Introduction.

Faye Glenn Abdellah was one of the most influential nursing theorist and public health
scientist. It is extremely rare to find someone who has dedicated all her life to the
advancement of the nursing profession and accomplished this feat with so much distinction
and merit.

Biography.
 Faye Glenn Abdellah was born on March 13, 1919 in New York City.
 Educational achievements.
In 1942, Abdellah earn a nursing diploma from Fitkin Memorial Hospital’s
School of Nursing, New Jersey. She received her Bachelor of Science degree in 1945,
a Master of Arts degree in 1947 and Doctor of Education in Teacher’s College,
Columbia University. In 1947 she also took Master of Arts degree in physiology in
1955.
 As an educator and researcher.
Abdellah went on to become a nursing instructor and researcher and helped
transform the focus of the profession from disease centered to patient centered. See
expanded the role of nurses to include care of families and the elderly. She worked
in many settings, She had been a staff nurse, a head nurse, a faculty member at Yale
University and at Columbia University, a public health nurse, a researcher, and an
author of more than 147 articles and books.

Faye Glen Abdellah’s theory twenty one nursing problems.

Three major categories.
1. Physical, sociological, and emotional needs of clients.
2. Types of interpersonal relationships between the nurse and patient.
3. Common elements of client care.

21 nursing problems basic to all patients.

1. To maintain good hygiene and physical comfort.
2. To promote optimal activity: exercise, rest and sleep.
3. To promote safety through the prevention of accidents, injury or other trauma and
through the prevention of the spread of infection.
4. To maintain good body mechanics and prevent and correct deformities.
Sustenal Care needs.
5. To facilitate the maintenance of a supply of oxygen to all body cells.
6. To facilitate the maintenance of nutrition of all body cells.
7. To facilitate the maintenance of elimination.
8. To facilitate the maintenance of fluid and electrolyte balance.
9. To recognise the physiological responses of the body to disease conditions.
10. To facilitate the maintenance of regulatory mechanisms and functions.
 11. To facilitate the maintenance of sensory functions.
Remedial care needs.
12. To identify and accept positive and negative expressions, feelings and reactions.
13. To identify and accept the interrelatedness of emotions and organic illness.
14. To facilitate the maintenance of effective verbal and non-verbal communication.
15. To promote the development of productive interpersonal relationships.
16. To facilitate progress towards achievement of personal spiritual goals.
17. To create and /or maintain a therapeutic environment.
18. To facilitate awareness of self as an individual with varying physical, emotional and
developmental needs.
Restorative care needs.
19. To accept the optimum possible goals in the light of limitations, physical and
emotional.
20. To use community resources as an aid in resolving problems arising from illness.
21. To understand the role of social problems as influencing factors in the case of
illness.

10 steps to identify the client’s problem.

1. Learn to know the patient.
2. Sort out relevant and significant data.
3. Make generalization about available data in relation to similar nursing problems
presented by other patients.
4. Identify the therapeutic plan.
5. Test generalizations with the patient and make additional generalizations.
6. Validate the patient’s conclusion about his nursing problems.
7. Continue to observe and evaluate the patient over a period of time to identify any
attitudes and clues affecting his behaviour.
8. Explored the patient’s and family’s reaction to the therapeutic plan and involve them
in the plan.
9. Identify how the nurses feels about the patient’s nursing problem.
10. Discuss and develop a comprehensive nursing care plan.

11 Nursing Skills.
1. Observation of health status.
2. Skills of communication.
3. Application of knowledge.
4. Teaching of patients and families.
5. Planning and Organization of work.
6. Use of resource materials.
7. Use of personal resources.
8. Problem-solving.
 9. Direction of work of others.
10. Therapeutic use of the self.
11. Nursing procedures.

Abdellah’s theory and the four major concepts.

1. Nursing:
 Nursing is a helping profession. In Abdellah’s model, nursing care is doing
something to or for the person or providing information to the person with
the goal of meeting needs, increasing or restoring self-help ability, or
elevating impairment.
 Nursing is broadly grouped into the 20 one problem areas to guide, care and
promote use of nursing judgment.
 She considers nursing to be comprehensive service that is based on art and
science and aims to help people, sick or well, cope with their health needs.
2. Person:
 Abdellah describes people as having physical, emotional, and sociological
needs. These needs may overt, consisting of largely physical needs or covert,
such as emotional and social needs.
 Patient is described as the only justification for the existence of nursing.
 Individuals and families are the recipients of nursing.
 Health, or achieving of it, is the purpose of nursing services.
3. Health:
 In patient centered approaches to nursing, Abdellah describes health as a
state mutually exclusive of illness.
 Although Abdallah does not give a definition of health, she speaks to “total
health needs” and “a healthy state of mind and body” in her description of
nursing as a comprehensive service.
4. Society or Environment:
 Society is included in “planning for optimum health on local, state, national
and international levels”. However, as she further delineated her ideas, the
focus of nursing service is clearly the individual.
 The environment is the home or community from which patient comes.

Abdellah’s Work and Characteristics of a Theory.

A. Characteristic 1.
 Abdellah’s theory has interrelated the concepts of health, nursing problems
and problem solving as she attempts to create a different way of viewing
nursing phenomenon.
 The result was the statement that nursing is the use of problem-solving
approach with key nursing problems related to health needs of people.
B. Characteristic 2.
 Problem solving is an activity that is inherently logical in nature.
 C. Characteristic 3.
 Framework seems to focus quite heavily on nursing practice and individuals.
This somewhat limits the ability to generalise although the problem-solving
approach is readily generalised to clients with specific health needs and
specific nursing problems.
D. Characteristic 4.
 One of the most important questions that arise when considering her work is
the role of client within the framework. This question could generate
hypothesis for testing and thus demonstrates the ability of Abdellah’s work
to generate hypothesis for testing.
E. Characteristic 5.
 The results of testing such hypothesis could contribute to the general body of
nursing knowledge.
F. Characteristic 6.
 Abdellah’s problem solving approach can easily be used by practitioners to
guide various activities within their practice. This is true when considering
nursing practice that deals with clients who have specific needs and specific
nursing problems.
G. Characteristic 7.
 Although consistency with other theories exits, many questions remained
unanswered.

Use of 21 problems in the nursing process.

Assessment phase.
 Nursing problems provide guidelines for the collection of data.
 A principle underlying the problem-solving approach is that for each
identified problem, pertinent data are collected.
 The overt or covert nature of the problems necessitates direct or indirect
approach, respectively.

Nursing diagnosis
 The results of data collection would determine the client’s specific overt or
covert problems.
 These specific problems would be grouped under one or more of the broader
nursing problems.
 This step is consistent with the involved in nursing diagnosis.

Planning phase.
  The statements of nursing problems most closely resemble goal statements.
Therefore, once the problem has been diagnosed, the goals have been
established.
 Given that these problems are called nursing problems, it becomes
reasonable to conclude that these goals are basically nursing goals.

Implementation.
 Using the goals as the framework, a plan is developed and appropriate
nursing interventions are determined.

Evaluation
 According to the American Nurses’ Association Standards of Nursing practice,
the plan is evaluated in terms of client’s progress or lack of progress towards
the achievement of the stated goals.
 This would be extremely difficult if not possible to do for Abdellah’s nursing
problem approach since it has been determined that the goals are nursing
goals, not the client goals.
 Thus, the most appropriate evaluation would be the nurse progress or lack of
progress towards the achievement of the stated goals.

Application of Abdellah theory.

Nursing practice.
 Abdellah’s theory help transform the focus of the profession from being disease -
centered to patient-centered.
 The theory categories nursing problems based on the individuals need and
developed a typology of nursing treatment and nursing goals which served as a basis
for determining and organising nursing care.
 The 21 nursing problems made nurses look at patients problem and plan nursing
care in a thorough and organised way.
 Client centered care emphasizes the principle that every nursing goal should be
geared towards treating the patient and not just the mere illness.
 It has ultimately helped nurses develop their individual critical-thinking skills leading
to increase in job satisfaction and more productive nurse-patient and nurse-family
interaction.
 Because of the strong, nurse-centered orientation in the 21 nursing problems, their
use in the nursing process is primarily to direct the nurse, indirectly the client
benefits.
 Abdellah’s theory helps the practicing nurse organised the administration of care,
nursing strategies and provides a scientific basis for making decisions.
Nursing education
 Abdellah theory can be used to organise teaching contents for nursing students to
evaluate a student’s performance in a clinical area, or both.

Nursing research
 Abdellah’s topology gave birth to more nursing research and studies.

Limitations.
 Very strong nursing centered orientation.
 Little emphasis on what the client is to achieve.
 Her framework is inconsistent with the concept of holism.
 Potential problems might be overlooked.

Conclusion.
 Abdellah’s theory provides a basic for determining and organising nursing care. The
problems also provide a basis for organising appropriate nursing strategies.
 It is anticipated that by solving the nursing problems, the client would be moved
toward health. The nurse’s philosophical frame of reference would determine
whether this theory and the 21 nursing problems would be implemented in practice.

Application.
The case of Simar.
He experienced severe chest pain. In addition, he experienced shortness of breath,
tachycardia, and profuse diaphoresis.

Assessment reveals:
Past history: he had
cardiac damage.
gone through similar
episodes since past two
years.
Main problems.

PAIN

Impaired cardiac functioning.

Work related stress.

Failure to seek medical attention.

Stages of illness. Abdellah nsg NSG interventions. NSG interventions

problem
Basic to care. 1.To maintain good 1. Administer Amount of pain.
hygiene and physical oxygen.
comfort. 2. Elevate headrest.
3. Re position of
client.
4. Administer
analgesics as
advised.
Susternal care 5 to facilitate the 1.Promote rest. Vital signs.
needs. maintenance of 2. Place in sitting
supply of oxygen to position.
body cells. 3. Promote the
breathing and
coughing exercise.
4. Implement
exercises as
 tolerated.
Remedial care 13 to identify and 1.To find the nature Knowledge of
needs. accept the inter of his job. relationship
relatedness of 2. Explore his work- between stress and
emotional and related goal. his illness.
organic illness. 3. Stress associated
with jobs.
Restorative care 20 to use 1.Teach early signs Knowledge about
needs. community and symptoms of the use of
resources as an aid cardiac distress. community
in resolving 2. Teach course of resources.
problems arising action.
from illness.