Nursing Conceptual Models PDF

Nursing Conceptual Models Pattern  Week 7-8 Pattern is defined as the distinguishing characteristic of an energy field perceived as 1. Martha Roger’s Science of Unitary Human...

Nursing Conceptual Models Pattern  Week 7-8 Pattern is defined as the distinguishing characteristic of an energy field perceived as 1. Martha Roger’s Science of Unitary Human single waves. Beings Conceptual Model  Pattern is a abstraction and it gives identity to Rogerian Mode the field. Roger’s theory states that the purpose of Pan Dimensionality nurses is to promote health and well-being for all persons wherever they are  Is defined as non- linear domain without spatial or temporal attributes. The belief of the coexistence of the human and the environment has greatly influenced the  Human beings are pan dimensional being and process of change toward better health have more than three dimensions. In short, a patient cannot be separated from Homeodynamic Principles the environment when addressing health and treatment.  Refers to the balance between the dynamic life process and environment. The model is based on four building block: energy field, universe of open systems, pattern,  Theses principles help view human as unitary and four dimensionality. human being. Science of Unitary Human Beings Resonancy The science comes from knowledge bases of  Wave patterns are continuously changing in many different sciences such as anthropology, environmental and human energy fields. psychology, sociology, astronomy, religion, Helicy philosophy, history, biology, physics, mathematics, and literature to create a model  The nature of change is unpredictable, of unitary human beings. continuous, and an innovative. 8 Concepts of the Theory Integrality Energy Field  Energy fields of humans and environment are in continuous mutual process.  It is inevitable part of life. Human and environment both have energy field which is Assumptions of the Theory open. Energy can freely flow between human Wholeness.Human being is considered as and environment. united whole. Human Openness Openness. A person and his environment are  There is no boundary or barrier that can continuously exchanging energy with each inhibit the flow of energy between humans and other. environment which leads to the continuous Unidirectionality. The life process of human movement or matter of energy. being evolves irreversibly and unidirectional. Example is birth to death. Pattern & Organization Pattern.  The more importance should be on the management of pain, supportive therapy and identifies individuals and reflects their rehabilitation. innovative wholeness. Next Topic Sentence & Thought. 2. Dorothea Orem’s Self Care Deficit Theory Humans are the only organisms able to think, imagine, have language and emotions. Self Care Deficit Theory 6 Domains of Energy Patterning and  Developed to improve quality of nursing and Corresponding Nursing Interventions: patient ability to meet demands of care  Connecting- guided imagery, therapeutic Purpose of the Theory touch, Reiki, music/color therapy, Aromatherapy To help promote patient to perform selfcare.  Conveying- Accupressure, Reflexology Patient can recover faster if they are  Converting- Herbal therapy, exercise, encouraged to perform self- care tasks to music/color therapy, Purpose meaning maintaining their health and well- being  Conserving-biofeedback,. Theory can apply to all types of nursing. relaxation/meditation, breathing, Herbal Example: rehab, primary care settings, nursing therapy, sleep and rest home, and elders.  Clearing- music/color therapy, Accupressure, Three Components of Theory: Aromatherapy, postural movement Self- care  Coursing- Yoga, massage, Polarity therapy, Self- care deficit exercise Nursing system 3 Steps in the Theory Process Self- care deficit Assessment- includes both the patient and environment is core of Orem’s theory because it determines when nursing is needed. Main purpose for. Voluntary Mutual Patterning- includes theory is for patient and families to maintain sharing knowledge, empowering the patient, control of health by actively performing for self nutrition, and pain. Self- care Evaluation Activity of person to do on own in maintaining Application in the Clinical Practice their health and well-being.  Nursing action is always focused on unitary When there is demand to care for oneself and human being and change the energy field that individual is capable to meet that demand, between human and environment. self care is possible.  Nursing action include all non-invasive Concepts: actions such as guided imagery, humor, therapeutic touch, music, etc. which are used to Self care agency increase the potential of human field.  Therapeutic self care demand Staying active Self care requisites: universal, developmental Nurse can meet needs of patients with setting and health deviation goals and interventions Self- Care Deficit Relevance of the Theory When individuals is not capable to meet the Allows the nurse to utilize patient’s own self- demand of care for self, self- care deficit occurs. care abilities This is the key to Orem’s theory.. Nurse can maximize the skills for the needs of the patient from an individualized plan of Nursing is required in self- care deficit to care. guide in meeting the demand. Promotes patient autonomy and 5 Methods of Helping independence. Acting for or doing for patient. Nurses focuses on self- care much more than Teaching patient. any other discipline in healthcare. Directing patient. It has been used in research. Supporting patient. It helps the nurse on what intervention are used based on the needs of the patient. Providing environment for patient. Questions? Next Topic Nursing System in the Theory Imogene King’s Goal Attainment Theory  Addresses and plans how needs of the patient can be met by the nurse, patient or Theory of Goal Attainment both. Describes the importance of the participation Three Types: of all individuals in decision making as well as choices, alternatives, and outcomes of nursing Wholly Compensatory System- patients not care. capable to perform self-care. It pertains to the importance of interaction, Partly Compensatory System- limited mobility perception, communication, transaction, self, due to illness. role, stress, growth and development, time and Supportive Educative System- patient is capable personal space. learning to perform. The practice of nursing is differentiated from Encourage Patient to Perform Self- Care other healthcare professions by what nurses do with and what they do for individuals. Geriatric patients- restorative programs The nurse and patient/client communicates Physical, occupational and speech therapy information in order to set goals mutually and Active ROM can facilitate building strength then acts to attain those goals. Walking- to maintain physical health According to King humans have three fundamental needs: ADLs  Information on health that can be accessed  If role conflict is experienced by nurse or and utilized. client or both, stress in nurse- client interaction will occur. Care that aims to prevent illness.  If nurse with special knowledge skill Care in times of need or illness. communicate appropriate information to client, 3 Interacting Systems Framework mutual goal setting and goal attainment will occur.  Personal System- the individual. Goal Attainment Diagram  Interpersonal System- individuals interacting with one another. ADPIE  Social System- groups of people in a Assessment community or society sharing common goals, Nursing Diagnosis interests and values. Planning Systems Framework Concepts Implementation  Personal System- coping, spirituality, perception, self, body image, growth and Evaluation development. Assessment  Interpersonal System- interaction, Assessment occur during interaction. communication, transaction, role, stress and coping. The nurse brings special knowledge and skills whereas client brings knowledge of self and  Social System- organization, authority, power, perception of problems of concern, to this status, and decision making. interaction. Proposition of King’s Theory During assessment nurse collects data  If perceptual interaction accuracy is present regarding client (his/her growth and in nurse- client interactions, transaction will development, perception of self and current occur. health status, roles, etc.).  If nurse and client make transaction, goal will Perception is the base for collection and be attained. interpretation of data.  If goal are attained, satisfaction will occur. Communication is required to verify accuracy of perception, for interaction and transaction.  If transactions are made in nurse- client interactions, growth and development will be Nursing Diagnosis enhanced. The data collected by assessment are used to  If role expectations and role performance as make nursing diagnosis in nursing process. perceived by nurse and client are congruent, In process of attaining goal the nurse transaction will occur. identifies the problems, concerns and disturbances about which person seek help. Planning  Bedside report is a good start After diagnosis, planning for interventions to Questions? solve these problems is done. Next Topic In goal attainment planning is represented by Betty Neuman’s System Model Neuman Model setting goals and making decisions about and being agreed on the means to achieve goals. The model is dynamic because it is based on the client’s continuous relationship to This part of transaction and client’s environmental stress factors, which have a participation is encouraged in making decision potential for causing a reaction, or obvious on the means to achieve the goals. symptomatic reaction to stress, or could affect Implementation reconstitution following diagnosis of stress. In nursing process implementation involves It is a complex systems model with focus on the actual activities to achieve the goals. stress reactions and stress reduction. In goal attainment it is the continuation of The Neuman model is based on the philosophy transaction. that each person is layered multidimensional being. Each layer in the model consists of 5 Evaluation person variables or subsystems It involves to finding out whether goals are. Physiological achieved or not. Psychological The described evaluation speaks about attainment of goal and effectiveness of nursing Socio- cultural care. Spiritual Application in Practice Developmental  Used for curriculum design in nursing The 5 Interacting Variables programs and used as frameworks for books.  Psychological- refers to bodily structure and  Relies on the participation of both nurse and internal function. patient for effectiveness.  Psychological- refers to mental processes and  It can be used in most any practice. interactive environmental effects, both  Reviewing the patient’s plan of care and internally and externally. providing the patient with information as well as  Socio- cultural- refers to combined effects of education each day. social cultural conditions and influences.  Providing the patient options for their plan of  Developmental- refers to age related care. developmental processes and activities.  Keeping the patient during the process of  Spiritual- refers to spiritual beliefs and care. influences.  Making decisions with the patient rather for Basic Structure of the System the patient.   the basic structure of the central core  This line is activated following invasion of the consists of basic survival factors. normal line of defense by environmental stressors.  The flexible and normal line of defense and the lines of resistance are essential functions as  The line of resistance contain certain known protective mechanisms for the basic structure and unknown internal and external resource to preserve client system integrity factors that support the client’s basic structure and normal defense line. Example of it is body. Flexible Line of Defense mobilization of white blood cells or activation of  It forms the outer layer of the defined client immune system mechanisms, its ineffectiveness system; whether a single client, a group or a leads to energy depletion and death. social issue.  Lifestyle, coping, client expectations,  The flexible line of defense is depicted as the motivation are all inherent within the lines of outer, broken circle surrounding the normal line defense and resistance, ultimately protecting of defense the basic structure..  It acts as a protective buffer system for the client’s normal stable state. Stability of Defenses in Health  It prevents stressor invasion of the client Stability of Defenses from Environment system, keeping the system free from stressor reactions.  As it expands away from the normal line of Nursing Intervention in Relation to the Defenses defense, greater protection is provided, as it  Nursing interventions can occur before or draws close, less protection is available. When after stressors at all levels of prevention. the normal line of defense is rendered  Client is viewed as an open system interacting ineffective in particular to a stressor impact, a with the environment through interpersonal reaction will occur within the client system. and extra personal factors. Coping patterns, lifestyle factors and beliefs will influence to changes. Normal Line of Defense Nursing Prevention  The flexible line of defense protects the normal line of defense. Interventions are made thru:  The line represents what the client has  They are based on become, the state to which the client has evolved over time or the wellness level. It is  The degree of reaction dynamic in terms of its ability to become and remain stabilized to deal with life stressor over  Resources time, thus protecting the basic structure and  Goals systems integrity.  Anticipated outcomes Line of Resistance Levels of Prevention  The model is a conceptual deductive theory based on causality. Primary Model Concept: People as Adoptive Systems Occurs before the system reacts to a stressor. It can strengthen a person.  People, individually and in groups are holistic adaptive systems, complete with coping Health promotion and injury prevention. processes acting to maintain adaptation and to Secondary promote person and environment as transformations. Occurs after the stressor has effected the environment. Model Concept: People as Adoptive Systems Focuses on preventing damage to internal Individuals core.  Regulator Subsystem- uses physiologic Tertiary processes such as chemical, neurologic, and endocrine response to cope with the changing Occurs after the system has been treated environment through secondary prevention measure.  Cognator Subsystem- involves the cognitive Focus on support. and emotional processes that involves the How Stressor Penetrates the Lines cognitive and emotional process that interact with the environment. Effects of the Stressor and How Nursing Prevention Works Example: a person sees an incoming car after stepping off a curb. The person’s body pumps Once an individual is exposed to stress, the adrenaline that provides energy to move out of flexible line of defense will be alarmed to the way (regulator), while emotion of fear is protect the normal line of defense to keep the experienced helping to escape (cognator). system free from stressor reactions. However, if this individual is continuously exposed to stress Groups and if the flexible line of defense is unable to  Stabilizer Subsystem- structures, values and cope, the normal line of defense will be altered. daily activities work together to accomplish the If this happens, the basic structure of the primary purpose of the group. individual will enter instability and illness develops. Example: the family’s purpose is to earn a living and provide nurturance and education for the Questions? children. Family values influence how members Next Topic respond to its environment in order to fulfill responsibilities to maintain the family. Sister Callista Roy’s Adaptation Model  Innovative Subsystem- response to Goal of the Nursing Model environmental change.  The promotion of adaptation for individuals Example: organizations plan activities and team and groups in each of the 4 adaptive modes, building sessions. During this time, the group thus contributing to health, quality of life, and dying with dignity. creates new goals and growth resulting in  Integrated Adaptation- structures and progression. functions of the adaptive modes are working together and meet human needs. Model Concept: People as Adoptive Systems  Compensatory Adaptation- occurs when Four Adaptive Modes: the cognator and regulator or stabilizer and innovator are activated by a challenge. 1.Physiologic-Physical: people as individuals  Compromised Adaptation- occurs when interact as physical beings with integrated and compensatory processes are environment. inadequate, creating an adaptation  Senses; fluid electrolyte, acid- base problem. balance; neurologic function; endocrine function Model Concept: Health 2. Self concept: composite beliefs and  Defined as the reflection of personal and feelings that a person holds about him or environmental interactions that are herself at a given time; sense or purpose. adoptive.  Involves developing self, perceiving self,  A process and focusing self.  A state of being. 3. Role Function- roles on people in society  Becoming whole and integrated in a way filing their needs for social integrity, relating that reflects individual and environment self to others. mutuality  Individual needs to know who one is in relation to others to act. Nursing Process in Relation to Adaptive 4. Interdependence modes: close Model relationship of people and their purpose, structure and development  Gathering of data about certain behavior of the person or group. Model Concept: Environment  Identifying the internal and external stimuli that influence behavior. Defined environment as all the conditions, circumstances and influences surrounding  Collaboration with the person or group and affecting the development and to set goals or behavioral outcomes. behavior or individuals and groups.  Interventions are based on the best way to assist the person in reaching the goal. Model Concept: Environment  Evaluation judges the effectiveness of Three categorized factors of environment the intervention. stimuli: Questions?  Focal- factors immediately affecting the Next Topic person. Dorothy Johnson’s Behavior System Model  Contextual- all other stimuli affecting situation. Definition of Nursing thru the Model  Residual- factors whose effect are  An external regulatory force which acts unclear. to preserve the organization and Model Concept: Environment integration of the patient’s behaviors at an Three levels of Adaptation: optimum level under those conditions in which the behaviors constitutes a threat to the physical or social health, or in which Behavioral Subsystem illness is found.  Attachment- goal attainment, form Goal of the Model relationships and social bonds  It advocates the fostering of the patient.  Aggressive- protect oneself to respond and effective behavioral functioning of the to threats. patient to prevent illness.  Dependency- attention, recognition,  The patient is defined as a behavior physical assistance. system composed of 7 behavioral  Ingestion- intake of nutrients to obtain subsystems. knowledge.  Assist the patient whose behavior is  Elimination- eliminate waste and to proportional to social demands express feelings..  To assist the patient who is able to  Sexual- to procreate, to have sexual modify his behavior in ways that it supports relationships, to develop gender- based biological imperatives. identity.  To assist the patient who is able to  Achievement- mastery or control of some benefit to the fullest extent during illness aspect of the environment. from the physician knowledge and skills.  Whose behavior does not give evidence System is out of Balance When: of unnecessary trauma as a consequence of  Insufficiency- does not get enough of illness. something.  Discrepancy- not optimally working. Purpose of the Model  Incompatibility- subsystems conflict.  Nurse creates a balance between client  Dominance- one subsystem is always and environment. used.  Protection from noxious stimuli that threaten the survival of the behavioral Functional Requirements Needed by Each system. Subsystem to Fulfill its Function  Nurturance, which provides adequate Nurturance input to sustain behavior. Simulation  Stimulation to continue growth of the Protection behavior. Nurse Goals Assumptions of the Model Contribute to patient welfare as that of  Form of the behavior can infer what fostering efficient and effective behavioral drive or what goal. functioning in the person both to prevent  Predisposition of act. illness and during and following illness.  Different choices/ scope of choices.  Outcomes are produced. How? Goal  Reduce stressful stimuli Set.  Support natural adaptive process. Choice  Makes changes to environment. Behavior  Focus is the patient not illness. Questions? End of Week 7-8