INTRODUCTION OF NURSING 1.3 Nursing Theories

INTRODUCTION OF NURSING



1.3 Nursing Theories



2 Hours




JULIE JAMES ABDULLAH

1. Describe the nursing theories and
Learning models




Outcomes 2. Apply nursing theories to nursing


practice.

1. Introduction to selected Nursing Theories

a. Environmental theory; Florence

Nightingale (1860)

b. Interpersonal relation model; Hildegrad

Peplau (1952, 1963, 1980)

c. Need Theory; Virginia Henderson (1966)


d. General Theory Of Nursing; Dorothea E.
Learning Orem (1971, 1980, 1985,1991, 1995)



e. System Model; Betty Neuman (1972,
Outline 1982, 1989, 1995)



f. Adaptation Model; Sister Callista Roy

(1970, 1976, 1984, 1991)

g. Human Caring Theory, Jean Watson

(1979, 1985, 1988)

h. Transcultural Nursing Model; Madeline

Leininger (1978, 1991)

2. Application of nursing theories to

nursing practice


a. Need Theory; Virginia Henderson

(1966)


b. General Theory Of Nursing;

Learning Dorothea E. Orem (1971, 1980,


1985,1991, 1995)
Outline c. Human Caring Theory, Jean



Watson (1979, 1985, 1988)


d. Transcultural Nursing Model;

Madeline Leininger (1978, 1991)



INTRODUCTION TO SELECTED







NURSING THEORIES

Introduction

















What Is Nursing Theory?


• Nursing theory is the term given to the body of knowledge that is used to support nursing

practice.


• Theory is the creative and systematic way of looking at the world or an aspect of it to
describe, explain, predict, or control it.


• The first term to consider in learning about theory is the concept.

Introduction














• Concepts may be empirical or abstract depending on their ability to be
observed in the real world.


• Concepts are said to be empirical when they can be observed or

experienced through the senses.



• Example: A stethoscope is an example of an empirical concept because it
can be seen and touched.


• Abstract concepts are those that are not observable, such as caring, hope

and infinity.



• A nursing theory provides the framework that links nursing research,
nursing practice, and nursing knowledge.

Nursing Theories And Models






































Follow the link given. Read these nursing theories articles and

present your description on the theories.

APPLICATION OF NURSING





THEORIES TO NURSING PRACTICE





























Need Theory; Virginia Henderson (1966)



Case Scenario














• Ms.X, 25 years old female client was admitted in the surgical unit, with attempted
suicide.


• Two weeks ago, she ingested toilet cleaner because of a family dispute.


• Ms. X lived a rural life and had studied till secondary 3.


• Upon history taking, her mother informed that her marriage was planned two days
before the incident.


• She was reluctant to share the reason for her suicide but stated that she was

stressed out and tried to kill herself.


• Later on, her mother reported that she was impulsive and emotional person and

was in live with someone but the family was willing for her marriage.

Case Scenario












• Her physical assessment revealed alert, oriented but depressed female.


• Her chief complaints were difficulty in breathing and mood swings.


• Her CT scan and endoscopy showed damaged larynx, mouth and stomach

ulcers respectively.


• The dietician advised liquid diet but Ms. X showed dislike and resisted

eating.


• Due to her limited intake, Foley’s catheter was passed for accurate record of

her daily intake and output.


• She was noncompliance towards her intake and developed dehydration,

irritability and insomnia as evidenced by dry mouth, sunken eyes with dark

circles around.

Henderson's 14 Components Assessment

Findings


Breathe normally.

Eat and drink adequately.


Eliminate body wastes


Movement and Posturing
Exercise 1 Sleep and rest.



Select suitable clothes-dress and undress

• How you apply Maintain body temperature

this theory to Keep the body clean and well groomed


nursing Avoid dangers in the environment


practices? Communication


Worship according to one’s faith

Work accomplishment


Play or participate in various forms of


recreation

Learn, discover, or satisfy the curiosity

Possible Nursing Diagnoses for Ms. X

















Breathing Activity intolerance related to dyspnea

Nutrition Nutritional Imbalance less than body requirement related to less desire to eat


Elimination Altered Elimination Pattern related to catheter in-placement

Movement and Posturing Impaired physical mobility related to fatigue and weakness





Sleep and Rest Disturbed Sleep pattern related to external factors i.e hospitalization

Safety High risk of Injury related to stress


Communication Impaired Verbal Communication related to larynx injury

Hygiene Hygiene Self-Care deficit related to stress and fatigue


Spirituality Spiritual distress related to inability to participate in religious activities

Learning Ineffective coping related to situational crisis and inadequate psychological resources

Planning


















Address all the physiological needs and provide respective nursing care.



Encourage client to identify her strengths and limitations, share her concerns, and



participate in activities of daily living



Discuss effective coping strategies and impulse control like talking, drawing any



pictures, asking questions for exploring her stress factors.



Encourage family support by asking mother why she was upset due to her marriage?



What were the domestic problems leading to suicidal attempt? Did she have any



suicidal thoughts before attempting suicide?

Interventions





Observe for strengths such as the ability to relate the facts and to recognize the source of
1
stressors.


Monitor risk of harming self or others.
2

Help client set realistic goals and identify personal skills and knowledge
3


Use empathetic communication, and encourage client/family to verbalize fears, express
4
emotions, and set goals.


Encourage client to make choices and participate in planning of care and scheduled activities
5

Encourage use of cognitive behavioral relaxation (e.g., music therapy, guided imagery).
6

Involve patient in spiritual activities
7


Discuss coping and stress management techniques like mind distraction, self-control and
8
effective decision making and recreation (watch tv, listen to music, outing)

Involve in daily life activities of hygiene and exercise.
9

Maintain airway and pain management medication, relaxation techniques)
10

APPLICATION OF NURSING





THEORIES TO NURSING PRACTICE






























General Theory Of Nursing; Dorothea E. Orem (1971, 1980, 1985,1991, 1995)

Orem’s general theory of nursing in three



related parts:-
























Theory of self Theory of self Theory of

care care deficit nursing system

Case Scenario












• Mrs. X came to the hospital with complaints of pain over all the joints,

stiffness which is more in the morning and reduces by the activities.


• She has these complaints since 5 years and has taken treatment from local

hospital.


• The symptoms were not reducing and came to Hospital for further

management.


• She was able to do the ADL by herself but the way she performed and the

posture she used was making her prone to develop the complications of the

disease.


• She also was malnourished and was not having awareness about the

deficiencies and effects.

Exercise 2 BASIC CONDITIONING FACTORS



Age



How you Gender


apply the Health state



scenario Development state



using these Socioculturalorientation


Health care system
forms

Family system
according to

Patern of living
the theory of

Environment
Orem? Resources

UNIVERSAL SELF-CARE REQUISITES




Air




Water




Food




Elimination




Activity / rest





Social interaction




Prevention of hazards




Promotion of normalcy

DEVELOPMENTAL SELF CARE REQUISITES




Maintain of developmental




environment









Prevention / management of the




conditions threatening the





normal development

APPLICATION OF NURSING





THEORIES TO NURSING PRACTICE





























Human Caring Theory, Jean Watson (1979, 1985, 1988)

Theory of Human Caring

















• people-oriented that accepts the peculiar dimensions of human integrity

without compromising its mind-bodyspirit







• The theory signifies that love is the most important healing source in

nursing care

Carative Factors

















• Watson views the “carative factors” as a guide for the core of nursing.



• She uses the term carative to contrast with conventional medicine’s

curative factors.



• Her carative factors attempt to “honor the human dimensions of


nursing’s work and the inner life world and subjective experiences of

the people we serve”

The carative factors are comprised of 10



elements








1. Humanistic-altruistic system of value.


2. Faith-Hope.

3. Sensitivity to self and others.


4. Helping-trusting, human care relationship.


5. Expressing positive and negative feelings.

6. Creative problem-solving caring process.


7. Transpersonal teaching-learning.

8. Supportive, protective, and/or corrective mental, physical, societal, and spiritual
environment.


9. Human needs assistance.


10. Existential-phenomenological-spiritual forces.

From Carative Factors To Clinical Caritas



Processes









1. Formation of humanistic-altruistic system of values, becomes:


"Practice of loving-kindness and equanimity within context of


caring consciousness";



2. Instillation of faith-hope, becomes: "Being authentically


present, and enabling and sustaining the deep belief system


and subjective life world of self and one-being-cared- for";



3. Cultivation of sensitivity to one’s self and to others, becomes:

"Cultivation of one’s own spiritual practices and transpersonal


self, going beyond ego self";

From Carative Factors To Clinical Caritas



Processes









4. Development of a helping-trusting, human caring relationship, becomes:


"Developing and sustaining a helping-trusting, authentic caring

relationship";


5. Promotion and acceptance of the expression of positive and negative

feelings, becomes: "Being present to, and supportive of the expression of


positive and negative feelings as a connection with deeper spirit of self

and the one-being-cared-for";


6. Systematic use of a creative problem-solving caring process, becomes:


"creative use of self and all ways of knowing as part of the caring process;

to engage in artistry of caring-healing practices";

From Carative Factors To Clinical Caritas



Processes











7. Promotion of transpersonal teaching-learning, becomes: "Engaging in

genuine teaching-learning experience that attends to unity of being and

meaning attempting to stay within other’s frame of reference";



8. Provision for a supportive, protective, and/or corrective mental, physical,

societal, and spiritual environment, becomes: "Creating healing

environment at all levels, (physical as well as non-physical, subtle

environment of energy and consciousness, whereby wholeness, beauty,


comfort, dignity, and peace are potentiated";

From Carative Factors To Clinical Caritas



Processes











9. Assistance with gratification of human needs, becomes: "assisting with
basic needs, with an intentional caring consciousness, administering

‘human care essentials’, which potentiate alignment of mind-bodyspirit,

wholeness, and unity of being in all aspects of care"; tending to both

embodied spirit and evolving spiritual emergence






10. Allowance for existential-phenomenological-spiritual forces, becomes:

"opening and attending to spiritual-mysterious, and existential

dimensions of one’s own life-death; soul care for self and the one-being-

care-for."

APPLICATION OF NURSING





THEORIES TO NURSING PRACTICE





























Transcultural Nursing Model; Madeline Leininger (1978, 1991)

Transcultural nursing is a comparative study of cultures to


understand similarities (culture universal) and difference

(culture-specific) across human groups (Leininger, 1991)


Transcultural 1. Culture 11. Bicultural



Nursing 2. Religion 12. Diversity




3. Ethnic 13. Acculturation



4. Ethnicity 14. Cultural shock

15. Ethnic groups
5. Cultural Identify

16. Ethnic identity
6. Culture-universals
17. Race
7. Culture-specifies
18. Cultural awareness

8. Material culture
19. Culturally congruent

9. Non-material culture care



10.Subculture 20. Culturally competent

care

Transcultural Nursing

















• To develop understanding, respect and appreciation for the individuality and diversity of

patients beliefs, values, spirituality and culture regarding illness, its meaning, cause,
treatment, and outcome.






• To encourage in developing and maintaining a program of physical, emotional and spiritual

self-care introduce therapies related to ones believe.

DISCUSSION

Discussion

















1. Is nursing theory important to nursing practice?



2. Do nursing theories improve patient outcomes? How?

QUIZ