The Health Promotion Model: Nola J. Pender Chapter 18 Overview of Pender’s Health Promotion Model Three major categories to consider in Pender’s health promotion model: Individual characteristics and experiences Behavior-specific cognitions and affect Behavioral outcome Individual Characteristics and Experiences: Prior Behavior Prior behavior directly and indirectly effects likelihood of engaging in health-promoting behaviors Direct effect of past behavior on current health-promoting behavior is due to habit formation Prior behavior indirectly influences health-promoting behavior through perceptions of self-efficacy, benefits, barriers & activity-related affect Individual Characteristics and Experiences: Personal Factors Personal biological factors include age, body mass index, pubertal status, menopausal status, aerobic capacity, strength, agility, or balance Personal psychological factors include self-esteem, self-motivation, perceived health status Personal sociocultural factors include education, ethnicity, acculturation, socioeconomic status Behavior-Specific Cognitions and Affect Perceived benefits of action or the anticipated positive outcomes resulting from health behavior Perceived barriers to action or anticipated, imagined, or real blocks or personal costs of a behavior Behavior-Specific Cognitions and Affect Perceived self-efficacy or the judgment of personal capability to organize and execute a health-promoting behavior Activity-related affect or the subjective positive or negative feelings that occur before, during, and following behavior based on the stimulus properties of the behavior Behavioral Outcome Commitment to a plan of action marks the beginning of a behavioral event Interventions in the health promotion model focus on raising consciousness related to: Health-promoting behaviors Promoting self-efficacy Enhancing the benefits of change Control of environment to support behavior change Managing the barriers to change Major Concepts of Nursing According to Pender Person: the individual who is the primary focus of the model Environment: the physical, interpersonal, and economic circumstances in which persons live Health: a positive high-level state Major Concepts of Nursing According to Pender Nursing: role of nurse includes raising consciousness related to health-promoting behaviors, promoting self-efficacy, enhancing the benefits of change, controlling the environment to support behavior change, and managing barriers to change Assumptions of the Health Promotion Model Persons seek to create conditions of living through which they can express their unique human potential Persons have the capacity for reflective self-awareness, including assessment of their own competencies Persons seek to actively regulate their own behavior Assumptions of the Health Promotion Model Persons value growth in directions viewed as positive and attempt to achieve a personally acceptable balance between change ...

1. The Health Promotion Model:
Nola J. Pender
Chapter 18
Overview of Pender’s Health Promotion Model
Three major categories to consider in Pender’s health promotion
model:
Individual characteristics and experiences
Behavior-specific cognitions and affect
Behavioral outcome
Individual Characteristics and Experiences: Prior Behavior
Prior behavior directly and indirectly effects likelihood of
engaging in health-promoting behaviors
Direct effect of past behavior on current health-promoting
behavior is due to habit formation
Prior behavior indirectly influences health-promoting behavior
through perceptions of self-efficacy, benefits, barriers &
activity-related affect
Individual Characteristics and Experiences: Personal Factors
Personal biological factors include age, body mass index,
pubertal status, menopausal status, aerobic capacity, strength,
agility, or balance
Personal psychological factors include self-esteem, self-
motivation, perceived health status
Personal sociocultural factors include education, ethnicity,

2. acculturation, socioeconomic status
Behavior-Specific Cognitions and Affect
Perceived benefits of action or the anticipated positive
outcomes resulting from health behavior
Perceived barriers to action or anticipated, imagined, or real
blocks or personal costs of a behavior
Behavior-Specific Cognitions and Affect
Perceived self-efficacy or the judgment of personal capability to
organize and execute a health-promoting behavior
Activity-related affect or the subjective positive or negative
feelings that occur before, during, and following behavior based
on the stimulus properties of the behavior
Behavioral Outcome
Commitment to a plan of action marks the beginning of a
behavioral event
Interventions in the health promotion model focus on raising
consciousness related to:
Health-promoting behaviors
Promoting self-efficacy
Enhancing the benefits of change
Control of environment to support behavior change
Managing the barriers to change
Major Concepts of Nursing
According to Pender
Person: the individual who is the primary focus of the model
Environment: the physical, interpersonal, and economic
circumstances in which persons live

3. Health: a positive high-level state
Major Concepts of Nursing
According to Pender
Nursing: role of nurse includes raising consciousness related to
health-promoting behaviors, promoting self-efficacy, enhancing
the benefits of change, controlling the environment to support
behavior change, and managing barriers to change
Assumptions of the Health
Promotion Model
Persons seek to create conditions of living through which they
can express their unique human potential
Persons have the capacity for reflective self-awareness,
including assessment of their own competencies
Persons seek to actively regulate their own behavior
Assumptions of the Health
Promotion Model
Persons value growth in directions viewed as positive and
attempt to achieve a personally acceptable balance between
change and stability
Persons, in all their biopsychosocial complexity, interact with
the environment progressively, transforming the environment
and being transformed themselves over time
Assumptions of the Health
Promotion Model
Health professionals constitute a part of the interpersonal

4. environment, which influences persons throughout their life
span
Self-initiated reconfiguration of person–environment interactive
patterns is essential for behavior change
Propositions of the Health
Promotion Model
Prior behavior and inherited and acquired characteristics
influence health beliefs, affect, and enactment of health-
promoting behavior
Persons commit to engaging in behaviors when they anticipate
deriving valued benefits
Perceived barriers can constrain commitment to action,
mediators of behavior, and actual behavior
Propositions of the Health
Promotion Model
Perceived competence or self-efficacy increases the likelihood
of commitment to action and actual performance of 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 lead to increased positive affect
Propositions of the Health
Promotion Model
When positive emotions or affect is associated with a behavior,
the probability of commitment and action are increased
Persons are more likely to commit to and engage in health-
promoting behaviors when significant others model the
behavior, expect the behavior to occur, and provide assistance

5. and support to enable the behavior
Propositions of the Health
Promotion Model
Family, peers, and healthcare providers are important sources of
interpersonal influence that can either increase or decrease
commitment to and engagement in health-promoting behavior
Situational influences in the external environment can either
increase or decrease commitment to or participation in health-
promoting behavior
Propositions of the Health
Promotion Model
The greater the commitment to a specific plan of action, the
more likely that health-promoting behaviors will be maintained
over time
Commitment to a plan of action is less likely to result in the
desired behavior when competing demands over which persons
have little control require immediate attention
Propositions of the Health
Promotion Model
Commitment to a plan of action is less likely to result in the
desired behavior when other actions are more attractive and
preferred over the target behavior
Persons can modify cognitions, affect, and the interpersonal and
physical environments to create incentives for health actions
Brief Critique of the Health

6. Promotion Model
Formulated using inductive reasoning and existing research
Simple to understand language
Health promotion is popular concept in nursing practice
Relationships among the various factors are linked and
relationships are identified and consistently defined
Pender’s Health Promotion Model as a Framework for Nursing
Practice
Assessment: nurse gathers data on prior related behavior of the
person, personal factors and perceptions of benefits from
actions, barriers to action, efficacy, and activity-related effects
and competing demands
Planning: nurse and patient work together to develop a health
promotion plan and patient commits to the plan
Pender’s Health Promotion Model as a Framework for Nursing
Practice
Implementation: actual incorporation of the health-promoting
behavior into the patient’s routine and life
Evaluation: based on the achievement of the action outcome or
the incorporation of a health-promoting behavior

7. My Information to Add In resume
Education
Currently enrolled in Bachelors of Science in Nursing in Grand
Canyon university
Diploma In General Nursing and Midwifery
2003-2006
Qualification
Registerd Professional Nurse 2016
Licensed Practical nurse 2014
Certification
· IV certified
· CPR certified
Professional Experience
Amar hospital Patiala,
India
· Medications
· Wound dressing
· Tube feedings
· Bedside patient care
Amrit Clinic Malerkotla India
· Care for pediatrics
· Assisted doctors in surgeries
Maxim health Care North
Brunswick, Nj
· Care for clients at their home
· Tracheostomy care- suctioning, tracheostomy change
· G-tube care-tube medications and feeding
· Accompany clients to physician’s appointment
· Complete nursing care and documentation
Bayada Home Health Care
· Care for clients at their home
· NG tube insertion- NG tube feeding and medications
· G-tube feeding, medication and care

8. · Care for Quadriplegic patients
· Open New cases for home care
· Supervisory visits to patients at their home
· Complete nursing care and documentation
Awards Received
· Care Giver of the Quarter in Maxim Health care
Language
· English, Hindi and Punjabi
Licensure -Registered Professional Nurse in New Jersey
Expire Date 05/31/2019
Health as Expanding Consciousness:
Margaret Newman
Chapter 17
Overview of Newman’s Theory of Health as Expanding
Consciousness
Major concepts are health, consciousness, patterns of movement
and space–time
Consciousness is the system’s ability to interact with the
environment
Pattern is the “information that depicts the whole and
understanding of the meaning of all of the relationships at once”

9. Overview of Newman’s Theory of Health as Expanding
Consciousness
Movement is reflection of consciousness that indicates inner
organization or disorganization of persons; it communicates
harmony or person’s pattern with the environment
Time is considered an index of consciousness
Dimensions of space–time–movement are complementary and
linked to one another
Major Concepts of Nursing
According to Newman
Person: a “center of consciousness within an overall pattern of
expanding consciousness” identified by individual patterns of
consciousness, and viewed as participants in the transformative
process
Environment: viewed as energy field, universe of open systems,
and as event, situation, or phenomena interacting with the
person
Major Concepts of Nursing
According to Newman
Health: synthesis that occurs due to the fusion of disease and
non-disease that forms health; health as concept is “pattern of
the whole”
Nursing: within the nurse-patient interaction the nurse is seen
as a “caring, pattern-recognizing presence” and the nursing
process is a process of pattern recognition
Explicit Assumptions of the Health as Expanding Consciousness
Theory
Health encompasses disease as a meaningful aspect of health; a

10. manifestation of underlying pattern of person–environment
interaction
Pathological conditions can be considered manifestations of
total pattern of individual
Health is the expression of consciousness
Explicit Assumptions of the Health as Expanding Consciousness
Theory
The pattern of the individual that eventually manifests itself as
pathology is primary and exists prior to structural or functional
changes
Removal of the pathology in itself will not change the pattern of
the individual
If becoming “ill” is the only way an individual’s pattern can
manifest itself, then that is health for that person
Implicit Assumptions of the Health as Expanding Consciousness
Theory
Humans are open energy systems
Humans are in continual interconnectedness with a universe of
open systems
Humans are continuously active in evolving their own pattern of
the whole
Implicit Assumptions of the Health as Expanding Consciousness
Theory
Humans are intuitive as well as cognitive and affective beings
Humans are capable of abstract thinking and sensation
Humans are more than the sum of their parts

11. Propositions of the Health as Expanding Consciousness Theory
Patterning of human health experiences occurs within the
context of the environment
Consciousness is a manifestation of evolving pattern of person–
environment interaction
The evolving pattern of person–environment interaction can be
viewed as a process of expanding consciousness
Propositions of the Health as Expanding Consciousness Theory
Movement is a pivotal choice point in the evolution of human
consciousness
When movement is no longer an option, we learn to transcend
the limitations of time–space–movement so as to reach higher
levels of consciousness
Movement is a reflection of consciousness
Time is a measure of consciousness
Propositions of the Health as Expanding Consciousness Theory
The consciousness that characterizes any form of life is
expressed in its movement
Manifestations of space–time–movement are indicators of
consciousness
The rhythm of living phenomena is a vivid portrayal of the
embeddedness of matter (consciousness) in space–time
Propositions of the Health as Expanding Consciousness Theory
A person comes into being from the ground of consciousness
and loses freedom as he or she is bound in time and finds
identity in space
Through movement, a person discovers the world of time–space

12. and establishes personal territory
Brief Critique of the Health as Expanding Consciousness
Theory
Derived from both inductive and deductive logic
Concepts clearly defined and used consistently throughout the
theory
Broad in scope and has been used in several different cultures
Theory is complex and must be understood as a whole rather
than by superficially examining the individual concepts in
attempt to use the theory
Newman’s Theory as a Framework for Nursing Practice
Five steps involved in the application of the theory to practice:
Engagement with the patient
Development of the narrative
Follow-up meetings
Application of the theory
Family and community patterns
Nursing Process Theory:
Ida Jean Orlando (Pelletier)
Chapter 16
Overview of Orlando’s Nursing Process Theory
Stresses reciprocal relationship between patient and nurse; what
the nurse and patient say and do during their interaction affects
both of them

13. Imperative that nurses share their perceptions with patients to
determine if their perception is congruent with the patient’s
perception of need
Focuses on producing improvement in the patient’s behavior
Major Concepts of Nursing
According to Orlando
Person: defines person in terms of patient or person with unmet
needs
Environment: assumes that a nursing situation occurs when
there is a nurse-patient contact
Health: assumes feelings of adequacy and well-being from
fulfilled needs contribute to health
Nursing: profession functions autonomously; function to meet
patient’s need for help
Assumptions of Orlando’s Nursing Process Theory About
Nursing
Nursing is a distinct profession, separate from other disciplines
Professional nursing has a distinct function and product
(outcome)
There is a difference between lay and professional nursing
Nursing is aligned with medicine
Assumptions of Orlando’s Nursing Process Theory About

14. Patients
Each patient’s needs for help are unique
Patients have an initial ability to communicate their needs for
help
When patients cannot meet their own needs they become
distressed
The patient’s behavior is meaningful
Patients are able and willing to communicate verbally
Assumptions of Orlando’s Nursing Process Theory About
Nurses
Nurse’s reaction to each patient is unique
Nurses should not add to the patient’s distress
Nurse’s mind is the major tool for helping patients
Nurse’s use of automatic responses prevents the responsibility
of nursing from being fulfilled
Nurse’s practice is improved through self-reflection
Assumptions of Orlando’s Nursing Process Theory About
Nurse-Patient Situation
The nurse–patient situation is a dynamic whole
The phenomenon of the nurse–patient encounter represents a
major source of nursing knowledge
Propositions of Orlando’s Nursing Process Theory
There is a relationship between the patient’s presenting
behavior and the presence of patient distress

15. There is a relationship between nurse’s use of Orlando’s distinct
nursing function and the nurse’s ability to recognize the need
for inquiry (deliberative nursing process) into the meaning of
the patient’s presenting behavior
Propositions of Orlando’s Nursing Process Theory
The more competent the nurse is in labeling his or her
perceptions, thoughts, and feelings, the more apt the nurse is to
find out the nature of the patient’s distress
If the nurse explores his or her immediate reaction with the
patient, the patient’s distress is lessened
Propositions of Orlando’s Nursing Process Theory
The nurse’s use of the deliberative nursing process will be less
costly than the nurse’s use of automatic personal responses
Patients’ experiencing repeated improvement as result of
deliberative nursing will have positive cumulative effects
Brief Critique of Orlando’s Nursing Process Theory
Developed inductively
Logical and applicable to nursing practice
Considered simple because it includes few concepts and
relationships
Internally consistent and meets the criteria for testability for a
middle-range theory
Effective practice theory that is especially helpful to new nurses
as they begin practice

16. Orlando’s Theory as Framework for Nursing Practice: Five
Interrelated Concepts
The organizing principle or professional nursing function
The problematic situation or the patient’s presenting behavior
The internal response or immediate reaction
Reflective inquiry or deliberative nursing process
Resolution or improvement
Orlando’s Theory as Framework for Nursing Practice
Assessment: nurse helps person express specific meaning of
behaviors in effort to determine source of distress; next, the
nurse should explore the distress to assess the help required.
The process used to share and validate the nurse’s direct and
indirect observations is known as the deliberative nursing
process.
Planning: participation from nurse and patient
Orlando’s Theory as Framework for Nursing Practice
Implementation:
Direct help occurs when the patient is unable to meet need and
the activity is confined to the nurse–patient
Indirect help occurs when activity to meet patient’s need
extends to arranging services
Evaluation: focus not on nurse’s activity; rather, if nurse’s
action helped patient communicate need for health and if need
was met