The Health Belief Model and the Transtheoretical Model are covered in Fundamentals of Nursing because they are, in fact, fundamental to nursing. As a nurse, you will have patients who need to change behavior to reach desired health outcomes, or because it would be dangerous to not change behavior. Diabetic patients will need to change eating habits to manage blood sugar, patients with emphysema will need to quit smoking, and more. Patients may or may not take action, and the process of change can be a gradual one.
Knowing the key facts about the Health Belief Model and Transtheoretical Model can help you understand and better work with patients who need to make a behavior change. This article covers the key facts on both of these models—to help you in your Fundamentals of Nursing studies and in clinical practice.
The Fundamentals of Nursing video series follows along with our Fundamentals of Nursing flashcards, which are intended to help RN and PN nursing students study for nursing school exams, including the ATI, HESI, and NCLEX.
Health Belief Model
The Health Belief Model is a theoretical model used to explain and predict an individual's health-related behaviors.
Components of the Health Belief model
The Health Belief Model is made up of several important components: perceptions of severity, susceptibility, benefits and barriers; modifying factors; cues to action; and self-efficacy.
Perception of Severity
How severe does the patient perceive a potential illness to be? The less severe that we perceive a potential illness to be, the less likely we are to take action against it.
Perception of Susceptibility
How susceptible to an illness does a patient perceive themselves to be?
The less susceptible to something that we perceive ourselves to be, the less likely we are to take action against it.
It's important to note that these components of the Health Belief Model are often perfectly logical frameworks for decision-making. For example, if a problem is actually not very severe, it makes sense to take less action against it. The problem arises when there is a misperception of severity, or susceptibility, or benefits, etc.
Fundamentals of Nursing - Flashcards
Perception of Benefits and Barriers
How beneficial does a patient perceive the health actions to be? How many barriers, or how big of a barrier, to action does a patient perceive?
If we do not believe that making health changes or undergoing a treatment will be beneficial ("It's not going to help") we are understandably less likely to do it. Similarly, if we believe that making health changes or complying with treatments will come with huge barriers (time, expense, lifestyle change, social effects), we are less likely to take that action.
Modifying factors
Modifying factors in the Health Belief Model include age, gender, socioeconomic background, and more. All of these factors have the potential to change how someone views their own health.
For example, if a patient is 100 years old, they might make a different judgment call on what treatments or changes to make than a 40 year old patient would.
Cues to action
In the Health Belief Model, cues to action are external messages that either prompt or dissuade behavior.
For example, government officials, celebrities, athletes, and many more public figures have publicly advocated getting vaccinated against COVID-19. There have been public service announcements, commercials, door-to-door campaigns, billboards and more—these are all examples of cues to action. In the case of an individual deciding whether or not to get vaccinated against COVID-19, these cues to action have been part of their Health Belief model.
Self-efficacy
In the Health Belief Model, self-efficacy is an individual's confidence in their ability to be successful. How does a patient see themselves? Do they see themself as someone who puts their mind to something, takes care of it, and gets it done? Or do they see themselves as someone who probably won't be successful when they try to implement a change?
The more successful someone believes they will be at making a change, the more likely they are to take action to make the change.
How is the Health Belief Model used in nursing?
In nursing, this model helps us to understand why patients may or may not be compliant with their patient teaching or participating in their prescribed treatments or therapies. Understanding potential reasons for noncompliance can help you apply effective strategies to influence patients to make healthy lifestyle changes or comply with treatment plans.
Transtheoretical Model
The Transtheoretical Model is a theory that describes the six stages associated with health behavior changes.
Stages in the Transtheoretical Model
There are six stages in the Transtheoretical Model: precontemplation, contemplation, preparation, action, maintenance, and termination.
Precontemplation
In the Transtheoretical Model, the precontemplation stage is before the patient has begun contemplating a change. The patient is not aware of a change that needs to be made. In this stage, it is unlikely that the patient will make a change in the next 6 months.
Contemplation
In the Transtheoretical Model, the contemplation stage begins when the patient has been made aware that they need to make a change. This means the patient is now thinking about it (contemplating). In this stage, it's likely that they will make a change in the next 6 months.
Preparation
In the Transtheoretical Model, the preparation stage is when the patient is preparing to make the change. This patient might be taking some small beginning action steps. During the preparation stage, the patient is likely to make the change in the next 30 days.
Action
In the Transtheoretical Model, the action stage is when the change has been made sometime within the last 6 months and the behavior is ongoing.
Maintenance
In the maintenance stage of the Transtheoretical Model, the patient has made the change and persisted with it for 6 months or more, and is continuing.
Termination
In the termination stage of the Transtheoretical Model, the patient has made a change and it's considered permanent—the desire to return to the previous behavior is gone. What is actually being terminated in this stage is the old behavior—it has been extinguished, and the change is the new normal.
How is the Transtheoretical Model used in nursing?
In nursing, it's important to identify which stage your patient might be in, when it comes to a health or behavior change. Understanding their stage of change can help you apply appropriate strategies to influence behavior towards desired health outcomes. This can help to "meet someone where they are," and provide strategies that will be most effective now, rather than strategies that might be helpful in the future, but aren't quite yet.
2 comments
I like that the red bold words are emphasized to remembering the stages! The examples you give really help out in understanding the stages.
Hi Meris,
Thank you for the video.
I already knew what these theories were. However, you helped me to clarify my understanding an apply theory to an intervention for my final project au uni.
Much appreciated!