Theory, Research, and Evidence-Based Practice

Theory, Research, and Evidence-Based Practice
As they explore the world around them, young children often want to know the ‘why’ and
‘how’ of the things they observe. This is similar to what researchers do when they approach
a new problem. Researchers develop new theories or build on old ones to explain the ‘why’
of the world around them. They use models and conceptual frameworks to help explain
‘how’ the processes and events they observe occur. Together, theories and models provide
an understanding of the world and allow researchers to explore it in meaningful ways.
Virtually all research questions can benefit from the use of an existing theory or model.
Researchers should consider their research questions and select the most suitable theory or
model, which then serves as a foundation for the research design. The selection of a theory
or model is an important part of the research process.
In this Discussion, you focus on the role of theory and models in research and evidence-
based practice.

Respond to at least two of your colleagues on two different days using one or more of the
following approaches:
�Ask a probing question, substantiated with additional background information, and
�Share an insight from having read your colleagues’ postings, synthesizing the
information to provide new perspectives.
�Offer and support an alternative perspective using readings from the classroom or from
your own review of the literature in the Walden Library.

Theory, Research, and Evidence- Based Practice

Effective medical intervention without interrupted engagement is vital in promoting the
survival as well as the quality of life of patients especially those infected with HIV. The article,
The Health Promotion Model in HIV Care, seeks to address the issue of adherence to HIV
medications and patient appointments. It uses the Health Care Model (HPM) which is a method
of nursing research that focuses on the characteristics as well as experiences of a person. It also
focuses on the behaviour specific cognitions and the related patient outcomes (Ng & Caires,
2016). The authors point out that the introduction of Antiretroviral therapy (ARV) has offered
multiple positive patient outcomes. Most patients who have been diagnosed with HIV and have
been prescribed ARVs have a prolonged life expectancy. As a result, HIV has ceased to be
classified as one of the terminal diseases by health care providers but just a chronic illness.
However, most patients with HIV often fail to take full advantage of best-managed treatment
plans since they do not adhere to regular clinical care. MacQueen et al., (2014) point out that
facilitation of adherence has been a major challenge not only in the United States but also across
the globe.

How Model was used in the Research Study
The authors propose that the HPM can be used to improve patient adherence. For
instance, the highlight that modification of individual experiences and characteristics such as
biological factors, social factors, cultural factors, and psychological factors can be modified and
improve patient adherence. The HPM through the Educational Adherence Strategy can be useful
in changing individual characteristics. Ng & Caires (2016) also illustrate that this strategy
focuses on providing accurate recommendations and instructions on activities of self-care during
scheduled medical appointments. Adherence interventions can be executed through the use of the
expertise of other health care members. Nurses, in particular, play a vital role not only in using
the Educational Adherence Strategy in routine patient care but also as team leaders who are
charged with the responsibility of facilitating collaborative care. The communication theory,
cognitive theory, and self- regulation model can also be used in changing patients’ experiences
and characteristics.
The HPM through the Behaviour-Specific Cognitions and Affect can also change the
perceptions of patients about the yearned personal benefits that result from certain health
behaviours. Often, research findings indicate that patient forgetfulness is the leading cause of
lack of adherence. However, this is a non-intentional factor which can be challenged and
improved through the use of reminder techniques such as alarms, phone messages or emails
(Katz et al., 2013). Clinicians can also monitor and assess adherence of patients by using
calendars, diaries, rewards, and offering consistent and concise feedback. According to Kim et
al., (2014) financial incentives can be used to promote adherence among HIV patients although
for a short while. The other concept of HPM entails the determination of a strategy for

implementing health behaviour. It can also use alternative behaviours which patients find hard to
control due to environmental contingencies.
Value of Basing Research on HPM
There are several advantages of basing research on Pender’s Health Promotion Model
(HPM). For instance, the model aids in planning and changing unhealthy behaviors hence
promoting health. The model is directed towards improving the level of well-being and self-
efficacy of the patient when the patient interacts with his/her surroundings. Additionally, the
model uses behavior-specific variables which aid in motivating patient factors that are useful in
promoting their engagement in health. HPM has also been adopted widely in research since it is
easy to track the outcomes that are, change in patient behavior after implementation.


Katz, I. T., Ryu, A. E., Onuegbu, A. G., Psaros, C., Weiser, S. D., Bangsberg, D. R., & Tsai, A.
C. (2013). The impact of HIV-related stigma on treatment adherence: systematic review
and meta-synthesis. Journal of the International AIDS Society, 16(3).
Kim, S. H., Gerver, S. M., Fidler, S., & Ward, H. (2014). Adherence to antiretroviral therapy in
adolescents living with HIV: systematic review and meta-analysis. Aids, 28(13), 1945-
MacQueen, K. M., Tolley, E. E., Owen, D. H., Amico, K. R., Morrow, K. M., Moench, T., … &
Friedland, B. (2014). An interdisciplinary framework for measuring and supporting
adherence in HIV prevention trials of ARV-based vaginal rings. J Int AIDS Soc, 17,

Ng, Yeow Chye, & Caires, Angela. (2016). The Health Promotion Model in HIV Care.
Aquichán, 16(4), 418-429.