Theoretical Foundations of Nursing: Grand Nursing Theories

Vocabulary practice flashcards covering Module 4: Grand Nursing Theories, including Madeleine Leininger's Culture Care Theory, Dorothea Orem's Self-Care Deficit Theory, Imogene King's Theory of Goal Attainment, Myra Estrin Levine's Conservation Model, and Betty Neuman's Systems Model.

Transcultural Nursing

A learned subfield or branch of nursing that focuses on the comparative study and analysis of cultures with respect to nursing and health-illness caring practices, beliefs, and values to provide meaningful and efficacious nursing care.

Ethnonursing

The study of nursing care beliefs, values, and practices as cognitively perceived and known by a designated culture through their direct experience, beliefs, and value system.

Culturally Congruent Care

Cognitively based assistive, supportive, facilitative, or enabling acts or decisions that are tailor-made to fit with individual, group, or institutional cultural values, beliefs, and lifeways to provide meaningful, beneficial, and satisfying health care services.

Sunrise Model

A model developed by Madeleine Leininger in a logical order to demonstrate the interrelationships of the concepts in her theory of Culture Care Diversity and Universality, enabling nurses to integrate cultural and social structure dimensions into practice.

Culture Care Diversity

The variabilities and/or differences in meanings, patterns, values, lifeways, or symbols of care within or between collectives that are related to assistive, supportive, or enabling human care expressions.

Culture Care Universality

The common, similar, or dominant uniform care meanings, patterns, values, lifeways, or symbols that are manifest among many cultures and reflect assistive, supportive, facilitative, or enabling ways to help people.

Generic (Folk or Lay) Care Systems

Culturally learned and transmitted, indigenous (or traditional), folk (home-based) knowledge and skills used to provide assistive, supportive, enabling, or facilitative acts toward or for another with needs to improve a human lifeway, health condition, or deal with handicaps and death.

Emic

Knowledge gained from direct experience or directly from those who have experienced; generic or folk knowledge.

Etic

Knowledge that describes the professional perspective; professional care knowledge.

Professional Care Systems

Formally taught, learned, and transmitted professional care, health, illness, wellness, and related knowledge and practice skills that prevail in professional institutions, usually with multidisciplinary personnel to serve consumers.

Ethnohistory

Past facts, events, instances, and experiences of individuals, groups, cultures, and institutions that are primarily people-centered (ethno) and describe, explain, and interpret human lifeways within particular cultural contexts over short or long periods of time.

Culture Shock

Feelings of discomfort, helplessness, and disorientation resulting when an outsider attempts to comprehend or adapt effectively to a different cultural group because of differences in cultural values, beliefs, and practices.

Cultural Imposition

Efforts of an outsider, both subtle and not so subtle, to impose his or her own cultural values, beliefs, and behaviors upon an individual, family, or group from another culture.

Culture Care Preservation or Maintenance

Assistive, supporting, facilitative, or enabling professional actions and decisions that help people of a particular culture to retain and/or preserve relevant care values so they can maintain well-being, recover from illness, or face handicaps and death.

Culture Care Accommodation or Negotiation

Assistive, supportive, facilitative, or enabling creative professional actions and decisions that help people of a designated culture to adapt to or negotiate with others for a beneficial or satisfying health outcome with professional care providers.

Culture Care Repatterning or Restructuring

Assistive, supporting, facilitative, or enabling professional actions and decisions that help clients reorder, change, or greatly modify their lifeways for a new, different, and beneficial health care pattern while respecting the clients' cultural values and beliefs.

Self-Care (Orem)

The performance or practice of activities that individuals initiate and perform on their own behalf in maintaining life, health, and well-being.

Self-Care Agency

The human's ability or power to engage in self-care, which is affected by basic conditioning factors.

Basic Conditioning Factors

Factors affecting self-care agency, including age, gender, developmental state, health state, socio-cultural orientation, health care system factors, family system factors, patterns of living, environmental factors, and resource adequacy and availability.

Therapeutic Self-Care Demand

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

Self-Care Deficit

A condition delineating when nursing is needed, occurring when an adult (or parent/guardian of a dependent) is incapable of or limited in the provision of continuous effective self-care.

Nursing Agency

A complex property or attribute of people educated and trained as nurses that enables them to act, to know, and to help others meet their therapeutic self-care demands by exercising or developing their own self-care agency.

Nursing System (Orem)

The product of a series of relations between a legitimate nurse and legitimate client, activated when the client's therapeutic self-care demand exceeds available self-care agency.

Universal Self-Care Requisites

Self-care requisites associated with life processes and the maintenance of the integrity of human structure and functioning, such as maintenance of sufficient intake of air, water, food, and elimination balance.

Developmental Self-Care Requisites

Either specialized expressions of universal self-care requisites that have been particularized for developmental processes, or new requisites derived from a condition or associated with an event.

Health Deviation Self-Care Requisites

Requisites required in conditions of illness, injury, or disease, or resulting from medical measures required to diagnose and correct the condition.

Wholly Compensatory Nursing System

A nursing system represented by a situation in which the individual is unable to engage in self-care actions requiring self-directed and controlled ambulation and manipulative movement, making them socially dependent on others.

Partial Compensatory Nursing System

A nursing system in which both nurse and patient perform care measures or other actions involving manipulative tasks or ambulation, with either having a major role.

Supportive-Educative System

A nursing system (also known as supportive-developmental system) in which the person is able to perform or should learn to perform required measures of therapeutic self-care but cannot do so without assistance.

Theory of Goal Attainment

Imogene King's theory stating that nursing is a process of human interactions between nurse and client whereby each perceives the other and the situation, and through communication, they set goals, explore means, and agree on means to achieve goals.

Dynamic Conceptual Systems

An approach developed by Imogene King to study systems as organized wholes rather than isolated parts within which nurses function, comprised of personal, interpersonal, and social systems.

Personal System (King)

An individual system (such as a patient or a nurse) comprehended through concepts of perception, self, growth and development, body image, space, and time.

Self (King)

A composite of thoughts and feelings which constitute a person's awareness of his individual existence, his conception of who and what he is.

Growth and Development (King)

The processes in people's lives through which they move from a potential for achievement to the actualization of self.

Body Image (King)

The way one perceives both one's body and others' reactions to one's appearance.

Space (King)

A physical area existing in all directions that is the same everywhere, defined as territory and by the behaviors of those occupying it.

Time (King)

A duration between one event and another as uniquely experienced by each human being; the relation of one event to another event.

Interpersonal Systems (King)

Systems formed by two or more interacting individuals, comprehended through concepts of interaction, communication, transaction, role, and stress.

Transactions (King)

A process of interactions in which human beings communicate with the environment to achieve goals that are valued; goal-directed human behaviors.

Stress (King)

A dynamic state whereby a human being interacts with the environment to maintain balance for growth, development, and performance, involving an exchange of energy and information between the person and the environment for regulation and control of stressors.

Power (King)

A social force that organizes and maintains society; the capacity or ability of a person or group to use and mobilize resources in organizations to achieve goals.

Status (King)

The position of an individual in a group or a group in relation to other groups in an organization, accompanied by privileges, duties, and obligations.

The Conservation Model

Myra Estrin Levine's model which views nursing intervention as a conservation activity aimed at keeping together the total person through the least amount of effort, utilizing four conservation principles.

Conservation of Energy

A principle of nursing aimed at balancing energy input and output to avoid excessive fatigue (e.g., rest, nutrition, exercise).

Conservation of Structural Integrity

A principle of nursing referring to maintaining or restoring the structure of the body, preventing physical breakdown, and promoting healing.

Conservation of Personal Integrity

A principle of nursing that recognizes the individual as one who strives for recognition, respect, self-awareness, selfhood, and self-determination.

Conservation of Social Integrity

A principle of nursing that exists when a patient is recognized as someone who resides within a family, community, religious group, ethnic group, political system, and nation.

Operational Environment (Levine)

An aspect of the external environment consisting of undetected natural forces that impinge on the individual.

Perceptual Environment (Levine)

An aspect of the external environment consisting of information that is recorded by the sensory organs.

Conceptual Environment (Levine)

An aspect of the environment influenced by language, culture, ideas, and cognition.

Adaptation (Levine)

The process of change and integration of the organism in which the individual retains integrity or wholeness.

Historicity (Levine)

A characteristic of adaptation stating that individual responses are based on past experiences, both personal and genetic.

Specificity (Levine)

A characteristic of adaptation stating that each system has very specific responses tailored to distinct challenges.

Redundancy (Levine)

A characteristic of adaptation where adaptive responses occur in cascading, non-linear sequences in which one sequence is not yet completed when the next begins.

Neuman Systems Model

A unique, open-system-based perspective developed by Betty Neuman that views the client as an open system responding to environmental stressors, consisting of a core structure protected by concentric rings.

Flexible Line of Defense

A protective accordion-like mechanism in Neuman's model that surrounds and protects the normal line of defense from invasion by stressors.

Normal Line of Defense

An adaptational level of health developed over time and considered normal for a particular individual client or system, used as a standard for wellness-deviance determination.

Lines of Resistance

Internal protection factors activated when stressors have penetrated the normal line of defense, functioning to stabilize and realign the client to the usual wellness state.

Created Environment (Neuman)

An environment unconsciously developed and used by the client to support protective coping.

Intrapersonal Stressors (Neuman)

Stressors that occur within the client system boundary and correlate with the internal environment.

Interpersonal Stressors (Neuman)

Stressors that occur outside the client system boundary, are proximal to the system, and have an impact on the system.

Extrapersonal Stressors (Neuman)

Stressors that occur outside the client system boundaries at a greater distance from the system than interpersonal stressors, such as social policy.

Entropy (Neuman)

A process of energy depletion and disorganization moving the client system toward illness or possible death.

Negentropy (Neuman)

A process of energy conservation that increases organization and complexity, moving the system toward stability or a higher degree of wellness.

Reconstitution (Neuman)

The return and maintenance of system stability following treatment of stressor reaction, which may result in a higher or lower level of wellness.

Primary Prevention (Neuman)

An intervention modality occurring before the system reacts to a stressor, focusing on strengthening the flexible line of defense through health promotion and reducing risk factors.

Secondary Prevention (Neuman)

An intervention modality occurring after the system reacts to a stressor, focusing on treatment of symptoms to strengthen internal lines of resistance and protect the basic structure.

Tertiary Prevention (Neuman)

An intervention modality occurring after secondary prevention as reconstitution begins, maintaining wellness and protecting client system reconstitution by supporting existing strengths and preserving energy.