Nursing Conceptual Models Sheryl Endterm Reviewer PDF

THEORITICAL FOUNDATION OF NUSING ENDTERM *Nursing Conceptual Models* Sister Callista Roy [THE ROY'S ADAPTATION MODEL (RAM)] Born on October 14, 1939 in Los Angeles, California 1976 -- Published "Introduction to Nursing; An Adaptation Model Became a nurse theorist & professor at the William...

THEORITICAL FOUNDATION OF NUSING ENDTERM *Nursing Conceptual Models* Sister Callista Roy [THE ROY'S ADAPTATION MODEL (RAM)] Born on October 14, 1939 in Los Angeles, California 1976 -- Published "Introduction to Nursing; An Adaptation Model Became a nurse theorist & professor at the William F. Connell School of Nursing in Boston Named a Living Legend [Roy's Adaptation Model (RAM)] - Derived from Harry Helson's work - Views the person as an adaptive system in constant interaction with an internal and external environment. [Adaptation] -- refers to the process and outcome whereby thinking and feeling persons as individuals or in groups, use conscious awareness and choice to create human & environmental integration. [COPING MECHANISMS] - *Regulator* -- coping mechanisms thru neural, chemical, and endocrine processes - *Cognator* -- coping mechanism thru learning, judgment, and emotion. [4 ADAPTIVE MODELS] - Physiological Adaptive Mode - *5 Physiological needs of this mode:* \- Oxygenation \- Nutrition \- Elimination \- Activity & Rest \- Protection - Self- Concept Adaptive Mode - - - Role function Adaptive Mode - - - Interdependence Adaptive Mode - - - Person experience stimuli in environment (stress) and uses coping mechanisms. Person's response could either be adaptive or ineffective. - - [METAPARADIGM] - *Person* - - *Environment* - Factors in the environment - - - - - - - *Health* - - - *Nursing* - [ROLE OF THE NURSE] - Facilitator of adaptation [NURSE USES THE SIX-STEP NURSING PROCESS] - Assessment of stimulus - Assessment of behavior - Nursing Diagnosis - Goal-setting - Intervention - Evaluation Martha Elizabeth Rogers [SCIENCE OF UNITARY HUMAN BEINGS] Born on May 12, 1914 in Dallas, Texas. Died on March 13, 1994 at the age of 79. 1970 - published her conceptual model - An Introduction to the Theoretical Basis of Nursing. [Science of Unitary Human Beings] \- Human beings are energy fields that interact constantly with the environment. [CONCEPTS] - Energy fields - - - Openness - - Pattern - - experiences, expressions, perceptions, and physical, mental, social and spiritual data. - Pandimensionality - - [HOMEODYNAMIC PRINCIPLES] - Resonancy - - Helicy - - Integrality - "Heilicy is the nature of change, Integrality is the process by which change takes place, and Resonancy is how change takes place." [METAPARADIGM] - *Person* - - *Environment* - "Environment & human fields change continuously in a mutual process." - *Health* - - - - *Nursing* - [ROLE OF THE NURSE] - Repatterning - Repattern the person and the environment to achieve maximum health potential for the person. [NOTES:] - Science of Unitary Human Being is used as a basis for non-invasive modalities such as therapeutic touch, humor, guided imagery, use of color, light, music, medication focusing on health potential of the person. - Rogers' "Science of Unitary Human Beings Theory" - emphasizes on viewing human beings and their environment as irreducible wholes, which has brought nursing focus on holism. - Rogers - stresses that human beings are unified wholes, greater than the sum of their parts. Dorothea Elizabeth Orem [SELF-CARE DEFICIT THEORY] Born in Baltimore, Maryland on July 15, 1914 Died on June 22, 2007 in Savannah, USA at the age of 92 1949 -1957 - Developed the definition of nursing practice. 1959 - First published her concept of self-care [Self-Care Deficit Nursing Theory] Orem's General Theory of Nursing in three related parts: A. Theory of Self-Care B. Theory of Self-Care Deficit C. Theory of Nursing System - Self-Care Theory - - *Universal Self-care Requisites that must be undertaken by the person in order to attain healthy living:* 1. Maintenance of a sufficient intake of air, water & food. 2. Provision of care associated with elimination processes & excrements. 3. Maintenance of balance between activity & rest. 4. Maintenance of balance between solitude & social interaction. 5. Prevention of hazards to human life, human functioning & human well-being. 6. Promotion of human functioning & development within social groups. - Self-care Deficit Theory - - - Nursing Systems Theory - [BASIC NURSING SYSTEMS] - *Wholly compensatory system* - - - *Partially compensatory system* - - - *Supportive-educative system* - - [METAPARADIGM] - *Person* - - *Environment* - - a. physical, chemical & biologic features b. socioeconomic features - *Health* - - *Nursing* - - [ROLES OF THE NURSE] - Diagnostic - - - Prescriptive - - Regulatory - - Control - Imogene King [INTERACTING SYSTEMS FRAMEWORK] [GOAL ATTAINMENT THEORY ] Born in January 30,1923 Died on December 24, 2007 at the age of 84 established to facilitate the dissemination & utilization of her interacting systems framework. [Interacting Systems Framework & Goal Attainment Theory] Theme - Interaction & Goal Attainment [Interacting Systems Framework] *Composed of the:* 1\. PERSONAL systems 2\. INTERPERSONAL systems 3\. SOCIAL systems *King proposed that the nurse interact on the system simultaneously at three different levels:* - PERSONAL( Individuals) - - INTERPERSONAL( Groups) - - SOCIAL SYSTEMS (Society) - *Each system identifies human beings as the basic element in the system -\> focuses on human behavior in a variety of social environment* [Theory of Goal Attainment] Basic Assumption: The nurse and the client communicate information, set goal mutually, and then act to attain those goals. [METAPARADIGM] - *PERSON* - - *Health* - - - - - - *Environment* - a. b. - *Nursing* - - Perceptions - - Judgment - - Action - - Reaction - - Interaction - - Transaction - *[Nurse & client mutually agrees on goals for client's health.]* Betty Neuman [SYSTEM MODEL] Born in 1924 on a farm near Lowell, Ohio 1972 -- first published her model & finally came out with her book - The Neuman Systems Model: Application to Nursing Education & Practice Became a licensed clinical marriage & family therapist -- emphasized on Christian counseling *The foundations of Neuman's model are primarily:* \- Hans Selye's stress theory \- Ludwig Von Bertalanffy's general systems theory \- Gerald Caplan's levels of prevention \- Kurt Lewin's field theory \- Pierre Teilhard de Chardin's philosophy of life - The Neuman model is considered a systems model. In a systems model, the main focus is the interaction of the parts, or subsystems within the system. [System Model ] [(Health Care Systems Model)] Basic components -\> stress & reaction to stress [CONCEPTS] - Open system - - Client Variables - *5 Client Variables* \- physiological \- psychological \- developmental \- socio-cultural \- spiritual - Lines of Resistance - - - - Normal Line of Defense - - - - Flexible Line of Defense - - *Reconstitution - is the increase in energy that occurs in relation to the degree of reaction to the stressor* [METAPARADIGM] - *Person* - - - *Environment* - Environmental Forces: a. b. c. - *Health* - - - - - *Nursing* - - - - [3 Prevention Modalities] a. Primary Prevention - b. Secondary Prevention - c. Tertiary Prevention - - Neuman System Model is based in General System Theory and views the client as an open system that responds to stressors in the environment - The client system is composed of a basic or core structure that is protected by lines of resistance. The usual level of health is identified as the normal line of defense that is protected by a flexible line of defense. - When stressors break through the flexible line of defense, the system is invaded, the lines of resistance are activated, and the system is described as moving into illness on a wellness-illness continumm. - Nursing interventions occur through three prevention modalities: Primary, Secondary, and Tertiary Prevention Dorothy Johnson [BEHAVIORAL SYSTEMS MODEL] Born on August 21, 1919 in Savannah, Georgia Influence on nursing (1950s) ! publications stressed the importance of research-based knowledge about the effect of nursing care on clients 1980 - published "Behavioral System Model for Nursing" Died in February 4, 1999 at the age of 80. [Behavioral Systems Model] *" The client is a living open system; a collection of behavioral subsytems that interrelate to form a behavioral system"* Role of a Nurse -- Restore Equilibrium [MAJOR CONCEPTS] - Equilibrium - - Tension - - - Stressors - [Behavioral System] - patterned repetitive, and purposeful ways of behaving. - a person tries to achieve stability & balance - reflects adjustments and adaptations. [Subsystem] - specialized tasks - have its own particular function and goal - continues to change through maturation, experience and learning. [Johnson's Behavioral Subsystems] - proposed that the client is a behavioral system, organized into seven subsystems of behavior which are as follows: - Attachment or affiliative subsystem - - Dependency Subsystem - - - Ingestive Subsystem - - - Eliminative Subsystem - - - Sexual Subsystem - - Aggressive Subsystem - - Achievement Subsystem - - Restorative Subsytem - [METAPARADIGM] - *Person* - - *Environment* - - *Health* - - *Nursing* - - *The Nurse must assist the client to return to a state of equilibrium.* - An imbalance in any of the behavioral subsystems results in disequilibrium. - It is nursing's role to assist the client to return to a state of equilibrium. *Nursing Theories* Hildegard Peplau [INTERPERSONAL RELATIONS THEORY] American nurse who is the only one to serve the American Nurses Association (ANA) as Executive Director and later as President. She became the first published nursing theorist since Florence Nightingale. "Mother of Psychiatric Nursing" and the "Nurse of the Century." [Interpersonal Relations Theory] - the nurse-client relationship as the foundation of nursing practice - emphasis on the give-and-take of nurse-client relationships that was seen by many as revolutionary - interpersonal model emphasizing the need for a partnership between nurse and client as opposed to the client passively receiving treatment and the nurse passively acting out doctor's orders [ASSUMPTIONS] 1\. Nurse and the patient can interact. 2\. Peplau emphasized that both the patient and nurse mature as the result of the therapeutic interaction. 3\. Communication and interviewing skills remain fundamental nursing tools. 4\. Peplau believed that nurses must clearly understand themselves to promote their client's growth and to avoid limiting the client's choices to those that nurses value. [METAPARADIGM] - *Person* - - - - *Health* - - *Environment (Society)* - - - *Nursing* - [THERAPEUTIC NURSE-CLIENT RELATIONSHIP] - a professional and planned relationship between client and nurse that focuses on the client's needs, feelings, problems, and ideas - interaction between two or more individuals with a common goal - the attainment of this goal, or any goal, is achieved through a series of steps following a sequential pattern 4 PHASES OF THE THERAPEUTIC NURSE-PATIENT RELATIONSHIP [Orientation Phase] 1. ORIENTATION PHASE - - - - - - [Working Phase] 2\. IDENTIFICATION PHASE - - - 3\. EXPLOITATION PHASE - - - - - - - - - - [Termination Phase] 4\. RESOLUTION PHASE - - - - - - - - [SUBCONCEPTS OF THE INTERPERSONAL RELATIONS THEORY] - Peplau's model has proved of great use to later nurse theorists and clinicians in developing more sophisticated and therapeutic nursing interventions [ROLES OF THE NURSE] - *Stranger* - - *Resource person* - larger context - *Teacher* - - Leader - - Surrogate - - Counselor - - Technical Expert - operates equipment *ADDITIONAL ROLES* \- Technical expert, Consultant, Health teacher, Tutor, Socializing, agent, Safety agent, Manager of environment, Mediator, Administrator, Recorder observer, Researcher - Having the knowledge of the seven roles of nursing, future nurses can apply for different roles in different situations, which will guarantee their patients to acquire the best care possible, and will ultimately speed along treatment and recovery. Ida Jean Orlando [DELIBERATIVE NURSING PROCESS THEORY] Orlando was an associate professor at Yale School of Nursing, and while there, served as the Director of the Graduate Program in Mental Health Psychiatric Nursing. first generation Irish American born in 1926. She received her nursing diploma from New York Medical College at the Lower Fifth Avenue Hospital School of Nursing. [Deliberative Nursing Process Theory] - is a nursing theory that allows nurses to create an effective nursing care plan that can also be easily adapted when and if any complications arise with the patient - is set in motion by the behavior of the patient - all patient behavior can be a cry for help, both verbal and nonverbal, and it is up to the nurse to interpret the behavior and determine the needs of the patient [FIVE STAGES] 1\. ASSESSMENT STAGE - - 2\. DIAGNOSIS STAGE - - 3\. PLANNING STAGE - - 4\. IMPLEMETATION STAGE - 5. EVALUATION - - - *If any new problems are identified in the evaluation stage, they can be addressed, and the process starts over again for those specific problems.* [CONCEPTS OF THE THEORY ] [(MAJOR DIMENSIONS)] 1.PROFESSIONAL NURSING FUNCTION - - 2. THE PATIENT'S PRESENTING BEHAVIOR - - - 3\. IMMEDIATE REACTION - - - 4\. DELIBERATIVE NURSING PROCESS - - - 5\. IMPROVEMENT - RESOLUTION - - - [APPLICATION] - The goal of this model is for a nurse to act deliberately rather than automatically. This way, a nurse will have a meaning behind the action which means the patient gets care geared specifically toward his or her needs at that time. - This nursing process is also one that can easily be adapted to different patients with different problems, and can be stopped at anytime, depending on the patient's progress or health. - This makes Orlando's theory universal for the nursing field. - Ida Jean Orlando's Deliberative Nursing Process directly addresses this need for flexibility, and helps nurses focus on the patient rather than simply sticking to a nursing care plan no matter what. Joyce Travelbee [HUMAN TO HUMAN RELATIONSHIP MODEL THEORY] \- deals with the interpersonal aspects of nursing, focusing especially on mental health. Joyce Travelbee, who developed the theory, explained that "human-to-human relationship is the means through which the purpose of nursing is fulfilled.". [SEVEN BASIC CONCEPTS] 1. **Suffering**, which is "an experience that varies in intensity, duration and depth...a feeling of unease, ranging from mild, transient mental, physical or mental discomfort to extreme pain...." 2. **Meaning**, which is the reason attributed to a person 3. **Nursing**, which helps a person find meaning in the experience of illness and suffering; has a responsibility to help people and their families find meaning; and the nurse's spiritual and ethical choices, and perceptions of illness and suffering, which are crucial to help patients find meaning. 4. **Hope**, which is a faith that can and will be a change that would bring something better with it. Six important characteristics of hope are: dependence on other people, future orientation, escape routes, the desire to complete a task or have an experience, confidence that others will be there when needed, and the acknowledgment of fears and moving forward towards its goal. 5. **Communication**, which is "a strict necessity for good nursing care." 6. **Self-therapy**, which is the ability to use one's own personality consciously and in full awareness in an attempt to establish relatedness and to structure nursing interventions. This refers to the nurse's presence physically and psychologically. 7. Targeted intellectual approach by the nurse toward the patient's situation. [METAPARDIGM] - *Person* - - - - *Health (Subjective & Objective)* - - - *Nursing* - - - *Environment* - - - - [OTHER TERMS] - Nurse- Patient Interaction - - Therapeutic use of self - [INTERACTION PROCESS] - through this meeting the nursing goals requires the creation of a genuine human-to-human relationship is established. [5 PHASES] 1. **The initial meeting or original encounter** - 2. **The visibility of personal and emerging identities** - 3. **Empathy** - 4. **Sympathy** - - - 5. **Establishing mutual understanding and rapport**. - - - - Lydia Hall [CARE, CORE, CURE THEORY] Lydia Hall was born on September 21, 1906 in New York City Lydia Hall graduated from York Hospital School of Nursing in 1927 with a diploma in nursing [CARE, CORE, CURE THEORY] [3C'S OF LYDIA HALL] - "participation in care, core and cure aspects of patient care, where **CARE** is the sole function of nurses, whereas the **CORE** and **CURE** are shared with other members of the health team." ASSUMPTIONS 1. The motivation and energy necessary for healing exist within the patient, rather than in the healthcare team. 2. The three aspects of nursing should not be viewed as functioning independently but as interrelated. 3. The three aspects interact, and the circles representing them change size, depending on the patient's total course of progress. [SUBCONCEPTS] - The three circles are: the core, the care, and the cure. The size of each circle constantly varies and depends on the state of the patient. - CARE CIRCLE - - - CORE CIRCLE - - - *[REFLECTIVE TECHNIQUE]* - *[MOTIVATIONS]* - - CURE CIRCLE - - APPLICATION - The core is the patient, the cure refers to the medical and nursing interventions and the care is the nurturing provided by nurses. - Nursing functions in all three of the circles but shares them to different degrees with other disciplines. This theory puts emphasis on the importance of the total patient rather than looking at one part or aspect. - There is also emphasis put on all three aspects of the theory, the three Cs, functioning together. [METAPARADIGM] - *Person* - - *Health* - - *Nursing* - - *Environment* - Faye Glenn Abdella [21 NURSING PROBLEMS] 1919 Abdellah's patient - centred approach to nursing was developed inductively from her practice and is considered a human needs theory. [21 Nursing Problems] - Nursing problems - synonymous to "nursing goals" or "nursing functions" - Nursing is the utilization of the problem-solvning techniques with chief nursing problems related to health requirements of clients. - Health need = Overt and Covert [METAPARADIGM] - *Person* - - - - - *Environment* - - - *Health* - - - *Nursing* - - - a. b. c. [21 NURSING PROBLEMS] - is one of the forerunners of the nursing diagnosis (NANDA) A. Biological/Physical Problems 1. 2. 3. 4. 5. 6. 7. 8. 9. 10. 11. B. Psychological Problems 12. 13. 14. 15. 16. 17. 18. 19. 20. 21. [ACCEPTANCE BY THE NURSING COMMUNITY] - *Nursing Practice* - problem-solving approach in nursing care, scientific, and systematic - *Nursing Education* - use of scientific body knowledge unique to nursing - *Nursing Reasearch* - basis for further researches Virginia Avenel Henderson [NEED THEORY] ▪ "Florence Nightingale of the 20^th^ Century\ ▪ "First Lady of Nursing"\ ▪ "First Truly International Nurse" ▪ "Modern Day Mother of Nursing" ▪ born in Kansas City, Missouri in 1897 and died at the age of 98 on 1996 ▪ In 1937, Henderson and others created a basic nursing curriculum for the National League for Nursing in which education was "patient centered and organized around nursing problems rather than medical diagnosis" [ROLE OF THE NURSE] - *Substitutive* - doing for the person - *Supplementary* - helping the person - *Complementary* - working with the person THEORY [Need Theory] - Nursing is doing things for the patients that they would do for themselves if they could, if they were physically able of had the required knowledge - Included 14 fundamental needs of human beings - Starts with physical needs and progress to psychosocial components [14 ESSENTIAL FUNCTIONS TOWARD INDEPENDENCE] 1. Breathe normally 2. Eat and drink adequately 3. Eliminate body wastes 4. Move and maintain desirable postures 5. Sleep and rest 6. Select suitable clothes -- dress and undress 7. Maintain body temperature within normal range by adjusting clothing and modifying environment 8. Keep the body clean and well groomed and protect the integument 9. Avoid dangers in the environment and avoid injuring othersPsychological Aspects of Communicating and Learning 10. Communicate with others in expressing emotions, needs, fears, or opinions. 11. Worship according to one's faith 12. Work in such a way that there is sense of accomplishment 13. Play or participate in various forms of recreation 14. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities. [METAPARADIGM] - *Person* - - *Environment* - - *Health* - - - *Nursing* - the unique function of the nurse is to assist the individual, sick or well, in performing the activities that contribute to health, its recovery or peaceful death [APPLICATION] - Henderson's Needs Theory can be applied to nursing practice as a way for nurses to set goals based on Henderson's 14 components. - Meeting the goal of achieving the 14 needs of the client can be a great basis to further improve one's performance towards nursing care. - In nursing research, each of her 14 fundamental concepts can serve as a basis for research although the statements were not written in testable terms. Nola Pender [HEALTH PROMOTION MODEL] - Purpose of the model is to assist nurses in understanding the major determinants of health behaviors as a basis for behavioral counseling to promote healthy lifestyle [PENDER'S MODEL ON 3 AREAS] A. Individual characteristics and experiences - and experiences that affect subsequent actions B. Behavior-specific cognitions and affect - - - C. Behavioral outcomes - 1. 2. 3. [FEATURES OF THE MODEL] a. It is based on the idea that human beings are rational and will seek their advantage in health b. Main purpose is to promote healthy lifestye and choices that affect the health of individuals [FUNCTION OF THE MODEL] - To show the individual as self-determining and is determined by personal history and general personal characteristics - Person is viewed as "being healthy, living it", rather than considering health as a static (opposite of dynamic) state [EFFECTS OF THE MODEL] a. It puts the responsibility of healthcare reform on the person, not on the profession b. The empowerment of the person will lead to healthy rational choices in lifestyle [SIGNIFICANCE OF THE MODEL] - The medical and nursing professions are not really the main ingredients in living a healthy lifestyle - they serve a secondary role to the person's basic rational choice of healthy living *A healthy lifestyle is the ultimate antidote to rising healthcare cost* Madeleine Leininger [Transcultural Care Theory] [CONCEPTS] - Transcultural Nursing - - Diversity - - Universality - [Transcultural Care Theory] [(Culture care or Culture Care Diversity and Universality)] - Based on the belief that people of different cultures can inform and are capable of guiding professionals to receive the kind of care they desire or need from others [METAPARIDM] - *Person* - - - - *Health* - - - *Environment* - - - *Nursing* - [MODES OF ACTION TO DELIVER CARE] 1. CULTURAL CARE PRESERVATION OR MAINTENANCE - 2. CULTURAL CARE ACCOMMODATION OR NEGOTIATION - 3. CULTURAL CARE RE PATTERNING AND/OR RESTRUCTURING - Margaret Newman [THEORY OF HEALTH AS EXPANDING CONSCIOUSNESS] - Arose from Roger's Science of Unitary Human Beings Theory - The model progressed to include all people regardless of the presence or absence of disease - Newman's theory asserts that every person in every situation, no matter how disordered and hopeless it seems, is part of the universal process of expanding consciousness. - This is a process of becoming more of oneself, of finding greater meaning in life, and of reaching new dimensions of connectedness with other people, as well as the world. - Interaction allows people to evolve their individual pattern of whole - Understanding the patient's pattern is essential - The pattern recognition is the expanding consciousness - The manifestation of disease depends on the pattern of the patient - Consciousness - - - Expanding Consciousness - - Pattern - [METAPARADIGM] - *Person* - - - - *Environment* - - *Health* - - - - *Nursing* - [GOAL OF NURSING] - Not to make people well or to prevent their getting sick, bu to [assist people to utilize the power] that is within them as they evolve toward higher levels of consciousness [PARADIGM SHIFT] 1. From treatment of symptoms to a search for pattern 2. From viewing disease and disruption as negative to viewing them as part of the self-organizing process of expanding consciousness 3. From viewing the nursing role as addressing, the problems of disease to assisting people to get in touch with their own pattern of expanding consciousness Rosemarie Rizzo Parse [Human Becoming Theory] [METAPARADIGM] - *PERSON* - - - [PRINCIPLES THAT CONSTITUTES THE THEORY] 1. Persons structure or choose the meaning of their realities 2. Human beings create pattern in day-to-day life that tell about personal meanings and values 3. Reasons always engage with and choose from infinite possibilities [THEMES] - MEANING - - - RHYTHMICITY - - - TRANSCENDENCE - - - *Environment* - - *Health* - - - *Nursing* - *Goal of Nursing - to help client achieve more and improve quality of life for them* *Local Theories and Models of Nursing Intervention* Rozzano Locsin [THEORY OF TECHNOLOGICAL COMPETENCE AS CARING IN NURSING] **Technology competence** - [Dimensions of Technological Value in the] [Theory] - Technology as completing human beings to re-formulate the ideal human being. - Technology as machine technologies. - Technologies that mimic human beings and human activities to meet the demands of nursing care practices. [METAPARADIGM] - *Person* - - - *Environment* - - - *Health* - - - *Nursing* - - *Nurses must help patients more fully* *understand the role of technology in their* *care.* Carolina S. Agravante [CASAGRA Transformative Leadership Model] - was considered a practice theory - is a psycho-spiritual model - Focus of the theory - type of leadership in nursing that can challenge the values of the changing world. [Elements of the theory] 1\. Servant-leader spirituality a\) Leadership role enables the nurse to follow the footsteps of Jesus Christ b\) This connotes caring and service 2\. Self-mastery a\) Has something to do with one's formal learning b\) Requires continuous learning 3\. Special expertise a\) nurse's level of competence in the particular nursing area *Implication to Nursing Education* - can apply this concept by being passionate about their craft. can also show willingness to impart their acquired knowledge to their students and colleagues in a selfless way. *Implications to nursing research* - her approach to the development of the theory can be modified to include nurses with different religion and employ nursing educators from a wider variety of schools to attain practicability. Carmelita C. Divinagracia [COMPOSURE Model] **Composure behaviors** - are sets of behavior or nursing measures that the nurse demonstrates to selected patients. COMPOSURE \- is an acronym which stands for **COMpetence**. **Presence and Prayer**. **Open-mindedness** **Stimulation.** **Understanding** **Respect and** **Relaxation** **Empathy** [3 Main Themes and sub themes] - Coordination \- Intra-organizational coordination \- Inter-organizational coordination \- Reciprocal interdependence - Communication \- Environmental factors \- Personal factors - Interpersonal Relationship \- Engagement \- Spirit \- Concern \- Support *Major Theme* \- Coordination \- Communication \- Interpersonal relationship *Minor Themes* \- Environmental factors \- Personal factors \- Engagement \- Esprit (Morale) \- Concern \- Support Sister Letty Kuan [Retirement and Role Discontinuity Model] \- "Graceful Aging" \- knowing the reasons and variables on how to make people happy at retirement. \- the nurse helps th eperson survive the struggles and crisis in life to lead the person in attaining gracefule aging [METAPARADIGM] - *Person* \- Refers to the elderly who is classified under age group of mid 70s up to the 80s. \- "Gerone": gracefully able to function as useful citizens - *Health* \- Is defined as aging that denotes a slow process of growth towards maturity of mind, body and spirit. - *Nursing* \- Is preparing the older person to have fulfilment in their retirement years, and assisting them in their elderly years in leaving a legacy. Carmencita Abaquin [PREPARE ME- HOLISTIC NURSING INTERVENTION] - provides a framework on non pharmacologic, non surgical approach of care to advanced cases of cancer patients. - Focus is not on cure but on assisting the patient to explore her humanity and internal serenity as one is faced with the challenge of life and death. - Nurses must be seen not as mere caregivers but facilitators of peaceful acceptance of condition. **Presence** \- Being with another person during the times of need. \- This includes the therapeutic communication, active listening, and touch. **Reminisce Therapy** \- Recall of past experiences, feelings, and thoughts to facilitate adaptation to present circumstances. Prayer, Relaxation-breathing \- Techniques to encourage and elicit relaxation for the purpose of decreasing undesirable signs and symptoms such as pain, muscle tension, and anxiety **Meditation** \- Encourages an elicit form of relaxation for the purpose of altering patient's level of awareness by focusing on an image of thought to facilitate inner sight which helps establish connection and relationship with God. **Values Clarification** \- Assisting another individual to clarify his own values about health and illness in order to facilitate effective decision making skills. \- Patient develops an open mind that will facilitate acceptance of disease state or may help deepen or enhance values. \- The process of value clarification helps one become internally consistent by achieving closer between what we do and what we feel. **Presence** **Reminisce Theraphy** **Prayer** **Relaxation - Breathing** **Meditation** **Values Clarification** Cecilia Laurente [THEORY OF NURSING PRACTICE AND CAREER] - Focused primarily on helping a patient through support systems, specifically the family. - Theory was based on her research study entitled "Categorization of Nursing Activities as Observed in Medical-Surgical Ward Units in Selected Government and Private Hospitals in Metro Manila". - The study was undertaken to determine the effects of nurses caring behaviors on the clients. - The first 5 caring behaviors cited by patients are: a\) respectfulness d) gentlenes b\) patience e) guidance c\) helpfulness - Other caring behaviors: a\) competence b\) therapeutic touch c\) verbal communication d\) close proximity/is accessible e\) active listening f\) smiling/ cheerful/ with humor g\) encouragement *Nurses caring behaviors* \- have impact on the well-being of the clients that go beyond physiologic responses. \- They feel that they are cared for by nurses, to boost their personhood and dignity Synchronicity in Human-Space-Time: A Theory of Nursing Engagement in a Global Community - Undergirds the innovative proess of nursing engagement expressed as a. Interpersonal relating b. Technological knowing c. Ryhtmical connecting d. Transformational engaging - Equitability - - - Emancipation - - Human Transcendence - -