Nursing Theories

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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.

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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.

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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.
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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).
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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).
  1. The nurse’s central purpose in nursing. It constitutes the nurse’s professional commitment.
  2. The prescription. It indicates the broad general action that the nurse deems appropriate to fulfillment of her central purpose.
  3. 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).

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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.
  1. Conservation of Energy: “The individual requires a balance of energy and a constant renewal of energy to maintain life activities” (Levine, 1990, p. 197).
  2. 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).
  3. 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).
  4. 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).

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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).
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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.”
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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).
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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.


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notes.nursium.com: Nursing Theories
Nursing Theories
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