Finals part 1 summary
- 1. THEORIST THEORY/CONCEPTS/COMPONENTS METAPARADIGM Hildegard Peplau - “Psychiatric Nurse of the Century” - First Book: Interpersonal Relations in Nursing INTERPERSONAL RELATIONS THEORY • The nurse-patient relationship was described as a four-phase phenomenon: a. Orientation - Initial interaction between nurse and patient - Nurse assists the patient in recognizing and understanding the patient experience b. Identification - Patient and nurse explore the experience and needs of patient c. Exploitation - Patient shift from dependent role to independent role - New goals are projected, but power is shifted to the patient d. Resolution - Patient earns independence over care - Patient puts goals aside and formulates a new one • Psychological Mothering: a. Patient is accepted unconditionally as a participant b. Recognition and response to patient’s readiness for growth c. Power shifts to the patient • Nursing Roles: a. Stranger - The nurse attempts to know the patient better - The nurse treats the patient with outmost courtesy - Occurs during the Identification Phase b. Resource Person - Nurse provides specific answers to questions - Nurse must change response to patient’s level of understanding c. Teacher - Determines how the patient understands the plan of care d. Leader - The nurse must act in behalf of the patient’s interest and at the same time enable him to make decisions over own care - Achieved through cooperation and active participation e. Surrogate - Temporary care giver f. Counselor - The nurse becomes a listening friend - The nurse gives sound empathic advises Person: • A man who is an organism that lives in an unstable balance of a given system Health: • For health to be achieved and maintained, needs must be met (physiological demands and interpersonal conditions) Environment: • Forces outside the organism Nursing: • Nursing is a significant, therapeutic interpersonal process Ida Jean Orlando NURSING PROCESS THEORY • Focus: Reciprocal relationship between nurse and patient • The nurse uses the standard nursing process in Orlando’s Nursing Process Discipline Theory, which follows: A – ssessment D – iagnosis P – lanning I – mplementation E – valuation Person: • Humans in need are the focus of nursing practice Health: • Health is a sense of helplessness as an initiator for necessity for nursing Environment: • Orlando disregarded environment in her theory Nursing:
- 2. • Nursing is unique and independent for individual’s need for help Joyce Travelbee HUMAN-TO-HUMAN RELATIONSHIP MODEL • The nurse and patient undergo series of interactional phases: a. Original Encounter - First impression of the nurse and patient to each other b. Emerging Identities - Nurse and patient perceiving each other as unique individuals - Link of relationship begins to form a. c. Empathy - Ability to share the person’s experience d. Sympathy - Nurse wants to lessen the cause of suffering - It goes beyond empathy b. e. Rapport - Nursing interventions that lessen cause of suffering - The patient shows trust and confidence to the nurse Person: • Human being is a unique, irreplaceable individual Health: • Health is measured subjectively and objectively. Environment: • Human conditions and life experiences encountered by men as suffering, hope, pain and illness Nursing: • Nursing is an interpersonal process whereby the nurse assists individual, family, community Lydia Hall CARE, CORE, CURE • Three components: a. Care - “The Body” - “Intimate bodily care” - Represents the nurses’ roles and focused on performing task to nurture patients b. Core - “The Person” - “Therapeutic Use of Self” - Represents the patient receiving nursing care - Involves therapeutic use of self - Emphasizes patient’s social, emotional, intellectual, spiritual needs - The nurse uses reflective technique c. Cure - “The Disease” - “Seeing the patient and family through medical care” - Represents nursing - Represents interventions geared towards treating the patient - The nurse shares with other health care professionals Person: • Source of energy and motivation for healing Health: • Health is a state of self- awareness Environment: • Environment should be conducive for self-development Nursing: • Nursing is participating in the care, core, cure aspects of nursing caring Faye Abdellah - “First woman to serve as Deputy Surgeon General of the United States” TWENTY-ONE NURSING PROBLEMS • Focus of theory: it is nursing-centered rather than patient-centered • Main Goal: Improvement of nursing education • Impact to nursing practice: helped transform focus of profession from disease-centered to patient-centered • Three chief components: a. Health b. Nursing problems c. Problem solving • Health needs are seen as: a. Overt – can-be-seen condition b. Covert – unseen or masked one Person: • Beneficiary of care Health: • Center and purpose of nursing services Environment: • Apex of nursing service is the individual Nursing: • Nursing is an all-inclusive service
- 3. • Problem-solving process includes: a. Identify the problem b. Select relevant data c. Devise hypotheses d. Test hypotheses through assortment of data e. Revise hypotheses • 21 NURSING PROBLEMS: A. BASIC TO ALL PATIENTS 1. To maintain good hygiene and physical comfort 2. To promote optimal activity: exercise, rest and sleep 3. To promote safety through the 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 deformity B. SUSTENAL CARE NEEDS 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 elimination 8. To facilitate the maintenance of fluid and electrolyte balance 9. To recognize the physiological 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. C. REMEDIAL CARE NEEDS 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 non-verbal communication 15. To promote the development of productive interpersonal relationships 16. To facilitate progress toward achievement of personal spiritual goals 17. To create and / or maintain a therapeutic environment 18. To facilitate awareness of self as an individual with varying physical, emotional, and developmental needs D. RESTORATIVE CARE NEEDS 19. To accept the optimum possible goals in the light of limitations, physical and emotional 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 case of illness Virginia Henderson - “First Lady of Nursing” - “First Truly International Nurse” 14 BASIC HUMAN NEEDS 1. Breathe normally. 2. Eat and drink adequately. 3. Eliminate body wastes. 4. Move and maintain desirable postures. 5. Sleep and rest. 6. Select suitable clothes-dress and undress. 7. Maintain body temperature within normal range by adjusting clothing and modifying environment Person: • Person is an individual who requires assistance to achieve health and independence Health: • Health is a quality of life and basic for human to function fully Environment: • The nurse must be educated about safety
- 4. 8. Keep the body clean and well-groomed and protect the integument 9. Avoid dangers in the environment and avoid injuring others. 10. Communicate with others in expressing emotions, needs, fears, or opinions. 11. Worship according to one’s faith. 12. Work in such a way that there is a sense of accomplishment. 13. Play or participate in various forms of recreation. 14. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities. • Emphasis: view the patient and family as a single unit • Three levels in nurse-patient relationship: a. Nurse as a substitute for the patient - The nurse serves as a substitute to what the patient lacks b. Nurse as a helper to the patient - Nurse focus on assisting the patient to meet needs c. Nurse as a partner with the patient - The nurse and patient formulate plan together - The nurse empowers the patient to make effective decisions regarding care plans Nursing: • Nurse functions independently from the physician • Nurse must help both sick and well individual Nola Pender HEALTH PROMOTION MODEL • Each person has unique characteristics and experiences • This are desired behavioral outcome that should result in improved health, enhanced functional ability, and better quality of life • Examples of health promoting behaviors: - Healthy diet - Exercise - Managing stress - Gain adequate rest and spiritual growth - Building positive relationships • Variables that influence individual to engage in health-promoting behaviors: a. Activity-related affect b. Commitment to a plan of action c. Immediate competing demand and preferences Person: • Individuals, family, community as active participants for the promotion of health Health: • Focus on health promotion and disease prevention Environment: • Environment wellness is manifested with balance between human beings and surroundings Nursing: • Helping individuals understand and perform health promoting behaviors Madeleine Leininger - “Culture Care or Culture Care Diversity and Universality” TRANCULTURAL NURSING • Culture - Learned, shared, and transmitted values, beliefs, norms, and lifeways of a particular group • Key component: Cultural Diversity (differences or variations that can be found in different cultures) Person: • Humans are caring and capable of being concerned about desires, welfare, and continued existence Health: • Health is universal and diverse Environment: • Environment as being the totality of an event, situation, or experience Nursing: • Three types of nursing actions: a. Cultural care preservation/maintenance b. Cultural care accommodation/negotiation
- 5. c. Cultural care repatterning/restructuring Margaret Newman HEALTH AS EXPANDING CONSCIOUSNESS • Focus: Health as expansion of consciousness • Goal: not to make people well, or to prevent their getting sick, but to assist people to utilize the power that is within them as they evolve toward higher levels of consciousness • Must include health of all persons regardless of presence or absence of disease • Health is the central of the theory and seen as the process of developing awareness for self and environment • Consciousness – manifestation of an evolving pattern of person-environment interaction Person: • Patients are viewed as participants in transformative process • Humans are unitary and cannot be divided into parts Health: • Pattern of the whole • Fusion of disease and non- disease • Health and illness are a unitary process Environment: • Interaction between human and environment as key process to create unique configurations for each individual • Viewed as a universe of open systems Nursing: • The focus of nursing is the primacy of relationships • The nurse must get in touch with the meaning of life through identification of meaning • Nursing is caring in the human health experience Rosemarie Parse HUMAN BECOMING THEORY • Purpose: Guide nurses in practice to focus on quality of life • The human becoming theory posits quality of life from person’s own perspective as the goal of nursing practice • Man Living Health o 2 paradigms (worldview of nursing) a. Totality Paradigm - Man is a combination of biological, psychological, sociological, spiritual factors b. Simultaneity Paradigm - Man is a unitary being in continuous, mutual interaction with environment • Three Principles: 1. Structuring meaning multidimensionality - Cocreating reality through the Languaging of valuing and imaging - SCENARIO: ▪ Imaging: an infertile couple believes there are many children in need of homes and plan to adopt ▪ Valuing: an older woman putting her health first as all her children moved out of the house ▪ Languaging: a man diagnosed with terminal illness finds words and strength to talk about it to his family 2. Cocreating rhythmical patterns of relating - Living the paradoxical unity of revealing- concealing and enabling-limiting while connecting-separating Person: • Open being who is more than and different from the sum of the parts Health: • Open process of being and becoming. • Involves synthesis of values Environment: • Everything in the person and his experiences • Inseparable, complimentary to and evolving with Nursing: • A human science and art that uses an abstract body of knowledge to serve people
- 6. - SCENARIO: ▪ Revealing-Concealing: a pregnant teenager must reveal the truth to her parents ▪ Enabling-Limiting: a patient chose to refuse a treatment ▪ Connecting-Separating: parents want more aggressive treatment for child; the husband disagrees causing a strain in the relationship 3. Contranscending with the possible - Powering the unique ways of originating in the process of transforming - SCENARIO: ▪ Powering: parents learn to be strong and move on with the death of their child ▪ Originating: a woman raises money for cancer research in honor of her mother ▪ Transforming: an elderly man accepts help as he is unable to care for his wife