Assessing of Effect of Educational Intervention based on Pender Health Promotion Model on the Medication Adherence of the Elderly with Type 2 Diabetes

BackgroundHeart failure is a common and chronic heart condition with high prevalence and mortality rates. This debilitating disease as an important predictor of health outcomes is directly related to patients' quality of life. Given that one of the main goals of heart failure treatment is to promote patients' quality of life and health status, conducting effective nursing interventions seems to be necessary in this regard. Therefore, the present study aimed to determine the effect of educational intervention based on Pender's health promotion model on quality of life and health promotion in patients with heart failure.MethodsThis is an experimental study in which a total of 80 patients with heart failure were recruited and randomly allocated to two groups of intervention and control (n = 40 in each group). The educational program was designed based on Pender's health promotion model and then provided for the patients in the intervention four subgroups (10 person in each group) during six sessions. Data were collected at three time-points of before, immediately after, and three months after the intervention using a demographic questionnaire, the Minnesota Living with Heart Failure Questionnaire (MLHFQ), and the Health-Promoting Lifestyle Profile II (HPLP-II). Data were then analyzed using SPSS Statistics for Windows, version 17.0 (SPSS Inc., Chicago, Ill., USA) and p value less than 0.05 was taken as statistically significant.ResultsBased on the results of the present study, no statistically significant difference was shown in terms of demographic characteristics between the two groups. It was also indicated that there was a statistically significant difference in the mean scores of all dimensions of quality of life (except in the physical dimension) between the two groups so that the overall mean score of quality of life increased significantly in the intervention group after the intervention (p < .05). Moreover, there were significant increases in the mean scores of health-promoting behaviors (except in the domain of physical activity) in the intervention group compared to the control group (p < .05) after intervention.ConclusionsThis study demonstrates a trend that Pender's health promotion model is effective in improving the quality of life of patients with heart failure except of the physical dimension, and strengthening their health-promoting behaviors in all dimensions except of the physical activity dimension.

Background: Chronic renal failure and hemodialysis treatment not only affect the physical health of patients, but also jeopardize other aspects of their health, including psychological and social aspects, and reduce their quality of life. Objectives: Accordingly, the present study aimed to investigate the effect of a training intervention developed based on Pender’s health promotion model on the lifestyle of patients undergoing hemodialysis. Methods: Adopting a pre-test and post-test design with a control group, this quasi-experimental study was conducted in 2022 on 60 hemodialysis patients visiting Ali Ibn Abi Talib and Khatam al-Anbiya hospitals in Zahedan, Iran. The patients were selected using convenience sampling and randomly assigned to two intervention and control groups (30 persons in each group). The participants in the intervention group received training based on Pender's health promotion model in six areas (nutrition, physical activity, health responsibility, interpersonal relationships, stress management, and self-actualization) during six 45-minute training sessions. Data were collected using Walker’s (1987) health-promoting lifestyle profile (HPLP-II) which was completed in three stages (before the intervention, one month, and three months after the intervention). Data were analyzed using the independent samples t-test, chi-square test, and repeated-measures analysis of variance (ANOVA) at a significant level (P &lt; 0.05). Results: The data analysis revealed that the mean total lifestyle scores before the intervention were not significantly different in the two groups (P = 0.47). However, the mean total lifestyle score of patients in the intervention group increased compared to the control group one month and three months after the intervention, repeated measures ANOVA did not show a significant interaction effect of time and group (P = 0.06). Similarly, the results of repeated measures ANOVA did not show any significant difference in terms of health responsibility (P = 0.61), stress management (P = 0.94) and relationships/social support (P = 0.22). Given the significant interaction effect of time and group in the repeated measures ANOVA in the dimensions of nutrition (P &lt; 0.001), physical activity (P &lt; 0.001), and self-actualization (P &lt; 0.03), point-by-point comparisons were performed again by time and group with Bonferroni correction. The results showed that the mean score of nutrition significantly improved one and three months after the intervention compared to the pre-intervention phase (P &lt; 0.001). Conclusions: The findings implied that the training intervention based on Pender’s health promotion model clinically improved the lifestyle of patients undergoing hemodialysis. However, sustaining continuous and lasting changes requires supportive programs and long-term monitoring. Further studies with larger sample sizes are recommended to evaluate the effects of the intervention using the Pender approach.

Background:Increasing of hospitalization rates of Coronary Artery Disease (CAD) management have created major challenge for the health system. Poor adherence to treatment is one of the main reasons for treatment failure, prolongation of treatment, and increase care costs. The aim of this research was to determine the effect of educational intervention based on Pender's Health Promotion Model (HPM) on adherence in patients with CAD.Materials and Methods:This randomized controlled clinical trial was held in an educational hospital in Isfahan, Iran, February 2018–May 2019. Data were collected from 64 patients with CAD, before, 1 and 3 months after the intervention. The instrument used included treatment adherence questionnaire and a checklist Pender's HPM. The study group received dietary, exercise, and medication education based on Pender's HPM in four sessions which were held in 4 weeks. The control group received the routine educational program of the hospital. The data was analyzed using descriptive statistics, repeated measures ANOVA, independent t, Chi-square, and Mann–Whitney tests via SPSS software.Results:The mean score of treatment adherence was significantly different between two groups in one (z = 5.28, df = 2, p < 0.001) and three (z = 4.51, df = 2, p < 0.001) months after the intervention. The mean (SD) of treatment adherence in the study group was 139.82 (27.44) 3 months after the intervention.Conclusions:Educational intervention based on Pender's HPM is more effective on treatment adherence than the routine method in the patients with CAD. It is recommended to integrate the Pender's HPM as a nursing care program for these patients.

To determine the effectiveness of nutrition education intervention based on Pender's Health Promotion Model in improving the frequency and nutrient intake of breakfast consumption among female Iranian students. The quasi-experimental study based on Pender's Health Promotion Model was conducted during April-June 2011. Information (data) was collected by self-administered questionnaire. In addition, a 3 d breakfast record was analysed. P < 0·05 was considered significant. Two middle schools in average-income areas of Qom, Iran. One hundred female middle-school students. There was a significant reduction in immediate competing demands and preferences, perceived barriers and negative activity-related affect constructs in the experimental group after education compared with the control group. In addition, perceived benefit, perceived self-efficacy, positive activity-related affect, interpersonal influences, situational influences, commitment to a plan of action, frequency and intakes of macronutrients and most micronutrients of breakfast consumption were also significantly higher in the experimental group compared with the control group after the nutrition education intervention. Constructs of Pender's Health Promotion Model provide a suitable source for designing strategies and content of a nutrition education intervention for improving the frequency and nutrient intake of breakfast consumption among female students.

Background: Electronic hookah smoking is one of the most avoidable risk factors for non-communicable diseases. It is also seen as a starting point for addiction. Pender's health promotion model is used to increase students' level of well-being and enhance preventive behaviors to prevent complications and subsequent effects of electronic hookah smoking. Aim: To evaluate the effect of educational program about electronic hookah smoking for male university students based on Pender's Health Promotion Model. Research design: A quasi-experimental design was used. Setting: This study was conducted at 6 faculties of Sohag University including faculty of Education, Social service, Arts, Law, Archaeology and Commerce. Sample: A convenience sample of 600 male university students was selected. Tools: Two tools were used in this study. Tool one: A structured interviewing questionnaire which consisted of the following parts: a) demographic characteristics of studied students. b) Knowledge of studied students about electronic hookah smoking. Tool two: Pender's health promotion model. Results: The current study showed that only 10 % of studied students had good knowledge at pre-educational program about electronic hookah smoking which improved to 86% at post program. Additionally, according to Pender's health promotion model, 25.7% of studied students had good beliefs at preprogram which increased to 87.8% of them had good beliefs at post-program. Conclusion: The study findings revealed to improvement in students' knowledge and beliefs after implementation of educational program about electronic hookah smoking Recommendations: Developing health educational program to increase awareness for male university students about prevention of electronic hookah smoking.

Background and ObjectivesPregnancy causes changes in women’s lifestyle; therefore, their health-promoting behaviors should be improved in order to avoid problems during this critical period, which requires knowledge of the factors affecting these behaviors. This study was conducted to determine the predictors of health-promoting lifestyles in pregnant women based on Pender’s health promotion model constructs.MethodsThis descriptive study was carried out on 300 pregnant women in their second and third trimesters of pregnancy and sought to determine the correlation between lifestyle and the constructs of Pender’s health promotion model. Data were collected using a demographic questionnaire, the Health Promoting Lifestyle Profile II (HPLP-II) and a questionnaire based on Pender’s model constructs. Data were analyzed using descriptive and analytical statistics.FindingsA health-promoting lifestyle had a significant positive correlation with the constructs of social support and perceived benefits and a significant negative correlation with the construct of perceived barriers (P<0.05). A health-promoting lifestyle also had a significant relationship with the constructs of perceived barriers, social support and perceived benefits in pregnant women (P<0.05) based on the results of the regression analysis. The regression coefficients showed that all the three variables can significantly explain the variance in health promoting lifestyles in pregnant women (P<0.05).ConclusionAccording to the results of the present study and based on the constructs of Pender’s health promotion model, social support, perceived benefits and perceived barriers were the most important predictors of health-promoting lifestyles in pregnant women. These predictor constructs are recommended to be further considered in designing and implementing training packages and interventions for promoting pregnant women’s lifestyle.

Background: Nursing students often struggle to maintain their health due to the rigorous demands of their curriculum, which frequently involves long hours of clinical work and exposure to stressful environments. Objective: This research study sought to investigate the effectiveness of a health promotion program based on Pender's Health Promotion Model (HPM) for nursing students with chronic illnesses. Methods: The study utilized a quasi-experimental design, including 105 nursing students from several institutions—55 participants belonging to an experimental group and 50 in the control group. To determine the students' quality of well-being prior- and post-treatment/phases, researchers monitored their health behaviors utilizing the Health-Promoting Lifestyle Profile II (HPLP-II) survey tool. The program included educational activities designed around coping with chronic diseases such as nutritional counseling or exercise planning also practical tools like stress management protocols/particulars along with peer support constructs/frameworks as key components in addressing adverse effects associated with such conditions. Results: Based on the results of the paired t-tests, a significant increase in HPLP-II scores was identified after the intervention in those assigned to the experimental group. Furthermore, an independent t-test highlighted that a significant difference existed between the average HPLP-II score for experimental and control groups. Discussion: These findings were scrutinized within Pender's Health Promotion Model framework to identify which aspects of the intervention contributed most efficiently to improved health behaviors and resultant outcomes. Conclusion: This research study established compelling evidence which supports the utilization of Pender's Health Promotion Model in improving health-promoting behaviors among nursing learners with chronic ailments. This finding could help nursing educators and healthcare professionals to outline interventions for this particular demographic group.

Empowering the older people on self-care to improve self-efficacy based on Pender's health promotion model: A randomized controlled trial.

Evaluation of the effect of training given according to Pender's Health Promotion Model on psychological insulin resistance

BACKGROUND:This study aimed to investigate the effect of educational intervention based on the Pender's health promotion model (HPM) on lifestyle and self-efficacy of the patients with diabetic foot ulcer.MATERIALS AND METHODS:In this clinical trial conducted in 2019, 74 patients based on inclusion criteria were selected through convenience sampling and allocated to two groups of intervention (n = 37) and control (n = 37) using the randomized permuted block method. In this study, Demographic characteristics and localized Diabetes Foot Care Self-Efficacy Scale and Health-Promoting Lifestyle Profile Questionnaire for diabetic foot care were completed by two groups. The obtained data were analyzed using SPSS 16 and through descriptive and comparative statistics, independent t-test, paired t-test, and ANCOVA.RESULTS:After the intervention, the mean score of the intervention group significantly increased in all lifestyle dimensions (P < 0.001). Furthermore, the mean score of self-effcacy increased in the intervention group after the intervention (P < 0.001). Comparing the change in the mean scores of lifestyle and self-efficacy in both the groups 50 days after the intervention, an increase was observed in the mean scores of self-efficacy (P < 0.001) as well as those of lifestyle and its dimensions in the intervention group compared to those in the control group (P < 0.001).CONCLUSION:Educational intervention based on the Pender's HPM can promote the self-efficacy, lifestyle, and its dimensions in the patients with diabetic foot ulcers. The results of this study can be used in educational interventions aiming at patients with diabetic foot ulcers to change their lifestyle and improve their self-efficacy.

The Pender's Health Promotion Model is a comprehensive solution to improve health and reduce the risk of chronic conditions. This study aimed to determine the effect of a care program based on the Pender's Health Promotion Model on the caregiving burden of family caregivers of patients with chronic heart failure. This semi-experimental study with a control group was conducted at the Imam Khomeini Heart Clinic in Saqqez in 2022-2023. In this study, 90 family caregivers from patients with chronic heart failure were randomized to intervention and control groups. Data were collected through a demographic information questionnaire and the Caregiver Burden Inventory (CBI) prior to and 50 days after the intervention. Data were analyzed using independent t-test, Chi-square, and paired t-test in SPSS V 25. A significance level of 5% was considered. The results of this study indicated that the control and intervention groups were homogeneous in terms of demographic characteristics (P = 0.643). The findings also showed a statistically significant difference in the mean scores of all dimensions of caregiving burden between the two groups after the intervention, such that the overall mean score of caregiving burden in the intervention group had a significant reduction (P < 0.0001). The present study demonstrated that a care program based on the Pender's Health Promotion Model can reduce the caregiving burden of family caregivers of patients suffering from chronic heart failure. Additionally based on health policies, this program can play an effective role in improving the quality of life of families with chronic heart failure patients and reducing their medical costs as a comprehensive solution for improving health and reducing the risk of chronic diseases.

Background:Family-centered empowerment of drug and stimulant users is an effective program for a better response to treatment, prevention of treatment adverse effects, and promotion quality of life (QoL) and lifestyle in the process of discontinuing drug abuse.Objectives:This study aimed to determine the effects of educational intervention, based on family-centered empowerment and Pender's health promotion models, on health-promoting lifestyle and health-related QoL among methamphetamine users and their families.Patients and Methods:In a randomized clinical trial, methamphetamine users, who were admitted to Tehran University of Medical Sciences Substance Abuse Treatment Centers, were randomly allocated to three groups: a group for training of methamphetamine users who were in recovery phase (intervention group 1;95 subjects);a group for training of a family member of methamphetamine users who were in recovery phase (intervention group 2; 95 subjects); and a control group (95 subjects). A demographic checklist and a standard questionnaire covering health-promoting lifestyle, health-related QoL, self-efficacy, perceived affect, perceived social support, and perceived barriers dimensions were used to gather required data. Independent-samples t test, paired-samples t-test, and ANCOVA were used to analyze the data.Results:Analysis of covariance showed that after adjusting for effects of pretest scores, the difference between mean post-test scores of health-promoting lifestyle scale, health-related QoL scale, and all constructs of Pender's health promotion model (self-efficacy, perceived affect, perceived social support, and perceived barriers) in the intervention group 1 and control group were significant (P< 0.0001). In addition, changes in mean scores of lifestyle scale (42.4 ± 13.6), QoL scale (29.1 ± 14.2), self-efficacy (16.1 ± 2.6), perceived affect (16.1 ± 8), social support (35.4 ± 12.4), and barriers (17.2 ± 15.8) before and after intervention were significant in the intervention group 2 (P < 0.0001).Conclusions:Application of family-centered empowerment model among methamphetamine users and their families is practically feasible and can result in enhancement and improvement of their QoL, lifestyle, and health promotion model constructs.

Pender's health promotion model explains the factors influencing health behaviors, which provides a framework for nursing practice and research. Functional exercise compliance in postoperative patients with breast cancer was in a low level, this article reviewed factors influencing functional exercise among breast cancer survivors through three aspects based on health promotion model and made some suggestions on nursing intervention, to promote the rehabilitation of this population. Key words: Breast neoplasms; Functional exercise; Pender's health promotion model

Despite highly effective asthma treatments, the prevalence of asthma is increasing in children and adolescents. Despite easy access to asthma control, sufficient control and management are not achieved. Asthma management is crucial to prevent the development of asthma symptoms and attacks, reduce repeated hospitalizations, and prevent a decrease in the quality of life for both the child and caregivers. This case study aims to increase the utilization of theories, models, and classification systems by evaluating a child diagnosed with asthma for 6 years and their caregivers based on Pender's health promotion model (PHPM). Furthermore, the study aims to establish a connection with NANDA, Nursing Interventions Classification (NIC), and Nursing Outcomes Classification (NOC), thereby formulating a nursing care plan. This case study evaluated a child diagnosed with asthma for 6 years and their caregivers based on PHPM. A nursing care plan was developed by establishing connections with NANDA, NIC, and NOC and based on Pender's health promotion. By establishing connections with NANDA, NIC, and NOC, a nursing care plan of a total of six included nursing diagnoses has been created as five based on the PHPM. The care plan implemented improved S.B.K.'s clinical condition. Furthermore, the mother's social support increased, and her confidence in managing asthma improved. As a result of implementing the model, the mother reached the potential to develop healthy behaviors for S.B.K. and make future-oriented plans. It is recommended that NANDA-I, NIC, and NOC, along with PHPM, be used in clinical nursing care and scientific research to enhance the presentation of quality care and the individual's future health potential.

Background: Stroke generates significant health and social burdens. Self-management has potential importance for supporting individuals in coping and continuing to progress after stroke. However, there is a lack of targeted programs to enhance self-management and reduce self-perceived burden (SPB) following stroke.Purpose: To evaluate the effects of a goal-oriented intervention on self-management behaviors and SPB among patients after acute stroke.Methods: This was a randomized controlled trial with a 4-weeks intervention. Participants were randomly allocated to the intervention (n = 48) or control group (n = 48). The intervention and control groups received eight sessions of goal-oriented self-management intervention based on Pender's health promotion model and control care, respectively. Self-management behaviors and SPB were evaluated and compared between the two groups.Results: After the 1-month follow-up, there were significant differences in the total self-management behaviors score and the scores of six of the self-management dimensions, excluding diet management, between the intervention group and the control group (t = −7.891– −2.815; p ≤ 0.006). Compared to the control group, the intervention group showed a significant decrease in the physical burden, emotional burden, and total SPB scores (t = 2.102–2.071; p = 0.015–0.041). The economic burden score was not significantly different between the two groups (t = 1.707; p = 0.091).Conclusion: The goal-oriented intervention based on Pender's health promotion model can effectively improve self-management behaviors and reduce physical and emotional SPB among stroke survivors.