NURSING AND NON NURSING THEORIS

Grand theories

• Broad in scope and complex

• Require specification thru’ research

• provide structural framework for broad, abstract ideas about nursing .

the self-care deficit nursing theory (dorothea orem)

• It provides a comprehensive framework for understanding when nursing care is needed

• when a patient cannot meet their own self-care demands.

• It doesn’t focus on a specific patient population, disease, or setting.

• Instead, it offers a universal perspective applicable across nursing.

• It is highly abstract, explaining what nursing is and its purpose.

2. The Roy Adaptation Model (Sister Callista Roy)

• It conceptualizes the person as an adaptive system, interacting with internal and external environments.

• The model is holistic and broad, addressing adaptation in physiological, self-concept, role function, and interdependence modes.

• It gives a general view of nursing goals (promoting adaptation) rather than step-by-step interventions, which makes it theoretical and abstract.

3. The Neuman System Model (Betty Neuman)

• It describes the client as an open system constantly interacting with stressors in the environment.

• It emphasizes prevention and wellness, addressing the whole person—physiological, psychological, sociocultural, developmental, and spiritual variables.

• It offers a global perspective on patient care, not just specific nursing actions, which places it in the grand theory category.

Middle – range Theories

• Limited scope

• less abstraction

• address specific phenomenon or concept

• precise & only analyses particular situation w/ limited number of variables.

• specific to health condition, patient

population, location of practice,&

nursing. interventions

Micro-range Theories (practice theory)

• Situation-specific

• Limited to particular populations/field of practice

• Most concrete & narrow in scope

• Linking concepts into statement observed in practice & research

• explores 1 particular situation found in nursing;identifies explicit goals and details how these goals will be achieved.

Descriptive Theories

• 1st level of theory development

• Describe phenomena, speculate on why phenomena occur

• Ability to explain, relate, and in some situations predict nursing phenomena

• Ex. Theories of Growth & Development

Prescriptive theories

• Address nursing interventions & predict consequence of specific nursing intervention

• Action oriented

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  • Ex. Mishel’s Theory of Uncertainty

"Needs "theories

helping individuals to fulfill their physical and mental needs.

"Interaction" theories

- evolve around relationships nurses with patients.

"Outcome “theories

nurse as changing force, who enables individuals to adapt to or cope with ill health

"Humanistic” theories-

developed in response to the psychoanalytic thought that a person’s destiny was determined early in life.

General Systems Theory

• purpose, content & process, breaking down “whole” & analyzing the parts

• relationships bet. parts of whole are examined to learn how they work together

• A system- made up of separate components. The parts rely on one another; interrelated, share a common purpose, and together form a whole

• Input - formation that enters the system

• Output - end product of a system

• Feedback - process through which output is returned to system

• Von Bertalanffy developed General System theory, which has the following assumptions:

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  • All systems must be goal directed

  • All systems are more than the sum of its parts

  • A system is ever changing and any change in one part affects the whole

  • Boundaries are implicit and human systems

are open and dynamic

change theory

• Kurt Lewin

• Growth & change - dynamic nature of basic human needs

• Reactions to change are grounded in the basic human needs for self – esteem, safety and security

• Change involves modification or alteration

• may be planned or unplanned

six (6) components of change theory

• Recognition of the area where change is needed

• Analysis of a situation to determine what forces exist to maintain the situation and what forces are working to change it

• Identification of methods by which change can occur

• Recognition of the influence of groups mores or customs on change

• Identification of the methods that the reference group uses to bring about change

• The actual process of change

3 Stages of Change:

• Unfreezing- recognition of change, dissolution old pattern

• Movement- behavior shift to new& more healthful pattern

• Refreezing- long–term solidification of new pattern of behavior

DEVELOPMENTAL THEORY

• orderly predictive process - with conception and continues through death

• four areas of developmental theory :

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  • Biophysical development

  • Psychoanalytic/Psychosocial development

  • Cognitive development

  • Moral development

BIOPHYSICAL DEVELOPMENT

way physical bodies grow& change

psychoanalytical PSYCHOSOCIAL THEORY

development of human personality, behavior & emotions

Cognitive development

Reasoning& thinking processes, including changes in how people come to perform intellectual operations.

moral development

description of moral reasoning

• how people think about the rules of ethical and moral conduct

• Moral development- ability of an individual to distinguish right from wrong & develop ethical values on which to base his or her actions

Adaptation theory

• ADAPTATION -adjustment of living matter to other living things & environmental conditions

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  • Continuous process

  • effects change & nvolves interaction and response

florence nightingale

“The most important practical lesson that can be given to nurses is to teach them what to observe- how to observe.... If you can not get the habit of observation one way or another, you had better give up being a nurse for it not your calling, however kind and anxious you may be”

person

• person as patient; dynamic & complex being

• recipient of care

• human being acted upon by nurse or affected by environment

• reparative powers to deal w/ disease

• recovery in patient’s hands—

health

• being well

• using every power to fullest extent

• DISEASE – a reparative process nature has instituted from a want of attention

• Control of disease= disease prevention = health maintenance

environment

• foundational component

on Nightingale’s theory

• external & internal aspects of life influence person( sick & healthy)

• From food & flowers , pt’s verbal & non verbal interactions w/ pt.

• improved living condition= uplifted social status

nursing

• essential for everybody’s well being

• nursing- having responsibility for someone else’s health

• Notes on Nursing: provide women w/ guidelines for providing nsg .care & give advice on how to “think like a nurse”…….

• *trained nurses applies scientific principles to work & more skilled in observing patient.

Environmental Model

Changing & manipulating environment in order to put pt in the best possible conditions for nature to act.

Nurturing environment, body could repair itself.

1. VENTILATION & WARMTH

• check for pt’s body temp. room temp. ventilation & effluvia or foul odors

• create plan to keep room well-ventilated & free of odor while maintaining pt’s body temp.

2. LIGHT

• room w/ adequate light

• create & implement adequate light w/o placing pt in direct light.

3. HEALTH OF HOUSES

• surrounding environment w/ pure air, water, efficient drainage, cleanliness & light

• proper garbage disposal, remove stagnant H2O

CLEANLINESS OF ROOMS & WALLS

remove dust, dampness & dirt

noise

• noise level at minimum

• never wake intentionally/accidentally 1ˢᵗ part of sleep

6. BED & BEDDING

dry, wrinkle-free, lowest height for comfort

7. PERSONAL CLEANLINESS

pt clean &dry at all times(PT & NURSE)

VARIETY

• stimulate variety in room & client

CHATTERING HOPES & ADVICE

talking w/o reason/ giving advice fact

10. TAKING FOOD

• Assess diet.

• Amount of food& drink / meal

PETTY MANAGEMENT

• control of environment( physically& administratively)

OBSERVATION OF SICK

Observe & record

"Lady with the Lamp"

Place: Florence, Italy

Birth: May 12, 1820 (International Nurses Day)

Her father provided her with reputable education which was uncommon for a Victorian woman.

According to Sir Thomas Cook, she was a linguist.

She was a wife of an aristocrat.

She was a Unitarian Christian and believed she had a religious calling.

First nursing theorist

Death: August 13, 1910

Founder of Modern Nursing" &" Legacy of Caring"

first nurse educator

Germany: place of the first nursing school

Pastor Theodor Fleidner: a protestant pastor who opened a hospital in Kaiserswerth, Germany with no staff thus designed a school of nursing.

Nightingale applied with a 12-page handwritten curriculum and became the 134th nursing student to attend the school.

She developed skills in both nursing care and management and used her gained knowledge as a reformer for the well-being of the citizens

Crimean War English VS. Turkish

-Hospital barracks were infested with fleas and rats.

-Sewage flowed under the wards

-Mortality rate at the hospital was 42.7% of those treated; higher from disease than from war injuries

-Six months later, mortality rate dropped to 2.2% and was achieved by attending to the environment of the soldiers.

-Heroine in Great Britain

-Awarded with Order of Merit by Great Britain

Environmental Theory

Theory basis: the inter-relationship of a healthful environment with nursing

External influences and conditions can prevent, suppress, or contribute to disease or death

Theory goal: Nurses help patients retain their own vitality by meeting their basic needs through control of the environment

Nursing's Focus: control of the environment for individuals, families & the community

Physical Environment

➤ Consists of physical elements where the patient is being treated

Affects all other aspects of the environment

Cleanliness of environment relates directly to disease prevention and patient mortality

Aspects of the physical environment influence the social and psychological environments of the person

Psychological Environment

Can be affected by a negative physical environment which then causes STRESS

Requires various activities to keep the mind active (i.e, manual work, appealing food, a pleasing environment)

Involves communication with the person, about the person, and about other people

⚫ communication should be therapeutic, soothing, & unhurried!

Social Environment

Involves collecting data about illness and disease prevention

Includes components of the physical environment - clean air, clean water, proper drainage

- Consists of a person's home or hospital room, as well as the total community that affects the patient's specific environment