Fundamentals chapter 3
To nightingale the knowledge required to provide good nursing was neither unique nor specialized rather
Nightingale viewed nursing as a central human activity grounded in observation reason and commonsense health practices
Theories articulate significant relationships between concepts in order to
Point to something larger such as gravity, the unconscious or the experience of pain
Henderson conceptualizes the nurses role as assisting the sick or healthy patients independence meeting 14 fundamental needs
...bathing normally Eating and drinking adequately Eliminating body wastes Moving and maintaining a desirable position Sleeping and resting Selecting sutable clothes Maintaining body temp Keeping the body clean and well groomed to protect the skin Avoid dangers and avoid injuring others Communicating w others in expressing emotions needs fears or opinions Worshipping according to ones faith Woorking in such a way that one feels a sense of accomplishment Playing or participating in various forms of recreation Learning discovering or satisfying the curiosity that leads to normal development and health and using available health facilities
Sister callista roys work focuses on the increasing complexity of person and environment self organization and on the relationship between and among persons universe and what can be considered a supreme being or god roy focues on the individual as a
...biopsychosocial adaptive system that employs a feedback cycle of input (stimuli) throughput (control processes) and output (behaviors or adaptive responses) both the pt and environment are sources of stimuli that require modification to promote adaptation an on going purposive response
Orem identifys 3 types of nursing systems (the 5 methods of helping can be used in each)
...wholly compensatory systems are required for individuals who are unable to control and monitor their environment and process information Partly compensatory systems are designed for individuals who are un able to perform some but not all self care activities Supportive education (developmental) systems are for persons who need to learn to perform self care measures and need assistance to do so
Betty neuman viwes the cilent as an open system consisting of a basic structure or central core of energy resources (psychological, psychological, sociocultural, developmental, and spiritual) surrounded by
2 concentric boundaries or rings refered to as lines of resistance whick represent internal factors that help the cilent defend against stressor
A philosophy is
A belief system, often an early effort to define nursing phenomenon and serves as the basis for later theoretical formulations
A group of related ideas or statements best defines
A conceptual framework
A set of shared understanding and assumptions about reality and the world is a definition for
A paradigm
A theroy may be defined as
A system of ideas that is presumed to explain a givien phenomenon.
A supposition or system of ideas that is proposed to explain a given phenomenon best defines
A theory
Self care agency is the
Ability to perform self care activities it consists of two agents a self care agent and a dependent care agent
Orems therapeutic self care demand refers to
All self care activities required to meet existing self care requisites aka actions to maintain health and wellbeing
An example of the lines of resistance is
An increase in the body's leukocyte count to combat infection
In 1966 Virginia Henderson described nursing in relation to the client and their environment but unlike nightingale Henderson sees the nurse as concerned with
Both healthy and ill individuals, acknowledges that nurses interact with clients even when recovery may not be feasible and mentions the teaching and advocacy roles of the nurse
Nightingale is often considered the first theorists describing nursing 150 years ago as
Establishing an environment that allows persons to recover from illness
Person environment health and nursing constitute the metaparadigm for nursing because they
Can be utilized in any setting when caring for a client
Nursing theories vary considerably in their level of abstraction;
Conceptualization of clients,health/illness, environment and nursing Ability to describe, explain or predict phenomena some theories are broad in scope others are limited
Madeleine leininger produced the sunrise model to depict her theory of
Cultural diversity and universality. It emphasizes that health and care are influenced by elements of the social structure such as technology religious and philosophical factors kinship and social systems cultural values political and legal factors economic and educational factors
In order for nurses to assist people of diverse cultures leininger presents 3 intervention modes
Culture care preservation and maintenance Culture care accommodation negotiation or both Culture care restructuring and repatterning She examines what is universal among cultures and what varies
The 4th phase of the nurse client relationship is
In the final phase old needs and goals are put aside and new ones adopted. I once older needs are resolved newer and more mature ones emerge
During the latter half of the 20th century disciplines seeking to establish themselves in universities had to
Demonstrate somthing that nightingale had not envisioned for nursing- a unique body of theoretical knowledge
Critical theory is used in academia to
Describe theories that help elucidate how social structures affect a wide variety of human experiences from art to social practices
Theroys are used to
Describe, predict, and control phenomena
In 1970 Martha Rogers presented her theory of unitary human beings she views the person as an irreducible whole the whole being greater than the sum of its parts she states humans are
Dynamic energy feilds in continous exchange with environmental feilds both are infinite
Debates about the role of theory in nursing practice provide
Evidence that nursing is maturing as both an academic discipline and a clinical profession
The third phase of the nurse client relationship is
Exploration the client derives full value from what the nurse offers through the relationship. The client uses available services based on self intrest and needs. Power shifts from the nurse to the client
The term practice discipline is used for
Fields of study in which the central focus is performance of a professional role
Nursing research is more often informed by midlevel theories that
Focus on the exploration of concepts such as pain, self-esteem, learning and hardness
Nurses applying rodgers theory in practice
Focus on the persons wholeness Seek to promote symphonic interaction between the two energy fields to strengthen the cogerence and integrity of the person Coordinate the human field with the rhythmicities of the environmental field Direct patterns of interaction between the two energy fields to promote maximum health potential
Imogene kings transaction process model was designed to describe the nature of and standard for nurse-client interactions that lead to
Goal attainment that nurses purposefully interact and mutually set explore and agree to means to achieve goals which represents outcomes. When nurses record this in a clients records nurses have data that represents evidence based nursing practice
In the natural sciences the main function of theory is to
Guide research In practice disciplines the main function of theory is to provide new possibilities for understanding the disciplines focus
The purpose of theory in science is to
Help scientists interpret phenomena
Orems self care deficit theory explains not only when nursing care is needed but also
How people can be assisted through 5 methods of helping acting or doing for Guiding Teaching Supporting And providing an environment that promots the pts abilities to meet current and future demands
Parse's human becoming theory proposes 3 assumptions about human becoming
Human becoming is freely choosing personal meaning in situations in the intersubjective process of relating value priorities Human becoming is cocreating rhymatic patterns or relating in mutual process with the universe Human becoming is cotranscending multidimensionally with the emerging possibles
Jean watson belives caring is central to nursing her major asumptions
Human caring in nursing is not just an emotion concern or attitued or benevolent desire caring connotes a person's response Caring is an intersubjective human process and is the moral idea of nursing Caring can b effectively demonstrated only interpersonally Effective caring promotes health and individual or family growth Caring promotes health more than does curing Caring responses accept a person not only as they are now but what they might become A caring environment offers the development of potential while allowing the person to choose the best action for the srlf at any given time Caring occasions involve action and choice by nurse and client if the caring occasion is transpersonal the limitsof openess expand as do human compacities The most abstract characteristics of a caring person is that the person is somehow responsive to another Human caring involves values a will and commitment to care knowledge caring actions and consequences The idea of caring is a starting point a stance an attitude that has to become a will an intention a commitment and a conscious judgment that manifest its selfin concrete acts
The second phase of the nurse client relationship is
Identification the client assumes a posture of dependance, interdependence or independence in a relation to the nurse (relatedness) the nurses focus is to assure the person that the nurse understands the interpersonal meaning of the clients situation
Neuman categorizes stressors as
Intrapersonal stressors which occor within the patient like an infection Interpersonal strossors between individuals like unrealistic role expations and extrapersonal stressors like those that occur outside the person like finacial concerns
The human field image perspective surpasses that of the physical body according to rodgers unitary man:
Is an irreducible four dimensional energy field identified by pattern Manifests characteristics different from the sum of the parts Interacts continously and creatively with the environment Behaves as a totality As a sentient being participates creatively in change
Four influential theories from the 2oth century were
Marxs theroy of alienation, freuds theory of the unconscious, darwins theory of evolution, and Einsteins theory of relativity
Parse's 3 assumptions focuse on
Meaning arises from a person's interrelationship with the world and refers to happenings to which the person attaches varying degrees of significance Rhythmicity is the movement toward greater diversity Cotranscendence is the process of reaching out beyond the self
Which provides the best explanation for describing nursing as a practice discipline
Nursing focuses on performing the professional role
Nightingale viewed nursing as a central human activity grounded in
Observation, reason, and commonsense health practices
The nurse - client relationship evolves in 4 phases the first is
Orientation the client seeks help and the nurse assists the client to understand the problem and the extent of the need for help
Paradigm refers to a
Pattern of shared understandings and assumptions about reality and the world
In the late 20th century much of the theoretical work in nursing focused on articulating relationships between 4 major concepts
Person environment health and nursing because these can be superimposed on almost anywork in nursing they are sometimes collectively known as a metaparadigm for nursing
Which is an accurate statement about the role of the nursing theory
Practice theories assist nurses to reflect on the effectiveness of what they do
Nursing interventions for neumans theory focus on retaining or maintaing systems stability these interventions are carried out in 3 ways
Primary-protecting the normal line of defense and strengthening the flexibility of the line of defense Secondary focuses on strengthening internal lines of reststance reducing the reaction and increasing resistance factors Tertiary prevention focuses on stability and proects reconstitution or return to wellness following treatment
Nightingale linked health with five environmental factors
Pure or fresh air, pure water, efficient drainage, cleanliness and light especially direct sun light
A conceptual framework is a group of
Related ideas, statements or concepts example freuds structure of the mind id ego and superego aka conceptual model or grand theories
Betty neuman developed a model based onthe individuals
Relationship to stress the reaction to it and reconstitution factors that are dynamic in nature reconstitution is the state of adaptation to stressors
In qualitative research theory can be used to help
Select the phenomenon frame the philosophical underpinnings of the study and guide data analysis and interpation
Dorothea Orems theory was first published in 1971 includes 3 related concepts
Self care Self care deficit and nursing systems
Self care theory is based on 4 concepts
Self care Self care agency Self care requisites Therapeutic self care demand
Imogene king slected 15 concepts from the nursing literature as essential knowledge for use by nurses they are
Self, role, perception, communication, interaction, transaction, growth, and development, stress, time, personal space, organization, status, power, authority, and decision making
Paradigms include our notations of reality that are largely unconscious or taken for granted most theories relfect
The dominant paradigm of a culture although some may grow out of developing rival paradigm
Disciplines without a strong theory and research base were refered to as
Soft a negative comparison with the hard natural sciences
To help clients fulfill their needs nurses assume many roles
Stranger teacher resource person surrogate leader and counselor peplaus model continues to be used w psych patients
According to betty neumans theory outside the lines of resistance are 2 lines of defense
The inner or normal line of defense depicted as a solid line represents the persons state of equilibrium or adaptation developed and maintained over time and considered normal for them. The flexible line of defense depicted as a broken line is dynamic and can be rapidly altered over a short period of time it is a proective buffer to prevent stressors from penetrating the normal line. Sleep deprivation can create rappid changes
In the late 20th century much of the theoretical work in nursing focused on articulating relationships among 4 major concepts
The person or client is the recipient of nursing care The environment is the internal and external surroundings that affect the client this includes family and friends Health is the degree of wellness or wellbeing that the client experiences Nursing is the attributes, characteristics, and actions of the nurse providing care on behalf of, or in conjunction with the client
The goal of roys model is to enhance life processes through adaptation in 4 modes
The physiological mode involves the body's basic physiological needs and ways of adapting with regard to fluid electrolytes activity and rest circulation and o2 nutrition and elimination protection the senses and neurologic and endocrine function The self-concept mode has 2 components the physical self which involves sensation and body image and the personal self which involves self idea self consistency and the moral ethical self The role function mode is determinedby the need for social integrity and refers to the performance of duties based on given positions with in society The interdependence mode involves ones relations w significant others and support systems that provide help affection and attention
Sister callista roy defines adaptation as
The process and outcome whereby thinking and feeling person uses conscious awareness and choice to create human and environmental integration
Adaptive response contribute to health which roy defines as
The process of being and becoming intergrated ineffective or maladaptive response do not contribute to health each pts adaptive level is unique and constantly changing
Imogene kings theory of goal attainment in 1981 was derived from her conceptual framework which shows
The relationship of personal systems (individuals) interpersonal systems (groups such as nurse client) and social systems (health care or education systems)
Hildegard peplau was a psychiatric nurse her interpersonal concepts in 1952 central to pleplaus theroy is the existence of a
Therapeutic relationship between the nurse and the client
Self care refers to
Those activities an individual performs independently throughout life to promote and maintain personal wellbeing
Self care requisites or self care needs are measures or actions taken to provide self care there are 3 categorys
Universal are common to all people like maintaining intake and elimination of air, water, and food, balancing rest solitude and social interaction preventing hazards to life and wellbeing The second is developmental requisites from maturation or associated conditions or events like change in body image or loss of spouse Third health deviation requisites result from illness injury or disease or its treatment like seeking health care taking meds living w effects of both