Knowing how to Integrate the Health Belief and Health Promotion Model
– Why is it essential for the psychiatric nurse practitioner to understand the family values and functions while organizing or considering a psychiatric patient’s care plan?
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A. Family Behavior and States of Health
Patterns of family healthcare utilization vary significantly from unit to unit, due to conceptual differences of health and illness and health beliefs among members of families.
a. Differences in Conceptualization of Health and Illness
Concepts of health and illness in families are formulated by culture, regions, social class, and gender. It is imperative that the family nurse clarifies a family’s definition of health and illness to assist families with setting realistic goals that the family nurse can incorporate into care plans.
b. Health Beliefs About Health Care Seeking and Health Action
Family health beliefs influence the care that families seek and promote within. Family members not ready to make changes to improve health will not embark on care. In addition, there are other variables that influence health promotion and prevention to consider.
Health Belief Model
The Health Belief Model is a comprehensive model that explores behavior for disease prevention and illness detection. This model is applied in research to studies on why people do not engage in activities that promote health and well-being. The model’s development has been supported by Levin’s theories on stress. The individual determines the outcomes of perceived stress not the physical environment. Individuals seek to avoid negatively valued aspects of life and avoid stress. The goal is to have a positive or neutral balence. The individual determines the seriousness of a disease based on perceived feelings and motivation to attain wellness.
Health Promotion Model
Nola Pender’s Health Promotion Model was expanded from the original Health Belief Model. The main concept in this newly enhanced model is that particular cognitions are motivated by specific behaviors. Nursing interventions can be centered on these 6 behavior-specific cognitions:
1. Perceived benefits of action
2. Perceived barriers to action
3. Perceived self-efficacy
4. Activity-related affect
5. Interpersonal influences (family, peers, providers); norms, support, models
6. Situational influences; options demand characteristics aesthetics
Families are challenged by internal and external variables that affect their health care function. In order for family members to be highly responsible for meeting health care needs they should be assured they are partners in their care; in addition, they need access to services including health insurance if needed.
B. Health Care Practices
Major goals of family nursing are health promotion and maintenance. Healthy People 2020 continues from its 2000 inception, as a 10 year plan by the US Department of Health and Human Services to improve the health of families in America by promoting goals and objectives for health promotion, and disease prevention. In addition, Friedman, Bowden, and Jones (2003) highlight 8 different areas as pertinent to health practices of families and this information can be found on pages 437-451.
C. Family Health Assessment
Interventions administered by family nurses, after completion of a comprehensive assessment and determination of nursing diagnoses can be specific to management of family behavior and include the following strategies:
· Self-confrontation: health changing behaviors occur when individuals realize incompatibilities with their own beliefs, values, and behaviors.
· Cognitive reframing: assists families to view past situations from a different perspective; promotes positive self-statements and increased personal control.
· Modeling: promotes learning from role models; family nurses can be this positive role model.
· Operant conditioning: consequences determine behavior; desirable behavior is reinforced and undesirable behavior is discouraged.
· Stimulus control: change the antecedents of the behavior; improved behavior occurs when these precursors do not exist.
US Department of Health and Human Services. (2021). Health People 2021. Retrieved from https://www.healthypeople.gov/2020
Friedman, M.M., Bowden, V.R., & Jones, E.G. (2003). Family nursing: Research, theory, and practice (5th ed.). Upper Saddle River, NJ: Prentice Hall.