CONCEPTUAL MODEL AND NURSING THEORY

PRESENTED BY:
3th GROUP AMIR SYAM EDY HAPSAH NIA ROSAMEY WARDIYAH

Metaparadigm Philosophies

The Holarchy of Contemporary Nursing Knowledge: Five Components

Conceptual Models Theories Methodologies for inquiry and practice
Jacqueline Fawcett, PhD, RN, FAAN Professor, 2006

CONCEPTUAL MODEL & NURSING THEORY

Concept
 Definition:

– an abstraction – creates an image of an idea we want to share – representations of particular aspects of human behavior and characteristics
 Pain  Coping  Grief  Resilience

Alexis Morgan, WWF Canada, Oct 2005

Conceptual Model
A visual method (diagram) of representing a set of causal relationships between factors that believed to impact one or more biodiversity targets.

Alexis Morgan, WWF Canada, Oct 2005

Theory
“…is a general statement that summarizes and organizes knowledge by proposing a general relationship between events - if it is a good one it will cover a large number of events and predict events that have not yet occurred or been observed”
Robson C.

The Holarchy of Contemporary Nursing Knowledge: Theories
One or more relatively concrete and specific concepts that are derived from a conceptual model, the propositions that narrowly describe those concepts, and the propositions that state relatively concrete and specific relations between two or more of the concepts

Jacqueline Fawcett, PhD, RN, FAAN Professor, May, 2006.

NURSING THEORY

Creates a conceptual framework for nursing assessment and intervention Means of interpreting nurses observations Comprises the core content of Nursing

Nursing Theories
 Conceptual

structure that organizes practice and research into ideas central to the discipline theories are reservoirs in which findings related to nursing concepts, such as comfort, healing, recovering, mobility, rest, caring, enabling, fatigue, and family care, are stored.”
Meleis, 1997

 “Nursing

“an internally consistent group of relational statements (concepts, definitions & propositions) that present a systematic view about phenomenon and that is useful for description, explanation, prediction and control. A theory ….is the primary means of meeting the goals of the nursing profession concerned with a clearly defined body of knowledge” Walker & Avant 1996 (cited by Jasper M in Hogston & Simpson))

Conceptual model

Theory

How may it be different ?

Conceptual Model
  abstract impressions organized into symbols of reality  Can be tested, changed, or used to guide research  An early of development theory process

Theory group of concepts that describe a pattern of reality Research questions, study variables Derived of conceptual models

The Holarchy of Contemporary Nursing Knowledge
Metaparadigm Philosophies Conceptual Models Theories Most abstract

Methodologies
Jacqueline Fawcett, PhD, RN, FAAN Professor, May, 2006.

Most concrete

The Holarchy of Contemporary Nursing Knowledge Translated for Empirical Nursing Research
Metaparadigm Philosophies Conceptual Models Theories Empirical Research Methods
Jacqueline Fawcett, PhD, RN, FAAN Professor, May, 2006. Study participants Settings Health conditions Research process Ethical conduct of research Approaches to knowledge development

Research guidelines

Research questions Study variables Research designs Samples Instruments Data analysis techniques

The Holarchy of Contemporary Nursing Knowledge Translated for Nursing Practice
Metaparadigm
Nursing participants Significant others Practice settings Health conditions Nursing process

Philosophies Conceptual Models Theories Practice Methodologies
Jacqueline Fawcett, PhD, RN, FAAN Professor, May, 2006.

Code of ethics Patient’s Rights Philosophy of nursing practice Professional nursing perspective Practice guidelines

Evidence

Standards for Practice Practice Tools Intervention protocols

Theory development
 

   

Starts with defining concepts, Next suggests relationships bxn concepts Tests and evaluates the relationships Modifies theory based on research findings Theories develop and mature Various stages with increasing complexity

SISTER CALLISTA ROY
6 Step Nursing Process : 1.Assesses the behaviours manifested from the four adaptive modes 2.Assess the stimuli, and categorize them into Assess the stimuli, and categorize them into type of stimuli type of stimuli 3.Create a nursing diagnosis of the person’s s adaptive state adaptive state 4.Set goals to improve adaptation 5.Implement interventions to achieve goals Implement interventions to achieve goals 6.Evaluate if goals have been met

Hildegard Peplau Interpersonal Relations Model
• Person An individual; a developing organism who tries to reduce anxiety caused by needs Lives in instable equilibrium • Environment- Not defined

Hildegard Peplau Interpersonal Relations Model

Health

Implies forward movement of the personality and human processes toward creative, constructive, productive, personal, and community living

Hildegard Peplau Interpersonal Relations Model

Nursing – A significant, therapeutic, interpersonal process that functions cooperatively with others to make health possible – Involves problemsolving

Virginia Henderson The Nature of Nursing
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 peaceful death) that he would perform unaided if he had the necessary strength, will, or knowledge.

the theory is useful in :

Dorothe a Orem SelfCare Model

1. developing and guiding practice and research. 2. gives directions to nursing-specific outcomes 3. related to knowing and meeting the therapeutic self-care demands, regulating the development and exercise of self-care agency, establishing self-care and self-management systems, and others. 4. the design of curriculums for preservice, Graduate, and continuing nursing education. 5. gives direction to nursing administration. The development of theory-based computer systems, assessment forms, and the overall structuring of the delivery of care attests to the usefulness of the theory (Tomey & Alligood,2002).

Jean Watson Philosophy and Science of Caring
The nurse’s role is to: 1. Establish a caring relationship with patients 2. Treat patients as holistic beings (body, mind and spirit) 3. Display unconditional acceptance 4. Treat patients with a positive regard 5. Display unconditional acceptance 6. Treat patients with a positive regard 7. Promote health through knowledge and intervention 8. Spend uninterrupted time with patients: “caring moments”

Recently Nursing Care Phenomenon

X Hospital Nurses
m syte nal ctio Fun

Client Y

with

Holistic need

Case:

Tn. Y, 67 thn. MRS X dengan KU: tidak bisa menggerakkan bagian kiri tubuhnya. Bibir mencong ke kanan. Dialami sejak 2 jam SMRS. Riwayat penyakit hipertensi sejak usia 30 tahun. Riwayat merokok satu bungkus per hari sejak usia 12 tahun. Tn. Y adalah seorang pensiunan ABRI. TTV : TD : 200/140 mmHg, P : 36 x/menit, N : 115 x/menit, S: 37,4°C. Pertolongan pertama pada Tn. Y diberikan di unit gawat darurat RS X. Klien ditangani dengan pemberian dan pemberian cairan infus sebagai jalur masuknya obat intravena serta pengawasan terhadap tanda-tanda vitalnya. Sebagian besar tindakan ini dilakukan oleh perawat sesuai dengan instruksi dokter.

In case :

Medical order nurses

assess
documentation

Balanced fluid & electrolit Supervise Vital Sign Give Medicine

client

suffer
Not satisfied
Independent Nothing change

 Kondisi

ruang perawatan: 1 perawat menangani 5 – 10 orang pasien tanpa melihat tingkat ketergantungan pasien.

Analysis

Analisis terhadap pelayanan perawat dalam kasus:
 Askep

tidak diterapkan dengan baik

– Perencanaan tindakan hanya sekedar untuk pendokumentasian. – Implementasi dilakukan tanpa menganalisis masalah klien dan tidak sesuai dengan perencanaan tindakan. – Jarang dilakukan evaluasi tindakan keperawatan.

Lanjutan…
Perhatian perawat yang kurang tentang kemandirian & kepuasan klien.  Perawat tidak mengerti tentang model keperawatan apa yang sedang dilaksanakannya.  Komunikasi terapeutik yang kurang.

Analisis kasus

Masalah keperawatan yang bisa muncul pada klien:
– – – – – – – – Nutrisi kurang dari kebutuhan tubuh Gangguan rasa nyaman Gangguan pola tidur Defisit perawatan diri Hambatan mobilitas fisik Kelemahan Ansietas Kurang pengetahuan

Berdasarkan model Handerson
Kebutuhan klien yang terganggu/tdk terpenuhi :  Kebutuhan akan nutrisi  Kebutuhan isthirahat dan tidur  Kebutuhan akan personal hygiene  Kebutuhan rasa aman dan nyaman  Kebutuhan mobilitas, pengaturan postur  Berkomunikasi dengan orang lain dan mengekspresikan emosi, keinginan, rasa takut dan pendapat.  Kebutuhan belajar.

Handerson’s Model
Manusia yg unik dan holistik 14 KDM Terganggu
Klien

Perawat

Puas
Mandiri
Askep profesional

Sbg central
figure

Menolong klien mencapai kemampuan memenuhi kebutuhannya secara mandiri

sakit

Penurunan kemandirian

Solusi menurut teori Handerson

Pada saat semua itu terjadi seharusnya, perawat ada di samping pasien, mendengarkan keluhannya, memberikan motivasi dan memberikan penjelasan terkait penyakitnya. Seandainya para ahli-ahli keperawatan kita melihat langsung fenomena tersebut, dia akan sangat besedih. Konsep, teori, dan standar asuhan telah dibuat. Namun, implementasinya di lapangan belum optimal.

Dorothea Orem
 Menurut

Orem, bila ditemukan seorang pasien dengan defisit perawatan diri, maka seorang perawat seyogyanya bertindak menuntun, membimbing, mendukung atau menyediakan lingkungan yang akan meningkatkan kemampuan pasien tersebut.

KESIMPULAN

Ada beberapa hal yang menjadi kesimpulan dari makalah ini :
– Perbedaan yang mendasar antara model konseptual dan teori keperawatan adalah bahwa sebuah konsep bisa berkembang menjadi sebuah teori. Konsep lebih menggambarkan simbol-simbol yang abstrak sedangkan teori lebih menggambarkan tentang polapola realita. – Konsep model dan teori keperawatan yang terkait dengan fenomena dalam makalah ini adalah yang dikemukakan oleh Virginia Henderson dan Dorothy E. Orem. – Virginia Henderson mengembangkan keperawatan berdasarkan 14 kebutuhan dasar manusia.

Lanjutan..
– Menurut Henderson, di sinilah letak peran seorang perawat sebagai penolong pasien dalam memenuhi kebutuhan-kebutuhan tersebut – Menurut Orem, bila perawat menemukan seorang individu mengalami defisit perawatan diri, perawat seharusnya menuntun, membimbing, mendukung atau menyediakan lingkungan yang akan meningkatkan kemampuan pasien tersebut. – konsep dan teori sangat berperan penting dalam perkembangan ilmu keperawatan menuju ke profesi keperawatan yang lebih baik.

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