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Premium member Presentation Transcript Conceptual & theoretical models of nursing practice: Conceptual & theoretical models of nursing practice CLIENTS Nirmala Roberts IndiaNursing Theories…: Nursing Theories… Nursing theory A body of knowledge used to support nursing practice. A framework designed to organize & explain knowledge more concretely A profession – Is Theory-guided & evidence-based Nursing is a professional discipline Nursing models - conceptual models, made out of theories and concepts A paradigm - A model that explains the linkages of science, philosophy, and theory accepted and applied by the discipline.Major assumptions, concepts and relationships: Major assumptions, concepts and relationships Scientific assumptions & Philosophical assumptions. Scientific Assumptions Systems of matter and energy progress to higher levels of complex self- organization. Consciousness and meaning are constitutive of person and environment integration Awareness of self and environment is rooted in thinking and feeling Humans by their decisions are accountable for the integration of creative processes.Major assumptions, concepts and relationships: Major assumptions, concepts and relationships Scientific Assumptions…( contd..) Thinking and feeling mediate human action System relationships include acceptance, protection, and fostering of interdependence Persons and the earth have common patterns and integral relationships Persons and environment transformations are created in human consciousness Integration of human and environment meanings results in adaptationMajor assumptions, concepts and relationships: Major assumptions, concepts and relationships Philosophical Assumptions Persons have mutual relationships with the world and God Human meaning is rooted in the omega point convergence of the universe. God is intimately revealed in the diversity of creation and is the common destiny of creation. Persons use human creative abilities of awareness, enlightenment, and faith. Persons are accountable for the processes of deriving, sustaining and transforming the universeComponents of a theory: Components of a theoryWhy theory in Nursing?: Why theory in Nursing? Contributes to knowledge development Directs education, research, and Practice Theory , education, research and clinical practice are linked Gives the profession a status in the universityThe living tree of Nursing theories: The living tree of Nursing theoriesParadigms in nursing: Paradigms in nursing = Intellectual perception or view, accepted by an individual or a society as a clear example, model, or pattern of how things work in the world…. Person – Recipient of care, including physical, spiritual, psychological, and sociocultural components Refers to individual, family, or community Environment - All internal and external conditions, circumstances, and influences affecting the person Health - Degree of wellness or illness experienced by the person Nursing - Actions, characteristics and attributes of person giving care .Nursing theorists..: Nursing theorists.. S No Nursing Theorists Theories & Concepts 1 Florence Nightingale Environmental theory 2 Hildegard Peplau Interpersonal relations theory 3 Virginia Henderson Fundamental needs theory 4 Martha Rogers Unitary beings theory 5 Dorothea Orem Self care deficit theory 6 Imogene King General systems & Goal attainment theory 7 Betty Neuman Systems model 8 Sr Callista Roy Adaptation theory 9 Faye Abdellah Nursing problems theory 10 Abraham Maslow Human needs theoryFlorence Nightingale - Environmental theory (1860 – 1969): Florence Nightingale - Environmental theory (1860 – 1969)Florence Nightingale’s Environmental theory: Florence Nightingale’s Environmental theory The first nurse theorist Defined nursing almost 150 years ago as “the act of utilizing the environment of the patient to assist him in his recovery” 5 environmental factors – Fresh air Pure water Efficient drainage Cleanliness Light Deficiencies of above cause illnessHildegard Peplau - Interpersonal relations model (1952): Hildegard Peplau - Interpersonal relations model (1952)Hildegard Peplau’s Interpersonal relations model: Hildegard Peplau’s Interpersonal relations model A psychiatric nurse Importance to therapeutic relationship between nurse and client, when the ‘need’ arises- The 4 phases - Orientation – Personal, problem, needs Identification – of related dependence, interdependence, independence with nurse Exploitation – client makes use of all the services Resolution – of older needs and evolution of newer onesVirginia Avenel Henderson - Fundamental needs theory 1897-1996: Virginia Avenel Henderson - Fundamental needs theory 1897-1996Virginia Avenel Henderson: Virginia Avenel Henderson Nursing - “The unique function of the nurse is to assist the individual, sick or well , in the performance of those activities contributing to health or its recovery (or to a peaceful death) that 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.” ‘Nursing’ separate from ‘medicine’ - independence & interdependence Importance to the client & his environment Concern with sick and well clients - even when recovery is not feasible Importance to teaching and advocacy roles of nurse Nurse’s role is assisting sick or well individuals to gain independence in meeting 14 fundamental needs…………….14 fundamental needs of clients… (Acc to Virginia Henderson): 14 fundamental needs of clients… (Acc to Virginia Henderson) Breathing normally. Eating and drinking adequately Eliminating body wastes Moving and maintaining a desirable position Sleeping and resting Selecting suitable clothes Maintaining normal body temperature by adjusting clothing and modifying the environment14 fundamental needs of clients… (Acc to Virginia Henderson): 14 fundamental needs of clients… (Acc to Virginia Henderson) 8. Keeping the body clean and well groomed to promote integument (skin) 9. Avoiding dangers in the environment and avoiding injuring others 10. Communicating with others in expressing emotions, needs, fears, or opinions. 11. Worshiping according to one’s faith 12. Working in such a way that one feels a sense of accomplishment 13. Playing or participating in various forms of recreation 14. Learning , discovering or satisfying the curiosity that leads to normal development and health, and using available health facilities.Martha Rogers - ‘Unitary beings’ theory: Martha Rogers - ‘Unitary beings’ theoryMartha Roger’s science of ‘Unitary beings’: Martha Roger’s science of ‘Unitary beings’ An irreducible whole - Behaves as a whole (= Holism) Is an irreducible 4 dimensional energy field The whole > sum of its parts – Manifests characteristics different from sum of its parts Interacts continually and creatively with the environmentMartha Roger’s science of ‘Unitary beings’: Martha Roger’s science of ‘Unitary beings’Dorothea Orem - Self care deficit theory: Dorothea Orem - Self care deficit theoryDorothea Orem’s Self care deficit Theory: Dorothea Orem’s Self care deficit Theory Three related dimensions : Self care Self care deficit Nursing systemsDorothea Orem’s Self care deficit Theory: Dorothea Orem’s Self c are deficit Theory 1 . Self care – 4 concepts - Self care –independent activities Self care agency - Client’s & significant other’s ability Self care requisites - Needs & actions - Universal requisites Developmental requisites Health deviation requisites Therapeutic self care demand – Activities to meet the existing self care requisitesDorothea Orem’s Self care deficit Theory: Dorothea Orem’s Self care deficit TheoryDorothea Orem’s Self care deficit Theory: Dorothea Orem’s Self c are deficit Theory 2. Self are deficit – When self care agency fails to meet the demandsDorothea Orem’s Self care deficit Theory: Dorothea Orem’s Self c are deficit Theory 3. Nursing systems – Assists through doing for, guiding, teaching, supporting and providing a suitable environment Wholly compensatory Partly compensatory Supportive - educativeDorothea Orem’s Self care deficit Theory: Dorothea Orem’s Self care deficit TheoryImogene King - General systems & Goal attainment theory: Imogene King - General systems & Goal attainment theoryImogene King : Imogene King General System’s Framework 3 types of dynamic, interacting systems: Personal systems (= individuals) Interpersonal systems (=dyadic interactions..) Social systems (= larger institutions….)Imogene King’s goal attainment theory: Imogene King’s goal attainment theorySr Callista Roy - Adaptation Model: Sr Callista Roy - Adaptation ModelSister Callista Roy 1939-: Sister Callista Roy 1939- Adaptation Model “Humans are biospychosocial adaptive systems who cope with environmental change through the process of adaptation.”Roy: Roy Enhance life processes through adaptation in 4 adaptive modes – Physiologic mode Self concept mode Role function mode Interdependence modeClient is the center of everything…: Client is the center of everything…Roy’s adaptation model: Roy’s adaptation modelFaye Glenn Abdellah - Nursing problems model (1919): Faye Glenn Abdellah - Nursing problems model (1919)Faye Glenn Abdellah - Nursing Problems: Faye Glenn Abdellah - Nursing Problems Patient-centered approaches Nurses should identify and solve specific problems Typology of 21 nursing problems in 3 areas – (1) the physical, sociological, and emotional needs of the patient (2) the type of IPRs between the nurse and the client (3) the common elements of patient careAbdellah’s Typology of 21 Nursing Problems: Abdellah’s Typology of 21 Nursing Problems 1. To promote good hygiene and physical comfort 2. To promote optimal activity, exercise, rest, and sleep 3. To promote safety through prevention of accidents, injury, or other trauma and through the prevention of the spread of infection 4. To maintain good body mechanics and prevent and correct deformities 5. To facilitate the maintenance of a supply of oxygen to all body cells 6. To facilitate the maintenance of nutrition of all body cells 7. To facilitate the maintenance of eliminationAbdellah’s Typology of 21 Nursing Problems: Abdellah’s Typology of 21 Nursing Problems 8. To facilitate the maintenance of fluid and electrolyte balance 9. To recognize the physiologic responses of the body to disease conditions 10. To facilitate the maintenance of regulatory mechanisms and functions 11. To facilitate the maintenance of sensory function 12. To identify and accept positive and negative expressions, feelings, and reactions 13. To identify and accept the interrelatedness of emotions and organic illness 14. To facilitate the maintenance of effective verbal and nonverbal communication 15. To promote the development of productive interpersonal relationshipsAbdellah’s Typology of 21 Nursing Problems…..: Abdellah’s Typology of 21 Nursing Problems….. 16. To facilitate progress toward achievement of personal spiritual goals 17. To create and maintain a therapeutic environment 18. To facilitate awareness of self as an individual with varying physical, emotional, and developmental needs 19. To accept the optimum possible goals in light of physical and emotional limitations 20. To use community resources as an aid in resolving problems arising from illness 21. To understand the role of social problems as influencing factors in the cause of illnessAbraham Maslow - Human needs theory: Abraham Maslow - Human needs theoryAbraham Maslow’s need theory: Abraham Maslow’s need theoryBetty Neuman - Systems model: Betty Neuman - Systems model“Health is a condition in which all parts and subparts are in harmony with the whole of the client.”: “Health is a condition in which all parts and subparts are in harmony with the whole of the client.”Betty Neman's systems model: Betty Neman's systems model Community health nurse and clinical psychologist Client – an open system surrounded by lines of resistance Stressors – Intrapersonal, interpersonal, extrapersonal Adaptation – by reconstitution by primary, secondary and tertiary preventionThe human system….: The human system…. Physiologic , psychologic , socio-cultural, developmental and spiritual variables occur , and are considered simultaneously in each concentric circleInternational Nurse’s Day 2012 Theme: International Nurse’s Day 2012 Theme Closing the Gap: From Evidence to Action You do not have the permission to view this presentation. In order to view it, please contact the author of the presentation.