TFN REVIEWER

Philosophy

Philosophy

a statement encompassing ontological claims about the phenomena of
central interest to a discipline, epistemic claims about how those
phenomena come to be known, and ethical claims about what the
members of a discipline value.

Conceptual Models

set of relatively abstract and general concepts that address the
phenomena of central interest to a discipline, the propositions that broadly
describe those concepts, and the propositions that state relatively abstract
and general relations between two or more concepts

Theory

A group of related concepts that propose actions that guide practice

Concept

Often called the building blocks of theories

Middle Range Theory

A theory comprising limited numbers of variables, each of limited scope.
Middle-range theories maybe descriptive, explanatory (specifying
relationships between two or more concepts), or predictive (envisioning
relationships between concepts or effects of certain concepts on others).

Metaparadigm

is a set of ideas that provide structure for how a discipline
should function. For a nursing discipline, these theories consist of four
basic concepts that address the patient as a whole, the patient’s health
and well-being, the patient’s environment and the nursing responsibilities.

Person

receiver of care.

Health

refers to the extent of wellness and health care access that a patient has.

Environment

The internal and external surrounding that affects the client

Nursing

The nursing component of the metaparadigm involves the delivery of
optimal health outcomes for the patient through a mutual relationship in
a safe and caring environment.

Profession

refers to a specialized field of practice founded on the
theoretical structure of the science or knowledge and accompanying practice abilities.

Discipline

refers to a branch of education, a department of learning, or a domain
of knowledge.

Theoretical Statement

Is a statement of how and why specific facts are related

Structure

A pattern or the arrangement of and relations between the parts or elements of something complex.

Assumptions

Accepted “truth” that are basic and fundamental to the theory

Models

A representation to better understand, explain or predict something

Purpose

t helps to describe, predict, or explain a phenomenon. Enables nurses to know “why” they are doing “what” they are doing

Education

Prepare students for practice as members of the professional
community.

Research

Offer a framework for generating knowledge and new ideas

Clinical Practice

serve to guide assessment, intervention and evaluation of nursing care

Florence Nightingale

• Mother of Modern Nursing

• Known for her Environmental Theory

• The Lady with a lamp

• Served the wounded soldiers during the Crimean War

• Born May 12, 1820 in Florence Italy

Nightingale’s Major concepts and definition

• Pure air

• Light - direct sunlight as particular need of patients

• Cleanliness

• Efficient drainage

• Pure water

Canons of the Environmental Theory

• Health of Houses

• Ventilation and warmth

• Light

• Noise

• Variety

• Bed and Beddings

• Cleanliness

• Personal Cleanliness

• Nutrition and Taking Food

• Chattering Hopes and Advice

• Observation of the Sick

• Petty Management

Nursing (Nightingale)

Nightingale believed that every woman, at one time in her life, would be a
nurse in the sense that nursing is being responsible for someone else’s health.

Person (Nightingale)

Nightingale referred to the person as a patient.

Health (Nightingale)

• Nightingale defined health as being well and using every power (resource) to the fullest extent in living life.

• he saw disease and illness as a
  reparative process

Environment

Nightingale’s concept of environment emphasized that nursing was “to assist nature in healing the patient.

Jean Watson

• Theory of Transpersonal Caring

• 10 Carative Factors

• Nursing: The Philosophy and Science of
  Caring (1979). Her first book.

• Grew up in West Virginia
  

Caring

Watson describes a “Transpersonal Caring Relationship” as a foundation for her theory; it is a “special kind of human care relationship-a union with another person-high regard for the whole person and their being-in-the-world.

Transpersonal Nurse

one who "has the ability to center
consciousness and intentionality on caring, healing, and wholeness, rather than on disease, illness and pathology."

Major Concepts and Definition

10 Carative Factors

• Formation of a Humanistic Altruistic System of Values

• Installation of Faith-Hope

• Cultivation of Sensitivity to Self and Others

• Development of a Helping-Trust Relationship

• Promotion and Acceptance of the Expression of Positive and Negative Feelings

• Systematic Use of the Scientific Problem-Solving Method for Decision Making

• Promotion of Interpersonal Teaching-Learning

• Provision for a Supportive, Protective, and Corrective Mental, Physical, Sociocultural, and Spiritual Environment

• Assistance with Gratification of Human Needs

• Allowance for Existential- Phenomenological Forces

Nursing (Watson)

According to Watson, the word nurse is both a noun and a verb. To her, nursing consists of “knowledge, thought, values, philosophy, commitment, and action with some degrees of passion.

Person (Watson)

Watson views the person as “a unity of mind/body/spirit/nature and she says
that personhood is tied to notions that one’s soul possess a body that is not confined by objective time and space.

Health (Watson)

Watson defined health the same as that of the World Health Organization “The positive state of physical, mental, and social well-being

Environment (Watson)

• Attending to supportive, protective and or corrective mental, physical, societal and spiritual environments.

• The caring is not only for sustaining humanity, but also for sustaining the plane

Patricia Benner

• Novice to Expert Theory

• Born August 1942 in Hampton Virginia

Novice

Beginner with no experience

Ex. Newly graduated nurse

Advanced Beginner

Demonstrates acceptable performance

Competent

2-3 years experience

Proficient

Perceives and understands situations as whole parts

Expert

No longer relies on principles, rules, or guidelines to connect situations and determine actions

Nursing (Bener)

Describe as caring relationship and condition and connection. Caring is primary because caring self is set possibility of giving help and receiving help

Person (Bener)

Describe as self- interpreting being and effortless nonreflective understanding of the self in the world

Health (Bener)

Define as what is assessed, whereas well-being is the human experience of health or wholeness. Well-being and being ill are understood as
distinct ways of being in the world.

Situation/Environment (Bener)

The situation is used as a term rather than environment because situation conveys social environment with social definition and meaningfulness. They use Phenomenological term being situated and situated meaning which are
defined by the person engaged in interaction, interpretation, and understanding
of situation.

Virginia Henderson

• Nursing Needs Theory

• The Nightingale of Modern Nursing 0r The 20th Century Florence Nightingale

• Entered Army School of Nursing in Washington, DC, in 1918

Major Assumptions (Henderson)

• Nurses care for patients until they can care for themselves once again

• Patients desire to return to health

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

• Mind and Body are inseparable and are interrelated

14 Components that make up basic nursing care

1. Breathe normally.
2. Eat and drink adequately.
3. Eliminate body wastes.
4. Move and maintain desirable postures.
5. Sleep and rest.
6. Select suitable clothes-dress and undress.
7. Maintain body temperature within normal range by adjusting clothing and
modifying environment
8. Keep the body clean and well-groomed and protect the integument
9. Avoid dangers in the environment and avoid injuring others.
1O. Communicate with others in expressing emotions, needs, fears, or
opinions.
11. Worship according to one’s faith.
12. Work in such a way that there is a sense of accomplishment.
13. Play or participate in various forms of recreation.
14. Learn, discover, or satisfy the curiosity that leads to normal
development and health and use the available health facilities.

Nursing (Henderson)

She defined nursing as “the unique
function of the nurse is to assist the individual, sick or well, in the performance of those activities contributing to health or its recovery that he would perform unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible.”

Person (Henderson)

Henderson states that individuals have basic needs that are components of health and require assistance to achieve health and independence or a peaceful death.

Health (Henderson)

• Health was taken
  to mean balance in all realms of human life.

• Not explicitly defined

Environment (Henderson)

According to 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

Henderson views the nursing process as “really the application of the logical approach to the solution of a problem.

Faye Glenn Abdellah

• Typology of 21 Nursing Problems

• Used Henderson’s 14 basic human needs

• Born March 13, 1919 in New York

21 areas of focus for nursing

Divided into three:

• Physical

• Sociological

• Emotional needs of the patient

Basic Needs

basic needs of an individual patient are to maintain good hygiene and physical comfort; promote optimal health through healthy activities, such as
exercise, rest and sleep; promote safety through the prevention of health hazards like accidents, injury or other trauma and through the prevention of the spread of infection; and maintain good body mechanics and prevent or correct deformity

Sustenal Care Needs

Sustenal care needs facilitate the maintenance of a supply of oxygen to all body cells; facilitate the maintenance of nutrition of all body cells; facilitate the maintenance of elimination; facilitate the maintenance of fluid and electrolyte balance; recognize the physiological responses of the body to disease conditions; facilitate the maintenance of regulatory mechanisms and functions; and facilitate the maintenance of sensory function.

Remedial Care Needs

Remedial care needs to identify and accept positive and negative expressions,
feelings, and reactions; identify and accept the interrelatedness of emotions and organic illness; facilitate the maintenance of effective verbal and non- verbal communication; promote the development of productive interpersonal relationships; facilitate progress toward achievement of personal spiritual
goals; create and maintain a therapeutic environment; and facilitate awareness
of the self as an individual with varying physical, emotional, and developmental
needs.

Restorative Care Needs

Restorative care needs include the acceptance of the optimum possible goals in light of limitations, both physical and emotional; the use of community
resources as an aid to resolving problems that arise from illness; and the understanding of the role of social problems as influential factors in the case of illness.

Major Assumptions (Abdellah)

The assumptions Abdellah’s “21 Nursing Problems Theory” relate to change and anticipated changes that affect nursing; the need to appreciate the interconnectedness of social enterprises and social problems; the impact of problems such as poverty, racism, pollution, education, and so forth on health and health care delivery; changing nursing education; continuing education for professional nurses; and development of nursing leaders from underserved groups.

Theoretical Assertions

The model has interrelated concepts of health and nursing problems, as well as problem-solving, which is an activity inherently logical in nature

Person (Abdellah)

• She describes the recipients of nursing as individuals (and families), although she does
  not delineate her beliefs or assumptions about the nature of human beings.

• describes people as having physical, emotional, and sociological needs.

• Patient is described as the only justification for the existence of nursing.

Health (Abdellah)

Abdellah does not give a definition of health, she speaks to “total health needs” and a “healthy state of mind and body” in her description of nursing as a
comprehensive service.

Environment (Abdellah)

he environment is the home or community
from which patient comes

Nursing (Abdellah)

• An overt nursing problem is an apparent condition faced by the patient or family, which the nurse can assist him or them to meet through the performance of her professional functions.

• The covert nursing problem is a concealed or hidden condition faced, by the patient or family, which the nurse can assist him or them to meet through the performance of her professional functions

Dorothea Orem

• Self-Care Deficit Nursing Theory

• Dorothea Elizabeth Orem

• Born July 15, 1914, in Baltimore, Maryland

• Earned Honorary Degree

Theory of Self-Care

Self-Care comprises the practice of activities that maturing and mature persons initiate and perform, within time frames, on their own behalf in the interest of maintaining life, healthful functioning,
continuing personal development, and well-being by meeting known requisites for functional and developmental regulations

Self-Care

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

Self-Care Agency

a human ability which is the “ability for engaging
in self care activities--- conditioned by age, developmental state, life experience, sociocultural orientation, health and available resources.

Therapeutic Self-Care Demand

“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”.

Basic Conditioning Factors

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

Self-Care Requisites

Actions directed towards provision of self-care.

Universal Self-Care Requisites

Associated with life processes and maintenance of the integrity of human structure and functioning.

Developmental Self-Care Requisites

Needs associated with developmental process derived from a condition or associated with an event

Health Deviation Self-Care Requisites

Required in conditions of illness, injury, or disease

Dependent-Care

refers to the care that is provided to a person who,
because of age or related factors, is unable to perform the self-care needed to maintain life, healthful functioning, continuing personal development, and well-being.

Dependent-Care Agency

refers to the 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 Deficit

is a 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 Demand

is the 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 operationa

Theory of Self-Care Deficit

Self-care deficit is the relationship between an individual’s therapeutic self-care demand and his or her powers of self-care agency in which
the constituent-developed self-care capabilities within self-care agency are inoperable or inadequate for knowing and meeting some
or all components of the existent or projected therapeutic self-care demand

Theory of Nursing Systems

Nursing systems are series and sequences of deliberate practical actions of nurses performed at times in coordination with the actions of their patients to know and meet components of patient’s therapeutic self-care demands and to protect and regulate the exercise of development of patients’ self-care agency

Wholly Compensatory System

The patient is dependent. The nurse is expected to accomplish all the patient’s therapeutic self- care or to compensate for the patient’s inability to engage in self-care or when the patient needs continuous guidance in self-care.

Partially Compensatory System

The patient can meet some needs. Needs nursing assistance. Both the nurse and the patient engage in meeting self-care needs.

Supportive-educative System

The patient can meet self-care requisites, but needs assistance with decision-making or knowledge and skills to lean self-care.

Person (Orem)

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

Environment (Orem)

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

Health (Orem)

When human beings are structurally and functionally whole or sound.

Nursing (Orem)

Is an art, a helping service, and a technology

Theory of Nursing Systems

The theory of nursing systems purposes that nursing is human actions: nursing systems are action systems formed (designed and produced) by nurses through the exercise of their nursing agency for persons with health-derived or
health-associated limitations in self-care or dependent-care.