Nursing Need Theory TFN NOTES (3rd Meeting) PDF

Nursing Need Theory Assumptions of this Theory By Virginia Henderson 1. Nurses care for patients until they can ★ Biography of Virginia Henderson care for themselves once again....

Nursing Need Theory Assumptions of this Theory By Virginia Henderson 1. Nurses care for patients until they can ★ Biography of Virginia Henderson care for themselves once again. 2. Although not precisely explained, patients - Virginia Avenel Henderson (November desire to return to health. 30, 1897 – March 19, 1996) 3. Nurses are willing to serve, and “nurses - She was a nurse, theorist, and author will devote themselves to the patient day known for her Need Theory and and night.” defining nursing as: “The unique 4. Henderson also believes that the “mind function of the nurse is to assist the and body are inseparable and are individual, sick or well, in the interrelated.” performance of those activities contributing to health or its recovery (or ★ Major Concepts of Need Theory to peaceful death) that he would perform unaided if he had the necessary 1. Individual strength, will or knowledge.” - Henderson states that individuals have - Henderson is also known as “The First basic health needs and require Lady of Nursing,” “The Nightingale of assistance to achieve health and Modern Nursing,” “Modern-Day independence or a peaceful death. Mother of Nursing,” and “The 20th - According to her, an individual achieves Century Florence Nightingale.” wholeness by maintaining physiological and emotional balance. - In 1921 after receiving her Diploma, - She defined the patient as someone who Virginia Henderson worked at the Henry needs nursing care but did not limit Street Visiting Nurse Service for two nursing to illness care. years after graduation. - Her theory presented the patient as a sum of parts with biopsychosocial needs, ★ Virginia Henderson’s Need Theory and the mind and body are inseparable and interrelated - The Need Theory emphasizes the importance of increasing the patient’s 2. Environment independence and focusing on the basic - Although the Need Theory did not human needs so that progress after explicitly define the environment, hospitalization would not be delayed. Henderson stated that maintaining a - Virginia Henderson developed the supportive environment conducive to Nursing Need Theory to define the health is one of her 14 activities for client unique focus of nursing practice. assistance. - The theory focuses on the importance of - Henderson’s theory supports the private increasing the patient’s independence to and public health sector’s tasks or hasten their progress in the hospital. agencies to keep people healthy. - Henderson’s theory emphasizes the - She believes that society wants and basic human needs and how nurses can expects the nurse’s act for individuals meet those needs. who cannot function independently. 3. Health ★ 14 Components of the Need Theory - Although not explicitly defined in Henderson’s theory, health was taken to mean balance in all realms of human life. - It is equated with the independence or ability to perform activities without aid in the 14 components or basic human needs. - On the other hand, nurses are key persons in promoting health, preventing illness, and curing. - According to Henderson, good health is a challenge because it is affected by numerous factors such as age, cultural background, emotional balance, and The prioritization of the 14 Activities was not others. clearly explained whether the first one is a prerequisite to the other. But still, it is 4. Nursing remarkable that Henderson was able to - Virginia Henderson wrote her definition of specify and characterize some of the needs nursing before the development of of individuals based on Abraham Maslow’s theoretical nursing. hierarchy of needs. - She defined nursing as “the unique function of the nurse is to assist the Because of the absence of a conceptual individual, sick or well, in the diagram, interconnections between performance of those activities Henderson’s principles’ concepts and contributing to health or its recovery that subconcepts are not delineated. he would perform unaided if he had the necessary strength, will or knowledge. And to do this in such a way as to help him gain independence as rapidly as possible.” - Nurses temporarily assist an individual who lacks the necessary strength, will, and knowledge to satisfy one or more of the 14 basic needs. - Her definition of nursing distinguished a nurse’s role in health care: The nurse is expected to carry out a physician’s therapeutic plan, but individualized care results from the nurse’s creativity in Since there is much similarity, Henderson’s planning for care. 14 components can be applied or compared - The nurse should be an independent to Abraham Maslow‘s Hierarchy of Needs. practitioner able to make an independent Components 1 to 9 are under Maslow’s judgment. Physiological Needs, whereas the 9th component is under the Safety Needs. The 10th and 11th components are under the Love and Belongingness category, and the 12th, 13th, and 14th components undergraduate and graduate levels and are under the Self-Esteem Needs. mentored many postdoctoral candidates. Strength of this Theory - Pender was and still supports nursing organizations where she devoted her - Virginia Henderson’s concept of nursing time, service, and knowledge. is widely accepted in nursing practice - She was the president of the Midwest today. Her theory and 14 components are relatively simple, logical, and applied to Nursing Research Society from 1985 individuals of all ages. to 1987. Weakness of this Theory ★ Nola Pender’s Health Promotion Model - There is an absence of a conceptual diagram that interconnects Henderson’s theory’s 14 concepts and subconcepts. - The Health Promotion Model, On assisting the individual in the dying developed by nursing theorist Nola process, there is little explanation of what Pender, has provided healthcare a new the nurse does to provide “peaceful path. death.” - According to Nola J. Pender, Health Promotion and Disease Prevention Health Promotion Model should focus on health care. - When health promotion and prevention By Nola Pender fail to anticipate predicaments and ★ Biography of Nola Pender problems, care in illness becomes the subsequent priority. - Nola J. Pender (1941– present) i - The Health Promotion Model was - She is a nursing theorist who developed designed to be a “complementary the Health Promotion Model in 1982. counterpart to models of health - She is also an author and a professor protection.” emeritus of nursing at the University of - It develops to incorporate behaviors for Michigan. improving health and applies across the life span. - On August 16, 1941, Nola Pender was - Its purpose is to help nurses know and born in Lansing, Michigan, to parents understand the major determinants of who advocated education for women. health behaviors as a foundation for Her first encounter with the nursing behavioral counseling to promote profession was when she was 7 years well-being and healthy lifestyles. old and witnessed the care given to her hospitalized aunt by nurses. This - Pender’s health promotion model situation led her to the desire to care for defines health as “a positive dynamic other people, and her goal was to help state not merely the absence of people care for themselves. disease.” - In 1962, Nola Pender began working on - Health promotion is directed at a medical-surgical unit and increasing a client’s level of well-being. subsequently in a pediatric unit in a - It describes the multi-dimensional Michigan hospital. nature of persons as they interact within - For 40 years at Michigan State the environment to pursue health. University, she trained students at  - The model focuses on the following activity-related affect, interpersonal three areas: individual characteristics influences, and situational influences). and experiences, behavior-specific cognitions and affect, and behavioral 5. Behavioral outcomes outcomes. - (commitment to a plan of action, immediate competing demands and Major Assumptions in Health preferences, and health-promoting Promotion Model behavior). 1. Individuals seek to regulate their own ★ Subconcepts of the Health behavior actively. Promotion Model 2. Individuals in all their biopsychosocial complexity interact with the environment, Personal Factors progressively transforming the - Personal factors are categorized as environment and being transformed over biological, psychological, and time. socio-cultural. These factors are 3. Health professionals constitute a part of predictive of a given behavior and the interpersonal environment, which shaped by the target behavior’s nature influences persons throughout their life being considered. span. 4. Self-initiated reconfiguration of ➔ Personal biological factors: Include person-environment interactive patterns variables such as age, gender, body is essential to behavior change. mass index, pubertal status, aerobic capacity, strength, agility, or balance. ★ Major Concepts ➔ Personal psychological factors: Include variables such as self-esteem, 1. Health promotion self-motivation, personal competence, - is defined as behavior motivated by the perceived health status, and definition of desire to increase well-being and health. actualize human health potential. It is an ➔ Personal socio-cultural factors: Include approach to wellness. variables such as race, ethnicity, acculturation, education, and 2. Health protection socioeconomic status. - or illness prevention is described as behavior motivated desire to actively Perceived Benefits of Action avoid illness, detect it early, or maintain - Anticipated positive outcomes that will functioning within illness constraints. occur from health behavior. - 3. Individual characteristics and Perceived Barriers to Action experiences - Anticipated, imagined, or real blocks and - (prior related behavior and personal personal costs of understanding a given factors). behavior. 4. Behavior-specific cognitions and Perceived Self-Efficacy affect - The judgment of personal capability to - (perceived benefits of action, perceived organize and execute a health-promoting barriers to action, perceived self-efficacy, behavior. - Perceived self-efficacy influences environmental contingencies such as perceived barriers to action, so higher work or family care responsibilities. efficacy results in lowered perceptions of ➔ Competing preferences: are alternative barriers to the behavior’s performance. behaviors over which individuals exert relatively high control, such as choice of Activity-Related Affect ice cream or apple for a snack. - Subjective positive or negative feeling occurs before, during, and following Health-Promoting Behavior behavior based on the stimulus - A health-promoting behavior is an properties of the behavior itself. endpoint or action-outcome directed toward attaining positive health outcomes Interpersonal Influences such as optimal wellbeing, personal - Cognition concerning behaviors, beliefs, fulfillment, and productive living. or attitudes of others. Interpersonal influences include norms (expectations Strength of this Theory of significant others), social support (instrumental and emotional - The Health Promotion Model is simple to understand, yet diving deeper shows its encouragement), and modeling complexity in its structure. (vicarious learning through observing - It is highly applicable in the community others engaged in a particular behavior). health setting. - Primary sources of interpersonal - It promotes the nursing profession’s influences are families, peers, and independent practice, being the primary healthcare providers. source of health-promoting interventions and education. Situational Influences Weakness of this Theory - Personal perceptions and cognitions of any given situation or context can - The Health Promotion Model of Pender facilitate or impede behavior. could not define the nursing metapradigm - Include perceptions of options available, or the concepts that a nursing theory demand characteristics, and aesthetic should have, man, nursing, environment, features of the environment in which and health. - Its applicability to an individual currently given health-promoting is proposed to experiencing a disease state was not take place. given emphasis. - Situational influences may have direct or - indirect influences on health behavior. Conclusion Commitment to Plan of Action - Due to its focus on health promotion and disease prevention per se, its relevance - The concept of intention and identification to nursing actions given to ill individuals of a planned strategy leads to the is obscure. implementation of health behavior. - But then again, this characteristic of her model also gives the concepts its Immediate Competing Demands and uniqueness. Preferences - Pender’s principles paved a new way of viewing nursing care, but then one should also be reminded that nursing’s curative ➔ Competing demands: are those aspect cannot be detached from our alternative behaviors over which practice. individuals have low control because of -  Transcultural Nursing perceived and known by a designated culture through their direct experience, By Madeleine Leininger beliefs, and value system (Leininger, ★ Biography of Madeleine Leininger 1979). - Madeleine Leininger (July 13, 1925 – 3. Nursing August 10, 2012) - Nursing is defined as a learned - She was an internationally known humanistic and scientific profession and educator, author, theorist, administrator, discipline which is focused on human researcher, consultant, public speaker, care phenomena and activities to assist, and the developer of the concept of support, facilitate, or enable individuals or transcultural nursing that has a great groups to maintain or regain their impact on how to deal with patients of well-being (or health) in culturally different culture and cultural meaningful and beneficial ways, or to background. help people face handicaps or death. ★ Leininger’s Transcultural Nursing 4. Professional Nursing Care (Caring) - Professional nursing care (caring) is Theory defined as formal and cognitively learned professional care knowledge and practice - The Transcultural Nursing Theory or skills obtained through educational Culture Care Theory by Madeleine institutions that are used to provide Leininger involves knowing and assistive, supportive, enabling, or understanding different cultures facilitative acts to or for another individual concerning nursing and health-illness or group to improve a human health caring practices, beliefs, and values to condition (or well-being), disability, provide meaningful and efficacious lifeway, or to work with dying clients. nursing care services to people’s cultural values health-illness context. 5. Cultural Congruent (Nursing) Care - Cultural congruent (nursing) care is ★ Major Concepts of Transcultural defined as those cognitively based Theory assistive, supportive, facilitative, or enabling acts or decisions that are 1. Transcultural Nursing tailor-made to fit with the individual, - Transcultural nursing is defined as a group, or institutional, cultural values, learned subfield or branch of nursing that beliefs, and lifeways to provide or support focuses upon the comparative study and meaningful, beneficial, and satisfying analysis of cultures concerning nursing health care, or well-being services. and health-illness caring practices, beliefs, and values to provide meaningful 6. Health and efficacious nursing care services to - It is a state of well-being that is culturally their cultural values and health-illness defined, valued, and practiced. context. - It reflects individuals’ (or groups) ‘ ability to perform their daily role activities in culturally expressed, beneficial, and 2. Ethnonursing patterned lifeways. - This is the study of nursing care beliefs, values, and practices as cognitively 7. Human Beings 13. Culture Care Universality - Such are believed to be caring and - Culture care universality indicates the capable of being concerned about others’ common, similar, or dominant uniform needs, well-being, and survival. care meanings, patterns, values, - Leininger also indicates that nursing as a lifeways, or symbols manifest among caring science should focus beyond many cultures and reflect assistive, traditional nurse-patient interactions and supportive, facilitative, or enabling ways dyads to include families, groups, to help people. (Leininger, 1991) communities, total cultures, and institutions. ★ Subconcepts 8. Society and Environment 1. Generic (Folk or Lay) Care Systems - Leininger did not define these terms; she - Generic (folk or lay) care systems are speaks instead of worldview, social culturally learned and transmitted, structure, and environmental context. indigenous (or traditional), folk (home-based) knowledge and skills used 9. Worldview to provide assistive, supportive, enabling, - Worldview is how people look at the or facilitative acts toward or for another world, or the universe, and form a individual, group, or institution with “picture or value stance” about the world evident or anticipated needs to and their lives. ameliorate or improve a human life way, health condition (or well-being), or to deal 10. Culture with handicaps and death situations. - Culture is learned, shared, and transmitted values, beliefs, norms, and 2. Professional Care Systems lifeways of a particular group that guides - Professional care systems are defined as their thinking, decisions, and actions in formally taught, learned, and transmitted patterned ways. professional care, health, illness, wellness, and related knowledge and 11. Culture Care practice skills that prevail in professional - Culture care is defined as the subjectively institutions, usually with multidisciplinary and objectively learned and transmitted personnel to serve consumers. values, beliefs, and patterned lifeways that assist, support, facilitate, or enable 3. Culture Shock another individual or group to maintain - Culture shock may result when an their well-being, health, improve their outsider attempts to comprehend or human condition lifeway, or deal with adapt effectively to a different cultural illness, handicaps or death. group. - The outsider is likely to experience 12. Culture Care Diversity feelings of discomfort and helplessness - Culture care diversity indicates the and some degree of disorientation variabilities and/or differences in because of the differences in cultural meanings, patterns, values, lifeways, or values, beliefs, and practices. symbols of care within or between - Culture shock may lead to anger and can collectives related to assistive, be reduced by seeking knowledge of the supportive, or enabling human care culture before encountering that culture. expressions.  - The cultural care worldview flows into knowledge about individuals, families, 4. Cultural Imposition groups, communities, and institutions in - Cultural imposition refers to the outsider’s diverse health care systems. This efforts, both subtle and not so subtle, to knowledge provides culturally specific impose their own cultural values, beliefs, meanings and expressions concerning care behaviors upon an individual, family, or and health. The next focus is on the generic group from another culture. (Leininger, or folk system, professional care 1978) systems, and nursing care. Information about these systems includes the ★ Sunrise Model of Madeleine characteristics and the specific care Leininger’s Theory features of each. This information allows for the identification of similarities and differences or cultural care universality and cultural care diversity. Next are nursing care decisions and actions which involve cultural care preservation or maintenance, cultural care accommodation or negotiation, and cultural care repatterning or restructuring. It is here that nursing care is delivered. Strength of this Theory - Leininger has developed the Sunrise Model in a logical order to demonstrate the interrelationships of the concepts in her theory of Culture Care Diversity and Universality. - Leininger’s theory is essentially parsimonious in that the necessary concepts are incorporated in such a manner that the theory and its model can be applied in many different settings. - it is highly generalizable. The concepts and relationships presented are at a level of abstraction, which allows them to be applied in many different situations. - Though not simple in terms, it can be The Sunrise Model is relevant because it easily understood upon the first contact. enables nurses to develop critical and complex thoughts about nursing practice. Weakness of this Theory These thoughts should consider and integrate cultural and social structure - The theory and model are not simple in terms dimensions in each specific context, besides nursing care’s biological and psychological aspects. Theory of Health as Expanding ★ Nursing Metaparadigm Consciousness By Margaret Newman ★ Biography of Margaret Newman - Born on October 10, 1933. - Bachelor's degree - University of Tennessee in 1962 - Master's degree - University of California in 1964 - Doctorate - New York University in 1971 - She has worked in - University of Tennessee, New York University, Pennsylvania State University, University of Minnesotat, University of Minnesota ★ Newman’s Theory of Health as Expanding Consciousness - It proposes that all individuals can achieve a state of health that involves the experience of interacting and connecting with the environment. - According to this theory, relationship are focus of nursing, by this focus, it will assist individuals in expanding consciousness  - Multi-dimensional ★ Model of her Theory - Qualitative - Little discussion on environment Theory of Human Becoming By Rosemarie Rizzo Parse ★ Biography of Rosemarie Rizzo Parse - This is the basic assumption of the theory that are focus on patterns - Pattern: refers to information that depicts the whole, understanding of meaning of all the relationship at once. The wholeness is identified in pattern and this pattern is constantly evolving. ★ Three Correlates of Consciousness 1. Movement 2. Time 3. Space The relevant of movement, time, and space was part of the original explication and ha re-emerged in the evolving pattern of unfolding consciousness. Strength of this Theory - Can be applied in any setting - “Generates caring interventions” Weakness of this Theory - Abstract ★ Theory of Human Becoming ★ Major Nursing Metaparadigm - This is a combination of biological, psychological , sociological, and spiritual factors. - The state of a person is also included in this theory. The quality of life, unitary being, and continuous interaction with it’s environment. - It is centered around 3 teams: Meaning, Rhytmicity, Transcendence - She created this theory which will guide the nurses to focus on the quality of life from each person’s own perspective as the goal of nursing - Emphasizes how individual choose and bear responsibility for patterns of personal health ★ Symbol of Human Becoming ★ Three Principles in the Theory - This symbolize the quality of life from the person’s perspective, also the research quality of life that has been implemented from a totality paradigm perspective, excluding the considerations of human as a unitary being. - BLACK AND WHITE: Represents the difference in concepts of human becoming theory from other nursing theories. - GREEN: Represents hope - CENTER JOINED or JOINING CENTER: Represents the relationship of the nurse and the patient - GREEN AND BLACK: The intertwining of these color represents the human and the universe relating to each other. They continually affect one another.  - Locsin represent the theoretical starting points for using up technology and caring as coordinated interaction in the nursing environment. - Theory based nursing practice is essential to high quality nursing and health care. - This theory views technology and caring coexisting harmoniously in the nursing practice ★ Overview of the Theory - Knowing: this is the technological Technological Competency as competence. Knowing the patient or other person. Caring in Nursing - Designing: How you will deliver care; By Rozzano C. Locsin Nursing Careplan - Implementing and Evaluating: ★ Technological Competency as Caring Implementing of intervention and then in Nursing evaluate. - Verifying Knowledge: You need to verify - Technological Competency: Nurse the scientific base knowledge regarding being a technological competence in the the implementation of the care as well as basis of knowledge, skills, and abilities how you will evaluate the care that you in technology. give to the patient. Relevance to the - As caring and nursing is the harmonious technology used in assisting giving care. coexistence between technologies and caring, - This technology brings the patient closer ★ Metaparadigm to the nurse. - Conversely, technology can also 1. Health increase the gap between the nurse and - Health is enhancing the personhood, the patient. allowing each person to develop and progress moment to moment.  ★ Theory in Practice 2. Nursing - Concept of caring and intentionality. Must possess compassion, confidence, commitment, honesty, and conscience because all of these are essential components of caring in nursing. 3. Environment - Aside from technological environment, parts of the life of a person is not inseparable, it is grafted as one aspect of one individual bodies. 4. Person - ? ★ Evaluation ★ Theory vs Practice ★ Importance of Nursing Knowledge