CHAPTER I

INTRODUCTION

This chapter presents the background of the study, statement of the problem,

significance of the study, scope and delimitations of the study and definition of terms.

Background of the Study

According to Dr. Nola Pender developed the Health Promotion Model (HPM)

focuses on helping people achieve higher levels of well-being. It encourages health

professionals to provide positive resources to help patients achieve behavior specific

changes. The goal of the Health Promotion Model is not just about helping patients

prevent illness through their behavior, but to look at ways in which a person can pursue

better health or ideal health.

The first international conference on health promotion occurred as a result of the

need for a new worldwide public health movement in 1896 (World Health Organization

[WHO], Ottawa, 1986). At this conference, participants identified health as " resources

for social, economic, and personal development, and an important dimension of quality

of life" and defined health promotion as the process of enabling people to improve health

(WHO, OTTAWA, 1986). The five health promotion actions identified at this conference

were: building healthy public policy, creating supportive environments, development of

personal skills, strengthening community actions and changing present health care

systems from a curative focus to a preventative focus. Health promotion is nursing

practice is an essential tool for nurses as they develop and deliver evidence-based health

promotion services to diverse population. Health promotion is for everyone becoming

healthier improves the quality of life for all individuals, including cancer survivors,

1
person with disabilities those with chronic diseases, and those of advanced age. The

American health association (AHA) recently issued an advisory statement that nurse

should routinely assess health behaviors just like vital signs and provide behavior change

counselling as an integral part of services to all patients (Spring, Ockene, Gidding,

Mozaffarian, Moore, Rosal, et al., 2013) The health promotion is any planned

combination of educational, political, environmental, regulatory, or organizational

mechanisms that support actions and conditions if living conducive to health of

individuals, group and communities (Joint committee, 2001, p. 101).

According to Kumar & Preetha (2012), the health promotion is an essential

approach to enhancing people's well-being and reducing the health risks associated with

non-communicable diseases (NCDs), the leading cause of morbidity and mortality

worldwide. NCDs such as lifestyle-related behaviors, unhealthy diet, tobacco use, alcohol

consumption and physical inactivity. Thus, most of NCDs are preventable simply and

affordably by a health-promoting lifestyle. Such health-promoting lifestyles are mainly

influenced by health promotion, which holds individuals accountable for their own

health.

According to Tambağ (2011), the Nursing professionals, the largest group among

health professionals, have a vital role in promoting health and healthy lifestyles while

providing health-related intervention to their clients. Thus, nurses must be able to

demonstrate healthy behavior to inform and guide individuals on healthy lifestyles. Since

most lifestyle habits of nurses are acquired early during their undergraduate education,

nursing students must have healthy lifestyle behaviors to become be competent nurses

and health promoters

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 In addition, health promotion by nurses can lead to many positive health

outcomes including adherence, quality of life, patients' knowledge of their illness and

self-management (Bosch-Capblanc et al., 2009; Keleher et al., 2009).

Statement of the problem

The study will aim to assess the effectiveness of Health Promotion Practices

among Nursing Students of Philippine Last Frontier College – College of Nursing in

Patient Care. This study will seek to answer the following questions:

1. What is the demographic profile of the respondents according to age, gender and

Year Level?

2. What is the level of effectiveness of Health Promotion Practices among Nursing

Students of Philippine Last Frontier College – College of Nursing in Patient Care?

3. Is there any significant relationship on the level of effectiveness of Health

Promotion Practices among Nursing Students of Philippine Last Frontier College

– College of Nursing in Patient Care according to age, gender and year level?

Hypothesis

There any no significant relationship on the level of effectiveness of Health

Promotion Practices among Nursing Students of Philippine Last Frontier College –

College of Nursing in Patient Care.

Significant of the Study

This research study aims to explore and analyze effectiveness of Health

Promotion Practices among Nursing Students of Philippine Last Frontier College –

College of Nursing in Patient Care, identify areas for improvement, and inform the

3
development of educational programs and interventions to enhance health promotion

practices and improve patient care and public health outcomes.

To the researchers it develops deeper insights, generate new ideas, and provide

evidence-based recommendations for improving health promotion practices among

nursing students.

To the Nursing students it serves as a guide for those who wish to conduct further

research on the topic, providing them with valuable knowledge and resources.

To the Nursing Educators and Administrator, the health promotion practices

among nursing students, allowing them to develop targeted interventions and educational

programs to enhance health promotion practices and improve patient care and public

health outcomes.

Scope and Delimitation of the Study

This study will focus on the effectiveness of Health Promotion Practices among

Nursing Students of Philippine Last Frontier College – College of Nursing in Patient

Care. It will be gathered at the Philippine Last Frontier College – College of Nursing

Department located at IPHO-Daerah Street, Bongao, Tawi-Tawi. This study will focus to

the forty (40) student who are officially enrolled in College of Nursing and it will be

divided into twenty (20) from third year level and twenty (20) from the second-year level.

This will be conduct on the second semester of academic year 2024-2025.

Purpose of the study

The purpose of this study is to assess effectiveness of Health Promotion Practices

among Nursing Students of Philippine Last Frontier College – College of Nursing in

Patient Care (PLFC). The results of this study will help college administrators and
4
nursing curriculum planners in designing, targeting, and implementing health-promoting

programs to increase awareness in this population.

Definition of Term

Age - the length of time that a person has lived or a thing has existed.

Gender - either of the two sexes (male and female), especially when considered with

reference to social and cultural differences rather than biological ones.

Health - refers to a state of complete physical, mental and social wellbeing being.

Nursing - is a profession focused on the care id individuals, families, and communities.

PLFC- is an educational institution dedicated to supporting them in transforming their

aspirations into reality. PLFC is not just a center of learning, but this is the home of

dreams and the dreamers.

Practices- refers to individuals’ role in maintaining health preventing disease.

Promotion - is the process of enabling people to increase control over and to improve

their health.

Students - a person formally engaged in learning especially one enrolled in a school or

college.

Year Level - a term used to describe the grade level or year of attendance of someone

who is in a school. Refers to the academic year of education that students have attained

currently; First Year or Freshman, Second Year or Sophomore, Third Year or Junior and

Fourth Year or Senior

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 CHAPTER II

REVIEW OF RELATED LITERATURE

This chapter deals with the related literature and studies that may help supplement the

conceptualization of the study.

Review Literature

According to World Health Organization (1998), it is essential to understanding

of health promotion is the concept of health. Health has multiple definitions and meaning

in 1948 when WHO defined health as a state of complete physical, social, and mental

wellbeing, and not merely the absence of disease or infirmity. This definition of health is

also limited to the individual and does not take into consideration the environment of

health is also limited to the individual and does not take into consideration the

environment in which the individual lives. Today many definitions of health still include

one dominant under planning, the idea that health is the absence of disease and illness

(Naidono & Willis, 2000).

In 1986 the world health organization held the first international conference on

health promotion to attempt to acquire health for all people (WHO, 1986). the first

attempt to have a consensus on the definition for health promotion occurred at this

conference (Green & Raeburn, 1988). The conference determined that the health

promotion is the process of enabling people to increase control over and to improve their

health (WHO, 1986). Today, this is the most globally recognized definition of health

promotion and is the one cited in the department of health and human services (2008)

glossary for developing healthy people 2020.

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 Moreover, Brontons et al., (2005) stated that health promotion, as well as

prevention of illness, is considered important tasks among general practitioners regarding

their daily activities and practice. Likewise, Whitehead and Irvine (2010), cited that the

position of health promotion of nursing among other health professionals is somehow

contradicting their policies, practice and even on their theories upon execution.

Health promotion is the science and art of helping people change their lifestyles to

move forward a state of optimal health, which is a balance of physical, emotional, social,

spiritual, and intellectual health. Lifestyle change can be facilitated through a

combination of learning experience that enhances awareness, increase motivation and

build skills and most importantly through creating supportive environments that provide

opportunities for positive health practices (O'Donnel, 2019), Nutbeam (1997). Arising

health promotion set-up among schools with positive effects is now evident. Health

promotion programs among schools are now emphasize as part of health advocacy.

Schools are now having an objective in achieving health promotion incorporated in

education as integrated of their task. (Leurs et al., 2005).

According to Kemppainen et al., (2013), health researcher of health promotion,

they cited that nurse seem to demonstrate health protection very well as part of their role.

Likewise, nurses are promoting of general health as evidence by excluding activities on

health promotion such as health teaching to give necessary information among students

with regards to their health status and how to achieve a positive outcome.

According to the World Health Organization, has for a long time promoted a

common approach to health policy by developing a series of targets for improved health

status, i.e. the Health for All Strategy—Targets for Health for All. Several health

7
conferences have been arranged by WHO. Two of the most significant conferences were

arranged in Alma Ata in 1978, resulting in the Alma-Ata Declaration, which emerged as

a milestone of the twentieth century in the field of public health. The second was

arranged in Ottawa, Canada, where 200 delegates from 38 nations came together and

made a commitment to health promotion; based on the Alma-Ata Declaration, the Ottawa

Charter for health promotion was born. This charter defined health promotion as ‘the

process of enabling people to increase control over, and to improve, their health. To reach

a state of complete physical mental and social wellbeing, an individual or group must be

able to identify and to realize aspirations, to satisfy needs, and to change or cope with the

environment’. The Ottawa Charter became a core policy document and a cornerstone in

establishing the health promotion field.

The Lancet—University of Oslo (UiO) Commission of Global Governance for

Health stated that ‘health is a precondition, outcome, and indicator of a sustainable

society, and should be adopted as a universal value and shared social goal and political

objective for all’. According to Samdal and Wold, health promotion is a modern ideology

and strategy to improve public health. It represents a reorientation of public health from

addressing individual risk factors of health or risk behaviors toward targeting

determinants of health and empowering individuals and communities to participate in

improving the health of their communities.

Health promotion is positive and dynamic. It opens up the field of health to

become an inclusive social, rather than an exclusive professional activity. It represents a

broadening of perspectives in relation to health education and to prevention as a whole’.

In these words, the former Chair of the Editorial Board of Health Promotion International

8
introduced this new scientific journal in 1986. She was one of the key persons strongly

and deeply involved in the discussions of the content of health promotion and how health

promotion differs from public health and disease prevention. Some of the key notions of

these discussions were summarized in a document by the WHO European Office; Scriven

and Orme described this publication as the emergence of health promotion as a major

movement.

The Core Principles and Strategies of Health Promotion

Health is seen as a resource of everyday life, not the objective of living. Health is a

positive concept emphasizing social and personal resources, as well as physical

capacities. The prerequisites for health as the fundamental conditions and resources are

peace, shelter, education, food, income, a stable ecosystem, sustainable resources, social

justice and equity. Three basic principles for health promotion work from the Ottawa

Charter: advocate, enable and mediate.

 Advocate: Political, economic, social, cultural, environmental, behavioral and

biological factors can all favor health or be harmful to it. Health promotion action

aims at making these conditions favorable through advocacy for health.

 Enable: Health promotion focuses on achieving equity in health. Health

promotion action aims at reducing differences in current health status and

ensuring equal opportunities and resources to enable all people to achieve their

fullest health potential. This includes a secure foundation in a supportive

environment, access to information, life skills and opportunities for making

healthy choices. People cannot achieve their fullest health potential unless they

are able to take control of those things which determine their health.

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  Mediate: The prerequisites and prospects for health cannot be ensured by the

health sector alone. Professional and social groups and health personnel have a

major responsibility to mediate between differing interests in society for the

pursuit of health.

Health Promotion Strategies Used by Nurses

To make a difference in patients’ health outcomes, you can apply numerous

strategies, chief among these being patient education, advocacy, and interprofessional

collaboration.

Patient education is a critical strategy in the promotion of health. To become a

proficient health educator, you need to understand the patient’s medical condition and

explain it in a way that is easily understood. More so, you should empower the patient to

manage their care. This involves teaching them about their medication and therapies,

explaining why they are necessary, the potential side effects, and how they help manage

their condition effectively. Your teaching might also involve lifestyle changes such as

improving nutrition, increasing exercise, quitting smoking, or managing stress better. But

remember, try to tailor your teaching to the patient’s age, culture, and ability to

understand medical terminology.

As an advocate, you support the patient’s rights and interests. Your role is to

ensure that your patient’s health care needs are met and their rights respected. This could

involve helping patients understand their healthcare rights and navigating the healthcare

system or assisting families in interacting with healthcare providers to make informed

decisions. Moreover, advocating doesn’t end at an individual level; you can be part of

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local, national, or global initiatives that contribute to advancing policies that positively

affect patient care.

As an Interprofessional collaboration involves working hand-in-hand with other

healthcare professionals to provide patient-centered care. This teamwork can greatly

improve healthcare outcomes as it allows a comprehensive assessment from multiple

disciplines. It may involve you liaising with doctors, physiotherapists, dietitians,

psychologists, and social workers to develop a care plan best suited for each patient.

A successful collaborative environment is reliant on trust, respect, open communication,

a clear understanding of each team member’s roles, and shared decision-making. It’s all

about improving health outcomes and giving the highest standard of patient care.

The Role of Nurses in Community/Public Health

As a nurse, you play an integral role in promoting community and public health.

Your active involvement in health campaigns, school outreach, and workplace initiatives

can make a significant impact on improving public health awareness and practices.

Active participation in health campaigns allows you to reach a broad segment of the

population. Your responsibilities might include organizing exercise programs in the

community, leading seminars on disease prevention, or providing free health screenings.

The goal of these campaigns isn’t just to provide immediate care, but to educate people

about the importance of their health and how to properly care for themselves. For

example, in a campaign geared toward diabetes awareness, your role might include not

just testing individuals for diabetes, but also teaching them about how to manage and

prevent diabetes through diet and lifestyle changes.

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Promoting Health

The ultimate goal of comprehensive health assessments is to promote overall health and

wellness. By establishing a baseline understanding of your patient’s health status, you can

recommend targeted health promotion strategies. These may range from lifestyle

modifications, like healthier eating or increased physical activity, to mental health

initiatives aimed at managing stress.

Remember, the goal here is not only to identify and solve problems, but also to

proactively enhance your patient’s overall well-being. Making recommendations for

health screenings, regular exercise, a balanced diet, and regular medical check-ups are all

important parts of health promotion and disease prevention.

Health Promotion Model by Nola J. Pender (1982)

According to Nola J. Pender, Health Promotion and Disease Prevention should

focus on health care. When health promotion and prevention fail to anticipate

predicaments and problems, care in illness becomes the subsequent priority. The Health

Promotion Model notes that each person has unique personal characteristics and

experiences that affect subsequent actions. The set of variables for behavioral specific

knowledge and effect have important motivational significance. These variables can be

modified through nursing actions. Health-promoting behavior is the desired behavioral

outcome and is the endpoint in the Health Promotion Model. Health-promoting behaviors

should result in improved health, enhanced functional ability, and better quality of life at

all development stages. The final behavioral demand is also influenced by the immediate

12
competing demand and preferences, which can derail intended health-promoting actions.

As regards health promotion, Nola Pender has written and issued various articles on

exercise, behavior change, and relaxation training. She also has served on editorial boards

and as an editor for journals and books.

Pender is also known as a scholar, presenter, and consultant in health promotion.

She has collaborated with nurse scientists in Japan, Korea, Mexico, Thailand, the

Dominican Republic, Jamaica, England, New Zealand, And Chile. By

contributing leadership as a consultant to research centers and giving scholar

consultations, Pender resumes influencing nursing. She also collaborates with the

American Journal of Health Promotion editor, promoting legislation to support health

promotion research.

Nola Pender’s Health Promotion Model theory was originally published in 1982

and later improved in 1996 and 2002. It has been used for nursing research, education,

and practice. Applying this nursing theory and the body of knowledge that has been

collected through observation and research, nurses are in the top profession to enable

people to improve their well-being with self-care and positive health behaviors. The

Health Promotion Model was designed to be a “complementary counterpart to models of

health protection.” It develops to incorporate behaviors for improving health and applies

across the life span. Its purpose is to help nurses know and understand the major

determinants of health behaviors as a foundation for behavioral counseling to promote

well-being and healthy lifestyles.

Pender’s health promotion model defines health as “a positive dynamic state not

merely the absence of disease.” Health promotion is directed at increasing a client’s level

13
of well-being. It describes the multi-dimensional nature of persons as they interact within

the environment to pursue health. The model focuses on the following three areas:

individual characteristics and experiences, behavior-specific cognitions and affect, and

behavioral outcomes. Health promotion is defined as behavior motivated by the desire to

increase well-being and actualize human health potential. It is an approach to wellness.

On the other hand, health protection or illness prevention is described as behavior

motivated desire to actively avoid illness, detect it early, or maintain functioning within

illness constraints.

1. Individual characteristics and experiences (prior related behavior and personal

factors).

2. Behavior-specific cognitions and affect (perceived benefits of action, perceived

barriers to action, perceived self-efficacy, activity-related affect, interpersonal

influences, and situational influences).

3. Behavioral outcomes (commitment to a plan of action, immediate competing

demands and preferences, and health-promoting behavior).

Due to its focus on health promotion and disease prevention per se, its relevance

to nursing actions given to ill individuals is obscure. But then again, this characteristic of

her model also gives the concepts its uniqueness. Pender’s principles paved a new way of

viewing nursing care, but then one should also be reminded that nursing’s curative aspect

cannot be detached from our practice.

Community health care setting is the best avenue in promoting health and

preventing illnesses. Using Pender’s Health Promotion Model, community programs may

be focused on activities that can improve people’s well-being. Health promotion and

14
disease prevention can more easily be carried out in the community than programs that

aim to cure disease conditions. To fully adhere to a health-promoting behavior, he or she

needs to shell out financial resources. This limits the application of Pender’s model. An

individual who economically or financially unstable might have a lesser commitment to

the planning of action, decreasing the ideal outcome of a health-promoting behavior even

if the individual has the necessary will to complete it. Although not stated in the model,

for example, in the Intensive Care Unit, the health promotion model may still be applied

in one way or another. This is projected towards improving health conditions and prevent

further debilitating conditions. Diet modifications and performing passive and active

range of motion exercises are examples of its application.

Related Studies

According to the study of Gorill Haugan and Monica Erikson (2021) entitled

Health Promotion in Health Care – Vital Theories and Research stated that currently, the

world faces a shift to an older population. For the first time in the history, now most

people can expect to live into their 60s and beyond. Within this trend of people living

longer, many grow very old; 80, 90 and 100 years. Today, 125 million people are

80 years or older; the proportion of ≥80 years increases the most. Age is not an illness,

still most chronically ill are older people. Consequently, all countries in the world face

major challenges to ensure that their health and social systems are ready to make the most

of this demographic shift. Globally, finding new and effective ways to improve people’s

health is crucial. Thus, in the years to come, health promotive initiatives will become

ever more important. Accordingly, learning how to reorient the health care sector in a

health promotion direction is highly needed. The salutogenic approach seems useful for

15
such a reorientation. Salutogenesis is a resource-oriented theoretical approach which

focuses on the origin of health along with people’s abilities and capacities for well-

functioning and well-being. Salutogenesis is an area of knowledge and learning, a way of

relating to others, and a way of working in a health-promoting manner. From the

salutogenic point of view, health is a movement on a continuum between ease and dis-

ease. In this approach, no one is categorized as healthy or diseased; we are all somewhere

between the imaginary poles of total wellness and total illness. This chapter, as well as

this book, comprehend the salutogenic health theory as a model of health and a life

orientation, representing a vital theoretical basis for the health promotion field.

Accordingly, this chapter presents some important points in the development of the

health promotion field, followed by the core principles and strategies of health promotion

and the promising potential of the salutogenic health theory.

According to study of Francesca Cercado et al (2023) entitled “Filipino Nursing

Students’ Health Promoting Behaviors during Pandemic”, Research on health promoting

behaviors can assist nursing students in identifying, maintaining, and improving health

behaviors. The notable impact and changes in lifestyle behaviors during the pandemic

necessitate a closer look into students' health-promoting behaviors. However, there is a

lacuna in the literature about health promoting activities of nursing students stuck at

home and attending online learning during the pandemic. Purpose: This study assessed

the level and predictors of health promoting behaviors of nursing students in a Philippine

public university during a pandemic. Methods: This study used a cross-sectional design

with 363 out of 531 undergraduate nursing students of a public university in the

Philippines as study participants. Data were gathered using an online survey last March

16
2022 employing the Health Promoting Lifestyle Profile (HPLP) II. Significant predictors

were identified using multiple linear regression analysis with the aid of SPSS version

26.0. Results: Results showed that nursing students had a high (M=2.80 out of 5) practice

of health promoting behaviors. Physical activity ranked the lowest among the six

dimensions of health promotion behaviors. The variables that predicted the health

promoting behaviors of nursing students were self-reported academic performance

(β=2.110, p=.000), family income level (β=.055, p=.001), and academic year level

(β=.057, p=.002). Conclusion: Nursing students should continue to maintain their good

practice of health promoting behaviors. However, more attention should be given to

engaging in physical activity to maintain holistic well-being.

According to the study of Younghui Hwang and Jihyun Oh (2020) entitled

“Factors Affecting Health-Promoting Behavior among Nursing Students”, that Health-

promoting behaviors help prevent chronic illness. Health-promoting behaviors of nursing

students can affect not only their own health, but also the health of their future patients,

for whom they can act as role models. Nursing students should participate in health-

promoting behaviors; however, nursing students often have unhealthy behaviors. This

study aimed to investigate the factors affecting health-promoting behaviors in nursing

students. A descriptive, self-report survey of 304 nursing students from three universities

in South Korea was conducted. Subjects’ general characteristics, health perceptions,

health concerns, and health-promoting behaviors were collected. Of the total participants,

90.1% were female and the mean age was 20.4 years. The mean score for health-

promoting behaviors was 2.47, higher than the midpoint. The mean for the subscale of

physical activity among health-promoting behaviors was the lowest. The main factors

17
affecting health-promoting behaviors were gender, health perceptions, health concern,

and time per week spent searching online for health-related information. The main factors

affecting physical activity were gender, health concern, and time per week spent

searching online for health-related information. Based on the study findings, it is

recommended that a program to empower nursing students to perform health-promoting

behaviors be incorporated into the nursing education curriculum with regard to unique

needs based on gender. Specifically, it would be effective to develop programs that are

easily accessible via the Internet.

According to the study of Christa A. Gallagher et al. (2021) entitled “Health

promotion and harm reduction attributes in One Health literature: A scoping review, that

One Health faces enormous pressure and challenges as it attempts to mitigate dynamic,

surprising and complex global events that threaten the health and sustainability of human

and animal populations and the biosphere. One Health practitioners and researchers need

every advantage to developing working solutions to the world's imminent complex

issues. Heath promotion and harm reduction, interrelated approaches that have seen much

success over decades of use in global public health, may be important models to consider.

Both use an upstream socioecological determinant of health approach to reach beyond the

health sector in all health efforts, and encourage active community participation and

empowerment to attain and sustain human and ecological health. This scoping review of

411 documents, believed to be the first to relate health promotion and harm reduction to

One Health, searched self-declared One Health research literature for evidence of health

promotion and harm reduction policies, principles and methodologies. It sought to answer

the questions: “What is the scope of practice of One Health in self-declared One Health

18
publications?” and “Are attributes of health promotion and harm reduction found in self-

declared One Health-reviewed research literature?” Over half of the papers revealed no

health promotion or harm reduction attributes while 7% were well-endowed with these

attributes. These 7% of papers focused on deep-seated, complex health issues with

systemic knowledge gaps and decision-making issues revolving around specific

population vulnerabilities, social inequities and competing stakeholders. Implementing

‘on the ground change’ was a common theme in the strongest health promotion/harm

reduction papers we identified. Alternatively, papers lacking health promotion or harm

reduction attributes focused on managing proximate risks, primarily for infectious

diseases. The addition of health promotion and harm reduction to One Health practices

may help the field rise to the growing expectations for its involvement in complex global

issues like pandemics and climate change. These studies provide valuable insights into

the health promotion practices and needs of nursing students, and can help inform the

development and implementation of effective health promotion programs in nursing

education.

According to the study of Leurs et al. (2005) entitled the “school-Based Health

Promotion Programs: Effectiveness and Implementation”, this research evaluates the

effectiveness of school-based health promotion programs. It finds that these programs

have positive impacts on student health outcomes and highlights the importance of

integrating health promotion into school objectives. The study provides insights into

successful program components and implementation strategies.

According to study of Edwards, L., & Johnson, M. (2020) entitled “Evaluating the

Role of Nurses in Promoting Adolescent Health in School Settings”, this study evaluates

19
the role of school nurses in promoting adolescent health. It finds that school nurses play a

crucial role in health promotion through direct interventions, health education, and

support for health-related policies. The study highlights the need for further training and

resources to maximize the impact of school nursing on adolescent health.

According to Brown, A., & Davis, K. (2016) “Integration of Health Promotion

into Nursing Education”, this study reviews how health promotion is integrated into

nursing education programs. It finds that while there are significant efforts to incorporate

health promotion into curricula, gaps remain in aligning educational content with

practical applications. The study suggests enhancements in curriculum design to better

prepare nursing students for effective health promotion practice.

On the article of Adele Philips (2019) entitled Effectiveness approaches to Health

Promotion in Nursing Practice, defines the concept of health promotion and explains why

it is essential for nurses to embed health promotion aims and values in their practice. It

discusses how health promotion contributes to the improvement and maintenance of

population health and contemporary public health agendas in the UK and worldwide.

Using several practical activities, this article aims to encourage nurses to identify their

own approach to promoting health in their professional role, consider how they can

implement 'Making Every Contact Count' with the patients they care for, and enhance the

overall effectiveness of their practice.

On the study of Derek Chambers and Susan Thompson (2008) entitled

Empowerment and its application in health promotion in acute care settings: Nurses’

Perception, that empowerment has long been a central tenet of health promotion theory.

Globally, governments have advocated the use of empowerment in their public health policies.

Nurses are seen as essential in the delivery of this agenda using the empowerment model to

20
engage patients in self-care and decision-making. Six different vignettes requiring a health

promotion intervention were shown to a convenience sample of 20 Registered Nurses in a

United Kingdom acute care hospital. The nurses were asked to describe how they would

meet the health promotion needs of the patients described in the vignettes. The data were

collected between 2005 and 2006 and analyzed using thematic analysis. Two types of

practitioners were identified: Type I divergent nurse health promotion practitioner and

Type II convergent nurse health promotion practitioner. The main factor distinguishing

the two types was the way in which they conceptualized the verb 'to empower'. The

theory of health promotion taught to participants does not seem to be applied in acute

care settings. This raises the possibility that Registered Nurses acting as mentors and role

models are convergent rather than divergent thinkers.

21
Conceptual Framework

Demographic Data of Nursing Students

of Philippine Last Frontier College
according to;
EFFECTIVENESS ON
 Age HEALTH PROMOTION
PRACTICES
 Gender

 Year Level

Figure 1.1: Conceptual Framework on Health Promotion Practices

The diagram above explores the relationship between demographic data of

nursing students and their health promotion practices. It represents the demographic

characteristics of nursing students at the Philippine Last Frontier College. The specific

factors considered are the age range of the students, the gender distribution of the

students and the academic year or level of the students. The framework emphasizes

practices that are both hospital-based and community-based. This suggests that the study

will investigate how nursing students engage in health promotion activities within

hospital settings and in the broader community. It suggests that the study aims to

understand how the demographic characteristics of nursing students influence their health

promotion practices and ultimately contribute to health promotion efforts. It indicates the

direction of influence from the Demographic data that is expected to influence the health

22
promotion practices of nursing students and Health promotion practices are expected to

contribute to overall health promotion efforts. In essence, the framework suggests that the

demographic characteristics of nursing students are likely to play a role in shaping their

health promotion practices, which in turn can impact health promotion outcomes.

Theoretical Framework

Perceived susceptibility

Perceived Severity
Action

DEMOGRAPHIC VARIABLES
Age, Gender and Year Level Perceived Benefits

Cues to Action
Perceived Barriers

Note: Adapted from Champion and Sugg Skinner (2008)

Figure 2.1. Theoretical Framework adapted from Health Belief Model Theory by Becker,

1950

The diagram above tells us about particular health-related behavior. According to

this model, the chances a person will adopt a healthy behavior depends on the outcome of

two assessment they make. Whether they believe in the susceptible to any associated

disease or illness. People evaluate the chances of developing the problems. Their

perceptions of the severity of the associated health problems.

The health belief model suggests that the students' health promotion practices are

influenced by their beliefs about the health problem, the potential benefits and barriers of

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engaging in healthy behaviors, and the factors that trigger their actions. This framework

can be used to understand the factors that influence nursing students' health promotion

practices and to develop interventions that address these factors.

CHAPTER 3

METHODOLOGY

This chapter presents different research methods, such as research designs, locale,

research instruments, data gathering procedure, and statistical treatment.

Research Design

This will be a quantitative, descriptive, cross-sectional research design which will

aim to assess the effectiveness of Health Promotion Practices among Nursing Students of

Philippine Last Frontier College – College of Nursing in Patient Care from Level II and

Level III by providing the respondents of a modified from the study entitled “The

Perceived Health Promotion Practices among nursing students in Saudi Arabia” authored

by Ameera Aldossary, Louise Barriball and Alison While from Nursing Department,

Prince Sultan Military College of Health Sciences, PO Box 33048, Dammam 33048,

Saudi Arabia and 2 Florence Nightingale School of Nursing & Midwifery, King’s

College London, James Clerk Maxwell Building, 57 Waterloo Rd, London SE1 8WA,

UK. The researchers will be able to gain information on the study chosen by gaining

information globally through identifying different practices.

Research Locale

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 The study will be conducted in the Philippine Last Frontier College – College of

Nursing department located at IPHO-Daerah, Barangay Tubig Tanah, Bongao, Tawi-

Tawi, Bangsamoro Autonomous Region in Muslim Mindanao, Philippines.

Research Respondent and Sampling Procedure

The non-probability sampling design will be specifically utilized using the

convenience sampling method in selecting respondents for this research study. The study

involves (40) forty Nursing students who are officially enrolled for the semester 2024-

2025, which involves (20) twenty students from Level II and (20) twenty students from

Level III.

Research Instrument

The data for this study will be collect from nursing students’ individually. The

questionnaire will comprise of question specifically focus on the demographic profile of

the participants includes age, gender, and year level which will use as a basis for

understanding how they promote health practices to their respective patients/clients in the

community and hospital-setting. While the part II will focus on the areas of health

promotion practice specifically on the promotion of general health. The promotion of

general health practice draws upon the Nurses’ views of Health Promotion Intervention

questionnaire which will be used to measure primary healthcare perception health

promotion.

The study will used a questionnaire that has been adapted from the work of “The

Perceived Health Promotion Practices among nursing students in Saudi Arabia” authored

by Ameera Aldossary, Louise Barriball and Alison While. The reliability of the

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questionnaire assessed using e Cohen’s kappa coefficient results from test – retest using

an almost perfect agreement (0.61– 1.0) for all items, thus demonstrating high reliability.

Reliability and validity

The validity and reliability of the assessment tool will be subjected to panels of

members of the College of Nursing in research who were the one to correct and advise

for any revisions.

Data Gathering

The letter of permission to conduct the study will be presented to the President of

the Philippine Last Frontier College and Dean of the College of Nursing Department. The

personal benefit in the research study will able to gain by doing this research may help

others in the present and future. Sharing the research results to the respondent will be

done after implementation phase and publication of the research finding and authorship.

Data Processing and Statistical Analysis

After collecting the questionnaires, the points will add for each question and the

responses that will be classified as a percentage of correct answer. After the

administration of the statements related to the health promotion practices, it will be

answerable with five (5)-point rating scale on each statement which form of strongly

agree as the highest with 5 points, agree with 4-points, neutral with 3-point scale,

disagree with 2-points scale and strongly disagree as 1 point in scale, data that will be

collected will tabulate, analyze and interpret by statistician.

The final score for each scale will be calculated by adding up the points obtain for

the corresponding questions. To analyze the gathered data frequency for every question,

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then follow by getting mean then compute for the weighted mean, t-test when group

according to gender and year level and the ANOVA test will be utilized when grouped

according age group.

SCALE EVALUATION
VALUE LIMITS DESCRIPTIVE EQUIVALENT
5 4.20-5.00 Strongly Agree
4 3.40-4.19 Agree
3 2.60-3.39 Neutral
2 1.80-2.59 Degree
1 1.00-1.79 Strongly disagree
(Adaptedfrom the research “The Perceived Health Promotion Practices among nursing students in Saudi Arabia” authored by Ameera Aldossary, Louise
Barriball and Alison While)
Ethical consideration

Content given out to the respondents of legal age during the conduct of the study

wherein the confidentiality of the information will be stressed out. All information

collected from the researcher participants used purely for research study. Research

participants will not to be subjected to any form of harm and perceived risks. They asked

to participate voluntarily and they have the right to pull out at any phase of the research

study. The principle for people, beneficence, and justice will be observe.

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