Introduction
Nursing theories have been developed and utilized in the clinical setting to address the diverse needs of different groups of patients. These models equip nurses with critical knowledge regarding the way certain issues have to be addressed and approach to be employed. Nurse practitioners can choose among various theories to help patients cope with their health problems in the most effective way. Nurses educate patients concerning their illnesses, risk factors, intervention peculiarities, and appropriate behavioral patterns to prevent new occurrences of the disease or manage the related symptoms. Patients with chronic conditions have to change their lifestyles to adapt to the needs associated with their health status. Several middle-range theories can be helpful when assisting such people. These models include the self-efficacy theory, health promotion model, and social support theory. This paper includes a brief review of studies based on the three theoretical paradigms mentioned above.
Self-Efficacy Theory
The self-efficacy theory is a widely used model in nursing as it enables healthcare professionals to help patients address their health issues effectively. Self-efficacy is referred to as patients’ confidence in their abilities to perform specific tasks (Resnick, 2020). The self-efficacy theory is grounded on the assumption that people develop certain behavioral patterns when they understand the positive outcomes and have mastered the necessary skills (Resnick, 2020). Nurses can help patients to develop self-efficacy by paying attention to these two domains. Nurse practitioners should educate patients on potential positive outcomes and the necessary skills to attain those outcomes. Based on the theory, several instruments have been developed and used in the clinical setting. These tools aim at measuring patients’ self-efficacy, understanding their perceived outcomes, and the existing skills needed to achieve the established goals.
As mentioned above, this framework is often employed when caring for patients with chronic conditions. Ramezani et al. (2019) implemented a study that explored the effects of an educational intervention on the self-efficacy of hemodialysis patients. Seventy hemodialysis patients took part in the study that involved the provision of educational services in the experimental group and casual care in the control group. The intervention lasted for two months and involved four one-hour sessions (Ramezani et al., 2019). The educational sessions were developed based on the premises of the self-efficacy theory with a focus on perceived outcomes and skill development. The researchers reported that the self-efficacy of the participants in the experimental group improved considerably three months after the intervention termination. Patients become more compliant with the prescribed treatment and are more willing to change their behaviors. This study can be regarded as an illustration of the way the self-efficacy model can be applied in the clinical setting and lead to positive patient outcomes.
Social Support Theory
The social support theory is also commonly utilized in nursing practice. It can be hard to motivate patients by solely explaining the benefits of the program and informing them about skills needed to shape their behaviors. Social support helps patients to remain engaged and continue their treatment. The supporters of the social support theory emphasize that people require support from their families, friends, peers, colleagues, and other individuals to be motivated to pursue their goals (Schaffer, 2020). It is noteworthy that there is still no consensus regarding the definition of social support, but researchers agree on its major components. One of the central elements of social support is the interaction between the recipients and the provider of support. At that, researchers come up with different dimensions of this support and various characteristics (Schaffer, 2020). For instance, some focus on the instrumental, while others consider the effects of informational or emotional support. The perceived need for social support and willingness to seek it attract much attention.
Social support theory is often utilized to improve patient adherence to prescribed treatment. For example, Gu et al. (2017) examined the effects of social support on diabetes patients’ medication adherence. The researchers recruited 412 patients with type 2 diabetes mellitus and assessed their medication use and perceived social support. Gu et al. (2017) found that patients were more responsible when social support was provided. The authors note that multiple aspects could have affected patients’ commitment to their treatment plans, but the link between perceived social support and medication adherence was apparent. Clearly, improved medication adherence leads to positive patient outcomes, so social support is seen as an important factor influencing the healing process in a positive way. This study suggests that the social support theory can be applied in order to improve patients’ health status. When treating patients, nurses should try to involve diverse stakeholders to help patients address their health problems effectively. These can be relatives or even the members of the community.
Health Promotion Model
Another theoretical framework that can be effectively utilized to help patients with chronic conditions is the health promotion model. This paradigm is related to the social theory but provides more insights into the development of desirable behavioral patterns. The theory was introduced by Nola J. Pender, who defined health as a dynamic state as people lived in the environment they changed and were transformed by it (McCullagh, 2020). The health promotion model encompasses the analysis of such domains as individual experiences and characteristics, behavior-specific cognitions (perceived benefits and barriers, interpersonal and situational influences, perceived self-efficacy, and activity-linked affect), and behavioral outcomes (McCullagh, 2020). The model is based on the assumption that people are willing to regulate their behaviors, so it is important to make sure this process results in positive changes rather than adverse effects. According to this paradigm, nurses play an important role in shaping patients’ behaviors as they are a part of the environment that has an impact on people. It is also stated that patients’ prior experiences, interactions, and skills should be analyzed when developing new behavioral patterns.
The health promotion model has been employed to improve patients’ physical and mental states. Khodaveisi et al. (2017) used the framework to shape the eating behaviors of overweight women. The researchers implemented a quasi-experimental study involving 108 females who were divided into two groups. The experimental group received educational services based on Pender’s model, while the control group had no intervention. It was found that the behaviors of the participants in the experimental group changed in terms of eating habits, perceived benefits and self-efficacy, as well as the commitment to changes and interpersonal relationships (Khodaveisi et al., 2017). This research can be seen as an illustration of the way the model can be applied in the clinical setting. Importantly, instead of focusing on a narrow health issue, patients learn to adopt a healthy lifestyle, which eventually leads to better health and the prevention of numerous problems.
Conclusion
To sum up, the reviewed articles provide insights into the central characteristics of the three theoretical frameworks under consideration. The social support theory, self-efficacy theory, and health promotion model are closely related to patient behaviors and ways to shape them. The frameworks also provide quite a clear description of the roles played by nurses in the process of change. Nurse practitioners become key players guiding patients in their way path to healthy behaviors and better quality of life. Importantly, the three theories imply the focus on interactions and people’s rational choices. Patient education is, therefore, an essential component of care provision, so nurses need to provide educational services. It is clear that patients need to receive information regarding their health conditions and potential threats, as well as the benefits of certain activities. Effective training builds the necessary skills and perceived self-efficacy in patients.
The review of the three articles shows that the three middle range theories in question can be effectively applied in nursing practice and research. Healthcare practitioners can design and assess various interventions aimed at addressing a variety of health issues. Further research can involve the exploration of particular topics that are regarded as interesting and beneficial, as well as those that seem unrelated and unnecessary by patients. The middle range theories under consideration highlight the primary domains to concentrate on when developing studies and interventions. This data can be instrumental in shaping the content of the educational element of the produced interventions. Clearly, patient perceived self-efficacy and social support, as well as their preparedness and willingness to change, are the most valuable aspects that can enhance the positive influence of an educational intervention for patients.
References
Gu, L., Wu, S., Zhao, S., Zhou, H., Zhang, S., Gao, M., Qu, Z., Zhang, W., & Tian, D. (2017). Association of social support and medication adherence in Chinese patients with type 2 diabetes mellitus. International Journal of Environmental Research and Public Health, 14(12), 1-10. Web.
Khodaveisi, M., Omidi, A., Farokhi, S., & Soltanian, A. R. (2017). The effect of Pender’s health promotion model in improving the nutritional behavior of overweight and obese women. International Journal of Community Based Nursing Midwifery, 5(2), 165–174. Web.
McCullagh, M. C. (2020). Health promotion. In S. Peterson & T. S. Bredow (Eds.), Middle range theories: Application to nursing research and practice (pp. 225-233). Wolters Kluwer Health.
Ramezani, T., Sharifirad, G., Rajati, F., Rajati, M., & Mohebi, S. (2019). Effect of educational intervention on promoting self-care in hemodialysis patients: Applying the self-efficacy theory. Journal of Education and Health Promotion, 8(1), 1–23. Web.
Resnick, B. (2020). Self-efficacy. In S. Peterson & T. S. Bredow (Eds.), Middle range theories: Application to nursing research and practice (pp. 91-106). Wolters Kluwer Health.
Schaffer, M. A. (2020). Social support. In S. Peterson & T. S. Bredow (Eds.), Middle range theories: Application to nursing research and practice (pp. 127-147). Wolters Kluwer Health.