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Theory Evaluation Paper: Pender’s Health Promotion Model

NU500-7A

February 6, 2022
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Theory Evaluation Paper: Pender’s Health Promotion Model

Nola Pender established the Pender Health Promotion Model (HPM) to guide nurses to

help their patients lead healthy lives by encouraging general wellbeing. The HPM framework

offers professionals in the nursing community strategies to promote a good lifestyle by

projecting on patients’ behavior (Grove et al., 2021). HPM is renowned for providing positive

results, as seen from research. The HPM model is acknowledged by nurses and utilized in

treating, education, and medical experimentation. Aqtam and Darawwad (2018) conducted

studies to determine the role of Pender’s model on health-promoting conduct. They discovered

that HPM is significant for nurses since it helps them comprehend and focus on adjusting a

patient's behavior. The HPM model was selected because it enables healthcare providers to

recognize ways to improve health, acknowledge barriers, and suggest healthy living behavior.

The significance of Pender’s Health Promotion Model in the nursing society can be understood

through an in-depth evaluation and analysis of the design.

Theory Description

Purpose

The Pender HPM is explained as a predictive, middle-range theory containing a restricted

scope and variables (Khoshnood et al., 2018). This characteristic makes the model effective in

research and practical nursing applications. The predictive ability of Pender’s Health Promotion

Model has relevance in the nursing community because it examines behavioral and

psychological variables that have predictive causes that can affect healthy living choices. Keegan

et al. (2012) state that the model is significant because it is not restricted to a few variables and

integrates older models known to boost a healthy lifestyle. The model incorporates health
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frameworks such as the theory of reasoned action, trans-theoretical model, and theory of planned

behavior.

Concepts

The main concepts of HPM include:

 Individual experiences and qualities

 Perceptions and influence that is particular to a specific behavior

 Behavioral consequences.

Nursing Theory (2020) states that according to HPM, people have distinctive mannerisms and

experiences which influence ensuing activities. Variables responsible for particular effects and

apprehension have significant inspirational relevance. Nurses can modify the different variables

to achieve the required behavioral results.

Definitions

The following assumptions define the HPM:

1. An individual has the desire to control their behavior diligently

2. Individuals make complex biopsychosocial interactions with the environment and

slowly modify themselves and their environment.

3. An individual’s interactive environment comprises healthcare practitioners who

impact them throughout their lifetime.

4. Behavior is changed through personally initiated reconstruction of an individual’s

environment-connected patterns.

Relationship

The three main concepts of Pender’s HPM can be expressed in several ways depending

on the circumstances input into the model. As a result of research and time, over thirteen
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theoretical statements have come from the model (Nursing Theory, 2020). These proposed

outcomes provide a basis from which to work when researching health behaviors.

Structure

The diagram in Figure 1 gives a visual representation of Pender’s HPM and the inter-

relationships of the theories' main concepts. Individual characteristics and experiences are input

into the model and are expressed as behavior-specific cognitions and affect. The behavior

outcome results from several factors that are influenced by several variables. Some are within the

individual to control, and others, such as immediate and competing demands, are not within the

control of the individual and can exert a negative outcome.

Figure 1

Pender’s Health Promotion Model

Note. From Theoretical basis for nursing (5th ed.), by M. McEwen & E.M. Wills, 2019, p. 229,

Wolters Kluwer. Copyright © 2019 Wolters Kluwer Health.

Assumptions

The former theory is based on the assumption that individuals will devote their resources

to expecting positive results (Khoshnood et al., 2018). This means that patients aspire for

objectives they perceive as obtainable and valuable. The revised theory emphasizes aspects

associated with behavior, for instance, the exercise of encouraging a healthy lifestyle

(Khoshnood et al., 2018). The primary assumption in this theory is that individuals will use self-

reliance as a motivation to change their behavior.

Theory Analysis

Theory’s Origin

The Health Promotion Model theory was designed by Nola Pender in 1982 and later

further developed in 1996. Analyses on the model were conducted for 27 years (Khoshnood et

al., 2018). According to Pender, motivation to establish the framework was from James Hall, a

doctoral aide who researched the role of thoughts in shaping individuals’ behaviors and

inspiration. HPM was developed and revised based on Fishbein and Bandura’s social learning

theories (Khoshnood et al., 2018).

Unique Focus

As designed and advanced by Pender, the Health Promotion Model has been adopted

worldwide for education, clinical medicine, and experimentation. The framework is significant in

assisting patients in attaining good health and recognizes circumstances that affect wellbeing.

The model is relevant in providing patients who require the resources necessary for realizing

particular behavioral transformations. Nurses use the framework while cooperating with the

patient to help them change their behavior to those that encourage healthy living (Khoshnood et
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al., 2018). The primary purpose of HPM is not only to assist patients to achieve good health but

also to identify behaviors that will help them get to their objective.

Content

The main concepts defined in the HPM by Pender include nursing, wellbeing,

environment, sickness, and person. The designer described a person as a cognitive-behavioral

entity that develops in an environment generated to fit prospective faculties. Pender believed that

patients required motivation to attain superiority (encourage healthy lifestyle) and sustain

balance in their environment. Pender described the environment to entail socioeconomic,

physical, and economic requirements of life. On the other hand, health is considered inborn and

attainable, according to Pender (Khoshnood et al. 2018). Adjustment in an individual’s way of

living leads to transforming behavior and gratifying care communication. Sickness is explained

as discerned incidents that take place in an individual’s lifetime that can be chronic or acute and

hinder or promote a person’s continual search for wellbeing. Nursing is elucidated as a detailed

plan for patients, their families, and the community that facilitates healthy living and preventive

care.

Theory Evaluation

Significance

The model's significance is that it helps to increase nursing mastery through advanced

research and recognizes crucial issues in the healthcare arena. The HPM framework

complements other theories by applying its illness preventative measures. Since health is

delineated as a state of positive welfare, nurses are capable of helping patients achieve healthy

living (Khoshnood et al., 2018). Behavior that promotes a healthy lifestyle improves aptitude and

standard of living. This importance of theory is crucial for individuals and the community at
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large. Grove et al. (2021) describe the theory as a significant source for creating studies because

it presents real-world problems that require investigation.

Comprehensiveness

The central utility aspect in any nursing model is usefulness and practicality in research,

clinical literacy, implementation, and management. Theories that are too difficult for application

cannot be considered to meet the specified utility standards. Practical models have concepts

significant to nursing as an occupation (Khoshnood et al., 2018). The HPM framework is

comprehensive since it has demonstrated its tenured capability to maintain its scientific

development and improvement since 1996.

Logical Congruence

The specification of logical congruence entails consistency which can be employed in

distinct ways. Coherence of the terms used in HPM theory is such that these concepts are used

according to their initial definition. The relationship between the different factors in the model is

connected, recognized, and regularly explained. Khoshnood et al. (2018) used various

experiments to analyze health issues in diverse cultures and discovered that Pender’s HPM

constantly envisioned behavioral results for patients.

Credibility

Credibility necessitates an empirical capacity that requires the declaration made by

theories to be consistent with experimental findings. The HPM framework is credible as it

continues to be endorsed by the latest research and literature. Khoshnood et al. (2018) state that

when a search on “Health Promotion Model” is done using EBSCO Host, CINHAL, and Med

Line, it produces many studies. The conciseness of the model makes it significant in advancing

nursing knowledge.
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Contribution to Nursing

The theory is essential in carrying out research that forecasts behaviors that promote or

impede an individual’s health. Nurses can delineate variables that help improve wellbeing by

looking into the background factors (Khoshnood et al., 2018). Investigational studies carried out

through this model assist nurses in discovering the connection between variables and encourage

preventative care.

Conclusion

The importance of Pender’s Health Promotion Model has been looked into through a

comprehensive analysis and evaluation of the framework. The model's primary purpose is to

encourage positive health outcomes through behavioral change. Nurses use the model to

determine which background factors are responsible for a patient’s sickness. Pender’s Health

Promotion Model is credible and effective in nursing practice, research, and clinical

administration.
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References

Aqtam, I., & Darawwad, M. (2018). Health promotion model: An integrative literature

review. Open Journal of Nursing, 8(07), 485.

Grove, S. K., Burns, N., & Gray, J. (2021). The practice of nursing research: Appraisal,

synthesis, and generation of evidence. Elsevier Health Sciences.

Keegan, J. P., Chan, F., Ditchman, N., & Chiu, C.Y. (2012). Predictive ability of Pender’s health

promotion model for physical activity and exercise in people with spinal cord injuries.

Rehabilitation Counseling Bulletin, 56(1), 34–47.

https://doi.org/10.1177/0034355212440732

Khoshnood, Z., Rayyani, M., & Tirgari, B. (2018). Theory analysis for Pender’s health

promotion model (HPM) by Barnum’s criteria: A critical perspective. International

Journal of Adolescent Medicine and Health, 32(4). https://doi.org/10.1515/ijamh-2017-

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McEwen, M., & Wills, E. M. (2019). Theoretical basis for nursing (5th ed.). Wolters Kluwer.

Nursing Theory (2020). Pender's health promotion model - nursing theory. https://nursing-

theory.org/theories-and-models/pender-health-promotion-model.php