NURSING THEORIES
Environmental Model (Florence
Nightingale)
IN SHORT: To help bring back OLOF, you have to change the environment to
HELP bring forth the restorative forces within the patient's body.
A person’s health was the direct
result of environmental influences, specifically cleanliness, light, pure air,
pure water, and efficient drainage. Through manipulating the environment,
nursing “aims to discover the laws of nature that would assist in putting the
patient in the best possible condition so that nature can effect a cure”
(Nightingale, 1859, p. 6).
Interpersonal Relations in Nursing
(Hildegard Peplau)
IN SHORT: There are three stages in a nurse-patient
relationship and the nurse has roles to play in each of these stages.
Defined the concepts and stages
involved in the development of the nurse-client relationship. From that
relationship, she identified the roles of the nurse as stranger, resource
person, teacher, leader, surrogate, and counselor.
14 Basic Needs of Clients (Virginia
Henderson)
IN SHORT: Depending on the condition of the patient, the nurse has to
assist the patient to regain the ability to perform these basic needs.
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 has the necessary strength, will, or knowledge. And to do
this in such a way as to help him gain independence as rapidly as possible.
(Henderson, 1966, p. 15). The 14 basic client needs are:
·
Breathe normally. Eat and drink
adequately.
·
Eliminate body wastes.
·
Move and maintain desirable postures.
·
Sleep and rest.
·
Select suitable clothes-dress and
undress.
·
Maintain body temperature within
normal range by adjusting clothing and modifying environment
·
Keep the body clean and well groomed
and protect the integument
·
Avoid dangers in the environment and
avoid injuring others.
·
Communicate with others in expressing
emotions, needs, fears, or opinions.
·
Worship according to one’s faith.
·
Work in such a way that there is a
sense of accomplishment.
·
Play or participate in various forms
of recreation.
·
Learn, discover, or satisfy the
curiosity that leads to normal development and health and use the available
health facilities.
[next]
Care-Core-Cure Model (Lydia Hall)
IN SHORT: The nurse is part of a team that takes care of the patient in
three major aspects:the person (care), the body (core), and the disease (cure).
Hall enumerated three aspects of the
person as patient: the person (care), the body (core), and the disease
(cure).
·
CARE
·
This part of the patient is concerned
with intimate bodily care (e.g., bathing, feeding, toileting, positioning,
moving, dressing, undressing, and maintaining a healthful environment) and
belongs exclusively to nursing. Nursing is required when people are not able to
undertake these activities for themselves.
·
CORE
·
The third area that nursing shares
with all of the helping professions is that of using relationships for
therapeutic effect—the core. This area emphasizes the social, emotional,
spiritual, and intellectual needs of the patient in relation to family, institution,
community, and the world (Hall, 1955, 1958, 1965).
·
CURE
·
This aspect of the patient is shared
with medicine. The nurse may assume medical functions, or help the patient with
these through comforting and nurturing.
[next]
Theory of Self-Care (Dorothea Orem)
IN SHORT: Self-care is an activity done by the
patient. When the patient is unable to perform this task, the nurse takes over.
According to this theory, self-care
is a learned behavior and a deliberate action in response to a need. Orem
identified three categories of self-care requisites: universal self-care
requisites, developmental self-care requisites, and health-deviation self-care
requisites. Universal self-care requisites are common to all human beings and
include both physiological and social interaction needs. Developmental
self-care requisites are the
needs that arise as the individual
grows and develops. Health-deviation self-care requisites result from the needs
produced by disease or illness states. Self-care is performed by mature and maturing
individuals. When someone else must perform a self-care need, it is
termed dependent care.
[next]
Behavioral System Model (Dorothy
Johnson)
IN SHORT: The patient exists as a behavioral system which interacts with
the environment and its systems (e.g. interpersonal, cultural, physical).
The behavioral system and the
environment are linked by interactions and transactions. We define the person
(behavioral system) as being comprised of subsystems and the environment as
being comprised of physical, interpersonal (e.g., father, friend, mother,
sibling), and sociocultural (e.g., rules and mores of home, school, country,
and other cultural contexts) components that supply the sustenal imperatives of
the person (Grubbs, 1980; Holaday, 1997; Johnson, 1990; Meleis, 1991).
[next]
21 Nursing Problem Areas (Faye Glenn
Abdellah)
IN SHORT: An expansion of the 14 Needs of the Patient.
Expanded Henderson’s 14 needs into 21
problems that she believed would serve as a knowledge base for nursing.
Strongly supported the idea that nursing research would be the key factor in
helping nursing to emerge as a true profession.
Prescriptive Theory (Ernestine
Weidenbach)
IN SHORT: The primary motivation of the nurse is to care; as such he/she
formulates ways and means to provide care; and the immediate environment
determines if this intervention is succesful.
“Account must be taken of the
motivating factors that influence the nurse not only in doing what she does but
also in doing it the way she does it with the realities that exist in the
situation in which she is functioning.” (Wiedenbach, 1970, p. 2).
- The
nurse’s central purpose in nursing. It
constitutes the nurse’s professional commitment.
- The
prescription. It indicates the
broad general action that the nurse deems appropriate to fulfillment of
her central purpose.
- The
realities.They are the aspects of the immediate
situations that influence the results the nurse achieves through what she
does (Wiedenbach, 1970, p. 3).
[next]
Four Principles of Conservation (Myra
Estrin Levine)
IN SHORT: The patient is considered as a holistic human being and in
caring for one, the nurse is to attend to these four conservation categories to
completely say the patient has returned to his/her OLOF.
Conservation is derived from the
Latin word “to keep together.” Levine believed in the wholeness of the human
being and the primary focus of conservation is to maintain that wholeness.
Levine viewed nursing as assisting clients with the conservation of their
uniqueness by helping clients to adapt appropriately.
- Conservation
of Energy: “The individual requires a balance of energy
and a constant renewal of energy to maintain life activities” (Levine,
1990, p. 197).
- Conservation
of Structural Integrity: “Structural
integrity is concerned with the processes of healing . . . to restore
wholeness and continuity after injury or illness” (Levine, 1989, p. 333).
- Conservation
of Personal Integrity: “Everyone seeks
to defend his or her identity as a self, in both that hidden, intensely
private person that dwells within and in the public faces assumed as
individuals move through their relationships with others” (Levine, 1989,
p. 334).
- Conservation of Social
Integrity:
“No diagnosis should be made that does not include the other persons whose
lives are entwined with that of the individual” (Levine, 1989, p. 336).
[next]
Goal-Attainment Theory (Imogene King)
IN SHORT: Achieving a favorable outcome equates to effective nursing
care.
The goal of nursing care is to help
individuals maintain health or regain health (King, 1990). Goal attainment
represents outcomes. Outcomes indicate effective nursing care. Nursing care is
a critical element to provide quality care that is also cost-effective.
Science of Unitary Human Being
(Martha Rogers)
IN SHORT: Nursing is an art! It is in the nurse's creativity
to use her knowledge to best bring back the health of the patient.
"Nursing is a learned profession: a science and an art. A science
is an organized body of abstract knowledge. The art involved in nursing is the
creative use of science for human betterment” (Rogers, 1990, p. 198).
Adaptation Model (Sister Callista
Roy)
IN SHORT: The nurse assists the patient in adapting to the patient's new
situation (diseased state).
A person is “an adaptive system . . .
a whole comprised of parts that function as a unity for some purpose. The world
around and within (the person as an adaptive system) is called the environment
and includes all conditions, circumstances, and influences that surround and
affect the development and behavior of the person” (Andrews & Roy,
1991, p. 4, 18).
[next]
Health Care System Model (Betty
Neuman)
IN SHORT: Disease and illness is a stressor and the nurse provides
interventions to relieve this stress.
This model of nursing focuses
attention on the response of the client system to actual or potential
environmental stressors, and the use of primary, secondary, and tertiary
nursing prevention interventions for retention, attainment, and maintenance of
optimal client system wellness. (Betty Neuman, 1996)
Theory of Transpersonal Caring (Jean
Watson)
IN SHORT: The patient is a holistic human being made up of the mind,
body, and soul and for him/her to return to his/her OLOF, all three must be
cared for.
Caring is the essence of nursing and
the most central and unifying focus of nursing practice. The goal of nursing
“is to help persons gain a higher degree of harmony with the mind, body, and
soul.”
[next]
Transcultural Nursing (Madeleine
Leininger)
IN SHORT: Nursing transcends culture; in that, there are certain unique
aspects of care that each culture can relate to.
Care is the essence and central
domain of nursing; it is the unique and dominant attribute of nursing. However,
forms, expressions, patterns, and processes of human care vary among all
cultures of the world. Yet, diversities and similarities (or commonalities) of
care exist within and between cultures worldwide (Leininger, 1991). Moreover,
the worldview and social structure factors—including religion (and
spirituality), political and economic considerations, kinship (family ties),
education, technology, language expressions, the environmental context, and
cultural history—are essential to understand and are powerful influences on
care outcomes (Leininger, 1991).
[next]
Theory of Human Becoming (Rosemarie
Rizzo Parse)
IN SHORT: Health is in constant change and nurses must help the patient be
prepared for that change.
Health is a “constantly changing
process of becoming that incorporates values. Because it is not a state, health
cannot be contrasted with disease.” Parse (1987, p. 169) states that “the
practice of nursing . . . is a subject-to-subject interrelationship, a loving,
true presence with the other to promote health and quality of life.”
Interpersonal Aspects of Nursing
(Joyce Travelbee)
IN SHORT: The nurse puts his/herself in the patient's shoes to understand
better how to care for the patient.
Sympathy, empathy, and rapport help
the nurse to comprehend and relate to the uniqueness of others. Travelbee
stressed on the human-to-human relationship and on finding meaning in
experiences such as pain, illness, and distress.
