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Nursing Theories

Nursing Theories

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Nursing Theories A companion to nursing theories and models -----------------------------------------------------------------------------INTRODUCTION TO NURSING THEORIES INTRODUCTION Nursing has made phenomenal

achievement in the last century that has lead to the recognition of nursing as an academic discipline and a profession. A move towards theory-based practice has made contemporary nursing more meaningful and significant by shifting nursing‟s focus from vocation to an organised profession. The need for knowledge-base to guide professional nursing practice had been realised in the first half of the twentieth century and many theoretical works have been contributed by nurses ever since, first with the goal of making nursing a recognised profession and later with the goal of delivering care to patients as professionals.

A theory is a group of related concepts that propose action that guide practice. A nursing theory is a set of concepts, definitions, relationships, and assumptions or propositions derived from nursing models or from other disciplines and project a purposive, systematic view of phenomena by designing specific inter-relationships among concepts for the purposes of describing, explaining, predicting, and /or prescribing.. Based on the knowledge structure levels the theoretical works in nursing can be studied

. Environment. Nursing theories and Middle range theories (Least abstract) NURSING PHILOSOPHIES Theory Florence Nightingale‟s Key emphasis Focuses on nursing and the patient Legacy of caring environment relationship. Conceptual models and Grand theories. Helping process meets needs through the art of individualizing care. Faye G.under the following headings: • Metaparadigm (Person. Nurses should identify patients „need-for – help‟ by: Ernestine Wiedenbach: The helping art of clinical nursing Observation Understanding client behaviour Identifying cause of discomfort Determining if clients can resolve problems or have a need for help Virginia Henderson‟s Nursing Derived a definition of nursing Identified 14 basic human needs on which nursing care is based. Health & Nursing) – (Most abstract) • • • Nursing philosophies.Abedellah‟s Typology of twenty one Nursing Patient‟s problems determine nursing care Definition of Patients require help towards achieving independence.

possibilities of coping possibilities for connecting with and concern for others. competent. Caring is a universal. CONCEPTUAL MODELS AND GRAND THEORIES . proficient and expert. social phenomenon that is only effective when practiced interpersonally considering humanistic aspects and caring. advanced beginner. Core model Jean Watson‟s Philosophy and Science of caring Nursing care is person directed towards self love. Caring creates . enabling connection and concern.problems Lydia E. It creates possibility for mutual helpfulness. possibilities for giving and receiving help Described systematically five stages of skill acquisition in nursing practice – novice. It sets up what matters. Hall :Care. Cure. Patricia Benner‟s Primacy of caring Caring is central to the essence of nursing. Caring is moral ideal: mind -body – soul engagement with one and other.

Dorothea E. Three Theories: Theory of Self-Care Theory of Self-Care Deficit Theory of Nursing Systems Wholly compensatory (doing for the patient) Partly compensatory (helping the patient do for himself or herself) Supportive.educative (Helping patient to learn self care and emphasizing on the importance of nurses‟ role Myra Estrin Levine‟s: The conservation model Holism integrity is maintained by conserving Proposed that the nurses use the principles of conservation of: Client Energy Personal integrity Structural integrity Social integrity A conceptual model with three nursing theories – Conservation Redundancy Therapeutic intention . Orem‟s Self care deficit theory in nursing Self–care maintains wholeness.

Sister Callista: Stimuli disrupt an adaptive system The individual is a biopsychosocial adaptive system within an environment. aggressive. Attachment. residual in these causes nursing ingestive-eliminative and Roy„s Adaptation model . Behavioural system also includes the subsystems of dependency. sexual. Individual as a behavioural system is composed of seven subsystems.Johnson‟s Individuals maintain stability and balance through adjustments and adaptation to the forces that impinges them. Disturbances problems. achievement. or the affiliative subsystems – is the corner stone of social Behavioural system model organisations. The individual and the environment provide three classes of stimuli-the focal. The unique focus of nursing is on the unitary or irreducible human being and the environment (both are energy fields) rather than health and illness Dorothy E.Roger‟s: Science of unitary human beings Person environment are energy fields that evolve negentropically Martha proposed that nursing was a basic scientific discipline Nursing is using knowledge for human betterment.Martha E.

From her major concepts (interaction. Secondary. role. an individual or demonstrates ineffective interventions Betty Neuman‟s : Health care systems model responses requiring nursing Reconstitution is a status of adaptation to stressors A conceptual model with two theories “Optimal patient stability and prevention as intervention” Neuman‟s model includes intrapersonal. Nursing actions (Primary. interpersonal and extrapersonal stressors. transaction. perception. interaction. Nursing is concerned with the whole person. communication. stress. Imogene attainment theory King‟s Goal Transactions provide a frame of reference toward goal setting. and Tertiary levels of prevention) focuses on the variables affecting the client‟s response to stressors. · Perceptions. growth and development) derived goal attainment theory. and transaction (Process of . Through regulator two and adaptive cognator.and contextual. A conceptual model of nursing from which theory of goal attainment is derived. adaptive responses mechanisms. Judgments and actions of the patient and the nurse lead to reaction.

Most individuals experience significant life events which can affect ALs causing actual and potential problems.J.Tierney for nursing based on a model of living .nursing). A conceptual model of nursing from which theory of goal attainment is derived. Nancy Roper. and A. This affects dependence – independence continuum which is bi-directional. Living is an amalgam of activities of living (ALs). solving actual problems and helping to cope. Nursing helps to maintain the individuality of person by preventing potential problems. WW.Logan A model Individuality in living.

Nurses must stay connected to patients and assure that patients get what they need. Stressed the importance of nurses‟ ability to understand own behaviour to help others identify perceived difficulties. Patient 2. focused on patient‟s verbal and non verbal expressions of need and nurse‟s reactions to patient‟s behaviour to alleviate distress. The four phases of nurse-patient Psychodynamic Theory relationships are: 1. Teacher 4. Exploitations 4. Elements of nursing situation: 1. Peplau: Nursing Interpersonal process is maturing force for personality. Nurse reactions 3. Identification 3. Counselor Ida Jean Orlando‟s Nursing Process Theory Interpersonal process alleviates distress. Surrogate 6. Stranger 2. Leader 5. Orientation 2. Nursing actions . Resolution The six nursing roles are: 1. Resource person 3.Hildegard E.

Health care needs are needs for comfort.Mercer‟s Parenting and maternal role attainment in diverse populations A complex theory to explain the factors impacting the development of maternal role over time. Nursing is accomplished through human to human relationships that began with: The original encounter and then progressed through stages of Emerging identities Developing feelings of empathy and sympathy. Kathryn E. until the nurse and patient attained rapport in the final stage. psycho spiritual. Ramona T. These needs include physical. arising from stressful health care situations that cannot be met by recipients‟ traditional support system.Joyce Travelbee‟s Human To Human Relationship Model Therapeutic human relationships. social and environmental :Maternal Role Attainment . Katharine Kolcaba‟s Theory of comfort Comfort is desirable holistic outcome of care. Barnard‟s Parent Child Interaction Model Growth and development of children and mother–infant relationships Individual characteristics of each member influence the parent–infant system and adaptive behaviour modifies those characteristics to meet the needs of the system.

distinctive and unifying feature of nursing Rosemarie Rizzo Parse‟s Indivisible beings and environment cocreate health. The nurse assists the client in interaction with the environment and co creating health :Theory of human becoming Nola J. model Promoting optimum health supersedes disease prevention. biological influences. Identifies cognitive. . culture. mutual and in constant interaction with environment. A theory of nursing derived from Roger‟s conceptual model.needs. Major concepts include care. caring.Pender‟s :The Health promotion. Comfort measures include those nursing interventions designed to address the specific comfort needs. cultural values and cultural variations Caring serves to ameliorate or improve human conditions and life base. Clients are open. perceptual factors in clients which are and interpersonal modified by demographical characteristics. Caring is universal and varies transculturally. Care is the essence and the dominant. Madeleine Leininger‟s Transcultural culture-care theory nursing.

Evelyn. Using the internet the nurses of the world can share ideas and knowledge. Tomey AM. guide research and curriculum and identify the goals of nursing practice. Mosby. Perry G Anne (1992) Fundamentals Of Nursing –Concepts Process & Practice 3rd ed. Nursing theorists and their work. Norwalk. MR.). 2.The base for professional Nursing Practice. Alligood M.Lillis Carol (2001)The Art & Science Of Nursing Care 4th ed. Mosby. Potter A Patricia. 2002 7.M. Philadelphia. used. 2002. 2nd Ed. Nursing Theories. 3. Lippincott Williams& wilkins. Lippincott. London Mosby Year Book. Philadelphia. . and applied in the theory based practice for the profession and the continued development of nursing and academic discipline REFERENCES 1. It is important the nursing knowledge is learnt. Lippincott. Meleis Ibrahim Afaf (1997) . A. McEwen Melanie (2002). Philadelphia.R. Theoretical Basis for Nursing Philadelphia. Philadelphia. Nursing theory utilization and application. 4. (5th ed. Appleton & Lange. carrying on the work begun by nursing theorists and continue the growth and development of new nursing knowledge.situational and behavioural factors that help predict in health promoting behaviour CONCLUSION The conceptual and theoretical nursing models help to provide knowledge to improve practice. George B. 5. Taylor Carol. Wills M. 3rd ed. Tomey. Julia . 6. Theoretical Nursing : Development & Progress 3rd ed. Alligood. The state of art and science of nursing theory is one of continuing growth.

definitions.APPLICATION OF THEORY IN NURSING PROCESS Introduction Theories are a set of interrelated concepts that give a systematic view of a phenomenon (an observable fact or event) that is explanatory & predictive in nature. systematic view of phenomena by designing specific inter-relationships among concepts for the purposes of describing. and guidance for research and education The main exponent of nursing – caring – cannot be measured. nursing continues to strive to establish a unique body of knowledge   . propositions & are based on assumptions. predicting. Objectives       Definition: to assess the patient condition by the various methods explained by the nursing theory to identify the needs of the patient to demonstrate an effective communication and interaction with the patient. They are derived through two principal methods. Importance of nursing theories:      Nursing theory aims to describe. and assumptions or propositions derived from nursing models or from other disciplines and project a purposive. and /or prescribing. enhanced professional status for nurses. improved communication between nurses. definitions. predict and explain the phenomenon of nursing It should provide the foundations of nursing practice. models. A nursing theory is a set of concepts. it is vital to have the theory to analyze and explain what nurses do As medicine tries to make a move towards adopting a more multidisciplinary approach to health care. help to generate further knowledge and indicate in which direction nursing should develop in the future Theory is important because it helps us to decide what we know and what we need to know It helps to distinguish what should form the basis of practice by explicitly describing nursing The benefits of having a defined body of theory in nursing include better patient care. Theories are composed of concepts. Nursing theory is an organized and systematic articulation of a set of statements related to questions in the discipline of nursing.. deductive reasoning and inductive reasoning. to select a theory for the application according to the need of the patient to apply the theory to solve the identified problems of the patient to evaluate the extent to which the process was fruitful. explaining. relationships.

Used by the practitioners to guide and improve their practice.      REFERENCES 1.specific principles and procedures or rules. Consistent with other validated theories.3rd ed. Generalizable. which are essential for effective decision making and implementation. People who do research and develop theories think differently about theory when they perceive the reality of practice. Missouri: Elsevier Mosby Publications.operatively with people who practice nursing. Tomey AM. 2002. and principles but will leave open unanswered questions that need to be investigated. explain. it must be developed co. Purposes of theory in practice:       Assist nurses to describe. Alligood. 2. Nursing Theory: Utilization &Application . Bases for hypotheses that can be tested. Increasing the general body of knowledge within the discipline through the research implemented to validate them. Help to establish criteria to measure the quality of nursing care Help build a common nursing terminology to use in communicating with other health professionals. and predict everyday experiences. Ideas are developed and words defined. and evaluation of nursing care. This can be seen as an attempt by the nursing profession to maintain its professional boundaries Characteristics of theories: Theories are        Interrelating concepts in such a way as to create a different way of looking at a particular phenomenon. Enhance autonomy (independence and self-governance) of nursing by defining its own independent functions. Theories do not provide the same type of procedural guidelines for practice as do situation. Tomey A M. Theory is ought to improve the nursing practice. (5th Application Goal Attainment Theory Application Orem's Self-care Deficit Theory Theories used in Community Health Nursing Application of Suchman’s Stages of Illness Mode Application of Betty Neuman's Systems Model in Nursing Care . Serve to guide assessment. Logical in nature. Provide a rationale for collecting reliable and valid data about the health status of clients. Procedural rules or principles help to standardise nursing practice and can also be useful in achieving minimum goals of quality of care. laws. If theory is expected to benefit practice. Nursing theorists and their work. intervention. MR. Alligood M R. One of the most common ways theory has been organized in practice is in the nursing process of analyzing assessment data.

Mosby.ed.).5th ed. .Nursing Theories: The Base for Professional Nursing Practice . George JB . Philadelphia. 2002 3. New Jersey :Prentice Hall.2002.

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