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Abueg, Dorothy Rose S.

BSNIV-B1

July 18, 2011 Elective Assignment

VIRGINIA HENDERSON
14 BASIC HUMAN NEEDS THEORY:

Breathe normally. Eat and drink adequately. Eliminate body wastes. Move and maintain desirable postures. Sleep and rest. Select suitable clothes-dress and undress. Maintain body temperature within normal range by adjusting clothing and modifying environment Keep the body clean and well groomed and protect the integument Avoid dangers in the environment and avoid injuring others. Communicate with others in expressing emotions, needs, fears, or opinions. Worship according to ones faith. Work in such a way that there is a sense of accomplishment. Play or participate in various forms of recreation. Learn, discover, or satisfy the curiosity that leads to normal development and health and use the available health facilities.

CONCEPTS:
Individual Have basic needs that are component of health. Requiring assistance to achieve health and independence or a peaceful death. Mind and body are inseparable and interrelated. Considers the biological, psychological, sociological, and spiritual components. The theory presents the patient as a sum of parts with biopsychosocial needs, and the patient is neither client nor consumer. Environment Settings in which an individual learns unique pattern for living. All external conditions and influences that affect life and development. Individuals in relation to families Minimally discusses the impact of the community on the individual and family. Supports tasks of private and public agencies Society wants and expects nurses to act for individuals who are unable to function independently. In return she expects society to contribute to nursing education. Basic nursing care involves providing conditions under which the patient can perform the 14 activities unaided Health

Definition based on individuals ability to function independently as outlined in the 14 components. Nurses need to stress promotion of health and prevention and cure of disease.

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Abueg, Dorothy Rose S. BSNIV-B1

July 18, 2011 Elective Assignment

Good health is a challenge. Affected by age, cultural background, physical, and intellectual capacities, and emotional balance Is the individuals ability to meet these needs independently? Nursing Temporarily assisting an individual who lacks the necessary strength, will and knowledge to satisfy 1 or more of 14 basic needs. Assists and supports the individual in life activities and the attainment of independence. Nurse serves to make patient complete whole", or "independent." The nurse is expected to carry out physicians therapeutic plan Individualized care is the result of the nurses creativity in planning for care. Use nursing research o Categorized Nursing : nursing care o Non nursing: ordering supplies, cleanliness and serving food. In the Nature of Nursing that the nurse is and should be legally, an independent practitioner and able to make independent judgments as long as s/he is not diagnosing, prescribing treatment for disease, or making a prognosis, for these are the physicians function. Nurse should have knowledge to practice individualized and human care and should be a scientific problem solver. In the Nature of Nursing Nurse role is, to get inside the patients skin and supplement his strength will or knowledge according to his needs. And nurse has responsibility to assess the needs of the individual patient, help individual meet their health need, and or provide an environment in which the individual can perform activity unaided Henderson's classic definition of nursing "I say that the nurse does for others what they would do for themselves if they had the strength, the will, and the knowledge. But I go on to say that the nurse makes the patient independent of him or her as soon as possible."

APPLICATION:

Assist nurses to describe, explain, and predict everyday experiences. Serve to guide assessment, interventions, and evaluation of nursing care. Provide a rationale for collecting reliable and valid data about the health status of clients, which are essential for effective decision making and implementation. Help to describe criteria to measure the quality of nursing care. Help build a common nursing terminology to use in communicating with other health professionals. Ideas are developed and words are defined. Enhance autonomy (independence and self-governance) of nursing through defining its own independent functions.

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Abueg, Dorothy Rose S. BSNIV-B1 21 NURSING PROBLEMS THEORY:

July 18, 2011 Elective Assignment

FAYE GLENN ABDELLAH

Three major categories Physical, sociological, and emotional needs of clients Types of interpersonal relationships between the nurse and patient Common elements of client care BASIC TO ALL PATIENTS To maintain good hygiene and physical comfort To promote optimal activity: exercise, rest and sleep To promote safety through the prevention of accidents, injury, or other trauma and through the prevention of the spread of infection To maintain good body mechanics and prevent and correct deformity SUSTENAL CARE NEEDS To facilitate the maintenance of a supply of oxygen to all body cells To facilitate the maintenance of nutrition of all body cells To facilitate the maintenance of elimination To facilitate the maintenance of fluid and electrolyte balance To recognize the physiological responses of the body to disease conditions To facilitate the maintenance of regulatory mechanisms and functions To facilitate the maintenance of sensory function. REMEDIAL CARE NEEDS To identify and accept positive and negative expressions, feelings, and reactions To identify and accept the interrelatedness of emotions and organic illness To facilitate the maintenance of effective verbal and non verbal communication To promote the development of productive interpersonal relationships To facilitate progress toward achievement of personal spiritual goals To create and / or maintain a therapeutic environment To facilitate awareness of self as an individual with varying physical , emotional, and developmental needs RESTORATIVE CARE NEEDS To accept the optimum possible goals in the light of limitations, physical and emotional To use community resources as an aid in resolving problems arising from illness To understand the role of social problems as influencing factors in the case of illness

CONCEPT:
Nursing Nursing is a helping profession. In Abdellahs model, nursing care is doing something to or for the person or providing information to the person with the goals of meeting needs, increasing or restoring self-help ability, or alleviating impairment. Nursing is broadly grouped into the 21 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.

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Abueg, Dorothy Rose S. BSNIV-B1


Person

July 18, 2011 Elective Assignment

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.

Health

In PatientCentered 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 service.

Society and 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.

APPLICATION:

Nurses can give better patient care through the organization of hospital facilities, services and staff around the changing medical and nursing needs of the patient Nurses can now care for the right patient in the right bed with the right services at the right time

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Abueg, Dorothy Rose S. BSNIV-B1

July 18, 2011 Elective Assignment

JOYCE TRAVELBEE
HUMAN TO HUMAN RELATIONSHIP MODEL THEORY:

Travelbee believed nursing is accomplished through human-to-human relationships that begin with the original encounter and then progress through stages of emerging identities, developing feelings of empathy, and later feelings of sympathy. The nurse and patient attain a rapport in the final stage. For meeting the goals of nursing it is a prerequisite to achieving a genuine human-to-human relationship. This relationship can only be established by an interaction process. It has five phases. o The inaugural meeting or original encounter o Visibility of personal identities/ emerging identities. o Empathy o Sympathy o Establishing mutual understanding and contact/ rapport Travelbee's ideas have greatly influenced the hospice movement in the west.

CONCEPT:
Person

Person is defined as a human being. Both the nurse and the patient are human beings.

Health Health is subjective and objective. Subjective health is an individually defined state of well being in accord with self-appraisal of physical-emotional-spiritual status. Objective health is an absence of discernible disease, disability of defect as measured by physical examination, laboratory tests and assessment by spiritual director or psychological counselor. Environment Environment is not clearly defined. Nursing "an interpersonal process whereby the professional nurse practitioner assists an individual, family or community to prevent or cope with experience or illness and suffering, and if necessary to find meaning in these experiences.

APPLICATION:

Nurses are responsible for helping the patient avoid and alleviate the distress of unmet needs. Nurse must have a systematic intellectual approach to the patient's situation. Nurse has a responsibility to help individuals and their families to find meaning. Nurse's job is to help the patient to maintain hope and avoid hopelessness.

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Abueg, Dorothy Rose S. BSNIV-B1

July 18, 2011 Elective Assignment

BETTY NEUMAN
SYSTEM MODEL IN NURSING PRACTICE THEORY:
PERSON VARIABLES Each layer, or concentric circle, of the Neuman model is made up of the five person variables. Ideally, each of the person variables should be considered simultaneously and comprehensively. 1. Physiological - refers of the physicochemical structure and function of the body. 2. Psychological - refers to mental processes and emotions. 3. Sociocultural - refers to relationships; and social/cultural expectations and activities. 4. Spiritual - refers to the influence of spiritual beliefs. 5. Developmental - refers to those processes related to development over the life span. CENTRAL CORE The basic structure, or central core, is made up of the basic survival factors that are common to the species (Neuman, 1995, in George, 1996). These factors include: system variables, genetic features, and the strengths and weaknesses of the system parts. Examples of these may include: hair color, body temperature regulation ability, functioning of body systems homeostatically, cognitive ability, physical strength, and value systems. The person's system is an open system and therefore is dynamic and constantly changing and evolving. Stability, or homeostasis, occurs when the amount of energy that is available exceeds that being used by the system. A homeostatic body system is constantly in a dynamic process of input, output, feedback, and compensation, which leads to a state of balance. FLEXIBLE LINES OF DEFENSE The flexible line of defense is the outer barrier or cushion to the normal line of defense, the line of resistance, and the core structure. If the flexible line of defense fails to provide adequate protection to the normal line of defense, the lines of resistance become activated. The flexible line of defense acts as a cushion and is described as accordion-like as it expands away from or contracts closer to the normal line of defense. The flexible line of defense is dynamic and can be changed/altered in a relatively short period of time. NORMAL LINE OF DEFENSE The normal line of defense represents system stability over time. It is considered to be the usual level of stability in the system. The normal line of defense can change over time in response to coping or responding to the environment. An example is skin, which is stable and fairly constant, but can thicken into a callus over time. LINES OF RESISTANCE The lines of resistance protect the basic structure and become activated when environmental stressors invade the normal line of defense. Example: activation of the immune response after invasion of microorganisms. If the lines of resistance are effective, the system can reconstitute and if the lines of resistance are not effective, the resulting energy loss can result in death. RECONSTITUTION Reconstitution is the increase in energy that occurs in relation to the degree of reaction to the stressor. Reconstitution begins at any point following initiation of treatment for invasion of

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Abueg, Dorothy Rose S. BSNIV-B1

July 18, 2011 Elective Assignment

stressors. Reconstitution may expand the normal line of defense beyond its previous level, stabilize the system at a lower level, or return it to the level that existed before the illness. STRESSORS The Neuman Systems Model looks at the impact of stressors on health and addresses stress and the reduction of stress (in the form of stressors). Stressors are capable of having either a positive or negative effect on the client system. A stressor is any environmental force which can potentially affect the stability of the system: they may be: o Intrapersonal - occur within person, e.g. emotions and feelings o Interpersonal - occur between individuals, e.g. role expectations o Extra personal - occur outside the individual, e.g. job or finance pressures The person has a certain degree of reaction to any given stressor at any given time. The nature of the reaction depends in part on the strength of the lines of resistance and defense. By means of primary, secondary and tertiary interventions, the person (or the nurse) attempts to restore or maintain the stability of the system. PREVENTION As defined by Neuman's model, prevention is the primary nursing intervention. Prevention focuses on keeping stressors and the stress response from having a detrimental effect on the body. Primary -Primary prevention occurs before the system reacts to a stressor. On the one hand, it strengthens the person (primarily the flexible line of defense) to enable him to better deal with stressors, and on the other hand manipulates the environment to reduce or weaken stressors. Primary prevention includes health promotion and maintenance of wellness. Secondary-Secondary prevention occurs after the system reacts to a stressor and is provided in terms of existing systems. Secondary prevention focuses on preventing damage to the central core by strengthening the internal lines of resistance and/or removing the stressor. Tertiary -Tertiary prevention occurs after the system has been treated through secondary prevention strategies. Tertiary prevention offers support to the client and attempts to add energy to the system or reduce energy needed in order to facilitate reconstitution.

CONCEPTS:
PERSON The person is a layered multidimensional being. Each layer consists of five person variables or subsystems: o Physical/Physiological o Psychological o Socio-cultural o Developmental o Spiritual The layers, usually represented by concentric circle, consist of the central core, lines of resistance, lines of normal defense, and lines of flexible defense. The basic core structure is comprised of survival mechanisms including: organ function, temperature control, genetic structure, response patterns, ego, and what Neuman terms 'knowns and commonalities'. Lines of resistance and two lines of defense protect this core. The person may in fact be an individual, a family, a group, or a community in Neuman's model. The person, with a core of basic structures, is seen as being in constant, dynamic interaction with the environment. Around the basic core structures are lines of defense and resistance (shown diagrammatically as concentric circles, with the lines of resistance nearer to the core. The person is seen as being in a state of constant change and-as an open system-in reciprocal interaction with the environment (i.e. affecting, and being affected by it).

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Abueg, Dorothy Rose S. BSNIV-B1

July 18, 2011 Elective Assignment

ENVIRONMENT The environment is seen to be the totality of the internal and external forces which surround a person and with which they interact at any given time. These forces include the intrapersonal, interpersonal and extra personal stressors which can affect the person's normal line of defense and so can affect the stability of the system. o The internal environment exists within the client system. o The external environment exists outside the client system. Neuman also identified a created environment which is an environment that is created and developed unconsciously by the client and is symbolic of system wholeness. HEALTH Neuman sees health as being equated with wellness. She defines health/wellness as "the condition in which all parts and subparts (variables) are in harmony with the whole of the client (Neuman, 1995)". As the person is in a constant interaction with the environment, the state of wellness (and by implication any other state) is in dynamic equilibrium, rather than in any kind of steady state. Neuman proposes a wellness-illness continuum, with the person's position on that continuum being influenced by their interaction with the variables and the stressors they encounter. The client system moves toward illness and death when more energy is needed than is available. The client system moves toward wellness when more energy is available than is needed. NURSING Neuman sees nursing as a unique profession that is concerned with all of the variables which influence the response a person might have to a stressor. The person is seen as a whole, and it is the task of nursing to address the whole person. Neuman defines nursing as actions which assist individuals, families and groups to maintain a maximum level of wellness, and the primary aim is stability of the patient/client system, through nursing interventions to reduce stressors. Neuman states that, because the nurse's perception will influence the care given, then not only must the patient/client's perceptions be assessed, but so must those of the caregiver (nurse). The role of the nurse is seen in terms of degrees of reaction to stressors, and the use of primary, secondary and tertiary interventions. APPLICATION:

Nurse may use the primary, secondary and tertiary prevention interventions for solving the problems in the client. Nurses can now provide care in a comprehensive manner. Viewing patient in a holistic manner. Nurses may use this theory for accurate assessment, planning, implementation and evaluation of the planned care for the patient. It can also be used in research to produce new nursing knowledge the\at I significant to the scope of nursing practice.

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Abueg, Dorothy Rose S. BSNIV-B1

July 18, 2011 Elective Assignment

JEAN WATSON
PHILOSOPHY AND SCIENCE OF CARING THEORY:
1. 2. 3. 4. 5. 6. 7. 8. The formation of a humanistic- altruistic system of values. The installation of faith-hope. The cultivation of sensitivity to ones self and to others. The development of a helping-trust relationship The promotion and acceptance of the expression of positive and negative feelings. The systematic use of the scientific problem-solving method for decision making The promotion of interpersonal teaching-learning. The provision for a supportive, protective and /or corrective mental, physical, socio-cultural and spiritual environment. 9. Assistance with the gratification of human needs. 10. The allowance for existential-phenomenological forces.

CONCEPT:
Human

She adopts a view of the human being as: .. a valued person in and of him or herself to be cared for, respected, nurtured, understood and assisted; in general a philosophical view of a person as a fully functional integrated self. He, human is viewed as greater than and different from, the sum of his or her parts.

Health A high level of overall physical, mental and social functioning A general adaptive-maintenance level of daily functioning The absence of illness (or the presence of efforts that leads its absence) Environment/society A caring attitude is not transmitted from generation to generation. It is transmitted by the culture of the profession as a unique way of coping with its environment. Nursing Nursing is concerned with promoting health, preventing illness, caring for the sick and restoring health. It focuses on health promotion and treatment of disease. a human science of persons and human health-illness experiences that are mediated by professional, personal, scientific, esthetic and ethical human transactions.

APPLICATION:
Through love and caring, better care for the patient will be given. The nurse must know himself will be able to have a more accepting relationship with another person. Besides from caring moment occasion, a nurse can share something of himself to the patient can help establish a connection, an intimacy, which will allow patient to relate with the nurse. In creating a healing environment at all levels, physical as well as nonphysical, subtle environment of energy and consciousness whereby wholeness, beauty, comfort, dignity and peace will be potentiated.

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Abueg, Dorothy Rose S. BSNIV-B1 HUMAN BECOMING THEORY THEORY:

July 18, 2011 Elective Assignment

ROSEMARIE RIZZO PARSE

Meaning Human Becoming is freely choosing personal meaning in situations in the intersubjective process of living value priorities. Mans reality is given meaning through lived experiences Man and environment cocreate Rhythmicity Human Becoming is cocreating rhythmical patterns of relating in mutual process with the universe. Man and environment cocreate ( imaging, valuing, languaging) in rhythmical patterns Transcendence Human Becoming is cotranscending multidimensionally with emerging possibles. Refers to reaching out and beyond the limits that a person sets One constantly transforms

CONCEPT:
Person: Open being who is more than and different from the sum of the parts Environment: Everything in the person and his experiences. Inseparable, complimentary to and evolving with Health: Open process of being and becoming. Involves synthesis of values Nursing: A human science and art that uses an abstract body of knowledge to serve people

APPLICATION:

A transformative approach to all levels of nursing Differs from the traditional nursing process, particularly in that it does not seek to fix problems Ability to see patients perspective allows nurse to be with patient and guide them toward desired health outcomes Nurse-person relationship co creates changing health patterns

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Abueg, Dorothy Rose S. BSNIV-B1 HUMANISTIC THEORY THEORY:


July 18, 2011 Elective Assignment

JOSEPHINE PATERSON AND LORETTA ZDERAD

Humanizing communication involves an awareness of the unique characteristics of being human. Dehumanizing communication ignores the unique characteristics of being human.

Patterns of interactions or skills: Communing: Dialogical, intimate communication between two or more people; the heart of humanistic communication. o Listening: is the core of communing and involves making a conscious effort to attend to what another person is saying, particularly to expressions of feelings, meanings, and perceived implications. o The central tripod of communing is trust, self-disclosure, and feedback. o Trust is one person relying on another, risking potential loss in attempting to achieve a goal, when the outcome is uncertain; and the potential for loss is greater than for gain if the trust is violated. o Self-disclosure is risking rejection in telling how one feels, thinks, and so on, regarding here and now or existential events o Feedback is describing anothers behavior, beliefs, and so on, plus giving ones evaluation or feelings. Assertiveness: expressing ones needs, thoughts, feelings or beliefs in a direct, honest, confident manner while being respectful of others thoughts, feelings or beliefs; asserting with authenticity. Confrontation: providing feedback about another plus requesting a change in his or her behavior; confronting with caring.

CONCEPT:
Human: Man is a living being capable of symbolizing, perceiving the negative, transcending his environment by his inventions, ordering his environment, striving for perfection, making choices, and self-reflecting. o Characteristics of humans: Living: able to function biologically and physiologically as an animalistic, viable entity. Communicating: able to label things and to talk about them when they are not present. Negativing: able to talk about the symbolic negative (-1, no, none, not), make rules (laws regarding the thou shalt nots), worry about what may not happen, and consider ones own non-existence. Inventing: able to be aware of, know, and do things beyond his or her relationship to the environment. Ordering: able to develop categories and hierarchies according to some value or theme; gives structure and system to ones environment. Dreaming: able to dream of how things could be if all were perfect; expectations, hopes for the future. Choosing: able to consider numerous alternatives, implications for the future.

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Abueg, Dorothy Rose S. BSNIV-B1

July 18, 2011 Elective Assignment

Self-reflecting: able to think about and talk about self, reflect on ones own behavior and understand self, body, behaviors, etc. Health: ones state of being, of becoming: of self-awareness. It is indicative of ones adaptation to the environment. Environment: Ones time/space/environment context. Nursing: the art and science of positive, humanistic intervention in the changing health status of human beings interacting in the environment of critical life situations. Its elements are communicating, caring, and coaching.

APPLICATION:
Encourages reflection, reflection being a learned process that can help enhance the experience of the nurse and prepare them for similar situations in the clinical environment. The ability to be with and travel with the patient in the routine of living is often overlooked, but is an essential part of the professional life of a nurse. Understanding the professional differences between other medical staff and allied health professionals, respect the difference and accept responsibility for challenges of nursing

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