Copy of Nursing Conceptual Model 2_Group 3.pdf

GROUP 3 NURSING CONCEPTUAL MODEL 2  INTRODUCTION The conceptual model of nursing serves as a structured framework for nurses to reflect upon, observe, and interpret various phenomena encountered in their practice.  OBJECTIVES At the end of the lesso...

GROUP 3 NURSING CONCEPTUAL MODEL 2  INTRODUCTION The conceptual model of nursing serves as a structured framework for nurses to reflect upon, observe, and interpret various phenomena encountered in their practice.  OBJECTIVES At the end of the lesson, the students would be able to: Explain various conceptual models in nursing and recognize which model is used in different nursing field. Identify the theorist behind every different theory. Apply the proper conceptual paradigm in nursing practice. NEUMAN’S MODEL SYSTEM The Neuman Systems Model is based on a holistic philosophy that integrates wellness, client perception and motivation, and a dynamic view of how energy and environmental interactions affect health. “I believe that the model is relevant for the future because of its dynamic and systematic nature; its concepts and propositions are timeless”. (Neuman, 2011) BETTY NEUMAN System Model  BETTY NEUMAN BORN Born: September 11, 1924 in Marietta, Ohio EDUCATION 1942: graduated from high school 1947: graduated from diploma program of People's Hospital in Akron, Ohio 1956: entered the baccalaureate program at the University of California- Los Angeles School of Nursing 1957: B.S. in public health nursing 1964-1966) she did graduate work in UCLA's program in Mental Health/Public Health CAREER 1944: she joined the Cadet Nurse Training Program 1947: work as a staff nurse, advancing to head nurse, in the communicable disease department of the Los Angeles General Hospital. Practiced bedside nurse as a staff, head & private duty nurse Community health nursing: school and industrial nurse 1973: state mental health consultant BOOK 1972: Nursing Research The Neuman Systems Model three editions Chapter's in Conceptual models for nursing practice & Nursing Theories and Practice  UNIQUIE PERSPECTIVE OF THE NEUMAN SYSTEM MODEL 1. Individual Uniqueness: Each client system is unique, composed of common factors within a normal response range. 2. Dynamic Interaction: Clients are constantly exchanging energy with their environment. 3. Stressors: Both known and unknown environmental stressors affect the client's stability and can challenge the flexible line of defense. 4. Normal Line of Defense: Each client has a typical wellness state that evolves over time through stress management, serving as a benchmark for assessing health deviations.  UNIQUIE PERSPECTIVE OF THE NEUMAN SYSTEM MODEL 5. Reaction to Stressors: When the flexible line of defense is overwhelmed, stressors breach the normal line of defense, with the client’s reaction influenced by various physiological, psychological, sociocultural, developmental, and spiritual factors. 6. Wellness Continuum: Wellness is a dynamic continuum of available energy to maintain stability, influenced by multiple factors. 7. Lines of Resistance: Internal resistance factors help stabilize and restore the client to their usual or improved wellness state after a stressor.  UNIQUIE PERSPECTIVE OF THE NEUMAN SYSTEM MODEL 8. Primary Prevention: Involves general knowledge applied to client assessment and intervention to identify and mitigate potential risk factors associated with environmental stressors, aiming to prevent reactions. Health promotion is a key aspect. 9. Secondary Prevention: Focuses on addressing symptoms after a reaction to stressors, prioritizing interventions, and treating to minimize harmful effects. 10. Tertiary Prevention: Relates to adaptive processes during reconstitution, moving the client back towards primary prevention by addressing maintenance factors. OPEN SYSTEM STRESSED AND REACTION FUNCTION OR PROCESS INPUT AND OUTPUT FEEDBACK SYSTEM  NEGENTROPY This refers to the process of energy conservation that helps the system progress towards stability or wellness. STABILITY stability is a dynamic and desirable state of balance where energy exchanges occur smoothly, maintaining the system’s integrity and moving towards optimal health. CREATED ENVIRONMENT The client unconsciously shapes the created environment to symbolically represent the completeness of the system. CLIENT SYSTEM The client system is a composite of five interacting variables— physiological, psychological, sociocultural, developmental, and spiritual—within the environment.  VARIABLES Physiological Variable: Refers to body structure and function. Psychological Variable: Involves mental processes interacting with the environment. Sociocultural Variable: Addresses the impact of social and cultural conditions. Developmental Variable: Relates to age-related processes and activities. Spiritual Variable: Concerns spiritual beliefs and influences.  STRESSOR Stressors are tension-producing stimuli that have the potential to disrupt system stability, leading to an outcome that may be positive or negative. They may arise from the following: - Intrapersonal - Interpersonal - Extrapersonal DEGREE OF REACTION The degree of reaction represents system instability that occurs when stressors invade the normal line of defense PREVENTION AS INTERVENTION Interventions are purposeful actions to help the client retain, attain, or maintain system stability. They can occur before or after protective lines of defense and resistance are penetrated. Neuman supports beginning intervention when austressor is suspected or identified. Interventions are based on possible or actual degree of reaction, resources, goals, and anticipated outcomes. Neuman identifies three levels of intervention: (1) primary, (2) secondary, and (3) tertiary  LEVEL OF PREVENTION Primary Prevention: Applied when a stressor is suspected but has not yet caused a reaction. Its goal is to reduce the likelihood of encountering the stressor or minimize the chance of a reaction. Secondary Prevention: Involves interventions after stress symptoms have appeared. It focuses on using the client’s internal and external resources to strengthen resistance and manage symptoms. Tertiary Prevention: Occurs after initial treatment or secondary prevention. It aims to readjust the client system towards optimal stability, prevent recurrence of issues, and ultimately circles back to primary prevention to maintain wellness. RECONSTITUTION Reconstitution occurs after treatment for stressor reactions. It represents return of the system to stability, which may be at a higher or lower level of wellness than before stressor invasion. SISTER CALISTA ROY Adaption Model  SISTER CALISTA ROY BACKGROUND 1963: Bachelor's degree in nursing from Mount Saint Mary's College in Los Angeles 1966: Master's degree in nursing from the University of California, Los Angeles 1973: Master's degree in sociology from University of California 1977: Doctorate degree in sociology from the University of California OCTOBER 14, 1939 AT LOS ANGELES CALISTA ROY’S BELIEF "I believe that theory is vital to the development of an autonomous and accountable nursing profession... believe that the model is relevant for the future because of its dynamic and systemic nature; its concepts and propositions are timeless" (Neuman,2011, p. 318) CAREER She is a highly respected nurse theorist, writer, lecturer, researcher, and teacher. She is currently Professor and Nurse Theorist at the Connell School of Nursing at Boston College. Roy holds concurrent appointments as Research Professor in Nursing at her alma mater, Mt. Saint Mary's College, Los Angeles, CA, and as Faculty Senior Scientist, Yvonne L. Munn Center for Nursing Research, Massachusetts General Hospital, Boston, MA. Roy has been a member of the Sisters of St. Joseph of Carondolet for more than 50 years THEORITICAL SOURCES Roy's Adaptation Model, developed in 1964, integrates Harry Helson's Adaptation Theory with Rapport's system definition. Contributed by over 1,500 faculty and students, it incorporates A.H. Maslow's concepts for a holistic approach to nursing practice, research, and education.  USE OF EMPIRICAL EVIDENCE Initial Research: A pilot study and survey research conducted from 1976 to 1977 provided preliminary support for the model Ongoing Support: Since then, the adaptation model has been validated through continued research in both practice and education. 7 MAJOR CONCEPT AND DEFINITION SYSTEM ADAPTION MODEL ADAPTION PROBLEM STIMULUS SUBSYSTEMS RESPONSES ADAPTIVE MODE SYSTEM ADAPTIVE LEVEL ADAPTIVE PROBLEM STIMULUS Focal Stimulus Contextual Stimuli Residual Stimuli RESPONSES Adaptive Responses Ineffective Responses MAJOR ASSUMPTIONS ASSUMPTIONS PHILOSOPIC ASSMPTIONS SCIENTIFIC ASSUMPTIONS CULTURAL ASSUMPTIONS  ASSUMPTIONS Person: A bio-psycho-social being constantly interacting with a changing environment. To cope with changes, the person uses both innate and acquired biological, psychological, and social mechanisms. Health and Illness: These are inherent dimensions of the person’s life, and adapting to environmental changes is essential for positive responses. Adaptation: The person’s ability to adapt is influenced by the stimuli encountered and their adaptation level, which defines the range of stimulation that can elicit a positive response. Modes of Adaptation 1. Physiologic Needs 2. Self-Concept 3. Role Function 4. Interdependence PHILOSOPICAL ASSUMPTIONS Mutual Relationships: Persons engage in reciprocal relationships with the world and a divine or God-figure. Human Meaning: Rooted in the concept of an omega point, which signifies a convergence of the universe’s ultimate purpose. Divine Presence: God is revealed through the diversity of creation and represents the common destiny of all creation. Human Creative Abilities: Persons utilize awareness, enlightenment, and faith. They are responsible for engaging in the process of understanding, sustaining, and transforming the universe.  SCIENTIFIC ASSUMPTIONS Systems of matter and energy progress to higher levels of complex self- organization. Consciousness and meaning are consistent of person and environment integration. Awareness of self and environment is rooted in thinking and feeling. Human decisions are accountable for the integration of creative processes. Thinking and feeling mediate human action. System relationships include acceptance, protection, and fostering interdependence. Persons and the Earth have common patterns and integral relations. Person and environment transformations created human consciousness. Integration of human and environment meanings result in adaptation. CULTURAL ASSUMPTIONS Experiences within a specific culture will influence how each element of the Roy adaptation model is expressed. Within a culture, there may be a concept that is central to the culture and will influence some or all of the elements of the Roy adaptation model to a greater or lesser extent. Cultural expressions of the elements of the Roy adaptation model may lead to changes in practice activities such as nursing assessment. As Roy adaptation model elements evolve within a cultural perspective, implications for education and research may differ from experience in the original culture.  NURSING METAPARADIGM Nursing: Differentiates between nursing as a science and nursing as a practice discipline. Person: Viewed as a living system where subsystems function together as a unified whole for a specific purpose. Health: Defined as a state and process of becoming an integrated and whole person. Lack of integration signifies lack of health. Health is linked to adaptation, with adaptive responses fostering integrity. Environment: Includes all conditions, circumstances, and influences that impact the development and behavior of individuals and groups. It affects the person as an adaptive system through various inputs, which can be positive or negative, and vary in intensity.  THEORITICAL ASSERTION Outcome Theory: Provides a clear conception of individuals as nursing clients and defines nursing as an external regulatory mechanism. Logical Form: Deductive: Based on Helson’s Theory, which includes focal, contextual, and residual stimuli. Inductive: Developed through research and practice experiences by Roy and her colleagues.  ACCEPTANCE BY THE NURSING COMMUNITY Utility: The model is practical as it outlines the features of the discipline and guides practice by addressing goals, values, client needs, and practitioner interventions. Nursing Process: 1. Assess behaviors 2. Assess stimuli 3. Diagnose 4. Set goals to promote adaptation 5. Implement nursing interventions 6. Evaluate  ACCEPTANCE BY THE NURSING COMMUNITY Evaluation of the Theory: Clarity: Logically structured, but it may not fully address spiritual, humanistic, and existential aspects. Simplicity: Although it has several major concepts and relational statements, the model is complex. Generality: Broadly applicable in nursing practice, though primarily focused on person-environment adaptation and client-specific issues. Empirical Precision: The model has testable hypotheses derived from it. Derivable Consequences: Provides a clearly defined nursing process that can guide clinical practice and generate new information through hypothesis testing. DOROTHY E. JOHNSON Behavioral System Model