168540329 nursing theories
TRANSCRIPT
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THEORETICALFOUNDATIONS OF
NURSING
Contessa M. Gabriel, RM,RN,MANProfessor
Ramon Magsaysay Technological University ba Zambales
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A. ENVIRONMENTAL THEORY
Florence Nightingale (1860)
“I think one’s feelings waste themselves in words;
they ought all to be distilled into actions which
bring results.”
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Florence Nightingale (1860)
Florence Nightingale defined Nursing“ the
act of utilizing the environment of the patient
to assist him in his recovery” (1860/1969) ,
that it involves the nurse 's initiative to
configure environmental settings
appropriate for the gradual restoration of the
patient's health, and that external factors
associated with the patient's surroundingsaffect life or biologic and physiologic
processes , and his development.
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Disease is a reparative process, and that the
manipulation of the environment - ventilation,
warmth, light, diet, cleanliness, and noise - would
contribute to the process and health of the patient·
Did not agree with the “germ theory of disease”
although she accepted the ill effects ofcontamination from organic materials from the
patients and the environment hence found
sanitation as important·
Also renowned for pioneering statistical analysisof healthcare.
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Environmental Factors Affecting Health:
pure or fresh air pure water
sufficient food supplies
efficient drainage
Cleanliness
light (especially direct sunlight )
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Adequate ventilation has also been regardedas a factor contributing to changes of the
patient’s process of illness recovery. Any
deficiency in one or more of these factorscould lead to impaired functioning of life
processes or diminished health status.
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She also emphasized in her environmentaltheory is the provision of a quiet or noise-
free and warm environment, attending to
patient’s dietary needs by assessment,documentation of time of food intake, and
evaluating it’s effects on the patient.
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Nightingale believed that the environment
was the major component creating illness ina patient; she regarded disease as “the
reactions of kindly nature against the
conditions in which we have placed
ourselves.” Her theory Contains three major
relationships:
1) environment to patient
2) nurse to environment
3) nurse to patient
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B. INTERACTIVE THEORIES
Hildegard Peplau (1952)
“The kind of person that the nurse
becomes makes a substantial differencein what each patient will learn as he or
she receives nursing care.”
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Hildegard Peplau (1952)
Psychodynamic Nursing; Mother of Psychiatric Nursing
She defined Nursing a s 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.”
Stressed the importance of the nurse’s ability tounderstand one’s own behavior to help others
identify felt difficulties.
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Dr. Peplau emphasized the nurse-client
relationship as the foundation of nursing practice. At the time, her research and
emphasis on the give-and-take of nurse-
client relationships was seen by many asrevolutionary. She described the nurse-
patient relationship as a four-phase
phenomenon. Each phase is unique and has
distinguished contributions on the outcome
of the nurse-patient interaction.
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Phases Of Nurse-Patient Relationship
1. Orientation Individual/family has a “felt need” and seeks
professional assistance from a nurse (who is a
stranger). This is the problem identification
phase.
2. Identification
Where the patient begins to have feelings of
belongingness and a capacity for dealing with the problem, creating an optimistic attitude from
which inner strength ensues. Here happens the
selection of appropriate professional assistance.
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3. Exploitation
The nurse uses communication tools to offerservices to the patient, who is expected to take
advantage of all services.
4. Resolution
Where patient’s needs have already been met by
the collaborative efforts between the patient and
the nurse.
Therapeutic relationship is terminated and thelinks are dissolved, as patient drifts away from
identifying with the nurse as the helping person.
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3. Teaching Role: Gives instruct ions and provides training;
involves analysis and synthesis of the learner’s experience.
4. Counseling Role: Helps client understand and integrate the
meaning of current life circumstances; provides guidance
and encouragement to make changes.
5. Surrogate Role: Helps clients clarify domains of
dependence, interdependence, and independence and acts
on clients behalf as advocate.
6. Leadership Role: Helps client assume maximum
responsibility for meeting treatment goals in a mutually
satisfying way.
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Additional Roles include:
1) Technical expert
2) Consultant
3) Health teacher
4) Tutor
5) Socializing agent
6) Safety agent
7) Manager of environment
8) Mediator9) Administrator
10) Recorder observer
11) Researcher
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“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, a means of locomotion for the infant, knowledge and confidence for the mother, the
mouthpiece for those too weak or withdrawn to speak and so
on.”
Virginia Henderson (1955)
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Henderson defined Nursing as “ assistingthe individual, sick or well, in the
performance of those activities contributing
to health or it’s recovery (or to peacefuldeath) that an individual would perform
unaided if he had the necessary strength,
will or knowledge”.
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“The unique function of the nurse is to
assist the individual, sick or well, in the performance of those activities contributing
to health or to recovery (or to a peaceful
death) that he would perform unaided if hehad the necessary strength, will, or
knowledge and to do this in such a way as
to help him gain independence as rapidly as
possible”
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8) Keeping the body c lean and well – groomed
9) Avoiding dangers in the environment10) Communicating with others
11) Worshipping according to one’s faith
12) Working in such a way that one feels a sense of
accomplishment13) Playing/participating in various forms of recreation
14) Learning, discovering or satisfying the curiosity that
leads to normal development and health and using
available health facilities.
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The Nurse-Patient Relationship:
Henderson stated that there are three levels
comprising the nurse-patient relationship:
1. The nurse as a substitute for the patient. In
times of illness, when the patient cannot functionfully, the nurse serves as the substitute as to what
the patient lacks such, as knowledge, will, and
strength in order to make him complete, whole
and independent once again.
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2. The nurse as a helper to the patient. In
situations where the patient cannot meet his basicneeds, the nurse serves as a helper to accomplish
them.
3. The nurse as a partner with the patient. As
partners , the nurse and the patient formulate the
care plan together. Both as an advocate and as a
resource person, the nurse can empower the
patient to make effective decisions regarding hiscare plans.
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Dynamic Nurse-Patient Relationship
“The role of the nurse is to find out and meet the
patient's immediate need for help. The patient's
presenting behavior may be a plea for help,however, the help needed may not be what
it appears to be.”
Ida Jean Orlando (1961)
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Nursing Process; Dynamic Nurse-Patient
Relationship
Orlando 's theory was developed in the late 1950s
from observations she recorded between a nurse
and patient.
Despite her efforts, she was only able to
categorize the records as "good" or "bad" nursing.
It then dawned on her that both the formulations
for "good" and "bad" nursing were contained inthe records. From these observations she
formulated the deliberative nursing process.
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Therefore, nurses need to use their perception, thoughts
about the perception, or the feeling engendered from theirthoughts to explore with patients the meaning of their
behavior. This process helps the nurse find out the nature
of the distress and what help the patient needs.
Orlando's theory remains one the of the most effective
practice theories available. The use of her theory keeps the
nurse's focus on the patient. The strength of the theory is
that it is clear, concise, and easy to use. While providing
the overall framework for nursing, the use of her theory
does not exclude nurses from using other theories whilecaring for the patient.
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Focused on patient’s verbal and nonverbal expressions of
need and the nurse’s reactions to the behavior
3 Elements of a Nursing Situation
1) Patient behaviors
2) Nurse reactions
3) Nurse actions Used the nursing process to meet patient’s needs through
deliberate action; advanced nursing beyond automatic
response to disciplined and professional response
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The major purpose of care is to achieve an
interpersonal relationship with theindividual that will facilitate the
development of the core.
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The theory consists of 3 major tenets:
The nurse functions differently in the 3 interlockingaspects of the patient:
1) Cure (Disease) shared with doctors
2) Core (Person) addressed by therapeutic use of self; shared
with psychiatry/psychology, religious ministry, etc.3) Care (Body) exclusive to nurses; involves intimate bodily
care like feeding, bathing and toileting
As the patient needs less medical care, he needs more
professional nursing careWholly professional nursing care will hasten recovery
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Joyce Travelbee (1966)
Human-to-Human Relationship Model“A nurse does not only seek to alleviate physical
pain or render physical care- she ministers to the
whole person. The existence of suffering, whether
physical, mental or spiritual is the proper concern
of the nurse.”
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Travelbee's experience in initial psych nursing practice at a
Catholic charity hospital led her to believe that the caregiven in these type of institutions lacked compass ion. She
felt nursing needed “ humanistic revolution" and a
renewed focus on caring as central to nursing--she
warned that if this didn't happen, consumers might seek a
"new and different kind of health care worker". Travelbee's ideas have greatly influenced the hospice movement.
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In her human-to-human relationship model, the nurse and
the patient undergoes the following series of interactional
phases:1) 1. Original Encounter- this is described as the first
impression by the nurse of the sick person and vice versa.
The nurse and patient see each other in stereotyped or
traditional roles.2) 2. Emerging Identities- this phase is described by the
nurse and patient perceiving each other as unique
individual. At this time, the link of relationship begins to
form.3) 3. Empathy- this phase is described as the ability to share
in the person’s experience.
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4. Sympathy- I t happens when the nurse wants to lessen the
cause of the patient’s suffering. It goes beyond empathy.
The nurse at this time should use a disciplined intellectualapproach together with therapeutic use of self to make
helpful nursing actions.
5. Rapport- this is described as nursing interventions that
lessens the patient’s suffering. The nurse and the sick person are relating as human being to human being. The
sick person shows trust and confidence in the nurse.
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Betty Neuman (1972)
“Health is a condition in which all parts and subparts
are in harmony with the whole of the client”
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Her theory incorporated the concept of a whole
person and an open system approach. The conceptis aimed towards the development of a person in a
state of wellness having the capacity to function
optimally. The main role of the nurse in her theory
is to help a person to adapt with environmental
stimuli causing illnesses back to a state of
wellness.
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Terms Related to Neuman’s System Theory Client
Variables
The clients’ variables can be one or combination of
the following: physiological, sociocultural, developmental
and spiritual. These variables function to achieve
stability in relation to the environmental stressors
experienced by the client.
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Lines of Resistance
Lines of Resistance act when the Normal Line of Defense
is invaded by too much stressor, producing alterations in
the client’s health.
Normal Line of Defense
To achieve the stability of the system, the Normal Line ofDefense must act in coordination with the normal wellness
state. It must reflect the actual range of responses that is
normally acted by clients in response to any stressors. It is
the baseline in determining the level of client within the
continuum of health.
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Flexible Line of Disease
It serves as a boundary for the Normal Line ofDefense to adjust to situations that threaten the
imbalance within the client’s stability.
Stressors
These are forces that produce tensions, alterations
or potential problems causing instability within the
client’s system.
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Reaction
These are the outcomes or produced results ofcertain stressors and actions of the lines resistance
of a client. It can be positive or negative
depending on the degree of reaction the client
produces to adjust and adapt with the
situation . Neuman specified these reaction as
negentropy or egentropy. Negentropy is set
towards stability or wellness while Egentropy is set towards disorganization of the system
producing illness.
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Dorothy Johnson (1971) Behavioral System Model
“Each individual has a predisposition to act, with
reference to the goal, in certain ways rather than in
other ways”
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Johnson believes that each individual has a
focusing and repeating ways of acting whichcovers a behavioral system distinct to that
individual. These behaviors are logical, fixed,
predictable and adequately secure and persistent to
be satisfying to depiction and clarification.
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Considered attachment or affiliative subsystem as
cornerstone of social organizations
Nursing problems arise because there are disturbances in
the structure or function of the subsystems:
1) Dependency
2) Achievement
3) Aggressive
4) Ingestive
5) Eliminative
6) Sexual
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Seven Behavioral Subsystems
1. The Attachment or Affiliative Subsystem iswell known as the earliest response system to expand
in the individual. The most favorable functioning
of this subsystem allows social inclusion,
closeness, and the pattern and continuance of astrong public bond.
2. The Dependency Subsystem are act ions that
trigger nurturing behaviors from other individuals
in the environment. The product of dependency
behavior is consent, interest or appreciation, and
physical support.
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5. The Sexual Subsystem imitates behaviors real ted to
procreation or reproduction.6. The Aggressive Subsystem relates to behaviors
concerned with the defense and self-preservation.
7. The Achievement Subsystem contains behaviors that
attempt to control the environment. Intellectual, physical,imaginative, mechanical, and communication skills are
some of the areas that Johnson distinguishes.
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Imogene King (1971) Goal Attainment Theory
“If the students can’t do the fundamentals,
how can they use advanced knowledge.”
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Interacting Systems Framework; Goal Attainment
Theory
Nursing is a process of human interaction between
nurses and patients who communicate to set goals,
explore means of attaining goals, and agree onwhat means to use
Perceptions, judgment and actions of nurse and
patient lead to reaction, interaction and transaction
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King stated that Nursing is a process of action, reaction,
and interaction whereby nurse and client share
information about their perception in the nursing situation.
Action
Action is a means of behavior or activities that are
towards the accomplishment of certain act. It is both physical
and mental.
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Reaction
In King’s theory, reaction is not specified butsomehow relates reaction as part of action.
According to her, reaction is a response to a
stimuli.
Interaction
Interaction, as defined by King, is any situation
wherein the nurse relates and deals with a clienteleor patient.
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Open System
It is the absence of boundary existence, where adynamic interaction between the internal and
external environment can exchange information
without barriers or hindrances.
King proposed that the nurse interacts in the
system simultaneously at three different levels.
These levels are independent and at the same timeco-exist to influence over-all nursing practice.
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Interacting systems:
1) Personal- how the nurse views and integrates self based
from personal goals and beliefs.
perception, self, body image, growth and development.
2) Interpersonal- how the nurse interrelates with a
coworker or patient, particularly in a nurse-patient
relationship.
role, interaction, communication, transaction, and stress.
3) Social- how the nurse interacts with co-workers,
superiors, subordinates and the client environment in
general
organization, power-authority status, decision making.
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Dorothea Orem (1971)
“Individuals, families, groups and communities need
to be taught self-care.”
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Orem defined Nursing as “The act of assisting others in
the provision and management of self-care to
maintain/improve human functioning at home level ofeffectiveness.”
The theory focuses on activities that adult individuals
perform on their own behalf to maintain life, health andwell-being. It has a strong health promotion and
maintenance focus.
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She identified 3 related concepts:
1. Self-care - activities an Individual performsindependently throughout life to promote and
maintain personal well-being.
2. Self-care deficit - results when self - care agency
(Individual’s ability) is not adequate to meet the
known self-care needs.
3. Nursing System - nursing interventions needed
when Individual is unable to perform thenecessary self-care activities:
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1) Wholly Compensatory - do for the patient.
nurse provides entire self-care for the client. Example: care of a new born , care of client recovering
from surgery in a post-anesthesia care unit
2) Partly Compensatory - help the patient do for himself.
nurse and client perform care, client can perform selectedself-care activities, but also accepts care done by the nurse
for needs the client cannot meet independently.
Example: Nurse can assist post operative client to
ambulate, Nurse can bring a meal tray for client who canfeed himself.
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3) Supportive Educative - help the patient learn to do for
himself; nurse has important role in designing nursingcare.
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.
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Faye Glen Abdellah (1960)
Twenty-One Nursing Problems
“I never wanted to be a medical doctor because I
could do all I wanted to do in nursing, which is acaring profession.”
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Problem solving was seen as the way of
presenting nursing(patient) problems as the patient
moved towards health.
Contributed to nursing theory development
through the systematic analysis of research reports
to formulate the 21 nursing problems that served
as an early guide for comprehensive nursing care
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Typology of Twenty-one Nursing Problems
1) To maintain good hygiene.
2) To promote optimal activity; exercise, rest and sleep.
3) To promote safety.
4) To maintain good body mechanics
5) To facilitate the maintenance of a supply of oxygen6) To facilitate maintenance of nutrition
7) To facilitate maintenance of elimination
8) To facilitate the maintenance of fluid and electrolyte
balance
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9) To recognize the physiologic response of the body to
disease conditions.10) To facilitate the maintenance of regulatory mechanisms
and functions.
11) To facilitate the maintenance of sensory functions
12) To identify and accept positive and negative expressions,feelings and reactions
13) To identify and accept the interrelatedness of emotions
and illness.
14) To facilitate the maintenance of effective verbal and non-verbal communication
15) To promote the development of productive in terpersonal
relationship
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16) To facilitate progress toward achievement of personal
spiritual goals
17) To create and maintain a therapeutic environment
18) To facilitate awareness of self as an individual with
varying needs.
19) To accept the optimum possible goals20) To use community resources as an a id in resolving
problems arising from illness.
21) To understand the role of social problems as influencing
factors
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Ernestine Wiedenbach (1964) Helping Art of Clinical Nursing
"My thesis is that nursing art is not comprised of rational
nor reactionary actions but rather of deliberative action."
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“…nursing is nurturing or caring for someone in a
motherly fashion.” Proposed that nurses identify patient’s need-for-
help by:
1) Observing behaviors regarding comfort
2) Exploring meanings of the behavior
3) Knowing the cause of discomfort
4) Knowing if they can solve on their own or need
help
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Wiedenbach conceptualizes nursing as the practice
identification of a patient’s need for help through
observation of presenting behaviors and symptoms,
exploration of the meaning of those symptoms with t he
patient, determining the cause(s) of discomfort, and
determining the patient’s ability to resolve the discomfort
or if the patient has a need for help from the nurse or otherhealthcare professionals.
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According to Wiedenbach there are four elements to
clinical nursing (1): philosophy, (2) purpose, (3)
practice, and (4) art. The nurses ’ philosophy was their attitude and belief about
life and how that effected reality for them. Philosophy is
what motivates the nurse to act in a certain way.
Wiedenbach also believed that there were 3 essentialcomponents associated with a nursing philosophy:
1) Reverence for life
2) Respect for the dignity, worth, autonomy and
individuality of each human being3) Resolution to act on personally and professionally held
beliefs
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Nurses ’ purpose is that which the nurse wants to
accomplish through what she does. It is all of the activities
directed towards the overall good of the patient. Practices are those observable nursing actions that are
affected by beliefs and feelings about meeting the patient’s
need for help.
The Art of nursing includes understanding patient’s needsand concerns, developing goals and actions intended to
enhance patient’s ability and directing the activities related
to the medical plan to improve the patient’s condition.
The nurses also focuses on prevention of complicationsrelated to reoccurrence or development of new concerns.
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Myra Estrin Levine (1977)
The Conservation Model
"Ethical behaviour is not the display of one's moral rectitude
in times of crisis. It is the day-to-day expression of one's
commitment to other persons and the ways in which human
beings relate to one another in their daily interactions.”
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She defined nursing as supportive & therapeutic
interventions based on scientific or therapeutic knowledge. Nursing actions based on four principles:
1) conservation of energy
2) structural integrity
3) personal integrity
4) Social integrity
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Major Concepts:
1) Wholism (Holism)
2) Adaptation - process whereby patients retain integrity; establish body economyto safeguard stability:
a) Environment
b) Organismic Response - (1)Fight or flight, (2)inflammatory response,
3)response to stress, (4)perceptual awareness
c) Trophicogenesis - alternative to nursing diagnosis
3) Conservation - 4 principles of conservation - Nursing intervention is based on
the conservation of the patients:
1) Energy
2) Structural Integrity
3) Personal Integrity
4) Social Integrity
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Sister Callista Roy (1979)
Adaptation Model
“The model provides a way of thinking about people
and their environment that is useful in any setting. It
helps one prioritize care and challenges the nurse tomove the patient from survival to transformation.”
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The degree of internal or external environmental change
and the person’s ability to cope with that change is likelyto determine the person’s health status. Nursing
interventions are aimed at promoting physiologic,
psychologic, and social functioning or adaptation.
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Madeleine Leininger (1985)
Transcultural Theory
“Care is the heart of nursing; Care is power; Care is
essential to healing; Care is curing; and Care is the
central and dominant focus of nursing and transcultural
nursing decisions and actions.”
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She stated that Nursing is a learned humanistic and
scientific profession and discipline which is focused onhuman 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.
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Transcultural nursing as 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. It focuses on the fact that different cultureshave different caring behaviors and different health and
illness values, beliefs, and patterns of behaviors.
Awareness of the differences allows the nurse to design
culture-specific nursing interventions.
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Margaret Jean Watson (1979)
Philosophy and Science of Caring
“Caring in nursing conveys physical Acts but embraces
the mind-body-spirit as it reclaims the embodied spirit as
its focus attention.”
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Philosophy and Science of Caring; Carative Factors
Caring is a universal social phenomenon that is onlyeffective when practiced interpersonally. Nurses should be
sensitized to humanistic aspects of caring.
Watson proposes seven assumptions about the science of
caring and ten primary carative factors to form theframework of her theory. The basic assumptions are:
1) Caring can be effectively demonstrate d and practiced
only interpersonally;
2) Effective caring promotes health and individual or familygrowth;
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3) Caring responses accept a person not only a s he or she is now but as what he
or she may become;
4) A caring environment is one that offers the development of potential while
allowing the person to choose the best action for himself or herself at a given
point in time
5) Caring is more “healthogenic” than is curing. The practice of caring integrates
biophysical knowledge of human behavior to generate or promote health and
to provide care to those who are ill. A science of caring is therefore
complementary to the science of curing.6) The practice of caring is central to nursing.
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Ten Carative Factors
1. The promotion of a humanistic - altruistic sys tem of values2. Instillation of faith - hope
3. The cultivation of sensitivity to one’s self and others
4. The development of a helping-trusting, human caring
relationship
5. Promotion and acceptance of the express ion of positive
and negative feelings.
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6. The systemic use of the scientific problem-solving method
for decision making
7. The promotion of interpersonal teaching- learning
8. The provision for supportive , protective and corrective
mental, physical, socio-cultural and spiritual environment
9. Assistance with the gratification of human needs
10.The allowance for existential phenomenological forces
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Martha Rogers (1970)
The Science of Unitary Human Beings, and Principles of
Homeodynamics
“Nursing is an art and science that is humanistic and
humanitarian. It is directed toward the unitary human and isconcerned with the nature and direction of human
development.”
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Nursing interventions seek to promote harmonious
interaction between persons and their environment,
strengthen the wholeness of the individual and redirecthuman and environmental patterns or organization to
achieve maximum health.
There are 5 Basic Assumptions:
1. The human being is a unified whole , possessing individual
integrity and manifesting characteristics that are more than
and different from the sum of parts.
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2. The individual and the environment are continuously
exchanging matter and energy with each other3. The life processes of human beings evolve irreversibly
and unidirectionally along a space-time continuum
4. Patterns identify human being and reflect their innovative
wholeness
5. The individual is characterized by the capacity for
abstraction and imagery, language and thought,
sensation and emotion
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Rosemarie Rizzo Parse (1981)
Theory of Human Becoming
“Nursing is a scientific discipline, the practice of
which is a performing art.”
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Three assumptions about Human Becoming
1) Human becoming is freely choosing personal meaning in
situation in the inter-subjective process of relating value
priorities
2) Human becoming is co-creating rhythmic pat terns or
relating in mutual process in the universe
3) Human becoming is co- transcending multidimensionally
with emerging possibilities.
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A unique, humanistic approach instead of a physiological basis for
nursing
Nursing is a human science that is not dependent on medicine or anydiscipline for its practice.
Major concepts include:
1) Imaging
2) Connecting-separating
3) Valuing
4) Powering
5) Languaging
6) Originating
7) Revealing-concealing8) Transforming
9) Enabling-limiting
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Merle Mishel - Uncertainty in Illness
Researched into experiences with
uncertainty as it relates to chronic and life-
threatening illness
Later reconceptualized to accommodate the
responses to uncertainty over time in people
with chronic conditions who may notresolve the uncertainty
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Margaret A. Newman - Model of Health
Major concepts are movement, time, space and
consciousness. “Movement is a reflection of
consciousness. Time is a function of movement. Time is a
measure of consciousness.”
The goal of nursing is not to promote wellness or to prevent illness, but to help people use the power within
them as they evolve toward a higher level of
consciousness.
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Evelyn Adam - Conceptual Model for Nursing
Used a model from Dorothy Johnson and definition ofnursing from Virginia Henderson
Identified assumptions, beliefs, and values, and major units
Included goal of the profession, beneficiary of the
professional service, role of the professional, source of the beneficiary’s difficulty, the intervention of the
professional, and the consequence.
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Nola J. Pender - Health Promotion Model
The goal of nursing care is the optimal health of the
individual
Developed the idea that promoting optimal health
supersedes disease prevention
Identifies cognitive-perceptual factors of a person, like
importance of health-promotion behavior and its perceived
barriers, and these factors are modified by demographics,
biology, interpersonal influences, and situational and
behavioral factors.
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Katherine Kolcaba - Theory of Comfort
Defined healthcare needs as those needs for comfortincluding physical, psycho-spiritual, social, and
environmental needs
Intervening factors influence client’s perception of
comfort: age, attitude, emotional support, experience,finance, prognosis
Types of comfort:
1) Relief when specific need is fulfilled
2) Sense of ease, calm, and contentment3) Transcendence or rising above the problems of pain
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Erikson, Tomlin and Swain - Modeling and Role-
Modeling
Synthesis of multiple theories related to basic needs,
developmental tasks, object attachment, and adaptive
coping potential
Views nursing as self-care based on the person’s
perception of the world and adaptation to stressors
Promotes growth and development while recognizing
individual differences according to worldview and inherent
endowment
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Ramona Mercer - Maternal Role
AttainmentFocused on parenting and maternal role
attainment in diverse populations
Developed a complex theory to explain thefactors impacting the maternal role over
time
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Kathryn Barnard - Parent-Child Interaction;
Child Health Assessment Interaction Theory Individual characteristics of each member
influence the parent-infant system and that
adaptive behavior modifies those characteristics to
meet the needs of the system
The theory is based on scales developed to
measure feeding, teaching, and environment
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Patricia Benner - Novice to Expert
Validated the Dreyfus Model of SkillAcquisition in nursing practice with the
systematic description of the 5 stages
(Novice, Advanced beginner, Competent,Proficient, and Expert)
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Roper, Logan, and Tierney - Model for Nursing Based on a Model of Living
Conceptual Components
12 Activities of Living (AL) - complex process of living in the view of anamalgam of activities
1) Maintain safe environment
2) Temperature
3) Communicate
4) Mobility
5) Breathe
6) Work and play
7) Eat and drink
8) Express sexuality
9) Eliminate10) Sleep
11) Personal cleansing and dressing
12) Dying
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Life span - concept of continuous change from birth to
death
Dependence-independence continuum
5 factors influencing AL: Biological, Psychological, Socio-
cultural, Environmental, Politicoeconomic.
The individuality of living is the way in which the
individual attends to ALs in regard to place on life span
and dependence-independence continuum and as
influenced by the 5 factors
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