Martha Rogers: Unitary Human Beings PDF

Core Concepts of SUHB TFN REVIEWER Major Assumptions Martha Rogers: Unitary Human Beings Wholeness: Humans are seen as unified Biography and Contributions who...

Core Concepts of SUHB TFN REVIEWER Major Assumptions Martha Rogers: Unitary Human Beings Wholeness: Humans are seen as unified Biography and Contributions wholes, with characteristics that exceed the sum of their parts. Martha Elizabeth Rogers (1914-1994) Openness: The universe is viewed as an was a pioneering American nurse and open system where energy fields are theorist known for her influential work in interconnected and continuously nursing theory. interacting. She authored the landmark book, An Unidirectionality: Life processes evolve Introduction to the Theoretical Basis of in a linear fashion along the space-time Nursing, which laid the foundation for her continuum, emphasizing the irreversible theoretical framework. nature of change. Rogers emphasized the inseparable Pattern and Organization: Each relationship between humans and their individual is characterized by unique environment in the context of health and patterns that reflect their wholeness and treatment. identity. Her work contributed significantly to the Sentience: Humans possess the capacity evolution of nursing as both a science for thought, emotion, and abstraction, and an art, focusing on holistic patient which are integral to their being. care. Rogers' theories have influenced nursing Key Concepts education and practice, promoting a more integrative approach to patient care. Energy Field: Both humans and their environments are seen as energy fields The Science of Unitary Human Beings (SUHB) that are open and allow for the free flow of energy. SUHB posits that nursing is both a Open Systems: There are no barriers to science and an art, focusing on the the flow of energy between humans and unitary human being as an integral part of their environments, facilitating continuous the universe. interaction. The theory emphasizes the Pattern: The unique characteristics of an interconnectedness of humans and their energy field, which are dynamic and environment, viewing them as a single continuously changing, providing identity entity. to the individual. Rogers' model includes two dimensions: Pan-dimensionality: This concept refers the science of nursing (knowledge from to the infinite nature of the human research) and the art of nursing (creative experience, emphasizing the holistic view application of that knowledge). of individuals. The model is based on basic assumptions about human life processes, including wholeness, openness, and Implications for Nursing Practice unidirectionality. Rogers' work has been continuously Nursing Practice and Education updated to reflect new understandings in nursing and health sciences. Rogers defined nursing practice as the application of scientific knowledge to  assist individuals in achieving maximum The SCDNT is a general theory that well-being. interrelates various concepts to provide a The nursing process is divided into two framework for understanding nursing. phases: evaluative (assessing well-being) It emphasizes the importance of self-care and interventive (implementing care and the role of nurses in supporting strategies). patients who cannot fully care for Educators using Rogers' model recognize themselves. the individuality of students, tailoring The theory is applicable to a wide variety interactions based on their unique of patients, making it versatile in clinical patterns and backgrounds. settings. The model encourages a holistic approach to nursing, integrating the patient's environment and personal Key Components of the Self-Care Deficit experiences into care plans. Theory Research and Application The Four Related Theories Research on Rogers' theory has explored Theory of Self-Care: Explains why and its applicability across various how individuals engage in self-care environments involving human beings. activities to maintain health. The theory promotes interventions that Theory of Dependent-Care: Describes focus on overall well-being rather than how family and friends provide care for just addressing disease states. individuals who are dependent due to Techniques such as guided imagery, health issues. relaxation, therapeutic touch, and Theory of Self-Care Deficit: Identifies meditation are encouraged as part of when individuals require nursing nursing interventions. assistance due to their inability to perform Rogers' framework has been influential in self-care. shaping modern nursing practices that Theory of Nursing Systems: Outlines prioritize patient-centered care. the relationships necessary for effective nursing care, including the roles of nurses Dorothea Orem: Self Care Deficit and patients. Theory Theory Assertions Biography of Dorothea Orem The SCDNT presents a comprehensive Born in Baltimore, Maryland, in 1914, view of nursing, integrating various Orem began her nursing career at aspects of patient care. Providence Hospital School of Nursing in It includes three systems: wholly Washington, DC, in the early 1930s. compensatory, partly compensatory, and Her experiences in nursing led her to supportive-educative, each serving develop theories aimed at improving different patient needs. nursing quality in general hospitals. Self-care agency is crucial, defined as the Orem's work is foundational in nursing ability of individuals to perform self-care theory, influencing both practice and activities, which can be supported by education in the field. nurses. Overview of the Self-Care Deficit Theory (SCDNT)  Wholly Compensatory System: For Practical Applications of the Self-Care Deficit patients who are completely unable to Theory perform self-care. Partly Compensatory System: For Nursing Interventions Based on SCDNT patients who can perform some self-care but require assistance. Nurses can use five methods to assist Supportive-Educative System: For patients in meeting their self-care needs: patients who can perform self-care but acting for another, guiding, providing need guidance and education. support, maintaining a supportive environment, and teaching. Each method is tailored to the individual Metaparadigm of Self-Care Deficit Theory patient's needs and circumstances, promoting autonomy and health. Key Concepts in the Metaparadigm Example: A nurse may teach a patient with diabetes how to manage their diet Person: Viewed as a whole, capable of and insulin administration effectively. self-care, and influenced by biological, symbolic, and social factors. Environment: Encompasses physical, Imogene King: Theory of Goal chemical, biological, and social factors Attainment that affect an individual's health and self-care capabilities. Biography and Contributions Health: Defined as a state of soundness in bodily and mental functioning, Imogene M. King was born on January emphasizing the importance of holistic 30, 1923, in West Point, Iowa, and care. passed away on December 24, 2007, in Nursing: The process of developing a St. Petersburg, Florida. care plan to meet the self-care needs of She was a pioneering nursing theorist patients, utilizing Orem's definitions. known for her Theory of Goal Attainment developed in the early 1960s. The Nursing Process in Orem's Model King's work is widely taught in nursing programs globally and is implemented in The nursing process consists of three various healthcare settings. main parts: assessment, diagnosis, and Her contributions include a conceptual implementation/evaluation. system and middle-range theory that Assessment: Involves collecting data to emphasizes nurse-patient partnerships identify self-care deficits and patient for achieving health outcomes. needs. King's theory has been instrumental in Diagnosis and Care Plan: Creating a improving the quality of patient care tailored nursing care plan based on the across diverse nursing practices. assessment findings. Implementation and Evaluation: Theoretical Framework Executing the care plan and evaluating its effectiveness in meeting patient goals. The Theory of Goal Attainment focuses on the attainment of goals through nurse-patient interactions. King identifies three fundamental needs of patients: health information, preventive care, and care during illness.  Health is defined as the ability to adjust to Nursing Process in King's Theory stressors in both internal and external environments using available resources. Assessment The environment is crucial for human interaction, encompassing both internal Nurses collect data on patients' growth, (personal) and external (social) factors. development, self-perception, and health status. Perception is crucial for data collection Key Components of the Theory and interpretation, requiring effective communication for accuracy. Interacting Systems Understanding the patient's perspective is essential for establishing a therapeutic Personal System: Involves the individual relationship. (patient or nurse) and includes concepts such as body image, growth, Nursing Diagnosis development, perception, self, space, and time. Based on assessment data, nurses Interpersonal System: Formed through identify problems and concerns that interactions between individuals, such as patients seek help for. the nurse-patient dyad or family groups, This step involves recognizing emphasizing communication and role disturbances that affect the patient's dynamics. health and well-being Social System: A broader system comprising societal groups, including Care Planning religious, educational, and healthcare systems, focusing on authority, Nurses create care plans with decision-making, and organizational interventions aimed at addressing structures. identified problems. Goal setting is a critical component, Major Assumptions guiding the decision-making process for achieving desired health outcomes. Nursing is defined as observable behavior within healthcare systems, aiming to help Implementation and Evaluation individuals maintain health and function in their roles. The implementation phase involves Individuals are seen as spiritual beings executing the care plan and engaging in with unique histories and cultures, ongoing transactions with the patient. capable of rational thought and Evaluation assesses whether the goals decision-making. were met and the effectiveness of the Health is a dynamic state requiring nursing interventions, providing feedback continuous adjustment to internal and for future care. external stressors, while illness disrupts this process. Dorothy Johnson's: Behavioral System Model The environment plays a critical role in in Nursing health maintenance, with constant interactions influencing health outcomes. Early Life Born on August 21, 1919, in Savannah, Georgia, as the youngest of seven children.  Father was a superintendent of a shrimp Passed away in February 1999 at the age and oyster factory; mother was an avid of 80. reader. Expressed satisfaction that her theory Completed an associate degree at was utilized in nursing practice and Armstrong Junior College in 1938. contributed to the development of nursing Took a year off during the Great as a profession. Depression to work as a governess in Miami, Florida, which sparked her interest in nursing and education. The Behavioral System Model Education Overview of the Model Graduated from Vanderbilt University Proposed in 1968, the model emphasizes School of Nursing in 1942, ranking as the the importance of behavioral functioning top student. in nursing. Received the prestigious Vanderbilt Defines nursing as an external regulatory Founder’s Medal for her academic force that maintains the organization and excellence. integration of patient behaviors. Pursued a Master’s in Public Health from Each individual has a unique behavioral Harvard University in 1948, further system characterized by patterned and enhancing her expertise in nursing. purposeful actions. Career and Appointments Components of the Behavioral System Model Initially worked as a staff nurse at the The model identifies seven behavioral Chatham-Savannah Health Council subsystems: (1943-1944). Served as an instructor and assistant 1. Affiliative: Relates to social interactions professor in pediatric nursing at and relationships. Vanderbilt University. 2. Dependency: Involves reliance on others From 1949 to 1978, held various positions for support and care. at the University of California, Los 3. Ingestive: Pertains to eating and nutrition Angeles, including assistant professor behaviors. and professor of nursing. 4. Eliminative: Concerns waste removal Worked as a pediatric nursing advisor in and bodily functions. Vellore, South India, in 1955-1956. 5. Sexual: Involves sexual behaviors and relationships. Awards and Honors 6. Aggressive: Relates to assertiveness and self-defense. Received the 1975 Faculty Award from 7. Achievement: Focuses on personal graduate students, recognizing her goals and accomplishments. teaching excellence. Honored with the 1977 Lulu Hassenplug Functional Requirements Distinguished Achievement Award from the California Nurses Association. Each subsystem has three functional In 1981, awarded for Excellence in requirements: Nursing by Vanderbilt University School of 1. Protection from noxious influences: Nursing. Ensuring safety from harmful factors. 2. Provision for a nurturing environment: Death Creating supportive surroundings for growth.  3. Stimulation for growth: Encouraging Significance of the Model development and adaptation. The model serves a dual purpose: it is Goals of Nursing in the Model significant for social life and individual well-being. The goals of nursing according to the Behavioral System balance reflects successful System Model include: adjustments and adaptations, indicating effective functioning. 1. Assisting patients in aligning their The model emphasizes the importance of behavior with social demands. understanding behavior in the context of 2. Helping patients modify behavior to goals and drives. support biological needs. 3. Enabling patients to benefit from medical Assumptions of Structure and Function knowledge during illness. 4. Preventing unnecessary trauma in Behavior can be inferred from the form it patients due to illness. takes and the consequences it achieves, indicating underlying drives. Each individual has a predisposition to act Assumptions of the Behavioral System Model in certain ways towards goals, termed a 'set'. Assumptions about System Subsystems possess a 'scope of action', which defines their choices and The system is characterized by behaviors. organization, interaction, Observable outcomes of individual interdependency, and integration of behavior provide insights into the behaviors. functioning of the system. A system strives for balance among various forces acting upon it, maintaining Functional Requirements for Subsystems equilibrium through adjustments. Behavioral systems require regularity and Systems must be protected from toxic constancy, serving significant functions in influences that they cannot manage. social life. Nurturing through appropriate environmental inputs is essential for Assumptions about Structure and Functions system health. Stimulation is necessary to promote The form of behavior and its growth and prevent stagnation. consequences can indicate the underlying drives or goals. Individuals have predispositions to act in Major Concepts in Johnson's Nursing Model certain ways, referred to as a 'set'. Each subsystem has a repertoire of Definitions of Key Concepts choices known as the 'scope of action'. Patient behavior produces observable Human Beings: Viewed as a behavioral outcomes, reflecting the effectiveness of system striving for balance and nursing interventions. adaptation. Environment: Implied to include all surrounding elements affecting the Overview of Johnson's Behavioral System human system, including stressors. Model Health: Defined as regularity and constancy in behavior, reflecting successful adaptations.  Nursing: An external force that preserves The nursing process begins with the organization of patient behavior under assessment and diagnosis, leading to a threat. care plan. Evaluation focuses on the balance of Behavioral System and Its Components subsystems, determining the effectiveness of interventions. Subsystems: Mini-systems that maintain Successful nursing involves maintaining relationships within the larger system. equilibrium in the behavioral system Structure: The parts that make up the during illness. whole system, influencing behavior. Boundaries: Distinctions between the Strengths and Weaknesses of the Model system's interior and exterior. Homeostasis: The process of The model guides nursing practice and maintaining stability within the system. education, generating new ideas and differentiating nursing from other professions. The Seven Subsystems of the Behavioral It has been applied in various settings, System Model including inpatient and community care. Complexity arises from interrelationships Overview of Subsystems among subsystems, requiring further empirical research. Attachment or Affiliative Subsystem: Focuses on social bonds and security, essential for survival. Conclusion Dependency Subsystem: Involves seeking approval and assistance, Summary of Key Points evolving from dependence on others to self-reliance. Johnson's model describes the person as Ingestive Subsystem: Concerns the a behavioral system with seven social aspects of eating, including timing interrelated subsystems. and conditions of food intake. Each subsystem contributes to the overall Eliminative Subsystem: Defines socially integrity of the behavioral system. acceptable behaviors for waste excretion, Balance and stability in the behavioral varying by culture. system lead to organized and predictable Sexual Subsystem: Encompasses behaviors, while imbalance results in biological and social factors affecting instability. sexual behavior and identity. Aggressive Subsystem: Relates to Sister Callista Roy's: Adaptation Model of self-preservation and protection, Nursing responding to threats. Achievement Subsystem: Involves Early Life and Education behaviors aimed at controlling the environment and achieving excellence. Born on October 14, 1939, Sister Callista Roy is a prominent nursing theorist and author. Application of the Behavioral System Model Received her Bachelor of Arts in Nursing in Nursing from Mount Saint Mary’s College in Los Angeles in 1963. Nursing Process and Evaluation Earned a Master’s degree in Nursing from the University of California in 1966,  followed by a Master’s and Doctorate in The model views individuals as Sociology in 1973 and 1977, respectively. interrelated systems striving to maintain Her educational journey was marked by a balance amidst various stimuli. seminar challenge from Dorothy E. First presented in the literature in 1970 in Johnson to develop a conceptual model an article titled "Adaptation: A Conceptual for nursing. Framework for Nursing." The model was influenced by concepts Career Highlights from various theorists, including Dorothy Johnson and Harry Helson. Worked as a pediatric nurse, where she observed children's resilience and Key Concepts of the Model adaptability to physical and psychological changes. Person: Defined as a holistic being in Developed the basic concepts of the constant interaction with the environment, Adaptation Model while studying at the utilizing both innate and acquired systems University of California from 1964 to of adaptation. 1966. Environment: Encompasses all external In 1968, her model was adopted as the factors affecting the individual, including philosophical foundation of the nursing social, cultural, and physical elements. curriculum at Mount Saint Mary’s College. Health: Viewed as a state of adaptation Served as an associate professor and to the environment, where individuals can chairperson of the Department of Nursing achieve their potential. at Mount Saint Mary’s College until 1982, Nursing: Defined as a process of later becoming a professor at both Mount promoting adaptation in individuals and Saint Mary’s College and the University of groups. Portland. Assumptions of the Adaptation Model Contributions to Nursing Scientific Assumptions: Include the Became a Robert Wood Johnson progression of systems to higher levels of postdoctoral fellow at the University of self-organization and the accountability of California, San Francisco, focusing on humans for their creative processes. nursing interventions for cognitive Philosophical Assumptions: Emphasize recovery in head injuries. mutual relationships with the world and In 1987, she took on the role of resident God, and the importance of human nurse theorist at Boston College School creative abilities in adaptation. of Nursing, teaching across various levels of nursing education. Founded the Boston Based Adaptation Major Works and Publications Research in Nursing Society (BBARNS) in 1991, later renamed the Roy Scholarly Contributions Adaptation Association. Sister Callista Roy has authored numerous publications on nursing theory, The Adaptation Model of Nursing many of which have been translated into multiple languages. Overview of the Adaptation Model Her most notable work is on the Roy Adaptation Model, which has been Developed in 1976, the Adaptation Model critiqued and synthesized by her aims to define the provision of nursing colleagues at the Roy Adaptation science. Association.  The model has influenced over 350 Positive environmental conditions can research projects published in English, enhance health, while negative conditions showcasing its global impact. can lead to maladaptation. Understanding the interplay between Impact on Nursing Education environment and health is essential for effective nursing interventions. The Adaptation Model has been integrated into nursing curricula worldwide, influencing how nursing is Defining Health in the Context of Adaptation taught and practiced. Roy's work has contributed to the Concept of Health development of nursing as a science, emphasizing the importance of adaptation Health is defined as the ability to cope in patient care. with life's challenges, including death, disease, and stress. It is not merely the absence of illness but Understanding the Environment in Roy's a dynamic state of adaptation to stimuli. Adaptation Model The coexistence of health and illness is a fundamental aspect of human experience. Definition of Environment Holistic Adaptation The environment encompasses the conditions, circumstances, and influences Holistic adaptation refers to the ability to that affect human development and maintain health by integrating various behavior. aspects of the self. It is viewed as a stimulus that Successful adaptation leads to a sense of necessitates adaptation, which can be completeness and unity within the either positive or negative. individual. Roy categorizes environmental stimuli Failure to adapt can negatively impact into three types: focal, contextual, and personal integrity and overall health. residual. Types of Stimuli Nursing and the Role of Adaptation Focal Stimuli: These are the primary Goals of Nursing stimuli that demand immediate attention from the individual. The primary goal of nursing is to promote Contextual Stimuli: These are the adaptation in individuals and groups additional stimuli present alongside focal across four adaptive modes. stimuli that influence their effects. Nurses facilitate adaptation by assessing Residual Stimuli: These are behaviors and enhancing interactions with environmental factors whose effects are the environment. unclear, often influenced by past Effective nursing interventions can lead to experiences. improved health outcomes and quality of life. Interaction of Environment and Health The Four Adaptive Modes The environment plays a crucial role in shaping health outcomes by providing Physiological-Physical Mode: Involves stimuli that individuals must adapt to. the physical and chemical processes  necessary for life, such as oxygenation Strengths of the Model and nutrition. Self-Concept Group Identity Mode: The model acknowledges the complexity Focuses on personal identity and of human beings and the multiple causes integrity, including body image and of health issues. self-ideals. It provides a logical sequence of concepts Role Function Mode: Addresses the that emphasize adaptation for maintaining roles individuals occupy in society and integrity. their understanding of these roles. The model is applicable across various Interdependence Mode: Emphasizes nursing practice settings, enhancing relational integrity through effective individualized patient care. communication and relationships. Weaknesses of the Model Adaptation Processes and Nursing The application of the model can be Interventions time-consuming, particularly in emergency situations. Levels of Adaptation The complexity of the model may hinder quick assessments and interventions. Integrated Process: Stable processes There is a lack of clarity on how to that meet environmental needs, such as prevent and resolve maladaptive breathing and successful relationships. responses. Compensatory Process: The body's attempt to meet environmental Betty Neuman: Neuman Systems challenges, such as coping with grief or Model starting a new job. Compromised Process: When the Biography of Betty Neuman body's systems fail to adequately respond to environmental challenges, leading to Betty Neuman was born in 1924 near health issues. Lowell, Ohio, and grew up on a farm, which instilled in her a desire to help Six-Step Nursing Process others. Her father, a farmer, died young, and her 1. Assess behaviors related to the four mother was a self-educated midwife, adaptive modes. influencing Neuman's early interest in 2. Identify and categorize stimuli as focal, nursing. contextual, or residual. Neuman's compassion for nursing 3. Formulate a nursing diagnosis based on developed while caring for her sick father, the adaptive state. shaping her career path. 4. Set goals to promote adaptation. She attended a one-room schoolhouse 5. Implement interventions to manage and later a high school with a library, stimuli. fostering her interest in human behavior. 6. Evaluate the effectiveness of the During WWII, she worked as an aircraft interventions in achieving adaptive goals. instrument technician before pursuing nursing. Neuman received her RN Diploma in 1947 from Peoples Hospital School of Nursing in Akron, Ohio. Analysis of Roy's Adaptation Model Education and Early Career  Neuman's nursing career began in Client Variables: The model identifies California, where she worked in various five variables that affect health: roles including hospital nurse and clinical physiological, psychological, instructor. sociocultural, developmental, and She earned a baccalaureate degree in spiritual. public health and psychology in 1957, Stressors: Neuman categorizes followed by a master's degree in mental stressors as intrapersonal, interpersonal, health in 1966 from UCLA. and extrapersonal, which can impact the Neuman developed the first community client's health. mental health program for graduate Reconstitution: This refers to the students in Los Angeles from 1967 to process of returning to a state of wellness 1973. after experiencing stress or illness. She was a pioneer in integrating nursing Prevention: The model emphasizes into mental health care, co-developing the primary, secondary, and tertiary nurse counselor role in community crisis prevention strategies to maintain health centers. and well-being. Neuman also had a brief career as a Holistic Care: The model promotes a fashion model and learned to fly, comprehensive approach to patient care, showcasing her diverse interests and addressing all aspects of a person's life. capabilities. Flexibility: The model's adaptability In 1985, she completed her doctoral allows nurses to tailor interventions to degree in clinical psychology at Pacific meet the unique needs of each patient. Western University. Contributions and Impact Development of the Neuman Systems Model Works and Publications Overview of the Neuman Systems Model Neuman published her first draft of the The Neuman Systems Model is a holistic Neuman Systems Model in 1972, approach to nursing that considers the followed by her book in 1982, which patient as a whole system. detailed its application in nursing It emphasizes the interaction between the education and practice. patient and their environment, focusing on She contributed to the book 'Conceptual stressors and the patient's response. Models for Nursing Practice' in 1971, The model incorporates various variables, which helped disseminate her ideas. including physiological, psychological, Neuman has been involved in numerous sociocultural, developmental, and spiritual publications, presentations, and factors. consultations on the model's application Neuman's model is widely accepted in in nursing. nursing curricula globally, influencing Her work has influenced nursing nursing education and practice. education programs and clinical practice The model allows for flexibility in facilities both nationally and addressing individual patient needs and internationally. circumstances. Neuman's teaching programs at UCLA It serves as a framework for were instrumental in developing her understanding patient care and nursing model, emphasizing the developing nursing interventions. importance of holistic care. She continues to consult and promote her Key Components of the Model model through the Neuman Systems  Model Trustees Group, established in Application of the Neuman Systems Model 1988. The model is applied in various nursing Awards and Recognition settings, including hospitals, community health, and mental health. Neuman has received several honorary It guides nurses in creating individualized doctorates, including from Neumann care plans that address the unique needs College and Grand Valley State of each patient. University. The model's flexibility allows for She was honored as an honorary adaptation in different cultural and clinical member of the American Academy of contexts. Nursing in 1993. It serves as a foundation for nursing The Walsh University Distinguished education, helping students understand Service Medal was awarded to her for holistic patient care. outstanding service to the community. The model encourages collaboration The Neuman Award was established in among healthcare professionals to her honor for outstanding service in the provide comprehensive care. nursing profession. Ongoing research and practice continue Her contributions to nursing have been to validate and refine the application of recognized globally, highlighting her the Neuman Systems Model. impact on the field. Neuman's work has paved the way for future nursing theories and practices, Overview of the Neuman Systems Model emphasizing the importance of holistic care. Definition and Purpose The Neuman Systems Model is a holistic, Theoretical Framework system-based approach to nursing that emphasizes flexibility in addressing Understanding Stress in Nursing patient responses to environmental stressors. Neuman's theory addresses the It aims to maintain client system stability relationship between individuals and through interventions categorized as stress, focusing on subjective primary, secondary, and tertiary nursing experiences. prevention. Stress is viewed as inevitable, painful, Betty Neuman describes the model as a and intensifying, impacting health and unique perspective that unifies various well-being. nursing concerns, treating the client as an The model outlines how individuals open system interacting with the perceive stressors as threatening and environment. beyond their control. Neuman emphasizes the importance of Key Components of the Model understanding reconstitution factors that help individuals recover from stress. The model identifies client variables: The model provides a framework for physiological, psychological, nurses to assess and address stress in sociocultural, developmental, and their patients. spiritual, which influence health By understanding stress responses, outcomes. nurses can develop effective interventions The client system is protected by lines of to support patient health. resistance, with a normal line of defense representing the usual health level.  Stressors can be intra-, inter-, or and energy depletion (entropy) in health extrapersonal, affecting the client outcomes. system's stability. Understanding the basic structure allows for targeted interventions that can Stressors and Health Continuum enhance client resilience and stability. Stressors invade the system when they breach the flexible line of defense, Assumptions of the Neuman Systems Model leading to illness on a wellness-illness continuum. Unique Client Systems The system can be reconstituted to restore the normal line of defense if Each client system is unique, composed adequate energy is available. of various factors and characteristics that The model emphasizes the dynamic influence responses to stressors. nature of health, where wellness and Known, unknown, and universal stressors illness exist on a continuum influenced by exist, each with different potentials to energy availability. disturb a client's stability. The interrelationships of client variables System of Organized Complexity at any time can affect the protective capacity of the flexible line of defense. The Neuman Systems Model is characterized as a system of organized Normal Line of Defense complexity, where all elements interact dynamically. Each client has evolved a normal range of It emphasizes the interconnectedness of responses to the environment, referred to various components within a client as the normal line of defense. system, highlighting the importance of This line serves as a standard for holistic care. measuring health deviations, indicating The model is designed to address both the system's stability. health and illness, viewing them as part of When the flexible line of defense fails, a continuum rather than as binary states. stressors can penetrate the normal line, It incorporates various factors that leading to health disturbances. influence health, including environmental, psychological, and physiological aspects. Dynamic Energy Exchange The model serves as a framework for understanding client needs and The client system is in constant energy developing appropriate nursing exchange with the environment, interventions. influencing health outcomes. Internal resistance factors, known as lines Basic Structure and Energy Resources of resistance, help stabilize the client and realign them to wellness. The basic structure of the model consists Nursing interventions are categorized into of core survival factors common to all primary, secondary, and tertiary species, including genetic features and prevention, each addressing different system variables. stages of stressor impact. Energy resources are crucial for maintaining system integrity and health, influencing how clients respond to Major Concepts in Neuman Systems Model stressors. The model identifies the importance of both energy conservation (negentropy) Human Being as an Open System symptom management and reducing harmful effects. Humans are viewed as open systems that Tertiary prevention involves the processes interact with internal and external of reconstitution, helping the client return environmental forces. to a state of wellness. The dynamic state of system stability is influenced by the constant change in Energy Conservation response to stressors. The model emphasizes the importance of Nursing interventions are designed to understanding the client's unique context conserve energy while helping the client in nursing care. adjust to stressors. The model emphasizes the importance of Environment's Role maintaining a balance between client system variables and environmental The environment is crucial to the system's stressors. function and includes all factors affecting Effective nursing care requires the client. understanding the dynamic interactions Three relevant environments are between the client and their environment. identified: internal, external, and created, each influencing health outcomes. Open System Characteristics The internal environment consists of forces within the client system, while the The Neuman Systems Model views the external environment encompasses client as an open system with continuous outside influences. input, output, and feedback processes. This organized complexity allows for a Health and Nursing Definitions comprehensive understanding of health and illness. Health is defined as the degree of system The model encourages a holistic stability, existing on a continuum from approach to nursing, considering all wellness to illness. aspects of the client's life. Optimal wellness occurs when system needs are met; illness arises when needs are unmet, leading to energy depletion Client Variables in the Neuman Systems and potential death. Model Nursing focuses on defining appropriate actions in response to stress-related Holistic View of the Client situations, aiming to help the system adapt and maintain stability. Neuman emphasizes a holistic approach, considering multiple variables simultaneously to understand the client as Nursing Interventions in the Neuman Systems a whole. Model The physiological variable encompasses the body's structure and functions, Prevention Modalities impacting overall health. The psychological variable includes Primary prevention aims to prevent mental processes and relationships, stressors from invading the system by which can affect coping mechanisms and identifying and mitigating risk factors. health outcomes. Secondary prevention occurs after a The sociocultural variable addresses the stressor has invaded, focusing on influence of social and cultural  expectations on health behaviors and The degree of reaction refers to the level practices. of instability experienced by the system The developmental variable considers the when stressors invade the normal line of client's life stages and developmental defense. processes, which can affect health status. Stability is defined as a state of balance The spiritual variable reflects the impact achieved through energy exchanges that of spiritual beliefs on health and coping help the client cope with stressors. strategies. The model emphasizes the importance of maintaining stability to preserve system Stressors and Their Impact integrity and promote health. Understanding the degree of reaction can Stressors are defined as phenomena that guide nursing interventions aimed at can penetrate the flexible and normal restoring balance and health. lines of defense, leading to health outcomes. Intrapersonal stressors occur within the Prevention and Intervention Strategies client system and relate to internal conflicts or issues. Levels of Prevention Interpersonal stressors arise from external relationships and can Primary prevention focuses on health significantly impact the client's health. promotion and wellness maintenance Extrapersonal stressors are more distant before stressors impact the system. influences, such as social policies, that Secondary prevention occurs after the can affect the client system. system reacts to stressors, aiming to treat Understanding the types of stressors is symptoms and restore stability. essential for developing effective Tertiary prevention supports the interventions to mitigate their impact. maintenance of wellness and reconstitution after treatment has begun. Each level of prevention plays a critical Lines of Defense and Reaction role in the overall health management of the client system. Flexible and Normal Lines of Defense Strengths and Weaknesses of the Model The flexible line of defense acts as a protective barrier against stressors, The model's flexibility allows for adapting to changes in the environment. application across various nursing The normal line of defense represents an disciplines, enhancing interdisciplinary individual's baseline health status, collaboration. developed over time through adaptation. It provides a comprehensive framework Lines of resistance are activated when for understanding client needs and stressors penetrate the normal line of developing targeted interventions. defense, triggering protective responses. However, the model requires further The model illustrates how these lines of clarification of terms and differentiation defense interact to maintain health and between stressor types. stability within the client system. The delineation of defense lines may not be clearly understood, complicating the application of the model in practice. Degree of Reaction and Stability Margaret A. Newman’s Nursing that state is considered health for that Theory: Health as Expanding individual. Consciousness expansion: Health is Consciousness fundamentally about expanding consciousness, which involves personal Introduction to Health as Expanding growth and deeper connections. Consciousness Developed in response to a 1978 nursing Theoretical Influences conference invitation, Newman's theory emphasizes health beyond the absence of disease. Key Theoretical Sources Influenced by Rogers’ Theory of Unitary Human Beings, which posits that health is Martha Rogers: Her Theory of Unitary a unitary phenomenon involving Human Beings serves as the foundational human-environment interactions. basis for Newman’s theory, emphasizing The theory addresses individuals facing the interconnectedness of humans and chronic illness, emphasizing that health their environment. can exist even in the presence of disease. Itzhak Bentov: Introduced the concept of Central to the theory is the idea that every the evolution of consciousness, stating individual is part of a universal process of that life is a process of expanding expanding consciousness, which involves consciousness and that consciousness personal growth and deeper connections reflects the quality of interactions with the with others. environment. The theory promotes the understanding Arthur Young: His Theory of Process that health is a dynamic process of describes the stages of consciousness becoming more of oneself and finding development, where individuals must meaning in life. discover new rules for self-identity and freedom. Core Assumptions of the Theory David Bohm: His Theory of Implicate suggests that the explicate order Health encompasses illness: Health (observable reality) is a manifestation of includes conditions traditionally viewed as the implicate order (underlying reality), illness or pathology, suggesting a broader which aligns with Newman's view of definition of health. health and consciousness. Pathology as a pattern: Pathological conditions reflect the total pattern of the individual, indicating that symptoms are Practical Implications for Nursing manifestations of deeper patterns. Primary patterns: The individual’s Nursing as a Partnership pattern exists prior to any structural or functional changes, highlighting the Nursing is viewed as a collaborative importance of understanding the person process between the nurse and patient, as a whole. where both parties grow in Symptom removal: Simply removing consciousness. symptoms does not alter the underlying Nurses play a crucial role in helping individual pattern, emphasizing the need patients recognize their inner power and for holistic care. potential for higher consciousness. Illness as health: If illness is the only The process involves understanding the way a patient’s pattern can manifest, then patient’s unique pattern and how it relates  to their environment, facilitating a holistic Nurses often encounter patients who approach to care. embody this theory, as they navigate the Nurses assist patients in navigating their uncertainties of health and illness. experiences of disease, recovery, and The theory emphasizes the importance of prevention, emphasizing the importance recognizing the evolving nature of health of personal meaning in health. and consciousness in nursing practice. The theory encourages nurses to adopt a broader perspective on health, recognizing the value of individual experiences and patterns. Health as Expanding Consciousness Health is viewed not merely as the Historical Context and Background absence of disease but as a manifestation of the rhythmic fluctuations Margaret A. Newman: Biography of life processes. Rogers posits that health and illness are Born on October 10, 1933, Newman part of a continuum, challenging pursued her education in nursing and traditional medical dichotomies. related fields. The evolving pattern of consciousness is Obtained a Bachelor's degree from the integral to understanding health, University of Tennessee in 1962, a suggesting that health is a dynamic and Master's degree from the University of holistic concept. California in 1964, and a Doctorate from This perspective encourages nurses to New York University in 1971. focus on the whole person rather than just Held academic positions at several symptoms, fostering a deeper connection prestigious institutions, including the with patients. University of Tennessee, New York The concept of health as expanding University, Pennsylvania State University, consciousness aligns with the need for a and the University of Minnesota. more compassionate and comprehensive Her work has significantly influenced approach to nursing. nursing theory and practice, particularly in understanding health as a dynamic and Major Concepts and Definitions evolving process. Understanding Health Theoretical Foundations Health is defined as a unitary process that encompasses both health and illness, Prigogine's Theory of Dissipative Structures reflecting the interconnectedness of life. The traditional medical view of health as Introduced by Ilya Prigogine in 1976, this merely the absence of disease is theory describes how systems can evolve challenged by this holistic perspective. from order to disorder and back to a new Health is seen as a pattern that evolves order. through interactions with the environment, A system experiences fluctuations until a emphasizing the importance of context. disruptive event occurs, leading to a The recognition of health as a pattern chaotic state before reorganizing at a allows for a more nuanced understanding higher level of complexity. of individual experiences and conditions. This theory is relevant in understanding This approach encourages a shift from health as a dynamic process rather than a symptom treatment to understanding the static state, particularly for individuals with underlying patterns of health. chronic illnesses. The Concept of Pattern environments, influencing health outcomes. A person's health is identified by their Recognizing the role of movement in unique pattern, which is influenced by nursing practice, such as in physical their environment and experiences. therapy and rehabilitation, is crucial for Patterns are dynamic and evolve through patient care. various states of order and disorder, Time is perceived subjectively, affecting reflecting the complexity of human life. how individuals experience health and Meaning is derived from recognizing illness, which can vary widely among these patterns, which can provide insights patients. into a person's health and well-being. Space refers to the environmental context The interconnectedness of patterns in which health occurs, emphasizing the highlights the importance of viewing importance of holistic care. health in a broader context, including social and environmental factors. Understanding patterns can aid nurses in Nursing Practice and Education developing personalized care strategies that resonate with patients' experiences. Nursing as a Partnership Nursing is defined as 'caring in the human Consciousness and Its Correlates health experience,' emphasizing the relational aspect of care. Defining Consciousness The partnership between nurse and client fosters growth in consciousness for both Consciousness is described as the parties, enhancing the healing process. informational capacity of a person, Nurses are encouraged to assist patients encompassing cognitive, affective, and in recognizing their patterns of physiological aspects. consciousness, promoting self-awareness It includes the interconnectedness of all and empowerment. living systems, emphasizing the holistic This approach shifts the focus from nature of health. merely treating symptoms to facilitating a The concept of consciousness extends deeper understanding of health. beyond individual awareness to include The collaborative nature of nursing the collective patterns of existence. practice aligns with Newman's vision of Understanding consciousness as a health as an evolving process. pattern allows for a deeper exploration of health and illness as interconnected Educational Implications phenomena. This perspective encourages nurses to Newman advocates for a diverse engage with patients on a more profound curriculum in nursing education, allowing level, recognizing their unique students to explore various health consciousness. models. Students should be encouraged to Correlates of Consciousness: Movement, choose approaches that resonate with Time, and Space their personal and professional experiences. Movement, time, and space are essential This flexibility in education promotes elements in understanding the evolving critical thinking and adaptability in nursing nature of consciousness. practice. These correlates highlight the dynamic interactions between individuals and their  Exposure to multiple health paradigms The model outlines four key domains of prepares nurses to address the conservation: energy, structural integrity, complexities of patient care effectively. personal integrity, and social integrity. The emphasis on personal relevance in education aligns with the holistic view of Purpose and Goals of the Model health and nursing. The primary goal is to improve the overall well-being of individuals by addressing Research and Inquiry the four domains of conservation. Nurses play a crucial role in helping Investigating Health Patterns patients maintain their integrity and health through effective conservation strategies. Research should focus on participatory The model promotes a holistic approach investigations, involving clients as to nursing care, recognizing the co-researchers in exploring health interconnectedness of the conservation patterns. principles. Newman's propositions regarding time, space, and movement have been tested, revealing insights into consciousness and The Four Principles of Conservation health. Negative correlations between depression Conservation of Energy and subjective time suggest complexities in the relationship between age and Energy conservation involves balancing consciousness. energy input and output to prevent The importance of cooperative inquiry fatigue, emphasizing adequate rest, highlights the need for collaborative nutrition, and exercise. approaches in health research. Examples include ensuring patients have Engaging clients in research fosters a sufficient rest and proper nutrition to deeper understanding of their health support their recovery process. experiences and patterns. Conservation of Structural Integrity Myra Estrin Levine Nursing Theory: The Conservation Model This principle focuses on maintaining or restoring the body's structure, preventing physical breakdown, and promoting Introduction to the Conservation Model healing. Nursing interventions may include Myra Estrin Levine's Conservation Model assisting patients with range of motion emphasizes nursing as a conservation exercises and ensuring personal hygiene activity, focusing on energy conservation is maintained. as a primary concern. The model guides nurses to prioritize the individual's responses and adaptive Conservation of Personal Integrity capabilities based on personal factors such as age, gender, and illness. Personal integrity involves recognizing The core principle is conservation, which the individual’s need for respect, allows individuals to adapt to health self-awareness, and self-determination. challenges with minimal effort, enhancing Nurses should acknowledge and respect their physical and emotional well-being. patients' personal space and autonomy in decision-making. Conservation of Social Integrity Assumptions and Relationships in Nursing Social integrity recognizes the individual Assumptions About Individuals as part of a larger community, including family, cultural, and social groups. Individuals actively participate in Interventions may involve helping patients interactions with their environment, maintain their roles and relationships seeking information and adapting to within their social networks. changes. Change is a fundamental aspect of life, continuously influencing individual Major Concepts of the Conservation Model experiences. Nursing Metaparadigm Assumptions About Nursing Environment: Encompasses both Nursing interventions must be tailored to internal and external factors affecting the the unique behaviors and needs of each individual, classified into operational, patient. perceptual, and conceptual environments. Patient-centered care emphasizes the Person: Defined as a unique individual individuality of each patient, requiring with integrity and wholeness. customized nursing approaches. Health: Described as the pattern of adaptive change in the individual. Relationships Among Conservation Nursing: Involves human interaction and Principles communication, rooted in relationships. Conservation of energy involves Adaptation and Conservation deliberate decisions to balance activity and energy levels. Adaptation is the process of change that Structural integrity conservation focuses allows individuals to maintain integrity on minimizing tissue damage during amidst environmental challenges. interventions. Conservation is the outcome of Personal integrity conservation allows adaptation, involving nursing interventions patients to make decisions about their and patient participation to achieve care, promoting autonomy. balance. Social integrity conservation supports maintaining relationships within the Subconcepts of Adaptation patient's social context. Historicity: Adaptation is influenced by past experiences, both personal and Analysis and Critique of the Conservation genetic. Model Specificity: Each system has unique responses to environmental changes, Unique Aspects of the Model such as physiological responses to maintain oxygen supply. Levine's emphasis on energy Redundancy: Changes occur in conservation distinguishes her model cascades, with interactions that are not from other nursing theories, guiding strictly linear. nursing actions effectively. The model's concepts of conservation, adaptation, and integrity are applicable across all age groups, addressing universal needs for energy management. Areas for Improvement These transitions occur as individuals progress through different stages of life, The operational definition of homeostasis such as adolescence to adulthood. in the model may require clarification, as Example: The transition from childhood to achieving homeostasis involves energy adolescence involves physical, emotional, expenditure. and social changes that can impact Rewording certain aspects of the model health. could enhance clarity and understanding Nurses can provide education and of its principles. support to help individuals adapt to these changes. Afaf Ibrahim Meleis's: Transition Theory in Nursing Situational Transitions Situational transitions are triggered by Definition and Purpose specific events, such as illness, injury, or loss. Transition Theory, developed by Afaf Example: A patient recovering from Meleis, focuses on the process of change surgery experiences a situational in individuals' lives and its impact on transition that affects their physical and health. emotional health. The theory emphasizes the role of nurses Nurses play a critical role in assessing the in facilitating and supporting patients needs of patients during these transitions through various life transitions. and providing appropriate interventions. It aims to define and understand the changes individuals experience, such as health status changes, developmental Health-Related Transitions transitions, and situational transitions. These transitions involve changes in health status, such as diagnosis of a Key Concepts of Transition Theory chronic illness or recovery from an acute condition. Transitions: Refers to the process of Example: Transitioning from a hospital change that individuals undergo, which setting to home care requires careful can be developmental, situational, or planning and support from healthcare health-related. providers. Nursing Role: Nurses are seen as Effective communication and education facilitators who help individuals navigate are essential for successful health-related these transitions, providing support and transitions. resources. Health Outcomes: The theory posits that Impact of Transitions on Health effective management of transitions can lead to improved health outcomes and overall well-being. Individual Variability The effects of transitions on health can vary significantly from one individual to another due to personal, social, and cultural factors. Types of Transitions Example: Two patients undergoing the same surgical procedure may have Developmental Transitions different recovery experiences based on their support systems and coping mechanisms.  Understanding individual differences is Quotable Insights crucial for tailoring nursing interventions. Pender emphasized the importance of Nursing Interventions proactive health measures, stating: > "Very early in my nursing career, it Nurses can implement various strategies became apparent to me that health to assist individuals in managing professionals intervened only after people transitions, including education, developed acute or chronic disease... I counseling, and support groups. committed myself to the proactive stance Example: Providing information about of health promotion and disease post-operative care can help patients feel prevention..." more confident and reduce anxiety during This quote reflects her commitment to recovery. health promotion and the belief that The goal is to empower individuals to take preventing disease is preferable to an active role in their health during managing it after it occurs. transitions. Measuring Outcomes The Health Promotion Model (HPM) Overview Evaluating the effectiveness of nursing Definition and Purpose interventions during transitions is essential for improving practice. The Health Promotion Model was Tools such as surveys and assessments proposed by Nola J. Pender in 1982 and can be used to measure patient revised in 1996. satisfaction and health outcomes It serves as a complementary counterpart post-transition. to existing health promotion models, Continuous feedback helps refine nursing focusing on enhancing well-being rather approaches to better support individuals than merely preventing disease. through their transitions. Pender defines health as a positive dynamic state, not just the absence of disease, emphasizing a holistic view of health. Nola Pender: Health Promotion Key Components of HPM Model The model highlights the Personal Background multi-dimensional nature of individuals as they interact with their environment to Nola J. Pender was born on August 16, pursue health. 1941, in Lansing, Michigan, USA. It recognizes that each person has unique She is the daughter of Frank Blunk and characteristics and experiences that Eileen Blunk, which may have influenced influence their health behaviors. her early interest in health and wellness. Health-promoting behaviors are the Pender's educational journey began at desired outcomes of the model, leading to Michigan State University, where she improved health and quality of life. earned her BSc in 1964 and MSc in 1965. She completed her PhD at Northwestern University in 1969, marking her as a Major Concepts of the Health Promotion pioneer in nursing theory and health Model promotion. Individual Characteristics and Experiences  Prior related behavior: The frequency of Health: The realization of human similar health behaviors in the past potential through goal-directed behavior influences current actions. and satisfying relationships, evolving over Personal factors include biological, time. sociocultural, and psychological aspects Illness: Events that can either hinder or that shape health behaviors. facilitate the pursuit of health, varying in duration from acute to chronic. Behavior-Specific Cognitions and Affect Perceived barriers to action: Individuals' Health Promotion vs. Health Protection perceptions of obstacles that may hinder health behaviors. Distinctions Between Concepts Perceived self-efficacy: The belief in one's ability to execute health behaviors Health Promotion: Focuses on successfully, which is crucial for enhancing well-being, motivated by motivation. personal goals and a positive approach to Activity-related affect: Emotional health. responses before, during, and after Health Protection: Centers on engaging in health behaviors, impacting preventing illness or injury, motivated by future actions. avoidance of health threats. Behavioral Outcomes Implications for Nursing Practice Health-promoting behavior is the ultimate Understanding the difference between goal of the HPM, leading to enhanced health promotion and health protection health and functional ability. can guide nursing interventions. The model acknowledges that immediate Nurses can implement strategies that competing demands and preferences can foster health-promoting behaviors while interfere with intended health behaviors. also addressing health protection needs. Key Concepts in Nursing Related to HPM Helen C. Erickson Modeling and Definitions of Key Terms Role Modeling Person: A biopsychosocial organism Background Information shaped by the environment, seeking to express human potential. Helen C. Erickson was born in 1936 and Environment: The social, cultural, and is a prominent figure in nursing theory. physical context influencing health She is currently a Professor Emeritus at behaviors, which can be manipulated for the University of Texas at Austin, positive outcomes. contributing to nursing education and Nursing: The collaborative process with research. individuals and communities to foster Her work focuses on the development of optimal health conditions. nursing theories that emphasize the importance of understanding clients' Health and Illness perspectives. Key Concepts of Role Modeling response to stress and the importance of adaptation. Understanding Modeling Commonalities and Differences Modeling is defined as gaining an understanding of the client's world from Commonalities among individuals include: their perspective, allowing for a tailored ○ Holism: Recognizing the approach to care. interconnectedness of various It involves the nurse accepting and aspects of a person. understanding the client, which is crucial ○ Basic Needs: The fundamental for effective nursing practice. requirements for survival and This concept emphasizes the importance well-being. of empathy and active listening in the ○ Lifetime Growth and nurse-client relationship. Development: The ongoing process of personal development Role Modeling in Nursing throughout life. Differences arise from: Role modeling involves planning and ○ Inherent Endowment: Unique implementing unique interventions for genetic and personal traits. each client based on their individual ○ Adaptation: The ability to adjust to needs. changes and challenges in life. The nurse facilitates health promotion through purposeful interventions, which are guided by the client's specific circumstances. This process begins when the nurse transitions from analysis to planning in the Metaparadigm Concepts nursing process. Person Theoretical Foundations The person is viewed as a holistic being with interacting subsystems: biophysical, Influential Theories psychological, social, and cognitive. Each individual has inherent genetic traits Erickson's theory draws from several and a spiritual drive that influences their foundational theories, including: health and behavior. ○ Maslow's Hierarchy of Needs: Emphasizes the importance of Environment meeting basic needs before higher-level needs can be The environment is not treated as a addressed. separate entity but as a context for ○ Erikson's Psychosocial Stages: interaction between the self and others. Focuses on the development of It includes cultural and individual factors, individuals across their lifespan. as well as internal and external stressors ○ Piaget's Cognitive Development: that affect adaptation. Highlights the cognitive processes involved in learning and Health adaptation. ○ General Adaptation Syndrome Health is defined as a state of physical, (GAS): Describes the body's mental, and social well-being, not merely the absence of disease.  It represents a dynamic equilibrium Anne Boykin and Savina O. among the various subsystems of a