Pender’s health promotion model was developed in the early 1980s with the aim of integrating nursing and behavioural science theory to promote high level personal health and well-being (Pender 1982 ,2006 ; Pender ,Murdaugh , and Parsons , 2010 )The HPM is multidimensional and reflects WHO principle of health promotion and also incorporates constructs from social-cognitive theory such as self-efficacy , and from the health belief model the concept of perceived barriers . Perceived barriers have been defined by Pender and colleagues as :