Conceptual Framework
Evaluation
Continuously observing to determine if the self-care requisites are being met; adjust plans if needs are not being met; "How much can the patient perform?"
Florence Nightingale
Environmental Theory - air, water, cleanliness, light, sounds, etc...
Dorothea Orem
Self Care Theory - self-care, self-caredeficit (5 methods), nursing systems (wholly & partially compensatory, and supportive-educative)
Process
Series of organized steps, changer or functions intended to bring desired result
Assessment
-nurse assesses the patient for any deficits between self care demands and ability to provide care; "what are the patient's needs?" Must Assess a. basic conditioning factors b. universal self-care requisites c. developmental self-care requisites d. health deviation self-care requisites
Assumptions
1. "taken for granted" statements 2. explains the nature of the concepts, definitions, purpose, relationships, and structure of a theory
Theory Components
1. set of related concepts 2. principles, 3. definitions 4. assumptions/prepositions (explanation of an idea)
(Components of Any Nursing Theory) Nursing
diagnosis and treatment of human responses to actual or potential health problems Ex: a. Create patient-centered plan b. Critical thinking skills c. Integration of knowledge, experience, attitudes and standards
(Components of Any Nursing Theory) Environment
factors found at home, school, workplace, community Ex: Positive or negative effect on person's health and healthcare needs
Goals
identifies goals to assist patient (planning); determines level of intervention and ways of assisting
Models
interactions among and between concepts of patterns
Nursing domain
knowledge and measuring, administration, practice, education, research, techniques to evaluate interventions; structure and rationale of nursing activities
Metaparadigm
most general statement of discipline and functions as a framework in which the more restricted structures of conceptuals model develop
Diagnosis
outlining the patient's actual and potential self-care deficits (NANDA); "Why is the patient unable to meet these needs?"
Wholly Compensatory
patient has everything done for him/her
Educative supportive
patient is capable of performing task but lacks knowledge or skills
Partially Compensatory
patient performs tasks; nurse intervenes with tasks patient cannot perform himself/herself
Purpose
purpose is to identify practice such as focus, means, and goals
(Components of Any Nursing Theory) Person
recipient of nursing care - Ex: Individual, family, groups, communities, those who cannot meet self-care needs (Orem)
Paradigm
refers to a pattern of shared understanding and assumptions about reality and the world
What was Orem's belief?
self-care was within capacity of patient and also a right and value
(Components of Any Nursing Theory) Health
state of complete mental, physical, social, and spiritual well-being; not merely the absence of disease or infirmity Healthy People 2020: promotes society of long, healthy lives
Proposition
statements that describe the relationship between concepts
Phenomenon
the term, description, or label given to describe an idea or responses about an event, a situation, a process, a group of events, or a group of situations
Goals of theoretical nursing models
to prove how it is different from other fields of medicine; explain/define phenomenon in nursing
Definition
communicate general meaning of a concept
Operational Theory
concepts are measured Ex: defining pain
Theoretical & Conceptual Theory
define a particular concept
Concept
1. building blocks of theories 2. words or phrases that identify, define, and establish structure and boundaries for ideas generated about a particular phenomenon
Ways of assisting the Patient
1. Doing for (WC or PC) 2. Teaching (PC or ES) 3. Provide a developmental environment (ES) 4. Guidance/counseling - help patient problem solve (PC or ES) 5. Supportive (PC or ES)
Dorothea Orem (DO)
1. Dorothea Orem 2. Self - Care Deficit Theory of Nursing a. Self Care b. Self Care Deficit c. Nursing System
(DO) Nursing Systems
1. Identify self-care demands 2. Identify self-care deficits if self care deficits and demands are greater than patient's ability -> intervention a. designed to supplement or replace self-care or dependent-care systems b. defines patient's role and nurse's role
Orem's Value System
1. Optimal health for all human beings 2. Independence in caring for one's healthcare needs 3. Values nursing as essentially useful to society for meeting above needs
Assumptions of Orem's Self-Care Theory
1. Patients should be self-reliant and responsible for their care and the care of their families 2. People are distinct individuals 3. Nursing is a form of action that involves two or more people Successfully meeting universal and developmental self-care requisites is an important component of primary care prevention and ill health 4. A person's knowledge of potential health problems is needed for promoting self-care behaviors 5. Self-care and dependent care are behaviors learned within a socio-cultural context
4 components of Nursing Metaparadigm
1. Person - patient, client, or human beings. 2. Environment - pos. or neg. conditions of person 3. Health - Wellness experience of client 4. Nursing - Attributes, characteristics, and actions of the nurse providing care THE ULTIMATE GOAL OF NURSING THEORIES IS TO IMPROVE PATIENT CARE
Maslow's Hierarchy of Needs in order
1. Self-Actualization 2. Esteem 3. Love & Belonging 4. Safety Needs 5. Physiological needs
Major Concepts of Orem's Model
1. Self-care needs or requisites 2. Every person has needs that must be met in order to stay alive and function in a normal manner
Levels of Intervention
1. Wholly compensatory 2. Partially compensatory
Conceptual framework
1. basic structure; supporting/underpinning everything 2. A group of related ideas, statements, or concepts. Often used interchangeably with the conceptual model and with grand theories.
Theory
A belief, policy, or procedure or proposed or followed as the bases of action. REfers to a logical group of general propositions used as principles of explanation
Erikson's Theory
A. Birth to 1 yr - Trust vs. Mistrust B. 1 yr - 3 yrs - Autonomy vs. Sense of Shame C. 3 yrs - 6 yrs - Initiative vs. Guilt D. 6 yrs - 11yrs - Industry vs. Inferiority E. Puberty - Identity vs. Role F. Young Adults - Intimacy vs. Isolation G. Middle Age - Generativity vs. Stagnation H. Old age - Integrity vs. despair
Sister Callista Roy
Adaptation Model Theory - Coping Process: accepting conditions without really finding ways to improve it - Holistic Approach: physiological, self-conception, role function, and interdependence
Orem's Approach to Nursing Process (ADPIE)
Assessment Diagnosis Planning Implementation Evaluation
Philosophy
Beliefs and values that define a way of thinking and are generally known and understood by a group or discipline
Domain
Perspective or territory of a profession or discipline
(DO) 3 Categories Self Care
a. Universal: air, water, food, elimination, hygiene, maintenance of activity and rest, maintenance of solitude and social interaction; prevention of hazards, promotion of normalcy, human development, and integrity of body and mind b. Developmental: includes special needs associated with development throughout the life cycle from conception to death c. health deviation: new requisites occurring when one is ill, seeking medical assistance ASAP, Learning to live with the effects of pathologic conditions
(DO) Self Care Deficit
a. demands on patient for self care are greater than the patient's abilities to meet those demands—determines "why" and "when" nursing is needed b. a deficit exists when a person is unable to meet one or more of self-care requisites
Implementation
carrying out plan based on fundamentals of nursing (interventions); help patient perform self-care
Nursing agency
classify level of work needed to provide for patient; knowledge, skills, and abilities to meet the needs of patient they cannot do themselves
