Health Belief Model in Nursing Studies

Nurses spend more time with patients than other health team members, and are crucial care providers of patient focused resources and education. Nurse is the one on which patient depends on, in terms of recovery and guidance. Ironically, professional nurse can provide care in better way by understanding not only the needs but also psychology of patient and their belief of health. Health Belief Model in Nursing Studies gives an opportunity to develop efficient understanding of health belief of a person and why he reacts to prevention and cure of a disease.

The health belief model is a, instrument for nurses, offering outline for helping their patients prevent chronic disease or, improve quality of life during suffering.

Nurses can use this model to explain patients' perceptions of risk and why they behave in a way that is harmful; this enables nurses to apply strategies that empower patients to make healthy lifestyle changes. Patients' perceptions can be affected by age, sex, and personality. patients who are overweight and diabetic or those who have high blood pressure or Cholesterol and eat processed convenience foods high in sodium. Nurses can use the health belief model in any of these conditions.

History and Orientation of Health Belief Model

The Health Belief Model (HBM) is a psychological model that attempts to explain and predict health behaviors. This is done by focusing on the attitudes and beliefs of individuals. 

The HBM was first developed in the 1950s by social psychologists Hochbaum, Rosenstock and Kegels working in the U.S. Public Health Services to explain the failure of people participating in programs to prevent and detect disease. Later, the model was extended by others to study people's behavioral responses to health-related conditions.

Actually, the model was developed in response to the failure of a free tuberculosis (TB) health screening program. Since then, the HBM has been adapted to explore a variety of long- and short term health behaviors, including sexual risk behaviors and the transmission of HIV/AIDS.

According to this model, your individual beliefs about health and health conditions play a role in determining your health-related behaviors. Key factors that affect your approach to health include:

• Any hurdles might be standing in a person’s way
• Exposure to information that encourage to take action
• How much of a benefit a person think will get from engaging in healthy behaviors
• How susceptible to illness, a person belief
• What are the consequences will be, of becoming sick in a person’s opinion
• Person’s confidence in ability to succeed

Health experts often look for ways that such health belief models can impact the actions people take, including behaviors that can have an impact on both individual and public health.

Assumptions and Statements

The HBM is based on the understanding that a person will take a health-related action (i.e., use condoms) if that person:

1 - Feels that a negative health condition (i.e., HIV) can be avoided,

2 - Has a positive expectation that by taking a recommended action, he/she will avoid a negative health condition (i.e., using condoms will be effective at preventing HIV), and

3 - Believes that he/she can successfully take a recommended health action (i.e., he/she can use condoms comfortably and with confidence).

The HBM was spelled out in terms of four constructs representing the perceived threat and net benefits:

    1 - Perceived susceptibility,
    2 - Perceived severity,
    3 - Perceived benefits, and 
    4 - Perceived barriers.

These concepts were proposed as accounting for people's "readiness to act." An added concept, cues to action, would activate that readiness and stimulate overt behavior. A current addition to the HBM is the concept of self-efficacy, or one's confidence in the ability to successfully perform an action. This concept was added by Rosenstock and others in 1988 to help the HBM better fit the challenges of changing habitual unhealthy behaviors, such as being sedentary, smoking, or overeating.

1 – Perceived Susceptibility

People will not change their health behaviors unless they believe that they are in danger.

For example:

• Individuals who do not think they will get the flu are less likely to get a yearly flu vaccine.
• People who think they are unlikely to get skin cancer are less likely to apply sunscreen
• People who do not think that they are at risk of acquiring HIV from unprotected intercourse are less likely to use a condom.
• Young people who don't think they're at risk of lung cancer are less likely to stop smoking.

Research proposes that assumptions to illness is an important predictor of preventive health behaviors.

2 - Perceived Severity

The probability will change health behaviors to avoid a consequence depends on how serious people believe the consequences will occur.

For example:

• If a couple in love, are unlikely to avoid kissing on the mouth just because one have sniffles and other might get cold. On the contrary, one probably would stop kissing if it might give a more serious illness.
• Likewise, fewer people are likely to consider condoms when they think Sexually Transmitted Diseases are a minor problem. Therefore receptiveness to messages about safe sex increased during the AIDS epidemic. The perceived severity increased massively. 

The severity of an illness can have a major impact on health consequences. However, a number of studies have shown that perceived severity is actually the least influential predictor of whether or not people will involve in preventive health behaviors

3 – Perceived Benefits

It's difficult to convince people to change a behavior if there isn't something in it for them. People don't want to give up something they enjoy if they don't also get something in return.

If people have motivation, they are problematic to convince for change their behavior, especially if they don't get something in return

For example:

• A smoker probably won't give up, if don't think that doing so will improve their life in some way.
• A couple might not choose to exercise safe sex if they don't see how it could make their sex life healthier. 
• People might not get vaccinated if they do not think there is a discrete benefit for them.

Perceived benefits are linked to other factors, including the perceived effectiveness of a behavior. If a person believe that getting regular exercise and eating a healthy diet can prevent heart disease, that belief increases the perceived benefits of those behaviors.

4 – Perceived Barriers

Majorly people don't change their health behaviors because they think doing so is going to be difficult. Changing your health behaviors can cost effort, money, and time. Usually perceived barriers include:

• Danger
• Expense
• Discomfort
• Inconvenience
• Social consequences
• Amount of effort required

Occasionally it's not just a matter of physical stress, but social challenges as well. 

For instance, 

• If everyone social group goes out drinking on Saturdays, it may be very difficult to cut down on one person’s alcohol intake.
• If a person think that condoms are a sign of mistrust in a relationship, he may be doubtful to bring them up. 

Perceived barriers to healthy behaviors have been shown to be the most powerful predictor of whether people are willing to engage in healthy behaviors or not

When promoting health-related behaviors, as vaccinations or Sexually Transmitted Disease prevention, finding ways to help people overcome perceived barriers is important. Disease prevention programs can often do this by increasing accessibility, reducing costs, or promoting self-efficacy beliefs.

Cue to action - The stimulus needed to trigger the decision-making process to accept a suggested health action.

These cues can be internal (e.g., chest pains, wheezing, etc.) or external (e.g., advice from others, illness of family member, newspaper article, etc.).

Self-efficacy - Refers to the level of a person's confidence in ability to successfully achieve a behavior. 

This construct was added to the model most recently in mid-1980. Self-efficacy is a construct in many behavioral theories as it directly relates to whether a person performs the desired behavior.

Health Belief Conceptual Model

The appropriate understanding of Health Belief Model (HBM) by a nurse can provided positive affect on certain health behaviors in or out hospital settings, using Health Belief model based education ifor nurses, can lead to increased knowledge and practically enhance effective health teaching to patient or community

Health Belief Model in Nursing Studies | POST RN BSN Nursing Resources