Nursing theory is a framework of concepts that guide nursing practice. It is developed through the relationships between research, practice, and experience. Nurses’ experiences and beliefs determine their research interests. The evidence gained through nursing research then influences nursing practice (Brykczynski, 2014). All nursing theories address the basic metaparadigm of person, environment, nursing science, and health.
The concepts of the nursing metaparadigm are influenced by the theorist’s education, practices, and beliefs (Brykczynski, 2014). The purpose of this paper is to delineate a nursing theory, and compare that theorists view of the nursing metaparadigm with that of this author. The established nursing theory chosen for comparison is Nola Pender’s Health Promotion Model.Personal Metaparadigm When first embarking in nursing, this author’s view of the metaparadigm was very simplistic. The patient was the person, the situation or environment the reason for admission, health was the lack of disease, and nursing was a moral responsibility to care for the patient.
As a newer nurse, there was a lack of critical thinking skills and experience to be able to recognize the “big picture”, or to anticipate patients’ needs. This author now views the person as a unique and complex individual with a specific set of needs. Situation can be seen as what is going on with a patient from their perspective, not just physically, but psychologically, emotionally, and spiritually. This allows the nurse to better serve the patient. Nursing care in this author’s model is based on the idea that nurses are morally and ethically responsible for the care of their patients. Nursing is a function of the relationship between nurses and patients; it should be a relationship built on mutual respect and understanding.
Without those elements it is harder to build trust and rapport, which makes the process of teaching and learning nearly impossible. The final element in the meta-components of nursing is the view of health. People’s perceptions of their well-being is influenced by their life experiences. Well-being has to do with more than just physical health, psychological outlook influences how healthy or unhealthy a person perceives themselves to be. This outlook in turn can be a defining factor in how they interpret and manage a diagnosis, particularly a serious and life altering one, like diabetes or heart failure.
TheoryNola Pender developed her Health Promotion Model (HPM) in response to the reactive nature of nursing practice at the time of its inception in the mid 1980s. Health professionals were largely intervening only after chronic health problems had already developed. Pender believed that health care costs could be reduced and the quality of patients lives improved with the promotion of healthy lifestyles. The HPM uses research from nursing, public health, and psychology; it uses positive motivation to create change in health behaviors (Alligood, 2018).
According to Saldanha Xavier, Santos, & Costa Silva, part of health promotion includes participation on the part of the patient in improving the quality of life (2017). In order to achieve optimal well-being, individuals must be able to identify their wants, satisfy their needs, and have the ability to positively alter their circumstances (Saldanha et al., 2017). This theory allows nurses to understand the source of health promotion behaviors to help coach and reinforce lifestyle modification. The theory was chosen because it closely aligns with this author’s more holistic take on the nursing metaparadigm.Literature ReviewIn Pender’s model, there are five components of the metaparadigm: person, environment, nursing, health, and illness.
The person is an organism shaped by the environment. According to Pender, the ability to control life events is a result of the relationship between interpersonal factors and external influences (1996). Life experiences shape behavior. The environment is the social, cultural, and physical context in which life takes place. The environment can be manipulated by the individual to enhance health seeking behaviors (Pender, 1996).
Nursing is a collaboration among patients, families, and communities to create the optimal conditions for health and wellness; this includes self-actualization and individual fulfillment (Bryer, Cherkis, & Raman, 2013). Health is defined as the fulfillment of human potential through goal-directed, self care behaviors. Illness is any event that can disrupt the journey to health (Pender, 1996). Pender’s HPM has been used in many nursing research studies with various populations, from nursing students to dialysis patients, and has helped these groups to realize their full potential and practice self care behaviors. Conclusion Pender’s Health Promotion Model is a nursing theory that serves to guide nursing practice. Like many other nursing theories, it focuses on the relationship between the person, health, the environment, and nursing.
The HPM aligns more with this author’s holistic concept of the nursing metaparadigm, particularly with respect to nursing and the nurse-patient relationship. Nurses within this theory are essentially helping patients help themselves, by allowing them to realize their potential as actualized human beings that can positively impact their health and well being.