Likelihood oftaking

recommendedpreventive health

action

Cues to action

Mass media campaignsAdvice from others

reminder postcard fromphysician or dentist

illness of family member

or friend newspaper ormagazine article

MODIFYING FACTORS LIKELIHOOD OF

ACTIONOL

INDIVIDUAL

PERCEPTIONS


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INDIVIDUAL PERCEPTIONS

TYPESPerceived Susceptibility

Perceived Severity

PERCEIVED THREAT OF DISEASE


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MODIFYING FACTORS

DEMOGRAPHIC VARIABLESAge, Gender, Educational level

SOCIOPSYCHOLOGIC VARIABLES

Social class, peer pressure, Personality

STRUCTURAL VARIABLES

Knowledge about the disease, priorcontact with the disease

CUES TO ACTION

Health advice, Illness of family

member,Mass media


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LIKELIHOOD OF ACTION

Perceived severity of health problem Perceived Benefits

Perceived Barriers

Self-efficacy


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ESSENTIAL FACTORS FOREFFECTIVENESS OF HBM

Readiness of individual to considerbehavioural changes to avoid disease or tominimize health risks

Existence and power of forces in theindividual s environment that urge changeand make it possible

Behaviors of the individual Each of these above factors are influenced

by personality, environment,past experience

with health services and health personnel


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EXAMPLES

Lifestyle modification among the obesewomen

Prevention of osteoporosis among

menopausal women Dietary modification among diabetics in

order to maintain glycemic levels

Health beliefs among Indian Muslimwomen towards mammography as ascreening procedure for breast cancer


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(age,gender,race,ethnicitySOCIOPHYCHOLOGIC

VARIABLES







to preventiveaction

Perceived threat of

disease X

Likelihood oftaking


action

Cues to action

Mass media campaignsAdvice from others

reminder postcard fromphysician or dentist

illness of family member

or friend newspaper ormagazine article

MODIFYING FACTORS LIKELIHOOD OFACTIONOL

INDIVIDUALPERCEPTIONS


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HEALTH PROMOTIONMODEL

I committed myself to the proactive stanceof health promotion and disease prevention

with the conviction that it is much better toexperience exuberant well-being and preventdisease than let disease happen when it isavoidable and then try and cope with it.

Nola J. Pender, PhD, RN, FAAN


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HPM

The Health Promotion Model (HPM) proposedby Nola J Pender (1982; revised, 1996) wasdesigned to be a complementary counterpart tomodels of health protection.

It defines health as a positive dynamic state notmerely the absence of disease.

Health promotion is directed at increasing aclients level of wellbeing.

It describes the multi dimensional nature ofpersons as they interact within theirenvironment to pursue health.

It is a wellness oriented framework forexplaining and predicting the health promotingcomponents of life


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PURPOSE

Integrating nursing and behavioralscience perspectives on factors thatinfluence health behaviors.

Exploring the biophysical processes that

motivate individuals to engage in behaviorsdirected toward health enhancement


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Major concepts

Individual characteristics and experiencesPrior related behavior and personalfactors

Behavior - specific cognitions and affect

Perceived benefits of action Perceived selfefficacyActivity related affectInterpersonal influences

Situational influences Behavioral outcomes

Commitment to a plan of actionImmediate competing demands

PreferencesHealth promoting behavior


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COGNITIVE/PERCEPTUAL

FACTORS

MODIFYING

FACTORS

PARTICIPATION IN HEALTH-

PROMRTING BEHAVIORS

Importance of

Health

Perceived Control

of Health

Perceived

Self-Efficacy

Definition of

Health

Perceived Health

Status

Perceived

Benefits of Health

Promoting

Behaviors

Demographic

Characteristics

Biologic

characteristics

Interpersonal

Influences

Situational

Factors

Behavioral

factorsLikelihood

Engaging in

Health-Promoting

Behaviors

Cues to action


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(1987)


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THEORETICAL PROPOSITIONS OF THE

HEALTH PROMOTION MODEL

Prior behavior and inherited and acquired characteristicsinfluence beliefs, affect, and enactment of health-promoting behavior.

Persons commit to engaging in behaviors from which

they anticipate deriving personally valued benefits. Perceived barriers can constrain commitment to action, a

mediator of behavior as well as actual behavior. Perceived competence or self-efficacy to execute a given

behavior increases the likelihood of commitment to

action and actual performance of the behavior. Greater perceived self-efficacy results in fewer perceived

barriers to a specific health behavior. Positive affect toward a behavior results in greater

perceived self-efficacy, which can in turn, result in

increased positive affect. When positive emotions or affect are associated with a

behavior, the probability of commitment and action isincreased.


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THEORETICAL PROPOSOTION Persons are more likely to commit to and engage in health-promoting

behaviors when significant others model the behavior, expect thebehavior to occur, and provide assistance and support to enable thebehavior.

Families, peers, and health care providers are important sources ofinterpersonal influence that can increase or decrease commitment to and

engagement in health-promoting behavior.

Situational influences in the external environment can increase ordecrease commitment to or participation in health-promoting behavior

The greater the commitments to a specific plan of action, the more likely

health-promoting behaviors are to be maintained over time

Commitment to a plan of action is less likely to result in the desiredbehavior when demands over which persons have little control requireimmediate attention. 13. Commitment to a plan of action is less likely toresult in the desired behavior when other actions are more attractive and

thus preferred over the target behavior.

Persons can modify cognitions, affect, and the interpersonal and physicalenvironment to create incentives for health actions.


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AREAS OF FOCUS IN HPM

Individual characteristics and experiences Behavior-specific cognitions and affect

Behavioral outcomes


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MAJOR CONCEPTS

Individual Characteristics and Experience

Prior related behavior

Frequency of the similar behavior in thepast.

Direct and indirect effects on the likelihood

of engaging in health promoting behaviors.


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PERSONAL FACTORS

Biological factorsAge, gender, body mass index, pubertal

status, aerobic capacity, strength,

agility, or balance Psychological factors

Self esteem, self motivation, personal

competence, perceived health statusand definition of health.

Socio-cultural factors

Race ethnicity, acculturation, educationand socioeconomic status.

Behavioral Specific Cognition and Affect


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PRIOR RELATED BEHAVIOUR PERCEIVED BENEFITS OF ACTION

Anticipated positive out comes that will occur from

health behavior

PERCEIVED BARRIERS TO ACTION

Anticipated, imagined or real blocks and personalcosts ofunderstanding a given behavior

PERCEIVED SELF EFFICACYJudgment of personal capability to organize

and execute a health-promoting behavior.

Perceived self efficacy influences perceived barriers toaction so higher efficacy result in lowered perceptions ofbarriers to the performance of the behavior.

ACTIVITY RELATED AFFECTSubjective positive or negative feeling that occurred

before, during and following behaviorActivity-related affect influences perceived self-

efficacy


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INFLUENCES

INTERPERSONAL INFLUENCESNorms (expectations of significant others)Social support (instrumental and emotionalencouragement)

Modeling (vicarious learning throughobserving others engaged in a particularbehavior)Primary sources of interpersonal influences(families, peers, and healthcare providers)

SITUATIONAL INFLUENCESPerceptions of options availableDemand characteristics

Aesthetic features of the environment

Situational influences may have direct or indirectinfluences on health behavior.


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ASSUMPTIONS

Individuals seek to actively regulate theirown behavior.

Individuals in all their biopsychosocialcomplexity interact with the environment,progressively transforming the environment andbeing transformed over time.

Health professionals constitute a part of theinterpersonal environment, which exertsinfluence on persons throughout their lifespan.

Self-initiated reconfiguration of person-environment interactive patterns is essential tobehavior change


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EXAMPLES

Foot care practices of Diabetic clients

Promoting quality of life amonghospitalized elderly

Predicting Lifestyles in workplace ofworkers in steel industry

Effects of stress management amonghypertensive clients


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(age,gender,race,ethnicity,)

Sociopsychologic variables







to preventiveaction

Perceived threat of

disease X

Likelihood oftaking


action

Cues to action

Mass media campaignsAdvice from othersreminder postcard from

physician or dentistillness of family memberor friend newspaper or

magazine article

MODIFYING FACTORS LIKELIHOOD OF

ACTIONOL

INDIVIDUAL

PERCEPTIONS


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Marriner TA, Raile AM. Nursing theorists and their work. 5th ed.Sakraida T.Nola J. Pender. The Health Promotion Model. St

Louis: Mosby; 2005

Polit DF, Beck CT. Nursing research: Principles and methods.

7th ed. Philadelphia: Lippincott Williams & Wilkins; 2007

Black JM, Hawks JH, Keene AM. Medical surgical nursing. 6thed. Philadelphia: Elsevier Mosby; 2006.

Potter PA, Perry AG. Fundamentals of nursing. 6th ed. St.Louis:

Elsevier Mosby; 2006.

Wills and McEwen(2007). Theoretical Basis for Nursing. 2nd

Edition. Philadelphia: Lippincott Williams and Wilkins.

Aonuevo, C., Abaquin, C., Balabagno, A., Corcega, T., Dones,

L., Kuan, L., et. al. (2000). Theoretical Foundation of Nursing.

Philippines: UP Open University

Kozier, B., Erb, G., Berman, A., Snyder, S. (2004).Fundamentals of Nursing: Concepts, Process, and Practice. 7th

Edition. Philippines: Pearson Education South Asia Pvt Ltd

University of Michigan School of Nursing (2006). Nora J. Pender

Site. Retrieved Jan 23, 2010 from

http://www.nursing.umich.edu/faculty/penderPender N J, S N Walker, K R Sechrist & M Frank-Stronbourg.

Nursing Research, 39, pp 326-332.

Thomas Butler.J,Principle of Health Education and Health

Promotion,Wadsworth / Thomson Learning,USA; 2001

REFERENCE
http://www.nursing.umich.edu/faculty/penderhttp://www.nursing.umich.edu/faculty/pender


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