M.

Sc DEGREE COURSE IN NURSING

ADVANCED NURSING PRACTICE

UNIT – VI
Philosophy and Theories of Nursing

Abdullah's Theory

DR. T.JAYADEEPA
VICE PRINCIPAL
 OBJECTIVES

• The students will be able to,

• Know about the theorist

• Metaparadigms

• 21 Typology of problems

• Application of theory

• Strength & weakness of theory

Faye Glenn Abdellah was
one of the most influential
nursing theorist and public
health scientists . It is
extremely rare to find
someone who has
dedicated all her life to the
advancement of the
nursing profession and
accomplish 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 earned a nursing diploma

from Fitkin Memorial Hospital's School of
Nursing New Jersey (now Ann May School of
Nursing).
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.
 As an Educator

Abdellah went on to become a nursing instructor and

researcher and helped transform the focus of the profession
from disease centered to patient centered. She 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.
She was selected as Deputy Surgeon General in 1982.
She retired in 1989.
 Influence the author to make theory

1937 – She wanted to be a nurse on the day she saw

Hindenburg explode.
1949 – She spent 40 years in Public Health Service where
she first became involved in research, being assigned to
perform studies to improve nursing practices.
1960 – She was influenced by the desire to promote client-
centered comprehensive nursing care.
 21 Typology of Nursing care

BASIC TO ALL PATIENTS

1.To maintain good hygiene and physical comfort – After colonoscopy,
patients are usually soiled from the procedure. It is therefore important
to clean them properly. Physical comfort through proper positioning in
bed.
2.To promote optimal activity: exercise, rest, and sleep – Patients who
were sedated during the procedure stay in the unit until the effect of the
sedation has decreased to a safe level. As a
nurse, make sure the patients are able to rest and sleep well by
providing a conducive environment for rest, such as decreasing
environmental noise and dimming the light if necessary.
3.To promote safety through prevention of accident, injury, or
other trauma and through the prevention of the spread of
infection – Making sure
the side rails are always up when leaving the patient . one way
we prevent the spread of infection is through proper
disinfection of the equipments .

4.To maintain good body mechanics and prevent and

correct deformity – Positioning the patient
properly, allowing for the normal anatomical position of body
parts.
5. facilitate the maintenance of a supply of oxygen to all body cells
– when patients manifest breathing problems, oxygen is attached
to them, usually via nasal cannula. Sedated patients are attached
to cardiac monitor and pulse oxi meter while having the oxygen
delivered. When the oxygen saturation falls below the normal
levels, the rate of oxygen is increased accordingly, as per
physician's order.

6. To facilitate the maintenance of nutrition of all body cells – patients

undergoing endoscopic procedures are on NPO. For this reason it is
important to monitor the blood glucose level. When the patient's blood
glucose falls from the normal value, we inject D50W to the patient or we
change the patient's IVF to a dextrose containing fluid.
7. To facilitate the maintenance of elimination – Providing
bedpans or urinals to patients and at times, insertion of
Foley catheter when the patient is not able to void.

8. To facilitate the maintenance of fluid and electrolyte

balance – Proper regulation of the intravenous solutions as

well as proper incorporations it may have. An example is
when patients have low serum potassium; KCl is
incorporated in the solution.
9.To recognize the physiological responses of the body to
disease conditions—pathological, physiological, and
compensatory – it is important to check the patients for signs of
internal gastrointestinal bleeding by monitoring the blood
pressure and cardiac rate.

10.To facilitate the maintenance of regulatory mechanisms and

functions – When a patient has a difficulty in breathing and is
showing an increase respiratory rate, elevating the head part of
the bed is done to facilitate the respiratory function.
 11. To facilitate the maintenance of sensory function –
Sometimes there are semi-conscious patients, in these cases,
it is still necessary to talk to them while performing nursing
interventions to maintain their auditory sense.
12. To identify and accept positive and negative expressions, feelings, and
reactions – most patients feel anxious before undergoing the
procedures. It is necessary to listen to the patients' expressions and
allow them to ask questions. To decrease their anxiety, proper
instructions are given, what they are to expect, how long the procedure
will take, what they should do during and after the procedure as well as
other concerns.

13. To identify and accept interrelatedness of emotions and organic illness

– Encourage patients to verbalize their feelings and allow them to cry
when they have the need to do so will help them emotionally. Some
patients are diagnosed with malignancy after the procedure and during
this time the emotional needs of the patient is a priority.
• 14. To facilitate the maintenance of effective verbal and nonverbal
communication – when patients are not able to express themselves
verbally, it is important to assess for nonverbal cues. For instance
when patients are in pain, assessing for facial grimacing.

15. To promote the development of productive interpersonal

relationships – allow the patient's significant others to stay with the
patient before and after the procedure. This allows for bonding and
promotes interpersonal relationship.
• 16. To facilitate progress toward achievement of personal
spiritual goals – nurse usually visits the patients in the unit.
Patients may benefit from this, allowing them time to practice
their faith.

17. To create and/or maintain a therapeutic environment -

providing proper lighting, proper room temperature, a quiet
environment are done to patients staying in the unit.
18. To facilitate awareness of self as an individual with varying
physical, emotional, and developmental needs – care to
patients vary according to their developmental needs. Allowing
the parents to stay during the procedure help the pediatric
patients in their emotional and developmental needs.
19. To accept the optimum possible goals in the light of limitations,
physical, and emotional – The goals for each patient vary depending on
the capability of the patient. The nutritional goal for a patient with a
PEG tube for instance will be
different, knowing that the patient has limited feeding options.
20. To use community resources as an aid in resolving problems arising
from illness – Some patients live far from the city and thus referral to
health centers is sometimes done.
 21. To understand the role of social problems as influencing
factors in the cause of illness – Some patients who are
diagnosed with amoebic colitis for instance are advised to
avoid buying street foods to which the preparation they are not
sure of, and also avoid drinking water that are not safe.
MAN / 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,
sociological and interpersonal
needs- which are often missed and
perceived incorrectly
The individuals (and families) are the
recipients of nursing, and health, or
achieving of it, is the purpose of
nursing services.
Health

Emphasis should be placed upon

prevention and rehabilitation. Holistic
approach must be taken by the nurse to
help the client achieve state of health.
However the nurse must accurately
identify the lacks or deficits regarding
health that the client is experiencing.
These lacks or deficits are the client’s
health needs.
ENVIRONMENT

 The environment is implicitly defined

by Abdellah as the home or community
from which patient comes. Society is
included in “planning for optimum
health.” However, as Abdellah further
delineated her ideas, the focus of
nursing service is clearly the individual.
NURSING

 These would mean a comprehensive nursing

service, this would include:
1. Recognizing the nursing problems of the
patient.
2. Deciding the appropriate actions to take in
terms of relevant nursing principles.
3. Providing continuous care of the
individual’s total health needs.
4. Providing continuous care to relieve pain and
discomfort.
5. Adjusting total nursing care plan to meet
the patient’s individual needs.
6.Helping the individual to become more self directing in attaining or
maintaining a healthy state of mind and body.

7.Instructing nursing personnel and family to help the individual

8.Helping the individual to adjust to his limitations and emotional problems.
9.Working with allied health professional in planning for optimum health
Carrying out continuous evaluation and research to improve nursing
techniques and to develop new techniques to meet all the health needs of the
people.
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 personnel resources
8. Problem-solving
9. Direction of work of others
10.Therapeutic use of the self
11.Nursing procedures
 Physical, Sociological,
emotional Needs

Common
Elements Of Interpersonal
Patient Area Relationship
PURPOSES
Nursing Practice
Abdeallah’s main goal is the
improvement of the nursing education.
The most important impact of
Abdellah’s theory to the nursing
practice is that it helped transform the
focus of the
profession from being “disease-
centered” to “patient-centered.”
The steps of the nursing process are
assessment, diagnosis, planning,
implem entation and evaluation
NURSING EDUCATION
 Professors and educators realized
the importance of client centered
care rather than focusing on medical
interventions. Nursing education then
slowly deviated its concentration from
the
complex, medical concepts, into
exercising better attention to the
client as the primary concern.
It’s very strong nurse-centered
orientation—is, on the other hand, it’s
major contribution to nursing
education.
NURSING RESEARCH

 Her theories continue to guide researchers to

focus on the body of nursing knowledge itself,
the identification of patient problems, the
organization of nursing interventions, the
improvement of nursing education, and the
structure of the curriculum.
 The extensive research done regarding the
patient’s needs and problems has served as a
foundation for the development of what is now
known as nursing diagnoses.
 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 a 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 that involved in nursing diagnosis
 PLANNING PHASE
 The statements of nursing problems most closely resemble goal
statements. Once the problem has been diagnosed, the nursing
goals have been established.
IMPLEMENTATION
Using the goals as the framework, a plan is developed
and
appropriate nursing interventions are determined.

EVALUATION
The most appropriate evaluation would be the nurse
progress or lack of progress toward the achievement of
the stated goals..
How to apply theory in to practice?
 STRENGHTS

(1)As logical and simple statement, Abdullah's problem

solving approach can easily be used by practitioner to
guide various activities within the nursing practice.
(2)The theoretical statement places more emphasis on
problems solving, an activity that is inherently logical in
nature.
(3)The problems solving approach is readily generalizable to
client with specific health needs and specific nursing
problems.
The major limitation of Abdellah theory and the twenty one
nursing problems is their very strong nursing centered
orientation. With the orientation appropriate use might be
the organization of teaching content for nursing students,
the evaluation of a students, performance in the clinical area
or both. But in terms of client care there is little emphasis
on what the client is to achieve.
Using Abdellah’s concepts of health, nursing problems, and
problem solving, the theoretical statement of nursing that can
be derived is the use of the problem solving approach with
key nursing problems related to health needs of people.
From this framework, 21 nursing problems were developed.
Abdellah’s theory provides a basis for determining and
organizing nursing care. The problems also provide a basis
for organizing appropriate nursing strategies.
 BIBLIOGRAPHY

1. Basavanthappa B.T, “Nursing Theories, Jaypee Brothers,

medical publishers (p) LTD, NewDelhi, 2007.PP. 52-60.

2. Melanie & Evelyh, “ Theoretical Basic for Nursing”,

Lippincott company, Philadelphia, 2001, pp 130-133.

3. Pasker marilya.” Nursing Theories and Nursing Practice”,

Davis company, Philadelphia, 2001, pp: 11-12.