E-Learning Keperawatan: HEALTH BELIEVE MODEL

Tuesday, November 11, 2008

HEALTH BELIEVE MODEL

Author : Luzni Novita
NPM : 220111080046

Model kepercayaan kesehatan adalah salah satu konsep yang paling banyak digunakan untuk memahami perilaku kesehatan.Berkembang pada awal tahun 1950.Merupakan model konsep yang sukses digunakan lebih dari setengah abad dalam mempromosikan keselamatan dan prilaku kesehatan antara lain, penggunaan kondom, seat belt, pemenuhan panggilan kesehatan, screening kesehatan dll.

Model kepercayaan kesehatan didasarkan kepada pemahaman seseorang percaya memelihara kesehatannya dihubungkan dengan aktifitasnya, contohnya jika orang tersebut :

menghindari perasaan mempunyai kondisi kesehatan yang lemah ( pada pasien - pasien HIV ).

Mempunyai harapan positif dengan kesehatannya, jika melaksanakan apa yang di rekomendasikan petugas kesehatan.

Percaya akan sukses dengan aktifitas yang di rekomendasikan oleh tim medis.

Menurut Rosenstock ( 1974 - 1977 ) bahwasannya model ini dekat dengan pendidikan kesehatan.

Konsep : Perilaku kesehatan merupakan fungsi dari pengetahuan dan sikap. Secara khusus bahwa persepsi seseorang tentang kerentanan dan kemujaraban pengobatan dapat mempengaruhi keputusan seseorang dalam prilaku kesehatannya.

Health believed model menurut Becker ( 1979 ) di tentukan oleh :

Percaya bahwa mereka rentan terhadap masalah kesehatan.

Menganggap serius masalah.

Yakin terhadap efektivitas pengobatan.

Tidak mahal

Menerima anjuran untuk mengambil tindakan kesehatan.

Kelemahan:

Bersaing dengan kepercayaan dan sikap - sikap lain

Pembentukan kepercayaan seiring dengan perubahan prilaku

MODEL KOMUNIKASI / PERSUASI ( McGuire 1964 )

Konsep : Komunikasi dapat mengubah sikap dan prilaku kesehatan secara langsung pada kausal yang sama. Input ( stimulus ) - output ( tanggapan terhadap stimulus ). Perubahan pengetahuan dan sikap merupakan pra kondisi dalam perubahan prilaku kesehatan.

Komponen health believed model

Kerentanan yang dirasakan: Persepsi terhadap resiko dari suatu kondisi kesehatan.

Kekerasan yang di rasakan : Keseriusan perhatiannya terhadap suatu penyakit.

Manfaat yang dirasakan : Efektifitas tindakan dalam mengurangi ancaman penyakit.
Variabel - variabel lain: Perbedaan demografi, sosiopsikologi, dan variabel struktural.

BAGAIMANA HBM BERKEMBANG

HBM pertama kali berkembang pada tahun 1950 oleh seorang psykologi sosial Godfrey Hochbaum, Irwin Rosenstock, dan stephen kegels bekerja dipelayanan kesehatan umum. Program ini dikembangkan karena ada kegagalan dalam program pelayanan kesehatan untuk membebaskanpenyakit TB.
TB screening program menyediakan layanan gratis dalam melakukan screening x-ray dengan menggunakan kendaraan.
Ketika petugas melakukan pelayanan banyak orang - orang yang tidak mau keluar rumah, namun demikian petugas dengan cepat mempelajari bagaimana meminta orang - orang untuk mau keluar rumah.
Petugas mempelajari bagaimana memotivasi orang- orang supaya keluar rumah dan mereka mengerti tentang resiko penyakit dan keuntungan dari pelayanan kesehatan gratis ini.Ini sebagai faktor penting untuk memotivasi mereka.

EMPAT KONSEP KUNCI YANG DILAKUKAN PERTAMA - TAMA

Perceived Susceptability
Perceived Severity
Perceived Benefite
Perceived Barriers

HBM dan penyuluhan sex sehat

Primary prevention ; contoh : program unt7uk mencegah kehamilan, mencegah penyakit menular melalui hubungan sex, promosi pengguanaan kondom mencegah HIV.
secondary Prevention : deteksi dini membantu / mengenalipenyakit menular atau HIV dan menurunkan penyebaran penyakit dikarenakan hu bungan sex yang tidak aman.

KRITIK TERHADAP HBM
1. Hubungan antara kepercayaan dengan prilaku tidak pernah selaras
2.Modifikasi kepercayaan sering gagal dan butuh alternatif pendekatan.
3.Berhubungan dengan kritik yang kedua yaitu faktor individu dan faktor lingkungan sisial harus menjadi target intervensi kesehatan.
4.Tidak adanya kuantifikasi terutama untuk skala ordinal
5.adanya victim-blamming.

Refensi :

Universitas of South Florida Health Behavior Change : Theories and Model (www.med.usf.edu)
American school health Association Behavioral Theories ( www.cast.ilstu.edu)
Marvin Eisen, et.al.A Health Believed Model-Social Learning Theory Approach to Adolescent Fertility Control:finding froms a Controlled Field trial.Health education Quarterly vol.19,1992

No comments:

Blog Contents

Florence Nightingales’s Environmental Theory

by Sudiryo NPM 220111080041

Florence Nightingales’s Environmental Theory

Defined Nursing: “The act of utilizing the environment of the patient to assist him in his recovery.”
Focuses on changing and manipulating the environment in order to put the patient in the best possible conditions for nature to act.
Identified 5 environmental factors: fresh air, pure water, efficient drainage, cleanliness/sanitation and light/direct sunlight.
Considered a clean, well-ventilated, quiet environment essential for recovery.
Deficiencies in these 5 factors produce illness or lack of health, but with a nurturing environment, the body could repair itself.

Virginia Henderson’s Definition of the Unique Function of Nursing

By Sudiryo NPM 220111080041

Virginia Henderson’s Definition of the Unique Function of Nursing

Defined Nursing: “Assisting the individual, sick or well, in the performance of those activities contributing to health or it’s recovery (or to peaceful death) that an individual would perform unaided if he had the necessary strength, will or knowledge”.
Identified 14 basic needs :
1. Breathing normally
2. Eating and drinking adequately
3. Eliminating body wastes
4. Moving and maintaining desirable position
5. Sleeping and resting
6. Selecting suitable clothes
7. Maintaining body temperature within normal range
8. Keeping the body clean and well-groomed
9. Avoiding dangers in the environment
10. Communicating with others
11. Worshipping according to one’s faith
12. Working in such a way that one feels a sense of accomplishment
13. Playing/participating in various forms of recreation
14. Learning, discovering or satisfying the curiosity that leads to normal development and health and using available health facilities.

Calixta Roy’s Adaptation Theory

By Sudiryo NPM 220111080041

Calixta Roy’s Adaptation Theory

Viewed humans as Biopsychosocial beings constantly interacting with a changing environment and who cope with their environment through Biopsychosocial adaptation mechanisms.
Focuses on the ability of Individuals., families, groups, communities, or societies to adapt to change.
The degree of internal or external environmental change and the person’s ability to cope with that change is likely to determine the person’s health status.
Nursing interventions are aimed at promoting physiologic, psychologic, and social functioning or adaptation.

Jean Watson’s The Philosophy and Science of Caring

By Sudiryo NPM 220111080041

Jean Watson’s The Philosophy and Science of Caring

Nursing is concerned with promotion health, preventing illness, caring for the sick, and restoring health.
Nursing is a human science of persons and human health-illness experiences that are mediated by professional, personal, scientific, esthetic and ethical human care transactions
She defined caring as a nurturant way or responding to a valued client towards whom the nurse feels a personal sense of commitment and responsibility. It is only demonstrated interpersonally that results in the satisfaction of certain human needs. Caring accepts the person as what he/she may become in a caring environment
Carative Factors:

1. The promotion of a humanistic-altruistic system of values
2. Instillation of faith-hope
3. The cultivation of sensitivity to one’s self and others
4. The development and acceptance of the expression of positive and negative feelings.
5. The systemic use of the scientific problem-solving method for decision making
6. The promotion of interpersonal teaching-learning
7. The provision for supportive, protective and corrective mental, physical, socio-cultural and spiritual environment
8. Assistance with the gratification of human needs
9. The allowance for existential phenomenological forces

Dorothea Orem’s Self-Care Theory

By Sudiryo, NPM 220111080041

Dorothea Orem’s Self-Care Theory

Defined Nursing: “The act of assisting others in the provision and management of self-care to maintain/improve human functioning at home level of effectiveness.”
Focuses on activities that adult individuals perform on their own behalf to maintain life, health and well-being.
Has a strong health promotion and maintenance focus.
Identified 3 related concepts:
1. Self-care - activities an Individual performs independently throughout life to promote and maintain personal well-being.
2. Self-care deficit - results when self-care agency (Individual’s ability) is not adequate to meet the known self-care needs.
3. Nursing System - nursing interventions needed when Individual is unable to perform the necessary self-care activities:
  1. Wholly compensatory - nurse provides entire self-care for the client.
    - Example: care of a new born, care of client recovering from surgery in a post-anesthesia care unit
  2. Partial compensatory - nurse and client perform care, client can perform selected self-care activities, but also accepts care done by the nurse for needs the client cannot meet independently.
    - Example: Nurse can assist post operative client to ambulate, Nurse can bring a meal tray for client who can feed himself
  3. Supportive-educative - nurse’s actions are to help the client develop/learn their own self-care abilities through knowledge, support and encouragement.
- - - Example: Nurse guides a mother how to breastfeed her baby, Counseling a psychiatric client on more adaptive coping strategies.

Madeleine Leininger’s Transcultural Care Theory and Ethno-nursing

Madeleine Leininger’s Transcultural Care Theory and Ethnonursing

Nursing is a learned humanistic and scientific profession and discipline which is focused on human care phenomena and activities in order to assist, support, facilitate, or enable individuals or groups to maintain or regain their well being (or health) in culturally meaningful and beneficial ways, or to help people face handicaps or death.
Transcultural nursing as a learned subfield or branch of nursing which focuses upon the comparative study and analysis of cultures with respect to nursing and health-illness caring practices, beliefs and values with the goal to provide meaningful and efficacious nursing care services to people according to their cultural values and health-illness context.
Focuses on the fact that different cultures have different caring behaviors and different health and illness values, beliefs, and patterns of behaviors.
Awareness of the differences allows the nurse to design culture-specific nursing interventions.

Hildegard Peplau’s Interpersonal Relations Theory

Hildegard Peplau’s Interpersonal Relations Theory

Defined Nursing: “An interpersonal process of therapeutic interactions between an Individual who is sick or in need of health services and a nurse especially educated to recognize, respond to the need for help.
Nursing is a “maturing force and an educative instrument”
Identified 4 phases of the Nurse - Patient relationship:
1. Orientation - individual/family has a “felt need” and seeks professional assistance from a nurse (who is a stranger). This is the problem identification phase.
2. Identification - where the patient begins to have feelings of belongingness and a capacity for dealing with the problem, creating an optimistic attitude from which inner strength ensues. Here happens the selection of appropriate professional assistance.
3. Exploitation - the nurse uses communication tools to offer services to the patient, who is expected to take advantage of all services.
4. Resolution - where patient’s needs have already been met by the collaborative efforts between the patient and the nurse. Therapeutic relationship is terminated and the links are dissolved, as patient drifts away from identifying with the nurse as the helping person.

Faye Glenn Abdellah’s Concept of Twenty One Nursing Problems

by Sudiryo, NPM : 220111080041

Faye Glenn Abdellah’s Concept of Twenty One Nursing Problems

Nursing is broadly grouped into 21 problem areas to guide care and promote the use of nursing judgement.
Nursing is a comprehensive service that is based on the art and science and aims to help people, sick or well, cope with their health needs.

21 Nursing Problems

To maintain good hygiene.
To promote optimal activity; exercise, rest and sleep.
To promote safety.
To maintain good body mechanics
To facilitate the maintenance of a supply of oxygen
To facilitate maintenance of nutrition
To facilitate maintenance of elimination
To facilitate the maintenance of fluid and electrolyte balance
To recognize the physiologic response of the body to disease conditions
To facilitate the maintenance of regulatory mechanisms and functions
To facilitate the maintenance of sensory functions
To identify and accept positive and negative expressions, feelings and reactions
To identify and accept the interrelatedness of emotions and illness.
To facilitate the maintenance of effective verbal and non-verbal communication
To promote the development of productive interpersonal relationship
To facilitate progress toward achievement of personal spiritual goals
To create and maintain a therapeutic environment
To facilitate awareness of self as an individual with varying needs.
To accept the optimum possible goals
To use community resources as an aid in resolving problems arising from illness.
To understand the role of social problems as influencing factors

Rosemarie Rizzo Parse’s Theory of Human Becoming

Martha Roger’s Concept of Science of Unitary Human Beings, and Principles of Homeodynamics

By Sudiryo NPM 220111080041

Martha Roger’s Concept of Science of Unitary Human Beings, and Principles of Homeodynamics

Nursing is an art and science that is humanistic and humanitarian. It is directed toward the unitary human and is concerned with the nature and direction of human development. The goal of nurses is to participate in the process of change..
Nursing interventions seek to promote harmonious interaction between persons and their environment, strengthen the wholeness of the Individual and redirect human and environmental patterns or organization to achieve maximum health.
5 basic assumptions:

1. The human being is a unified whole, possessing individual integrity and manifesting characteristics that are more than and different from the sum of parts.
2. The individual and the environment are continuously exchanging matter and energy with each other
3. The life processes of human beings evolve irreversibly and unidirectionally along a space-time continuum
4. Patterns identify human being and reflect their innovative wholeness
5. The individual is characterized by the capacity for abstraction and imagery, language and thought, sensation and emotion