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Using Commitment to Health Theory to help patients adopt healthy behaviors

Tuesday, 14 July 2009: 4:05 PM

Cynthia W. Kelly, PhD, RN
Nursing, Xavier University, Cincinnati, OH

Learning Objective 1: identify the main concepts in Commitment to Health Theory.

Learning Objective 2: apply Commitment to Health Theory in the clinical setting.

Purpose: This presentation introduces Commitment to Health Theory, which was published in July 2008. This Middle Range Theory was empirically developed. Commitment to Health (CTH) is derived from Prochaska and DiClemente’s Transtheorectical Model of Behavior Change. CTH is designed to predict the likelihood of behavior change between the Action and Maintenance Stages of Change. The presentation will identify the concepts, the concept definitions, assumptions and relational statements.

Methods: Commitment is defined as a freely chosen internal resolve to perform health behaviors, even when encumbered or inconvenienced by difficulties. Health is defined as optimal level of well-being. Commitment is an independent continuous variable, but can be categorized into three time oriented categories, (1) low level, (2) middle level and (3) high level commitment. The higher level of commitment, the more likely the individual will adopt long term behavior change.

Results: Nurses can use the theory to understand the cognitive processes of patients when confronted with a behavior that puts them at risk for current or future health concerns. The nurse can discuss with patients their commitment level and work with them to increase commitment. Nurses can also extent their involvement in change by using the nursing diagnosis Regime management, the Nursing intervention therapeutic enhancement (Kelly, 2008) and the nursing outcome Commitment to Health Scale (Kelly, 2005).
Conclusion: The presenation will introduce new mediating concepts identified in current research specific for diet, exercise and smoking behavior change. These are importance of change, confidence of change and their relationship with with commitment and stage of change.

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