NURSING THEORIES
1. Nightingale’s Environmental Theory
- What nursing has to do is to put the individual in best position for nature to work on him.
- Nursing Action: manipulation of elements in the environment to contribute to reparative process.
10 ELEMENTS FOUND IN ENVIRONMENT
1. Air – importance to have moving air in room of patient to contribute in proper ventilation.
2. Light – patient should be near windows to be able to see sunlight and give hope.
3. Health of houses – environmental sanitation.
4. Cleanliness
5. Beddings – change linens/beddings in patients room to promote comfort.
6. Nutrition
7. Variety – change in environment for patient.
8. Ventilation – promote warming.
9. Noise – due to nurses clothing or roaming around.
10. Chattering hopes – deals with social aspect; nurse should be cautious with words when at bedside, talk about positive things.
2. Virginia Henderson’s Definition of Nursing
- Assisting individuals sick or well in the performance of activity.
- Role of nurse is complimentary.
- Supplementary
- Individual person is a whole, complete and individual being.
NURSE- PERSON INTERACTION
14 BASIC COMPONENTS OF NURSING CARE
1. Breathe normally
2. Eat, drink adequately
3. Eliminate body waste
4. Move and maintain desirable posture
5. Sleep and rest
6. Select suitable clothes
7. Maintain body temperature
8. Keep body clean and well groomed
9. Avoid dangers in environment
10. Communicate with others
11. Worship according to ones faith
12. Work for accomplishment
13. Participate in recreation
14. Learn to satisfy the curiosity that leads to normal development
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3. Martha Roger’s Science of Unitary Human Beings
A. Nursing is humanistic science
B. Parallel with Ludwig von Bertalanffy’s General System Theory
C. 5 assumptions about human beings
1. Man is a unified whole – whole not equal to sum of parts.
2. Individual and environment are continuously exchanging matter and energy.
3. Lifecycle evolves irreversibly and uni-directionally along space and time continuum.
4. Life patterns identify individuals.
5. Humans have the capacity for absorption and imagery, language and thought, sensation and emotion.
GENERAL SYSTEM THEORY
- A set of interacting parts/ components with a boundary that filters the input and output from and to the environment.
- Input and output: matter, energy, information.
- Whole: physical, psychological, spiritual, intellectual.
4. Dorothea Orem’s Self Care Deficit Theory
- Man is an integrated whole, biologically, symbolically and socially.
- Man is self reliant and responsible for self care.
- Man is requisite for all.
- Nursing is a service, art and technology.
3 SUB THEORIES
1. Self Care – universal self care, developmental.
2. Self Care Deficit – demands, capabilities, deficits.
3. Theory of Nursing Systems – wholly compensatory, partly supportive-educative.
UNIVERSAL SELF CARE REQUISITES
1. Sufficient intake of air
2. Sufficient intake of water
3. Sufficient intake of food
4. Satisfactory eliminative functions
5. Activity balanced with rest
6. Time spent alone balanced with time spent with others
7. Prevention of danger
8. Being normal
DEVELOPMENT OF SELF CARE REQUISITES
- Specialized expression of universal self-care requisites for development process.
HEATH DEVIATION
- Additional demands for health care due to illness, disease or injury.
THEORY OF NURSING SYSTEM
1. Wholly compensatory – nurse acts for patient.
2. Partly compensatory – both nurse and patient.
3. Supportive-Educative – patient able to perform self care.
B. SYSTEM THEORIES
5. Sister Callista Roy’s Adaptation Model
- Grounded on humanism.
- Person is adaptive system with coping mechanism.
- Goal of nursing is to promote persons adaptation.
STIMULI
1. Focal - immediate
2. Contextual – other internal and external factors
3. Residual – may or may not have effect like attitudes and beliefs.
COPING MECHANISMS
1. Regulator – neural – chemical – endocrine.
2. Cognator – processed through cognition.
ADAPTIVE MODES
- Physiologic – adaptive mode
- Self concept mode
- Interdependence mode
- Role function mode- Adaptive/effective response
- Maladaptive/ineffective response
6. Imogene King’s Goal-Attainment Theory
- Nursing is a process of human interaction between the nurse, client, each person perceive the other and situation and explore the means to achieve them.
- Humans are open systems in constant interaction with their environment.
- Nursing focus: human interact with the environment.
- Nursing Goal: humanistic maintenance of individuals and groups.
- Interacting components are personal, interpersonal, social.
- Elements: interaction, communication, transaction role, stress.
COMPONENTS PERSONAL SYSTEM
- Perception, self, growth and development, image, space, learning time.
- Organization, authority, power, status, decision making.
7. Betty Neuman’s Health Care Systems Model
- Based on 2 components stress, reaction to stress.
- Client (individual, group, community) is an open system in interaction with environment.
4 CONCEPTS
A. CLIENT
Flexible – keeps system free from stressor reaction or symptom-matology.
Line of Resistance – consist of internal defensive processes. Ex. Immune response.
B. ENVIRONMENT
- Environment has potential to alter system stability due to internal and external stressors.
STRESSORS CAN BE
1. Extra personal – unemployment, microorganisms, peer pressure, radiation.
2. Inter personal – between 2 or more individual (parent expectations).
3. Intra personal – anger, physical abilities, financial condition.
- Environment can also be source of resources that may help client cope with stressors.
C. HEALTH
D. NURSING
- Primary: protection of normal line of defense.
- Secondary: protection of basic structure by strengthening internal line of resistance.
Ex. Treatment of symptoms, energy conservation
- Tertiary: promotion of reconstitution by supporting existing strengths and resources.
8. Dorothy Johnson’s Behavioral Systems Model
Mans subsystem
- Behavioral subsystem: addressed by nursing intervention.
- Biological subsystem: addressed by medical intervention.
Goal of Nursing
a. demonstrate behavior commensurate to social demands.
b. modify behavior to support biological needs.
c. benefit from physicians skill and knowledge.
d. demonstrate behavior that does not give evidence of unnecessary trauma.
- Nursing focus: behavior modification to foster equilibrium.
C. INTERPERSONAL/CARING THEORIES
9. Hildegard Peplau’s Interpersonal Relationship in Nursing
- purpose of nursing is to educate and to be a nurturing force to a patient for him to get a new view of himself.
- interaction is a maturing force.
PHASE OF NURSE – PATIENT RELATIONSHIP
1. Orientation – leveling off between nurse and client in term of expectation.
2. Identification – selective response of the client to those who can meet his needs; affected by clients belief.
3. Exploitation – client takes control of the situation by extracting help from nurse.
4. Resolution – evaluation of care and discharge of client.
10. Madeleine Leininger’s Transcultural Care Theory
- Culture: way of life, total of all the material and non material’s produced by the people at their level of social development.
- has universalities: same as other culture (hygiene, nutritional needs).
- diversities: cultural peculiarities (caring ).
11. Ida Jean Orlando’s Dynamic Nurse-Client Relationship
- Types of nursing response: deliberate action(based on correct identification of patients needs) and automatic action.
- nursing function is concerned with providing direct assistance to individuals in whatever setting to avoid, diminish, relieve individual’s sense of helplessness.
- Nursing disciplined professional response.
12 Jean Watson’s Philosophy and Science of Caring
- Nursing is the science of caring.
- Caring is more healthogenic than caring.
- Main focus of nursing is on curative factors that are derived from humanistic perspectives combined with a scientific base.
10 CARATIVE FACTORS
1. Formation of a humanistic-altruistic value system.
2. Faith – hope
3. Cultivation of sensitivity to self and others.
(First 3 factors are the foundations for caring)
4. Establishing a helping trust relation
5. Expression of feelings, both positive and negative.
6. Research and systematic problem solving.
7. Promotion of interpersonal teaching-learning.
8. Provisions for a supportive, protective and corrective mental, physical, sociocultural and spiritual environment.
9. Assistance with the gratification of human.
10. Allowance for existential phenomenological factors.
D. CLIENT CENTERED THEORIES
13. Faye Glen Abdellah’s 21 Nursing Problems
- Nursing in the use of the problem solving approach
- Covert: psychological problem
- Overt: obvious (physical manifestations of health problems)
14. Lydia Hall’s Theory of Core, Care, Cure
- Patient is composed of 3 elements: body, pathology, person
- Nursing is helping clients move in the direction of self awareness
- Nursing operates in all 3 elements
- Core: the person, therapeutic use of self
- Care: the body, intimate body care (nurturing component)
- Cure: the disease, medical care (client advocate)
15. Myra Estrine Levine’s Four Conservation Principles of Nursing
- Promotion of the wholeness of the person
- By improving the clients patterns of adaptive response
CONSERVATION
- Defends wholeness of living systems by ensuring their ability to confront change
16. Nola J. Pender’s Health Promotion Model
- Directed towards increasing the level of well being and self actualization of a given individual or group
- Example: 6 – 8 hours of sleep
- Disease prevention/Health protection: action directed towards decreasing the probability of experiencing illness by active protection of the body against pathological stressors.
- Example: BCG vaccination
HEALTHY LIFESTYLE
- Adequate nutrition 3 times a day
- Regular exercise 3 times a week
- Not smoking
- Moderate intake of alcohol
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