Jump to ContentJump to Main Navigation
Show Summary Details
More options …

International Journal of Adolescent Medicine and Health

Editor-in-Chief: Merrick, Joav

Editorial Board: Birch, Diana ML / Blum, Robert W. / Greydanus, MD, Dr. HC (Athens), Donald E. / Hardoff, Daniel / Kerr, Mike / Levy, Howard B / Morad, Mohammed / Omar, Hatim A. / de Paul, Joaquin / Rydelius, Per-Anders / Shek, Daniel T.L. / Sher, Leo / Silber, Tomas J. / Towns, Susan / Urkin, Jacob / Verhofstadt-Deneve, Leni / Zeltzer, Lonnie / Tenenbaum, Ariel

CiteScore 2018: 0.79

SCImago Journal Rank (SJR) 2018: 0.350
Source Normalized Impact per Paper (SNIP) 2018: 0.476

See all formats and pricing
More options …
Ahead of print


Theory analysis for Pender’s health promotion model (HPM) by Barnum’s criteria: a critical perspective

Zohreh Khoshnood
  • Nursing Research Center, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran (Islamic Republic of)
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Masoud Rayyani
  • Nursing Research Center, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran (Islamic Republic of)
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
/ Batool Tirgari
  • Corresponding author
  • Nursing Research Center, Razi School of Nursing and Midwifery, Kerman University of Medical Sciences, Kerman, Iran (Islamic Republic of)
  • Email
  • Other articles by this author:
  • De Gruyter OnlineGoogle Scholar
Published Online: 2018-01-13 | DOI: https://doi.org/10.1515/ijamh-2017-0160



Analysis of nursing theoretical works and its role in knowledge development is presented as an essential process of critical reflection. Health promotion model (HPM) focuses on helping people achieve higher levels of well-being and identifies background factors that influence health behaviors.


This paper aims to evaluate, and critique HPM by Barnum’s criteria.


The present study reviewed books and articles derived from Proquest, PubMed, Blackwell Databases. The method of evaluation for this model is based on Barnum’s criteria for analysis, application and evaluation of nursing theories. The criteria selected by Barnum embrace both internal and external criticism. Internal criticism deals with how theory components fit with each other (internal construction of theory) and external criticism deals with the way in which theory relates to the extended world (which considers theory in its relationships to human beings, nursing, and health).


The electronic database search yielded over 27,717 titles and abstracts. Following removal of duplicates, 18,963 titles and abstracts were screened using the inclusion criteria and 1278 manuscripts were retrieved. Of these, 80 were specific to HPM and 23 to analysis of any theory in nursing relating to the aim of this article. After final selection using the inclusion criteria for this review, 28 manuscripts were identified as examining the factors contributing to theory analysis. Evaluation of health promotion theory showed that the philosophical claims and their content are consistent and clear. HPM has a logical structure and was applied to diverse age groups from differing cultures with varying health concerns.


In conclusion, among the strategies for theory critique, the Barnum approach is structured and accurate, considers theory in its relationship to human beings, community psychiatric nursing, and health. While according to Pender, nursing assessment, diagnosis and interventions are utilized to operationalize the HPM through practical application and research.

Keywords: analysis; nursing theory; theory evaluation; the Pender’s health promotion theory


  • [1]

    Alligood MR. Nursing theorists and their work, 8th ed. St. Louis, Missouri: Elsevier Health Sciences; 2014.Google Scholar

  • [2]

    Edwards SD. Critical review of RR Parse’s the human becoming school of thought. A perspective for nurses and other health professionals. J Adv Nurs. 2000;31:190–6.CrossrefGoogle Scholar

  • [3]

    Chinn PL, Kramer MK. Integrated theory & knowledge development in nursing, 9th ed. St. Louis, Missouri: Mosby/Elsevier; 2015.Google Scholar

  • [4]

    Fawcett J, Desanto-Madeya S. Contemporary nursing knowledge: analysis and evaluation of nursing models and theories, 3rd ed. Philadelphia: FA Davis Company; 2013.Google Scholar

  • [5]

    Walker LO, Avant KC. Strategies for theory construction in nursing, 5th ed. Upper Saddle River: Pearson/Prentice Hall; 2013. 241 pp.Google Scholar

  • [6]

    An J-Y, Hayman LL, Panniers T, Carty B. Theory development in nursing and healthcare informatics: a model explaining and predicting information and communication technology acceptance by healthcare consumers. Adv Nurs Sci. 2007;30:E37–49.CrossrefGoogle Scholar

  • [7]

    Smith MJ, Liehr PR. Evaluation of middle range theories. In: Gaubard A, Rosen J, editors. Middle range theory for nursing. New York: Springer; 2008. p. 13.Google Scholar

  • [8]

    Garcia DS. Evaluation of 3 behavioral theories for application in health promotion strategies for Hispanic women. Adv Nurs Sci. 2016;39:165–80.Web of ScienceCrossrefGoogle Scholar

  • [9]

    Mohsenipoua H, Majlessi F, Shojaeizadeh D, Rahimiforooshani A, Ghafari R, Habibi V. Predictors of health-promoting behaviors in coronary artery bypass surgery patients: an application of Pender’s health promotion model. Iran Red Crescent Med J. 2016;18:1–9.Web of ScienceGoogle Scholar

  • [10]

    Orem DE, Taylor SG, Renpenning KM. Nursing concepts of practice, 6th ed. St Louis,MO: Mosby; 2001.Google Scholar

  • [11]

    Zare M, Asadi Z, Vahedian Shahroodi M, Bahrami-Taghanaki H. Investigating the relationship between components of Pender’s Health Promotion Model and self-care behaviors among patients with Smear-positive pulmonary tuberculosis. Evidence Based Care. 2017;6:7–17.Google Scholar

  • [12]

    Clark DJ. Old wine in new bottles: delivering nursing in the 21st century. J Nurs Scholarsh. 2000;32:11.PubMedCrossrefGoogle Scholar

  • [13]

    Walker LO, Avant KC. Strategies for theory construction in nursing. Norwalk, CT: Appleton & Lange; 1988.Google Scholar

  • [14]

    Meleis AI. Theoretical nursing: development and progress. Philadelphia: Lippincott Williams & Wilkins; 2011.Google Scholar

  • [15]

    Janík MZ, Hodboďová Z. The Vietnam War, Public Opinion and American Culture. Masaryk, University Brno: Faculty of education, Department of English Language and Literature; 2008.Google Scholar

  • [16]

    Üstün BT, Jakob R. Calling a spade a spade: meaningful definitions of health conditions. Bull World Health Organ. 2005;83:802.PubMedGoogle Scholar

  • [17]

    Pender NJ. Heath Promotion Model Manual. 2011.Google Scholar

  • [18]

    Crothers L, Hughes T, Morine K. Theory and cases in school-based consultation. New York: Routledge; 2008.Google Scholar

  • [19]

    Eldredge LK, Markham CM, Kok G, Ruiter RA, Parcel GS. Planning health promotion programs: an intervention mapping approach. New York: John Wiley & Sons; 2016.Google Scholar

  • [20]

    Bandura A. Health promotion from the perspective of social cognitive theory. Psychol Health 1998;13:623–49.CrossrefGoogle Scholar

  • [21]

    Bandura A. Health promotion by social cognitive means. Health Educ Behav. 2004;31:143–64.PubMedCrossrefGoogle Scholar

  • [22]

    Parsons MA, Pender NJ, Murdaugh CL. Health promotion in nursing practice. London: Pearson Higher Education; 2011.Google Scholar

  • [23]

    Peterson SJ, Bredow TS. Middle range theories: application to nursing research. Philadelphia: Lippincott Williams & Wilkins; 2009.Google Scholar

  • [24]

    Augoustinos M, Walker I, Donaghue N. Social cognition: an integrated introduction. London: Sage; 2014.Google Scholar

  • [25]

    Painter JE, Borba CP, Hynes M, Mays D, Glanz K. The use of theory in health behavior research from 2000 to 2005: a systematic review. Ann Behav Med. 2008;35:358.CrossrefWeb of ScienceGoogle Scholar

  • [26]

    Frenk J, Chen L, Bhutta ZA, Cohen J, Crisp N, Evans T, et al. Health professionals for a new century: transforming education to strengthen health systems in an interdependent world. Lancet. 2010;376:1923–58.CrossrefWeb of ScienceGoogle Scholar

  • [27]

    Butts JB, Rich KL. Philosophies and theories for advanced nursing practice. Burlington, MA: Jones & Bartlett Publishers; 2013.Google Scholar

  • [28]

    Mohamadian H, Eftekhar Ardebili H, Rahimi Foroushani A, Taghdisi M, Shojaiezade D. Evaluation of Pender’s health promotion model for predicting adolescent girls’ quality of life. J Sch Public Health Inst Public Health Res. 2011;8:1–13.Google Scholar

  • [29]

    Brenda JS, Barbara Velsor F. Health promotion in adolescents: a review of Pender’s health promotion model. Nurs Sci Q. 2006;19:366–73.CrossrefPubMedGoogle Scholar

  • [30]

    Barnum BS. Nursing theory: analysis, application, evaluation. Glenview: Scott Foresman & Company,; 1990.Google Scholar

  • [31]

    Chinn PL, Kramer MK, Chin PL. Integrated knowledge development in nursing, 8th ed. St. Louis, MO: Elsevier Mosby; 2004.Google Scholar

  • [32]

    Sørensen K, Van den Broucke S, Fullam J, Doyle G, Pelikan J, Slonska Z, et al. Health literacy and public health: a systematic review and integration of definitions and models. BMC Public Health. 2012;12:1.Web of ScienceGoogle Scholar

  • [33]

    Alpar ŞE, Şenturan L, Karabacak Ü, Sabuncu N. Change in the health promoting lifestyle behaviour of Turkish University nursing students from beginning to end of nurse training. Nurse Educ Pract. 2008;8:382–8.PubMedCrossrefGoogle Scholar

  • [34]

    McCullagh M. Health promotion. In: Peterson SJ, Bredow TS, editors. Middle range theories: applications to nursing research. Philadelphia: Lippincott Williams & Wilkins; 2009. pp. 290–303.Google Scholar

  • [35]

    Heydari A, Khorashadizadeh F. Pender’s health promotion model in medical research. Studies 2014;41:59.Google Scholar

  • [36]

    McEwen M, Wills EM, Williams L. Theoretical basis for nursing. Philadelphia: Lippincott Williams & Wilkins; 2007.Google Scholar

  • [37]

    Rawlett K. Analytical evaluation of the health belief model and the vulnerable populations conceptual model applied to a medically underserved, rural population. Int J Appl Sci Technol. 2011;1:6.Google Scholar

  • [38]

    Fayers P, Machin D. Quality of life: the assessment, analysis and interpretation of patient-reported outcomes. New York: John Wiley & Sons; 2013.Google Scholar

  • [39]

    Williams A, Wold J, Dunkin J, Idleman L, Jackson C. CVD prevention strategies with urban and rural African American women. Appl Nurs Res. 2004;17:187–194. CrossrefGoogle Scholar

  • [40]

    Ronis DL, Hong OS, Lusk SL. Comparison of the original and revised structures of the health promotion model in predicting construction workers’ use of hearing protection. Res Nurs Health. 2006;29:3–17.PubMedCrossrefGoogle Scholar

About the article

Received: 2017-09-17

Accepted: 2017-10-09

Published Online: 2018-01-13

Citation Information: International Journal of Adolescent Medicine and Health, 20170160, ISSN (Online) 2191-0278, DOI: https://doi.org/10.1515/ijamh-2017-0160.

Export Citation

©2018 Walter de Gruyter GmbH, Berlin/Boston.Get Permission

Citing Articles

Here you can find all Crossref-listed publications in which this article is cited. If you would like to receive automatic email messages as soon as this article is cited in other publications, simply activate the “Citation Alert” on the top of this page.

Masoud Khodaveisi, Aliasghar Jafari, Afsar Omidi, Ghodratolah Roshanaei, and Akbar Sazvar
Sport Sciences for Health, 2019
Ebrahim Naimi, Amin Babuei, Moslem Moslemirad, Karim Rezaei, and Owrang Eilami
Journal of Religion and Health, 2019

Comments (0)

Please log in or register to comment.
Log in