Nola Pender
Nola Pender
  • Professor Emeritus, University of Michigan, School of Nursing
  • PhD, Northwestern University, Evanston, IL
  • BS, Michigan State University, East Lansing, MI
  • Identifies behavioral perspectives that relate to whether people will engage in health promoting behavior.
  • Goal: person engages in positive health outcomes.
  • Focus: optimal health of the patient
Pender first published HPM in 1982 after seeing an absence of health promotion in health care.

Three Important Factors

(relating to person engaging in health promoting behavior)
  1. Individual characteristics
  2. Behavior-specific cognitions and affect
  3. Behavioral outcome

Three Important Factors

(relating to person engaging in health promoting behavior)
  1. Individual characteristics
    • Prior related behaviors and personal factors provide baseline experiences
    • Personal factors: biological, psychological, sociocultural

Three Important Factors

(relating to person engaging in health promoting behavior)
  1. Individual characteristics
    • Example (biological): Given two people have trained in the same manner over the years and they are healthy, it is usually easier for a 25 year old man to run a marathon than a 58 year old man.

Three Important Factors

(relating to person engaging in health promoting behavior)
  1. Behavior-specific cognitions and affect
    • Perceived benefits and barriers to action
    • Perceived self-efficacy
    • Activity-related affect
    • Interpersonal influences
    • Situational influences

Three Important Factors

(relating to person engaging in health promoting behavior)
  1. Behavior-specific cognitions and affect
    • Perceived benefits to action
      • Extrinsic and intrinsic rewards
        • Example: If I do a 5 minute meditation, I think I will be calmer and more alert.

Three Important Factors

(relating to person engaging in health promoting behavior)
  1. Behavior-specific cognitions and affect
    • Perceived benefits to action
      • Example: Supermarkets with fruit are not in my neighborhood, and fruit is too costly.

Three Important Factors

(relating to person engaging in health promoting behavior)
  1. Behavioral outcome
    • Example: An 89 year old man with diabetes may feel it is too late to change his eating patterns.
Understand Phenomena

Nurse can look at factors that impact a patient’s involvement in healthy behavior.

Usefulness

Applicable to nursing practice, evidence-based practice and research.

Article (citation below) describes research using the HPM.

Outcome

Health promotion is part of nursing practice. ANA definition of a professional nurse includes the “promotion of health.”

Family and Community Health, 25

Grubbs, L., & Carter, J. (2002). The relationship of perceived benefits and barriers to reported exercise behaviors in college undergraduates. Family & Community Health, 25(2), 76-84.

Bandura’s Social Cognitive theory
A major concept of Bandura’s theory is self-efficacy, which is the confidence a person has in successfully carrying out an action. For example,
if someone enrolled in a ballroom dance class,their low level of self-efficacy as a dancer could increase the likelihood that they would drop out of the class.

Click on the factors that influence Mariel to engage in health-promoting behavior.

Mariel

Mariel a 14 year freshman in high school. Her parents were born in Puerto Rico. She tried out for soccer team but did not make the team. She is upset and feels like a “total failure”. The coach said she has is a “potential talent” and should try out when she gets into a regular practice regimen.Her parents feel bad for her, but do not think sports are that important for a girl. However, they said that they will attend her games if she gets on the team. Daniel, her 16 year old brother said that he would help and go with her to the nearby soccer field after school.

Prior related behavior: negative impact

Personal cognitions and affect: negative

Interpersonal influence – coach: positive, support

Situational influence – family: negative

Situational influence – family: positive

Situational influence – family: positive

Field near home

Hildegard Peplau
Hildegard Peplau
  • September 1, 1909 – March 17, 1999
  • Professor Emeritus, Rutgers University, College of Nursing
  • 1954-1974: Faculty, Rutgers University
  • Founded MS in Psychiatric Nursing Program at Rutgers University
  • MA and EdD, Teachers College, Columbia University, NYC
  • Nursing theory for interpersonal care of patients
  • Nurse-patient relationship fundamental to providing optimum nursing care: empathy important component
Peplau’s theory was partly based on induction (through her clinical work with patients) and partly based on deduction through her application of induction (her clinical work and deduction: application of psychological theories).
She studied with Harry Stack Sullivan, a famous interpersonal theorist who developed the Interpersonal Theory of Psychiatry (another middle range theory): a grounded theory derived from practice (qualitative research).
  • Stages of the nurse-patient relationship
  • Attending to the mental health needs and problems of patients
  • Emotional functioning

Patient participates in the nurse-patient relationship focused on higher level functioning. Patient and nurse focus on patient’s problems through interpersonal relationships. What the patient learns through the therapeutic relationship the patient can take outside the relationship to focus on working on healthier interpersonal relationships.

Stages of Nurse-Patient Relationship

  1. Orientation
  2. Identification
  3. Exploitation (Working Stage)
  4. Resolution
Select the stage of the Nurse-Patient Relationship to the correct statenent.
“I see it is difficult for you to express your feelings.”
“You tried to talk with your sister more openly about your feelings.”
“You made a plan regarding how you are going to deal with the family reunion.”
“I see that you are ready to do things on your own.”
Teacher
Leader
Surrogate
Resource
Stranger
Sullivan, Freud, and Maslow
Click on each area of the metaparadigm to learn more.
Person

Nurse and client

Nursing

Interpersonal therapeutic process

Health

Movement of personality toward creative, constructive living

Environment

Therapeutic relationship

Patient with Anxiety

  • Developed operational definition of anxiety
  • Mild, moderate, severe, and panic