Power as knowing participation in change: A model for Nursing intervention




Branum, Quie

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This study explored the role of philosophy of science in the development of theory within a science and the determination of appropriate methods of study and verification of theory. The current debate between historicism and logical empiricism was discussed briefly and nursing models consistent with the historicism as a philosophy of science were identified.

A historicist critique of the current research methods and traditions in the study of noncompliance were presented. The examination divided the studies into general research and research done within a specific model of health behavior such as the Health Belief Model. Shortcomings in the use of this research were identified; in particular, the role of the patient as passive recipient of the health care worker's greater knowledge and decision-making and the lack of success in prediction and production of compliant behavior were criticized.

Using the conceptual model of Dr. Martha E. Rogers, the patient was conceptualized as the decision-maker with an individually defined concept of health. Failure on the part of the patient to make a desired change is viewed as inadequate power rather than resistance to change.

Barrett's theory that power is knowing participation in change was developed into the model presented here. Knowing participation is awareness of choice, feeling free to act on the choice and the intentional act. The patient in continual, mutual process with the nurse can enhance the patient's power. A more knowledgeable powerful patient makes better decisions and feels more free to act on that decision. Because of the probabilistic nature of change, there are no guarantees that a knowledgeable patient will choose to follow recommendations of the health care worker. The important thing is that the patient make an informed choice and accept the responsibility for personal health.



Role of Philosophy of Science, Theory development, Health Belief Model