Theoretical Foundations of Nursing PDF

THEORETICAL FOUNDATIONS OF NURSING 1ST SEMESTER MIDTERM / PRNU 110 The first published nursing theory (1860). Persons are in relation with the environment....

THEORETICAL FOUNDATIONS OF NURSING 1ST SEMESTER MIDTERM / PRNU 110 The first published nursing theory (1860). Persons are in relation with the environment. INTRODUCTION OF CLIENT-CENTERED THEORY Stresses the healing properties of the physical environment (fresh air, light, warmth, and CLIENT-CENTERED THEORY cleanliness) an approach that focuses on understanding and Health is “the positive of which the pathology is the treating the individual as a whole person. The negative” person receiving care is actively involved in “Nature alone cures” assessing their own needs. Family and friends are also involved, where appropriate, in the care THEORY BASIS planning process. the inter-relationship of a healthful environment with nursing external influences and conditions can prevent, suppress, or contribute to diseas THEORISTS THEORY GOAL These are theorists who contributed to the overall meaning Nurses help patients retain their own vitality by of Client-Centered Theory. meeting their basic needs through control of the environment. NAMES NURSING’S FOCUS control of the environment for individuals, ★ Florence Nightingale families & the community. ★ Faye Abdellah ★ Virginia Henderson ★ Dorothea Orem COMPONENTS OF HER ENVIRONMENTAL THEORY ★ Myra Estrin Levine ★ Martha Rogers ★ Health of Houses ★ Dorothy Johnson ★ Ventilation and Warming ★ Lydia Hall ★ Light ★ Rosemarie Rizzo Parse ★ Noise ★ Nola Pender ★ Variety ★ Callista Roy ★ Bed and Bedding ★ Cleanliness of Rooms and Walls ★ Personal Cleanliness FLORENCE NIGHTINGALE ★ Nutrition and Taking Food ★ Chattering Hopes and Advices ★ Observation of the Sick Founder of modern nursing ★ Social Considerations “Environmental Theory” NURSING FLORENCE NIGHTINGALE’S METAPARADIGM According to her, nursing is “the act of utilizing the environment of the patient to assist him in his PERSON ➔ “The patient” Recovery is in the recovery.” ➔ A human being patient’s power as There are 5 environmental factors: acted upon by long as a safe ○ Fresh air a nurse, or environment exists ○ Pure water affected by the ○ Efficient drainage environment. ○ Sanitation/cleanliness ➔ Has reparative ○ Light and direct sunlight powers ENVIRONMENTAL THEORY ➔ The Includes everything Client-Centered theories PAGE 1  THEORETICAL FOUNDATIONS OF NURSING 1ST SEMESTER MIDTERM / PRNU 110 foundational from a person’s food ENVIRON component of to a nurse’s verbal & AS A COMPREHENSIVE SERVICE, NURSING INCLUDES: MENT Nightingale’s nonverbal theory interactions with 1. Recognizing the nursing problems of the patient ➔ The external the patient 2. Deciding the appropriate course of action to conditions & take in terms of relevant nursing principles forces that 3. Providing continuous care of the individuals affect one’s life total needs and 4. Providing continuous care to relieve pain and development discomfort and provide immediate security for the individual Image or icon HEALTH ➔ Maintained by Disease is viewed as 5. Adjusting the total nursing care plan to meet using a a reparative process the patient’s individual needs person’s instituted by nature 6. Helping the individual to become more self healing powers directing in attaining or maintaining a healthy to their fullest Health & disease are state of mind &. extent. the focus of the 7. Instructing nursing personnel and family to ➔ Maintained by nurse help the individual do for himself that which he controlling the can within his limitations Image or icon environmental Nurses help patients 8. Helping the individual to adjust to his factors to through their limitations and emotional problems prevent disease healing process 9. Working with allied health professions in planning for optimum health on local, state, NURSING ➔ Nursing is a Nursing education national and international levels discipline belongs in the hands 10. Carrying out continuous evaluation and distinct from of nurses! research to improve nursing techniques and to medicine develop new techniques to meet the health focusing on the needs of people patient’s reparative process rather PHILOSOPHICAL UNDERPINNINGS than on their Abdellah’s patient-centered approach to nursing disease!! was developed inductively from her practice and is considered a human needs theory. The theory was created to assist with nursing FAYE ABDELLAH education and is most applicable to the education of nurses. In 1960, influenced by the desire to promote client-centred comprehensive nursing care 10 STEPS TO IDENTIFYING THE CLIENT’S PROBLEMS Abdellah described nursing as a service to individuals, to families, and, therefore to, to 1. Learn to know the patient society. 2. Sort out relevant and significant data pioneer nursing researcher, helped transform 3. Make generalizations about available data in nursing theory, nursing care and nursing relation to similar nursing problems presented education by other patients 4. Identify the therapeutic plan Image or icon NURSING 5. Test generalizations with the patient and make additional generalizations According to her, nursing is based on an art and 6. Validate the patient’s conclusions about his science that mold the attitudes, intellectual nursing problems competencies, and technical skills of the individual 7. Continue to observe and evaluate the patient nurse into the desire and ability to help people , sick over a period of time to identify any attitudes or well, cope with their health needs. Client-Centered theories PAGE 2  THEORETICAL FOUNDATIONS OF NURSING 1ST SEMESTER MIDTERM / PRNU 110 and clues affecting his behavior Image or icon 10. To facilitate the maintenance 8. Explore the patient’s and family’s reaction to of regulatory mechanisms and the therapeutic plan and involve them in the functions plan 11. To facilitate the maintenance 9. Identify how the nurses feels about the of sensory function patient’s nursing problems 10. Discuss and develop a comprehensive nursing REMEDIAL 12. To identify and accept positive care plan. CARE NEEDS and negative expressions, feelings, and reactions 13. To identify and accept the 11 NURSING SKILLS interrelatedness of emotions 1. Observation of health status and organic illness 2. Skills of communication 14. To facilitate the maintenance 3. Application of knowledge of effective verbal and non 4. Teaching of patients and families Image or icon verbal communication 5. Planning and organization of work 15. To promote the development 6. Use of resource materials of productive interpersonal 7. Use of personnel resources Image or icon relationships 8. Problemsolving 16. To facilitate progress toward 9. Direction of work of others achievement of personal 10. Therapeutic use of the self spiritual goals 11. Nursing procedures 17. To create and / or maintain a therapeutic environment ABDELLAH’S TYPOLOGY OF 21 NURSING PROBLEMS 18. To facilitate awareness of self as an individual with varying BASIC TO ALL 1. To maintain good hygiene and physical , emotional, and PATIENTS physical comfort developmental needs 2. To promote optimal activity: exercise, rest and sleep RESTORATIVE 19. To accept the optimum 3. To promote safety through the CARE NEEDS possible goals in the light of prevention of accidents, limitations, physical and injury, or other trauma and emotional through the prevention of the 20. To use community resources spread of infection as an aid in resolving problems 4. To maintain good body arising from illness mechanics and prevent and 21. To understand the role of correct deformities social problems as influencing 5. To facilitate the maintenance factors in the case of illness of a supply of oxygen to all body cells 6. To facilitate the maintenance FAYE ABDELLAH’S METAPARADIGM of nutrition for all body cells 7. To facilitate the maintenance PERSON ➔ People have ➔ Patient: The physical, core reason of elimination emotional, for 8. To facilitate the maintenance and nursing's of fluid and electrolyte sociological existence. balance needs. ➔ Recipients 9. To recognize the physiologic ➔ Overt of Care: responses of the body to needs: Individuals disease Mostly and conditions—pathologic, physical. families. physiologic, and compensatory Client-Centered theories PAGE 3  THEORETICAL FOUNDATIONS OF NURSING 1ST SEMESTER MIDTERM / PRNU 110 ➔ Covert ➔ Goal of for the ➔ Alleviating needs: Nursing: To person. any Emotional achieve and ➔ Providing impairment. and social. maintain information ➔ Nursing is health. to the viewed as a person. comprehens ➔ “planning The environment is ive service for the home or based on ENVIRON optimum community from both art MENT health on which patient and science. local, state, comes. national, and VIRGINIA HENDERSON internation al levels”. In 1996, Virginia Henderson’s definition of the However, as unique function of nursing was a major stepping she further stone in the emergence of nursing as a discipline delineated separate from medicine. her ideas, Henderson describes nursing in relation to the the focus of client and the client’s environment. nursing Henderson sees the nurse as concerned with both service is healthy and ill individuals, acknowledges that clearly the nurses interact with clients even when recovery individual may not be feasible, and mentions the teaching ➔ and advocacy roles of the nurse. HEALTH ➔ Mutually Abdellah doesn't exclusive of explicitly define 14 COMPONENTS OF BASIC NURSING CARE illness. health, but she ➔ Nursing is emphasizes: 1. Breathing normally viewed as a 2. Eating and drinking adequately comprehensive Addressing 3. Eliminating body wastes service that total health 4. Moving and maintaining a desirable position focuses on needs. 5. Sleeping and resting these aspects Achieving a 6. Selecting suitable clothes of health. healthy 7. Maintaining body temperature within normal state of range by adjusting clothing and modifying the mind and environment body. 8. Keeping the body clean and well groomed to protect the integuments 9. Avoiding dangers in the environment and NURSING ➔ Nursing is a ➔ The goals of avoiding injuring others helping nursing 10. Communicating with others in expressing profession. care are: emotions, needs, fears, or opinions ➔ In ➔ Meeting the 11. Worshipping according to one’s faith Abdellah’s patient's 12. working in such a way that one feels a sense of model, needs. accomplishment nursing ➔ Increasing 13. Playing or participating in various forms of care or restoring recreation involves: their ability 14. Learning, discovering, or satisfying the curiosity ➔ Doing for that leads to normal development and health, something self-care. and using available health facilities Client-Centered theories PAGE 4  THEORETICAL FOUNDATIONS OF NURSING 1ST SEMESTER MIDTERM / PRNU 110 VIRGINIA HENDERSON’S METAPARADIGM DOROTHEA OREM PERSON ➔ Individual “Self-care deficit nursing theory” requiring 1949-1957 Orem worked for the Division of assistance Hospital and Institutional Services of the Indiana to achieve State Board of Health. Her goal was to upgrade health and the quality of nursing in general hospitals independen throughout the state. During this time she ce or a developed her definition of nursing practice. peaceful 1959 Orem subsequently served as acting dean of death. Mind the school of Nursing and as an assistant and body professor of nursing education at CUA. She are continued to develop her concept of nursing and inseparable. self care during this time. ENVIRON ➔ All external Orem's Nursing: Concept of Practice was first MENT conditions and published in 1971 and subsequently in 1980,1985, influences that 1991, 1995, and 2001. affect life and Continues to develop her theory after her development retirement in 1984 HEALTH ➔ Equated with ➔ Breathing, THEORY OF SELF CARE independence, eating, Self care – practice of activities that individual viewed in drinking, initiates and perform on their own behalf in terms of the maintaining maintaining life ,health and well being. client’s ability comfort, Self care agency – is a human ability which is "the to perform 14 sleeping, ability for engaging in self care” components of resting Conditioned by age developmental state, life nursing care clothing, experience sociocultural orientation health and unaided: maintaining available resources body Therapeutic self care demand – "totality of self care temperature, actions to be performed for some duration in order to ensuring meet self care requisites by using valid methods and safety, related sets of operations and actions" communicatin g, worshiping, UNIVERSAL SELF CARE REQUISITES working, Associated with life processes and the maintenance recreation, and of the integrity of human structure and functioning continuing Common to all , ADL Identifies these requisites as: development. ○ Maintenance of sufficient intake of air ,water, food NURSING ➔ Assists and ○ Provision of care associated with supports the elimination process individual in Balance between activity and rest, between life activities solitude and social interaction and the Prevention of hazards to human life well being and attainment of Promotion of human functioning independence. DEVELOPMENTAL SELF CARE REQUISITES Client-Centered theories PAGE 5  THEORETICAL FOUNDATIONS OF NURSING 1ST SEMESTER MIDTERM / PRNU 110 Associated with developmental processes/ derived regarding care from a condition…. Or associated with an event E.g. Design of a adjusting to a new job adjusting to body changes nursing system and plan for HEALTH DEVIATION SELF CARE delivery of care Required in conditions of illness ,injury, or disease Production and these include: management of ○ Seeking and securing appropriate medical nursing systems assistance ○ Being aware of and attending to the effects and results of pathologic COLLECT DATA IN THREE AREAS conditions Step 1 ○ Effectively carrying out medically ○ The person’s health status prescribed measures ○ The physician’s perspective of the person’s ○ Modifying self concepts in accepting health status oneself as being in a particular state of ○ The person’s perspective of his or her health and in specific forms of health care health ○ Learning to live with effects of pathologic ○ The health goals within the context of life conditions history ,life style, and health status ○ The person’s requirements for self care THEORY OF SELF CARE DEFICIT ○ The person’s capacity to perform self care Step 2 This specifies when nursing is needed: ○ Nurse designs a system that is wholly or ○ Nursing is required when an adult (or in partly compensatory or supportive the case of a dependent ,the parent) is educative. incapable or limited in the provision of ○ The 2 actions are: continuous effective self care Bringing out a good organization of the components of patients’ 5 METHODS OF HELPING ACCORDING TO OREM therapeutic self care demands Selection of combination of ways 1. Acting for and doing for others of helping that will be effective 2. Guiding others and efficient in compensating 3. Supporting another for/ overcoming patient’s self 4. Providing an environment promoting personal care deficits development in relation to meet future Step 3 demands ○ Nurse assists the patient or family in self 5. Teaching another care matters to achieve identified and described health and health related results..collecting evidence in evaluating COMPARISON OF OREM’S NURSING PROCESS AND THE results achieved against results specified NURSING PROCESS in the nursing system design ○ Actions are directed by etiology NURSING PROCESS OREM’S NURSING component of nursing diagnosis PROCESS ○ Evaluation Assessment Diagnosis and DOROTHEA OREM’S METAPARADIGM Nursing Diagnosis prescription Plans with ;determine why PERSON ➔ Human ➔ A unity that scientific nursing is needed. being – has can rationale analyze and the capacity function Implementation interpret –make to reflect biologically, Evaluation judgment ,symbolize symbolicall Client-Centered theories PAGE 6  THEORETICAL FOUNDATIONS OF NURSING 1ST SEMESTER MIDTERM / PRNU 110 and use y and nurses to help and the symbols socially individuals or nursing ➔ Conceptuali groups under perspective zed as a their care to ➔ To maintain a total being maintain or state of health with change ➔ To regain universal conditions in normal or near ,developme themselves or normal state of ntal needs their health in the and capable environments event of of disease or continuous injury self care ➔ Environment NOLA J. PENDER components ENVIRON are “Health promotion model” MENT environmental Nola Pender is a nursing theorist, author and factors academic. She is a professor emerita of nursing at ,environmental the University of Michigan. She created the Health elements, Promotion Model. She has been designated a conditions ,and Living Legend of the American Academy of developmental Nursing. environment HEALTH ➔ Health and ➔ It includes that HEALTH PROMOTION MODEL healthy are which makes a Purpose: Help nurses understand major health terms used to person behavior determinants. Basis for behavioral describe living human,…opera counseling to promote healthy lifestyles. things … it is ting in when they are conjunction PHILOSOPHICAL ROOTS structurally with Reciprocal interaction world view: humans are and physiological holistic but can be studied in parts within the context functionally and of the whole. whole or sound psychophysiolo Humans interact with and shape their environment to … wholeness or gical meet goals. integrity. mechanisms and a material THEORETICAL ROOTS structure and in relation to Expectancy Value Theory: Actions are taken to and achieve perceived possible goals with valued interacting outcomes. with other Social Cognitive Theory: Interaction of thoughts, human beings behavior, and environment. Behavior change requires thinking change. NURSING ➔ art, a helping ➔ Encompasses service, and a the patient’s HEALTH PROMOTION MODEL ASSUMPTIONS technology, perspective of ➔ Actions health 1. People seek to create conditions to express their deliberately condition ,the health potential. selected and physician’s 2. People have self-awareness and can assess performed by perspective , their competencies. Client-Centered theories PAGE 7  THEORETICAL FOUNDATIONS OF NURSING 1ST SEMESTER MIDTERM / PRNU 110 3. Growth in positive directions is valued, with potential. balance between change and stability. 4. Individuals regulate their own behavior. ENVIRON ➔ The social, 5. People interact with and transform the MENT cultural, and environment over time. physical 6. Health professionals influence individuals context that throughout their lifespan. can be shaped 7. Self-initiated changes in person-environment by the interactions are essential for behavior change. individual to promote health behaviors. THEORETICAL PROPOSITIONS HEALTH ➔ The realization ➔ Health is an of potential evolving 1. Prior behavior and characteristics influence through experience. health-promoting behavior. goal-directed Illnesses are 2. People engage in behaviors for personally behavior, discrete events valued benefits. self-care, and affecting the 3. Perceived barriers can limit commitment to fulfilling quest for action. relationships, health. 4. Self-efficacy increases commitment and while performance. maintaining 5. Higher self-efficacy reduces perceived barriers. harmony with 6. Positive emotions toward a behavior enhance the self-efficacy. environment. 7. Positive affect increases commitment to health behavior. NURSING ➔ Collaboration 8. Modeling and support from others (family, with peers, healthcare providers) increases individuals, engagement. families, and 9. Situational factors influence health behavior communities to engagement. create optimal 10. Commitment increases likelihood of sustained conditions for health behaviors. health and 11. Competing demands can disrupt planned health well-being. behaviors. 12. Preferences for other behaviors can reduce commitment to the target behavior. SR. CALLISTA ROY 13. People can modify cognition, affect, and influences to incentivize health behaviors. “Adaptation Model” Born in October 1939 in California. A member of the Sisters of Saint Joseph of Carondelet. NOLA J. PENDER’S METAPARADIGM Education: Undergraduate degrees in nursing. PERSON ➔ Biopsychosocia ➔ Individual Master's and doctorate in sociology. l being shaped characterist Held professor status at Mount St. Mary’s College by the ics and life and was a postdoctoral fellow at the University of environment experiences California. Authored numerous books and articles, but seeks to shape receiving many personal and professional awards. create health Inspired by Johnson to create a nursing model, environments behaviors. focusing on children's adaptability to physical and for human psychological changes. Client-Centered theories PAGE 8  THEORETICAL FOUNDATIONS OF NURSING 1ST SEMESTER MIDTERM / PRNU 110 Her model was first implemented at Mount St. Neurologic function Mary’s College as the foundation for their nursing Endocrine function program. In 1977, the model was formally presented. SELF-CONCEPT-G ➔ focuses on psychological ROUP IDENTITY and spiritual integrity and THE ROY ADAPTATION MODEL MODE a sense of unity, meaning, Sister Callista Roy defines adaptation as the process purposefulness in the and outcome whereby the thinking and feeling person universe. uses conscious awareness and choice to create human and environmental integration. ROLE FUNCTION ➔ refers to the roles that This model comprises the four domain concepts MODE individuals occupy in (person, health, nursing, environment) and involves society fulfilling the need six step nursing process. for social integrity; it is knowing who one is, in relation to others. INTERDEPENDEN ➔ the close relationships of CE MODE people and their purpose, structure and development individually and in groups and the adaptation potential of these relationships SUB CONCEPTS Adaptive responses are those that promote the integrity of the person. The person’s integrity, or wholeness, is behaviorally FOUR ADAPTIVE MODES demonstrated when the person is able to meet the goals in terms of survival, growth, reproduction and PHYSIOLOGICAL- ➔ The processes are mastery. PHYSICAL MODE essential for the function Ineffective responses do not support these goals. and activities of living (Roy & Andrews, 1991) organisms. Coping mechanisms describe the control processes of ➔ Physiologic integrity is the the person as an adaptive system. Some coping underlying need, mechanisms are inherited or genetic, such as white maintained through blood cell defense mechanism against bacteria that adaptation to changes. seek to invade the body. ➔ Adaptation in groups Other mechanisms are learned, such as the use of manifests in how human antiseptics to cleanse a wound. systems use basic operating resources. TWO COPING SUBSYSTEMS The basic needs include: Oxygenation Nutrition COGNATOR SUBSYSTEM REGULATOR SUBSYSTEM Elimination Activity and rest “A major coping A basic type of Protection process involving adaptive process Complex processes are related to: four that responds Senses cognitive-emotive automatically Fluid and electrolytes channels: through neural, Client-Centered theories PAGE 9  THEORETICAL FOUNDATIONS OF NURSING 1ST SEMESTER MIDTERM / PRNU 110 perceptual and chemical, and process of information endocrine coping being and processing, channels. becoming learning, integrated and judgment, and whole. emotion.” NURSING ➔ Goal of Adaptation–The nursing–The “process and Focal stimuli – Those stimuli that are the proximate “promotion of outcome whereby causes of the situation. adaptation in thinking and feeling Contextual stimuli – All other stimuli in the internal each of the four persons as or external environment, which may or may not modes.” individuals or in affect the situation. groups use Residual stimuli – Those immeasurable and conscious unknowable stimuli that also exist and may affect the awareness and situation. choice to create human and SR. CALLISTA ROY’S METAPARADIGM environmental integration.” PERSON ➔ “The human adaptive system” and MYRA ESTRIN LEVIN defined as “a whole with “Conservation model” parts that Developed in the early 1970s as a framework for function as a medical-surgical nursing. unity for some Based on principles of physical science. purpose. Integrates concepts from various authors to form Human the Conservation Model. systems include people… CONSERVATION MODEL CONCEPTS groups… Wholeness: organizations, ○ Health is a dynamic interaction between communities, the person and the environment. and society as ○ Wholeness exists when adaptation a whole.” (Roy ensures integrity across all dimensions of & Andrews, life. 1999) Adaptation: ○ A process of change where the individual ENVIRON ➔ Conditions, maintains integrity with the internal and MENT circumstances external environment. and influences ○ Conservation is the outcome of that… affect adaptation, focusing on balancing energy the resources. development Conservation: and behavior of ○ Ensures wholeness by achieving a balance humans as of energy supply and demand. adaptive ○ Emphasizes maintaining the individual’s systems. life systems through both nursing interventions and patient participation. HEALTH ➔ A state and Client-Centered theories PAGE 10  THEORETICAL FOUNDATIONS OF NURSING 1ST SEMESTER MIDTERM / PRNU 110 Can be equated with CONSERVATION PRINCIPLES Homeostasis Conservation of Energy Stability ○ Maintaining a balance between energy Equilibrium expenditure and conservation, measured Balance through temperature, pulse, and blood pressure. THREE PARTS OF ADAPTATION Conservation of Structural integrity ○ Preventing physical breakdown and promoting healing (e.g., skin care, regular HISTORICITY SPECIFICITY REDUNDANCY patient repositioning). Refers to There is a system Person displays Conservation of personal integrity person’s genetic to deal with each multiple ○ Protecting the patient's self-identity and makeup task responses to personal space. dysfunction Conservation of social integrity Happens at the unique ○ Helping patients maintain their social cellular level stimulus-respon Multiple roles and relationships. se pathways, systems deal based on task oriented with threat METAPARADIGM CONCEPT personal and Person genetic past Interacting ○ A holistic being encompassing physical, history sequences of psychosocial, cultural, and spiritual events aspects. ○ Strives for wholeness and integrity in all areas of life. ORGANISMIC RESPONSE Environment A change in behavior of an individual during an ○ Completes the wholeness of the individual attempt to adapt to the environment. and affects adaptation. It helps individual to protect and maintain their ○ Divided into perceptual, conceptual, and integrity. operational environments. There are four types: Health ○ Health is a pattern of adaptive change, a TYPES OF RESPONSES balance between stability and disruption. ○ Involves physical, mental, and social FIGHT OR FLIGHT ➔ Quick response to threat well-being, not just the absence of or perceived threat disease. Nursing INFLAMMATORY- ➔ Restores physical ○ A human interaction where the nurse IMMUNE wholeness (healing) helps the patient adapt and maintain wholeness. STRESS ➔ Integrated Response ○ Focuses on supporting the patient's ability developed over time to conserve energy and integrity. Person and Environment PERCEPTUAL ➔ Focusing on specific ○ Levine’s Conservation Model discussed AWARENESS aspects of environment the way in which the person and the environment become congruent over time. THEORIES DERIVED FROM THE MODEL ○ The terms described are; adaptation and organismic response. 1. Theory of Redundancy – Aging is seen as the diminishing availability of redundant systems that ADAPTATION maintain physical and social well-being. 2. Theory of Therapeutic Intention – Nursing Process of interacting with environment interventions aim to facilitate natural healing Process of change or of life Client-Centered theories PAGE 11  THEORETICAL FOUNDATIONS OF NURSING 1ST SEMESTER MIDTERM / PRNU 110 processes and support the body’s regulatory Involves the Therapeutic use of self systems. The nurse is able to help the patient verbally express feelings regarding the disease process and CONTRIBUTIONS TO NURSING its effects, as well as discuss the patient’s role in Provided systematic approach to view patients recovery or healing process. holistically Patient is able to maintain who they are Advocated for the use of the scientific process in (self-identity) nursing, now known as evidence-based practice. Emphasis on social,emotional,spiritual and intellectual needs Patient makes more rapid progress towards LYDIA ELOISE HALL recovery and rehabilitation Core, Care, Cure Lydia Eloise Hall (1906–1969) was a nursing theorist known for her Care, Cure, Core model, where care is the nurse's primary role, while core and cure are shared with the healthcare team. She graduated in nursing in 1927, earned a Bachelor’s in public health in 1932, and a master’s from Columbia University in 1942. Hall worked in preventative health and cardiovascular research, later becoming a professor at Columbia. She CURE passed away on February 27, 1969. Care based on pathological and therapeutic sciences CARE Application of medical knowledge by nurses Nurse assisting the doctor in performing tasks Nurturing component of care Nurse is patient advocate in this area Involves the concept of “Mothering” Nurses role changes from positive quality to Provides bodily care for the patient and helps the negative quality patient to complete such basic daily biologic Medical surgical and rehabilitative care activities COOPERATE WITH FAMILIES OR CARE GIVERS Provides teaching and learning activities Nurses goal is to “comfort” the patient Patient may explore and share feelings with nurse Nurse is concerned with intimate bodily care Nurse applies knowledge of natural and biological sciences to provide a strong theoretical base for nursing implementations. Nurse act as potential comforter CORE Emphasis placed on the importance of total person approach Patient care is based on social sciences Client-Centered theories PAGE 12  THEORETICAL FOUNDATIONS OF NURSING 1ST SEMESTER MIDTERM / PRNU 110 Importance placed on all three aspects ess with functioning together conscious All three aspects interact and change in size , selection of depending on the patient’s total course of behaviors progress. that are optimal for LYDIA HALL’S METAPARADIGM that individual. PERSON ➔ The ➔ The source individual of energy human who and NURSING ➔ Nursing is is 16 years motivation identified as of age or for healing consisting of older and is the participation in past the individual the care, core, acute stage care and cure of a long recipient, aspects of term illness not the patient care. is the focus health care of nursing provider. care in MARTHA ROGERS Hall’s work. Unitary Human Beings ENVIRON ➔ The concept ➔ Hall is Born: May 12, 1914, in Dallas, Texas. MENT of credited Education: University of Tennessee (1931–1933), society/envi with diploma in nursing from Knoxville General ronment is developing Hospital School (1936), Bachelor of Science from dealt with in the concept George Peabody College (1937). relation to of Loeb Career: Public health nurse in Michigan the Center (1937–1939), Hartford Visiting Nurses Association individual. because she (1940–1945). assumed Advanced Degrees: Master's in public health that the (1952) and Doctor of Science (1954) from Johns hospital Hopkins University. environmen Appointed professor and head of the Division of t during Nursing at New York University in 1954. treatment of acute illness ENERGY FIELDS creates a Fundamental unit of both living and non-living difficult things. psychologic Infinite, pandimensional, and unpredictable. al Central to the concept of the "Unitary Human experience Being." for the ill individual. PATTERNS Represent the entirety of a person’s existence. HEALTH ➔ Health can Intangible and invisible but manifest in all be inferred interactions. to be a state of self-awaren HOMEODYNAMICS Client-Centered theories PAGE 13  THEORETICAL FOUNDATIONS OF NURSING 1ST SEMESTER MIDTERM / PRNU 110 Resonancy: Continuous movement from lower to NURSING ➔ Requires ➔ Purpose is higher frequency patterns between person and specific to promote environment, associated with well-being. learning. health and Helicy: Unpredictable changes between person ➔ Considered well-being and environment fostering creativity, innovation, both an for all and problem-solving. empirical individuals. Integrality: Continuous, interactive rhythms science and ➔ Exists to between the person and the environment. an art. serve Synchrony: Simultaneous changes between person humanity and environment. and life Reciprocity: Continuous interaction between the processes. person and the environment. MARTHA ROGER’S METAPARADIGM DOROTHY JOHNSON PERSON ➔ An open ➔ Non-reduci “Behavioral Systems Model” system that ble and Her definition of nursingis (1980): is comprises ○ Nursing is an external regulatory force continuousl patterns aimed at preserving patient behavior's y and organization and integration at optimal interacting pandimensi levels, especially during illness or with the onal energy behavior threatening physical or social environmen fields. health. t. ENVIRON ➔ A FOUR NURSING GOALS MENT multidimen 1. Assist patients in meeting social demands. sional, 2. Modify behavior to support biological imperatives. irreducible 3. Help patients fully benefit from medical care. sharing of 4. Minimize trauma caused by illness. energy and patterns BEHAVIORAL SYSTEMS MODEL with Focuses on fostering efficient and effective humans patient behavior to prevent illness. through Functionaal requirements for subsystems: synchronou ○ Protection from harmful influences. s interactions ○ Nurturing through environmental support.. ○ Stimulation to promote growth and prevent stagnation. HEALTH ➔ the absence ➔ Involves of illness or dynamic, SUBSYSTEMS wellness. creative ➔ Relates to unity with AFFILIATIVE ➔ Develops early, supports an one’s social inclusion and individual's environmen bonding. value t. system & DEPENDENCY ➔ Seeks attention, cultural recognition, and physical interpretati help. on. Client-Centered theories PAGE 14  THEORETICAL FOUNDATIONS OF NURSING 1ST SEMESTER MIDTERM / PRNU 110 INGESTIVE ➔ Involves social and KEY CONCEPTS OF THEORY OF HUMAN BECOMING biological aspects of food intake. Human-Universe-Health Process: The human being is in a continuous process of becoming, ELIMINATIVE ➔ Relates to socially creating their existence with the world. acceptable waste Paradoxes in Human Becoming: Emphasizes excretion. paradoxical, rhythmic patterns in the relationship between humans and their environment. SEXUAL ➔ Influenced by biological and social factors THREE MAJOR THEMES (procreation, Meaning: Involves imagining, valuing, and gratification). laguaging. Rhythmicity: involves revealing-concealing, AGGRESIVE ➔ Self-protection and enabling-limiting, and connecting-separating. territorial behavior. Transcendence: involves powering, originating, and transforming. ACHIEVEMENT ➔ Aims at mastering control over the self or environment ASSUMPTIONS ABOUT HUMAN AND BECOMING RESTORATIVE ➔ Focuses on rest, sleep, and Coexistence: Humans co-create their reality (ADDED LATER) comfort. through rhythmical patterns with the universe. Choice and Responsibility: Humans actively choose meanings in situations and are responsible METAPARADIGM for their decisions. Unity: Humans are more than the sum of their PERSON ➔ Comprises biological and parts and continuously reshape their behavioral systems. relationships. Nursing addresses the Transcendence: Humans grow beyond limitations behavioral system through multidimensional possibilities. Becoming: A continuous process of growth and ENVIRONMENT ➔ Implicitly includes all reconstitution of health and values. surrounding elements affecting behavior HEALTH AND BECOMING HEALTH ➔ Defined as consistent Health: Health is intertwined with becoming and behavior indicating reflects the individual's pattern of relating, value successful adaptation priorities, and connections with the environment. Inter-subjectivity: Health and becoming are NURSING ➔ Focuses on maintaining achieved through relationships and behavioral equilibrium subject-to-subject interactions. during illness. METAPARADIGM ROSEMARIE RIZZO PARSE PERSON ➔ An open being, co-creating patterns of relating with “Theory of Human Becoming” others. This theory was developed by Rosemarie Rizzo Parse in 1970’s, first published in 1981. ENVIRONMENT ➔ The universe, inseparable Influenced European philosophers Heidegger, from the person, evolving Sartre, Merleau-Ponty, and nursing theorist together. Martha Rogers. Client-Centered theories PAGE 15  THEORETICAL FOUNDATIONS OF NURSING 1ST SEMESTER MIDTERM / PRNU 110 HEALTH ➔ A dynamic process of changing life meanings, emerging from one's relationships with the universe. NURSING ➔ A basic science practiced as a performing art. Client-Centered theories PAGE 16