NURSING THEORIES BASED ON SYSTEM o Activation of immune system

THEORY FRAMEWORK  Mode of Prevention in Nursing (Prevention =

1. Betty Neuman (1924-) Intervention):

- Health: She views health as levels of wellness  Interventions used by nurses are purposeful

or stable lines of defense. Health and wellness actions to retain, attain and maintain system

exist if all parts and subparts are in harmony balance for the client

with the whole person.  Primary

- Optimal system stability = optimal state of o Occurs before the system reacts to stressor

wellness o Health promotions and maintenance of wellness

- Nursing: unique profession in that it is o There is a degree of risk

concerned with all the variables affecting an o Immunization, health education, exercise and

individual’s response to stressors. lifestyle changes

- Person (client):  Secondary

 Open system o Occurs after the system reacts to stressor and

there are existing symptoms
 Individual, family, group or community
o Strengthening the internal lines of resistance and
 As an open system, continuously
reduce reaction
become more differentiated or complex
o To regain optimal system stability
 Being in constant change or in motion
o Analgesics, positioning to reduce pain
with reciprocal interaction with the
 Tertiary
environment
o After the system has been treated through
achieve optimal system stability.
secondary prevention
- THE NEUMAN SYSTEM MODEL
o Protect the client system reconstitution by
 Client System
supporting existing strength and continuing to
 Flexible line of defense
conserve energy.
o Initial response or protection of
o May begin after reconstitution (state of adaptation
the system
or return to system stability) began
o Prevent stressors from
o Client’s participation in rehabilitation program
invading the system
o Dynamic, can be altered over
2. Dorothy Johnson (1919-1999)
a short period of time
- Behavioral System Concept
 Normal line of defense
- “there is organization, interaction,
o Usual level of stability,
interdependency, and integration of the parts
normalcy and wellness;
and elements of behavior that go to make up
stability overtime
the system”
o Baseline determination of
- Assumptions
wellness
 Patterns of behavior of man reflects
o Usual coping patterns, lifestyle
what goal he is attempting to achieve.
and developmental stage
 Each subsystem has the tendency to
 Lines of resistance
achieve one unified goal and that is to
o Protect the basic structure
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 achieve balance within the system. THEORETICAL WORKS ON INTERACTION &
However, the method may vary. INTERPERSONAL RELATIONSHIP
 Each subsystem has available choices
1. Imogene King (1923-2007)
or alternatives from which choices can
- Assumptions
be made.
 Human beings are open systems in
 The behavioral subsystem produces
constant interaction with their
observable outcomes – that is, the
environment.
individual’s behavior
 The nursing focus is human being
- Seven Behavioral Subsystems
interacting with the environment
 Attachment or affiliative
 The nursing goal is to help individuals
 Dependency
and groups maintain health.
 Ingestive
- Central theme: Process of human interaction
 Eliminative
- Person: Humans are open system who are
 Sexual
social, rational, perceiving, controlling,
 Aggressive purposeful, action, and time oriented.
 Achievement - 3 Interacting system
- Central theme: human as a behavioral system  Social
- Person: have two major systems, the biologic
 Interpersonal
and behavioral.
 Personal
- Environment: Society is the environment in
- Environment: Internal and external
which an individual exists thereby influencing
environment continually interacts to assist in
the individual’s behavior.
adjustment to change.
- Health: Health is a dynamic state influenced by
- Health: is a purposeful, adaptive response to
biologic, psychologic, and social factors.
internal and external stimuli to maintain
- Nursing: Nursing is an art and science whose
balance and comfort.
primary goal is to foster balance within an
- Nursing: is perceiving, thinking, relating,
individual by providing external assistance
judging, and acting with an individual who
before and during balance disturbances.
comes to nursing situations. Together, they
• Nursing care is directed towards maintenance
explore means and agree on means to achieve
of the client’s state of equilibrium
goals.
• Clients were “stressed” by stimulus that leads
- Transaction Model
to disturbances/tension within the system
 Propositions
 Perceptual accuracy, role
• Focus of nursing:
congruency, and
1. returning the client to a state of
communication in a nurse-
equilibrium
client interaction leads to
2. Maintaining & supporting the client’s
transactions;
“natural” defenses and adaptive process.

2
  Transaction leads to goal - Nursing:
attainment and growth and  The critical work of psychiatric nursing
development is to help people develop a sense of
 Goal attainment leads to self through a healing interpersonal
satisfaction and to effective relationship.
nursing care  The instrument for the delivery of
 Theory of Goal Attainment interpersonal nursing is the therapeutic
use of self.
 Interpersonal process whereby the
professional nurse practitioner assists
an individual, family and community to
prevent or cope with the experience of
illness and suffering and if necessary,
to find meaning in these experience
 Therapeutic use of self is the ability to
use one's personality consciously and

 in the context of in full awareness in an attempt to

interpersonal systems establish relatedness and to structure

 what nurses do with and for nursing interventions. Refers to the

the individuals. nurse's presence, "a physical `being

 Interaction, communication, there’, and

transaction, role, stress, psychological `being with' a patient for

growth and development, time, the purpose of meeting the patient's

personal space health care needs"

 Transaction: a series of exchange  Human to human relationship

between human beings and their

environment that seek
to reach goals of worth to the
participants.
2. Joyce Travelbee (1926-1973)
- Central theme: sick person finding meaning in
illness and suffering and human to human
relationship
- Person: A unique irreplaceable individual who
is in a continuous process of becoming,
evolving, and changing.  Original encounter - first
- Environment: not defined; Human conditions impression by the nurse and
and life experiences the ill person
- Health: includes the individual’s perception of
health and the absence of disease
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  Emerging identities - nurse o Identified six nursing roles: counseling role,
and patient perceiving each leadership role, surrogate role, stranger
other as a unique person. role, resource person, and teaching role.
Bond begins to form o Views nursing as educative and
 Empathy - ability to share in therapeutic.
the other person’s experience o Roles:
 Sympathy - the nurse has the  Teacher: imparts knowledge (need
desire to alleviate the cause of or interest)
the patient’s illness or suffering  Resource: specific, needed info –
 Rapport - nursing actions are understanding a problem or new
being done to relieve the situation
patient’s distress  Counselor: aids another in
3. Hildegard Peplau (1909-1999) recognizing, facing, accepting and
- Interpersonal Relations in Nursing resolving problems  role is to
- Central theme: Described the dynamic listen to what the problem is and
relationship between the nurse and the patient. help, not solve it
 relationship is not fixed, there is change  Leader: initiate and maintain
- Person: Man is an organism that lives in an group goals
unstable equilibrium, psychological,  Technician: physical care through
physiological, and social fluidity. Striving to clinical skills and operating
reduce tension generated by needs machine
- Environment: Fluid context of the nurse- client  Surrogate: nurturing care
relationship.  adjusts depending on situation o Nursing is a healing art (because you’re
kaya ‘fluid’ using your therapeutic self)
 Consider culture and moral values o The nurse and patient respect each other
when hospitalized as individuals, both of them growing and
 Today nurses consider cultural learning (although more ang patient)
background and home and work o The goal of the nurse and the client is
background (because it affects how the achieved through a series of steps
nurse interacts with patient) following a sequential and systematic
- Health: Life is the process of striving in the pattern
direction of stable equilibrium, i.e., a fixed
pattern that is never reached except in death. o 3 Phases of Nurse-Client Relationship
 There’s a constant struggle to balance; It is  Pre-orientation
the forward movement of the personality.  No contact between nurse
- Nursing: Nursing is the therapeutic ( means and patient yet
to be beneficial to the other person)  Reading of chart of patient
interpersonal process carried out through the only, to get to know the
relationship between the person and the nurse. medications, progress,
etc. of the patient

4
 Orientation  Potential problems during the
 Nurse needs to be aware (usually) working and termination
of her personal reactions phase:
to the patient. 1. Transference
 Nurse and patient: - Patient becomes psychologically
a. meet as strangers  or emotionally dependent to the
rapport is important here nurse
to earn trust - Patient feels that it is not yet time
b. becomes more to end the relationship
comfortable with one 2. Counter transference
another - Final resolution is difficult for the
c. work together to nurse
recognize, clarify and - Patient is willing to terminate the
define the existing relationship, but the nurse
problem continuously visits
 Working the patient
 Nurse mostly uses
THEORETICAL WORKS ON ADAPTATION
communication tools to
explore and deal with 1. Sister Callista Roy
client’s problem - Adaptation Theory
 Nurse aids the patient in - Person: as an adaptive system that is in
using services to help constant interaction with the environment
solve the problem - Central theme: the person in constant
 patient works interaction with the changing environment
collaboratively with the
nurse to meet the - Adaptation level:
challenges and work o Integrated - adaptation level working as a
toward maximum health. whole
 Termination o Compensatory - human response system is
 Patient's needs have been activated
met o Compromised - when integrated and
 Patient and nurse compensatory process are not providing for
terminate their therapeutic adaptation
relationship and dissolves - Health: Health is a state or process of being or
the link between them. becoming an integrated and whole person.
 Patient becomes - Nursing: A theoretical system of knowledge
independent from the that prescribes a process of analysis and action
nurse related to the care of the ill or potentially ill
persons.

5
  The goal of nursing: the promotion of 2. Myra Estrin Levine
adaptive responses in relation to the - The Conservation Principle: A Model for Health
four adaptive modes - Central Theme: Adaptation, Conservation and
 adaptive responses – activities that Integrity
positively affect health - Adaptation
 Nursing activities support adaptive  The life process by which, over time,
responses and seek to reduce the people maintain their wholeness or
ineffective responses integrity as they respond to
- 4 Adaptive Modes environmental challenges.
1. Physiological-physical mode  The consequence of interaction
 physical responses & interactions with between person and environment
the environment  With historical process, specificity and
 Maintenance of physiologic integrity redundancy
(oxygenation, nutrition, elimination, - Conservation
activity & rest & protection)  Product of adaptation = wholeness and
2. Self-concept-group identity mode integrity
 need to know the self with a sense of  Ensuring the ability of the system to
unity continue to function in the face of
 consist of beliefs & feelings about severe challenges.
oneself  Provides the current survival but also
 central to the person’s behavior future vitality in facing challenges in the
 components: most economical way possible.
- Physical self: body sensation & body  4 PRINCIPLES OF CONSERVATION
image  Conservation of energy of the
- Personal self: self-consistency, self-ideal, individual
& the moral-ethical-spiritual self o The body is spending
3. Role Function Mode its energy resources
 a set of expectations of how a person on the process of
in a particular position will behave healing.

 Underlying need: social integrity o Limitation of activities,

 the roles of an individual in a society gradual resumption of

4. Interdependence Mode activities, rest

 Interdependent relationships of  Conservation of the structural

individuals and groups integrity of the individual

 Underlying need: relational integrity or o Integrity – being in

security in relationship control of one’s life,

having the freedom to
 Focuses on giving-receiving of love,
choose, to move w/o
respect and value with significant
constraints, decide
others and support system

6
 w/o apology,  In need of nursing when suffering arise.
indebtedness or guilt. Independence are set aside and
o Structural integrity – accepts services of another
healing process - Health
o A mind set to perfect  Goal of conservation
restoration of  Health and diseases are patterns of
structural integrity adaptive change
through life.  Successful adaptations are the ones
 Conservation of the personal that achieve the best fit in the most
integrity of the individual conserving manner.
o Sense of self, self-
awareness - Environment
o Identification of self-  Adaptation and conservation is through
actualization human interaction with the
o Likened to environment
independence  social context is an important
 Conservation of the social consideration of the wholeness of an
integrity of the individual individual.
o Definition of self that  3 aspects of environment:
goes beyond the  Operational – undetected
individual and natural forces that impinge on
includes the the individual
wholeness of each  Perceptual – information that
person. is recorded by the sensory
o Relationships with organs
others define the self  Conceptual – influenced by
o One’s identity is language, culture, ideas and
connected to family, cognition.
friends, community, - Nursing
workplace, school,
 To take care of others when they need
culture, ethnicity,
to be taken care of although this need
religion etc.
is only temporary.
- Person:
 Nursing takes place whenever there is
 focus should be on person’s
an individual who needs care to some
wholeness
degree.
 Continually adapts interactions with
environment which results in PERSON THEORIES: ON HUMAN DEVELOPMENT

conservation. 1. Margaret Newman

- Health as Expanding Consciousness
- Concepts and Assumptions:
7
  Health encompasses conditions known  A fusion of disease and non-disease
as disease (disease isn’t separate, it is create s a synthesis that is regarded as
included in the process of health) health
 Disease can be considered a  Interaction pattern of a person with the
manifestation of an underlying pattern environment.
of the person - A Paradigm shift:
 The pattern of the person that  To see health as the pattern of the
manifests itself as disease is primary whole, one needs to see disease not as
and exists prior to structural or a separate entity but as a manifestation
functional changes  kailangan may of the evolving pattern of person-
sakit muna bago may changes sa environment interaction.
lifestyle, etc.  Health and Disease
 Health is the expansion of  Fluctuations in patterns
consciousness (sickness) can provide the
- Nursing: disturbance needed to
 The role of the nurse is to help clients reorganize the relationships of
get in touch with the meaning of their a pattern more harmoniously.
lives by identification of the meanings  We grow or evolve through
 Is a process of caring through pattern experiencing disequilibrium
recognition  nurse says what is and learning how to attain a
wrong and what needs to change new sense of balance.
 Insight into this pattern provides the  From treatment of symptoms to a
client the understanding of which search for pattern.  para di na
action should be taken to open the way bumalik sa pattern yung patient
for changes.  From viewing disease and disruption
- Environment: Not explicitly defined but is being as negative to viewing them as part of
described as being the larger whole, which is the self-organizing process of
contains the consciousness of the individual expanding consciousness.  to make
within the family and community interactions them aware that there is a need to
- Person: change their lifestyle
 Client, patient, individual, human being  From viewing the nursing role as
 Includes family and community addressing the problems of disease to
 Participants in the transformative assisting people to get in touch with
process their own pattern of expanding

 Centers of consciousness within an consciousness.

overall patterns of expanding 2. Rosemarie Rizzo Parse

consciousness - Community: A Human Becoming Perspective

- Central theme:
- Health:  Humans are intentional beings
involved with their world, having a
8
 fundamental nature of knowing, being
present, and open to their world.
 The unitary human is one who co-
participates in the universe in creating
becoming and who is whole, open and
free to choose ways of becoming.
 Refers to how a person would like to
become as a human
- Health:
 A way of being in the world; it is not a
continuum of healthy to ill, nor is it a
dichotomy of health or illness, rather it
is the living of day-to-day ways of
being.
 A synthesis of values, a way of living
 A personal commitment
 A process of changing life’s meanings
as a result of the collective
relationships with others and the
universe.
- Environment: The world, the universe and
those who occupy spaces along with others
who freely choose to be in the situation.
- Nursing:
 A basic science, the practice of which
is performing art.
 The knowledge base of nursing is
science of the art and the performance
of the art is the creative living of the
knowledge
3. Josephine G. Paterson and Loretta T. Zderad
- Central Theme: Humanistic Nursing
- Necessary for us to understand our patients
more in relation to their experiences
- Nursing
 Nursing is concerned with the
individual’s unique being and striving
towards becoming, nurtured in
relationships.
 concerned with the phenomenological
experiences of individuals and the
exploration of human experiences
 A nurturing response of one person to
another in a time of need that aims
toward the development of well-being
(nurturing) and more-being (human
potential).
 Nursing helps increase the possibility
of making responsible choices, since
this is how human beings are able to
become.
- Person
 an individual being necessarily related
to other men in time and space. Human
beings are characterized as being
capable, open to options, persons with
values, and the unique manifestations
of their past, present, and future.
 People find meaning in their existence
by sharing and relating to others.
- Environment
 phenomenon of society or
environment is the community.
 Community is defined as 2 or more
persons striving together, living-dying
all at once.
- Health
 a matter of personal survival, a process
of experiencing one's potential for well-
being and more-being, a quality of
living and dying. It is more than the
absence of the disease.
 Health is a process of finding meaning
in life.
 Well-being implies a steady state
 More-being refers to being in the
process of becoming all that is humanly
possible
9
 4. Martha Rogers
- Science of Unitary Human Beings
- Central theme: Unitary Human Being
 An irreducible, indivisible energy field
identified by pattern and manifesting
characteristics that are specific to the
whole and which cannot be predicted
from knowledge of the parts
 A unified whole having its own
distinctive characteristics which cannot
be perceived by looking at, describing, - Assessment:
or summarizing the parts  Nurse sharing of reaction to the
 Emphasis on looking at the client as a patient’s behavior
whole, and not in their sub-parts  Gathering of data about the patient’s
 Theory mostly focuses on client needs through the 5 senses
- Person: a unified being with individuality  Trust is needed here to establish a
 In continuous exchange of energy with relationship and rapport with patient
the environment - Nursing diagnosis:
 Integral with the universe  The product of analysis of the patient’s
- Environment: An energy field  source of needs and problems
input for the client, which stimulates and  Prioritization
sustains the system of man  Immediate resolution of the problem
- Health: Not specifically addressed, but  given attention one at a time
emerges out of interaction between human and - Planning: Writing outcomes, goals, objectives
environment, moves forward, and maximizes and deciding appropriate nursing action/plan.
human potential - Implementation:
- Nursing: art and a science directed toward the  Carrying out the planned action
unitary human and concerned with the nature  Appropriate for the patient
and direction of human development
 Nurse considers all possible effects of
the action.
PROCESS THEORIES - Evaluation
 Based on objective criteria:
1. Ida Jean Orlando-Pelletier
 “Was the outcome achieved?”
- Nursing Process: considered as a nursing
 “Did the nurse help the
care plan
patient?”
 Focused on the dynamic nurse-patient
 Patient should be relieved upon
relationship
evaluation after the nursing care plan
 Function, process and principles
 Based on the interaction between the
patient and the nurse

10
 - Health: not defined but assumed that freedom
from mental or physical discomfort and feelings
of adequacy and well-being contribute to health
- Professional Nursing: Finding out and meeting
the client’s immediate need for help. 
according to prioritization
 Verbal behavior - encompasses all the
patient's use of language
 Nonverbal behavior - includes
physiological responses, motor
activity, vocal activity
- NOTE:
 Inconsistency between these two types
of behavior should alert the nurse that
the client needs help.
 All patient behavior, no matter how
insignificant, must be considered an
expression of need for help until its
meaning is understood.
 Improvement in patient's behavior
indicating resolution of the need is the
desired result.
- Environment: not fully defined
- Person: Unique individual behaving verbally
and non-verbally
2. Patricia Benner
- Stages of Clinical Competence
- Central theme: How nurses learn to do nursing
(stages of clinical competence)
- Stage 1: NOVICE
 No experience of the situations in
which one is expected to perform
 Is taught rules to help one to perform
 Rules are context-free and
independent of specific cases
tend to be applied universally
(limited & inflexible)
 “Just tell me what I need to do and I'll
do it.”
 Student nurses and a beginning nurse
in an unfamiliar area or situation; newly
hired
- Stage 2: ADVANCED BEGINNER
 Can demonstrate marginally
acceptable performance
 Has experience with enough real
situations (sometimes with the help of
a mentor) recurring meaningful
situational components
 Based on experience, begins to
formulate principles to guide action
 Nurses with 1 year experience
- Stage 3: COMPETENT
 Has been on the job in the same or
similar situations two or three years
 Does not have enough experience to
recognize a situation in terms of an
overall picture or in terms of which
aspects are most important
 Begins to see one’s actions in terms of
long-range goals or plans of which one
is consciously aware which leads to
competence
 Considerable conscious, abstract,
analytic contemplation of the problem
 plan → perspective
 plan → efficiency and organization
 Lacks speed and flexibility but with a
feeling of mastery and the ability to
11
 cope with and manage the many
contingencies of clinical nursing
 Can be a senior nurse already
- Stage 4: PROFICIENT
 Perceives the meaning of a situation in
terms of long-term goals (holistic
understanding)
 Based on experience: what events to
expect in a given situation  need to
modify plans in response to events 
improved decision making
 With 3 to 5 years of experience
 Can recognize when the expected
normal picture does not materialize
 Performance guided by maxims that
provide direction as to what must be
taken into account & that reflect
nuances of the situation  improved
decision making
- Stage 5: EXPERT
 With an enormous background of
experience
 Has an intuitive grasp of each situation
 zeroes in on the problem without
wasteful consideration of a large range
of unfruitful, alternative diagnoses and
solutions
 No longer relies on maxims to connect
understanding of the situation to an
appropriate action
 Operates from a deep understanding
of the total situation
 Performance fluid and flexible and
highly proficient
 Uses analytic tools for situations with
which the nurse has had no previous
experience & when the expert gets a
wrong grasp of the situation and then
finds that events and behaviors are not
occurring as expected
 5-10 years
- Person: self-interpreting being. They do not
come into the world predefined but gets defined
in the course of living a life; need to be
educated
- Environment: Benner used the term situation
rather than environment. Situation conveys a
social environment with social definition and
meaningfulness.
- Health: Based on the lived experience of being
healthy or ill.
- Nursing: A caring relationship, an enabling
condition of connection and concern
3. Ernestine Wiedenbach
- The Prescriptive Theory of Nursing
- Central Theme: Quality of health that the nurse
desires to sustain in her patient and specifies
what she recognizes to be her responsibility in
caring.
- Prescription: directive to activity which specifies
the nature of action and the thinking process.
 each action has a rationale/explanation for
its need
 Voluntary action
 Mutually understood and agreed upon
 Recipient-directed
 Practitioner directed
- Prescriptive Theory
 The conceptualization of a desired
situation and the prescription by which
it is brought about.
 Directs action toward an explicit goal.
 3 factors or concepts:
 Central purpose  rationale,
why you’re doing this
 Prescription
 Realities  factors to consider
that would affect the
prescription or action
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- Concepts and Assumptions:
 Nurse identifies her own philosophy
and recognizes that the patient has
autonomy and individuality, nurse will
work with the patient to develop a
prescription or plan for his/her care.
- 5 Realities:
 Agent – practicing nurse who is
committed and competent in nursing
 Recipient – patient who has the ability
to cope with problems
 Goal – desired outcome; what the
nurse wishes to achieve
 Means – activities and devices used to
attain goal
 Environment – incorporated within the
realities
 Nursing
 Goal-directed activity requiring
the application of knowledge
and skill toward meeting a
need for help experienced by a
patient. It is a helping process
that restores patient’s ability to
cope with demands.
 Nursing act is based on
thought through the kind of
results nurse wants, executes
action to obtain result and

 Framework – the context in which accepts responsibility for acts

nursing is practiced and constitutes and the outcome of actions.

currently existing limits 4. Joyce Fitzpatrick

- 3 Components for a Nursing Philosophy - Life Perspective Rhythm Model

 A reverence for the gift of life - Main theme: Classification of nursing

 Respect for the dignity, worth, diagnoses, interventions & outcomes

autonomy and individuality of each - Person:

human being o  Concept of both self and others having

 A resolution to act dynamically in unique biological, psychological,

relation to one’s belief emotional, social, cultural and spiritual

- Realities attitude

 Offer uniqueness to every situation  Thriving on honor and dignity, self-

 Have to be recognized and dealt with evaluation and growth and

to achieve the goal development

- Metaparadigm  Development happens within the social

 Person – Possesses unique potential, setting interacting with environment

strives towards self-direction, and

needs stimulation - Health:

 Health – not defined but supports  Dynamic state of being resulting from

WHO definition of health as the state interaction of person and environment

of complete physical, mental and  Optimal health: Actualization of both

social well being and not merely the innate and obtained human potential

absence of a disease and infirmity. as a result of rewarding relationships

with others. It is goal directed

13
  Health is ‘adjustment’ – “as needed  Sociocultural factors such as
basis” race, ethnicity, education,
- Environment: Not defined. Assumed to be in
the setting where the individual is interacting.
- Nursing: A practice of discipline and a
profession that is based upon a synthesized
body of knowledge, which is derived from
inquiry and clinical evaluation promoting
wellness and diminishing illness.
5. Nola Pender
- Health Promotion Model
- Concepts:
 Health promoting behavior - An end
point or action outcome that is directed
toward attaining positive health
socioeconomic status
outcomes such as optimum well being,
 Perceived benefits of action -
personal fulfillment and productive
Anticipated positive outcome that will
living.
result from health behaviors
 Prior related behavior - Frequency of
 Perceived barriers to action -
the similar behavior in the past that
Anticipated, imagined or real blocks
directly and indirectly leads to
and personal costs of undertaking a
engagement to health promoting
given behavior.
behaviors.
 Perceived self-efficacy - Judgment of
 Personal Factors:
personal capability to organize and
 Biological factors such as age,
execute a health promoting behavior
gender, body mass index,
 Perceived benefits of action -
strength, agility, etc.
Anticipated positive outcome that will
 Psychological factors such as
result from health behaviors
self-esteem, self-motivation,
 Activity-related affect - Subjective
personal competence,
positive or negative feelings that occur
perceived health status
before, during and following behavior.
It affects perceived self-efficacy – the
more positive the feelings, the greater
is the efficacy
 Interpersonal influences - These are
the person’s thinking regarding the
behavior, beliefs or attitudes of others.
It includes norms, social support and
modeling.

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 Situational influences - Perception of and being transformed
available options, demand overtime.
characteristics and aesthetic features o Health professionals constitute
of the environment to which the health a part of the interpersonal
promoting behavior is proposed to take environment, which exerts
place. influence on persons
 Commitment to a plan of action - The throughout their life span.
concept of intention and identification - Health
of planned strategy to implement of  An outcome of health promoting
health behavior behavior
 Immediate competing demands and  Enhanced well-being and actualized
preferences potential o optimum well-being,
o Competing demands- personal fulfillment and productive
alternative behaviors over living.
which the individuals have low - Environment
control because of  Bio-psycho-social situations
environmental contingencies  Interacting with persons
e.g. work or family
responsibilities
o Competing preferences –
alternative behaviors over
which individuals exert
relatively high control e.g.
choice of ice cream or an apple
for snack
 Major Assumptions
o Person seek to create
conditions of living through
which they can express their
unique human potential.
o Persons have the capacity for
reflective self-awareness,
including assessment of their
own competency.
o Individuals seek to actively
regulate their own behavior.
o Individuals interact with their
environment, progressively
transform their environment

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