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FAYE GLENN ABDELLAH’S TWENTY-ONE NURSING PROBLEMS THEORY OF NURSING Presented by: Wesleysgen Gacal & Janeah Gerena HISTORY AND BACKGROUND Faye Glenn Abdellah, was born on March 13, 1919, in New York City. She was a pioneer in nursing who shifted the focus from dise...

FAYE GLENN ABDELLAH’S TWENTY-ONE NURSING PROBLEMS THEORY OF NURSING Presented by: Wesleysgen Gacal & Janeah Gerena HISTORY AND BACKGROUND Faye Glenn Abdellah, was born on March 13, 1919, in New York City. She was a pioneer in nursing who shifted the focus from disease to patient- centered care. She served as a public health nurse for 40 years and developed teaching methods based on scientific research. Abdellah was inspired by the 1937 Hindenburg explosion and earned a nursing diploma from Fitkin Memorial Hospital’s School of Nursing. She later earned three degrees from Columbia University, including a Bachelor of Science in Nursing, a Master of Arts in Physiology, and a Doctor of Education.  TRANSFORMED NURSING PROFESSION Abdellah, a nursing instructor and researcher, played a significant role in transforming the nursing profession from disease-centered to patient- centered. She expanded the role of nurses to include family and elderly care and taught research methods and theory at various universities. Abdellah was the first Dean of the Graduate School of Nursing at the Uniformed Services University of Health Science in 1993. She advocated for degree programs for nursing education based on research and emphasized the importance of theory and research. Her research evolved to include physiology, chemistry, and behavioral sciences. In 1957, she led a research team in Manchester, Connecticut, which established the groundwork for progressive patient care, which included critical care, which was not widely accepted at the time, was later adopted as an essential part of long-term health care.  ESTABLISHED STANDARDS Abdellah developed the Patient Assessment of Care Evaluation (PACE), a system measuring the quality of healthcare facilities, and a classification system for patient care. Her work was foundational in the development of Diagnostic Related Groups (DRGs), which became the standard coding system used by Medicare. DRGs categorize patients based on primary and secondary diagnoses, reducing healthcare costs by allowing providers to charge less for procedures. Abdellah’s work also led to the ongoing development of an international nursing practice classification system.  SERVED IN MILITARY Abdellah serve for 40 years in the U.S. Public Health Service (PHS), Commissioned Corps nurse, she was the first nurse officer to achieve the rank of two-star rear admiral during the Korean War. She focused on elderly care and was a pioneer gerontological nursing, influencing public policy on nursing homes. Abdellah established nursing home standards in the 1970s, identifying fire hazards and difficulty in tracing ownership. She believes nurses should be more involved in public policy discussions about nursing home regulation. In 1981, she was appointed deputy surgeon general by U.S. Surgeon General C. Everett Koop, where she educated Americans about public health issues and improved the health and safety of the elderly. She also worked with physicians to inform them of the latest research on health issue for older patients.  INTERNATIONAL CONTRIBUTIONS Abdellah, a nursing expert, has shared her theories with caregivers worldwide, leading seminars in various countries and serving as a research consultant to the World Health Organization. She has written numerous articles and books, including “Effect of Nurse Staffing on Satisfactions with Nursing Care (1959)”, “Patient-centered Approaches to Nursing” (1960), “Better Patient Care through Nursing Research” (1956; revised 1986), and “Intensive Care, Concepts and Practices for Clinical Nurse Specialists” (1969). She has received over 70 awards and honorary degrees, and is a fellow of the American Academy of Nursing. Abdellah was named to the Nursing Hall of Fame at Columbia University in 1999 and inducted into the National Women’s Hall of Fame in 2000. She emphasized the importance of taking the lead and collaborating to change the world.  OVERVIEW OF ABDELLAH’S “PATIENT-CENTERED APPROACHES TO NURSING MODEL” Abdellah and colleagues developed a list of 21 nursing problems. They also identified 10 steps to identify the client’s problems and 11 nursing skills to be used in developing a treatment typology  10 STEPS TO IDENTIFY THE CLIENT'S PROBLEMS Learn to know the patient Sort out relevant and significant data Make generalizations about available data in relation to similar nursing problems presented by other patients Identify the therapeutic plan Test generalizations with the patient and make additional generalizations  10 STEPS TO IDENTIFY THE CLIENT'S PROBLEMS Validate the patient's conclusions about his nursing problems Continue to observe and evaluate the patient over a period of time to identify any attitudes and cues affecting his behavior Explore the patient's and family's reaction to the therapeutic plan and involve them in the plan Identify how the nurse feels about the patient's nursing problems  11 NURSING SKILLS OBSERVATION OF HEALTH STATUS SKILLS OF COMMUNICATION APPLICATION OF KNOWLEDGE TEACHING OF PATIENTS AND FAMILIES PLANNING AND ORGANIZATION OF WORK USE RESOURCE MATERIALS  11 NURSING SKILLS USE OF PERSONAL RESOURCES PROBLEM-SOLVING DIRECTION OF WORK OF OTHERS THERAPEUTIC USE OF SELF NURSING PROCEDURES THE TWENTY-ONE NURSING PROBLEMS ARE DIVIDED INTO THREE MAJOR CATEGORIES Physical, sociological, and emotional needs of clients Types of interpersonal relationships between rhe nurse and patient Common elements of client care  Classification of the Twenty-one Nursing Problems (Faye Abdellah, et al, 1960, 1965) BASIC TO ALL PATIENTS 1. To maintain good hygiene and physical comfort. 2. To promote optimal activity: exercise, rest, and sleep. 3. To promote safety through the prevention of accidents, injury or other trauma and through the prevention of the spread of infection. 4. To maintain good body mechanics and prevent and correct deformity. Classification of the Twenty-one Nursing Problems (Faye Abdellah, et al, 1960, 1965) SUSTENAL CARE NEEDS . To facilitate the maintenance of a supply of 5 oxygen to all body cells. 6. To facilitate the maintenance of nutrition of all body cells. 7. To facilitate the maintenance of elimination Classification of the Twenty-one Nursing Problems (Faye Abdellah, et al, 1960, 1965) SUSTENAL CARE NEEDS . To facilitate the maintenance of fluid and electrolytes 8 balance. 9. To recognize the physiological responses of the body to disease conditions 10. To facilitate the maintenance of regulatory mechanisms and functions. 11. To facilitate the maintenance of sensory functions. Classification of the Twenty-one Nursing Problems (Faye Abdellah, et al, 1960, 1965) REMEDIAL CARE NEEDS 1 2. To identify and accept positive and negative expressions, feelings, and reactions 13. To identify and accept the interrelatedness of emotions and organic illness. 14. To facilitate the maintenance of effective verbal and nonverbal communication 15. To promote the development of productive interpersonal relationship Classification of the Twenty-one Nursing Problems (Faye Abdellah, et al, 1960, 1965) REMEDIAL CARE NEEDS 1 6. To facilitate progress toward achievement of personal spiritual goals 17. To create and/ or maintain a therapeutic environment 18. To facilitate awareness of self as an individual with varying physical, emotional, and developmental needs Classification of the Twenty-one Nursing Problems (Faye Abdellah, et al, 1960, 1965) RESTORATION CARE NEEDS 1 9. To accept the optimum possible goals in the light of limitations, physical and emotional. 20. To use community resources as an aid in resolving problems arising from illness. 21. To understand the role of social problems as influencing factors in the case of illness.  NURSING PROBLEMS Nursing problem presented by a patient is a condition faced by the patient or patient's family that the nurse through the performance of professional functions can assist them to meet. The problem can be either can overt or overt nursing problem.  n overt nursing problem is an apparent condition faced by the patient or A family, which the nurse can assist him or them to meet through the performance of her professional functions. The covert nursing problem is concealed or hidden condition faced, by the patient or family, which the nurse can assist him or them to meet through the performance of her personal functions  NURSING PROBLEMS The problem can be either can overt or overt nursing problem. In her attempt to bring nursing practice into its proper relationship with restorative and preventive measures for meeting total client needs, she seems to swing rhe pendulum to the opposite pole, from the disease orientation to nursing orientation, while leaving the client somewhere in the middle PROBLEM SOLVING The problem solving process involves identifying the problem, selecting pertinent data, formulating hypothesis, testing hypothesis through the collection of data, and revising hypothesis where necessary on the basis of conclusion obtained from the data.  FAYE ABDELLAH'S METAPARADIGM PERSON Abdellah describes people as having physical, emotional, and sociological needs. These needs may be overt, consisting of largely physical needs or covert such as emotional and social needs. Patient is describe as the only justification for existence of nursing. Individuals (and families) are recipients of nursing. Health or achieving of it is purpose of nursing service  FAYE ABDELLAH'S METAPARADIGM ENVIRONMENT Society is included in "planning for optimum health on local, national, and international levels". However, as Abdellah further delineated her ideas, the focus of nursing service is clearly the individual. The environment is the home or community from which patient comes.  FAYE ABDELLAH'S METAPARADIGM HEALTH In Patient - Centered Approaches to Nursing, Abdellah describes health as state mutually exclusive of illness. Although Abdellah does not give a definition of health, she speaks to "total health needs" and "a health state of mindnand body" in her description of nursing as a comprehensive service.   AYE ABDELLAH'S METAPARADIGM F NURSING Nursing is a helping profession. In Abdellah's model, nursing care is doing something to or for the person or providing information to the person with the goals of meeting needs, increasing or restoring self-help ability, or alleviating impairment Nursing is broadly grouped into the 21 problem areas to guide care and promote use of nursing judgement. She considers nursing to be comprehensive service that is based on art and science and aims to help people, sick or well, cope with their health needs.