Nursing Health Model

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Discuss how psychological and sociological concepts and theories can inform health promotion in nursing practice.

For the purpose of the assignment the contents will discuss Prochaska and DiClemente’s Stages of Change Model in conjunction with empowerment and self-efficacy. To support the assignment a case study will be used to aid the application of the theories and models when applied to nursing practice.

The case study used in this assignment is 50 year old woman, Alison Stevenson, a single, unemployed mother of three young children who lives in East Belfast. Alison has been smoking for 30 years and a year ago was diagnosed with bilateral lung carcinoma. Currently she has been admitted to hospital with Chronic Obstructive Pulmonary Disease (COPD). Smoking not only affects you physically but it affects those around you in the form of passive smoking caused by side stream smoke. Alison wants to prolong her life for as long as possible, for the sake of her two children. Alison will liaise with nurses on the ward and services available to be provided with suitable advice and aids. This is to help her to quit smoking and change her health behaviour. COPD is the 5th biggest killer in the UK and worldwide. There are an estimated 3 million people with COPD in the UK (British Lung Foundation, 2011), smoking being the main cause (HSE, 2010). Smoking cessation is the only therapeutic intervention which slows the rate of decline of lung function (Booker, 2007). Cancer research UK indicated that 107,000 people dying in 2007 from smoking-related diseases and around 86% of lung cancer deaths in the UK are caused by tobacco smoking. Social and psychological aspects in addition to pharmacological addiction can cause smoking to be triggered by a complex combination of behaviours (Croghan et al. 2005). When a chemical is depended on to suppress stress, help deal with mental/emotional conflict or provide enjoyment, is seen to be a person who has psychological dependence (Roper et al. 1996). Health promotion is now seen to a fundamental part in the nurse’s role and always has been just undefined (Pender et al. 2010). Growth, disease prevention and improvement in well-being are seen as a dynamic system in relation to health promotion. It is expected of the nurse to encourage, support and educate clients into changing their smoking habits. The Department of health stated 1998 that “the nurse is ideally and uniquely placed to perform this role.” The most important and influential thing to help a client stop smoking is nursing intervention (Wilkinson et al. 2006). Reinforcing feelings of whether to quit smoking or not is becoming more acceptable in today’s society as smoking is no longer the “norm”. ‘Prochaska and DiClemente’s Stages of Change Model’ ideally allows staff to promote smoking cessation programmes. Effective intervention can be offered and developed to promote health behavioural change due to the specificity of this model. The case study in this essay will express the progressive changes and experience whilst changing her health behaviour. There are various stages of change in this model and it helps in identifying the individual’s position in the cycle of events. Therefore the process of behavioural change occurs over time and not immediately. This allows change to be more effective and reduces risk of relapse. The stages of change for this model are pre-contemplation, contemplation, preparation, action, maintenance and termination (Prochaska et al. 2002). A circular model is normally used to represent these stages, comparable to a revolving door (Hunt et al. 2001). Hesitation may be experienced by those individuals who are not yet entirely willing to change, become dedicated and stick to it. A client’s stage of change needs to be taken into consideration therefore subsequently motivate through effective communication strategies. Simple questions about a client’s behaviour can be used by the nurse to determine which stage...
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