NR 501 Week 5: Annotated Bibliography

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NR501NP Week Five Assignment

Nursing theories and models define nursing as a specialized profession, unlike other medical disciplines. They seek to offer frameworks that guide the best practices in nursing at all levels of comprehension. Every nursing theory or model has well-defined concepts and often focuses on various areas of care. The purpose of this paper is to discuss scholarly literature addressing five theories: the Health Belief Model, Transtheoretical Model of Behavioral Change, Social Cognitive Theory, Family Systems Theory, and Family Assessment and Intervention Model and their impact on future NP practice.

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Health Belief Model

Mercadante, A. R., & Law, A. V. (2021). Will they, or Won’t they? Examining patients’ vaccine intention for flu and COVID-19 using the Health Belief Model. Research in Social and Administrative Pharmacy, 17(9), 1596-1605.

              The study aimed to establish the influence of the COVID-19 pandemic on the influenza vaccine uptake, on patient perceptions of vaccinations, vaccine intent, and health behaviors. The study also aimed to examine vaccine intention using the Health Belief Model. The researchers administered an online Qualtrics-based survey to eligible respondents: non-pregnant respondents 18 years and above within the US who could independently fill the entire questionnaire in English. The study found that being within 18–49 years, having a household income of $20,000 or below, and knowing a person affected by the COVID-19 pandemic significantly influenced the acceptance of the vaccine by respondents and negatively affected health behavior. The study confirmed the influence of Perceived Benefits and Perceived Barriers on the intent to get vaccinated for flu and COVID-19 vaccines.

                   The article relates to the Health Belief Model (HBM) since it demonstrates that Cues to Action significantly affect health promotion and preventive practices like vaccination. The study results established that individuals in the US likely make decisions anchored in perceived individual benefits and risks instead of the population threat of infection and its dreadful consequences. The article is pertinent to my future PMHNP practice since it proves that health education and promotion messages on mental health should focus on a simple and balanced view of benefits and risks. The PMHNP must understand that individuals will practice the recommended health promotion interventions based on perceived benefits and risks and not necessarily the threat of developing a psychiatric disorder or the consequences.

Transtheoretical Model of Behavioral Change

Shaver, E. R., McGlumphy, K. C., Gill, A. K., & Hasson, R. E. (2019). Application of the transtheoretical model to physical activity and exercise behaviors in African-American adolescents. American Journal of Health Behavior43(1), 119–132.

The study evaluated the inter-relationships between the constructs of the Transtheoretical Model (TTM) (stages of change, self-efficacy, decisional balance, processes of change). It established the effectiveness of TTM in predicting physical activity among African-American youth. The study included a sample of 109 African-American youth, and the TTM constructs were measured using the Patient-Centered Assessment and Counseling for Exercise questionnaire. The study findings showed a higher self-efficacy at higher stages of change in male and female participants. Stages of change projected MVPA in females, with those in the maintenance stage having markedly more MVPA than those in the pre-contemplation, contemplation, and preparation stages.

Shaver et al. (2019) study relate to TTM since it demonstrates that higher levels of self-efficacy are observed at higher stages of change, like the maintenance phase. It demonstrated that an individual’s willingness to change behavior increased through the TTM stages. This was seen with more participants engaging in MVPA as they moved through the stages of change. For instance, the higher a person’s score on the stages of change, the more likely he/she was to participate in moderate-to-vigorous physical activity. The article may be relevant to future NP practice since the PMHNP needs to assess the stage a patient belongs, in the stages of change. A patient at the higher stage is more likely to adhere to the recommended lifestyle modification practices and health promotion behaviors than one at the lower stage. Therefore, the PMHNP has much more convincing and follow-up to do with patients in the pre-contemplation and contemplation stages than those in the action and maintenance stages.

Social Cognitive Theory

Hagger, M. S., Smith, S. R., Keech, J. J., Moyers, S. A., & Hamilton, K. (2020). Predicting social distancing intention and behavior during the COVID-19 pandemic: An integrated social cognition model. Annals of Behavioral Medicine, 54(10), 713–727. 

The study employed an integrated social cognition model to identify factors that determine social distancing behavior and the processes involved with regard to the COVID-19 pandemic. The study sample included 365 Australian and 440 U.S. residents. They completed online self-report measures of social cognition constructs, intention, habit, action planning, and past behavior concerning social distancing behavior. The study found that subjective norm, moral norm, and perceived behavioral control (PBC) were constant predictors of intention. Besides, intention, action planning, and habit during follow-up were predictors of social distancing behavior. The study findings show the importance of subjective norms, moral obligation, and PBC as determining factors of social distancing intent as well as intention and habit as behavioral determinants.

The article relates to Social Cognitive theory since it shows that intention and habit are major predictors of behavior change. It highlights the significance of social and moral beliefs and perceptions of control in projecting intention and habit and the intention in predicting behavior. Besides, the article applies to PMHNP practice since the NP should bear in mind that healthcare interventions aimed at improving health behavior should be accompanied by messages indicating individuals’ obligations to significant others. The messages should also highlight the moral essence of adopting the recommended healthcare interventions for oneself and others.

Family Systems Theory

Kerr, K. B. (2021). Applying Bowen Theory to Psychiatric Assessment and Disposition in the ED. Journal of the American Psychiatric Nurses Association, 107839032098763. Doi: 10.1177/1078390320987636 

The study evaluated whether a nurse psychiatric assessor’s theoretical orientation would impact the inpatient admission rate among patients on psychiatric evaluation in an emergency department (ED). The theoretical orientation in this study was Bowen family systems theory or Bowen theory. A clinician/researcher with vast experience applying Bowel family systems theory in clinical practice worked in a Crisis Management Service performing psychiatric evaluation and disposition in a busy community hospital ED. The psychiatric hospitalization rate of the clinician/researcher was significantly lower than that of other clinicians. The study results suggested that the clinician/researcher’s operationalization of the Bowen family systems theory was the most important factor in contributing to the reduced hospitalization rate because the general training and experience of the clinicians were similar.

The article is pertinent to Bowen family systems theory since it establishes that actualizing family strengths by viewing the family as a resource instead of a stressor makes a difference in the future paths of patients. The article recommends that psychiatrists and psychologists adopt a new theoretical approach to Family Systems theory, which could improve their clinical results. The article relates to future PMHNP practice because the NP could use the family systems theory approach in conducting psychiatric assessments. The PMHNP could view a patient’s family as the primary factor contributing to symptoms but also as the natural unit and the best built-in resource to deal with the symptoms.

Family Assessment and Intervention Model

Rosenstrøm, S., Chou, W. X., & Brødsgaard, A. (2022). How Family Members Experienced a Family-Focused Atrial Fibrillation Intervention in an Outpatient Setting-A Qualitative Study. SAGE open nursing8, 23779608221114265.

              The study objectively analyzed the research on the efficacy of the Calgary Family Intervention Model (CFIM) in helping bedside education by nurses and identifying facilitators and barriers to utilizing the Model. The study found substantial evidence to deduce that the CFIM is an extremely useful model that nurses can use in offering bedside education and improving overall patient and family outcomes. This is because it facilitates communication, collaboration, and therapeutic conversations.

                   The article relates to the Family Assessment and Intervention Model since it demonstrates the family as a unit of care and collaboration. It demonstrates that stronger nurse–family relationships promote better coordination of care plans and enhanced patient understanding. The article further relates to future PMHNP practice since it demonstrates that the CFIM is an excellent tool that the PMHNP can use to provide health education to improve patient and family mental health outcomes. The PMHNP can use the tool to improve the mental healthcare provided to patients and families.


The articles in the above bibliography examined the impact of different theories and models in various aspects of healthcare, including modifying behavior, providing health education, and assessing individuals’ intent for a particular behavior. The articles apply to my future PMHNP practice since they can guide me in assessing patients’ likelihood to change their behavior and identifying how to provide health education to foster adherence to the recommended interventions. The PMHNP can also use the theories to guide mental health care and education provision.

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