So, who is Cheryl Cox. Cox has had a lot of roles throughout her career. She has worked as a
teacher and professor. She researched and developed the theory I will be talking about, the
Interaction Model of the Client Health Behavior.
She received her bachelor’s degree from the University of Tennessee in 1970
She went ahead to receive her master’s degree from Vanderbilt in 1972
Got her PhD from the University of Rochester 10 years later and is still actively involved in
researching how her theory can continue to increase better health outcomes in the pediatric
oncology population
So what’s the Interaction Model of the Client Health Behavior”. The theory explains how the
variables of a patient’s background such as demographics and previous healthcare experience
can affect how well they will use the intervention strategies available to influence a better health
outcome
I chose this theory because I work in the critical care unit and I have seen how acknowledging a
patient’s background in their plan of care has helped to get a positive health outcome. For
example, recognizing a patient's culture on pain and educating him so that he understands that
admitting pain does not make him weak. It will just make it easier for his me to effectively
manage his pain.
Researching this theory will definitely help me use the various variables in my patient’s
background in personalizing care. This could ultimately translate to a positive health outcome.
The theory consists of three major elements, client singularity, client – professional relationship
and health outcome
The first element is the client singularity. This is the unique intrapersonal configuration of an
individual. This includes background variables, motivation, cognitive appraisal, and affective
response.
The background variables are demographic characteristics, social influence which is determined
by the people the patient relates with, previous healthcare experience and environmental
resources such as money and access to enough health care facilities
Motivation is the readiness of the client to follow through with the health intervention provided
Cognitive appraisal is the client’s way of interpreting a health condition for example a person’s
religion could determine their view of getting blood products
Affective response is the emotion the client has toward the health concern. If a person is
frightened about a surgical procedure, it will determine if they will consent to the procedure
The second element of this theory is the client – professional relationship: This is the extent to
which the provider attends to the client’s singularity and puts the singularity into consideration
when personalizing the intervention strategies for the patient. Components of this element
includes affective support, healthcare information, decisional control, and professional-technical
competencies
Affective support is supporting the patient emotionally especially if they are anxious or scared
about their health
Healthcare information which is providing the right information for the patient so that they can
make informed decisions
Decisional control is having the power to participate in making decisions that will turn into good
health outcomes
Professional-technical competencies is basically the skills and competencies of the provider.
The third element of this theory is the health outcome which is a measure of the Health state that
is associated with certain health behaviors. It could be negative or positive outcome
The utilization of health care services, we want increased utilization of health care services as
this shows they are more in control of their health
clinical health-status indicators,
severity of health care problem,
adherence to the recommended health care regimen for example, When a patient is not
compliant with blood pressure medication they will have a negative health outcome.
This is a pictorial representation of the Interaction Model of the Health Care Behavior. Like I
said in the previous slides the major elements are the client singularity, client- professional
relationship and health outcome. This diagram shows you the how these elements interact and
personalize care for the patient based on all these elements
This is a table showing all the elements, variables and their definitions relevant to childhood
cancer survivors
Cox’s theory has contributed greatly to nursing research. She developed a model that
creates awareness on the effect providers have on patients to influence their health outcome
Cox's theory places vital importance on the nurse to the patient relationship because a good
relationship encourages communication. Good communication can help tailor care for patients
and reduce risky health behaviors, especially in the pediatric cancer population where she did a
lot of research on.
I used the Chinn and Kramer model to critique the theory. The model critiques the theory by
assessing its clarity, simplicity, accessibility, generalizability and importance.
Cox defined the major elements of the theory and provided examples of the variables associated
with them. It was easy for me to understand the concepts, relationship between concepts and the
expected outcome. She made it relatable as it’s easy for me to correlate this to my clinical
practice and see how it applies in a clinical setting. Also, she used diagrams and tables making
the model visual to the reader.
In terms of simplicity, there are lots of concepts that need to be known and understood
individually while also trying to identify the relationships between these concepts. The number
of concepts makes the model somewhat difficult to grasp and apply within the nursing practice.
Although the concepts are easy to use individually, it could be hard to utilize all the concepts on
one patient at a time
In terms of Accessibility, this theory has some concepts that one can identify with in real life
situations while others will need a little explanation for a reader or provider to understand.
Variables such as the background profile are utilized often in my clinical practice while terms
such as affective support will need some explanation before I can apply it to patients. This model
can easily be tested and replicated as it has been used for weight management in children,
community elders, and pediatric cancer patients
When it comes to Generalizability Cox has applied this theory to community-based elders,
women and pediatric cancer patients while emphasizing personalized care such that nursing
interventions are tailored to each client’s needs. This theory is applicable in any practice
especially since its concepts can be translated to any diagnosis, population or practice.
Cox’s theory is very valuable in nursing practice, education and research. She created a model
that emphasizes the effect providers have on patients in terms of influencing their health
outcome. Her work has helped to improve patient health behavior through encouraging a better
nurse-patient relationship. The theory helps to determine the variables deterring patients from
having positive health outcomes and giving patients the ability to be in charge of their health.
Cox’ theory has helped to improve patient health behavior through nurse – patient relationship.
This is by encouraging good relationship which translates to better communication between both
parties
Her theory has helped to determine the deterrents to making positive health outcomes by using
client singularity variables when assessing patients and this has helped to greatly improve
outcomes especially in pediatric cancer patients
Encouraging patients to be in charge of their health such as managing dietary habits to avoid
obesity