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Preventive models

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Preventive models

  1. 1.  It is an idea that explains by using symbolic and physical visualization  Symbolic model may be verbal, schematic or quantitative.  Verbal models are worded statements  Schematic models may be diagrams, drawings, graphs or pictures.  Te models help us in facilitate thinking about concepts and relationships between them or to map out research process.
  2. 2.  They are made up of abstract and general ideas and propositions that specify their relationships.  Concept: Complex mental formulation of an object, properly, or event that is derived from individual perceptual experience. It can be Abstract or Concrete in nature.
  3. 3.  Given by Edelman and Mandle, 2002  Holism acknowledges and respects the interaction of a person’s mind, body and spirit within the environment. Holism is an antidote to the atomistic approach of contemporary science.  An atomistic approach takes things apart , examining the person piece by piece in an attempt to understand the larger picture.
  4. 4.  Holism is based on the belief that people (or their parts) can not be fully understood if examined solely in pieces apart from their environment. Holism sees people as ever charging systems of energy.  According to model, nurses using the nursing process consider clients the ultimate experts regarding their own health and respect client’s subjective experience as relevant in maintaining health or assisting in healing.
  5. 5.  In holistic model of health, clients are involved in their healing process, thereby assuming some responsibility for health maintenance.  Nurses recognize the natural healing abilities of the body and incorporate complementary and alternative interventions, such as music therapy, reminiscence, relaxation therapy, therapeutic touch, and guided imagery because they are effective, economical, noninvasive, non-pharmacological complements to traditional medical care.
  6. 6.  Model had its inception during 1950’s when America developed polio vaccine.  Unwillingness of people to immunise the child surprised health professionals  A model was developed by social psychologists & other public health workers known as Godfrey Hochbaum, Irwin Rosenstock and Stephen Kegels
  7. 7.  The current dynamics controls an individual rather than prior experiences- Kurt Lewis  Rosenstock proposed a health belief model intended to predict which individuals would or would not use such preventive measures as screening for early detection of cancer.  Becker (1974) modified the health belief model to include these components: individual perception, modifying factors and variables likely to affect initiating action.
  8. 8.  Based on motivational theory.  Useful tool in developing programs for helping people change to healthier lifestyles and develop more positive attitude.  It postulates that health seeking behaviour is influenced by person’s perception of threat posed by the health problem and associated with action aimed at producing threat.
  9. 9.  The major determinant of preventive health behavior is the avoidance of the diseases.
  10. 10.  Perceived susceptibility to disease  Perceived seriousness of diseases  Perceived barriers  Cues to action  Self efficacy
  11. 11.  Perceived susceptibility: Perception of getting a disease or condition.  Perceived seriousness: Perception that disease state or condition is harmful & has serious consequences  Perceived threat: Perceived susceptibility & perceived seriousness combines to determine perceived threat.
  12. 12.  Demographic variables Age, sex, race & ethnicity  Sociopsychological variables Social pressure or influence from peers or other reference group  Structural variables: Knowledge about the target disease and prior contact with it  Cues to action: Cues can be external or internal
  13. 13.  Perceived benefit: Belief that health action is of some value  Perceived barrier : Belief that health action would be associated with hindrance.
  14. 14. Demographic variables Perceived benefits minus Perceived barriers to preventive Action Perceived susceptibility Perceived seriousness of disease Likelihood of taking Recommended preventive health action Perceived threat of disease HEALTH BELIEF MODEL(Becker:1974) Cues to action Individual perceptions Modifying factors Likelihood of action
  15. 15.  Client motivation to become well.  Degree of lifestyle change necessary  Perceived severity of health care problem  Value placed on reducing the threat of illness  Difficulty in understanding and performing specific behavior.  Degree of inconvenience of illness or regimen.  Belief that the prescribed therapy will not help.
  16. 16.  Complexity, side effects and duration of proposed therapy.  Degree of satisfaction and type of relationship with the health care providers.  Overall cost of prescribed therapy.
  17. 17.  Model variables can be used as catalyst to stimulate an action  Modification of client’s distorted perceptions  Reducing the barrier to action  Supporting positive actions
  18. 18.  Preventive health behaviors: It includes health promoting(e.g. diet, exercise and health risk(e.g.smoking) behaviours as well as vaccination and contraceptive practices.  Sick role behaviors: It refers to the compliance with recommended medical regimens
  19. 19.  Understanding of regional culture of the students  Incorporated in nursing curricula as an aspect of client motivation, compliance or desired health outcome  Flexibility in presenting course content
  20. 20.  A parent will organize immunization for a child if he/she: ◦ believes there is a danger of the child contracting the disease (perceived susceptibility) ◦ believes that immunization is effective in eliminating the danger (perceived benefits) ◦ trusts that the method is safe and has an acceptable level of risk (possibly through education and media information) ◦ has the means to access the vaccination service (no barriers to behavior change)
  21. 21. Positive criticism  Offers an important insight into explaining health behavior  It is effective in promoting behavior change through the alterations of patient’s perspectives. Negative criticism  Exclusively focused on individual determinants of behavior  Does not acknowledge responsibility of the health professional to reduce barriers to action  It places the burden of action exclusively on the client
  22. 22.  Proposed by Nola J Pender (1982; revised, 1996).  Designed to be a “complementary counterpart to models of health protection.”  Health as a positive dynamic state not merely the absence of disease.  Health promotion is directed at increasing a client’s level of wellbeing.  The model describes the multi dimensional nature of persons as they interact within their environment to pursue health.
  23. 23.  Individual characteristics and experiences  Behavior-specific cognitions and affect  Behavioral outcomes Health promoting behavior is the desired behavioral outcome and is the end point in the HPM.
  24. 24.  Persons seek to create conditions of living through which they can express their unique human health potential.  Persons have the capacity for reflective self- awareness, including assessment of their own competencies.  Persons value growth in directions viewed as positive and attempts to achieve a personally acceptable balance between change and stability.
  25. 25.  Individuals seek to actively regulate their own behavior.  Individuals in all their bio-psychosocial complexity interact with the environment, progressively transforming the environment and being transformed over time.  Health professionals constitute a part of the interpersonal environment, which exerts influence on persons throughout their lifespan.  Self-initiated reconfiguration of person- environment interactive patterns is essential to behavior change.
  26. 26. Individual Characteristics and Experience  PRIOR RELATED BEHAVIOR :Frequency of the similar behaviour in the past. Direct and indirect effects on the likelihood of engaging in health promoting behaviors.  PERSONAL FACTORS : Personal factors categorized as biological, psychological and socio-cultural. These factors are predictive of a given behavior and shaped by the nature of the target behaviour being considered.
  27. 27.  Personal biological factors: Include variable such as age gender body mass index pubertal status, aerobic capacity, strength, agility, or balance.  Personal psychological factors: Include variables such as self esteem self motivation personal competence perceived health status and definition of health.  Personal socio-cultural factors: Include variables such as race ethnicity, education and socioeconomic status.
  28. 28. Behavioural Specific Cognition and Affect  PERCEIVED BENEFITS OF ACTION : Anticipated positive out comes that will occur from health behaviour.  PERCEIVED BARRIERS TO ACTION: Anticipated, imagined or real blocks and personal costs of understanding a given behaviour.  PERCEIVED SELF EFFICACY: Judgment of personal capability to organise and execute a health- promoting behaviour.
  29. 29.  ACTIVITY RELATED AFFECT: Subjective positive or negative feeling that occur before, during and following behavior based on the stimulus properties of the behaviour itself.  INTERPERSONAL INFLUENCES : Cognition concerning behaviours, beliefs, or attitudes of the others. Interpersonal influences include: norms, social support and modelling. Primary sources of interpersonal influences are families, peers, and healthcare providers.  SITUATIONAL INFLUENCES: Personal perceptions and cognitions of any given situation or context that can facilitate or impede behaviour. Include perceptions of options available, demand characteristics and aesthetic features of the environment.
  30. 30. Behavioural Outcome  COMMITMENT TO PLAN OF ACTION: The concept of intention and identification of a planned strategy leads to implementation of health behaviour.  IMMEDIATE COMPETING DEMANDS AND PREFERENCES:Competing demands are those alternative behaviour over which individuals have low control because there are environmental contingencies such as work or family care responsibilities. Competing preferences are alternative behaviour over which individuals exert relatively high control, such as choice of ice cream or apple for a snack
  31. 31.  HEALTH PROMOTING BEHAVIOUR : Endpoint or action outcome directed toward attaining positive health outcome such as optimal well- being, personal fulfillment, and productive living.
  32. 32.  Helps in understanding how the consumers can be motivated to attain the personal health.  Important for health planners of health care delivery and those who provide care.
  33. 33.  Primary tool for research.  Model has implications by emphasizing the importance of individual assessment of the factors believed to influence health behavior changes.
  34. 34.  Positive:  Theory is simple to understand, clear and accessible.  It is highly generalisable to adult population.  Model can influence interaction between nurse and consumers.  Negative:  Relationships require further clarifications  Sets have interactive effects that result in action.