The discipline of nursing now has a growing and rich body of theoretical models that provide useful perspectives from which we can build practices addressing some of the most pervasive health challenges we and our patients face. These models also facilitate the design and implementation of research projects that add to the evidence required for effective outcomes of practice. Our current featured article is an example! The title is “The Health Change Trajectory Model: An Integrated Model of Health Change” by Deborah Christensen, BSN, RN. Here is a message Ms. Christensen has prepared for the ANS blog:
Health change appraisal is unique to each individual with dynamic changes across the lifespan. To promote understanding of evolution and change in health care appraisal, I developed the Health Change Trajectory Model by
integrating concepts from uncertainty in illness and illness trajectory theories. The integrated model is applicable to any change in health, not just the occurrence of chronic illness.
Nurses are the key health care providers who assist others in understanding and coping with health changes. Placing the experience of health change in a trajectory framework offers a new and creative perspective for nurses as they assist patients and families with positive adaptation to changes in health throughout the life course. Conceptualizing the nurse as health change management partner emphasizes the nurse and patient/client partnership with patients clearly in charge of shaping their health management trajectory.
Studies from uncertainty in illness theory indicate that there are phases when uncertainty can be perceived as an opportunity rather than a threat. For example, in several types of cancer there are periods of remission (comeback phase) interrupted by disease progression (acute or downward phase). Through genomic research and the development of targeted and immunotherapies, patients may have several different treatment options that can be perceived as opportunities. Further, the experience of decreased energy in the absence of illness can be perceived as a threat or as an opportunity for positive changes in physical activity and nutrition. How is uncertainty perceived in these situations? How can uncertainty as opportunity be supported? I believe that in answering these questions, nursing interventions can be developed to help patients move toward adaptation and a balanced perceptual shift from threat to opportunity in uncertainty, thus, optimizing their health change trajectory. The Heath Change Trajectory Model provides the theoretical framework for exploration of all perceived health changes, not just those specific to chronic illness, as unique opportunities for a more optimistic view of health change.
This article will be featured on the ANS web site for the next couple of weeks and will be available at no charge while it is featured! So please visit the web site to get your copy, and come back to this blog and share your feedback and ideas! We would be delighted to hear from you!