The Health Belief Model (HBM) of health behaviour change was originally developed in the 1950s in order to understand and explain why vaccination and screening programs being implemented at the time were not meeting with success (Edberg 2007). It was later extended to account for preventive health actions and illness behaviours (Roden 2004). Succinctly, it suggests that behaviour change is influenced by an individuals’ assessment of the benefits and achievability of the change versus the cost of it (Naidoo and Wills 2000).
For the purposes of this assignment, the author has been provided with an example client, Thomas. In order to better explain the workings of the HBM, the author will relate back to Thomas in discussing this model and how it can be implemented, along with the nurses’ responsibilities in doing so. Next, the author will explain the Stages of Change Model and Motivational Interviewing, both of which assist practitioners in implementing the HBM with clients. Finally, there will be a brief discussion of some of the strengths and weaknesses of the model.
Our example client, Thomas, is a recently unemployed man in his late 50s. He has recently been in contact with the local community nurse, presenting with a leg ulcer. He lives with his wife, and their grandchildren who they care for following the death of their daughter four years ago. Thomas is a heavy smoker and drinks moderately but regularly in the nearby village to escape the stress he states he feels from the children. He is clinically obese at 19 stone and gets little exercise. He has a poor diet, and while his wife is aware of the importance of healthy eating, she lacks the confidence to make changes. When referring to Thomas in this assignment the author is assumed to be taking the part of a student nurse developing a plan of care with Thomas using the HBM.
As healthcare professionals or “experts”, nurses can often, with the best of intentions, deprive clients of autonomy by monopolising their care, believing that we are acting in their best interests. In Thomas’ case we could identify his smoking, drinking, lack of exercise, low motivation and possible unresolved grief stemming from the death of his daughter as problems. However, the essence of the Health Belief Model is that of empowerment, we act as facilitators to support our clients in identifying areas they may wish to change (Kiger 2004). While still undoubtedly the experts, we do not use our knowledge to hold ourselves apart, but to act as facilitators and catalysts for changing to more positive health behaviours. Thomas’ perceptions of his problems may be very different to our own, or he may feel unable to change. So the issue for the practitioner becomes not, “how do we fix the problem?” but, “how do we assist our clients in identifying problem areas they may wish to change and empower them to make that change?” In order to see how this may be achieved, the author will now discuss the HBM as a framework...