CA 2_Funda (TFN)

Theory

set of concepts that explains a phenomenon

Man

Health

Environment

Nursing

What are the 4 metaparadigm?

M - H - E - N

Man (Person)

• refers to all human beings

• are the recipients of nursing care; they include individuals, families, communities, and groups

Environment

• includes factors that affect individuals internally and externally

• it means not only in the everyday surroundings but all setting where nursing care is provided

Health

generally addresses the person’s state of well-being

Nursing

Goal is to place the individual in the best condition for good healthcare

Florence Nightingale, Lydia Hall, Imogene King, Myra Estrin Levine

Joyce Travelbee, Virginia Henderson

Faye Glenn Abdellah, Dorothy Orem, Dorothy E. Johnson

Betty Neuman

Madeleine Leininger, Ida Jean Orlando, Sister Callista Roy

Jean Watson, Hildegard Peplau, Ernestine Wiedenbach, Martha Rogers, Rosemarie Rizzo Parse, and Patricia Benner

Enumerate the nursing theorists?

FLIM - JV - FDD - B - MIS - JHEMRP

Florence Nightingale

• First nursing theorist

• Theory: ENVIRONMENTAL THEORY (1860)

Air

Fire

Water

Earth

Drainage

Nightingale’s theory includes 5 concepts (environmental factors), what are these?

Air

Proper ventilation

Fire

Proper lighting (sunlight exposure)

Water

Potable and clean water

Earth

Cleanliness (therapeutic environment)

Florence Nightingale

Defined Nursing: “The act of utilizing the environment of the patient to assist him in his recovery.”

Florence Nightingale

She focuses on changing and manipulating the environment in order to put the patient in the best possible conditions for nature to act.

Man

Health

Environment

Nursing

What are the 4 Metaparadigms according to F.N.?

M - H - E - N

Man

An individual with vital reparative processes to deal with disease

Health

Focus is on the reparative process of getting well

Environment

External conditions that affect life and individuals’ development.

Nursing

Goal is to place the individual in the best condition for good healthcare

May 12, 1820 in the city of Florence, Italy

When and where was F.N. born?

Germany for 3-6 months

Where did she studied nursing and how many months did she studied there?

October 1854 – February 1856

When did the Crimean War started and ended?

38; Crimean

Florence Nightingale brought a team of __ volunteer nurses to care for the British soldiers fighting in the _____ War, which was intended to limit Russian expansion into Europe.

34 years old

How old was F.N. when she tend to the soldiers during the Crimean War?

Notes on Nursing: What It Is, and What it Is Not

a book written by F.N to help ordinary women care for their families

Modern Nursing

Aside from being called as the “Lady of the Lamp”, F.N. was also known as the founder of _______ since she is an innovative person (manipulating the environment = good health).

August 1910 (90 years old)

When and at what age did F.N. died?

10 years; 80 years old

F.N. suffered being blind for how many years? And at what age she did went blind?

INTERPERSONAL RELATIONS THEORY (1951)

What is the theory of Hildegard Peplau?

Hildegard Peplau

She defined nursing as: “An interpersonal process of therapeutic interactions between an individual who is sick or in need of health services and a nurse especially educated to recognize, respond to the need for help.”

Pre-orientation

Orientation

Exploitation

Termination

What are the 4 phases of Nurse-Patient Relationship accdg to Peplau?

Pre-orientation

During this phase in NPR, you will prepare for your meeting with the patient. You will review their chart, and examine your thoughts and feelings about working with the patient.

Orientation

During this phase in NPR, you will perform introductions with the patient, establish rapport, establish boundaries, and explain patient confidentiality.

You will set mutually agreed-upon goals with the patient and establish the date, time, place and duration of meetings.

Exploitation

During this phase in NPR, you will gather data and identify and practice problem-solving skills and coping skills with your patient.

You will provide education to the patient, and then evaluate the progress being made towards the agreed-upon goals.

Termination

During this phase in NPR, you will summarize goals that were achieved during the relationship, discuss incorporation of new coping mechanisms and problem-solving skills into the patient's life, and discuss their discharge plans.

HUMAN-TO-HUMAN RELATIONSHIP MODEL (1966, 1971)

What is the theory of Joyce Travelbee?

Joyce Travelbee

She postulated the Interpersonal Aspects of Nursing Model. She advocated that the goal of nursing individual or family in preventing or coping with illness, regaining health finding meaning in illness, or maintaining maximal degree of health.

Joyce Travelbee

She further viewed that interpersonal process is a human-to-human relationship formed during illness and “experience of suffering”

Joyce Travelbee

She believed that a person is a unique, irreplaceable individual who is in a continuous process of becoming, evolving and changing.

CORE, CARE AND CURE MODEL (1964)

What is the theory of Lydia Hall?

Care

Core

Cure

What are the overlapping parts involved in Lydia Hall’s theory?

Nurse

Care refers to whom?

Care

Represents nurturance and is exclusive to nursing

Patient

Core refers to whom?

Core

Involves the therapeutic use of self and emphasizes the use of reflection.

Doctor

Cure refers to whom?

Cure

Focuses on nursing related to the physician’s orders.

care

The major purpose of ___ is to achieve an interpersonal relationship with the individual that will facilitate the development of the core.

CONSERVATION MODEL OF NURSING (1973)

What is the theory of Myra Estrin Levine?

Myra Estrin Levine

Believes nursing intervention is a conservation activity, with conservation of energy as a primary concern, four conservation principles of nursing:

• conservation of client energy

• conservation of structured integrity

• conservation of personal integrity

• conservation of social integrity

Openness

Pattern

Organization

Energy

What are the 4 conservation principles accdg to Myra Levine?

O - P - O - E

Openness

refers to the individual's capacity to adapt to environmental changes and embrace new information and experiences

Pattern

Health is seen as a pattern of adaptation, and well-being is the goal of this adaptive change. 

Organization

emphasizes the structured and ordered way the individual's various systems function together to maintain a state of balance and wholeness.

Energy

vital force that supports life processes and the individual's ability to adapt to stressors and maintain their integrity.

THE NATURE OF NURSING MODEL (1955)

What is the theory of Virginia Henderson?

Virginia Henderson

She identified fourteen basic needs. She postulated that the unique function of the nurse is to assist the clients, sick or well in the performance of those activities contributing to health or its recovery, the clients would perform unaided if they had the necessary strength, will or knowledge.

Virginia Henderson

She further believed that nursing involves assisting the client in gaining independence as rapidly as possible, or assisting him achieves peaceful death if recovery is no longer possible.

Virginia Henderson

She defined nursing as: “Assisting the individual, sick or well, in the performance of those activities contributing to health or its recovery (or to peaceful death) that an individual would perform unaided if he had the necessary strength, will or knowledge”.

normally

Eliminating

desirable position

clothes

body temperature

body

dangers

Communicating

faith

accomplishment

recreation

14 Basic Needs accdg to Virginia Henderson

1. Breathing _____

2. Eating and drinking adequately

3. _____ body wastes

4. Moving and maintaining _____ _____

5. Sleeping and resting

6. Selecting suitable _____

7. Maintaining _____ _____ within normal range

8. Keeping the _____ clean and well-groomed

9. Avoiding _____ in the environment

10. _____ with others

11. Worshipping according to one’s _____

12. Working in such a way that one feels a sense of _____

13. Playing/participating in various forms of _____

14. Learning, discovering or satisfying the curiosity that leads to normal development and health and using available health facilities.

21 NURSING PROBLEMS (1960)

What is the theory of Faye Glenn Abdellah?

Faye Glenn Abdellah

She defined nursing as service to individual and families; therefore the society. Furthermore, she conceptualized nursing as an art and a science that molds the attitudes, intellectual competencies and technical skills of the individual nurse into the desire and ability to help people, sick or well, and cope with their health needs.

Spirituality

Stress

Emotional aspects

What are the 3 factors that F.G. Abdellah emphasized in her theory?

hygiene

optimal activity

safety

body mechanics

oxygen

nutrition

elimination

fluid and electrolyte balance

disease

sensory

emotions and illness

interpersonal

spiritual

therapeutic

21 Nursing Problems accdg to Faye Glenn Abdellah

1. To maintain good ______.

2. To promote ______ ______; exercise, rest and sleep.

3. To promote ______.

4. To maintain good ______ ______

5. To facilitate the maintenance of a supply of ______

6. To facilitate maintenance of ______

7. To facilitate maintenance of ______

8. To facilitate the maintenance of ______ and ______ balance

9. To recognize the physiologic response of the body to ______ conditions

10. To facilitate the maintenance of regulatory mechanisms and functions

11. To facilitate the maintenance of ______ functions

12. To identify and accept positive and negative expressions, feelings and reactions

13. To identify and accept the interrelatedness of ______ and ______.

14. To facilitate the maintenance of effective verbal and non-verbal communication

15. To promote the development of productive ______ relationship

16. To facilitate progress toward achievement of personal ______ goals

17. To create and maintain a ______ environment

18. To facilitate awareness of self as an individual with varying needs.

19. To accept the optimum possible goals

20. To use community resources as an aid in resolving problems arising from illness.

21. To understand the role of social problems as influencing factors

SELF-CARE DEFICIT THEORY (1970, 1985)

What is the theory of Dorothea Orem?

Dorothea Orem

She defined nursing as: “The act of assisting others in the provision and management of self-care to maintain/improve human functioning at home level of effectiveness.”

Self-care Deficit Theory

What theory is this?

• Focuses on activities that adult individuals perform on their own behalf to maintain life, health and well-being.

• Has a strong health promotion and maintenance focus.

Self-care

Health

Nursing system

In Orem’s theory, what are the 3 identified related concepts?

Self-care

activities an individual performs independently throughout life to promote and maintain personal well-being

Health

results when self-care agency (Individual’s ability) is not adequate to meet the known self-care needs

Nursing system

nursing interventions needed when Individual is unable to perform the necessary self-care activities: Wholly compensatory, Partial compensatory, and Supportive-educative

Wholly compensatory

nurse provides entire self-care for the client.

• Example: care of a newborn, care of clients recovering from surgery in a post-anesthesia care unit

Partial compensatory

nurse and client perform care; client can perform selected self-care activities, but also accepts care done by the nurse for needs the client cannot meet independently.

Supportive-educative

nurse’s actions are to help the client develop/learn their own self-care abilities through knowledge, support and encouragement.

• Example: Nurse guides a mother how to breastfeed her baby, Counseling a psychiatric client on more adaptive coping strategies.

Dorothy E. Johnson

Who is the author of Behavioral System Model (1980)?

Behavioral System Model (1980)

• Focuses on how the client adapts to illness; the goal of nursing is to reduce stress so that the client can move more easily through recovery.

• Viewed the patient’s behavior as a system, which is a whole with interacting parts.

Dorothy E. Johnson

• She viewed that each person strives to achieve balance and stability both internally and externally and to function effectively by adjusting and adapting to environmental forces through learned pattern of response.

• She believed that the patient strives to become a person whose behavior is commensurate with social demands; who is able to modify his behavior in ways that support biologic imperatives; who is able to benefit to the fullest extent during illness from the health care professional’s knowledge and skills; and whose behavior does not give evidence of unnecessary trauma as a consequence of illness

Affiliative

Aggressive

Achievement

Ingestive

Dependence

Eliminated

Sexual role identity behavior

According to Johnson, each person as a behavioral system is composed of seven subsystems namely?

AAA - I - D - E - S

Affiliative

Security seeking behavior.

Aggressive

Self – protective behavior.

Achievement

Master of oneself and one’s environment according to internalized standards of excellence.

Ingestive

Taking in nourishment in socially and culturally acceptable ways.

Dependence

Nurturance – seeking behavior.

Eliminated

Riddling the body of waste in socially and culturally acceptable ways.

HEALTH CARE SYSTEM MODEL

What is the theory of Betty Neuman?

Stress reduction

According to Betty Neuman, ______ is a goal of system model of nursing practice. Nursing actions are in primary, secondary or tertiary level of prevention.

Health Care System Model

This theory states that:

• To address the effects of stress and reactions to it on the development and maintenance of health.

• The concern of nursing is to prevent stress invasion, to protect the client’s basic structure and to obtain or maintain a maximum level of wellness.

• The nurse helps the client, through primary, secondary, and tertiary prevention modes, to adjust to environmental stressors and maintain client stability.

Madeleine Leininger

She is the author of TRANSCULTURAL CARE THEORY AND ETHNONURSING (1978, 1984), who is she?

Madeleine Leininger

She advocated that nursing is a humanistic and scientific mode of helping a client through specific cultural caring processes (cultural values, beliefs and practices) to improve or maintain a health condition.

Nursing

Accdg to Leininger, _____ is a learned humanistic and scientific profession and discipline which is focused on human care phenomena and activities in order to assist, support, facilitate, or enable individuals or groups to maintain or regain their well being (or health) in culturally meaningful and beneficial ways, or to help people face handicaps or death.

Transcultural Nursing

is a learned subfield or branch of nursing which focuses upon the comparative study and analysis of cultures with respect to nursing and health-illness caring practices, beliefs and values with the goal to provide meaningful and efficacious nursing care services to people according to their cultural values and health-illness context.

GOAL ATTAINMENT THEORY (1971, 1981)

What is the theory of Imogene King?

Nursing process

is defined as dynamic interpersonal process between nurse, client and health care system

Imogene King

She described nursing as a helping profession that assists individuals and groups in society to attain, maintain, and restore health. If is this not possible, nurses help individuals die with dignity.

Imogene King

In addition, she viewed nursing as an interaction process between client and nurse whereby during perceiving, setting goals, and acting on them transactions occurred and goals are achieved.

Sister Callista Roy

Who is the author of ADAPTATION MODEL (1979)?

Sister Callista Roy

Viewed humans as Biopsychosocial beings constantly interacting with a changing environment and who cope with their environment through Biopsychosocial adaptation mechanisms.

Sister Callista Roy

She viewed each person as a unified biopsychosocial system in constant interaction with a changing environment. She contented that the person as an adaptive system, functions as a whole through interdependence of its part. The system consists of input, control processes, output feedback.

THEORY OF HUMAN CARING (1979)

What is the theory of Jean Watson?