Mental health is one of the most misunderstood fields of nursing. Physicians frequently misconstrue the complexities of individual’s symptoms. This misunderstanding results in several unsuccessful trials of medication therapy while avoiding the root cause of the illness. Health promotion in the field of mental health is a slow timely process that requires a broad approach to treatment. Nola Pender’s Health Promotion Theory speaks to altering unhealthy behaviors to endorse health. Theoretical concepts on person, environment, nursing, health, illness, and reflects social cognitive philosophy. Personal traits and environment are connected and can shape one’s behavior. Pender believes the environment encompasses a social, cultural, and physical context in which life unfolds and individuals can be both sources of and adapt to healthy behavioral changes (Petiprin 2016). The real question is how effective behavioral therapy in mental health is? This paper will expound on the purpose of the Health Promotion Model, demonstrate influences for selecting the noted theory to narrate mental health needs, exemplify plans to implement the theoretical model into current mental health practice, and barriers that may interfere with implementation. The purpose of this paper is to reveal the contribution Nola Pender Health Promotion Model can bring to the advancement of mental health and patient/s welfare within mental health treatment.
Introduction
Nola Pender’s Health Promotion Model defines health as a positive dynamic state being without illness and focuses on improving an individual’s state of well-being (Petiprin 2016). This model serves as a reflection of the social cognitive theory, in which cognition affects action and environmental events are indirectly projected as functioning control over behaviors (Misener, Phillips, McGraw 2000). Pender purposes that conduct can change via one’s perception and the benefits of that change can improve the quality of life by pursuing self-enrichment goals. The Health Promotion Model has three structural components: personal traits and experiences, (including environmental factors) specific congenital behavioral effects, and the outcome of behaviors (Petiprin 2016). Pender’s theory focuses on promoting health mentally, physically, emotionally, socially, and spiritually.
The Motivation for Theoretical Philosophy
Mental Health is composed of a variety of symptoms, predisposing factors, and is individually specific. Behaviors are actions learned through cultural methods, reactions to things experienced, and means to maintain self-control within self and the environment. Pender’s Health Promotion Model relates to mental health in a way that some other theories may not. Operating in crisis stabilization is another motivating factor. Crisis stabilization involves constantly seeing the same patients with the same problems based mainly on non-compliance as a result of environmental, financial, and emotional stressors. Stays range from 3-10 days when the patients come to detox off substances and/or receive medication adjust based on mental status. Through this process it is difficult to focus on the overall needs of the patient, yet it could be the ultimate cause of frequent re-admission. Promoting healthy behaviors along individual therapy and medication management could be the key to improving patient’s overall well-being. There is a need for the promotion of health by altering behaviors or ways of responding, within mental health care. This theory will allow people suffering from mental illness to retain some self-control, aid in their control of negative health diminishing behaviors, and encourage health-promoting behaviors that may enhance their quality of life.
Health-Promoting Behaviors
Pender model includes thirteen theoretical statements (Petiprin 2016 p.1):
“Prior behavior and inherited and acquired characteristics influence beliefs, effect, and enactment of health-promoting behaviors.”
“Persons commit to engaging in behaviors from which they anticipate deriving personally valued benefits.”
“Perceived barriers can constrain a commitment to action, a mediator of behavior as well as actual behaviors.”
“Perceived competence or self-efficacy to execute a given behavior increases the likelihood of commitment to action and actual performance of the behavior.”
“Greater perceived self-efficacy results in fewer perceived barriers to specific health behavior.”
“Positive affect toward a behavior results in greater perceived self-efficacy, which can, in turn, result in increased positive affect.”
“When positive emotions or affect are associated with a behavior, the probability of commitment and action is 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 aid and support to enable the behavior.”
“Families, peers, and health care providers are important sources of the interpersonal influence that 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.”
“The greater the commitments to a specific plan of action, the more likely health-promoting behaviors are to 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 requires immediate attention.”
“Persons can modify cognitions, affect, and the interpersonal and physical environment to create incentives for health actions” (Petiprin 2016 p.1).
Implementation of Healthy Behaviors
Implementing healthy behaviors in mental health can be a challenging task. To promote healthy inpatient behaviors, healthcare workers must also be seeking to improved personal well-being. Healthcare workers must seek to promote healthy behaviors by example. Nurses displaying healthy behaviors allows them to be more relatable to the challenges of continuing healthy habits and enhances the relationship between the nurse and patient. The patient is not only encouraged via speech but by illustration. Although goals may not be the same for the nurse and patient, knowing that caretakers are striving to improve well-being adds merit. Implementation would include collective and individual behavioral modification therapy, endorsing and assessing patients self- reflecting goals. Educating patients regarding the benefits of improving behaviors, encouraging patients to seek assistance when needed, and improve patient-staff relationships would also be a necessity. Every visit, an individual should feel more equipped to control behaviors and positively respond to triggers and/or stressors. Also, implantation of therapy should be peer-peer therapy because peers have a greater understanding of each other struggles. More empowered individuals should be asked to lead groups to encourage healthy behaviors of peers. The more involved patients are in their care the greater the outcome of them achieving stability and well-being will be.
Patient Barriers That Affecting Implementation.
Patients constantly express a need for self-worth and feel belong in the community. Patients’ perceptions of self are distorted due to frequent negative experiences, current economic status, unemployment, financial instability, and developments of mental trauma impacting their thoughts. The term social functioning was interpreted in a peer group study, stating social functioning includes having a support system, feeling safe and accomplished within their community, feeling less judgment, and more access to jobs (Hannigan B; Bartlett H; Clilverd A (2007). Their depression and behaviors were a result of limitation of healthcare, limited jobs, and not feeling safe. These barriers to patient stability affect their willingness to apply healthy behaviors. The stresses of their current status block their positivity and willingness to thrive. Positive health-promoting behaviors would have a greater effect at younger ages permitting manifestation of those behaviors with age. Group therapy is also important so that professionals will gain understanding of their healthcare situation and perceptions. There can also be barriers related to age, culture, gender, and stage of illness.
Healthcare Barriers that Affect Implementations
Healthcare professionals along with their practices can also be a barrier to implementing healthy-behavior (Barnes, Almasy 2005). Barriers consist of limited study of health promotion in mental health, limited advancement of healthy behaviors, and ineffective coping techniques to advanced mental health. The cost of treatment, and limited time spent with healthcare professionals to gain knowledge of patient conditions is also a barrier. Pender’s model can be used in the development and treatment to enhance compliance with medication and therapy (Lannon SL1997). Healthcare professionals view medication refusal or non-compliance as the patient being difficult while failing to assess the truth behind the refusal. Patients should have the right to refuse treatment unless they are a threat to themselves or others then crisis interventions are necessary. To control or decrease the behaviors medical profession initially or only seeking medication therapy. Although medication therapy is very useful and effective, it may not always be the immediate answer. Fears of aggressive actions, fearing the unknown, patients’ non-compliance, decreased relationship, and array individual therapies needed for patient care sometimes hinder the implementation of social modification therapy. Interventions are needed to promote medication, therapy, behavioral control, and compliance while assessing the reasoning behind the patient’s hesitance to comply.
Methods to Overcome Barriers
Restricting barriers, in a mental health setting, can be a bet taxing. Maslow’s hierocracy of needs is a great tool to use in treatment of mental illness. Physiological needs must be met first. Health-promoting behaviors can be achieved by providing resources and assisting patients to meet their needs McLeod (2018). Assistance with safety, love and belonging, self-esteem and finally self-actualization then follows. Building trusting therapeutic relationships is most effective in limiting barriers. The Health Promotion Model empowers nurses to inspire first self-care and then build patients’ capacity to perform via education and person development (McEwen, M. & Wills, E. 2019). Implementing health-promoting behaviors may allow more understanding of the patient’s mental state through behavioral modification techniques. Encouraging patients to obtain more self-control over conditions, teaching positive methods to cope throughout the disease’s process, and education on when to seek assistance are key factors to assist in the decreased psychiatric hospital stays more patient compliance, and increased patient- staff trusting relationships.
Conclusion
Mental health can truly be impacted by the benefits of promoting healthy behaviors of a patient as well as healthcare providers. Pender’s theory speaks to many healthcare fields. Though mental health can greatly benefit from this model by exhibiting the holistic care values. Guided care within the mental health framework requires the support of first the patient, then the staff, families and overall the community. We all suffer or have suffered from mental instability whether it be situational or genetically acquired. The advancement of mental health could help us all in some way. A daily goal should be striving to improve self: mind, body, soul and even the environment we live in.
References
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