THEORIST THEORY/CONCEPTS/COMPONENTS METAPARADIGM

Hildegard Peplau INTERPERSONAL RELATIONS THEORY Person:

- “Psychiatric Nurse of  The nurse-patient relationship was described as a  A man who is an organism that
the Century” four-phase phenomenon: lives in an unstable balance of a
- First Book: a. Orientation given system
Interpersonal - Initial interaction between nurse and patient Health:
Relations in Nursing - Nurse assists the patient in recognizing and  For health to be achieved and
understanding the patient experience maintained, needs must be met
b. Identification (physiological demands and
- Patient and nurse explore the experience and interpersonal conditions)
needs of patient Environment:
c. Exploitation  Forces outside the organism
- Patient shift from dependent role to Nursing:
independent role  Nursing is a significant,
- New goals are projected, but power is shifted to therapeutic interpersonal
the patient process
d. Resolution
- Patient earns independence over care
- Patient puts goals aside and formulates a new
one

 Psychological Mothering:
a. Patient is accepted unconditionally as a
participant
b. Recognition and response to patient’s readiness
for growth
c. Power shifts to the patient

 Nursing Roles:
a. Stranger
- The nurse attempts to know the patient better
- The nurse treats the patient with outmost
courtesy
- Occurs during the Identification Phase
b. Resource Person
- Nurse provides specific answers to questions
- Nurse must change response to patient’s level of
understanding
c. Teacher
- Determines how the patient understands the
plan of care
d. Leader
- The nurse must act in behalf of the patient’s
interest and at the same time enable him to
make decisions over own care
- Achieved through cooperation and active
participation
e. Surrogate
- Temporary care giver
f. Counselor
- The nurse becomes a listening friend
- The nurse gives sound empathic advises
Ida Jean Orlando NURSING PROCESS THEORY Person:
 Focus: Reciprocal relationship between nurse  Humans in need are the focus of
and patient nursing practice
 The nurse uses the standard nursing process in Health:
Orlando’s Nursing Process Discipline Theory,  Health is a sense of helplessness
which follows: as an initiator for necessity for
A – ssessment nursing
D – iagnosis Environment:
P – lanning  Orlando disregarded
I – mplementation environment in her theory
E – valuation Nursing:
  Nursing is unique and
independent for individual’s
need for help
Joyce Travelbee HUMAN-TO-HUMAN RELATIONSHIP MODEL Person:
 The nurse and patient undergo series of  Human being is a unique,
interactional phases: irreplaceable individual
a. Original Encounter Health:
- First impression of the nurse and patient to each  Health is measured subjectively
other and objectively.
b. Emerging Identities Environment:
- Nurse and patient perceiving each other as  Human conditions and life
unique individuals experiences encountered by
- Link of relationship begins to form men as suffering, hope, pain and
a. c. Empathy illness
- Ability to share the person’s experience Nursing:
d. Sympathy  Nursing is an interpersonal
- Nurse wants to lessen the cause of suffering process whereby the nurse
- It goes beyond empathy assists individual, family,
b. e. Rapport community
- Nursing interventions that lessen cause of
suffering
- The patient shows trust and confidence to the
nurse
Lydia Hall CARE, CORE, CURE Person:
 Three components:  Source of energy and motivation
a. Care for healing
- “The Body” Health:
- “Intimate bodily care”  Health is a state of self-
- Represents the nurses’ roles and focused on awareness
performing task to nurture patients Environment:
b. Core  Environment should be
- “The Person” conducive for self-development
- “Therapeutic Use of Self” Nursing:
- Represents the patient receiving nursing care  Nursing is participating in the
- Involves therapeutic use of self care, core, cure aspects of
- Emphasizes patient’s social, emotional, nursing caring
intellectual, spiritual needs
- The nurse uses reflective technique
c. Cure
- “The Disease”
- “Seeing the patient and family through medical
care”
- Represents nursing
- Represents interventions geared towards treating
the patient
- The nurse shares with other health care
professionals
Faye Abdellah TWENTY-ONE NURSING PROBLEMS Person:
- “First woman to serve  Focus of theory: it is nursing-centered rather  Beneficiary of care
as Deputy Surgeon than patient-centered Health:
General of the United  Main Goal: Improvement of nursing education  Center and purpose of nursing
States”  Impact to nursing practice: helped transform services
focus of profession from disease-centered to Environment:
patient-centered  Apex of nursing service is the
individual
 Three chief components: Nursing:
a. Health  Nursing is an all-inclusive service
b. Nursing problems
c. Problem solving

 Health needs are seen as:

a. Overt – can-be-seen condition
b. Covert – unseen or masked one
  Problem-solving process includes:
a. Identify the problem
b. Select relevant data
c. Devise hypotheses
d. Test hypotheses through assortment of data
e. Revise hypotheses

 21 NURSING PROBLEMS:
A. 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 deformity
B. 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 disease conditions
10. To facilitate the maintenance of regulatory
mechanisms and functions
11. To facilitate the maintenance of sensory function.
C. 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 toward 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
D. 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
Virginia Henderson 14 BASIC HUMAN NEEDS Person:
- “First Lady of  Person is an individual who
Nursing” 1. Breathe normally.  requires assistance to achieve
- “First Truly 2. Eat and drink adequately. health and independence
International Nurse” 3. Eliminate body wastes. Health:
4. Move and maintain desirable postures.  Health is a quality of life and
5. Sleep and rest. basic for human to function fully
6. Select suitable clothes-dress and undress. Environment:
7. Maintain body temperature within normal range  The nurse must be educated
by adjusting clothing and modifying environment about safety
 8. Keep the body clean and well-groomed and Nursing:
protect the integument  Nurse functions independently
9. Avoid dangers in the environment and avoid from the physician
injuring others.  Nurse must help both sick and
10. Communicate with others in expressing well individual
emotions, needs, fears, or opinions.
11. Worship according to one’s faith.
12. Work in such a way that there is a sense of
accomplishment.
13. Play or participate in various forms of recreation.
14. Learn, discover, or satisfy the curiosity that leads
to normal development and health and use the
available health facilities.
 Emphasis: view the patient and family as a single
unit

 Three levels in nurse-patient relationship:

a. Nurse as a substitute for the patient
- The nurse serves as a substitute to what the
patient lacks
b. Nurse as a helper to the patient
- Nurse focus on assisting the patient to meet
needs
c. Nurse as a partner with the patient
- The nurse and patient formulate plan together
- The nurse empowers the patient to make
effective decisions regarding care plans
Nola Pender HEALTH PROMOTION MODEL Person:
 Each person has unique characteristics and  Individuals, family, community
experiences as active participants for the
 This are desired behavioral outcome that should promotion of health
result in improved health, enhanced functional Health:
ability, and better quality of life  Focus on health promotion and
 Examples of health promoting behaviors: disease prevention
- Healthy diet Environment:
- Exercise  Environment wellness is
- Managing stress manifested with balance
- Gain adequate rest and spiritual growth between human beings and
- Building positive relationships surroundings
Nursing:
 Variables that influence individual to engage in  Helping individuals understand
health-promoting behaviors: and perform health promoting
a. Activity-related affect behaviors
b. Commitment to a plan of action
c. Immediate competing demand and
preferences
Madeleine Leininger TRANCULTURAL NURSING Person:
- “Culture Care or  Culture  Humans are caring and capable
Culture Care Diversity - Learned, shared, and transmitted values, beliefs, of being concerned about
and Universality” norms, and lifeways of a particular group desires, welfare, and continued
 Key component: Cultural Diversity (differences or existence
variations that can be found in different cultures) Health:
 Health is universal and diverse
Environment:
 Environment as being the
totality of an event, situation, or
experience
Nursing:
 Three types of nursing actions:
a. Cultural care
preservation/maintenance
b. Cultural care
accommodation/negotiation
 c. Cultural care
repatterning/restructuring
Margaret Newman HEALTH AS EXPANDING CONSCIOUSNESS Person:
 Focus: Health as expansion of consciousness  Patients are viewed as
 Goal: not to make people well, or to prevent their participants in transformative
getting sick, but to assist people to utilize the process
power that is within them as they evolve toward  Humans are unitary and cannot
higher levels of consciousness be divided into parts
Health:
 Must include health of all persons regardless of  Pattern of the whole
presence or absence of disease  Fusion of disease and non-
 Health is the central of the theory and seen as disease
the process of developing awareness for self and  Health and illness are a unitary
environment process
 Consciousness – manifestation of an evolving Environment:
pattern of person-environment interaction  Interaction between human and
environment as key process to
create unique configurations for
each individual
 Viewed as a universe of open
systems
Nursing:
 The focus of nursing is the
primacy of relationships
 The nurse must get in touch
with the meaning of life through
identification of meaning
 Nursing is caring in the human
health experience
Rosemarie Parse HUMAN BECOMING THEORY Person:
 Purpose: Guide nurses in practice to focus on  Open being who is more than
quality of life and different from the sum of
 The human becoming theory posits quality of life the parts
from person’s own perspective as the goal of Health:
nursing practice  Open process of being and
becoming.
 Man Living Health  Involves synthesis of values
o 2 paradigms (worldview of nursing) Environment:
a. Totality Paradigm  Everything in the person and his
- Man is a combination of biological, psychological, experiences
sociological, spiritual factors  Inseparable, complimentary to
b. Simultaneity Paradigm and evolving with
- Man is a unitary being in continuous, mutual Nursing:
interaction with environment  A human science and art that
uses an abstract body of
 Three Principles: knowledge to serve people
1. Structuring meaning multidimensionality
- Cocreating reality through the Languaging of
valuing and imaging
- SCENARIO:
 Imaging: an infertile couple believes there
are many children in need of homes and plan
to adopt
 Valuing: an older woman putting her health
first as all her children moved out of the
house
 Languaging: a man diagnosed with terminal
illness finds words and strength to talk about
it to his family
2. Cocreating rhythmical patterns of relating
- Living the paradoxical unity of revealing-
concealing and enabling-limiting while
connecting-separating
- SCENARIO:
 Revealing-Concealing: a pregnant teenager
must reveal the truth to her parents
 Enabling-Limiting: a patient chose to refuse a
treatment
 Connecting-Separating: parents want more
aggressive treatment for child; the husband
disagrees causing a strain in the relationship
3. Contranscending with the possible
- Powering the unique ways of originating in the
process of transforming
- SCENARIO:
 Powering: parents learn to be strong and
move on with the death of their child
 Originating: a woman raises money for
cancer research in honor of her mother
 Transforming: an elderly man accepts help
as he is unable to care for his wife