Application and Effectiveness of the Nola Pender Model in Nursing: A Narrative Review
Abstract
Background: Health behavior encompasses the behaviors and decisions individuals make regarding their daily activities, which can impact their health and well‑being. This study aimed to explore the application and effectiveness of Nola Pender’s health promotion model in nursing practice.
Materials and Methods: This narrative review was conducted between 2018 and 2022. The keywords, such as “Nola, Pender,” “lifestyle,” “effectiveness,” and “Nursing,” were used, both in English and Spanish. These keywords were individually searched in international databases, such as Scielo, PubMed, Science Direct, and Google Scholar. Inclusion criteria were full texts of original articles and articles related to the use and effectiveness of the Nola Pender model in nursing practice. Studies with abstracts only, other nursing models, duplicates, or insufficient methodological rigor were excluded. Each article was evaluated for methodological rigor, clarity of objectives, study design, and relevance to nursing. A total of 32 articles met the criteria.
Results: The analysis of the selected documents identified applications of the model in the promotion of eating habits, sexual and reproductive health, management of arterial hypertension, chronic obstructive pulmonary disease, participation in community activities and lifestyles in general. The Pender model proved to be effective in adherence to treatment, stress management and cardiovascular disease, hand hygiene, smoking reduction, and exercise promotion.
Conclusions: The scientific literature analyzed shows the effectiveness of the Nola Pender model in nursing practice for health‑promoting behaviors both individually and collectively. The model proposed by Pender provides different strategies with beneficial results for the health and well‑being of people.
Keywords
Full Text:
PDFReferences
Hoyos GP, Borjas DM, Ramos AS, Meléndez RM. El modelo de promoción de la salud de Nola Pender. Una reflexión en torno a su comprensión. Eneo Unam 2011;8:8.
Triviño Vargas ZG, MX. Factores predictores de conductas promotoras de salud en docentes de enfermería de tres universidades de Cali, Colombia. Univ y Salud 2018;20:160.
González Aguilera MJ, Miranda Vidal P, Sánchez Ahumada V, Vega Jil V, Mosqueda Díaz SA. Factores relacionados con la violencia de pareja adolescente desde el modelo de Nola Pender: Una revisión integrativa. Rev iberoam Educ investi Enferm 2021;11:30 43.
Ministerio de salud y protección social; Subdirección de Enfermedades No Trasmisibles. Páginas Prevención de enfermedades no transmisibles; 2022. Available from: https://www.minsalud.gov.co/salud/publica/PENT/Paginas/ Enfermedades-no-transmisibles.aspx. [Last accessed on 2024 Jun].
Salomé A, Molina H, Maricela P, Herrera M, Rocío V, Tierra T. El profesional de enfermería en la promoción de salud en el segundo nivel de atención. Revista Eugenio Espejo 2022;16:98 111.
Estrada JC. El cuidado de enfermería en pacientes con riesgo cardiovascular sustentado en la teoría de Nola J Pender. Investig en Enfermería Imagen y Desarro 2017;19:107.
Goodarzi Khoigani M, Moghadam MB, Nadjarzadeh A, Mardanian F, Fallahzadeh H, Mazloomy Mahmoodabad S. Impact of nutrition education in improving dietary pattern during pregnancy based on Pender’s health promotion model: A randomized clinical trial. Iran J Nurs Midwifery Res 2018;23:18 25.
FernándezSilva CA, Lopez Andrade CM. Adherencia al tratamiento antirretroviral como conducta promotora de salud en adultos mayores. Rev Cuid 2018;9:2201 14. Available from: https://www.redalyc.org/articulo.oa?id=359557443010.
Felipe R, Esteban C, Rivera JP. Efectividad de intervención basada en modelo de Nola Pender en promoción de estilos de vida saludables de universitarios peruanos Effectiveness of an Intervention Based on the Nola Pender Model in Promoting Healthy Lifestyles in Peruvian Universities. Rev Cubana Enfer 2019;35:1 10.
Peraza C, Benítez F, Galeano Y. Modelo de promoción de salud en la Universidad Metropolitana de Ecuador. MediSur 2019;17:903 6.
Karasu F, Aylaz R. Evaluation of meaning of life and self care agency in nursing care given to chronic obstructive pulmonary patients according to health promotion model. Appl Nurs Res 2020;51:151208.
Shaahmadi F, Shojaeizadeh D, Sadeghi R, Arefi Z. Factors influencing health promoting behaviours in women of reproductive age in Iran: Based on Pender’s health promotion model. Open Access Maced J Med Sci 2019;7:2360 4.
Bijani M, Rostami K, Ghasemi A, Emami M, Fereidouni Z. Investigation of diabetes prevention behaviors among teachers of different level of education based on Pender model in selected educational centers in southwestern Iran, 2019. Rev Latinoam Hipertens 2019;14:290 4.
Bessa CC, Alexandrino L. Controle de saúde de celíacos: análise segundo o modelo de promoção da saúde de Pender. Texto e Context Enferm 2020;29:1 11.
García FM, Rojas JA. Estilos de vida en estudiantes de pregrado. Rev Conrado 2020;16:69 75. Available from: http://scielo.sld.cu/ pdf/rc/v16n75/1990-8644-rc-16-75-69.pdf.
Karataş T, Polat Ü. Effect of nurse led program on the exercise behavior of coronary artery patients: Pender’s Health Promotion Model. Patient Educ Couns 2021;104:1183 92.
Gorbani F, Mahmoodi H, Sarbakhsh P, Shaghaghi A. Predictive performance of Pender’s health promotion model for hypertension control in Iranian patients. Vasc Health Risk Manag 2020;16:299 305.
Goudarzi H, Barati M, Bashirian BM. Determinants of medication adherence among hypertensive patients using the Pender’s health promotion model. J Educ Health Promot 2020;9:89.
Masoudi R, Lotfizade M, Gheysarieha RL. Evaluating the effect of Pender’s health promotion model on self efficacy and treatment adherence behaviors among patients undergoing hemodialysis. J Educ Health Promot 2020;9:89.
Bahabadi FJ, Estebsari F, Rohani C, Kandi ZR, Sefidkar R, Mostafaei D. Predictors of health promoting lifestyle in pregnant women based on Pender’s health promotion model. Int J Womens Health 2020;12:71 7.
Torres IL, Vásquez LE, Rojas DM. Nursing care of a patient with cluster headache based on the Nola Pender health promotion model: Case report. Rev Cient Soc Enferm Neurol (Engl ed) 2023;57:36 42.
Chen H, Hsieh P. Applying the Pender’s health promotion model to identify the factors related to older adults’ participation in community based health promotion activities. Int J Environ Res Public Health 2021;18:9985.
Habibzadeh H, Shariati A, Mohammadi F, Babayi S. The effect of educational intervention based on Pender’s health promotion model on quality of life and health promotion in patients with heart failure: An experimental study. BMC Cardiovasc Disord 2021;21:478.
Chen Y, Wei Y, Lang H, Xiao T, Hua Y, Li L, et al. Effects of a goal oriented intervention on self management behaviors and self perceived burden after acute stroke: A randomized controlled trial. Front Neurol 2021;12:650138.
Khosravi N, Alami A, Aelami MH, Khosrovan S. Improving hand hygiene compliance of intensive care unit by using Pender’s model. Ethiop J Health Sci 2021;31:553 60.
Faroughi F, Shahriari M, Keshvari M, Shirani F. The effect of an educational intervention based on Pender’s health promotion model on treatment adherence in the patients with coronary artery disease. Iran J Nurs Midwifery Res 2021;26:216 22.
Sany SB, Shahroodi MV, Khaboshan ZH, Orooji A, Esmaeily H, Jafari A, et al. Predictors of physical activity among women in Bojnourd, north east of Iran: Pender’s health promotion model. Arch Public Health 2021;79:178.
Haghi R, Ashouri A, Karimy M, Rouhani Tonekaboni N, Kasmaei P, Pakdaman F, et al. The role of correlated factors based on Pender health promotion model in brushing behavior in the 13 16 years old students of Guilan, Iran. Ital J Pediatr 2021;47:111.
Sabooteh S, Feizi A, Shekarchizadeh P, Shahnazi H, Mostafavi F. Designing and evaluation of E health educational intervention on students’ physical activity: An application of Pender’s health promotion model. BMC Public Health 2021;21:657.
Espinosa JN, Malagón MY, Granados SP, Clavijo OS, Herrera MC, Díaz Heredia LP. Barriers and facilitators that influence on adopting healthy lifestyles in people with cardiovascular disease. Investigación y Educación en Enfermería 2021;39. Available from: https://doi.org/10.17533/udea.iee. v39n3e04.
Castro MC, Ticona CV, Rayme MI, Sosa JC. Estilos de vida asociados a la adherencia al tratamiento en pacientes hipertensos. Arch Venez Farmacol y Ter 2021;40:389 95. Available from: https://search.ebscohost.com/login.aspx?direct=true&AuthType= ip,url,uid,cookie&db=lth&AN=152530027〈=es&site=ehost-live%0A10.5281/zenodo.5227306.
Cardoso RB, Caldas CP, Brandão MAG, Souza PA, Santana RF. Healthy aging promotion model referenced in Nola Pender's theory. Rev Bras Enferm. 2021;75:e20200373. doi:10.1590/0034-7167-2020-0373.
Neri MF, Silva RA, do Nascimento JC, do Sousa É, Rocha R, Barros LM, et al. Hand hygiene determinants of informal caregivers in hospitals under Pender’s perspective. Rev Bras Enferm 2021;75:e20210012.
Santi DB, Rossa R, Bomfim LD, Dias AR, Higarashi IH, Baldissera VD. Adolescent health in the Covid 19 pandemic: A construction through Nola Pender’s model. Rev Bras Enferm 2022;75:e20210696.
Santos MJ, Ferreira MM, Ferreira EM. Sexual and reproductive health risk behaviours: Higher education students’ perceptions. Rev Bras Enferm 2022;75:e20210712.
Baracaldo Campo HA, Meneses Pérez DA. Proceso de enfermería para la cesación del hábito tabáquico en paciente con EPOC: Reporte de caso. MedUNA 2022;25:42 51.
Ahmadi Tabatabai SV, Esmailinejad AS, Sadeghi R, Zeidabadi B. Factors influencing the consumption of fruits and vegetables in diabetic patients based on Pender's health promotion model. J Educ Health Promot. 2022;11:51. doi:10.4103/jehp.jehp_183_21.
Bijani M, Rostami K, Ghasemi A, Emami M, Fereidouni Z. Investigation of diabetes prevention behaviors among teachers of different level of education based on Pender model in selected educational centers in southwestern Iran, 2019. Rev Latinoam Hipertens 2019;14:290 4. Available from: https://www.redalyc. org/journal/1702/170263002016/html/.
Bağrıaçık E, Bayraktar N. Evaluation of the effect of training given according to Pender's Health Promotion Model on psychological insulin resistance. Hum Nutr Metab. 2022;29:200153. doi:10.1016/j.hnm.2022.200153
Gurbuz IZ, Akin S. Relationship between quality of life, self-efficacy and social support in patients with multiple sclerosis. Int J Palliat Nurs. 2023;29:598-612. doi:10.12968/ ijpn.2023.29.12.598.
Hamzehgardeshi Z, Mohammadi N, Rezaeian M. The effect of health promotion model-based interventions on preventive behaviors: A systematic review. J Educ Health Promot. 2023;12:277. doi:10.4103/jehp.jehp_271_23.
Esteban RF, Caycho Rodríguez T, Arias SA, Guerra MR, Vilchez CC, Orci KC, et al. Efectividad de intervención basada en modelo de Nola Pender en promoción de estilos de vida saludable de universitarios peruanos. Rev Cubana Enferm 2019;35. Available from: http://scielo.sld.cu/scielo. php?script=sci_arttext&pid=S0864-03192019000400009.
Beydokhti TB, Dehnoalian A, Moshki M, Akbary A. Effect of educational counseling program based on precede proceed model during Pregnancy on postpartum depression. Nurs Open 2021;8:1578 86.
Younas A, Rasheed SP, Sundus A, Inayat S. Nurses’ perspectives of self awareness in nursing practice: A descriptive qualitative study. Nurs Health Sci 2020;22:398 405.
Ydalsys NH. Efectividad de intervención de Enfermería en conocimientos para mejorar el estado de salud en adultos diabéticos. En: 1er Simposio para el desarrollo de las Especialidades de Enfermería; 2022.
Jalali A, Ziapour A, Ezzati E, Kazemi S, Kazeminia M. The impact of training based on the Pender health promotion model on self efficacy: A systematic review and meta analysis. Am J Health Promot 2024;38:918 29.
Jalali A, Rajati F, Kazeminia M. Empowering the older people on self care to improve self efficacy based on Pender’s health promotion model: A randomized controlled trial. Geriatr Nurs 2025;61:574 9.
Upreti AS, Aryal B, Kuikel J, Sharma MK. Dietary practices of type 2 diabetes mellitus patients concerning Pender’s health Promotion Model in Lalitpur district, Nepal. Hum Nutr Metab 2024;38:200288.
Santos MG, Pleutim NI, Queiroz Cardoso AI, Ramalho LD, Souza VS, Teston EF. Use of the health promotion model by nursing in primary care: An integrative review. Rev Bras Enferm 2025;78:e20240096.
Bakhshi H, Firoozbakht M, Jamali N, Jahanfar S. Effect of a mobile app based nutritional education intervention based on the health promotion model on gestational weight gain: Protocol for a randomized controlled trial. Trials 2024;25:361.
Refbacks
- There are currently no refbacks.

