Module 2- TFN Notes PDF

NON-NURSING THEORIES IMPORTANCE OF BORROWED THEORIES IN NURSING - Knowledge is not the private domain of one discipline - The use of knowledge generated by any discipline is not borrowed but shared - Shared theory does not lessen nursing education but enhances it - Nursing theories incor...

NON-NURSING THEORIES IMPORTANCE OF BORROWED THEORIES IN NURSING - Knowledge is not the private domain of one discipline - The use of knowledge generated by any discipline is not borrowed but shared - Shared theory does not lessen nursing education but enhances it - Nursing theories incorporate concepts and theories shared with other disciplines to guide theory development, research, and practice ABRAHAM MASLOW - American psychologist who studied the needs or motivations of the individual - People are motivated to achieve certain needs - When one need is fulfilled, a person seeks to fulfil the next one, and so on (Maslow, 1943) ➔ Motives- arousing and directive force of human behavior - Human motivation is based on people seeking fulfillment and change through personal growth - Love, personal fulfillment, the need to belong, and self esteem ➔ HIERARCHY OF NEEDS 1. Physiological Needs- food, air, shelter, sleep, sex, etc. - Lower needs which keep the individual alive - Sex needs have to be met for the survival of the human race, not the individual (not for pleasure, only between married people who want to procreate) 2. Safety Needs- need to avoid pain, to obtain bodily comforts and to be free from fear and insecurity - Freedom from any harm, fear, or threats - Still part of the lower needs 3. Love and Belongingness Needs- need to belong and to love - Identification with a group, need to give and receive affection and love - Beginning of the higher needs 4. Self-esteem Needs- feeling of success and self-worth, competence, and mastery of the environment - Includes the need to accomplish and to achieve - Acknowledge and celebrate small successes of patients 5. Cognitive Needs- knowledge, meaning, etc. - Applicable to people who go for Master’s and PhDs after Bachelor’s 6. Aesthetic Needs- appreciation and search for beauty, balance, form, etc. 7. Self-actualization Needs- need to know about ourselves and the world around us - Need to create and appreciate beauty - Tendency to be an inner-directed achiever - Not about perfection - Achieving one’s full potential - Less than 2% of the population achieve self-actualization 8. Self Transcendence Needs- other-focused instead of self-focused  - Concerned with higher goals than those which are self-serving - Expansion of one’s consciousness beyond the self, to something higher (often divine or spiritual in nature) - Could be achieved through faith in God or recognition of some system of spirituality or idea of the soul - Often being done by Pope, saints, and holy personalities - EX: helping others achieve self-actualization ➔ 7 COMMON TRAITS OF SELF TRANSCENDENCE 1. A will to find meaning in their lives 2. Creating something for the world 3. Receptive to the inherent beauty in the world 4. Focus shifts from selfhood to well-being of others 5. Change for motivation of values 6. A steady stream of elevated emotions 7. Morally concerned for others ➔ SELF TRANSCENDENCE IN NURSING - Can act as both encouragement and inspiration for the patient to achieve wellness, and as motivation and purpose for the nurse who is acting as a caregiver ➔ CONCEPTS OF MASLOW’S HIERARCHY OF NEEDS - Basic needs must be reasonably met before higher needs can be approached and met - As the lower needs are met, the person tends to move upward to meet the next higher level of needs - Lower needs are very powerful. Even if an individual have progressed to the higher needs, if satisfaction of a lower need is blocked, we will move down again to the lower needs until it is met ➔ CHARACTERISTICS OF HUMAN NEEDS 1. Universal- all must meet these needs 2. Deferred depending on the priority - EX: Patient scheduled for operation is instructed not to eat or drink from 12 midnight until the time for operation to promote safety but they complain of being thirsty, so as not to be dehydrated, drinking of water is permitted 3. Met in different ways - EX: Muslims do not eat pork, 7th Day Adventists are vegetarians and not eligible for blood transfusion 4. Needs are interrelated - EX: Family relationship is disturbed when in financial crisis 5. Unmet needs lead to a problem, then illness - EX: Inadequate food intake leads to malnutrition malnutrition can lead to death ➔ WHICH OF THE NEEDS WILL BE PRIORITIZED?  - Those who live way below the poverty line with no certainty as to where their next meal will come from - People in war-torn countries who live in constant fear of bombs and bullets or of being branded as subversives by the ruling party - People who have all the material things they need and who feel very comfortable where they are have never known what it is to love, to be loved, and to belong to a loving family ➔ APPLICATION OF MASLOW’S HIERARCHY OF NEEDS TO NURSING - Prioritization of Care: the need to maintain life and physical integrity is given top priority in nursing care - EX: A nurse attended to a patient in the ER by first relieving the patient’s difficulty breathing before gathering information about the patient’s condition by interview - Understanding of human behavior and its consequences: the behavior of the client will give clues to his or her needs CARL ROGERS - A humanistic American psychologist who focused on therapeutic relationship - First to use the term “client” ➔ PERSON-CENTERED THEORY - Self-concept is the most important feature of personality, and it includes all the thoughts, feelings, and beliefs people have about themselves - There should be agreement on the self-concept according to self and according to others to facilitate self-actualization - Will can affect a person’s recovery and will to live ➔ CLIENT-CENTERED THERAPY CONCEPT - Form of talk-psychotherapy - Aims to provide clients with an opportunity to develop a sense of self wherein they can realize how their attitudes, feelings, and behavior are negatively affected and make an effort to find their true positive potential - Each person experiences the world differently and knows his or her own experiences best - Nurses should validate patients’ feelings and conditions along with their observations (never assume that a patient feels a certain way) ➔ APPLICATION OF PERSON-CENTERED THEORY IN NURSING - Client-centered approach in nursing care - Focus on the role of the client as an important instrument in the healing process - A supportive and nurturing nurse-client relationship - The nurse has a supportive role, rather than a directive or expert one - The nurse must support the self-esteem of the client through: Unconditional positive regard  - Non-judgemental attitude towards the client Genuineness - realness, honesty, and sincerity toward the client Empathic understanding - ability to sense the feelings and meaning from the client and to convey the understanding towards the client ➔ WHAT IS CLIENT-CENTERED APPROACH IN NURSING? - Knowing the patient as an individual - Being responsive - Providing care that is meaningful - Respecting the individual’s values, preferences, and needs - Fostering trusting caregiving relationships - Emphasizing freedom of choice - Promoting physical and emotional comfort - Involving the person’s family and friends as appropriate - EX: A 35-year old client who is already in her 7th month of pregnancy came to the Health Center for consultation. The nurse asked the client how she is able to perform her role at home and what difficulty does she encounter when performing her role. ➔ IMPORTANCE OF KNOWING THE LIFE STORY OF THE PATIENT OR CLIENT - In order to achieve care that is person-centered, nurses need to understand the biographies of their patients and their relatives. Paying attention to the life stories and experiences of patients is the only way nurses will get to know their patients and their aspirations for the future. LUDWIG VON BERTALANFFY - An Austrian-born biologist - Proponent of the General Systems Theory ➔ WHAT IS A SYSTEM? - A system is a set of components or units interacting with each other within a boundary that filters the kind or rate of flow of inputs and outputs to and fro from the system - Man is a system - EX: communication process, interpersonal system ➔ ELEMENTS OF A SYSTEM 1. Input (received) 2. Process (transformed) 3. Output (released) 4. Feedback (positive, negative, or neutral) ➔ CONCEPTS OF THE GENERAL SYSTEMS THEORY - Systems can be open or closed, simple or complex - Open Systems: move in the direction of higher organization  Constantly affected by the environment Always on a constant state of change Move in the direction of higher organization - Closed Systems: move toward disorder, illness, and death Do not exchange matter, energy, and information with the environment EX: depressed patient, patient recieving IV fluid, patient with chest tube - Simple Systems: the gas exchange in the alveoli - Complex Systems: Human body development Pathophysiology Personality development - Man, having biological and social systems has subsystems interacting with each other - The interrelatedness of all parts of the system is the basis of the holistic approach of the nurse ➔ TYPES OF INPUT TO OUTPUT PROCESS 1. Matter to matter - EX: baking bread- ingredients (input); bread (output) 2. Matter to energy - EX: metabolism- food (input); energy (output) 3. Matter to information - EX: blood sample- blood (input); component information (output) 4. Energy to matter - EX: laser-induced tissue repair- laser energy (input); new tissue (output) 5. Information to matter - EX: 3D bioprinting- model of tissue from patient scan (input); printed physical model of tissue (output) ➔ APPLICATIONS OF THE GENERAL SYSTEMS THEORY TO NURSING - People interact with the environment by adjusting themselves to it or adjusting it to themselves - The nurse looks at environmental factors influencing the patient’s health KURT LEWIN - A German psychologist - Father of modern psychology ➔ FIELD THEORY - Focused on the subjective reality of an individual - Asserts that if a person is to be understood, he must be seen in the light of how she views the world (subjective reality), not merely in terms of how the world really is (objective reality) - Field: realities in the environment of an individual that is working together to move towards or against his or her goal  - Emphasized the importance of understanding how the relationship between the individual and the influences in the environment - Life Space: Psychological field : Subjective concept of a person about himself : Behavior is understood and determined depending on the 3 major life spaces: home life, professional or student life, social life - An individual lives in a life space: his environment - External forces (things, conditions, situations) act on him - Internal forces (drives, ideas, concepts, feelings, attitudes, and insights) that interact with him ➔ CONCEPTS OF FIELD THEORY - Human behavior is the function of both the person and the environment - Human motivation is goal-directed and purposeful - Human behavior is greatly influenced by the surroundings ➔ APPLICATIONS OF FIELD THEORY TO NURSING - Environmental data are collected in the assessment of the individual, family, and community (external factors) - Health education involves motivation of the patient - As much as possible, the nurse gives priority to needs recognized by the patient himself (subjective reality) ➔ MODEL OF CHANGE (KURT LEWIN) - 3 stages of change - Unfreezing, change, refreezing - Asserts that previous or prior learning has to be rejected and replaced before change can manifest - Depends on the driving force and resistant force - Driving force: nurse; Resistant force: patient - Unfreeze: refers to readiness and motivation to change : Present behavior is established by past learning and cultural influences : Requires adding new forces for change or removal of some of the existing factors that inhibits change to manifest - Change: there is sufficient dissatisfaction with the current conditions that leads them to a real desire to make some change (facilitate motivation) - Activities that facilitate change: Imitation of role model Trial and error learning - Refreeze: new behavior becomes habitual, which includes developing a new self-concept and identity and establishing new interpersonal relationships ➔ APPLICATION TO NURSING - Planning and providing health teachings - Making the patients aware of their present health conditions and the consequence of their current health practices = dissatisfaction - Patients follow the health teachings ERIK H. ERIKSON - A german psychologist - Proponent of the psychosocial developmental theory ➔ PSYCHOSOCIAL DEVELOPMENTAL THEORY - People continue to develop through life - There are 8 stages of development or levels of accomplishment - Each stage signifies a task to be accomplished by an individual so as to move forward to the next task - Failure to complete a developmental stage influences the person’s ability to progress to the next level - Environment is highly influential to the development 1. Trust vs. Mistrust - Infancy - Viewing the world as safe and reliable, relationship as nurturing, stable and dependable, consistency in treatment - Hope (develops from trust, love, and acceptance) 2. Autonomy vs. Shame and Doubt - Toddler - Achieving a sense of control and free will - Will 3. Initiative vs. Guilt - Preschool - Beginning development of conscience, learning to manage conflict and anxiety - Purpose 4. Industry vs. Inferiority - School age - Emerging confidence in own abilities, taking pleasure in accomplishments - Competence (recognition and competition) 5. Identity vs. Role Confusion - Adolescence - Establishing a sense of self and belonging - Fidelity (reliance on peers or friends) 6. Intimacy vs. Isolation - Young adult  - Forming adult, loving relationships and meaningful attachments to others - Love 7. Generativity vs. Stagnation - Middle adult - Being creative and productive; establishing the next generation - Care 8. Ego Integrity vs. Despair - Maturity - Accepting responsibility for one’s self and others - Wisdom ➔ APPLICATIONS OF PSYCHOSOCIAL DEVELOPMENTAL THEORY TO NURSING - Nurses can enhance a client’s development by being aware of the individual’s developmental stage and assisting ith the development of coping skills related to stressors experienced that specific level - EX: in the nursery, the nurse attends immediately to the needs of a crying infant (trust vs. mistrust) - Nurses should be aware that the resolution of the developmental task in each stage may be negative or positive - Nurses can strengthen a client;s positive resolution of a developmental task by providing the individual with appropriate opportunities and encouragement - EX: a nurse encourages a 65 year old male patient (integrity vs. despair) to participate in community activities such as church activities, bingo socials, and the like