Nola Pender’s Health Promotion Model. This model looks at the patient’s characteristics and behaviors and how nursing interventions can help adapt, add, or improve the patient’s healthy behaviors. Pender believed that health is a positive dynamic state, meaning that overall health includes physical, mental, and social wellbeing, not merely the absence of illness or disease (Current Nursing, 2020). Pender’s model is foundational in public health and disease prevention and has helped outline how nursing practice can spark the patient’s healthy lifestyle changes. This theory focuses on inciting behavioral changes that promote self-care and prevention of illness by looking at biological, psychological, and sociocultural factors (Gonzalo, 2021). This is done by examining the benefits, barriers, influences, commitment, and self-efficacy of the patient’s actions.
This model can be used to prevent disease, obesity, and future spread of infection. A limitation of this model can be related to the patient’s willingness to change and the nurse’s ability to provide adequate education and reassess interventions when necessary. Increasing responsibilities at the bedside, increased charting, increased acuity, and a lack of nurse-patient ratios can significantly impact the success of this model in an acute care setting. Additionally, ethical issues can be raised in terms of the scope of public health and disease prevention and how it relates to religious beliefs. For example, sexual health promotes the use of birth control and contraceptive methods, and some religions disapprove of contraception and have procreation views. Another example of ethical issues in health promotion can be seen with the highly politicized 2020 mask mandates and the individual’s right to choose their health behaviors.
Dorothea Orem’s Self-Care Deficit Theory focuses on the idea of promoting patient independence over self-care (Current Nursing, 2020). This theory can be applied to guide nursing care, essentially individualizing plans of care where deficits lie. Orem believed that a patient could better recover if nurses worked to maintain patient independence. This can range from providing total care, assistance with using the restroom and bathing, and providing education to allow the patient to care for self. The nurse’s role is to assess the patient’s strengths, weaknesses, limitations, and needs; and then form appropriate interventions that promote patient independence (Current Nursing, 2020). I believe that having patient autonomy and independence can help institute behavioral changes within the patient.
Promoting self-care in patients can also promote health maintenance; encouraging and advocating for patient self-care can help patients make lifelong behavioral changes. A limitation of Orem’s theory is that it is very focused on self-care tasks and can often overlook the patient’s spiritual and emotional needs (Current Nursing, 2020). Additionally, this theory can be limited by the patient’s understanding of their illness, ability to understand teaching, or the family’s ability to assist with self-care needs successfully. For example, if a patient needs assistance with home wound care, the patient and family may be taught how to dress the wound appropriately, but perhaps the patient and family members don’t have the stomach for wound care. Or maybe there are barriers to learning. Ethical concerns can arise if nursing interventions go against a patient’s cultural or religious beliefs.
I find both of these models useful, but I believe as a future informatics nurse that Pender’s Health Promotion Model would help incite behavioral changes. Pender’s model essentially embodies provoking behavioral changes; keeping this in mind, future research and implementation of technologies can be used within this model’s framework to promote disease prevention and optimal health behaviors.
References
Current Nursing. (2020). Nursing theories: Open access articles on nursing theories and models. https://currentnursing.com/nursing_theory/application_self_care_deficit_theory.html
DeNisco, S. M., & Barker, A. M. (2016). Advanced practice nursing: Essential knowledge for the profession (3rd ed.). Jones & Bartlett Learning.
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