Pender’s Health Promotion Model in Substance Use Disorder PDF

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Using Pender's Health Promotion Model in a medication-assisted treatment setting. How the model relates to the course of treatment of addiction....

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Pender’s Health Promotion Model in Substance Use Disorder

Sherrell Cauley Herzing University NU500 Theoretical Foundations for Nursing Dr. Simon-Campbell August 29, 2021

2 Pender’s Health Promotion Model in Substance Use Disorder Nola Pender developed the Health Promotion Model (HPM) to prevent patients from developing acute and/or chronic health conditions. The HPM is a descriptive high-middle range nursing theory whose scope is focused on behavioral lifestyle modifications that improve health (Hendricks, 2015). Before the development of the model, treatment was reactive rather than proactive. Negative motivation was used to influence behavioral changes in patients. The HPM focused on how positive motivation can influence the models’ concepts. The model’s concepts are broken down into three categories. There are individual characteristics, behavior-specific cognitions and affect, and behavioral outcomes. The concepts are structured to illustrate the direction in which they influence each other. Individual characteristics influence behavior-specific cognitions and affect. Some behavior-specific cognitions affect each other in an upward linear movement, while all strive to influence a healthpromoting behavior. Theory Description Despite significant effort devoted to developing and testing treatments for substance use disorders, most individuals who receive treatment in the United States do not receive evidence-based care (Padwa & Kaplan, 2017). Therefore, putting evidence-based knowledge into practice is a must. The biopsychosocial model (BPS) is currently the foundation for treatment in a SUD clinic. The BPS model of addiction states that genetic/biological, psychological, and sociocultural factors contribute to substance consumption and should be considered for its prevention and treatment (Becoña, 2018). It is a holistic model and is effective in meeting patients where they are in their sobriety journey. Nevertheless, additional strategies are needed to move patients from active use to being sober. Utilizing BPM and HPM together will provide care providers with an advanced skillset. These two theories not only provide insight into the different internal and external elements that affect someone's decisions, but they also provide steps to move patients in a positive direction from negative decision making to positive decision

3 making. The goal is the health-promoting behavior of no longer abusing substances and maintaining a healthy lifestyle. Rationale Implementing the HPM into practice would not require a great deal of effort. How BPS is utilized in the SUD clinic would allow the HPM to seamlessly be added. Questionnaires can be created based upon the main concepts of the HPM to gauge a patient’s current desire to achieve the health-promoting behavior of sobriety. The questionnaire would be broken down into categories and subcategories based upon the main concepts. The questionnaire would be completed upon admission to the clinic and updated every 90 days. During the 90 days, nurses and counselors would employ patient-centered care techniques to assist the patient to become sober. The questionnaire would be used every 90 days to measure the progress the patient has made to attain the goal. At this time their treatment plan will be updated with the treatment goals of the next 90-day period. Some will achieve their goals faster than others and some may never achieve their goal. Nonetheless, the nurses and counselors will continue to provide the care needed. Implementation Plan Implementing the HPM into practice would not require a great deal of effort. How BPS is utilized in the SUD clinic would allow the HPM to seamlessly be added. Questionnaires can be created based upon the main concepts of the HPM to gauge a patient’s current desire to achieve the health-promoting behavior of sobriety. The questionnaire would be broken down into categories and subcategories based upon the main concepts. The questionnaire would be completed upon admission to the clinic and updated every 90 days. During the 90 days, nurses and counselors would employ patient-centered care techniques to assist the patient to become sober. The questionnaire would be used every 90 days to measure the progress the patient has made to attain the goal. At this time their treatment plan will be updated with the treatment goals of the next 90-day period. Some will achieve their goals faster than

4 others and some may never achieve their goal. Nonetheless, the nurses and counselors will continue to provide the care needed. Barriers to Implementation The main barrier to implementing the HPM is patients. Many are reluctant to change and will do anything to continue with the status quo. The models’ purpose is to prevent acute and/or chronic conditions from happening. Unfortunately, in the substance use population, their addiction cannot be preventive, however, HPM can prevent future health illnesses due to the addiction. Those with substance use disorder tend to be highly suspicious of others and this is another barrier. The last barrier may not be experienced by all patients. Drug abusers gradually lose positive support from their family, friends, and important persons, and this leads to a reduction in perceived social support (Farnia et al., 2018). The support they receive usually comes from others suffering from SUD and it encourages them to stay in their addiction. The higher the support received from parents, family members, friends, and important persons in life, the lower the tendency to abuse drugs. In other words, social support acts as a protective shield, and people with low positive social support are more vulnerable to drug abuse (Farnia et al., 2018). Therefore, the patient experiences a tug of war and must work to change their external environment. Healthcare providers can overcome these barriers by using motivational interviewing, cognitivebehavioral therapy (CBT), and dialectal behavioral therapy (DBT). Motivational interviewing (MI) is one of the best-studied evidence-based therapies (EBTs) for SUD. It is a client-centered therapeutic modality that consists of a relational and technical component (Dickerson et al., 2018). The relational component refers to providers developing a partnership with clients by being empathic, empowering, compassionate, and emphasizing client autonomy (Dickerson et al., 2018). CBT teaches patients to recognize and change their maladaptive behaviors. CBT can help people with coping skills, identifying risky situations and what to do about them, and preventing relapse (Miller, 2021). This approach is

5 advantageous when coupled with other therapies. Lastly, DBT includes evidence-based strategies that help patients with SUDs learn several skills that can be effective in reducing or stopping substance use, including mindfulness, distress tolerance, interpersonal effectiveness, and emotional regulation (Worley, 2020). Using these interconnected EBTs gives patients the best chance at recovering and sustaining sobriety. Conclusion Pender’s Health Promotion Model was the initial foray into preventive treatment. Before the HPM, medicine was reactive, and treatment focused on treating patients after they developed acute/chronic conditions. This is costly both monetarily and to patient outcomes. By accepting people as biopsychosocial beings the HPM clinicians can effectively assist patients in achieving their highest level of health and well-being, which for most will be continued sobriety.

6 References American Addiction Centers. (2021, June 28). Addiction statistics: Drug & Substance Abuse Statistics. American Addiction Centers. https://americanaddictioncenters.org/rehab-guide/addictionstatistics. Becoña, E. (2018). Brain Disease or Biopsychosocial Model in Addiction? Remembering the Vietnam Veteran Study. Psicothema, 30(3), 270–275. https://doi.org/10.7334/psicothema2017.303 Dickerson, D., Moore, L. A., Rieckmann, T., Croy, C. D., Venner, K., Moghaddam, J., Gueco, R., & Novins, D. K. (2018). Correlates of Motivational Interviewing Use among Substance Use Treatment Programs serving American Indians/Alaska Natives. The Journal of Behavioral Health Services & Research, 45(1), 31–45. https://doi.org/10.1007/s11414-016-9549-0 Farnia, V., Alikhani, M., Jalali, A., Golshani, S., Salemi, S., Hookari, S., Moradi, M., & Juibari, T. A. (2018). The Role of Attachment Styles and Perceived Social Support in Prediction of Methamphetamine Abuse. Journal of Substance Use, 23(4), 377–383. https://doi.org/10.1080/14659891.2018.1436598 Hendricks, K. (2015). Analysis of Pender's Health Promotion Model. https://otterbein.digication.com/kathryn_hendricks_rn_msn_npbc/Application_of_Theory_Resear ch. Miller, L. (2021, July 20). Substance Abuse Treatment, Techniques & Therapy Programs. American Addiction Centers. https://americanaddictioncenters.org/therapy-treatment. Padwa, H., & Kaplan, C. D. (2017). Translating Science to Practice: Lessons learned Implementing Evidence-Based Treatments in US Substance Use Disorder Treatment Programs. European Journal on Criminal Policy and Research, 24(2), 171–182. https://doi.org/10.1007/s10610-017-9360-3 Worley, J. (2020). Therapy Strategies for Substance Use Disorders. Journal of Psychosocial Nursing & Mental Health Services, 58(3), 14–18. https://doi.org/10.3928/02793695-20200115-02...