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Perceived barriers can constrain commitment to action (a mediator of behavior), as well as actual behavior.Perceived competence or self-efficacy to execute a given behavior 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.(Butts & Rich, 2018, p. 449-450; Pender et al., 2002, p. 63-64)
Propositions ContinuedWhen positive emotions or affect are 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 and support to enable the behavior.Family, peers, and healthcare providers are important sources of interpersonal influence who can increase or decrease commitment to and engagement in health-promoting behavior.Situational influences in the external environment can increase or decrease commitment to or participation in health-promoting behavior.(Butts & Rich, 2018, p. 250; Pender, et al., 2002, p. 63-64)
Propositions ContinuedThe greater the commitment to a specific plan of action, the more likely 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.Commitment to a plan of action is less likely to result in the desired behavior when other actions are more attractive and thus preferred over the target behavior.Persons can modify cognitions, affect, and the interpersonal and physical environments to create incentives for health actions (Pender et al., 2002, pp. 63–64).Positive affect toward a behavior results in greater perceived self-efficacy, which can, in turn, result in increased positive affect(Butts & Rich, 2018, p. 450; Pender et al., 2002, p. 63-64)
Analysis of Pender’s TheoryHPM is a middle range theory.Focuses on behavioral lifestyle modificationsTo improve functional ability To improve quality of lifeThis model is constructed upon two social theories. Fishbein’s(1967) theory of reasoned action Bandura’s (1977) social learning theory(Butts & Rich, 2018)Recognizes the individual as the sum of individual parts interacting within their environment Recognizes the four nursing metaparadigm: health, person, environment and nurse.HPM provides a counterpart to models based on illness-prevention. HPM is not limited to specific health behaviorsUseful in many different settings Provides nurses with steps toward goal-directed care that influence individuals toward health and wellness.
Weaknesses of Pender’s TheoryPender’s HPM Model focuses on individuals rather than communities and families as a wholeHPM Model may not be applicable to adolescentsHPM Model may not be applicable to those who cannot exercise independent decision making