NCM 100 Semi-Finals PDF

NCM 100 SEMI-FINALS Jamila Claire V. De Los Reyes, MSN, RN Faculty, College of Nursing  COURSE OUTLINE FOR SEMI FINALS 1.NOLA PENDER 2.MEDELEINE LEINGER 3.MARGARET NEWMAN 4.ROSEMARIE RIZZO PARSE 5.ROZZANO LOCSIN 6.IDA JEAN ORLANDO 7.JEAN WATSON NOLA PENDER (Heal...

NCM 100 SEMI-FINALS Jamila Claire V. De Los Reyes, MSN, RN Faculty, College of Nursing  COURSE OUTLINE FOR SEMI FINALS 1.NOLA PENDER 2.MEDELEINE LEINGER 3.MARGARET NEWMAN 4.ROSEMARIE RIZZO PARSE 5.ROZZANO LOCSIN 6.IDA JEAN ORLANDO 7.JEAN WATSON NOLA PENDER (Health Promotion Model) Nola Pender developed the “Health Promotion Model”in 1982. Main purpose: to plan for and change unhealthy behaviors and promote health > Her model indicates preventative health measures and describes the critical function of nurses in helping patients prevent illness by self- care and bold alternatives. > She has been named a living legend of the American Academy of nursing in 2012. > On the other hand, Health protection or illness prevention is described as: 1. behavior motivated desire to actively avoid illness (Health promotion) 2. detect it early (early detection of diseases) 3. maintain functioning within the constraints of illness (restoration while on rehabilitation) Categorized as biological, psychological and socio-cultural. These factors are predictive of a given behavior and shaped by the nature of the target behavior being considered. 1. Personal biological factors include variables such as age, gender, BMI, pubertal status, aerobic capacity, strength, agility or balance. 2. Personal psychological factors include such as self-esteem, self-motivation, personal competence, perceived health status and definition of health. 3. Personal socio-cultural factors include variables such as race, ethnicity, socio- culturation, education and socio-economic status. A. Perceived benefits of action (anticipated positive outcomes that will occur from health behavior)e.g. enough rest and sleep results to good memory functioning. B. Perceived barriers to action (anticipated imagined or real blocks and personal cost of understanding and given behavior) e.g. undergo to any surgical procedure- pain, cost or discomfort C. Perceived self-efficacy (judgment of personal capability to organize and execute a health-promoting behavior). It influences perceived barriers to action so higher efficacy results in lowered perceptions of barriers to the performance of the behavior. e.g. if a person feels poor in mathematics then the self-efficacy is low. D. Activity-related Affect > Subjective positive or negative feeling that occurs before, during and following behavior based from the stimulus properties of the behavior itself > It influences perceived self-efficacy, which means the more positive the subjective feeling, the greater the feeling of efficacy. In turn, increased feelings of efficacy can generate a further positive affect. E. Interpersonal Influences (the primary source are: Families, peers, and Health Care providers) > Cognition concerning behavior, belief, or attitudes of the others. > It includes: 1. Norms (expectations of significant others)- A pattern or trait which is standard 2. Social support (instrumental and emotional encouragement) 3. Modeling (vicarious learning through observing others engaged in a particular behavior) F. Situational Influences (Place, social, and time) > Personal perceptions and cognitions of any given situation or context that can facilitate or impede behavior. > Include perceptions of options available, demand characteristics and aesthetic features of the environment in which given health promoting is proposed to take place. > May have direct or indirect influences on health behavior. > Commitment to a plan of action= the concept of intention and identification of a planned strategy leads to the implementation of health behavior. >Immediate competing demands and preferences: A) Demands= alternative behaviors over which individuals have low control because there are environmental contingencies such as work or family care responsibilities. B) Preferences= alternative behaviors over which individual exert relatively high control, such as choice of ice cream or apple for a snack > Health-promoting behavior= is an endpoint or action outcome that is directed toward attaining positive health outcomes such as optimal wellbeing personal fulfillment, and productive living. > Was not able to define the nursing metaparadigm or the concepts that a nursing theory should have. > Her conceptual framework contains multiple concepts which may invite confusion to the readers. > Lacks emphasis to an individual currently experiencing a disease state. (prevent-promote-curative)  Madeleine Leininger (Transcultural Nursing) > She was born in Nebraska in July 13, 1925 and died on Aug. 10, 2012 due to lung failure. > Madeleine Leininger creatively developed the “Theory of Culture Care: Diversity and Universality with the goal to provide culturally congruent holistic care. Her theory is to provide care measures that are in harmony with an individual or groups' cultural belief, practices, and values. > In 1960's she coined the term culturally congruent care, which is the primary goal of transcultural nursing practice. > Culturally congruent Care is possible when the following occurs within the Nurse-Client relationship. > These definitions and the tenets are important to understand. >Understanding such key terms is crucial to - understanding the theory > The following are basic summary of the tenets: a. CARE= is to assist others with real or anticipated needs in an effort to improve a human condition of concern or to face death. b. CARING= is an action or activity directed towards providing care. c. Culture= refers to learned, shared, and transmitted values, beliefs, norms, and lifeways of a specific individual or group that guide their thinking, decisions, actions, and patterned ways of living. d. Cultural Care= refers to multiple aspects of culture that influence and enable a person or group to improve their human conditions or to deal with illness or death. e. Cultural Care Diversity= refers to the differences in meaning, values, or acceptable modes of care within or between different groups of people. f. Cultural Care Universality= refers to common care of similar meanings that are evident among many cultures. g. Nursing= is a learned profession with a disciplined focused on care phenomena. h. World view= refers to the way people tend to look at the world or universe in creating a personal view of what life is about. i. Cultural and Social Structure Dimensions= include factors related to religion, social structure, political/legal concerns, economics, educational patterns, the use of technologies, cultural values, and ethnohistory that influence cultural responses of human beings within a cultural content. j. Health= refers a state of well-being that is culturally defined and valued by a designated culture. k. Cultural Care Preservation or Maintenance= refers to nursing care activities that help people of particular cultures to retain and use core cultural care values related to Health Care concerns or conditions. l. Cultural Care Accommodation or negotiation = refers to creative nursing actions that help people of particular culture adapt to or negotiate with others in the Health Care community in an effort to attain the shared goal of an optimal health outcome for client of a designated culture. 1. Cultural Care Preservation or Maintenance= refers to nursing care activities that help people of particular cultures to retain and use core cultural care values related to Health Care concerns or conditions. 2. Cultural Care Accommodation or negotiation = refers to creative nursing actions that help people of particular culture adapt to or negotiate with others in the Health Care community in an effort to attain the shared goal of an optimal health outcome for client of a designated culture. 3. Cultural Care Repatterning or reconstructing= refers to therapeutic actions taken by culturally competent nurse(s) or family. These actions enable or assist a client to modify personal health behaviors towards beneficial outcomes while respecting the client's cultural values. * Nurses who understand and value the practice of culturally competent care are able to effect positive changes in Health Care practices for clients of designated cultures. * Sharing a cultural identity requires a knowledge of transcultural nursing concepts and principles, along with an awareness of current research findings. * Culturally competent nursing care can only occur when client beliefs and values are thoughtfully and skillfully incorporated into nursing care plans. * Caring is the core of nursing culturally competent nursing guides the nurse to provide optimal holistic, culturally based care. * These practices also help the client to care for himself and others within a familiar, supportive and meaningful cultural context. * Continual improvement and expansion of modern technologies and other nursing and general science knowledge are integrated into practice if they are appropriate. * Today nurses faced daily with unpleasant cultural d i ve rs i t y b e ca u s e o f t h e i n c re a s i n g n u m b e r o f immigrants and refugees. * Commitment to learning and practicing culturally competent care offers great satisfaction and many other rewards to those who can provide holistic supportive care to all patients. Example of unpleasant cultural diversity: > differences in speech patterns, etiquette, verbal and non verbal communication (conflict) * Her theory attempts to provide culturally congruent nursing care through “cognitively based assistive, supportive, facilitative, or enabling acts or decisions that are mostly tailor-made to fit with individual, group's, or institution's cultural values, beliefs, and life ways” Example of congruent nursing care: > demonstrate empathy in interaction with patients. > using medical translator to overcome language barrier > Implementing policies that support cultural equity in health care Margaret A. Newman's theory asserts that every person in every situation, no matter how disordered and hopeless it seems, is part of the universal process of Expanding consciousness. > She authored the theory of “health as Expanding Consciousness” The nurse’s understanding of people help them use the power within to develop the higher level of consciousness. Therefore, it helps to realize the disease process , its recovery and prevention. Newman also explains the interrelatedness of TIME, SPACE and MOVEMENT. Time and space are temporal pattern of the patient, and they have complimentary relationship. People are constantly changing through time and space, and it shows a unique pattern of reality. MOVEMENT is means whereby space and time become reality. Humankind is in a constant state of motion changing internally (at the cellular level) and externally (through body movement and interaction with the environment). This movement through time and space is what gives humankind a unique perception of reality. MOVEMENT brings change and enables the individual to experience the world. Newman explained that individuals came into being from a state of consciousness, and they are bound in TIME, found their identity in SPACE, and, throughout MOVEMENT, learned the “law” of the way that things worked; then they made choices that ultimately took t h e m b e y o n d S PA C E a n d T I M E t o a s t a t e o f A B S O LU T E CONSCIOUSNESS. Newman views the expansion of consciousness as what life and health is all about, and the SENSE OF TIME is an indicator in the changing level of consciousness. Stimulated by concerns for those whom health as the absence of disease or disability is not possible. = the nurse often relate to such people: 1. people facing the uncertainty (unpredictable) 2. debilitation (serious weakness and loss of energy) 3. loss and eventual death associated with chronic illness. (by Newman, 2010) Nurse and patient coming together and moving apart in process recognition, insight and transformation  MAJOR CONCEPTS Health is the “pattern of the whole” of a person and includes disease as a manifestation of the pattern of the whole, based on the premise that LIFE IS AN ONGOING PROCESS OF EXPANDING CONSCIOUSNESS. Newman sees life process as progression towards higher level of consciousness. Pattern is information that depicts the whole and understanding of the meaning of all relationships at once. (e.g. genetic pattern, cellular activities) Consciousness is both the informational capacity of the system and the ability of the system to interact with its environment. It includes not only cognitive and affective awareness, but also the interconnectedness of the entire living system which includes psychochemical maintenance and growth process as well as the immune system. Nursing= “is caring in the human health experience” > is seen as a partnership between the nurse and client, with both grow in the “sense of higher levels of consciousness” * Person/Human= the human is unitary, that is cannot be divided into parts, and is inseparable from the larger unitary field”. A person as individuals, and human being as a species are identified by their pattern of consciousness” Environment = is described as a “universe of open systems” Health= Health and illness are synthesized as health-the fusion on one state of being (disease) with its opposite (non-disease) results in what can be regarded as health”.  Rosemarie Rizzo Parse (Human Becoming Theory of Nursing) 1992 Originally known as MAN-LIVING-HEALTH THEORY, 1981 It believes that the human being, the environment and h e a l t h a re c l o s e l y l i n ke d , making it difficult to characterize the three concepts individually. Rosemarie Rizzo Parse theory of human becoming > guides the practice of nurses to focus on quality of life as it is described and lived... >it rates quality of life from each person’s perspective as the goal of the practice of nursing. > Man is a combination of biological, psychological, sociological and spiritual factors.  THREE THEMES OF HUMAN BECOMING 1. Meaning is choosing personal meaning in situations, and that a person’s reality is given meaning through experiences he or she lives in the environment 2. Rhythmicity cocreating rhythmical patterns of relating with the universe, and that a person and the environment cocreate in rhythmical patterns. 3. Transcendence says that Human Becoming refers to reaching beyond the limits a person sets, and that a person is constantly transforming him or herself.  METAPARADIGM person (referred to as “man” throughout the theory) as an open being who is more than and different from the sum of the parts. environment is everything in the person and his or her experiences. The environment is inseparable from the person, as well as complementary to and evolving with the person. Health is the open process of being and becoming, and involves the synthesis of values. Nursing is described as a human science and art that uses an abstract body of knowledge to help people.  The theory allows nurses to create a stronger nurse-patient relationship because the nurse is not focused on “fixing ” problems, but is viewing the patient as a whole person living experiences through his or her environment. The model gives nurses the ability to see the patient’s perspective. This allows the nurse to be “with” the patient, and guide him or her toward the health goals. The nurse-patient relationship co- creates changing health patterns.  Rozzano Locsin (Technological Competency as Caring in Nursing): Locsin’s perspective of caring and understanding human beings relates to the simultaneity paradigm. According to this paradigm people are believed to be more than just the sum of their parts. People are considered whole at all times, regardless of being sick, or if technologies are utilized on them.  The role of nursing is not to fix the broken patient or make them whole but to care and know the patient fully. He sees technology as an extension of caring that enables a greater sense of knowing. The idea of knowing is a central idea throughout Locsin’s work. Knowing is a mutual process between the nurse and those being nursed. They must come together and know each other in order to have mutual knowing and acceptance  The person being nursed is thought to be unique and necessitates creative and imaginative ways of being cared for. Today’s technologies have created innovative ways to care for such people. Locsin does not define a human being as being purely natural, but references those who have implanted devices such as cardiac pacemakers, insulin pumps and artificial limbs as also being whole is a middle range theory grounded in Nursing as Caring (Boykin & Schoenhofer, 2001). It is illustrated in the practice of nursing grounded in the harmonious coexistence between technology and caring in nursing.  The assumptions of the theory are: Persons are caring by virtue of their humanness (Boykin & Schoenhofer, 2001). Persons are whole or complete in the moment (Boykin & Schoenhofer, 2001). Knowing persons is a process of nursing that allows for continuous appreciation of persons moment to moment (Locsin, 2005). Technology is used to know wholeness of persons moment to moment (Locsin, 2004). Nursing is a discipline and a professional practice (Boykin & Schoenhofer, 2001). The focus of nursing is nurturing persons living caring and growing in caring. As an expression of nursing, caring is the intentional and authentic presence of the nurse with another person who is recognized as living caring and growing in caring. A nursing situation is a shared lived experience in which the caring between nurse and nursed enhances personhood. The nurse intentionally enters a nursing situation with the purpose of coming to know the person as caring, offering a direct invitation to the nursed to express what matters most in the moment, hearing calls for caring, and responding with caring nurturance created in the context of the nursing situation.  The PROCESS OF NURSING ACCORDING TO LOCSIN A. Knowing: The process of knowing person is guided by technological knowing in which persons are appreciated as participants in their care rather than as objects of care. B. Designing: Both the nurse and the one nursed (patient) plan a mutual care process from which the nurse can organize a rewarding nursing practice that is responsive to the patient’s desire for care.  The PROCESS OF NURSING ACCORDING TO LOCSIN C. Participation in appreciation: The simultaneous practice of conjoined activities which are crucial to knowing persons. In this stage of the process is the alternating rhythm of implementation and evaluation. D. Verifying knowledge: The continuous, circular process demonstrates the ever-changing, dynamic nature of knowing in nursing. Knowledge about the person that is derived from knowing, designing, and implementing further informs the nurse and the one nursed.  Ida Jean Orlando's Theory of Deliberative Nursing Process O r l a n d o ’s n u r s i n g t h e o r y stresses the reciprocal relationship between patient and nurse. What the nurse and the patient say and do affects them both. She views nursing’s professional function as finding out and meeting the patient’s immediate need for help.  The theory was developed in the late 1950s Categorized them and labeled as “good” and “bad” nursing. Good Nurses focused on the intermediate verbal and non-verbal behavior of the patient. Bad Nurses focus on anything unrelated to the patient's behavior.  COLLEGE OF NURSING Calayan Educational Foundation, Inc. > She proposed that “patients have their own meaning and interpretations of situations and therefore nurses must validate their inferences and analyses with patients before drawing conclusions” > It allows nurses to formulate an effective nursing care plan that can also be easily adapted when and if any complexity comes up with the patient  COLLEGE OF NURSING Calayan Educational Foundation, Inc. * The Dynamic Nurse-Patient Relationship (first book,1961) > The theory focuses on the interaction between the nurse and patient, perception validation, and the use of the nursing process to produce positive outcomes or patient improvement. > She said, nurses have to find out and meet the patient's immediate need for help.  THE MAJOR DIMENSIONS OF ORLNADO’S NURSING PROCESS THEORY The Nursing Process Discipline Theory labels the purpose of nursing to supply the help a patient needs for their needs to be met. If the patient has an immediate need for help, and the nurse discovers and meets that need, the purpose of nursing has been achieved. THE FUNCTION OF PROFESSIONAL NURSING:THE ORGANIZING PRINCIPLE Nursing is responsive to individuals who suffer or who anticipate a sense of helplessness, it focused on the process of care in an immediate experience. Concerned with providing direct assistance to a patient in whatever setting they are found to avoid, relieve, diminishing, or curing the patient’s sense of helplessness.  Presenting Behavior - Problematic Situation To find out the immediate need for help, the nurse must first recognize the situation as problematic. Both the patient and the nurse participate in the exploratory process to identify the problem as well as the solution. The nurse patient situation is a dynamic whole; each is affected by the behavior of the other. The interactions is unique for each situation. The patient’s behavior stimulates the nurse’s immediate reaction and becomes the starting point of the investigation.  Immediate Reaction - Internal Response The patient perceives objects with his or her five senses. These perceptions stimulate automatic thought, and each thought stimulates an automatic feeling, causing the patient to act. These three items are the patient’s immediate response. The immediate response reflects how the nurse experiences his or her participation in the nurse-patient relationship.  Deliberative Nursing Process - Reflective Inquiry The deliberative nursing process views the nurse patient situation as a dynamic whole. The nurse’s behavior affects the patient, and the nurse is affected by the patient’s behavior. Understanding the patient’s behavior is a complex process in which observations and thoughts are used in a serial responsive way to get the “facts of the case”.  Improvement Resolution In the resolution, the nurse’s actions are not evaluated. Instead, the result of his or her actions is evaluated to determine whether their actions served to help the patient communicate his or her need for help and how it was met. In each contact, the nurse repeats learning how he or she can help the patient. The nurse’s own individuality and that of the patient require going through this each time the nurse is called upon to render service to those who need him or her. Philosophy and Theory of Transpersonal Caring (1979-1985) Compassion is often a trait required of nurses, since taking care of patients’ needs is their primary purpose. It addresses how nurses care for their patients, and how that caring translates into better health plans to help patients get healthy. According to Watson, the major elements of her theory are: The carative factor The transpersonal caring relationship The caring occasion/ caring moment  Her main concepts include the 10 carative factors and the transpersonal caring relationship, caring moment, caring occasion, caring healing modalities, caring consciousness. She described a “transpersonal caring relationship” as foundational to her theory; it is a special kind of human care relationship—a union with another person— high regard for the person. Set the foundation for the caring-loving relationship essential to nursing practice.  10 Carative Factor The formation of humanistic-altruistic system of values The instillation of faith-hope The cultivation of sensitivity to one’s self and to others The development of a helping-trust relationship The promotion and acceptance of the expression of positive and negative feelings  The systematic use of the scientific problem-solving method for decision making The promotion of interpersonal teaching-learning The provision for a supportive, protectie, and corrective mental, physical,sociocultural, and spiritual environment Assistance with the gratification of human needs The allowance of existential-phenomenological forces; became “allowance for existential-phenomenological spiritual forces” (2004)  Transpersonal means to go beyond one’s own ego and the here and now, as it allows one to reach deeper spiritual connections in promoting the patient’s comfort and healing. The GOAL of a transpersonal caring relationship corresponds to protecting, enhancing, and preserving the person’s dignity, humanity, wholeness and inner harmony. According to Watson, a caring occasion is the moment (focal point in space and time) when the nurse and another person come together in such a way that an occasion for human caring is created. Watson insist that the nurse, also needs to be aware of her own consciousness and authentic presence of being in a caring moment with her patient.  Transpersonal Caring Relationship For Watson, the transpersonal caring relationship characterizes a special kind of human care relationship that depends on: The nurse moral commitment in protecting and enhancing human dignity as well as the deeper/higher self The nurse caring consciousness communicated to preserve and honor the embodied spirit, therefore, not reducing the person to the moral status of an object The nurse caring consciousness and connection having the potential to heal since experience, perception, and intentional connection are taking place. “The nurse’s caring consciousness becomes essential for the connection and understanding of the other person’s perspective”  Metaparadigm of Watson She uses society instead of environment T h e s o c i e t y p r o v i d e s t h e va l u e s t h a t determine how one should behave and what goals one should strive toward. Environment A caring attitude is not transmitted from generation to generation by genes. The culture of the profession transmits it as a unique way of coping with its environment.”  Metaparadigm of Watson She used Human being A human is viewed as greater than and different from the sum of his or her parts. Human being is a valued person to be cared Person for, respected, nurtured, understood, and assisted; in general, a philosophical view of a person as a fully functional integrated self  Metaparadigm of Watson Health is the unity and harmony within the mind, body, and soul defined as a high level of overall physical, mental, and social functioning; a general Health adaptive-maintenance level of daily functioning; and the absence of illness  Metaparadigm of Watson is a human science of persons and human health-illness experiences mediated by professional, personal, scientific, esthetic, and ethical human care transactions. Nursing Nursing is concerned with promoting health, preventing illness, caring for the sick and restoring health. It focuses on health promotion and treatment of disease.She believes that h o l i s t i c h e a l t h c a r e i s c e n t ra l t o t h e practiceof caring in nursing  COLLEGE OF NURSING Calayan Educational Foundation, Inc. For Final term: THEORIES RELEVANT TO NURSING PRACTICE