Henderson-King (TFN)

Virgina Henderson

Nursing Need Theory

Nursing Need Theory

focuses on the importance of increasing the patient’s independence to hasten their progress in hospital

The Nightingale of Modern Nursing

Virginia Henderson

14 components of basic nursing care

Virginia Henderson

What is nursing for Henderson?

nurse does for others what they would do for themselves if they had the strength, the will, and the knowledge

Who said that “the nurse is temporarily the consciousness of the unconscious, the love of life for the suicidal, the leg of the amputee, the eyes of the newly blind..” ?

Virginia Henderson

First Major Assumption of Virginia Henderson

Nurses care for patients until they can care for themselves once again. Although not precisely explained

Second Major Assumption of Virgina Henderson

Patients desire to return to health.

Third Major Assumption of Virginia Henderson

Nurses are willing to serve and that “nurses will devote themselves to the patient day and night.

Fourth Major Assumption of Virginia Henderson

Henderson also believes that the “mind and body are inseparable and are interrelated.”

What is nursing for Henderson

the unique function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health

What is person for Henderson

someone who needs nursing care but did not limit nursing to illness care

What is health for Henderson

balance in all realms of human life

What is environment for Henderson

everything that is outside of the patient but is connected to the patient is considered the environment & the environment should support the 14 fundamental needs

Nursing process for Henderson

the application of the logical approach to the solution of a problem

Who developed the 21 nursing problems theory

Faye Abdellah

She used Henderson’s 14 basic human needs and nursing research to establish the classification of nursing problems.

Faye Abdellah

physical, sociological, emotional needs of the patient

categories of Abdellah’s 21 nursing problems theory

who said that nursing is based on an art and science that mould the attitudes, intellectual competencies, and technical skills of the individual nurse into the desire and ability to help people, sick or well, cope with their health needs

Faye Abdellah

the types of nurse-parient interpersonal relationships

categories of Abdellah’s 21 nursing problems theory

the common elements of patient care

categories of Abdellah’s 21 nursing problems theory

four categories of patient needs

basic to all patients

four categories of patient needs

sustenal care needs

four categories of patient needs

remedial care needs

four categories of patient needs

restorative care needs

maintain good hygiene and physical comfort

basic needs

promote optimal health through healthy activities, such as exercise, rest and sleep

basic needs

promote safety through the prevention of health hazards like accidents, injury or other trauma and through the prevention of the spread of infection

basic needs

maintain good body mechanics and prevent or correct deformity

basic needs

facilitate the maintenance of a supply of oxygen to all body cells

sustenal care needs

facilitate the maintenance of nutrition of all body cells

sustenal care needs

facilitate the maintenance of elimination

sustenal care needs

recognize the physiological responses of the body to disease conditions

sustenal care needs

facilitate the maintenance of regulatory mechanisms and functions; and facilitate the maintenance of sensory function

sustenal care needs

identify and accept positive and negative expressions, feelings, and reactions

remedial care needs

identify and accept the interrelatedness of emotions and organic illness

remedial care needs

facilitate the maintenance of effective verbal and non- verbal communication

remedial care needs

promote the development of productive interpersonal relationships

remedial care needs

include the acceptance of the optimum possible goals in light of limitations, both physical and emotional

restorative care needs

the use of community resources as an aid to resolving problems that arise from illness

restorative care needs

the understanding of the role of social problems as influential factors in the case of illness

restorative care needs

what is person for Abdellah

recipients of nursing as individuals and families and describes people as having physical, emotional, and sociological needs

what is health for abdellah

purpose of nursing services, state of mutually exclusive of illness

what is environment for Abdellah

the home or community from which patient comes

what is nursing for Abdellah

nursing problem may be overt/covert

overt nursing problem

apparent condition faced by patient

covert nursing problem

hidden or concealed condition faced by patient

Who developed self-care deficit nursing theory

Dorothea Orem

focuses on each individual’s ability to perform self-care

Self-Care deficit nursing theory

Theory of Self-Care

includes self-care, self-care agency, therapeutic self-care demand, self-care requisites

Practice of activities that individuals initiate and perform independently on their behalf in maintaining life, health, and well being

self-care

ability for engaging in self care activities conditioned by age, developmental state, life experience, sociocultural orientation, health and available resources

self care agency

Totality of self care actions to be performed for some duration in order to meet self-care requisites by using valid methods and related sets of operations and actions

therapeutic self-care demand

affect the value of therapeutic self-care demand and/or the self-care agency of an individual at particular times and under specific circumstances

Basic conditioning factors

actions directed towards provision of self-care

self-care requisites

universal self-care requisites

three categories of self-care requisites

developmental self-care requisites

three categories of self-care requisites

health deviation self-care requisites

three categories of self-care requisites

associated with life processes and maintenance of the integrity of human structure and functioning

universal self-care requisites

refers to the care that is provided to a person who because of age or related factors, is unable to perform the self-care

dependent care

acquired ability of a person to know and meet the therapeutic self-care demand of the dependent person and/or regulate the development and exercise of the dependent’s self-care agency

dependent-care agency

relationship that exists when the dependent-care provider’s agency is not adequate to meet the therapeutic self-care demand of the person receiving dependent-care

dependent-care deficit

summation of care measures at a specific point in time or over a duration of time for meeting the dependent’s therapeutic, self-care demand when his or her self-care agency is not adequate or operational

dependent-care demand

relationship between an individual’s therapeutic self-care demand and his or her powers of self-care agenc

theory of self-care deficit

series and sequences of deliberate practical actions of nurses performed at times in coordination with the actions of their patients

theory of nursing systems

patient is dependent, nurse accomplishes patient’s therapeutic self-care

wholly compensatory system

patient can meet some needs, nurses give assistance

partially compensatory system

patient can meet self-care requisites, but needs assistance with decision making

supportive-educative system

what is person for Orem

a total being with universal, developmental needs and capable of continuous self-care

what is environment for Orem

Components are environmental factors, environmental elements, conditions, and developmental environment

what is health for orem

When human beings are structurally and functionally whole or sound

what is nursing for orem

Is an art, a helping service, and a technology

Self-Care Deficit Nursing Theory was represented by the following theories:

1. Theory of Nursing Systems

2. Theory of Self-Care Deficit

3. Theory of Self-Care

purposes that nursing is human actions

theory of nursing systems

the requirements of persons for nursing are associated with the subjectivity of mature and maturing persons to health-related or health care-related action limitations

theory of self-care deficit

Self-care is a human regulatory function that individuals must, with deliberation, perform themselves or must have performed for them to maintain life, health, development, and well-being. Self-Care is an action system

theory of self-care

explains how self-care system is modified it is directed toward a person who is socially dependent and needs assistance in meeting his or her self-care requisites

theory of dependent care

Neuman’s Systems Model

Betty Neuman

Neuman Systems Model

focuses attention on the response of the client system to actual or potential environmental stressors, and the use of primary, secondary, and tertiary nursing prevention interventions for retention, attainment, and maintenance of optimal client system wellness

Purpose of Neuman Systems Model

provide unity, or a focal point, for student learning

Neumans Systems Model

10 propositions

Betty Neuman

First Proposition of Neuman

Although each individual client or group as a client system is unique, each system is a composite of common known factors or innate characteristics within a normal, given range of response contained within a basic structure.

2nd Proposition of Neuman

Many known, unknown, and universal environmental stressors exist. Each differs in its potential for disturbing a client’s usual stability level or normal line of defense. The particular interrelationships of client variables—physiological, psychological, sociocultural, developmental, and spiritual—at any point in time can affect the degree to which a client is protected by the flexible line of defense against possible reaction to a single stressor or a combination of stressors.

3rd Proposition of Neuman

Each individual client-client system has evolved a normal range of response to the environment that is referred to as a normal line of defense, or usual wellness/stability state. It represents change over time through coping with diverse stress encounters. The normal line of defense can be used as a standard from which to measure health deviation.

4th Proposition of Neuman

When the cushioning, accordionlike effect of the flexible line of defense is no longer capable of protecting the client-client system against an environmental stressor, the stressor breaks through the normal line of defense. The interrelationships of variables— physiological, psychological, sociocultural, developmental, and spiritual—determine the nature and degree of system reaction or possible reaction to the stressor

5th Proposition of Neuman

The client, whether in a state of wellness or illness, is a dynamic composite of the interrelationships of variables—physiological, psychological, sociocultural, developmental, and spiritual. Wellness is on a continuum of available energy to support the system in an optimal state of system stability.

6th Proposition of Neuman

Implicit within each client system are internal resistance factors know as lines of resistance, which function to stabilize and return the client to the usual wellness state (normal line of defense) or possibly to a higher level of stability following an environmental stressor reaction.

7th Proposition of Neuman

Primary prevention relates to general knowledge that is applied in client assessment and intervention in identification and reduction or mitigation of possible or actual risk factors associated with environmental stressors to prevent possible reaction. The goal of health promotion is included in primary prevention.

8th Proposition of Neuman

Secondary prevention relates to symptomatology following a reaction to stressors, appropriate ranking of intervention priorities, and treatment to reduce their noxious effects.

9th Proposition of Neuman

Tertiary prevention relates to the adaptive processes taking place as reconstitution begins and maintenance factors move the client back in a circular manner toward primary prevention.

10th Proposition of Neuman

The client as a system is in a dynamic, constant energy exchange with the environment.

Nursing for Neuman

nursing is concerned with the whole person

Person for Neuman

an open client system in reciprocal interaction with the environment

Health for Neuman

acontinuumofwellnesstoillnessthatisdynamicinnatureandis constantly changing

Environment for Neuman

All the internal and external factors that surround and influence the client system

3 Stressors in the Environment

Intrapersonal, Interpersonal, Extrapersonal

Stressors

3 Relevant Environments (Neuman)

Internal, External, Created

Internal Environment

interpersonal, with all interactions contained within the client