Appendix A: Matrix of Theoretical Models


Theoretical Model Description of Theoretical Model Type of health care change situation where model best applies
Change Theory by Kurt Lewin: Late 1930s With this model, changes take place in a series of steps, including unfreezing of events, changing circumstances, and refreezing under new conditions (Current Nursing, 2011). For example, unfreezing is the period when change is proposed by allowing people to recognize that a behavior or process is unproductive and ineffective, thereby enabling people to observe that a different method is likely to be beneficial (Current Nursing, 2011). Next, the change initiative represents a means of moving towards a new process or method to improve efficiency and productivity (Current Nursing, 2011). Finally, the refreezing step involves the implementation of the new change effort as part of the daily routine in order to achieve greater outcomes for the healthcare team (Current Nursing, 2011). In this context, it is important to recognize the value of change as it occurs in a series of stages in order to ensure that the change initiative is managed properly and will succeed as a new practice method (Current Nursing, 2011). This model best applies to situations that involve the failure of a specific method or standard operating procedure that requires an overhaul. This is not uncommon in healthcare organizations, particularly when department personnel discover that their actions are not always effective in enabling healthcare practice to continue at the desired level. It is important to recognize that the change initiative must also represent the best interests of the organization and its people and must undergo the three steps prior to full implementation. This will ensure that the change initiative is as successful as possible, given the circumstances of the events that mandate the change initiative to begin with.
Theory of Planned Behavior This model represents a series of events that are based upon behaviors that are deliberate in nature and are planned according to an individual’s needs at any given point in time (University of Twente, 2013). In this context, “Intention is the cognitive representation of a person’s readiness to perform a given behavior, and it is considered to be the immediate antecedent of behavior” (University of Twente, 2013). It is expected that behaviors will be based upon the frameworks associated with the desire to perform specific behaviors and to refrain from performing other types of behaviors in the process (University of Twente, 2013). This is an important theoretical perspective because it demonstrates that individuals ultimately make the decision to act in one way or another rather than having the decision or behavior made for them (University of Twente, 2013). Therefore, it is important to provide individuals with the tools that are required to ensure that outcomes are effectively met in the desired manner (University of Twente, 2013). Many healthcare providers are accustomed to promoting specific behaviors in their patients to improve health-related outcomes. Under these conditions, it is expected that individuals will also seek opportunities for growth and change that will accommodate specific interventions. This is accomplished by recognizing patterns in behavior that will lead to specific results within a given patient population. This practice is accomplished by the recognition of attitudes, beliefs, and perceptions in the workplace that support specific decisions that are made. This is an important tool in creating an environment that enables specific behaviors to be recognized for their value and contribution to a given situation and to also determine how to best move forward in promoting specific behaviors to accomplish a series of goals and objectives accordingly.
Health Belief Model This model addresses the relevance of specific behaviors and how they impact disease and other related risks (Current Nursing, 2011). In this context, there is a dependence on the ability of patients, for example, to make decisions that will positively impact their behavior rather than lead to negative outcomes (Current Nursing, 2011). This is often difficult because patients might be fearful of the unknown; therefore, they might engage in behaviors that turn out to have negative consequences (Current Nursing, 2011). The model also supports the belief that patients who may come face to face with specific health risks are likely to alter their behaviors accordingly to ensure that they will have healthier outcomes throughout the life span (Current Nursing, 2011). Many patients who possess fears regarding their health and wellbeing are likely to refrain from specific behaviors because they are fearful of the unknown. At the same time, other patients might continue to exercise negative behaviors even though they might place themselves at a greater risk for disease in one or more forms. For patients at a high risk due to their specific behaviors, it is important to recognize these concerns and to take the steps that are necessary to provide education to modify specific beliefs so that more appropriate behaviors are conducted. This is an ongoing practice that must be achieved in order to improve health and wellbeing. When patients possess specific beliefs regarding an illness or condition, fear and apprehension may take over. However, this is likely to be overcome when there are significant reasons to modify these behaviors as necessary to improve health and wellbeing over time.







Current Nursing (2011). Change Theory: Kurt Lewin. Retrieved from

Current Nursing (2011). Health Belief Model. Retrieved from


University of Twente (2013). Theory of planned behavior/reasoned action. Retrieved               from