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1、Copyright 2008 Delmar. All rights reserved.Chapter 13Principles of Health Promotion汽车防盗器 :/zg001gpsCopyright 2008 Delmar. All rights reserved.2Healthy People 2010 Health of the total population and the consequences of the determinants of health: Biology Behavior Social environment Physical environme

2、nt Policies InterventionCopyright 2008 Delmar. All rights reserved.3Healthy People 2010 Policies InterventionCopyright 2008 Delmar. All rights reserved.4Holistic Concept of Health Nursing and public health view of health as a holistic concept Encompasses Physical Psychological Social Spiritual dimen

3、sionCopyright 2008 Delmar. All rights reserved.5Smith Model of Health Four models: Clinical health Role performance health Adaptive health1. Eudaemonic healthCopyright 2008 Delmar. All rights reserved.6Pender Actualization of inherent and acquired human potential through Goal directed behavior Compe

4、tent self care Satisfying relationships while maintaining structural integrity with environmentsCopyright 2008 Delmar. All rights reserved.7Health Promotion History WHO Ottawa Charter Multidisciplinary practice Florence Nightingale (1859) wellness-illness continuum Promoted health through education

5、Nursing care included personal living and healthful environmentsCopyright 2008 Delmar. All rights reserved.8Health Promotion History Nursings meta-paradigm Person Environment Health NursingCopyright 2008 Delmar. All rights reserved.9Health Promotion History 1973 ANA Standards of Nursing Practice 197

6、9 Healthy People: Surgeon Generals Report on Health Promotion and DiseaseCopyright 2008 Delmar. All rights reserved.10Theoretical Foundations Behavioral Model Behavior is a function of the rational decision making process Lewin Positive valence Negative valence Value expectancy theoryCopyright 2008

7、Delmar. All rights reserved.11Health Belief Model Based on value expectancy theory Rosenstock (1966) added variables to the model Variables that explain or predict behavior: Susceptibility Severity Barriers Cues to actionCopyright 2008 Delmar. All rights reserved.12Penders Health Promotion ModelPend

8、er modified the Health Belief ModelIntegrates concepts from HBM and social cognitive theoryRevised in 2002Copyright 2008 Delmar. All rights reserved.13Penders Health Promotion Model Concepts grouped in three major categories:1. Individual characteristics and experiences Prior-related behavior Person

9、al factorsCopyright 2008 Delmar. All rights reserved.14Penders Health Promotion Model Concepts grouped in three major categories2. Behavior-specific cognitions and affect Perceived benefits Perceived barriers to the actionCopyright 2008 Delmar. All rights reserved.15Penders Health Promotion Model Co

10、ncepts grouped in three major categories3. Perceived self-efficacy Activity related affect Interpersonal influences Situational influences Behavioral outcomeCopyright 2008 Delmar. All rights reserved.16Theory of Planned Behavior Extension of the theory of reasoned action Intention Attitude Subjectiv

11、e norm Perceived behavioral control Outcome expectancyCopyright 2008 Delmar. All rights reserved.17Transtheoretical Model of Behavioral Change Individuals progress through stages during behavioral change process Precontemplation stage Contemplation stage Preparation stage Action stage Maintenance st

12、ageCopyright 2008 Delmar. All rights reserved.18Transtheoretical Model of Behavioral Change Three constructs that influence behavior change: Process of change Self-efficacy1. Decisional changeCopyright 2008 Delmar. All rights reserved.19Ecological Models Social Cognitive Theory Triadic reciprocal de

13、terminism Outcome expectanciesCopyright 2008 Delmar. All rights reserved.20Ecological Models Bandura self-efficacy expectations Developed from four sources of information:Enactive attainmentVicarious experiences Verbal persuasionPhysiological or emotional arousalCopyright 2008 Delmar. All rights res

14、erved.21Ecological Models Ecological model of health behavior Five system levelsIntrapersonalInterpersonalOrganizationalCommunity1. Public policyCopyright 2008 Delmar. All rights reserved.22Other Ecological Frameworks Integrative Model for Community Health Promotion and the Structural Model of Healt

15、h Behavior (SMHB) Three foci of care: Illness/disease prevention Health promotion Illness careCopyright 2008 Delmar. All rights reserved.23Other Ecological Frameworks SMHB includes four factors that influence health at the population level Availability/accessibility of consumer products Physical structures Social structures and policies Media and cultural messagesCopyright 2008 Delmar. All rights reserved.24Focus on Population Emphasis is on lowering the average risk of all individuals in the community Three approaches: Framework for health communicatio