A CRITICAL FEMINIST PERSPECTIVE OF THE HEALTH BELIEF MODEL - IMPLICATIONS FOR NURSING THEORY, RESEARCH, PRACTICE, AND EDUCATION

The health care system is in a state of crisis, and nursing is in a unique position to influence the decisions that are made regarding health care reform. However, without transforming our ways of knowing and being, the changes that are needed to meet the challenges of the future may not become a reality. Nursing theory, research, and practice reflect the historical, social, and political ideologies of western tradition. Consequently, the knowledge gained from the majority of nursing research has primarily developed from an empiricism or logical positivist philosophy. The underlying assumption of this school of thought is that only empirically quantifiable and measureable matters yield the truth, suggesting that there is only one reality. Because one cannot be socially critical as an empiricist, nurse educators have begun to question the adequacy of the empiricist philosophy and method of research for meeting changing societal demands. Social behavioral theories in general and the Health Belief Model in particular have frequently guided nursing research in an attempt to increase knowledge of health-related behaviors. Too often these theories have done little to increase our knowledge of women and people of color. For the most part, they have contributed to the oppression of individuals and groups. A critical feminist perspective can be useful in the understanding of health practices that are based on contextual knowledge. The purpose of this article is to increase awareness and understanding of the underlying assumptions, constraints, and contradictions that are embedded within social behavioral theories such as the Health Belief Model. The article will also discuss how theories predicted on the logical positive philosophy limit the understanding of health-related behaviors.