HEALTH PROMOTIONAL MODEL
By NOLA J. PENDER
Heath Promotional Model

It encourages scholars to look
integratively at variables that
have been shown to impact
health behavior.

It synthesizes research
findings from nursing
psychology and public health
into an explanatory model of
health behavior that still must
not merely the absence
of disease’.


pursue health
ENVIRONMENT

METAPARADIGMS
through which they can
express their unique

become transformed
themselves over time
NURSING

toward self-attribution,
self-evaluation, and self-
awareness, including the
assessment of his own
efficacy.
Health Promotion Model

attempts to achieve a
personally acceptable

balance between change
& stability
Man also seek to actively
regulate their own
behavior
HEALTH

Defines health as “a
positive dynamic state
Nursing is a helping
profession that
empowers patients
for reflective self-

Person always interact
with the environment,
transform the
environment
progressively, and
human health potential
Man also has the capacity
competencies
Man values growth in
positive directions and
client’s level of wellbeing.
It describes the multidimensional nature of
persons as they interact
within the environment to
undergo further testing.
PERSON
 Man seeks to create
conditions of living
Health promotion is
directed at increasing a

It focuses on ten
categories of
determinants of healthpromoting behaviors
It views person’s healthpromoting behavior in the
light of his individual

characteristics and
experiences
The person’s level of
cognitive abilities and
affect also play a major
10. Personal factors (biological,
role in the development
psychological, sociocultural)
of these healthpromoting behaviors
CONCEPTS AND DEFINITIONS
PERSONAL FACTORS –
HEALTH PROMOTION –
categorized as biological,
psychological and socio-cultural.
defined as behavior motivated
by the desire to increase wellbeing and actualize human
These factors are predictive of
a given behavior and shaped by
the nature of the target
health potential. It is an
approach to wellness
behavior being considered
 Biological – age, gender,
HEALTH PROTECTION – or
illness prevention is described
as behavior motivated desire to
BMI, pubertal status,
aerobic capacity,
strength, agility, etc.
actively avoid illness, detect it
early, or maintain functioning
 Psychological - selfesteem, self-motivation,
within the constraints of illness
TEN DETERMINANTS OF HEALTHPROMOTING BEHAVIORS
1. Prior related Behavior
2. Perceived benefits of action
(health-promoting behaviors)
3. Perceived barriers to action
(health-promoting behaviors)
4. Perceived self-efficacy
5. Activity-related affect
6. Interpersonal influences
(family, friends, providers),
norms, support, and models
7. Situational influences (options,
demand characteristics,
aesthetics)
8. Immediate competing demand
(low control) and preferences
(high control)
9. Commitment to a plan of action
personal competence,
perceived health status,
& definition of health
 Socio-cultural – race,
ethnicity, acculturation,
education and
socioeconomic status
PERCEIVED BENEFITS OF
ACTION – anticipated positive
outcomes that will occur from
health behavior
PERCIEVED BARRIERS TO
ACTION – anticipated,
imagined or real blocks and
personal costs of understanding
a given behavior
PERCEIVED SELF-EFFICACY –
judgment of personal capability
to organize and execute a
health-promoting behavior. It
influences perceived barriers to
action so higher efficacy
results in lowered perceptions
of barriers to the performance
of the behavior
ACTIVITY-RELATED AFFECT
 Subjective positive or
negative feeling that
occurs before, during and
following behavior based
on the stimulus
SITUATIONAL INFLUENCES

situation or context that
can facilitate or impede

Influences perceived
self-efficacy, which
means the more positive
the subjective feeling,
the greater the feeling
of efficacy
INTERPERSONAL
INFLUENCES

environment in which
given health promoting is
proposed to take place


Cognition concerning
behaviors, beliefs, or
emotional
encouragement) and
modeling (vicarious
learning through
observing others engaged
in a particular behavior

Primary sources of
interpersonal influences
are families, peers and
healthcare providers
Competing demands – are
those alternative
behaviors over which
individuals have low
control because there
Interpersonal influences
include norms
(expectations of
significant others), social
support (instrumental and
It may have direct or
indirect influences on
health behavior
IMMEDIATE COMPETING
DEMANDS & PREFERENCES
attitudes of the others

behavior
Include perceptions of
options available, demand
characteristics and
aesthetic features of the
properties of the
behavior itself.

Personal perceptions and
cognitions of any given
are environmental
contingencies such as
work or family care

responsibilities
Competing preferences –
are alternative behaviors
over which individuals
exert relatively high
control, such as choice of
ice cream or apple for a
snack
COMMITMENT TO PLAN OF
ACTION – the concept of
intention and identification of a
planned strategy leads to the
implementation of health

Human beings know and
behavior
appraise objects, conditions,
HEALTH-PROMOTING
BEHAVIOR – an endpoint or
and situations
Human beings sense, reflect,
action outcome that is directed
toward attaining positive health
outcomes such as optimal
wellbeing, personal fulfillment,
and productive living.
“Nursing is a helping profession that
empowers patients towards selfattribution, self-evaluation, and self-


reason, and understand
Human beings actions are selfdetermined, even when

emotional
Human beings are capable of
prolonging reflection through
strategies such as asking
questions
efficacy”
MYRA LEVINE(1973)
FOUR CONSERVATION PRINCIPLES
Described the four Conservation
OF NURSING by MYRA ESTRINE
LEVINE
The goal of the Four Conservation
Principles of Nursing, created by
Myra Estrine Levine, is to promote
adaptation and maintain wholeness by
using the principles of conservation.
The model guides the nurse in
focusing on the influences and
responses at the organismic level.
Princples – she advocated that
nursing is human interaction and
proposed four conservation
principles of nursing which are
concerned with the unity and
integrity of the individual
FOUR CONSERVATION
PRINCIPLES

human body functions by
utilizing energy. The human
body needs energy producing
There are assumptions made by the
theory

input (food, oxygen, fluids)
to allow energy utilization as
The nurse creates an
environment in which healing
can occur

A human being is more than the
sum of his or her parts

Human being respond in a

predictable way
Human beings are unique in
their responses
Conservation of Energy – the

output
Conservation of Structural
Integrity – the human body
has structural boundaries
(skin and mucous membrane)
that must be maintained to
facilitate health and prevent

harmful agents from
Organismic response is a change in the
entering the human body
behavior of a patient during an
Conservation of Personal
Integrity – The nursing
attempt to adapt to the environment.
These responses help the patient
intervention of the individual
client’s personality – Every
individual has a sense of
protect and maintain his or her
integrity. There are four types of
these responses:
identity, self-worth and
self-esteem, which must be
preserved and enhanced by

nurses
Conservation of Social
Integrity – the social
integrity of the client
reflects the family and the
community in which the
client functions. Health care
institution may separate
individuals from their family.
It is important for nurses to
consider the individual in the
context of the family
According to Levine, the patient and
environment have three concepts:
adaptation, organismic response, and
conservation
Adaptation has three characteristic:
history, specificity, and redundancy.
Historicity states that adaptations
are grounded in history and await the
challenges to which they respond.
Specificity refers to the individual
responses and their adaptive pattern,
which varies on the basis of specific
genetic structure. Finally, redundancy
explains the options available to the
patient to ensure continued
adaptation
1. Fight or flight, which is an
instantaneous response to real
or imagined threat. It is the
most primitive response
2. Inflammatory, which is a
response intended to provide
for structural integrity and the
promotional of healing
3. Stress, which is a response
developed over time and
influenced by each stressful
experience the patient
encounters
4. Perceptual, which involves
gathering information from the
environment and converting it
into a meaning experience
Levine’s theory includes nine models
of guided assessment
1. Vital signs
2. Body movement and positioning
3. Ministration of personal hygiene
needs
4. Pressure gradient system in
nursing interventions
5. Nursing determination in provision
of nutritional needs’
6. Pressure gradient system in
nursing
7. Local application of heat and cold
8. Administration of medicine
9. Establishing an aseptic
environment