THEORY Orem’s model and the nursing process

- what happens first ● Assessment

● Evaluation
Florence Nightingale ● Planning
- envisioned nurses as body of educated nurse ● Implementation
Ernestine Wiedenbach Metaparadigm
● The Helping Art of Nursing Person- integrated as “whole”
● Influenced by Ida Orlando Health- state of wholeness
4 elements in Clinical Nursing Environment- encompasses the elements external to man
● Philosophy- attitude or belief towards life Nursing- art, a helping serving and a technology
● Nursing- needs of patients through symptoms
● Purpose- accomplish through her actions Myra Estrin Levin
● Practice- observable nursing actions ● Nursing is Human interaction
Person- endowed with unique potential to develop self ● Conservation Model Theory
Environment- conglomerate of objects - focused in promoting adaptation and maintaining wholeness
Health- Not defined ● Conservation- to keep together
Framework on Conservation
Virginia Henderson ● Energy
● Nursing Need Theory ● Structural integrity
● Modern legend in nursing ● Personal integrity
● Foremost nurse of the 20th century ● Social integrity
Nursing- Unique function of nursing is to assist
Metaparadigm Jean Watson
Person- have basic needs that are component of health ● Theory of Human Caring
Environment- unique pattern of living ● The nurse is also cared of
Health- function independently ● The model emphasizes humanistic aspects
● Middle-range theory
● Focuses on interconnectedness of patient and nurse
Carative factors- guides the care of nursing Fay Glenn Abdellah
Metaparadigm ● 21 Nursing Problems
Person- subjective and unique ● Country’s leading researcher in health
Environment- crucial to holistic healing ● Based on problem-solving method
Health- unity between physical, social, mental and spiritual ● Patient Centered care- required you to take active role
Nursing- connective bond ● 10 steps to identify client’s problem
● Nursing skills- observation of health
Nola Pender ● status skills of communication
● Health Promotion Model ● Identification and Classification of
-aims overall health-promoting lifestyle ● Problems- typology of 21 nursing
Major Concept ● problems
● Person- self concept Metaparadigm
● Health- pursuit health through life span Person- Having physical, emotional, social needs
● Health promotion- client behavior toward developing well being Health- state mutually exclusive of illness
● Health protection- client behavior toward preventing illness Environment- home for community
● Environment- comfortable Nursing- helping profession
● Nursing promote wellness by health promote education
Key Concepts Dorothea Elizabeth Orem
● Individual Experiences
● Self care theory
● Behavior Specific Affect
● Concept of Practice
● Behavioral Outcomes
● Member of a curriculum subcommittee at Catholic unit
● Mid-range theory
Dorothy Johnson Orem’s conceptual Framework:
● Behavioral System Model ● Orem’s self care- identify the demand if higher/lower
● Based on Nightingale’s belief that nursing’s goal is to help individuals ● Self care demands- ability to meet demands
prevent from disease ● Nursing Agency- deficit
Function requirements for BSM
● Protection
 ● Nurturance Imogene King
● Stimulation ● Founder of king international group
Subsystems- interrelated parts that function ● Goal Attainment Theory
together to form a whole 3 Frameworks
Attachment Subsystem- most critical ● Personal- how the nurse views
● Dependency Subsystem- promotes helping behavior ● Interpersonal- how the nurse interrelates
● Ingestive- has to do with what, how much, how ● Social- how the nurse interact
● Eliminate- when, how and under conditions ● Action- means of behavior
● Sexual- dual function ● Response- reacting
● Achievement- to control an aspect of self ● Interaction- deals with the clients
● Aggressive-protective- protection and preservation ● Open system- absence of boundary existence
Metaparadigm ● Preposition- if goals are achieved, satisfaction happens
● Person- behavioural system with patterned 3 health needs
● Nursing- external force that acts to preserve the organization 1. Information
● Environment- consists of factors that are not part of BMS 2. Care for illness prevention
3. Total care
Sister Callista Roy Metaparadigm
● Roy Adaptation Model ● Person- existing in open system
● Adaptation- a conceptual framework for nursing ● Health- ability of person to adjust stressors
● Considered a “systems” model ● Environment- process of balance
Defines: ● Nursing- interacts and communicate with the client
● Adaptation- process and outcome whereby thinking and feeling persons
● Nursing- health care profession that focuses on human life processes Ida Jean Orlando
● Nursing science- developing system of knowledge ● Deliberative Nursing Process
● Nursing practice- essential services -motion by the behavior of patient
Goal of Nursing- promotion of adaptation for individuals and groups in 4 adaptive 5 stages
models 1. Assessment-completes a holistic assessment of patient’s needs
2. Diagnosis- uses clinical judgment about health problems
3. Planning- problems identified in the diagnosis
4. Implementation- uses the nursing care plan
5. Evaluation- looks at the progress of the patient
Goal: nurse to act deliberately rather than automatically
Metaparadigm
● Human- an individual in need
● Health- being without physical or emotional discomfort
● Environment- occurs when there’s a nurse-patient contact
Nursing- distinct profession
Hildelgard E. Peplau
● Theory of Interpersonal Relations
● Nursing is therapeutic
● Middle Range theory
Roles of Nurse in Therapeutic Relationship
● Stranger- offering the client the same assistance
● Resource- providing specific answers to questions
● Teacher- helping the client to learn formally or informally
● Leader- offering direction
● Surrogate- substitute
● Counselor- promoting experience
Metaparadigm
● Person- developing organism
● Environment- existing forces
● Health- word symbol that implies forward movement
● Nursing- significant therapeutic interpersonal process
4 Adaptive Models
● Physiological- physical and chemical processes
● Self concept-focuses on psychological and spiritual integrity
● Role function- roles that individuals occupy in society
● Interdependence- close relationship of people and their purpose
Defines:
● Person- holistic human adaptive system
● Health- state and process of becoming integrated and a whole
● Environment- stimulate the person to make adaptive responses
Betty Neuman
● Systems Model Theory
LOD- Line of Defense
● Primary Prevention- reduction of possible risk factors
● Secondary Prevention- reduce the noxious effects
● Tertiary Prevention- adjustment of processes
● Content- comprise the whole client system
● Entropy- process of energy depletion
● Flexible LOD- protective
● Normal LOD- usual state of LOD
LOR- Line of Resistance -series of concentric circles
● Stressors- environmental factors
● Prevention- primary nursing intervention
Defines:
● Person- multidimensional being
● Environment- totality if the internal and external forces
● Health- equated with wellness
● Nursing- unique profession concerned with all variables
Madeleine Leininger ● Environment- human condition and life experiences encountered by the
• Culture Care Diversity and Universality Theory patient
• Mid-range theory ● Nursing- interpersonal process
Metaparadigm
• Person- caring and capable of being concerned about basic needs
• Environment- Not defined
• Nursing- a learned humanistic and scientific profession focused on human care
phenomena
● Professional Nursing Care- formal and cognitively learned professional
care knowledge
● Culturally Congruent (Nursing)
● Ethnonursing- the study of nursing care beliefs
● Transcultural Nursing- evolving knowledge and practices related to new
field

Joyce Travelbee
• Human to Human Relationship Model
-an experience or series of experiences between a nurse and the recipient of his or
her care.
Interactional Phases
• Original Encounter- first impression by the nurse of sick person
• Emerging Identities- the time when relationship begins
• Empathy- the ability to share in the person’s experience
• Sympathy- the nurse wants to lessen the cause of patient’s suffering
• Rapport- describes as nursing interventions
Metaparadigm
● Person- human being
● Health- subjective and objective