Notre Dame University

GRADUATE SCHOOL
Cotabato City

A Written Report in Philosophy of Science and Theories in Nursing

A Paper Presented to

The Faculty of the Graduate School

Of Notre Dame University, Cotabato City

In Partial Fulfillment

Of the Requirement for the Degree

Masters of Arts in Nursing

Submitted to:

Prof. Norma C. Salgado, RN, MAN

Submitted by:

Dave C. del Rosario, RN

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 FAYE GLENN ABDELLAH
Born on March 13, 1919, in New York City

EDUCATIONAL ACHIEVEMENTS

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 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 B.Sc 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 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. She explained the role of nurses

to include care of families and the elderly.

 She worked in many setting. 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.

WHAT HAS INFLUENCED FAYE ANDELLAH IN THE DEVELOPMENT HER OWN

MODEL OF NURSING

 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.

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 ABDELLAH’S TYPOLOGY OF 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 prevention of accident, injury, or other trauma and through

the prevention of the spread of infection

4. To maintain good mechanics and prevent and correct deformity.

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 recognize the physiological responses of the body to dieses condition- pathological,

physiological, and compensatory.

10. To facilitate the maintenance of regulatory mechanisms and functions.

11. To facilitate the maintenance of sensory function.

REMEDIAL CARE NEEDS:-

12. To identify and accept positive and negative expressions, feelings and reactions. 13.

To identify and accept interrelatedness of emotions and organic illness.

14. To facilitate the maintenance of effective verbal and nonverbal communication.

15. To promote the development of productive interpersonal relationships.

16. To facilitate progress toward achievement of personal spiritual goals.

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

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 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 cause of illness.

THEORETICAL ASSUMPTIONS

 The language of Abdellah’s framework is readable and clear.

 Consistent with the decade in which she was writing, she uses the term ‘she’ for nurses,

‘he’ for doctors and patients.

 Assumptions are related to change and anticipated change that affect nursing.

 The need to appropriate the interconnectedness of social enterprises and social problem;

 The impact of problems such as poverty, racism, pollution, education and so forth on

health care delivery;

 Correct identification of nursing problems influences the judgment in selecting the next

step in solving the client nursing problems.

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 ABDELLAH’S METAPARADIGM INNURSING

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

 In patient –centered approaches to nursing, Abdellah describes health as a state mutually

exclusive of illness.

 Although Abdellah 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 services.

ENVIRONMENT/SOCIETY

 The environment is implicitly defined by Abdellah as the home or community from which

patient comes.

 Society in included in “planning for optimum health”.

 However, as Abdellah further delineated her ideas, the focus of nursing service is clearly

the individual.

NURSING

 Nursing is a helping profession.

 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.

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 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.

STEPS TO IDENTIFY THE CLIENT’S PROBLEM

 Learn to know the patient

 Sort out relevant and significant data

 Make generalizations about available data in relation to similar nursing problems

presented by other patients

 Identify the therapeutic plan

 Validate the patient's conclusions about his nursing problems

11 NURSING SKILLS

 Observation of health status

 Skills of communication

 Application of knowledge

 Teaching of patients and families

 Planning and organization of work

 Use of resource materials

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 Use of personnel resources

 Problem solving

 Direction of work of others

 Therapeutic use of the self

 Nursing procedure.

THEORETICAL ASSERTIONS

 “The nursing problem and nursing treatment typologies are the principles of nursing

practice and constitute the unique body of knowledge that is nursing”

 “Correct identification of the nursing problem influences the nurse’s judgment in

selecting steps in solving the patient’s problem

 The core of nursing is the patient/client problems that focus on the patient and his/her

problems.

LOGICAL FORM

 The logical form is best described as an inductive approach that generalized from

particulars. Abdellah used her multiple observations from the previously mentioned studies as the

basis for her typology. Therefore the typology developed inductively from research toward

theory.

PRACTICE

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 Abdellah’s typology of 21 nursing problems helps practice in an organized, systematic way.

The use of this scientific base enabled the nurse to understand the reasons for his or her

actions. Using the 21 nursing problems, the clinical practitioner could assess the patient,

make a nursing diagnosis

 Abdellah’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, implementation and

evaluation.

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 educators were aware that changes were needed if nurses were to become

autonomous.

 They recognized that the greatest weakness in the profession was the lack of a scientific body

of knowledge unique to nursing.

RESEARCH

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 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 diagnosis

 Function studies examined the amount of time the nurse spent with the patient.

 Abdellah and Strachman extended the research and used the typology as the basis for

developing the nursing care model used for planning staffing patterns in clinical settings.

 Abdellah envisioned that patient are consisted of intensive care, intermediate care, long term

care, self-care, and home-care units. By grouping patients according to similar needs rather

than by diagnoses, nursing service could provide the best staffing patterns to meet patients’

needs.

 1965 – Abdellah and Levine –“ Better Patient Care Through Nursing Research, the first

major textbook in nursing research.

CRITIQUE

CLARITY

 Semantic

o Short

o Concise

o Straight-forward

 Structure

o Clear

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 o Easy for nurses to follow

o Step by step guide

SIMPLICITY

 The typology is very simple and it is descriptive of the nursing problems

thought to be common among patients.

 The concepts of nursing, nursing problems, and problem solving process,

which are central to this work, are defined explicitly.

 The concepts of person, health, and environment, which are associated

with the nursing paradigm today, are implied

 This model has a limited number of concepts and its only structure is a list.

A somewhat mixed approached to concept.

 Nursing and nursing problems are connotatively defined, whereas the

problem solving process is defined denotatively.

GENERALITY

 The 21 nursing problems are general and linked to neither time nor

environment

 There should be more emphasis on environment.

 Use of the typology of 21 nursing problems to focus on the psychosocial

and emotional needs that patients present.

 The broadest goal is to affect nursing education positively; whereas sub

goals are to provide a scientific basis for practice and to provide a method

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 of qualitative evaluation of educational experiences for students. The goals

are appropriate for nursing.

EMPERICAL PRECISION

 The concepts are very specific with empirical referents that are easily

identifiable. It is within the domain of nursing

 Ready linkage of the concepts and the typology to reality is secondary to

an inductive approach to theory development.

DERIVABLE CONSEQUENCES

 The typology provided a general framework, but despite the title of the

book “ Patient-Centered Approaches to Nursing, it neither continued

specific nursing actions nor patient-centered outcomes.

 The emphasis on problem solving is not limited by time or space and

therefore provides a means for continued growth and change in the

provision of nursing care.

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