Exploring Nursing Theories and Models PDF

NCM 100 EXPLORING NURSING THEORIES AND MODELS BSN1-07 GROUP 1 SR. CALLISTA ROY: ADAPTATION MODEL OF NURSING Sr. Callista Roy Born: October 14, 1939, in Los Angeles, California. A highly respected nurse, theorist, writer, lecturer, researcher, teacher, and member of the Sis...

NCM 100 EXPLORING NURSING THEORIES AND MODELS BSN1-07 GROUP 1 SR. CALLISTA ROY: ADAPTATION MODEL OF NURSING Sr. Callista Roy Born: October 14, 1939, in Los Angeles, California. A highly respected nurse, theorist, writer, lecturer, researcher, teacher, and member of the Sisters of Saint Joseph of Carondelet. Known for developing the Adaptation Model of Nursing. “The goal of nursing is the promotion of adaptation for individuals and groups in each of the four adaptive modes, thus, contributing to health, quality of life, and dying with dignity” Adaption is the “process and outcome whereby thinking and feeling persons as individuals or in groups use conscious awareness and choice to create human and environmental integration.” Education 1963 - Bachelor’s Degree in Nursing, Mount Saint Mary’s College, Los Angeles. 1966 - Master’s Degree in Nursing, University of California, Los Angeles (UCLA). 1973 - Master’s Degree in Sociology, University of California, Los Angeles (UCLA). 1977 - Doctorate in Sociology, University of California, Los Angeles (UCLA). 1983-1985 - Robert Wood Johnson Postdoctoral Fellow in Neuroscience, University of California, San Francisco. Her early experiences as a pediatric nurse were pivotal in shaping her theoretical contributions. Observing children's resilience and ability to adapt to significant physical and psychological challenges led her to focus on adaptation as a central theme in nursing care. This insight became the foundation of her later work in developing the Roy Adaptation Model. Career and Contributions 1960s: Pediatric staff nurse, where she observed children's resilience and adaptability, inspiring her nursing model. 1964–1966: Developed the basic concepts of the Roy Adaptation Model during graduate studies at UCLA. 1968: Operationalized her model when Mount Saint Mary’s College adopted the adaptation framework as its nursing curriculum's philosophical foundation. 1970: Published her seminal article on the Roy Adaptation Model in Nursing Outlook. 1982: Associate Professor and Chairperson of the Department of Nursing, Mount Saint Mary’s College. 1983: Promoted to Professor at Mount Saint Mary’s College and the University of Portland, Oregon. 1983–1985: Conducted research as a Clinical Nurse Scholar, focusing on cognitive recovery in head injuries and nursing models' influence on clinical decision-making. 1987: Appointed Nurse Theorist at Boston College School of Nursing. 1999: Published The Roy Adaptation Model with refinement and restatement of her theory. Achievements & Recognitions 1978: Fellow, American Academy of Nursing 1979: Recognized in World Who’s Who of Women 1981: National Founder’s Award for Excellence in Fostering Professional Nursing Standards 1984: Honorary Doctorate of Humane Letters, Alverno College 1985: Honorary Doctorate, Eastern Michigan University 1986: American Journal of Nursing Book of the Year Award for Essentials of the Roy Adaptation Model 1989: Fulbright Senior Scholar Award from the Australian-American Educational Foundation 1991: Martha Rogers Award for Advancing Nursing Science, National League for Nursing 1999: Honorary Doctorate, St. Joseph’s College, Maine 2007: Recognized as a Living Legend by the American Academy of Nursing Recipient of the Outstanding Alumna award and the Carondelet Medal from Mount Saint Mary’s College. Initiated and taught a summer master’s program at the University of Portland. Published extensively on the Roy Adaptation Model and presented lectures and workshops worldwide. Key Components of Roy’s Adaptation Model 1. Input (Stimuli) Includes environmental factors or conditions (stimuli) that affect an individual’s adaptation. Stimuli are categorized into three types: Focal Stimuli: The immediate concern or issue affecting the individual. Contextual Stimuli: Secondary factors that influence the focal stimuli. Residual Stimuli: Background factors that might indirectly affect the person. 2. Adaptation Level Refers to the individual’s ability to adapt based on the stimuli received. Influenced by a combination of internal and external factors. 1. Integrated Process: Stable and well-functioning systems meet environmental needs effectively (e.g., breathing, spiritual fulfillment, successful relationships). 2. Compensatory Process: Systems are challenged by environmental demands but actively working to adapt (e.g., coping with grief, adjusting to a new job). 3. Compromised Process: Systems are failing to meet environmental demands adequately, resulting in dysfunction. Key Components of Roy’s Adaptation Model 3. Control Processes (Coping Mechanisms) These mechanisms involve two subsystems: Regulator Subsystem: Handles automatic physiological responses through neural, chemical, and endocrine systems. Cognator Subsystem: Involves cognitive and emotional processes, such as perception, learning, judgment, and emotion, to manage stimuli. Key Components of Roy’s Adaptation Model 4. Effectors The four adaptive modes where the control processes influence behavior: Physiological Function: Addresses the basic physical needs of the body. Self-Concept: Involves psychological and spiritual integrity, promoting a sense of purpose and meaning. Role Function: Relates to fulfilling roles in society and maintaining relationships. Interdependence: Focuses on interactions, relationships, and support systems. 5. Output (Responses) Can be categorized as: Adaptive Responses: Promotes health and integration. Ineffective Responses: Leads to poor health outcomes or maladaptation. 6. Feedback Loop The output (adaptive or ineffective responses) provides feedback that influences future input and adaptation levels, creating a continuous cycle of adaptation. Adaptation Model: Patient A nurse’s role in the Adaptation Model is to manipulate stimuli by removing, decreasing, increasing or altering stimuli so that the patient: 1. Assess the behaviors manifested from the four adaptive modes. 2. Assess the stimuli, categorize them as focal, contextual, or residual. 3. Make a statement or nursing diagnosis of the person’s adaptive state. 4. Set a goal to promote adaptation. 5. Implement interventions aimed at managing the stimuli. 6. Evaluate whether the adaptive goal has been met. Metaparadigm PERSON Based on Roy, humans are holistic beings that are in constant interaction with their environment. Humans use a system of adaptation, both innate and acquired, to respond to the environmental stimuli they experience. Human systems can be individuals or groups, such as families, organizations, and the wholeglobal community. ENVIRONMENT The environment is defined as conditions, circumstances, and influences that affect the development and behavior of humans as an adaptive system. The environment is a stimulus or input that requires a person to adapt. These stimuli can be positive or negative. HEALTH Health is defined as the state where humans can continually adapt to stimuli. If a human can continue to adapt holistically, they will be able to maintain health to reach completeness and unity within themselves. If they cannot adapt accordingly, the integrity of the person can be affected negatively. NURSING In Adaptation Model, nurses are facilitators of adaptation. They assess the patient’s behaviors for adaptation, promote positive adaptation by enhancing environment interactions and helping patients react positively to stimuli. Open Discussion Q When was Callista Roy Born? & A A. October 13, 1939 B. October 14, 1939 C. October 15, 1939 D. October 16, 1939 Open Discussion Q When was Callista Roy Born? & A A. October 13, 1939 B. October 14, 1939 C. October 15, 1939 D. October 16, 1939 Open Discussion Q What are the 3 types of stimuli present in Callista & Roy’s Adaptation Model? A A. Consciousness, Awareness of Self, and Meaning B. Physiologic-physical, Role function, and Interdependence C. Integrated, Compensatory, and Compromised D. Focal, Contextual, and Residual Open Discussion Q What are the 3 types of stimuli present in Callista & Roy’s Adaptation Model? A A. Consciousness, Awareness of Self, and Meaning B. Physiologic-physical, Role function, and Interdependence C. Integrated, Compensatory, and Compromised D. Focal, Contextual, and Residual Open Discussion Q What led to Roy’s focus to create the Central & Theme for her Adaptation Model? A A. Observing children's resilience and ability to adapt to significant physical and psychological challenges B. Roy’s mother was a nurse who took care of children C. A and B D. All of the Above Open Discussion Q What was Roy’s Central Theme for her & Adaptation Model? A A. Observing children's resilience and ability to adapt to significant physical and psychological challenges B. Roy’s mother was a nurse who took care of children C. A and B D. All of the Above Open Discussion Q What are the nurses’ role in the Adaptation Model? & A A. Facilitators of adaptation B. Intermediaries of adaptation C. Advisors of adaptation D. Mentors of adaptation Open Discussion Q What are the nurses’ role in the Adaptation Model? & A A. Facilitators of adaptation B. Intermediaries of adaptation C. Advisors of adaptation D. Mentors of adaptation BETTY NEUMAN: SYSTEMS MODEL Born: September 11, 1924 in Marietta, Ohio Hospital nurse, school nurse, industrial nurse, counselor and professor 1982 - First edition of Neuman Systems Model: Application to Nursing Education and Practice was published Advocated for holistic and systems-based care in nursing Authored multiple works to refine and apply her model Early Life & Education: Grew up on a farm in Ohio which helped develop her compassion for people in need 1947: Completed her initial nursing education at Peoples Hospital School of Nursing in Akron, Ohio (now called General Hospital) 1957: Bachelor’s degree in Public Health and Psychology at UC Los Angeles (UCLA) 1966: Master’s degree in Mental Health and Public Health Consultation at UCLA 1985: Completed Doctoral degree in Clinical Psychology at Pacific Western University Neuman developed, taught, and refined community mental health programs at UCLA Designed a nursing conceptual model for students to expand their understanding of client variables beyond the medical model Taught nurse continuing education at UCLA for 14 years and worked as a clinical marriage and family therapist ata private practice Systems Model: Overview Views individuals, families, or communities as systems interacting with internal and external environments which emphasizes prevention as an essential nursing intervention Focuses its attention on the response of the client system to actual or potential environment stressors Believed if a client does not maintain equilibrium it will lead to illnesses Conceptual Model and Grand Theory Each concentric circle or layer is made up of five variable areas which occur simultaneously: Physiologic Psychologic Socio-cultural Developmental Spiritual Systems Model Flexible Line of Defense: Initial response or protection barrier to prevent stressors from breaking through the normal line of defense Normal Line of Defense: Represents stability over time or normal wellness state. When this line is invaded symptoms of instability or illness will be present Lines of Resistance: Protects the basic structure. Becomes activated when NLOD is invaded. Basic Core Structure: Made up of basic survival factors (e.g - normal temperature, genetic structure, response patterns, organ strength, ego structure, etc.) Nursing Interventions Focuses on retaining or maintaining system stability Neuman supports beginning intervention when stressor is suspected or identified Interventions are based on possible or actual degree of reaction, resources, goals, and anticipated outcomes Carried out on three preventative levels: Primary: prevention is used before a reaction to stressors occurs (reduce possibility of encounter with stressors and strengthen FLOD) Secondary: involves the treatment of symptoms following a reaction to stressors Tertiary: involves maintenance of optimal wellness following treatment (readaptation, re-education to prevent future occurences, maintenance of stability) Metaparadigm NURSING: Nursing is a “unique profession that is concerned with all the variables affection clients in their environment” Perceptual field of the caregiver and the client must be assessed to maintain a maximum level of wellness HUMAN BEING: Clients or client system which may be an individual, family, group, community, or social issue. Interrelationships among physiological, psychological, sociocultural, developmental, and spiritual factors HEALTH: Continuum from wellness to illness that is dynamic in nature and is constantly changing (stability occurs when all system’s parts are in balance) ENVIRONMENT: Internal and external forces surrounding the client, influencing and being influcenced by the client (e.g - stressors that can alter the systems stability) Works Clinical instructor at University of Southern California Medical Center One out of two nurses to develop the nurse counselor role within community crisis centers in Los Angeles 1960s she developed and published her first explicit teaching and practice model for mental health consultation before the creation of her systems model Neuman is a fellow of the American Association of Marriage and Family Therapy and of the American Academy of Nursing Remains as an advisory role for the Neuman Systems Model Trustees Group in Seattle Awards 1992: Honorary Doctorate of Letters, Neuman College, Aston, PA 1993: Honorary Member of the Fellowship of the American Academy of Nursing 1998: Honorary Doctor of Science, Grand Valley State University, Michigan Open Discussion Q The outer ring in Neuman’s system theory is & known as the: A A. Basic Structure Energy Resource B. Lines of Resistance C. Flexible Line of Defense D. Normal Line of Defense Open Discussion Q The outer ring in Neuman’s system theory is & known as the: A A. Basic Structure Energy Resource B. Lines of Resistance C. Flexible Line of Defense D. Normal Line of Defense Open Discussion Q What year was the Systems Model Published? & A A. 1960 B. 1972 C. 1980 D. 1982 Open Discussion Q What year was the Systems Model Published? & A A. 1960 B. 1972 C. 1980 D. 1982 Open Discussion Q The Flexible Line of Defense serves as a & protective buffer: A A. True B. False Open Discussion Q The Flexible Line of Defense serves as a & protective buffer: A A. True B. False Open Discussion Neuman describes “Environment” as: Q & A. Continuum from wellness to illness that is dynamic A in nature and is constantly changing B. Internal and external forces surrounding the client, influencing and being influenced by the client C. Clients or client system which may be an individual, family, group, community, or social issue. D. A warm and fuzzy place Open Discussion Neuman describes “Environment” as: Q & A. Continuum from wellness to illness that is dynamic in nature and is constantly changing A B. Internal and external forces surrounding the client, influencing and being influenced by the client C. Clients or client system which may be an individual, family, group, community, or social issue. D. A warm and fuzzy place MADELEINE LEININGER: THEO R Y OF CULT U R E CARE DIVE R S I TY & UNIV ERSALITY Madeleine M. Leining er Born : July 23, 1925 Died : August 10, 2012 Renowned educator, author, researcher, and nursing theorist Developed the Theory of Culture Care Diversity and Universality (Grand Theory) After years of excellence, she died on August 10, 2012 at her home in Omaha, Nebraska Early Life Lived in Sutton, Nebraska She graduated from Sutton High School alongside her four siblings Pursued a career in nursing, due to her aunt’s congenital heart disease Education Graduated with a diploma in nursing from St. Anthony’s Hospital School of Nursing in Denver, Colorado, and the U.S. Army Nurse Corps. 1905 - Earned a bachelor's degree in biological science from Benedictine College in Atchison, Kansas. 1954 - Earned her master's degree in psychiatric nursing from the Catholic University of America. 1965 - Became the first professional nurse to earn a Ph.D. in anthropology at the University of Washington in Seattle. Career Served as an instructor, staff nurse, and head nurse on a medical-surgical unit. Opened a new psychiatric unit while director of the nursing service at St. Joseph' s Hospital in Omaha, Nebraska. Developed the first master' s-level clinical specialist program in child psychiatric nursing. 1969 to 1974 - Appointed Dean of the University of Washington, School of Nursing. 1974 - She founded the field of transcultural nursing, now a globally recognized approach to nursing. Works Wrote and edited 27 books and founded the Journal of Transcultural Nursing. Published 200 articles and book chapters, produced numerous audio and video recordings, and developed a software program. Given over 850 keynotes and public lectures in the US and around the world. 1989 to 1995 - Established the Journal of Transcultural Nursing and served as editor. Initiated and promoted transcultural nurses worldwide certification (CTN) for client safety and knowledge care for people of diverse cultures. Awards 1 9 6 0 - A w a r d e d a N a t i o n a l L e a g u e o f N u r s i n g f e l l o w s h i p i n t h e E a s t e rn H ig h la n ds o f New Guinea. S h e w o n t h e P r e s i d e n t ’ s A w a r d f o r E x c e l l e n c e i n T e a c h in g , t h e B o a rd o f G o v e rn o rs D i s t i n g u i s h e d F a c u l t y A w a r d , a n d t h e G e r s h e n s o n R e s e a rc h F e llo w s h ip A w a rd a t Wayne State University. 1 9 9 8 - H o n o r e d a s t h e L i v i n g L e g e n d b y t h e A m e r i c a n A c a de m y o f N u rs in g a n d D i s t i n g u i s h e d F e l l o w , R o y a l C o l l e g e o f N u r s i n g i n A u s t ra lia. 1 9 8 3 - T h e L e i n i n g e r T r a n s c u l t u r a l N u r s i n g A w a r d w a s e s t a blis h e d t o re c o g n iz e o u t s t a n d i n g a n d c r e a t i v e l e a d e r s i n t r a n s c u l t u r a l n u r s in g. Theory of Culture Care Diversity and Universality Culture Care: Care that is aligned with the patient’s cultural beliefs and practices. Goal: To provide care that is meaningful and relevant to the patient’s cultural background. Example: A nurse adapting care to meet dietary preferences or spiritual needs. Cultural Diversity and Universality: Health beliefs and practices vary widely across cultures Despite differences, all cultures share basic aspects of care, such as the need to care for the sick, provide comfort, and address pain. Application: Nurses need to recognize both universal care needs and cultural- specific variations. Sunrise Enabler Model Sunrise Enabler Purpose: Helps nurses understand how cultural factors impact healthcare decisions. Components: Includes family structure, economic systems, language, and environmental factors. Application : Guides nurses in tailoring care to a patient's cultural context, ensuring care is respectful and effective. Theory of Culture Care Diversity and Universality Ethnonursing Research Method : A qualitative research method developed by Leininger to study culture-specific care. Method :Focuses on gathering insights from the emic (insider) perspective, emphasizing the lived experiences of the cultural group. Purpose :To ensure cultural relevance and improve nursing care practices by understanding care beliefs and values. Care Modes : Preservation: Keeping or maintaining beneficial cultural practices Accommodation: Adapting cultural practices to align with healthcare needs Re-patterning: Modifying harmful cultural practices to improve health outcomes Example: A nurse working with a patient to preserve cultural traditions while accommodating necessary medical treatments. Nursing Metaparadigm Nur si ng - Bot h a huma ni st i c an d sc i en ti fi c di sc i pl i ne f oc u s e d on as s i s t i ng i ndi vi dua l s an d g ro ups to m ai n ta i n, or r e gai n w e l l - be i ng i n cul t ural l y me a ni ng ful ways. Per son - Vi ewed as a huma n bei n g c apabl e o f c ari ng and c onc e r ne d f or ot hers’ ne e ds a nd survi val. Hea l th - St at e o f w e l l -be i ng , wh i c h i s c ul tural l y de te r mi ne d and i nvol v es t h e a bi l i t y t o perfo rm dai l y ro l es i n a w ay that al i gns w i th cul t ural pract i ce s a nd val ues. Env i r onme nt - Concep t s such a s wo rl dvi ew, so c i al e nv i r onme nt cont ex t , and st r uct ur e are di sc ussed i n rel a ti on to c u l tu r e. Application to Nursing Practice Improves Patient Outcomes: Culturally congruent care enhances satisfaction, trust, and compliance. Practical Examples: Nurses use Sunrise Enabler to assess cultural factors in patients' lives Nurses apply Care Modes to tailor care Challenges in Applying Leininger's Theory Cultural Ignorance: Lack of cultural awareness and knowledge among nurses. Resistance: Some nurses may be resistant to incorporating cultural factors into practice. Systemic Limitations: Insufficient resources or education on transcultural nursing. Example: Nurses might struggle to understand cultural barriers in providing end-of-life care, leading to conflicts or misunderstandings. Open Discussion Q Where was Madeleine M. Leininger born? & A A. Atchison, Kansas B. Sutton, Nebraska C. Denver, Colorado D. Omaha, Nebraska Open Discussion Q Where was Madeleine M. Leininger born? & A A. Atchison, Kansas B. Sutton, Nebraska C. Denver, Colorado D. Omaha, Nebraska Open Discussion What is the nurse’s role in transcultural care Q & according to Leininger's theory? A A. To provide the same care to all patients, regardless of their culture and background. B. To treat only those patients who share the same cultural background or values as the nurse. C. To recognize and respect cultural differences, adapting to each patient's needs and preferences. D. To focus solely on medical treatment and physical health, without considering the patient’s cultural needs. Open Discussion What is the nurse’s role in transcultural care Q & according to Leininger's theory? A A. To provide the same care to all patients, regardless of their culture and background. B. To treat only those patients who share the same cultural background or values as the nurse. C. To recognize and respect cultural differences, adapting to each patient's needs and preferences. D. To focus solely on medical treatment and physical health, without considering the patient’s cultural needs. Open Discussion Q When did Madeleine M. Leininger passed away? & A A. August 10, 2012 B. March 25, 2011 C. November 7, 2012 D. September 13, 2010 Open Discussion Q When did Madeleine M. Leininger passed away? & A A. August 10, 2012 B. March 25, 2011 C. November 7, 2012 D. September 13, 2010 Open Discussion Which of the following best exemplifies cultural Q & care in nursing? A A. Asking the patient about their cultural beliefs before beginning any treatment to ensure respectful and individualistic care. B. Urgently implementing a patient’s cultural preferences into the treatment plan. C. Providing care that is specifically tailored to each patient’s cultural background. D. All of the above. Open Discussion Which of the following best exemplifies cultural Q & care in nursing? A A. Asking the patient about their cultural beliefs before beginning any treatment to ensure respectful and individualistic care. B. Urgently implementing a patient’s cultural preferences into the treatment plan. C. Providing care that is specifically tailored to each patient’s cultural background. D. All of the above. MYRA LEVINE: CONSERVATION MODEL Myra Estrin Levine Birth: 1920 Death: 1996 She was born in Chicago, Illinois She had a diverse and impactful Nursing career. Private nurse (1994) Civillian nurse in the U.S Army (1945) Surgical supervisor at the University of Chicago Clinics (1951-1952) & Henry Ford Hospital in Detroit (1956-1962) Nursing educator & Professor Ermita in Medical-Surgical Nursing (1987) Education: 1994: Received her diploma in nursing from the Cook County School of Nursing. 1994: Continued to finish her Bachelor of Science in Nursing at the University of Chicago. 1962: Postgraduate Studies, Master of Science in Nursing at Wayne State University in Detroit. Works: Introduction to Clinical Nursing (1969 & 1973): Provided foundational nursing knowledge for nursing practices. Won the American Journal of Nursing Book of the Year award. Renewal for Nursing (1971): Rejuvenation of the nursing profession and the significance of it in healthcare. Later on, translated into Hebrew. Theory The Conservation Model of Nursing This framework laid the foundation of nursing care and a holistic approach to nursing that integrates the physical, social, and psychological aspects of patient care. This is built on the idea that nursing interventions should aim to preserve the energy and integrity of a patient in four key areas. The Four Conservation Principle Proposed the four conservation principles to guide nursing care in support of the patient’s unique adaptive efforts to conserve “the unity and integrity of the individual”. The Four Conservation Principle 1. Conservation of Energy Energy balance is essential for all life processes (First law of thermodynamics) Maintaining the energy of a patient to facilitate healing. Nursing interventions must balance energy resources with energy expenditure during illness, especially chronic conditions. 2. Conservation of Structural Integrity Making sure that physical body structures are intact. Nursing care must maintain energy for life functions while conserving body structure. Nursing interventions should minimize structural damage and prevent permanent disability, focusing on rehabilitation. The Four Conservation Principle 3. Personal Integrity Conservation Preserving the sense of self, including the identity, self-worth, and autonomy of a patient. Nursing interventions should include education, patient decision-making, privacy protection, and cultural respect. Support individual psychological and behavioral responses to health challenges to strengthen personal integrity. 4. Conservation of Social Integrity Fostering and maintaining meaningful connections with the social environment, especially within the family and community. Nursing Interventions should support family connections, cultural affiliations, and spiritual needs. The nurse-patient relationship is a key social interaction, where integrity is mirrored between patient and nurse. Metaparadigm 1. Nursing A caring process aimed at helping individuals conserve integrity and adapt to promote well-being. 2. Person A holistic being whose wholeness is maintained through conserving energy, structure, personal integrity, and social integrity. 3. Health A state of wholeness and balance achieved through successful adaptation to the environment. 4. Environment Internal and external factors influencing adaptation, including physical, social, cultural, and psychological elements. Conservation Derived from the Latin conservatio, meaning “to keep together” (Levine, 1973). Refers to the natural law describing how complex systems continue to function even when challenged. This allows individuals to face challenges, adapt, and maintain their uniqueness (Levine, 1990). In nursing, the objective is to conserve the person’s wholeness (Levine, 1971a). Adaptation The process by which individuals maintain health and integrity amid internal and external changes. Levine perceives this as essential for preserving organismic integrity and allowing individuals to adjust to different environments. Health and diseases are patterns of adaptive change. Adaptation Adaptation has three key characteristics: historicity, specificity, and redundancy. Aging may result from the failure of redundant processes (Levine, 1991). The role of the nurse is to support the patient in effectively adapting to environmental or physiological stressors. Organismic Response (Holistic Response) Adaptation is a holistic process involving biological, psychosocial, and spiritual responses. The person is an integrated system responding to stimuli in emotional, physical, and social dimensions. Every adaptive change impacts the whole individual. Changes in one can affect others. Organismic Response (Holistic Response) 1. Response to Fear (Flight or Fight) A basic biological reaction to perceived threats, activating alertness and key neuroendocrine responses (Levine, 1969b, 1973). 2. Inflammatory-immune Response Protects the body from irritants and pathogens, playing a key role in healing, though it consumes energy. Nursing focuses on supporting this process and controlling environmental risks (Levine, 1969b, 1973, 1989). Organismic Response (Holistic Response) 3. Response to Stress Stress responses involve biological and behavioral changes, especially involving adrenocortical hormones. Chronic stress can deplete adaptive energy, leading to exhaustion or damage (Levine, 1969b). 4. Sensory Response Individuals constantly respond to sensory stimuli from the environment, which helps maintain safety and promote well-being (Levine, 1967b, 1969b). Awards 1973 - Honored as charter fellow of the American Academy of Nursing (FAAN) 1973 1976 - Honorary member of the American Mental Health Aid to Israel 1977 - Honorary recognition from the Illinois Nurses Association 1977 - Elizabeth Russell Belford award for excellence in teaching from Sigma Theta Tau International 1982 - Recognized in Who’s Who in American Women and Who’s Who in American Nursing (being listed means recognition of significant contributions and achievements to society) 1992 - Honorary Doctorate of humane letters from Loyola University  Application to Nursing Practices Levine's Conservation Model guides nurses to provide holistic care by focusing on preserving a patient's integrity. It emphasizes energy conservation, protecting structural integrity, supporting personal integrity through respect and autonomy, and fostering social integrity via family and social connections. The model encourages individualized care that addresses the physical, emotional, and social aspects of health, helping patients adapt to illness or recovery while maintaining their overall well-being. Open Discussion Q ? & Wh en w as M y ra Lev ine b o rn A A. September 23, 1921 B. 1921 C. September 21, 1920 D. 1920 Open Discussion Q ? & Wh en w as M y ra Lev ine b o rn A A. September 23, 1921 B. 1921 C. September 21, 1920 D. 1920 Open Discussion ch of th e follow in g is a key fo cu s of M yra Q Whi n M od el in nu rs ing? & Levine' s C on servat io A er in g pa tie nt in de pe nd en ce th ro ug h no n- A. Fost intervention g en er gy co ns er va tio n, st ru ct ur al in te gr ity, B. Promotin personal integrity, and social integrity cu si ng so le ly on m ed ic al in te rv en tio ns and C. Fo procedures en tr at in g on th e ph ys io lo gi cal as pe ct of care only D. Conc Open Discussion ch of th e follow in g is a key fo cu s of M yra Q Whi n M od el in nu rs ing? & Levine' s C on servat io A er in g pa tie nt in de pe nd en ce th ro ug h no n- A. Fost intervention g en er gy co ns er va tio n, st ru ctural inte grity, B. Promotin personal integrity, and social integrity cu si ng so le ly on m ed ic al in te rv en tio ns and C. Fo procedures en tr at in g on th e ph ys io lo gi cal as pe ct of care only D. Conc Open Discussion od el , how is th e Q In Myra Levine’ s C on se rvat io n M & stress response categorized? A se to environmental stressors to restore A. As a respon balance As a physiological reaction to disease-causing B. pathogens nal resp onse to pers on al relationships C. As an emotio a long-term re action to chro nic illne ss D. As Open Discussion od el , how is th e Q In Myra Levine’ s C on se rvat io n M & stress response categorized? A onse to en viro nm en tal stre ssor s to A. As a resp restore balance As a physiologica l reac tion to dise as e-ca using B. pathogens nal resp onse to pers on al relationships C. As an emotio a long-term re action to chro nic illne ss D. As Open Discussion In applying M yr a L ev in e’ s C on serv at io n M od el , how Q m an ag e a pati en t’ s en er gy du ri ng & shou ld nu rses A recovery? ag ing co nsta nt ac tiv ity to pr om ote strength A. By encour nc ing re st an d activ ity to av oid en er gy B. By bala depletion sing on ly on th e pa tie nt 's ph ys ical sy m ptoms C. By focu stric ting al l ph ys ical m ov em en t to pr event D. By re fatigue Open Discussion In applying M yr a L ev in e’ s C on serv at io n M od el , how Q m an ag e a pati en t’ s en er gy du ri ng & shou ld nu rses A recovery? ag ing co nsta nt ac tivity to pr om ote strength A. By encour nc ing re st an d activ ity to av oid en ergy B. By bala depletion sing on ly on th e pa tie nt 's ph ys ical sy m ptoms C. By focu stric tin g al l ph ysical m ov em en t to pr event D. By re fatigue References: Gonzalo, A. (2024, April 30) Madeleine Leininger: Transcultural Nursing Theory. https://nurseslabs.com/madeleine-leininger-transcultural-nursing-theory/#h-death WHAT IS INTERACTION-ORIENTED THEORY? Interaction-Oriented Theory emphasizes that communication is a dynamic, two-way process. It focuses on the interactions between individuals and how these interactions co-create meaning. In nursing, this theory highlights that the meaning of what we communicate is not simply based on the words we use, but on the relationship, the context, and the ongoing interaction between the nurse and the patient. In simple terms, it’s not just about delivering information to the patient but about engaging with them in a way that promotes understanding, empathy, and collaboration in their care. Interaction-oriented theory includes eight theories, which are: 1. Peplau's Theory of Interpersonal Relationship 2. Nursing Process Theory (Ida Jean Orlando) 3. The Helping Art of Clinical Nursing (Ernestine Weidenbach) 4. Goal Attainment Theory and Interacting Systems Theory (Imogene King) 5. Humanistic Nursing Practice Theory (Josephine Paterson and Loretta Zderad) 6. Modeling and Role Modeling Theory(Helen Erickson, Evelyn Tomlin, Mary Ann Swain) 7. Nursing as Caring Theory (Ann Boykin and Savina Schoenhofer) 8. Human to Human Relationship Model (Joyce Travelbee) Key Principles of Interaction-Oriented Theory in Nursing: Communication as a Process: C o m m u n i c a t i o n i s n o t a o n e - t i m e e v e n t , b u t a n o n g o in g pro c e s s. E v e ry interaction you have with a patient builds on previous ones. T h e r e l a t i o n s h i p y o u b u i l d w i t h y o u r p a t i e n t o v e r t i m e in flu e n c e s t h e ir t r u s t , w i l l i n g n e s s t o s h a r e c o n c e r n s , a n d t h e i r o v e r a l l h e a lt h e x pe rie n c e. Co-construction of Meaning: M e a n i n g i s c o - c o n s t r u c t e d i n e v e r y i n t e r a c t i o n. T h i s m e a n s t h a t bo t h t h e n u rs e a n d t h e p a t i e n t a c t i v e l y p a r t i c i p a t e i n c r e a t i n g m e a n in g fro m t h e ir c o n v e rs a t io n s. F o r e x a m p l e , w h e n e x p l a i n i n g a d i a g n o s i s o r t r e a t m e n t p l a n , i t ’ s im po rt a n t t o c h e c k f o r u n d e r s t a n d i n g , a s t h e p a t i e n t m a y i n t e rpre t in fo rm a t io n diffe re n t ly b a s e d o n t h e i r c u l t u r a l b a c k g r o u n d , e d u c a t i o n , o r p e r s o n a l e x pe rie n c e s. Key Principles of Interaction-Oriented Theory in Nursing: Context Matters: The context in which communication occurs is essential. In nursing, the context could refer to the physical environment (hospital room vs. clinic), the emotional state of the patient, or the cultural norms of both the patient and the nurse. For example, a patient’s cultural beliefs may influence how they perceive healthcare or certain treatments, and this context should guide the nurse’s approach to communication. Relational Focus: The theory emphasizes the relationship between communicators. In nursing, this is especially significant because the nurse-patient relationship is foundation al to patient-centered care. Good communication isn’t just about relaying information; it’s about building trust, showing empathy, and creating a supportive environment where the patient feels heard and respected. HILDEGARD PEPLAU: INTERPERSONAL RELATIONS THEORY Hildegard Elizabeth Peplau Birth: September 1, 1909 Death: March 17, 1999 She was born and raised in Reading, Pennsylvania, USA Died peacefully in her sleep at Sherman Oaks, California The first published nursing theorist since Florence Nightingale Early Life S h e w a s t h e s e c o n d d a u g h t e r , h a v i n g t w o si st er s a n d t h r ee b r ot h er s ( s e c o n d o f s i x c h i l d r e n ) , o f G u s t a v a n d O t y l l i e P ep l a u F r o m a y o u n g a g e , P e p l a u w a s d e t e r m i n e d t o g o b ey on d t r a d i t i on a l women’s roles S h e s a w n u r s i n g a s o n e o f t h e l i m i t e d c a r e e r o pt i on s a v a i l a b l e t o w om en a t that time Education 1 9 3 1 – G r a d u a t e d f r o m P o t t s t o w n , P e n n s y l v a n i a S c h ool of N u r si n g 1 9 4 3 – S h e e a r n e d a B a c h e l o r ’ s d e g r e e i n I n t e r p er son a l Psy c h ol og y a t Bennington College, Vermont 1 9 4 7 – H e l d h e r m a s t e r ’ s a n d d o c t o r a l d e g r e e s f r om T ea c h er s C ol l eg e, Columbia University Career F o c u s e d h e r l i f e l o n g w o r k o n a d a p t i n g S u l l i v a n ’ s I n t er p er son a l T h eor y f or nursing practices. 1943 to 1945 – Served as an Army Corps Nurse Stationed at the 312th Field Station Hospital in England A l l o w i n g h e r t h e o p p o r t u n i t y t o w o r k w i t h l e a d i n g f i g u r es i n American and British psychiatry 1 9 5 4 t o 1 9 7 4 – F a c u l t y m e m b e r a t t h e C o l l e g e o f N u r s i n g a t R u t g er s University D e v e l o p e d t h e f i r s t g r a d u a t e p r o g r a m f o r c l i n i c a l sp ec i a l i st i n psychiatric nursing S e r v e d a s a n a d v i s o r t o t h e W o r l d H e a l t h O r g a n iz a t i on ( W H O ) Works 1 9 5 2 – I n t e r p e r s o n a l R e l a t i o n s i n N u r s i n g ( b u t w a s c om p l et ed i n 1 9 48) Translated into nine languages 1 9 8 9 – r e i s s u e d i n G r e a t B r i t a i n b y M a c m i l l a n o f L o n d on 1 9 8 9 – S p r i n g e r p u b l i s h e d a v o l u m e o f s e l e c t e d w or k s of Pep l a y f r om previously unpublished papers. Awards and Honors 1955 – Named one of “50 Great Americans” in Who’s Who by Marquis R e c o g n i z e d w i d e l y a s t h e “ M o t h e r o f P s y c h i a t r i c N u r si n g ” 1 9 6 6 – H o n o r e d a s a “ L i v i n g L e g e n d ” b y A m e r i c a n A c a d em y of N u r si n g 1 9 7 7 – R e c e i v e d t h e “ C h r i s t i a n e R e i m a n n P r i z e ” f o r h er c on t r i b u t i on s t o nursing and healthcare 1988 – Instated into the ANA Hall of Fame Metaparadigm in Nursing PERSON Peplau defines man as an organism that “strives in its own way to reduce tension generated by needs.” The client is an individual with a felt need. HEALTH Health is defined as “a word symbol that implies forward movement of personality and other ongoing human processes in the direction of creative, constructive, productive, personal, and community living.” ENVIRONMENT Although Peplau does not directly address society/environment, she does encourage the nurse to consider the patient’s culture and mores when the patient adjusts to the hospital routine. Nursing She considers nursing to be a “significant, therapeutic, interpersonal process. Theory Interpersonal Relations Theory Hildegard Peplau defined nursing as: “An interpersonal process of t h e r a p e u t i c i n t e r a c t i o n s b e t w e e n a n i n d i v i d u a l w h o i s si c k or i n n eed of h e a l t h s e r v i c e s a n d a n u r s e e s p e c i a l l y e d u c a t e d t o r ec og n i z e, r esp on d t o t h e need for help.” S i n c e n u r s i n g i s a t h e r a p e u t i c i n t e r a c t i o n b e t w een a p a t i en t a n d a n u r s e , f o s t e r i n g r e s p e c t a n d g r o w t h t h r o u g h m u t u a l l ea r n i n g a n d response to stimuli. E m p h a s i z e s t h e n u r s e - p a t i e n t r e l a t i o n s h i p a s t her a p eu t i c p r oc ess The Four Phases of the Nurse-Patient Relationship 1. Orientation Phase The nurse and patient meet initially (as strangers) Defines the problem and needs of the patient Client: shares needs and seeks assistance Nurse: responds to the needs and identifies the problem 2. Identification Phase T h e p a t i e n t d e v e l o p s a p a r t n e r s h i p w i t h t h e n u r se, r ec og n i z i n g t h ei r n e e d s a n d c o l l a b o r a t i n g t o i d e n t i f y p r o b l e m s , ex p l or e sol u t i on s, a n d better understand their condition. The Four Phases of the Nurse-Patient Relationship 3. Exploitation Phase T h e p a t i e n t u t i l i z e s n u r s i n g s u p p o r t , u t i l i z i n g r esou r c es, g u i d a n c e, a n d a s s i s t a n c e t o r e s o l v e i s s u e s i d e n t i f i e d i n e a r l i e r p h a ses. N u r s e a i d s t h e p a t i e n t i n e x p l o i t i n g a l l a v e n u e s of h el p Progress is made towards the final phase 4. Resolution Phase T h e p a t i e n t ' s i n d e p e n d e n c e a n d a b i l i t y t o m a n a g e t h ei r h ea l t h i n d e p e n d e n t l y a r e a c h i e v e d i n t h e f i n a l p h a s e , l ea d i n g t o t h e t er m i n a t i on of the therapeutic relationship. Roles of the Nurse (According to Peplau) Stranger ▷ The nurse and the patient are strangers, and the relationship is based on a professional role Resource Person ▷ Nurse provides information and clarifications about the patient’s needs Teacher ▷ Nurse helps the patient to learn and provide information about their health Leader ▷ Offers direction and guide to the client Surrogate ▷ Serves as a substitute in offering care and comfort, for similar roles like a family member Counselor ▷ Provides emotional support and help Technical Expert ▷ Provides physical care for the patient and operates equipment Application to Nursing Practices Peplau's Theory of Interpersonal Relationships emphasizes the importance of the nurse-patient relationship in nursing practice. It emphasizes the role of effective communication, empathy, and open dialogue in building trust and understanding. Nurses should actively listen, provide empathetic responses, and engage in open dialogue to create a supportive environment. Empathy fosters emotional connection and a safe space for patients to express concerns. The collaborative nature of the nurse-patient relationship encourages shared responsibility for the patient's health, empowering them to take ownership of their care. Open Discussion Q In what year did Peplau graduated from Pottstown, & Pennsylvania School of Nursing? A A. 1931 B. 1937 C. 1930 D. 1938 Open Discussion Q In what year did Peplau graduated from Pottstown, & Pennsylvania School of Nursing? A A. 1931 B. 1937 C. 1930 D. 1938 Open Discussion Q What is the primary focus of Peplau’s Theory of & Interpersonal Relationships? A A. Nurse-patient communication B. Nurse-patient physical care C. Nurse-patient emotional bonding D. Nurse-patient relationship and its role in promoting health Open Discussion Q What is the primary focus of Peplau’s Theory of & Interpersonal Relationships? A A. Nurse-patient communication B. Nurse-patient physical care C. Nurse-patient emotional bonding D. Nurse-patient relationship and its role in promoting health Open Discussion Q In Peplau’s theory, which role involves the nurse & providing specific answers to the patient’s questions? A A. Stranger B. Teacher C. Resource person D. Leader Open Discussion Q In Peplau’s theory, which role involves the nurse & providing specific answers to the patient’s questions? A A. Stranger B. Teacher C. Resource person D. Leader Open Discussion Q Hildegard Peplau is born at & Sherman Oaks, California A A. True B. False Open Discussion Q Hildegard Peplau is born at & Sherman Oaks, California A A. True B. False References: Gonzalo, A. (2024, April 30). Hildegard Peplau - Interpersonal Relations Theory. Nurseslabs. https://nurseslabs.com/hildegard-peplaus-interpersonal-relations-theory/ Petiprin, A. (2020). Hildegard Peplau. Nursing Theory. https://nursing- theory.org/nursing-theorists/Hildegard-Peplau.php