Diabetes Education and Prevention Health Promotion

Health Promotion: Diabetes Education and Prevention
Given the need for specificity in nursing theory for addressing a particular topic such as diabetes education and prevention, Nola Pender’s Health Promotion Model would seem to be particularly useful. The model is designed to assist people in making needed lifestyle changes. It is based upon the presumption that people wish to maximize their health potential and possess enough self-awareness to grow in their capacity to self-regulate (Pender, 2013, p.5). While health professionals can act as facilitators, ultimately the model focuses on people’s ability to engage in self-initiated changes in behavior and in their environment. Type 2 diabetes is a lifestyle ailment for most individuals. Although the nurse can act as a teacher and a guide, it is the individual who is suffering from diabetes who must make decisions on a daily basis that will affect his or her life.
Pender’s model is particularly useful for diabetes education because it does not focus on end-of-life-care and is not particularly abstract. It is designed to facilitate a teaching plan, which is the objective of this particular initiative. It is founded in social science theory, one critical aspect of the approach which stresses how lived behaviors are experienced in a specific context. “Expectancy value theory” suggests that “individuals engage in actions to achieve goals that are perceived as possible and that result in valued outcomes” as well as cognitive behavioral approaches which suggest that changes in thinking result in changes in behavior (Pender, 2013, p.3). In other words, the nurse begins with the expectation that people will want to change, which increases the likelihood they will change, versus assuming (as some healthcare providers do) that it is so unlikely that patients will be willing to change diet and exercise habits, that dependence on medications and suffering complications are virtually inevitable.
Secondly, the model has a very specific definition of nursing which is useful for promoting patient empowerment. “Nursing is collaboration with individuals, families, and communities to create the most favorable conditions for the expression of optimal health and high-level well-being” (Pender, 2013, p.2). Diabetes is particularly rife in communities which have high populations of historically discriminated-against minorities. It is also much more prevalent in communities with low socio-economic status. There is less likely to be disposable income to buy healthier foods and less time and access to safe places to exercise. Finally, health is defined as goal-directed behavior; once again, the ability of human beings to change their health status is vital (Pender, 2013). Environment is an important component of the model, and changing the attitudes of patients as well as motivating them to change their communities (for example, lobbying for more supermarkets and more physical education in schools) is required.
In short, the Pender Model views the nurse as partnering with the community and the individual facing the health risk, rather than doing something to the patient or imposing decisions upon the patient. The Pender Model was specifically designed for this purpose, so I think in comparison to other theories it possesses very few shortcomings in delivering diabetes education. The greatest challenge is empowering individuals to take care of themselves when the environmental factors surrounding them are against them; for example, when individuals are very economically limited in terms of the foods they can purchase and access to regular healthcare and wellness promotion strategies. Still, the Pender Model at least stresses to the nurse the nurse’s responsivity to empower the patient within real, existing constraints versus assuming the patient is living in the ideal environment. Recommendations for self-care must reflect the patient’s realities.

References
Pender, N. (2013). The health promotion manual. Retrieved from:
http://research2vrpractice.org/wp- content/uploads/2013/02/HEALTH_PROMOTION_MANUAL_Rev_5-2011.pdf